PRINTER'S NO.  245

  

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

  

  

REFERRED TO VETERANS AFFAIRS AND EMERGENCY PREPAREDNESS, FEBRUARY 19, 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

19

PRELIMINARY PROVISIONS

 


1

Sec.

2

7201.  Short title of chapter.

3

7202.  Declaration of policy.

4

7203.  Definitions.

5

7204.  Emergency medical services system programs.

6

7205.  Duties of department.

7

7206.  Emergency medical services patient care reports.

8

7207.  Pennsylvania Trauma Systems Foundation.

9

7208.  State Advisory Board.

10

7209.  Regional emergency medical services councils.

11

§ 7201.  Short title of chapter.

12

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

13

Medical Services System Act.

14

§ 7202.  Declaration of policy.

15

The General Assembly finds and declares as follows:

16

(1)  Emergency medical services is an essential public

17

service and frequently the health care safety net for many

18

Commonwealth residents.

19

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

20

are high quality and coordinated emergency and urgent medical

21

services readily available to the residents of this

22

Commonwealth to prevent premature death and reduce suffering

23

and disability which arise from severe illness and injury.

24

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

25

achieved through a regulated and coordinated emergency

26

medical services system.

27

(4)  Transportation of both emergency and nonemergency

28

patients is an integral part of the health care delivery

29

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

30

that the emergency medical services system serve all persons

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1

in this Commonwealth who:

2

(i)  require medical care to address illness or

3

injury;

4

(ii)  need transportation to a hospital or other

5

health care facility to receive that care; and

6

(iii)  require medical assessment, monitoring,

7

assistance, treatment or observation during

8

transportation.

9

(5)  It serves the public interest if the emergency

10

medical services system is able to quickly adapt and evolve

11

to meet the needs of the residents of this Commonwealth for

12

emergency and urgent medical care and to reduce their illness

13

and injury risks.

14

(6)  It serves the public interest if the emergency

15

medical services system provides community-based health

16

promotion services that are integrated with the overall

17

health care system.

18

(7)  Emergency medical services should be acknowledged,

19

promoted and supported as an essential public service.

20

(8)  This chapter shall be liberally construed to

21

establish and maintain an effective and efficient emergency

22

medical services system which is accessible on a uniform

23

basis to residents of this Commonwealth and to visitors to

24

this Commonwealth.

25

(9)  Residents of this Commonwealth and visitors to this

26

Commonwealth should have prompt and unimpeded access to

27

urgent and emergency medical care throughout this

28

Commonwealth.

29

(10)  The Department of Health should continually assess

30

and, as needed, revise the functions of emergency medical

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1

services agencies and providers and other components of the

2

emergency medical services system that it regulates under

3

this chapter, to:

4

(i)  improve the quality of emergency medical

5

services provided in this Commonwealth;

6

(ii)  have the emergency medical services system

7

adapt to changing needs of the residents of this

8

Commonwealth; and

9

(iii)  promote the recruitment and retention of

10

persons willing and qualified to serve as emergency

11

medical services providers in this Commonwealth.

12

(11)  The emergency medical services system should be

13

fully integrated with the overall health care system, and in

14

particular with the public health system, to identify, modify

15

and manage illness and injury and illness and injury risks.

16

§ 7203.  Definitions.

17

The following words and phrases when used in this chapter

18

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

19

context clearly indicates otherwise:

20

"Advanced emergency medical services."  Emergency medical

21

services exceeding the scope of practice of an emergency medical

22

technician.

23

"Advanced emergency medical technician."  An individual who

24

is certified by the Department of Health as an advanced

25

emergency medical technician.

26

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

27

(1)  is maintained or operated to transport emergency

28

medical service providers above the advanced emergency

29

medical technician level, equipment and supplies to

30

rendezvous with the crew of an ambulance for the purpose of

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1

providing advanced emergency medical services to patients;

2

and

3

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

4

"ALS."  Advanced life support.

5

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

6

maintained or operated for the purpose of providing emergency

7

medical services to and transportation of patients.

8

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

9

or older and satisfies one of the following:

10

(1)  Possesses a certificate evidencing successful

11

completion of an advanced first aid course sponsored by the

12

American Red Cross and a current certificate evidencing

13

successful completion of a cardiopulmonary resuscitation

14

course acceptable to the Department of Health.

15

(2)  Possesses a current certificate evidencing

16

successful completion of a course determined by the

17

Department of Health to be equivalent to the requirements in

18

paragraph (1).

19

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

20

medical services included within, but not exceeding, the scope

21

of practice of an emergency medical technician.

22

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

23

(1)  is maintained or operated to transport emergency

24

medical services providers, equipment and supplies to

25

rendezvous with the crew of an ambulance for the purpose of

26

providing emergency medical services at or below the advanced

27

emergency medical technician level to patients; and

28

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

29

"BLS."  Basic life support.

30

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

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1

Directors of the Pennsylvania Emergency Health Services Council.

2

"Commonwealth emergency medical services medical director" or

3

"Commonwealth EMS medical director."  A physician who is

4

approved and employed by the Department of Health to advise and

5

formulate policy on matters pertaining to emergency medical

6

services.

7

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

8

"Emergency."  A physiological or psychological illness or

9

injury of an individual, such that a prudent layperson who

10

possesses an average knowledge of health and medicine could

11

reasonably expect the absence of immediate emergency medical

12

services to result in:

13

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

14

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

15

unborn child, in serious jeopardy;

16

(2)  serious impairment of bodily functions; or

17

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

18

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

19

certified by the Department of Health as an emergency medical

20

responder.

21

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

22

(1)  The medical care, including medical assessment,

23

monitoring, treatment, transportation and observation, which

24

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

25

reported emergency to:

26

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

27

deterioration in physiological or psychological

28

condition; or

29

(ii)  address pain or morbidity associated with the

30

person's condition.

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1

(2)  The transportation of an individual with medical

2

assessment, monitoring, treatment or observation of the

3

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

4

medical assessment, monitoring, treatment or observation

5

during the transport.

6

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

7

entity that engages in the business or service of providing

8

emergency medical services to patients within this Commonwealth

9

by operating any of the following:

10

(1)  An ambulance.

11

(2)  An advanced life support squad vehicle.

12

(3)  A basic life support squad vehicle.

13

(4)  A quick response service.

14

(5)  A special operations EMS service. This paragraph

15

includes, but is not limited to:

16

(i)  a tactical EMS service;

17

(ii)  a wilderness EMS service;

18

(iii)  a mass-gathering EMS service; and

19

(iv)  an urban search and rescue EMS service.

20

(6)  A vehicle or service which provides emergency

21

medical services outside of a health care facility, as

22

prescribed by the Department of Health by regulation.

23

"Emergency medical services agency medical director" or "EMS

24

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

25

contracts with or volunteers with an emergency medical services

26

agency either directly or through an intermediary to:

27

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

28

emergency medical services providers utilized by the

29

emergency medical services agency; and

30

(2)  provide medical guidance and advice to the emergency

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1

medical services agency.

2

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

3

of the following:

4

(1)  An emergency medical responder.

5

(2)  An emergency medical technician.

6

(3)  An advanced emergency medical technician.

7

(4)  A paramedic.

8

(5)  A prehospital registered nurse.

9

(6)  A prehospital physician extender.

10

(7)  A prehospital emergency medical services physician.

11

(8)  An individual prescribed by regulation of the

12

Department of Health to provide specialized emergency medical

13

services.

14

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

15

arrangement of personnel, facilities and equipment to prevent

16

and manage emergencies in a geographic area.

17

"Emergency medical services vehicle operator" or "EMS vehicle

18

operator."  An individual certified by the Department of Health

19

to operate a ground emergency medical services vehicle.

20

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

21

is certified by the Department of Health as an emergency medical

22

technician.

23

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

24

a health care facility licensed under Federal or State law.

25

"Foundation."  The Pennsylvania Trauma Systems Foundation, a

26

nonprofit Pennsylvania corporation whose function is to accredit

27

trauma centers in this Commonwealth.

28

"Hospital."  An institution having an organized medical staff

29

that is primarily engaged in providing to inpatients, by or

30

under the supervision of physicians, diagnostic and therapeutic

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1

services or rehabilitation services for the care or

2

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

3

mentally ill persons. The term includes a facility for the

4

diagnosis and treatment of disorders within the scope of

5

specific medical specialties. The term does not include a

6

facility caring exclusively for the mentally ill.

7

"Medical command facility."  A distinct unit which contains

8

the necessary equipment and personnel for providing medical

9

command to and control over emergency medical services

10

providers.

11

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

12

command physician to an emergency medical services provider who

13

is functioning on behalf of an emergency medical services

14

agency.

15

"Medical command physician."  A physician certified by the

16

Department of Health to give medical command orders to emergency

17

medical services providers.

18

"Medical monitoring."  Performing continuous or periodic

19

observations of an individual's condition or continuation of an

20

ordered treatment plan for an individual to prevent pain,

21

suffering or the exacerbation of a preexisting condition.

22

"Medical observation."  Performing continuous or periodic

23

observations of an individual's stable condition to determine

24

whether there is a change in that condition.

25

"Paramedic."  An individual who is certified by the

26

Department of Health as a paramedic.

27

"Patient."  An individual for whom an emergency medical

28

services provider is:

29

(1)  providing emergency medical services on behalf of an

30

EMS agency; or

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1

(2)  required to provide emergency medical services on

2

behalf of an EMS agency because the individual's condition

3

requires or may require medical observation, monitoring,

4

assessment or treatment for an illness, disease, injury or

5

other disability.

6

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

7

the quality and efficiency of services ordered or performed by

8

emergency medical services providers and physicians who direct

9

or supervise EMS providers under this chapter and the

10

regulations of the Department of Health.

11

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

12

to practice medicine or osteopathic medicine in this

13

Commonwealth.

14

"Prehospital emergency medical services physician" or

15

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

16

the Department of Health as a prehospital emergency medical

17

services physician.

18

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

19

assistant who is certified by the Department of Health as a

20

prehospital physician extender.

21

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

22

who is certified by the Department of Health as a prehospital

23

registered nurse.

24

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

25

emergency medical services providers of an EMS agency:

26

(1)  respond to an actual, reported or perceived

27

emergency; and

28

(2)  provide emergency medical services to patients

29

pending the arrival of an ambulance.

30

"Regional emergency medical services council" or "regional

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1

EMS medical director."  A nonprofit incorporated entity or

2

appropriate equivalent that is assigned by the Department of

3

Health to:

4

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

5

emergency medical services systems within a specific

6

geographic area of this Commonwealth; and

7

(2)  coordinate those systems into a regional emergency

8

medical services system.

9

"Regional emergency medical services medical director" or

10

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

11

regional emergency medical services council.

12

"Review organization."  A committee which engages in peer

13

review as authorized by the regulations of the Department of

14

Health.

15

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

16

the United States Bureau of the Census.

17

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

18

hospital where provisions have been made for a concentration of

19

physicians, nurses and others who have special skills and

20

experiences to provide medical care for critically ill patients.

21

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

22

the Pennsylvania Trauma Systems Foundation.

23

§ 7204.  Emergency medical services system programs.

24

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

25

guide and coordinate programs on the following matters to

26

promote effective and efficient operation of Statewide and

27

regional EMS systems:

28

(1)  The number and distribution of EMS providers and

29

other persons integral to an EMS system, such as medical

30

command physicians and EMS agency medical directors, with

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1

appropriate training and experience.

2

(2)  Reasonably accessible training for EMS providers and

3

other persons integral to an EMS system, including clinical

4

training and continuing education programs coordinated with

5

other programs providing similar, complementary and

6

supplemental training and education.

7

(3)  The joining of personnel, facilities and equipment

8

coordinated through a communication system to ensure that EMS

9

requests will be handled by communications facilities that:

10

(i)  utilize emergency medical telecommunications

11

screening to determine the appropriate emergency agency

12

response;

13

(ii)  are accessible to the general public through a

14

common telephone number and, where feasible, through the

15

universal emergency telephone number 911; and

16

(iii)  will have direct communications with

17

appropriate personnel facilities and equipment resources.

18

(4)  The number and distribution of ambulances and other

19

EMS vehicles in which:

20

(i)  ambulances and other vehicles meet appropriate

21

criteria relating to location, design, performance and

22

equipment; and

23

(ii)  operators and other personnel staffing vehicles

24

meet appropriate training and experience requirements.

25

(5)  The number and accessibility of facilities that:

26

(i)  are collectively capable of providing EMS on a

27

continuous basis;

28

(ii)  have appropriate specialty capabilities;

29

(iii)  meet appropriate standards relating to

30

capacity, location, personnel and equipment; and

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1

(iv)  are coordinated with other health care

2

facilities and resource centers.

3

(6)  Access and transportation to trauma centers and

4

specialty care receiving facilities.

5

(7)  Transfer of patients between facilities or to

6

programs offering necessary follow-up care and

7

rehabilitation.

8

(8)  Utilization of appropriate personnel, facilities and

9

equipment of each entity providing EMS.

10

(9)  Regional EMS councils that provide persons residing

11

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

12

interest in the provision of health care, with an adequate

13

opportunity to participate in the making of policy for the

14

regional EMS system.

15

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

16

services.

17

(11)  A standardized data collection system that covers

18

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

19

to, the dispatch report and contact, treatment and transport

20

of a patient in the EMS system.

