PRINTER'S NO. 2073
No. 1420 Session of 2008
INTRODUCED BY BAKER, WAUGH, ROBBINS, TOMLINSON, ORIE, MUSTO,
RAFFERTY, REGOLA, C. WILLIAMS, BRUBAKER, GORDNER, McILHINNEY,
MELLOW AND O'PAKE, MAY 22, 2008
REFERRED TO VETERANS AFFAIRS AND EMERGENCY PREPAREDNESS,
MAY 22, 2008
AN ACT
1 Amending Titles 35 (Health and Safety) and 75 (Vehicles) of the
2 Pennsylvania Consolidated Statutes, regulating emergency
3 medical services systems; providing for licensure; conferring
4 powers and duties on the Department of Health; further
5 defining "emergency vehicle"; providing for penalties;
6 providing for Emergency Medical Services Operating Fund
7 distributions; and making a related repeal.
8 The General Assembly of the Commonwealth of Pennsylvania
9 hereby enacts as follows:
10 Section 1. Title 35 of the Pennsylvania Consolidated
11 Statutes is amended by adding a chapter to read:
12 CHAPTER 72
13 EMERGENCY MEDICAL SERVICES SYSTEM
14 Subchapter
15 A. Preliminary Provisions
16 B. Program
17 C. Miscellaneous Provisions
18 SUBCHAPTER A
19 PRELIMINARY PROVISIONS
1 Sec.
2 7201. Short title of chapter.
3 7202. Declaration of policy.
4 7203. Definitions.
5 7204. Emergency medical services system programs.
6 7205. Duties of department.
7 7206. Emergency medical services patient care reports.
8 7207. Pennsylvania Trauma Systems Foundation.
9 7208. State Advisory Board.
10 7209. Regional emergency medical services councils.
11 § 7201. Short title of chapter.
12 This chapter shall be known and may be cited as the Emergency
13 Medical Services System Act.
14 § 7202. Declaration of policy.
15 The General Assembly finds and declares as follows:
16 (1) Emergency medical services is an essential public
17 service and frequently the health care safety net for many
18 Commonwealth residents.
19 (2) It is in the public interest to assure that there
20 are high quality and coordinated emergency and urgent medical
21 services readily available to the residents of this
22 Commonwealth to prevent premature death and reduce suffering
23 and disability which arise from severe illness and injury.
24 (3) The public interest under paragraph (2) is best
25 achieved through a regulated and coordinated emergency
26 medical services system.
27 (4) Transportation of both emergency and nonemergency
28 patients is an integral part of the health care delivery
29 system in this Commonwealth, and it is in the public interest
30 that the emergency medical services system serve all persons
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1 in this Commonwealth who:
2 (i) require medical care to address illness or
3 injury;
4 (ii) need transport to a hospital or other health
5 care facility to receive that care; and
6 (iii) require medical assessment, monitoring,
7 assistance, treatment or observation during any
8 transport.
9 (5) It serves the public interest if the emergency
10 medical services system is able to quickly adapt and evolve
11 to meet the needs of the residents of this Commonwealth for
12 emergency and urgent medical care and to reduce their illness
13 and injury risks.
14 (6) It serves the public interest if the emergency
15 medical services system provides community-based health
16 promotion services that are integrated with the overall
17 health care system.
18 (7) Emergency medical services should be acknowledged,
19 promoted and supported as an essential public service.
20 (8) This chapter shall be liberally construed to
21 establish and maintain an effective and efficient emergency
22 medical services system which is accessible on a uniform
23 basis to residents of this Commonwealth and to visitors to
24 this Commonwealth.
25 (9) Residents of this Commonwealth and visitors to this
26 Commonwealth should have prompt and unimpeded access to
27 urgent and emergency medical care throughout this
28 Commonwealth.
29 (10) The Department of Health should continually assess
30 and, as needed, revise the functions of emergency medical
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1 services agencies and providers and other components of the
2 emergency medical services system that it regulates under
3 this chapter, to:
4 (i) improve the quality of emergency medical
5 services provided in this Commonwealth;
6 (ii) have the emergency medical services system
7 adapt to changing needs of the residents of this
8 Commonwealth; and
9 (iii) promote the recruitment and retention of
10 persons willing and qualified to serve as emergency
11 medical services providers in this Commonwealth.
12 (11) The emergency medical services system should be
13 fully integrated with the overall health care system, and in
14 particular with the public health system, to identify, modify
15 and manage illness and injury and illness and injury risks.
16 § 7203. Definitions.
17 The following words and phrases when used in this chapter
18 shall have the meanings given to them in this section unless the
19 context clearly indicates otherwise:
20 "Advanced emergency medical services." Emergency medical
21 services exceeding the scope of practice of an emergency medical
22 technician.
23 "Advanced emergency medical technician." An individual who
24 is certified by the Department of Health as an advanced
25 emergency medical technician.
26 "Advanced life support squad vehicle." A vehicle which:
27 (1) is maintained or operated to transport emergency
28 medical service providers above the advanced emergency
29 medical technician level, equipment and supplies to
30 rendezvous with the crew of an ambulance for the purpose of
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1 providing advanced emergency medical services to patients;
2 and
3 (2) is not used in the transport of patients.
4 "ALS." Advanced life support.
5 "Ambulance." A ground, water or air vehicle which is
6 maintained or operated for the purpose of providing emergency
7 medical services to and transportation of patients.
8 "Ambulance attendant." An individual who is 16 years of age
9 or older and satisfies one of the following:
10 (1) Possesses a certificate evidencing successful
11 completion of an advanced first aid course sponsored by the
12 American Red Cross and a current certificate evidencing
13 successful completion of a cardiopulmonary resuscitation
14 course acceptable to the Department of Health.
15 (2) Possesses a current certificate evidencing
16 successful completion of a course determined by the
17 Department of Health to be equivalent to the requirements in
18 paragraph (1).
19 "Basic emergency medical services." Emergency medical
20 services included within but not exceeding the scope of practice
21 of an emergency medical technician.
22 "Basic life support squad vehicle." A vehicle which:
23 (1) is maintained or operated to transport emergency
24 medical services providers, equipment and supplies to
25 rendezvous with the crew of an ambulance for the purpose of
26 providing emergency medical services at or below the advanced
27 emergency medical technician level to patients; and
28 (2) is not used in the transport of patients.
29 "BLS." Basic life support.
30 "Board." The State Advisory Board, which is the Board of
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1 Directors of the Pennsylvania Emergency Health Services Council.
2 "Commonwealth emergency medical services medical director."
3 A physician who is approved and employed by the Department of
4 Health to advise and formulate policy on matters pertaining to
5 emergency medical services.
6 "Department." The Department of Health of the Commonwealth.
7 "Emergency." A physiological or psychological illness or
8 injury of an individual such that a prudent layperson who
9 possesses an average knowledge of health and medicine could
10 reasonably expect the absence of immediate emergency medical
11 services to result in:
12 (1) placing the health of the individual or, with
13 respect to a pregnant woman, the health of the woman or her
14 unborn child, in serious jeopardy;
15 (2) serious impairment of bodily functions; or
16 (3) serious dysfunction of a bodily organ or part.
17 "Emergency medical responder" or "EMR." An individual who is
18 certified by the Department of Health as an emergency medical
19 responder.
20 "Emergency medical services" or "EMS." Any of the following:
21 (1) The medical care, including medical assessment,
22 monitoring, treatment, transportation and observation, which
23 may be provided to a person in responding to an actual or
24 reported emergency to:
25 (i) prevent or protect against loss of life or a
26 deterioration in physiological or psychological
27 condition; or
28 (ii) address pain or morbidity associated with the
29 person's condition.
30 (2) The transport of an individual with medical
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1 assessment, monitoring, treatment or observation of the
2 individual who, due to the individual's condition, requires
3 medical assessment, monitoring, treatment or observation
4 during the transport.
5 "Emergency medical services agency." An entity that engages
6 in the business or service of providing emergency medical
7 services to patients within this Commonwealth by operating any
8 of the following:
9 (1) An ambulance.
10 (2) An advanced life support squad vehicle.
11 (3) A basic life support squad vehicle.
12 (4) A quick response service.
13 (5) A special operations EMS service. This paragraph
14 includes, but is not limited to:
15 (i) a tactical EMS service;
16 (ii) a wilderness EMS service;
17 (iii) a mass-gathering EMS service; and
18 (iv) an urban search and rescue EMS service.
19 (6) A vehicle or service which provides emergency
20 medical services outside of a health care facility, as
21 prescribed by the Department of Health by regulation.
22 "Emergency medical services agency medical director." A
23 physician who is employed by, contracts with or volunteers with
24 an emergency medical services agency either directly or through
25 an intermediary to:
26 (1) evaluate the quality of patient care provided by the
27 emergency medical services providers utilized by the
28 emergency medical services agency; and
29 (2) provide medical guidance and advice to the emergency
30 medical services agency.
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1 "Emergency medical services provider." Any of the following:
2 (1) An emergency medical responder.
3 (2) An emergency medical technician.
4 (3) An advanced emergency medical technician.
5 (4) A paramedic.
6 (5) A prehospital registered nurse.
7 (6) A prehospital physician extender.
8 (7) A prehospital emergency medical services physician.
9 (8) An individual prescribed by regulation of the
10 Department of Health to provide specialized emergency medical
11 services.
12 "Emergency medical services system." The arrangement of
13 personnel, facilities and equipment to prevent and manage
14 emergencies in a geographic area.
15 "Emergency medical services vehicle operator." An individual
16 certified by the Department of Health to operate a ground
17 emergency medical services vehicle.
18 "Emergency medical technician" or "EMT." An individual who
19 is certified by the Department of Health as an emergency medical
20 technician.
21 "Facility." A physical location at which an entity operates
22 a health care facility licensed under Federal or State law.
23 "Foundation." The Pennsylvania Trauma Systems Foundation, a
24 nonprofit Pennsylvania corporation whose function is to accredit
25 trauma centers in this Commonwealth.
26 "Hospital." An institution having an organized medical staff
27 that is primarily engaged in providing to inpatients, by or
28 under the supervision of physicians, diagnostic and therapeutic
29 services or rehabilitation services for the care or
30 rehabilitation of injured, disabled, pregnant, diseased, sick or
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1 mentally ill persons. The term includes a facility for the
2 diagnosis and treatment of disorders within the scope of
3 specific medical specialties. The term does not include a
4 facility caring exclusively for the mentally ill.
5 "Medical command facility." A distinct unit which contains
6 the necessary equipment and personnel for providing medical
7 command to and control over emergency medical services
8 providers.
9 "Medical command order." An order issued by a medical
10 command physician to an emergency medical services provider who
11 is functioning on behalf of an emergency medical services
12 agency.
13 "Medical command physician." A physician certified by the
14 Department of Health to give medical command orders to emergency
15 medical services providers.
16 "Medical monitoring." Performing continuous or periodic
17 observations of an individual's condition or continuation of an
18 ordered treatment plan for an individual to prevent pain,
19 suffering or the exacerbation of a preexisting condition.
20 "Medical observation." Performing continuous or periodic
21 observations of an individual's stable condition to determine
22 whether there is a change in that condition.
23 "Paramedic." An individual who is certified by the
24 Department of Health as a paramedic.
25 "Patient." An individual for whom an emergency medical
26 services provider is:
27 (1) providing emergency medical services on behalf of an
28 EMS agency; or
29 (2) required to provide emergency medical services on
30 behalf of an EMS agency because the individual's condition
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1 requires or may require medical observation, monitoring,
2 assessment or treatment for an illness, disease, injury or
3 other disability.
4 "Peer review." The evaluation by health care providers of
5 the quality and efficiency of services ordered or performed by
6 emergency medical services providers and physicians who direct
7 or supervise EMS providers under this chapter and the
8 regulations of the Department of Health.
9 "Physician." A person who has a currently registered license
10 to practice medicine or osteopathic medicine in this
11 Commonwealth.
12 "Prehospital emergency medical services physician." A
13 physician who is certified by the Department of Health as a
14 prehospital emergency medical services physician.
15 "Prehospital physician extender" or "PHPE." A physician
16 assistant who is certified by the Department of Health as a
17 prehospital physician extender.
18 "Prehospital registered nurse" or "PHRN." A registered nurse
19 who is certified by the Department of Health as a prehospital
20 registered nurse.
21 "Quick response service" or "QRS." An operation in which
22 emergency medical services providers of an EMS agency:
23 (1) respond to an actual, reported or perceived
24 emergency; and
25 (2) provide emergency medical services to patients
26 pending the arrival of an ambulance.
27 "Regional emergency medical services council." A nonprofit
28 incorporated entity or appropriate equivalent that is assigned
29 by the Department of Health to:
30 (1) plan, develop, maintain, expand and improve
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1 emergency medical services systems within a specific
2 geographic area of this Commonwealth; and
3 (2) coordinate those systems into a regional emergency
4 medical services system.
5 "Regional emergency medical services medical director." The
6 medical director of a regional emergency medical services
7 council.
8 "Review organization." A committee which engages in peer
9 review as authorized by the regulations of the Department of
10 Health.
11 "Rural area." An area outside urbanized areas as defined by
12 the United States Bureau of the Census.
13 "Special care unit." An appropriately equipped area of a
14 hospital where provision has been made for a concentration of
15 physicians, nurses and others who have special skills and
16 experiences to provide medical care for critically ill patients.
17 "Trauma center." A facility accredited as a trauma center by
18 the Pennsylvania Trauma Systems Foundation.
19 § 7204. Emergency medical services system programs.
20 (a) Planning and coordination.--The department shall plan,
21 guide and coordinate programs on the following matters to
22 promote effective and efficient operation of Statewide and
23 regional EMS systems:
24 (1) The number and distribution of EMS providers and
25 other persons integral to an EMS system, such as medical
26 command physicians and EMS agency medical directors, with
27 appropriate training and experience.
28 (2) Reasonably accessible training for EMS providers and
29 other persons integral to an EMS system, including clinical
30 training and continuing education programs coordinated with
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1 other programs providing similar, complementary and
2 supplemental training and education.
3 (3) The joining of personnel, facilities and equipment
4 coordinated through a communication system to ensure that EMS
5 requests will be handled by communications facilities that:
6 (i) utilize emergency medical telecommunications
7 screening to determine the appropriate emergency agency
8 response;
9 (ii) are accessible to the general public through a
10 common telephone number and, where feasible, through the
11 universal emergency telephone number 911; and
12 (iii) will have direct communications with
13 appropriate personnel facilities and equipment resources.
14 (4) The number and distribution of ambulances and other
15 EMS vehicles in which:
16 (i) ambulances and other vehicles meet appropriate
17 criteria relating to location, design, performance and
18 equipment; and
19 (ii) operators and other personnel staffing vehicles
20 meet appropriate training and experience requirements.
21 (5) The number and accessibility of facilities that:
22 (i) are collectively capable of providing EMS on a
23 continuous basis;
24 (ii) have appropriate specialty capabilities;
25 (iii) meet appropriate standards relating to
26 capacity, location, personnel and equipment; and
27 (iv) are coordinated with other health care
28 facilities and resource centers.
29 (6) Access and transportation to trauma centers and
30 specialty care receiving facilities.
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1 (7) Transfer of patients between facilities or to
2 programs offering necessary follow-up care and
3 rehabilitation.
4 (8) Utilization of appropriate personnel, facilities and
5 equipment of each entity providing EMS.
6 (9) Regional EMS councils that provide persons residing
7 in an EMS region, and who have no professional or financial
8 interest in the provision of health care, with an adequate
9 opportunity to participate in the making of policy for the
10 regional EMS system.
11 (10) The provision of EMS to all persons requiring those
12 services.
13 (11) A standardized data collection system that covers
14 all phases of the EMS incident, including, but not limited
15 to, the dispatch report and contact, treatment and transport
16 of a patient in the EMS system.
17 (12) Programs of public education, information and
18 prevention, integrated with public health education and
19 taking into account needs of visitors and residents,
20 concerning methods for accessing EMS and stressing
21 dissemination of information as to first aid and
22 cardiopulmonary resuscitation.
23 (13) The provision of periodic comprehensive review and
24 evaluation of the extent and quality of the EMS provided in
25 each regional EMS system and reports to the department of
26 each review or evaluation.
27 (14) Plans to assure that each regional EMS system will
28 be able to provide or secure EMS during mass casualty
29 situations, natural disasters and declared states of
30 emergency in accordance with Chapter 71 (relating to general
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1 provisions) and the instructions of the Pennsylvania
2 Emergency Management Agency.
3 (15) Appropriate intrastate and interstate arrangements
4 for the provision of EMS as needed.
5 (b) Limitations.--This section is intended to identify EMS
6 objectives to be pursued and achieved by the department in its
7 role as lead agency for EMS. Nothing herein shall be construed
8 to confer regulatory powers upon the department beyond those
9 conferred elsewhere in this chapter.
10 § 7205. Duties of department.
11 (a) Duty.--It shall be the duty of the department to assist
12 in the development of local EMS systems; plan, guide and
13 coordinate development of regional EMS systems into a unified
14 Statewide system; and coordinate systems in this Commonwealth
15 with similar systems in neighboring states.
16 (b) Authority.--The department shall be the lead agency for
17 EMS in this Commonwealth. The department is authorized to:
18 (1) Coordinate a program for planning, developing,
19 maintaining, expanding, improving and upgrading EMS systems
20 in this Commonwealth.
21 (2) Establish, by regulation, standards and criteria
22 governing the awarding and administration of contracts and
23 grants under this chapter for initiation, maintenance and
24 improvement of regional EMS systems.
25 (3) Require collection and maintenance of patient data
26 and information in EMS patient care reports by EMS agencies.
