PRINTER'S NO. 1526
No. 1282 Session of 2005
INTRODUCED BY CAUSER, O'NEILL, BAKER, BASTIAN, BOYD,
CALTAGIRONE, CRAHALLA, DENLINGER, DeWEESE, D. EVANS,
GINGRICH, GRUCELA, HERMAN, KILLION, MILLARD, PAYNE, PHILLIPS,
PICKETT, READSHAW, REED, REICHLEY, SAYLOR, SOLOBAY, STERN,
SURRA, E. Z. TAYLOR, THOMAS, TRUE, WASHINGTON, WILT AND
YOUNGBLOOD, APRIL 6, 2005
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
APRIL 6, 2005
AN ACT
1 Amending the act of July 3, 1985 (P.L.164, No.45), entitled "An
2 act relating to the prevention and reduction of premature
3 death and disability in this Commonwealth; providing for
4 assistance, coordination and support of the development and
5 maintenance of a comprehensive emergency medical services
6 system and for qualifications, eligibility and certification
7 of emergency medical services personnel and licensing
8 ambulance services; imposing powers and duties on the
9 Department of Health; and making repeals," amending the title
10 of the act; creating the Pennsylvania Emergency Medical
11 Services Agency; and providing for transfer of duties of the
12 Department of Health under the act to the Pennsylvania
13 Emergency Medical Services Agency.
14 The General Assembly of the Commonwealth of Pennsylvania
15 hereby enacts as follows:
16 Section 1. The title of the act of July 3, 1985 (P.L.164,
17 No.45), known as the Emergency Medical Services Act, is amended
18 to read:
19 AN ACT
20 Relating to the prevention and reduction of premature death and
21 disability in this Commonwealth; creating the Pennsylvania
1 Emergency Medical Services Agency; providing for assistance,
2 coordination and support of the development and maintenance
3 of a comprehensive emergency medical services system and for
4 qualifications, eligibility and certification of emergency
5 medical services personnel and licensing ambulance services;
6 imposing powers and duties on the Department of Health and
7 the Pennsylvania Emergency Medical Services Agency; and
8 making repeals.
9 Section 2. Section 2 of the act is amended to read:
10 Section 2. Legislative findings and intent.
11 (a) Findings.--The General Assembly finds it to be in the
12 public interest to assure readily available and coordinated
13 emergency medical services of the highest quality to the people
14 of Pennsylvania. The purposes of emergency medical services are
15 to prevent premature death and reduce suffering and disability
16 that arise from critical illness and injury.
17 (b) Intent.--
18 (1) It is the intention of the General Assembly and the
19 purpose of this act to establish and maintain an effective
20 and efficient emergency medical services system which is
21 accessible on a uniform basis to all Pennsylvania residents
22 and to visitors to this Commonwealth.
23 (2) The General Assembly further intends that residents
24 and visitors to this Commonwealth should have prompt and
25 unimpeded access to basic and advanced life support emergency
26 medical care throughout this Commonwealth.
27 (3) It is the intent of the General Assembly that the
28 [Secretary of Health] director of the Pennsylvania Emergency
29 Medical Services Agency, in developing a stratified system of
30 trauma care, shall, whenever feasible, involve local citizens
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1 in the decisionmaking process.
2 Section 3. Section 3 of the act, amended October 21, 1988
3 (P.L.1055, No.121) and October 5, 1994 (P.L.557, No.82), is
4 amended to read:
5 Section 3. Definitions.
6 The following words and phrases when used in this act shall
7 have the meanings given to them in this section unless the
8 context clearly indicates otherwise:
9 "Advanced life support." The advanced prehospital and
10 interhospital emergency medical care of serious illness or
11 injury by appropriately trained health professionals and by
12 certified EMT-paramedics.
13 "Advanced life support service medical director." A medical
14 command physician or a physician meeting equivalent
15 qualifications, as established by the [Department of Health]
16 Pennsylvania Emergency Medical Services Agency by regulation,
17 who is employed by, contracts with or volunteers with, either
18 directly or through an intermediary, an advanced life support
19 service to provide medical guidance and advice to the ambulance
20 service and to evaluate the quality of patient care provided by
21 the emergency medical services personnel utilized by the
22 ambulance service.
23 "Agency." The Pennsylvania Emergency Medical Services
24 Agency.
25 "Ambulance." Any vehicle which is specifically designed,
26 constructed or modified and equipped, and is used or intended to
27 be used, and is maintained or operated, for the purpose of
28 providing emergency medical care to, and transportation of,
29 patients. The term includes advanced or basic life support
30 vehicles that may or may not transport patients.
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1 "Ambulance attendant." An individual who holds a valid
2 certificate evidencing the successful completion of a course in
3 advanced first aid sponsored by the American Red Cross and a
4 valid certificate evidencing the successful completion of a
5 course in cardiopulmonary resuscitation sponsored by the
6 American Heart Association or the American Red Cross, or an
7 individual who can evidence the successful completion of an
8 equivalent training program approved by the [department]
9 Pennsylvania Emergency Medical Services Agency.
10 "Ambulance service." An entity [which] that meets the
11 requirements for ambulance service licensure in this
12 Commonwealth and regularly engages in the [business or service
13 of providing emergency medical care and transportation of
14 patients within this Commonwealth. The term includes mobile
15 advanced life support services that may or may not transport
16 patients.] provision of emergency medical services or other
17 medical monitoring or treatment that is rendered or offered
18 prior to or during the transportation to, from or between an
19 acute care facility or other health care facility. An ambulance
20 service may also engage in the transportation of any person
21 between an acute care, rehabilitation, clinic, physician office
22 or other health care facility that may require medical
23 monitoring, observation, treatment or care for an illness,
24 disease or injury or other disability and transportation by
25 means other than an ambulance may endanger the patient's health.
26 "Basic life support services." The prehospital or
27 interhospital emergency medical care and management of illness
28 or injury performed by specially trained and certified or
29 licensed personnel.
30 "Commonwealth emergency medical director." A medical command
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1 physician or a physician meeting equivalent qualifications, as
2 established by the [Department of Health] Pennsylvania Emergency
3 Medical Services Agency by regulation and approved by the
4 [Department of Health] Pennsylvania Emergency Medical Services
5 Agency to advise, formulate and direct policy on matters
6 pertaining to emergency medical services.
7 "Council." The State Advisory Council, which shall be known
8 as the Board of Directors of the Pennsylvania Emergency Health
9 Services Council.
10 "Department." The Department of Health of the Commonwealth.
11 "Director." The Director of the Pennsylvania Emergency
12 Medical Services Agency.
13 "Emergency." A combination of circumstances resulting in a
14 need for immediate medical intervention.
15 "Emergency medical services." The services utilized in
16 responding to the needs of an individual for immediate medical
17 care in order to prevent loss of life or aggravation of
18 physiological or psychological illness or injury.
19 "Emergency medical services council." A nonprofit
20 incorporated entity or appropriate equivalent whose function is
21 to plan, develop, maintain, expand and improve emergency medical
22 services systems within a specific geographical area of this
23 Commonwealth and which is deemed by the [department]
24 Pennsylvania Emergency Medical Services Agency as being
25 representative of the health professions and major private and
26 public and voluntary agencies, organizations and institutions
27 concerned with providing emergency medical services.
28 "Emergency medical services training manual." A manual
29 adopted by the [Department of Health] Pennsylvania Emergency
30 Medical Services Agency to aid advanced life support service
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1 medical directors in determining whether EMT-paramedics and
2 prehospital registered nurses have demonstrated competency in
3 the knowledge and skills necessary to be granted or maintain
4 medical command authorization.
5 "Emergency medical services system." The arrangement of
6 personnel, facilities and equipment for the effective and
7 coordinated delivery of emergency medical services required in
8 prevention and management of incidents which occur either as a
9 result of a medical emergency or of an accident, natural
10 disaster or similar situation.
11 "Emergency medical technician." An individual who is trained
12 to provide emergency medical services and is certified as such
13 by the [department] Pennsylvania Emergency Medical Services
14 Agency in accordance with the current national standard
15 curriculum for basic emergency medical technicians as set forth
16 in the rules and regulations promulgated by the [department]
17 Pennsylvania Emergency Medical Services Agency.
18 "Emergency medical technician-paramedic (referred to as EMT-
19 paramedic)." An emergency medical technician specifically
20 trained to provide advanced life support services who is
21 certified as such by the [department] Pennsylvania Emergency
22 Medical Services Agency in accordance with the current national
23 standard curriculum for emergency medical technician-paramedics
24 as set forth in the rules and regulations promulgated by the
25 [department] Pennsylvania Emergency Medical Services Agency.
26 "Facility." A hospital.
