PRIOR PRINTER'S NOS. 245, 678

PRINTER'S NO.  1071

  

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

  

  

SENATOR CORMAN, APPROPRIATIONS, RE-REPORTED AS AMENDED,JUNE 1, 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 council."  A nonprofit incorporated entity or appropriate

2

equivalent that is assigned by the Department of Health to:

3

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

4

emergency medical services systems within a specific

5

geographic area of this Commonwealth; and

6

(2)  coordinate those systems into a regional emergency

7

medical services system.

8

"Regional emergency medical services medical director" or

9

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

10

regional emergency medical services council.

11

"Review organization."  A committee which engages in peer

12

review as authorized by the regulations of the Department of

13

Health.

14

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

15

the United States Bureau of the Census.

16

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

17

hospital where provisions have been made for a concentration of

18

physicians, nurses and others who have special skills and

19

experiences to provide medical care for critically ill patients.

20

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

21

the Pennsylvania Trauma Systems Foundation.

22

§ 7204.  Emergency medical services system programs.

23

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

24

guide and coordinate programs on the following matters to

25

promote effective and efficient operation of Statewide and

26

regional EMS systems:

27

(1)  The number and distribution of EMS providers and

28

other persons integral to an EMS system, such as medical

29

command physicians and EMS agency medical directors, with

30

appropriate training and experience.

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1

(2)  Reasonably accessible training for EMS providers and

2

other persons integral to an EMS system, including clinical

3

training and continuing education programs coordinated with

4

other programs providing similar, complementary and

5

supplemental training and education.

6

(3)  The joining of personnel, facilities and equipment

7

coordinated through a communication system to ensure that EMS

8

requests will be handled by communications facilities that:

9

(i)  utilize emergency medical telecommunications

10

screening to determine the appropriate emergency agency

11

response;

12

(ii)  are accessible to the general public through a

13

common telephone number and, where feasible, through the

14

universal emergency telephone number 911; and

15

(iii)  will have direct communications with

16

appropriate personnel facilities and equipment resources.

17

(4)  The number and distribution of ambulances and other

18

EMS vehicles in which:

19

(i)  ambulances and other vehicles meet appropriate

20

criteria relating to location, design, performance and

21

equipment; and

22

(ii)  operators and other personnel staffing vehicles

23

meet appropriate training and experience requirements.

24

(5)  The number and accessibility of facilities that:

25

(i)  are collectively capable of providing EMS on a

26

continuous basis;

27

(ii)  have appropriate specialty capabilities;

28

(iii)  meet appropriate standards relating to

29

capacity, location, personnel and equipment; and

30

(iv)  are coordinated with other health care

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1

facilities and resource centers.

2

(6)  Access and transportation to trauma centers and

3

specialty care receiving facilities.

4

(7)  Transfer of patients between facilities or to

5

programs offering necessary follow-up care and

6

rehabilitation.

7

(8)  Utilization of appropriate personnel, facilities and

8

equipment of each entity providing EMS.

9

(9)  Regional EMS councils that provide persons residing

10

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

11

interest in the provision of health care, with an adequate

12

opportunity to participate in the making of policy for the

13

regional EMS system.

14

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

15

services.

16

(11)  A standardized data collection system that covers

17

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

18

to, the dispatch report and contact, treatment and transport

19

of a patient in the EMS system.

20

(12)  Programs of public education, information and

21

prevention, integrated with public health education and

22

taking into account needs of visitors and residents,

23

concerning methods for accessing EMS and stressing

24

dissemination of information as to first aid and

25

cardiopulmonary resuscitation.

26

(13)  The provision of periodic comprehensive review and

27

evaluation of the extent and quality of the EMS provided in

28

each regional EMS system and reports to the department of

29

each review or evaluation.

30

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

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1

be able to provide or secure EMS during mass casualty

2

situations, natural disasters and declared states of

3

emergency in accordance with Chapter 71 (relating to general

4

provisions) and the instructions of the Pennsylvania

5

Emergency Management Agency.

6

(15)  Appropriate intrastate and interstate arrangements

7

for the provision of EMS as needed.

8

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

9

objectives to be pursued and achieved by the department in its

10

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

11

to confer regulatory powers upon the department beyond those

12

conferred elsewhere in this chapter.

13

§ 7205.  Duties of department.

14

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

15

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

16

coordinate the development of regional EMS systems into a

17

unified Statewide system; and coordinate systems in this

18

Commonwealth with similar systems in neighboring states.

19

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

20

EMS in this Commonwealth. The department is authorized to:

21

(1)  Coordinate a program for planning, developing,

22

maintaining, expanding, improving and upgrading EMS systems

23

in this Commonwealth.

24

(2)  Establish, by regulation, standards and criteria

25

governing the awarding and administration of contracts and

26

grants under this chapter for initiation, maintenance and

27

improvement of regional EMS systems.

28

(3)  Require collection and maintenance of patient data

29

and information in EMS patient care reports by EMS agencies.

30

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

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1

and information regarding patients who utilize emergency

2

departments without being admitted to the facility and

3

patients admitted through emergency departments, trauma

4

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

5

protects and maintains the confidential nature of patient

6

records. The data and information shall be reasonable in

7

detail and shall be collected pursuant to regulations issued

8

by the department. Data and information shall be limited to

9

that which may be used for specific planning, research and

10

quality improvement purposes and shall not be duplicative of

11

data and information already available to the department.

12

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

13

section 7211 (relating to comprehensive plan).

14

(6)  Define and approve training programs and accredit

15

educational institutions for EMS training of EMS providers.

16

(7)  Provide technical assistance to local governments,

17

EMS agencies and other entities for the purpose of assuring

18

effective planning and execution of EMS.

19

(8)  Administer contracts and grants authorized under

20

this chapter and other grants pertaining to EMS.

21

(9)  Establish standards for the licensing, registration

22

and operation of EMS agencies, and inspect EMS agencies for

23

compliance with this chapter and regulations adopted under

24

this chapter.

25

(10)  Maintain a quality improvement program for the

26

purpose of monitoring and improving the delivery of EMS.

27

(11)  Promulgate regulations to establish standards and

28

criteria for EMS systems.

29

(12)  Integrate all trauma centers accredited pursuant to

30

section 7207 (relating to Pennsylvania Trauma Systems

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1

Foundation) into the Statewide EMS system.

2

(13)  Recommend to 911 and other EMS agency dispatchers

3

protocols with respect to the type and quantity of EMS

4

resources to dispatch to emergencies.

5

(14)  Investigate, based upon complaints and information

6

received, possible violations of this chapter and regulations

7

under this chapter and take disciplinary actions, seek

8

injunctions and refer matters for criminal prosecution.

9

(15)  Investigate complaints concerning delivery of

10

services by trauma centers and forward investigation results

11

to the appropriate accrediting entity with a recommendation

12

for action.

13

(16)  Enter into agreements with other states which may

14

include, as appropriate to effectuate the purposes of this

15

chapter, the acceptance of EMS resources of other states that

16

do not fully satisfy the requirements of this chapter or

17

regulations adopted under this chapter.

18

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

19

and protocols, including bypass protocols, for evaluation,

20

triage, treatment, transport, transfer and referral of patients

21

to ensure that they receive appropriate EMS and are transported

22

to the most appropriate facility. Regional EMS councils shall

23

not be eligible for contracts or grant funds or State EMS

24

Operating Fund disbursements unless they assist in ensuring

25

regional implementation of the criteria and protocols. Protocols

26

under this subsection are not subject to the rulemaking process.

27

§ 7206.  Emergency medical services patient care reports.

28

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

29

responding EMS providers complete an EMS patient care report for

30

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

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1

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

2

the department by regulation exempts certain types of patient

3

contact from the reporting requirement. The department shall

4

employ an electronic EMS patient care reporting process that

5

shall solicit standardized data and patient information. The

6

department may require an EMS agency to complete a different

7

standardized report or different fields in a standardized report

8

based upon the type of resources the EMS agency uses in

9

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

10

paper report for extraordinary reasons as determined by the

11

department on a case-by-case basis.

12

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

13

solicited on the form or other reporting process developed by

14

the department. The reporting process shall solicit essential

15

information in reasonable detail. The department may also use

16

the reporting process to collect data to enhance its ability to

17

carry out its responsibilities under sections 7204 (relating to

18

emergency medical services system programs) and 7205 (relating

19

to duties of department).

20

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

21

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

22

information about the patient and EMS performed on the patient

23

that is solicited through the reporting process shall be

24

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

25

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

26

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

27

or a regional EMS council, as determined by department

28

regulation, data that is solicited through the reporting

29

process.

30

(e)  Confidentiality.--

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1

(1)  Patient information collected by an EMS agency shall

2

be confidential and shall not be released by the EMS agency

3

or a health care facility except as follows:

4

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

5

or to a person who is authorized to exercise the rights

6

of the patient with respect to securing the report.

7

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

8

jurisdiction, including a subpoena when it constitutes a

9

court order, except that disclosure pursuant to a

10

subpoena shall not be permitted as to information in the

11

report that is of such nature that disclosure pursuant to

12

a subpoena is not otherwise authorized by law.

13

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

14

medical record may be released under the law.

15

(iv)  For billing purposes.

16

(v)  For quality improvement activities.

17

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

18

the purpose of investigating possible violations of this

19

chapter or related regulations.

20

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

21

authorized by the department, for the purpose of the

22

agency performing official government duties.

23

(2)  Notwithstanding the duty of confidentiality

24

applicable to department and regional EMS councils concerning

25

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

26

specific research or EMS planning purposes approved by the

27

department, subject to department approval and supervision to

28

ensure that use of the report is strictly limited to the

29

purposes of the research.

30

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

- 18 -

 


1

offer reporting forms or software marketed as appropriate for

2

use in making reports required under this section unless the

3

vendor submits the product to the department for review and

4

receives department approval. Thereafter, the vendor shall

5

submit any modification of the product to the department for

6

review and approval if the vendor intends to offer the modified

7

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

8

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

9

shall publish a notice of the changes in the Pennsylvania

10

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

11

than 60 days following publication. After publication of

12

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

13

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

14

forms or software approved by the department prior to

15

publication of the changes, unless the vendor clearly discloses

16

that the forms or software were approved prior to publication of

17

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

18

penalty for each day a vendor violates the provisions of this

19

subsection.

20

§ 7207.  Pennsylvania Trauma Systems Foundation.

21

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

22

develop a private voluntary accreditation program to:

23

(1)  Establish standards for the operation of trauma

24

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

25

guidelines for trauma centers defined by the American College

26

of Surgeons. Additionally, Level III trauma centers shall

27

meet accreditation criteria for Level III trauma centers

28

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

29

as the Pennsylvania Trauma Systems Stabilization Act. For the

30

purpose of reaccreditation, the standards shall require, at a

- 19 -

 


1

minimum, that each Level I trauma center establish that 600

2

severe and urgent injury cases have been treated per year and

3

each Level II trauma center establish that 350 severe and

4

urgent injury cases have been treated per year.

5

(2)  Evaluate a hospital making application to the

6

foundation to determine if the hospital meets the

7

foundation's standards. An evaluation shall include hospital

8

site visits by accreditation survey teams composed of

9

independent, qualified persons selected by the foundation.

10

(3)  Issue certificates of accreditation to hospitals

11

that meet the accreditation standards. Certificates of

12

accreditation shall be valid for a period not to exceed three

13

years. Certificates of accreditation may be revoked by the

14

foundation if it is determined that the trauma center no

15

longer meets accreditation standards as set forth in this

16

chapter.

17

(4)  Establish an appeal mechanism for reconsideration of

18

accreditation decisions.

19

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

20

of the foundation under this section may file a petition for

21

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

22

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

23

trauma center unless it has a current certificate of

24

accreditation issued under this section.