21

(12)  Programs of public education, information and

22

prevention, integrated with public health education and

23

taking into account needs of visitors and residents,

24

concerning methods for accessing EMS and stressing

25

dissemination of information as to first aid and

26

cardiopulmonary resuscitation.

27

(13)  The provision of periodic comprehensive review and

28

evaluation of the extent and quality of the EMS provided in

29

each regional EMS system and reports to the department of

30

each review or evaluation.

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1

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

2

be able to provide or secure EMS during mass casualty

3

situations, natural disasters and declared states of

4

emergency in accordance with Chapter 71 (relating to general

5

provisions) and the instructions of the Pennsylvania

6

Emergency Management Agency.

7

(15)  Appropriate intrastate and interstate arrangements

8

for the provision of EMS as needed.

9

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

10

objectives to be pursued and achieved by the department in its

11

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

12

to confer regulatory powers upon the department beyond those

13

conferred elsewhere in this chapter.

14

§ 7205.  Duties of department.

15

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

16

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

17

coordinate the development of regional EMS systems into a

18

unified Statewide system; and coordinate systems in this

19

Commonwealth with similar systems in neighboring states.

20

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

21

EMS in this Commonwealth. The department is authorized to:

22

(1)  Coordinate a program for planning, developing,

23

maintaining, expanding, improving and upgrading EMS systems

24

in this Commonwealth.

25

(2)  Establish, by regulation, standards and criteria

26

governing the awarding and administration of contracts and

27

grants under this chapter for initiation, maintenance and

28

improvement of regional EMS systems.

29

(3)  Require collection and maintenance of patient data

30

and information in EMS patient care reports by EMS agencies.

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1

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

2

and information regarding patients who utilize emergency

3

departments without being admitted to the facility and

4

patients admitted through emergency departments, trauma

5

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

6

protects and maintains the confidential nature of patient

7

records. The data and information shall be reasonable in

8

detail and shall be collected pursuant to regulations issued

9

by the department. Data and information shall be limited to

10

that which may be used for specific planning, research and

11

quality improvement purposes and shall not be duplicative of

12

data and information already available to the department.

13

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

14

section 7211 (relating to comprehensive plan).

15

(6)  Define and approve training programs and accredit

16

educational institutions for EMS training of EMS providers.

17

(7)  Provide technical assistance to local governments,

18

EMS agencies and other entities for the purpose of assuring

19

effective planning and execution of EMS.

20

(8)  Administer contracts and grants authorized under

21

this chapter and other grants pertaining to EMS.

22

(9)  Establish standards for the licensing, registration

23

and operation of EMS agencies, and inspect EMS agencies for

24

compliance with this chapter and regulations adopted under

25

this chapter.

26

(10)  Maintain a quality improvement program for the

27

purpose of monitoring and improving the delivery of EMS.

28

(11)  Promulgate regulations to establish standards and

29

criteria for EMS systems.

30

(12)  Integrate all trauma centers accredited pursuant to

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1

section 7207 (relating to Pennsylvania Trauma Systems

2

Foundation) into the Statewide EMS system.

3

(13)  Recommend to 911 and other EMS agency dispatchers

4

protocols with respect to the type and quantity of EMS

5

resources to dispatch to emergencies.

6

(14)  Investigate, based upon complaints and information

7

received, possible violations of this chapter and regulations

8

under this chapter and take disciplinary actions, seek

9

injunctions and refer matters for criminal prosecution.

10

(15)  Investigate complaints concerning delivery of

11

services by trauma centers and forward investigation results

12

to the appropriate accrediting entity with a recommendation

13

for action.

14

(16)  Enter into agreements with other states which may

15

include, as appropriate to effectuate the purposes of this

16

chapter, the acceptance of EMS resources of other states that

17

do not fully satisfy the requirements of this chapter or

18

regulations adopted under this chapter.

19

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

20

and protocols, including bypass protocols, for evaluation,

21

triage, treatment, transport, transfer and referral of patients

22

to ensure that they receive appropriate EMS and are transported

23

to the most appropriate facility. Regional EMS councils shall

24

not be eligible for contracts or grant funds or State EMS

25

Operating Fund disbursements unless they assist in ensuring

26

regional implementation of the criteria and protocols. Protocols

27

under this subsection are not subject to the rulemaking process.

28

§ 7206.  Emergency medical services patient care reports.

29

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

30

responding EMS providers complete an EMS patient care report for

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1

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

2

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

3

the department by regulation exempts certain types of patient

4

contact from the reporting requirement. The department shall

5

employ an electronic EMS patient care reporting process that

6

shall solicit standardized data and patient information. The

7

department may require an EMS agency to complete a different

8

standardized report or different fields in a standardized report

9

based upon the type of resources the EMS agency uses in

10

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

11

paper report for extraordinary reasons as determined by the

12

department on a case-by-case basis.

13

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

14

solicited on the form or other reporting process developed by

15

the department. The reporting process shall solicit essential

16

information in reasonable detail. The department may also use

17

the reporting process to collect data to enhance its ability to

18

carry out its responsibilities under sections 7204 (relating to

19

emergency medical services system programs) and 7205 (relating

20

to duties of department).

21

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

22

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

23

information about the patient and EMS performed on the patient

24

that is solicited through the reporting process shall be

25

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

26

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

27

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

28

or a regional EMS council, as determined by department

29

regulation, data that is solicited through the reporting

30

process.

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1

(e)  Confidentiality.--

2

(1)  Patient information collected by an EMS agency shall

3

be confidential and shall not be released by the EMS agency

4

or a health care facility except as follows:

5

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

6

or to a person who is authorized to exercise the rights

7

of the patient with respect to securing the report.

8

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

9

jurisdiction, including a subpoena when it constitutes a

10

court order, except that disclosure pursuant to a

11

subpoena shall not be permitted as to information in the

12

report that is of such nature that disclosure pursuant to

13

a subpoena is not otherwise authorized by law.

14

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

15

medical record may be released under the law.

16

(iv)  For billing purposes.

17

(v)  For quality improvement activities.

18

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

19

the purpose of investigating possible violations of this

20

chapter or related regulations.

21

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

22

authorized by the department, for the purpose of the

23

agency performing official government duties.

24

(2)  Notwithstanding the duty of confidentiality

25

applicable to department and regional EMS councils concerning

26

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

27

specific research or EMS planning purposes approved by the

28

department, subject to department approval and supervision to

29

ensure that use of the report is strictly limited to the

30

purposes of the research.

- 18 -

 


1

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

2

offer reporting forms or software marketed as appropriate for

3

use in making reports required under this section unless the

4

vendor submits the product to the department for review and

5

receives department approval. Thereafter, the vendor shall

6

submit any modification of the product to the department for

7

review and approval if the vendor intends to offer the modified

8

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

9

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

10

shall publish a notice of the changes in the Pennsylvania

11

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

12

than 60 days following publication. After publication of

13

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

14

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

15

forms or software approved by the department prior to

16

publication of the changes, unless the vendor clearly discloses

17

that the forms or software were approved prior to publication of

18

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

19

penalty for each day a vendor violates the provisions of this

20

subsection.

21

§ 7207.  Pennsylvania Trauma Systems Foundation.

22

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

23

develop a private voluntary accreditation program to:

24

(1)  Establish standards for the operation of trauma

25

centers in this Commonwealth, adopting, at a minimum, current

26

guidelines for trauma centers defined by the American College

27

of Surgeons. Additionally, Level III trauma centers shall

28

meet accreditation criteria for Level III trauma centers

29

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

30

as the Pennsylvania Trauma Systems Stabilization Act. For the

- 19 -

 


1

purpose of reaccreditation, the standards shall require, at a

2

minimum, that each Level I trauma center establish that 600

3

severe and urgent injury cases have been treated per year and

4

each Level II trauma center establish that 350 severe and

5

urgent injury cases have been treated per year.

6

(2)  Evaluate a hospital making application to the

7

foundation to determine if the hospital meets the

8

foundation's standards. An evaluation shall include hospital

9

site visits by accreditation survey teams composed of

10

independent, qualified persons selected by the foundation.

11

(3)  Issue certificates of accreditation to hospitals

12

that meet the accreditation standards. Certificates of

13

accreditation shall be valid for a period not to exceed three

14

years. Certificates of accreditation may be revoked by the

15

foundation if it is determined that the trauma center no

16

longer meets accreditation standards as set forth in this

17

chapter.

18

(4)  Establish an appeal mechanism for reconsideration of

19

accreditation decisions.

20

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

21

of the foundation under this section may file a petition for

22

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

23

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

24

trauma center unless it has a current certificate of

25

accreditation issued under this section.

26

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

27

foundation shall consist of the following voting members: five

28

representatives of State organizations representing physicians;

29

five representatives of State organizations representing

30

hospitals; three representatives of State organizations

- 20 -

 


1

representing registered professional nurses; two representatives

2

of other Statewide EMS organizations having expertise in the

3

delivery of trauma services; the chairman and minority chairman

4

of the Public Health and Welfare Committee of the Senate or

5

designees chosen from among the members of the committee; the

6

chairman and minority chairman of the Health and Human Services

7

Committee of the House of Representatives or designees chosen

8

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

9

Health or a designee. The bylaws of the foundation shall

10

identify a method to select members to achieve professional and

11

geographic balance on the board of directors. Terms of office

12

shall be limited to three years.

13

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

14

maintain statistics on mortality and morbidity on multisystem

15

trauma victims. The data collection shall be coordinated and

16

performed in conjunction with State data collection activities.

17

§ 7208.  State Advisory Board.

18

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

19

composed of volunteer, professional and paraprofessional

20

organizations involved in EMS. The board shall be geographically

21

representative of the provider organizations that represent EMS

22

providers, firefighters, regional EMS councils, physicians,

23

hospital administrators and other health care providers

24

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

25

organizations. Each organization that is a member of the

26

Pennsylvania Emergency Health Services Council and is elected to

27

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

28

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

29

(1)  Elect officers.

30

(2)  Advise the department concerning manpower and

- 21 -

 


1

training, communications, EMS agencies, content of

2

regulations, standards and policies promulgated by the

3

department under this chapter and other subjects deemed

4

appropriate by the department.

5

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

6

the Statewide EMS system plan, or any proposed revisions

7

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

8

plan.

9

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

10

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

11

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

12

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

13

consecutive terms.

14

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

15

board shall constitute a quorum for the transaction of business.

16

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

17

compensation, except the Pennsylvania Emergency Health Services

18

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

19

pay necessary and reasonable expenses incurred by members of the

20

board while performing their official duties.

21

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

22

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

23

under subsection (b). Contracts and grants between the

24

department and the board for the performance of work other than

25

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

26

to contracts and grants) where applicable.

27

§ 7209.  Regional emergency medical services councils.

28

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

29

department in carrying out the provisions of this chapter. Each

30

regional EMS council shall adhere to policy direction from the

- 22 -

 


1

department.

2

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

3

organizational structure of a regional EMS council shall be

4

representative of the public, health professions and major

5

private and public voluntary agencies, organizations and

6

institutions concerned with providing EMS in the region and

7

shall be one of the following:

8

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

9

council, meeting requirements for representation.

10

(2)  A representative public entity administering a

11

compact or other area-wide arrangement or consortium.

12

(3)  Any other public or private nonprofit entity that

13

meets requirements for representation as determined by the

14

department.

15

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

16

the department:

17

(1)  Assist the department in achieving the Statewide and

18

regional EMS system components and goals described under

19

section 7204 (relating to emergency medical services system

20

programs).

21

(2)  Assist the department in the collection and

22

maintenance of standardized data and information as provided

23

in section 7206 (relating to emergency medical services

24

patient care reports).

25

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

26

regional EMS system plan for the EMS region the department

27

has designated and for which the department has contracted or

28

provided a grant to it to serve.

29

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

30

regional EMS system plans.

- 23 -

 


1

(5)  Assure the reasonable availability of training and

2

continuing education programs for EMS providers.

3

(6)  Provide necessary and reasonable staff services and

4

appropriate and convenient office facilities that can serve

5

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

6

and coordinative and evaluative functions of the council.

7

(7)  Establish a mechanism to provide for input from

8

facilities and EMS agencies in the EMS region in decisions

9

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

10

governing body.

11

(8)  Establish, subject to department approval, regional

12

EMS triage, treatment and transportation protocols consistent

13

with Statewide protocols adopted by the department. A

14

regional EMS council may also establish, subject to

15

department approval, additional triage, treatment and

16

transportation protocols. No regional protocol shall be

17

subject to the rulemaking process.

18

(9)  Advise public safety answering points and municipal

19

and county governments as to the EMS resources available for

20

dispatching and recommend dispatch criteria that may be

21

developed by the department or the council as approved by the

22

department.

23

(10)  Assist the department in achieving a unified

24

Statewide EMS system.

25

(11)  Designate a regional EMS medical director and

26

establish a medical advisory committee and a quality

27

improvement committee.

28

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

29

department approval, and require its board or advisory

30

council members, officials and employees to agree to the

- 24 -

 


1

policy in writing.

2

(13)  Perform other duties assigned by the department to

3

assist the department in carrying out the requirements of

4

this chapter.

5

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

6

consult with the regional EMS medical directors in developing

7

and adopting EMS protocols and may consult with them on any

8

matter involved in the department's administration of this

9

chapter.