27 "First responder." An individual who is certified by the
28 [Department of Health] Pennsylvania Emergency Medical Services
29 Agency as a first responder.
30 "Foundation." The Pennsylvania Trauma System Foundation.
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1 "Health professional." A licensed physician who has
2 education and continuing education in advanced life support and
3 prehospital care or a prehospital registered nurse.
4 "Hospital." An institution having an organized medical staff
5 which is primarily engaged in providing to inpatients, by or
6 under the supervision of physicians, diagnostic and therapeutic
7 services or rehabilitation services for the care or
8 rehabilitation of injured, disabled, pregnant, diseased, sick or
9 mentally ill persons. The term includes facilities for the
10 diagnosis and treatment of disorders within the scope of
11 specific medical specialties, but not facilities caring
12 exclusively for the mentally ill.
13 "Invalid coach." A [vehicle which is primarily maintained,
14 operated and intended to be used for routine transport of
15 persons who are convalescent or otherwise nonambulatory and do
16 not ordinarily require emergency medical treatment while in
17 transit. Such vehicles shall not be considered ambulance or
18 emergency medical service vehicles.] paratransit or wheelchair
19 accessible vehicle that is regulated by the Pennsylvania Public
20 Utility Commission, is not a licensed ambulance or an advanced
21 life support squad unit in this Commonwealth and is primarily
22 maintained, operated and intended to be used for the conveyance
23 of persons who are not patients and do not require medical
24 monitoring, observation, treatment or care for an illness,
25 disease or injury or other disability.
26 "Medical command." An order given to a provider of emergency
27 medical services by an authorized medical command physician who
28 meets qualifications prescribed by the [department] Pennsylvania
29 Emergency Medical Services Agency.
30 "Medical command facility." The distinct unit within a
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1 facility that contains the necessary equipment and personnel for
2 providing medical command and control to an ambulance service.
3 "Patient." An individual [who is sick, injured, wounded or
4 otherwise incapacitated and helpless and who needs immediate
5 medical attention.] whose condition may require medical
6 monitoring, observation, treatment or care for an illness,
7 disease or injury or other disability.
8 "Pennsylvania Trauma Systems Foundation." A nonprofit
9 Pennsylvania corporation whose function is to accredit trauma
10 centers in this Commonwealth. The board of directors of the
11 foundation shall consist of the following 19 voting members:
12 five representatives of State organizations that represent
13 physicians; five representatives of State organizations that
14 represent hospitals; two representatives of State organizations
15 that represent registered professional nurses; two
16 representatives of other Statewide emergency medical service
17 organizations with expertise in delivery of trauma services; the
18 Chairman and Minority Chairman of the House Health and Welfare
19 Committee, or their designees, from the committee membership;
20 the Chairman and Minority Chairman of the Senate Public Health
21 and Welfare Committee, or their designees, from the committee
22 membership; [and] the Secretary of Health, or his designee[.];
23 and the Director of the Pennsylvania Emergency Medical Services
24 Agency, or the director's designee. The bylaws of the foundation
25 shall identify a method to select members to achieve
26 professional and geographic balance on the board. Terms of
27 office shall be limited to three years.
28 "Prehospital registered nurse." A professional registered
29 nurse who has the knowledge and skills to provide advanced life
30 support services and is recognized as such by the [Department of
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1 Health] Pennsylvania Emergency Medical Services Agency.
2 "Providers of emergency medical services." Any facility,
3 basic life support service or advanced life support service.
4 "Rescue vehicle." A vehicle which is designed or modified
5 and equipped for rescue operations to release persons from
6 entrapment and which is not routinely used for emergency medical
7 care or transport of patients.
8 "Rural area." An area outside urbanized areas as defined by
9 the United States Bureau of the Census.
10 "Secretary." The Secretary of Health of the Commonwealth.
11 "Special care unit." An appropriately equipped area of the
12 hospital where provision has been made for a concentration of
13 physicians, nurses and others who have special skills and
14 experiences to provide medical care for critically ill patients.
15 "Trauma center." A facility accredited in accordance with
16 section 6.
17 "Volunteer Ambulance Services Certification (VASC)." The
18 program administered by the [department] Pennsylvania Emergency
19 Medical Services Agency on the effective date of this act for
20 the purpose of certifying ambulance services.
21 Section 4. The act is amended by adding sections to read:
22 Section 3.1. Creation.
23 To assure prompt, proper and effective discharge of
24 Commonwealth responsibilities relating to readily available and
25 coordinated emergency medical services, there is hereby formally
26 created the Pennsylvania Emergency Medical Services Agency.
27 Section 3.2. Organization of Pennsylvania Emergency Medical
28 Services Agency.
29 This agency shall consist of and be organized substantially
30 as follows:
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1 (a) Council.--Primary responsibility for overall policy and
2 direction of a Statewide emergency medical services program
3 shall be vested in a body legally known as the Pennsylvania
4 Emergency Medical Services Council, which shall be composed of
5 the following or their designee: the Governor, Lieutenant
6 Governor, Secretary of Health, Attorney General, General
7 Counsel, Secretary of Public Welfare, Commissioner of the
8 Pennsylvania State Police, Physician General, State Fire
9 Commissioner, State EMS Commissioner/Director, Director of the
10 Pennsylvania Emergency Medical Agency, President of the
11 Ambulance Association of Pennsylvania, President of the
12 Pennsylvania Trauma Systems Foundation, President of the
13 Pennsylvania Chapter American College of Emergency Physicians,
14 President of the Emergency Nurses Association, President of the
15 Hospital and Health Systems Association of Pennsylvania,
16 chairperson of the Patient Safety Authority, President pro
17 tempore of the Senate, Minority Leader of the Senate, Speaker of
18 the House of Representatives and Minority Leader of the House of
19 Representatives. The Governor may authorize up to two emergency
20 medical services professionals and up to two public members at
21 large to be nonvoting members of the council. The Governor may
22 designate a member to serve as chairman. A simple majority of
23 the members shall constitute a quorum.
24 (b) Compensation and expenses.--The members shall serve
25 without compensation, but may be reimbursed for their actual and
26 necessary traveling and other expenses incurred in connection
27 with attendance at meetings.
28 (c) Regular meetings.--For the conduct of routine business,
29 including particularly the consideration of matters of basic
30 policy, the council shall meet at the call of the chairman and
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1 at least three times during each calendar year.
2 (d) State director.--To supervise the work and activities
3 comprising the Statewide emergency medical services system, the
4 Governor shall appoint an individual to act on a full-time basis
5 as director of the agency. The director shall perform all such
6 fiscal, planning, administrative, operational and other duties
7 as may be assigned to the director by the council.
8 (e) Staff.--The council shall, within the limitations of
9 appropriations made to the agency, arrange for the employment of
10 such professional, technical, administrative and other staff
11 personnel as may be deemed essential to the development and
12 maintenance of a Statewide emergency medical services system
13 prescribed in this act. All such personnel shall be employed and
14 subject to pertinent provisions of the act of August 5, 1941
15 (P.L.752, No.286), known as the Civil Service Act.
16 (f) Office space, equipment and services.--The agency shall
17 be furnished necessary and appropriate office space, furniture,
18 equipment, supplies and services in the same general manner as
19 are other Commonwealth departments and agencies.
20 (g) Administrative provisions.--Except as otherwise provided
21 in this act, the agency shall be subject to the provisions of
22 the act of April 9, 1929 (P.L.177, No.175), known as The
23 Administrative Code of 1929.
24 Section 5. Section 4 of the act is amended to read:
25 Section 4. Emergency medical services system.
26 The [secretary] director shall plan, guide and coordinate
27 programs to ensure that the Commonwealth's emergency medical
28 services system shall:
29 (1) Include an adequate number of health professionals
30 and other health personnel with appropriate training and
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1 experience.
2 (2) Provide continuous training for its personnel,
3 including clinical training and continuing education programs
4 which are coordinated with other programs in the system's
5 service area which provide similar training and education.
6 (3) Join personnel, facilities and equipment,
7 coordinated by a central communication system, so that
8 requests for emergency medical services will be handled by
9 communications facilities which:
10 (i) utilize emergency medical telecommunications
11 screening to determine the appropriate emergency service
12 response;
13 (ii) are accessible to the general public through a
14 common telephone number and, where feasible, the
15 universal emergency telephone number 911; and
16 (iii) will have direct communications with the
17 personnel, facilities and equipment of this system and
18 with other appropriate emergency medical services
19 systems.
20 (4) Include an adequate number of ambulances and other
21 transportation means to meet the individual characteristics
22 of the system's service area wherein:
23 (i) the ambulances and other vehicles meet criteria
24 relating to location, design, performance and equipment;
25 and
26 (ii) all operators and other personnel staffing the
27 vehicles meet appropriate training and experience
28 requirements.
