HOUSE AMENDED

 

PRIOR PRINTER'S NOS. 245, 678, 1071

PRINTER'S NO.  1312

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

SENATE BILL

 

No.

240

Session of

2009

  

  

INTRODUCED BY BAKER, WAUGH, WASHINGTON, RAFFERTY, ALLOWAY, ROBBINS, BRUBAKER, MUSTO, ORIE, EARLL, FERLO, GORDNER, O'PAKE, STOUT, YAW, TOMLINSON, ERICKSON, BROWNE, WOZNIAK AND BOSCOLA, FEBRUARY 19, 2009

  

  

AS RE-REPORTED FROM COMMITTEE ON APPROPRIATIONS, HOUSE OF REPRESENTATIVES, AS AMENDED, JULY 15, 2009   

  

  

  

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

 


1

PRELIMINARY PROVISIONS

2

Sec.

3

7201.  Short title of chapter.

4

7202.  Declaration of policy.

5

7203.  Definitions.

6

7204.  Emergency medical services system programs.

7

7205.  Duties of department.

8

7206.  Emergency medical services patient care reports.

9

7207.  Pennsylvania Trauma Systems Foundation.

10

7208.  State Advisory Board.

11

7209.  Regional emergency medical services councils.

12

§ 7201.  Short title of chapter.

13

This chapter shall be known and may be cited as the Emergency

14

Medical Services System Act.

15

§ 7202.  Declaration of policy.

16

The General Assembly finds and declares as follows:

17

(1)  Emergency medical services is an essential public

18

service and frequently the health care safety net for many

19

Commonwealth residents.

20

(2)  It is in the public interest to assure that there

21

are high quality and coordinated emergency and urgent medical

22

services readily available to the residents of this

23

Commonwealth to prevent premature death and reduce suffering

24

and disability which arise from severe illness and injury.

25

(3)  The public interest under paragraph (2) is best

26

achieved through a regulated and coordinated emergency

27

medical services system.

28

(4)  Transportation of both emergency and nonemergency

29

patients is an integral part of the health care delivery

30

system in this Commonwealth, and it is in the public interest

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1

that the emergency medical services system serve all persons

2

in this Commonwealth who:

3

(i)  require medical care to address illness or

4

injury;

5

(ii)  need transportation to a hospital or other

6

health care facility to receive that care; and

7

(iii)  require medical assessment, monitoring,

8

assistance, treatment or observation during

9

transportation.

10

(5)  It serves the public interest if the emergency

11

medical services system is able to quickly adapt and evolve

12

to meet the needs of the residents of this Commonwealth for

13

emergency and urgent medical care and to reduce their illness

14

and injury risks.

15

(6)  It serves the public interest if the emergency

16

medical services system provides community-based health

17

promotion services that are integrated with the overall

18

health care system.

19

(7)  Emergency medical services should be acknowledged,

20

promoted and supported as an essential public service.

21

(8)  This chapter shall be liberally construed to

22

establish and maintain an effective and efficient emergency

23

medical services system which is accessible on a uniform

24

basis to residents of this Commonwealth and to visitors to

25

this Commonwealth.

26

(9)  Residents of this Commonwealth and visitors to this

27

Commonwealth should have prompt and unimpeded access to

28

urgent and emergency medical care throughout this

29

Commonwealth.

30

(10)  The Department of Health should continually assess

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1

and, as needed, revise the functions of emergency medical

2

services agencies and providers and other components of the

3

emergency medical services system that it regulates under

4

this chapter, to:

5

(i)  improve the quality of emergency medical

6

services provided in this Commonwealth;

7

(ii)  have the emergency medical services system

8

adapt to changing needs of the residents of this

9

Commonwealth; and

10

(iii)  promote the recruitment and retention of

11

persons willing and qualified to serve as emergency

12

medical services providers in this Commonwealth.

13

(11)  The emergency medical services system should be

14

fully integrated with the overall health care system, and in

15

particular with the public health system, to identify, modify

16

and manage illness and injury and illness and injury risks.

17

§ 7203.  Definitions.

18

The following words and phrases when used in this chapter

19

shall have the meanings given to them in this section unless the

20

context clearly indicates otherwise:

21

"Advanced emergency medical services."  Emergency medical

22

services exceeding the scope of practice of an emergency medical

23

technician.

24

"Advanced emergency medical technician."  An individual who

25

is certified by the Department of Health as an advanced

26

emergency medical technician.

27

"Advanced life support squad vehicle."  A vehicle which:

28

(1)  is maintained or operated to transport emergency

29

medical service providers above the advanced emergency

30

medical technician level, equipment and supplies to

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1

rendezvous with the crew of an ambulance for the purpose of

2

providing advanced emergency medical services to patients;

3

and

4

(2)  is not used in the transportation of patients.

5

"ALS."  Advanced life support.

6

"Ambulance."  A ground, water or air vehicle which is

7

maintained or operated for the purpose of providing emergency

8

medical services to and transportation of patients.

9

"Ambulance attendant."  An individual who is 16 years of age

10

or older and satisfies one of the following:

11

(1)  Possesses a certificate evidencing successful

12

completion of an advanced first aid course sponsored by the

13

American Red Cross and a current certificate evidencing

14

successful completion of a cardiopulmonary resuscitation

15

course acceptable to the Department of Health.

16

(2)  Possesses a current certificate evidencing

17

successful completion of a course determined by the

18

Department of Health to be equivalent to the requirements in

19

paragraph (1).

20

"Basic emergency medical services" or "basic EMS."  Emergency

21

medical services included within, but not exceeding, the scope

22

of practice of an emergency medical technician.

23

"Basic life support squad vehicle."  A vehicle which:

24

(1)  is maintained or operated to transport emergency

25

medical services providers, equipment and supplies to

26

rendezvous with the crew of an ambulance for the purpose of

27

providing emergency medical services at or below the advanced

28

emergency medical technician level to patients; and

29

(2)  is not used in the transportation of patients.

30

"BLS."  Basic life support.

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1

"Board."  The State Advisory Board, which is the Board of

2

Directors of the Pennsylvania Emergency Health Services Council.

3

"Commonwealth emergency medical services medical director" or

4

"Commonwealth EMS medical director."  A physician who is

5

approved and employed by the Department of Health to advise and

6

formulate policy on matters pertaining to emergency medical

7

services.

8

"Department."  The Department of Health of the Commonwealth.

9

"Emergency."  A physiological or psychological illness or

10

injury of an individual, such that a prudent layperson who

11

possesses an average knowledge of health and medicine could

12

reasonably expect the absence of immediate emergency medical

13

services to result in:

14

(1)  placing the health of the individual or, with

15

respect to a pregnant woman, the health of the woman or her

16

unborn child, in serious jeopardy;

17

(2)  serious impairment of bodily functions; or

18

(3)  serious dysfunction of a bodily organ or part.

19

"Emergency medical responder" or "EMR."  An individual who is

20

certified by the Department of Health as an emergency medical

21

responder.

22

"Emergency medical services" or "EMS."  Any of the following:

23

(1)  The medical care, including medical assessment,

24

monitoring, treatment, transportation and observation, which

25

may be provided to a person in responding to an actual or

26

reported emergency to:

27

(i)  prevent or protect against loss of life or a

28

deterioration in physiological or psychological

29

condition; or

30

(ii)  address pain or morbidity associated with the

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1

person's condition.

2

(2)  The transportation of an individual with medical

3

assessment, monitoring, treatment or observation of the

4

individual who, due to the individual's condition, requires

5

medical assessment, monitoring, treatment or observation

6

during the transport.

7

"Emergency medical services agency" or "EMS agency."  An

8

entity that engages in the business or service of providing

9

emergency medical services to patients within this Commonwealth

10

by operating any of the following:

11

(1)  An ambulance.

12

(2)  An advanced life support squad vehicle.

13

(3)  A basic life support squad vehicle.

14

(4)  A quick response service.

15

(5)  A special operations EMS service. This paragraph

16

includes, but is not limited to:

17

(i)  a tactical EMS service;

18

(ii)  a wilderness EMS service;

19

(iii)  a mass-gathering EMS service; and

20

(iv)  an urban search and rescue EMS service.

21

(6)  A vehicle or service which provides emergency

22

medical services outside of a health care facility, as

23

prescribed by the Department of Health by regulation.

24

"Emergency medical services agency medical director" or "EMS

25

agency medical director."  A physician who is employed by,

26

contracts with or volunteers with an emergency medical services

27

agency either directly or through an intermediary to:

28

(1)  evaluate the quality of patient care provided by the

29

emergency medical services providers utilized by the

30

emergency medical services agency; and

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1

(2)  provide medical guidance and advice to the emergency

2

medical services agency.

3

"Emergency medical services provider" or "EMS provider."  Any

4

of the following:

5

(1)  An emergency medical responder.

6

(2)  An emergency medical technician.

7

(3)  An advanced emergency medical technician.

8

(4)  A paramedic.

9

(5)  A prehospital registered nurse.

10

(6)  A prehospital physician extender.

11

(7)  A prehospital emergency medical services physician.

12

(8)  An individual prescribed by regulation of the

13

Department of Health to provide specialized emergency medical

14

services.

15

"Emergency medical services system" or "EMS system."  The

16

arrangement of personnel, facilities and equipment to prevent

17

and manage emergencies in a geographic area.

18

"Emergency medical services vehicle operator" or "EMS vehicle

19

operator."  An individual certified by the Department of Health

20

to operate a ground emergency medical services vehicle.

21

"Emergency medical technician" or "EMT."  An individual who

22

is certified by the Department of Health as an emergency medical

23

technician.

24

"Facility."  A physical location at which an entity operates

25

a health care facility licensed under Federal or State law.

26

"Foundation."  The Pennsylvania Trauma Systems Foundation, a

27

nonprofit Pennsylvania corporation whose function is to accredit

28

trauma centers in this Commonwealth that receive or seek to

<--

29

receive Commonwealth funds.

30

"Hospital."  An institution having an organized medical staff

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1

that is primarily engaged in providing to inpatients, by or

2

under the supervision of physicians, diagnostic and therapeutic

3

services or rehabilitation services for the care or

4

rehabilitation of injured, disabled, pregnant, diseased, sick or

5

mentally ill persons. The term includes a facility for the

6

diagnosis and treatment of disorders within the scope of

7

specific medical specialties. The term does not include a

8

facility caring exclusively for the mentally ill.

9

"Medical command facility."  A distinct unit which contains

10

the necessary equipment and personnel for providing medical

11

command to and control over emergency medical services

12

providers.

13

"Medical command order."  An order issued by a medical

14

command physician to an emergency medical services provider who

15

is functioning on behalf of an emergency medical services

16

agency.

17

"Medical command physician."  A physician certified by the

18

Department of Health to give medical command orders to emergency

19

medical services providers.

20

"Medical monitoring."  Performing continuous or periodic

21

observations of an individual's condition or continuation of an

22

ordered treatment plan for an individual to prevent pain,

23

suffering or the exacerbation of a preexisting condition.

24

"Medical observation."  Performing continuous or periodic

25

observations of an individual's stable condition to determine

26

whether there is a change in that condition.

27

"Paramedic."  An individual who is certified by the

28

Department of Health as a paramedic.

29

"Patient."  An individual for whom an emergency medical

30

services provider is:

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1

(1)  providing emergency medical services on behalf of an

2

EMS agency; or

3

(2)  required to provide emergency medical services on

4

behalf of an EMS agency because the individual's condition

5

requires or may require medical observation, monitoring,

6

assessment or treatment for an illness, disease, injury or

7

other disability.

8

"Peer review."  The evaluation by health care providers of

9

the quality and efficiency of services ordered or performed by

10

emergency medical services providers and physicians who direct

11

or supervise EMS providers under this chapter and the

12

regulations of the Department of Health.

13

"Physician."  A person who has a currently registered license

14

to practice medicine or osteopathic medicine in this

15

Commonwealth.

16

"Prehospital emergency medical services physician" or

17

"prehospital EMS physician."  A physician who is certified by

18

the Department of Health as a prehospital emergency medical

19

services physician.

20

"Prehospital physician extender" or "PHPE."  A physician

21

assistant who is certified by the Department of Health as a

22

prehospital physician extender.

23

"Prehospital registered nurse" or "PHRN."  A registered nurse

24

who is certified by the Department of Health as a prehospital

25

registered nurse.

26

"Quick response service" or "QRS."  An operation in which

27

emergency medical services providers of an EMS agency:

28

(1)  respond to an actual, reported or perceived

29

emergency; and

30

(2)  provide emergency medical services to patients

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1

pending the arrival of an ambulance.

2

"Regional emergency medical services council" or "regional

3

EMS council."  A nonprofit incorporated entity or appropriate

4

equivalent that is assigned by the Department of Health to:

5

(1)  plan, develop, maintain, expand and improve

6

emergency medical services systems within a specific

7

geographic area of this Commonwealth; and

8

(2)  coordinate those systems into a regional emergency

9

medical services system.

10

"Regional emergency medical services medical director" or

11

"regional EMS medical director."  The medical director of a

12

regional emergency medical services council.

13

"Review organization."  A committee which engages in peer

14

review as authorized by the regulations of the Department of

15

Health.

16

"Rural area."  An area outside urbanized areas as defined by

17

the United States Bureau of the Census.

18

"Special care unit."  An appropriately equipped area of a

19

hospital where provisions have been made for a concentration of

20

physicians, nurses and others who have special skills and

21

experiences to provide medical care for critically ill patients.

22

"Trauma center."  A facility accredited as a trauma center by

23

the Pennsylvania Trauma Systems Foundation.

24

§ 7204.  Emergency medical services system programs.

25

(a)  Planning and coordination.--The department shall plan,

26

guide and coordinate programs on the following matters to

27

promote effective and efficient operation of Statewide and

28

regional EMS systems:

29

(1)  The number and distribution of EMS providers and

30

other persons integral to an EMS system, such as medical

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1

command physicians and EMS agency medical directors, with

2

appropriate training and experience.

3

(2)  Reasonably accessible training for EMS providers and

4

other persons integral to an EMS system, including clinical

5

training and continuing education programs coordinated with

6

other programs providing similar, complementary and

7

supplemental training and education.

8

(3)  The joining of personnel, facilities and equipment

9

coordinated through a communication system to ensure that EMS

10

requests will be handled by communications facilities that:

11

(i)  utilize emergency medical telecommunications

12

screening to determine the appropriate emergency agency

13

response;

14

(ii)  are accessible to the general public through a

15

common telephone number and, where feasible, through the

16

universal emergency telephone number 911; and

17

(iii)  will have direct communications with

18

appropriate personnel facilities and equipment resources.

19

(4)  The number and distribution of ambulances and other

20

EMS vehicles in which:

21

(i)  ambulances and other vehicles meet appropriate

22

criteria relating to location, design, performance and

23

equipment; and

24

(ii)  operators and other personnel staffing vehicles

25

meet appropriate training and experience requirements.

26

(5)  The number and accessibility of facilities that:

27

(i)  are collectively capable of providing EMS on a

28

continuous basis;

29

(ii)  have appropriate specialty capabilities;

30

(iii)  meet appropriate standards relating to

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1

capacity, location, personnel and equipment; and

2

(iv)  are coordinated with other health care

3

facilities and resource centers.

4

(6)  Access and transportation to trauma centers and

5

specialty care receiving facilities.

6

(7)  Transfer of patients between facilities or to

7

programs offering necessary follow-up care and

8

rehabilitation.

9

(8)  Utilization of appropriate personnel, facilities and

10

equipment of each entity providing EMS.

11

(9)  Regional EMS councils that provide persons residing

12

in an EMS region, and who have no professional or financial

13

interest in the provision of health care, with an adequate

14

opportunity to participate in the making of policy for the

15

regional EMS system.

16

(10)  The provision of EMS to all persons requiring those

17

services.

18

(11)  A standardized data collection system that covers

19

all phases of the EMS incident, including, but not limited

20

to, the dispatch report and contact, treatment and transport

21

of a patient in the EMS system.

22

(12)  Programs of public education, information and

23

prevention, integrated with public health education and

24

taking into account needs of visitors and residents,

25

concerning methods for accessing EMS and stressing

26

dissemination of information as to first aid and

27

cardiopulmonary resuscitation.

28

(13)  The provision of periodic comprehensive review and

29

evaluation of the extent and quality of the EMS provided in

30

each regional EMS system and reports to the department of

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1

each review or evaluation.

2

(14)  Plans to assure that each regional EMS system will

3

be able to provide or secure EMS during mass casualty

4

situations, natural disasters and declared states of

5

emergency in accordance with Chapter 71 (relating to general

6

provisions) and the instructions of the Pennsylvania

7

Emergency Management Agency.