27 (4) Collect, as deemed necessary and appropriate, data
28 and information regarding patients who utilize emergency
29 departments without being admitted to the facility and
30 patients admitted through emergency departments, trauma
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1 centers or directly to special care units, in a manner that
2 protects and maintains the confidential nature of patient
3 records. The data and information shall be reasonable in
4 detail and shall be collected pursuant to regulations issued
5 by the department. Data and information shall be limited to
6 that which may be used for specific planning, research and
7 quality improvement purposes and shall not be duplicative of
8 data and information already available to the department.
9 (5) Prepare and revise a Statewide EMS system plan under
10 section 7211 (relating to comprehensive plan).
11 (6) Define and approve training programs and accredit
12 educational institutions for EMS training of EMS providers.
13 (7) Provide technical assistance to local governments,
14 EMS agencies and other entities for the purpose of assuring
15 effective planning and execution of EMS.
16 (8) Administer contracts and grants authorized under
17 this chapter and other grants pertaining to EMS.
18 (9) Establish standards for the licensing, registration
19 and operation of EMS agencies, and inspect EMS agencies for
20 compliance with this chapter and regulations adopted under
21 this chapter.
22 (10) Maintain a quality improvement program for the
23 purpose of monitoring and improving the delivery of EMS.
24 (11) Promulgate regulations to establish standards and
25 criteria for EMS systems.
26 (12) Integrate all trauma centers accredited pursuant to
27 section 7207 (relating to Pennsylvania Trauma Systems
28 Foundation) into the Statewide EMS system.
29 (13) Recommend to 911 and other EMS agency dispatchers
30 protocols with respect to the type and quantity of EMS
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1 resources to dispatch to emergencies.
2 (14) Investigate, based upon complaints and information
3 received, possible violations of this chapter and regulations
4 under this chapter and take disciplinary actions, seek
5 injunctions and refer matters for criminal prosecution.
6 (15) Investigate complaints concerning delivery of
7 services by trauma centers and forward investigation results
8 to the appropriate accrediting entity with a recommendation
9 for action.
10 (16) Enter into agreements with other states which may
11 include, as appropriate to effectuate the purposes of this
12 chapter, the acceptance of EMS resources of other states that
13 do not fully satisfy the requirements of this chapter or
14 regulations adopted under this chapter.
15 (c) EMS protocols.--The department shall establish criteria
16 and protocols, including bypass protocols, for evaluation,
17 triage, treatment, transport, transfer and referral of patients
18 to ensure that they receive appropriate EMS and are transported
19 to the most appropriate facility. Regional EMS councils shall
20 not be eligible for contracts or grant funds or State EMS
21 Operating Fund disbursements unless they assist in ensuring
22 regional implementation of the criteria and protocols. Protocols
23 under this subsection are not subject to the rulemaking process.
24 § 7206. Emergency medical services patient care reports.
25 (a) Preparation.--An EMS agency shall ensure that its
26 responding EMS providers complete an EMS patient care report for
27 each response made in which it encounters a patient or a person
28 who has been identified as a patient to the EMS agency, unless
29 the department by regulation exempts certain types of patient
30 contact from the reporting requirement. The department shall
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1 employ an electronic EMS patient care reporting process that
2 shall solicit standardized data and patient information. The
3 department may require an EMS agency to complete a different
4 standardized report or different fields in a standardized report
5 based upon the type of resources the EMS agency uses in
6 responding. The department shall permit an EMS agency to file a
7 paper report for extraordinary reasons as determined by the
8 department on a case-by-case basis.
9 (b) Content.--The report shall contain information as
10 solicited on the form or other reporting process developed by
11 the department. The reporting process shall solicit essential
12 information in reasonable detail. The department may also use
13 the reporting process to collect data to enhance its ability to
14 carry out its responsibilities under sections 7204 (relating to
15 emergency medical services system programs) and 7205 (relating
16 to duties of department).
17 (c) Patient medical record.--If a patient is transported to
18 a hospital or from a hospital to another health care facility,
19 information about the patient and EMS performed on the patient
20 that is solicited through the reporting process shall be
21 provided by the EMS agency to the hospital or other health care
22 facility and become part of the patient's medical record.
23 (d) Reporting.--An EMS agency shall report to the department
24 or a regional EMS council, as determined by department
25 regulation, data that is solicited through the reporting
26 process.
27 (e) Confidentiality.--
28 (1) Patient information collected by an EMS agency shall
29 be confidential and shall not be released by the EMS agency
30 or a health care facility except as follows:
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1 (i) To the patient who is the subject of the report
2 or to a person who is authorized to exercise the rights
3 of the patient with respect to securing the report.
4 (ii) Pursuant to an order of a court of competent
5 jurisdiction, including a subpoena when it constitutes a
6 court order, except that disclosure pursuant to a
7 subpoena shall not be permitted as to information in the
8 report that is of such nature that disclosure pursuant to
9 a subpoena is not otherwise authorized by law.
10 (iii) To a health care provider to whom a patient's
11 medical record may be released under the law.
12 (iv) For billing purposes.
13 (v) For quality improvement activities.
14 (vi) To the department or a regional EMS council for
15 the purpose of investigating possible violations of this
16 chapter or related regulations.
17 (vii) To a government agency or its agent, as
18 authorized by the department, for the purpose of the
19 agency performing official government duties.
20 (2) Notwithstanding the duty of confidentiality
21 applicable to department and regional EMS councils concerning
22 reports under paragraph (1), the report may be released for
23 specific research or EMS planning purposes approved by the
24 department, subject to department approval and supervision to
25 ensure that use of the report is strictly limited to the
26 purposes of the research.
27 (f) Vendors.--A vendor may not sell or otherwise provide or
28 offer reporting forms or software marketed as appropriate for
29 use in making reports required under this section unless the
30 vendor submits the product to the department for review and
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1 receives department approval. Thereafter, the vendor shall
2 submit any modification of the product to the department for
3 review and approval if the vendor intends to offer the modified
4 product for use in the EMS patient care reporting process. If
5 the department makes changes to the EMS patient care report, it
6 shall publish a notice of the changes in the Pennsylvania
7 Bulletin. The effective date for the changes shall be no fewer
8 than 60 days following publication. After publication of
9 changes, a vendor may not market a product as one appropriate
10 for use in making an EMS patient care report, any reporting
11 forms or software approved by the department prior to
12 publication of the changes unless the vendor clearly discloses
13 that the forms or software were approved prior to publication of
14 the changes. The department may assess a vendor a $5,000 civil
15 penalty for each day a vendor violates the provisions of this
16 subsection.
17 § 7207. Pennsylvania Trauma Systems Foundation.
18 (a) Trauma center accreditation.--The foundation shall
19 develop a private voluntary accreditation program to:
20 (1) Establish standards for the operation of trauma
21 centers in this Commonwealth, adopting, at a minimum, current
22 guidelines for trauma centers defined by the American College
23 of Surgeons for Level I, Level II and Level III trauma
24 centers. Additionally, Level III trauma centers shall meet
25 accreditation criteria for Level III trauma centers imposed
26 by the act of March 24, 2004, (P.L.148, No.15), known as the
27 Pennsylvania Trauma Systems Stabilization Act. For the
28 purpose of reaccreditation, the standards shall require, at a
29 minimum, that each Level I trauma center establish that 600
30 severe and urgent injury cases have been treated per year and
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1 each Level II trauma center establish that 350 severe and
2 urgent injury cases have been treated per year.
3 (2) Evaluate a hospital making application to the
4 foundation to determine if the hospital meets the
5 foundation's standards. Evaluation shall include hospital
6 site visits by accreditation survey teams composed of
7 independent, qualified persons selected by the foundation.
8 (3) Issue certificates of accreditation to hospitals
9 that meet the accreditation standards. Certificates of
10 accreditation shall be valid for a period not to exceed three
11 years. Certificates of accreditation may be revoked by the
12 foundation if it is determined that the trauma center no
13 longer meets accreditation standards as set forth in this
14 chapter.
15 (4) Establish an appeal mechanism for reconsideration of
16 accreditation decisions.
17 (b) Judicial review.--A person aggrieved by a determination
18 of the foundation under this section may file a petition for
19 review within 30 days in an appropriate court of common pleas.
20 (c) Prohibition.--No hospital shall hold itself out as a
21 trauma center unless it has a current certificate of
22 accreditation issued under this section.
23 (d) Board of directors.--The board of directors of the
24 foundation shall consist of the following voting members: five
25 representatives of State organizations representing physicians;
26 five representatives of State organizations representing
27 hospitals; two representatives of State organizations
28 representing registered professional nurses; two representatives
29 of other Statewide EMS organizations having expertise in
30 delivery of trauma services; the chairman and minority chairman
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1 of the Public Health and Welfare Committee of the Senate, or
2 designees chosen from among the members of the committee; the
3 chairman and minority chairman of the Health and Human Services
4 Committee of the House of Representatives, or designees chosen
5 from among the members of the committee; and the Secretary of
6 Health or a designee. The bylaws of the foundation shall
7 identify a method to select members to achieve professional and
8 geographic balance on the board of directors. Terms of office
9 shall be limited to three years.
10 (e) Data collection.--The foundation shall compile and
11 maintain statistics on mortality and morbidity on multisystem
12 trauma victims. The data collection shall be coordinated and
13 performed in conjunction with State data collection activities.
14 § 7208. State Advisory Board.
15 (a) Designation and composition.--The board shall be
16 composed of volunteer, professional and paraprofessional
17 organizations involved in EMS. The board shall be geographically
18 representative of the provider organizations that represent EMS
19 providers, firefighters, regional EMS councils, physicians,
20 hospital administrators and other health care providers
21 concerned with EMS. The board may be composed of up to 30
22 organizations. Each organization that is a member of the
23 Pennsylvania Emergency Health Services Council, and elected to
24 serve as a member on the board, shall have one vote on the
25 board.
26 (b) Duties.--The duties of the board shall be to:
27 (1) Elect officers.
28 (2) Advise the department concerning manpower and
29 training, communications, EMS agencies, content of
30 regulations, standards and policies promulgated by the
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1 department under this chapter and other subjects deemed
2 appropriate by the department.
3 (3) Serve as the forum for discussion on the content of
4 the Statewide EMS system plan, or any proposed revisions
5 thereto, and advise the department as to the content of the
6 plan.
7 (c) Open meetings.--Meetings of the board shall be held in
8 accordance with 65 Pa.C.S. Ch. 7 (relating to open meetings).
9 (d) Terms.--A voting member of the board shall serve a
10 three-year term. A voting member shall not serve more than two
11 consecutive terms.
12 (e) Quorum.--A simple majority of the voting members of the
13 board shall constitute a quorum for the transaction of business.
14 (f) Compensation.--Members of the board shall serve without
15 compensation, except the Pennsylvania Emergency Health Services
16 Council, through its contract or grant with the department, may
17 pay necessary and reasonable expenses incurred by members of the
18 board while performing their official duties.
19 (g) Contracts and grants.--The department shall contract
20 with or provide a grant to the board for performance of its work
21 under subsection (b). Contracts and grants between the
22 department and the board for the performance of work other than
23 under subsection (b) shall be subject to section 7212 (relating
24 to contracts and grants) where applicable.
25 § 7209. Regional emergency medical services councils.
26 (a) Purpose.--Regional EMS councils shall assist the
27 department in carrying out the provisions of this chapter. Each
28 regional EMS council shall adhere to policy direction from the
29 department.
30 (b) Organization.--For purposes of this chapter, the
20080S1420B2073 - 22 -
1 organizational structure of a regional EMS council shall be
2 representative of the public, health professions and major
3 private and public voluntary agencies, organizations and
4 institutions concerned with providing EMS in the region and
5 shall be one of the following:
6 (1) A unit of general local government, with an advisory
7 council, meeting requirements for representation.
8 (2) A representative public entity administering a
9 compact or other area-wide arrangement or consortium.
10 (3) Any other public or private nonprofit entity that
11 meets requirements for representation as determined by the
12 department.
13 (c) Duties.--Each regional EMS council shall, if directed by
14 the department:
15 (1) Assist the department in achieving the Statewide and
16 regional EMS system components and goals described in section
17 7204 (relating to emergency medical services system
18 programs).
19 (2) Assist the department in the collection and
20 maintenance of standardized data and information as provided
21 in section 7206 (relating to emergency medical services
22 patient care reports).
23 (3) Prepare, annually review and revise as needed a
24 regional EMS system plan for the EMS region the department
25 has designated and for which the department has contracted or
26 provided a grant to it to serve.
27 (4) Carry out, to the extent feasible, the Statewide and
28 regional EMS system plans.
29 (5) Assure the reasonable availability of training and
30 continuing education programs for EMS providers.
20080S1420B2073 - 23 -
1 (6) Provide necessary and reasonable staff services and
2 appropriate and convenient office facilities that can serve
3 as the EMS region's location for the planning, maintenance
4 and coordinative and evaluative functions of the council.
5 (7) Establish a mechanism to provide for input from
6 facilities and EMS agencies in the EMS region in decisions
7 that include, but are not limited to, membership on its
8 governing body.
9 (8) Establish, subject to department approval, regional
10 EMS triage, treatment and transport protocols consistent with
11 Statewide protocols adopted by the department. A regional EMS
12 council may also establish, subject to department approval,
13 additional triage, treatment and transport protocols. No
14 regional protocol shall be subject to the rulemaking process.
15 (9) Advise public safety answering points and municipal
16 and county governments as to the EMS resources available for
17 dispatching and recommend dispatch criteria that may be
18 developed by the department or the council as approved by the
19 department.
20 (10) Assist the department in achieving a unified
21 Statewide EMS system.
22 (11) Designate a regional EMS medical director and
23 establish a medical advisory committee and a quality
24 improvement committee.
25 (12) Develop a conflict of interest policy, subject to
26 department approval, and require its board or advisory
27 council members, officials and employees to agree to the
28 policy in writing.
29 (13) Perform other duties assigned by the department to
30 assist the department in carrying out the requirements of
20080S1420B2073 - 24 -
1 this chapter.
2 (d) Regional EMS medical directors.--The department shall
3 consult with the regional EMS medical directors in developing
4 and adopting EMS protocols and may consult with them on any
5 matter involved in the department's administration of this
6 chapter.
7 SUBCHAPTER B
8 PROGRAM
9 Sec.
10 7211. Comprehensive plan.
11 7212. Contracts and grants.
12 7213. Emergency medical services providers.
13 7214. Emergency medical responders.
14 7215. Emergency medical technicians.
15 7216. Advanced emergency medical technicians.
16 7217. Paramedics.
17 7218. Prehospital registered nurses.
18 7219. Prehospital physician extenders.
19 7220. Prehospital emergency medical services physicians.
20 7221. Certification sanctions.
21 7222. Emergency medical services vehicle operators.
22 7223. Suspension of certification.
23 7224. Emergency medical services instructors.
24 7225. Medical director of emergency medical services agency.
25 7226. Medical command physicians and facility medical
26 directors.
27 7227. Medical command facilities.
28 7228. Receiving facilities.
29 7229. Emergency medical services agencies.
30 7230. Advanced life support ambulances.
20080S1420B2073 - 25 -
1 7231. Air ambulances.
2 7232. Advanced life support squad vehicles.
3 7233. Basic life support ambulances.
4 7234. Basic life support squad vehicles.
5 7235. Quick response services.
6 7236. Special operations emergency medical services.
7 7237. First aid and other safety services.
8 7238. Other vehicles and services.
9 7239. Stretcher and wheelchair vehicles.
10 7240. Conditional temporary licenses.
11 7241. Plans of correction.
12 7242. Emergency medical services agency license sanctions.
13 § 7211. Comprehensive plan.
14 (a) Preparation.--
15 (1) The department, with the assistance of the board,
16 shall prepare a Statewide EMS system plan, which plan shall
17 include both short-range and long-range goals and objectives,
18 and shall make the plan available to the General Assembly and
19 all concerned agencies, entities and individuals.
20 (2) A regional EMS system plan, upon approval of the
21 department, shall:
22 (i) Become part of the Statewide EMS system plan.
23 (ii) Include for the EMS region the same types of
24 information that subsection (b) requires for the
25 Statewide plan.
26 (b) Contents.--At a minimum, the Statewide plan shall
27 contain:
28 (1) An inventory of EMS resources available within this
29 Commonwealth.
30 (2) An assessment of the effectiveness of the existing
20080S1420B2073 - 26 -
1 EMS system and a determination of the need for changes to the
2 EMS system.
3 (3) Performance measures for delivery of EMS to all
4 persons in this Commonwealth.
5 (4) Methods to be used in achieving the stated
6 performance measures.
7 (5) A schedule for achievement of the stated performance
8 measures.
9 (6) A method for monitoring and evaluating whether the
10 stated performance measures are being achieved.
11 (7) Estimated costs for achieving the stated performance
12 measures.
13 (c) Revisions.--
14 (1) The department shall collect and analyze EMS data
15 for the purpose of:
16 (i) Revising the Statewide EMS system plan,
17 including determining the status of the Statewide EMS
18 system, the degree of compliance with the requirements of
19 this chapter and the effectiveness of EMS systems in
20 reducing morbidity and mortality associated with medical
21 emergencies.
22 (ii) Planning future EMS system initiatives.
23 (2) Persons regulated by the department under this
24 chapter and dispatchers of EMS agencies shall provide data,
25 without charge, as reasonably requested by the department and
26 regional EMS councils, to aid them in developing and revising
27 Statewide and regional EMS system plans and in conducting
28 investigations under this chapter as authorized by the
29 department.
30 (d) Annual reports.--The department shall annually publish
20080S1420B2073 - 27 -
1 comprehensive and specific reports of activity and plan
2 implementation.
3 (e) Use of Statewide plan.--
4 (1) The department shall use the Statewide plan for
5 contract and grant purposes as set forth in section 7212(a)
6 (relating to contract and grants).
7 (2) Nothing in the Statewide plan shall be construed to
8 vest the department with any regulatory authority.
9 § 7212. Contracts and grants.
10 (a) General power.--The department may enter into contracts
11 or grants with entities to serve as regional EMS councils
12 responsible for the initiation, expansion, maintenance and
13 improvement of regional EMS systems that are in accordance with
14 the Statewide EMS system plan.
