PRINTER'S NO. 3457
No. 2502 Session of 2000
INTRODUCED BY BENNINGHOFF, ARGALL, ARMSTRONG, BARD, BASTIAN,
BATTISTO, CAPPABIANCA, CLYMER, M. COHEN, CURRY, DALLY,
DeWEESE, FAIRCHILD, FLEAGLE, FLICK, FRANKEL, GEORGE, GRUCELA,
HALUSKA, HARHAI, HENNESSEY, HERMAN, HORSEY, JAMES, LEVDANSKY,
MAHER, MAITLAND, MANDERINO, MASLAND, McCALL, McGILL,
McILHATTAN, MELIO, S. MILLER, NAILOR, ORIE, PIPPY, PLATTS,
ROHRER, ROSS, RUBLEY, SATHER, SAYLOR, SEYFERT, SNYDER,
SOLOBAY, STABACK, STEELMAN, STERN, E. Z. TAYLOR, TIGUE,
TRELLO, TRUE, TULLI, VANCE, WILLIAMS, WILT, WOJNAROSKI,
YOUNGBLOOD AND YUDICHAK, MAY 2, 2000
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES, MAY 2, 2000
AN ACT
1 Amending the act of July 3, 1985 (P.L.164, No.45), entitled "An
2 act relating to the prevention and reduction of premature
3 death and disability in this Commonwealth; providing for
4 assistance, coordination and support of the development and
5 maintenance of a comprehensive emergency medical services
6 system and for qualifications, eligibility and certification
7 of emergency medical services personnel and licensing
8 ambulance services; imposing powers and duties on the
9 Department of Health; and making repeals," adding
10 definitions; providing for duties of municipalities, counties
11 and public service answering points, for certain civil
12 immunity and for designation of quick response services; and
13 further providing for legislative findings and intent, for
14 the emergency medical services system, and for duties of the
15 Department of Health, the Pennsylvania Trauma Systems
16 Foundation, the emergency medical services councils and the
17 State Advisory Council.
18 The General Assembly of the Commonwealth of Pennsylvania
19 hereby enacts as follows:
20 Section 1. Section 2 of the act of July 3, 1985 (P.L.164,
21 No.45), known as the Emergency Medical Services Act, is amended
1 to read:
2 Section 2. Legislative findings and intent.
3 (a) Findings.--The General Assembly finds it to be in the
4 public interest to assure readily available and coordinated
5 emergency medical services of the highest quality to the people
6 of Pennsylvania. The purposes of emergency medical services are
7 to prevent premature death and reduce suffering and disability
8 that arise from critical illness and injury.
9 (b) Intent.--
10 (1) It is the intention of the General Assembly and the
11 purpose of this act to establish and maintain an effective
12 and efficient emergency medical services system which is
13 accessible on a uniform basis to all Pennsylvania residents
14 and to visitors to this Commonwealth.
15 (2) The General Assembly further intends that residents
16 and visitors to this Commonwealth should have prompt and
17 unimpeded access to basic and advanced life support emergency
18 medical care throughout this Commonwealth.
19 (3) It is the intent of the General Assembly that the
20 Secretary of Health, in developing a stratified system of
21 trauma care, shall, whenever feasible, involve local citizens
22 in the decisionmaking process.
23 (4) It is the intent of the General Assembly to involve
24 municipal and county governments in the administration of
25 emergency medical services by having municipalities assess
26 municipal needs for and municipal interests affected by
27 emergency medical services coverage within their borders and
28 designating ambulance services and quick response services to
29 best serve those needs and interests, having counties
30 integrate those decisions into countywide emergency medical
20000H2502B3457 - 2 -
1 services dispatch procedures and providing civil immunity to
2 municipalities, municipal governing bodies, counties, county
3 governing bodies, the department, emergency medical services
4 councils, the council, the foundation and public service
5 answering points relating to designation of ambulance
6 services and emergency medical services dispatch procedures
7 developed or implemented pursuant to this act.
