1.1                          A bill for an act 
  1.2             relating to health; modifying provisions relating to 
  1.3             emergency medical services; amending Minnesota 
  1.4             Statutes 2002, sections 144E.01, subdivision 1; 
  1.5             144E.27, subdivisions 1, 2, 4; 144E.286, by adding a 
  1.6             subdivision; 144E.305, subdivision 2; 144E.41; 
  1.7             144E.50, subdivisions 5, 6; repealing Minnesota 
  1.8             Statutes 2002, sections 144E.01, subdivision 3; 
  1.9             144E.286, subdivisions 1, 2; Minnesota Rules, parts 
  1.10            4690.1500, subpart 3; 4690.7900, subpart 6. 
  1.11  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.12     Section 1.  Minnesota Statutes 2002, section 144E.01, 
  1.13  subdivision 1, is amended to read: 
  1.14     Subdivision 1.  [MEMBERSHIP.] (a) The emergency medical 
  1.15  services regulatory board consists of the following members, all 
  1.16  of whom must work in Minnesota, except for the person listed in 
  1.17  clause (14):  
  1.18     (1) an emergency physician certified by the American board 
  1.19  of emergency physicians; 
  1.20     (2) a representative of Minnesota hospitals; 
  1.21     (3) a representative of fire chiefs; 
  1.22     (4) a full-time firefighter who serves as a first responder 
  1.23  and who is a member of a professional firefighter's union; 
  1.24     (5) a volunteer firefighter who serves as a first 
  1.25  responder; 
  1.26     (6) an attendant currently practicing on a licensed 
  1.27  ambulance service who is a paramedic or an emergency medical 
  1.28  technician; 
  2.1      (7) an ambulance director for a licensed ambulance service; 
  2.2      (8) a representative of sheriffs; 
  2.3      (9) a member of a local board of health to represent 
  2.4   community health services; 
  2.5      (10) two representatives of regional emergency medical 
  2.6   services programs, one of whom must be from the metropolitan 
  2.7   regional emergency medical services program; 
  2.8      (11) a registered nurse currently practicing in a hospital 
  2.9   emergency department; 
  2.10     (12) a pediatrician, certified by the American board of 
  2.11  pediatrics, with experience in emergency medical services; 
  2.12     (13) a family practice physician who is currently involved 
  2.13  in emergency medical services; 
  2.14     (14) a public member who resides in Minnesota and is at 
  2.15  least 65 years of age; and 
  2.16     (15) the commissioners of health and public safety or their 
  2.17  designees. 
  2.18     (b) The governor shall appoint members under paragraph (a). 
  2.19  Appointments under clauses (1) to (9) and (11) to (13) are 
  2.20  subject to the advice and consent of the senate.  In making 
  2.21  appointments under clauses (1) to (9) and (11) to (13), the 
  2.22  governor shall consider recommendations of the American college 
  2.23  of emergency physicians, the Minnesota hospital association, the 
  2.24  Minnesota and state fire chief's association, the Minnesota 
  2.25  ambulance association, the Minnesota emergency medical services 
  2.26  association, the Minnesota state sheriff's association, the 
  2.27  association of Minnesota counties, the Minnesota nurses 
  2.28  association, and the Minnesota chapter of the academy of 
  2.29  pediatrics. 
  2.30     (c) No member appointed under paragraph (a) may serve 
  2.31  consecutive terms. 
  2.32     (d) At least seven members appointed under paragraph (a) 
  2.33  must reside outside of the seven-county metropolitan area, as 
  2.34  defined in section 473.121. 
  2.35     Sec. 2.  Minnesota Statutes 2002, section 144E.27, 
  2.36  subdivision 1, is amended to read: 
  3.1      Subdivision 1.  [TRAINING PROGRAMS.] Curriculum for initial 
  3.2   and refresher training programs must meet the current standards 
  3.3   of the United States Department of Transportation first 
  3.4   responder curriculum or its equivalent as determined by the 
  3.5   board.  A training program instructor must be a first responder, 
  3.6   EMT, EMT-I, EMT-P, physician, physician assistant, or registered 
  3.7   nurse. 
