SF 166

as introduced - 88th Legislature (2013 - 2014) Posted on 04/19/2013 08:16am

A bill for an act
relating to emergency medical services; modifying certain provisions to include
advanced emergency medical technicians; updating inspection provisions;
providing requirements for emergency medical responder registration; amending
Minnesota Statutes 2012, sections 144E.101, subdivision 7; 144E.18; 144E.27,
subdivision 1, by adding a subdivision; 144E.285, subdivisions 2, 4.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2012, section 144E.101, subdivision 7, is amended to
read:

Subd. 7.

Advanced life support.

(a) Except as provided in paragraphs (f) and (g),
an advanced life-support ambulance shall be staffed by at least:

(1) one EMT new text begin or one AEMT new text end and one paramedic;

(2) one EMT new text begin or one AEMT new text end and one registered nurse who is an EMT new text begin or an AEMT new text end , is
currently practicing nursing, and has passed a paramedic practical skills test approved by
the board and administered by an education program; or

(3) one EMT new text begin or one AEMT new text end and one physician assistant who is an EMT new text begin or an AEMT new text end ,
is currently practicing as a physician assistant, and has passed a paramedic practical skills
test approved by the board and administered by an education program.

(b) An advanced life-support service shall provide basic life support, as specified
under subdivision 6, paragraph (a), advanced airway management, manual defibrillation,
and administration of intravenous fluids and pharmaceuticals.

(c) In addition to providing advanced life support, an advanced life-support service
may staff additional ambulances to provide basic life support according to subdivision 6
and section 144E.103, subdivision 1.

(d) An ambulance service providing advanced life support shall have a written
agreement with its medical director to ensure medical control for patient care 24 hours
a day, seven days a week. The terms of the agreement shall include a written policy
on the administration of medical control for the service. The policy shall address the
following issues:

(1) two-way communication for physician direction of ambulance service personnel;

(2) patient triage, treatment, and transport;

(3) use of standing orders; and

(4) the means by which medical control will be provided 24 hours a day.

The agreement shall be signed by the licensee's medical director and the licensee or
the licensee's designee and maintained in the files of the licensee.

(e) When an ambulance service provides advanced life support, the authority
of a paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician
assistant-EMT to determine the delivery of patient care prevails over the authority of
an EMT.

(f) Upon application from an ambulance service that includes evidence demonstrating
hardship, the board may grant a variance from the staff requirements in paragraph (a),
clause (1), and may authorize an advanced life-support ambulance to be staffed by a
registered emergency medical responder driver with a paramedic for all emergency calls
and interfacility transfers. The variance shall apply to advanced life-support ambulance
services until the ambulance service renews its license. When the variance expires, an
ambulance service may apply for a new variance under this paragraph. This paragraph
applies only to an ambulance service whose primary service area is mainly located outside
the metropolitan counties listed in section 473.121, subdivision 4, and outside the cities
of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance based in a
community with a population of less than 1,000 persons.

(g) After an initial emergency ambulance call, each subsequent emergency
ambulance response, until the initial ambulance is again available, and interfacility
transfers, may be staffed by one registered emergency medical responder driver and an
EMT or paramedic. This paragraph applies only to an ambulance service whose primary
service area is mainly located outside the metropolitan counties listed in section 473.121,
subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
Cloud, or an ambulance based in a community with a population of less than 1,000 persons.

Sec. 2.

Minnesota Statutes 2012, section 144E.18, is amended to read:

144E.18 INSPECTIONS.

The board may inspect ambulance services as frequently as deemed necessary to
determine whether an ambulance service is in compliance with sections 144E.001 to
144E.33 and rules adopted under those sections. The board may review at any time
documentation new text begin or electronic files new text end required to be on file with a licensee.

Sec. 3.

Minnesota Statutes 2012, section 144E.27, subdivision 1, is amended to read:

Subdivision 1.