25

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

26

foundation shall consist of the following voting members: five

27

representatives of State organizations representing physicians;

28

five representatives of State organizations representing

29

hospitals; three representatives of State organizations

30

representing registered professional nurses; two representatives

- 20 -

 


1

of other Statewide EMS organizations having expertise in the

2

delivery of trauma services; the chairman and minority chairman

3

of the Public Health and Welfare Committee of the Senate or

4

designees chosen from among the members of the committee; the

5

chairman and minority chairman of the Health and Human Services

6

Committee of the House of Representatives or designees chosen

7

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

8

Health or a designee. The bylaws of the foundation shall

9

identify a method to select members to achieve professional and

10

geographic balance on the board of directors. Terms of office

11

shall be limited to three years.

12

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

13

maintain statistics on mortality and morbidity on multisystem

14

trauma victims. The data collection shall be coordinated and

15

performed in conjunction with State data collection activities.

16

§ 7208.  State Advisory Board.

17

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

18

composed of volunteer, professional and paraprofessional

19

organizations involved in EMS. The board shall be geographically

20

representative of the provider organizations that represent EMS

21

providers, firefighters, regional EMS councils, physicians,

22

hospital administrators and other health care providers

23

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

24

organizations. Each organization that is a member of the

25

Pennsylvania Emergency Health Services Council and is elected to

26

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

27

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

28

(1)  Elect officers.

29

(2)  Advise the department concerning manpower and

30

training, communications, EMS agencies, content of

- 21 -

 


1

regulations, standards and policies promulgated by the

2

department under this chapter and other subjects deemed

3

appropriate by the department.

4

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

5

the Statewide EMS system plan, or any proposed revisions

6

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

7

plan.

8

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

9

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

10

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

11

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

12

consecutive terms.

13

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

14

board shall constitute a quorum for the transaction of business.

15

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

16

compensation, except the Pennsylvania Emergency Health Services

17

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

18

pay necessary and reasonable expenses incurred by members of the

19

board while performing their official duties.

20

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

21

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

22

under subsection (b). Contracts and grants between the

23

department and the board for the performance of work other than

24

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

25

to contracts and grants) where applicable.

26

§ 7209.  Regional emergency medical services councils.

27

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

28

department in carrying out the provisions of this chapter. Each

29

regional EMS council shall adhere to policy direction from the

30

department.

- 22 -

 


1

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

2

organizational structure of a regional EMS council shall be

3

representative of the public, health professions and major

4

private and public voluntary agencies, organizations and

5

institutions concerned with providing EMS in the region and

6

shall be one of the following:

7

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

8

council, meeting requirements for representation.

9

(2)  A representative public entity administering a

10

compact or other area-wide arrangement or consortium.

11

(3)  Any other public or private nonprofit entity that

12

meets requirements for representation as determined by the

13

department.

14

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

15

the department:

16

(1)  Assist the department in achieving the Statewide and

17

regional EMS system components and goals described under

18

section 7204 (relating to emergency medical services system

19

programs).

20

(2)  Assist the department in the collection and

21

maintenance of standardized data and information as provided

22

in section 7206 (relating to emergency medical services

23

patient care reports).

24

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

25

regional EMS system plan for the EMS region the department

26

has designated and for which the department has contracted or

27

provided a grant to it to serve.

28

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

29

regional EMS system plans.

30

(5)  Assure the reasonable availability of training and

- 23 -

 


1

continuing education programs for EMS providers.

2

(6)  Provide necessary and reasonable staff services and

3

appropriate and convenient office facilities that can serve

4

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

5

and coordinative and evaluative functions of the council.

6

(7)  Establish a mechanism to provide for input from

7

facilities and EMS agencies in the EMS region in decisions

8

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

9

governing body.

10

(8)  Establish, subject to department approval, regional

11

EMS triage, treatment and transportation protocols consistent

12

with Statewide protocols adopted by the department. A

13

regional EMS council may also establish, subject to

14

department approval, additional triage, treatment and

15

transportation protocols. No regional protocol shall be

16

subject to the rulemaking process.

17

(9)  Advise public safety answering points and municipal

18

and county governments as to the EMS resources available for

19

dispatching and recommend dispatch criteria that may be

20

developed by the department or the council as approved by the

21

department.

22

(10)  Assist the department in achieving a unified

23

Statewide EMS system.

24

(11)  Designate a regional EMS medical director and

25

establish a medical advisory committee and a quality

26

improvement committee.

27

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

28

department approval, and require its board or advisory

29

council members, officials and employees to agree to the

30

policy in writing.

- 24 -

 


1

(13)  Perform other duties assigned by the department to

2

assist the department in carrying out the requirements of

3

this chapter.

4

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

5

consult with the regional EMS medical directors in developing

6

and adopting EMS protocols and may consult with them on any

7

matter involved in the department's administration of this

8

chapter.

9

SUBCHAPTER B

10

PROGRAM

11

Sec.

12

7211.  Comprehensive plan.

13

7212.  Contracts and grants.

14

7213.  Emergency medical services providers.

15

7214.  Emergency medical responders.

16

7215.  Emergency medical technicians.

17

7216.  Advanced emergency medical technicians.

18

7217.  Paramedics.

19

7218.  Prehospital registered nurses.

20

7219.  Prehospital physician extenders.

21

7220.  Prehospital emergency medical services physicians.

22

7221.  Certification sanctions.

23

7222.  Emergency medical services vehicle operators.

24

7223.  Suspension of certification.

25

7224.  Emergency medical services instructors.

26

7225.  Medical director of emergency medical services agency.

27

7226.  Medical command physicians and facility medical

28

directors.

29

7227.  Medical command facilities.

30

7228.  Receiving facilities.

- 25 -

 


1

7229.  Emergency medical services agencies.

2

7230.  Advanced life support ambulances.

3

7231.  Air ambulances.

4

7232.  Advanced life support squad vehicles.

5

7233.  Basic life support ambulances.

6

7234.  Basic life support squad vehicles.

7

7235.  Quick response services.

8

7236.  Special operations emergency medical services.

9

7237.  First aid and other safety services.

10

7238.  Other vehicles and services.

11

7239.  Stretcher and wheelchair vehicles.

12

7240.  Conditional temporary licenses.

13

7241.  Plans of correction.

14

7242.  Emergency medical services agency license sanctions.

15

§ 7211.  Comprehensive plan.

16

(a)  Preparation.--

17

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

18

shall prepare a Statewide EMS system plan, which plan shall

19

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

20

and shall make the plan available to the General Assembly and

21

all concerned agencies, entities and individuals.

22

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

23

department, shall:

24

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

25

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

26

information that subsection (b) requires for the

27

Statewide plan.

28

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

29

contain:

30

(1)  An inventory of EMS resources available within this

- 26 -

 


1

Commonwealth.

2

(2)  An assessment of the effectiveness of the existing

3

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

4

EMS system.

5

(3)  Performance measures for delivery of EMS to all

6

persons in this Commonwealth.

7

(4)  Methods to be used in achieving the stated

8

performance measures.

9

(5)  A schedule for achievement of the stated performance

10

measures.

11

(6)  A method for monitoring and evaluating whether the

12

stated performance measures are being achieved.

13

(7)  Estimated costs for achieving the stated performance

14

measures.

15

(c)  Revisions.--

16

(1)  The department shall collect and analyze EMS data

17

for the purpose of:

18

(i)  Revising the Statewide EMS system plan,

19

including determining the status of the Statewide EMS

20

system, the degree of compliance with the requirements of

21

this chapter and the effectiveness of EMS systems in

22

reducing morbidity and mortality associated with medical

23

emergencies.

24

(ii)  Planning future EMS system initiatives.

25

(2)  Persons regulated by the department under this

26

chapter and dispatchers of EMS agencies shall provide data,

27

without charge, as reasonably requested by the department and

28

regional EMS councils, to aid them in developing and revising

29

Statewide and regional EMS system plans and in conducting

30

investigations under this chapter as authorized by the

- 27 -

 


1

department.

2

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

3

comprehensive and specific reports of activity and plan

4

implementation.

5

(e)  Use of Statewide plan.--

6

(1)  The department shall use the Statewide plan for

7

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

8

(relating to contracts and grants).

9

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

10

vest the department with any regulatory authority.

11

§ 7212.  Contracts and grants.

12

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

13

or grants with entities to serve as regional EMS councils

14

responsible for the initiation, expansion, maintenance and

15

improvement of regional EMS systems that are in accordance with

16

the Statewide EMS system plan.

17

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

18

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

19

regional EMS council shall carry out the duties assigned by the

20

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

21

medical services councils).

22

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

23

regional EMS councils, the department may allocate Emergency

24

Medical Services Operating Fund moneys appropriated to the

25

department only for the following purposes:

26

(1)  Providing programs of public education, information,

27

health promotion and prevention regarding EMS.

28

(2)  Purchasing ambulances, other EMS vehicles, medical

29

equipment and rescue equipment.

30

(3)  Applying to costs associated with conducting

- 28 -

 


1

training and testing programs for EMS providers.

2

(4)  Applying to costs associated with inspections and

3

investigations conducted to assist the department to carry

4

out its regulatory authority under this chapter.

5

(5)  Purchasing communications equipment and services,

6

including alerting equipment, provided that the purchases are

7

in accordance with the Statewide EMS system plan.

8

(6)  Assisting with the merger of EMS agencies or

9

assisting an EMS agency to acquire another EMS agency, when

10

the department determines circumstances exist such that the

11

transaction and financial assistance are needed to serve the

12

public interest.

13

(7)  Applying to costs associated with the maintenance

14

and operation of regional EMS councils. Those costs may

15

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

16

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

17

office space, and other costs incidental to the conduct of

18

business which are deemed by the department to be necessary

19

and appropriate for carrying out the purposes of this

20

chapter.

21

(8)  Applying to costs associated with collection and

22

analysis of data necessary to evaluate the effectiveness of

23

EMS systems in providing EMS and to administer quality

24

improvement programs.

25

(9)  Applying to costs associated with assisting EMS

26

agencies to recruit and retain EMS providers.

27

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

28

regional EMS councils, the department may not allocate Emergency

29

Medical Services Operating Fund moneys appropriated to the

30

department for the following purposes:

- 29 -

 


1

(1)  Acquisition, construction or rehabilitation of

2

facilities or buildings, except renovation as may be

3

necessary for the implementation or modification of EMS

4

communication systems.

5

(2)  Purchasing hospital equipment, other than

6

communications equipment for medical command and receiving

7

facilities, unless the equipment is used or intended to be

8

used in an equipment exchange program with EMS agencies.

9

(3)  Maintenance of ambulances, other EMS vehicles and

10

equipment.

11

(4)  Applying to costs deemed by the department as

12

inappropriate for carrying out the purposes of this chapter.

13

(5)  Applying to costs which are normally borne by

14

patients, except for extraordinary costs as determined by the

15

department.

16

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

17

this chapter shall make reports to the department as may be

18

required by the department.

19

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

20

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

21

entity to serve as a regional EMS council unless:

22

(1)  The entity has submitted a contract or grant

23

application to the department in a form and format prescribed

24

by the department that is consistent with the Statewide and

25

regional EMS system plans.

26

(2)  The application addresses planning, maintenance and

27

improvement of the regional EMS system.

28

(3)  The entity demonstrates to the department's

29

satisfaction the qualifications and commitment to plan,

30

maintain and improve a regional EMS system, and that the

- 30 -

 


1

entity has the required organizational structure and

2

provisions for representation of appropriate entities.

3

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

4

technical assistance, as appropriate, to regional EMS councils

5

and to such other eligible entities as necessary for the purpose

6

of their carrying out the provisions of contracts and grants

7

under this section, with special consideration for contractors

8

and grantees representing rural areas.

9

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

10

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

11

reimbursement and in installments and on conditions as the

12

department determines will most effectively carry out the

13

provisions of this chapter.

14

(i)  Other funds considered.--

15

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

16

under this section, the amount of funds available to the

17

contractor or grantee from non-State contributions and

18

Federal grant or contract programs pertaining to EMS shall be

19

taken into consideration.

20

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

21

contributions" include the outlay of cash and in-kind

22

services to the contractor or grantee or toward the operation

23

of a regional EMS system by private, public or government

24

third parties, including the Federal Government.