10

SUBCHAPTER B

11

PROGRAM

12

Sec.

13

7211.  Comprehensive plan.

14

7212.  Contracts and grants.

15

7213.  Emergency medical services providers.

16

7214.  Emergency medical responders.

17

7215.  Emergency medical technicians.

18

7216.  Advanced emergency medical technicians.

19

7217.  Paramedics.

20

7218.  Prehospital registered nurses.

21

7219.  Prehospital physician extenders.

22

7220.  Prehospital emergency medical services physicians.

23

7221.  Certification sanctions.

24

7222.  Emergency medical services vehicle operators.

25

7223.  Suspension of certification.

26

7224.  Emergency medical services instructors.

27

7225.  Medical director of emergency medical services agency.

28

7226.  Medical command physicians and facility medical

29

directors.

30

7227.  Medical command facilities.

- 25 -

 


1

7228.  Receiving facilities.

2

7229.  Emergency medical services agencies.

3

7230.  Advanced life support ambulances.

4

7231.  Air ambulances.

5

7232.  Advanced life support squad vehicles.

6

7233.  Basic life support ambulances.

7

7234.  Basic life support squad vehicles.

8

7235.  Quick response services.

9

7236.  Special operations emergency medical services.

10

7237.  First aid and other safety services.

11

7238.  Other vehicles and services.

12

7239.  Stretcher and wheelchair vehicles.

13

7240.  Conditional temporary licenses.

14

7241.  Plans of correction.

15

7242.  Emergency medical services agency license sanctions.

16

§ 7211.  Comprehensive plan.

17

(a)  Preparation.--

18

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

19

shall prepare a Statewide EMS system plan, which plan shall

20

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

21

and shall make the plan available to the General Assembly and

22

all concerned agencies, entities and individuals.

23

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

24

department, shall:

25

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

26

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

27

information that subsection (b) requires for the

28

Statewide plan.

29

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

30

contain:

- 26 -

 


1

(1)  An inventory of EMS resources available within this

2

Commonwealth.

3

(2)  An assessment of the effectiveness of the existing

4

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

5

EMS system.

6

(3)  Performance measures for delivery of EMS to all

7

persons in this Commonwealth.

8

(4)  Methods to be used in achieving the stated

9

performance measures.

10

(5)  A schedule for achievement of the stated performance

11

measures.

12

(6)  A method for monitoring and evaluating whether the

13

stated performance measures are being achieved.

14

(7)  Estimated costs for achieving the stated performance

15

measures.

16

(c)  Revisions.--

17

(1)  The department shall collect and analyze EMS data

18

for the purpose of:

19

(i)  Revising the Statewide EMS system plan,

20

including determining the status of the Statewide EMS

21

system, the degree of compliance with the requirements of

22

this chapter and the effectiveness of EMS systems in

23

reducing morbidity and mortality associated with medical

24

emergencies.

25

(ii)  Planning future EMS system initiatives.

26

(2)  Persons regulated by the department under this

27

chapter and dispatchers of EMS agencies shall provide data,

28

without charge, as reasonably requested by the department and

29

regional EMS councils, to aid them in developing and revising

30

Statewide and regional EMS system plans and in conducting

- 27 -

 


1

investigations under this chapter as authorized by the

2

department.

3

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

4

comprehensive and specific reports of activity and plan

5

implementation.

6

(e)  Use of Statewide plan.--

7

(1)  The department shall use the Statewide plan for

8

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

9

(relating to contracts and grants).

10

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

11

vest the department with any regulatory authority.

12

§ 7212.  Contracts and grants.

13

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

14

or grants with entities to serve as regional EMS councils

15

responsible for the initiation, expansion, maintenance and

16

improvement of regional EMS systems that are in accordance with

17

the Statewide EMS system plan.

18

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

19

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

20

regional EMS council shall carry out the duties assigned by the

21

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

22

medical services councils).

23

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

24

regional EMS councils, the department may allocate Emergency

25

Medical Services Operating Fund moneys appropriated to the

26

department only for the following purposes:

27

(1)  Providing programs of public education, information,

28

health promotion and prevention regarding EMS.

29

(2)  Purchasing ambulances, other EMS vehicles, medical

30

equipment and rescue equipment.

- 28 -

 


1

(3)  Applying to costs associated with conducting

2

training and testing programs for EMS providers.

3

(4)  Applying to costs associated with inspections and

4

investigations conducted to assist the department to carry

5

out its regulatory authority under this chapter.

6

(5)  Purchasing communications equipment and services,

7

including alerting equipment, provided that the purchases are

8

in accordance with the Statewide EMS system plan.

9

(6)  Assisting with the merger of EMS agencies or

10

assisting an EMS agency to acquire another EMS agency, when

11

the department determines circumstances exist such that the

12

transaction and financial assistance are needed to serve the

13

public interest.

14

(7)  Applying to costs associated with the maintenance

15

and operation of regional EMS councils. Those costs may

16

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

17

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

18

office space, and other costs incidental to the conduct of

19

business which are deemed by the department to be necessary

20

and appropriate for carrying out the purposes of this

21

chapter.

22

(8)  Applying to costs associated with collection and

23

analysis of data necessary to evaluate the effectiveness of

24

EMS systems in providing EMS and to administer quality

25

improvement programs.

26

(9)  Applying to costs associated with assisting EMS

27

agencies to recruit and retain EMS providers.

28

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

29

regional EMS councils, the department may not allocate Emergency

30

Medical Services Operating Fund moneys appropriated to the

- 29 -

 


1

department for the following purposes:

2

(1)  Acquisition, construction or rehabilitation of

3

facilities or buildings, except renovation as may be

4

necessary for the implementation or modification of EMS

5

communication systems.

6

(2)  Purchasing hospital equipment, other than

7

communications equipment for medical command and receiving

8

facilities, unless the equipment is used or intended to be

9

used in an equipment exchange program with EMS agencies.

10

(3)  Maintenance of ambulances, other EMS vehicles and

11

equipment.

12

(4)  Applying to costs deemed by the department as

13

inappropriate for carrying out the purposes of this chapter.

14

(5)  Applying to costs which are normally borne by

15

patients, except for extraordinary costs as determined by the

16

department.

17

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

18

this chapter shall make reports to the department as may be

19

required by the department.

20

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

21

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

22

entity to serve as a regional EMS council unless:

23

(1)  The entity has submitted a contract or grant

24

application to the department in a form and format prescribed

25

by the department that is consistent with the Statewide and

26

regional EMS system plans.

27

(2)  The application addresses planning, maintenance and

28

improvement of the regional EMS system.

29

(3)  The entity demonstrates to the department's

30

satisfaction the qualifications and commitment to plan,

- 30 -

 


1

maintain and improve a regional EMS system, and that the

2

entity has the required organizational structure and

3

provisions for representation of appropriate entities.

4

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

5

technical assistance, as appropriate, to regional EMS councils

6

and to such other eligible entities as necessary for the purpose

7

of their carrying out the provisions of contracts and grants

8

under this section, with special consideration for contractors

9

and grantees representing rural areas.

10

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

11

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

12

reimbursement and in installments and on conditions as the

13

department determines will most effectively carry out the

14

provisions of this chapter.

15

(i)  Other funds considered.--

16

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

17

under this section, the amount of funds available to the

18

contractor or grantee from non-State contributions and

19

Federal grant or contract programs pertaining to EMS shall be

20

taken into consideration.

21

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

22

contributions" include the outlay of cash and in-kind

23

services to the contractor or grantee or toward the operation

24

of a regional EMS system by private, public or government

25

third parties, including the Federal Government.

26

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

27

into contracts and grants with organizations other than regional

28

EMS councils in order to assist the department in complying with

29

the provisions of this section and chapter.

30

(k)  Public disclosure.--

- 31 -

 


1

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

2

finalized contracts and grants shall be deemed public records

3

subject to disclosure.

4

(2)  The department may not disclose information in

5

contracts or grants that could be used by persons to

6

undermine measures to combat, respond to or recover from

7

terrorist attacks.

8

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

9

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

10

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

11

department, without undertaking a competitive bidding process,

12

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

13

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

14

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

15

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

16

contract or grant, demonstrated its ability and commitment to

17

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

18

regional EMS system consistent with the terms of the prior

19

contract or grant.

20

§ 7213.  Emergency medical services providers.

21

(a)  Certification.--The department shall issue

22

certifications for the following types of EMS providers, which

23

shall be permanent, subject to disciplinary action pursuant to

24

section 7221 (relating to certification sanctions):

25

(1)  Emergency medical responder.

26

(2)  Emergency medical technician.

27

(3)  Advanced emergency medical technician.

28

(4)  Paramedic.

29

(5)  Prehospital registered nurse.

30

(6)  Prehospital physician extender.

- 32 -

 


1

(7)  Prehospital EMS physician.

2

(8)  Any other class of EMS provider the department

3

establishes by regulation.

4

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

5

department may establish, by regulation as the need arises,

6

classes of EMS providers to provide specialized EMS. The

7

regulations shall establish certification, practice,

8

disciplinary and other provider standards consistent with the

9

purposes of this chapter, and the statutory regulatory schemes

10

applicable to paramedics except as necessary to meet the special

11

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

12

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

13

certification shall complete an application for certification on

14

a form or through an electronic application process prescribed

15

by the department.

16

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

17

coordinate the education of EMS providers.

18

(1)  The department shall develop standards through

19

regulations for the accreditation, reaccreditation and

20

operation of educational institutes to provide the training

21

persons must successfully complete to be certified as EMS

22

providers.

23

(2)  The department shall develop standards through

24

regulations for the approval of continuing education courses

25

for EMS providers and for the accreditation of persons and

26

Commonwealth agencies that provide continuing education EMS

27

providers may take to secure renewal of registration.

28

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

29

shall review and update the permitted scope of continuing

30

education programs not less than biennially.

- 33 -

 


1

(4)  If the educational institute or provider of

2

continuing education courses fails to satisfy the operational

3

standards or fails to continue to meet the accreditation

4

standards, the department may take one or more of the

5

following actions:

6

(i)  Deny the application for reaccreditation.

7

(ii)  Impose terms of probation.

8

(iii)  Revoke, suspend, limit or otherwise restrict

9

the accreditation.

10

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

11

each infraction.

12

(e)  Examinations.--

13

(1)  A person who intends to secure EMS provider

14

certification shall take the required certification

15

examinations within one year after completing the EMS

16

provider training required for certification.

17

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

18

person who fails a written or practical skills examination

19

for an EMS provider certification may repeat the failed

20

examination without retaking the examination the person

21

passed.

22

(3)  A person who fails the written examination three

23

times shall complete a refresher course approved by the

24

department or repeat the EMS provider training program before

25

taking the examination again.

26

(4)  A person who fails the practical skills examination

27

three times shall complete a remedial course approved by the

28

department or repeat the EMS provider training program before

29

again taking the examination.

30

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

- 34 -

 


1

who does not pass the required examinations within two years

2

after completing the EMS provider training program shall

3

receive no credit for an examination previously passed and

4

shall repeat the training program for the EMS provider

5

certification before the person may take the certification

6

examinations again.

7

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

8

certification examination change after the person has failed

9

the examination, the person may not retake the examination

10

unless the person meets the new standards.

11

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

12

standards in this subsection.

13

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

14

EMS provider certifications by reciprocity or endorsement as

15

follows:

16

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

17

certification of a type of EMS provider in another state,

18

determines that the criteria is substantially equivalent to

19

the criteria for a similar certification in this

20

Commonwealth, the department may enter into a reciprocity

21

agreement with its counterpart certifying agency in the other

22

state to certify that type of EMS provider based solely on

23

the other state's certification of the provider. No

24

reciprocity agreement may deprive the department from denying

25

a certification based on disciplinary considerations.

26

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

27

examination approved by another state for EMS provider

28

certification or continuing education, or upon review of a

29

national course or examination, determines that the course or

30

examination meets or exceeds the standards for such a course

- 35 -

 


1

or examination for a similar type of certification in this

2

Commonwealth, or for registration of the certification, the

3

department may endorse the course or examination as meeting

4

the course or examination requirements for that type of EMS

5

provider certification in acting upon an applicant's

6

application for certification or registration of the

7

certification in this Commonwealth.

8

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

9

Pennsylvania Bulletin a list of skills within the scope of

10

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

11

by publication as necessary.

12

(h)  Medical command orders and protocols.--

13

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

14

physician, shall provide EMS pursuant to department-approved

15

protocols and medical command orders.

16

(2)  The protocols shall identify circumstances in which

17

an EMS provider shall seek direction from a medical command

18

physician, which direction may be given by the physician in

19

person or through an authorized agent or via radio or other

20

telecommunications device approved by the department, and

21

shall address the responsibilities of an EMS provider when

22

medical command cannot be secured or is disrupted.

23

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

24

(1)  An applicant for an EMS provider certification shall

25

report to the department all misdemeanor, felony and other

26

criminal convictions that are not summary or equivalent

27

offenses, and all disciplinary sanctions that have been

28

imposed upon a license, certification or other authorization

29

of the applicant to practice an occupation or profession, and

30

any exclusion from a Federal or State health care program of

- 36 -

 


1

the applicant or an entity in which the applicant had equity

2

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

3

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

4

the time of the exclusion.

