SENATE AMENDED
        PRIOR PRINTER'S NOS. 3315, 3484               PRINTER'S NO. 3633

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 2473 Session of 1988


        INTRODUCED BY LLOYD, HAYES, HUTCHINSON, BELFANTI, SHOWERS, NOYE,
           BOWSER, KUKOVICH, SCHULER, TELEK, RAYMOND, DISTLER, TIGUE,
           JADLOWIEC, HESS, PUNT, BLACK, HASAY, McCALL, BOWLEY, HERMAN,
           GODSHALL, SAURMAN, FOSTER, MERRY, LEVDANSKY, JACKSON, BUNT,
           McVERRY, FARGO, MORRIS, HONAMAN, MOEHLMANN, STABACK, CARLSON,
           SCHEETZ, HALUSKA, BELARDI, BURD, COLE, SERAFINI, DIETTERICK,
           JOHNSON, S. H. SMITH, BATTISTO, MAINE, KASUNIC AND BROUJOS,
           MAY 16, 1988

        SENATOR PETERSON, PUBLIC HEALTH AND WELFARE, IN SENATE, AS
           AMENDED, JULY 5, 1988

                                     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," FURTHER PROVIDING   <--
    10     FOR SUPPORT OF EMERGENCY MEDICAL SERVICES; REQUIRING BYPASS
    11     PROTOCOLS; EXTENDING CERTAIN PROVISIONS OF THE ACT; AND
    12     excluding volunteer fire and ambulance departments from
    13     certain provisions of the act.

    14     The General Assembly of the Commonwealth of Pennsylvania
    15  hereby enacts as follows:
    16     SECTION 1.  THE DEFINITION OF "PENNSYLVANIA TRAUMA SYSTEMS     <--
    17  FOUNDATION" IN SECTION 3 OF THE ACT OF JULY 3, 1985 (P.L.164,
    18  NO.45), KNOWN AS THE EMERGENCY MEDICAL SERVICES ACT, IS AMENDED
    19  TO READ:


