as introduced - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 02/03/1999 |
1.1 A bill for an act 1.2 relating to health; modifying standards for ambulance 1.3 services; modifying provisions for first responders; 1.4 providing for certification of emergency medical 1.5 technicians; providing for certification of medical 1.6 response units; providing for emergency medical 1.7 technician instructor certification; requiring 1.8 approval of training programs; setting fees; providing 1.9 for reports of misconduct; providing criminal and 1.10 civil penalties; amending Minnesota Statutes 1998, 1.11 sections 13.99, subdivision 38a, and by adding a 1.12 subdivision; 144E.001, by adding subdivisions; 1.13 144E.10, subdivision 1; 144E.11, by adding a 1.14 subdivision; 144E.16, subdivision 4; 144E.18; 144E.27, 1.15 by adding subdivisions; and 145A.02, subdivision 10; 1.16 proposing coding for new law in Minnesota Statutes, 1.17 chapter 144E; repealing Minnesota Statutes 1998, 1.18 sections 144E.16, subdivisions 1, 2, 3, and 6; 1.19 144E.17; 144E.25; and 144E.30, subdivisions 1, 2, and 1.20 6; Minnesota Rules, parts 4690.0100, subparts 4, 13, 1.21 15, 19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 1.22 4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, 1.23 subparts 1 and 2; 4690.0900; 4690.1000; 4690.1100; 1.24 4690.1200; 4690.1300; 4690.1600; 4690.1700; 4690.2100; 1.25 4690.2200, subparts 1, 3, 4, and 5; 4690.2300; 1.26 4690.2400, subparts 1, 2, and 3; 4690.2500; 4690.2900; 1.27 4690.3000; 4690.3700; 4690.3900; 4690.4000; 4690.4100; 1.28 4690.4200; 4690.4300; 4690.4400; 4690.4500; 4690.4600; 1.29 4690.4700; 4690.4800; 4690.4900; 4690.5000; 4690.5100; 1.30 4690.5200; 4690.5300; 4690.5400; 4690.5500; 4690.5700; 1.31 4690.5800; 4690.5900; 4690.6000; 4690.6100; 4690.6200; 1.32 4690.6300; 4690.6400; 4690.6500; 4690.6600; 4690.6700; 1.33 4690.6800; 4690.7000; 4690.7100; 4690.7200; 4690.7300; 1.34 4690.7400; 4690.7500; 4690.7600; 4690.7700; 4690.7800; 1.35 4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000. 1.36 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.37 Section 1. Minnesota Statutes 1998, section 13.99, 1.38 subdivision 38a, is amended to read: 1.39 Subd. 38a. [AMBULANCE SERVICE DATA.] Data required to be 1.40 reported by ambulance services under section144E.17,2.1subdivision 1,144E.123 are classified under that section. 2.2 Sec. 2. Minnesota Statutes 1998, section 13.99, is amended 2.3 by adding a subdivision to read: 2.4 Subd. 39b. [EMT, EMT-I, EMT-P, OR FIRST RESPONDER 2.5 MISCONDUCT.] Reports of emergency medical technician, emergency 2.6 medical technician-intermediate, emergency medical 2.7 technician-paramedic, or first responder misconduct are 2.8 classified under section 144E.305, subdivision 3. 2.9 Sec. 3. Minnesota Statutes 1998, section 144E.001, is 2.10 amended by adding a subdivision to read: 2.11 Subd. 1a. [ADVANCED AIRWAY MANAGEMENT.] "Advanced airway 2.12 management" means insertion of an endotracheal tube or creation 2.13 of a surgical airway. 2.14 Sec. 4. Minnesota Statutes 1998, section 144E.001, is 2.15 amended by adding a subdivision to read: 2.16 Subd. 1b. [ADVANCED LIFE SUPPORT.] "Advanced life support" 2.17 means rendering basic life support and rendering intravenous 2.18 therapy, drug therapy, intubation, and defibrillation as 2.19 outlined in the United States Department of Transportation 2.20 emergency medical technician-paramedic curriculum or its 2.21 equivalent, as approved by the board. 2.22 Sec. 5. Minnesota Statutes 1998, section 144E.001, is 2.23 amended by adding a subdivision to read: 2.24 Subd. 3a. [AMBULANCE SERVICE PERSONNEL.] "Ambulance 2.25 service personnel" means individuals who are authorized by a 2.26 licensed ambulance service to provide emergency care for the 2.27 ambulance service and are: 2.28 (1) EMTs, EMT-Is, or EMT-Ps; 2.29 (2) Minnesota registered nurses who are EMTs, are currently 2.30 practicing nursing, and have passed a paramedic practical skills 2.31 test, as approved by the board and administered by a training 2.32 program approved by the board; or 2.33 (3) Minnesota registered physician assistants who are EMTs, 2.34 are currently practicing as physician assistants, and have 2.35 passed a paramedic practical skills test, as approved by the 2.36 board and administered by a training program approved by the 3.1 board. 3.2 Sec. 6. Minnesota Statutes 1998, section 144E.001, is 3.3 amended by adding a subdivision to read: 3.4 Subd. 4a. [BASIC AIRWAY MANAGEMENT.] "Basic airway 3.5 management" means: 3.6 (1) resuscitation by mouth-to-mouth, mouth-to-mask, bag 3.7 valve mask, or oxygen powered ventilators; 3.8 (2) insertion of an oropharyngeal, nasal pharyngeal, 3.9 pharyngeal tracheo lumen esophageal obturator, or esophageal 3.10 gastric tube airway; or 3.11 (3) establishment of an esophageal tracheal airway. 3.12 Sec. 7. Minnesota Statutes 1998, section 144E.001, is 3.13 amended by adding a subdivision to read: 3.14 Subd. 4b. [BASIC LIFE SUPPORT.] "Basic life support" means 3.15 rendering basic-level emergency care, including, but not limited 3.16 to, basic airway management, cardiopulmonary resuscitation, 3.17 controlling shock and bleeding, and splinting fractures, as 3.18 outlined in the United States Department of Transportation 3.19 emergency medical technician-basic curriculum or its equivalent, 3.20 as approved by the board. 3.21 Sec. 8. Minnesota Statutes 1998, section 144E.001, is 3.22 amended by adding a subdivision to read: 3.23 Subd. 5a. [CLINICAL TRAINING SITE.] "Clinical training 3.24 site" means a licensed health care facility. 3.25 Sec. 9. Minnesota Statutes 1998, section 144E.001, is 3.26 amended by adding a subdivision to read: 3.27 Subd. 5b. [DEFIBRILLATOR.] "Defibrillator" means an 3.28 automatic, semiautomatic, or manual device that delivers an 3.29 electric shock at a preset voltage to the myocardium through the 3.30 chest wall and that is used to restore the normal cardiac rhythm 3.31 and rate when the heart has stopped beating or is fibrillating. 3.32 Sec. 10. Minnesota Statutes 1998, section 144E.001, is 3.33 amended by adding a subdivision to read: 3.34 Subd. 5c. [EMERGENCY MEDICAL TECHNICIAN OR EMT.] 3.35 "Emergency medical technician" or "EMT" means a person who has 3.36 successfully completed the United States Department of 4.1 Transportation emergency medical technician-basic course or its 4.2 equivalent, as approved by the board, and has been issued valid 4.3 certification by the board. 4.4 Sec. 11. Minnesota Statutes 1998, section 144E.001, is 4.5 amended by adding a subdivision to read: 4.6 Subd. 5d. [EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE OR 4.7 EMT-I.] "Emergency medical technician-intermediate" or "EMT-I" 4.8 means a person who has successfully completed the United States 4.9 Department of Transportation emergency medical 4.10 technician-intermediate course or its equivalent, as approved by 4.11 the board, and has been issued valid certification by the board. 4.12 Sec. 12. Minnesota Statutes 1998, section 144E.001, is 4.13 amended by adding a subdivision to read: 4.14 Subd. 5e. [EMERGENCY MEDICAL TECHNICIAN-PARAMEDIC OR 4.15 EMT-P.] "Emergency medical technician-paramedic" or "EMT-P" 4.16 means a person who has successfully completed the United States 4.17 Department of Transportation emergency medical technician 4.18 course-paramedic or its equivalent, as approved by the board, 4.19 and has been issued valid certification by the board. 4.20 Sec. 13. Minnesota Statutes 1998, section 144E.001, is 4.21 amended by adding a subdivision to read: 4.22 Subd. 5f. [EMERGENCY MEDICAL TECHNICIAN INSTRUCTOR.] 4.23 "Emergency medical technician instructor" means a person who has 4.24 been certified by the board to teach an EMT, EMT-I, or EMT-P 4.25 course. 4.26 Sec. 14. Minnesota Statutes 1998, section 144E.001, is 4.27 amended by adding a subdivision to read: 4.28 Subd. 8a. [MEDICAL CONTROL.] "Medical control" means 4.29 direction by a physician or a physician's designee of 4.30 out-of-hospital emergency medical care. 4.31 Sec. 15. Minnesota Statutes 1998, section 144E.001, is 4.32 amended by adding a subdivision to read: 4.33 Subd. 8b. [MEDICAL RESPONSE UNIT.] "Medical response unit" 4.34 means an organized group of persons that has been certified by 4.35 the board to provide medical care at the scene of an injury, 4.36 illness, or pregnancy in an out-of-hospital setting. A medical 5.1 response unit does not transport patients. 5.2 Sec. 16. Minnesota Statutes 1998, section 144E.001, is 5.3 amended by adding a subdivision to read: 5.4 Subd. 9a. [PART-TIME ADVANCED LIFE SUPPORT.] "Part-time 5.5 advanced life support" means rendering basic life support and 5.6 advanced life support for less than 24 hours of every day. 5.7 Sec. 17. Minnesota Statutes 1998, section 144E.001, is 5.8 amended by adding a subdivision to read: 5.9 Subd. 9b. [PHYSICIAN.] "Physician" means a person licensed 5.10 to practice medicine under chapter 147. 