8 Section 2. Section 3 of the act is amended by adding
9 definitions to read:
10 * * *
11 "County." A county of the second class, second class A or
12 third through eighth class within this Commonwealth. The term
13 includes a county which has adopted a home rule charter or
14 optional plan of government under the former act of April 13,
15 1972 (P.L.184, No.62), known as the Home Rule Charter and
16 Optional Plans Law, or under 53 Pa.C.S. Pt. III Subpt. E
17 (relating to home rule and optional plan government) or which
18 has adopted a charter pursuant to Article XXXI-C of the act of
19 July 28, 1953 (P.L.723, No.230), known as the Second Class
20 County Code. The term does not include a county of the first
21 class.
22 "County governing body." The board of county commissioners,
23 including the successor in function to the board of county
24 commissioners in a county which has adopted a home rule charter
25 under the former act of April 13, 1972 (P.L.184, No.62), known
26 as the Home Rule Charter and Optional Plans Law, or under 53
27 Pa.C.S. Pt. III Subpt. E (relating to home rule and optional
28 plan government), or the governing body of a second class county
29 established pursuant to Article XXXI-C of the act of July 28,
30 1953 (P.L.723, No.230), known as the Second Class County Code.
20000H2502B3457 - 3 -
1 * * *
2 "Municipal governing body." The city council, borough
3 council, incorporated town council, board of township
4 commissioners, board of township supervisors, governing council
5 of a home rule municipality or optional plan municipality, or
6 governing council of a city of the first class or of any similar
7 general purpose unit of government which may hereafter be
8 created by statute.
9 "Municipal service area." A specific geographic area
10 established by a municipal or county governing body within which
11 a primary responder is designated pursuant to section 7.1 of
12 this act to provide prehospital emergency medical care and
13 transportation.
14 "Municipality." A city of the first class, city of the
15 second class, city of the second class A, city of the third
16 class, borough, incorporated town, township of the first class,
17 township of the second class, home rule municipality, optional
18 plan municipality, optional form municipality or similar general
19 purpose unit of government which may hereafter be created by
20 statute.
21 * * *
22 "Primary responder." An ambulance service designated as the
23 first to be dispatched by a public safety answering point
24 pursuant to section 7.1 of this act.
25 * * *
26 "Public safety answering point" or "PSAP." The first point
27 at which calls for emergency assistance from individuals are
28 answered, operated 24 hours a day. The term includes a "911
29 emergency communication system" or "911 system" operated
30 pursuant to the act of July 9, 1990 (P.L.340, No.78), known as
20000H2502B3457 - 4 -
1 the Public Safety Emergency Telephone Act.
2 "Quick response service" or "QRS." An individual,
3 individuals or entity, other than an ambulance service, which is
4 recognized by the department as being capable of responding to
5 an emergency when dispatched by virtue of utilizing either:
6 (1) an ambulance attendant or other individual or
7 individuals certified or recognized pursuant to this act to
8 provide emergency medical services; or
9 (2) an individual or individuals possessing training at
10 least equivalent to that required of an ambulance attendant.
11 * * *
12 Section 3. Sections 4 and 5(b) of the act are amended by
13 adding paragraphs to read:
14 Section 4. Emergency medical services system.
15 The secretary shall plan, guide and coordinate programs to
16 ensure that the Commonwealth's emergency medical services system
17 shall:
18 * * *
19 (16) Assist municipalities and counties in facilitating
20 emergency medical services coverage for their community which
21 meets goals set forth in the Statewide emergency medical
22 services development plan.
23 Section 5. Duties of department.
24 * * *
25 (b) Authority.--The department shall be the Commonwealth
26 lead agency for emergency medical services in this Commonwealth.
27 The department shall have authority to:
28 * * *
29 (7.1) Assist municipal and county governing bodies in
30 making and implementing municipal service area and primary
20000H2502B3457 - 5 -
1 responder designations.
2 (7.2) Within 180 days of the effective date of this
3 section, publish in the Pennsylvania Bulletin, with a 90-day
4 public comment period, a policy statement containing a list
5 of suggested criteria for use by municipal governing bodies
6 and county governing bodies in the designation of primary
7 responders which shall include guidance for the designation
8 of municipal service areas. During the 90-day public comment
9 period, the department shall conduct at least one public
10 hearing on the policy statement. Upon review and
11 consideration of testimony provided at the public hearing and
12 comments received during the public comment period, but in no
13 event later than 90 days following the close of the public
14 comment period, the department shall publish a final policy
15 statement in the Pennsylvania Bulletin. Subsequent changes to
16 the initial final policy statement shall be made and
17 published in the Pennsylvania Bulletin pursuant to the
18 provisions of this paragraph. The department shall consult
19 with the Council in the initial development of and any
20 subsequent changes to the policy statement.
