language to be deleted (2) new language
relating to emergency medical services; modifying certain provisions to include advanced emergency medical technicians; updating inspection provisions; providing requirements for emergency medical responder registration;
amending Minnesota Statutes 2012, sections 144E.101, subdivision 7; 144E.18; 144E.27, subdivision 1, by adding a subdivision; 144E.285, subdivisions 2, 4.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
(a) Except as provided in paragraphs (f) and (g), an advanced life-support ambulance shall be staffed by at least:
(1) one EMT and one paramedic;
(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 an education 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 an education program.
(b) An advanced life-support service shall provide basic life support, as specified under subdivision 6, paragraph (a), advanced airway management, manual defibrillation, and administration of intravenous fluids and pharmaceuticals.
(c) In addition to providing advanced life support, an advanced life-support service may staff additional ambulances to provide basic life support according to subdivision 6 and section 144E.103, subdivision 1.
(d) An ambulance service providing advanced life support shall have a written agreement with its medical director to ensure medical control for patient care 24 hours a day, seven days a week. The terms of the agreement shall include a written policy on the administration of medical control for the service. The policy shall address the following issues:
(1) two-way communication for physician direction of ambulance service personnel;
(2) patient triage, treatment, and transport;
(3) use of standing orders; and
(4) the means by which medical control will be provided 24 hours a day.
The agreement shall be signed by the licensee's medical director and the licensee or the licensee's designee and maintained in the files of the licensee.
(e) When an ambulance service provides advanced life support, the authority of a paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician assistant-EMT to determine the delivery of patient care prevails over the authority of an EMT.
(f) Upon application from an ambulance service that includes evidence demonstrating hardship, the board may grant a variance from the staff requirements in paragraph (a), clause (1), and may authorize an advanced life-support ambulance to be staffed by a registered emergency medical responder driver with a paramedic for all emergency calls and interfacility transfers. The variance shall apply to advanced life-support ambulance services until the ambulance service renews its license. When the variance expires, an ambulance service may apply for a new variance under this paragraph. This paragraph applies only to an ambulance service whose primary service area is mainly located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance based in a community with a population of less than 1,000 persons.
(g) After an initial emergency ambulance call, each subsequent emergency ambulance response, until the initial ambulance is again available, and interfacility transfers, may be staffed by one registered emergency medical responder driver and an EMT or paramedic. This paragraph applies only to an ambulance service whose primary service area is mainly located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance based in a community with a population of less than 1,000 persons.
The board may inspect ambulance services as frequently as deemed necessary to determine whether an ambulance service is in compliance with sections 144E.001 to 144E.33 and rules adopted under those sections. The board may review at any time documentation required to be on file with a licensee.
(a) Curriculum for initial and refresher education programs must meet the United States Department of Transportation Emergency Medical Responder Education Standards or its equivalent as determined by the board. An education program instructor must be an emergency medical responder, EMT, AEMT, paramedic, physician, physician assistant, or registered nurse.
(b) The National EMS Education Standards by the NHTSA, United States Department of Transportation contains the minimal entry level of knowledge and skills for emergency medical responders. Medical directors of emergency medical responder groups may expand the knowledge and skill set.
(a) In addition to the requirements under subdivision 1, paragraph (b), an education program applying for approval to teach paramedics must be administered by an educational institution accredited by the Commission of Accreditation of Allied Health Education Programs (CAAHEP).
(b) A paramedic education program that is administered by an educational institution not accredited by CAAHEP, but that is in the process of completing the accreditation process, may be granted provisional approval by the board upon verification of submission of its self-study report and the appropriate review fee to CAAHEP.
(c) An educational institution that discontinues its participation in the accreditation process must notify the board immediately and provisional approval shall be withdrawn.
(d) This subdivision does not apply to a paramedic education program when the program is operated by an advanced life-support ambulance service licensed by the Emergency Medical Services Regulatory Board under this chapter, and the ambulance service meets the following criteria:
(1) covers a rural primary service area that does not contain a hospital within the primary service area or contains a hospital within the primary service area that has been designated as a critical access hospital under section 144.1483, clause (11);
(2) has tax-exempt status in accordance with the Internal Revenue Code, section 501(c)(3);
(3) received approval before 1991 from the commissioner of health to operate a paramedic education program;
(4) operates the paramedic education program exclusively to train paramedics for the local ambulance service; and
(5) limits enrollment in the paramedic program to five candidates per biennium.
An education program shall apply to the board for reapproval at least three months prior to the expiration date of its approval and must:
(1) submit an application prescribed by the board specifying any changes from the information provided for prior approval and any other information requested by the board to clarify incomplete or ambiguous information presented in the application; and
(2) comply with the requirements under subdivision 1, paragraph (b), clauses (2) to (9).
Presented to the governor April 12, 2013
Signed by the governor April 15, 2013, 3:02 p.m.