8

(15)  Appropriate intrastate and interstate arrangements

9

for the provision of EMS as needed.

10

(b)  Limitations.--This section is intended to identify EMS

11

objectives to be pursued and achieved by the department in its

12

role as lead agency for EMS. Nothing herein shall be construed

13

to confer regulatory powers upon the department beyond those

14

conferred elsewhere in this chapter.

15

§ 7205.  Duties of department.

16

(a)  Duty.--It shall be the duty of the department to assist

17

in the development of local EMS systems; plan, guide and

18

coordinate the development of regional EMS systems into a

19

unified Statewide system; and coordinate systems in this

20

Commonwealth with similar systems in neighboring states.

21

(b)  Authority.--The department shall be the lead agency for

22

EMS in this Commonwealth. The department is authorized to:

23

(1)  Coordinate a program for planning, developing,

24

maintaining, expanding, improving and upgrading EMS systems

25

in this Commonwealth.

26

(2)  Establish, by regulation, standards and criteria

27

governing the awarding and administration of contracts and

28

grants under this chapter for initiation, maintenance and

29

improvement of regional EMS systems.

30

(3)  Require collection and maintenance of patient data

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1

and information in EMS patient care reports by EMS agencies.

2

(4)  Collect, as deemed necessary and appropriate, data

3

and information regarding patients who utilize emergency

4

departments without being admitted to the facility and

5

patients admitted through emergency departments, trauma

6

centers or directly to special care units, in a manner that

7

protects and maintains the confidential nature of patient

8

records. The data and information shall be reasonable in

9

detail and shall be collected pursuant to regulations issued

10

by the department. Data and information shall be limited to

11

that which may be used for specific planning, research and

12

quality improvement purposes and shall not be duplicative of

13

data and information already available to the department.

14

(5)  Prepare and revise a Statewide EMS system plan under

15

section 7211 (relating to comprehensive plan).

16

(6)  Define and approve training programs and accredit

17

educational institutions for EMS training of EMS providers.

18

(7)  Provide technical assistance to local governments,

19

EMS agencies and other entities for the purpose of assuring

20

effective planning and execution of EMS.

21

(8)  Administer contracts and grants authorized under

22

this chapter and other grants pertaining to EMS.

23

(9)  Establish standards for the licensing, registration

24

and operation of EMS agencies, and inspect EMS agencies for

25

compliance with this chapter and regulations adopted under

26

this chapter.

27

(10)  Maintain a quality improvement program for the

28

purpose of monitoring and improving the delivery of EMS.

29

(11)  Promulgate regulations to establish standards and

30

criteria for EMS systems.

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1

(12)  Integrate all trauma centers accredited pursuant to

2

section 7207 (relating to Pennsylvania Trauma Systems

3

Foundation) into the Statewide EMS system.

4

(13)  Recommend to 911 and other EMS agency dispatchers

5

protocols with respect to the type and quantity of EMS

6

resources to dispatch to emergencies.

7

(14)  Investigate, based upon complaints and information

8

received, possible violations of this chapter and regulations

9

under this chapter and take disciplinary actions, seek

10

injunctions and refer matters for criminal prosecution.

11

(15)  Investigate complaints concerning delivery of

12

services by trauma centers and forward investigation results

13

to the appropriate accrediting entity with a recommendation

14

for action.

15

(16)  Enter into agreements with other states which may

16

include, as appropriate to effectuate the purposes of this

17

chapter, the acceptance of EMS resources of other states that

18

do not fully satisfy the requirements of this chapter or

19

regulations adopted under this chapter.

20

(c)  EMS protocols.--The department shall establish criteria

21

and protocols, including bypass protocols, for evaluation,

22

triage, treatment, transport, transfer and referral of patients

23

to ensure that they receive appropriate EMS and are transported

24

to the most appropriate facility. Regional EMS councils shall

25

not be eligible for contracts or grant funds or State EMS

26

Operating Fund disbursements unless they assist in ensuring

27

regional implementation of the criteria and protocols. Protocols

28

under this subsection are not subject to the rulemaking process.

29

§ 7206.  Emergency medical services patient care reports.

30

(a)  Preparation.--An EMS agency shall ensure that its

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1

responding EMS providers complete an EMS patient care report for

2

each response made in which it encounters a patient or a person

3

who has been identified as a patient to the EMS agency, unless

4

the department by regulation exempts certain types of patient

5

contact from the reporting requirement. The department shall

6

employ an electronic EMS patient care reporting process that

7

shall solicit standardized data and patient information. The

8

department may require an EMS agency to complete a different

9

standardized report or different fields in a standardized report

10

based upon the type of resources the EMS agency uses in

11

responding. The department shall permit an EMS agency to file a

12

paper report for extraordinary reasons as determined by the

13

department on a case-by-case basis.

14

(b)  Content.--The report shall contain information as

15

solicited on the form or other reporting process developed by

16

the department. The reporting process shall solicit essential

17

information in reasonable detail. The department may also use

18

the reporting process to collect data to enhance its ability to

19

carry out its responsibilities under sections 7204 (relating to

20

emergency medical services system programs) and 7205 (relating

21

to duties of department).

22

(c)  Patient medical record.--If a patient is transported to

23

a hospital or from a hospital to another health care facility,

24

information about the patient and EMS performed on the patient

25

that is solicited through the reporting process shall be

26

provided by the EMS agency to the hospital or other health care

27

facility and become part of the patient's medical record.

28

(d)  Reporting.--An EMS agency shall report to the department

29

or a regional EMS council, as determined by department

30

regulation, data that is solicited through the reporting

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1

process.

2

(e)  Confidentiality.--

3

(1)  Patient information collected by an EMS agency shall

4

be confidential and shall not be released by the EMS agency

5

or a health care facility except as follows:

6

(i)  To the patient who is the subject of the report

7

or to a person who is authorized to exercise the rights

8

of the patient with respect to securing the report.

9

(ii)  Pursuant to an order of a court of competent

10

jurisdiction, including a subpoena when it constitutes a

11

court order, except that disclosure pursuant to a

12

subpoena shall not be permitted as to information in the

13

report that is of such nature that disclosure pursuant to

14

a subpoena is not otherwise authorized by law.

15

(iii)  To a health care provider to whom a patient's

16

medical record may be released under the law.

17

(iv)  For billing purposes.

18

(v)  For quality improvement activities.

19

(vi)  To the department or a regional EMS council for

20

the purpose of investigating possible violations of this

21

chapter or related regulations.

22

(vii)  To a government agency or its agent, as

23

authorized by the department, for the purpose of the

24

agency performing official government duties.

25

(2)  Notwithstanding the duty of confidentiality

26

applicable to department and regional EMS councils concerning

27

reports under paragraph (1), the report may be released for

28

specific research or EMS planning purposes approved by the

29

department, subject to department approval and supervision to

30

ensure that use of the report is strictly limited to the

- 18 -

 


1

purposes of the research.

2

(f)  Vendors.--A vendor may not sell or otherwise provide or

3

offer reporting forms or software marketed as appropriate for

4

use in making reports required under this section unless the

5

vendor submits the product to the department for review and

6

receives department approval. Thereafter, the vendor shall

7

submit any modification of the product to the department for

8

review and approval if the vendor intends to offer the modified

9

product for use in the EMS patient care reporting process. If

10

the department makes changes to the EMS patient care report, it

11

shall publish a notice of the changes in the Pennsylvania

12

Bulletin. The effective date for the changes shall be no fewer

13

than 60 days following publication. After publication of

14

changes, a vendor may not market a product as one appropriate

15

for use in making an EMS patient care report, any reporting

16

forms or software approved by the department prior to

17

publication of the changes, unless the vendor clearly discloses

18

that the forms or software were approved prior to publication of

19

the changes. The department may assess a vendor a $5,000 civil

20

penalty for each day a vendor violates the provisions of this

21

subsection.

22

§ 7207.  Pennsylvania Trauma Systems Foundation.

23

(a)  Trauma center accreditation.--The foundation shall

24

develop a private voluntary accreditation program to:

25

(1)  Establish standards for the operation of trauma

26

centers in this Commonwealth that receive or seek to receive

<--

27

Commonwealth funds, adopting, at a minimum, current

28

guidelines for trauma centers defined by the American College

29

of Surgeons. Additionally, Level III trauma centers shall

30

meet accreditation criteria for Level III trauma centers

- 19 -

 


1

imposed by the act of March 24, 2004, (P.L.148, No.15), known

2

as the Pennsylvania Trauma Systems Stabilization Act. For the

3

purpose of reaccreditation, the standards shall require, at a

4

minimum, that each Level I trauma center establish that 600

5

severe and urgent injury cases have been treated per year and

6

each Level II trauma center establish that 350 severe and

7

urgent injury cases have been treated per year.

8

(2)  Evaluate a hospital making application to the

9

foundation to determine if the hospital meets the

10

foundation's standards. An evaluation shall include hospital

11

site visits by accreditation survey teams composed of

12

independent, qualified persons selected by the foundation.

13

(3)  Issue certificates of accreditation to hospitals

14

that meet the accreditation standards. Certificates of

15

accreditation shall be valid for a period not to exceed three

16

years. Certificates of accreditation may be revoked by the

17

foundation if it is determined that the trauma center no

18

longer meets accreditation standards as set forth in this

19

chapter.

20

(4)  Establish an appeal mechanism for reconsideration of

21

accreditation decisions.

22

(b)  Judicial review.--A person aggrieved by a determination

23

of the foundation under this section may file a petition for

24

review within 30 days in an appropriate court of common pleas.

25

(c)  Prohibition.--No hospital shall hold itself out as a

26

trauma center unless it has a current certificate of

27

accreditation issued under this section.

28

(d)  Board of directors.--The board of directors of the

29

foundation shall consist of the following voting members: five

30

representatives of State organizations representing physicians;

- 20 -

 


1

five representatives of State organizations representing

2

hospitals; three representatives of State organizations

3

representing registered professional nurses; two representatives

4

of other Statewide EMS organizations having expertise in the

5

delivery of trauma services; the chairman and minority chairman

6

of the Public Health and Welfare Committee of the Senate or

7

designees chosen from among the members of the committee; the

8

chairman and minority chairman of the Health and Human Services

9

Committee of the House of Representatives or designees chosen

10

from among the members of the committee; and the Secretary of

11

Health or a designee. The bylaws of the foundation shall

12

identify a method to select members to achieve professional and

13

geographic balance on the board of directors. Terms of office

14

shall be limited to three years.

15

(e)  Data collection.--The foundation shall compile and

16

maintain statistics on mortality and morbidity on multisystem

17

trauma victims. The data collection shall be coordinated and

18

performed in conjunction with State data collection activities.

19

§ 7208.  State Advisory Board.

20

(a)  Designation and composition.--The board shall be

21

composed of volunteer, professional and paraprofessional

22

organizations involved in EMS. The board shall be geographically

23

representative of the provider organizations that represent EMS

24

providers, firefighters, regional EMS councils, physicians,

25

hospital administrators and other health care providers

26

concerned with EMS. The board may be composed of up to 30

27

organizations. Each organization that is a member of the

28

Pennsylvania Emergency Health Services Council and is elected to

29

serve as a member on the board shall have one vote on the board.

30

(b)  Duties.--The duties of the board shall be to:

- 21 -

 


1

(1)  Elect officers.

2

(2)  Advise the department concerning manpower and

3

training, communications, EMS agencies, content of

4

regulations, standards and policies promulgated by the

5

department under this chapter and other subjects deemed

6

appropriate by the department.

7

(3)  Serve as the forum for discussion on the content of

8

the Statewide EMS system plan, or any proposed revisions

9

thereto, and advise the department as to the content of the

10

plan.

11

(c)  Open meetings.--Meetings of the board shall be held in

12

accordance with 65 Pa.C.S. Ch. 7 (relating to open meetings).

13

(d)  Terms.--A voting member of the board shall serve a

14

three-year term. A voting member shall not serve more than two

15

consecutive terms.

16

(e)  Quorum.--A simple majority of the voting members of the

17

board shall constitute a quorum for the transaction of business.

18

(f)  Compensation.--Members of the board shall serve without

19

compensation, except the Pennsylvania Emergency Health Services

20

Council, through its contract or grant with the department, may

21

pay necessary and reasonable expenses incurred by members of the

22

board while performing their official duties.

23

(g)  Contracts and grants.--The department shall contract

24

with or provide a grant to the board for performance of its work

25

under subsection (b). Contracts and grants between the

26

department and the board for the performance of work other than

27

under subsection (b) shall be subject to section 7212 (relating

28

to contracts and grants) where applicable.

29

§ 7209.  Regional emergency medical services councils.

30

(a)  Purpose.--Regional EMS councils shall assist the

- 22 -

 


1

department in carrying out the provisions of this chapter. Each

2

regional EMS council shall adhere to policy direction from the

3

department.

4

(b)  Organization.--For purposes of this chapter, the

5

organizational structure of a regional EMS council shall be

6

representative of the public, health professions and major

7

private and public voluntary agencies, organizations and

8

institutions concerned with providing EMS in the region and

9

shall be one of the following:

10

(1)  A unit of general local government, with an advisory

11

council, meeting requirements for representation.

12

(2)  A representative public entity administering a

13

compact or other area-wide arrangement or consortium.

14

(3)  Any other public or private nonprofit entity that

15

meets requirements for representation as determined by the

16

department.

17

(c)  Duties.--Each regional EMS council shall, if directed by

18

the department:

19

(1)  Assist the department in achieving the Statewide and

20

regional EMS system components and goals described under

21

section 7204 (relating to emergency medical services system

22

programs).

23

(2)  Assist the department in the collection and

24

maintenance of standardized data and information as provided

25

in section 7206 (relating to emergency medical services

26

patient care reports).

27

(3)  Prepare, annually review and revise, as needed, a

28

regional EMS system plan for the EMS region the department

29

has designated and for which the department has contracted or

30

provided a grant to it to serve.

- 23 -

 


1

(4)  Carry out, to the extent feasible, the Statewide and

2

regional EMS system plans.

3

(5)  Assure the reasonable availability of training and

4

continuing education programs for EMS providers.

5

(6)  Provide necessary and reasonable staff services and

6

appropriate and convenient office facilities that can serve

7

as the EMS region's location for the planning, maintenance

8

and coordinative and evaluative functions of the council.

9

(7)  Establish a mechanism to provide for input from

10

facilities and EMS agencies in the EMS region in decisions

11

that include, but are not limited to, membership on its

12

governing body.

13

(8)  Establish, subject to department approval, regional

14

EMS triage, treatment and transportation protocols consistent

15

with Statewide protocols adopted by the department. A

16

regional EMS council may also establish, subject to

17

department approval, additional triage, treatment and

18

transportation protocols. No regional protocol shall be

19

subject to the rulemaking process.

20

(9)  Advise public safety answering points and municipal

21

and county governments as to the EMS resources available for

22

dispatching and recommend dispatch criteria that may be

23

developed by the department or the council as approved by the

24

department.

25

(10)  Assist the department in achieving a unified

26

Statewide EMS system.

27

(11)  Designate a regional EMS medical director and

28

establish a medical advisory committee and a quality

29

improvement committee.

30

(12)  Develop a conflict of interest policy, subject to

- 24 -

 


1

department approval, and require its board or advisory

2

council members, officials and employees to agree to the

3

policy in writing.

4

(13)  Perform other duties assigned by the department to

5

assist the department in carrying out the requirements of

6

this chapter.

7

(d)  Regional EMS medical directors.--The department shall

8

consult with the regional EMS medical directors in developing

9

and adopting EMS protocols and may consult with them on any

10

matter involved in the department's administration of this

11

chapter.

12

SUBCHAPTER B

13

PROGRAM

14

Sec.

15

7211.  Comprehensive plan.

16

7212.  Contracts and grants.

17

7213.  Emergency medical services providers.

18

7214.  Emergency medical responders.

19

7215.  Emergency medical technicians.

20

7216.  Advanced emergency medical technicians.

21

7217.  Paramedics.

22

7218.  Prehospital registered nurses.

23

7219.  Prehospital physician extenders.

24

7220.  Prehospital emergency medical services physicians.

25

7221.  Certification sanctions.

26

7222.  Emergency medical services vehicle operators.

27

7223.  Suspension of certification.

28

7224.  Emergency medical services instructors.

29

7225.  Medical director of emergency medical services agency.

30

7226.  Medical command physicians and facility medical

- 25 -

 


1

directors.