5

(2)  The applicant shall also provide the department with

6

a certified copy of the criminal charging, judgment and

7

sentencing documents for each conviction and a certified copy

8

of an adjudication or other document imposing discipline

9

against the applicant.

10

(3)  The department may not certify an applicant until

11

the department receives the documents, unless the applicant

12

establishes that the documents from which certified copies

13

are to be made no longer exist.

14

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

15

convictions, disciplinary sanctions and exclusions and

16

provide the same documents to the department within 30 days

17

after each conviction, discipline and exclusion.

18

(j)  Identification.--

19

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

20

practice as an EMS provider if requested when providing

21

services as an EMS provider.

22

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

23

to practice" means a card or certificate issued by the

24

department that shows current registration of the EMS

25

provider's certification.

26

(k)  Change of address.--

27

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

28

certification shall ensure that the department has the

29

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

30

all times.

- 37 -

 


1

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

2

number nor any other residential contact information provided

3

to the department shall be deemed a public record.

4

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

5

shall maintain current registration of his certification as an

6

EMS provider.

7

(m)  Downgrading certification or practice.--

8

(1)  An EMS provider who has a currently registered

9

certification as an advanced EMT or higher-level EMS provider

10

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

11

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

12

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

13

(relating to emergency medical services agencies), may

14

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

15

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

16

agency permits.

17

(2)  Upon expiration of the biennial registration period,

18

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

19

whose practice for an EMS agency has been downgraded pursuant

20

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

21

current registration of the EMS provider's certification by

22

meeting the biennial registration requirements for that

23

certification.

24

(3)  An EMS provider who has a currently registered

25

certification as an advanced EMT or higher-level EMS provider

26

and does not meet the requirements for biennial registration

27

of that certification may apply to and secure from the

28

department registration of a lower-level EMS provider

29

certification if the EMS provider meets the registration

30

requirements for that certification.

- 38 -

 


1

(4)  Instead of a registration certificate, the

2

department shall issue a lower-level certification to an EMS

3

provider who does not already have that certification and

4

applies for a registration of that certification under this

5

subsection.

6

(5)  An EMS provider whose practice level has been

7

downgraded under this section and who does not maintain

8

current registration of the higher-level certification may

9

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

10

higher-level certification when providing EMS.

11

(n)  Biennial registrations.--

12

(1)  The biennial registration of each EMS provider

13

certification, subject to a biennial registration requirement

14

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

15

(2)  The continuing education requirements for the

16

biennial registration following the initial registration of a

17

certification shall be prorated based upon the month in which

18

the EMS provider became certified, with any fractional

19

requirement rounded down.

20

(o)  Exceptions for members of armed forces returning from

21

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

22

from active military service who have a certification

23

registration that expired during their tours of duty or will

24

expire within 12 months after their return from military duty

25

may secure an exception to satisfying the continuing education

26

requirements for certification registration as follows:

27

(1)  EMS providers who have a triennial certification

28

registration requirement may secure an exception to the

29

period of time in which they would otherwise need to meet

30

continuing education requirements for triennial registration

- 39 -

 


1

of their certifications, as the department deems appropriate.

2

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

3

biennial certification registration requirement may secure an

4

exception to the period of time in which they would otherwise

5

need to meet continuing education requirements for biennial

6

registration of their certifications, as the department deems

7

appropriate. Before an EMS provider without a current

8

biennial registration begins to work for an EMS agency, the

9

EMS agency medical director must determine that the EMS

10

provider has continuing competency in the knowledge and

11

skills required to provide the services the EMS agency will

12

assign to the EMS provider.

13

(3)  EMS providers may seek an exception to their

14

continuing education requirements for certification

15

registration by asking the department to endorse their

16

relevant military training as satisfying some or all of the

17

applicable continuing education requirements.

18

§ 7214.  Emergency medical responders.

19

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

20

BLS skills involving basic interventions with minimum EMS

21

equipment as follows:

22

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

23

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

24

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

25

assist that EMS provider.

26

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

27

(3)  In another capacity as authorized by the department

28

by regulation.

29

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

30

an individual who meets all of the following:

- 40 -

 


1

(1)  Is at least 16 years of age.

2

(2)  Has successfully completed an EMR training course

3

approved by the department.

4

(3)  Has a current certificate evidencing successful

5

completion of a CPR course acceptable to the department.

6

(4)  Has passed an EMR skills practical examination

7

approved by the department.

8

(5)  Has passed a written EMR certification examination

9

approved by the department.

10

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

11

deemed registered for three years after issuance. An EMR must

12

register the EMR certification at three-year intervals by

13

completing an application for triennial registration on a form

14

or through an electronic process, as prescribed by the

15

department. The following shall apply:

16

(1)  The department shall issue a triennial registration

17

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

18

following:

19

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

20

registration no later than:

21

(A)  30 days before the current registration is

22

to expire; or

23

(B)  a lesser time established by regulation of

24

the department.

25

(ii)  Successfully:

26

(A)  completes EMR triennial registration

27

practical skills and written knowledge examinations

28

approved by the department; or

29

(B)  secures continuing education credits for EMR

30

triennial registration as required by the department

- 41 -

 


1

in continuing education programs approved by the

2

department.

3

(2)  An EMR whose registration of an EMR certification

4

has expired must qualify for a triennial registration of the

5

certification as prescribed by regulation of the department.

6

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

7

certified as a first responder on the effective date of this

8

section shall be considered to be an EMR with a current

9

registration and shall be subject to the triennial registration

10

requirements of an EMR. The registration of the EMR

11

certification shall expire on the same date the first responder

12

certification would have expired if the first responder

13

certification remained in effect.

14

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

15

is an ambulance attendant on the effective date of this section

16

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

17

shall be subject to the triennial registration requirements of

18

an EMR. The registration of the EMR certification shall expire

19

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

20

ambulance attendant expire and would have needed to be renewed.

21

§ 7215.  Emergency medical technicians.

22

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

23

involving basic interventions and equipment found on an EMS

24

vehicle as follows:

25

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

26

ambulance.

27

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

28

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

29

setting until an ambulance arrives, and then may assist the

30

ambulance crew.

- 42 -

 


1

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

2

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

3

by regulation of the department.

4

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

5

regulation of the department.

6

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

7

an individual who meets all of the following:

8

(1)  Is at least 16 years of age.

9

(2)  Has successfully completed an EMT training course

10

which:

11

(i)  teaches basic EMS; and

12

(ii)  is approved by the department.

13

(3)  Has a current certificate evidencing successful

14

completion of a CPR course acceptable to the department.

15

(4)  Has passed an EMT skills practical examination

16

approved by the department.

17

(5)  Has passed a written EMT certification examination

18

approved by the department.

19

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

20

deemed registered for three years after issuance. An EMT must

21

register the EMT certification at three-year intervals by

22

completing an application for triennial registration on a form

23

or through an electronic process, as prescribed by the

24

department. The following shall apply:

25

(1)  The department shall issue a triennial registration

26

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

27

following:

28

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

29

registration no later than:

30

(A)  30 days before the current registration is

- 43 -

 


1

to expire; or

2

(B)  a lesser time established by regulation of

3

the department.

4

(ii)  Successfully:

5

(A)  completes EMT triennial registration

6

practical skills and written knowledge examinations

7

approved by the department; or

8

(B)  secures continuing education credits for EMT

9

triennial registration as required by the department

10

in continuing education programs approved by the

11

department.

12

(2)  An EMT whose registration of an EMT certification

13

has expired must qualify for a triennial registration of the

14

certification as prescribed by regulation of the department.

15

§ 7216.  Advanced emergency medical technicians.

16

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

17

and ALS skills which include interventions and administration of

18

medications with basic and advanced equipment found on an EMS

19

vehicle as follows:

20

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

21

ambulance.

22

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

23

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

24

emergency until an ambulance arrives at the scene and then

25

may assist the ambulance crew.

26

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

27

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

28

by regulation of the department.

29

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

30

by regulation of the department.

- 44 -

 


1

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

2

advanced EMT an individual who meets all of the following:

3

(1)  Is at least 18 years of age.

4

(2)  Has successfully completed a course under

5

subparagraph (i) or (ii):

6

(i)  An advanced EMT training course which:

7

(A)  teaches basic life support skills;

8

(B)  teaches advanced life support skills deemed

9

appropriate by regulation of the department; and

10

(C)  is approved by the department.

11

(ii)  An EMT course and secured training and

12

education, through continuing education courses, in

13

skills included in the scope of practice for an advanced

14

EMT for which the applicant did not receive training in

15

the EMT course.

16

(3)  Has a current certificate evidencing successful

17

completion of a CPR course acceptable to the department.

18

(4)  Has passed an advanced EMT skills practical

19

examination approved by the department.

20

(5)  Has passed a written advanced EMT certification

21

examination approved by the department.

22

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

23

is deemed registered when the certification is issued. The

24

initial registration shall expire as set forth in section

25

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

26

Except for the initial registration period, an advanced EMT must

27

register the advanced EMT certification at two-year intervals by

28

completing an application for biennial registration on a form or

29

through an electronic process, as prescribed by regulation of

30

the department. The following shall apply:

- 45 -

 


1

(1)  The department shall issue a biennial registration

2

of an advanced EMT certification to an advanced EMT who meets

3

all of the following:

4

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

5

registration no later than:

6

(A)  30 days before the current registration is

7

to expire; or

8

(B)  a lesser time established by regulation of

9

the department.

10

(ii)  Successfully:

11

(A)  completes advanced EMT biennial registration

12

practical skills and written knowledge examinations

13

approved by the department; or

14

(B)  secures continuing education credits for

15

advanced EMT biennial registration as required by the

16

department in continuing education programs approved

17

by the department.

18

(2)  An advanced EMT whose registration of an advanced

19

EMT certification has expired must qualify for a biennial

20

registration of the certification as prescribed by regulation

21

of the department.

22

§ 7217.  Paramedics.

23

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

24

provider than an advanced EMT. A paramedic performs basic and

25

advanced EMS skills which include interventions and

26

administration of medications with basic and advanced equipment

27

found on an EMS vehicle as follows:

28

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

29

ambulance.

30

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

- 46 -

 


1

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

2

emergency until an ambulance arrives at the scene and then

3

may assist the ambulance crew.

4

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

5

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

6

by regulation of the department.

7

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

8

regulation of the department.

9

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

10

paramedic training course required for certification as a

11

paramedic, an individual must satisfy all of the following:

12

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

13

commences.

14

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

15

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

16

or advanced EMT.

17

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

18

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

19

(1)  Is at least 18 years of age.

20

(2)  Has successfully completed a paramedic training

21

course which:

22

(i)  teaches basic life support skills;

23

(ii)  teaches advanced life support skills deemed

24

appropriate by regulation of the department; and

25

(iii)  is approved by the department.

26

(3)  Has a current certificate evidencing successful

27

completion of a CPR course acceptable to the department.

28

(4)  Has passed a paramedic skills practical examination

29

approved by the department.

30

(5)  Has passed a written paramedic certification

- 47 -

 


1

examination approved by the department.

2

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

3

deemed registered when the certification is issued. The initial

4

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

5

(relating to emergency medical services providers). Except for

6

the initial registration period, a paramedic must register the

7

paramedic certification at two-year intervals by completing an

8

application for biennial registration on a form or through an

9

electronic process as prescribed by regulation of the

10

department. The following shall apply:

11

(1)  The department shall issue a biennial registration

12

of a paramedic certification to a paramedic who meets all of

13

the following:

14

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

15

registration no later than:

16

(A)  30 days before the current registration is

17

to expire; or

18

(B)  a lesser time established by regulation of

19

the department.

20

(ii)  Successfully secures continuing education

21

credits for paramedic biennial registration as required

22

by the department in continuing education programs

23

approved by the department.

24

(2)  A paramedic whose registration of a paramedic

25

certification has expired must qualify for a biennial

26

registration of the certification as prescribed by regulation

27

of the department.

28

§ 7218.  Prehospital registered nurses.

29

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

30

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

- 48 -

 


1

basic and advanced EMS skills and, as authorized by the

2

department, additional nursing skills within the scope of

3

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

4

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

5

successor act, as follows:

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, as prescribed by regulation of the department.

13

(4)  In another capacity as authorized by regulation of

14

the department.

15

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

16

an individual who meets all of the following:

17

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

18

State Board of Nursing.

19

(2)  Is at least 18 years of age.

20

(3)  Has a current certificate evidencing successful

21

completion of a CPR course acceptable to the department.

22

(4)  Has passed a PHRN skills practical examination

23

approved by the department.

24

(5)  Has passed a written PHRN certification examination

25

approved by the department.

26

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

27

registered when the certification is issued. The initial

28

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

29

(relating to emergency medical services providers). Except for

30

the initial registration period, a PHRN must register the PHRN

- 49 -

 


1

certification at two-year intervals by completing an application

2

for biennial registration on a form or through an electronic

3

process, as prescribed by regulation of the department. The

4

following shall apply:

5

(1)  The department shall issue a biennial registration

6

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

7

following:

8

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

9

registration no later than:

10

(A)  30 days before the current registration is

11

to expire; or

12

(B)  a lesser time established by regulation of

13

the department.

14

(ii)  Has current registration of a registered nurse

15

license.

