1.1                          A bill for an act 
  1.2             relating to health; modifying standards for ambulance 
  1.3             services; providing for certification of emergency 
  1.4             medical technicians; providing for certification of 
  1.5             medical response units; providing for emergency 
  1.6             medical technician instructor certification; requiring 
  1.7             approval of training programs; setting fees; providing 
  1.8             criminal and civil penalties; amending Minnesota 
  1.9             Statutes 1996, section 13.99, by adding a subdivision; 
  1.10            Minnesota Statutes 1997 Supplement, sections 13.99, 
  1.11            subdivision 38a; 144E.001, by adding subdivisions; 
  1.12            144E.16, subdivision 4; 144E.18; 144E.35, subdivision 
  1.13            1; 144E.41; and 145A.02, subdivision 10; proposing 
  1.14            coding for new law in Minnesota Statutes, chapter 
  1.15            144E; repealing Minnesota Statutes 1997 Supplement, 
  1.16            sections 144E.16, subdivisions 1, 2, 3, and 6; 
  1.17            144E.17; 144E.25; and 144E.30, subdivisions 1, 2, and 
  1.18            6; Minnesota Rules, parts 4690.0100, subparts 4, 13, 
  1.19            15, 19, 20, 21, 22, 23, 24, 26, 27, 28, and 29; 
  1.20            4690.0300; 4690.0400; 4690.0500; 4690.0600; 4690.0700; 
  1.21            4690.0800, subparts 1, 2, and 3; 4690.0900; 4690.1000; 
  1.22            4690.1100; 4690.1200; 4690.1300; 4690.1600; 4690.1700; 
  1.23            4690.2100; 4690.2200; 4690.2300; 4690.2400; 4690.2500; 
  1.24            4690.2900; 4690.3000; 4690.3100; 4690.3600; 4690.3700; 
  1.25            4690.3900; 4690.4000; 4690.4100; 4690.4200; 4690.4300; 
  1.26            4690.4400; 4690.4500; 4690.4600; 4690.4700; 4690.4800; 
  1.27            4690.4900; 4690.5000; 4690.5100; 4690.5200; 4690.5300; 
  1.28            4690.5400; 4690.5500; 4690.5700; 4690.5800; 4690.5900; 
  1.29            4690.6000; 4690.6100; 4690.6200; 4690.6300; 4690.6400; 
  1.30            4690.6500; 4690.6600; 4690.6700; 4690.6800; 4690.7000; 
  1.31            4690.7100; 4690.7200; 4690.7300; 4690.7400; 4690.7500; 
  1.32            4690.7600; 4690.7700; 4690.7800; 4690.8300, subparts 
  1.33            1, 2, 3, 4, and 5; and 4735.5000. 
  1.34  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.35     Section 1.  Minnesota Statutes 1997 Supplement, section 
  1.36  13.99, subdivision 38a, is amended to read: 
  1.37     Subd. 38a.  [AMBULANCE SERVICE DATA.] Data required to be 
  1.38  reported by ambulance services under section 144E.17, 
  1.39  subdivision 1, 144E.123 are classified under that section. 
  2.1      Sec. 2.  Minnesota Statutes 1996, section 13.99, is amended 
  2.2   by adding a subdivision to read: 
  2.3      Subd. 39b.  [EMT MISCONDUCT.] Reports of emergency medical 
  2.4   technician misconduct are classified under section 144E.281, 
  2.5   subdivision 3. 
  2.6      Sec. 3.  Minnesota Statutes 1997 Supplement, section 
  2.7   144E.001, is amended by adding a subdivision to read: 
  2.8      Subd. 1a.  [ADVANCED AIRWAY MANAGEMENT.] "Advanced airway 
  2.9   management" means insertion of an endotracheal tube or creation 
  2.10  of a surgical airway.  
  2.11     Sec. 4.  Minnesota Statutes 1997 Supplement, section 
  2.12  144E.001, is amended by adding a subdivision to read: 
  2.13     Subd. 1b.  [ADVANCED LIFE SUPPORT.] "Advanced life support" 
  2.14  means rendering basic life support and rendering intravenous 
  2.15  therapy, drug therapy, intubation, and defibrillation as 
  2.16  outlined in an advanced emergency care course approved by the 
  2.17  board and meeting the current national paramedic curriculum of 
  2.18  the United States Department of Transportation. 