2

7227.  Medical command facilities.

3

7228.  Receiving facilities.

4

7229.  Emergency medical services agencies.

5

7230.  Advanced life support ambulances.

6

7231.  Air ambulances.

7

7232.  Advanced life support squad vehicles.

8

7233.  Basic life support ambulances.

9

7234.  Basic life support squad vehicles.

10

7235.  Quick response services.

11

7236.  Special operations emergency medical services.

12

7237.  First aid and other safety services.

13

7238.  Other vehicles and services.

14

7239.  Stretcher and wheelchair vehicles.

15

7240.  Conditional temporary licenses.

16

7241.  Plans of correction.

17

7242.  Emergency medical services agency license sanctions.

18

§ 7211.  Comprehensive plan.

19

(a)  Preparation.--

20

(1)  The department, with the assistance of the board,

21

shall prepare a Statewide EMS system plan, which plan shall

22

include both short-range and long-range goals and objectives,

23

and shall make the plan available to the General Assembly and

24

all concerned agencies, entities and individuals.

25

(2)  A regional EMS system plan, upon approval of the

26

department, shall:

27

(i)  Become part of the Statewide EMS system plan.

28

(ii)  Include for the EMS region the same types of

29

information that subsection (b) requires for the

30

Statewide plan.

- 26 -

 


1

(b)  Contents.--At a minimum, the Statewide plan shall

2

contain:

3

(1)  An inventory of EMS resources available within this

4

Commonwealth.

5

(2)  An assessment of the effectiveness of the existing

6

EMS system and a determination of the need for changes to the

7

EMS system.

8

(3)  Performance measures for delivery of EMS to all

9

persons in this Commonwealth.

10

(4)  Methods to be used in achieving the stated

11

performance measures.

12

(5)  A schedule for achievement of the stated performance

13

measures.

14

(6)  A method for monitoring and evaluating whether the

15

stated performance measures are being achieved.

16

(7)  Estimated costs for achieving the stated performance

17

measures.

18

(c)  Revisions.--

19

(1)  The department shall collect and analyze EMS data

20

for the purpose of:

21

(i)  Revising the Statewide EMS system plan,

22

including determining the status of the Statewide EMS

23

system, the degree of compliance with the requirements of

24

this chapter and the effectiveness of EMS systems in

25

reducing morbidity and mortality associated with medical

26

emergencies.

27

(ii)  Planning future EMS system initiatives.

28

(2)  Persons regulated by the department under this

29

chapter and dispatchers of EMS agencies shall provide data,

30

without charge, as reasonably requested by the department and

- 27 -

 


1

regional EMS councils, to aid them in developing and revising

2

Statewide and regional EMS system plans and in conducting

3

investigations under this chapter as authorized by the

4

department.

5

(d)  Annual reports.--The department shall annually publish

6

comprehensive and specific reports of activity and plan

7

implementation.

8

(e)  Use of Statewide plan.--

9

(1)  The department shall use the Statewide plan for

10

contract and grant purposes as set forth in section 7212(a)

11

(relating to contracts and grants).

12

(2)  Nothing in the Statewide plan shall be construed to

13

vest the department with any regulatory authority.

14

§ 7212.  Contracts and grants.

15

(a)  General power.--The department may enter into contracts

16

or grants with entities to serve as regional EMS councils

17

responsible for the initiation, expansion, maintenance and

18

improvement of regional EMS systems that are in accordance with

19

the Statewide EMS system plan.

20

(b)  Limitation.--An entity with which the department enters

21

into a contract or grant under this section to serve as a

22

regional EMS council shall carry out the duties assigned by the

23

department under section 7209(c) (relating to regional emergency

24

medical services councils).

25

(c)  Purposes.--In contracting with or giving a grant to

26

regional EMS councils, the department may allocate Emergency

27

Medical Services Operating Fund moneys appropriated to the

28

department only for the following purposes:

29

(1)  Providing programs of public education, information,

30

health promotion and prevention regarding EMS.

- 28 -

 


1

(2)  Purchasing ambulances, other EMS vehicles, medical

2

equipment and rescue equipment.

3

(3)  Applying to costs associated with conducting

4

training and testing programs for EMS providers.

5

(4)  Applying to costs associated with inspections and

6

investigations conducted to assist the department to carry

7

out its regulatory authority under this chapter.

8

(5)  Purchasing communications equipment and services,

9

including alerting equipment, provided that the purchases are

10

in accordance with the Statewide EMS system plan.

11

(6)  Assisting with the merger of EMS agencies or

12

assisting an EMS agency to acquire another EMS agency, when

13

the department determines circumstances exist such that the

14

transaction and financial assistance are needed to serve the

15

public interest.

16

(7)  Applying to costs associated with the maintenance

17

and operation of regional EMS councils. Those costs may

18

include, but shall not be limited to, salaries, wages and

19

benefits of staff, travel, equipment and supplies, leasing of

20

office space, and other costs incidental to the conduct of

21

business which are deemed by the department to be necessary

22

and appropriate for carrying out the purposes of this

23

chapter.

24

(8)  Applying to costs associated with collection and

25

analysis of data necessary to evaluate the effectiveness of

26

EMS systems in providing EMS and to administer quality

27

improvement programs.

28

(9)  Applying to costs associated with assisting EMS

29

agencies to recruit and retain EMS providers.

30

(d)  Restriction.--In contracting with or providing grants to

- 29 -

 


1

regional EMS councils, the department may not allocate Emergency

2

Medical Services Operating Fund moneys appropriated to the

3

department for the following purposes:

4

(1)  Acquisition, construction or rehabilitation of

5

facilities or buildings, except renovation as may be

6

necessary for the implementation or modification of EMS

7

communication systems.

8

(2)  Purchasing hospital equipment, other than

9

communications equipment for medical command and receiving

10

facilities, unless the equipment is used or intended to be

11

used in an equipment exchange program with EMS agencies.

12

(3)  Maintenance of ambulances, other EMS vehicles and

13

equipment.

14

(4)  Applying to costs deemed by the department as

15

inappropriate for carrying out the purposes of this chapter.

16

(5)  Applying to costs which are normally borne by

17

patients, except for extraordinary costs as determined by the

18

department.

19

(e)  Reports.--The recipient of a contract or grant under

20

this chapter shall make reports to the department as may be

21

required by the department.

22

(f)  Contract and grant prerequisites.--The department shall

23

not contract with or provide a grant to an entity for that

24

entity to serve as a regional EMS council unless:

25

(1)  The entity has submitted a contract or grant

26

application to the department in a form and format prescribed

27

by the department that is consistent with the Statewide and

28

regional EMS system plans.

29

(2)  The application addresses planning, maintenance and

30

improvement of the regional EMS system.

- 30 -

 


1

(3)  The entity demonstrates to the department's

2

satisfaction the qualifications and commitment to plan,

3

maintain and improve a regional EMS system, and that the

4

entity has the required organizational structure and

5

provisions for representation of appropriate entities.

6

(g)  Technical assistance.--The department shall provide

7

technical assistance, as appropriate, to regional EMS councils

8

and to such other eligible entities as necessary for the purpose

9

of their carrying out the provisions of contracts and grants

10

under this section, with special consideration for contractors

11

and grantees representing rural areas.

12

(h)  Payments.--Payments pursuant to a contract or grant

13

under this section may be made in advance or by way of

14

reimbursement and in installments and on conditions as the

15

department determines will most effectively carry out the

16

provisions of this chapter.

17

(i)  Other funds considered.--

18

(1)  In determining the amount of a contract or grant

19

under this section, the amount of funds available to the

20

contractor or grantee from non-State contributions and

21

Federal grant or contract programs pertaining to EMS shall be

22

taken into consideration.

23

(2)  For purposes of this subsection, "non-State

24

contributions" include the outlay of cash and in-kind

25

services to the contractor or grantee or toward the operation

26

of a regional EMS system by private, public or government

27

third parties, including the Federal Government.

28

(j)  Other contracts and grants.--The department may enter

29

into contracts and grants with organizations other than regional

30

EMS councils in order to assist the department in complying with

- 31 -

 


1

the provisions of this section and chapter.

2

(k)  Public disclosure.--

3

(1)  Subject to the provisions of paragraph (2),

4

finalized contracts and grants shall be deemed public records

5

subject to disclosure.

6

(2)  The department may not disclose information in

7

contracts or grants that could be used by persons to

8

undermine measures to combat, respond to or recover from

9

terrorist attacks.

10

(l)  Sole source contract or grant.--Upon expiration of a

11

contract or grant with an entity to carry out the duties of a

12

regional EMS council as set forth in subsection (c), the

13

department, without undertaking a competitive bidding process,

14

may enter into a new contract or grant with the same entity for

15

that entity to continue to serve as a regional EMS council and

16

perform the duties set forth in subsection (c), as determined by

17

the department, if that entity, in carrying out the prior

18

contract or grant, demonstrated its ability and commitment to

19

the department's satisfaction to plan, maintain and improve the

20

regional EMS system consistent with the terms of the prior

21

contract or grant.

22

§ 7213.  Emergency medical services providers.

23

(a)  Certification.--The department shall issue

24

certifications for the following types of EMS providers, which

25

shall be permanent, subject to disciplinary action pursuant to

26

section 7221 (relating to certification sanctions):

27

(1)  Emergency medical responder.

28

(2)  Emergency medical technician.

29

(3)  Advanced emergency medical technician.

30

(4)  Paramedic.

- 32 -

 


1

(5)  Prehospital registered nurse.

2

(6)  Prehospital physician extender.

3

(7)  Prehospital EMS physician.

4

(8)  Any other class of EMS provider the department

5

establishes by regulation.

6

(b)  Other emergency medical services providers.--The

7

department may establish, by regulation as the need arises,

8

classes of EMS providers to provide specialized EMS. The

9

regulations shall establish certification, practice,

10

disciplinary and other provider standards consistent with the

11

purposes of this chapter, and the statutory regulatory schemes

12

applicable to paramedics except as necessary to meet the special

13

EMS needs for which the class of EMS provider is created.

14

(c)  Application.--An applicant for EMS provider

15

certification shall complete an application for certification on

16

a form or through an electronic application process prescribed

17

by the department.

18

(d)  Education.--The department shall assist, encourage and

19

coordinate the education of EMS providers.

20

(1)  The department shall develop standards through

21

regulations for the accreditation, reaccreditation and

22

operation of educational institutes to provide the training

23

persons must successfully complete to be certified as EMS

24

providers.

25

(2)  The department shall develop standards through

26

regulations for the approval of continuing education courses

27

for EMS providers and for the accreditation of persons and

28

Commonwealth agencies that provide continuing education EMS

29

providers may take to secure renewal of registration.

30

(3)  The department, in consultation with the board,

- 33 -

 


1

shall review and update the permitted scope of continuing

2

education programs not less than biennially.

3

(4)  If the educational institute or provider of

4

continuing education courses fails to satisfy the operational

5

standards or fails to continue to meet the accreditation

6

standards, the department may take one or more of the

7

following actions:

8

(i)  Deny the application for reaccreditation.

9

(ii)  Impose terms of probation.

10

(iii)  Revoke, suspend, limit or otherwise restrict

11

the accreditation.

12

(iv)  Impose a civil penalty not exceeding $1,000 for

13

each infraction.

14

(e)  Examinations.--

15

(1)  A person who intends to secure EMS provider

16

certification shall take the required certification

17

examinations within one year after completing the EMS

18

provider training required for certification.

19

(2)  Except as otherwise provided in this subsection, a

20

person who fails a written or practical skills examination

21

for an EMS provider certification may repeat the failed

22

examination without retaking the examination the person

23

passed.

24

(3)  A person who fails the written examination three

25

times shall complete a refresher course approved by the

26

department or repeat the EMS provider training program before

27

taking the examination again.

28

(4)  A person who fails the practical skills examination

29

three times shall complete a remedial course approved by the

30

department or repeat the EMS provider training program before

- 34 -

 


1

again taking the examination.

2

(5)  A person who fails either examination six times or

3

who does not pass the required examinations within two years

4

after completing the EMS provider training program shall

5

receive no credit for an examination previously passed and

6

shall repeat the training program for the EMS provider

7

certification before the person may take the certification

8

examinations again.

9

(6)  If the standards a person needs to satisfy to take a

10

certification examination change after the person has failed

11

the examination, the person may not retake the examination

12

unless the person meets the new standards.

13

(7)  The department may, by regulation, change the

14

standards in this subsection.

15

(f)  Reciprocity and endorsement.--The department may issue

16

EMS provider certifications by reciprocity or endorsement as

17

follows:

18

(1)  If the department, upon review of the criteria for

19

certification of a type of EMS provider in another state,

20

determines that the criteria is substantially equivalent to

21

the criteria for a similar certification in this

22

Commonwealth, the department may enter into a reciprocity

23

agreement with its counterpart certifying agency in the other

24

state to certify that type of EMS provider based solely on

25

the other state's certification of the provider. No

26

reciprocity agreement may deprive the department from denying

27

a certification based on disciplinary considerations.

28

(2)  If the department, upon review of a course or an

29

examination approved by another state for EMS provider

30

certification or continuing education, or upon review of a

- 35 -

 


1

national course or examination, determines that the course or

2

examination meets or exceeds the standards for such a course

3

or examination for a similar type of certification in this

4

Commonwealth, or for registration of the certification, the

5

department may endorse the course or examination as meeting

6

the course or examination requirements for that type of EMS

7

provider certification in acting upon an applicant's

8

application for certification or registration of the

9

certification in this Commonwealth.

10

(g)  Skills.--The department shall publish in the

11

Pennsylvania Bulletin a list of skills within the scope of

12

practice of each type of EMS provider. The list shall be updated

13

by publication as necessary.

14

(h)  Medical command orders and protocols.--

15

(1)  An EMS provider, other than a prehospital EMS

16

physician, shall provide EMS pursuant to department-approved

17

protocols and medical command orders.

18

(2)  The protocols shall identify circumstances in which

19

an EMS provider shall seek direction from a medical command

20

physician, which direction may be given by the physician in

21

person or through an authorized agent or via radio or other

22

telecommunications device approved by the department, and

23

shall address the responsibilities of an EMS provider when

24

medical command cannot be secured or is disrupted.

25

(i)  Reports of convictions, discipline and exclusions.--

26

(1)  An applicant for an EMS provider certification shall

27

report to the department all misdemeanor, felony and other

28

criminal convictions that are not summary or equivalent

29

offenses, and all disciplinary sanctions that have been

30

imposed upon a license, certification or other authorization

- 36 -

 


1

of the applicant to practice an occupation or profession, and

2

any exclusion from a Federal or State health care program of

3

the applicant or an entity in which the applicant had equity

4

or capital, stock or profits of the entity equal to at least

5

5% of the value of the property or assets of the entity at

6

the time of the exclusion.

7

(2)  The applicant shall also provide the department with

8

a certified copy of the criminal charging, judgment and

9

sentencing documents for each conviction and a certified copy

10

of an adjudication or other document imposing discipline

11

against the applicant.

12

(3)  The department may not certify an applicant until

13

the department receives the documents, unless the applicant

14

establishes that the documents from which certified copies

15

are to be made no longer exist.

16

(4)  An EMS provider shall report the same type of

17

convictions, disciplinary sanctions and exclusions and

18

provide the same documents to the department within 30 days

19

after each conviction, discipline and exclusion.

20

(j)  Identification.--

21

(1)  An EMS provider shall provide proof of authority to

22

practice as an EMS provider if requested when providing

23

services as an EMS provider.

24

(2)  For purposes of this subsection, "proof of authority

25

to practice" means a card or certificate issued by the

26

department that shows current registration of the EMS

27

provider's certification.

28

(k)  Change of address.--

29

(1)  An EMS provider and an applicant for EMS provider

30

certification shall ensure that the department has the

- 37 -

 


1

current address at which the person can be reached by mail at

2

all times.

3

(2)  Neither an EMS provider's home address, telephone

4

number nor any other residential contact information provided

5

to the department shall be deemed a public record.

6

(l)  Current registration.--To provide EMS, an EMS provider

7

shall maintain current registration of his certification as an

8

EMS provider.

9

(m)  Downgrading certification or practice.--

10

(1)  An EMS provider who has a currently registered

11

certification as an advanced EMT or higher-level EMS provider

12

and is not permitted to practice at that level by an EMS

13

agency pursuant to sections 7225(b)(2) (relating to medical

14

director of emergency medical services agency) and 7229(k)

15

(relating to emergency medical services agencies), may

16

function as a lower-level EMS provider for that EMS agency,

17

as authorized by the EMS agency medical director, if the EMS

18

agency permits.

19

(2)  Upon expiration of the biennial registration period,

20

an EMS provider who is at or above the advanced EMT level and

21

whose practice for an EMS agency has been downgraded pursuant

22

to sections 7225(b)(2) and 7229(k) may choose to maintain

23

current registration of the EMS provider's certification by

24

meeting the biennial registration requirements for that

25

certification.