15 (b) Limitation.--An entity with which the department enters
16 into a contract or grant under this section to serve as a
17 regional EMS council shall carry out the duties assigned by the
18 department under section 7209(c) (relating to regional emergency
19 medical services councils).
20 (c) Purposes.--In contracting with or giving a grant to
21 regional EMS councils, the department may allocate Emergency
22 Medical Services Operating Fund moneys appropriated to the
23 department only for the following purposes:
24 (1) Providing programs of public education, information,
25 health promotion and prevention regarding EMS.
26 (2) Purchasing ambulances, other EMS vehicles, medical
27 equipment and rescue equipment.
28 (3) Applying to costs associated with conducting
29 training and testing programs for EMS providers.
30 (4) Applying to costs associated with inspections and
20080S1420B2073 - 28 -
1 investigations conducted to assist the department to carry
2 out its regulatory authority under this chapter.
3 (5) Purchasing communications equipment and services,
4 including alerting equipment, provided that the purchases are
5 in accordance with the Statewide EMS system plan.
6 (6) Assisting with the merger of EMS agencies or
7 assisting an EMS agency to acquire another EMS agency, when
8 the department determines circumstances exist such that the
9 transaction and financial assistance are needed to serve the
10 public interest.
11 (7) Applying to costs associated with the maintenance
12 and operation of regional EMS councils. Those costs may
13 include, but shall not be limited to, salaries, wages and
14 benefits of staff; travel; equipment and supplies; leasing of
15 office space; and other costs incidental to the conduct of
16 business which are deemed by the department to be necessary
17 and appropriate for carrying out the purposes of this
18 chapter.
19 (8) Applying to costs associated with collection and
20 analysis of data necessary to evaluate the effectiveness of
21 EMS systems in providing EMS and to administer quality
22 improvement programs.
23 (9) Applying to costs associated with assisting EMS
24 agencies to recruit and retain EMS providers.
25 (d) Restriction.--In contracting with or providing grants to
26 regional EMS councils, the department may not allocate Emergency
27 Medical Services Operating Fund moneys appropriated to the
28 department for the following purposes:
29 (1) Acquisition, construction or rehabilitation of
30 facilities or buildings, except renovation as may be
20080S1420B2073 - 29 -
1 necessary for the implementation or modification of EMS
2 communication systems.
3 (2) Purchasing hospital equipment, other than
4 communications equipment for medical command and receiving
5 facilities, unless the equipment is used or intended to be
6 used in an equipment exchange program with EMS agencies.
7 (3) Maintenance of ambulances, other EMS vehicles and
8 equipment.
9 (4) Applying to costs deemed by the department as
10 inappropriate for carrying out the purposes of this chapter.
11 (5) Applying to costs which are normally borne by
12 patients, except for extraordinary costs as determined by the
13 department.
14 (e) Reports.--The recipient of a contract or grant under
15 this chapter shall make reports to the department as may be
16 required by the department.
17 (f) Contract and grant prerequisites.--The department shall
18 not contract with or provide a grant to an entity for that
19 entity to serve as a regional EMS council unless:
20 (1) The entity has submitted a contract or grant
21 application to the department in a form and format prescribed
22 by the department that is consistent with the Statewide and
23 regional EMS system plans.
24 (2) The application addresses planning, maintenance and
25 improvement of the regional EMS system.
26 (3) The entity demonstrates to the department's
27 satisfaction the qualifications and commitment to plan,
28 maintain and improve a regional EMS system, and that the
29 entity has the required organizational structure and
30 provision for representation of appropriate entities.
20080S1420B2073 - 30 -
1 (g) Technical assistance.--The department shall provide
2 technical assistance, as appropriate, to regional EMS councils
3 and to such other eligible entities as necessary for the purpose
4 of their carrying out the provisions of contracts and grants
5 under this section, with special consideration for contractors
6 and grantees representing rural areas.
7 (h) Payments.--Payments pursuant to a contract or grant
8 under this section may be made in advance or by way of
9 reimbursement and in installments and on conditions as the
10 department determines will most effectively carry out the
11 provisions of this chapter.
12 (i) Other funds considered.--
13 (1) In determining the amount of a contract or grant
14 under this section, the amount of funds available to the
15 contractor or grantee from non-State contributions and
16 Federal grant or contract programs pertaining to EMS shall be
17 taken into consideration.
18 (2) For purposes of this subsection, "non-State
19 contributions" include the outlay of cash and in-kind
20 services to the contractor or grantee or toward the operation
21 of a regional EMS system by private, public or government
22 third parties, including the Federal Government.
23 (j) Other contracts and grants.--The department may enter
24 into contracts and grants with organizations other than regional
25 EMS councils in order to assist the department in complying with
26 the provisions of this section and chapter.
27 (k) Public disclosure.--
28 (1) Subject to the provisions of paragraph (2),
29 finalized contracts and grants shall be deemed public records
30 subject to disclosure.
20080S1420B2073 - 31 -
1 (2) The department may not disclose information in
2 contracts or grants that could be used by persons to
3 undermine measures to combat, respond to or recover from
4 terrorist attacks.
5 (l) Sole source contract or grant.--Upon expiration of a
6 contract or grant with an entity to carry out the duties of a
7 regional EMS council as set forth in subsection (c), the
8 department, without undertaking a competitive bidding process,
9 may enter into a new contract or grant with the same entity for
10 that entity to continue to serve as a regional EMS council and
11 perform the duties set forth in subsection (c), as determined by
12 the department, if that entity in carrying out the prior
13 contract or grant demonstrated its ability and commitment to the
14 department's satisfaction to plan, maintain and improve the
15 regional EMS system consistent with the terms of the prior
16 contract or grant.
17 § 7213. Emergency medical services providers.
18 (a) Certification.--The department shall issue
19 certifications for the following types of EMS providers, which
20 shall be permanent, subject to disciplinary action pursuant to
21 section 7221 (relating to certification sanctions):
22 (1) Emergency medical responder.
23 (2) Emergency medical technician.
24 (3) Advanced emergency medical technician.
25 (4) Paramedic.
26 (5) Prehospital registered nurse.
27 (6) Prehospital physician extender.
28 (7) Prehospital EMS physician.
29 (8) Any other class of EMS provider the department
30 establishes by regulation.
20080S1420B2073 - 32 -
1 (b) Other emergency medical services providers.--The
2 department may establish by regulation as the need arises
3 classes of EMS providers to provide specialized EMS. The
4 regulations shall establish certification, practice,
5 disciplinary and other provider standards consistent with the
6 purposes of this chapter, and the statutory regulatory schemes
7 applicable to paramedics except as necessary to meet the special
8 EMS needs for which the class of EMS provider is created.
9 (c) Application.--An applicant for EMS provider
10 certification shall complete an application for certification on
11 a form or through an electronic application process prescribed
12 by the department.
13 (d) Education.--The department shall assist, encourage and
14 coordinate the education of EMS providers.
15 (1) The department shall develop standards through
16 regulations for the accreditation, reaccreditation and
17 operation of educational institutes to provide the training
18 persons must successfully complete to be certified as EMS
19 providers.
20 (2) The department shall develop standards through
21 regulations for the approval of continuing education courses
22 for EMS providers and the accreditation of persons and
23 Commonwealth agencies that provide continuing education EMS
24 providers may take to secure renewal of registration.
25 (3) The department, in consultation with the board,
26 shall review and update the permitted scope of continuing
27 education programs not less than biennially.
28 (4) If the educational institute or provider of
29 continuing education courses fails to satisfy the operational
30 standards or continue to meet the accreditation standards,
20080S1420B2073 - 33 -
1 the department may take one or more of the following actions:
2 (i) Deny the application for reaccreditation.
3 (ii) Impose terms of probation.
4 (iii) Revoke, suspend, limit or otherwise restrict
5 the accreditation.
6 (iv) Impose a civil penalty not exceeding $1,000 for
7 each infraction.
8 (e) Examinations.--
9 (1) A person who intends to secure EMS provider
10 certification shall take the required certification
11 examinations within one year after completing the EMS
12 provider training required for certification.
13 (2) Except as otherwise provided in this subsection, a
14 person who fails a written or practical skills examination
15 for an EMS provider certification may repeat the failed
16 examination without retaking the examination the person
17 passed.
18 (3) A person who fails the written examination three
19 times shall complete a refresher course approved by the
20 department or repeat the EMS provider training program before
21 taking the examination again.
22 (4) A person who fails the practical skills examination
23 three time shall complete a remedial course approved by the
24 department or repeat the EMS provider training program before
25 again taking the examination.
26 (5) A person who fails either examination six times or
27 who does not pass the required examinations within two years
28 after completing the EMS provider training program shall
29 receive no credit for an examination previously passed and
30 shall repeat the training program for the EMS provider
20080S1420B2073 - 34 -
1 certification before the person may take the certification
2 examinations again.
3 (6) If the standards a person needs to satisfy to take a
4 certification examination change after the person has failed
5 the examination, the person may not retake the examination
6 unless the person meets the new standards.
7 (7) The department may, by regulation, change the
8 standards in this subsection.
9 (f) Reciprocity and endorsement.--The department may issue
10 EMS provider certifications by reciprocity or endorsement as
11 follows:
12 (1) If the department, upon review of the criteria for
13 certification of a type of EMS provider in another state,
14 determines that the criteria is substantially equivalent to
15 the criteria for a similar certification in this
16 Commonwealth, the department may enter into a reciprocity
17 agreement with its counterpart certifying agency in the other
18 state to certify that type of EMS provider based solely on
19 the other state's certification of the provider. No
20 reciprocity agreement may deprive the department from denying
21 a certification based on disciplinary considerations.
22 (2) If the department, upon review of a course or an
23 examination approved by another state for EMS provider
24 certification or continuing education, or upon review of a
25 national course or examination, determines that the course or
26 examination meets or exceeds the standards for such a course
27 or examination for a similar type of certification in this
28 Commonwealth, or for registration of the certification, the
29 department may endorse the course or examination as meeting
30 the course or examination requirements for that type of EMS
20080S1420B2073 - 35 -
1 provider certification in acting upon an applicant's
2 application for certification or registration of the
3 certification in this Commonwealth.
4 (g) Skills.--The department shall publish in the
5 Pennsylvania Bulletin a list of skills within the scope of
6 practice of each type of EMS provider. The list shall be updated
7 by publication as necessary.
8 (h) Medical command orders and protocols.--
9 (1) An EMS provider, other than a prehospital EMS
10 physician, shall provide EMS pursuant to department-approved
11 protocols and medical command orders.
12 (2) The protocols shall identify circumstances in which
13 an EMS provider shall seek direction from a medical command
14 physician, which direction may be given by the physician in
15 person or through an authorized agent or via radio or other
16 telecommunications device approved by the department, and
17 shall address the responsibilities of an EMS provider when
18 medical command cannot be secured or is disrupted.
19 (i) Reports of convictions, discipline and exclusions.--
20 (1) An applicant for an EMS provider certification shall
21 report to the department all misdemeanor, felony and other
22 criminal convictions that are not summary or equivalent
23 offenses, and all disciplinary sanctions that have been
24 imposed upon a license, certification or other authorization
25 of the applicant to practice an occupation or profession, and
26 any exclusion from a Federal or State health care program of
27 the applicant or an entity in which the applicant had equity
28 or capital, stock or profits of the entity equal to at least
29 5% of the value of the property or assets of the entity at
30 the time of the exclusion.
20080S1420B2073 - 36 -
1 (2) The applicant shall also provide the department with
2 a certified copy of the criminal charging, judgment and
3 sentencing documents for each conviction and a certified copy
4 of an adjudication or other document imposing discipline
5 against the applicant.
6 (3) The department may not certify an applicant until
7 the department receives the documents, unless the applicant
8 establishes that the documents from which certified copies
9 are to be made no longer exist.
10 (4) An EMS provider shall report the same type of
11 convictions, disciplinary sanctions and exclusions and
12 provide the same documents to the department within 30 days
13 after each conviction, discipline and exclusion.
14 (j) Identification.--
15 (1) An EMS provider shall provide proof of authority to
16 practice as an EMS provider if requested when providing
17 services as an EMS provider.
18 (2) For purposes of this subsection, "proof of authority
19 to practice" means a card or certificate issued by the
20 department that shows current registration of the EMS
21 provider's certification.
22 (k) Change of address.--
23 (1) An EMS provider and an applicant for EMS provider
24 certification shall ensure that the department has the
25 current address at which the person can be reached by mail at
26 all times.
27 (2) Neither an EMS provider's home address, telephone
28 number nor any other residential contact information provided
29 to the department shall be deemed a public record.
30 (l) Current registration.--To provide EMS, an EMS provider
20080S1420B2073 - 37 -
1 shall maintain current registration of his certification as an
2 EMS provider.
3 (m) Downgrading certification or practice.--
4 (1) An EMS provider who has a currently registered
5 certification as an advanced EMT or higher-level EMS provider
6 and is not permitted to practice at that level by an EMS
7 agency pursuant to sections 7225(b)(2) (relating to medical
8 director of emergency medical services agency) and 7229(k)
9 (relating to emergency medical services agencies), may
10 function as a lower-level EMS provider for that EMS agency,
11 as authorized by the EMS agency medical director, if the EMS
12 agency permits.
13 (2) Upon expiration of the biennial registration period,
14 an EMS provider who is at or above the advanced EMT level and
15 whose practice for an EMS agency has been downgraded pursuant
16 to sections 7225(b)(2) and 7229(k) may choose to maintain
17 current registration of the EMS provider's certification by
18 meeting the biennial registration requirements for that
19 certification.
20 (3) An EMS provider who has a currently registered
21 certification as an advanced EMT or higher-level EMS provider
22 and does not meet the requirements for biennial registration
23 of that certification may apply to and secure from the
24 department registration of a lower-level EMS provider
25 certification if the EMS provider meets the registration
26 requirements for that certification.
27 (4) Instead of a registration certificate, the
28 department shall issue a lower-level certification to an EMS
29 provider who does not already have that certification and
30 applies for a registration of that certification under this
20080S1420B2073 - 38 -
1 subsection.
2 (5) An EMS provider whose practice level has been
3 downgraded under this section and who does not maintain
4 current registration of the higher-level certification may
5 not display an insignia, patch or any other indicia of the
6 higher-level certification when providing EMS.
7 (n) Biennial registrations.--
8 (1) The biennial registration of each EMS provider
9 certification subject to a biennial registration requirement
10 shall expire on January 1 of the next even-numbered year.
11 (2) The continuing education requirements for the
12 biennial registration following the initial registration of a
13 certification shall be prorated based upon the month in which
14 the EMS provider became certified, with any fractional
15 requirement rounded down.
16 § 7214. Emergency medical responders.
17 (a) Scope of practice.--An EMR performs for an EMS agency
18 BLS skills involving basic interventions with minimum EMS
19 equipment as follows:
20 (1) As a member of a QRS to stabilize and improve a
21 patient's condition in an out-of-hospital emergency until a
22 higher-level EMS provider arrives at the scene and then may
23 assist that EMS provider.
24 (2) As a member of the crew of an ambulance.
25 (3) In another capacity as authorized by the department
26 by regulation.
27 (b) Certification.--The department shall certify as an EMR
28 an individual who meets all of the following:
29 (1) Is at least 16 years of age.
30 (2) Has successfully completed an EMR training course
20080S1420B2073 - 39 -
1 approved by the department.
2 (3) Has a current certificate evidencing successful
3 completion of a CPR course acceptable to the department.
4 (4) Has passed an EMR skills practical examination
5 approved by the department.
6 (5) Has passed a written EMR certification examination
7 approved by the department.
8 (c) Triennial registration.--An EMR's certification is
9 deemed registered for three years after issuance. An EMR must
10 register the EMR certification at three-year intervals by
11 completing an application for triennial registration on a form
12 or through an electronic process, as prescribed by the
13 department. The following shall apply:
14 (1) The department shall issue a triennial registration
15 of an EMR certification to an EMR who meets all of the
16 following:
17 (i) Has a current registration and applies for a new
18 registration no later than:
19 (A) 30 days before the current registration is
20 to expire; or
21 (B) a lesser time established by regulation of
22 the department.
23 (ii) Successfully:
24 (A) completes EMR triennial registration
25 practical skills and written knowledge examinations
26 approved by the department; or
27 (B) secures continuing education credits for EMR
28 triennial registration as required by the department
29 in continuing education programs approved by the
30 department.
20080S1420B2073 - 40 -
1 (2) An EMR whose registration of an EMR certification
2 has expired must qualify for a triennial registration of the
3 certification as prescribed by regulation of the department.
4 (d) Transition for first responders.--An individual who is
5 certified as a first responder on the effective date of this
6 section shall be considered to be an EMR with a current
7 registration and shall be subject to the triennial registration
8 requirements of an EMR. The registration of the EMR
9 certification shall expire on the same date the first responder
10 certification would have expired if the first responder
11 certification remained in effect.
12 (e) Transition for ambulance attendants.--An individual who
13 is an ambulance attendant on the effective date of this section
14 shall be considered to be an EMR with a current registration and
15 shall be subject to the triennial registration requirements of
16 an EMR. The registration of the EMR certification shall expire
17 on the same date that the person's qualifications as an
18 ambulance attendant expire and would have needed to be renewed.
19 § 7215. Emergency medical technicians.
20 (a) Scope of practice.--An EMT performs basic EMS skills
21 involving basic interventions and equipment found on an EMS
22 vehicle as follows:
23 (1) For an EMS agency as a member of the crew of an
24 ambulance.
25 (2) For an EMS agency as a member of a QRS to stabilize
26 and improve a patient's condition in an out-of-hospital
27 setting until an ambulance arrives, and then may assist the
28 ambulance crew.
29 (3) As a first aid or safety officer, or in a similar
30 capacity, for or independent of an EMS agency, as prescribed
20080S1420B2073 - 41 -
1 by regulation of the department.