  3.8      Sec. 3.  Minnesota Statutes 2002, section 144E.27, 
  3.9   subdivision 2, is amended to read: 
  3.10     Subd. 2.  [REGISTRATION.] To be eligible for registration 
  3.11  with the board as a first responder, an individual shall 
  3.12  register the following persons as first responders: 
  3.13     (1) a person who successfully completes complete a 
  3.14  board-approved initial or refresher first responder training 
  3.15  program.  Registration under this clause is valid for two years 
  3.16  and expires at the end of the month in which the registration 
  3.17  was issued; or 
  3.18     (2) a person who is be credentialed as a first responder by 
  3.19  the National Registry of Emergency Medical 
  3.20  Technicians.  Registration under this clause expires the same 
  3.21  day as the National Registry credential. 
  3.22     Sec. 4.  Minnesota Statutes 2002, section 144E.27, 
  3.23  subdivision 4, is amended to read: 
  3.24     Subd. 4.  [EXPIRATION.] (a) A first responder registration 
  3.25  issued by the board or the commissioner of health before August 
  3.26  1, 1997, expires in 1999 at the end of the month in which it was 
  3.27  issued. as follows: 
  3.28     (1) for initial registration granted between January 1 and 
  3.29  June 30 of an even-numbered year, the expiration date is 
  3.30  September 30 of the next even-numbered year; 
  3.31     (2) for initial registration granted between July 1 and 
  3.32  December 31 of an even-numbered year, the expiration date is 
  3.33  September 30 of the second odd-numbered year; 
  3.34     (3) for initial registration granted between January 1 and 
  3.35  June 30 of an odd-numbered year, the expiration date is 
  3.36  September 30 of the next odd-numbered year; and 
  4.1      (4) for initial registration granted between July 1 and 
  4.2   December 31 of an odd-numbered year, the expiration date is 
  4.3   September 30 of the second even-numbered year. 
  4.4      (b) Subsequent registration renewals expire on September 30 
  4.5   and are valid for two years. 
  4.6      Sec. 5.  Minnesota Statutes 2002, section 144E.286, is 
  4.7   amended by adding a subdivision to read: 
  4.8      Subd. 3.  [EXAMINER QUALIFICATIONS.] An examiner testing 
  4.9   EMT, EMT-I, or EMT-P practical skills must be certified at or 
  4.10  above the level the examiner is testing or must be a registered 
  4.11  nurse, physician, or physician assistant.  A physician must be 
  4.12  available to answer questions relating to the evaluation of 
  4.13  skill performance at the EMT-I and EMT-P practical examination. 
  4.14     Sec. 6.  Minnesota Statutes 2002, section 144E.305, 
  4.15  subdivision 2, is amended to read: 
  4.16     Subd. 2.  [MANDATORY REPORTING.] (a) A licensee shall 
  4.17  report to the board conduct by a first responder, EMT, EMT-I, or 
  4.18  EMT-P that they reasonably believe constitutes grounds for 
  4.19  disciplinary action under section 144E.27, subdivision 5, or 
  4.20  144E.28, subdivision 5.  The licensee shall report to the board 
  4.21  within 60 days of obtaining knowledge of the conduct 
  4.22  constituting grounds for disciplinary action. 
  4.23     (b) A licensee shall report to the board any dismissal from 
  4.24  employment of a first responder, EMT, EMT-I, or EMT-P.  A 
  4.25  licensee shall report the resignation of a first responder, EMT, 
  4.26  EMT-I, or EMT-P before the conclusion of any disciplinary 
  4.27  proceeding or before commencement of formal charges but after 
  4.28  the first responder, EMT, EMT-I, or EMT-P has knowledge that 
  4.29  formal charges are contemplated or in preparation.  The licensee 
  4.30  shall report to the board within 60 days of the resignation or 
  4.31  initial determination to dismiss.  An individual's exercise of 
  4.32  rights under a collective bargaining agreement does not extend 
  4.33  the licensee's time period for reporting under this subdivision. 
  4.34     Sec. 7.  Minnesota Statutes 2002, section 144E.41, is 
  4.35  amended to read: 
  4.36     144E.41 [PROGRAM ELIGIBILITY; QUALIFIED AMBULANCE SERVICE 
  5.1   PERSONNEL.] 
  5.2      (a) Persons eligible to participate in the ambulance 
  5.3   service personnel longevity award and incentive program are 
  5.4   qualified ambulance service personnel. 