26

(3)  An EMS provider who has a currently registered

27

certification as an advanced EMT or higher-level EMS provider

28

and does not meet the requirements for biennial registration

29

of that certification may apply to and secure from the

30

department registration of a lower-level EMS provider

- 38 -

 


1

certification if the EMS provider meets the registration

2

requirements for that certification.

3

(4)  Instead of a registration certificate, the

4

department shall issue a lower-level certification to an EMS

5

provider who does not already have that certification and

6

applies for a registration of that certification under this

7

subsection.

8

(5)  An EMS provider whose practice level has been

9

downgraded under this section and who does not maintain

10

current registration of the higher-level certification may

11

not display an insignia, patch or any other indicia of the

12

higher-level certification when providing EMS.

13

(n)  Biennial registrations.--

14

(1)  The biennial registration of each EMS provider

15

certification, subject to a biennial registration requirement

16

shall expire on January 1 of the next even-numbered year.

17

(2)  The continuing education requirements for the

18

biennial registration following the initial registration of a

19

certification shall be prorated based upon the month in which

20

the EMS provider became certified, with any fractional

21

requirement rounded down.

22

(o)  Exceptions for members of armed forces returning from

23

tour of duty.--EMS providers and EMS vehicle operators returning

24

from active military service who have a certification

25

registration that expired during their tours of duty or will

26

expire within 12 months after their return from military duty

27

may secure an exception to satisfying the continuing education

28

requirements for certification registration as follows:

29

(1)  EMS providers who have a triennial certification

30

registration requirement may secure an exception to the

- 39 -

 


1

period of time in which they would otherwise need to meet

2

continuing education requirements for triennial registration

3

of their certifications, as the department deems appropriate.

4

(2)  EMS providers and EMS vehicle operators who have a

5

biennial certification registration requirement may secure an

6

exception to the period of time in which they would otherwise

7

need to meet continuing education requirements for biennial

8

registration of their certifications, as the department deems

9

appropriate. Before an EMS provider without a current

10

biennial registration begins to work for an EMS agency, the

11

EMS agency medical director must determine that the EMS

12

provider has continuing competency in the knowledge and

13

skills required to provide the services the EMS agency will

14

assign to the EMS provider.

15

(3)  EMS providers may seek an exception to their

16

continuing education requirements for certification

17

registration by asking the department to endorse their

18

relevant military training as satisfying some or all of the

19

applicable continuing education requirements.

20

§ 7214.  Emergency medical responders.

21

(a)  Scope of practice.--An EMR performs for an EMS agency

22

BLS skills involving basic interventions with minimum EMS

23

equipment as follows:

24

(1)  As a member of a QRS to stabilize and improve a

25

patient's condition in an out-of-hospital emergency until a

26

higher-level EMS provider arrives at the scene and then may

27

assist that EMS provider.

28

(2)  As a member of the crew of an ambulance.

29

(3)  In another capacity as authorized by the department

30

by regulation.

- 40 -

 


1

(b)  Certification.--The department shall certify as an EMR

2

an individual who meets all of the following:

3

(1)  Is at least 16 years of age.

4

(2)  Has successfully completed an EMR training course

5

approved by the department.

6

(3)  Has a current certificate evidencing successful

7

completion of a CPR course acceptable to the department.

8

(4)  Has passed an EMR skills practical examination

9

approved by the department.

10

(5)  Has passed a written EMR certification examination

11

approved by the department.

12

(c)  Triennial registration.--An EMR's certification is

13

deemed registered for three years after issuance. An EMR must

14

register the EMR certification at three-year intervals by

15

completing an application for triennial registration on a form

16

or through an electronic process, as prescribed by the

17

department. The following shall apply:

18

(1)  The department shall issue a triennial registration

19

of an EMR certification to an EMR who meets all of the

20

following:

21

(i)  Has a current registration and applies for a new

22

registration no later than:

23

(A)  30 days before the current registration is

24

to expire; or

25

(B)  a lesser time established by regulation of

26

the department.

27

(ii)  Successfully:

28

(A)  completes EMR triennial registration

29

practical skills and written knowledge examinations

30

approved by the department; or

- 41 -

 


1

(B)  secures continuing education credits for EMR

2

triennial registration as required by the department

3

in continuing education programs approved by the

4

department.

5

(2)  An EMR whose registration of an EMR certification

6

has expired must qualify for a triennial registration of the

7

certification as prescribed by regulation of the department.

8

(d)  Transition for first responders.--An individual who is

9

certified as a first responder on the effective date of this

10

section shall be considered to be an EMR with a current

11

registration and shall be subject to the triennial registration

12

requirements of an EMR. The registration of the EMR

13

certification shall expire on the same date the first responder

14

certification would have expired if the first responder

15

certification remained in effect.

16

(e)  Transition for ambulance attendants.--An individual who

17

is an ambulance attendant on the effective date of this section

18

shall be considered to be an EMR with a current registration and

19

shall be subject to the triennial registration requirements of

20

an EMR. The registration of the EMR certification shall expire

21

on the same date that the person's qualifications as an

22

ambulance attendant expire and would have needed to be renewed.

23

§ 7215.  Emergency medical technicians.

24

(a)  Scope of practice.--An EMT performs basic EMS skills

25

involving basic interventions and equipment found on an EMS

26

vehicle as follows:

27

(1)  For an EMS agency as a member of the crew of an

28

ambulance.

29

(2)  For an EMS agency as a member of a QRS to stabilize

30

and improve a patient's condition in an out-of-hospital

- 42 -

 


1

setting until an ambulance arrives, and then may assist the

2

ambulance crew.

3

(3)  As a first aid or safety officer, or in a similar

4

capacity, for or independent of an EMS agency, as prescribed

5

by regulation of the department.

6

(4)  For an EMS agency in another capacity authorized by

7

regulation of the department.

8

(b)  Certification.--The department shall certify as an EMT

9

an individual who meets all of the following:

10

(1)  Is at least 16 years of age.

11

(2)  Has successfully completed an EMT training course

12

which:

13

(i)  teaches basic EMS; and

14

(ii)  is approved by the department.

15

(3)  Has a current certificate evidencing successful

16

completion of a CPR course acceptable to the department.

17

(4)  Has passed an EMT skills practical examination

18

approved by the department.

19

(5)  Has passed a written EMT certification examination

20

approved by the department.

21

(c)  Triennial registration.--An EMT's certification is

22

deemed registered for three years after issuance. An EMT must

23

register the EMT certification at three-year intervals by

24

completing an application for triennial registration on a form

25

or through an electronic process, as prescribed by the

26

department. The following shall apply:

27

(1)  The department shall issue a triennial registration

28

of an EMT certification to an EMT who meets all of the

29

following:

30

(i)  Has a current registration and applies for a new

- 43 -

 


1

registration no later than:

2

(A)  30 days before the current registration is

3

to expire; or

4

(B)  a lesser time established by regulation of

5

the department.

6

(ii)  Successfully:

7

(A)  completes EMT triennial registration

8

practical skills and written knowledge examinations

9

approved by the department; or

10

(B)  secures continuing education credits for EMT

11

triennial registration as required by the department

12

in continuing education programs approved by the

13

department.

14

(2)  An EMT whose registration of an EMT certification

15

has expired must qualify for a triennial registration of the

16

certification as prescribed by regulation of the department.

17

§ 7216.  Advanced emergency medical technicians.

18

(a)  Scope of practice.--An advanced EMT performs basic EMS

19

and ALS skills which include interventions and administration of

20

medications with basic and advanced equipment found on an EMS

21

vehicle as follows:

22

(1)  For an EMS agency as a member of the crew of an

23

ambulance.

24

(2)  For an EMS agency as a member of a QRS to stabilize

25

and improve a patient's condition in an out-of-hospital

26

emergency until an ambulance arrives at the scene and then

27

may assist the ambulance crew.

28

(3)  As a first aid or safety officer, or in a similar

29

capacity, for or independent of an EMS agency, as prescribed

30

by regulation of the department.

- 44 -

 


1

(4)  For an EMS agency in another capacity as authorized

2

by regulation of the department.

3

(b)  Certification.--The department shall certify as an

4

advanced EMT an individual who meets all of the following:

5

(1)  Is at least 18 years of age.

6

(2)  Has successfully completed a course under

7

subparagraph (i) or (ii):

8

(i)  An advanced EMT training course which:

9

(A)  teaches basic life support skills;

10

(B)  teaches advanced life support skills deemed

11

appropriate by regulation of the department; and

12

(C)  is approved by the department.

13

(ii)  An EMT course and secured training and

14

education, through continuing education courses, in

15

skills included in the scope of practice for an advanced

16

EMT for which the applicant did not receive training in

17

the EMT course.

18

(3)  Has a current certificate evidencing successful

19

completion of a CPR course acceptable to the department.

20

(4)  Has passed an advanced EMT skills practical

21

examination approved by the department.

22

(5)  Has passed a written advanced EMT certification

23

examination approved by the department.

24

(c)  Biennial registration.--An advanced EMT's certification

25

is deemed registered when the certification is issued. The

26

initial registration shall expire as set forth in section

27

7213(n) (relating to emergency medical services providers).

28

Except for the initial registration period, an advanced EMT must

29

register the advanced EMT certification at two-year intervals by

30

completing an application for biennial registration on a form or

- 45 -

 


1

through an electronic process, as prescribed by regulation of

2

the department. The following shall apply:

3

(1)  The department shall issue a biennial registration

4

of an advanced EMT certification to an advanced EMT who meets

5

all of the 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)  Successfully:

13

(A)  completes advanced EMT biennial registration

14

practical skills and written knowledge examinations

15

approved by the department; or

16

(B)  secures continuing education credits for

17

advanced EMT biennial registration as required by the

18

department in continuing education programs approved

19

by the department.

20

(2)  An advanced EMT whose registration of an advanced

21

EMT certification has expired must qualify for a biennial

22

registration of the certification as prescribed by regulation

23

of the department.

24

§ 7217.  Paramedics.

25

(a)  Scope of practice.--A paramedic is a higher level EMS

26

provider than an advanced EMT. A paramedic performs basic and

27

advanced EMS skills which include interventions and

28

administration of medications with basic and advanced equipment

29

found on an EMS vehicle as follows:

30

(1)  For an EMS agency as a member of the crew of an

- 46 -

 


1

ambulance.

2

(2)  For an EMS agency as a member of a QRS to stabilize

3

and improve a patient's condition in an out-of-hospital

4

emergency until an ambulance arrives at the scene and then

5

may assist the ambulance crew.

6

(3)  As a first aid or safety officer, or in a similar

7

capacity, for or independent of an EMS agency, as prescribed

8

by regulation of the department.

9

(4)  For an EMS agency in another capacity authorized by

10

regulation of the department.

11

(b)  Paramedic training.--To be eligible to enroll in a

12

paramedic training course required for certification as a

13

paramedic, an individual must satisfy all of the following:

14

(1)  Be at least 18 years of age when the course

15

commences.

16

(2)  Have a high school diploma or its equivalent.

17

(3)  Be currently certified by the department as an EMT

18

or advanced EMT.

19

(c)  Certification.--The department shall certify as a

20

paramedic an EMT or advanced EMT who meets all of the following:

21

(1)  Is at least 18 years of age.

22

(2)  Has successfully completed a paramedic training

23

course which:

24

(i)  teaches basic life support skills;

25

(ii)  teaches advanced life support skills deemed

26

appropriate by regulation of the department; and

27

(iii)  is approved by the department.

28

(3)  Has a current certificate evidencing successful

29

completion of a CPR course acceptable to the department.

30

(4)  Has passed a paramedic skills practical examination

- 47 -

 


1

approved by the department.

2

(5)  Has passed a written paramedic certification

3

examination approved by the department.

4

(d)  Biennial registration.--A paramedic's certification is

5

deemed registered when the certification is issued. The initial

6

registration shall expire as set forth in section 7213(n)

7

(relating to emergency medical services providers). Except for

8

the initial registration period, a paramedic must register the

9

paramedic certification at two-year intervals by completing an

10

application for biennial registration on a form or through an

11

electronic process as prescribed by regulation of the

12

department. The following shall apply:

13

(1)  The department shall issue a biennial registration

14

of a paramedic certification to a paramedic who meets all of

15

the following:

16

(i)  Has a current registration and applies for a new

17

registration no later than:

18

(A)  30 days before the current registration is

19

to expire; or

20

(B)  a lesser time established by regulation of

21

the department.

22

(ii)  Successfully secures continuing education

23

credits for paramedic biennial registration as required

24

by the department in continuing education programs

25

approved by the department.

26

(2)  A paramedic whose registration of a paramedic

27

certification has expired must qualify for a biennial

28

registration of the certification as prescribed by regulation

29

of the department.

30

§ 7218.  Prehospital registered nurses.

- 48 -

 


1

(a)  Scope of practice.--A PHRN is a higher level EMS

2

provider than an advanced EMT. A PHRN performs for an EMS agency

3

basic and advanced EMS skills and, as authorized by the

4

department, additional nursing skills within the scope of

5

practice of a registered nurse under the act of May 22, 1951

6

(P.L.317, No.69), known as The Professional Nursing Law, or a

7

successor act, as follows:

8

(1)  As a member of the crew of an ambulance.

9

(2)  As a member of a QRS to stabilize and improve a

10

patient's condition in an out-of-hospital emergency until an

11

ambulance arrives at the scene and then may assist the

12

ambulance crew.

13

(3)  As a first aid or safety officer, or in a similar

14

capacity, as prescribed by regulation of the department.

15

(4)  In another capacity as authorized by regulation of

16

the department.

17

(b)  Certification.--The department shall certify as a PHRN

18

an individual who meets all of the following:

19

(1)  Has a current license as a registered nurse with the

20

State Board of Nursing.

21

(2)  Is at least 18 years of age.

22

(3)  Has a current certificate evidencing successful

23

completion of a CPR course acceptable to the department.

24

(4)  Has passed a PHRN skills practical examination

25

approved by the department.

26

(5)  Has passed a written PHRN certification examination

27

approved by the department.

28

(c)  Biennial registration.--A PHRN's certification is deemed

29

registered when the certification is issued. The initial

30

registration shall expire as set forth in section 7213(n)

- 49 -

 


1

(relating to emergency medical services providers). Except for

2

the initial registration period, a PHRN must register the PHRN

3

certification at two-year intervals by completing an application

4

for biennial registration on a form or through an electronic

5

process, as prescribed by regulation of the department. The

6

following shall apply:

7

(1)  The department shall issue a biennial registration

8

of a PHRN certification to a PHRN who meets all of the

9

following:

10

(i)  Has a current registration and applies for a new

11

registration no later than:

12

(A)  30 days before the current registration is

13

to expire; or

14

(B)  a lesser time established by regulation of

15

the department.

16

(ii)  Has current registration of a registered nurse

17

license.

18

(iii)  Successfully secures continuing education

19

credits for a PHRN biennial registration as required by

20

the department, in continuing education programs approved

21

by the department.

22

(2)  A PHRN whose registration of a PHRN certification

23

has expired must qualify for a biennial registration of the

24

certification as prescribed by regulation of the department.

25

§ 7219.  Prehospital physician extenders.

26

(a)  Scope of practice.--A PHPE is a higher level EMS

27

provider than an advanced EMT. A PHPE performs for an EMS agency

28

basic and advanced EMS skills and, as authorized by regulation

29

of the department, additional physician assistant skills within

30

the scope of practice of a physician assistant under the act of

- 50 -

 


1

December 20, 1985 (P.L.457, No.112), known as the Medical

2

Practice Act of 1985, or the act of October 5, 1978 (P.L.1109,

3

No.261), known as the Osteopathic Medical Practice Act, or a

4

successor act, as follows, but supervision of a PHPE shall be

5

conducted as set forth in this chapter:

6

(1)  As a member of the crew of an ambulance.

7

(2)  As a member of a QRS to stabilize and improve a

8

patient's condition in an out-of-hospital emergency until an

9

ambulance arrives at the scene and then may assist the

10

ambulance crew.

11

(3)  As a first aid or safety officer, or in a similar

12

capacity, for an EMS agency as prescribed by regulation of

13

the department.

14

(4)  In another capacity as authorized by regulation of

15

the department.

16

(b)  Certification.--The department shall certify as a PHPE a

17

physician assistant who meets all of the following:

18

(1)  Has a currently registered license as a physician

19

assistant with the State Board of Medicine or the State Board

20

of Osteopathic Medicine.

21

(2)  Is at least 18 years of age.

22

(3)  Has a current certificate evidencing successful

23

completion of a CPR course acceptable to the department.

24

(4)  Has passed a PHPE skills practical examination

25

approved by the department.

26

(5)  Has passed a written PHPE certification examination

27

approved by the department.