5.11 Sec. 18. Minnesota Statutes 1998, section 144E.001, is 5.12 amended by adding a subdivision to read: 5.13 Subd. 9c. [PHYSICIAN ASSISTANT.] "Physician assistant" 5.14 means a person registered to practice as a physician assistant 5.15 under chapter 147A. 5.16 Sec. 19. Minnesota Statutes 1998, section 144E.001, is 5.17 amended by adding a subdivision to read: 5.18 Subd. 9d. [PREHOSPITAL CARE DATA.] "Prehospital care data" 5.19 means information collected by ambulance service personnel about 5.20 the circumstances related to an emergency response and patient 5.21 care activities provided by the ambulance service personnel in a 5.22 prehospital setting. 5.23 Sec. 20. Minnesota Statutes 1998, section 144E.001, is 5.24 amended by adding a subdivision to read: 5.25 Subd. 11. [PROGRAM MEDICAL DIRECTOR.] "Program medical 5.26 director" means a physician who is responsible for ensuring an 5.27 accurate and thorough presentation of the medical content of an 5.28 emergency care training program; certifying that each student 5.29 has successfully completed the training course; and in 5.30 conjunction with the program coordinator, planning the clinical 5.31 training. 5.32 Sec. 21. Minnesota Statutes 1998, section 144E.001, is 5.33 amended by adding a subdivision to read: 5.34 Subd. 12. [REGISTERED NURSE.] "Registered nurse" means a 5.35 person licensed to practice professional nursing under chapter 5.36 148. 6.1 Sec. 22. Minnesota Statutes 1998, section 144E.001, is 6.2 amended by adding a subdivision to read: 6.3 Subd. 13. [STANDING ORDER.] "Standing order" means a type 6.4 of medical protocol that provides specific, written orders for 6.5 actions, techniques, or drug administration when communication 6.6 has not been established for direct medical control. 6.7 Sec. 23. Minnesota Statutes 1998, section 144E.001, is 6.8 amended by adding a subdivision to read: 6.9 Subd. 14. [TRAINING PROGRAM COORDINATOR.] "Training 6.10 program coordinator" means an individual who serves as the 6.11 administrator of an emergency care training program and who is 6.12 responsible for planning, conducting, and evaluating the 6.13 program; selecting students and certified instructors; 6.14 documenting and maintaining records; developing a curriculum; 6.15 and assisting in the coordination of examination sessions and 6.16 clinical training. 6.17 Sec. 24. Minnesota Statutes 1998, section 144E.10, 6.18 subdivision 1, is amended to read: 6.19 Subdivision 1. [LICENSE REQUIRED.] No natural person, 6.20 partnership, association, corporation, or unit of government may 6.21 operate an ambulance service within this state unless it 6.22 possesses a valid license to do so issued by the board. The 6.23 license shall specify the base of operations, the primary 6.24 service area, and the type or types of ambulance service for 6.25 which the licensee is licensed. The licensee shall obtain a new 6.26 license if it wishes to expand its primary service area, or to 6.27 provide a new type or types of service.The cost of licenses6.28shall be in an amount prescribed by the board pursuant to6.29section 144E.05. Licenses shall expire and be renewed in6.30accordance with rules adopted by the board.6.31 Sec. 25. [144E.101] [AMBULANCE SERVICE REQUIREMENTS.] 6.32 Subdivision 1. [PERSONNEL.] (a) No publicly or privately 6.33 owned ambulance service shall be operated in the state unless 6.34 its ambulance service personnel are certified, appropriate to 6.35 the type of ambulance service being provided, according to 6.36 section 144E.28 or meet the staffing criteria specific to the 7.1 type of ambulance service. 7.2 (b) An ambulance service shall have a medical director as 7.3 provided under section 144E.265. 7.4 Subd. 2. [PATIENT CARE.] When a patient is being 7.5 transported, at least one of the ambulance service personnel 7.6 must be in the patient compartment. If advanced life support 7.7 procedures are required, an EMT-P, a registered nurse qualified 7.8 under section 144E.001, subdivision 3a, clause (2), or a 7.9 physician assistant qualified under section 144E.001, 7.10 subdivision 3a, clause (3), shall be in the patient compartment. 7.11 Subd. 3. [CONTINUAL SERVICE.] An ambulance service shall 7.12 offer service 24 hours per day every day of the year, unless 7.13 otherwise authorized under subdivisions 8 and 9. 7.14 Subd. 4. [DENIAL OF SERVICE PROHIBITED.] An ambulance 7.15 service shall not deny prehospital care to a person needing 7.16 emergency ambulance service because of inability to pay or 7.17 because of the source of payment for services if the need 7.18 develops within the licensee's primary service area or when 7.19 responding to a mutual aid call. Transport for the patient may 7.20 be limited to the closest appropriate emergency medical facility. 7.21 Subd. 5. [TYPES OF SERVICE.] The board shall regulate the 7.22 following types of ambulance service: 7.23 (1) basic life support; 7.24 (2) advanced life support; 7.25 (3) part-time advanced life support; and 7.26 (4) specialized life support. 7.27 Subd. 6. [BASIC LIFE SUPPORT.] (a) A basic life support 7.28 ambulance shall be staffed by at least two EMTs who provide a 7.29 level of care so as to ensure that: 7.30 (1) life-threatening situations and potentially serious 7.31 injuries are recognized; 7.32 (2) patients are protected from additional hazards; 7.33 (3) basic treatment to reduce the seriousness of emergency 7.34 situations is administered; and 7.35 (4) patients are transported to an appropriate medical 7.36 facility for treatment. 8.1 (b) A basic life support service shall provide basic airway 8.2 management. 8.3 (c) By January 1, 2000, a basic life support service shall 8.4 provide automatic defibrillation, as provided in section 8.5 144E.103, subdivision 1, paragraph (b). 8.6 (d) A basic life support service licensee's medical 8.7 director may authorize the ambulance service personnel to carry 8.8 and to use medical antishock trousers and to perform intravenous 8.9 infusion if the ambulance service personnel have been properly 8.10 trained. 8.11 Subd. 7. [ADVANCED LIFE SUPPORT.] (a) An advanced life 8.12 support ambulance shall be staffed by at least: 8.13 (1) one EMT and one EMT-P; 8.14 (2) one EMT and one registered nurse who is an EMT, is 8.15 currently practicing nursing, and has passed a paramedic 8.16 practical skills test approved by the board and administered by 8.17 a training program; or 8.18 (3) one EMT and one physician assistant who is an EMT, is 8.19 currently practicing as a physician assistant, and has passed a 8.20 paramedic practical skills test approved by the board and 8.21 administered by a training program. 8.22 (b) An advanced life support service shall provide basic 8.23 life support, as specified under subdivision 6, paragraph (a), 8.24 advanced airway management, manual defibrillation, and 8.25 administration of intravenous fluids and pharmaceuticals. 8.26 (c) In addition to providing advanced life support, an 8.27 advanced life support service may staff additional ambulances to 8.28 provide basic life support according to subdivision 6. When 8.29 routinely staffed and equipped as a basic life support service 8.30 according to subdivision 6 and section 144E.103, subdivision 1, 8.31 the vehicle shall not be marked as advanced life support. 8.32 (d) An ambulance service providing advanced life support 8.33 shall have a written agreement with its medical director to 8.34 ensure medical control for patient care 24 hours a day, seven 8.35 days a week. The terms of the agreement shall include a written 8.36 policy on the administration of medical control for the 9.1 service. The policy shall address the following issues: 9.2 (i) two-way communication for physician direction of 9.3 ambulance service personnel; 9.4 (ii) patient triage, treatment, and transport; 9.5 (iii) use of standing orders; and 9.6 (iv) the means by which medical control will be provided 24 9.7 hours a day. 9.8 The agreement shall be signed by the licensee's medical 9.9 director and the licensee or the licensee's designee and 9.10 maintained in the files of the licensee. 9.11 (e) When an ambulance service provides advanced life 9.12 support, the authority of an EMT-P, Minnesota registered 9.13 nurse-EMT, or Minnesota registered physician assistant-EMT to 9.14 determine the delivery of patient care prevails over the 9.15 authority of an EMT. 9.16 Subd. 8. [PART-TIME ADVANCED LIFE SUPPORT.] (a) A 9.17 part-time advanced life support service shall meet the staffing 9.18 requirements under subdivision 7, paragraph (a); provide service 9.19 as required under subdivision 7, paragraph (b), for less than 24 9.20 hours every day; and meet the equipment requirements specified 9.21 in section 144E.103. 9.22 (b) A part-time advanced life support service shall have a 9.23 written agreement with its medical director to ensure medical 9.24 control for patient care during the time the service offers 9.25 advanced life support. The terms of the agreement shall include 9.26 a written policy on the administration of medical control for 9.27 the service and address the issues specified in subdivision 7, 9.28 paragraph (d). 