29 (5) Include an adequate number of easily accessible
30 facilities which:
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1 (i) are collectively capable of providing emergency
2 medical services on a continuous basis;
3 (ii) have appropriate nonduplicative and categorized
4 capabilities;
5 (iii) meet appropriate standards relating to
6 capacity, location, personnel and equipment; and
7 (iv) are coordinated with other health care
8 facilities of the system.
9 (6) Provide access, including appropriate
10 transportation, to trauma centers in the system's service
11 area or, if there are no centers or an inadequate number of
12 centers in the area, provide access to the centers in
13 neighboring areas if access to those centers is feasible in
14 terms of time and distance.
15 (7) Provide, as necessary, for transfer of patients to
16 facilities or programs which offer followup care and
17 rehabilitation as is necessary to effect the maximum recovery
18 of the patient.
19 (8) Provide for the effective utilization of the
20 appropriate personnel, facilities and equipment of each
21 entity providing emergency medical services in the system's
22 service area.
23 (9) Be organized in a manner that provides persons who
24 reside in the system's service area and who have no
25 professional or financial interest in the provision of health
26 care with an adequate opportunity to participate in the
27 making of policy for the system.
28 (10) Provide necessary emergency medical services to all
29 patients requiring the services.
30 (11) Provide for a standardized patient data collection
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1 system which covers all phases of the system.
2 (12) Provide programs of public education, information
3 and prevention in the system's service area, taking into
4 account the needs of visitors to and residents of that area
5 to know or easily access the means of obtaining emergency
6 medical services. These programs shall stress the general
7 dissemination of information regarding appropriate methods of
8 first aid and cardiopulmonary resuscitation and the
9 availability of first aid training programs in the area.
10 (13) Provide for:
11 (i) Periodic, comprehensive review and evaluation of
12 the extent and quality of the emergency health care
13 services provided in the system's service area.
14 (ii) Submission to the [department] agency of the
15 reports of each review and evaluation.
16 (14) Have a plan to assure that the system will be
17 capable of providing emergency medical services in the
18 system's service area during mass casualty situations,
19 natural disasters or declared states of emergency in
20 consonance with 35 Pa.C.S. § 7101 et seq. (relating to
21 emergency management services) and in coordination with the
22 Pennsylvania Emergency Management Agency.
23 (15) Provide for the establishment of appropriate
24 arrangements with ambulance services serving neighboring
25 areas for the provision of emergency medical services on a
26 reciprocal basis where access to such areas would be more
27 appropriate and effective in terms of the services available,
28 time and distance.
29 Section 6. Section 5 of the act, amended October 21, 1988
30 (P.L.1055, No.121), is amended to read:
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1 Section 5. Duties of [department] Pennsylvania Emergency
2 Medical Services Agency.
3 (a) Duty.--It shall be the duty of the [secretary] director
4 to plan, guide, assist and coordinate the development of
5 areawide emergency medical services systems into a unified
6 Statewide system and to coordinate the system with similar
7 systems in neighboring states.
8 (b) Authority.--The [department] agency shall be the
9 Commonwealth lead agency for emergency medical services in this
10 Commonwealth. The [department] agency shall have authority to:
11 (1) Maintain and coordinate a program for planning,
12 developing, maintaining, expanding, improving and upgrading
13 emergency medical services systems throughout this
14 Commonwealth.
15 (2) Establish, by regulation, standards and criteria
16 governing the award and administration of contracts under
17 this act.
18 (3) Require the collection and maintenance of
19 standardized patient data and information by ambulance
20 services licensed under section 12. Each ambulance service
21 shall insure that the responding ambulance personnel will
22 complete a summary for each ambulance call to which they
23 respond containing such information as prescribed and on
24 forms provided by the [department] agency. Such summary
25 information shall require essential information only and
26 shall be reasonable in detail. Reports required pursuant to
27 this section shall be confidential and not open to public
28 inspection or dissemination. This shall not restrict the
29 collection and analysis of data by the [department] agency or
30 by those with whom the [department] agency contracts, subject
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1 to strict supervision by the [department] agency to insure
2 that the use of the reports is limited to specific research
3 and planning purposes.
4 (4) Collect, as deemed necessary and appropriate, data
5 and information regarding patients admitted to a facility
6 through the emergency department, through a trauma center or
7 directly to a special care unit, in a manner which protects
8 and maintains the confidential nature of patient records.
9 Such data and information shall include essential information
10 only, shall be reasonable in detail and shall be collected
11 pursuant to regulations issued by the [department] agency.
12 Such data and information shall be limited to specific
13 planning, research and quality assurance purposes and shall
14 not be duplicative of data and information already available
15 to the agency or the department.
16 (5) Prepare a Commonwealth plan for emergency medical
17 services development in accordance with the provisions of
18 section 9.
19 (6) Define and approve training programs and accredit
20 educational institutions for emergency medical services
21 training of emergency medical services personnel, including,
22 but not limited to, emergency medical technicians and EMT-
23 paramedics and other emergency medical services personnel.
24 (7) Provide technical assistance to local government,
25 emergency medical services providers and other entities for
26 the purpose of assuring effective planning and execution of
27 programs under this act.
28 (8) Administer contracts authorized under this act and
29 grants pursuant to 23 U.S.C. § 402, pertaining to emergency
30 medical services and all other Federal laws pertaining to
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1 emergency medical services.
2 (9) Establish minimum standards for, license and inspect
3 ambulance services in accordance with section 12.
4 (10) Maintain a quality assurance program for the
5 purpose of monitoring the delivery of emergency medical
6 services.
7 (11) Promulgate rules and regulations to establish
8 standards and criteria for emergency medical services
9 systems.
10 (12) Integrate all trauma centers accredited pursuant to
11 section 6 into the emergency medical services system.
12 (13) Investigate complaints related to the delivery of
13 services by trauma centers and forward the results of the
14 investigation to the accrediting entity with a recommendation
15 for action.
16 (14) Compile and maintain statistics on mortality and
17 morbidity on multisystem trauma victims. This data collection
18 shall be coordinated and performed in conjunction with other
19 data collection activities.
20 (c) Bypass protocols.--The department shall establish not
21 later than September 30, 1988, and regional councils shall
22 implement not later than December 31, 1988, criteria for
23 evaluation, triage, treatment, transport, transfer and referral,
24 including bypass protocols, of acutely ill and injured persons
25 to the most appropriate facility. Regional councils shall not be
26 eligible for contract funds or State emergency medical services
27 operating fund disbursements unless criteria and protocols have
28 been established.
29 Section 7. Section 7 of the act is amended to read:
30 Section 7. State Advisory Council.
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1 (a) Designation and composition.--The State Advisory Council
2 shall be known as the Board of Directors of the Pennsylvania
3 Emergency Health Services Council which shall be composed of
4 volunteer, professional and paraprofessional organizations
5 involved in emergency medical services. The council shall be
6 geographically representative of the provider organizations
7 which represent emergency medical technicians, EMT-paramedics,
8 registered nurses, firefighters, emergency medical services
9 councils, physicians, hospital administrators and other health
10 care providers concerned with emergency medical services. The
11 council may be composed of up to 30 organizations. Each
12 organization shall have one voting member.
13 (b) Duties.--The council shall:
14 (1) Elect its own officers.
15 (2) Advise the [department] agency on matters relating
16 to manpower and training, communications, ambulance services,
17 special care units and the content of rules, regulations,
18 standards and policies promulgated by the [department] agency
19 under this act, and such other subjects as may be deemed
20 appropriate by the [department] agency.
21 (3) Serve as the forum for discussion on the content of
22 the Statewide emergency medical services development plan, or
23 any proposed revisions thereto, and advise the [department]
24 agency as to the content of the plan.
25 (c) Open meetings.--All meetings of the council shall be
26 held in accordance with the provisions of the act of July 19,
27 1974 (P.L.486, No.175), referred to as the Public Agency Open
28 Meeting Law.
29 (d) Terms.--A voting member of the council shall serve a
30 three-year term. A voting member shall not serve more than two
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1 consecutive terms.
2 (e) Quorum.--A simple majority of the voting members of the
3 council will constitute a quorum for the transaction of
4 business.
5 (f) Compensation.--Members of the council shall serve
6 without compensation, except the [department] agency may pay
7 necessary and reasonable expenses incurred by members while
8 performing official duties.
9 Section 8. Section 8 of the act, amended October 21, 1988
10 (P.L.1055, No.121), is amended to read:
11 Section 8. Emergency medical services councils.
12 (a) Purpose.--Emergency medical services councils shall
13 assist the [department] agency in carrying out the provisions of
14 this act. Every emergency medical services council shall adhere
15 to policy direction established by the [department] agency.