  2.19     Sec. 5.  Minnesota Statutes 1997 Supplement, section 
  2.20  144E.001, is amended by adding a subdivision to read: 
  2.21     Subd. 3a.  [AMBULANCE SERVICE PERSONNEL.] "Ambulance 
  2.22  service personnel" means EMTs, EMT-Is, or EMT-Ps certified by 
  2.23  the board and Minnesota licensed physicians who are authorized 
  2.24  by a licensed ambulance service to provide emergency care for 
  2.25  the ambulance service. 
  2.26     Sec. 6.  Minnesota Statutes 1997 Supplement, section 
  2.27  144E.001, is amended by adding a subdivision to read: 
  2.28     Subd. 4a.  [BASIC AIRWAY MANAGEMENT.] "Basic airway 
  2.29  management" means:  
  2.30     (1) resuscitation by mouth-to-mouth, mouth-to-mask, bag 
  2.31  valve mask, or oxygen powered ventilators; 
  2.32     (2) insertion of an oropharyngeal, nasal pharyngeal, 
  2.33  pharyngeal tracheo lumen esophageal obturator, or esophageal 
  2.34  gastric tube airway; or 
  2.35     (3) creation of an esophageal tracheal airway. 
  2.36     Sec. 7.  Minnesota Statutes 1997 Supplement, section 
  3.1   144E.001, is amended by adding a subdivision to read: 
  3.2      Subd. 4b.  [BASIC LIFE SUPPORT.] "Basic life support" means 
  3.3   rendering basic-level emergency care, including basic airway 
  3.4   management, cardiopulmonary resuscitation, controlling shock and 
  3.5   bleeding, and splinting fractures as outlined in a basic 
  3.6   emergency care course approved by the board and meeting the 
  3.7   current national curriculum of the United States Department of 
  3.8   Transportation. 
  3.9      Sec. 8.  Minnesota Statutes 1997 Supplement, section 
  3.10  144E.001, is amended by adding a subdivision to read: 
  3.11     Subd. 5a.  [CLINICAL TRAINING SITE.] "Clinical training 
  3.12  site" means a licensed health care facility or the facilities of 
  3.13  a licensed ambulance service. 
  3.14     Sec. 9.  Minnesota Statutes 1997 Supplement, section 
  3.15  144E.001, is amended by adding a subdivision to read: 
  3.16     Subd. 5b.  [DEFIBRILLATOR.] "Defibrillator" means an 
  3.17  automatic, semiautomatic, or manual device that delivers an 
  3.18  electric shock at a preset voltage to the myocardium through the 
  3.19  chest wall.  It is used for restoring the normal cardiac rhythm 
  3.20  and rate when the heart has stopped beating or is fibrillating. 
  3.21     Sec. 10.  Minnesota Statutes 1997 Supplement, section 
  3.22  144E.001, is amended by adding a subdivision to read: 
  3.23     Subd. 5c.  [EMERGENCY MEDICAL TECHNICIAN OR EMT.] 
  3.24  "Emergency medical technician" or "EMT" means a person who has 
  3.25  successfully completed the United States Department of 
  3.26  Transportation emergency medical technician-basic course or its 
  3.27  equivalent, as approved by the board, and has been issued valid 
  3.28  certification by the board. 
  3.29     Sec. 11.  Minnesota Statutes 1997 Supplement, section 
  3.30  144E.001, is amended by adding a subdivision to read: 
  3.31     Subd. 5d.  [EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE OR 
  3.32  EMT-I.] "Emergency medical technician-intermediate" or "EMT-I" 
  3.33  means a person who has successfully completed the United States 
  3.34  Department of Transportation emergency medical 
  3.35  technician-intermediate course or its equivalent, as approved by 
  3.36  the board, and has been issued valid certification by the board. 
  4.1      Sec. 12.  Minnesota Statutes 1997 Supplement, section 
  4.2   144E.001, is amended by adding a subdivision to read: 
  4.3      Subd. 5e.  [EMERGENCY MEDICAL TECHNICIAN-PARAMEDIC OR 
  4.4   EMT-P.] "Emergency medical technician-paramedic" or "EMT-P" 
  4.5   means a person who has successfully completed the United States 
  4.6   Department of Transportation emergency medical technician 
  4.7   course-paramedic or its equivalent, as approved by the board, 
  4.8   and has been issued valid certification by the board. 