25

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

26

into contracts and grants with organizations other than regional

27

EMS councils in order to assist the department in complying with

28

the provisions of this section and chapter.

29

(k)  Public disclosure.--

30

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

- 31 -

 


1

finalized contracts and grants shall be deemed public records

2

subject to disclosure.

3

(2)  The department may not disclose information in

4

contracts or grants that could be used by persons to

5

undermine measures to combat, respond to or recover from

6

terrorist attacks.

7

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

8

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

9

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

10

department, without undertaking a competitive bidding process,

11

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

12

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

13

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

14

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

15

contract or grant, demonstrated its ability and commitment to

16

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

17

regional EMS system consistent with the terms of the prior

18

contract or grant.

19

§ 7213.  Emergency medical services providers.

20

(a)  Certification.--The department shall issue

21

certifications for the following types of EMS providers, which

22

shall be permanent, subject to disciplinary action pursuant to

23

section 7221 (relating to certification sanctions):

24

(1)  Emergency medical responder.

25

(2)  Emergency medical technician.

26

(3)  Advanced emergency medical technician.

27

(4)  Paramedic.

28

(5)  Prehospital registered nurse.

29

(6)  Prehospital physician extender.

30

(7)  Prehospital EMS physician.

- 32 -

 


1

(8)  Any other class of EMS provider the department

2

establishes by regulation.

3

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

4

department may establish, by regulation as the need arises,

5

classes of EMS providers to provide specialized EMS. The

6

regulations shall establish certification, practice,

7

disciplinary and other provider standards consistent with the

8

purposes of this chapter, and the statutory regulatory schemes

9

applicable to paramedics except as necessary to meet the special

10

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

11

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

12

certification shall complete an application for certification on

13

a form or through an electronic application process prescribed

14

by the department.

15

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

16

coordinate the education of EMS providers.

17

(1)  The department shall develop standards through

18

regulations for the accreditation, reaccreditation and

19

operation of educational institutes to provide the training

20

persons must successfully complete to be certified as EMS

21

providers.

22

(2)  The department shall develop standards through

23

regulations for the approval of continuing education courses

24

for EMS providers and for the accreditation of persons and

25

Commonwealth agencies that provide continuing education EMS

26

providers may take to secure renewal of registration.

27

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

28

shall review and update the permitted scope of continuing

29

education programs not less than biennially.

30

(4)  If the educational institute or provider of

- 33 -

 


1

continuing education courses fails to satisfy the operational

2

standards or fails to continue to meet the accreditation

3

standards, the department may take one or more of the

4

following actions:

5

(i)  Deny the application for reaccreditation.

6

(ii)  Impose terms of probation.

7

(iii)  Revoke, suspend, limit or otherwise restrict

8

the accreditation.

9

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

10

each infraction.

11

(e)  Examinations.--

12

(1)  A person who intends to secure EMS provider

13

certification shall take the required certification

14

examinations within one year after completing the EMS

15

provider training required for certification.

16

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

17

person who fails a written or practical skills examination

18

for an EMS provider certification may repeat the failed

19

examination without retaking the examination the person

20

passed.

21

(3)  A person who fails the written examination three

22

times shall complete a refresher course approved by the

23

department or repeat the EMS provider training program before

24

taking the examination again.

25

(4)  A person who fails the practical skills examination

26

three times shall complete a remedial course approved by the

27

department or repeat the EMS provider training program before

28

again taking the examination.

29

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

30

who does not pass the required examinations within two years

- 34 -

 


1

after completing the EMS provider training program shall

2

receive no credit for an examination previously passed and

3

shall repeat the training program for the EMS provider

4

certification before the person may take the certification

5

examinations again.

6

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

7

certification examination change after the person has failed

8

the examination, the person may not retake the examination

9

unless the person meets the new standards.

10

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

11

standards in this subsection.

12

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

13

EMS provider certifications by reciprocity or endorsement as

14

follows:

15

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

16

certification of a type of EMS provider in another state,

17

determines that the criteria is substantially equivalent to

18

the criteria for a similar certification in this

19

Commonwealth, the department may enter into a reciprocity

20

agreement with its counterpart certifying agency in the other

21

state to certify that type of EMS provider based solely on

22

the other state's certification of the provider. No

23

reciprocity agreement may deprive the department from denying

24

a certification based on disciplinary considerations.

25

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

26

examination approved by another state for EMS provider

27

certification or continuing education, or upon review of a

28

national course or examination, determines that the course or

29

examination meets or exceeds the standards for such a course

30

or examination for a similar type of certification in this

- 35 -

 


1

Commonwealth, or for registration of the certification, the

2

department may endorse the course or examination as meeting

3

the course or examination requirements for that type of EMS

4

provider certification in acting upon an applicant's

5

application for certification or registration of the

6

certification in this Commonwealth.

7

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

8

Pennsylvania Bulletin a list of skills within the scope of

9

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

10

by publication as necessary.

11

(h)  Medical command orders and protocols.--

12

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

13

physician, shall provide EMS pursuant to department-approved

14

protocols and medical command orders.

15

(2)  The protocols shall identify circumstances in which

16

an EMS provider shall seek direction from a medical command

17

physician, which direction may be given by the physician in

18

person or through an authorized agent or via radio or other

19

telecommunications device approved by the department, and

20

shall address the responsibilities of an EMS provider when

21

medical command cannot be secured or is disrupted.

22

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

23

(1)  An applicant for an EMS provider certification shall

24

report to the department all misdemeanor, felony and other

25

criminal convictions that are not summary or equivalent

26

offenses, and all disciplinary sanctions that have been

27

imposed upon a license, certification or other authorization

28

of the applicant to practice an occupation or profession, and

29

any exclusion from a Federal or State health care program of

30

the applicant or an entity in which the applicant had equity

- 36 -

 


1

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

2

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

3

the time of the exclusion.

4

(2)  The applicant shall also provide the department with

5

a certified copy of the criminal charging, judgment and

6

sentencing documents for each conviction and a certified copy

7

of an adjudication or other document imposing discipline

8

against the applicant.

9

(3)  The department may not certify an applicant until

10

the department receives the documents, unless the applicant

11

establishes that the documents from which certified copies

12

are to be made no longer exist.

13

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

14

convictions, disciplinary sanctions and exclusions and

15

provide the same documents to the department within 30 days

16

after each conviction, discipline and exclusion.

17

(j)  Identification.--

18

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

19

practice as an EMS provider if requested when providing

20

services as an EMS provider.

21

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

22

to practice" means a card or certificate issued by the

23

department that shows current registration of the EMS

24

provider's certification.

25

(k)  Change of address.--

26

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

27

certification shall ensure that the department has the

28

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

29

all times.

30

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

- 37 -

 


1

number nor any other residential contact information provided

2

to the department shall be deemed a public record.

3

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

4

shall maintain current registration of his certification as an

5

EMS provider.

6

(m)  Downgrading certification or practice.--

7

(1)  An EMS provider who has a currently registered

8

certification as an advanced EMT or higher-level EMS provider

9

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

10

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

11

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

12

(relating to emergency medical services agencies), may

13

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

14

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

15

agency permits.

16

(2)  Upon expiration of the biennial registration period,

17

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

18

whose practice for an EMS agency has been downgraded pursuant

19

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

20

current registration of the EMS provider's certification by

21

meeting the biennial registration requirements for that

22

certification.

23

(3)  An EMS provider who has a currently registered

24

certification as an advanced EMT or higher-level EMS provider

25

and does not meet the requirements for biennial registration

26

of that certification may apply to and secure from the

27

department registration of a lower-level EMS provider

28

certification if the EMS provider meets the registration

29

requirements for that certification.

30

(4)  Instead of a registration certificate, the

- 38 -

 


1

department shall issue a lower-level certification to an EMS

2

provider who does not already have that certification and

3

applies for a registration of that certification under this

4

subsection.

5

(5)  An EMS provider whose practice level has been

6

downgraded under this section and who does not maintain

7

current registration of the higher-level certification may

8

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

9

higher-level certification when providing EMS.

10

(n)  Biennial registrations.--

11

(1)  The biennial registration of each EMS provider

12

certification, subject to a biennial registration requirement

13

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

14

(2)  The continuing education requirements for the

15

biennial registration following the initial registration of a

16

certification shall be prorated based upon the month in which

17

the EMS provider became certified, with any fractional

18

requirement rounded down.

19

(o)  Exceptions for members of armed forces returning from

20

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

21

from active military service who have a certification

22

registration that expired during their tours of duty or will

23

expire within 12 months after their return from military duty

24

may secure an exception to satisfying the continuing education

25

requirements for certification registration as follows:

26

(1)  EMS providers who have a triennial certification

27

registration requirement may secure an exception to the

28

period of time in which they would otherwise need to meet

29

continuing education requirements for triennial registration

30

of their certifications, as the department deems appropriate.

- 39 -

 


1

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

2

biennial certification registration requirement may secure an

3

exception to the period of time in which they would otherwise

4

need to meet continuing education requirements for biennial

5

registration of their certifications, as the department deems

6

appropriate. Before an EMS provider without a current

7

biennial registration begins to work for an EMS agency, the

8

EMS agency medical director must determine that the EMS

9

provider has continuing competency in the knowledge and

10

skills required to provide the services the EMS agency will

11

assign to the EMS provider.

12

(3)  EMS providers may seek an exception to their

13

continuing education requirements for certification

14

registration by asking the department to endorse their

15

relevant military training as satisfying some or all of the

16

applicable continuing education requirements.

17

§ 7214.  Emergency medical responders.

18

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

19

BLS skills involving basic interventions with minimum EMS

20

equipment as follows:

21

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

22

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

23

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

24

assist that EMS provider.

25

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

26

(3)  In another capacity as authorized by the department

27

by regulation.

28

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

29

an individual who meets all of the following:

30

(1)  Is at least 16 years of age.

- 40 -

 


1

(2)  Has successfully completed an EMR training course

2

approved by the department.

3

(3)  Has a current certificate evidencing successful

4

completion of a CPR course acceptable to the department.

5

(4)  Has passed an EMR skills practical examination

6

approved by the department.

7

(5)  Has passed a written EMR certification examination

8

approved by the department.

9

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

10

deemed registered for three years after issuance. An EMR must

11

register the EMR certification at three-year intervals by

12

completing an application for triennial registration on a form

13

or through an electronic process, as prescribed by the

14

department. The following shall apply:

15

(1)  The department shall issue a triennial registration

16

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

17

following:

18

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

19

registration no later than:

20

(A)  30 days before the current registration is

21

to expire; or

22

(B)  a lesser time established by regulation of

23

the department.

24

(ii)  Successfully:

25

(A)  completes EMR triennial registration

26

practical skills and written knowledge examinations

27

approved by the department; or

28

(B)  secures continuing education credits for EMR

29

triennial registration as required by the department

30

in continuing education programs approved by the

- 41 -

 


1

department.

2

(2)  An EMR whose registration of an EMR certification

3

has expired must qualify for a triennial registration of the

4

certification as prescribed by regulation of the department.

5

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

6

certified as a first responder on the effective date of this

7

section shall be considered to be an EMR with a current

8

registration and shall be subject to the triennial registration

9

requirements of an EMR. The registration of the EMR

10

certification shall expire on the same date the first responder

11

certification would have expired if the first responder

12

certification remained in effect.

13

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

14

is an ambulance attendant on the effective date of this section

15

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

16

shall be subject to the triennial registration requirements of

17

an EMR. The registration of the EMR certification shall expire

18

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

19

ambulance attendant expire and would have needed to be renewed.

20

§ 7215.  Emergency medical technicians.

21

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

22

involving basic interventions and equipment found on an EMS

23

vehicle as follows:

24

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

25

ambulance.

26

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

27

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

28

setting until an ambulance arrives, and then may assist the

29

ambulance crew.

30

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

- 42 -

 


1

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

2

by regulation of the department.

3

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

4

regulation of the department.

5

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

6

an individual who meets all of the following:

7

(1)  Is at least 16 years of age.