16 (b) Organization.--For purposes of this act, the
17 organizational structure of an emergency medical services
18 council shall be one of the following:
19 (1) A unit of general local government, with an advisory
20 council, meeting requirements for representation.
21 (2) A representative public entity administering a
22 compact or other areawide arrangement or consortium.
23 (3) Any other public or private nonprofit entity which
24 meets requirements for representation.
25 (c) Duties.--Each emergency medical services council shall:
26 (1) Assist the [department] agency in achieving the
27 emergency medical services system described in section 4.
28 (2) Assist the [department] agency in the collection and
29 maintenance of standardized patient data and information as
30 provided in section 5.
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1 (3) Prepare plans for expanding or improving emergency
2 medical services in the area; the plans shall contain such
3 information as prescribed by the [secretary] director.
4 (4) Carry out, to the extent feasible, the emergency
5 medical services plans.
6 (5) Assure the reasonable availability of training
7 programs for emergency medical technicians and EMT-paramedics
8 under section 12(f).
9 (6) Provide necessary and reasonable staff services and
10 appropriate and convenient office facilities that can serve
11 as an areawide location for the planning, developmental
12 maintenance, coordinative and evaluative functions of the
13 council.
14 (7) Establish a mechanism to provide for input from
15 local emergency medical services providers, in decisions
16 which include, but are not limited to, membership on its
17 governing body.
18 Section 9. Sections 9 and 10 of the act are amended to read:
19 Section 9. Comprehensive emergency medical services development
20 plan.
21 (a) Preparation.--The department, with the assistance of the
22 council, shall prepare a Statewide emergency medical services
23 development plan, to be completed not later than one year from
24 the effective date of this act, and shall make the plan
25 available to the General Assembly and all concerned agencies,
26 entities and individuals.
27 (b) Content.--At a minimum, the plan shall contain:
28 (1) An inventory of emergency services resources
29 available within this Commonwealth.
30 (2) An assessment of the effectiveness of existing
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1 services and a determination of the need for additional
2 services.
3 (3) A statement of goals and specific measurable
4 objectives for delivery of emergency medical services to all
5 persons in this Commonwealth.
6 (4) Methods to be used in achieving the stated
7 objectives.
8 (5) A schedule for achievement of the stated objectives.
9 (6) A method for evaluating the stated objectives.
10 (7) Estimated costs for achieving the stated objectives.
11 (c) Revisions.--The [department] agency shall collect and
12 analyze emergency medical services data for the purpose of:
13 (1) revising annually the emergency medical services
14 development plan, including the status of emergency medical
15 services development, the degree of compliance with the
16 requirements of this act and the effectiveness of emergency
17 medical services systems in reducing morbidity and mortality
18 associated with medical emergencies; and
19 (2) planning future program efforts.
20 (d) Annual reports.--The [department] agency shall,
21 annually, publish comprehensive, specific reports of activity
22 and plan implementation.
23 Section 10. Contracts for initiation, maintenance, expansion or
24 improvement of emergency medical services
25 systems.
26 (a) General power.--The [secretary] director may enter into
27 contracts with emergency medical services councils and other
28 appropriate entities for the initiation, expansion, maintenance
29 and improvement of emergency medical services systems which are
30 in accordance with the Statewide emergency medical services
20050H1282B1526 - 21 -
1 plan.
2 (b) Limitation.--If any contracts are entered into under
3 this section for organization of an emergency medical services
4 council, no other contract may be entered into under this
5 section for any other emergency medical services council for the
6 same area or for an area which includes, in whole or substantial
7 part, such area.
8 (c) Purposes.--Contracts under subsection (a) may only be
9 used for:
10 (1) Providing programs of public education, information
11 and prevention regarding emergency medical services.
12 (2) Purchasing ambulances, medical equipment and rescue
13 equipment.
14 (3) Costs associated with the conduct of training
15 programs for prehospital and interhospital emergency medical
16 services personnel.
17 (4) Costs associated with ambulance service inspection
18 conducted to assist the [department] agency with ambulance
19 service licensure.
20 (5) Purchasing communications, including alerting
21 equipment, provided that the purchases are in accordance with
22 the Statewide telecommunications plan.
23 (6) Purchasing certain equipment for hospital emergency
24 departments if the equipment is used or intended to be used
25 in equipment exchange programs with ambulance services.
26 (7) Costs associated with maintenance and operation of
27 emergency medical services councils. Costs may include, but
28 shall not be limited to, salaries, wages and benefits of
29 staff; travel; equipment and supplies; leasing of office
30 space; and other costs incidental to the conduct of business
20050H1282B1526 - 22 -
1 which are deemed by the [secretary] director to be necessary
2 and appropriate for carrying out the purposes of this act.
3 (8) Costs associated with collection and analysis of
4 data necessary to evaluate the effectiveness of emergency
5 medical services systems in providing emergency medical
6 services.
7 (d) Restriction.--Contract funds may not be used for:
8 (1) Acquisition, construction or rehabilitation of
9 facilities or buildings, except renovation as may be
10 necessary for the implementation of 911 and emergency medical
11 services communication systems.
12 (2) Purchasing hospital equipment unless such equipment
13 is used or intended to be used in an equipment exchange
14 program with ambulance services.
15 (3) Maintenance of ambulances, medical equipment or
16 rescue equipment except as authorized in subsection (c)(2).
17 (4) Costs deemed by the [secretary] director as
18 inappropriate for carrying out the purposes of this act.
19 (5) Costs which are normally borne by patients.
20 (e) Reports.--The recipient of a contract under this act
21 shall make reports to the [department] agency as may be required
22 by the [secretary] director.
23 (f) Application prerequisite.--No contract may be made under
24 this section unless:
25 (1) An application has been submitted to the
26 [department] agency in a form and format prescribed by the
27 [department] agency.
28 (2) The application demonstrates the need for planning,
29 initiation, maintenance, expansion or improvement of an
30 emergency medical services system.
20050H1282B1526 - 23 -
1 (3) The application contains data and information which
2 demonstrates the qualifications of the applicant to plan,
3 initiate, expand or improve an emergency medical services
4 system and which includes organizational structure and
5 provision for representation of appropriate entities.
6 (4) The application contains an assurance that planning
7 for an emergency medical services system is conducted in
8 cooperation with each areawide health systems agency, where
9 available, whose plan covers, in whole or in part, such area.
10 (g) Technical assistance.--The [department] agency shall
11 provide technical assistance, as appropriate, to emergency
12 medical services councils and to such other eligible entities as
13 necessary for the purpose of their carrying out the provisions
14 of contracts under this section, with special consideration for
15 contractors representing rural areas.
16 (h) Payments.--Payments pursuant to contracts under this
17 section may be made in advance or by way of reimbursement and in
18 such installments and on such conditions as the [secretary]
19 director determines will most effectively carry out the
20 provisions of this act.
21 (i) Other grants considered.--In determining the amount of
22 any contract under this act, the amount of funds available to
23 the applicant from nonstate contributions and Federal grant or
24 contract programs pertaining to emergency medical services shall
25 be taken into consideration. Nonstate contributions include the
26 outlay of cash and in-kind services of the contractor or to the
27 contractor or toward the operation of an emergency medical
28 services system by private, public or governmental third
29 parties, including the Federal Government.
30 (j) Other contracts.--Except as provided in subsection (c),
20050H1282B1526 - 24 -
1 the [secretary] director may enter into contracts with
2 organizations other than emergency medical services councils in
3 order to assist the [department] agency in complying with the
4 provisions of this act.
5 (k) Public disclosure.--Finalized contracts shall be deemed
6 public records.
7 Section 10. Section 11 of the act, amended October 5, 1994
8 (P.L.557, No.82), is amended to read:
9 Section 11. Emergency medical services personnel.
10 (a) Education.--The [department] agency shall assist,
11 encourage and coordinate the education of first responders,
12 emergency medical technicians and EMT-paramedics, who shall be
13 certified by the [department] agency upon successful completion
14 of courses of instruction recognized by the [department] agency
15 and written and practical skill examinations administered by the
16 [department] agency or its designees.
17 (1) The [department] agency shall develop standards in
18 the form of rules and regulations for the accreditation of
19 appropriate educational institutes and shall be empowered to
20 recognize such institutes as meeting such standards.
21 (2) First responder, emergency medical technician and
22 EMT-paramedic students enrolled in courses recognized by the
23 [department] agency shall be subject to the appropriate
24 liability exemptions listed in this section, as shall
25 participating institutes, organizations and facilities
26 pursuant to the provisions of subsection (j)(3).
27 (a.1) Certification of first responders.--
28 (1) A first responder performs basic life support
29 activities, as authorized by the [Department of Health]
30 agency, to stabilize and improve a patient's condition in a
20050H1282B1526 - 25 -
1 prehospital setting until more highly trained emergency
2 medical services personnel arrive at the scene.