  4.9      Sec. 13.  Minnesota Statutes 1997 Supplement, section 
  4.10  144E.001, is amended by adding a subdivision to read: 
  4.11     Subd. 5f.  [EMERGENCY MEDICAL TECHNICIAN 
  4.12  INSTRUCTOR.] "Emergency medical technician instructor" means a 
  4.13  person who has been certified by the board to teach an EMT, 
  4.14  EMT-I, or EMT-P course. 
  4.15     Sec. 14.  Minnesota Statutes 1997 Supplement, section 
  4.16  144E.001, is amended by adding a subdivision to read: 
  4.17     Subd. 8a.  [MEDICAL CONTROL.] "Medical control" means 
  4.18  direction by a physician of out-of-hospital emergency medical 
  4.19  care that is provided through direct oral communication by radio 
  4.20  or telephone. 
  4.21     Sec. 15.  Minnesota Statutes 1997 Supplement, section 
  4.22  144E.001, is amended by adding a subdivision to read: 
  4.23     Subd. 8b.  [MEDICAL RESPONSE UNIT.] "Medical response unit" 
  4.24  means an organized group of persons that has been certified by 
  4.25  the board to provide medical care at the scene of an injury, 
  4.26  illness, or pregnancy in an out-of-hospital setting.  A medical 
  4.27  response unit does not transport patients. 
  4.28     Sec. 16.  Minnesota Statutes 1997 Supplement, section 
  4.29  144E.001, is amended by adding a subdivision to read: 
  4.30     Subd. 9a.  [PREHOSPITAL CARE DATA.] "Prehospital care data" 
  4.31  means information collected by ambulance service personnel about 
  4.32  the circumstances related to an emergency response and patient 
  4.33  care activities provided by the ambulance service personnel in a 
  4.34  prehospital setting. 
  4.35     Sec. 17.  Minnesota Statutes 1997 Supplement, section 
  4.36  144E.001, is amended by adding a subdivision to read: 
  5.1      Subd. 11.  [STANDING ORDER.] "Standing order" means a type 
  5.2   of medical protocol that provides specific, written orders for 
  5.3   actions, techniques, or drug administration when communication 
  5.4   has not been established for direct medical control. 
  5.5      Sec. 18.  Minnesota Statutes 1997 Supplement, section 
  5.6   144E.001, is amended by adding a subdivision to read: 
  5.7      Subd. 12.  [TRAINING PROGRAM COORDINATOR.] "Training 
  5.8   program coordinator" means an individual who serves as the 
  5.9   administrator of an emergency care training program and who is 
  5.10  responsible for planning, conducting, and evaluating the 
  5.11  program; selecting students and certified instructors; 
  5.12  documenting and maintaining records; developing a curriculum; 
  5.13  and assisting in the coordination of examination sessions and 
  5.14  clinical training. 
  5.15     Sec. 19.  [144E.101] [AMBULANCE SERVICE REQUIREMENTS.] 
  5.16     Subdivision 1.  [PERSONNEL.] (a) No publicly or privately 
  5.17  owned ambulance service shall be operated in the state unless 
  5.18  its ambulance service personnel are certified, appropriate to 
  5.19  the type of ambulance service being provided, according to 
  5.20  section 144E.28 or are currently licensed as physicians under 
  5.21  chapter 147. 
  5.22     (b) An ambulance service shall have a medical director as 
  5.23  provided under section 144E.265. 
  5.24     Subd. 2.  [PATIENT CARE.] When a patient is being 
  5.25  transported, at least one of the ambulance service personnel 
  5.26  must be in the patient compartment.  If advanced life support 
  5.27  procedures are required, the ambulance service personnel with 
  5.28  the highest level of emergency medical service certification or 
  5.29  a physician shall be in the patient compartment. 
  5.30     Subd. 3.  [CONTINUAL SERVICE.] Each ambulance service shall 
  5.31  offer service 24 hours per day every day of the year, unless 
  5.32  otherwise authorized under subdivision 8. 
  5.33     Subd. 4.  [DENIAL OF SERVICE PROHIBITED.] An ambulance 
  5.34  service shall not deny prehospital care to a person needing 
  5.35  emergency ambulance service because of inability to pay or 
  5.36  because of the source of payment for services if the need 
  6.1   develops within the licensee's primary service area or when 
  6.2   responding to a mutual aid call.  Transport for the patient may 
  6.3   be limited to the closest appropriate emergency medical facility.
  6.4      Subd. 5.  [TYPES OF SERVICE.] The board shall regulate the 
  6.5   following types of ambulance service: 
  6.6      (1) basic life support; 
  6.7      (2) advanced life support; and 
  6.8      (3) specialized life support. 