28

(c)  Biennial registration.--A PHPE's certification is deemed

29

registered when the certification is issued. The initial

30

registration shall expire as set forth in section 7213(n)

- 51 -

 


1

(relating to emergency medical services providers). Except for

2

the initial registration period, a PHPE must register the PHPE

3

certification at two-year intervals by completing an application

4

for biennial registration on a form or through an electronic

5

process as prescribed by regulation of the department. The

6

following shall apply:

7

(1)  The department shall issue a biennial registration

8

of a PHPE certification to a PHPE who:

9

(i)  Has a current registration and applies for a new

10

registration no later than:

11

(A)  30 days before the current registration is

12

to expire; or

13

(B)  a lesser time as established by regulation

14

of the department.

15

(ii)  Has current registration of a physician

16

assistant license.

17

(iii)  Successfully secures continuing education

18

credits for PHPE biennial registration as required by the

19

department in continuing education programs approved by

20

the department.

21

(2)  A PHPE whose registration of a PHPE certification

22

has expired must qualify for a biennial registration of the

23

certification as prescribed by regulation of the department.

24

§ 7220.  Prehospital emergency medical services physicians.

25

(a)  Scope of practice.--A prehospital EMS physician is a

26

higher level EMS provider than an advanced EMT. A prehospital

27

EMS physician performs for an EMS agency basic and advanced EMS

28

skills within the scope of practice of a physician under the act

29

of December 20, 1985 (P.L.457, No.112), known as the Medical

30

Practice Act of 1985, or the act of October 5, 1978 (P.L.1109,

- 52 -

 


1

No.261), known as the Osteopathic Medical Practice Act, as

2

applicable, or a successor act, as follows:

3

(1)  As a member of the crew of an ambulance.

4

(2)  As a member of a QRS to stabilize and improve a

5

patient's condition in an out-of-hospital emergency.

6

(3)  As a first-aid or safety officer, or in a similar

7

capacity, as prescribed by regulation of the department.

8

(4)  In another capacity authorized by regulation of the

9

department.

10

(b)  Certification.--The department shall certify as a

11

prehospital EMS physician a physician who has:

12

(1)  Successfully completed one or more of the following:

13

(i)  An emergency medicine residency program that is

14

accredited by a residency program accrediting body

15

recognized by the State Board of Medicine or the State

16

Board of Osteopathic Medicine.

17

(ii)  The first year of an emergency medicine

18

residency program that satisfies the requirements of

19

subparagraph (i) and has successfully completed programs

20

approved by the department in advanced cardiac life

21

support, advanced trauma life support and advanced

22

pediatric life support.

23

(iii)  An anesthesia, family practice, internal

24

medicine or general surgery residency program that is

25

accepted by either the State Board of Medicine or the

26

State Board of Osteopathic Medicine as providing the

27

graduate medical training the board requires for issuance

28

of a physician license without restriction and the

29

successful completion of programs approved by the

30

department in advanced cardiac life support, advanced

- 53 -

 


1

trauma life support and advanced pediatric life support.

2

(2)  A current certificate evidencing successful

3

completion of a CPR course acceptable to the department.

4

(3)  Passed an EMS skills practical examination approved

5

by the department or served as a prehospital health

6

professional physician prior to the effective date of this

7

section.

8

(c)  Biennial registration.--A prehospital EMS physician's

9

certification is deemed registered when the certification is

10

issued. The initial registration shall expire under section

11

7213(n) (relating to emergency medical services providers).

12

Except for the initial registration period, a prehospital EMS

13

physician shall register the prehospital EMS physician

14

certification at two-year intervals by completing an application

15

for biennial registration on a form or through an electronic

16

process as prescribed by the department. The following shall

17

apply:

18

(1)  The department shall issue a biennial registration

19

of a prehospital EMS physician certification to a prehospital

20

EMS physician who meets all of the following:

21

(i)  Has a current registration and applies for a new

22

registration no later than 30 days before the current

23

registration is to expire or within a lesser time period

24

as the department may establish by regulation.

25

(ii)  Has current registration of a physician

26

license.

27

(iii)  Successfully secures continuing education

28

credits for prehospital EMS physician biennial

29

registration as required by the department in continuing

30

education programs approved by the department.

- 54 -

 


1

(2)  A prehospital EMS physician whose registration of a

2

prehospital EMS physician certification has expired shall

3

qualify for a biennial registration of the certification as

4

prescribed by regulation of the department.

5

(d)  Transition for prehospital health professional

6

physicians.--A physician who served as a prehospital health

7

professional physician prior to the effective date of this

8

section and who satisfies the certification requirements under

9

subsection (b)(1) may serve as a prehospital EMS physician for

10

90 days after the effective date of this section without having

11

secured a certification as a prehospital EMS physician.

12

§ 7221.  Certification sanctions.

13

(a)  Grounds for discipline.--The department may discipline

14

an EMS provider or applicant for EMS provider certification for

15

any of the following reasons:

16

(1)  Lack of physical or mental ability to provide

17

adequate services.

18

(2)  Deceptive or fraudulent procurement or

19

representation of certification or registration credentials,

20

or for making misleading, deceptive or untrue representations

21

to secure or aid or abet another person to secure a

22

certification, license, registration or any other

23

authorization issued by the department under this chapter.

24

(3)  Willful or negligent misconduct in providing EMS or

25

practicing beyond the scope of certification authorization

26

without legal authority to do so.

27

(4)  Abuse or abandonment of a patient.

28

(5)  The rendering of services while under the influence

29

of alcohol, illegal drugs or the knowing abuse of legal

30

drugs.

- 55 -

 


1

(6)  The operation of an emergency vehicle in a reckless

2

manner or while under the influence of alcohol, illegal drugs

3

or the knowing abuse of legal drugs.

4

(7)  Disclosure of medical or other information about a

5

patient where prohibited by Federal or State law.

6

(8)  Willful preparation or filing of a false medical

7

report or record or the inducement of others to do so.

8

(9)  Destruction of a medical report or record required

9

to be maintained.

10

(10)  Refusal to render emergency medical care because of

11

a patient's race, sex, creed, national origin, sexual

12

preference, age, handicap, medical problem or financial

13

inability to pay.

14

(11)  Failure to comply with department-approved

15

protocols.

16

(12)  Failure to comply with reporting requirements

17

imposed under this chapter or as established by the

18

department.

19

(13)  Practicing without the current registration of a

20

certification.

21

(14)  Conviction of a felony, a crime related to the

22

practice of the EMS provider or a crime involving moral

23

turpitude. For the purposes of this paragraph, a conviction

24

includes a judgment of guilt, a plea of guilty or a plea of

25

nolo contendere.

26

(15)  Willful falsification of or a failure to complete

27

details on an EMS patient care report.

28

(16)  Misappropriation of drugs or EMS agency property.

29

(17)  Having a certification or other authorization to

30

practice a profession or occupation revoked, suspended or

- 56 -

 


1

subjected to other disciplinary sanction.

2

(18)  Violating or aiding or abetting another person to

3

violate a duty imposed under this chapter, a regulation

4

promulgated under this chapter or an order of the department

5

previously entered in a disciplinary proceeding.

6

(19)  Based upon a finding of misconduct by the relevant

7

Federal or State agency, having been excluded from a Federal

8

or State health care program or having had equity or capital,

9

stock or profits of an entity equal to 5% or more of the

10

value of the property or assets of the entity when it was

11

excluded from a Federal or State health care program.

12

(20)  Any other reason as determined by the department

13

which poses a threat to the health and safety of the public.

14

(b)  Disciplinary options.--If the department is empowered to

15

take disciplinary action against an individual under this

16

section, the department may do one or more of the following:

17

(1)  Deny the application for certification.

18

(2)  Issue a public reprimand.

19

(3)  Revoke, suspend, limit or otherwise restrict the

20

certification.

21

(4)  Require the person to take refresher educational

22

courses.

23

(5)  Impose a civil money penalty not exceeding $1,000

24

for each incident in which the EMS provider engages in

25

conduct that constitutes a basis for discipline.

26

(6)  Stay enforcement of any suspension, revocation or

27

other discipline and place the individual on probation with

28

the right to vacate the probationary order for noncompliance.

29

(c)  Registration of certification.--The department shall not

30

deny a registration of an EMS provider certification without

- 57 -

 


1

giving the applicant prior notice of the reason for the denial

2

and providing an opportunity for a hearing.

3

(d)  Reinstatement.--A person whose certification has been

4

revoked may not apply for reinstatement of that certification. A

5

person may petition the department for allowance to apply for a

6

new certification five years from the effective date of the

7

revocation by filing with the department a petition that avers

8

facts to establish that the person has been rehabilitated to an

9

extent that issuing the person a certification would not be

10

detrimental to the public interest. The department may grant or

11

deny the petition, without conducting a hearing, if it accepts

12

as true all facts averred, other than the conclusory averments,

13

such as that the person has been rehabilitated. If the

14

department grants the person allowance to apply for a new

15

certification, the person shall repeat the training program and

16

the certification examinations for the level of certification

17

for which the person is applying and satisfy all other

18

requirements for the certification that exist at the time of

19

reapplication. If the department does not grant the person

20

allowance to apply for a new certification, the person may not

21

again petition the department for allowance to apply for a new

22

certification until another year from the date of denial.

23

§ 7222.  Emergency medical services vehicle operators.

24

(a)  Certification.--An EMS vehicle operator certification

25

shall be permanent, subject to disciplinary action under this

26

section. The department shall certify as an EMS vehicle operator

27

a person who meets all of the following:

28

(1)  Completes an application for an EMS vehicle operator

29

certification on a form or through an electronic application

30

process, as prescribed by the department.

- 58 -

 


1

(2)  Is at least 18 years of age.

2

(3)  Has a current license to operate the vehicle.

3

(4)  Is not addicted to alcohol or drugs.

4

(5)  Is free from physical or mental defect or disease

5

that may impair the person's ability to drive an EMS vehicle.

6

(6)  Has successfully completed an emergency vehicle

7

operator's course of instruction approved by the department.

8

(7)  Has not:

9

(i)  Been convicted within the last four years prior

10

to the date of application of driving under the influence

11

of alcohol or drugs.

12

(ii)  Within the last two years prior to the date of

13

application, been convicted of reckless driving or had a

14

driver's license suspended due to use of drugs or alcohol

15

or a moving traffic violation.

16

(8)  Has successfully completed an emergency vehicle

17

operator's course of instruction approved by the department

18

following a disqualification from certification under

19

paragraph (7), regardless of whether the person successfully

20

completed the course previously.

21

(b)  Registration.--An EMS vehicle operator, other than an

<--

22

EMS vehicle operator who operates a vehicle exclusively for a

23

QRS, shall register the EMS vehicle operator's certification. An

<--

24

EMS vehicle operator who operates an EMS vehicle exclusively for

25

a QRS shall have no registration requirements. Except as

26

otherwise provided in this subsection, an EMS vehicle operator's

27

certification shall be deemed registered for three years after

28

issuance. An EMS vehicle operator may not operate a ground EMS

29

vehicle unless the certification is currently registered. The

30

following shall apply:

- 59 -

 


1

(1)  The department shall issue a registration of an EMS

2

vehicle operator's certification to an EMS vehicle operator

3

who meets all of the following:

4

(i)  Completes an application for registration on a

5

form or through an electronic application process, as

6

prescribed by the department.

7

(ii)  Has a current registration and applies for a

8

new registration no later than 30 days before the current

9

registration is to expire, or within a lesser time period

10

as the department may establish by regulation.

11

(iii)  Has a current license to operate the vehicle.

12

(iv)  Successfully completes continuing education

13

credits for EMS vehicle operators as required by the

14

department in continuing education programs approved by

15

the department.

16

(2)  If a person who is issued an EMS vehicle operator's

17

certification also has an EMS provider's certification, the

18

registration of the EMS vehicle operator's certification

19

shall expire at the same time as the registration of the EMS

20

provider's certification. If the person does not maintain

21

current registration of the EMS provider's certification, the

22

registration of the EMS vehicle operator's certification

23

shall continue on the same renewal cycle. If an EMS vehicle

24

operator who is an EMS provider becomes certified as a

25

higher-level EMS provider, the registration of the EMS

26

vehicle operator's certification shall expire at the same

27

time as the registration of the higher-level EMS provider's

28

certification.

29

(3)  If an EMS provider's certification is subject to a

30

biennial registration cycle, the continuing education

- 60 -

 


1

requirements for the registration of the EMS vehicle

2

operator's certification following the initial registration

3

of the certification shall be prorated based upon the month

4

in which the EMS provider became certified, with any

5

fractional requirement rounded down.

6

(4)  An EMS vehicle operator whose registration of an EMS

7

vehicle operator's certification has expired shall qualify

8

for a biennial registration of the certification as

9

prescribed by regulation of the department.

10

(c)  Transition for EMS vehicle operators.--An individual who

11

served as an EMS vehicle operator prior to the effective date of

12

this section, and who satisfies the EMS vehicle operator's

13

certification requirements under subsection (a), may serve as an

14

EMS vehicle operator for 90 days after the effective date of

15

this section without having secured a certification as an EMS

16

vehicle operator.

17

(d)  Grounds for discipline.--The department may suspend or

18

revoke, or, as applicable, refuse to issue an EMS vehicle

19

operator's certification for any of the following reasons:

20

(1)  Lack of physical or mental ability to operate an EMS

21

vehicle.

22

(2)  Deceptive or fraudulent procurement or

23

representation of certification or registration credentials,

24

or making misleading, deceptive or untrue representations to

25

secure a certification or registration.

26

(3)  The operation of an emergency vehicle in a reckless

27

manner or while under the influence of alcohol, illegal drugs

28

or the knowing abuse of legal drugs.

29

(4)  Having a driver's license suspended due to use of

30

alcohol or drugs or a moving traffic violation.

- 61 -

 


1

(5)  Conviction of a felony or crime involving moral

2

turpitude. For the purposes of this paragraph, a conviction

3

includes a judgment of guilt, a plea of guilty or a plea of

4

nolo contendere.

5

(6)  Failing to perform a duty imposed upon an EMS

6

vehicle operator under this chapter or a related regulation.

7

(7)  Other reasons as determined by the department which

8

pose a threat to the health and safety of the public.

9

(e)  Suspension of certification.--If the department suspends

10

a certification, it may also impose conditions for the lifting

11

of the suspension, including requiring the person to

12

successfully repeat an emergency vehicle operator's course

13

approved by the department.

14

(f)  Reporting responsibilities and automatic suspension.--An

15

EMS vehicle operator shall report to the department within 30

16

days a suspension of that person's driver's license or a

17

conviction of reckless driving, a felony, a misdemeanor or any

18

other crime that is not a summary offense or equivalent. For a

19

conviction of driving under the influence of alcohol or drugs,

20

reckless driving or for suspension of a driver's license, the

21

certification shall automatically be suspended for the periods

22

of time specified in subsection (a)(7).

23

(g)  Change of address.--

24

(1)  An EMS vehicle operator and an applicant for an EMS

25

vehicle operator's certification shall ensure that the

26

department has the current address at which the person can be

27

reached by mail at all times.

28

(2)  Neither an EMS vehicle operator's home address,

29

telephone number nor any other residential contact

30

information provided to the department shall be deemed a

- 62 -

 


1

public record.

2

§ 7223.  Suspension of certification.

3

(a)  Temporary suspensions.--The department may temporarily

4

suspend the certification of an EMS provider or EMS vehicle

5

operator without a hearing if the department determines that the

6

person is a clear and immediate danger to the public health and

7

safety. Notice to a provider or operator of a temporary

8

suspension shall include a written statement of the underlying

9

factual allegations. After issuance of the notice, the

10

department shall commence formal disciplinary action against the

11

person under section 7221 (relating to certification sanctions)

12

or 7222 (relating to emergency medical services vehicle

13

operators). Within 30 days following the issuance of an order

14

temporarily suspending the certification, the department shall

15

conduct a preliminary hearing to determine if there is a prima

16

facie case supporting the temporary suspension. The person may

17

be present at the preliminary hearing and may be represented by

18

counsel, cross-examine witnesses, inspect physical evidence,

19

call witnesses and offer testimony and other evidence. If the

20

department determines that there is not a prima facie case, the

21

suspension shall be lifted immediately. If the department

22

determines that there is a prima facie case, the temporary

23

suspension shall remain in effect until vacated by the

24

department, but not longer than 180 days unless agreed upon by

25

the parties.

26

(b)  Automatic suspensions.--The department shall

27

automatically suspend a certification issued under this chapter

28

upon receiving a certified copy of court records establishing

29

that the person has been adjudicated as incapacitated under 20

30

Pa.C.S. § 5511 (relating to petition and hearing; independent

- 63 -

 


1

evaluation) or an equivalent statutory provision. The department

2

shall lift the suspension upon the person establishing to the

3

department that the person has been adjudicated to have regained

4

capacity under 20 Pa.C.S. § 5517 (relating to adjudication of

5

capacity and modification of existing orders) or an equivalent

6

statutory provision.