3 (2) The [department] agency shall certify any person as
4 a first responder who:
5 (i) Completes an application on a form prescribed by
6 the [department] agency.
7 (ii) Is at least 16 years of age.
8 (iii) Successfully completes a first responder
9 training course approved by the [department] agency.
10 (iv) Has taken and successfully passed a written
11 examination prescribed by the [department] agency.
12 (v) Has taken and successfully passed a practical
13 test of first responder skills prescribed by the
14 [department] agency.
15 (3) A certification is valid for a period of three
16 years, subject to disciplinary action pursuant to subsection
17 (j.1). The [department] agency shall recertify as a first
18 responder an individual who complies with all of the
19 following:
20 (i) Completes an application on a form prescribed by
21 the [department] agency.
22 (ii) Is or was previously certified as a first
23 responder.
24 (iii) Successfully completes:
25 (A) a first responder practical skills and
26 written knowledge examination prescribed by the
27 [department] agency; or
28 (B) a continuing education program for first
29 responders approved or recognized by the [department]
30 agency.
20050H1282B1526 - 26 -
1 (iv) The [department] agency, in consultation with
2 the State Advisory Council, shall review and update
3 continuing education programs not less than biennially.
4 (4) A person who has received certification as a first
5 responder pursuant to the voluntary first responder
6 certification program conducted by the [department] agency
7 prior to the effective date of this amendatory act shall be
8 deemed certified under the act. The certification shall be
9 valid for three years after issued, and recertification
10 requirements of paragraph (3) shall then apply.
11 (b) Certification of emergency medical technician.--
12 (1) The [department] agency shall certify any person as
13 an emergency medical technician who:
14 (i) Has completed a basic training program for
15 emergency medical technicians approved by the
16 [department] agency, which program follows in accordance
17 with the current national standard curriculum for
18 emergency medical technicians as set forth in the rules
19 and regulations promulgated by the [department] agency.
20 (ii) Has taken and successfully passed a written
21 examination prescribed by the [department] agency.
22 (iii) Has taken and successfully passed a practical
23 test of emergency medical technician skills prescribed by
24 the [department] agency.
25 (iv) Is at least 16 years of age.
26 (2) A person who meets the requirements of this
27 subsection shall be certified as an emergency medical
28 technician within this Commonwealth for a period of three
29 years, subject to disciplinary action pursuant to subsection
30 (j.1).
20050H1282B1526 - 27 -
1 (3) (i) A person certified as an emergency medical
2 technician shall be recertified by filing with the
3 [department] agency proof of successful completion of:
4 (A) [a department-approved] an agency-approved
5 continuing education and training program; or
6 (B) having passed the [department-approved]
7 agency-approved written and practical skills
8 recertification examinations.
9 (ii) The [department] agency, in consultation with
10 the council, shall review and update continuing education
11 and training programs not less than biennially.
12 (4) Notwithstanding the provisions of the act of July
13 20, 1974 (P.L.551, No.190), known as the Medical Practice Act
14 of 1974, or the provisions of any act to the contrary, any
15 person with a valid certification from the [department]
16 agency as an emergency medical technician may, in the case of
17 an emergency, perform those duties as deemed appropriate by
18 the [department] agency in accordance with rules and
19 regulations promulgated under this act.
20 (c) Eligibility.--To be eligible to enroll in a course
21 leading to certification as an EMT-paramedic, a person shall:
22 (1) be at least 18 years of age;
23 (2) have a high school diploma or its equivalent; and
24 (3) be currently certified by the [department] agency as
25 an emergency medical technician.
26 (d) Certification of EMT-paramedic.--
27 (1) The [department] agency shall certify a person as an
28 EMT-paramedic, provided the person meets the requirements of
29 subsection (c) and:
30 (i) Completes a training course for EMT-paramedics
20050H1282B1526 - 28 -
1 approved by the [department] agency, which course follows
2 in accordance with the current national standard
3 curriculum for emergency medical technician-paramedics as
4 set forth in the rules and regulations promulgated by the
5 [department] agency.
6 (ii) Is verified as having demonstrated competency
7 in all required skills.
8 (iii) Takes and passes a written examination for
9 EMT-paramedics prescribed by the [department] agency.
10 (2) A person who initially meets the requirements of
11 paragraph (1) shall be considered permanently certified as an
12 EMT-paramedic within this Commonwealth, subject to
13 disciplinary action pursuant to subsection (j.1).
14 (i) The advanced life support service medical
15 director shall have continued authority to grant or deny
16 medical command authorization to an EMT-paramedic and
17 shall review, document and advise each EMT-paramedic of
18 his or her status at least once annually.
19 (ii) The advanced life support service medical
20 director shall base a decision on whether to grant or
21 deny medical command authorization upon:
22 (A) demonstrated competency in knowledge and
23 skills by an EMT-paramedic as defined by the
24 [department] agency through regulation and published
25 in the emergency medical services training manual;
26 and
27 (B) completion of continuing education
28 requirements as adopted by [department] agency
29 regulations.
30 Until such time as interim regulations are adopted by
20050H1282B1526 - 29 -
1 the [department] agency, an EMT-paramedic's receipt
2 or annual retention of medical command authorization
3 shall depend upon that person successfully
4 demonstrating to the advanced life support service
5 medical director the competence and skills to perform
6 the functions of an emergency medical technician and
7 the functions that an EMT-paramedic is authorized to
8 perform pursuant to medical command authorization as
9 set forth in [department] agency regulations.
10 (iii) The [department] agency, in consultation with
11 the council, shall review and update continuing education
12 requirements and the emergency medical services training
13 manual not less than biennially.
14 (iv) An EMT-paramedic denied medical command
15 authorization shall have the right to appeal the decision
16 to the regional medical director and then to the
17 [department] agency.
18 (v) Notwithstanding an EMT-paramedic certification
19 to provide advanced life support services, an EMT-
20 paramedic may not provide those services unless the EMT-
21 paramedic has medical command authorization to do so.
22 (vi) An EMT-paramedic who does not maintain medical
23 command authorization and who chooses to function at the
24 basic life support service level must apply to the
25 [department] agency for certification as an emergency
26 medical technician in accordance with [department] agency
27 regulations. An EMT-paramedic who is certified as an
28 emergency medical technician under this provision shall
29 retain paramedic certification and must apply to an
30 advanced life support service medical director for
20050H1282B1526 - 30 -
1 medical command authorization prior to returning to
2 paramedic status. While practicing without medical
3 command authorization, EMT-paramedics shall not hold
4 themselves out as paramedics to patients and emergency
5 medical service personnel and shall function as emergency
6 medical technicians in all respects.
7 (vii) An EMT-paramedic shall register biennially
8 with the [department] agency.
9 (3) Notwithstanding the provisions of the Medical
10 Practice Act of 1974, or the provisions of any other act to
11 the contrary, any person with a valid certification from the
12 [department] agency as an EMT-paramedic may, in the case of
13 an emergency, perform those duties as deemed appropriate by
14 the [department] agency in accordance with rules and
15 regulations promulgated under this act.
16 (e) Scope of practice of emergency medical technician and
17 EMT-paramedic.--The services provided by an emergency medical
18 technician or EMT-paramedic are limited to the services required
19 in responding to the perceived needs of an individual for
20 immediate medical care in order to prevent loss of life or
21 aggravation of physiological or psychological illness or injury.
22 Such services shall only be delivered in a prehospital,
23 interhospital or emergency care setting in a hospital, shall not
24 include diagnosis and treatment of nonurgent care and shall be
25 subject to rules and regulations promulgated by the [department]
26 agency.
27 (e.1) Prehospital registered nurses.--
28 (1) The [department] agency shall permanently recognize
29 a registered nurse in good standing in this Commonwealth as a
30 prehospital registered nurse, subject to disciplinary action
20050H1282B1526 - 31 -
1 pursuant to subsection (j.1), who:
2 (i) Is at least 18 years of age.
3 (ii) Holds current acknowledgments evidencing
4 successful completion of basic and advanced cardiac life
5 support training programs recognized by the [department]
6 agency.
7 (iii) Demonstrates successful completion of a
8 prehospital registered nurse program recognized or
9 approved by the [department] agency or a knowledge and
10 skills assessment process developed by the [department]
11 agency upon consideration of the Emergency Nurses
12 Association National Standard Curriculum Guidelines for
13 Prehospital Nursing or similar program.
14 (iv) Successfully completes an emergency medical
15 technician practical skills examination approved by the
16 [department] agency.
17 (v) Successfully completes an advanced life support
18 written examination approved by the [department] agency.