2 (4) For an EMS agency in another capacity authorized by
3 regulation of the department.
4 (b) Certification.--The department shall certify as an EMT
5 an individual who meets all of the following:
6 (1) Is at least 16 years of age.
7 (2) Has successfully completed an EMT training course
8 which:
9 (i) teaches basic EMS; and
10 (ii) is approved by the department.
11 (3) Has a current certificate evidencing successful
12 completion of a CPR course acceptable to the department.
13 (4) Has passed an EMT skills practical examination
14 approved by the department.
15 (5) Has passed a written EMT certification examination
16 approved by the department.
17 (c) Triennial registration.--An EMT's certification is
18 deemed registered for three years after issuance. An EMT must
19 register the EMT certification at three-year intervals by
20 completing an application for triennial registration on a form
21 or through an electronic process, as prescribed by the
22 department. The following shall apply:
23 (1) The department shall issue a triennial registration
24 of an EMT certification to an EMT who meets all of the
25 following:
26 (i) Has a current registration and applies for a new
27 registration no later than:
28 (A) 30 days before the current registration is
29 to expire; or
30 (B) a lesser time established by regulation of
20080S1420B2073 - 42 -
1 the department.
2 (ii) Successfully:
3 (A) completes EMT triennial registration
4 practical skills and written knowledge examinations
5 approved by the department; or
6 (B) secures continuing education credits for EMT
7 triennial registration as required by the department
8 in continuing education programs approved by the
9 department.
10 (2) An EMT whose registration of an EMT certification
11 has expired must qualify for a triennial registration of the
12 certification as prescribed by regulation of the department.
13 § 7216. Advanced emergency medical technicians.
14 (a) Scope of practice.--An advanced EMT performs basic EMS
15 and ALS skills which include interventions and administration of
16 medications with basic and advanced equipment found on an EMS
17 vehicle as follows:
18 (1) For an EMS agency as a member of the crew of an
19 ambulance.
20 (2) For an EMS agency as a member of a QRS to stabilize
21 and improve a patient's condition in an out-of-hospital
22 emergency until an ambulance arrives at the scene and then
23 may assist the ambulance crew.
24 (3) An a first aid or safety officer, or in a similar
25 capacity, for or independent of an EMS agency, as prescribed
26 by regulation of the department.
27 (4) For an EMS agency in another capacity as authorized
28 by regulation of the department.
29 (b) Certification.--The department shall certify as an
30 advanced EMT an individual who meets all of the following:
20080S1420B2073 - 43 -
1 (1) Is at least 18 years of age.
2 (2) Has successfully completed a course under
3 subparagraph (i) or (ii):
4 (i) An advanced EMT training course which:
5 (A) teaches basic life support skills;
6 (B) teaches advanced life support skills deemed
7 appropriate by regulation of the department; and
8 (C) is approved by the department.
9 (ii) An EMT course and secured training and
10 education, through continuing education courses, in
11 skills included in the scope of practice for an advanced
12 EMT for which the applicant did not receive training in
13 the EMT course.
14 (3) Has a current certificate evidencing successful
15 completion of a CPR course acceptable to the department.
16 (4) Has passed an advanced EMT skills practical
17 examination approved by the department.
18 (5) Has passed a written advanced EMT certification
19 examination approved by the department.
20 (c) Biennial registration.--An advanced EMT's certification
21 is deemed registered when the certification is issued. The
22 initial registration shall expire as set forth in section
23 7213(n) (relating to emergency medical services providers).
24 Except for the initial registration period, an advanced EMT must
25 register the advanced EMT certification at two-year intervals by
26 completing an application for biennial registration on a form or
27 through an electronic process, as prescribed by regulation of
28 the department. The following shall apply:
29 (1) The department shall issue a biennial registration
30 of an advanced EMT certification to an advanced EMT who meets
20080S1420B2073 - 44 -
1 all of the following:
2 (i) Has a current registration and applies for a new
3 registration no later than:
4 (A) 30 days before the current registration is
5 to expire; or
6 (B) a lesser time established by regulation of
7 the department.
8 (ii) Successfully:
9 (A) completes advanced EMT biennial registration
10 practical skills and written knowledge examinations
11 approved by the department; or
12 (B) secures continuing education credits for
13 advanced EMT biennial registration as required by the
14 department in continuing education programs approved
15 by the department.
16 (2) An advanced EMT whose registration of an advanced
17 EMT certification has expired must qualify for a biennial
18 registration of the certification as prescribed by regulation
19 of the department.
20 § 7217. Paramedics.
21 (a) Scope of practice.--A paramedic is a higher level EMS
22 provider than an advanced EMT. A paramedic performs basic and
23 advanced EMS skills which include interventions and
24 administration of medications with basic and advanced equipment
25 found on an EMS vehicle as follows:
26 (1) For an EMS agency as a member of the crew of an
27 ambulance.
28 (2) For an EMS agency as a member of a QRS to stabilize
29 and improve a patient's condition in an out-of-hospital
30 emergency until an ambulance arrives at the scene and then
20080S1420B2073 - 45 -
1 may assist the ambulance crew.
2 (3) As a first aid or safety officer, or in a similar
3 capacity, for or independent of an EMS agency, as prescribed
4 by regulation of the department.
5 (4) For an EMS agency in another capacity authorized by
6 regulation of the department.
7 (b) Paramedic training.--To be eligible to enroll in a
8 paramedic training course required for certification as a
9 paramedic, an individual must satisfy all of the following:
10 (1) Be at least 18 years of age when the course
11 commences.
12 (2) Have a high school diploma or its equivalent.
13 (3) Be currently certified by the department as an EMT
14 or advanced EMT.
15 (c) Certification.--The department shall certify as a
16 paramedic an EMT or advanced EMT who meets all of the following:
17 (1) Is at least 18 years of age.
18 (2) Has successfully completed a paramedic training
19 course which:
20 (i) teaches basic life support skills;
21 (ii) teaches advanced life support skills deemed
22 appropriate by regulation of the department; and
23 (iii) is approved by the department.
24 (3) Has a current certificate evidencing successful
25 completion of a CPR course acceptable to the department.
26 (4) Has passed a paramedic skills practical examination
27 approved by the department.
28 (5) Has passed a written paramedic certification
29 examination approved by the department.
30 (d) Biennial registration.--A paramedic's certification is
20080S1420B2073 - 46 -
1 deemed registered when the certification is issued. The initial
2 registration shall expire as set forth in section 7213(n)
3 (relating to emergency medical services providers). Except for
4 the initial registration period, a paramedic must register the
5 paramedic certification at two-year intervals by completing an
6 application for biennial registration on a form or through an
7 electronic process as prescribed by regulation of the
8 department. The following shall apply:
9 (1) The department shall issue a biennial registration
10 of a paramedic certification to a paramedic who meets all of
11 the following:
12 (i) Has a current registration and applies for a new
13 registration no later than:
14 (A) 30 days before the current registration is
15 to expire; or
16 (B) a lesser time established by regulation of
17 the department.
18 (ii) Successfully secures continuing education
19 credits for paramedic biennial registration as required
20 by the department in continuing education programs
21 approved by the department.
22 (2) A paramedic whose registration of a paramedic
23 certification has expired must qualify for a biennial
24 registration of the certification as prescribed by regulation
25 of the department.
26 § 7218. Prehospital registered nurses.
27 (a) Scope of practice.--A PHRN is a higher level EMS
28 provider than an advanced EMT. A PHRN performs for an EMS agency
29 basic and advanced EMS skills and as authorized by the
30 department additional nursing skills within the scope of
20080S1420B2073 - 47 -
1 practice of a registered nurse under the act of May 22, 1951
2 (P.L.317, No.69), known as The Professional Nursing Law, or a
3 successor act, as follows:
4 (1) As a member of the crew of an ambulance.
5 (2) As a member of a QRS to stabilize and improve a
6 patient's condition in an out-of-hospital emergency until an
7 ambulance arrives at the scene and then may assist the
8 ambulance crew.
9 (3) As a first aid or safety officer, or in a similar
10 capacity, as prescribed by regulation of the department.
11 (4) In another capacity as authorized by regulation of
12 the department.
13 (b) Certification.--The department shall certify as a PHRN
14 an individual who meets all of the following:
15 (1) Has a current license as a registered nurse with the
16 State Board of Nursing.
17 (2) Is at least 18 years of age.
18 (3) Has a current certificate evidencing successful
19 completion of a CPR course acceptable to the department.
20 (4) Has passed a PHRN skills practical examination
21 approved by the department.
22 (5) Has passed a written PHRN certification examination
23 approved by the department.
24 (c) Biennial registration.--A PHRN's certification is deemed
25 registered when the certification is issued. The initial
26 registration shall expire as set forth in section 7213(n)
27 (relating to emergency medical services providers). Except for
28 the initial registration period, a PHRN must register the PHRN
29 certification at two-year intervals by completing an application
30 for biennial registration on a form or through an electronic
20080S1420B2073 - 48 -
1 process, as prescribed by regulation of the department. The
2 following shall apply:
3 (1) The department shall issue a biennial registration
4 of a PHRN certification to a PHRN who meets all of the
5 following:
6 (i) Has a current registration and applies for a new
7 registration no later than:
8 (A) 30 days before the current registration is
9 to expire; or
10 (B) a lesser time established by regulation of
11 the department.
12 (ii) Has current registration of a registered nurse
13 license.
14 (iii) Successfully secures continuing education
15 credits for PHRN biennial registration as required by the
16 department in continuing education programs approved by
17 the department.
18 (2) A PHRN whose registration of a PHRN certification
19 has expired must qualify for a biennial registration of the
20 certification as prescribed by regulation of the department.
21 § 7219. Prehospital physician extenders.
22 (a) Scope of practice.--A PHPE is a higher level EMS
23 provider than an advanced EMT. A PHPE performs for an EMS agency
24 basic and advanced EMS skills and as authorized by regulation of
25 the department additional physician assistant skills within the
26 scope of practice of a physician assistant under the act of
27 December 20, 1985 (P.L.457, No.112), known as the Medical
28 Practice Act of 1985, or the act of October 5, 1978 (P.L.1109,
29 No.261), known as the Osteopathic Medical Practice Act, or a
30 successor act, as follows, but supervision of a PHPE shall be
20080S1420B2073 - 49 -
1 conducted as set forth in this chapter:
2 (1) As a member of the crew of an ambulance.
3 (2) As a member of a QRS to stabilize and improve a
4 patient's condition in an out-of-hospital emergency until an
5 ambulance arrives at the scene and then may assist the
6 ambulance crew.
7 (3) As a first aid or safety officer, or in a similar
8 capacity, for an EMS agency as prescribed by regulation of
9 the department.
10 (4) In another capacity as authorized by regulation of
11 the department.
12 (b) Certification.--The department shall certify as a PHPE a
13 physician assistant who meets all of the following:
14 (1) Has a currently registered license as a physician
15 assistant with the State Board of Medicine or the State Board
16 of Osteopathic Medicine.
17 (2) Is at least 18 years of age.
18 (3) Has a current certificate evidencing successful
19 completion of a CPR course acceptable to the department.
20 (4) Has passed a PHPE skills practical examination
21 approved by the department.
22 (5) Has passed a written PHPE certification examination
23 approved by the department.
24 (c) Biennial registration.--A PHPE's certification is deemed
25 registered when the certification is issued. The initial
26 registration shall expire as set forth in section 7213(n)
27 (relating to emergency medical services providers). Except for
28 the initial registration period, a PHPE must register the PHPE
29 certification at two-year intervals by completing an application
30 for biennial registration on a form or through an electronic
20080S1420B2073 - 50 -
1 process as prescribed by regulation of the department. The
2 following shall apply:
3 (1) The department shall issue a biennial registration
4 of a PHPE certification to a PHPE who:
5 (i) Has a current registration and applies for a new
6 registration no later than:
7 (A) 30 days before the current registration is
8 to expire; or
9 (B) a lesser time as established by regulation
10 of the department.
11 (ii) Has current registration of a physician
12 assistant license.
13 (iii) Successfully secures continuing education
14 credits for PHPE biennial registration as required by the
15 department in continuing education programs approved by
16 the department.
17 (2) A PHPE whose registration of a PHPE certification
18 has expired must qualify for a biennial registration of the
19 certification as prescribed by regulation of the department.
20 § 7220. Prehospital emergency medical services physicians.
21 (a) Scope of practice.--A prehospital EMS physician is a
22 higher level EMS provider than an advanced EMT. A prehospital
23 EMS physician performs for an EMS agency basic and advanced EMS
24 skills within the scope of practice of a physician under the act
25 of December 20, 1985 (P.L.457, No.112), known as the Medical
26 Practice Act of 1985 or the act of October 5, 1978 (P.L.1109,
27 No.261), known as the Osteopathic Medical Practice Act, as
28 applicable, or a successor act, as follows:
29 (1) As a member of the crew of an ambulance.
30 (2) As a member of a QRS to stabilize and improve a
20080S1420B2073 - 51 -
1 patient's condition in an out-of-hospital emergency.
2 (3) As a first aid or safety officer, or in a similar
3 capacity, as prescribed by regulation of the department.
4 (4) In another capacity authorized by regulation of the
5 department.
6 (b) Certification.--The department shall certify as a
7 prehospital EMS physician a physician who has:
8 (1) Successfully completed one or more of the following:
9 (i) An emergency medicine residency program that is
10 accredited by a residency program accrediting body
11 recognized by the State Board of Medicine or the State
12 Board of Osteopathic Medicine.
13 (ii) The first year of an emergency medicine
14 residency program that satisfies the requirements of
15 subparagraph (i) and has successfully completed programs
16 approved by the department in advanced cardiac life
17 support, advanced trauma life support and advanced
18 pediatric life support.
19 (iii) An anesthesia, family practice, internal
20 medicine or general surgery residency program that is
21 accepted by either the State Board of Medicine or the
22 State Board of Osteopathic Medicine as providing the
23 graduate medical training the board requires for issuance
24 of a physician license without restriction and has
25 successfully completed programs approved by the
26 department in advanced cardiac life support, advanced
27 trauma life support and advanced pediatric life support.
28 (2) A current certificate evidencing successful
29 completion of a CPR course acceptable to the department.
30 (3) Passed an EMS skills practical examination approved
20080S1420B2073 - 52 -
1 by the department or served as a prehospital health
2 professional physician prior to the effective date of this
3 section.
4 (c) Biennial registration.--A prehospital EMS physician's
5 certification is deemed registered when the certification is
6 issued. The initial registration shall expire under section
7 7213(n) (relating to emergency medical services providers).
8 Except for the initial registration period, a prehospital EMS
9 physician shall register the prehospital EMS physician
10 certification at two-year intervals by completing an application
11 for biennial registration on a form or through an electronic
12 process as prescribed by the department. The following shall
13 apply:
14 (1) The department shall issue a biennial registration
15 of a prehospital EMS physician certification to a prehospital
16 EMS physician who meets all of the following:
17 (i) Has a current registration and applies for a new
18 registration no later than 30 days before the current
19 registration is to expire or within a lesser time period
20 as the department may establish by regulation.
21 (ii) Has current registration of a physician
22 license.
23 (iii) Successfully secures continuing education
24 credits for prehospital EMS physician biennial
25 registration as required by the department in continuing
26 education programs approved by the department.
27 (2) A prehospital EMS physician whose registration of a
28 prehospital EMS physician certification has expired shall
29 qualify for a biennial registration of the certification as
30 prescribed by regulation of the department.
20080S1420B2073 - 53 -
1 (d) Transition for prehospital health professional
2 physicians.--A physician who served as a prehospital health
3 professional physician prior to the effective date of this
4 section and who satisfies the certification requirements under
5 subsection (b)(1) may serve as a prehospital EMS physician for
6 90 days after the effective date of this section without having
7 secured a certification as a prehospital EMS physician.
8 § 7221. Certification sanctions.
9 (a) Grounds for discipline.--The department may discipline
10 an EMS provider or applicant for EMS provider certification for
11 any of the following reasons:
12 (1) Lack of physical or mental ability to provide
13 adequate services.
14 (2) Deceptive or fraudulent procurement or
15 representation of certification or registration credentials,
16 or for making misleading, deceptive or untrue representations
17 to secure or aid or abet another person to secure a
18 certification, license, registration or any other
19 authorization issued by the department under this chapter.
20 (3) Willful or negligent misconduct in providing EMS or
21 practicing beyond the scope of certification authorization
22 without legal authority to do so.
23 (4) Abuse or abandonment of a patient.
24 (5) The rendering of services while under the influence
25 of alcohol, illegal drugs or the knowing abuse of legal
26 drugs.
27 (6) The operation of an emergency vehicle in a reckless
28 manner or while under the influence of alcohol, illegal drugs
29 or the knowing abuse of legal drugs.
30 (7) Disclosure of medical or other information about a
20080S1420B2073 - 54 -
1 patient where prohibited by Federal or State law.
2 (8) Willful preparation or filing of a false medical
3 report or record or the inducement of others to do so.
4 (9) Destruction of a medical report or record required
5 to be maintained.
6 (10) Refusal to render emergency medical care because of
7 a patient's race, sex, creed, national origin, sexual
8 preference, age, handicap, medical problem or financial
9 inability to pay.
10 (11) Failure to comply with department-approved
11 protocols.
12 (12) Failure to comply with reporting requirements
13 imposed under this chapter or as established by the
14 department.
15 (13) Practicing without the current registration of a
16 certification.
17 (14) Conviction of a felony, a crime related to the
18 practice of the EMS provider or a crime involving moral
19 turpitude. For the purposes of this paragraph a conviction
20 includes a judgment of guilt, a plea of guilty or a plea of
21 nolo contendere.
22 (15) Willful falsification of or a failure to complete
23 details on an EMS patient care report.
24 (16) Misappropriation of drugs or EMS agency property.
25 (17) Having a certification or other authorization to
26 practice a profession or occupation revoked, suspended or
27 subjected to other disciplinary sanction.