7

§ 7224.  Emergency medical services instructors.

8

(a)  Certification.--An EMS instructor's certification is

9

permanently subject to disciplinary action under this section.

10

The department shall certify as an EMS instructor a person who:

11

(1)  Completes an application for an EMS instructor's

12

certification on a form or through an electronic application

13

process, as prescribed by the department.

14

(2)  Is at least 18 years of age.

15

(3)  Has successfully completed an EMS instructor's

16

course approved by the department, or possesses a bachelor's

17

degree in education, a teacher's certification in education

18

or a doctorate or master's degree.

19

(4)  Is certified and currently registered as an EMT or

20

higher-level EMS provider.

21

(5)  Possesses current certification in a CPR course

22

acceptable to the department or current certification as a

23

CPR instructor.

24

(6)  Has at least one year's experience working as an EMT

25

or higher-level EMS provider.

26

(7)  Has provided at least 20 hours of monitored

27

instruction time in an EMS provider's certification program.

28

(b)  Triennial registration.--

29

(1)  An EMS instructor's certification is deemed

30

registered for three years after issuance. An EMS instructor

- 64 -

 


1

shall register the EMS instructor's certification at three-

2

year intervals by completing an application for triennial

3

registration on a form or through an electronic process, as

4

prescribed by the department. An EMS instructor may not teach

5

in an accredited EMS institute, pursuant to an EMS

6

instructor's certification, unless the certification is

7

currently registered. The department shall issue a triennial

8

registration of an EMS instructor's certification to an EMS

9

instructor who:

10

(i)  Has completed an application for triennial

11

registration on a form or through an electronic

12

application process, as prescribed by the department.

13

(ii)  Has a current registration and applies for a

14

new registration no later than 30 days before the current

15

registration is to expire, or within lesser time as the

16

department may establish by regulation.

17

(iii)  Has taught at least 60 hours of EMS provider's

18

certification or rescue courses approved by the

19

department during the previous three years.

20

(iv)  Is certified and currently registered as an EMT

21

or higher-level EMS provider.

22

(v)  Possesses current certification in a CPR course

23

acceptable to the department or current certification as

24

a CPR instructor.

25

(2)  An EMS instructor whose registration as an EMS

26

instructor's certification has expired shall qualify for a

27

triennial registration of the certification as prescribed by

28

regulation of the department.

29

(c)  Regulations.--The department may adopt regulations to

30

set standards for EMS instructors in providing instruction in

- 65 -

 


1

EMS institutions.

2

(d)  Grounds for discipline.--The department may impose

3

discipline against an EMS instructor for the following reasons:

4

(1)  Any reason an EMS provider may be disciplined under

5

section 7221 (relating to certification sanctions).

6

(2)  Providing instruction while under the influence of

7

alcohol, illegal drugs or the knowing abuse of legal drugs.

8

(3)  Failing to perform a duty imposed upon an EMS

9

instructor by this chapter or a related regulation.

10

(4)  Other reasons as determined by the department that

11

pose a threat to the health, safety or welfare of students.

12

(e)  Disciplinary options.--If the department is empowered to

13

impose discipline against an individual under this section, the

14

department may do one or more of the following:

15

(1)  Deny the application for certification.

16

(2)  Issue a public reprimand.

17

(3)  Revoke, suspend, limit or otherwise restrict the

18

certification.

19

(4)  Impose a civil money penalty not exceeding $1,000

20

for each incident in which the EMS instructor engages in

21

conduct 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

(f)  Construction.--This section shall not be construed to

26

require the certification as EMS instructors of all instructors

27

of EMS courses accepted toward educational requirements for EMS

28

provider's certification or toward continuing education

29

requirements for the registration of EMS provider's

30

certifications.

- 66 -

 


1

§ 7225.  Medical director of emergency medical services agency.

2

(a)  Qualifications.--To qualify and continue to function as

3

an EMS agency medical director, an individual shall:

4

(1)  Be a physician.

5

(2)  Satisfy one of the following:

6

(i)  Have successfully completed an emergency

7

medicine residency program accredited by a residency

8

program accrediting body recognized by the State Board of

9

Medicine or the State Board of Osteopathic Medicine.

10

(ii)  Have successfully completed a residency program

11

in surgery, internal medicine, family medicine,

12

pediatrics or anesthesiology, accredited by a residency

13

program accrediting body recognized by the State Board of

14

Medicine or the State Board of Osteopathic Medicine. The

15

physician shall also have successfully completed or

16

taught an advanced cardiac life support course acceptable

17

to the department within the preceding two years and have

18

completed, at least once, an advanced trauma life support

19

course acceptable to the department and an advanced

20

pediatric life support course acceptable to the

21

department, or other programs determined by the

22

department to meet or exceed the standards of these

23

programs.

24

(iii)  Have served as an advanced life support

25

service medical director under the act of July 3, 1985

26

(P.L.164, No.45), known as the Emergency Medical Services

27

Act, prior to the effective date of this chapter.

28

(3)  Have a valid Drug Enforcement Agency number.

29

(4)  Have completed the EMS agency medical director's

30

course, an EMS fellowship or other EMS training program that

- 67 -

 


1

is determined by the department to be equivalent. This

2

training shall assure that the EMS agency medical director

3

has knowledge of:

4

(i)  The scope of practice of EMS providers.

5

(ii)  The provision of EMS pursuant to department-

6

approved protocols.

7

(iii)  The interface between EMS providers and

8

medical command physicians.

9

(iv)  Quality improvement principles.

10

(v)  Emergency medical dispatch principles and EMS

11

agency communication capabilities.

12

(vi)  EMS system design and operation.

13

(vii)  Federal and State laws and regulations

14

regarding EMS.

15

(viii)  Regional and State mass casualty and disaster

16

plans.

17

(b)  Roles and responsibilities.--An EMS agency medical

18

director is responsible for the following:

19

(1)  Reviewing department-approved EMS protocols that are

20

applicable to the EMS agency and ensuring that its EMS

21

providers and other relevant personnel are familiar with the

22

protocols applicable to them.

23

(2)  Conducting for and reporting to the EMS agency the

24

following:

25

(i)  An initial assessment of an EMS provider at or

26

above the advanced EMT level to determine whether the EMS

27

provider has demonstrated competency in the knowledge and

28

skills one must have to competently perform the skills

29

within the scope of practice of the EMS provider at that

30

level, and a commitment to adequately perform other

- 68 -

 


1

functions relevant to the EMS provider providing EMS at

2

that level. This subparagraph does not apply if the EMS

3

provider was working for the EMS agency at the same level

4

prior to the physician becoming the medical director for

5

the EMS agency and the EMS provider was credentialed at

6

that EMS agency within the last year as being able to

7

perform at the EMS provider's certification level.

8

(ii)  At least annually, an assessment of each EMS

9

provider at or above the advanced EMT level as to whether

10

the EMS provider has demonstrated competency in the

11

knowledge and skills an EMS provider must have to

12

competently perform the skills within the scope of

13

practice of the EMS provider at that level, and a

14

commitment to adequately perform other functions relevant

15

to the EMS provider providing EMS at that level.

16

(3)  Participating in and reviewing quality improvement

17

reviews of patient care provided by the EMS agency and

18

participating in the Statewide and regional quality

19

improvement program.

20

(4)  Providing medical guidance and advice to the EMS

21

agency.

22

(5)  Providing guidance with respect to the ordering,

23

stocking and replacement of drugs, and compliance with laws

24

and regulations impacting upon the EMS agency's acquisition,

25

storage and use of those drugs.

26

(6)  Maintaining a liaison with the regional EMS medical

27

director.

28

(7)  Recommending to the department suspension,

29

revocation or restriction of EMS provider's certifications.

30

(8)  Reviewing regional mass casualty and disaster plans.

- 69 -

 


1

(9)  Performing other functions as the department may

2

impose by regulation.

3

§ 7226.  Medical command physicians and facility medical

4

directors.

5

(a)  Role of medical command physician.--A medical command

6

physician communicates with and issues medical command orders to

7

EMS providers when they seek direction. A medical command

8

physician shall have an arrangement with a medical command

9

facility to provide medical command on its behalf, and shall

10

function under the direction of a medical command facility

11

medical director and under the policies and procedures of the

12

medical command facility. A medical command physician shall

13

provide medical command to EMS providers consistent with

14

Statewide protocols and protocols that are in effect in either

15

the region in which treatment originates or the region from

16

which the EMS providers begin receiving medical command from a

17

medical command physician. For good cause, a medical command

18

physician may give medical command orders that are inconsistent

19

with these protocols.

20

(b)  Certification.--The department shall certify as a

21

medical command physician a physician who was approved as a

22

medical command physician in this Commonwealth immediately prior

23

to the effective date of this section. The department shall also

24

certify as a medical command physician a physician who:

25

(1)  Completes an application for medical command

26

physician certification on a form or through an electronic

27

application process, as prescribed by the department.

28

(2)  Satisfies one of the following:

29

(i)  Has successfully completed an emergency medicine

30

residency program accredited by a residency program

- 70 -

 


1

accrediting body recognized by the State Board of

2

Medicine or the State Board of Osteopathic Medicine.

3

(ii)  Has successfully completed or taught an

4

advanced cardiac life support course acceptable to the

5

department within the preceding two years and has

6

successfully completed or taught an advanced trauma life

7

support course acceptable to the department and an

8

advanced pediatric life support course acceptable to the

9

department, or other programs determined by the

10

department to meet or exceed the standards of these

11

programs.

12

(iii)  Has had an emergency medicine practice in

13

another jurisdiction and establishes to the department

14

that the physician has a combination of training,

15

education and emergency medicine practice that makes the

16

physician qualified to serve as a medical command

17

physician.

18

(3)  Has completed a medical command course offered or

19

approved by the department.

20

(4)  Is practicing as an emergency medicine physician or

21

is participating as a resident in a second or subsequent year

22

in an emergency medicine residency program or has had at

23

least three years' experience as a full-time emergency

24

medicine physician.

25

(5)  Has a current Drug Enforcement Agency number, except

26

for an emergency medicine resident who is authorized to use a

27

hospital's Drug Enforcement Agency number for practice within

28

the emergency medicine residency program.

29

(6)  Has an arrangement with a medical command facility

30

to serve as a medical command physician for that facility

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1

after receiving certification as a medical command physician.

2

(c)  Triennial registration.--A medical command physician's

3

certification is deemed registered for three years after

4

issuance. A medical command physician shall triennially register

5

the physician's certification with the department, on a form or

6

through an electronic application process, as prescribed by the

7

department, as a condition for continued practice as a medical

8

command physician. The department shall issue a triennial

9

registration of a medical command physician's certification to a

10

medical command physician within 30 days after the physician

11

applies for a new registration if the physician demonstrates

12

that the physician continues to meet the requirements for the

13

certification, except the requirements of subsection (b)(2), and

14

satisfies such other requirements as the department may impose

15

by regulation.

16

(d)  Residents.--A physician who is in a second year in an

17

emergency medicine residency program may issue medical command

18

orders only to the extent that performance of that function is a

19

component of and within the framework of the emergency medicine

20

residency program, and may do so only with supervision by a

21

medical command physician who has served as a medical command

22

physician for at least two years, has completed two years in an

23

emergency medicine residency program or has secured medical

24

command certification by satisfying subsection (b)(2)(iii).

25

(e)  Role of medical command facility medical director.--A

26

medical command facility medical director shall be responsible

27

for the following in a medical command facility:

28

(1)  Medical command.

29

(2)  Quality improvement.

30

(3)  Serving as a liaison with the regional EMS council

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1

medical director.

2

(4)  Participating in prehospital training activities.

3

(5)  Verifying to the department that a physician seeking

4

a medical command physician's certification, based upon the

5

physician's arrangement with the medical command facility,

6

meets all certification requirements.

7

(6)  Ensuring that the medical command facility satisfies

8

statutory and regulatory requirements.

9

(f)  Certification.--The department shall certify as a

10

medical command facility medical director a physician who was

11

approved as a medical command facility medical director in this

12

Commonwealth immediately prior to the effective date of this

13

section. The department shall also certify as a medical command

14

facility medical director a physician who:

15

(1)  Completes an application for medical command

16

facility medical director certification on a form or through

17

an electronic application process, as prescribed by the

18

department.

19

(2)  Is currently serving as a medical command physician.

20

(3)  Satisfies one of the following:

21

(i)  Has successfully completed a residency program

22

in emergency medicine accredited by a residency program

23

accrediting body recognized by the State Board of

24

Medicine or the State Board of Osteopathic Medicine.

25

(ii)  Has successfully:

26

(A)  completed a residency program in surgery,

27

internal medicine, family medicine, pediatrics or

28

anesthesiology accredited by a residency program

29

accrediting body recognized by the State Board of

30

Medicine or the State Board of Osteopathic Medicine;

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1

and

2

(B)  completed or taught:

3

(I)  an advanced cardiac life support course

4

acceptable to the department within the preceding

5

two years;

6

(II)  an advanced trauma life support course

7

acceptable to the department; and

8

(III)  an advanced pediatric life support

9

course acceptable to the department.

10

(4)  Has experience in prehospital and emergency

11

department care of acutely ill or injured patients.

12

(5)  Has experience in providing medical command

13

direction to EMS providers.

14

(6)  Has experience in the training of EMS providers both

15

below and above the advanced EMT level.

16

(7)  Has experience in the medical audit, review and

17

critique of EMS providers below and above the advanced EMT

18

level.

19

(8)  Has an arrangement with a medical command facility

20

to serve as its medical director after receiving

21

certification as a medical command facility medical director.

22

(g)  Triennial registration.--A medical command facility

23

medical director's certification is deemed registered for three

24

years after issuance. A medical command facility medical

25

director shall triennially register the physician's

26

certification with the department on a form or through an

27

electronic application process, as prescribed by the department,

28

as a condition for continued practice as a medical command

29

facility medical director. The department shall issue a

30

triennial registration of a medical command facility medical

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1

director certification to a medical command facility medical

2

director within 30 days after the physician applies for a new

3

registration, if the physician demonstrates that the physician

4

continues to meet the requirements for the certification, except

5

the requirements of subsection (f)(3), and satisfies such other

6

requirements as the department may impose by regulation.

7

(h)  Grounds for discipline.--The department may discipline a

8

medical command physician or medical command facility medical

9

director for the following reasons:

10

(1)  Violating a responsibility imposed on the physician

11

by this chapter or the related regulations.

12

(2)  Without good cause, failing to comply with a medical

13

treatment, transport or transfer protocol established or

14

approved by the department.

15

(i)  Types of discipline authorized.--When the department is

16

empowered to discipline a medical command physician or medical

17

command facility medical director under subsection (h), the

18

department may do one or more of the following:

19

(1)  Deny the application for a certification.

20

(2)  Issue a public reprimand.

21

(3)  Revoke, suspend, limit or otherwise restrict or

22

condition the certification.

23

(4)  Impose a civil money penalty not exceeding $1,000

24

for each incident in which the physician engages in conduct

25

that constitutes a basis for discipline.

26

(5)  Stay enforcement of any suspension, revocation or

27

other discipline and place the individual on probation with

28

the right to vacate the probationary order for noncompliance.

29

§ 7227.  Medical command facilities.

30

(a)  Certification required.--To operate as a medical command

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1

facility, a medical unit must be certified by the department as

2

a medical command facility. The department shall issue a

3

certification to each medical unit that operated as a medical

4

command facility immediately prior to the effective date of this

5

section.

6

(b)  Application.--Application for certification shall be on

7

a form or through an electronic application process prescribed

8

by the department. The application shall solicit information

9

necessary to determine that the applicant meets the

10

certification requirements of this chapter.

11

(c)  Requirements.--An applicant shall establish that the

12

applicant:

13

(1)  Is a distinct medical unit operated by a hospital or

14

consortium of hospitals.

15

(2)  Possesses the necessary equipment and personnel for

16

providing medical command to and control over EMS providers.

17

(3)  Employs a medical command facility medical director.

18

(4)  Has taken measures necessary to ensure that a

19

medical command physician is available to provide medical

20

command at all times.

21

(5)  Meets the communication, recordkeeping and other

22

requirements of the department.

23

(d)  Additional requirements.--In addition to the

24

requirements of subsection (c), the department may establish by

25

regulation requirements for a medical command facility to ensure

26

that it operates in an effective and efficient manner to achieve

27

the purposes for which it is certified.