  6.9      Subd. 6.  [BASIC LIFE SUPPORT.] (a) A basic life support 
  6.10  service shall be staffed by at least two EMTs or one EMT and one 
  6.11  physician and provide a level of care so as to ensure that: 
  6.12     (1) life-threatening situations and potentially serious 
  6.13  injuries are recognized; 
  6.14     (2) patients are protected from additional hazards; 
  6.15     (3) basic treatment to reduce the seriousness of emergency 
  6.16  situations is administered; and 
  6.17     (4) patients are transported to an appropriate medical 
  6.18  facility for treatment. 
  6.19     (b) A basic life support service shall provide basic airway 
  6.20  management.  By January 1, 2000, a basic life support service 
  6.21  shall provide automatic defibrillation, as provided in section 
  6.22  144E.103, subdivision 1, paragraph (b).  The licensee's medical 
  6.23  director may authorize the ambulance service personnel to carry 
  6.24  and to use medical antishock trousers and to perform intravenous 
  6.25  infusion if the ambulance service personnel have been properly 
  6.26  trained. 
  6.27     (c) A basic life support service may provide advanced life 
  6.28  support, upon approval by its medical director, when an EMT-P or 
  6.29  a physician is available to staff the ambulance, the ambulance 
  6.30  is equipped according to section 144E.103, subdivision 2, and 
  6.31  the requirements under subdivision 7 are met.  
  6.32     Subd. 7.  [ADVANCED LIFE SUPPORT.] (a) An advanced life 
  6.33  support service shall be staffed by at least one EMT and one 
  6.34  EMT-P or one EMT and one physician. 
  6.35     (b) An advanced life support service shall provide basic 
  6.36  life support, as specified under subdivision 6, paragraph (b), 
  7.1   advanced airway management, manual defibrillation, and 
  7.2   administration of intravenous fluids and pharmaceuticals. 
  7.3      (c) In addition to providing advanced life support, an 
  7.4   advanced life support service may staff additional ambulances to 
  7.5   provide basic life support according to subdivision 6.  When 
  7.6   routinely staffed and equipped as a basic life support service 
  7.7   according to subdivision 6 and section 144E.103, subdivision 1, 
  7.8   the vehicle shall not be marked as advanced life support.  
  7.9      (d) Each ambulance service providing advanced life support 
  7.10  shall have a written agreement with its medical director to 
  7.11  provide medical control for patient care by means of immediate 
  7.12  two-way voice communication 24 hours a day, seven days a week.  
  7.13  The terms of the agreement shall include a written policy on the 
  7.14  administration of medical control for the service.  The policy 
  7.15  shall address the following issues:  
  7.16     (i) two-way communication for physician direction of 
  7.17  ambulance service personnel; 
  7.18     (ii) patient triage, treatment, and transport; 
  7.19     (iii) use of standing orders; and 
  7.20     (iv) the means by which medical control will be provided 24 
  7.21  hours a day. 
  7.22     The agreement shall be signed by the licensee's medical 
  7.23  director and the licensee or the licensee's designee and 
  7.24  maintained in the files of the licensee. 
  7.25     (e) When an ambulance service provides advanced life 
  7.26  support, the authority of the EMT-P or physician to determine 
  7.27  the delivery of patient care prevails over the authority of the 
  7.28  EMT. 
  7.29     Subd. 8.  [SPECIALIZED LIFE SUPPORT.] A specialized life 
  7.30  support service shall provide basic or advanced life support as 
  7.31  designated by the board, and shall be restricted by the board to:
  7.32     (1) operation less than 24 hours of every day; 
  7.33     (2) designated segments of the population; 
  7.34     (3) certain types of medical conditions; or 
  7.35     (4) air ambulance service that includes fixed-wing and 
  7.36  rotor-wing. 
  8.1      Subd. 9.  [DRIVER.] A driver of an ambulance must possess a 
  8.2   current driver's license issued by any state and have attended 
  8.3   an emergency vehicle driving course approved by the licensee.  
  8.4   The emergency vehicle driving course must include actual driving 
  8.5   experience. 
  8.6      Subd. 10.  [PERSONNEL ROSTER.] (a) Each ambulance service 
  8.7   shall maintain a current roster of its ambulance service 
  8.8   personnel, including the name, address, and qualifications of 
  8.9   its ambulance personnel, and files documenting personnel 
  8.10  qualifications. 
  8.11     (b) The licensee shall maintain the name and address of its 
  8.12  medical director and a written statement signed by the medical 
  8.13  director indicating acceptance of the responsibilities specified 
  8.14  in section 144E.265, subdivision 2, in its files. 