  5.5      (b) Qualified ambulance service personnel are ambulance 
  5.6   attendants, ambulance drivers, and ambulance service medical 
  5.7   directors or medical advisors who meet the following 
  5.8   requirements: 
  5.9      (1) employment of the person by or provision by the person 
  5.10  of service to an ambulance service that is licensed as such by 
  5.11  the state of Minnesota and that provides ambulance services that 
  5.12  are generally available to the public and are free of unfair 
  5.13  discriminatory practices under chapter 363; 
  5.14     (2) performance by the person during the 12 months ending 
  5.15  as of the immediately previous June 30 of all or a predominant 
  5.16  portion of the person's services in the state of Minnesota or on 
  5.17  behalf of Minnesota residents, as verified by August 1 annually 
  5.18  in an affidavit from the chief administrative officer of the 
  5.19  ambulance service; 
  5.20     (3) current certification of the person during the 12 
  5.21  months ending as of the immediately previous June 30 by the 
  5.22  Minnesota department of health as an ambulance attendant, 
  5.23  ambulance driver, or ambulance service medical director or 
  5.24  medical advisor under section 144E.265 or 144E.28, and 
  5.25  supporting rules, and current active ambulance service 
  5.26  employment or service provision status of the person, as 
  5.27  verified by August 1 annually in an affidavit from the chief 
  5.28  administrative officer of the ambulance service; and 
  5.29     (4) conformance by the person with the definition of the 
  5.30  phrase "volunteer ambulance attendant" under section 144E.001, 
  5.31  subdivision 15, except that for the salary limit specified in 
  5.32  that provision there must be substituted, for purposes of this 
  5.33  section only, a limit of $3,000 for calendar year 1993, and 
  5.34  $3,000 multiplied by the cumulative percentage increase in the 
  5.35  national Consumer Price Index, all items, for urban wage earners 
  5.36  and clerical workers, as published by the federal Department of 
  6.1   Labor, Bureau of Labor Statistics, since December 31, 1993, and 
  6.2   for an ambulance service medical director, conformance based 
  6.3   solely on the person's hourly stipends or salary for service as 
  6.4   a medical director.  
  6.5      (c) The term "active ambulance service employment or 
  6.6   service provision status" means being in good standing with and 
  6.7   on the active roster of the ambulance service making the 
  6.8   certification. 
  6.9      (d) The maximum period of ambulance service employment or 
  6.10  service provision for which a person may receive credit towards 
  6.11  an award under this chapter, including prior service credit 
  6.12  under section 144E.45, subdivision 2, paragraph (c), is 20 years.
  6.13     (e) For a person who is employed by or provides service to 
  6.14  more than one ambulance service concurrently during any period 
  6.15  during the 12-month period, credit towards an award under this 
  6.16  chapter is limited to one ambulance service during any period.  
  6.17  The creditable period is with the ambulance service for which 
  6.18  the person undertakes the greatest portion of employment or 
  6.19  service hours. 
  6.20     Sec. 8.  Minnesota Statutes 2002, section 144E.50, 
  6.21  subdivision 5, is amended to read: 
  6.22     Subd. 5.  [DISTRIBUTION.] Money from the fund shall be 
  6.23  distributed according to this subdivision.  Ninety-three and 
  6.24  one-third percent of the fund shall be distributed annually on a 
  6.25  contract for services basis with each of the eight regional 
  6.26  emergency medical services systems designated by the board.  The 
  6.27  systems shall be governed by a body consisting of appointed 
  6.28  representatives from each of the counties in that region and 
  6.29  shall also include representatives from emergency medical 
  6.30  services organizations.  The board shall contract with a 
  6.31  regional entity only if the contract proposal satisfactorily 
  6.32  addresses proposed emergency medical services activities in the 
  6.33  following areas:  personnel training, transportation 
  6.34  coordination, public safety agency cooperation, communications 
  6.35  systems maintenance and development, public involvement, health 
  6.36  care facilities involvement, and system management.  If each of 
  7.1   the regional emergency medical services systems submits a 
  7.2   satisfactory contract proposal, then this part of the fund shall 
  7.3   be distributed evenly among the regions.  If one or more of the 
  7.4   regions does not contract for the full amount of its even share 
  7.5   or if its proposal is unsatisfactory, then the board may 
  7.6   reallocate the unused funds to the remaining regions on a pro 
  7.7   rata basis shall expeditiously distribute any undesignated 
  7.8   funds, through a fiduciary agent if necessary, to maintain 
  7.9   support to emergency medical services providers in that region.  