19 A person who has received recognition as a health
20 professional registered nurse pursuant to the voluntary
21 health professional registered nurse recognition program
22 conducted by the department prior to the effective date of
23 this amendatory act shall be deemed to have [department]
24 agency recognition as a prehospital registered nurse under
25 the act.
26 (2) A prehospital registered nurse who is certified as
27 an emergency medical technician or EMT-paramedic shall retain
28 certification consistent with other provisions of this act.
29 (3) The advanced life support service medical director
30 shall have continued authority to grant or deny medical
20050H1282B1526 - 32 -
1 command authorization to a prehospital registered nurse and
2 shall review, document and advise each prehospital registered
3 nurse of his or her status at least one time annually. The
4 advanced life support service medical director shall base a
5 decision on whether to grant or deny medical command
6 authorization upon:
7 (i) demonstrated competency in knowledge and skills
8 as defined by the [department] agency through
9 regulations; and
10 (ii) completion of continuing education requirements
11 as adopted by [department] agency regulations.
12 Until such time as interim regulations are adopted by the
13 [department] agency, a prehospital registered nurse's receipt
14 or annual retention of medical command authorization shall
15 depend upon that person successfully demonstrating to the
16 advanced life support service medical director the competence
17 and skills to perform the functions of an emergency medical
18 technician and the functions that an EMT-paramedic is
19 authorized to perform pursuant to medical command
20 authorization as set forth in [department] agency
21 regulations.
22 (4) A prehospital registered nurse denied medical
23 command authorization shall have the right to appeal the
24 decision to the regional medical director and then to the
25 [department] agency.
26 (5) A prehospital registered nurse who does not maintain
27 medical command authorization and who chooses to function at
28 the basic life support services level must apply to the
29 [department] agency for recognition as an emergency medical
30 technician in accordance with [department] agency
20050H1282B1526 - 33 -
1 regulations.
2 (6) The [department] agency, in consultation with the
3 council, shall update the current prehospital registered
4 nurse educational program not less than biennially.
5 (7) Consistent with the provisions of this act, a
6 prehospital registered nurse's practice scope shall be
7 governed by the provisions of the act of May 22, 1951
8 (P.L.317, No.69), known as The Professional Nursing Law, and
9 49 Pa. Code Ch. 21 (relating to State Board of Nursing).
10 (8) A prehospital registered nurse shall register
11 biennially with the [department] agency.
12 (f) Physician communication.--Any licensed physician who is
13 approved for such responsibility by the regional emergency
14 medical services council, which shall notify the [department]
15 agency of such approval, may give appropriate medical commands
16 via radio or other telecommunications device to a first
17 responder, an emergency medical technician or EMT-paramedic or
18 health professional consistent with respective levels of skill
19 and education and regulations promulgated pursuant to this act.
20 (g) Drug administration.--Every licensed physician giving a
21 medical command to an EMT-paramedic or health professional
22 requiring administration of a drug shall first identify the drug
23 and then specify the dosage and the manner of administration.
24 (h) Standing orders.--When specified in the approved
25 emergency medical services council transfer and medical
26 treatment protocols established pursuant to rules and
27 regulations, a first responder, an emergency medical technician,
28 EMT-paramedic or health professional may perform specific
29 emergency skills and treatment prior to the initiation of
30 medical command.
20050H1282B1526 - 34 -
1 (i) Care where communications are disrupted.--If
2 telecommunications cannot be established between a first
3 responder, an emergency medical technician or an EMT-paramedic,
4 or a health professional and a licensed physician, or if
5 telecommunications once established are interrupted and cannot
6 be reestablished, a first responder, an emergency medical
7 technician or an EMT-paramedic or health professional may
8 initiate and continue emergency medical care in accordance with
9 the approved emergency medical services council transfer and
10 medical treatment protocols established pursuant to rules and
11 regulations.
12 (j) Liability.--
13 (1) No authorized medical command physician who in good
14 faith gives instructions to a first responder, an emergency
15 medical technician or EMT-paramedic or health professional
16 shall be liable for any civil damages as a result of issuing
17 the instructions, unless guilty of gross or willful
18 negligence.
19 (2) No first responder, emergency medical technician or
20 EMT-paramedic or health professional who in good faith
21 attempts to render or facilitate emergency medical care
22 authorized by this act shall be liable for civil damages as a
23 result of any acts or omissions, unless guilty of gross or
24 willful negligence. This provision shall apply to students
25 enrolled in approved courses of instruction and supervised
26 pursuant to rules and regulations.
27 (3) No approved emergency medical services training
28 institute nor any entity participating as part of any
29 approved educational program offered by such institute as
30 authorized by this act shall be liable for any civil damages
20050H1282B1526 - 35 -
1 as a result of primary and continuing educational practice by
2 duly enrolled students under proper supervision, unless
3 guilty of gross or willful negligence.
4 (4) No medical command facility recognized by the
5 [department] agency which in good faith provides medical
6 commands to a first responder, an emergency medical
7 technician, EMT-paramedic or health professional in
8 accordance with this act shall be liable for any civil
9 damages as a result of issuing instructions, unless guilty of
10 gross or willful negligence.
11 (5) No first responder, emergency medical technician or
12 EMT-paramedic or health professional who in good faith
13 attempts to render emergency care authorized by this act at
14 an emergency scene while enroute to a place of employment
15 shall receive any form of reprimand or penalty by an employer
16 as a result of late arrival at the place of employment. An
17 employer may request written verification from any such first
18 responder, emergency medical technician, EMT-paramedic or
19 health professional, who shall obtain the written
20 verification from either the police officer or ambulance
21 personnel who is in charge at the emergency scene.
22 (6) No advanced life support service medical director or
23 regional medical director who in good faith gives
24 instructions to or provides primary and continuing
25 educational training to a first responder, an emergency
26 medical technician, EMT-paramedic or health professional
27 shall be liable for any civil damages for issuing the
28 instructions, education or training unless guilty of gross or
29 willful negligence.
30 (j.1) Suspension, revocation or refusal of [department]
20050H1282B1526 - 36 -
1 agency certification or recognition.--
2 (1) The [department] agency may suspend, revoke or
3 refuse to issue or renew the certification or recognition of
4 emergency medical services personnel upon investigation,
5 hearing and disposition for the following reasons:
6 (i) Demonstrated incompetence to provide adequate
7 services.
8 (ii) Deceptive or fraudulent procurement of
9 certification credentials.
10 (iii) Willful or negligent practice beyond the scope
11 of certification authorization.
12 (iv) Abuse or abandonment of a patient.
13 (v) The rendering of services while under the
14 influence of alcohol or illegal drugs.
15 (vi) The operation of an emergency vehicle in a
16 reckless manner or while under the influence of illegal
17 drugs or alcohol.
18 (vii) Disclosure of medical or other information
19 where prohibited by Federal or State law.
20 (viii) Willful preparation or filing of false
21 medical reports or records or the inducement of others to
22 do so.
23 (ix) Destruction of medical records required to be
24 maintained.
25 (x) Refusal to render emergency medical care because
26 of a patient's race, sex, creed, national origin, sexual
27 preference, age, handicap, medical problem or financial
28 inability to pay.
29 (xi) Failure to comply with [department-approved]
30 agency-approved regional emergency medical service
20050H1282B1526 - 37 -
1 council treatment and transfer protocols.
2 (xii) Failure to comply with ambulance trip
3 reporting requirements as established by the [department]
4 agency.
5 (xiii) Failure to meet recertification requirements.
6 (xiv) Conviction of a felony or crime involving
7 moral turpitude. Conviction includes a judgment of guilt,
8 a plea of guilty or a plea of nolo contendere.
9 (xv) A willful or consistent pattern of failure to
10 complete details on a patient's medical record.
11 (xvi) Misuse or misappropriation of drugs or
12 medication.
13 (xvii) Having a certification or other authorization
14 to practice a health care profession or occupation
15 revoked, suspended or subjected to disciplinary sanction.
16 (xviii) Failure to comply with skill maintenance
17 requirements established by the [department] agency.
18 (xix) Violating a duty imposed by this act, a
19 regulation promulgated under this act or an order of the
20 department or agency previously entered in a disciplinary
21 proceeding.
22 (xx) Other reasons as determined by the [department]
23 agency which pose a threat to the health and safety of
24 the public.
25 (2) If the [department] agency is empowered to take
26 disciplinary or corrective action against an individual under
27 this section, the [department] agency may do any of the
28 following:
29 (i) Deny the application for certification or
30 recognition.
20050H1282B1526 - 38 -
1 (ii) Administer a written reprimand with or without
2 probation.
3 (iii) Revoke, suspend, limit or otherwise restrict
4 the certification or recognition.
5 (iv) Require the person to take refresher
6 educational courses.
7 (v) Stay enforcement of any suspension and place the
8 individual on probation with the right to vacate the
9 probationary order for noncompliance.