9.29 Subd. 9. [SPECIALIZED LIFE SUPPORT.] A specialized life 9.30 support service shall provide basic or advanced life support as 9.31 designated by the board, and shall be restricted by the board to: 9.32 (1) operation less than 24 hours of every day; 9.33 (2) designated segments of the population; 9.34 (3) certain types of medical conditions; or 9.35 (4) air ambulance service that includes fixed-wing and 9.36 rotor-wing. 10.1 Subd. 10. [DRIVER.] A driver of an ambulance must possess 10.2 a current driver's license issued by any state and must have 10.3 attended an emergency vehicle driving course approved by the 10.4 licensee. The emergency vehicle driving course must include 10.5 actual driving experience. 10.6 Subd. 11. [PERSONNEL ROSTER AND FILES.] (a) An ambulance 10.7 service shall maintain: 10.8 (1) at least two ambulance service personnel on a written 10.9 on-call schedule; 10.10 (2) a current roster of its ambulance service personnel, 10.11 including the name, address, and qualifications of its ambulance 10.12 service personnel; and 10.13 (3) files documenting personnel qualifications. 10.14 (b) A licensee shall maintain in its files the name and 10.15 address of its medical director and a written statement signed 10.16 by the medical director indicating acceptance of the 10.17 responsibilities specified in section 144E.265, subdivision 2. 10.18 Subd. 12. [MUTUAL AID AGREEMENT.] A licensee shall have a 10.19 written agreement with at least one neighboring licensed 10.20 ambulance service for coverage during times when the licensee's 10.21 ambulances are not available for service in its primary service 10.22 area. The agreement must specify the duties and 10.23 responsibilities of the agreeing parties. A copy of each mutual 10.24 aid agreement shall be maintained in the files of the licensee. 10.25 Subd. 13. [SERVICE OUTSIDE PRIMARY SERVICE AREA.] A 10.26 licensee may provide its services outside of its primary service 10.27 area only if requested by a transferring physician or ambulance 10.28 service licensed to provide service in the primary service area 10.29 when it can reasonably be expected that: 10.30 (1) the response is required by the immediate medical need 10.31 of an individual; and 10.32 (2) the ambulance service licensed to provide service in 10.33 the primary service area is unavailable for appropriate response. 10.34 Sec. 26. [144E.103] [EQUIPMENT.] 10.35 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Every ambulance 10.36 in service for patient care shall carry, at a minimum: 11.1 (1) oxygen; 11.2 (2) airway maintenance equipment in various sizes to 11.3 accommodate all age groups; 11.4 (3) splinting equipment in various sizes to accommodate all 11.5 age groups; 11.6 (4) dressings, bandages, and bandaging equipment; 11.7 (5) an emergency obstetric kit; 11.8 (6) equipment to determine vital signs in various sizes to 11.9 accommodate all age groups; 11.10 (7) a stretcher; 11.11 (8) a defibrillator; and 11.12 (9) a fire extinguisher. 11.13 (b) A basic life support service has until January 1, 2000, 11.14 to equip each ambulance in service for patient care with a 11.15 defibrillator. 11.16 Subd. 2. [ADVANCED LIFE SUPPORT REQUIREMENTS.] In addition 11.17 to the requirements in subdivision 1, an ambulance used in 11.18 providing advanced life support must carry drugs and drug 11.19 administration equipment and supplies as approved by the 11.20 licensee's medical director. 11.21 Subd. 3. [STORAGE.] All equipment carried in an ambulance 11.22 must be securely stored. 11.23 Subd. 4. [SAFETY RESTRAINTS.] An ambulance must be 11.24 equipped with safety straps for the stretcher and seat belts in 11.25 the patient compartment for the patient and ambulance personnel. 11.26 Sec. 27. Minnesota Statutes 1998, section 144E.11, is 11.27 amended by adding a subdivision to read: 11.28 Subd. 9. [RENEWAL REQUIREMENTS.] An ambulance service 11.29 license expires two years from the date of licensure. An 11.30 ambulance service must apply to the board for license renewal at 11.31 least one month prior to the expiration date of the license and 11.32 must submit: 11.33 (1) an application prescribed by the board specifying any 11.34 changes from the information provided for prior licensure and 11.35 any other information requested by the board to clarify 11.36 incomplete or ambiguous information presented in the 12.1 application; and 12.2 (2) the appropriate fee as required under section 144E.29. 12.3 Sec. 28. [144E.121] [AIR AMBULANCE SERVICE REQUIREMENTS.] 12.4 Subdivision 1. [AVIATION COMPLIANCE.] An air ambulance 12.5 service must comply with the regulations of the Federal Aviation 12.6 Administration and the rules of the Minnesota department of 12.7 transportation, aeronautics division. 12.8 Subd. 2. [PERSONNEL.] (a) With the exception of pilots, 12.9 each of the air ambulance emergency medical personnel must: 12.10 (1) possess current certification, appropriate to the type 12.11 of ambulance service being provided, according to section 12.12 144E.28, be a registered nurse, or be a physician assistant; and 12.13 (2) be trained to use the equipment on the air ambulance. 12.14 (b) Emergency medical personnel for an air ambulance 12.15 service must receive training approved by the licensee's medical 12.16 director that includes instruction in the physiological changes 12.17 due to decreased atmospheric pressure, acceleration, vibration, 12.18 and changes in altitude; medical conditions requiring special 12.19 precautions; and contraindications to air transport. 12.20 (c) A licensee's medical director must sign and file a 12.21 statement with the licensee that each of its emergency medical 12.22 personnel has successfully completed the training under 12.23 paragraph (b). 12.24 (d) A licensee shall retain documentation of compliance 12.25 with this subdivision in its files. 12.26 Subd. 3. [EQUIPMENT.] An air ambulance must carry 12.27 equipment appropriate to the level of service being provided. 12.28 Equipment that is not permanently stored on or in an air 12.29 ambulance must be kept separate from the air ambulance in a 12.30 modular prepackaged form. 12.31 Sec. 29. [144E.123] [PREHOSPITAL CARE DATA.] 12.32 Subdivision 1. [COLLECTION AND MAINTENANCE.] A licensee 12.33 shall collect and provide prehospital care data to the board in 12.34 a manner prescribed by the board. At a minimum, the data must 12.35 include items identified by the board that are part of the 12.36 National Uniform Emergency Medical Services Data Set. A 13.1 licensee shall maintain prehospital care data for every response. 13.2 Subd. 2. [COPY TO RECEIVING HOSPITAL.] If a patient is 13.3 transported to a hospital, a copy of the ambulance report 13.4 delineating prehospital medical care given shall be provided to 13.5 the receiving hospital. 13.6 Subd. 3. [REVIEW.] Prehospital care data may be reviewed 13.7 by the board or its designees. The data shall be classified as 13.8 private data on individuals under chapter 13, the Minnesota 13.9 Government Data Practices Act. 13.10 Subd. 4. [PENALTY.] Failure to report all information 13.11 required by the board under this section shall constitute 13.12 grounds for license revocation. 13.13 Sec. 30. [144E.125] [OPERATIONAL PROCEDURES.] 13.14 A licensee shall establish and implement written procedures 13.15 for responding to ambulance service complaints, maintaining 13.16 ambulances and equipment, procuring and storing drugs, and 13.17 controlling infection. The licensee shall maintain the 13.18 procedures in its files. 13.19 Sec. 31. [144E.127] [INTERHOSPITAL TRANSFER.] 13.20 When transporting a patient from one licensed hospital to 13.21 another, a licensee may substitute for one of the required 13.22 ambulance service personnel, a physician, a registered nurse, or 13.23 physician's assistant who has been trained to use the equipment 13.24 in the ambulance and is knowledgeable of the licensee's 13.25 ambulance service protocols. 13.26 Sec. 32. Minnesota Statutes 1998, section 144E.16, 13.27 subdivision 4, is amended to read: 13.28 Subd. 4. [TYPES OF SERVICES TO BE REGULATED.](a)The 13.29 board may adopt rules needed to regulate ambulance services in 13.30 the following areas: 13.31 (1) applications for licensure; 13.32 (2) personnel qualifications and staffing standards; 13.33 (3) quality of life support treatment; 13.34 (4) restricted treatments and procedures; 13.35 (5) equipment standards; 13.36 (6) ambulance standards; 14.1 (7) communication standards, equipment performance and 14.2 maintenance, and radio frequency assignments; 14.3 (8) advertising; 14.4 (9) scheduled ambulance services; 14.5 (10) ambulance services in time of disaster; 14.6 (11) basic, intermediate, advanced, and refresher emergency 14.7 care course programs; 14.8 (12) continuing education requirements; 14.9 (13) trip reports; 14.10 (14) license fees, vehicle fees, and expiration dates; and 14.11 (15) waivers and variances. 