SCS/HB 1473 - This act substantially revises the law governing organizations providing emergency medical services and the delivery of those services.

References to "attendant" and "attendant-drivers" are deleted, and definitions of "emergency medical technician" (EMT), basic and paramedic, are added. Air ambulances are included in the requirement that owners and operators engaged in the transportation of patients hold a currently valid license for an ambulance service. The ground ambulance must be under the immediate supervision and direction of a person holding a valid emergency medical technician license. Each ambulance service is responsible for assuring that any driver is competent in emergency vehicle operations. No ambulance service license is required if the service or employee is rendering assistance at the request of a licensed service in the case of an emergency or major catastrophe.

The Department shall license emergency medical technicians and any ambulance service and emergency medical response agency which provides advanced life support. Licenses shall be for a period of three years. The Department may promulgate rules relating to the requirements for each license. No fee will be required for an ambulance service or emergency medical response agency owned or operated by a political subdivision of the state, or by EMTs employed by a political subdivision.

The Department shall certify training entities for first responders, emergency medical dispatchers, emergency technicians- basic and paramedic and shall promulgate rules relating to minimum requirements. Periodic reviews of the training entity will be conducted.

Dispatch agencies are required to have a memorandum of understanding with all ambulance services that it dispatches. A dispatch agency must have a medical director if it provides pre- arrival medical instructions. Each ambulance shall be staffed with a minimum of one EMT and one other crew member as set forth by Department rules.

Licenses and renewal applications may be denied, as well as suspended or revoked, by the Director, for failure to comply with provisions of law. Grounds for taking disciplinary action are listed. Upon suspension, revocation or termination of an ambulance service or emergency medical response agency license, no person shall be permitted to operate the service or agency, provided that an alternate service or agency is available for the area served by the entity being disciplined. Aggrieved parties may appeal to the Administrative Hearing Commission within thirty days.

A uniform data collection system will be developed and administered by the Department on all ambulance runs and injured patients, and the Department may require health care providers to supply certain additional data for regional medical peer review. Information generated by peer review activity or for the purpose of complying with a Department request will be protected from discovery or disclosure.

The expiration date of the licenses of ground ambulance vehicles and air ambulance aircraft that have or are qualified to have a valid license on the effective date of this act is extended to August 28, 1998. All such services shall have one year after this act is effective to comply with its provisions and with rules developed as a result of its enactment.

Several changes were made by the SCS to SB 625:

(1) A definition of Emergency Medical Dispatcher was added;

(2) Subsections 6 and 7 of section 190.105 have been changed. These subsections provide that a contract with a political subdivision expands the ambulance service area without further action by the Department of Health, provided the service meets all other licensure requirements. Subsequent termination of a contract results in a corresponding reductio of the service area;

(3) The provisions regarding disciplinary action against ambulance services by the Department and the Directors ability to establish ground ambulance service areas are deleted for this act. (Section 190.105);

(4) Language is added providing that an applicant must submit certification from each political subdivision in which the applicant proposes to operate. (Section 190.108);

(5) Language is added pertaining to the requirement of a license for advanced life support. (Section 190.133, p. 22);

(6) Peer review section (Section 190.196) is deleted;

(7) Section 190.197 is added to SCS/SB 625 and pertains to automatic external defibrillators and the training required of those persons who may be called upon to use this equipment.

Finally, two additions were incorporated into the perfected version of SCS/SB 625.

(1) Section 190.044 was added. This addition provides that no taxpayer in a third classification county can be required to pay property taxes for ground ambulance service to an ambulance district and a fire protection district.

Any taxpayer residing in the area subject to the double tax may file a petition with the county clerk requesting that the double tax be eliminated and only one tax be imposed. Procedures for the vote and the elimination of one tax are set out in Section 190.044.

(2) A provision was added to Section 190.199 which pertains to automatic external defibrillators. This new provision would permit any person to utilize an automatic external defibrillator to revive a person in the absence of trained personnel.

This act is identical to SCS/SB 625.
TOM MORTON