28 (18) Violating, or aiding or abetting another person to
29 violate, a duty imposed under this chapter, a regulation
30 promulgated under this chapter or an order of the department
20080S1420B2073 - 55 -
1 previously entered in a disciplinary proceeding.
2 (19) Based upon a finding of misconduct by the relevant
3 Federal or State agency, having been excluded from a Federal
4 or State health care program or having had equity or capital,
5 stock or profits of an entity equal to 5% or more of the
6 value of the property or assets of the entity when it was
7 excluded from a Federal or State health care program.
8 (20) Any other reason as determined by the department
9 which poses a threat to the health and safety of the public.
10 (b) Disciplinary options.--If the department is empowered to
11 take disciplinary action against an individual under this
12 section, the department may do one or more of the following:
13 (1) Deny the application for certification.
14 (2) Issue a public reprimand.
15 (3) Revoke, suspend, limit or otherwise restrict the
16 certification.
17 (4) Require the person to take refresher educational
18 courses.
19 (5) Impose a civil money penalty not exceeding $1,000
20 for each incident in which the EMS provider engages in
21 conduct that constitutes a basis for discipline.
22 (6) Stay enforcement of any suspension, revocation or
23 other discipline and place the individual on probation with
24 the right to vacate the probationary order for noncompliance.
25 (c) Registration of certification.--The department shall not
26 deny a registration of an EMS provider certification without
27 giving the applicant prior notice of the reason for the denial
28 and providing an opportunity for a hearing.
29 (d) Reinstatement.--A person whose certification has been
30 revoked may not apply for reinstatement of that certification. A
20080S1420B2073 - 56 -
1 person may petition the department for allowance to apply for a
2 new certification five years from the effective date of the
3 revocation by filing with the department a petition that avers
4 facts to establish that the person has been rehabilitated to an
5 extent that issuing the person a certification would not be
6 detrimental to the public interest. The department may grant or
7 deny the petition, without conducting a hearing, if it accepts
8 as true all facts averred, other than the conclusory averments,
9 such as that the person has been rehabilitated. If the
10 department grants the person allowance to apply for a new
11 certification, the person shall repeat the training program and
12 the certification examinations for the level of certification
13 for which the person is applying and satisfy all other
14 requirements for the certification that exist at the time of
15 reapplication. If the department does not grant the person
16 allowance to apply for a new certification, the person may not
17 again petition the department for allowance to apply for a new
18 certification until another year from the date of denial.
19 § 7222. Emergency medical services vehicle operators.
20 (a) Certification.--An EMS vehicle operator certification
21 shall be permanent, subject to disciplinary action under this
22 section. The department shall certify as an EMS vehicle operator
23 a person who meets all of the following:
24 (1) Completes an application for an EMS vehicle operator
25 certification on a form or through an electronic application
26 process, as prescribed by the department.
27 (2) Is at least 18 years of age.
28 (3) Has a current license to operate the vehicle.
29 (4) Is not addicted to alcohol or drugs.
30 (5) Is free from physical or mental defect or disease
20080S1420B2073 - 57 -
1 that may impair the person's ability to drive an EMS vehicle.
2 (6) Has successfully completed an emergency vehicle
3 operator's course of instruction approved by the department.
4 (7) Has not:
5 (i) Been convicted within the last four years prior
6 to the date of application of driving under the influence
7 of alcohol or drugs.
8 (ii) Within the last two years prior to the date of
9 application, been convicted of reckless driving or had a
10 driver's license suspended due to use of drugs or alcohol
11 or a moving traffic violation.
12 (8) Has successfully completed an emergency vehicle
13 operator's course of instruction approved by the department
14 following a disqualification from certification under
15 paragraph (7), regardless of whether the person successfully
16 completed the course previously.
17 (b) Registration.--An EMS vehicle operator shall register
18 the EMS vehicle operator's certification. Except as otherwise
19 provided in this subsection, an EMS vehicle operator's
20 certification shall be deemed registered for three years after
21 issuance. An EMS vehicle operator may not operate a ground EMS
22 vehicle unless the certification is currently registered. The
23 following shall apply:
24 (1) The department shall issue a registration of an EMS
25 vehicle operator certification to an EMS vehicle operator who
26 meets all of the following:
27 (i) Completes an application for registration on a
28 form or through an electronic application process, as
29 prescribed by the department.
30 (ii) Has a current registration and applies for a
20080S1420B2073 - 58 -
1 new registration no later than 30 days before the current
2 registration is to expire, or within a lesser time period
3 as the department may establish by regulation.
4 (iii) Has a current license to operate the vehicle.
5 (iv) Successfully completes continuing education
6 credits for EMS vehicle operators as required by the
7 department in continuing education programs approved by
8 the department.
9 (2) If a person who is issued an EMS vehicle operator
10 certification also has an EMS provider certification, the
11 registration of the EMS vehicle operator certification shall
12 expire at the same time as the registration of the EMS
13 provider certification. If the person does not maintain
14 current registration of the EMS provider certification, the
15 registration of the EMS vehicle operator certification shall
16 continue on the same renewal cycle. If an EMS vehicle
17 operator who is an EMS provider becomes certified as a
18 higher-level EMS provider, the registration of the EMS
19 vehicle operator certification shall expire at the same time
20 as the registration of the higher-level EMS provider
21 certification.
22 (3) If an EMS provider certification is subject to a
23 biennial registration cycle, the continuing education
24 requirements for the registration of the EMS vehicle operator
25 certification following the initial registration of the
26 certification shall be prorated based upon the month in which
27 the EMS provider became certified, with any fractional
28 requirement rounded down.
29 (4) An EMS vehicle operator whose registration of an EMS
30 vehicle operator certification has expired shall qualify for
20080S1420B2073 - 59 -
1 a biennial registration of the certification as prescribed by
2 regulation of the department.
3 (c) Transition for EMS vehicle operators.--An individual who
4 served as an EMS vehicle operator prior to the effective date of
5 this section and who satisfies the EMS vehicle operator
6 certification requirements under subsection (a) may serve as an
7 EMS vehicle operator for 90 days after the effective date of
8 this section without having secured a certification as an EMS
9 vehicle operator.
10 (d) Grounds for discipline.--The department may suspend or
11 revoke, or, as applicable, refuse to issue an EMS vehicle
12 operator certification for any of the following reasons:
13 (1) Lack of physical or mental ability to operate an EMS
14 vehicle.
15 (2) Deceptive or fraudulent procurement or
16 representation of certification or registration credentials,
17 or making misleading, deceptive or untrue representations to
18 secure a certification or registration.
19 (3) The operation of an emergency vehicle in a reckless
20 manner or while under the influence of alcohol, illegal drugs
21 or the knowing abuse of legal drugs.
22 (4) Having a driver's license suspended due to use of
23 alcohol or drugs or a moving traffic violation.
24 (5) Conviction of a felony or crime involving moral
25 turpitude. For the purposes of this paragraph a conviction
26 includes a judgment of guilt, a plea of guilty or a plea of
27 nolo contendere.
28 (6) Failing to perform a duty imposed upon an EMS
29 vehicle operator under this chapter or a related regulation.
30 (7) Other reasons as determined by the department which
20080S1420B2073 - 60 -
1 pose a threat to the health and safety of the public.
2 (e) Suspension of certification.--If the department suspends
3 a certification it may also impose conditions for the lifting of
4 the suspension including requiring the person to successfully
5 repeat an emergency vehicle operator's course approved by the
6 department.
7 (f) Reporting responsibilities and automatic suspension.--An
8 EMS vehicle operator shall report to the department within 30
9 days a suspension of that person's driver's license or a
10 conviction of reckless driving, a felony, a misdemeanor or any
11 other crime that is not a summary offense or equivalent. For a
12 conviction of driving under the influence of alcohol or drugs or
13 reckless driving, or for suspension of a driver's license, the
14 certification shall automatically be suspended for the periods
15 of time specified in subsection (a)(7).
16 (g) Change of address.--
17 (1) An EMS vehicle operator and an applicant for an EMS
18 vehicle operator certification shall ensure that the
19 department has the current address at which the person can be
20 reached by mail at all times.
21 (2) Neither an EMS vehicle operator's home address,
22 telephone number nor any other residential contact
23 information provided to the department shall be deemed a
24 public record.
25 § 7223. Suspension of certification.
26 (a) Temporary suspensions.--The department may temporarily
27 suspend the certification of an EMS provider or EMS vehicle
28 operator without a hearing if the department determines that the
29 person is a clear and immediate danger to the public health and
30 safety. Notice to a provider or operator of a temporary
20080S1420B2073 - 61 -
1 suspension shall include a written statement of the underlying
2 factual allegations. After issuance of the notice, the
3 department shall commence formal disciplinary action against the
4 person under section 7221 (relating to certification sanctions)
5 or 7222 (relating to emergency medical services vehicle
6 operators). Within 30 days following the issuance of an order
7 temporarily suspending the certification, the department shall
8 conduct a preliminary hearing to determine if there is a prima
9 facie case supporting the temporary suspension. The person may
10 be present at the preliminary hearing and may be represented by
11 counsel, cross-examine witnesses, inspect physical evidence,
12 call witnesses and offer testimony and other evidence. If the
13 department determines that there is not a prima facie case, the
14 suspension shall be lifted immediately. If the department
15 determines that there is a prima facie case, the temporary
16 suspension shall remain in effect until vacated by the
17 department, but not longer than 180 days unless agreed upon by
18 the parties.
19 (b) Automatic suspensions.--The department shall
20 automatically suspend a certification issued under this chapter
21 upon receiving a certified copy of court records establishing
22 that the person has been adjudicated as incapacitated under 20
23 Pa.C.S. § 5511 (relating to petition and hearing; independent
24 evaluation) or an equivalent statutory provision. The department
25 shall lift the suspension upon the person establishing to the
26 department that the person has been adjudicated to have regained
27 capacity under 20 Pa.C.S. § 5517 (relating to adjudication of
28 capacity and modification of existing orders) or an equivalent
29 statutory provision.
30 § 7224. Emergency medical services instructors.
20080S1420B2073 - 62 -
1 (a) Certification.--An EMS instructor certification is
2 permanent subject to disciplinary action under this section. The
3 department shall certify as an EMS instructor a person who:
4 (1) Completes an application for an EMS instructor
5 certification on a form or through an electronic application
6 process, as prescribed by the department.
7 (2) Is at least 18 years of age.
8 (3) Has successfully completed an EMS instructor course
9 approved by the department, or possesses a bachelor's degree
10 in education, a teacher's certification in education, or a
11 doctorate or master's degree.
12 (4) Is certified and currently registered as an EMT or
13 higher-level EMS provider.
14 (5) Possesses current certification in a CPR course
15 acceptable to the department or current certification as a
16 CPR instructor.
17 (6) Has at least one year's experience working as an EMT
18 or higher-level EMS provider.
19 (7) Has provided at least 20 hours of monitored
20 instruction time in an EMS provider certification program.
21 (b) Triennial registration.--
22 (1) An EMS instructor's certification is deemed
23 registered for three years after issuance. An EMS instructor
24 shall register the EMS instructor's certification at three-
25 year intervals by completing an application for triennial
26 registration on a form or through an electronic process, as
27 prescribed by the department. An EMS instructor may not teach
28 in an accredited EMS institute, pursuant to an EMS instructor
29 certification, unless the certification is currently
30 registered. The department shall issue a triennial
20080S1420B2073 - 63 -
1 registration of an EMS instructor certification to an EMS
2 instructor who:
3 (i) Has completed an application for triennial
4 registration on a form or through an electronic
5 application process, as prescribed by the department.
6 (ii) Has a current registration and applies for a
7 new registration no later than 30 days before the current
8 registration is to expire, or within lesser time as the
9 department may establish by regulation.
10 (iii) Has taught at least 60 hours of EMS provider
11 certification or rescue courses approved by the
12 department during the previous three years.
13 (iv) Is certified and currently registered as an EMT
14 or higher-level EMS provider.
15 (v) Possesses current certification in a CPR course
16 acceptable to the department or current certification as
17 a CPR instructor.
18 (2) An EMS instructor whose registration as an EMS
19 instructor certification has expired shall qualify for a
20 triennial registration of the certification as prescribed by
21 regulation of the department.
22 (c) Regulations.--The department may adopt regulations to
23 set standards for EMS instructors in providing instruction in
24 EMS institutions.
25 (d) Grounds for discipline.--The department may impose
26 discipline against an EMS instructor for the following reasons:
27 (1) Any reason an EMS provider may be disciplined under
28 section 7221 (relating to certification sanctions).
29 (2) Providing instruction while under the influence of
30 alcohol, illegal drugs or the knowing abuse of legal drugs.
20080S1420B2073 - 64 -
1 (3) Failing to perform a duty imposed upon an EMS
2 instructor by this chapter or a related regulation.
3 (4) Other reasons as determined by the department that
4 pose a threat to the health, safety or welfare of students.
5 (e) Disciplinary options.--If the department is empowered to
6 impose discipline against an individual under this section, the
7 department may do one or more of the following:
8 (1) Deny the application for certification.
9 (2) Issue a public reprimand.
10 (3) Revoke, suspend, limit or otherwise restrict the
11 certification.
12 (4) Impose a civil money penalty not exceeding $1,000
13 for each incident in which the EMS instructor engages in
14 conduct that constitutes a basis for discipline.
15 (5) Stay enforcement of any suspension, revocation or
16 other discipline and place the individual on probation with
17 the right to vacate the probationary order for noncompliance.
18 (f) Construction.--This section shall not be construed to
19 require the certification as EMS instructors of all instructors
20 of EMS courses accepted toward educational requirements for EMS
21 provider certification or toward continuing education
22 requirements for the registration of EMS provider
23 certifications.
24 § 7225. Medical director of emergency medical services agency.
25 (a) Qualifications.--To qualify and continue to function as
26 an EMS agency medical director, an individual shall:
27 (1) Be a physician.
28 (2) Satisfy one of the following:
29 (i) Have successfully completed an emergency
30 medicine residency program accredited by a residency
20080S1420B2073 - 65 -
1 program accrediting body recognized by the State Board of
2 Medicine or the State Board of Osteopathic Medicine.
3 (ii) Have successfully completed a residency program
4 in surgery, internal medicine, family medicine,
5 pediatrics or anesthesiology, accredited by a residency
6 program accrediting body recognized by the State Board of
7 Medicine or the State Board of Osteopathic Medicine. The
8 physician shall also have successfully completed or
9 taught an advanced cardiac life support course acceptable
10 to the department within the preceding two years and have
11 completed, at least once, an advanced trauma life support
12 course acceptable to the department and an advanced
13 pediatric life support course acceptable to the
14 department, or other programs determined by the
15 department to meet or exceed the standards of these
16 programs.
17 (iii) Have served as an advanced life support
18 service medical director under the act of July 3, 1985
19 (P.L.164, No.45), known as the Emergency Medical Services
20 Act, prior to the effective date of this chapter.
21 (3) Have a valid Drug Enforcement Agency number.
22 (4) Have completed the EMS agency medical director
23 course, an EMS fellowship or other EMS training program that
24 is determined by the department to be equivalent. This
25 training shall assure that the EMS agency medical director
26 has knowledge of:
27 (i) The scope of practice of EMS providers.
28 (ii) The provision of EMS pursuant to department-
29 approved protocols.
30 (iii) The interface between EMS providers and
20080S1420B2073 - 66 -
1 medical command physicians.
2 (iv) Quality improvement principles.
3 (v) Emergency medical dispatch principles and EMS
4 agency communication capabilities.
5 (vi) EMS system design and operation.
6 (vii) Federal and State laws and regulations
7 regarding EMS.
8 (viii) Regional and State mass casualty and disaster
9 plans.
10 (b) Roles and responsibilities.--An EMS agency medical
11 director is responsible for the following:
12 (1) Reviewing department-approved EMS protocols that are
13 applicable to the EMS agency and ensuring that its EMS
14 providers and other relevant personnel are familiar with the
15 protocols applicable to them.
16 (2) Conducting for and reporting to the EMS agency the
17 following:
18 (i) An initial assessment of an EMS provider at or
19 above the advanced EMT level to determine whether the EMS
20 provider has demonstrated competency in the knowledge and
21 skills one must have to competently perform the skills
22 within the scope of practice of the EMS provider at that
23 level, and a commitment to adequately perform other
24 functions relevant to the EMS provider providing EMS at
25 that level. This subparagraph does not apply if the EMS
26 provider was working for the EMS agency, at the same
27 level, prior to the physician becoming the medical
28 director for the EMS agency and the EMS provider was
29 credentialed at that EMS agency within the last year as
30 being able to perform at the EMS provider's certification
20080S1420B2073 - 67 -
1 level.
2 (ii) At least annually, an assessment of each EMS
3 provider at or above the advanced EMT level as to whether
4 the EMS provider has demonstrated competency in the
5 knowledge and skills an EMS provider must have to
6 competently perform the skills within the scope of
7 practice of the EMS provider at that level, and a
8 commitment to adequately perform other functions relevant
9 to the EMS provider providing EMS at that level.
10 (3) Participating in and reviewing quality improvement
11 reviews of patient care provided by the EMS agency and
12 participating in the Statewide and regional quality
13 improvement program.
14 (4) Providing medical guidance and advice to the EMS
15 agency.
16 (5) Providing guidance with respect to the ordering,
17 stocking and replacement of drugs, and compliance with laws
18 and regulations impacting upon the EMS agency's acquisition,
19 storage and use of those drugs.
20 (6) Maintaining a liaison with the regional EMS medical
21 director.
22 (7) Recommending to the department suspension,
23 revocation or restriction of EMS provider certifications.
24 (8) Reviewing regional mass casualty and disaster plans.
25 (9) Performing other functions as the department may
26 impose by regulation.
27 § 7226. Medical command physicians and facility medical
28 directors.