21 * * *
22 Section 4. Section 6 of the act is amended by adding a
23 subsection to read:
24 Section 6. Pennsylvania Trauma Systems Foundation.
25 * * *
26 (g) Resource to governing bodies of municipalities and
27 counties.--Upon request from a municipal or county governing
28 body, the foundation shall act as a resource for the governing
29 body and shall provide information regarding trauma systems and
30 centers relative to the designation of primary responders by the
20000H2502B3457 - 6 -
1 municipal or county governing body.
2 Section 5. Section 7(a) and (b) of the act are amended to
3 read:
4 Section 7. State Advisory Council.
5 (a) Designation and composition.--The State Advisory Council
6 shall be known as the Board of Directors of the Pennsylvania
7 Emergency Health Services Council which shall be composed of
8 volunteer, professional and paraprofessional organizations
9 involved in emergency medical services and representatives of
10 municipalities and counties. The council shall be geographically
11 representative of the [provider] organizations which represent
12 emergency medical technicians, EMT-paramedics, registered
13 nurses, firefighters, emergency medical services councils,
14 municipalities, counties, physicians, hospital administrators
15 and other health care providers concerned with emergency medical
16 services. The council may be composed of up to 30 organizations.
17 Each organization shall have one voting member.
18 (b) Duties.--The council shall:
19 (1) Elect its own officers.
20 (2) Advise the department on matters relating to
21 manpower and training, communications, ambulance services,
22 special care units and the content of rules, regulations,
23 standards and policies promulgated by the department under
24 this act, including initial development of and any subsequent
25 changes to policy statements published by the department
26 pursuant to section 5(b)(8) of this act, and such other
27 subjects as may be deemed appropriate by the department.
28 (3) Serve as the forum for discussion on the content of
29 the Statewide emergency medical services development plan, or
30 any proposed revisions thereto, and advise the department as
20000H2502B3457 - 7 -
1 to the content of the plan.
2 * * *
3 Section 6. The act is amended by adding a section to read:
4 Section 7.1. Responsibilities of municipalities and counties.
5 (a) Designation of municipal service area.--Within 180 days
6 of the effective date of this section and thereafter on a
7 schedule which coincides with the expiration of the designation
8 of primary responders, a municipal governing body shall
9 designate one or more municipal service areas within its
10 municipal boundaries. The designated municipal service area or
11 areas shall include all of the geographic area within the
12 boundaries of the municipality. A municipal service area shall
13 be designated by the municipal governing body by majority vote
14 at a public meeting, which may be the same meeting at which the
15 municipal governing body designates the primary responder for
16 that municipal service area.
17 (b) Designation of primary responder.--
18 (1) Designation requirements.--Within 180 days of the
19 effective date of this section, a municipal governing body
20 shall designate a primary responder to provide emergency
21 medical services within a municipal service area pursuant to
22 this section. Nothing in this section shall preclude a
23 municipal governing body from designating a quick response
24 service to serve a municipal service area provided that the
25 municipal governing body also designates an ambulance service
26 pursuant to the provisions of this section to serve as its
27 primary responder in that municipal service area. A municipal
28 governing body which designates as its primary responder in
29 any municipal service area an ambulance service which will
30 provide only basic life support services shall also designate
20000H2502B3457 - 8 -
1 pursuant to this section an ambulance service which will
2 provide advanced life support services.
3 (2) Primary responder designations.--
4 (i) Prior to its designation, an ambulance service
5 must be licensed pursuant to this act.
6 (ii) The designation of a primary responder shall be
7 made by:
8 (A) execution of a contract with the designated
9 ambulance service following issuance of a request for
10 proposal; or
11 (B) adoption of an ordinance or resolution.
12 (iii) As part of the designation process, the
13 governing body shall consider the suggested criteria
14 published by the department pursuant to section 5(b)(8)
15 of this act for each ambulance service under
16 consideration.