28

(e)  Triennial registration.--A medical command facility's

29

certification is deemed registered for three years after

30

issuance. A medical command facility must register its

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1

certification at three-year intervals by completing an

2

application for triennial registration on a form or through an

3

electronic application process prescribed by the department. The

4

department shall grant or deny recertification within 30 days of

5

receipt of the application.

6

(f)  Inspections and inquiries.--The department shall conduct

7

an inspection of the medical unit of each applicant and also

8

inspect existing medical command facilities from time to time as

9

appropriate, but not less than once every three years. The

10

department shall have full and free access to examine the

11

medical command facility and its records relating to its

12

operation as a medical command facility. The medical command

13

facility shall fully respond to any inquiry by the department

14

relevant to the determination of whether the facility meets

15

certification and operational requirements.

16

(g)  Grounds for discipline.--The department may discipline a

17

medical command facility for the following reasons:

18

(1)  Violating a requirement of this section.

19

(2)  Violating a certification requirement or an

20

operational requirement imposed under subsection (d).

21

(3)  Refusing to permit an inspection or respond to an

22

inquiry under subsection (f).

23

(4)  Failing to comply, without just cause, with a

24

medical treatment, transport or transfer protocol approved by

25

the department.

26

(h)  Types of discipline.--When the department is empowered

27

to discipline a medical command facility, the department may do

28

one or more of the following:

29

(1)  Deny the application for a certification.

30

(2)  Issue a public reprimand.

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1

(3)  Revoke, suspend, limit or otherwise restrict or

2

condition the certification.

3

(4)  Impose a civil money penalty of up to $5,000 for

4

each act that presents a basis for discipline.

5

(5)  Stay enforcement of any suspension, revocation or

6

other discipline and place the facility on probation with the

7

right to vacate the probationary order for noncompliance.

8

§ 7228.  Receiving facilities.

9

(a)  Purpose.--A receiving facility is a facility to which an

10

ambulance may transport a patient who requires prompt medical

11

care in addition to that provided by the ambulance crew after

12

the crew responds to an emergency.

13

(b)  Requirements.--A receiving facility shall include, but

14

need not be limited to, a fixed location having an organized

15

emergency department, including a physician trained to manage

16

cardiac, trauma, pediatric, medical, behavioral and all-hazards

17

emergencies, who is present in the facility and available to the

18

emergency department 24 hours per day and seven days per week.

19

By regulation, the department may authorize other types of

20

facilities to serve as receiving facilities for purposes of

21

serving patients who have special medical needs.

22

(c)  Patient transports.--Unless directed otherwise by a

23

medical command physician, the initial transport of a patient

24

following an ambulance response to a reported emergency shall be

25

to a receiving facility pursuant to a protocol under section

26

7205(c) (relating to duties of department) or 7209(c)(8)

27

(relating to regional emergency medical services councils) or

28

such other location as the department designated by protocol.

29

§ 7229.  Emergency medical services agencies.

30

(a)  License required.--A person may not, as an owner, agent

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1

or otherwise, operate, conduct, maintain, advertise or otherwise

2

engage in or profess to be engaged in operating or providing an

3

ambulance, advanced life support squad vehicle, basic life

4

support squad vehicle, quick response service, special

5

operations EMS service or other vehicle or service as prescribed

6

by the department by regulation to provide EMS outside a health

7

care facility or on roadways, airways or waterways of this

8

Commonwealth unless the person holds a current EMS agency

9

license authorizing the particular service or operation.

10

(b)  Application.--An application for an EMS agency license

11

shall be submitted on a form or through an electronic

12

application process prescribed by the department.

13

(c)  Issuance of license.--The department shall issue a

14

license to an applicant when it is satisfied that:

15

(1)  The applicant and persons having substantial

16

ownership interests in the applicant are responsible persons

17

and the EMS agency will be staffed by and conduct its

18

activities utilizing responsible persons. For purposes of

19

this paragraph:

20

(i)  a responsible person is a person who has not

21

engaged in any act contrary to justice, honesty or good

22

morals which indicates that the person is likely to

23

betray the public trust in carrying out the activities of

24

an EMS agency, or a person who has engaged in such

25

conduct but has been rehabilitated and establishes that

26

he or she is not likely to again betray the public trust;

27

(ii)  a person has a substantial ownership interest

28

if the person has equity in the capital, stock or the

29

profits of the EMS agency equal to 5% or more of the

30

value of the property or assets of the EMS agency; and

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1

(iii)  a person staffs an EMS agency if the person

2

engages in an activity integral to operation of the EMS

3

agency, including, but not limited to, making or

4

participating in the making or execution of management

5

decisions, providing EMS, billing, call-taking and

6

dispatching.

7

(2)  The applicant meets supply and equipment

8

requirements and each ambulance or other vehicle that will be

9

used in providing EMS is adequately constructed and equipped

10

and will be maintained and operated to safely and efficiently

11

render the services offered.

12

(3)  The applicant will meet the staffing standards for

13

its vehicles and services.

14

(4)  The applicant will provide safe and efficient

15

services that are adequate for the emergency medical care,

16

the treatment and comfort and, when appropriate, the

17

transportation of patients.

18

(5)  The applicant will have an EMS agency medical

19

director who, in addition to satisfying the criteria of

20

section 7225(a) (relating to medical director of emergency

21

medical services agency), satisfies other criteria the

22

department may establish by regulation based on the types of

23

vehicles and services the applicant intends to provide under

24

the EMS agency license.

25

(6)  The applicant is in compliance with the rules and

26

regulations promulgated under this chapter.

27

(d)  Persons under 18 years of age.--An EMS agency shall

28

ensure that a person under 18 years of age, when providing EMS

29

on behalf of the EMS agency, is directly supervised by an EMS

30

provider who is at least 21 years of age who has the same or

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1

higher level of EMS provider certification and at least one year

2

of active practice as an EMS provider.

3

(e)  Triennial registration.--An EMS agency's license is

4

deemed registered for three years after the issuance. An EMS

5

agency must register its license at three-year intervals by

6

completing an application on a form or through an electronic

7

application process prescribed by the department. The department

8

shall act on the application within 90 days of receipt of a

9

complete and accurate application. The department shall not deny

10

a registration of a license without giving the applicant prior

11

notice of the reason for denial and providing an opportunity for

12

a hearing.

13

(f)  Nontransferability of license.--An EMS agency may not

14

transfer its license. An EMS agency may enter into a contract

15

with another entity for that entity to manage the EMS agency if

16

that entity has been approved by the department to manage an EMS

17

agency. The department may deny approval to an entity to provide

18

management services for an EMS agency if:

19

(1)  the entity is not in compliance with this chapter or

20

applicable regulations;

21

(2)  the entity is not a responsible person as defined in

22

subsection (c)(1)(i);

23

(3)  a person having a substantial ownership interest in

24

the entity is not a responsible person;

25

(4)  the entity will not be staffed by or conduct its

26

activities through responsible persons; or

27

(5)  the entity refuses to provide the department with

28

records or information reasonably requested to enable the

29

department to make a determination.

30

(g)  Display.--As prescribed by department regulation, a

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1

current department-issued inspection sticker shall be displayed

2

on each ambulance, advanced life support squad vehicle, basic

3

life support squad vehicle and, as required by regulation, any

4

other EMS vehicle authorized by the department.

5

(h)  Inspection.--The department or its agent shall inspect

6

an applicant's vehicles, equipment and personnel qualifications

7

prior to granting an EMS agency license and shall inspect an EMS

8

agency from time to time, as deemed appropriate and necessary,

9

but not less than once every three years.

10

(i)  Dispatching.--

11

(1)  An EMS agency that operates a communications center

12

dispatching EMS resources shall use call-takers and

13

dispatchers who satisfy the requirements of the Pennsylvania

14

Emergency Management Agency under section 3(a)(6) of the act

15

of July 9, 1990 (P.L.340, No.78), known as the Public Safety

16

Emergency Telephone Act, and shall use an emergency medical

17

dispatch program approved by the department. An emergency

18

medical dispatch program is a system or program that enables

19

patients to be assessed and treated via telecommunication by

20

using accepted medical dispatch standards.

21

(2)  Operation by an EMS agency of a communications

22

center that dispatches EMS resources shall be considered part

23

of the EMS agency's licensed operation and shall be subject

24

to the requirements of this chapter and the department's

25

regulations.

26

(j)  Construction, equipment and supplies.--Within two years

27

after the effective date of this chapter, the department shall

28

publish in the Pennsylvania Bulletin, and update as necessary,

29

vehicle construction and equipment and supply requirements for

30

EMS agencies in this Commonwealth based upon the types of EMS

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1

vehicles operated and the services provided.

2

(k)  Implementation of credentialing decisions.--An EMS

3

agency may not permit an EMS provider at or above the advanced

4

EMT level to provide EMS at that level unless its EMS agency

5

medical director apprises that the EMS provider satisfies the

6

criteria of section 7225(b)(2). An EMS agency may permit an EMS

7

provider who does not satisfy the section 7225(b)(2) criteria to

8

continue to work for the EMS agency at a lower EMS provider

9

level if the EMS provider is authorized to do so by the EMS

10

agency medical director. The EMS agency shall notify the

11

department of that decision within ten days after it is made. If

12

the EMS agency medical director has determined that the EMS

13

provider has not demonstrated competency in the knowledge and

14

skills necessary to competently perform the skills within the

15

scope of practice of the EMS provider at that level or has not

16

demonstrated a commitment to adequately perform other functions

17

relevant to the EMS provider providing EMS at that level, and

18

the EMS agency medical director chooses to impose restrictions

19

on the EMS provider's practice, such as requiring the EMS

20

provider to function under the supervision of another EMS

21

provider or requiring the EMS provider to contact a medical

22

command physician prior to providing EMS, then the EMS agency

23

may permit the EMS provider to provide EMS only with the

24

restrictions directed by the EMS agency medical director.

25

(l)  Staffing.--The department may by regulation revise the

26

staffing standards for ambulances, squad vehicles and quick

27

response services set forth in sections 7230 (relating to

28

advanced life support ambulances), 7231 (relating to air

29

ambulances), 7232 (relating to advanced life support squad

30

vehicles), 7233 (relating to basic life support ambulances),

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1

7234 (relating to basic life support squad vehicles) and 7235

2

(relating to quick response services).

3

(m)  Custody or control of patient.--If a law enforcement

4

officer is at the scene of a police incident when an EMS

5

provider arrives, the law enforcement officer may preclude the

6

EMS provider from entering the scene to provide EMS until the

7

law enforcement officer determines that it is safe for the EMS

8

provider to enter. Under such circumstances, the law enforcement

9

officer shall permit the EMS provider access to the patient

10

before the officer transports the patient. If, pursuant to a

11

medical treatment protocol or medical command order, an EMS

12

agency is required to transport to a receiving facility a

13

patient whom a law enforcement officer has taken or wants to

14

take into custody or whom the law enforcement officer believes

15

needs to be spoken with immediately, the EMS agency shall

16

transport the patient to a receiving facility and the law

17

enforcement officer shall have discretion to accompany the

18

patient in the EMS vehicle and authority to employ security

19

precautions deemed necessary by the law enforcement officer to

20

ensure the safety of the officer and others, except that the

21

security precautions shall not unreasonably interfere with the

22

provision of EMS to the patient.

23

(n)  Cessation of operations.--Upon suspension or revocation

24

of a license, the EMS agency shall cease operations and no

25

person shall permit or cause the EMS agency to continue.

26

(o)  Discontinuance or reduction of service.--An EMS agency

27

shall not discontinue providing service it is licensed to

28

provide or reduce the hours when it provides service until a

29

minimum of 90 days after notifying the department in writing of

30

the change. Notice shall include a statement that the licensee

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1

has notified the chief executive officer of each political

2

subdivision in the licensee's service area of the intent to

3

discontinue providing the service or reduce the hours it

4

provides the service and that the intent to discontinue or

5

reduce hours has been advertised in a newspaper of general

6

circulation in the licensee's service area.

7

(p)  Regulations.--The department shall promulgate

8

regulations setting forth requirements for EMS agencies in this

9

Commonwealth based upon the types of EMS vehicles they operate

10

and the services they provide.

11

(q)  Transition for ambulance services and quick response

12

services.--Upon the effective date of this section, an entity

13

that is licensed as an ambulance service or recognized as a QRS

14

immediately prior to the effective date of this section may

15

continue to operate as an EMS agency if it meets the staffing

16

and other operational requirements of this chapter, and it shall

17

be considered to be an EMS agency with a current registration of

18

its license. The initial registration of the EMS agency's

19

license shall expire on the same date that the entity's license

20

as an ambulance service or recognition as a QRS would have

21

expired if it had remained in effect.

22

(r)  Exemptions.--The following are exempt from the licensing

23

provisions of this chapter:

24

(1)  Privately owned vehicles not ordinarily used to

25

transport patients.

26

(2)  An EMS agency licensed in another state and not

27

under this chapter that is dispatched to respond to an

28

emergency within this Commonwealth when an EMS vehicle or

29

service licensed under this chapter is unable to respond

30

within a reasonable time or its response is not sufficient to

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1

deal with the emergency.

2

(3)  An EMS agency licensed in another state that limits

3

its operations in this Commonwealth to the transportation,

4

and provision of medical care incidental to transportation of

5

patients and other persons requiring transportation by EMS

6

vehicles from locations outside this Commonwealth to

7

locations within this Commonwealth.

8

(4)  EMS vehicles owned and operated by an agency of the

9

Federal Government.

10

§ 7230.  Advanced life support ambulances.

11

(a)  Purpose.--An ALS ambulance crew provides medical

12

assessment, triage, monitoring, treatment, transportation and

13

observation of patients who require EMS above the skill level of

14

an advanced EMT.

15

(b)  Staffing requirements.--

16

(1)  Except as otherwise provided in this section,

17

minimum staffing requirements for an ALS ambulance when

18

responding to a call to provide EMS for a patient requiring

19

EMS above the skill level of an advanced EMT is one EMS

20

provider at or above the EMT level, one EMS provider above

21

the advanced EMT level and one EMS vehicle operator. Only the

22

two EMS providers need to respond if one of them is also the

23

EMS vehicle operator. When present, an EMS provider qualified

24

to provide the type and level of EMS required by the patient

25

must attend to the patient at the scene and during

26

transportation. If a member of the ambulance crew arrives at

27

the scene before another crew member, that person shall begin

28

providing EMS to the patient at that person's skill level.

29

(2)  Minimum staffing requirements for an ALS ambulance

30

is the same as for a BLS ambulance when the ALS ambulance

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1

responds to a call to provide EMS for a patient requiring EMS

2

at or below the skill level of an advanced EMT.

3

§ 7231.  Air ambulances.

4

(a)  Purpose.--An air ambulance is a rotorcraft staffed by a

5

crew that provides medical assessment, treatment, monitoring,

6

observation and transportation of patients who require EMS where

7

time to administer definitive care is of the essence and

8

transportation by air ambulance to a facility able to provide

9

the care is faster than transportation by ground ambulance, or

10

require EMS provided by specialized equipment or providers not

11

available on a ground ambulance and the air ambulance can

12

provide this faster than the patient would receive such care at

13

a receiving facility if transported by ground ambulance.

14

(b)  Staffing requirements.--Minimum staffing standards for

15

an air ambulance when dispatched to provide or when providing

16

medical assessment, treatment, monitoring, observation or

17

transportation of a patient is one pilot and two EMS providers

18

other than the pilot who are above the advanced EMT level, with

19

at least one of those two EMS providers specially trained in air

20

medical transport.

21

§ 7232.  Advanced life support squad vehicles.

22

(a)  Purpose.--An ALS squad vehicle transports EMS providers

23

above the advanced EMT level, along with equipment and supplies,

24

to rendezvous with an ambulance crew or to respond prior to

25

arrival of an ambulance, in order to provide medical assessment,

26

monitoring, treatment and observation of a patient who requires

27

EMS at or above the skill level of an advanced EMT. An ALS squad

28

vehicle does not transport patients.

29

(b)  Staffing requirements.--Minimum staffing for an ALS

30

squad unit responding to a call to provide EMS for a patient who

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1

requires EMS above the skill level of an advanced EMT shall be

2

one EMS provider above the advanced EMT level and one EMS

3

vehicle operator, except that the EMS provider may staff the

4

vehicle alone if the EMS provider is also an EMS vehicle

5

operator.

6

§ 7233.  Basic life support ambulances.

7

(a)  Purpose.--A BLS ambulance crew provides medical

8

assessment, triage, monitoring, treatment, transportation and

9

observation of patients who require EMS at or below the skill

10

level of an advanced EMT and also transports patients who

11

require EMS above the skill level of an advanced EMT when an EMS

12

provider above the level of an advanced EMT rendezvous with the

13

BLS ambulance before or during transport of the patient and

14

accompanies the patient during the transport after arrival.