8

(2)  Has successfully completed an EMT training course

9

which:

10

(i)  teaches basic EMS; and

11

(ii)  is approved by the department.

12

(3)  Has a current certificate evidencing successful

13

completion of a CPR course acceptable to the department.

14

(4)  Has passed an EMT skills practical examination

15

approved by the department.

16

(5)  Has passed a written EMT certification examination

17

approved by the department.

18

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

19

deemed registered for three years after issuance. An EMT must

20

register the EMT certification at three-year intervals by

21

completing an application for triennial registration on a form

22

or through an electronic process, as prescribed by the

23

department. The following shall apply:

24

(1)  The department shall issue a triennial registration

25

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

26

following:

27

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

28

registration no later than:

29

(A)  30 days before the current registration is

30

to expire; or

- 43 -

 


1

(B)  a lesser time established by regulation of

2

the department.

3

(ii)  Successfully:

4

(A)  completes EMT triennial registration

5

practical skills and written knowledge examinations

6

approved by the department; or

7

(B)  secures continuing education credits for EMT

8

triennial registration as required by the department

9

in continuing education programs approved by the

10

department.

11

(2)  An EMT whose registration of an EMT certification

12

has expired must qualify for a triennial registration of the

13

certification as prescribed by regulation of the department.

14

§ 7216.  Advanced emergency medical technicians.

15

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

16

and ALS skills which include interventions and administration of

17

medications with basic and advanced equipment found on an EMS

18

vehicle as follows:

19

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

20

ambulance.

21

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

22

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

23

emergency until an ambulance arrives at the scene and then

24

may assist the ambulance crew.

25

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

26

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

27

by regulation of the department.

28

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

29

by regulation of the department.

30

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

- 44 -

 


1

advanced EMT an individual who meets all of the following:

2

(1)  Is at least 18 years of age.

3

(2)  Has successfully completed a course under

4

subparagraph (i) or (ii):

5

(i)  An advanced EMT training course which:

6

(A)  teaches basic life support skills;

7

(B)  teaches advanced life support skills deemed

8

appropriate by regulation of the department; and

9

(C)  is approved by the department.

10

(ii)  An EMT course and secured training and

11

education, through continuing education courses, in

12

skills included in the scope of practice for an advanced

13

EMT for which the applicant did not receive training in

14

the EMT course.

15

(3)  Has a current certificate evidencing successful

16

completion of a CPR course acceptable to the department.

17

(4)  Has passed an advanced EMT skills practical

18

examination approved by the department.

19

(5)  Has passed a written advanced EMT certification

20

examination approved by the department.

21

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

22

is deemed registered when the certification is issued. The

23

initial registration shall expire as set forth in section

24

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

25

Except for the initial registration period, an advanced EMT must

26

register the advanced EMT certification at two-year intervals by

27

completing an application for biennial registration on a form or

28

through an electronic process, as prescribed by regulation of

29

the department. The following shall apply:

30

(1)  The department shall issue a biennial registration

- 45 -

 


1

of an advanced EMT certification to an advanced EMT who meets

2

all of the following:

3

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

4

registration no later than:

5

(A)  30 days before the current registration is

6

to expire; or

7

(B)  a lesser time established by regulation of

8

the department.

9

(ii)  Successfully:

10

(A)  completes advanced EMT biennial registration

11

practical skills and written knowledge examinations

12

approved by the department; or

13

(B)  secures continuing education credits for

14

advanced EMT biennial registration as required by the

15

department in continuing education programs approved

16

by the department.

17

(2)  An advanced EMT whose registration of an advanced

18

EMT certification has expired must qualify for a biennial

19

registration of the certification as prescribed by regulation

20

of the department.

21

§ 7217.  Paramedics.

22

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

23

provider than an advanced EMT. A paramedic performs basic and

24

advanced EMS skills which include interventions and

25

administration of medications with basic and advanced equipment

26

found on an EMS vehicle as follows:

27

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

28

ambulance.

29

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

30

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

- 46 -

 


1

emergency until an ambulance arrives at the scene and then

2

may assist the ambulance crew.

3

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

4

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

5

by regulation of the department.

6

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

7

regulation of the department.

8

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

9

paramedic training course required for certification as a

10

paramedic, an individual must satisfy all of the following:

11

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

12

commences.

13

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

14

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

15

or advanced EMT.

16

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

17

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

18

(1)  Is at least 18 years of age.

19

(2)  Has successfully completed a paramedic training

20

course which:

21

(i)  teaches basic life support skills;

22

(ii)  teaches advanced life support skills deemed

23

appropriate by regulation of the department; and

24

(iii)  is approved by the department.

25

(3)  Has a current certificate evidencing successful

26

completion of a CPR course acceptable to the department.

27

(4)  Has passed a paramedic skills practical examination

28

approved by the department.

29

(5)  Has passed a written paramedic certification

30

examination approved by the department.

- 47 -

 


1

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

2

deemed registered when the certification is issued. The initial

3

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

4

(relating to emergency medical services providers). Except for

5

the initial registration period, a paramedic must register the

6

paramedic certification at two-year intervals by completing an

7

application for biennial registration on a form or through an

8

electronic process as prescribed by regulation of the

9

department. The following shall apply:

10

(1)  The department shall issue a biennial registration

11

of a paramedic certification to a paramedic who meets all of

12

the following:

13

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

14

registration no later than:

15

(A)  30 days before the current registration is

16

to expire; or

17

(B)  a lesser time established by regulation of

18

the department.

19

(ii)  Successfully secures continuing education

20

credits for paramedic biennial registration as required

21

by the department in continuing education programs

22

approved by the department.

23

(2)  A paramedic whose registration of a paramedic

24

certification has expired must qualify for a biennial

25

registration of the certification as prescribed by regulation

26

of the department.

27

§ 7218.  Prehospital registered nurses.

28

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

29

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

30

basic and advanced EMS skills and, as authorized by the

- 48 -

 


1

department, additional nursing skills within the scope of

2

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

3

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

4

successor act, as follows:

5

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

6

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

7

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

8

ambulance arrives at the scene and then may assist the

9

ambulance crew.

10

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

11

capacity, as prescribed by regulation of the department.

12

(4)  In another capacity as authorized by regulation of

13

the department.

14

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

15

an individual who meets all of the following:

16

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

17

State Board of Nursing.

18

(2)  Is at least 18 years of age.

19

(3)  Has a current certificate evidencing successful

20

completion of a CPR course acceptable to the department.

21

(4)  Has passed a PHRN skills practical examination

22

approved by the department.

23

(5)  Has passed a written PHRN certification examination

24

approved by the department.

25

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

26

registered when the certification is issued. The initial

27

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

28

(relating to emergency medical services providers). Except for

29

the initial registration period, a PHRN must register the PHRN

30

certification at two-year intervals by completing an application

- 49 -

 


1

for biennial registration on a form or through an electronic

2

process, as prescribed by regulation of the department. The

3

following shall apply:

4

(1)  The department shall issue a biennial registration

5

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

6

following:

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 established by regulation of

12

the department.

13

(ii)  Has current registration of a registered nurse

14

license.

15

(iii)  Successfully secures continuing education

16

credits for a PHRN biennial registration as required by

17

the department, in continuing education programs approved

18

by the department.

19

(2)  A PHRN whose registration of a PHRN certification

20

has expired must qualify for a biennial registration of the

21

certification as prescribed by regulation of the department.

22

§ 7219.  Prehospital physician extenders.

23

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

24

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

25

basic and advanced EMS skills and, as authorized by regulation

26

of the department, additional physician assistant skills within

27

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

28

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

29

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

30

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

- 50 -

 


1

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

2

conducted as set forth in this chapter:

3

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

4

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

5

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

6

ambulance arrives at the scene and then may assist the

7

ambulance crew.

8

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

9

capacity, for an EMS agency as prescribed by regulation of

10

the department.

11

(4)  In another capacity as authorized by regulation of

12

the department.

13

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

14

physician assistant who meets all of the following:

15

(1)  Has a currently registered license as a physician

16

assistant with the State Board of Medicine or the State Board

17

of Osteopathic Medicine.

18

(2)  Is at least 18 years of age.

19

(3)  Has a current certificate evidencing successful

20

completion of a CPR course acceptable to the department.

21

(4)  Has passed a PHPE skills practical examination

22

approved by the department.

23

(5)  Has passed a written PHPE certification examination

24

approved by the department.

25

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

26

registered when the certification is issued. The initial

27

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

28

(relating to emergency medical services providers). Except for

29

the initial registration period, a PHPE must register the PHPE

30

certification at two-year intervals by completing an application

- 51 -

 


1

for biennial registration on a form or through an electronic

2

process as prescribed by regulation of the department. The

3

following shall apply:

4

(1)  The department shall issue a biennial registration

5

of a PHPE certification to a PHPE who:

6

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

7

registration no later than:

8

(A)  30 days before the current registration is

9

to expire; or

10

(B)  a lesser time as established by regulation

11

of the department.

12

(ii)  Has current registration of a physician

13

assistant license.

14

(iii)  Successfully secures continuing education

15

credits for PHPE biennial registration as required by the

16

department in continuing education programs approved by

17

the department.

18

(2)  A PHPE whose registration of a PHPE certification

19

has expired must qualify for a biennial registration of the

20

certification as prescribed by regulation of the department.

21

§ 7220.  Prehospital emergency medical services physicians.

22

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

23

higher level EMS provider than an advanced EMT. A prehospital

24

EMS physician performs for an EMS agency basic and advanced EMS

25

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

26

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

27

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

28

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

29

applicable, or a successor act, as follows:

30

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

- 52 -

 


1

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

2

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

3

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

4

capacity, as prescribed by regulation of the department.

5

(4)  In another capacity authorized by regulation of the

6

department.

7

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

8

prehospital EMS physician a physician who has:

9

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

10

(i)  An emergency medicine residency program that is

11

accredited by a residency program accrediting body

12

recognized by the State Board of Medicine or the State

13

Board of Osteopathic Medicine.

14

(ii)  The first year of an emergency medicine

15

residency program that satisfies the requirements of

16

subparagraph (i) and has successfully completed programs

17

approved by the department in advanced cardiac life

18

support, advanced trauma life support and advanced

19

pediatric life support.

20

(iii)  An anesthesia, family practice, internal

21

medicine or general surgery residency program that is

22

accepted by either the State Board of Medicine or the

23

State Board of Osteopathic Medicine as providing the

24

graduate medical training the board requires for issuance

25

of a physician license without restriction and the

26

successful completion of programs approved by the

27

department in advanced cardiac life support, advanced

28

trauma life support and advanced pediatric life support.

29

(2)  A current certificate evidencing successful

30

completion of a CPR course acceptable to the department.

- 53 -

 


1

(3)  Passed an EMS skills practical examination approved

2

by the department or served as a prehospital health

3

professional physician prior to the effective date of this

4

section.

5

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

6

certification is deemed registered when the certification is

7

issued. The initial registration shall expire under section

8

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

9

Except for the initial registration period, a prehospital EMS

10

physician shall register the prehospital EMS physician

11

certification at two-year intervals by completing an application

12

for biennial registration on a form or through an electronic

13

process as prescribed by the department. The following shall

14

apply:

15

(1)  The department shall issue a biennial registration

16

of a prehospital EMS physician certification to a prehospital

17

EMS physician who meets all of the following:

18

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

19

registration no later than 30 days before the current

20

registration is to expire or within a lesser time period

21

as the department may establish by regulation.

22

(ii)  Has current registration of a physician

23

license.

24

(iii)  Successfully secures continuing education

25

credits for prehospital EMS physician biennial

26

registration as required by the department in continuing

27

education programs approved by the department.

28

(2)  A prehospital EMS physician whose registration of a

29

prehospital EMS physician certification has expired shall

30

qualify for a biennial registration of the certification as

- 54 -

 


1

prescribed by regulation of the department.

2

(d)  Transition for prehospital health professional

3

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

4

professional physician prior to the effective date of this

5

section and who satisfies the certification requirements under

6

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

7

90 days after the effective date of this section without having

8

secured a certification as a prehospital EMS physician.