14.12(b) These rules shall apply to the following types of14.13ambulance service:14.14(1) basic ambulance service that provides a level of care14.15to ensure that life-threatening situations and potentially14.16serious injuries can be recognized, patients will be protected14.17from additional hazards, basic treatment to reduce the14.18seriousness of emergency situations will be administered, and14.19patients will be transported to an appropriate medical facility14.20for treatment;14.21(2) intermediate ambulance service that provides (i) basic14.22ambulance service, and (ii) intravenous infusions or14.23defibrillation or both;14.24(3) advanced ambulance service that provides (i) basic14.25ambulance service, and (ii) advanced airway management,14.26defibrillation, and administration of intravenous fluids and14.27pharmaceuticals. Vehicles of advanced ambulance service14.28licensees not equipped or staffed at the advanced ambulance14.29service level shall not be identified to the public as capable14.30of providing advanced ambulance service;14.31(4) specialized ambulance service that provides basic,14.32intermediate, or advanced service as designated by the board,14.33and is restricted by the board to (i) less than 24 hours of14.34every day, (ii) designated segments of the population, or (iii)14.35certain types of medical conditions; and14.36(5) air ambulance service, that includes fixed-wing and15.1helicopter, and is specialized ambulance service.15.2Until rules are promulgated, the current provisions of15.3Minnesota Rules shall govern these services.15.4 Sec. 33. Minnesota Statutes 1998, section 144E.18, is 15.5 amended to read: 15.6 144E.18 [INSPECTIONS.] 15.7 The board may inspect ambulance services as frequently as 15.8 deemed necessary to determine whether an ambulance service is in 15.9 compliance with sections 144E.001 to 144E.33 and rules adopted 15.10 under those sections.These inspections shall be for the15.11purpose of determining whether the ambulance and equipment is15.12clean and in proper working order and whether the operator is in15.13compliance with sections 144E.001 to 144E.16 and any rules that15.14the board adopts related to sections 144E.001 to 144E.16.The 15.15 board may review at any time documentation required to be on 15.16 file with a licensee. 15.17 Sec. 34. [144E.19] [DISCIPLINARY ACTION.] 15.18 Subdivision 1. [SUSPENSION; REVOCATION; NONRENEWAL.] The 15.19 board may suspend, revoke, refuse to renew, or place conditions 15.20 on the license of a licensee upon finding that the licensee has 15.21 violated a provision of this chapter or rules adopted under this 15.22 chapter or has ceased to provide the service for which the 15.23 licensee is licensed. 15.24 Subd. 2. [NOTICE; CONTESTED CASE.] (a) Before taking 15.25 action under subdivision 1, the board shall give notice to a 15.26 licensee of the right to a contested case hearing under chapter 15.27 14. If a licensee requests a contested case hearing within 30 15.28 days after receiving notice, the board shall initiate a 15.29 contested case hearing according to chapter 14. 15.30 (b) The administrative law judge shall issue a report and 15.31 recommendation within 30 days after closing the contested case 15.32 hearing record. The board shall issue a final order within 30 15.33 days after receipt of the administrative law judge's report. 15.34 Subd. 3. [TEMPORARY SUSPENSION.] (a) In addition to any 15.35 other remedy provided by law, the board may temporarily suspend 15.36 the license of a licensee after conducting a preliminary inquiry 16.1 to determine whether the board believes that the licensee has 16.2 violated a statute or rule that the board is empowered to 16.3 enforce and determining that the continued provision of service 16.4 by the licensee would create an imminent risk to public health 16.5 or harm to others. 16.6 (b) A temporary suspension order prohibiting a licensee 16.7 from providing ambulance service shall give notice of the right 16.8 to a preliminary hearing according to paragraph (d) and shall 16.9 state the reasons for the entry of the temporary suspension 16.10 order. 16.11 (c) Service of a temporary suspension order is effective 16.12 when the order is served on the licensee personally or by 16.13 certified mail, which is complete upon receipt, refusal, or 16.14 return for nondelivery to the most recent address provided to 16.15 the board for the licensee. 16.16 (d) At the time the board issues a temporary suspension 16.17 order, the board shall schedule a hearing, to be held before a 16.18 group of its members designated by the board, that shall begin 16.19 within 60 days after issuance of the temporary suspension order 16.20 or within 15 working days of the date of the board's receipt of 16.21 a request for a hearing from a licensee, whichever is sooner. 16.22 The hearing shall be on the sole issue of whether there is a 16.23 reasonable basis to continue, modify, or lift the temporary 16.24 suspension. A hearing under this paragraph is not subject to 16.25 chapter 14. 16.26 (e) Evidence presented by the board or licensee may be in 16.27 the form of an affidavit. The licensee or the licensee's 16.28 designee may appear for oral argument. 16.29 (f) Within five working days of the hearing, the board 16.30 shall issue its order and, if the suspension is continued, 16.31 notify the licensee of the right to a contested case hearing 16.32 under chapter 14. 16.33 (g) If a licensee requests a contested case hearing within 16.34 30 days after receiving notice under paragraph (f), the board 16.35 shall initiate a contested case hearing according to chapter 14. 16.36 The administrative law judge shall issue a report and 17.1 recommendation within 30 days after the closing of the contested 17.2 case hearing record. The board shall issue a final order within 17.3 30 days after receipt of the administrative law judge's report. 17.4 Sec. 35. [144E.26] [MEDICAL RESPONSE UNIT CERTIFICATION.] 17.5 Subdivision 1. [CERTIFICATION VOLUNTARY.] A medical 17.6 response unit that is routinely dispatched to the scene of 17.7 medical emergencies to provide care at a level consistent with 17.8 the scope of the United States Department of Transportation 17.9 first responder or emergency medical technician curriculum may 17.10 be certified by the board. 17.11 Subd. 2. [QUALIFICATIONS.] To be certified by the board, a 17.12 medical response unit shall: 17.13 (1) submit an application form prescribed by the board; 17.14 (2) submit a letter from the appropriate municipality, 17.15 township, or county governing body recognizing the medical 17.16 response unit as the unit in its geographical area designated to 17.17 respond to a medical emergency; 17.18 (3) be dispatched by a public safety answering point, as 17.19 defined under section 403.02, subdivision 5, or an ambulance 17.20 service; 17.21 (4) have a medical director, as provided under section 17.22 144E.265; 17.23 (5) be staffed by at least one first responder or one EMT 17.24 as appropriate to the level of care given; and 17.25 (6) submit the appropriate fee as required under section 17.26 144E.29. 17.27 Subd. 3. [RENEWAL REQUIREMENTS.] A medical response unit's 17.28 certification expires two years from the date of certification. 17.29 A medical response unit may apply to the board for renewal prior 17.30 to the expiration date of its certification and must: 17.31 (1) submit an application prescribed by the board 17.32 specifying any changes from the information provided for prior 17.33 approval and any other information requested by the board to 17.34 clarify incomplete or ambiguous information presented in the 17.35 application; 17.36 (2) comply with subdivision 2, clauses (2) to (6); and 18.1 (3) submit the appropriate fee as required under section 18.2 144E.29. 18.3 Sec. 36. [144E.265] [MEDICAL DIRECTOR.] 18.4 Subdivision 1. [REQUIREMENTS.] A medical director shall: 18.5 (1) be currently licensed as a physician in this state; 18.6 (2) have experience in, and knowledge of, emergency care of 18.7 acutely ill or traumatized patients; and 18.8 (3) be familiar with the design and operation of local, 18.9 regional, and state emergency medical service systems. 18.10 Subd. 2. [RESPONSIBILITIES.] Responsibilities of the 18.11 medical director shall include, but are not limited to: 18.12 (1) approving standards for training and orientation of 18.13 personnel that impact patient care; 18.14 (2) approving standards for purchasing equipment and 18.15 supplies that impact patient care; 18.16 (3) establishing standing orders for prehospital care; 18.17 (4) approving triage, treatment, and transportation 18.18 protocols; 18.19 (5) participating in the development and operation of 18.20 continuous quality improvement programs including, but not 18.21 limited to, case review and resolution of patient complaints; 18.22 (6) establishing procedures for the administration of 18.23 drugs; and 18.24 (7) maintaining the quality of care according to the 18.25 standards and procedures established under clauses (1) to (6). 18.26 Subd. 3. [ANNUAL ASSESSMENT; AMBULANCE SERVICE.] Annually, 18.27 the medical director or the medical director's designee shall 18.28 assess the practical skills of each person on the ambulance 18.29 service roster and sign a statement verifying the proficiency of 18.30 each person. The statements shall be maintained in the 18.31 licensee's files. 