  8.15     Subd. 11.  [MUTUAL AID AGREEMENT.] A licensee shall have a 
  8.16  written agreement with at least one neighboring licensed 
  8.17  ambulance service for coverage during times when the licensee's 
  8.18  ambulances are not available for service in its primary service 
  8.19  area.  The agreement must specify the duties and 
  8.20  responsibilities of the agreeing parties.  A copy of each mutual 
  8.21  aid agreement shall be maintained in the files of the licensee. 
  8.22     Subd. 12.  [SERVICE OUTSIDE PRIMARY SERVICE AREA.] A 
  8.23  licensee may provide its services outside of its primary service 
  8.24  area only if requested by a transferring physician or ambulance 
  8.25  service licensed to provide service in the primary service area 
  8.26  when it can reasonably be expected that: 
  8.27     (1) the response is required by the immediate medical need 
  8.28  of an individual; and 
  8.29     (2) the ambulance service licensed to provide service in 
  8.30  the primary service area is unavailable for appropriate response.
  8.31     Sec. 20.  [144E.103] [EQUIPMENT.] 
  8.32     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Every ambulance 
  8.33  in service for patient care, at a minimum, shall carry:  
  8.34     (1) oxygen; 
  8.35     (2) airway maintenance equipment in various sizes to 
  8.36  accommodate all age groups; 
  9.1      (3) splinting equipment in various sizes to accommodate all 
  9.2   age groups; 
  9.3      (4) dressings, bandages, and bandaging equipment; 
  9.4      (5) an emergency obstetric kit; 
  9.5      (6) equipment to determine vital signs in various sizes to 
  9.6   accommodate all age groups; 
  9.7      (7) a stretcher; 
  9.8      (8) a defibrillator; and 
  9.9      (9) a fire extinguisher. 
  9.10     (b) A basic life support service has until January 1, 2000, 
  9.11  to equip each ambulance in service for patient care with a 
  9.12  defibrillator. 
  9.13     Subd. 2.  [ADVANCED LIFE SUPPORT REQUIREMENTS.] In addition 
  9.14  to the requirements in subdivision 1, an ambulance used in 
  9.15  providing advanced life support must carry drugs and drug 
  9.16  administration equipment and supplies as approved by the 
  9.17  licensee's medical director. 
  9.18     Subd. 3.  [STORAGE.] All equipment carried in an ambulance 
  9.19  must be stored so that the patient and ambulance personnel are 
  9.20  not injured or inconvenienced in the event of a sudden stop or 
  9.21  movement of the ambulance during transport. 
  9.22     Subd. 4.  [SAFETY RESTRAINTS.] An ambulance must be 
  9.23  equipped with restraining straps for the stretcher and seat 
  9.24  belts in the patient compartment for the patient and ambulance 
  9.25  personnel. 
  9.26     Sec. 21.  [144E.121] [AIR AMBULANCE SERVICE REQUIREMENTS.] 
  9.27     Subdivision 1.  [AVIATION COMPLIANCE.] An air ambulance 
  9.28  service must comply with the regulations of the Federal Aviation 
  9.29  Administration and the rules of the Minnesota department of 
  9.30  transportation, aeronautics division. 
  9.31     Subd. 2.  [PERSONNEL.] (a) Air ambulance emergency medical 
  9.32  personnel must possess current certification, appropriate to the 
  9.33  type of ambulance service being provided, according to section 
  9.34  144E.28.  
  9.35     (b) The emergency medical personnel must have received 
  9.36  training approved by the licensee's medical director that 
 10.1   included instruction in the physiological changes due to 
 10.2   decreased atmospheric pressure, acceleration, vibration, and 
 10.3   changes in altitude; medical conditions requiring special 
 10.4   precautions; and contraindications to air transport. 
 10.5      (c) The medical director must sign and file a statement 
 10.6   with the licensee that each emergency medical personnel has 
 10.7   successfully completed the training under paragraph (b). 
 10.8      (d) The licensee shall retain documentation of compliance 
 10.9   with this subdivision in its files. 
 10.10     Subd. 3.  [EQUIPMENT.] An air ambulance must carry 
 10.11  extrication equipment, a fire extinguisher, reflective 
 10.12  triangles, and any other equipment required by rules adopted 
 10.13  under sections 144E.001 to 144E.33.  Equipment that is not 
 10.14  permanently stored on or in an air ambulance must be kept 
 10.15  separate from the air ambulance in a modular prepackaged form.  
