SENATE AMENDED
PRIOR PRINTER'S NOS. 1966, 3005, 3296, PRINTER'S NO. 3718
3340, 3514, 3543
No. 1603 Session of 1975
INTRODUCED BY MESSRS. BERLIN, IRVIS, GALLAGHER, MANDERINO,
REED, MILLIRON, MRS. KELLY, MRS. TOLL, MESSRS. MISCEVICH,
DiCARLO, FEE, COWELL, STAPLETON, GARZIA, NOYE, PETRARCA,
ROSS, O'CONNELL, GREEN, LETTERMAN, PRATT AND DeWEESE,
JULY 9, 1975
SENATOR COPPERSMITH, PUBLIC HEALTH AND WELFARE, IN SENATE,
AS AMENDED, SEPTEMBER 21, 1976
AN ACT
1 To provide assistance and encouragement for the development of
2 comprehensive area emergency medical services systems.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short Title.--This act may be known and cited as
6 the "Emergency Medical Services Systems Act."
7 Section 2. Definitions.--For the purposes of this act:
8 "Emergency health services council" means an organization
9 not-for-profit which is recognized by the Department of Health
10 as representative of the health professions and major public and
11 voluntary agencies, organizations and institutions concerned
12 with providing emergency health care; and whose functions are to
13 develop and implement comprehensive emergency health services
14 programs within a defined area of the Commonwealth.
15 "Emergency medical services system" means a system which
1 provides for the arrangement of personnel, facilities and
2 equipment for the effective and coordinated delivery of
3 emergency health care services required in management of
4 incidents which occur either as a result of a patient's
5 condition or of natural disasters or similar situations.
6 "Rural" means an area outside the standard metropolitan
7 statistical area.
8 "Secretary" means the Secretary of Health.
9 Section 3. Grants and Contracts for Organization of
10 Emergency Health Services Councils.--(a) The secretary shall
11 make grants to and enter into contracts with eligible entities
12 as defined in section 7(a) for projects to organize emergency
13 health services councils.
14 (b) If any grants or contracts are entered into under this
15 section for organization of an emergency health services
16 council, no other grant or contract may be entered into under
17 this section for any other council for the same area or for an
18 area which includes, in whole or substantial part, such area.
19 (c) Reports of any studies assisted under this section shall
20 be submitted to the Department of Health at such intervals as
21 may be prescribed, and a comprehensive emergency health services
22 plan for the geographic area served by the council shall be
23 submitted not later than one year from the date the grant was
24 made or the contract entered into, as the case may be.
25 (d) An application for a grant or contract under this
26 section shall:
27 (1) demonstrate the need of the area for which the study and
28 planning will be done for an emergency medical services system;
29 (2) contain qualitative data that the applicant is qualified
30 to plan an emergency medical services system for such area; and
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1 (3) contain pertinent information assuring that the planning
2 will be conducted in cooperation with each areawide
3 comprehensive health planning agency whose plan covers, in whole
4 or in part, such area.
5 (e) Project funds under this section may be used only for
6 the following purposes:
7 (1) Salaries and related benefits and travel of council
8 staff.
9 (2) Leasing or rental of office space.
10 (3) Procurement of office furniture, equipment and supplies.
11 (4) Printing and duplicating costs.
12 (f) In the event that an established entity has received,
13 prior to the effective date of this act, from the Department of
14 Health, a declaration of recognition that agency shall become
15 the emergency health services council under this act.
16 Section 4. Training in Emergency Medical Services.--(a)
17 Grants may be made and contracts entered into with schools of
18 medicine, osteopathy, nursing, training centers for allied
19 health professions, teaching hospitals and other appropriate
20 entities to assist in meeting the cost of training programs in
21 the techniques and methods of providing emergency medical
22 services, including the skills required in connection with the
23 provision of ambulance services.
24 (b) No grant or contract may be made or entered into under
25 this section unless an application has been submitted to the
26 Department of Health. Such application shall be in such format
27 as prescribed by regulation. Grantees and contractees under this
28 section shall make such reports at such intervals, and
29 containing such information, as required.
30 Section 5. Grants and Contracts for Establishing or
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1 Expansion and Improvement of Emergency Health Services
2 Systems.--(a) The secretary shall make grants to and enter into
3 contacts with eligible entities, as defined in section 7(a) for
4 the establishment, initial operation or expansion and
5 improvement of emergency medical services systems which
6 coordinate with the Statewide emergency medical services plan.
7 (b) (1) Grants and contracts under this section may only be
8 used for costs associated with establishment, expansion and
9 improvement of emergency medical services systems through:
10 (i) Purchasing of ambulance and ambulance equipment.
11 (ii) Purchasing of communications equipment.
12 (iii) Purchasing of certain equipment for hospital emergency
13 departments.
14 (iv) Providing programs of public education and information
15 regarding the emergency medical services system.
16 (2) Project funds may not be used for the following:
17 (i) Construction of new facilities.