17 (iv) Regardless of the manner of designation
18 selected pursuant to this paragraph, the municipal
19 governing body shall conduct at least one public hearing
20 prior to designating a primary responder. In addition to
21 other statutory notice requirements, the municipal
22 governing body shall provide written notice prior to the
23 hearing to the county governing body in which the
24 municipality is located, the public safety answering
25 point which serves the municipality and the emergency
26 medical services council in which the municipality is
27 located.
28 (v) In addition to other statutory notice
29 requirements, the municipal governing body shall provide
30 written notice prior to the public meeting at which
20000H2502B3457 - 9 -
1 designation of a primary responder is to be considered to
2 the county governing body in which the municipality is
3 located, the public safety answering point which serves
4 the municipality and the emergency medical services
5 council in which the municipality is located.
6 (vi) The designation of a primary responder shall
7 continue for a period of not less than two years nor more
8 than five years from the date the designation is
9 finalized, unless terminated sooner pursuant to
10 subparagraph (vii) or (viii). Not more than 90 days nor
11 less than 30 days prior to completion of the designation
12 period the municipal governing body shall:
13 (A) after consideration of the criteria
14 published by the department pursuant to section
15 5(b)(8), continue the existing designation for a
16 period of not less than two years nor more than five
17 years by approval at a public meeting by majority
18 vote, with written notification of the continuation
19 provided to the county governing body, the public
20 safety answering point, and the emergency medical
21 services council pursuant to subsection (d); or
22 (B) make a new designation pursuant to the
23 provisions of this section.
24 If a designation has not been made pursuant to clause (A)
25 or (B) 30 days prior to the completion of the designation
26 period, the municipal governing body shall immediately
27 provide written notice thereof to the county governing
28 body in which the municipality is located, the public
29 safety answering point which serves the municipality, and
30 the emergency medical services council in which the
20000H2502B3457 - 10 -
1 municipality is located, and the county governing body
2 shall designate a primary responder pursuant to paragraph
3 (5).
4 (vii) A municipal governing body may, after
5 reasonable inquiry and provision of written notification
6 to the primary responder, the county governing body in
7 which the municipality is located, the public safety
8 answering point which serves the municipality, and the
9 emergency medical services council in which the
10 municipality is located, by majority vote at a public
11 meeting terminate the designation of a primary responder
12 at any time if the municipal governing body determines
13 that continuation of the designation adversely affects
14 patient care or the emergency medical services system.
15 This termination for cause provision shall be included in
16 any contract, ordinance or resolution entered into or
17 approved pursuant to this section. At the same public
18 meeting at which a primary responder designation is
19 terminated pursuant to this paragraph, the municipal
20 governing body shall, by majority vote, designate an
21 interim primary responder, who shall serve in that
22 capacity for a period not to exceed 90 days or until a
23 primary responder is designated pursuant to this section,
24 whichever occurs first. In the event a primary responder
25 designation is terminated pursuant to this paragraph,
26 written notification thereof and of the appointment of an
27 interim primary responder shall be provided verbally
28 immediately following the meeting to the public safety
29 answering point which serves the municipality and in
30 writing within 24 hours following the meeting to the
20000H2502B3457 - 11 -
1 county governing body in which the municipality is
2 located, the public safety answering point which serves
3 the municipality, and the emergency medical services
4 council in which the municipality is located.
5 (viii) A municipal governing body may, upon a two-
6 thirds vote at a public meeting, terminate the
7 designation of a primary responder, provided that at
8 least 180 days' written notice of the termination has
9 been given to the primary responder, the county governing
10 body in which the municipality is located, the public
11 safety answering point which serves the municipality, and
12 the emergency medical services council in which the
13 municipality is located. This termination for other than
14 cause provision shall be included in any contract,
15 ordinance or resolution entered into or approved pursuant
16 to this section. If the municipal governing body has not
17 designated a new primary responder pursuant to this
18 section 15 days prior to the expiration of the 180-day
19 notice period, the municipal governing body shall provide
20 written notice thereof to the county governing body in
21 which the municipality is located, the public safety
22 answering point which serves the municipality, and the
23 emergency medical services council in which the
24 municipality is located, and the county governing body
25 shall make the designation pursuant to paragraph (5).