18.32 Sec. 37. Minnesota Statutes 1998, section 144E.27, is 18.33 amended by adding a subdivision to read: 18.34 Subd. 5. [DENIAL, SUSPENSION, REVOCATION.] (a) The board 18.35 may deny, suspend, revoke, place conditions on, or refuse to 18.36 renew the registration of an individual who the board determines: 19.1 (1) violates sections 144E.001 to 144E.33 or the rules 19.2 adopted under those sections; 19.3 (2) misrepresents or falsifies information on an 19.4 application form for registration; 19.5 (3) is convicted or pleads guilty or nolo contendere to any 19.6 felony or gross misdemeanor or any misdemeanor relating to 19.7 sexual misconduct or the illegal use of drugs or alcohol; 19.8 (4) is actually or potentially unable to provide emergency 19.9 medical services with reasonable skill and safety to patients by 19.10 reason of illness, use of alcohol, drugs, chemicals, or any 19.11 other material, or as a result of any mental or physical 19.12 condition; 19.13 (5) engages in unethical conduct, including, but not 19.14 limited to, conduct likely to deceive, defraud, or harm the 19.15 public, or demonstrating a willful or careless disregard for the 19.16 health, welfare, or safety of the public; or 19.17 (6) maltreats or abandons a patient. 19.18 (b) Before taking action under paragraph (a), the board 19.19 shall give notice to an individual of the right to a contested 19.20 case hearing under chapter 14. If an individual requests a 19.21 contested case hearing within 30 days after receiving notice, 19.22 the board shall initiate a contested case hearing according to 19.23 chapter 14. 19.24 (c) The administrative law judge shall issue a report and 19.25 recommendation within 30 days after closing the contested case 19.26 hearing record. The board shall issue a final order within 30 19.27 days after receipt of the administrative law judge's report. 19.28 (d) After six months from the board's decision to deny, 19.29 revoke, place conditions on, or refuse renewal of an 19.30 individual's registration for disciplinary action, the 19.31 individual shall have the opportunity to apply to the board for 19.32 reinstatement. 19.33 Sec. 38. Minnesota Statutes 1998, section 144E.27, is 19.34 amended by adding a subdivision to read: 19.35 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 19.36 other remedy provided by law, the board may temporarily suspend 20.1 the registration of an individual after conducting a preliminary 20.2 inquiry to determine whether the board believes that the 20.3 individual has violated a statute or rule that the board is 20.4 empowered to enforce and determining that the continued 20.5 provision of service by the individual would create an imminent 20.6 risk to public health or harm to others. 20.7 (b) A temporary suspension order prohibiting an individual 20.8 from providing emergency medical care shall give notice of the 20.9 right to a preliminary hearing according to paragraph (d) and 20.10 shall state the reasons for the entry of the temporary 20.11 suspension order. 20.12 (c) Service of a temporary suspension order is effective 20.13 when the order is served on the individual personally or by 20.14 certified mail, which is complete upon receipt, refusal, or 20.15 return for nondelivery to the most recent address provided to 20.16 the board for the individual. 20.17 (d) At the time the board issues a temporary suspension 20.18 order, the board shall schedule a hearing, to be held before a 20.19 group of its members designated by the board, that shall begin 20.20 within 60 days after issuance of the temporary suspension order 20.21 or within 15 working days of the date of the board's receipt of 20.22 a request for a hearing from the individual, whichever is 20.23 sooner. The hearing shall be on the sole issue of whether there 20.24 is a reasonable basis to continue, modify, or lift the temporary 20.25 suspension. A hearing under this paragraph is not subject to 20.26 chapter 14. 20.27 (e) Evidence presented by the board or the individual may 20.28 be in the form of an affidavit. The individual or the 20.29 individual's designee may appear for oral argument. 20.30 (f) Within five working days of the hearing, the board 20.31 shall issue its order and, if the suspension is continued, 20.32 notify the individual of the right to a contested case hearing 20.33 under chapter 14. 20.34 (g) If an individual requests a contested case hearing 20.35 within 30 days after receiving notice under paragraph (f), the 20.36 board shall initiate a contested case hearing according to 21.1 chapter 14. The administrative law judge shall issue a report 21.2 and recommendation within 30 days after the closing of the 21.3 contested case hearing record. The board shall issue a final 21.4 order within 30 days after receipt of the administrative law 21.5 judge's report. 21.6 Sec. 39. [144E.28] [CERTIFICATION OF EMT, EMT-I, AND 21.7 EMT-P.] 21.8 Subdivision 1. [REQUIREMENTS.] To be eligible for 21.9 certification by the board as an EMT, EMT-I, or EMT-P, an 21.10 individual shall: 21.11 (1) successfully complete the United States Department of 21.12 Transportation course, or its equivalent as approved by the 21.13 board, specific to the EMT, EMT-I, or EMT-P classification; 21.14 (2) pass the written and practical examinations approved by 21.15 the board and administered by the board or its designee, 21.16 specific to the EMT, EMT-I, or EMT-P classification; and 21.17 (3) submit the appropriate fee as required under section 21.18 144E.29. 21.19 Subd. 2. [EXPIRATION DATES.] Certification expiration 21.20 dates are as follows: 21.21 (1) for initial certification granted between January 1 and 21.22 June 30 of an even-numbered year, the expiration date is March 21.23 31 of the next even-numbered year; 21.24 (2) for initial certification granted between July 1 and 21.25 December 31 of an even-numbered year, the expiration date is 21.26 March 31 of the second odd-numbered year; 21.27 (3) for initial certification granted between January 1 and 21.28 June 30 of an odd-numbered year, the expiration date is March 31 21.29 of the next odd-numbered year; and 21.30 (4) for initial certification granted between July 1 and 21.31 December 31 of an odd-numbered year, the expiration date is 21.32 March 31 of the second even-numbered year. 21.33 Subd. 3. [RECIPROCITY.] The board may certify an 21.34 individual who possesses a current National Registry of 21.35 Emergency Medical Technicians registration from another 21.36 jurisdiction and submits the appropriate fee as required under 22.1 section 144E.29. The board certification classification shall 22.2 be the same as the National Registry's classification. 22.3 Certification shall be for the duration of the applicant's 22.4 registration period in another jurisdiction, not to exceed two 22.5 years. 22.6 Subd. 4. [DENIAL, SUSPENSION, REVOCATION.] (a) The board 22.7 may deny, suspend, revoke, place conditions on, or refuse to 22.8 renew the certification of an individual who the board 22.9 determines: 22.10 (1) violates sections 144E.001 to 144E.33 or the rules 22.11 adopted under those sections; 22.12 (2) misrepresents or falsifies information on an 22.13 application form for certification; 22.14 (3) is convicted or pleads guilty or nolo contendere to any 22.15 felony or gross misdemeanor or any misdemeanor relating to 22.16 sexual misconduct or the illegal use of drugs or alcohol; 22.17 (4) is actually or potentially unable to provide emergency 22.18 medical services with reasonable skill and safety to patients by 22.19 reason of illness, use of alcohol, drugs, chemicals, or any 22.20 other material, or as a result of any mental or physical 22.21 condition; 22.22 (5) engages in unethical conduct, including, but not 22.23 limited to, conduct likely to deceive, defraud, or harm the 22.24 public or demonstrating a willful or careless disregard for the 22.25 health, welfare, or safety of the public; or 22.26 (6) maltreats or abandons a patient. 22.27 (b) Before taking action under paragraph (a), the board 22.28 shall give notice to an individual of the right to a contested 22.29 case hearing under chapter 14. If an individual requests a 22.30 contested case hearing within 30 days after receiving notice, 22.31 the board shall initiate a contested case hearing according to 22.32 chapter 14 and no disciplinary action shall be taken at that 22.33 time. 22.34 (c) The administrative law judge shall issue a report and 22.35 recommendation within 30 days after closing the contested case 22.36 hearing record. The board shall issue a final order within 30 23.1 days after receipt of the administrative law judge's report. 23.2 (d) After six months from the board's decision to deny, 23.3 revoke, place conditions on, or refuse renewal of an 23.4 individual's certification for disciplinary action, the 23.5 individual shall have the opportunity to apply to the board for 23.6 reinstatement. 23.7 Subd. 5. [TEMPORARY SUSPENSION.] (a) In addition to any 23.8 other remedy provided by law, the board may temporarily suspend 23.9 the certification of an individual after conducting a 23.10 preliminary inquiry to determine whether the board believes that 23.11 the individual has violated a statute or rule that the board is 23.12 empowered to enforce and determining that the continued 23.13 provision of service by the individual would create an imminent 23.14 risk to public health or harm to others. 