29 (a) Role of medical command physician.--A medical command
30 physician communicates with and issues medical command orders to
20080S1420B2073 - 68 -
1 EMS providers when they seek direction. A medical command
2 physician shall have an arrangement with a medical command
3 facility to provide medical command on its behalf, and shall
4 function under the direction of a medical command facility
5 medical director and under the policies and procedures of the
6 medical command facility. A medical command physician shall
7 provide medical command to EMS providers consistent with
8 Statewide protocols and protocols that are in effect in either
9 the region in which treatment originates or the region from
10 which the EMS providers begin receiving medical command from a
11 medical command physician. A medical command physician may give
12 medical command orders that are inconsistent with these
13 protocols only when extraordinary circumstances justify a
14 departure from the protocols to protect the patient's well-
15 being.
16 (b) Certification.--The department shall certify as a
17 medical command physician a physician who was approved as a
18 medical command physician in this Commonwealth immediately prior
19 to the effective date of this section. The department shall also
20 certify as a medical command physician a physician who:
21 (1) Completes an application for medical command
22 physician certification on a form or through an electronic
23 application process, as prescribed by the department.
24 (2) Satisfies one of the following:
25 (i) Has successfully completed an emergency medicine
26 residency program accredited by a residency program
27 accrediting body recognized by the State Board of
28 Medicine or the State Board of Osteopathic Medicine.
29 (ii) Has successfully completed or taught an
30 advanced cardiac life support course acceptable to the
20080S1420B2073 - 69 -
1 department within the preceding two years and has
2 successfully completed or taught an advanced trauma life
3 support course acceptable to the department and an
4 advanced pediatric life support course acceptable to the
5 department, or other programs determined by the
6 department to meet or exceed the standards of these
7 programs.
8 (iii) Has had an emergency medicine practice in
9 another jurisdiction and establishes to the department
10 that the physician has a combination of training,
11 education and emergency medicine practice that makes the
12 physician qualified to serve as a medical command
13 physician.
14 (3) Has completed a medical command course offered or
15 approved by the department.
16 (4) Is practicing as an emergency medicine physician or
17 is participating as a resident in a second or subsequent year
18 in an emergency medicine residency program, or has had at
19 least three years' experience as a full-time emergency
20 medicine physician.
21 (5) Has a current Drug Enforcement Agency number, except
22 for an emergency medicine resident who is authorized to use a
23 hospital's Drug Enforcement Agency number for practice within
24 the emergency medicine residency program.
25 (6) Has an arrangement with a medical command facility
26 to serve as a medical command physician for that facility
27 after receiving certification as a medical command physician.
28 (c) Triennial registration.--A medical command physician's
29 certification is deemed registered for three years after
30 issuance. A medical command physician shall triennially register
20080S1420B2073 - 70 -
1 the physician's certification with the department, on a form or
2 through an electronic application process, as prescribed by the
3 department, as a condition for continued practice as a medical
4 command physician. The department shall issue a triennial
5 registration of a medical command physician certification to a
6 medical command physician within 30 days after the physician
7 applies for a new registration if the physician demonstrates
8 that the physician continues to meet the requirements for the
9 certification, except the requirements of subsection (b)(2),
10 and satisfies such other requirements as the department may
11 impose by regulation.
12 (d) Residents.--A physician who is in a second year in an
13 emergency medicine residency program may issue medical command
14 orders only to the extent that performance of that function is a
15 component of and within the framework of the emergency medicine
16 residency program, and may do so only with supervision by a
17 medical command physician who has served as a medical command
18 physician for at least two years, has completed two years in an
19 emergency medicine residency program, or has secured medical
20 command certification by satisfying subsection (b)(2)(iii).
21 (e) Role of medical command facility medical director.--A
22 medical command facility medical director shall be responsible
23 for the following in a medical command facility:
24 (1) Medical command.
25 (2) Quality improvement.
26 (3) Serving as a liaison with the regional EMS council
27 medical director.
28 (4) Participating in prehospital training activities.
29 (5) Verifying to the department that a physician seeking
30 medical command physician certification, based upon the
20080S1420B2073 - 71 -
1 physician's arrangement with the medical command facility,
2 meets all certification requirements.
3 (6) Ensuring that the medical command facility satisfies
4 statutory and regulatory requirements.
5 (f) Certification.--The department shall certify as a
6 medical command facility medical director a physician who was
7 approved as a medical command facility medical director in this
8 Commonwealth immediately prior to the effective date of this
9 section. The department shall also certify as a medical command
10 facility medical director a physician who:
11 (1) Completes an application for medical command
12 facility medical director certification on a form or through
13 an electronic application process, as prescribed by the
14 department.
15 (2) Is currently serving as a medical command physician.
16 (3) Satisfies one of the following:
17 (i) Has successfully completed a residency program
18 in emergency medicine accredited by a residency program
19 accrediting body recognized by the State Board of
20 Medicine or the State Board of Osteopathic Medicine.
21 (ii) Has successfully:
22 (A) completed a residency program in surgery,
23 internal medicine, family medicine, pediatrics or
24 anesthesiology accredited by a residency program
25 accrediting body recognized by the State Board of
26 Medicine or the State Board of Osteopathic Medicine;
27 and
28 (B) completed or taught:
29 (I) an advanced cardiac life support course
30 acceptable to the department within the preceding
20080S1420B2073 - 72 -
1 two years;
2 (II) an advanced trauma life support course
3 acceptable to the department; and
4 (III) an advanced pediatric life support
5 course acceptable to the department.
6 (4) Has experience in prehospital and emergency
7 department care of acutely ill or injured patients.
8 (5) Has experience in providing medical command
9 direction to EMS providers.
10 (6) Has experience in the training of EMS providers both
11 below and above the advanced EMT level.
12 (7) Has experience in the medical audit, review and
13 critique of EMS providers below and above the advanced EMT
14 level.
15 (8) Has an arrangement with a medical command facility
16 to serve as its medical director after receiving
17 certification as a medical command facility medical director.
18 (g) Triennial registration.--A medical command facility
19 medical director's certification is deemed registered for three
20 years after issuance. A medical command facility medical
21 director shall triennially register the physician's
22 certification with the department on a form or through an
23 electronic application process, as prescribed by the department,
24 as a condition for continued practice as a medical command
25 facility medical director. The department shall issue a
26 triennial registration of a medical command facility medical
27 director certification to a medical command facility medical
28 director within 30 days after the physician applies for a new
29 registration, if the physician demonstrates that the physician
30 continues to meet the requirements for the certification, except
20080S1420B2073 - 73 -
1 the requirements of subsection (f)(3), and satisfies such other
2 requirements as the department may impose by regulation.
3 (h) Grounds for discipline.--The department may discipline a
4 medical command physician or medical command facility medical
5 director for the following reasons:
6 (1) Violating a responsibility imposed on the physician
7 by this chapter or the related regulations.
8 (2) Without good cause, failing to comply with a medical
9 treatment, transport or transfer protocol established or
10 approved by the department.
11 (i) Types of discipline authorized.--When the department is
12 empowered to discipline a medical command physician or medical
13 command facility medical director under subsection (h), the
14 department may do one or more of the following:
15 (1) Deny the application for a certification.
16 (2) Issue a public reprimand.
17 (3) Revoke, suspend, limit or otherwise restrict or
18 condition the certification.
19 (4) Impose a civil money penalty not exceeding $1,000
20 for each incident in which the physician engages in conduct
21 that constitutes a basis for discipline.
22 (5) Stay enforcement of any suspension, revocation or
23 other discipline and place the individual on probation with
24 the right to vacate the probationary order for noncompliance.
25 § 7227. Medical command facilities.
26 (a) Certification required.--To operate as a medical command
27 facility, a medical unit must be certified by the department as
28 a medical command facility. The department shall issue a
29 certification to each medical unit that operated as a medical
30 command facility immediately prior to the effective date of this
20080S1420B2073 - 74 -
1 section.
2 (b) Application.--Application for certification shall be on
3 a form or through an electronic application process prescribed
4 by the department. The application shall solicit information
5 necessary to determine that the applicant meets the
6 certification requirements of this chapter.
7 (c) Requirements.--An applicant shall establish that the
8 applicant:
9 (1) Is a distinct medical unit operated by a hospital or
10 consortium of hospitals.
11 (2) Possesses the necessary equipment and personnel for
12 providing medical command to and control over EMS providers.
13 (3) Employs a medical command facility medical director.
14 (4) Has taken measures necessary to ensure that a
15 medical command physician is available to provide medical
16 command at all times.
17 (5) Meets the communication, recordkeeping and other
18 requirements of the department.
19 (d) Additional requirements.--In addition to the
20 requirements of subsection (c), the department may establish by
21 regulation requirements for a medical command facility to ensure
22 that it operates in an effective and efficient manner to achieve
23 the purposes for which it is certified.
24 (e) Triennial registration.--A medical command facility's
25 certification is deemed registered for three years after
26 issuance. A medical command facility must register its
27 certification at three-year intervals by completing an
28 application for triennial registration on a form or through an
29 electronic application process prescribed by the department. The
30 department shall grant or deny recertification within 30 days of
20080S1420B2073 - 75 -
1 receipt of the application.
2 (f) Inspections and inquiries.--The department shall conduct
3 an inspection of the medical unit of each applicant and also
4 inspect existing medical command facilities from time to time as
5 appropriate, but not less than once every three years. The
6 department shall have full and free access to examine the
7 medical command facility and its records relating to its
8 operation as a medical command facility. The medical command
9 facility shall fully respond to any inquiry by the department
10 relevant to the determination of whether the facility meets
11 certification and operational requirements.
12 (g) Grounds for discipline.--The department may discipline a
13 medical command facility for the following reasons:
14 (1) Violating a requirement of this section.
15 (2) Violating a certification requirement or an
16 operational requirement imposed under subsection (d).
17 (3) Refusing to permit an inspection or respond to an
18 inquiry under subsection (f).
19 (4) Failing to comply, without just cause, with a
20 medical treatment, transport or transfer protocol approved by
21 the department.
22 (h) Types of discipline.--When the department is empowered
23 to discipline a medical command facility, the department may do
24 one or more of the following:
25 (1) Deny the application for a certification.
26 (2) Issue a public reprimand.
27 (3) Revoke, suspend, limit or otherwise restrict or
28 condition the certification.
29 (4) Impose a civil money penalty of up to $5,000 for
30 each act that presents a basis for discipline.
20080S1420B2073 - 76 -
1 (5) Stay enforcement of any suspension, revocation or
2 other discipline and place the facility on probation with the
3 right to vacate the probationary order for noncompliance.
4 § 7228. Receiving facilities.
5 (a) Purpose.--A receiving facility is a facility to which an
6 ambulance may transport a patient who requires prompt medical
7 care in addition to that provided by the ambulance crew after
8 the crew responds to an emergency.
9 (b) Requirements.--A receiving facility shall include, but
10 need not be limited to, a fixed location having an organized
11 emergency department, including a physician trained to manage
12 cardiac, trauma, pediatric, medical, behavioral and all-hazards
13 emergencies, who is present in the facility and available to the
14 emergency department 24 hours per day and seven days per week.
15 By regulation, the department may authorize other types of
16 facilities to serve as receiving facilities for purposes of
17 serving patients who have special medical needs.
18 (c) Patient transports.--Unless directed otherwise by a
19 medical command physician, the initial transport of a patient
20 following an ambulance response to a reported emergency shall be
21 to a receiving facility pursuant to a protocol under section
22 7205(c) (relating to duties of department) or 7209(c)(8)
23 (relating to regional emergency medical services councils) or
24 such other location as the department designated by protocol.
25 § 7229. Emergency medical services agencies.
26 (a) License required.--A person may not, as an owner, agent
27 or otherwise, operate, conduct, maintain, advertise or otherwise
28 engage in or profess to be engaged in operating or providing an
29 ambulance, advanced life support squad vehicle, basic life
30 support squad vehicle, quick response service, special
20080S1420B2073 - 77 -
1 operations EMS service or other vehicle or service as prescribed
2 by the department by regulation to provide EMS outside a health
3 care facility or on roadways, airways or waterways of this
4 Commonwealth unless the person holds a current EMS agency
5 license authorizing the particular service or operation.
6 (b) Application.--An application for an EMS agency license
7 shall be submitted on a form or through an electronic
8 application process prescribed by the department.
9 (c) Issuance of license.--The department shall issue a
10 license to an applicant when it is satisfied that:
11 (1) The applicant and persons having substantial
12 ownership interests in the applicant are responsible persons
13 and the EMS agency will be staffed by and conduct its
14 activities utilizing responsible persons. For purposes of
15 this paragraph:
16 (i) a responsible person is a person who has not
17 engaged in any act contrary to justice, honesty or good
18 morals which indicates that the person is likely to
19 betray the public trust in carrying out the activities of
20 an EMS agency, or a person who has engaged in such
21 conduct but has been rehabilitated and establishes that
22 he or she is not likely to again betray the public trust;
23 (ii) a person has a substantial ownership interest
24 if the person has equity in the capital, stock or the
25 profits of the EMS agency equal to 5% or more of the
26 value of the property or assets of the EMS agency; and
27 (iii) a person staffs an EMS agency if the person
28 engages in an activity integral to operation of the EMS
29 agency, including, but not limited to, making or
30 participating in the making or execution of management
20080S1420B2073 - 78 -
1 decisions, providing EMS, billing, call-taking and
2 dispatching.
3 (2) The applicant meets supply and equipment
4 requirements and each ambulance or other vehicle that will be
5 used in providing EMS is adequately constructed and equipped
6 and will be maintained and operated to safely and efficiently
7 render the services offered.
8 (3) The applicant will meet the staffing standards for
9 its vehicles and services.
10 (4) The applicant will provide safe and efficient
11 services that are adequate for the emergency medical care,
12 the treatment and comfort and, when appropriate, the
13 transportation of patients.
14 (5) The applicant will have an EMS agency medical
15 director who, in addition to satisfying the criteria of
16 section 7225(a) (relating to medical director of emergency
17 medical services agency), satisfies other criteria the
18 department may establish by regulation based on the types of
19 vehicles and services the applicant intends to provide under
20 the EMS agency license.
21 (6) The applicant is in compliance with the rules and
22 regulations promulgated under this chapter.
23 (d) Persons under 18 years of age.--An EMS agency shall
24 ensure that a person under 18 years of age, when providing EMS
25 on behalf of the EMS agency, is directly supervised by an EMS
26 provider who is at least 21 years of age who has the same or
27 higher level of EMS provider certification and at least one year
28 of active practice as an EMS provider.
29 (e) Triennial registration.--An EMS agency's license is
30 deemed registered for three years after the issuance. An EMS
20080S1420B2073 - 79 -
1 agency must register its license at three-year intervals by
2 completing an application on a form or through an electronic
3 application process prescribed by the department. The department
4 shall act on the application within 90 days of receipt of a
5 complete and accurate application. The department shall not deny
6 a registration of a license without giving the applicant prior
7 notice of the reason for denial and providing an opportunity for
8 a hearing.
9 (f) Nontransferability of license.--An EMS agency may not
10 transfer its license. An EMS agency may enter into a contract
11 with another entity for that entity to manage the EMS agency if
12 that entity has been approved by the department to manage an EMS
13 agency. The department may deny approval to an entity to provide
14 management services for an EMS agency if:
15 (1) the entity is not in compliance with this chapter or
16 applicable regulations;
17 (2) the entity is not a responsible person as defined in
18 subsection (c)(1)(i);
19 (3) a person having a substantial ownership interest in
20 the entity is not a responsible person;
21 (4) the entity will not be staffed by or conduct its
22 activities through responsible persons; or
23 (5) the entity refuses to provide the department with
24 records or information reasonably requested to enable the
25 department to make a determination.
26 (g) Display.--As prescribed by department regulation, a
27 current department-issued inspection sticker shall be displayed
28 on each ambulance, advanced life support squad vehicle, basic
29 life support squad vehicle and, as required by regulation, any
30 other EMS vehicle authorized by the department.
20080S1420B2073 - 80 -
1 (h) Inspection.--The department or its agent shall inspect
2 an applicant's vehicles, equipment and personnel qualifications
3 prior to granting an EMS agency license and shall inspect an EMS
4 agency from time to time, as deemed appropriate and necessary,
5 but not less than once every three years.
6 (i) Dispatching.--
7 (1) An EMS agency that operates a communications center
8 dispatching EMS resources shall use call-takers and
9 dispatchers who satisfy the requirements of the Pennsylvania
10 Emergency Management Agency under section 3(a)(6) of the act
11 of July 9, 1990 (P.L.340, No.78), known as the Public Safety
12 Emergency Telephone Act, and shall use an emergency medical
13 dispatch program approved by the department. An emergency
14 medical dispatch program is a system or program that enables
15 patients to be assessed and treated via telecommunication by
16 using accepted medical dispatch standards.
17 (2) Operation by an EMS agency of a communications
18 center that dispatches EMS resources shall be considered part
19 of the EMS agency's licensed operation and shall be subject
20 to the requirements of this chapter and the department's
21 regulations.
22 (j) Construction, equipment and supplies.--Within two years
23 after the effective date of this chapter, the department shall
24 publish in the Pennsylvania Bulletin, and update as necessary,
25 vehicle construction and equipment and supply requirements for
26 EMS agencies in this Commonwealth based upon the types of EMS
27 vehicles operated and the services provided.