 10.16     Sec. 22.  [144E.123] [PREHOSPITAL CARE DATA.] 
 10.17     Subdivision 1.  [COLLECTION AND MAINTENANCE.] A licensee 
 10.18  shall collect and provide prehospital care data to the board in 
 10.19  a manner prescribed by the board.  At a minimum, the data must 
 10.20  include items identified by the board that are part of the 
 10.21  National Uniform Emergency Medical Services Data Set.  A 
 10.22  licensee shall maintain prehospital care data for every response.
 10.23     Subd. 2.  [COPY TO RECEIVING HOSPITAL.] If a patient is 
 10.24  transported to a hospital, a copy of the ambulance report 
 10.25  delineating prehospital medical care given shall be provided to 
 10.26  the receiving hospital. 
 10.27     Subd. 3.  [REVIEW.] Prehospital care data may be reviewed 
 10.28  by the board or its designees.  The data shall be classified as 
 10.29  private data on individuals under chapter 13, the Minnesota 
 10.30  Government Data Practices Act. 
 10.31     Subd. 4.  [PENALTY.] Failure to report all information 
 10.32  required by the board under this section shall constitute 
 10.33  grounds for license revocation. 
 10.34     Sec. 23.  [144E.125] [OPERATIONAL PROCEDURES.] 
 10.35     A licensee shall establish and implement written procedures 
 10.36  for responding to ambulance service complaints, maintenance of 
 11.1   ambulances and equipment, procurement and storage of drugs, and 
 11.2   infection control.  The licensee shall maintain the procedures 
 11.3   in its files. 
 11.4      Sec. 24.  [144E.127] [INTERHOSPITAL TRANSFER.] 
 11.5      When transporting a patient from one licensed hospital to 
 11.6   another, a licensee may substitute for one of the ambulance 
 11.7   service personnel a registered nurse licensed under chapter 147 
 11.8   or physician's assistant registered under chapter 147A who has 
 11.9   been trained to use the equipment in the ambulance and is 
 11.10  knowledgeable of the licensee's ambulance service protocols. 
 11.11     Sec. 25.  Minnesota Statutes 1997 Supplement, section 
 11.12  144E.16, subdivision 4, is amended to read: 
 11.13     Subd. 4.  [TYPES OF SERVICES TO BE REGULATED.] (a) The 
 11.14  board may adopt rules needed to regulate ambulance services in 
 11.15  the following areas: 
 11.16     (1) applications for licensure; 
 11.17     (2) personnel qualifications and staffing standards; 
 11.18     (3) quality of life support treatment; 
 11.19     (4) restricted treatments and procedures; 
 11.20     (5) equipment standards; 
 11.21     (6) ambulance standards; 
 11.22     (7) communication standards, equipment performance and 
 11.23  maintenance, and radio frequency assignments; 
 11.24     (8) advertising; 
 11.25     (9) scheduled ambulance services; 
 11.26     (10) ambulance services in time of disaster; 
 11.27     (11) basic, intermediate, advanced, and refresher emergency 
 11.28  care course programs; 
 11.29     (12) continuing education requirements; 
 11.30     (13) trip reports; 
 11.31     (14) license fees, vehicle fees, and expiration dates; and 
 11.32     (15) waivers and variances. 
 11.33     (b) These rules shall apply to the following types of 
 11.34  ambulance service: 
 11.35     (1) basic ambulance service that provides a level of care 
 11.36  to ensure that life-threatening situations and potentially 
 12.1   serious injuries can be recognized, patients will be protected 
 12.2   from additional hazards, basic treatment to reduce the 
 12.3   seriousness of emergency situations will be administered, and 
 12.4   patients will be transported to an appropriate medical facility 
 12.5   for treatment; 
 12.6      (2) intermediate ambulance service that provides (i) basic 
 12.7   ambulance service, and (ii) intravenous infusions or 
 12.8   defibrillation or both; 
 12.9      (3) advanced ambulance service that provides (i) basic 
 12.10  ambulance service, and (ii) advanced airway management, 
 12.11  defibrillation, and administration of intravenous fluids and 
 12.12  pharmaceuticals.  Vehicles of advanced ambulance service 
 12.13  licensees not equipped or staffed at the advanced ambulance 
 12.14  service level shall not be identified to the public as capable 
 12.15  of providing advanced ambulance service; 
 12.16     (4) specialized ambulance service that provides basic, 
 12.17  intermediate, or advanced service as designated by the board, 
 12.18  and is restricted by the board to (i) less than 24 hours of 
 12.19  every day, (ii) designated segments of the population, or (iii) 
 12.20  certain types of medical conditions; and 
 12.21     (5) air ambulance service, that includes fixed-wing and 
 12.22  helicopter, and is specialized ambulance service. 