9

§ 7221.  Certification sanctions.

10

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

11

an EMS provider or applicant for EMS provider certification for

12

any of the following reasons:

13

(1)  Lack of physical or mental ability to provide

14

adequate services.

15

(2)  Deceptive or fraudulent procurement or

16

representation of certification or registration credentials,

17

or for making misleading, deceptive or untrue representations

18

to secure or aid or abet another person to secure a

19

certification, license, registration or any other

20

authorization issued by the department under this chapter.

21

(3)  Willful or negligent misconduct in providing EMS or

22

practicing beyond the scope of certification authorization

23

without legal authority to do so.

24

(4)  Abuse or abandonment of a patient.

25

(5)  The rendering of services while under the influence

26

of alcohol, illegal drugs or the knowing abuse of legal

27

drugs.

28

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

29

manner or while under the influence of alcohol, illegal drugs

30

or the knowing abuse of legal drugs.

- 55 -

 


1

(7)  Disclosure of medical or other information about a

2

patient where prohibited by Federal or State law.

3

(8)  Willful preparation or filing of a false medical

4

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

5

(9)  Destruction of a medical report or record required

6

to be maintained.

7

(10)  Refusal to render emergency medical care because of

8

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

9

preference, age, handicap, medical problem or financial

10

inability to pay.

11

(11)  Failure to comply with department-approved

12

protocols.

13

(12)  Failure to comply with reporting requirements

14

imposed under this chapter or as established by the

15

department.

16

(13)  Practicing without the current registration of a

17

certification.

18

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

19

practice of the EMS provider or a crime involving moral

20

turpitude. For the purposes of this paragraph, a conviction

21

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

22

nolo contendere.

23

(15)  Willful falsification of or a failure to complete

24

details on an EMS patient care report.

25

(16)  Misappropriation of drugs or EMS agency property.

26

(17)  Having a certification or other authorization to

27

practice a profession or occupation revoked, suspended or

28

subjected to other disciplinary sanction.

29

(18)  Violating or aiding or abetting another person to

30

violate a duty imposed under this chapter, a regulation

- 56 -

 


1

promulgated under this chapter or an order of the department

2

previously entered in a disciplinary proceeding.

3

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

4

Federal or State agency, having been excluded from a Federal

5

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

6

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

7

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

8

excluded from a Federal or State health care program.

9

(20)  Any other reason as determined by the department

10

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

11

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

12

take disciplinary action against an individual under this

13

section, the department may do one or more of the following:

14

(1)  Deny the application for certification.

15

(2)  Issue a public reprimand.

16

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

17

certification.

18

(4)  Require the person to take refresher educational

19

courses.

20

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

21

for each incident in which the EMS provider engages in

22

conduct that constitutes a basis for discipline.

23

(6)  Stay enforcement of any suspension, revocation or

24

other discipline and place the individual on probation with

25

the right to vacate the probationary order for noncompliance.

26

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

27

deny a registration of an EMS provider certification without

28

giving the applicant prior notice of the reason for the denial

29

and providing an opportunity for a hearing.

30

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

- 57 -

 


1

revoked may not apply for reinstatement of that certification. A

2

person may petition the department for allowance to apply for a

3

new certification five years from the effective date of the

4

revocation by filing with the department a petition that avers

5

facts to establish that the person has been rehabilitated to an

6

extent that issuing the person a certification would not be

7

detrimental to the public interest. The department may grant or

8

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

9

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

10

such as that the person has been rehabilitated. If the

11

department grants the person allowance to apply for a new

12

certification, the person shall repeat the training program and

13

the certification examinations for the level of certification

14

for which the person is applying and satisfy all other

15

requirements for the certification that exist at the time of

16

reapplication. If the department does not grant the person

17

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

18

again petition the department for allowance to apply for a new

19

certification until another year from the date of denial.

20

§ 7222.  Emergency medical services vehicle operators.

21

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

22

shall be permanent, subject to disciplinary action under this

23

section. The department shall certify as an EMS vehicle operator

24

a person who meets all of the following:

25

(1)  Completes an application for an EMS vehicle operator

26

certification on a form or through an electronic application

27

process, as prescribed by the department.

28

(2)  Is at least 18 years of age.

29

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

30

(4)  Is not addicted to alcohol or drugs.

- 58 -

 


1

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

2

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

3

(6)  Has successfully completed an emergency vehicle

4

operator's course of instruction approved by the department.

5

(7)  Has not:

6

(i)  Been convicted within the last four years prior

7

to the date of application of driving under the influence

8

of alcohol or drugs.

9

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

10

application, been convicted of reckless driving or had a

11

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

12

or a moving traffic violation.

13

(8)  Has successfully completed an emergency vehicle

14

operator's course of instruction approved by the department

15

following a disqualification from certification under

16

paragraph (7), regardless of whether the person successfully

17

completed the course previously.

18

(b)  Registration.--An EMS vehicle operator, other than an

<--

19

EMS vehicle operator who operates a vehicle exclusively for a

20

QRS, shall register the EMS vehicle operator's certification. An

<--

21

EMS vehicle operator who operates an EMS vehicle exclusively for

22

a QRS shall have no registration requirements. Except as

23

otherwise provided in this subsection, an EMS vehicle operator's

24

certification shall be deemed registered for three years after

25

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

26

vehicle unless the certification is currently registered. The

27

following shall apply:

28

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

29

vehicle operator's certification to an EMS vehicle operator

30

who meets all of the following:

- 59 -

 


1

(i)  Completes an application for registration on a

2

form or through an electronic application process, as

3

prescribed by the department.

4

(ii)  Has a current registration and applies for a

5

new registration no later than 30 days before the current

6

registration is to expire, or within a lesser time period

7

as the department may establish by regulation.

8

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

9

(iv)  Successfully completes continuing education

10

credits for EMS vehicle operators as required by the

11

department in continuing education programs approved by

12

the department.

13

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

14

certification also has an EMS provider's certification, the

15

registration of the EMS vehicle operator's certification

16

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

17

provider's certification. If the person does not maintain

18

current registration of the EMS provider's certification, the

19

registration of the EMS vehicle operator's certification

20

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

21

operator who is an EMS provider becomes certified as a

22

higher-level EMS provider, the registration of the EMS

23

vehicle operator's certification shall expire at the same

24

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

25

certification.

26

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

27

biennial registration cycle, the continuing education

28

requirements for the registration of the EMS vehicle

29

operator's certification following the initial registration

30

of the certification shall be prorated based upon the month

- 60 -

 


1

in which the EMS provider became certified, with any

2

fractional requirement rounded down.

3

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

4

vehicle operator's certification has expired shall qualify

5

for a biennial registration of the certification as

6

prescribed by regulation of the department.

7

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

8

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

9

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

10

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

11

EMS vehicle operator for 90 days after the effective date of

12

this section without having secured a certification as an EMS

13

vehicle operator.

14

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

15

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

16

operator's certification for any of the following reasons:

17

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

18

vehicle.

19

(2)  Deceptive or fraudulent procurement or

20

representation of certification or registration credentials,

21

or making misleading, deceptive or untrue representations to

22

secure a certification or registration.

23

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

24

manner or while under the influence of alcohol, illegal drugs

25

or the knowing abuse of legal drugs.

26

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

27

alcohol or drugs or a moving traffic violation.

28

(5)  Conviction of a felony or crime involving moral

29

turpitude. For the purposes of this paragraph, a conviction

30

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

- 61 -

 


1

nolo contendere.

2

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

3

vehicle operator under this chapter or a related regulation.

4

(7)  Other reasons as determined by the department which

5

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

6

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

7

a certification, it may also impose conditions for the lifting

8

of the suspension, including requiring the person to

9

successfully repeat an emergency vehicle operator's course

10

approved by the department.

11

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

12

EMS vehicle operator shall report to the department within 30

13

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

14

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

15

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

16

conviction of driving under the influence of alcohol or drugs,

17

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

18

certification shall automatically be suspended for the periods

19

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

20

(g)  Change of address.--

21

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

22

vehicle operator's certification shall ensure that the

23

department has the current address at which the person can be

24

reached by mail at all times.

25

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

26

telephone number nor any other residential contact

27

information provided to the department shall be deemed a

28

public record.

29

§ 7223.  Suspension of certification.

30

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

- 62 -

 


1

suspend the certification of an EMS provider or EMS vehicle

2

operator without a hearing if the department determines that the

3

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

4

safety. Notice to a provider or operator of a temporary

5

suspension shall include a written statement of the underlying

6

factual allegations. After issuance of the notice, the

7

department shall commence formal disciplinary action against the

8

person under section 7221 (relating to certification sanctions)

9

or 7222 (relating to emergency medical services vehicle

10

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

11

temporarily suspending the certification, the department shall

12

conduct a preliminary hearing to determine if there is a prima

13

facie case supporting the temporary suspension. The person may

14

be present at the preliminary hearing and may be represented by

15

counsel, cross-examine witnesses, inspect physical evidence,

16

call witnesses and offer testimony and other evidence. If the

17

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

18

suspension shall be lifted immediately. If the department

19

determines that there is a prima facie case, the temporary

20

suspension shall remain in effect until vacated by the

21

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

22

the parties.

23

(b)  Automatic suspensions.--The department shall

24

automatically suspend a certification issued under this chapter

25

upon receiving a certified copy of court records establishing

26

that the person has been adjudicated as incapacitated under 20

27

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

28

evaluation) or an equivalent statutory provision. The department

29

shall lift the suspension upon the person establishing to the

30

department that the person has been adjudicated to have regained

- 63 -

 


1

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

2

capacity and modification of existing orders) or an equivalent

3

statutory provision.

4

§ 7224.  Emergency medical services instructors.

5

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

6

permanently subject to disciplinary action under this section.

7

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

8

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

9

certification on a form or through an electronic application

10

process, as prescribed by the department.

11

(2)  Is at least 18 years of age.

12

(3)  Has successfully completed an EMS instructor's

13

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

14

degree in education, a teacher's certification in education

15

or a doctorate or master's degree.

16

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

17

higher-level EMS provider.

18

(5)  Possesses current certification in a CPR course

19

acceptable to the department or current certification as a

20

CPR instructor.

21

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

22

or higher-level EMS provider.

23

(7)  Has provided at least 20 hours of monitored

24

instruction time in an EMS provider's certification program.

25

(b)  Triennial registration.--

26

(1)  An EMS instructor's certification is deemed

27

registered for three years after issuance. An EMS instructor

28

shall register the EMS instructor's certification at three-

29

year intervals by completing an application for triennial

30

registration on a form or through an electronic process, as

- 64 -

 


1

prescribed by the department. An EMS instructor may not teach

2

in an accredited EMS institute, pursuant to an EMS

3

instructor's certification, unless the certification is

4

currently registered. The department shall issue a triennial

5

registration of an EMS instructor's certification to an EMS

6

instructor who:

7

(i)  Has completed an application for triennial

8

registration on a form or through an electronic

9

application process, as prescribed by the department.

10

(ii)  Has a current registration and applies for a

11

new registration no later than 30 days before the current

12

registration is to expire, or within lesser time as the

13

department may establish by regulation.

14

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

15

certification or rescue courses approved by the

16

department during the previous three years.

17

(iv)  Is certified and currently registered as an EMT

18

or higher-level EMS provider.

19

(v)  Possesses current certification in a CPR course

20

acceptable to the department or current certification as

21

a CPR instructor.

22

(2)  An EMS instructor whose registration as an EMS

23

instructor's certification has expired shall qualify for a

24

triennial registration of the certification as prescribed by

25

regulation of the department.

26

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

27

set standards for EMS instructors in providing instruction in

28

EMS institutions.

29

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

30

discipline against an EMS instructor for the following reasons:

- 65 -

 


1

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

2

section 7221 (relating to certification sanctions).

3

(2)  Providing instruction while under the influence of

4

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

5

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

6

instructor by this chapter or a related regulation.

