PRINTER'S NO. 1234
No. 1060 Session of 2003
INTRODUCED BY VANCE, EGOLF, DeWEESE, MARSICO, BARD, BARRAR, BEBKO-JONES, BELFANTI, BROWNE, BUNT, CAPPELLI, CRAHALLA, CREIGHTON, DIVEN, J. EVANS, FLEAGLE, FLICK, GABIG, GEIST, GILLESPIE, HARHAI, HARPER, HORSEY, LAUGHLIN, MAITLAND, McNAUGHTON, MELIO, R. MILLER, S. MILLER, NICKOL, O'NEILL, PRESTON, READSHAW, REICHLEY, RUBLEY, SATHER, SAYLOR, SOLOBAY, E. Z. TAYLOR, THOMAS, TRUE, WATSON AND YOUNGBLOOD, APRIL 2, 2003
REFERRED TO COMMITTEE ON VETERANS AFFAIRS AND EMERGENCY PREPAREDNESS, APRIL 2, 2003
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," transferring the 10 emergency medical services powers and duties from the 11 Department of Health to the Pennsylvania Emergency Management 12 Agency. 13 The General Assembly of the Commonwealth of Pennsylvania 14 hereby enacts as follows: 15 Section 1. The definitions of "department" and "secretary" 16 in section 3 of the act of July 3, 1985 (P.L.164, No.45), known 17 as the Emergency Medical Services Act, are amended to read: 18 Section 3. Definitions. 19 The following words and phrases when used in this act shall
1 have the meanings given to them in this section unless the 2 context clearly indicates otherwise: 3 * * * 4 "Department." [The Department of Health of the 5 Commonwealth.] The Pennsylvania Emergency Management Agency. 6 * * * 7 ["Secretary." The Secretary of Health of the Commonwealth.] 8 * * * 9 Section 2. Sections 4, 5(a) and 6(f) of the act are amended 10 to read: 11 Section 4. Emergency medical services system. 12 The [secretary] department shall plan, guide and coordinate 13 programs to ensure that the Commonwealth's emergency medical 14 services system shall: 15 (1) Include an adequate number of health professionals 16 and other health personnel with appropriate training and 17 experience. 18 (2) Provide continuous training for its personnel, 19 including clinical training and continuing education programs 20 which are coordinated with other programs in the system's 21 service area which provide similar training and education. 22 (3) Join personnel, facilities and equipment, 23 coordinated by a central communication system, so that 24 requests for emergency medical services will be handled by 25 communications facilities which: 26 (i) utilize emergency medical telecommunications 27 screening to determine the appropriate emergency service 28 response; 29 (ii) are accessible to the general public through a 30 common telephone number and, where feasible, the 20030H1060B1234 - 2 -
1 universal emergency telephone number 911; and 2 (iii) will have direct communications with the 3 personnel, facilities and equipment of this system and 4 with other appropriate emergency medical services 5 systems. 6 (4) Include an adequate number of ambulances and other 7 transportation means to meet the individual characteristics 8 of the system's service area wherein: 9 (i) the ambulances and other vehicles meet criteria 10 relating to location, design, performance and equipment; 11 and 12 (ii) all operators and other personnel staffing the 13 vehicles meet appropriate training and experience 14 requirements. 15 (5) Include an adequate number of easily accessible 16 facilities which: 17 (i) are collectively capable of providing emergency 18 medical services on a continuous basis; 19 (ii) have appropriate nonduplicative and categorized 20 capabilities; 21 (iii) meet appropriate standards relating to 22 capacity, location, personnel and equipment; and 23 (iv) are coordinated with other health care 24 facilities of the system. 25 (6) Provide access, including appropriate 26 transportation, to trauma centers in the system's service 27 area or, if there are no centers or an inadequate number of 28 centers in the area, provide access to the centers in 29 neighboring areas if access to those centers is feasible in 30 terms of time and distance. 20030H1060B1234 - 3 -
1 (7) Provide, as necessary, for transfer of patients to 2 facilities or programs which offer follow-up care and 3 rehabilitation as is necessary to effect the maximum recovery 4 of the patient. 5 (8) Provide for the effective utilization of the 6 appropriate personnel, facilities and equipment of each 7 entity providing emergency medical services in the system's 8 service area. 9 (9) Be organized in a manner that provides persons who 10 reside in the system's service area and who have no 11 professional or financial interest in the provision of health 12 care with an adequate opportunity to participate in the 13 making of policy for the system. 14 (10) Provide necessary emergency medical services to all 15 patients requiring the services. 16 (11) Provide for a standardized patient data collection 17 system which covers all phases of the system. 18 (12) Provide programs of public education, information 19 and prevention in the system's service area, taking into 20 account the needs of visitors to and residents of that area 21 to know or easily access the means of obtaining emergency 22 medical services. These programs shall stress the general 23 dissemination of information regarding appropriate methods of 24 first aid and cardiopulmonary resuscitation and the 25 availability of first aid training programs in the area. 26 (13) Provide for: 27 (i) Periodic, comprehensive review and evaluation of 28 the extent and quality of the emergency health care 29 services provided in the system's service area. 30 (ii) Submission to the department of the reports of 20030H1060B1234 - 4 -