23.15 (b) A temporary suspension order prohibiting an individual 23.16 from providing emergency medical care shall give notice of the 23.17 right to a preliminary hearing according to paragraph (d) and 23.18 shall state the reasons for the entry of the temporary 23.19 suspension order. 23.20 (c) Service of a temporary suspension order is effective 23.21 when the order is served on the individual personally or by 23.22 certified mail, which is complete upon receipt, refusal, or 23.23 return for nondelivery to the most recent address provided to 23.24 the board for the individual. 23.25 (d) At the time the board issues a temporary suspension 23.26 order, the board shall schedule a hearing, to be held before a 23.27 group of its members designated by the board, that shall begin 23.28 within 60 days after issuance of the temporary suspension order 23.29 or within 15 working days of the date of the board's receipt of 23.30 a request for a hearing from the individual, whichever is 23.31 sooner. The hearing shall be on the sole issue of whether there 23.32 is a reasonable basis to continue, modify, or lift the temporary 23.33 suspension. A hearing under this paragraph is not subject to 23.34 chapter 14. 23.35 (e) Evidence presented by the board or the individual may 23.36 be in the form of an affidavit. The individual or individual's 24.1 designee may appear for oral argument. 24.2 (f) Within five working days of the hearing, the board 24.3 shall issue its order and, if the suspension is continued, 24.4 notify the individual of the right to a contested case hearing 24.5 under chapter 14. 24.6 (g) If an individual requests a contested case hearing 24.7 within 30 days of receiving notice under paragraph (f), the 24.8 board shall initiate a contested case hearing according to 24.9 chapter 14. The administrative law judge shall issue a report 24.10 and recommendation within 30 days after the closing of the 24.11 contested case hearing record. The board shall issue a final 24.12 order within 30 days after receipt of the administrative law 24.13 judge's report. 24.14 Subd. 6. [RENEWAL.] (a) Before the expiration date of 24.15 certification, an applicant for renewal of certification as an 24.16 EMT shall: 24.17 (1) successfully complete a course in cardiopulmonary 24.18 resuscitation that is approved by the board or the licensee's 24.19 medical director; 24.20 (2) take the United States Department of Transportation EMT 24.21 refresher course and successfully pass the practical skills test 24.22 portion of the course, or successfully complete 48 hours of 24.23 continuing education in EMT programs that are consistent with 24.24 the United States Department of Transportation National Standard 24.25 Curriculum or its equivalent as approved by the board or as 24.26 approved by the licensee's medical director and pass a practical 24.27 skills test approved by the board and administered by a training 24.28 program approved by the board. Twenty-four of the 48 hours must 24.29 include at least four hours of instruction in each of the 24.30 following six categories: 24.31 (i) airway management and resuscitation procedures; 24.32 (ii) circulation, bleeding control, and shock; 24.33 (iii) human anatomy and physiology, patient assessment, and 24.34 medical emergencies; 24.35 (iv) injuries involving musculoskeletal, nervous, 24.36 digestive, and genito-urinary systems; 25.1 (v) environmental emergencies and rescue techniques; and 25.2 (vi) emergency childbirth and other special situations; and 25.3 (3) submit the appropriate fee as required under section 25.4 144E.29. 25.5 (b) Before the expiration date of certification, an 25.6 applicant for renewal of certification as an EMT-I or EMT-P 25.7 shall: 25.8 (1) for an EMT-I, successfully complete a course in 25.9 cardiopulmonary resuscitation that is approved by the board or 25.10 the licensee's medical director and for an EMT-P, successfully 25.11 complete a course in advanced cardiac life support that is 25.12 approved by the board or the licensee's medical director; 25.13 (2) successfully complete 48 hours of continuing education 25.14 in emergency medical training programs, appropriate to the level 25.15 of the applicant's EMT-I or EMT-P certification, that are 25.16 consistent with the United States Department of Transportation 25.17 National Standard Curriculum or its equivalent as approved by 25.18 the board or as approved by the licensee's medical director. An 25.19 applicant may take the United States Department of 25.20 Transportation Emergency Medical Technician refresher course or 25.21 its equivalent without the written or practical test as approved 25.22 by the board, and as appropriate to the applicant's level of 25.23 certification, as part of the 48 hours of continuing education. 25.24 Each hour of the refresher course counts toward the 48-hour 25.25 continuing education requirement; and 25.26 (3) submit the appropriate fee required under section 25.27 144E.29. 25.28 (c) Continuing education credit may be given for the 25.29 following programs that comply with the requirements of 25.30 paragraph (d): 25.31 (1) emergency medical training courses; 25.32 (2) conventions; 25.33 (3) workshops and seminars; 25.34 (4) lectures; 25.35 (5) correspondence work; and 25.36 (6) self-study. 26.1 (d) No program shall be given credit that involves 26.2 television viewing in the home, correspondence work, or 26.3 self-study unless approved by the Continuing Education 26.4 Coordinating Board for Emergency Medical Services or the board. 26.5 (e) Certification shall be renewed every two years. 26.6 (f) If the applicant does not meet the renewal requirements 26.7 under this subdivision, the applicant's certification expires. 26.8 Subd. 7. [REINSTATEMENT.] (a) Within four years of a 26.9 certification expiration date, a person whose certification has 26.10 expired under subdivision 6, paragraph (f), may have the 26.11 certification reinstated upon submission of evidence to the 26.12 board of training equivalent to the continuing education 26.13 requirements of subdivision 6 and upon payment of the 26.14 certification fee. 26.15 (b) If more than four years have passed since a certificate 26.16 expiration date, an applicant must complete the initial 26.17 certification process required under subdivision 1. 26.18 Sec. 40. [144E.283] [EMT INSTRUCTOR CERTIFICATION.] 26.19 Subdivision 1. [QUALIFICATIONS.] The board shall grant 26.20 certification as an emergency medical technician instructor to 26.21 an applicant who files a completed application and furnishes 26.22 evidence satisfactory to the board that the applicant: 26.23 (1) possesses valid certification, registration, or 26.24 licensure as an EMT, EMT-I, EMT-P, physician, physician's 26.25 assistant, or registered nurse; 26.26 (2) has two years of active emergency medical practical 26.27 experience; 26.28 (3) is recommended by a medical director of a licensed 26.29 hospital, ambulance service, or training program approved by the 26.30 board; 26.31 (4) successfully completes the United States Department of 26.32 Transportation Emergency Medical Services Instructor Training 26.33 Program or its equivalent as approved by the board; and 26.34 (5) submits the appropriate fee as required under section 26.35 144E.29. 26.36 Subd. 2. [EXPIRATION.] Certification expires two years 27.1 from the date of the initial certification and must be renewed 27.2 every two years. 27.3 Subd. 3. [RENEWAL.] (a) An applicant shall submit an 27.4 application to the board for renewal at least three months prior 27.5 to the expiration date of the certification and must furnish 27.6 evidence satisfactory to the board that the applicant: 27.7 (1) complies with the requirements of subdivision 1; 27.8 (2) has at least 40 hours of experience as an instructor in 27.9 an emergency medical technician course approved by the board 27.10 under section 144E.285; and 27.11 (3) has attended at least eight hours of continuing 27.12 education encompassing the course topics of the United States 27.13 Department of Transportation national standard curriculum for an 27.14 Emergency Medical Services Instructor Training Program or its 27.15 equivalent as approved by the board. 27.16 (b) An emergency medical technician instructor whose 27.17 certification expires for nonrenewal must obtain a new 27.18 certification by applying to the board and meeting the 27.19 requirements of subdivision 1. 27.20 Sec. 41. [144E.285] [TRAINING PROGRAMS.] 27.21 Subdivision 1. [APPROVAL REQUIRED.] (a) All training 27.22 programs for an EMT, EMT-I, or EMT-P must be approved by the 27.23 board. 