16

(iii)  Successfully secures continuing education

17

credits for a PHRN biennial registration as required by

18

the department, in continuing education programs approved

19

by the department.

20

(2)  A PHRN whose registration of a PHRN certification

21

has expired must qualify for a biennial registration of the

22

certification as prescribed by regulation of the department.

23

§ 7219.  Prehospital physician extenders.

24

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

25

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

26

basic and advanced EMS skills and, as authorized by regulation

27

of the department, additional physician assistant skills within

28

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

29

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,

- 50 -

 


1

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

2

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

3

conducted as set forth in this chapter:

4

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

5

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

6

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

7

ambulance arrives at the scene and then may assist the

8

ambulance crew.

9

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

10

capacity, for an EMS agency as prescribed by regulation of

11

the department.

12

(4)  In another capacity as authorized by regulation of

13

the department.

14

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

15

physician assistant who meets all of the following:

16

(1)  Has a currently registered license as a physician

17

assistant with the State Board of Medicine or the State Board

18

of Osteopathic Medicine.

19

(2)  Is at least 18 years of age.

20

(3)  Has a current certificate evidencing successful

21

completion of a CPR course acceptable to the department.

22

(4)  Has passed a PHPE skills practical examination

23

approved by the department.

24

(5)  Has passed a written PHPE certification examination

25

approved by the department.

26

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

27

registered when the certification is issued. The initial

28

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

29

(relating to emergency medical services providers). Except for

30

the initial registration period, a PHPE must register the PHPE

- 51 -

 


1

certification at two-year intervals by completing an application

2

for biennial registration on a form or through an electronic

3

process as prescribed by regulation of the department. The

4

following shall apply:

5

(1)  The department shall issue a biennial registration

6

of a PHPE certification to a PHPE who:

7

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

8

registration no later than:

9

(A)  30 days before the current registration is

10

to expire; or

11

(B)  a lesser time as established by regulation

12

of the department.

13

(ii)  Has current registration of a physician

14

assistant license.

15

(iii)  Successfully secures continuing education

16

credits for PHPE biennial registration as required by the

17

department in continuing education programs approved by

18

the department.

19

(2)  A PHPE whose registration of a PHPE certification

20

has expired must qualify for a biennial registration of the

21

certification as prescribed by regulation of the department.

22

§ 7220.  Prehospital emergency medical services physicians.

23

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

24

higher level EMS provider than an advanced EMT. A prehospital

25

EMS physician performs for an EMS agency basic and advanced EMS

26

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

27

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

28

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

29

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

30

applicable, or a successor act, as follows:

- 52 -

 


1

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

2

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

3

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

4

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

5

capacity, as prescribed by regulation of the department.

6

(4)  In another capacity authorized by regulation of the

7

department.

8

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

9

prehospital EMS physician a physician who has:

10

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

11

(i)  An emergency medicine residency program that is

12

accredited by a residency program accrediting body

13

recognized by the State Board of Medicine or the State

14

Board of Osteopathic Medicine.

15

(ii)  The first year of an emergency medicine

16

residency program that satisfies the requirements of

17

subparagraph (i) and has successfully completed programs

18

approved by the department in advanced cardiac life

19

support, advanced trauma life support and advanced

20

pediatric life support.

21

(iii)  An anesthesia, family practice, internal

22

medicine or general surgery residency program that is

23

accepted by either the State Board of Medicine or the

24

State Board of Osteopathic Medicine as providing the

25

graduate medical training the board requires for issuance

26

of a physician license without restriction and the

27

successful completion of programs approved by the

28

department in advanced cardiac life support, advanced

29

trauma life support and advanced pediatric life support.

30

(2)  A current certificate evidencing successful

- 53 -

 


1

completion of a CPR course acceptable to the department.

2

(3)  Passed an EMS skills practical examination approved

3

by the department or served as a prehospital health

4

professional physician prior to the effective date of this

5

section.

6

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

7

certification is deemed registered when the certification is

8

issued. The initial registration shall expire under section

9

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

10

Except for the initial registration period, a prehospital EMS

11

physician shall register the prehospital EMS physician

12

certification at two-year intervals by completing an application

13

for biennial registration on a form or through an electronic

14

process as prescribed by the department. The following shall

15

apply:

16

(1)  The department shall issue a biennial registration

17

of a prehospital EMS physician certification to a prehospital

18

EMS physician who meets all of the following:

19

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

20

registration no later than 30 days before the current

21

registration is to expire or within a lesser time period

22

as the department may establish by regulation.

23

(ii)  Has current registration of a physician

24

license.

25

(iii)  Successfully secures continuing education

26

credits for prehospital EMS physician biennial

27

registration as required by the department in continuing

28

education programs approved by the department.

29

(2)  A prehospital EMS physician whose registration of a

30

prehospital EMS physician certification has expired shall

- 54 -

 


1

qualify for a biennial registration of the certification as

2

prescribed by regulation of the department.

3

(d)  Transition for prehospital health professional

4

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

5

professional physician prior to the effective date of this

6

section and who satisfies the certification requirements under

7

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

8

90 days after the effective date of this section without having

9

secured a certification as a prehospital EMS physician.

10

§ 7221.  Certification sanctions.

11

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

12

an EMS provider or applicant for EMS provider certification for

13

any of the following reasons:

14

(1)  Lack of physical or mental ability to provide

15

adequate services.

16

(2)  Deceptive or fraudulent procurement or

17

representation of certification or registration credentials,

18

or for making misleading, deceptive or untrue representations

19

to secure or aid or abet another person to secure a

20

certification, license, registration or any other

21

authorization issued by the department under this chapter.

22

(3)  Willful or negligent misconduct in providing EMS or

23

practicing beyond the scope of certification authorization

24

without legal authority to do so.

25

(4)  Abuse or abandonment of a patient.

26

(5)  The rendering of services while under the influence

27

of alcohol, illegal drugs or the knowing abuse of legal

28

drugs.

29

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

30

manner or while under the influence of alcohol, illegal drugs

- 55 -

 


1

or the knowing abuse of legal drugs.

2

(7)  Disclosure of medical or other information about a

3

patient where prohibited by Federal or State law.

4

(8)  Willful preparation or filing of a false medical

5

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

6

(9)  Destruction of a medical report or record required

7

to be maintained.

8

(10)  Refusal to render emergency medical care because of

9

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

10

preference, age, handicap, medical problem or financial

11

inability to pay.

12

(11)  Failure to comply with department-approved

13

protocols.

14

(12)  Failure to comply with reporting requirements

15

imposed under this chapter or as established by the

16

department.

17

(13)  Practicing without the current registration of a

18

certification.

19

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

20

practice of the EMS provider or a crime involving moral

21

turpitude. For the purposes of this paragraph, a conviction

22

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

23

nolo contendere.

24

(15)  Willful falsification of or a failure to complete

25

details on an EMS patient care report.

26

(16)  Misappropriation of drugs or EMS agency property.

27

(17)  Having a certification or other authorization to

28

practice a profession or occupation revoked, suspended or

29

subjected to other disciplinary sanction.

30

(18)  Violating or aiding or abetting another person to

- 56 -

 


1

violate a duty imposed under this chapter, a regulation

2

promulgated under this chapter or an order of the department

3

previously entered in a disciplinary proceeding.

4

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

5

Federal or State agency, having been excluded from a Federal

6

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

7

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

8

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

9

excluded from a Federal or State health care program.

10

(20)  Any other reason as determined by the department

11

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

12

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

13

take disciplinary action against an individual under this

14

section, the 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)  Require the person to take refresher educational

20

courses.

21

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

22

for each incident in which the EMS provider engages in

23

conduct that constitutes a basis for discipline.

24

(6)  Stay enforcement of any suspension, revocation or

25

other discipline and place the individual on probation with

26

the right to vacate the probationary order for noncompliance.

27

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

28

deny a registration of an EMS provider certification without

29

giving the applicant prior notice of the reason for the denial

30

and providing an opportunity for a hearing.

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1

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

2

revoked may not apply for reinstatement of that certification. A

3

person may petition the department for allowance to apply for a

4

new certification five years from the effective date of the

5

revocation by filing with the department a petition that avers

6

facts to establish that the person has been rehabilitated to an

7

extent that issuing the person a certification would not be

8

detrimental to the public interest. The department may grant or

9

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

10

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

11

such as that the person has been rehabilitated. If the

12

department grants the person allowance to apply for a new

13

certification, the person shall repeat the training program and

14

the certification examinations for the level of certification

15

for which the person is applying and satisfy all other

16

requirements for the certification that exist at the time of

17

reapplication. If the department does not grant the person

18

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

19

again petition the department for allowance to apply for a new

20

certification until another year from the date of denial.

21

§ 7222.  Emergency medical services vehicle operators.

22

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

23

shall be permanent, subject to disciplinary action under this

24

section. The department shall certify as an EMS vehicle operator

25

a person who meets all of the following:

26

(1)  Completes an application for an EMS vehicle operator

27

certification on a form or through an electronic application

28

process, as prescribed by the department.

29

(2)  Is at least 18 years of age.

30

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

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1

(4)  Is not addicted to alcohol or drugs.

2

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

3

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

4

(6)  Has successfully completed an emergency vehicle

5

operator's course of instruction approved by the department.

6

(7)  Has not:

7

(i)  Been convicted within the last four years prior

8

to the date of application of driving under the influence

9

of alcohol or drugs.

10

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

11

application, been convicted of reckless driving or had a

12

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

13

or a moving traffic violation.

14

(8)  Has successfully completed an emergency vehicle

15

operator's course of instruction approved by the department

16

following a disqualification from certification under

17

paragraph (7), regardless of whether the person successfully

18

completed the course previously.

19

(b)  Registration.--An EMS vehicle operator shall register

20

the EMS vehicle operator's certification. Except as otherwise

21

provided in this subsection, an EMS vehicle operator's

22

certification shall be deemed registered for three years after

23

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

24

vehicle unless the certification is currently registered. The

25

following shall apply:

26

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

27

vehicle operator's certification to an EMS vehicle operator

28

who meets all of the following:

29

(i)  Completes an application for registration on a

30

form or through an electronic application process, as

- 59 -

 


1

prescribed by the department.

2

(ii)  Has a current registration and applies for a

3

new registration no later than 30 days before the current

4

registration is to expire, or within a lesser time period

5

as the department may establish by regulation.

6

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

7

(iv)  Successfully completes continuing education

8

credits for EMS vehicle operators as required by the

9

department in continuing education programs approved by

10

the department.

11

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

12

certification also has an EMS provider's certification, the

13

registration of the EMS vehicle operator's certification

14

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

15

provider's certification. If the person does not maintain

16

current registration of the EMS provider's certification, the

17

registration of the EMS vehicle operator's certification

18

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

19

operator who is an EMS provider becomes certified as a

20

higher-level EMS provider, the registration of the EMS

21

vehicle operator's certification shall expire at the same

22

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

23

certification.

24

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

25

biennial registration cycle, the continuing education

26

requirements for the registration of the EMS vehicle

27

operator's certification following the initial registration

28

of the certification shall be prorated based upon the month

29

in which the EMS provider became certified, with any

30

fractional requirement rounded down.

- 60 -

 


1

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

2

vehicle operator's certification has expired shall qualify

3

for a biennial registration of the certification as

4

prescribed by regulation of the department.

5

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

6

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

7

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

8

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

9

EMS vehicle operator for 90 days after the effective date of

10

this section without having secured a certification as an EMS

11

vehicle operator.

12

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

13

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

14

operator's certification for any of the following reasons:

15

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

16

vehicle.

17

(2)  Deceptive or fraudulent procurement or

18

representation of certification or registration credentials,

19

or making misleading, deceptive or untrue representations to

20

secure a certification or registration.

21

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

22

manner or while under the influence of alcohol, illegal drugs

23

or the knowing abuse of legal drugs.

24

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

25

alcohol or drugs or a moving traffic violation.

26

(5)  Conviction of a felony or crime involving moral

27

turpitude. For the purposes of this paragraph, a conviction

28

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

29

nolo contendere.

30

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

- 61 -

 


1

vehicle operator under this chapter or a related regulation.

2

(7)  Other reasons as determined by the department which

3

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

4

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

5

a certification, it may also impose conditions for the lifting

6

of the suspension, including requiring the person to

7

successfully repeat an emergency vehicle operator's course

8

approved by the department.

9

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

10

EMS vehicle operator shall report to the department within 30

11

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

12

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

13

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

14

conviction of driving under the influence of alcohol or drugs,

15

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

16

certification shall automatically be suspended for the periods

17

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

18

(g)  Change of address.--

19

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

20

vehicle operator's certification shall ensure that the

21

department has the current address at which the person can be

22

reached by mail at all times.

23

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

24

telephone number nor any other residential contact

25

information provided to the department shall be deemed a

26

public record.

27

§ 7223.  Suspension of certification.

28

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

29

suspend the certification of an EMS provider or EMS vehicle

30

operator without a hearing if the department determines that the

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1

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

2

safety. Notice to a provider or operator of a temporary

3

suspension shall include a written statement of the underlying

4

factual allegations. After issuance of the notice, the

5

department shall commence formal disciplinary action against the

6

person under section 7221 (relating to certification sanctions)

7

or 7222 (relating to emergency medical services vehicle

8

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

9

temporarily suspending the certification, the department shall

10

conduct a preliminary hearing to determine if there is a prima

11

facie case supporting the temporary suspension. The person may

12

be present at the preliminary hearing and may be represented by

13

counsel, cross-examine witnesses, inspect physical evidence,

14

call witnesses and offer testimony and other evidence. If the

15

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

16

suspension shall be lifted immediately. If the department

17

determines that there is a prima facie case, the temporary

18

suspension shall remain in effect until vacated by the

19

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

20

the parties.