26 (ix) A municipal governing body shall periodically
27 review the performance of its designated primary
28 responder, provided that terminations of a primary
29 responder prior to the end of the period of designation
30 may only be effectuated pursuant to the provisions of
20000H2502B3457 - 12 -
1 subparagraph (vii) or (viii). This review shall be
2 conducted at no less than two year intervals and shall
3 include consideration of the criteria published by the
4 department pursuant to section 5(b)(8).
5 (3) A municipal governing body shall assure that a
6 procedure is in place to respond to emergency calls placed to
7 a public safety answering point in the event a primary
8 responder is unable to respond.
9 (4) Two or more municipal governing bodies may jointly
10 cooperate in designating municipal service areas and primary
11 responders to serve a municipal service area which includes
12 all or a portion of those municipalities, provided that such
13 designation in each municipality shall be made pursuant to
14 this section.
15 (5) In the event a municipal governing body provides
16 written notification to the county governing body in the
17 county in which the municipality is located that it has
18 determined not to designate municipal service areas or a
19 primary responder for all or any portion of the area within
20 its municipal boundaries or if the municipal governing body
21 fails to make such designations within in this subsection,
22 the county governing body shall make the designations using
23 the procedures set forth in this section and for these
24 purposes references herein to the municipal governing body
25 shall be construed to be references to the county governing
26 body. A designation made by a county governing body pursuant
27 to this paragraph shall remain if effect for two years,
28 provided, however, that if the county governing body is
29 required to make a designation, the county governing body
30 may, at a public meeting by majority vote, designate an
20000H2502B3457 - 13 -
1 interim primary responder who shall serve in that capacity
2 for a period not to exceed 90 days or until a primary
3 responder is designated by the county governing body pursuant
4 to this paragraph, whichever occurs first. If the municipal
5 governing body subsequently desires to designate its
6 municipal service areas or primary responders, the municipal
7 governing body shall inform the county governing body, the
8 public safety answering point which serves the municipality
9 and the emergency medical services council in which the
10 municipality is located, in writing of its intent at least 45
11 days prior to the expiration of the then existing
12 designations made by the county governing body. The municipal
13 governing body shall thereafter make those designations
14 pursuant to this section.
15 (6) Nothing in this section shall be construed to
16 prohibit the designation of an out-of-State emergency medical
17 services provider as a primary responder, provided that:
18 (i) the emergency medical services provider is
19 licensed as an ambulance service by the department
20 pursuant to this act;
21 (ii) the designation is made pursuant to this
22 section; and
23 (iii) the emergency medical services provider
24 complies with all applicable emergency medical services
25 council protocols established for the provision of
26 emergency medical services.
27 (c) Existing public safety answering point dispatch
28 procedures.--
29 (1) Existing public safety answering point dispatch
30 procedures shall remain in effect for 180 days following the
20000H2502B3457 - 14 -
1 effective date of this section or until municipal service
2 area and primary responder designations have been made
3 pursuant to this section, whichever occurs first.
4 (2) (i) Notwithstanding the provisions of subsections
5 (a) and (b), if a municipal governing body desires to
6 continue beyond the period specified in paragraph (1) the
7 public safety answering point dispatching procedures for
8 ambulance services and quick response services in effect
9 within the municipality on the effective date of this
10 section, the municipal governing body may continue to use
11 that procedure beyond the period specified in paragraph
12 (1) by providing written notification thereof, including
13 the period for continuation, to the county governing body
14 in which the municipality is located, the public safety
15 answering point which serves the municipality, and the
16 emergency medical services council in which the
17 municipality is located. A municipal governing body which
18 does not provide written notification of continuation of
19 its use of existing public safety answering point
20 dispatch procedures within 180 days following the
21 effective date of this section shall be required to make
22 designations pursuant to subsections (a) and (b).
23 (ii) Dispatching procedures which are continued by a
24 municipal governing body pursuant to subparagraph (i) may
25 remain in effect for up to four years following the date
26 on which written notification of the continuation is
27 provided to the county governing body in which the
28 municipality is located, the public safety answering
29 point which serves the municipality, and the emergency
30 medical services council in which the municipality is
20000H2502B3457 - 15 -
1 located. Thereafter, the municipal governing body shall
2 make designations pursuant to subsections (a) and (b).