18 (ii) Acquisition of facilities.
19 (iii) Purchase of built-in hospital equipment which will be
20 used more than 25% of the time for nonemergency uses.
21 (iv) Establishment, expansion or improvement of services or
22 facilities involved in the care of patients in the normal
23 hospital environs or in any other care facility, except for
24 those customarily associated with the emergency department.
25 (v) Maintenance of equipment or replacement of supplies.
26 (vi) Costs normally borne by the patient.
27 (3) Each grant or contract under this section shall be made
28 for costs of establishment and operation in the year for which
29 the grant or contract is made. If a grant or contract is made
30 under this section for a system, one additional grant or
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1 contract for that system shall be made after a review of the
2 first nine months' activities of the applicant carried out under
3 the first grant or contract, if it is determined that the
4 applicant is satisfactorily progressing in the establishment and
5 operation of the system in accordance with the plan contained in
6 his application, pursuant to section 7, for the first grant or
7 contract.
8 (4) Subject to section 7(e):
9 (i) The amount of the first grant or contract under this
10 section for an emergency medical services system may not exceed
11 50% of the eligible costs.
12 (ii) The amount of the second grant or contract under this
13 section for a system may not exceed 25% of the eligible costs.
14 Section 6. Grants and Contracts for Research.--(a) The
15 secretary may make grants to public or nonprofit entities and
16 enter into contracts with public entities and nonprofit
17 organizations for the support of research in emergency medical
18 techniques, methods, devices and delivery. Special consideration
19 shall be given to applications for grants or contracts for
20 research relating to the delivery of emergency medical services
21 in rural areas.
22 (b) No grant may be made or contract entered into under this
23 section for amounts in excess of $35,000 unless the application
24 has been recommended for approval by a peer review panel
25 designated or established by the secretary. Any application for
26 a grant or contract under this section shall be submitted in
27 such form and manner and contain such information as prescribed
28 in regulations.
29 (c) The recipient of a grant or contract under this section
30 shall make such reports as may be required by regulation.
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1 Section 7. General Provisions Respecting Grants and
2 Contracts.--(a) For purposes of sections 3, 5 and 6, the term
3 "eligible entity" means:
4 (1) a unit of general local government;
5 (2) an emergency health services council;
6 (3) a public entity administering a compact or other
7 regional arrangement or consortium; or
8 (4) any other public entity and any nonprofit entity.
9 (b) (1) No grant or contract may be made under this act
10 unless an application has been submitted to, and approved by,
11 the Department of Health
12 (2) No application for a grant or contract under sections 3,
13 5 or 6 may be approved unless:
14 (i) the application meets the application requirements of
15 such sections;
16 (ii) each areawide Health Service Agency, if any, whose plan
17 covers, in whole or in part, the service area of such system,
18 has had not less than 30 days, measured from the date a copy of
19 the application was submitted to the agency by the applicant, in
20 which to comment on the application;
21 (iii) the applicant agrees to maintain such records and make
22 such reports as necessary to carry out the provisions of this
23 section; and
24 (iv) the application is submitted in such form and such
25 manner and contains such information, including specification of
26 applicable provisions of law or regulations which restrict the
27 full utilization of the training and skills of health
28 professions and allied and other health personnel in the
29 provision of health care services in such a system, as
30 prescribed in regulations.
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1 (v) an emergency medical services system shall:
2 (A) include an adequate number of health professionals,
3 allied health professionals, and other health personnel with
4 appropriate training and experience;
5 (B) provide for its personnel continuous training, including
6 clinical training and continuing education programs which are
7 coordinated with other programs in the system's service area
8 which provide similar training and education;
9 (C) join the personnel, facilities and equipment of the
10 system by a central communications system so that requests for
11 emergency health care services will be handled by a
12 communications facility which (I) utilizes emergency medical
13 telephonic screening to determine the appropriate emergency
14 service response, (II) utilizes the universal emergency
15 telephone number 911, and (III) will have direct communication
16 network connections with the personnel, facilities, and
17 equipment of the system and with other appropriate emergency
18 medical services systems;
19 (D) include an adequate number of necessary ground, air, and
20 water vehicles and transportation means to meet the individual
21 characteristics of the system's service area which (I) vehicles
22 and facilities meet design criteria relating to location,
23 design, performance, and equipment, and (II) the operators and
24 other personnel of these said vehicles and facilities meet
25 appropriate training and experience requirements;
26 (E) include an adequate number of easily accessible
27 emergency medical services facilities which are collectively
28 capable of providing services on a continuous basis, which have
29 appropriate nonduplicative and categorized capabilities, which
30 meet appropriate standards relating to capacity, location,
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1 personnel, and equipment and which are coordinated with other
2 health care facilities of the system;
3 (F) provide access, including appropriate transportation, to
4 specialized critical medical care units in the system's service
5 area, or, if there are no such units or an inadequate number of