 12.23     Until rules are promulgated, the current provisions of 
 12.24  Minnesota Rules shall govern these services. 
 12.25     Sec. 26.  Minnesota Statutes 1997 Supplement, section 
 12.26  144E.18, is amended to read: 
 12.27     144E.18 [INSPECTIONS.] 
 12.28     The board may inspect ambulance services as frequently as 
 12.29  deemed necessary to determine whether the ambulance service is 
 12.30  in compliance with sections 144E.001 to 144E.33 and rules 
 12.31  adopted under those sections.  These inspections shall be for 
 12.32  the purpose of determining whether the ambulance and equipment 
 12.33  is clean and in proper working order and whether the operator is 
 12.34  in compliance with sections 144E.001 to 144E.16 and any rules 
 12.35  that the board adopts related to sections 144E.001 to 
 12.36  144E.16.  The board may review at any time documentation 
 13.1   required to be on file with the licensee. 
 13.2      Sec. 27.  [144E.19] [SUSPENSION; REVOCATION; NONRENEWAL.] 
 13.3      Subdivision 1.  [CONTESTED CASE.] The board may initiate a 
 13.4   contested case hearing under chapter 14 upon reasonable notice 
 13.5   to suspend, revoke, refuse to renew, or place conditions on the 
 13.6   license of a licensee upon finding that the licensee has 
 13.7   violated a provision of this chapter or rules adopted under this 
 13.8   chapter, or has ceased to provide the service for which the 
 13.9   licensee is licensed.  The board shall render a final decision 
 13.10  in the case according to sections 14.61 and 14.62. 
 13.11     Subd. 2.  [NOTICE.] A licensee whose license is suspended 
 13.12  or revoked, has conditions placed on it, or is refused renewal 
 13.13  shall be notified of the decision by certified mail.  The notice 
 13.14  shall be mailed to the address shown on the application or the 
 13.15  last known address of the licensee.  The notice shall state the 
 13.16  reasons why the license was suspended or revoked, had conditions 
 13.17  placed on it, or was refused renewal and shall inform the 
 13.18  licensee of the right to a contested case hearing under chapter 
 13.19  14. 
 13.20     Subd. 3.  [TEMPORARY SUSPENSION.] (a) In addition to any 
 13.21  other remedy provided by law, the board may temporarily suspend 
 13.22  the license of a licensee after conducting a preliminary inquiry 
 13.23  to determine if the board believes that the licensee has 
 13.24  violated a statute or rule that the board is empowered to 
 13.25  enforce and that the continued provision of service by the 
 13.26  licensee would create an imminent risk to public health or harm 
 13.27  to others. 
 13.28     (b) A temporary suspension order prohibiting the licensee 
 13.29  from providing ambulance service shall give notice of the right 
 13.30  to a hearing according to paragraph (d) and shall state the 
 13.31  reasons for the entry of the temporary suspension order. 
 13.32     (c) Service of a temporary suspension order is effective 
 13.33  when the order is served on the licensee personally or by 
 13.34  certified mail, which is complete upon receipt, refusal, or 
 13.35  return for nondelivery to the most recent address provided to 
 13.36  the board for the licensee. 
 14.1      (d) At the time the board issues a temporary suspension 
 14.2   order, the board shall schedule a hearing, to be held before a 
 14.3   group of its members designated by the board, that shall begin 
 14.4   within 60 days after issuance of the temporary suspension order 
 14.5   or within 15 working days of the date of the board's receipt of 
 14.6   a request for a hearing from a licensee, whichever is sooner.  
 14.7   The hearing shall be on the sole issue of whether there is a 
 14.8   reasonable basis to continue, modify, or lift the temporary 
 14.9   suspension.  A hearing under this paragraph is not subject to 
 14.10  chapter 14.  
 14.11     (e) Evidence presented by the board or licensee shall be in 
 14.12  the form of an affidavit.  The licensee or counsel of record may 
 14.13  appear for oral argument. 
 14.14     (f) Within five working days of the hearing, the board 
 14.15  shall issue its order and, if the suspension is continued, 
 14.16  schedule a contested case hearing under chapter 14 within 30 
 14.17  days of the issuance of the order.  The administrative law judge 
 14.18  shall issue a report and recommendation within 30 days after the 
 14.19  closing of the contested case hearing record.  The board shall 
 14.20  issue a final order within 30 days after receipt of the 
 14.21  administrative law judge's report. 