3 (iii) If a municipal governing body continues its
4 existing public safety answering point dispatch
5 procedures pursuant to subparagraphs (i) and (ii) and
6 prior to the expiration date established pursuant to
7 subparagraph (ii) determines to effectuate a change in
8 those procedures, the municipal governing body shall make
9 designations pursuant to subsections (a) and (b).
10 (d) Notice and recognition of designations of municipal
11 service areas and primary responders.--At least five days prior
12 to the effective date of the designation of a municipal service
13 area or a primary responder or a quick response service by a
14 municipal governing body, the municipal governing body shall
15 provide written notice of such designation to the county
16 governing body in the county in which the municipality is
17 located, the public safety answering point which serves the
18 municipality, and the emergency medical services council in
19 which the municipality is located. If the county governing body
20 designates a municipal service area or a primary responder or a
21 quick response service pursuant to subsection (b)(5), this
22 notice shall be provided by the county governing body to the
23 municipal governing body, the public safety answering point
24 which serves the municipality, and the emergency medical
25 services council in which the municipality is located. Within 30
26 days following receipt of written notice from a municipal
27 governing body or a county governing body, the public safety
28 answering point shall implement emergency medical services
29 dispatch procedures based on the municipal service area and
30 primary responder or quick response service designations made by
20000H2502B3457 - 16 -
1 the municipal governing body or the county governing body
2 pursuant to this section.
3 (e) Ambulance service contracts.--Nothing in this section
4 shall be construed to impair the ability of an ambulance service
5 to enter into a contract for the provision of emergency medical
6 services with:
7 (1) an individual through arrangements commonly know as
8 "memberships" or through similar arrangements;
9 (2) a convalescent nursing home, extended care facility
10 or skilled nursing facility as defined in the act of December
11 15, 1982 (P.L.1291, No.292), known as the Medicare Supplement
12 Insurance Act;
13 (3) any insurance company, association or reciprocal
14 nonprofit hospital plan corporation;
15 (4) any nonprofit professional health service plan;
16 (5) any health maintenance organization organized and
17 regulated under the act of December 29, 1972 (P.L.1701,
18 No.364), known as the Health Maintenance Organization Act;
19 (6) any risk-assuming preferred provider organization
20 organized and regulated under the act of May 17, 1921
21 (P.L.682, No.284), known as The Insurance Company Law of
22 1921; or
23 (7) any adult day-care center, mental health
24 establishment or personal care home as defined in Article X
25 of the act of June 13, 1967 (P.L.31, No.21), known as the
26 Public Welfare Code.
27 (f) Civil immunity.--No civil liability shall be imputed to
28 a municipality, a municipal governing body, a county, a county
29 governing body, the department, an emergency medical services
30 council, the council, the foundation or a public safety
20000H2502B3457 - 17 -
1 answering point for designations made pursuant to this section
2 or for dispatching ambulance services or quick response services
3 in compliance with designations made pursuant to this section.
4 Section 7. Section 8(c) of the act is amended by adding a
5 paragraph to read:
6 Section 8. Emergency medical services councils.
7 * * *
8 (c) Duties.--Each emergency medical services council shall:
9 * * *
10 (8) Assist municipal and county governing bodies in
11 making and implementing municipal service area and primary
12 responder and quick response service designations.
13 Section 8. The act is amended by adding a section to read:
14 Section 12.1. Quick response services.
15 (a) Regulations.--The department shall adopt regulations to:
16 (1) Establish responsibilities of a quick response
17 service in communicating with ambulance services and public
18 safety answering points.
19 (2) Prescribe requirements which need to be satisfied
20 for EMT-paramedics and health professional to provide advance
21 life support services to patients when they respond on behalf
22 of a quick response service.
23 (3) Facilitate the integration of quick response
24 services into the Statewide emergency medical services
25 system.
26 (b) Removal of recognition.--The department may remove the
27 recognition of a quick response service for its failure to
28 satisfy a regulation adopted pursuant to subsection (a).
29 Section 9. This act shall take effect as follows:
30 (1) Sections 4 and 6 of this act shall take effect in
20000H2502B3457 - 18 -
1 180 days.
2 (2) The remainder of this act shall take effect
3 immediately.
C27L35MSP/20000H2502B3457 - 19 -