6 them in such area, provide access to such units in neighboring
7 areas if access to such units is feasible in terms of time and
8 distance;
9 (G) provide for the effective utilization of the appropriate
10 personnel, facilities, and equipment of each agency providing
11 emergency services in the system's service area;
12 (H) be organized in a manner that provides persons who
13 reside in the system's service area and who have no professional
14 training or financial interest in the provision of health care
15 with an adequate opportunity to participate in the making of
16 policy for the system;
17 (I) provide, without prior inquiry as to ability to pay,
18 necessary emergency medical services to all patients requiring
19 such services;
20 (J) provide for transfer of patients to facilities and
21 programs which offer such followup care and rehabilitation as is
22 necessary to effect the maximum recovery of the patient;
23 (K) provide for a standardized patient data collection
24 system which data shall cover all phases of the system;
25 (L) provide programs of public education and information in
26 the system's service area, taking into account the needs of
27 visitors to, as well as residents of, that area to know or be
28 able to learn immediately the means of obtaining emergency
29 medical services, which programs stress the general
30 dissemination of information regarding appropriate methods of
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1 first aid and cardiopulmonary resuscitation and regarding the
2 availability of first aid training programs in the area;
3 (M) provide for (I) periodic, comprehensive and independent
4 review and evaluation of the extent and quality of the emergency
5 health care services provided in the system's service area, and
6 (II) submission to the Department of Health of the reports of
7 each such review and evaluation;
8 (N) have a plan to assure that the system will be capable of
9 providing emergency medical services in the system's service
10 area during mass casualty situations, natural disasters, or
11 declared states of emergency; and
12 (O) provide for the establishment of appropriate
13 arrangements with emergency medical services systems or similar
14 entities serving neighboring areas for the provision of
15 emergency medical services on a reciprocal basis where access to
16 such services would be more appropriate and effective in terms
17 of the services available, time and distance.
18 The secretary shall by regulations prescribe standards and
19 criteria for the requirements prescribed by this subsection. In
20 prescribing such standards and criteria, the secretary shall
21 consider relevant standards and criteria prescribed by other
22 public agencies and by private organizations.
23 (c) The Department of Health shall provide technical
24 assistance, as appropriate, to eligible entities as necessary
25 for the purpose of their preparing applications or otherwise
26 qualifying for or carrying out grants or contracts under
27 sections 3, 4, 5 or 6, with special consideration for applicants
28 in rural areas.
29 (d) Payments under grants and contracts under this act may
30 be made in advance or by way of reimbursement and in such
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1 installments and on such conditions as the secretary determines
2 will most effectively carry out this act.
3 (e) In determining the amount of any grant or contract under
4 sections 3, 4, 5 or 6, the amount of funds available to the
5 applicant from Federal grant or contract programs pertaining to
6 emergency health services shall be taken into consideration.
7 (f) Non-State contributions shall be cash and may include
8 the outlay of money to the grantee by private, public or
9 governmental third parties, including the Federal government.
10 (g) Anyone applying for and/or receiving funds under this
11 act shall not be precluded from applying for and/or receiving
12 funds under any other State or Federal program.
13 Section 8. Administration.--(a) The secretary shall
14 administer the program of grants and contracts authorized by
15 this act through an identifiable administrative unit within the
16 Department of Health. Such unit shall also be responsible for
17 collecting, analyzing, cataloging, and disseminating all data
18 useful in the development and operation of emergency medical
19 services systems, including data derived from reviews and
20 evaluations of emergency medical services systems assisted under
21 section 5.
22 (b) The secretary may waive compliance with regulations as
23 they pertain to certain specific eligible entities if he
24 determines that compliance is not necessary for a specific
25 eligible entity to set up and operate an emergency medical
26 services system.
27 Section 9. Annual Report.--The secretary shall prepare and
28 submit annually to the General Assembly a report on the
29 administration of this act. Each report shall include an
30 evaluation of the adequacy of the provision of emergency medical
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1 services in the Commonwealth during the period covered by the
2 report, and evaluation of the extent to which the needs for such
3 services are being adequately met through assistance provided
4 under this act, and his recommendations for such legislation as
5 he determines is required to provide emergency medical services
6 at a level adequate to meet such needs.
7 Section 10. Appropriations to Rural Areas.--Not less than
8 20% of the appropriations made pursuant to this act shall be
9 made available for grants and contracts under this act for such
10 fiscal year for emergency medical services systems which service
11 or will serve rural areas.
12 Section 11. Legislative Intent.--(a) This act shall not <--
13 authorize the secretary to effect mandatory licensure,
14 certification or training of ambulance services and personnel.
15 (b) REENACTMENT REQUIREMENT.-- This act shall expire if not <--
16 reenacted by the General Assembly prior to the end of the fiscal
17 year ending June 30, 1979 and every third fiscal year
18 thereafter.
19 Section 12. Effective Date.--This act shall take effect July <--
20 1, 1976. IMMEDIATELY. <--
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