21

(b)  Automatic suspensions.--The department shall

22

automatically suspend a certification issued under this chapter

23

upon receiving a certified copy of court records establishing

24

that the person has been adjudicated as incapacitated under 20

25

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

26

evaluation) or an equivalent statutory provision. The department

27

shall lift the suspension upon the person establishing to the

28

department that the person has been adjudicated to have regained

29

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

30

capacity and modification of existing orders) or an equivalent

- 63 -

 


1

statutory provision.

2

§ 7224.  Emergency medical services instructors.

3

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

4

permanently subject to disciplinary action under this section.

5

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

6

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

7

certification on a form or through an electronic application

8

process, as prescribed by the department.

9

(2)  Is at least 18 years of age.

10

(3)  Has successfully completed an EMS instructor's

11

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

12

degree in education, a teacher's certification in education

13

or a doctorate or master's degree.

14

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

15

higher-level EMS provider.

16

(5)  Possesses current certification in a CPR course

17

acceptable to the department or current certification as a

18

CPR instructor.

19

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

20

or higher-level EMS provider.

21

(7)  Has provided at least 20 hours of monitored

22

instruction time in an EMS provider's certification program.

23

(b)  Triennial registration.--

24

(1)  An EMS instructor's certification is deemed

25

registered for three years after issuance. An EMS instructor

26

shall register the EMS instructor's certification at three-

27

year intervals by completing an application for triennial

28

registration on a form or through an electronic process, as

29

prescribed by the department. An EMS instructor may not teach

30

in an accredited EMS institute, pursuant to an EMS

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1

instructor's certification, unless the certification is

2

currently registered. The department shall issue a triennial

3

registration of an EMS instructor's certification to an EMS

4

instructor who:

5

(i)  Has completed an application for triennial

6

registration on a form or through an electronic

7

application process, as prescribed by the department.

8

(ii)  Has a current registration and applies for a

9

new registration no later than 30 days before the current

10

registration is to expire, or within lesser time as the

11

department may establish by regulation.

12

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

13

certification or rescue courses approved by the

14

department during the previous three years.

15

(iv)  Is certified and currently registered as an EMT

16

or higher-level EMS provider.

17

(v)  Possesses current certification in a CPR course

18

acceptable to the department or current certification as

19

a CPR instructor.

20

(2)  An EMS instructor whose registration as an EMS

21

instructor's certification has expired shall qualify for a

22

triennial registration of the certification as prescribed by

23

regulation of the department.

24

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

25

set standards for EMS instructors in providing instruction in

26

EMS institutions.

27

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

28

discipline against an EMS instructor for the following reasons:

29

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

30

section 7221 (relating to certification sanctions).

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1

(2)  Providing instruction while under the influence of

2

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

3

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

4

instructor by this chapter or a related regulation.

5

(4)  Other reasons as determined by the department that

6

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

7

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

8

impose discipline against an individual under this section, the

9

department may do one or more of the following:

10

(1)  Deny the application for certification.

11

(2)  Issue a public reprimand.

12

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

13

certification.

14

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

15

for each incident in which the EMS instructor engages in

16

conduct that constitutes a basis for discipline.

17

(5)  Stay enforcement of any suspension, revocation or

18

other discipline and place the individual on probation with

19

the right to vacate the probationary order for noncompliance.

20

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

21

require the certification as EMS instructors of all instructors

22

of EMS courses accepted toward educational requirements for EMS

23

provider's certification or toward continuing education

24

requirements for the registration of EMS provider's

25

certifications.

26

§ 7225.  Medical director of emergency medical services agency.

27

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

28

an EMS agency medical director, an individual shall:

29

(1)  Be a physician.

30

(2)  Satisfy one of the following:

- 66 -

 


1

(i)  Have successfully completed an emergency

2

medicine residency program accredited by a residency

3

program accrediting body recognized by the State Board of

4

Medicine or the State Board of Osteopathic Medicine.

5

(ii)  Have successfully completed a residency program

6

in surgery, internal medicine, family medicine,

7

pediatrics or anesthesiology, accredited by a residency

8

program accrediting body recognized by the State Board of

9

Medicine or the State Board of Osteopathic Medicine. The

10

physician shall also have successfully completed or

11

taught an advanced cardiac life support course acceptable

12

to the department within the preceding two years and have

13

completed, at least once, an advanced trauma life support

14

course acceptable to the department and an advanced

15

pediatric life support course acceptable to the

16

department, or other programs determined by the

17

department to meet or exceed the standards of these

18

programs.

19

(iii)  Have served as an advanced life support

20

service medical director under the act of July 3, 1985

21

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

22

Act, prior to the effective date of this chapter.

23

(3)  Have a valid Drug Enforcement Agency number.

24

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

25

course, an EMS fellowship or other EMS training program that

26

is determined by the department to be equivalent. This

27

training shall assure that the EMS agency medical director

28

has knowledge of:

29

(i)  The scope of practice of EMS providers.

30

(ii)  The provision of EMS pursuant to department-

- 67 -

 


1

approved protocols.

2

(iii)  The interface between EMS providers and

3

medical command physicians.

4

(iv)  Quality improvement principles.

5

(v)  Emergency medical dispatch principles and EMS

6

agency communication capabilities.

7

(vi)  EMS system design and operation.

8

(vii)  Federal and State laws and regulations

9

regarding EMS.

10

(viii)  Regional and State mass casualty and disaster

11

plans.

12

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

13

director is responsible for the following:

14

(1)  Reviewing department-approved EMS protocols that are

15

applicable to the EMS agency and ensuring that its EMS

16

providers and other relevant personnel are familiar with the

17

protocols applicable to them.

18

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

19

following:

20

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

21

above the advanced EMT level to determine whether the EMS

22

provider has demonstrated competency in the knowledge and

23

skills one must have to competently perform the skills

24

within the scope of practice of the EMS provider at that

25

level, and a commitment to adequately perform other

26

functions relevant to the EMS provider providing EMS at

27

that level. This subparagraph does not apply if the EMS

28

provider was working for the EMS agency at the same level

29

prior to the physician becoming the medical director for

30

the EMS agency and the EMS provider was credentialed at

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1

that EMS agency within the last year as being able to

2

perform at the EMS provider's certification level.

3

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

4

provider at or above the advanced EMT level as to whether

5

the EMS provider has demonstrated competency in the

6

knowledge and skills an EMS provider must have to

7

competently perform the skills within the scope of

8

practice of the EMS provider at that level, and a

9

commitment to adequately perform other functions relevant

10

to the EMS provider providing EMS at that level.

11

(3)  Participating in and reviewing quality improvement

12

reviews of patient care provided by the EMS agency and

13

participating in the Statewide and regional quality

14

improvement program.

15

(4)  Providing medical guidance and advice to the EMS

16

agency.

17

(5)  Providing guidance with respect to the ordering,

18

stocking and replacement of drugs, and compliance with laws

19

and regulations impacting upon the EMS agency's acquisition,

20

storage and use of those drugs.

21

(6)  Maintaining a liaison with the regional EMS medical

22

director.

23

(7)  Recommending to the department suspension,

24

revocation or restriction of EMS provider's certifications.

25

(8)  Reviewing regional mass casualty and disaster plans.

26

(9)  Performing other functions as the department may

27

impose by regulation.

28

§ 7226.  Medical command physicians and facility medical

29

directors.

30

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

- 69 -

 


1

physician communicates with and issues medical command orders to

2

EMS providers when they seek direction. A medical command

3

physician shall have an arrangement with a medical command

4

facility to provide medical command on its behalf, and shall

5

function under the direction of a medical command facility

6

medical director and under the policies and procedures of the

7

medical command facility. A medical command physician shall

8

provide medical command to EMS providers consistent with

9

Statewide protocols and protocols that are in effect in either

10

the region in which treatment originates or the region from

11

which the EMS providers begin receiving medical command from a

12

medical command physician. For good cause, a medical command

13

physician may give medical command orders that are inconsistent

14

with these protocols.

15

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

16

medical command physician a physician who was approved as a

17

medical command physician in this Commonwealth immediately prior

18

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

19

certify as a medical command physician a physician who:

20

(1)  Completes an application for medical command

21

physician certification on a form or through an electronic

22

application process, as prescribed by the department.

23

(2)  Satisfies one of the following:

24

(i)  Has successfully completed an emergency medicine

25

residency program accredited by a residency program

26

accrediting body recognized by the State Board of

27

Medicine or the State Board of Osteopathic Medicine.

28

(ii)  Has successfully completed or taught an

29

advanced cardiac life support course acceptable to the

30

department within the preceding two years and has

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1

successfully completed or taught an advanced trauma life

2

support course acceptable to the department and an

3

advanced pediatric life support course acceptable to the

4

department, or other programs determined by the

5

department to meet or exceed the standards of these

6

programs.

7

(iii)  Has had an emergency medicine practice in

8

another jurisdiction and establishes to the department

9

that the physician has a combination of training,

10

education and emergency medicine practice that makes the

11

physician qualified to serve as a medical command

12

physician.

13

(3)  Has completed a medical command course offered or

14

approved by the department.

15

(4)  Is practicing as an emergency medicine physician or

16

is participating as a resident in a second or subsequent year

17

in an emergency medicine residency program or has had at

18

least three years' experience as a full-time emergency

19

medicine physician.

20

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

21

for an emergency medicine resident who is authorized to use a

22

hospital's Drug Enforcement Agency number for practice within

23

the emergency medicine residency program.

24

(6)  Has an arrangement with a medical command facility

25

to serve as a medical command physician for that facility

26

after receiving certification as a medical command physician.

27

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

28

certification is deemed registered for three years after

29

issuance. A medical command physician shall triennially register

30

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

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1

through an electronic application process, as prescribed by the

2

department, as a condition for continued practice as a medical

3

command physician. The department shall issue a triennial

4

registration of a medical command physician's certification to a

5

medical command physician within 30 days after the physician

6

applies for a new registration if the physician demonstrates

7

that the physician continues to meet the requirements for the

8

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

9

satisfies such other requirements as the department may impose

10

by regulation.

11

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

12

emergency medicine residency program may issue medical command

13

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

14

component of and within the framework of the emergency medicine

15

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

16

medical command physician who has served as a medical command

17

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

18

emergency medicine residency program or has secured medical

19

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

20

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

21

medical command facility medical director shall be responsible

22

for the following in a medical command facility:

23

(1)  Medical command.

24

(2)  Quality improvement.

25

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

26

medical director.

27

(4)  Participating in prehospital training activities.

28

(5)  Verifying to the department that a physician seeking

29

a medical command physician's certification, based upon the

30

physician's arrangement with the medical command facility,

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1

meets all certification requirements.

2

(6)  Ensuring that the medical command facility satisfies

3

statutory and regulatory requirements.

4

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

5

medical command facility medical director a physician who was

6

approved as a medical command facility medical director in this

7

Commonwealth immediately prior to the effective date of this

8

section. The department shall also certify as a medical command

9

facility medical director a physician who:

10

(1)  Completes an application for medical command

11

facility medical director certification on a form or through

12

an electronic application process, as prescribed by the

13

department.

14

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

15

(3)  Satisfies one of the following:

16

(i)  Has successfully completed a residency program

17

in emergency medicine accredited by a residency program

18

accrediting body recognized by the State Board of

19

Medicine or the State Board of Osteopathic Medicine.

20

(ii)  Has successfully:

21

(A)  completed a residency program in surgery,

22

internal medicine, family medicine, pediatrics or

23

anesthesiology accredited by a residency program

24

accrediting body recognized by the State Board of

25

Medicine or the State Board of Osteopathic Medicine;

26

and

27

(B)  completed or taught:

28

(I)  an advanced cardiac life support course

29

acceptable to the department within the preceding

30

two years;

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1

(II)  an advanced trauma life support course

2

acceptable to the department; and

3

(III)  an advanced pediatric life support

4

course acceptable to the department.

5

(4)  Has experience in prehospital and emergency

6

department care of acutely ill or injured patients.

7

(5)  Has experience in providing medical command

8

direction to EMS providers.

9

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

10

below and above the advanced EMT level.

11

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

12

critique of EMS providers below and above the advanced EMT

13

level.

14

(8)  Has an arrangement with a medical command facility

15

to serve as its medical director after receiving

16

certification as a medical command facility medical director.

17

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

18

medical director's certification is deemed registered for three

19

years after issuance. A medical command facility medical

20

director shall triennially register the physician's

21

certification with the department on a form or through an

22

electronic application process, as prescribed by the department,

23

as a condition for continued practice as a medical command

24

facility medical director. The department shall issue a

25

triennial registration of a medical command facility medical

26

director certification to a medical command facility medical

27

director within 30 days after the physician applies for a new

28

registration, if the physician demonstrates that the physician

29

continues to meet the requirements for the certification, except

30

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

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1

requirements as the department may impose by regulation.