28 (k) Implementation of credentialing decisions.--An EMS
29 agency may not permit an EMS provider at or above the advanced
30 EMT level to provide EMS at that level unless its EMS agency
20080S1420B2073 - 81 -
1 medical director apprises that the EMS provider satisfies the
2 criteria of section 7225(b)(2). An EMS agency may permit an EMS
3 provider who does not satisfy the section 7225(b)(2) criteria to
4 continue to work for the EMS agency at a lower EMS provider
5 level if the EMS provider is authorized to do so by the EMS
6 agency medical director. The EMS agency shall notify the
7 department of that decision within ten days after it is made. If
8 the EMS agency medical director has determined that the EMS
9 provider has not demonstrated competency in the knowledge and
10 skills necessary to competently perform the skills within the
11 scope of practice of the EMS provider at that level or has not
12 demonstrated a commitment to adequately perform other functions
13 relevant to the EMS provider providing EMS at that level, and
14 the EMS agency medical director chooses to impose restrictions
15 on the EMS provider's practice, such as requiring the EMS
16 provider to function under the supervision of another EMS
17 provider or requiring the EMS provider to contact a medical
18 command physician prior to providing EMS, then the EMS agency
19 may permit the EMS provider to provide EMS only with the
20 restrictions directed by the EMS agency medical director.
21 (l) Staffing.--The department may by regulation revise the
22 staffing standards for ambulances, squad vehicles and quick
23 response services set forth in sections 7230 (relating to
24 advanced life support ambulances), 7231 (relating to air
25 ambulances), 7232 (relating to advanced life support squad
26 vehicles), 7233 (relating to basic life support ambulances),
27 7234 (relating to basic life support squad vehicles) and 7235
28 (relating to quick response services).
29 (m) Custody or control of patient.--If a law enforcement
30 officer is at the scene of a police incident when an EMS
20080S1420B2073 - 82 -
1 provider arrives, the law enforcement officer may preclude the
2 EMS provider from entering the scene to provide EMS until the
3 law enforcement officer determines that it is safe for the EMS
4 provider to enter. Under such circumstances, the law enforcement
5 officer shall permit the EMS provider access to the patient
6 before the officer transports the patient. If, pursuant to a
7 medical treatment protocol or medical command order, an EMS
8 agency is required to transport to a receiving facility a
9 patient whom a law enforcement officer has taken or wants to
10 take into custody or whom the law enforcement officer believes
11 needs to be spoken with immediately, the EMS agency shall
12 transport the patient to a receiving facility and the law
13 enforcement officer shall have discretion to accompany the
14 patient in the EMS vehicle and authority to employ security
15 precautions deemed necessary by the law enforcement officer to
16 ensure the safety of the officer and others, except that the
17 security precautions shall not unreasonably interfere with the
18 provision of EMS to the patient.
19 (n) Cessation of operations.--Upon suspension or revocation
20 of a license, the EMS agency shall cease operations and no
21 person shall permit or cause the EMS agency to continue.
22 (o) Discontinuance or reduction of service.--An EMS agency
23 shall not discontinue providing service it is licensed to
24 provide or reduce the hours when it provides service until a
25 minimum of 90 days after notifying the department in writing of
26 the change. Notice shall include a statement that the licensee
27 has notified the chief executive officer of each political
28 subdivision in the licensee's service area of the intent to
29 discontinue providing the service or reduce the hours it
30 provides the service and that the intent to discontinue or
20080S1420B2073 - 83 -
1 reduce hours has been advertised in a newspaper of general
2 circulation in the licensee's service area.
3 (p) Regulations.--The department shall promulgate
4 regulations setting forth requirements for EMS agencies in this
5 Commonwealth based upon the types of EMS vehicles they operate
6 and the services they provide.
7 (q) Transition for ambulance services and quick response
8 services.--Upon the effective date of this section, an entity
9 that is licensed as an ambulance service or recognized as a QRS
10 immediately prior to the effective date of this section may
11 continue to operate as an EMS agency if it meets the staffing
12 and other operational requirements of this chapter, and it shall
13 be considered to be an EMS agency with a current registration of
14 its license. The initial registration of the EMS agency license
15 shall expire on the same date that the entity's license as an
16 ambulance service or recognition as a QRS would have expired if
17 it had remained in effect.
18 (r) Exemptions.--The following are exempt from the licensing
19 provisions of this chapter:
20 (1) Privately owned vehicles not ordinarily used to
21 transport patients.
22 (2) An EMS agency licensed in another state and not
23 under this chapter that is dispatched to respond to an
24 emergency within this Commonwealth when an EMS vehicle or
25 service licensed under this chapter is unable to respond
26 within a reasonable time or its response is not sufficient to
27 deal with the emergency.
28 (3) An EMS agency licensed in another state that limits
29 its operations in this Commonwealth to the transportation,
30 and provision of medical care incidental to transportation,
20080S1420B2073 - 84 -
1 of patients and other persons requiring transport by EMS
2 vehicles from locations outside this Commonwealth to
3 locations within this Commonwealth.
4 (4) EMS vehicles owned and operated by an agency of the
5 Federal Government.
6 § 7230. Advanced life support ambulances.
7 (a) Purpose.--An ALS ambulance crew provides medical
8 assessment, triage, monitoring, treatment, transportation and
9 observation of patients who require EMS above the skill level of
10 an advanced EMT.
11 (b) Staffing requirements.--
12 (1) Except as otherwise provided in this section,
13 minimum staffing requirements for an ALS ambulance when
14 responding to a call to provide EMS for a patient requiring
15 EMS above the skill level of an advanced EMT is one EMS
16 provider at or above the EMT level, one EMS provider above
17 the advanced EMT level and one EMS vehicle operator. Only the
18 two EMS providers need to respond if one of them is also the
19 EMS vehicle operator. When present, an EMS provider qualified
20 to provide the type and level of EMS required by the patient
21 must attend to the patient at the scene and during the
22 transport. If a member of the ambulance crew arrives at the
23 scene before another crew member, that person shall begin
24 providing EMS to the patient at that person's skill level.
25 (2) Minimum staffing requirements for an ALS ambulance
26 is the same as for a BLS ambulance when the ALS ambulance
27 responds to a call to provide EMS for a patient requiring EMS
28 at or below the skill level of an advanced EMT.
29 § 7231. Air ambulances.
30 (a) Purpose.--An air ambulance is a rotorcraft staffed by a
20080S1420B2073 - 85 -
1 crew that provides medical assessment, treatment, monitoring,
2 observation and transportation of patients who require EMS where
3 time to administer definitive care is of the essence and
4 transportation by air ambulance to a facility able to provide
5 the care is faster than transportation by ground ambulance, or
6 require EMS provided by specialized equipment or providers not
7 available on a ground ambulance and the air ambulance can
8 provide this faster than the patient would receive such care at
9 a receiving facility if transported by ground ambulance.
10 (b) Staffing requirements.--Minimum staffing standards for
11 an air ambulance when dispatched to provide or when providing
12 medical assessment, treatment, monitoring, observation or
13 transportation of a patient is one pilot and two EMS providers
14 other than the pilot who are above the advanced EMT level, with
15 at least one of those two EMS providers specially trained in air
16 medical transport.
17 § 7232. Advanced life support squad vehicles.
18 (a) Purpose.--An ALS squad vehicle transports EMS providers
19 above the advanced EMT level, along with equipment and supplies,
20 to rendezvous with an ambulance crew, or to respond prior to
21 arrival of an ambulance, in order to provide medical assessment,
22 monitoring, treatment and observation of a patient who requires
23 EMS at or above the skill level of an advanced EMT. An ALS squad
24 vehicle does not transport patients.
25 (b) Staffing requirements.--Minimum staffing for an ALS
26 squad unit responding to a call to provide EMS for a patient who
27 requires EMS above the skill level of an advanced EMT shall be
28 one EMS provider above the advanced EMT level and one EMS
29 vehicle operator, except that the EMS provider may staff the
30 vehicle alone if the EMS provider is also an EMS vehicle
20080S1420B2073 - 86 -
1 operator.
2 § 7233. Basic life support ambulances.
3 (a) Purpose.--A BLS ambulance crew provides medical
4 assessment, triage, monitoring, treatment, transportation and
5 observation of patients who require EMS at or below the skill
6 level of an advanced EMT and also transports patients who
7 require EMS above the skill level of an advanced EMT when an EMS
8 provider above the level of an advanced EMT rendezvous with the
9 BLS ambulance before or during transport of the patient and
10 accompanies the patient during the transport after arrival.
11 (b) Staffing requirements.--
12 (1) Except as provided in paragraph (2), minimum
13 staffing for a BLS ambulance when responding to a call to
14 provide EMS is an ambulance attendant, EMR or EMT, a second
15 EMS provider at or above the EMT level, and an EMS vehicle
16 operator, except that only the two EMS providers need to
17 respond if one of them is also the EMS vehicle operator. When
18 present, an EMS provider above the EMR level must attend to
19 the patient at the scene and during patient transport.
20 (2) Two years after the effective date of this section,
21 the minimum staffing for a BLS ambulance when responding to a
22 call to provide EMS is an EMS provider at or above the EMR
23 level, an EMS provider at or above the EMT level, and an EMS
24 vehicle operator, except that only two EMS providers need to
25 respond if one of them is also the EMS vehicle operator. When
26 present, an EMS provider above the EMR level must attend to
27 the patient at the scene and during patient transport.
28 (3) If dispatched to provide EMS for a patient who
29 requires EMS above the skill level of an advanced EMT, the
30 BLS ambulance shall respond as set forth in this subsection.
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1 If the BLS ambulance crew members arrive at the scene before
2 a higher-level EMS provider of an ALS ambulance or ALS squad
3 vehicle, the BLS crew members shall provide EMS to the
4 patient at their skill level, including transport of the
5 patient to a receiving facility if needed, until higher-level
6 EMS is afforded by the arrival of a higher-level EMS
7 provider, after which the BLS ambulance crew shall relinquish
8 primary responsibility for the patient to the higher-level
9 EMS provider.
10 (4) When transporting from a sending hospital a patient
11 who requires EMS above the skill level of an advanced EMT, if
12 a registered nurse, physician assistant or physician from the
13 sending or receiving hospital joins the ambulance crew,
14 brings on board the ambulance all equipment and supplies to
15 provide the patient with reasonably anticipated EMS above the
16 skill level of an advanced EMT and attends to the patient
17 during the patient transport, the minimum staffing
18 requirements for the BLS ambulance are as set forth in
19 paragraphs (1) and (2).
20 § 7234. Basic life support squad vehicles.
21 (a) Purpose.--A BLS squad vehicle transports an EMS
22 provider, along with basic EMS equipment and supplies, to
23 respond prior to arrival of an ambulance in order to provide EMS
24 at or below the advanced EMT level of care. A BLS squad vehicle
25 is not utilized to transport patients.
26 (b) Staffing requirements.--Minimum staffing for a BLS squad
27 vehicle when responding to a call to provide EMS for a patient
28 is one EMS provider at or above the EMT level and an EMS vehicle
29 operator, except that an EMS provider who is also an EMS vehicle
30 operator may staff the vehicle alone.
20080S1420B2073 - 88 -
1 § 7235. Quick response services.
2 (a) Purpose.--A QRS uses EMS providers to respond to calls
3 for EMS and provide EMS to patients before an ambulance arrives.
4 (b) Staffing requirements.--The minimum staffing requirement
5 for a QRS is one EMS provider.
6 § 7236. Special operations emergency medical services.
7 (a) Purpose.--A special operations EMS service provides EMS
8 in situations or austere environments that require specialized
9 knowledge, equipment or vehicles to access a patient or address
10 the patient's emergency medical needs. The department shall by
11 regulation provide for specific types of special operations EMS
12 teams.
13 (b) Personnel requirements.--By regulation, the department
14 may establish additional training or expertise requirements for
15 the EMS agency medical director and the EMS providers who staff
16 a special operations EMS service.
17 (c) Other requirements.--By regulation, the department may
18 establish staffing, equipment, supply and any other requirement
19 for a special operations EMS service.
20 (d) Extraordinary applications.--An entity may propose to
21 provide a special operations EMS need that has not been
22 addressed by applying to the department for an EMS agency
23 license to carry out the special operations EMS or, if it is
24 licensed as an EMS agency, the entity may apply to the
25 department to be authorized to provide the special operations
26 EMS under its license. The department shall address each
27 application on an individual basis and may conditionally deny or
28 grant an application as appropriate to protect the public health
29 and safety. The grant of an application shall be subject to
30 compliance with any later-adopted regulations addressing the
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1 type of special operations EMS being provided by the entity.
2 (e) Protocols.--The department may include in its Statewide
3 EMS protocols special operations EMS protocols.
4 § 7237. First aid and other safety services.
5 (a) Purpose.--An EMS agency may provide EMS at industrial
6 sites, amusement parks or other locations in need of the
7 service. No ambulance or other EMS vehicle shall be required for
8 this purpose.
9 (b) Staffing.--The minimum staffing requirement is one EMS
10 provider.
11 (c) Other requirements.--As assigned by the EMS agency, the
12 EMS provider may provide EMS and other medical safety services
13 up to the level for which the EMS provider has the credentials
14 to provide EMS for the EMS agency.
15 (d) Protocols.--An EMS provider shall follow protocols
16 approved by the department when providing EMS under this
17 section.
18 § 7238. Other vehicles and services.
19 The department may by regulation prescribe EMS vehicle and
20 service standards for EMS vehicles and services not specified in
21 this chapter. If the department establishes standards under this
22 section, an EMS agency license shall be required to operate the
23 EMS vehicle or provide the service, and an EMS agency may not
24 operate the vehicle or provide the service unless approved to do
25 so by the department.
26 § 7239. Stretcher and wheelchair vehicles.
27 (a) Stretcher vehicle.--A stretcher vehicle is a ground
28 vehicle other than an ambulance that is utilized to transport by
29 stretcher persons who do not receive and cannot reasonably be
30 anticipated to require medical assessment, monitoring, treatment
20080S1420B2073 - 90 -
1 or observation during transport, but who, due to their physical
2 condition, require vehicle transport while on a stretcher or in
3 a wheelchair.
4 (b) Wheelchair vehicle.--A wheelchair vehicle is a ground
5 vehicle other than an ambulance that is used to transport by
6 wheelchair persons who do not receive and cannot reasonably be
7 anticipated to require medical assessment, monitoring, treatment
8 or observation during transport, but who, due to their physical
9 condition, require vehicle transport while on a stretcher or in
10 a wheelchair.
11 (c) Prohibition.--Operation by an entity of a stretcher
12 vehicle or wheelchair vehicle to transport a person who is known
13 or reasonably should be known by the entity to require medical
14 assessment, monitoring, treatment or observation during
15 transport shall constitute unlawful operation of an ambulance
16 for purposes of section 7256(a) and (c) (relating to penalties),
17 and if used as an ambulance by an EMS agency shall constitute
18 misconduct in operating an EMS agency under section 7242(a)(7)
19 (relating to emergency medical services agency license
20 sanctions). For purposes of this section, unlawful operation
21 includes, but is not limited to, the transport of the person to
22 or from a facility, a physician's office or any other location
23 to receive or from which the person received health care
24 services.
25 § 7240. Conditional temporary licenses.
26 When an EMS agency or an applicant for a license to operate
27 as an EMS agency does not provide service 24 hours per day and
28 seven days per week or is unable to participate in a county-
29 level or broader-level emergency medical response plan approved
30 by the department, the department shall issue a conditional
20080S1420B2073 - 91 -
1 temporary license for operation of the EMS agency when the
2 department determines that it is in the public interest, subject
3 to such terms as the department deems appropriate. A conditional
4 temporary license shall be valid for one year and may be renewed
5 as many times as the department determines that it is in the
6 public interest to do so.
7 § 7241. Plans of correction.
8 (a) Correction of violation.--Upon determining that an EMS
9 agency has violated this chapter or regulations promulgated
10 under this chapter, the department may issue a written notice to
11 the EMS agency specifying the violation or violations that have
12 been found. The notice shall require the EMS agency to take
13 immediate action to discontinue the violation or submit a plan
14 of correction to the department, or both, to bring the EMS
15 agency into compliance with applicable requirements. If the
16 nature of the violation is such that the EMS agency cannot
17 remedy the problem immediately, and a plan of correction is
18 therefore required, the department may direct that the violation
19 be remedied within a specified period of time. The EMS agency
20 shall submit a plan of correction within 30 days of the
21 department's issuance of the written notice. If immediate
22 corrective action is required, the notice from the department
23 shall request, and the EMS agency shall provide, prompt
24 confirmation that the corrective action has been taken.
25 (b) Discretion.--The department shall not afford the EMS
26 agency an opportunity to correct a violation without facing
27 disciplinary charges if the department determines that it is not
28 in the public interest to do so.
29 § 7242. Emergency medical services agency license sanctions.
30 (a) Grounds for discipline.--The department may discipline
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1 an EMS agency or, as applicable, refuse to issue an EMS agency
2 license for any of the following reasons:
3 (1) Violating the requirements of this chapter or
4 regulation adopted under this chapter.
5 (2) Failing to submit a plan of correction acceptable to
6 the department or correct a deficiency as required under
7 section 7241 (relating to plans of correction) or failing to
8 comply with the plan of correction.
9 (3) Refusing to accept a conditional temporary license
10 properly sought by the department or to abide by its terms.
11 (4) Fraud or deceit in obtaining or attempting to obtain
12 a license.
13 (5) Lending its license or, except as permitted under
14 section 7229(f) (relating to emergency medical services
15 agencies), enabling another person to manage or operate the
16 EMS agency or any service covered by the license.
17 (6) Using the license of another or in any way knowingly
18 aiding or abetting the improper granting of a license,
19 certification, accreditation or other authorization issued
20 under this chapter.
21 (7) Incompetence, negligence or misconduct in operating
22 the EMS agency or in providing EMS to patients.
23 (8) The licensee is not a responsible person or is not
24 staffed by responsible persons and refuses to remove from its
25 staff the irresponsible person or persons when directed to do
26 so by the department. For purposes of this paragraph, "staff"
27 and "responsible person" shall have the meanings set forth in
28 section 7229(c)(1).
29 (9) Refusing to respond to an emergency and render EMS
30 because of a patient's race, sex, creed, national origin,
20080S1420B2073 - 93 -
1 sexual preference, age, handicap, medical problem or
2 financial inability to pay.
3 (10) Conviction of a felony, or a crime involving moral
4 turpitude or related to the practice of the EMS agency.