     1  SECTION 3.  DEFINITIONS.
     2     THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS ACT SHALL
     3  HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
     4  CONTEXT CLEARLY INDICATES OTHERWISE:
     5     * * *
     6     "PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION."  A NONPROFIT
     7  PENNSYLVANIA CORPORATION WHOSE FUNCTION IS TO ACCREDIT TRAUMA
     8  CENTERS IN THIS COMMONWEALTH. THE BOARD OF DIRECTORS OF THE
     9  FOUNDATION SHALL CONSIST OF THE FOLLOWING 19 VOTING MEMBERS:
    10  FIVE REPRESENTATIVES OF STATE ORGANIZATIONS THAT REPRESENT
    11  PHYSICIANS; FIVE REPRESENTATIVES OF STATE ORGANIZATIONS THAT
    12  REPRESENT HOSPITALS; TWO REPRESENTATIVES OF STATE ORGANIZATIONS
    13  THAT REPRESENT REGISTERED PROFESSIONAL NURSES; TWO
    14  REPRESENTATIVES OF OTHER STATEWIDE EMERGENCY MEDICAL SERVICE
    15  ORGANIZATIONS WITH EXPERTISE IN DELIVERY OF TRAUMA SERVICES; THE
    16  CHAIRMAN AND MINORITY CHAIRMAN OF THE HOUSE HEALTH AND WELFARE
    17  COMMITTEE, OR THEIR DESIGNEES, FROM THE COMMITTEE MEMBERSHIP;
    18  THE CHAIRMAN AND MINORITY CHAIRMAN OF THE SENATE PUBLIC HEALTH
    19  AND WELFARE COMMITTEE, OR THEIR DESIGNEES, FROM THE COMMITTEE
    20  MEMBERSHIP; AND THE SECRETARY OF HEALTH, OR HIS DESIGNEE. THE
    21  BYLAWS OF THE FOUNDATION SHALL IDENTIFY A METHOD TO SELECT
    22  MEMBERS TO ACHIEVE PROFESSIONAL AND GEOGRAPHIC BALANCE ON THE
    23  BOARD. TERMS OF OFFICE SHALL BE LIMITED TO THREE YEARS [AND NO
    24  PERSON SHALL BE ELIGIBLE FOR APPOINTMENT TO MORE THAN TWO
    25  CONSECUTIVE TERMS].
    26     * * *
    27     SECTION 2.  SECTION 5 OF THE ACT IS AMENDED BY ADDING A
    28  SUBSECTION TO READ:
    29  SECTION 5.  DUTIES OF DEPARTMENT.
    30     * * *
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     1     (C)  BYPASS PROTOCOLS.--THE DEPARTMENT SHALL ESTABLISH NOT
     2  LATER THAN SEPTEMBER 30, 1988, AND REGIONAL COUNCILS SHALL
     3  IMPLEMENT NOT LATER THAN DECEMBER 31, 1988, CRITERIA FOR
     4  EVALUATION, TRIAGE, TREATMENT, TRANSPORT, TRANSFER AND REFERRAL,
     5  INCLUDING BYPASS PROTOCOLS, OF ACUTELY ILL AND INJURED PERSONS
     6  TO THE MOST APPROPRIATE FACILITY. REGIONAL COUNCILS SHALL NOT BE
     7  ELIGIBLE FOR CONTRACT FUNDS OR STATE EMERGENCY MEDICAL SERVICES
     8  OPERATING FUND DISBURSEMENTS UNLESS CRITERIA AND PROTOCOLS HAVE
     9  BEEN ESTABLISHED.
    10     SECTION 3.  SECTION 8(C) OF THE ACT IS AMENDED BY ADDING A
    11  PARAGRAPH TO READ:
    12  SECTION 8.  EMERGENCY MEDICAL SERVICES COUNCILS.
    13     * * *
    14     (C)  DUTIES.--EACH EMERGENCY MEDICAL SERVICES COUNCIL SHALL:
    15         * * *
    16         (7)  ESTABLISH A MECHANISM TO PROVIDE FOR INPUT FROM
    17     LOCAL EMERGENCY MEDICAL SERVICES PROVIDERS, IN DECISIONS
    18     WHICH INCLUDE, BUT ARE NOT LIMITED TO, MEMBERSHIP ON ITS
    19     GOVERNING BODY.
    20     Section 1 4.  Section 12(e)(4) of the act of July 3, 1985      <--
    21  (P.L.164, No.45), known as the Emergency Medical Services Act,
    22  is amended to read:
    23  Section 12.  Minimum standards for ambulance service.
    24     * * *
    25     (e)  Minimum standards for staffing.--Minimum staffing
    26  standards for ambulance services which operate at the basic life
    27  support level of care shall be as follows:
    28         * * *
    29         (4)  Three years after the effective date of this act,
    30     all ambulances, when transporting a patient or patients,
    19880H2473B3633                  - 3 -

