HF 2591

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; allowing first responders to a basic life support ambulance with
certain conditions; allowing staffing flexibility for rural ambulance providers;
amending Minnesota Statutes 2006, section 144E.101, subdivision 7; Minnesota
Statutes 2007 Supplement, section 144E.101, subdivision 6.

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

Section 1.

Minnesota Statutes 2007 Supplement, section 144E.101, subdivision 6,
is amended to read:

Subd. 6.

Basic life support.

(a) deleted text begin Except as provided in paragraph (e), deleted text end A basic life
support ambulance shall be staffed by at least two ambulance service personnel, at least
one of which must be an EMT, who new text begin is responsible for patient care and the other attendant
may be a certified first responder. The ambulance service personnel shall new text end provide a level
of care deleted text begin so as deleted text end to ensure that:

(1) life-threatening situations and potentially serious injuries are recognized;

(2) patients are protected from additional hazards;

(3) basic treatment to reduce the seriousness of emergency situations is administered;
and

(4) patients are transported to an appropriate medical facility for treatment.

(b) A basic life support service shall provide basic airway management.

(c) By January 1, 2001, a basic life support service shall provide automatic
defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).

(d) A basic life support service licensee's medical director may authorize the
ambulance service personnel to carry and to use medical antishock trousers and to perform
intravenous infusion if the ambulance service personnel have been properly trained.

deleted text begin (e) Upon application from an ambulance service that includes evidence
demonstrating hardship, the board may grant a variance from the staff requirements in
paragraph (a) and may authorize a basic life support ambulance to be staffed by one EMT
and one first responder. The variance shall apply to basic life support ambulances operated
by the ambulance service until the ambulance service renews its license. When a variance
expires, an ambulance service may apply for a new variance under this paragraph. For
purposes of this paragraph, "ambulance service" means either an ambulance service whose
primary service area is 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 service based in a community with a population of less than 1,000. deleted text end

Sec. 2.

Minnesota Statutes 2006, section 144E.101, subdivision 7, is amended to read:

Subd. 7.

Advanced life support.

(a) An advanced life support ambulance shall be
staffed by at least:

(1) one EMT new text begin or registered first responder, new text end and one EMT-P;

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

(3) one EMT and one physician assistant who is an EMT, is currently practicing as a
physician assistant, and has passed a paramedic practical skills test approved by the board
and administered by a training 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. deleted text begin When routinely staffed and equipped as a basic life support service according to
subdivision 6 and section 144E.103, subdivision 1, the vehicle shall not be marked as
advanced life support. deleted text end new text begin This paragraph applies only to an ambulance service whose
primary service area is 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 service based in a community with a population of less than 1,000. new text end

(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:

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

(ii) patient triage, treatment, and transport;

(iii) use of standing orders; and

(iv) 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 an EMT-P, Minnesota registered nurse-EMT, or Minnesota registered physician
assistant-EMT to determine the delivery of patient care prevails over the authority of
an EMT.