1 each review and evaluation. 2 (14) Have a plan to assure that the system will be 3 capable of providing emergency medical services in the 4 system's service area during mass casualty situations, 5 natural disasters or declared states of emergency in 6 consonance with 35 Pa.C.S. § 7101 et seq. (relating to 7 emergency management services) and in coordination with the 8 Pennsylvania Emergency Management Agency. 9 (15) Provide for the establishment of appropriate 10 arrangements with ambulance services serving neighboring 11 areas for the provision of emergency medical services on a 12 reciprocal basis where access to such areas would be more 13 appropriate and effective in terms of the services available, 14 time and distance. 15 Section 5. Duties of department. 16 (a) Duty.--It shall be the duty of the [secretary] 17 department to plan, guide, assist and coordinate the development 18 of areawide emergency medical services systems into a unified 19 Statewide system and to coordinate the system with similar 20 systems in neighboring states. 21 * * * 22 Section 6. Pennsylvania Trauma Systems Foundation. 23 * * * 24 (f) Duty of [secretary] department.--If the foundation has 25 not begun an accreditation program by June 30, 1985, in 26 accordance with this section, the [secretary] department shall 27 establish a trauma center accreditation program. 28 Section 3. Section 8(c) of the act, amended October 21, 1988 29 (P.L.1055, No.121), is amended to read: 30 Section 8. Emergency medical services councils. 20030H1060B1234 - 5 -
1 * * * 2 (c) Duties.--Each emergency medical services council shall: 3 (1) Assist the department in achieving the emergency 4 medical services system described in section 4. 5 (2) Assist the department in the collection and 6 maintenance of standardized patient data and information as 7 provided in section 5. 8 (3) Prepare plans for expanding or improving emergency 9 medical services in the area; the plans shall contain such 10 information as prescribed by the [secretary] department. 11 (4) Carry out, to the extent feasible, the emergency 12 medical services plans. 13 (5) Assure the reasonable availability of training 14 programs for emergency medical technicians and EMT-paramedics 15 under section 12(f). 16 (6) Provide necessary and reasonable staff services and 17 appropriate and convenient office facilities that can serve 18 as an areawide location for the planning, developmental 19 maintenance, coordinative and evaluative functions of the 20 council. 21 (7) Establish a mechanism to provide for input from 22 local emergency medical services providers, in decisions 23 which include, but are not limited to, membership on its 24 governing body. 25 Section 4. Section 10 of the act is amended to read: 26 Section 10. Contracts for initiation, maintenance, expansion or 27 improvement of emergency medical services 28 systems. 29 (a) General power.--The [secretary] department may enter 30 into contracts with emergency medical services councils and 20030H1060B1234 - 6 -
1 other appropriate entities for the initiation, expansion, 2 maintenance and improvement of emergency medical services 3 systems which are in accordance with the Statewide emergency 4 medical services plan. 5 (b) Limitation.--If any contracts are entered into under 6 this section for organization of an emergency medical services 7 council, no other contract may be entered into under this 8 section for any other emergency medical services council for the 9 same area or for an area which includes, in whole or substantial 10 part, such area. 11 (c) Purposes.--Contracts under subsection (a) may only be 12 used for: 13 (1) Providing programs of public education, information 14 and prevention regarding emergency medical services. 15 (2) Purchasing ambulances, medical equipment and rescue 16 equipment. 17 (3) Costs associated with the conduct of training 18 programs for prehospital and interhospital emergency medical 19 services personnel. 20 (4) Costs associated with ambulance service inspection 21 conducted to assist the department with ambulance service 22 licensure. 23 (5) Purchasing communications, including alerting 24 equipment, provided that the purchases are in accordance with 25 the Statewide telecommunications plan. 26 (6) Purchasing certain equipment for hospital emergency 27 departments if the equipment is used or intended to be used 28 in equipment exchange programs with ambulance services. 29 (7) Costs associated with maintenance and operation of 30 emergency medical services councils. Costs may include, but 20030H1060B1234 - 7 -
1 shall not be limited to, salaries, wages and benefits of 2 staff; travel; equipment and supplies; leasing of office 3 space; and other costs incidental to the conduct of business 4 which are deemed by the [secretary] department to be 5 necessary and appropriate for carrying out the purposes of 6 this act. 7 (8) Costs associated with collection and analysis of 8 data necessary to evaluate the effectiveness of emergency 9 medical services systems in providing emergency medical 10 services. 11 (d) Restriction.--Contract funds may not be used for: 12 (1) Acquisition, construction or rehabilitation of 13 facilities or buildings, except renovation as may be 14 necessary for the implementation of 911 and emergency medical 15 services communication systems. 16 (2) Purchasing hospital equipment unless such equipment 17 is used or intended to be used in an equipment exchange 18 program with ambulance services. 19 (3) Maintenance of ambulances, medical equipment or 20 rescue equipment except as authorized in subsection (c)(2). 21 (4) Costs deemed by the [secretary] department as 22 inappropriate for carrying out the purposes of this act. 23 (5) Costs which are normally borne by patients. 24 (e) Reports.--The recipient of a contract under this act 25 shall make reports to the department as may be required by the 26 [secretary] department. 27 (f) Application prerequisite.--No contract may be made under 28 this section unless: 29 (1) An application has been submitted to the department 30 in a form and format prescribed by the department. 20030H1060B1234 - 8 -
1 (2) The application demonstrates the need for planning,
2 initiation, maintenance, expansion or improvement of an
3 emergency medical services system.