2

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

3

medical command physician or medical command facility medical

4

director for the following reasons:

5

(1)  Violating a responsibility imposed on the physician

6

by this chapter or the related regulations.

7

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

8

treatment, transport or transfer protocol established or

9

approved by the department.

10

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

11

empowered to discipline a medical command physician or medical

12

command facility medical director under subsection (h), the

13

department may do one or more of the following:

14

(1)  Deny the application for a certification.

15

(2)  Issue a public reprimand.

16

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

17

condition the certification.

18

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

19

for each incident in which the physician engages in conduct

20

that constitutes a basis for discipline.

21

(5)  Stay enforcement of any suspension, revocation or

22

other discipline and place the individual on probation with

23

the right to vacate the probationary order for noncompliance.

24

§ 7227.  Medical command facilities.

25

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

26

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

27

a medical command facility. The department shall issue a

28

certification to each medical unit that operated as a medical

29

command facility immediately prior to the effective date of this

30

section.

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1

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

2

a form or through an electronic application process prescribed

3

by the department. The application shall solicit information

4

necessary to determine that the applicant meets the

5

certification requirements of this chapter.

6

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

7

applicant:

8

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

9

consortium of hospitals.

10

(2)  Possesses the necessary equipment and personnel for

11

providing medical command to and control over EMS providers.

12

(3)  Employs a medical command facility medical director.

13

(4)  Has taken measures necessary to ensure that a

14

medical command physician is available to provide medical

15

command at all times.

16

(5)  Meets the communication, recordkeeping and other

17

requirements of the department.

18

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

19

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

20

regulation requirements for a medical command facility to ensure

21

that it operates in an effective and efficient manner to achieve

22

the purposes for which it is certified.

23

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

24

certification is deemed registered for three years after

25

issuance. A medical command facility must register its

26

certification at three-year intervals by completing an

27

application for triennial registration on a form or through an

28

electronic application process prescribed by the department. The

29

department shall grant or deny recertification within 30 days of

30

receipt of the application.

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1

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

2

an inspection of the medical unit of each applicant and also

3

inspect existing medical command facilities from time to time as

4

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

5

department shall have full and free access to examine the

6

medical command facility and its records relating to its

7

operation as a medical command facility. The medical command

8

facility shall fully respond to any inquiry by the department

9

relevant to the determination of whether the facility meets

10

certification and operational requirements.

11

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

12

medical command facility for the following reasons:

13

(1)  Violating a requirement of this section.

14

(2)  Violating a certification requirement or an

15

operational requirement imposed under subsection (d).

16

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

17

inquiry under subsection (f).

18

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

19

medical treatment, transport or transfer protocol approved by

20

the department.

21

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

22

to discipline a medical command facility, the department may do

23

one or more of the following:

24

(1)  Deny the application for a certification.

25

(2)  Issue a public reprimand.

26

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

27

condition the certification.

28

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

29

each act that presents a basis for discipline.

30

(5)  Stay enforcement of any suspension, revocation or

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1

other discipline and place the facility on probation with the

2

right to vacate the probationary order for noncompliance.

3

§ 7228.  Receiving facilities.

4

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

5

ambulance may transport a patient who requires prompt medical

6

care in addition to that provided by the ambulance crew after

7

the crew responds to an emergency.

8

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

9

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

10

emergency department, including a physician trained to manage

11

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

12

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

13

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

14

By regulation, the department may authorize other types of

15

facilities to serve as receiving facilities for purposes of

16

serving patients who have special medical needs.

17

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

18

medical command physician, the initial transport of a patient

19

following an ambulance response to a reported emergency shall be

20

to a receiving facility pursuant to a protocol under section

21

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

22

(relating to regional emergency medical services councils) or

23

such other location as the department designated by protocol.

24

§ 7229.  Emergency medical services agencies.

25

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

26

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

27

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

28

ambulance, advanced life support squad vehicle, basic life

29

support squad vehicle, quick response service, special

30

operations EMS service or other vehicle or service as prescribed

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1

by the department by regulation to provide EMS outside a health

2

care facility or on roadways, airways or waterways of this

3

Commonwealth unless the person holds a current EMS agency

4

license authorizing the particular service or operation.

5

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

6

shall be submitted on a form or through an electronic

7

application process prescribed by the department.

8

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

9

license to an applicant when it is satisfied that:

10

(1)  The applicant and persons having substantial

11

ownership interests in the applicant are responsible persons

12

and the EMS agency will be staffed by and conduct its

13

activities utilizing responsible persons. For purposes of

14

this paragraph:

15

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

16

engaged in any act contrary to justice, honesty or good

17

morals which indicates that the person is likely to

18

betray the public trust in carrying out the activities of

19

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

20

conduct but has been rehabilitated and establishes that

21

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

22

(ii)  a person has a substantial ownership interest

23

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

24

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

25

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

26

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

27

engages in an activity integral to operation of the EMS

28

agency, including, but not limited to, making or

29

participating in the making or execution of management

30

decisions, providing EMS, billing, call-taking and

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1

dispatching.

2

(2)  The applicant meets supply and equipment

3

requirements and each ambulance or other vehicle that will be

4

used in providing EMS is adequately constructed and equipped

5

and will be maintained and operated to safely and efficiently

6

render the services offered.

7

(3)  The applicant will meet the staffing standards for

8

its vehicles and services.

9

(4)  The applicant will provide safe and efficient

10

services that are adequate for the emergency medical care,

11

the treatment and comfort and, when appropriate, the

12

transportation of patients.

13

(5)  The applicant will have an EMS agency medical

14

director who, in addition to satisfying the criteria of

15

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

16

medical services agency), satisfies other criteria the

17

department may establish by regulation based on the types of

18

vehicles and services the applicant intends to provide under

19

the EMS agency license.

20

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

21

regulations promulgated under this chapter.

22

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

23

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

24

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

25

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

26

higher level of EMS provider certification and at least one year

27

of active practice as an EMS provider.

28

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

29

deemed registered for three years after the issuance. An EMS

30

agency must register its license at three-year intervals by

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1

completing an application on a form or through an electronic

2

application process prescribed by the department. The department

3

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

4

complete and accurate application. The department shall not deny

5

a registration of a license without giving the applicant prior

6

notice of the reason for denial and providing an opportunity for

7

a hearing.

8

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

9

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

10

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

11

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

12

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

13

management services for an EMS agency if:

14

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

15

applicable regulations;

16

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

17

subsection (c)(1)(i);

18

(3)  a person having a substantial ownership interest in

19

the entity is not a responsible person;

20

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

21

activities through responsible persons; or

22

(5)  the entity refuses to provide the department with

23

records or information reasonably requested to enable the

24

department to make a determination.

25

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

26

current department-issued inspection sticker shall be displayed

27

on each ambulance, advanced life support squad vehicle, basic

28

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

29

other EMS vehicle authorized by the department.

30

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

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1

an applicant's vehicles, equipment and personnel qualifications

2

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

3

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

4

but not less than once every three years.

5

(i)  Dispatching.--

6

(1)  An EMS agency that operates a communications center

7

dispatching EMS resources shall use call-takers and

8

dispatchers who satisfy the requirements of the Pennsylvania

9

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

10

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

11

Emergency Telephone Act, and shall use an emergency medical

12

dispatch program approved by the department. An emergency

13

medical dispatch program is a system or program that enables

14

patients to be assessed and treated via telecommunication by

15

using accepted medical dispatch standards.

16

(2)  Operation by an EMS agency of a communications

17

center that dispatches EMS resources shall be considered part

18

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

19

to the requirements of this chapter and the department's

20

regulations.

21

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

22

after the effective date of this chapter, the department shall

23

publish in the Pennsylvania Bulletin, and update as necessary,

24

vehicle construction and equipment and supply requirements for

25

EMS agencies in this Commonwealth based upon the types of EMS

26

vehicles operated and the services provided.

27

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

28

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

29

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

30

medical director apprises that the EMS provider satisfies the

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1

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

2

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

3

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

4

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

5

agency medical director. The EMS agency shall notify the

6

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

7

the EMS agency medical director has determined that the EMS

8

provider has not demonstrated competency in the knowledge and

9

skills necessary to competently perform the skills within the

10

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

11

demonstrated a commitment to adequately perform other functions

12

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

13

the EMS agency medical director chooses to impose restrictions

14

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

15

provider to function under the supervision of another EMS

16

provider or requiring the EMS provider to contact a medical

17

command physician prior to providing EMS, then the EMS agency

18

may permit the EMS provider to provide EMS only with the

19

restrictions directed by the EMS agency medical director.

20

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

21

staffing standards for ambulances, squad vehicles and quick

22

response services set forth in sections 7230 (relating to

23

advanced life support ambulances), 7231 (relating to air

24

ambulances), 7232 (relating to advanced life support squad

25

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

26

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

27

(relating to quick response services).

28

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

29

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

30

provider arrives, the law enforcement officer may preclude the

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1

EMS provider from entering the scene to provide EMS until the

2

law enforcement officer determines that it is safe for the EMS

3

provider to enter. Under such circumstances, the law enforcement

4

officer shall permit the EMS provider access to the patient

5

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

6

medical treatment protocol or medical command order, an EMS

7

agency is required to transport to a receiving facility a

8

patient whom a law enforcement officer has taken or wants to

9

take into custody or whom the law enforcement officer believes

10

needs to be spoken with immediately, the EMS agency shall

11

transport the patient to a receiving facility and the law

12

enforcement officer shall have discretion to accompany the

13

patient in the EMS vehicle and authority to employ security

14

precautions deemed necessary by the law enforcement officer to

15

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

16

security precautions shall not unreasonably interfere with the

17

provision of EMS to the patient.

18

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

19

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

20

person shall permit or cause the EMS agency to continue.

21

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

22

shall not discontinue providing service it is licensed to

23

provide or reduce the hours when it provides service until a

24

minimum of 90 days after notifying the department in writing of

25

the change. Notice shall include a statement that the licensee

26

has notified the chief executive officer of each political

27

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

28

discontinue providing the service or reduce the hours it

29

provides the service and that the intent to discontinue or

30

reduce hours has been advertised in a newspaper of general

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1

circulation in the licensee's service area.

2

(p)  Regulations.--The department shall promulgate

3

regulations setting forth requirements for EMS agencies in this

4

Commonwealth based upon the types of EMS vehicles they operate

5

and the services they provide.

6

(q)  Transition for ambulance services and quick response

7

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

8

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

9

immediately prior to the effective date of this section may

10

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

11

and other operational requirements of this chapter, and it shall

12

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

13

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

14

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

15

as an ambulance service or recognition as a QRS would have

16

expired if it had remained in effect.

17

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

18

provisions of this chapter:

19

(1)  Privately owned vehicles not ordinarily used to

20

transport patients.

21

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

22

under this chapter that is dispatched to respond to an

23

emergency within this Commonwealth when an EMS vehicle or

24

service licensed under this chapter is unable to respond

25

within a reasonable time or its response is not sufficient to

26

deal with the emergency.

27

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

28

its operations in this Commonwealth to the transportation,

29

and provision of medical care incidental to transportation of

30

patients and other persons requiring transportation by EMS

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1

vehicles from locations outside this Commonwealth to

2

locations within this Commonwealth.

3

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

4

Federal Government.

5

§ 7230.  Advanced life support ambulances.

6

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

7

assessment, triage, monitoring, treatment, transportation and

8

observation of patients who require EMS above the skill level of

9

an advanced EMT.

10

(b)  Staffing requirements.--

11

(1)  Except as otherwise provided in this section,

12

minimum staffing requirements for an ALS ambulance when

13

responding to a call to provide EMS for a patient requiring

14

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

15

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

16

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

17

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

18

EMS vehicle operator. When present, an EMS provider qualified

19

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

20

must attend to the patient at the scene and during

21

transportation. If a member of the ambulance crew arrives at

22

the scene before another crew member, that person shall begin

23

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

24

(2)  Minimum staffing requirements for an ALS ambulance

25

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

26

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

27

at or below the skill level of an advanced EMT.

28

§ 7231.  Air ambulances.

29

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

30

crew that provides medical assessment, treatment, monitoring,

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1

observation and transportation of patients who require EMS where

2

time to administer definitive care is of the essence and

3

transportation by air ambulance to a facility able to provide

4

the care is faster than transportation by ground ambulance, or

5

require EMS provided by specialized equipment or providers not

6

available on a ground ambulance and the air ambulance can

7

provide this faster than the patient would receive such care at

8

a receiving facility if transported by ground ambulance.

9

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

10

an air ambulance when dispatched to provide or when providing

11

medical assessment, treatment, monitoring, observation or

12

transportation of a patient is one pilot and two EMS providers

13

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

14

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

15

medical transport.

16

§ 7232.  Advanced life support squad vehicles.

17

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

18

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

19

to rendezvous with an ambulance crew or to respond prior to

20

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

21

monitoring, treatment and observation of a patient who requires

22

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

23

vehicle does not transport patients.

24

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

25

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

26

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

27

one EMS provider above the advanced EMT level and one EMS

28

vehicle operator, except that the EMS provider may staff the

29

vehicle alone if the EMS provider is also an EMS vehicle

30

operator.

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1

§ 7233.  Basic life support ambulances.

2

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

3

assessment, triage, monitoring, treatment, transportation and

4

observation of patients who require EMS at or below the skill

5

level of an advanced EMT and also transports patients who

6

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

7

provider above the level of an advanced EMT rendezvous with the

8

BLS ambulance before or during transport of the patient and

9

accompanies the patient during the transport after arrival.