  7.10  Six and two-thirds percent of the fund shall be used by the 
  7.11  board to support regionwide reporting systems and to provide 
  7.12  other regional administration and technical assistance. 
  7.13     Sec. 9.  Minnesota Statutes 2002, section 144E.50, 
  7.14  subdivision 6, is amended to read: 
  7.15     Subd. 6.  [AUDITS.] (a) Each regional emergency medical 
  7.16  services board designated by the board shall be audited either 
  7.17  annually or biennially by an independent auditor who is either a 
  7.18  state or local government auditor or a certified public 
  7.19  accountant who meets the independence standards specified by the 
  7.20  General Accounting Office for audits of governmental 
  7.21  organizations, programs, activities, and functions.  The audit 
  7.22  shall cover all funds received by the regional board, including 
  7.23  but not limited to, funds appropriated under this section, 
  7.24  section 144E.52, and section 169.686, subdivision 3.  Expenses 
  7.25  associated with the audit are the responsibility of the regional 
  7.26  board. 
  7.27     (b) A biennial audit specified in paragraph (a) shall be 
  7.28  performed within 60 days following the close of the biennium.  
  7.29  Copies of the audit and any accompanying materials shall be 
  7.30  filed by October 1 of each odd-numbered year, beginning in 1999, 
  7.31  with the board, the legislative auditor, and the state auditor. 
  7.32     (c) An annual audit specified in paragraph (a) shall be 
  7.33  performed within 120 days following the close of the regional 
  7.34  emergency medical services board's fiscal year.  Copies of the 
  7.35  audit and any accompanying materials shall be filed within 150 
  7.36  days following the close of the regional emergency medical 
  8.1   services board's fiscal year, beginning in the year 2000, with 
  8.2   the board, the legislative auditor, and the state auditor. 
  8.3      (d) If the audit is not conducted as required in paragraph 
  8.4   (a) or copies filed as required in paragraph (b) or (c), or if 
  8.5   the audit determines that funds were not spent in accordance 
  8.6   with this chapter, the board shall immediately reduce funding to 
  8.7   the regional emergency medical services board as follows: 
  8.8      (1) if an audit was not conducted or if an audit was 
  8.9   conducted but copies were not provided as required, funding 
  8.10  shall be reduced by up to 100 percent; and 
  8.11     (2) if an audit was conducted and copies provided, and the 
  8.12  audit identifies expenditures made that are not in compliance 
  8.13  with this chapter, funding shall be reduced by the amount in 
  8.14  question plus ten percent.  
  8.15  A funding reduction under this paragraph is effective for the 
  8.16  fiscal year in which the reduction is taken and the following 
  8.17  fiscal year. 
  8.18     (e) The board shall distribute any funds withheld from a 
  8.19  regional board under paragraph (d) to the remaining regional 
  8.20  boards on a pro rata basis according to subdivision 5.  
  8.21     Sec. 10.  [TRANSITION.] 
  8.22     To accommodate the transition to a uniform expiration date 
  8.23  under Minnesota Statutes, section 144E.27, subdivision 4, a 
  8.24  first responder registration issued by the board before the 
  8.25  effective date of this act shall be renewed in the same manner 
  8.26  as provided for an initial registration under Minnesota 
  8.27  Statutes, section 144E.27, subdivision 4. 
  8.28     Sec. 11.  [REPEALER.] 
  8.29     Minnesota Statutes 2002, sections 144E.01, subdivision 3; 
  8.30  and 144E.286, subdivisions 1 and 2; and Minnesota Rules, parts 
  8.31  4690.1500, subpart 3; and 4690.7900, subpart 6, are repealed. 
  8.32     Sec. 12.  [EFFECTIVE DATE.] 
  8.33     Sections 1 to 11 are effective the day following final 
  8.34  enactment.