4 (3) The application contains data and information which
5 demonstrates the qualifications of the applicant to plan,
6 initiate, expand or improve an emergency medical services
7 system and which includes organizational structure and
8 provision for representation of appropriate entities.
9 (4) The application contains an assurance that planning
10 for an emergency medical services system is conducted in
11 cooperation with each areawide health systems agency, where
12 available, whose plan covers, in whole or in part, such area.
13 (g) Technical assistance.--The department shall provide
14 technical assistance, as appropriate, to emergency medical
15 services councils and to such other eligible entities as
16 necessary for the purpose of their carrying out the provisions
17 of contracts under this section, with special consideration for
18 contractors representing rural areas.
19 (h) Payments.--Payments pursuant to contracts under this
20 section may be made in advance or by way of reimbursement and in
21 such installments and on such conditions as the [secretary]
22 department determines will most effectively carry out the
23 provisions of this act.
24 (i) Other grants considered.--In determining the amount of
25 any contract under this act, the amount of funds available to
26 the applicant from nonstate contributions and Federal grant or
27 contract programs pertaining to emergency medical services shall
28 be taken into consideration. Nonstate contributions include the
29 outlay of cash and in-kind services of the contractor or to the
30 contractor or toward the operation of an emergency medical
20030H1060B1234 - 9 -
1 services system by private, public or governmental third 2 parties, including the Federal Government. 3 (j) Other contracts.--Except as provided in subsection (c), 4 the [secretary] department may enter into contracts with 5 organizations other than emergency medical services councils in 6 order to assist the department in complying with the provisions 7 of this act. 8 (k) Public disclosure.--Finalized contracts shall be deemed 9 public records. 10 Section 5. Section 11(a.1) of the act, amended October 5, 11 1994 (P.L.557, No.82), is amended to read: 12 Section 11. Emergency medical services personnel. 13 * * * 14 (a.1) Certification of first responders.-- 15 (1) A first responder performs basic life support 16 activities, as authorized by the [Department of Health] 17 department, to stabilize and improve a patient's condition in 18 a prehospital setting until more highly trained emergency 19 medical services personnel arrive at the scene. 20 (2) The department shall certify any person as a first 21 responder who: 22 (i) Completes an application on a form prescribed by 23 the department. 24 (ii) Is at least 16 years of age. 25 (iii) Successfully completes a first responder 26 training course approved by the department. 27 (iv) Has taken and successfully passed a written 28 examination prescribed by the department. 29 (v) Has taken and successfully passed a practical 30 test of first responder skills prescribed by the 20030H1060B1234 - 10 -
1 department. 2 (3) A certification is valid for a period of three 3 years, subject to disciplinary action pursuant to subsection 4 (j.1). The department shall recertify as a first responder an 5 individual who complies with all of the following: 6 (i) Completes an application on a form prescribed by 7 the department. 8 (ii) Is or was previously certified as a first 9 responder. 10 (iii) Successfully completes: 11 (A) a first responder practical skills and 12 written knowledge examination prescribed by the 13 department; or 14 (B) a continuing education program for first 15 responders approved or recognized by the department. 16 (iv) The department, in consultation with the State 17 Advisory Council, shall review and update continuing 18 education programs not less than biennially. 19 (4) A person who has received certification as a first 20 responder pursuant to the voluntary first responder 21 certification program conducted by the department prior to 22 the effective date of this amendatory act shall be deemed 23 certified under the act. The certification shall be valid for 24 three years after issued, and recertification requirements of 25 paragraph (3) shall then apply. 26 * * * 27 Section 6. Section 12(d) of the act is amended to read: 28 Section 12. Minimum standards for ambulance service. 29 * * * 30 (d) Rules and regulations.--Within one year of the effective 20030H1060B1234 - 11 -
1 date of this act, the [secretary] department shall promulgate
2 rules and regulations setting forth the minimum essential
3 equipment for ambulances used to provide basic or advanced life
4 support services in this Commonwealth and shall prescribe design
5 criteria for any vehicle used or intended to be used as an
6 ambulance. Equipment listed shall include the minimum essential
7 equipment required for effective operation and rendering of
8 appropriate emergency medical care in accordance with current
9 national standards.
10 * * *
11 Section 7. All powers and duties vested in the Secretary of
12 Health and the Department of Health by this act are hereby
13 transferred to the Pennsylvania Emergency Management Agency.
14 Section 8. This act shall take effect in 90 days.
B11L35JLW/20030H1060B1234 - 12 -