10 (k) Continuity of care.--Until rules and regulations are
11 promulgated under this act, certified prehospital personnel
12 shall comply with the rules and regulations in effect on the
13 effective date of this act.
14 Section 11. Section 12 of the act, amended October 21, 1988
15 (P.L.1055, No.121) and October 5, 1994 (P.L.557, No.82), is
16 amended to read:
17 Section 12. Minimum standards for ambulance service.
18 (a) License required.--Two years after the effective date of
19 the rules and regulations promulgated under this act, no person,
20 as an owner, agent or otherwise, shall operate, conduct,
21 maintain, advertise or otherwise engage in or profess to be
22 engaged in providing a basic life support ambulance service or
23 an advanced life support service upon the highways or in any
24 other public place within this Commonwealth unless that person
25 holds a currently valid license as a basic life support
26 ambulance service or advanced life support ambulance service
27 issued by the [department] agency pursuant to this act or unless
28 such person is exempted under the provisions of subsection (r).
29 (b) Application.--A person desiring to secure a license to
30 maintain and operate an ambulance service shall submit an
20050H1282B1526 - 39 -
1 application to the department within one year from the effective
2 date of rules and regulations promulgated under this act.
3 Applications for an ambulance service license shall be made on
4 forms prescribed by the department and shall contain such
5 information as the department considers necessary to determine
6 that the ambulance service meets the requirements under this act
7 and related rules and regulations. Applications for renewal of a
8 license shall be made on forms prescribed by the [department]
9 agency in accordance with the rules and regulations promulgated
10 by the [department] agency.
11 (c) Fees.--The [department] agency shall levy no fee for
12 licenses for basic or advanced life support ambulance services.
13 (d) Rules and regulations.--Within one year of the effective
14 date of this act, the secretary shall promulgate rules and
15 regulations setting forth the minimum essential equipment for
16 ambulances used to provide basic or advanced life support
17 services in this Commonwealth and shall prescribe design
18 criteria for any vehicle used or intended to be used as an
19 ambulance. Equipment listed shall include the minimum essential
20 equipment required for effective operation and rendering of
21 appropriate emergency medical care in accordance with current
22 national standards.
23 (e) Minimum standards for staffing.--Minimum staffing
24 standards for ambulance services which operate at the basic life
25 support level of care shall be as follows:
26 (1) Upon the effective date of this act, all ambulances
27 in this Commonwealth, when transporting a patient or
28 patients, shall be operated with a minimum staffing of two
29 persons, one of whom shall accompany the patient in the
30 patient compartment during transport.
20050H1282B1526 - 40 -
1 (2) One year after the effective date of this act, each
2 ambulance service shall require that an ambulance, when
3 transporting a patient or patients, except for routine
4 transfer of convalescent or other nonemergency cases, shall
5 be staffed by at least two persons. One person shall at least
6 qualify as an ambulance attendant as defined in this act and
7 shall accompany the patient in the patient compartment of the
8 ambulance during transport.
9 (3) Two years after the effective date of this act, all
10 ambulances, when transporting a patient or patients, except
11 for routine transfer of convalescent or other nonemergency
12 cases, shall be staffed by at least two persons, who shall,
13 at least, qualify as ambulance attendants. At least one
14 attendant shall accompany the patient in the patient
15 compartment of the ambulance during transport.
16 (4) Three years after the effective date of this act,
17 all ambulances, when transporting a patient or patients,
18 except for routine transfer of convalescent or other
19 nonemergency cases, shall be staffed by at least two persons,
20 one of whom shall be an emergency medical technician, EMT-
21 paramedic or health professional, and one of whom shall, at
22 least, qualify as an ambulance attendant. The emergency
23 medical technician, EMT-paramedic or health professional
24 shall accompany the patient in the patient compartment. This
25 paragraph shall not be applicable to any ambulance operated
26 by a volunteer fire department or by a volunteer ambulance or
27 rescue service until July 3, 1990, and shall thereafter not
28 be applicable to any ambulance operated by a volunteer fire
29 department or by a volunteer ambulance or rescue service if
30 such department or service has a provisional license to
20050H1282B1526 - 41 -
1 operate without complying with this subsection.
2 (f) Training.--The [department] agency shall assure the
3 availability of emergency medical technician training for those
4 individuals who show evidence of sponsorship by a licensed
5 ambulance service as provided by this act or by a person or
6 entity having made application to become a licensed ambulance
7 service. This training shall be available to each county of this
8 Commonwealth during day and evening hours at reasonable cost in
9 accordance with policies and guidelines published by the
10 [department] agency upon advice from the council.
11 (g) Staff for advanced life support service.--
12 (1) Upon the effective date of this act, each advanced
13 life support service shall require that at least two persons
14 shall respond to calls for assistance. This staff shall
15 consist of one of the following:
16 (i) Two health professionals.
17 (ii) One health professional and either one
18 emergency medical technician or one EMT-paramedic.
19 (iii) One emergency medical technician and one EMT-
20 paramedic.
21 (iv) Two EMT-paramedics.
22 (2) Paragraph (1) shall not apply as follows:
23 (i) Temporary licenses may be issued to advanced
24 life support services which are not generally able to
25 provide this service 24 hours per day and 7 days per week
26 in accordance with subsection (n).
27 (ii) An advanced life support ambulance service may
28 be staffed by one EMT-paramedic or one health
29 professional when responding to calls for assistance,
30 provided that the minimum advanced life support staffing
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1 requirements set forth in this subsection are met during
2 emergency medical treatment and transport of the patient.
3 (3) An advanced life support service shall have an
4 advanced life support service medical director.
5 (h) Issuance of license.--The [department] agency shall
6 issue a license to an ambulance service pursuant to this act
7 when it is satisfied that the following standards have been met:
8 (1) The ambulance service is staffed by responsible
9 persons.
10 (2) The ambulance or other vehicle used to provide
11 emergency medical services is adequately constructed,
12 equipped, maintained and operated to safely and efficiently
13 render the services offered.
14 (3) The ambulance service meets the required staffing
15 standards set forth in this act.
16 (4) The ambulance service provides safe and efficient
17 services which are adequate for the emergency medical care,
18 the treatment and comfort and, when appropriate, the
19 transportation of patients.
20 (5) There is compliance with the rules and regulations
21 promulgated by the [department] agency under this act.
22 (i) Nontransferability of license.--A license to operate a
23 basic life support ambulance service, or an advanced life
24 support service, is not transferable and shall remain valid for
25 a period of three years unless revoked or suspended by the
26 [department] agency.
27 (j) Display.--The license shall at all times be posted in a
28 conspicuous place on the ambulance or mobile advanced life
29 support vehicle.
30 (k) Inspection.--Each basic life support ambulance service
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1 and advanced life support ambulance service and its vehicles,
2 equipment and personnel qualifications shall be inspected by the
3 [department] agency or its representative. The inspections shall
4 be conducted, from time to time, as deemed appropriate and
5 necessary, but not less than once every three years.
6 (l) Refusal or suspension.--The [department] agency may
7 refuse to renew a license or may suspend or revoke a license of
8 an ambulance service for the following reasons:
9 (1) A serious violation of the provisions of this act or
10 of the regulations for minimum ambulance standards
11 promulgated under this act. For purposes of this paragraph, a
12 serious violation is one which poses a continued significant
13 threat to the health of the patient.
14 (2) Failure of a licensee to submit a reasonable
15 timetable to correct deficiencies.
16 (3) The existence of a continuing pattern of
17 deficiencies over a period of three or more years.
18 (4) Failure, by the holder of a provisional license, to
19 correct deficiencies in accordance with a timetable submitted
20 by the applicant or licensee and agreed upon by the
21 [department] agency.
22 (5) Fraud or deceit in obtaining or attempting to obtain
23 a license.
24 (6) Lending, borrowing or using the license of another,
25 or in any way knowingly aiding or abetting the improper
26 granting of a license.
27 (7) Incompetence, negligence or misconduct in operating
28 the ambulance service or in providing emergency medical
29 services to patients.
30 (m) Provisional license.--
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1 (1) When there are numerous deficiencies or a serious
2 specific deficiency in compliance with this act or rules or
3 regulations promulgated thereunder, the [department] agency
4 may issue a provisional license for a period not to exceed
5 six months for operation of an ambulance service when the
6 [department] agency deems it is in the public interest to do
7 so.
8 (2) In accordance with regulations, the [department]
9 agency may renew a provisional license for a period not to
10 exceed six months, except that the [department] agency may
11 renew a provisional license for a period of 12 months in the
12 case of a volunteer fire department or a volunteer ambulance
13 or rescue service which does not meet the minimum standards
14 for staffing at the basic life support level of care.