7

(4)  Other reasons as determined by the department that

8

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

9

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

10

impose discipline against an individual under this section, the

11

department may do one or more of the following:

12

(1)  Deny the application for certification.

13

(2)  Issue a public reprimand.

14

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

15

certification.

16

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

17

for each incident in which the EMS instructor engages in

18

conduct that constitutes a basis for discipline.

19

(5)  Stay enforcement of any suspension, revocation or

20

other discipline and place the individual on probation with

21

the right to vacate the probationary order for noncompliance.

22

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

23

require the certification as EMS instructors of all instructors

24

of EMS courses accepted toward educational requirements for EMS

25

provider's certification or toward continuing education

26

requirements for the registration of EMS provider's

27

certifications.

28

§ 7225.  Medical director of emergency medical services agency.

29

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

30

an EMS agency medical director, an individual shall:

- 66 -

 


1

(1)  Be a physician.

2

(2)  Satisfy one of the following:

3

(i)  Have successfully completed an emergency

4

medicine residency program accredited by a residency

5

program accrediting body recognized by the State Board of

6

Medicine or the State Board of Osteopathic Medicine.

7

(ii)  Have successfully completed a residency program

8

in surgery, internal medicine, family medicine,

9

pediatrics or anesthesiology, accredited by a residency

10

program accrediting body recognized by the State Board of

11

Medicine or the State Board of Osteopathic Medicine. The

12

physician shall also have successfully completed or

13

taught an advanced cardiac life support course acceptable

14

to the department within the preceding two years and have

15

completed, at least once, an advanced trauma life support

16

course acceptable to the department and an advanced

17

pediatric life support course acceptable to the

18

department, or other programs determined by the

19

department to meet or exceed the standards of these

20

programs.

21

(iii)  Have served as an advanced life support

22

service medical director under the act of July 3, 1985

23

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

24

Act, prior to the effective date of this chapter.

25

(3)  Have a valid Drug Enforcement Agency number.

26

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

27

course, an EMS fellowship or other EMS training program that

28

is determined by the department to be equivalent. This

29

training shall assure that the EMS agency medical director

30

has knowledge of:

- 67 -

 


1

(i)  The scope of practice of EMS providers.

2

(ii)  The provision of EMS pursuant to department-

3

approved protocols.

4

(iii)  The interface between EMS providers and

5

medical command physicians.

6

(iv)  Quality improvement principles.

7

(v)  Emergency medical dispatch principles and EMS

8

agency communication capabilities.

9

(vi)  EMS system design and operation.

10

(vii)  Federal and State laws and regulations

11

regarding EMS.

12

(viii)  Regional and State mass casualty and disaster

13

plans.

14

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

15

director is responsible for the following:

16

(1)  Reviewing department-approved EMS protocols that are

17

applicable to the EMS agency and ensuring that its EMS

18

providers and other relevant personnel are familiar with the

19

protocols applicable to them.

20

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

21

following:

22

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

23

above the advanced EMT level to determine whether the EMS

24

provider has demonstrated competency in the knowledge and

25

skills one must have to competently perform the skills

26

within the scope of practice of the EMS provider at that

27

level, and a commitment to adequately perform other

28

functions relevant to the EMS provider providing EMS at

29

that level. This subparagraph does not apply if the EMS

30

provider was working for the EMS agency at the same level

- 68 -

 


1

prior to the physician becoming the medical director for

2

the EMS agency and the EMS provider was credentialed at

3

that EMS agency within the last year as being able to

4

perform at the EMS provider's certification level.

5

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

6

provider at or above the advanced EMT level as to whether

7

the EMS provider has demonstrated competency in the

8

knowledge and skills an EMS provider must have to

9

competently perform the skills within the scope of

10

practice of the EMS provider at that level, and a

11

commitment to adequately perform other functions relevant

12

to the EMS provider providing EMS at that level.

13

(3)  Participating in and reviewing quality improvement

14

reviews of patient care provided by the EMS agency and

15

participating in the Statewide and regional quality

16

improvement program.

17

(4)  Providing medical guidance and advice to the EMS

18

agency.

19

(5)  Providing guidance with respect to the ordering,

20

stocking and replacement of drugs, and compliance with laws

21

and regulations impacting upon the EMS agency's acquisition,

22

storage and use of those drugs.

23

(6)  Maintaining a liaison with the regional EMS medical

24

director.

25

(7)  Recommending to the department suspension,

26

revocation or restriction of EMS provider's certifications.

27

(8)  Reviewing regional mass casualty and disaster plans.

28

(9)  Performing other functions as the department may

29

impose by regulation.

30

§ 7226.  Medical command physicians and facility medical

- 69 -

 


1

directors.

2

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

3

physician communicates with and issues medical command orders to

4

EMS providers when they seek direction. A medical command

5

physician shall have an arrangement with a medical command

6

facility to provide medical command on its behalf, and shall

7

function under the direction of a medical command facility

8

medical director and under the policies and procedures of the

9

medical command facility. A medical command physician shall

10

provide medical command to EMS providers consistent with

11

Statewide protocols and protocols that are in effect in either

12

the region in which treatment originates or the region from

13

which the EMS providers begin receiving medical command from a

14

medical command physician. For good cause, a medical command

15

physician may give medical command orders that are inconsistent

16

with these protocols.

17

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

18

medical command physician a physician who was approved as a

19

medical command physician in this Commonwealth immediately prior

20

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

21

certify as a medical command physician a physician who:

22

(1)  Completes an application for medical command

23

physician certification on a form or through an electronic

24

application process, as prescribed by the department.

25

(2)  Satisfies one of the following:

26

(i)  Has successfully completed an emergency medicine

27

residency program accredited by a residency program

28

accrediting body recognized by the State Board of

29

Medicine or the State Board of Osteopathic Medicine.

30

(ii)  Has successfully completed or taught an

- 70 -

 


1

advanced cardiac life support course acceptable to the

2

department within the preceding two years and has

3

successfully completed or taught an advanced trauma life

4

support course acceptable to the department and an

5

advanced pediatric life support course acceptable to the

6

department, or other programs determined by the

7

department to meet or exceed the standards of these

8

programs.

9

(iii)  Has had an emergency medicine practice in

10

another jurisdiction and establishes to the department

11

that the physician has a combination of training,

12

education and emergency medicine practice that makes the

13

physician qualified to serve as a medical command

14

physician.

15

(3)  Has completed a medical command course offered or

16

approved by the department.

17

(4)  Is practicing as an emergency medicine physician or

18

is participating as a resident in a second or subsequent year

19

in an emergency medicine residency program or has had at

20

least three years' experience as a full-time emergency

21

medicine physician.

22

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

23

for an emergency medicine resident who is authorized to use a

24

hospital's Drug Enforcement Agency number for practice within

25

the emergency medicine residency program.

26

(6)  Has an arrangement with a medical command facility

27

to serve as a medical command physician for that facility

28

after receiving certification as a medical command physician.

29

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

30

certification is deemed registered for three years after

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1

issuance. A medical command physician shall triennially register

2

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

3

through an electronic application process, as prescribed by the

4

department, as a condition for continued practice as a medical

5

command physician. The department shall issue a triennial

6

registration of a medical command physician's certification to a

7

medical command physician within 30 days after the physician

8

applies for a new registration if the physician demonstrates

9

that the physician continues to meet the requirements for the

10

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

11

satisfies such other requirements as the department may impose

12

by regulation.

13

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

14

emergency medicine residency program may issue medical command

15

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

16

component of and within the framework of the emergency medicine

17

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

18

medical command physician who has served as a medical command

19

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

20

emergency medicine residency program or has secured medical

21

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

22

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

23

medical command facility medical director shall be responsible

24

for the following in a medical command facility:

25

(1)  Medical command.

26

(2)  Quality improvement.

27

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

28

medical director.

29

(4)  Participating in prehospital training activities.

30

(5)  Verifying to the department that a physician seeking  

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1

a medical command physician's certification, based upon the

2

physician's arrangement with the medical command facility,

3

meets all certification requirements.

4

(6)  Ensuring that the medical command facility satisfies

5

statutory and regulatory requirements.

6

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

7

medical command facility medical director a physician who was

8

approved as a medical command facility medical director in this

9

Commonwealth immediately prior to the effective date of this

10

section. The department shall also certify as a medical command

11

facility medical director a physician who:

12

(1)  Completes an application for medical command

13

facility medical director certification on a form or through

14

an electronic application process, as prescribed by the

15

department.

16

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

17

(3)  Satisfies one of the following:

18

(i)  Has successfully completed a residency program

19

in emergency medicine accredited by a residency program

20

accrediting body recognized by the State Board of

21

Medicine or the State Board of Osteopathic Medicine.

22

(ii)  Has successfully:

23

(A)  completed a residency program in surgery,

24

internal medicine, family medicine, pediatrics or

25

anesthesiology accredited by a residency program

26

accrediting body recognized by the State Board of

27

Medicine or the State Board of Osteopathic Medicine;

28

and

29

(B)  completed or taught:

30

(I)  an advanced cardiac life support course

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1

acceptable to the department within the preceding

2

two years;

3

(II)  an advanced trauma life support course

4

acceptable to the department; and

5

(III)  an advanced pediatric life support

6

course acceptable to the department.

7

(4)  Has experience in prehospital and emergency

8

department care of acutely ill or injured patients.

9

(5)  Has experience in providing medical command

10

direction to EMS providers.

11

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

12

below and above the advanced EMT level.

13

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

14

critique of EMS providers below and above the advanced EMT

15

level.

16

(8)  Has an arrangement with a medical command facility

17

to serve as its medical director after receiving

18

certification as a medical command facility medical director.

19

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

20

medical director's certification is deemed registered for three

21

years after issuance. A medical command facility medical

22

director shall triennially register the physician's

23

certification with the department on a form or through an

24

electronic application process, as prescribed by the department,

25

as a condition for continued practice as a medical command

26

facility medical director. The department shall issue a

27

triennial registration of a medical command facility medical

28

director certification to a medical command facility medical

29

director within 30 days after the physician applies for a new

30

registration, if the physician demonstrates that the physician

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1

continues to meet the requirements for the certification, except

2

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

3

requirements as the department may impose by regulation.

4

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

5

medical command physician or medical command facility medical

6

director for the following reasons:

7

(1)  Violating a responsibility imposed on the physician

8

by this chapter or the related regulations.

9

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

10

treatment, transport or transfer protocol established or

11

approved by the department.

12

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

13

empowered to discipline a medical command physician or medical

14

command facility medical director under subsection (h), the

15

department may do one or more of the following:

16

(1)  Deny the application for a certification.

17

(2)  Issue a public reprimand.

18

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

19

condition the certification.

20

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

21

for each incident in which the physician engages in conduct

22

that constitutes a basis for discipline.

23

(5)  Stay enforcement of any suspension, revocation or

24

other discipline and place the individual on probation with

25

the right to vacate the probationary order for noncompliance.

26

§ 7227.  Medical command facilities.

27

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

28

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

29

a medical command facility. The department shall issue a

30

certification to each medical unit that operated as a medical

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1

command facility immediately prior to the effective date of this

2

section.

3

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

4

a form or through an electronic application process prescribed

5

by the department. The application shall solicit information

6

necessary to determine that the applicant meets the

7

certification requirements of this chapter.

8

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

9

applicant:

10

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

11

consortium of hospitals.

12

(2)  Possesses the necessary equipment and personnel for

13

providing medical command to and control over EMS providers.

14

(3)  Employs a medical command facility medical director.

15

(4)  Has taken measures necessary to ensure that a

16

medical command physician is available to provide medical

17

command at all times.

18

(5)  Meets the communication, recordkeeping and other

19

requirements of the department.

20

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

21

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

22

regulation requirements for a medical command facility to ensure

23

that it operates in an effective and efficient manner to achieve

24

the purposes for which it is certified.

25

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

26

certification is deemed registered for three years after

27

issuance. A medical command facility must register its

28

certification at three-year intervals by completing an

29

application for triennial registration on a form or through an

30

electronic application process prescribed by the department. The

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1

department shall grant or deny recertification within 30 days of

2

receipt of the application.