5 (11) Making misrepresentations in seeking funds made
6 available through the department.
7 (12) Failing to continue to meet applicable licensure
8 requirements.
9 (13) Violating an order previously issued by the
10 department in a disciplinary matter.
11 (b) Disciplinary options.--If the department is empowered to
12 impose discipline against an EMS agency under this section, the
13 department may do one or more of the following:
14 (1) Deny the application for a license.
15 (2) Administer a written reprimand with or without
16 probation.
17 (3) Revoke, suspend, limit or otherwise restrict the
18 license.
19 (4) Impose a civil penalty not exceeding $5,000 for each
20 incident in which the EMS agency engages in conduct that
21 constitutes a basis for discipline.
22 (5) Stay enforcement of any suspension, revocation or
23 other discipline and place the facility on probation with the
24 right to vacate the probationary order for noncompliance.
25 SUBCHAPTER C
26 MISCELLANEOUS PROVISIONS
27 Sec.
28 7251. Limitations on liability.
29 7252. Peer review.
30 7253. Support of emergency medical services.
20080S1420B2073 - 94 -
1 7254. Prohibited acts.
2 7255. Surrender of license, accreditation or certification.
3 7256. Penalties.
4 7257. Adjudications and judicial review.
5 § 7251. Limitations on liability.
6 The following shall apply:
7 (1) No medical command physician, medical command
8 facility medical director or medical command facility, which
9 in good faith provides a medical command to an EMS provider
10 or student enrolled in an EMS course of instruction approved
11 by the department, shall be liable for civil damages as a
12 result of issuing the instruction, absent a showing of gross
13 negligence or willful misconduct.
14 (2) No EMS agency, EMS agency medical director or EMS
15 provider who in good faith attempts to render or facilitate
16 emergency medical care authorized by this chapter shall be
17 liable for civil damages as a result of an act or omission,
18 absent a showing of gross negligence or willful misconduct.
19 This paragraph shall also apply to students enrolled in
20 approved courses of instruction and supervised pursuant to
21 rules and regulations.
22 (3) No approved EMS training institute nor any entity
23 participating as part of any approved educational program
24 offered by the institute as authorized by this chapter shall
25 be liable for any civil damages as a result of primary and
26 continuing educational practice by duly enrolled students
27 under proper supervision, absent a showing of gross
28 negligence or willful misconduct.
29 (4) No EMS provider who in good faith attempts to render
30 emergency care authorized by this chapter at an emergency
20080S1420B2073 - 95 -
1 scene while en route to a place of employment shall receive
2 any form of reprimand or penalty by an employer as a result
3 of late arrival at the place of employment. An employer may
4 require written verification from the EMS provider, who shall
5 obtain the written verification from either the police
6 officer or other person who is in charge at the emergency
7 scene.
8 (5) No EMS agency medical director or regional medical
9 director who in good faith gives instructions to or provides
10 primary and continuing educational training to an EMS
11 provider shall be liable for civil damages for issuing the
12 instructions, education or training, absent a showing of
13 gross negligence or willful misconduct.
14 (6) Neither the department, the Commonwealth EMS Medical
15 Director, a regional EMS council medical director nor any
16 other official or employee of the department or a regional
17 EMS council shall be liable for civil damages arising out of
18 an EMS provider or a student enrolled in an EMS course of
19 instruction approved by the department following protocols
20 approved under this chapter.
21 (7) No EMS provider or EMS agency may be subject to
22 civil liability based solely on failure to obtain consent in
23 rendering EMS to any person, regardless of age, where the
24 person is unable to give consent for any reason, including
25 minority, and where there is no other person reasonably
26 available who is legally authorized to give or refuse to give
27 consent, if the EMS provider has acted in good faith and
28 without knowledge of facts negating consent.
29 (8) No EMS provider or EMS agency may be subject to
30 civil liability based solely on refusal to provide treatment
20080S1420B2073 - 96 -
1 or services requested by the patient or the person
2 responsible for making medical care decisions for the patient
3 if the treatment or services requested are not prescribed or
4 authorized by Statewide or regional protocols established
5 under this chapter and the EMS provider has:
6 (i) contacted a medical command physician who
7 refused to authorize the requested treatment or service;
8 or
9 (ii) made a good faith effort to contact a medical
10 command physician and was unable to do so.
11 (9) No dispatcher of EMS who in good faith collects
12 information about a patient from a caller or makes dispatch
13 assignments based upon the information collected may be
14 subject to civil liability based upon the information
15 collected or a dispatch assignment, absent a showing of gross
16 negligence or willful misconduct.
17 § 7252. Peer review.
18 (a) Immunity from liability.--
19 (1) A person who provides information to a review
20 organization shall have the same protections from civil and
21 criminal liability as a person who provides information to a
22 review organization under the act of July 20, 1974 (P.L.564,
23 No.193), known as the Peer Review Protection Act.
24 (2) An individual who is a member or employee of a
25 review organization, or who furnishes professional counsel or
26 services to the organization, shall have the same protections
27 from civil and criminal liability for the performance of any
28 duty, function or activity authorized or required of the
29 review organization as a person who performs the duty,
30 function or activity under the Peer Review Protection Act.
20080S1420B2073 - 97 -
1 (b) Confidentiality of review organization's records.--The
2 proceedings and records of a review organization shall be held
3 in confidence and shall have the same protections from discovery
4 and introduction into evidence in civil proceedings as they
5 would under the Peer Review Protection Act. A person who was in
6 attendance at a meeting of a review organization shall be
7 subject to the same testimony restrictions as a person who was
8 in attendance at a meeting of a review organization under the
9 Peer Review Protection Act.
10 § 7253. Support of emergency medical services.
11 (a) Emergency Medical Services Operating Fund.--There is
12 established a special fund to be known as the Emergency Medical
13 Services Operating Fund, which shall be administered by the
14 department.
15 (b) Source.--The following are the sources of the Emergency
16 Medical Services Operating Fund:
17 (1) Money collected under 75 Pa.C.S. §§ 3121 (relating
18 to EMS costs) and 3807(b)(1)(ix) (relating to Accelerated
19 Rehabilitative Disposition).
20 (2) All fees, fines and civil penalties collected by the
21 department under this chapter.
22 (3) Appropriations.
23 (4) Contributions.
24 (c) Purpose of fund.--Except as provided under subsection
25 (d), 75% of the money from the Emergency Medical Services
26 Operating Fund shall be disbursed by the department for only the
27 following uses:
28 (1) To eligible EMS agencies for applicable purposes
29 stated under section 7212(c) (relating to contracts and
30 grants), with at least 10% of these funds to be allocated to
20080S1420B2073 - 98 -
1 provide additional financial assistance for those EMS systems
2 serving rural areas.
3 (2) To the board for the performance of duties imposed
4 upon it under this chapter.
5 (3) To regional EMS councils for the development,
6 maintenance and improvement of EMS systems, including
7 ambulance and communications equipment and for training,
8 education and EMS agency licensure purposes.
9 (4) To other contractors and grantees as authorized
10 under section 7212(j).
11 (d) Allocation to Catastrophic Medical and Rehabilitation
12 Fund.--Twenty-five percent of the money in the Emergency Medical
13 Services Operating Fund shall be allocated to a Catastrophic
14 Medical and Rehabilitation Fund for victims of trauma. After the
15 exhaustion of all alternative financial resources, other than
16 those excluded by the department from consideration, the
17 catastrophic fund shall be available for the purchase of
18 medical, rehabilitation and attendant care services for trauma
19 victims and may be made available for the purchase of supportive
20 services such as respite care and counseling services for the
21 family or household members of trauma victims. The department
22 may, by regulation, prioritize the distribution of funds by and
23 within classification of traumatic injury.
24 (e) Audit.--The Auditor General shall review collections and
25 expenditures made under this section and report its findings to
26 the General Assembly annually. The audit shall include a review
27 of the collections and expenditures of the regional EMS
28 councils.
29 § 7254. Prohibited acts.
30 (a) Making false ambulance requests.--It shall be unlawful
20080S1420B2073 - 99 -
1 for any person to intentionally report a medical emergency and
2 summon an EMS response if the person does not have good cause to
3 believe that there is a medical emergency for which an EMS
4 response is needed. A person violating this subsection commits a
5 summary offense.
6 (b) Obstruction.--It is unlawful for any person to
7 intentionally impede or obstruct any EMS provider in the
8 performance of official duties, if the EMS provider displays
9 accepted department insignia or credentials. A person violating
10 this subsection commits a summary offense.
11 (c) Impersonating an emergency medical services provider.--
12 It is unlawful for any person to display an insignia or
13 credentials or act in any manner that would lead reasonable
14 persons to conclude that the person is an EMS provider if that
15 person is not an EMS provider with a current registration to
16 practice or that the person is a higher-level EMS provider than
17 the level at which the person is certified and currently
18 registered to practice. A person violating this subsection
19 commits a summary offense.
20 (d) Misrepresentation of license.--It is unlawful for any
21 person who does not possess an EMS agency license issued by the
22 department under this chapter to advertise, display vehicle
23 markings or exhibit any other means that would lead a reasonable
24 person to conclude that the person is a licensed EMS agency or
25 provides a type or level of emergency care other than that for
26 which the person is licensed to provide. A person violating this
27 subsection commits a summary offense.
28 § 7255. Surrender of license, accreditation or certification.
29 The department shall require a person whose license,
30 accreditation or certification has been suspended or revoked
20080S1420B2073 - 100 -
1 under this chapter to return to the department in the manner the
2 department directs the license, accreditation document or
3 certificate. A person who fails to do so commits a misdemeanor
4 of the third degree.
5 § 7256. Penalties.
6 (a) Unlicensed agency.--A person who operates a service or
7 vehicle for which a license is required under section 7229
8 (relating to emergency medical services agencies) and who does
9 not have a license to operate the service or vehicle commits a
10 misdemeanor of the third degree.
11 (b) Unauthorized practice.--A person who provides EMS
12 without an EMS provider certification or other legal authority
13 to provide EMS commits a misdemeanor of the third degree. A
14 provider who provides EMS without a current registration of the
15 EMS provider's certification and without other legal authority
16 to provide EMS commits a summary offense.
17 (c) Fine.--In addition to any other civil remedy or criminal
18 penalty provided for under this chapter, the department may levy
19 a civil penalty of up to $5,000 per day upon a person who owns
20 or operates an EMS agency in this Commonwealth, without having a
21 license to operate that agency in this Commonwealth and a fine
22 of up to $1,000 per day upon a person who provides EMS without
23 an EMS provider certification or other legal authority to
24 provide EMS.
25 § 7257. Adjudications and judicial review.
26 Except as provided under this chapter for an emergency
27 suspension, the department shall hold hearings and issue
28 adjudications in accordance with 2 Pa.C.S. (relating to
29 administrative law and procedure). The adjudications may be
30 appealed to the Commonwealth Court under 42 Pa.C.S. § 763
20080S1420B2073 - 101 -
1 (relating to direct appeals from government agencies).
2 Section 2. The definition of "emergency vehicle" in section
3 102 of Title 75 is amended to read:
4 § 102. Definitions.
5 Subject to additional definitions contained in subsequent
6 provisions of this title which are applicable to specific
7 provisions of this title, the following words and phrases when
8 used in this title shall have, unless the context clearly
9 indicates otherwise, the meanings given to them in this section:
10 * * *
11 "Emergency vehicle." A fire department vehicle, police
12 vehicle, sheriff vehicle, ambulance, advanced life support squad
13 vehicle, basic life support squad vehicle, blood delivery
14 vehicle, human organ delivery vehicle, hazardous material
15 response vehicle, armed forces emergency vehicle, one vehicle
16 operated by a coroner or chief county medical examiner and one
17 vehicle operated by a chief deputy coroner or deputy chief
18 county medical examiner used for answering emergency calls, a
19 vehicle owned by or leased to a regional emergency medical
20 services council that is used as authorized by the Department of
21 Health to respond to an actual or potential disaster, mass
22 casualty situation or substantial threat to the public health,
23 any vehicle owned and operated by the Philadelphia Parking
24 Authority established in accordance with 53 Pa.C.S. Ch. 55
25 (relating to parking authorities) and used in the enforcement of
26 53 Pa.C.S. Ch. 57 (relating to taxicabs and limousines in first
27 class cities), or any other vehicle designated by the State
28 Police under section 6106 (relating to designation of emergency
29 vehicles by Pennsylvania State Police), or a privately owned
30 vehicle used in answering an emergency call when used by any of
20080S1420B2073 - 102 -
1 the following:
2 (1) A police chief and assistant chief.
3 (2) A fire chief, assistant chief and, when a fire
4 company has three or more fire vehicles, a second or third
5 assistant chief.
6 (3) A fire police captain and fire police lieutenant.
7 (4) An ambulance corps commander and assistant
8 commander.
9 (5) A river rescue commander and assistant commander.
10 (6) A county emergency management coordinator.
11 (7) A fire marshal.
12 (8) A rescue service chief and assistant chief.
13 * * *
14 Section 3. Chapter 31 of Title 75 is amended by adding a
15 subchapter to read:
16 SUBCHAPTER C
17 FINES
18 Sec.
19 3121. EMS costs.
20 § 3121. EMS costs.
21 In addition to any other costs that may be imposed under this
22 part for a traffic violation, except for a parking violation, a
23 cost of $10 shall be imposed. Money collected shall be forwarded
24 to the State Treasurer for deposit in the Emergency Medical
25 Services Operating Fund.
26 Section 4. Section 3807(b)(1)(vii) of Title 75 is amended
27 and the paragraph is amended by adding a subparagraph to read:
28 § 3807. Accelerated Rehabilitative Disposition.
29 * * *
30 (b) Evaluation and treatment.--
20080S1420B2073 - 103 -
1 (1) A defendant offered Accelerated Rehabilitative
2 Disposition for a violation of section 3802 is, as a
3 condition of participation in the program, subject to the
4 following requirements in addition to any other conditions of
5 participation imposed by the court:
6 * * *
7 (vii) The defendant must pay any other fee,
8 surcharge or cost required by law. Except as set forth in
9 subparagraph (vi) [or], (viii) or (ix), a fee or
10 financial condition imposed by a judge as a condition of
11 Accelerated Rehabilitative Disposition or any other
12 preliminary disposition of any charge under this chapter
13 shall be distributed as provided for in 42 Pa.C.S. §§
14 3571 (relating to Commonwealth portion of fines, etc.)
15 and 3573 (relating to municipal corporation portion of
16 fines, etc.).
17 * * *
18 (ix) The defendant shall pay a cost of $25 which
19 shall be forwarded to the State Treasurer for deposit in
20 the Emergency Medical Services Operating Fund.
21 * * *
22 Section 5. The addition of 35 Pa.C.S. Ch. 72 is a
23 continuation of the former act of July 3, 1985, (P.L.164,
24 No.45), known as the Emergency Medical Services Act. Except as
25 otherwise provided in 35 Pa.C.S. Ch. 72, all activities
26 initiated under the Emergency Medical Services Act shall
27 continue and remain in full force and effect and may be
28 completed under 35 Pa.C.S. Ch. 72. Resolutions, orders,
29 regulations, rules and decisions which were made under the
30 Emergency Medical Services Act and which are in effect on the
20080S1420B2073 - 104 -
1 effective date of this section shall remain in full force and
2 effect until revoked, vacated or modified under 35 Pa.C.S. Ch.
3 72. Contracts, obligations and agreements entered into under the
4 Emergency Medical Services Act are not affected nor impaired by
5 the repeal of the Emergency Medical Services Act.
6 Section 6. Repeals are as follows:
7 (1) The General Assembly declares that the repeal under
8 paragraph (2) is necessary to effectuate the addition of 35
9 Pa.C.S. Ch. 72.
10 (2) The act of July 3, 1985, (P.L.164, No.45), known as
11 the Emergency Medical Services Act, is repealed.
12 Section 7. The Department of Health, in consultation with
13 the board, shall promulgate all regulations needed to implement
14 this act within two years after the effective date of this
15 section. This act shall be liberally construed for that purpose,
16 and the absence of express authority to adopt regulations in any
17 provision of this act shall not be construed to preclude the
18 authority to adopt regulations to carry out that provision. Upon
19 promulgation of all regulations under this section, the
20 Secretary of Health shall transmit notice to the Legislative
21 Reference Bureau for publication in the Pennsylvania Bulletin.
22 Section 8. Any reference in a statute or regulation to an
23 ambulance service shall be interpreted as referencing an
24 emergency medical services agency and any reference to the act
25 of July 3, 1985 (P.L.164, No.45), known as the Emergency Medical
26 Services Act, shall be construed as a reference to 72 Pa.C.S.
27 Ch. 72.
28 Section 9. This act shall take effect as follows:
29 (1) The addition of the following provisions of 35
30 Pa.C.S. shall take effect 180 days after publication of the
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1 notice under section 7 of this act:
2 (i) Section 7213(a), (c), (d) and (n).
3 (ii) Section 7214.
4 (iii) Section 7215.
5 (iv) Section 7216.
6 (v) Section 7217.
7 (vi) Section 7218.
8 (vii) Section 7219.
9 (viii) Section 7220.
10 (ix) Section 7222.
11 (x) Section 7229.
12 (xi) Section 7230.
13 (xii) Section 7231.
14 (xiii) Section 7232.
15 (xiv) Section 7233.
16 (xv) Section 7234.
17 (xvi) Section 7235.
18 (xvii) Section 7236.
19 (xviii) Section 7237.
20 (xix)Section 7238.
21 (xx) Section 7240.
22 (xxi) Section 7241.
23 (xxii) Section 7242.
24 (2) The following provisions shall take effect
25 immediately:
26 (i) The amendment of the definition of "emergency
27 vehicle" in 75 Pa.C.S. § 102.
28 (ii) Section 5 of this act.
29 (iii) Section 6 of this act.
30 (iv) Section 7 of this act.
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1 (v) This section.
2 (3) The remainder of this act shall take effect in 180
3 days.
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