27.24 (b) To be approved by the board, a training program must: 27.25 (1) submit an application prescribed by the board that 27.26 includes: 27.27 (i) type and length of course to be offered; 27.28 (ii) names, addresses, and qualifications of the program 27.29 medical director, program training coordinator, and certified 27.30 instructors; 27.31 (iii) names and addresses of clinical sites, including a 27.32 contact person and telephone number; 27.33 (iv) admission criteria for students; and 27.34 (v) materials and equipment to be used; 27.35 (2) for each course, implement the most current version of 27.36 the United States Department of Transportation curriculum or its 28.1 equivalent as determined by the board applicable to EMT, EMT-I, 28.2 or EMT-P training; 28.3 (3) have a program medical director and a program 28.4 coordinator; 28.5 (4) utilize instructors certified under section 144E.283 28.6 for teaching at least 50 percent of the course content. The 28.7 remaining 50 percent of the course may be taught by guest 28.8 lecturers approved by the training program coordinator or 28.9 medical director; 28.10 (5) have at least one instructor for every ten students at 28.11 the practical skill stations; 28.12 (6) maintain a written agreement with a licensed hospital 28.13 or licensed ambulance service designating a clinical training 28.14 site; 28.15 (7) retain documentation of program approval by the board, 28.16 course outline, and student information; 28.17 (8) notify the board of the starting date of a course prior 28.18 to the beginning of a course; and 28.19 (9) submit the appropriate fee as required under section 28.20 144E.29. 28.21 Subd. 2. [EMT-P REQUIREMENTS.] (a) In addition to the 28.22 requirements under subdivision 1, paragraph (b), a training 28.23 program applying for approval to teach EMT-P curriculum must be 28.24 administered by an educational institution accredited by the 28.25 Commission of Accreditation of Allied Health Education Programs 28.26 (CAAHEP). 28.27 (b) An EMT-P training program that is administered by an 28.28 educational institution not accredited by CAAHEP, but that is in 28.29 the process of completing the accreditation process, may be 28.30 granted provisional approval by the board upon verification of 28.31 submission of its self-study report and the appropriate review 28.32 fee to CAAHEP. 28.33 (c) An educational institution that discontinues its 28.34 participation in the accreditation process must notify the board 28.35 immediately and provisional approval shall be withdrawn. 28.36 Subd. 3. [EXPIRATION.] Training program approval shall 29.1 expire two years from the date of approval. 29.2 Subd. 4. [REAPPROVAL.] A training program shall apply to 29.3 the board for reapproval at least three months prior to the 29.4 expiration date of its approval and must: 29.5 (1) submit an application prescribed by the board 29.6 specifying any changes from the information provided for prior 29.7 approval and any other information requested by the board to 29.8 clarify incomplete or ambiguous information presented in the 29.9 application; and 29.10 (2) comply with the requirements under subdivision 1, 29.11 paragraph (b), clauses (2) to (8). 29.12 Subd. 5. [DISCIPLINARY ACTION.] (a) The board may deny, 29.13 suspend, revoke, place conditions on, or refuse to renew 29.14 approval of a training program that the board determines: 29.15 (1) violated subdivisions 1 to 4 or rules adopted under 29.16 sections 144E.001 to 144E.33; or 29.17 (2) misrepresented or falsified information on an 29.18 application form provided by the board. 29.19 (b) Before taking action under paragraph (a), the board 29.20 shall give notice to a training program of the right to a 29.21 contested case hearing under chapter 14. If a training program 29.22 requests a contested case hearing within 30 days after receiving 29.23 notice, the board shall initiate a contested case hearing 29.24 according to chapter 14. 29.25 (c) The administrative law judge shall issue a report and 29.26 recommendation within 30 days after closing the contested case 29.27 hearing record. The board shall issue a final order within 30 29.28 days after receipt of the administrative law judge's report. 29.29 (d) After six months from the board's decision to deny, 29.30 revoke, place conditions on, or refuse approval of a training 29.31 program for disciplinary action, the training program shall have 29.32 the opportunity to apply to the board for reapproval. 29.33 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 29.34 other remedy provided by law, the board may temporarily suspend 29.35 approval of the training program after conducting a preliminary 29.36 inquiry to determine whether the board believes that the 30.1 training program has violated a statute or rule that the board 30.2 is empowered to enforce and determining that the continued 30.3 provision of service by the training program would create an 30.4 imminent risk to public health or harm to others. 30.5 (b) A temporary suspension order prohibiting the training 30.6 program from providing emergency medical care training shall 30.7 give notice of the right to a preliminary hearing according to 30.8 paragraph (d) and shall state the reasons for the entry of the 30.9 temporary suspension order. 30.10 (c) Service of a temporary suspension order is effective 30.11 when the order is served on the training program personally or 30.12 by certified mail, which is complete upon receipt, refusal, or 30.13 return for nondelivery to the most recent address provided to 30.14 the board for the training program. 30.15 (d) At the time the board issues a temporary suspension 30.16 order, the board shall schedule a hearing, to be held before a 30.17 group of its members designated by the board, that shall begin 30.18 within 60 days after issuance of the temporary suspension order 30.19 or within 15 working days of the date of the board's receipt of 30.20 a request for a hearing from the training program, whichever is 30.21 sooner. The hearing shall be on the sole issue of whether there 30.22 is a reasonable basis to continue, modify, or lift the temporary 30.23 suspension. A hearing under this paragraph is not subject to 30.24 chapter 14. 30.25 (e) Evidence presented by the board or the individual may 30.26 be in the form of an affidavit. The training program or counsel 30.27 of record may appear for oral argument. 30.28 (f) Within five working days of the hearing, the board 30.29 shall issue its order and, if the suspension is continued, 30.30 notify the training program of the right to a contested case 30.31 hearing under chapter 14. 30.32 (g) If a training program requests a contested case hearing 30.33 within 30 days of receiving notice under paragraph (f), the 30.34 board shall initiate a contested case hearing according to 30.35 chapter 14. The administrative law judge shall issue a report 30.36 and recommendation within 30 days after the closing of the 31.1 contested case hearing record. The board shall issue a final 31.2 order within 30 days after receipt of the administrative law 31.3 judge's report. 31.4 Subd. 7. [AUDIT.] The board may audit training programs 31.5 approved by the board. The audit may include, but is not 31.6 limited to, investigation of complaints, course inspection, 31.7 classroom observation, review of instructor qualifications, and 31.8 student interviews. 31.9 Sec. 42. [144E.286] [EXAMINER QUALIFICATIONS FOR EMERGENCY 31.10 MEDICAL TECHNICIAN TESTING.] 31.11 Subdivision 1. [EMT TESTING.] An examiner testing basic 31.12 level EMT practical skills must: 31.13 (1) be certified as an EMT, EMT-I, or EMT-P; 31.14 (2) have two years or 4,000 hours' experience in emergency 31.15 medical care; 31.16 (3) be certified in basic cardiac life support; and 31.17 (4) be approved by the board. 31.18 Subd. 2. [EMT-I OR EMT-P TESTING.] (a) An examiner testing 31.19 EMT-I or EMT-P level practical skills must be approved by the 31.20 board and: 31.21 (1) be a physician or registered nurse; or 31.22 (2) be a certified EMT-P, have two years or 4,000 hours' 31.23 experience in emergency medical care and be certified in basic 31.24 cardiac life support. 31.25 (b) A physician must be available to answer questions 31.26 relating to the evaluation of skill performance at the practical 31.27 examination. 31.28 Sec. 43. [144E.29] [FEES.] 31.29 (a) The board shall charge the following fees: 31.30 (1) initial application for and renewal of an ambulance 31.31 service license, $150; 31.32 (2) each ambulance operated by a licensee, $96. The 31.33 licensee shall pay an additional $96 fee for the full licensing 31.34 period or $4 per month for any fraction of the period for each 31.35 ambulance added to the ambulance service during the licensing 31.36 period; 32.1 (3) initial application for and renewal of certification as 32.2 an EMT, EMT-I, or EMT-P, $10; 32.3 (4) initial application for and renewal of certification as 32.4 a medical response unit, $20; 32.5 (5) initial application for and renewal of certification as 32.6 an EMT instructor, $10; 32.7 (6) initial application for and renewal of approval for a 32.8 training program, $100; and 32.9 (7) duplicate of an original license, certification, or 32.10 approval, $25. 32.11 (b) With the exception of paragraph (a), clause (7), all 32.12 fees are for a two-year period. All fees are nonrefundable. 32.13 (c) Fees collected by the board shall be deposited as 32.14 nondedicated receipts in the trunk highway fund. 32.15 Sec. 44. [144E.305] [REPORTING MISCONDUCT.] 32.16 Subdivision 1. [VOLUNTARY REPORTING.] A person who has 32.17 knowledge of any conduct constituting grounds for discipline 32.18 under section 144E.27, subdivision 5, or 144E.28, subdivision 4, 32.19 may report the alleged violation to the board. 