15

(b)  Staffing requirements.--

16

(1)  Except as provided under paragraph (2), minimum

17

staffing for a BLS ambulance when responding to a call to

18

provide EMS is an ambulance attendant, EMR or EMT, a second

19

EMS provider at or above the EMT level, and an EMS vehicle

20

operator, except that only the two EMS providers need to

21

respond if one of them is also the EMS vehicle operator. When

22

present, an EMS provider above the EMR level must attend to

23

the patient at the scene and during patient transportation.

24

(2)  Two years after the effective date of this section,

25

the minimum staffing for a BLS ambulance when responding to a

26

call to provide EMS is an EMS provider at or above the EMR

27

level, an EMS provider at or above the EMT level, and an EMS

28

vehicle operator, except that only two EMS providers need to

29

respond if one of them is also the EMS vehicle operator. When

30

present, an EMS provider above the EMR level must attend to

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1

the patient at the scene and during patient transportation.

2

(3)  If dispatched to provide EMS for a patient who

3

requires EMS above the skill level of an advanced EMT, the

4

BLS ambulance shall respond as set forth in this subsection.

5

If the BLS ambulance crew members arrive at the scene before

6

a higher-level EMS provider of an ALS ambulance or ALS squad

7

vehicle, the BLS crew members shall provide EMS to the

8

patient at their skill level, including transportation of the

9

patient to a receiving facility if needed, until higher-level

10

EMS is afforded by the arrival of a higher-level EMS

11

provider, after which the BLS ambulance crew shall relinquish

12

primary responsibility for the patient to the higher-level

13

EMS provider.

14

(4)  When transporting from a sending hospital a patient

15

who requires EMS above the skill level of an advanced EMT, if

16

a registered nurse, physician assistant or physician from the

17

sending or receiving hospital joins the ambulance crew,

18

brings on board the ambulance all equipment and supplies to

19

provide the patient with reasonably anticipated EMS above the

20

skill level of an advanced EMT and attends to the patient

21

during the patient transportation, the minimum staffing

22

requirements for the BLS ambulance are as set forth in

23

paragraphs (1) and (2).

24

§ 7234.  Basic life support squad vehicles.

25

(a)  Purpose.--A BLS squad vehicle transports an EMS

26

provider, along with basic EMS equipment and supplies, to

27

respond prior to arrival of an ambulance in order to provide EMS

28

at or below the advanced EMT level of care. A BLS squad vehicle

29

is not utilized to transport patients.

30

(b)  Staffing requirements.--Minimum staffing for a BLS squad

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1

vehicle when responding to a call to provide EMS for a patient

2

is one EMS provider at or above the EMT level and an EMS vehicle

3

operator, except that an EMS provider who is also an EMS vehicle

4

operator may staff the vehicle alone.

5

§ 7235.  Quick response services.

6

(a)  Purpose.--A QRS uses EMS providers to respond to calls

7

for EMS and provide EMS to patients before an ambulance arrives.

8

(b)  Staffing requirements.--The minimum staffing requirement

9

for a QRS is one EMS provider.

10

§ 7236.  Special operations emergency medical services.

11

(a)  Purpose.--A special operations EMS service provides EMS

12

in situations or austere environments that require specialized

13

knowledge, equipment or vehicles to access a patient or address

14

the patient's emergency medical needs. The department shall by

15

regulation provide for specific types of special operations EMS

16

teams.

17

(b)  Personnel requirements.--By regulation, the department

18

may establish additional training or expertise requirements for

19

the EMS agency medical director and the EMS providers who staff

20

a special operations EMS service.

21

(c)  Other requirements.--By regulation, the department may

22

establish staffing, equipment, supply and any other requirement

23

for a special operations EMS service.

24

(d)  Extraordinary applications.--An entity may propose to

25

provide a special operations EMS need that has not been

26

addressed by applying to the department for an EMS agency

27

license to carry out the special operations EMS or, if it is

28

licensed as an EMS agency, the entity may apply to the

29

department to be authorized to provide the special operations

30

EMS under its license. The department shall address each

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1

application on an individual basis and may conditionally deny or

2

grant an application as appropriate to protect the public health

3

and safety. The grant of an application shall be subject to

4

compliance with any later-adopted regulations addressing the

5

type of special operations EMS being provided by the entity.

6

(e)  Protocols.--The department may include in its Statewide

7

EMS protocols special operations EMS protocols.

8

§ 7237.  First aid and other safety services.

9

(a)  Purpose.--An EMS agency may provide EMS at industrial

10

sites, amusement parks or other locations in need of the

11

service. No ambulance or other EMS vehicle shall be required for

12

this purpose.

13

(b)  Staffing.--The minimum staffing requirement is one EMS

14

provider.

15

(c)  Other requirements.--As assigned by the EMS agency, the

16

EMS provider may provide EMS and other medical safety services

17

up to the level for which the EMS provider has the credentials

18

to provide EMS for the EMS agency.

19

(d)  Protocols.--An EMS provider shall follow protocols

20

approved by the department when providing EMS under this

21

section.

22

§ 7238.  Other vehicles and services.

23

The department may by regulation prescribe EMS vehicle and

24

service standards for EMS vehicles and services not specified in

25

this chapter. If the department establishes standards in this

26

section, an EMS agency license shall be required to operate the

27

EMS vehicle or provide the service, and an EMS agency may not

28

operate the vehicle or provide the service unless approved to do

29

so by the department.

30

§ 7239.  Stretcher and wheelchair vehicles.

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1

(a)  Stretcher vehicle.--A stretcher vehicle is a ground

2

vehicle other than an ambulance that is utilized to transport by

3

stretcher persons who do not receive and cannot reasonably be

4

anticipated to require medical assessment, monitoring, treatment

5

or observation during transportation, but who, due to their

6

physical condition, require vehicle transportation while on a

7

stretcher or in a wheelchair.

8

(b)  Wheelchair vehicle.--A wheelchair vehicle is a ground

9

vehicle other than an ambulance that is used to transport by

10

wheelchair persons who do not receive and cannot reasonably be

11

anticipated to require medical assessment, monitoring, treatment

12

or observation during transportation, but who, due to their

13

physical condition, require vehicle transportation while on a

14

stretcher or in a wheelchair.

15

(c)  Prohibition.--Operation by an entity of a stretcher

16

vehicle or wheelchair vehicle to transport a person who is known

17

or reasonably should be known by the entity to require medical

18

assessment, monitoring, treatment or observation during

19

transportation shall constitute unlawful operation of an

20

ambulance for purposes of section 7256(a) and (c) (relating to

21

penalties), and if used as an ambulance by an EMS agency shall

22

constitute misconduct in operating an EMS agency under section

23

7242(a)(7) (relating to emergency medical services agency

24

license sanctions). For purposes of this section, unlawful

25

operation includes, but is not limited to, the transportation of

26

the person to or from a facility, a physician's office or any

27

other location to receive or from which the person received

28

health care services.

29

§ 7240.  Conditional temporary licenses.

30

When an EMS agency or an applicant for a license to operate

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1

as an EMS agency does not provide service 24 hours per day and

2

seven days per week or is unable to participate in a county-

3

level or broader-level emergency medical response plan approved

4

by the department, the department shall issue a conditional

5

temporary license for operation of the EMS agency when the

6

department determines that it is in the public interest, subject

7

to such terms as the department deems appropriate. A conditional

8

temporary license shall be valid for one year and may be renewed

9

as many times as the department determines that it is in the

10

public interest to do so.

11

§ 7241.  Plans of correction.

12

(a)  Correction of violation.--Upon determining that an EMS

13

agency has violated this chapter or regulations promulgated

14

under this chapter, the department may issue a written notice to

15

the EMS agency specifying the violation or violations that have

16

been found. The notice shall require the EMS agency to take

17

immediate action to discontinue the violation or to submit a

18

plan of correction to the department, or both, to bring the EMS

19

agency into compliance with applicable requirements. If the

20

nature of the violation is such that the EMS agency cannot

21

remedy the problem immediately, and a plan of correction is

22

therefore required, the department may direct that the violation

23

be remedied within a specified period of time. The EMS agency

24

shall submit a plan of correction within 30 days of the

25

department's issuance of the written notice. If immediate

26

corrective action is required, the notice from the department

27

shall request, and the EMS agency shall provide, prompt

28

confirmation that the corrective action has been taken.

29

(b)  Discretion.--The department shall not afford the EMS

30

agency an opportunity to correct a violation without facing

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1

disciplinary charges if the department determines that it is not

2

in the public interest to do so.

3

§ 7242.  Emergency medical services agency license sanctions.

4

(a)  Grounds for discipline.--The department may discipline

5

an EMS agency or, as applicable, refuse to issue an EMS agency

6

license for any of the following reasons:

7

(1)  Violating the requirements of this chapter or

8

regulation adopted under this chapter.

9

(2)  Failing to submit a plan of correction acceptable to

10

the department or correct a deficiency as required under

11

section 7241 (relating to plans of correction) or failing to

12

comply with the plan of correction.

13

(3)  Refusing to accept a conditional temporary license

14

properly sought by the department or to abide by its terms.

15

(4)  Fraud or deceit in obtaining or attempting to obtain

16

a license.

17

(5)  Lending its license or, except as permitted under

18

section 7229(f) (relating to emergency medical services

19

agencies), enabling another person to manage or operate the

20

EMS agency or any service covered by the license.

21

(6)  Using the license of another or in any way knowingly

22

aiding or abetting the improper granting of a license,

23

certification, accreditation or other authorization issued

24

under this chapter.

25

(7)  Incompetence, negligence or misconduct in operating

26

the EMS agency or in providing EMS to patients.

27

(8)  The licensee is not a responsible person or is not

28

staffed by responsible persons and refuses to remove from its

29

staff the irresponsible person or persons when directed to do

30

so by the department. For purposes of this paragraph, "staff"

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1

and "responsible person" shall have the meanings set forth in

2

section 7229(c)(1).

3

(9)  Refusing to respond to an emergency and render EMS

4

because of a patient's race, sex, creed, national origin,

5

sexual preference, age, handicap, medical problem or

6

financial inability to pay.

7

(10)  Conviction of a felony or a crime involving moral

8

turpitude or related to the practice of the EMS agency.

9

(11)  Making misrepresentations in seeking funds made

10

available through the department.

11

(12)  Failing to continue to meet applicable licensure

12

requirements.

13

(13)  Violating an order previously issued by the

14

department in a disciplinary matter.

15

(b)  Disciplinary options.--If the department is empowered to

16

impose discipline against an EMS agency under this section, the

17

department may do one or more of the following:

18

(1)  Deny the application for a license.

19

(2)  Administer a written reprimand with or without

20

probation.

21

(3)  Revoke, suspend, limit or otherwise restrict the

22

license.

23

(4)  Impose a civil penalty not exceeding $5,000 for each

24

incident in which the EMS agency engages in conduct that

25

constitutes a basis for discipline.

26

(5)  Stay enforcement of any suspension, revocation or

27

other discipline and place the facility on probation with the

28

right to vacate the probationary order for noncompliance.

29

SUBCHAPTER C

30

MISCELLANEOUS PROVISIONS

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1

Sec.

2

7251.  Limitations on liability.

3

7252.  Peer review.

4

7253.  Support of emergency medical services.

5

7254.  Prohibited acts.

6

7255.  Surrender of license, accreditation or certification.

7

7256.  Penalties.

8

7257.  Adjudications and judicial review.

9

§ 7251.  Limitations on liability.

10

The following shall apply:

11

(1)  No medical command physician, medical command

12

facility medical director or medical command facility, which

13

in good faith provides a medical command to an EMS provider

14

or student enrolled in an EMS course of instruction approved

15

by the department, shall be liable for civil damages as a

16

result of issuing the instruction, absent a showing of gross

17

negligence or willful misconduct.

18

(2)  No EMS agency, EMS agency medical director or EMS

19

provider who in good faith attempts to render or facilitate

20

emergency medical care authorized by this chapter shall be

21

liable for civil damages as a result of an act or omission,

22

absent a showing of gross negligence or willful misconduct.

23

This paragraph shall also apply to students enrolled in

24

approved courses of instruction and supervised pursuant to

25

rules and regulations.

26

(3)  No approved EMS training institute nor any entity

27

participating as part of any approved educational program

28

offered by the institute as authorized by this chapter shall

29

be liable for any civil damages as a result of primary and

30

continuing educational practice by duly enrolled students

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1

under proper supervision, absent a showing of gross

2

negligence or willful misconduct.

3

(4)  No EMS provider who in good faith attempts to render

4

emergency care authorized by this chapter at an emergency

5

scene while en route to a place of employment shall receive

6

any form of reprimand or penalty by an employer as a result

7

of late arrival at the place of employment. An employer may

8

require written verification from the EMS provider, who shall

9

obtain the written verification from either the police

10

officer or other person who is in charge at the emergency

11

scene.

12

(5)  No EMS agency medical director or regional medical

13

director who in good faith gives instructions to or provides

14

primary and continuing educational training to an EMS

15

provider shall be liable for civil damages for issuing the

16

instructions, education or training, absent a showing of

17

gross negligence or willful misconduct.

18

(6)  Neither the department, the Commonwealth EMS Medical

19

Director, a regional EMS council medical director nor any

20

other official or employee of the department or a regional

21

EMS council shall be liable for civil damages arising out of

22

an EMS provider or a student enrolled in an EMS course of

23

instruction approved by the department following protocols

24

approved under this chapter.

25

(7)  No EMS provider or EMS agency may be subject to

26

civil liability based solely on failure to obtain consent in

27

rendering EMS to any person, regardless of age, where the

28

person is unable to give consent for any reason, including

29

minority, and where there is no other person reasonably

30

available who is legally authorized to give or refuse to give

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1

consent, if the EMS provider has acted in good faith and

2

without knowledge of facts negating consent.

3

(8)  No EMS provider or EMS agency may be subject to

4

civil liability based solely on refusal to provide treatment

5

or services requested by the patient or the person

6

responsible for making medical care decisions for the patient

7

if the treatment or services requested are not prescribed or

8

authorized by Statewide or regional protocols established

9

under this chapter and the EMS provider has:

10

(i)  contacted a medical command physician who

11

refused to authorize the requested treatment or service;

12

or

13

(ii)  made a good faith effort to contact a medical

14

command physician and was unable to do so.

15

(9)  No dispatcher of EMS who in good faith collects

16

information about a patient from a caller or makes dispatch

17

assignments based upon the information collected may be

18

subject to civil liability based upon the information

19

collected or a dispatch assignment, absent a showing of gross

20

negligence or willful misconduct.

21

§ 7252.  Peer review.

22

(a)  Immunity from liability.--

23

(1)  A person who provides information to a review

24

organization shall have the same protections from civil and

25

criminal liability as a person who provides information to a

26

review organization under the act of July 20, 1974 (P.L.564,

27

No.193), known as the Peer Review Protection Act.

28

(2)  An individual who is a member or employee of a

29

review organization or who furnishes professional counsel or

30

services to the organization shall have the same protections

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1

from civil and criminal liability for the performance of any

2

duty, function or activity authorized or required of the

3

review organization as a person who performs the duty,

4

function or activity under the Peer Review Protection Act.

5

(b)  Confidentiality of review organization's records.--The

6

proceedings and records of a review organization shall be held

7

in confidence and shall have the same protections from discovery

8

and introduction into evidence in civil proceedings as they

9

would under the Peer Review Protection Act. A person who was in

10

attendance at a meeting of a review organization shall be

11

subject to the same testimony restrictions as a person who was

12

in attendance at a meeting of a review organization under the

13

Peer Review Protection Act.

14

§ 7253.  Support of emergency medical services.

15

(a)  Emergency Medical Services Operating Fund.--There is

16

established a special fund to be known as the Emergency Medical

17

Services Operating Fund, which shall be administered by the

18

department.

19

(b)  Source.--The following are the sources of the Emergency

20

Medical Services Operating Fund:

21

(1)  Money collected under 75 Pa.C.S. §§ 3121 (relating

22

to EMS costs) and 3807(b)(1)(ix) (relating to Accelerated

23

Rehabilitative Disposition).

24

(2)  All fees, fines and civil penalties collected by the

25

department under this chapter.

26

(3)  Appropriations.

27

(4)  Contributions.

28

(c)  Purpose of fund.--Except as provided under subsection

29

(d), 75% of the money from the Emergency Medical Services

30

Operating Fund shall be disbursed by the department for only the

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1

following uses:

2

(1)  To eligible EMS agencies for applicable purposes

3

stated under section 7212(c) (relating to contracts and

4

grants), with at least 10% of these funds to be allocated to

5

provide additional financial assistance for those EMS systems