15 (n) Temporary license.--When a new or existing advanced life
16 support service cannot provide service 24 hours a day, 7 days a
17 week, the [department] agency may issue a temporary license for
18 operation of the advanced life support service when the
19 [department] agency deems it is in the public interest to do so.
20 The temporary license shall be valid for a period of one year
21 and may be renewed for the same incremental period not to exceed
22 two years.
23 (o) Violation.--
24 (1) Upon determining that a violation of this act or
25 rules and regulations promulgated thereunder exists, the
26 [department] agency shall issue a written notice to the
27 ambulance service specifying the violation or violations that
28 have been found. The notice shall require the ambulance
29 service to take action or submit a plan of correction to the
30 [department] agency that shall bring the ambulance service
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1 into compliance with applicable law or regulations within a
2 specified period of time. The plan of correction must be
3 submitted within 30 days of receipt of the written notice.
4 (2) If, after such reasonable time for compliance, the
5 [department] agency determines that the violation persists,
6 the [department] agency shall afford the holder of the
7 license an opportunity for an administrative hearing to be
8 conducted by the [department] agency pursuant to Title 2 of
9 the Pennsylvania Consolidated Statutes (relating to
10 administrative law and procedure). If, after the hearing, the
11 [department] agency rules that the license shall be suspended
12 or revoked, appeals may be taken as provided by law.
13 (p) Cessation of service.--Upon suspension or revocation of
14 a license, the service shall cease operations and no person
15 shall permit or cause the service to continue.
16 (q) Discontinuance of service.--Holders of licenses to
17 operate a basic life support ambulance service or an advanced
18 life support service shall not discontinue service until 90 days
19 after the holder notifies the [department] agency, in writing,
20 that the service is to be discontinued. Notice to the
21 [department] agency shall include a statement that the licensee
22 has notified the chief executive officer of each political
23 subdivision in the licensee's ambulance service area of the
24 intent to discontinue ambulance service and that the intent to
25 discontinue service has been advertised in a newspaper of
26 general circulation in the licensee's service area.
27 (r) License not required.--For ambulance services owned and
28 operated by a hospital licensed under Chapter 8 of the act of
29 July 19, 1979 (P.L.130, No.48), known as the Health Care
30 Facilities Act, a separate ambulance service license pursuant to
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1 this act shall not be required. All such ambulance services
2 shall, nevertheless, be subject to the standards and criteria
3 set forth in this act and the rules and regulations promulgated
4 thereunder.
5 (s) VASC services.--Basic life support ambulance services
6 that are VASC certified upon the effective date of the rules and
7 regulations for ambulance licensure promulgated under this act
8 shall be deemed in compliance with this act until the expiration
9 of their current VASC certification. Prior to the expiration of
10 VASC certification, an ambulance service shall obtain a license
11 pursuant to the provisions of this act.
12 (t) Exemptions.--The following are exempted from the
13 licensing provisions of this act:
14 (1) Privately owned vehicles not ordinarily used to
15 transport patients.
16 (2) A vehicle rendering temporary service as an
17 ambulance in an emergency when ambulances based in the
18 locality of the emergency are insufficient to render services
19 required.
20 (3) Services located or headquartered outside this
21 Commonwealth which do not routinely transport patients from
22 locations beyond the limits of this Commonwealth to locations
23 within this Commonwealth.
24 (4) Ambulances and ambulance services owned and operated
25 by an agency of the Federal Government.
26 (5) Invalid coaches.
27 (6) Rescue vehicles.
28 Section 12. Section 14 of the act, amended October 21, 1988
29 (P.L.1055, No.121), October 5, 1994 (P.L.557, No.82) and July
30 15, 2004 (P.L.709, No.78), is amended to read:
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1 Section 14. Support of emergency medical services.
2 (a) Fine.--A $10 fine shall be levied on all traffic
3 violations exclusive of parking offenses. These fines shall be
4 in addition to other fines imposed at the discretion of the
5 court.
6 (b) Accelerated Rehabilitative Disposition fee.--A fee of
7 $25 shall be imposed as costs upon persons admitted to programs
8 for Accelerated Rehabilitative Disposition for offenses
9 enumerated in 75 Pa.C.S. § 3802 (relating to driving under
10 influence of alcohol or controlled substance).
11 (c) Emergency Medical Services Operating Fund.--Money
12 collected shall be paid to the court imposing the fine, or fee,
13 which shall forward it to the State Treasurer for deposit into a
14 special fund to be known as the Emergency Medical Services
15 Operating Fund. Moneys in the fund shall be appropriated
16 annually by the General Assembly.
17 (d) Purpose of fund.--All money from the Emergency Medical
18 Services Operating Fund shall be disbursed by the [department]
19 agency to eligible providers of emergency medical services, as
20 determined by the [department] agency by regulation, to the
21 State Advisory Council and to regional emergency medical
22 services councils for the initiation, expansion, maintenance and
23 improvement of emergency medical services, including ambulance
24 and communications equipment and for training, education and
25 ambulance licensure purposes. These funds shall not be used for
26 any other purposes.
27 (e) Allocation to Catastrophic Medical and Rehabilitation
28 Fund.--Twenty-five percent of the fund shall be allocated to a
29 Catastrophic Medical and Rehabilitation Fund for victims of
30 trauma. The catastrophic fund shall be available to trauma
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1 victims to purchase medical, rehabilitation and attendant care
2 services when all alternative financial resources have been
3 exhausted. The [department] agency may, by regulation,
4 prioritize the distribution of funds by classification of
5 traumatic injury.
6 (f) Audit.--The Auditor General shall review collections and
7 expenditures made pursuant to the provisions of this section and
8 report its findings to the General Assembly annually. This audit
9 shall include a review of the collections and expenditures of
10 the emergency medical services councils.
11 Section 13. Sections 15 and 17 of the act are amended to
12 read:
13 Section 15. Prohibited acts.
14 (a) Making false ambulance requests.--It shall be unlawful
15 for any person to intentionally report a medical emergency and
16 summon an ambulance when such person does not have good cause to
17 believe that the services of an ambulance are needed. A person
18 violating this subsection commits a summary offense.
19 (b) Obstruction.--It is unlawful for any person to
20 intentionally impede or obstruct any ambulance attendant,
21 emergency medical technician or EMT-paramedic or health
22 professional in the performance of official duties, provided
23 that the ambulance attendant, emergency medical technician or
24 EMT-paramedic displays accepted American Red Cross or
25 [department] agency insignia or credentials. A person violating
26 this subsection commits a summary offense.
27 (c) Impersonating ambulance personnel.--It is unlawful for
28 any person who is not an ambulance attendant, emergency medical
29 technician, EMT-paramedic or health professional to display an
30 insignia or credentials or act in any manner that would lead
20050H1282B1526 - 49 -
1 reasonable persons to conclude that the person is an ambulance
2 attendant, emergency medical technician, EMT-paramedic or health
3 professional. A person violating this subsection commits a
4 summary offense.
5 (d) Misrepresentation of license.--It shall be unlawful for
6 any person who does not possess a valid ambulance service
7 license issued by the [department] agency to advertise, display
8 vehicle markings or exhibit any other means that would lead a
9 reasonable person to conclude that such service holds such
10 license, is a licensed service or provides a level of emergency
11 care beyond the level of care actually provided. A person
12 violating this subsection commits a summary offense.
13 Section 17. Allocations.
14 Of all funds available to the [department] agency for the
15 initiation, expansion, maintenance, evaluation and improvement
16 of emergency medical services systems, at least 75% shall be
17 allocated for the direct support of emergency medical services
18 systems, with at least 10% of these funds to be allocated to
19 provide additional financial assistance for those emergency
20 medical services systems serving rural areas.
21 Section 14. Section 17.1 of the act, added October 5, 1994
22 (P.L.557, No.82), is amended to read:
23 Section 17.1. Rules and regulations.
24 The [Department of Health] Pennsylvania Emergency Medical
25 Services Agency, in consultation with the State Advisory
26 Council, may promulgate rules and regulations as may be
27 necessary to carry out the provisions of this act.
28 Section 15. All allocations, appropriations, equipment,
29 files, records and other material that are used, employed or
30 expended by the Department of Health, in connection with its
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1 powers, duties and functions under the act, are hereby
2 transferred to the Pennsylvania Emergency Medical Services
3 Agency. Any personnel employed by the Department of Health in
4 connection with its powers, duties or functions under the act
5 may be transferred to the Pennsylvania Emergency Medical
6 Services Agency.
7 Section 16. The regulations of the Department of Health for
8 the administration of the powers, duties and functions under
9 this act shall remain in effect until such time as new
10 regulations are promulgated by the Pennsylvania Emergency
11 Medical Services Agency.
12 Section 17. This act shall take effect in 60 days.
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