32.20 Subd. 2. [MANDATORY REPORTING.] (a) A licensee or medical 32.21 response unit shall report to the board conduct by a first 32.22 responder, EMT, EMT-I, or EMT-P that it reasonably believes 32.23 constitutes grounds for disciplinary action under section 32.24 144E.27, subdivision 5, or 144E.28, subdivision 4. 32.25 (b) A licensee or medical response unit shall report to the 32.26 board any disciplinary action it takes to limit the scope of 32.27 practice of a first responder, EMT, EMT-I, or EMT-P including, 32.28 but not limited to, dismissal from employment. A licensee or 32.29 medical response unit shall report the resignation of a first 32.30 responder, EMT, EMT-I, or EMT-P before the conclusion of any 32.31 disciplinary proceeding or before commencement of formal charges 32.32 but after the first responder, EMT, EMT-I, or EMT-P has 32.33 knowledge that formal charges are contemplated or in 32.34 preparation. Reporting under this paragraph is required only if 32.35 the action pertains to grounds for disciplinary action under 32.36 section 144E.27, subdivision 5, or 144E.28, subdivision 4. 33.1 (c) An individual registered or certified by the board 33.2 under section 144E.27 or 144E.28 shall report to the board 33.3 personal knowledge of conduct by a first responder, EMT, EMT-I, 33.4 or EMT-P the individual reasonably believes constitutes grounds 33.5 for disciplinary action under section 144E.27, subdivision 5, or 33.6 144E.28, subdivision 4. 33.7 Subd. 3. [IMMUNITY.] (a) An individual, licensee, medical 33.8 response unit, health care facility, business, or organization 33.9 is immune from civil liability or criminal prosecution for 33.10 submitting in good faith a report to the board under subdivision 33.11 1 or 2 or for otherwise reporting in good faith to the board 33.12 violations or alleged violations of sections 144E.001 to 144E.33. 33.13 Reports are classified as confidential data on individuals or 33.14 protected nonpublic data under section 13.02 while an 33.15 investigation is active. All communications or information 33.16 received by or disclosed to the board relating to disciplinary 33.17 matters of any person or entity subject to the board's 33.18 regulatory jurisdiction are confidential and privileged and any 33.19 disciplinary hearing shall be closed to the public. 33.20 (b) Members of the board, persons employed by the board, 33.21 persons engaged in the investigation of violations and in the 33.22 preparation and management of charges of violations of sections 33.23 144E.001 to 144E.33 on behalf of the board, and persons 33.24 participating in the investigation regarding charges of 33.25 violations are immune from civil liability and criminal 33.26 prosecution for any actions, transactions, or publications, made 33.27 in good faith, in the execution of, or relating to, their duties 33.28 under sections 144E.001 to 144E.33. 33.29 (c) For purposes of this section, a member of the board is 33.30 considered a state employee under section 3.736, subdivision 9. 33.31 Sec. 45. [144E.31] [CORRECTION ORDER AND FINES.] 33.32 Subdivision 1. [CORRECTION ORDER.] (a) If the board finds 33.33 that a licensee or training program has failed to comply with an 33.34 applicable law or rule and the violation does not imminently 33.35 endanger the public health or safety, the board may issue a 33.36 correction order to the licensee or training program. 34.1 (b) The correction order shall state: 34.2 (1) the conditions that constitute a violation of the law 34.3 or rule; 34.4 (2) the specific law or rule violated; and 34.5 (3) the time allowed to correct the violation. 34.6 Subd. 2. [RECONSIDERATION.] (a) If the licensee or 34.7 training program believes that the contents of the board's 34.8 correction order are in error, the licensee or training program 34.9 may ask the board to reconsider the parts of the correction 34.10 order that are alleged to be in error. 34.11 (b) The request for reconsideration must: 34.12 (1) be in writing; 34.13 (2) be delivered by certified mail; 34.14 (3) specify the parts of the correction order that are 34.15 alleged to be in error; 34.16 (4) explain why they are in error; and 34.17 (5) include documentation to support the allegation of 34.18 error. 34.19 (c) A request for reconsideration does not stay any 34.20 provision or requirement of the correction order. The board's 34.21 disposition of a request for reconsideration is final and not 34.22 subject to appeal under chapter 14. 34.23 Subd. 3. [FINE.] (a) The board may order a fine 34.24 concurrently with the issuance of a correction order, or after 34.25 the licensee or training program has not corrected the violation 34.26 within the time specified in the correction order. 34.27 (b) A licensee or training program that is ordered to pay a 34.28 fine shall be notified of the order by certified mail. The 34.29 notice shall be mailed to the address shown on the application 34.30 or the last known address of the licensee or training program. 34.31 The notice shall state the reasons the fine was ordered and 34.32 shall inform the licensee or training program of the right to a 34.33 contested case hearing under chapter 14. 34.34 (c) A licensee or training program may appeal the order to 34.35 pay a fine by notifying the board by certified mail within 15 34.36 calendar days after receiving the order. A timely appeal shall 35.1 stay payment of the fine until the board issues a final order. 35.2 (d) A licensee or training program shall pay the fine 35.3 assessed on or before the payment date specified in the board's 35.4 order. If a licensee or training program fails to fully comply 35.5 with the order, the board shall suspend the license or cancel 35.6 approval until there is full compliance with the order. 35.7 (e) Fines shall be assessed as follows: 35.8 (1) $150 for violation of section 144E.123; 35.9 (2) $400 for violation of sections 144E.06, 144E.07, 35.10 144E.101, 144E.103, 144E.121, 144E.125, 144E.265, 144E.285, and 35.11 144E.305; 35.12 (3) $750 for violation of rules adopted under section 35.13 144E.16, subdivision 4, clause (8); and 35.14 (4) $50 for violation of all other sections under this 35.15 chapter or rules adopted under this chapter that are not 35.16 specifically enumerated in clauses (1) to (3). 35.17 (f) Fines collected by the board shall be deposited as 35.18 nondedicated receipts in the trunk highway fund. 35.19 Subd. 4. [ADDITIONAL PENALTIES.] This section does not 35.20 prohibit the board from suspending, revoking, placing conditions 35.21 on, or refusing to renew a licensee's license or a training 35.22 program's approval in addition to ordering a fine. 35.23 Sec. 46. [144E.33] [PENALTY.] 35.24 A person who violates a provision of sections 144E.001 to 35.25 144E.33 is guilty of a misdemeanor. 35.26 Sec. 47. Minnesota Statutes 1998, section 145A.02, 35.27 subdivision 10, is amended to read: 35.28 Subd. 10. [EMERGENCY MEDICAL CARE.] "Emergency medical 35.29 care" means activities intended to protect the health of persons 35.30 suffering a medical emergency and to ensure rapid and effective 35.31 emergency medical treatment. These activities include the 35.32 coordination or provision of training, cooperation with public 35.33 safety agencies, communications, life-support transportationas35.34definedundersection 144E.16sections 144E.06 to 144E.19, 35.35 public information and involvement, and system management. 35.36 Sec. 48. [REVISOR'S INSTRUCTION.] 36.1 In each section of Minnesota Statutes referred to in column 36.2 A, the revisor of statutes shall delete the reference in column 36.3 B and insert the reference in column C. 36.4 Column A Column B Column C 36.5 144E.10, subd. 2 144E.16 144E.101 to 144E.127 36.6 144E.12 144E.16 144E.121 to 144E.127 36.7 144E.13 144E.16 144E.101 to 144E.127 36.8 144E.14 144E.16 144E.101 to 144E.127 36.9 144E.35, subd. 1 144E.16 144E.285 36.10 144E.41 144E.16 144E.265 or 144E.28 36.11 353.64, subd. 10 144E.16 144E.28 36.12 147A.09, subd. 2 144E.16, 144E.127 36.13 subd. 2, 36.14 para. (c) 36.15 Sec. 49. [REPEALER.] 36.16 Minnesota Statutes 1998, sections 144E.16, subdivisions 1, 36.17 2, 3, and 6; 144E.17; 144E.25; and 144E.30, subdivisions 1, 2, 36.18 and 6, are repealed. Minnesota Rules, parts 4690.0100, subparts 36.19 4, 13, 15, 19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 36.20 4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, subparts 36.21 1 and 2; 4690.0900; 4690.1000; 4690.1100; 4690.1200; 4690.1300; 36.22 4690.1600; 4690.1700; 4690.2100; 4690.2200, subparts 1, 3, 4, 36.23 and 5; 4690.2300; 4690.2400, subparts 1, 2, and 3; 4690.2500; 36.24 4690.2900; 4690.3000; 4690.3700; 4690.3900; 4690.4000; 36.25 4690.4100; 4690.4200; 4690.4300; 4690.4400; 4690.4500; 36.26 4690.4600; 4690.4700; 4690.4800; 4690.4900; 4690.5000; 36.27 4690.5100; 4690.5200; 4690.5300; 4690.5400; 4690.5500; 36.28 4690.5700; 4690.5800; 4690.5900; 4690.6000; 4690.6100; 36.29 4690.6200; 4690.6300; 4690.6400; 4690.6500; 4690.6600; 36.30 4690.6700; 4690.6800; 4690.7000; 4690.7100; 4690.7200; 36.31 4690.7300; 4690.7400; 4690.7500; 4690.7600; 4690.7700; 36.32 4690.7800; 4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000, 36.33 are repealed.