Education programs.

deleted text begin (a) Curriculum for initial and refresher
education programs must meet the United States Department of Transportation Emergency
Medical Responder Education Standards or its equivalent as determined by the board. deleted text end An
education program instructor must be an emergency medical responder, EMT, AEMT,
paramedic, physician, physician assistant, or registered nurse.

deleted text begin (b) The National EMS Education Standards by the NHTSA, United States
Department of Transportation contains the minimal entry level of knowledge and skills
for emergency medical responders. Medical directors of emergency medical responder
groups may expand the knowledge and skill set.
deleted text end

Sec. 4.

Minnesota Statutes 2012, section 144E.27, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Approval required. new text end

new text begin (a) All education programs for an emergency
medical responder must be approved by the board.
new text end

new text begin (b) To be approved by the board, an education program must:
new text end

new text begin (1) submit an application prescribed by the board that includes:
new text end

new text begin (i) type and length of course to be offered;
new text end

new text begin (ii) names, addresses, and qualifications of the program medical director, program
education coordinator, and instructors;
new text end

new text begin (iii) admission criteria for students; and
new text end

new text begin (iv) materials and equipment to be used;
new text end

new text begin (2) for each course, implement the most current version of the United States
Department of Transportation EMS Education Standards, or its equivalent as determined
by the board applicable to Emergency Medical Responder registration education;
new text end

new text begin (3) have a program medical director and a program coordinator;
new text end

new text begin (4) have at least one instructor for every ten students at the practical skill stations;
new text end

new text begin (5) retain documentation of program approval by the board, course outline, and
student information; and
new text end

new text begin (6) submit the appropriate fee as required under section 144E.29.
new text end

new text begin (c) The National EMS Education Standards by the NHTSA, United States
Department of Transportation contains the minimal entry level of knowledge and skills
for emergency medical responders. Medical directors of emergency medical responder
groups may expand the knowledge and skill set.
new text end

Sec. 5.

Minnesota Statutes 2012, section 144E.285, subdivision 2, is amended to read:

Subd. 2.

new text begin AEMT and new text end paramedic requirements.

(a) In addition to the requirements
under subdivision 1, paragraph (b), an education program applying for approval to teach
new text begin AEMTs and new text end paramedics must be administered by an educational institution accredited by
the Commission of Accreditation of Allied Health Education Programs (CAAHEP).

(b) deleted text begin A deleted text end new text begin An AEMT and new text end paramedic education program that is administered by
an educational institution not accredited by CAAHEP, but that is in the process of
completing the accreditation process, may be granted provisional approval by the board
upon verification of submission of its self-study report and the appropriate review fee
to CAAHEP.

(c) An educational institution that discontinues its participation in the accreditation
process must notify the board immediately and provisional approval shall be withdrawn.

(d) This subdivision does not apply to a paramedic education program when the
program is operated by an advanced life-support ambulance service licensed by the
Emergency Medical Services Regulatory Board under this chapter, and the ambulance
service meets the following criteria:

(1) covers a rural primary service area that does not contain a hospital within the
primary service area or contains a hospital within the primary service area that has been
designated as a critical access hospital under section 144.1483, clause (11);

(2) has tax-exempt status in accordance with the Internal Revenue Code, section
501(c)(3);

(3) received approval before 1991 from the commissioner of health to operate
a paramedic education program;

(4) operates deleted text begin the deleted text end new text begin an AEMT and new text end paramedic education program exclusively to train
paramedics for the local ambulance service; and

(5) limits enrollment in the new text begin AEMT and new text end paramedic program to five candidates per
biennium.

Sec. 6.

Minnesota Statutes 2012, section 144E.285, subdivision 4, is amended to read:

Subd. 4.

Reapproval.

An education program shall apply to the board for reapproval
at least three months prior to the expiration date of its approval and must:

(1) submit an application prescribed by the board specifying any changes from the
information provided for prior approval and any other information requested by the board
to clarify incomplete or ambiguous information presented in the application; and

(2) comply with the requirements under subdivision 1, paragraph (b), clauses (2) to
deleted text begin (9) deleted text end new text begin (10) new text end .