3

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

4

an inspection of the medical unit of each applicant and also

5

inspect existing medical command facilities from time to time as

6

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

7

department shall have full and free access to examine the

8

medical command facility and its records relating to its

9

operation as a medical command facility. The medical command

10

facility shall fully respond to any inquiry by the department

11

relevant to the determination of whether the facility meets

12

certification and operational requirements.

13

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

14

medical command facility for the following reasons:

15

(1)  Violating a requirement of this section.

16

(2)  Violating a certification requirement or an

17

operational requirement imposed under subsection (d).

18

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

19

inquiry under subsection (f).

20

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

21

medical treatment, transport or transfer protocol approved by

22

the department.

23

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

24

to discipline a medical command facility, the department may do

25

one or more of the following:

26

(1)  Deny the application for a certification.

27

(2)  Issue a public reprimand.

28

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

29

condition the certification.

30

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

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1

each act that presents a basis for discipline.

2

(5)  Stay enforcement of any suspension, revocation or

3

other discipline and place the facility on probation with the

4

right to vacate the probationary order for noncompliance.

5

§ 7228.  Receiving facilities.

6

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

7

ambulance may transport a patient who requires prompt medical

8

care in addition to that provided by the ambulance crew after

9

the crew responds to an emergency.

10

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

11

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

12

emergency department, including a physician trained to manage

13

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

14

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

15

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

16

By regulation, the department may authorize other types of

17

facilities to serve as receiving facilities for purposes of

18

serving patients who have special medical needs.

19

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

20

medical command physician, the initial transport of a patient

21

following an ambulance response to a reported emergency shall be

22

to a receiving facility pursuant to a protocol under section

23

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

24

(relating to regional emergency medical services councils) or

25

such other location as the department designated by protocol.

26

§ 7229.  Emergency medical services agencies.

27

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

28

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

29

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

30

ambulance, advanced life support squad vehicle, basic life

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1

support squad vehicle, quick response service, special

2

operations EMS service or other vehicle or service as prescribed

3

by the department by regulation to provide EMS outside a health

4

care facility or on roadways, airways or waterways of this

5

Commonwealth unless the person holds a current EMS agency

6

license authorizing the particular service or operation.

7

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

8

shall be submitted on a form or through an electronic

9

application process prescribed by the department.

10

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

11

license to an applicant when it is satisfied that:

12

(1)  The applicant and persons having substantial

13

ownership interests in the applicant are responsible persons

14

and the EMS agency will be staffed by and conduct its

15

activities utilizing responsible persons. For purposes of

16

this paragraph:

17

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

18

engaged in any act contrary to justice, honesty or good

19

morals which indicates that the person is likely to

20

betray the public trust in carrying out the activities of

21

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

22

conduct but has been rehabilitated and establishes that

23

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

24

(ii)  a person has a substantial ownership interest

25

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

26

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

27

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

28

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

29

engages in an activity integral to operation of the EMS

30

agency, including, but not limited to, making or

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1

participating in the making or execution of management

2

decisions, providing EMS, billing, call-taking and

3

dispatching.

4

(2)  The applicant meets supply and equipment

5

requirements and each ambulance or other vehicle that will be

6

used in providing EMS is adequately constructed and equipped

7

and will be maintained and operated to safely and efficiently

8

render the services offered.

9

(3)  The applicant will meet the staffing standards for

10

its vehicles and services.

11

(4)  The applicant will provide safe and efficient

12

services that are adequate for the emergency medical care,

13

the treatment and comfort and, when appropriate, the

14

transportation of patients.

15

(5)  The applicant will have an EMS agency medical

16

director who, in addition to satisfying the criteria of

17

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

18

medical services agency), satisfies other criteria the

19

department may establish by regulation based on the types of

20

vehicles and services the applicant intends to provide under

21

the EMS agency license.

22

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

23

regulations promulgated under this chapter.

24

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

25

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

26

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

27

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

28

higher level of EMS provider certification and at least one year

29

of active practice as an EMS provider.

30

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

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1

deemed registered for three years after the issuance. An EMS

2

agency must register its license at three-year intervals by

3

completing an application on a form or through an electronic

4

application process prescribed by the department. The department

5

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

6

complete and accurate application. The department shall not deny

7

a registration of a license without giving the applicant prior

8

notice of the reason for denial and providing an opportunity for

9

a hearing.

10

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

11

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

12

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

13

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

14

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

15

management services for an EMS agency if:

16

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

17

applicable regulations;

18

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

19

subsection (c)(1)(i);

20

(3)  a person having a substantial ownership interest in

21

the entity is not a responsible person;

22

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

23

activities through responsible persons; or

24

(5)  the entity refuses to provide the department with

25

records or information reasonably requested to enable the

26

department to make a determination.

27

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

28

current department-issued inspection sticker shall be displayed

29

on each ambulance, advanced life support squad vehicle, basic

30

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

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1

other EMS vehicle authorized by the department.

2

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

3

an applicant's vehicles, equipment and personnel qualifications

4

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

5

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

6

but not less than once every three years.

7

(i)  Dispatching.--

8

(1)  An EMS agency that operates a communications center

9

dispatching EMS resources shall use call-takers and

10

dispatchers who satisfy the requirements of the Pennsylvania

11

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

12

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

13

Emergency Telephone Act, and shall use an emergency medical

14

dispatch program approved by the department. An emergency

15

medical dispatch program is a system or program that enables

16

patients to be assessed and treated via telecommunication by

17

using accepted medical dispatch standards.

18

(2)  Operation by an EMS agency of a communications

19

center that dispatches EMS resources shall be considered part

20

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

21

to the requirements of this chapter and the department's

22

regulations.

23

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

24

after the effective date of this chapter, the department shall

25

publish in the Pennsylvania Bulletin, and update as necessary,

26

vehicle construction and equipment and supply requirements for

27

EMS agencies in this Commonwealth based upon the types of EMS

28

vehicles operated and the services provided.

29

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

30

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

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1

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

2

medical director apprises that the EMS provider satisfies the

3

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

4

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

5

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

6

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

7

agency medical director. The EMS agency shall notify the

8

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

9

the EMS agency medical director has determined that the EMS

10

provider has not demonstrated competency in the knowledge and

11

skills necessary to competently perform the skills within the

12

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

13

demonstrated a commitment to adequately perform other functions

14

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

15

the EMS agency medical director chooses to impose restrictions

16

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

17

provider to function under the supervision of another EMS

18

provider or requiring the EMS provider to contact a medical

19

command physician prior to providing EMS, then the EMS agency

20

may permit the EMS provider to provide EMS only with the

21

restrictions directed by the EMS agency medical director.

22

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

23

staffing standards for ambulances, squad vehicles and quick

24

response services set forth in sections 7230 (relating to

25

advanced life support ambulances), 7231 (relating to air

26

ambulances), 7232 (relating to advanced life support squad

27

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

28

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

29

(relating to quick response services).

30

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

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1

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

2

provider arrives, the law enforcement officer may preclude the

3

EMS provider from entering the scene to provide EMS until the

4

law enforcement officer determines that it is safe for the EMS

5

provider to enter. Under such circumstances, the law enforcement

6

officer shall permit the EMS provider access to the patient

7

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

8

medical treatment protocol or medical command order, an EMS

9

agency is required to transport to a receiving facility a

10

patient whom a law enforcement officer has taken or wants to

11

take into custody or whom the law enforcement officer believes

12

needs to be spoken with immediately, the EMS agency shall

13

transport the patient to a receiving facility and the law

14

enforcement officer shall have discretion to accompany the

15

patient in the EMS vehicle and authority to employ security

16

precautions deemed necessary by the law enforcement officer to

17

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

18

security precautions shall not unreasonably interfere with the

19

provision of EMS to the patient.

20

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

21

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

22

person shall permit or cause the EMS agency to continue.

23

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

24

shall not discontinue providing service it is licensed to

25

provide or reduce the hours when it provides service until a

26

minimum of 90 days after notifying the department in writing of

27

the change. Notice shall include a statement that the licensee

28

has notified the chief executive officer of each political

29

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

30

discontinue providing the service or reduce the hours it

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1

provides the service and that the intent to discontinue or

2

reduce hours has been advertised in a newspaper of general

3

circulation in the licensee's service area.

4

(p)  Regulations.--The department shall promulgate

5

regulations setting forth requirements for EMS agencies in this

6

Commonwealth based upon the types of EMS vehicles they operate

7

and the services they provide.

8

(q)  Transition for ambulance services and quick response

9

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

10

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

11

immediately prior to the effective date of this section may

12

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

13

and other operational requirements of this chapter, and it shall

14

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

15

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

16

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

17

as an ambulance service or recognition as a QRS would have

18

expired if it had remained in effect.

19

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

20

provisions of this chapter:

21

(1)  Privately owned vehicles not ordinarily used to

22

transport patients.

23

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

24

under this chapter that is dispatched to respond to an

25

emergency within this Commonwealth when an EMS vehicle or

26

service licensed under this chapter is unable to respond

27

within a reasonable time or its response is not sufficient to

28

deal with the emergency.

29

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

30

its operations in this Commonwealth to the transportation,

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1

and provision of medical care incidental to transportation of

2

patients and other persons requiring transportation by EMS

3

vehicles from locations outside this Commonwealth to

4

locations within this Commonwealth.

5

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

6

Federal Government.

7

§ 7230.  Advanced life support ambulances.

8

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

9

assessment, triage, monitoring, treatment, transportation and

10

observation of patients who require EMS above the skill level of

11

an advanced EMT.

12

(b)  Staffing requirements.--

13

(1)  Except as otherwise provided in this section,

14

minimum staffing requirements for an ALS ambulance when

15

responding to a call to provide EMS for a patient requiring

16

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

17

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

18

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

19

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

20

EMS vehicle operator. When present, an EMS provider qualified

21

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

22

must attend to the patient at the scene and during

23

transportation. If a member of the ambulance crew arrives at

24

the scene before another crew member, that person shall begin

25

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

26

(2)  Minimum staffing requirements for an ALS ambulance

27

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

28

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

29

at or below the skill level of an advanced EMT.

30

§ 7231.  Air ambulances.

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1

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

2

crew that provides medical assessment, treatment, monitoring,

3

observation and transportation of patients who require EMS where

4

time to administer definitive care is of the essence and

5

transportation by air ambulance to a facility able to provide

6

the care is faster than transportation by ground ambulance, or

7

require EMS provided by specialized equipment or providers not

8

available on a ground ambulance and the air ambulance can

9

provide this faster than the patient would receive such care at

10

a receiving facility if transported by ground ambulance.

11

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

12

an air ambulance when dispatched to provide or when providing

13

medical assessment, treatment, monitoring, observation or

14

transportation of a patient is one pilot and two EMS providers

15

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

16

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

17

medical transport.

18

§ 7232.  Advanced life support squad vehicles.

19

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

20

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

21

to rendezvous with an ambulance crew or to respond prior to

22

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

23

monitoring, treatment and observation of a patient who requires

24

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

25

vehicle does not transport patients.

26

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

27

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

28

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

29

one EMS provider above the advanced EMT level and one EMS

30

vehicle operator, except that the EMS provider may staff the

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1

vehicle alone if the EMS provider is also an EMS vehicle

2

operator.

3

§ 7233.  Basic life support ambulances.

4

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

5

assessment, triage, monitoring, treatment, transportation and

6

observation of patients who require EMS at or below the skill

7

level of an advanced EMT and also transports patients who

8

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

9

provider above the level of an advanced EMT rendezvous with the

10

BLS ambulance before or during transport of the patient and

11

accompanies the patient during the transport after arrival.

12

(b)  Staffing requirements.--

13

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

14

staffing for a BLS ambulance when responding to a call to

15

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

16

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

17

operator, except that only the two EMS providers need to

18

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

19

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

20

the patient at the scene and during patient transportation.

21

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

22

the minimum staffing for a BLS ambulance when responding to a

23

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

24

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

25

vehicle operator, except that only two EMS providers need to

26

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

27

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

28

the patient at the scene and during patient transportation.