     1     except for routine transfer of convalescent or other
     2     nonemergency cases, shall be staffed by at least two persons,
     3     one of whom shall be an emergency medical technician, EMT-
     4     paramedic or health professional, and one of whom shall, at
     5     least, qualify as an ambulance attendant. The emergency
     6     medical technician, EMT-paramedic or health professional
     7     shall accompany the patient in the patient compartment. This
     8     clause shall not be applicable to any ambulance operated by a
     9     volunteer fire department or by a volunteer ambulance or
    10     rescue service until July 3, 1990.
    11     * * *
    12     Section 2.  This act shall take effect July 3, 1988.           <--
    13     SECTION 5.  SECTION 14 OF THE ACT IS AMENDED TO READ:          <--
    14  SECTION 14.  SUPPORT OF EMERGENCY MEDICAL SERVICES.
    15     (A)  FINE.--A $10 FINE SHALL BE LEVIED ON ALL [MOVING]
    16  TRAFFIC VIOLATIONS EXCLUSIVE OF PARKING OFFENSES. THESE FINES
    17  SHALL BE IN ADDITION TO OTHER FINES IMPOSED AT THE DISCRETION OF
    18  THE COURT.
    19     (B)  ACCELERATED REHABILITATIVE DISPOSITION FEE.--A FEE OF
    20  $25 SHALL BE IMPOSED AS COSTS UPON PERSONS ADMITTED TO PROGRAMS
    21  FOR ACCELERATED REHABILITATIVE DISPOSITION FOR OFFENSES
    22  ENUMERATED IN 75 PA.C.S. § 3731 (RELATING TO DRIVING UNDER
    23  INFLUENCE OF ALCOHOL OR CONTROLLED SUBSTANCE).
    24     [(B)] (C)  EMERGENCY MEDICAL SERVICES OPERATING FUND.--MONEY
    25  COLLECTED SHALL BE PAID TO THE COURT IMPOSING THE FINE, OR FEE,
    26  WHICH SHALL FORWARD IT TO THE STATE TREASURER FOR DEPOSIT INTO A
    27  SPECIAL [REVOLVING] FUND TO BE KNOWN AS THE EMERGENCY MEDICAL
    28  SERVICES OPERATING FUND. MONEYS IN THE FUND SHALL BE
    29  APPROPRIATED ANNUALLY BY THE GENERAL ASSEMBLY.
    30     [(C)] (D)  PURPOSE OF FUND.--ALL MONEY FROM THE EMERGENCY
    19880H2473B3633                  - 4 -

     1  MEDICAL SERVICES OPERATING FUND SHALL BE DISBURSED BY THE
     2  DEPARTMENT DIRECTLY TO PROVIDERS OF EMERGENCY MEDICAL SERVICES
     3  FOR THE INITIATION, EXPANSION, MAINTENANCE AND IMPROVEMENT OF
     4  EMERGENCY MEDICAL SERVICES AND SHALL NOT BE USED FOR DEPARTMENT
     5  OF HEALTH OR REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL
     6  ADMINISTRATIVE COSTS.
     7     [(D)] (E)  ALLOCATION TO CATASTROPHIC MEDICAL AND
     8  REHABILITATION FUND.--TWENTY-FIVE PERCENT OF THE FUND SHALL BE
     9  ALLOCATED TO A CATASTROPHIC MEDICAL AND REHABILITATION FUND FOR
    10  VICTIMS OF TRAUMA. THE CATASTROPHIC FUND SHALL BE AVAILABLE TO
    11  TRAUMA VICTIMS WHO, ON OR AFTER JULY 1, 1984, INCURRED THE
    12  TRAUMA, TO PURCHASE MEDICAL, REHABILITATION AND ATTENDANT CARE
    13  SERVICES WHEN ALL ALTERNATIVE FINANCIAL RESOURCES HAVE BEEN
    14  EXHAUSTED. THE DEPARTMENT MAY, BY REGULATION, PRIORITIZE THE
    15  DISTRIBUTION OF FUNDS BY CLASSIFICATION OF TRAUMATIC INJURY.
    16     (F)  AUDIT.--THE AUDITOR GENERAL SHALL REVIEW COLLECTIONS AND
    17  EXPENDITURES MADE PURSUANT TO THE PROVISIONS OF THIS SECTION AND
    18  REPORT ITS FINDINGS TO THE GENERAL ASSEMBLY ANNUALLY. THIS AUDIT
    19  SHALL INCLUDE A REVIEW OF THE COLLECTIONS AND EXPENDITURES OF
    20  THE EMERGENCY MEDICAL SERVICES COUNCILS.
    21     SECTION 6.  THIS ACT SHALL TAKE EFFECT AS FOLLOWS:
    22         (1)  SECTION 4 OF THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
    23         (2)  THE REMAINDER OF THIS ACT SHALL TAKE EFFECT IN 60
    24     DAYS.




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