10

(b)  Staffing requirements.--

11

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

12

staffing for a BLS ambulance when responding to a call to

13

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

14

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

15

operator, except that only the two EMS providers need to

16

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

17

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

18

the patient at the scene and during patient transportation.

19

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

20

the minimum staffing for a BLS ambulance when responding to a

21

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

22

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

23

vehicle operator, except that only two EMS providers need to

24

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

25

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

26

the patient at the scene and during patient transportation.

27

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

28

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

29

BLS ambulance shall respond as set forth in this subsection.

30

If the BLS ambulance crew members arrive at the scene before

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1

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

2

vehicle, the BLS crew members shall provide EMS to the

3

patient at their skill level, including transportation of the

4

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

5

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

6

provider, after which the BLS ambulance crew shall relinquish

7

primary responsibility for the patient to the higher-level

8

EMS provider.

9

(4)  When transporting from a sending hospital a patient

10

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

11

a registered nurse, physician assistant or physician from the

12

sending or receiving hospital joins the ambulance crew,

13

brings on board the ambulance all equipment and supplies to

14

provide the patient with reasonably anticipated EMS above the

15

skill level of an advanced EMT and attends to the patient

16

during the patient transportation, the minimum staffing

17

requirements for the BLS ambulance are as set forth in

18

paragraphs (1) and (2).

19

§ 7234.  Basic life support squad vehicles.

20

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

21

provider, along with basic EMS equipment and supplies, to

22

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

23

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

24

is not utilized to transport patients.

25

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

26

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

27

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

28

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

29

operator may staff the vehicle alone.

30

§ 7235.  Quick response services.

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1

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

2

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

3

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

4

for a QRS is one EMS provider.

5

§ 7236.  Special operations emergency medical services.

6

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

7

in situations or austere environments that require specialized

8

knowledge, equipment or vehicles to access a patient or address

9

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

10

regulation provide for specific types of special operations EMS

11

teams.

12

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

13

may establish additional training or expertise requirements for

14

the EMS agency medical director and the EMS providers who staff

15

a special operations EMS service.

16

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

17

establish staffing, equipment, supply and any other requirement

18

for a special operations EMS service.

19

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

20

provide a special operations EMS need that has not been

21

addressed by applying to the department for an EMS agency

22

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

23

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

24

department to be authorized to provide the special operations

25

EMS under its license. The department shall address each

26

application on an individual basis and may conditionally deny or

27

grant an application as appropriate to protect the public health

28

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

29

compliance with any later-adopted regulations addressing the

30

type of special operations EMS being provided by the entity.

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1

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

2

EMS protocols special operations EMS protocols.

3

§ 7237.  First aid and other safety services.

4

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

5

sites, amusement parks or other locations in need of the

6

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

7

this purpose.

8

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

9

provider.

10

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

11

EMS provider may provide EMS and other medical safety services

12

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

13

to provide EMS for the EMS agency.

14

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

15

approved by the department when providing EMS under this

16

section.

17

§ 7238.  Other vehicles and services.

18

The department may by regulation prescribe EMS vehicle and

19

service standards for EMS vehicles and services not specified in

20

this chapter. If the department establishes standards in this

21

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

22

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

23

operate the vehicle or provide the service unless approved to do

24

so by the department.

25

§ 7239.  Stretcher and wheelchair vehicles.

26

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

27

vehicle other than an ambulance that is utilized to transport by

28

stretcher persons who do not receive and cannot reasonably be

29

anticipated to require medical assessment, monitoring, treatment

30

or observation during transportation, but who, due to their

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1

physical condition, require vehicle transportation while on a

2

stretcher or in a wheelchair.

3

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

4

vehicle other than an ambulance that is used to transportation

5

by wheelchair persons who do not receive and cannot reasonably

6

be anticipated to require medical assessment, monitoring,

7

treatment or observation during transportation, but who, due to

8

their physical condition, require vehicle transportation while

9

on a stretcher or in a wheelchair.

10

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

11

vehicle or wheelchair vehicle to transport a person who is known

12

or reasonably should be known by the entity to require medical

13

assessment, monitoring, treatment or observation during

14

transportation shall constitute unlawful operation of an

15

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

16

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

17

constitute misconduct in operating an EMS agency under section

18

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

19

license sanctions). For purposes of this section, unlawful

20

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

21

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

22

other location to receive or from which the person received

23

health care services.

24

§ 7240.  Conditional temporary licenses.

25

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

26

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

27

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

28

level or broader-level emergency medical response plan approved

29

by the department, the department shall issue a conditional

30

temporary license for operation of the EMS agency when the

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1

department determines that it is in the public interest, subject

2

to such terms as the department deems appropriate. A conditional

3

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

4

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

5

public interest to do so.

6

§ 7241.  Plans of correction.

7

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

8

agency has violated this chapter or regulations promulgated

9

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

10

the EMS agency specifying the violation or violations that have

11

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

12

immediate action to discontinue the violation or to submit a

13

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

14

agency into compliance with applicable requirements. If the

15

nature of the violation is such that the EMS agency cannot

16

remedy the problem immediately, and a plan of correction is

17

therefore required, the department may direct that the violation

18

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

19

shall submit a plan of correction within 30 days of the

20

department's issuance of the written notice. If immediate

21

corrective action is required, the notice from the department

22

shall request, and the EMS agency shall provide, prompt

23

confirmation that the corrective action has been taken.

24

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

25

agency an opportunity to correct a violation without facing

26

disciplinary charges if the department determines that it is not

27

in the public interest to do so.

28

§ 7242.  Emergency medical services agency license sanctions.

29

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

30

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

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1

license for any of the following reasons:

2

(1)  Violating the requirements of this chapter or

3

regulation adopted under this chapter.

4

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

5

the department or correct a deficiency as required under

6

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

7

comply with the plan of correction.

8

(3)  Refusing to accept a conditional temporary license

9

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

10

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

11

a license.

12

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

13

section 7229(f) (relating to emergency medical services

14

agencies), enabling another person to manage or operate the

15

EMS agency or any service covered by the license.

16

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

17

aiding or abetting the improper granting of a license,

18

certification, accreditation or other authorization issued

19

under this chapter.

20

(7)  Incompetence, negligence or misconduct in operating

21

the EMS agency or in providing EMS to patients.

22

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

23

staffed by responsible persons and refuses to remove from its

24

staff the irresponsible person or persons when directed to do

25

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

26

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

27

section 7229(c)(1).

28

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

29

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

30

sexual preference, age, handicap, medical problem or

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1

financial inability to pay.

2

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

3

turpitude or related to the practice of the EMS agency.

4

(11)  Making misrepresentations in seeking funds made

5

available through the department.

6

(12)  Failing to continue to meet applicable licensure

7

requirements.

8

(13)  Violating an order previously issued by the

9

department in a disciplinary matter.

10

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

11

impose discipline against an EMS agency under this section, the

12

department may do one or more of the following:

13

(1)  Deny the application for a license.

14

(2)  Administer a written reprimand with or without

15

probation.

16

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

17

license.

18

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

19

incident in which the EMS agency engages in conduct that

20

constitutes a basis for discipline.

21

(5)  Stay enforcement of any suspension, revocation or

22

other discipline and place the facility on probation with the

23

right to vacate the probationary order for noncompliance.

24

SUBCHAPTER C

25

MISCELLANEOUS PROVISIONS

26

Sec.

27

7251.  Limitations on liability.

28

7252.  Peer review.

29

7253.  Support of emergency medical services.

30

7254.  Prohibited acts.

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1

7255.  Surrender of license, accreditation or certification.

2

7256.  Penalties.

3

7257.  Adjudications and judicial review.

4

§ 7251.  Limitations on liability.

5

The following shall apply:

6

(1)  No medical command physician, medical command

7

facility medical director or medical command facility, which

8

in good faith provides a medical command to an EMS provider

9

or student enrolled in an EMS course of instruction approved

10

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

11

result of issuing the instruction, absent a showing of gross

12

negligence or willful misconduct.

13

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

14

provider who in good faith attempts to render or facilitate

15

emergency medical care authorized by this chapter shall be

16

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

17

absent a showing of gross negligence or willful misconduct.

18

This paragraph shall also apply to students enrolled in

19

approved courses of instruction and supervised pursuant to

20

rules and regulations.

21

(3)  No approved EMS training institute nor any entity

22

participating as part of any approved educational program

23

offered by the institute as authorized by this chapter shall

24

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

25

continuing educational practice by duly enrolled students

26

under proper supervision, absent a showing of gross

27

negligence or willful misconduct.

28

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

29

emergency care authorized by this chapter at an emergency

30

scene while en route to a place of employment shall receive

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1

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

2

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

3

require written verification from the EMS provider, who shall

4

obtain the written verification from either the police

5

officer or other person who is in charge at the emergency

6

scene.

7

(5)  No EMS agency medical director or regional medical

8

director who in good faith gives instructions to or provides

9

primary and continuing educational training to an EMS

10

provider shall be liable for civil damages for issuing the

11

instructions, education or training, absent a showing of

12

gross negligence or willful misconduct.

13

(6)  Neither the department, the Commonwealth EMS Medical

14

Director, a regional EMS council medical director nor any

15

other official or employee of the department or a regional

16

EMS council shall be liable for civil damages arising out of

17

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

18

instruction approved by the department following protocols

19

approved under this chapter.

20

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

21

civil liability based solely on failure to obtain consent in

22

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

23

person is unable to give consent for any reason, including

24

minority, and where there is no other person reasonably

25

available who is legally authorized to give or refuse to give

26

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

27

without knowledge of facts negating consent.

28

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

29

civil liability based solely on refusal to provide treatment

30

or services requested by the patient or the person

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1

responsible for making medical care decisions for the patient

2

if the treatment or services requested are not prescribed or

3

authorized by Statewide or regional protocols established

4

under this chapter and the EMS provider has:

5

(i)  contacted a medical command physician who

6

refused to authorize the requested treatment or service;

7

or

8

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

9

command physician and was unable to do so.

10

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

11

information about a patient from a caller or makes dispatch

12

assignments based upon the information collected may be

13

subject to civil liability based upon the information

14

collected or a dispatch assignment, absent a showing of gross

15

negligence or willful misconduct.

16

§ 7252.  Peer review.

17

(a)  Immunity from liability.--

18

(1)  A person who provides information to a review

19

organization shall have the same protections from civil and

20

criminal liability as a person who provides information to a

21

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

22

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

23

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

24

review organization or who furnishes professional counsel or

25

services to the organization shall have the same protections

26

from civil and criminal liability for the performance of any

27

duty, function or activity authorized or required of the

28

review organization as a person who performs the duty,

29

function or activity under the Peer Review Protection Act.

30

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

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1

proceedings and records of a review organization shall be held

2

in confidence and shall have the same protections from discovery

3

and introduction into evidence in civil proceedings as they

4

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

5

attendance at a meeting of a review organization shall be

6

subject to the same testimony restrictions as a person who was

7

in attendance at a meeting of a review organization under the

8

Peer Review Protection Act.

9

§ 7253.  Support of emergency medical services.

10

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

11

established a special fund to be known as the Emergency Medical

12

Services Operating Fund, which shall be administered by the

13

department.

14

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

15

Medical Services Operating Fund:

16

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

17

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

18

Rehabilitative Disposition).

19

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

20

department under this chapter.

21

(3)  Appropriations.

22

(4)  Contributions.

23

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

24

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

25

Operating Fund shall be disbursed by the department for only the

26

following uses:

27

(1)  To eligible EMS agencies for applicable purposes

28

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

29

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

30

provide additional financial assistance for those EMS systems

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1

serving rural areas.

2

(2)  To the board for the performance of duties imposed

3

upon it under this chapter.

4

(3)  To regional EMS councils for the development,

5

maintenance and improvement of EMS systems, including

6

ambulance and communications equipment and for training,

7

education and EMS agency licensure purposes.

8

(4)  To other contractors and grantees as authorized

9

under section 7212(j).

10

(d)  Allocation to Catastrophic Medical and Rehabilitation

11

Fund.--Twenty-five percent of the money in the Emergency Medical

12

Services Operating Fund shall be allocated to a Catastrophic

13

Medical and Rehabilitation Fund for victims of trauma. After the

14

exhaustion of all alternative financial resources, other than

15

those excluded by the department from consideration, the

16

catastrophic fund shall be available for the purchase of

17

medical, rehabilitation and attendant care services for trauma

18

victims and may be made available for the purchase of supportive

19

services such as respite care and counseling services for the

20

family or household members of trauma victims. The department

21

may, by regulation, prioritize the distribution of funds by and

22

within classification of traumatic injury.

23

(e)  Audit.--The Auditor General shall review collections and

24

expenditures made under this section and report its findings to

25

the General Assembly annually. The audit shall include a review

26

of the collections and expenditures of the regional EMS

27

councils.

28

§ 7254.  Prohibited acts.

29

(a)  Making false ambulance requests.--It shall be unlawful

30

for any person to intentionally report a medical emergency and

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1

summon an EMS response if the person does not have good cause to

2

believe that there is a medical emergency for which an EMS

3

response is needed. A person violating this subsection commits a

4

summary offense.</