29

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

30

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

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1

BLS ambulance shall respond as set forth in this subsection.

2

If the BLS ambulance crew members arrive at the scene before

3

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

4

vehicle, the BLS crew members shall provide EMS to the

5

patient at their skill level, including transportation of the

6

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

7

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

8

provider, after which the BLS ambulance crew shall relinquish

9

primary responsibility for the patient to the higher-level

10

EMS provider.

11

(4)  When transporting from a sending hospital a patient

12

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

13

a registered nurse, physician assistant or physician from the

14

sending or receiving hospital joins the ambulance crew,

15

brings on board the ambulance all equipment and supplies to

16

provide the patient with reasonably anticipated EMS above the

17

skill level of an advanced EMT and attends to the patient

18

during the patient transportation, the minimum staffing

19

requirements for the BLS ambulance are as set forth in

20

paragraphs (1) and (2).

21

§ 7234.  Basic life support squad vehicles.

22

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

23

provider, along with basic EMS equipment and supplies, to

24

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

25

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

26

is not utilized to transport patients.

27

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

28

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

29

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

30

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

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1

operator may staff the vehicle alone.

2

§ 7235.  Quick response services.

3

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

4

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

5

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

6

for a QRS is one EMS provider.

7

§ 7236.  Special operations emergency medical services.

8

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

9

in situations or austere environments that require specialized

10

knowledge, equipment or vehicles to access a patient or address

11

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

12

regulation provide for specific types of special operations EMS

13

teams.

14

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

15

may establish additional training or expertise requirements for

16

the EMS agency medical director and the EMS providers who staff

17

a special operations EMS service.

18

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

19

establish staffing, equipment, supply and any other requirement

20

for a special operations EMS service.

21

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

22

provide a special operations EMS need that has not been

23

addressed by applying to the department for an EMS agency

24

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

25

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

26

department to be authorized to provide the special operations

27

EMS under its license. The department shall address each

28

application on an individual basis and may conditionally deny or

29

grant an application as appropriate to protect the public health

30

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

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1

compliance with any later-adopted regulations addressing the

2

type of special operations EMS being provided by the entity.

3

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

4

EMS protocols special operations EMS protocols.

5

§ 7237.  First aid and other safety services.

6

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

7

sites, amusement parks or other locations in need of the

8

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

9

this purpose.

10

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

11

provider.

12

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

13

EMS provider may provide EMS and other medical safety services

14

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

15

to provide EMS for the EMS agency.

16

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

17

approved by the department when providing EMS under this

18

section.

19

§ 7238.  Other vehicles and services.

20

The department may by regulation prescribe EMS vehicle and

21

service standards for EMS vehicles and services not specified in

22

this chapter. If the department establishes standards in this

23

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

24

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

25

operate the vehicle or provide the service unless approved to do

26

so by the department.

27

§ 7239.  Stretcher and wheelchair vehicles.

28

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

29

vehicle other than an ambulance that is utilized to transport by

30

stretcher persons who do not receive and cannot reasonably be

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1

anticipated to require medical assessment, monitoring, treatment

2

or observation during transportation, but who, due to their

3

physical condition, require vehicle transportation while on a

4

stretcher or in a wheelchair.

5

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

6

vehicle other than an ambulance that is used to transport by

7

wheelchair persons who do not receive and cannot reasonably be

8

anticipated to require medical assessment, monitoring, treatment

9

or observation during transportation, but who, due to their

10

physical condition, require vehicle transportation while on a

11

stretcher or in a wheelchair.

12

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

13

vehicle or wheelchair vehicle to transport a person who is known

14

or reasonably should be known by the entity to require medical

15

assessment, monitoring, treatment or observation during

16

transportation shall constitute unlawful operation of an

17

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

18

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

19

constitute misconduct in operating an EMS agency under section

20

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

21

license sanctions). For purposes of this section, unlawful

22

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

23

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

24

other location to receive or from which the person received

25

health care services.

26

§ 7240.  Conditional temporary licenses.

27

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

28

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

29

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

30

level or broader-level emergency medical response plan approved

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1

by the department, the department shall issue a conditional

2

temporary license for operation of the EMS agency when the

3

department determines that it is in the public interest, subject

4

to such terms as the department deems appropriate. A conditional

5

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

6

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

7

public interest to do so.

8

§ 7241.  Plans of correction.

9

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

10

agency has violated this chapter or regulations promulgated

11

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

12

the EMS agency specifying the violation or violations that have

13

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

14

immediate action to discontinue the violation or to submit a

15

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

16

agency into compliance with applicable requirements. If the

17

nature of the violation is such that the EMS agency cannot

18

remedy the problem immediately, and a plan of correction is

19

therefore required, the department may direct that the violation

20

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

21

shall submit a plan of correction within 30 days of the

22

department's issuance of the written notice. If immediate

23

corrective action is required, the notice from the department

24

shall request, and the EMS agency shall provide, prompt

25

confirmation that the corrective action has been taken.

26

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

27

agency an opportunity to correct a violation without facing

28

disciplinary charges if the department determines that it is not

29

in the public interest to do so.

30

§ 7242.  Emergency medical services agency license sanctions.

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1

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

2

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

3

license for any of the following reasons:

4

(1)  Violating the requirements of this chapter or

5

regulation adopted under this chapter.

6

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

7

the department or correct a deficiency as required under

8

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

9

comply with the plan of correction.

10

(3)  Refusing to accept a conditional temporary license

11

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

12

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

13

a license.

14

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

15

section 7229(f) (relating to emergency medical services

16

agencies), enabling another person to manage or operate the

17

EMS agency or any service covered by the license.

18

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

19

aiding or abetting the improper granting of a license,

20

certification, accreditation or other authorization issued

21

under this chapter.

22

(7)  Incompetence, negligence or misconduct in operating

23

the EMS agency or in providing EMS to patients.

24

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

25

staffed by responsible persons and refuses to remove from its

26

staff the irresponsible person or persons when directed to do

27

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

28

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

29

section 7229(c)(1).

30

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

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1

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

2

sexual preference, age, handicap, medical problem or

3

financial inability to pay.

4

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

5

turpitude or related to the practice of the EMS agency.

6

(11)  Making misrepresentations in seeking funds made

7

available through the department.

8

(12)  Failing to continue to meet applicable licensure

9

requirements.

10

(13)  Violating an order previously issued by the

11

department in a disciplinary matter.

12

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

13

impose discipline against an EMS agency under this section, the

14

department may do one or more of the following:

15

(1)  Deny the application for a license.

16

(2)  Administer a written reprimand with or without

17

probation.

18

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

19

license.

20

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

21

incident in which the EMS agency engages in conduct that

22

constitutes a basis for discipline.

23

(5)  Stay enforcement of any suspension, revocation or

24

other discipline and place the facility on probation with the

25

right to vacate the probationary order for noncompliance.

26

SUBCHAPTER C

27

MISCELLANEOUS PROVISIONS

28

Sec.

29

7251.  Limitations on liability.

30

7252.  Peer review.

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1

7253.  Support of emergency medical services.

2

7254.  Prohibited acts.

3

7255.  Surrender of license, accreditation or certification.

4

7256.  Penalties.

5

7257.  Adjudications and judicial review.

6

§ 7251.  Limitations on liability.

7

The following shall apply:

8

(1)  No medical command physician, medical command

9

facility medical director or medical command facility, which

10

in good faith provides a medical command to an EMS provider

11

or student enrolled in an EMS course of instruction approved

12

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

13

result of issuing the instruction, absent a showing of gross

14

negligence or willful misconduct.

15

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

16

provider who in good faith attempts to render or facilitate

17

emergency medical care authorized by this chapter shall be

18

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

19

absent a showing of gross negligence or willful misconduct.

20

This paragraph shall also apply to students enrolled in

21

approved courses of instruction and supervised pursuant to

22

rules and regulations.

23

(3)  No approved EMS training institute nor any entity

24

participating as part of any approved educational program

25

offered by the institute as authorized by this chapter shall

26

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

27

continuing educational practice by duly enrolled students

28

under proper supervision, absent a showing of gross

29

negligence or willful misconduct.

30

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

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1

emergency care authorized by this chapter at an emergency

2

scene while en route to a place of employment shall receive

3

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

4

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

5

require written verification from the EMS provider, who shall

6

obtain the written verification from either the police

7

officer or other person who is in charge at the emergency

8

scene.

9

(5)  No EMS agency medical director or regional medical

10

director who in good faith gives instructions to or provides

11

primary and continuing educational training to an EMS

12

provider shall be liable for civil damages for issuing the

13

instructions, education or training, absent a showing of

14

gross negligence or willful misconduct.

15

(6)  Neither the department, the Commonwealth EMS Medical

16

Director, a regional EMS council medical director nor any

17

other official or employee of the department or a regional

18

EMS council shall be liable for civil damages arising out of

19

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

20

instruction approved by the department following protocols

21

approved under this chapter.

22

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

23

civil liability based solely on failure to obtain consent in

24

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

25

person is unable to give consent for any reason, including

26

minority, and where there is no other person reasonably

27

available who is legally authorized to give or refuse to give

28

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

29

without knowledge of facts negating consent.

30

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

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1

civil liability based solely on refusal to provide treatment

2

or services requested by the patient or the person

3

responsible for making medical care decisions for the patient

4

if the treatment or services requested are not prescribed or

5

authorized by Statewide or regional protocols established

6

under this chapter and the EMS provider has:

7

(i)  contacted a medical command physician who

8

refused to authorize the requested treatment or service;

9

or

10

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

11

command physician and was unable to do so.

12

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

13

information about a patient from a caller or makes dispatch

14

assignments based upon the information collected may be

15

subject to civil liability based upon the information

16

collected or a dispatch assignment, absent a showing of gross

17

negligence or willful misconduct.

18

§ 7252.  Peer review.

19

(a)  Immunity from liability.--

20

(1)  A person who provides information to a review

21

organization shall have the same protections from civil and

22

criminal liability as a person who provides information to a

23

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

24

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

25

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

26

review organization or who furnishes professional counsel or

27

services to the organization shall have the same protections

28

from civil and criminal liability for the performance of any

29

duty, function or activity authorized or required of the

30

review organization as a person who performs the duty,

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1

function or activity under the Peer Review Protection Act.

2

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

3

proceedings and records of a review organization shall be held

4

in confidence and shall have the same protections from discovery

5

and introduction into evidence in civil proceedings as they

6

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

7

attendance at a meeting of a review organization shall be

8

subject to the same testimony restrictions as a person who was

9

in attendance at a meeting of a review organization under the

10

Peer Review Protection Act.

11

§ 7253.  Support of emergency medical services.

12

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

13

established a special fund to be known as the Emergency Medical

14

Services Operating Fund, which shall be administered by the

15

department.

16

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

17

Medical Services Operating Fund:

18

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

19

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

20

Rehabilitative Disposition).

21

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

22

department under this chapter.

23

(3)  Appropriations.

24

(4)  Contributions.

25

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

26

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

27

Operating Fund shall be disbursed by the department for only the

28

following uses:

29

(1)  To eligible EMS agencies for applicable purposes

30

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

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1

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

2

provide additional financial assistance for those EMS systems

3

serving rural areas.

4

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

5

upon it under this chapter.

6

(3)  To regional EMS councils for the development,

7

maintenance and improvement of EMS systems, including

8

ambulance and communications equipment and for training,

9

education and EMS agency licensure purposes.

10

(4)  To other contractors and grantees as authorized

11

under section 7212(j).

12

(d)  Allocation to Catastrophic Medical and Rehabilitation

13

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

14

Services Operating Fund shall be allocated to a Catastrophic

15

Medical and Rehabilitation Fund for victims of trauma. After the

16

exhaustion of all alternative financial resources, other than

17

those excluded by the department from consideration, the

18

catastrophic fund shall be available for the purchase of

19

medical, rehabilitation and attendant care services for trauma

20

victims and may be made available for the purchase of supportive

21

services such as respite care and counseling services for the

22