 14.22     Sec. 28.  [144E.26] [MEDICAL RESPONSE UNIT CERTIFICATION.] 
 14.23     Subdivision 1.  [CERTIFICATION REQUIRED.] A medical 
 14.24  response unit that is routinely dispatched to the scene of 
 14.25  medical emergencies to provide care at a level consistent with 
 14.26  the scope of the United States Department of Transportation 
 14.27  first responder or emergency medical technician curriculum must 
 14.28  be certified by the board. 
 14.29     Subd. 2.  [QUALIFICATIONS.] To be certified by the board, a 
 14.30  medical response unit shall: 
 14.31     (1) submit an application form prescribed by the board; 
 14.32     (2) submit a letter from the municipal council or county 
 14.33  sheriff recognizing the medical response unit as the unit in its 
 14.34  geographical area designated to respond to a medical emergency; 
 14.35     (3) be dispatched by a public safety answering point, as 
 14.36  defined under section 403.02, subdivision 5, or an ambulance 
 15.1   service; 
 15.2      (4) have a medical director, as provided under section 
 15.3   144E.265; and 
 15.4      (5) submit the appropriate fee as required under section 
 15.5   144E.29. 
 15.6      Subd. 3.  [EXEMPTION.] Nothing in this section prohibits 
 15.7   law enforcement or fire service personnel from providing medical 
 15.8   care at the scene of a medical emergency when responding to the 
 15.9   scene for a reason other than to provide medical care.  
 15.10     Sec. 29.  [144E.265] [MEDICAL DIRECTOR.] 
 15.11     Subdivision 1.  [REQUIREMENTS.] A medical director shall: 
 15.12     (1) be currently licensed as a physician in this state; 
 15.13     (2) have experience in, and knowledge of, emergency care of 
 15.14  acutely ill or traumatized patients; and 
 15.15     (3) be familiar with the design and operation of local, 
 15.16  regional, and state emergency medical service systems. 
 15.17     Subd. 2.  [RESPONSIBILITIES.] Responsibilities of the 
 15.18  medical director shall include: 
 15.19     (1) approving standards for training and orientation of 
 15.20  personnel that impact patient care; 
 15.21     (2) approving standards for purchasing equipment and 
 15.22  supplies that impact patient care; 
 15.23     (3) establishing standing orders for prehospital care; 
 15.24     (4) approving triage, treatment, and transportation 
 15.25  protocols; 
 15.26     (5) participating in the development and operation of 
 15.27  continuous quality improvement programs including case review 
 15.28  and resolution of patient complaints; 
 15.29     (6) establishing procedures for the administration of 
 15.30  drugs; and 
 15.31     (7) maintaining the quality of care according to the 
 15.32  standards and procedures established under clauses (1) to (6). 
 15.33     Subd. 3.  [ANNUAL ASSESSMENT; AMBULANCE SERVICE.] Annually, 
 15.34  the medical director or the medical director's designee shall 
 15.35  assess the practical skills of each EMT, EMT-I, and EMT-P on the 
 15.36  ambulance service roster and sign a statement verifying the 
 16.1   proficiency of each EMT, EMT-I, and EMT-P.  If a licensed 
 16.2   physician routinely serves as a member of the ambulance service 
 16.3   personnel, the medical director or the medical director's 
 16.4   designee shall sign a statement verifying that the physician has 
 16.5   been trained to use the equipment on the ambulance and is 
 16.6   knowledgeable of the licensee's service protocols.  The 
 16.7   statements shall be maintained in the licensee's files.  
 16.8      Sec. 30.  [144E.267] [DISASTER EXEMPTION.] 
 16.9      Sections 144E.001 to 144E.33 and rules adopted under those 
 16.10  sections shall not apply to ambulance services during a time of 
 16.11  disaster, mass casualty, or other public emergency.  The board 
 16.12  reserves the right to determine whether a disaster, mass 
 16.13  casualty, or other public emergency has occurred. 
 16.14     Sec. 31.  [144E.28] [CERTIFICATION OF EMT, EMT-I, AND 
 16.15  EMT-P.] 
 16.16     Subdivision 1.  [REQUIREMENTS.] To be eligible for 
 16.17  certification by the board as an EMT, EMT-I, or EMT-P, an 
 16.18  individual shall: 
 16.19     (1) successfully complete the United States Department of 
 16.20  Transportation course, or its equivalent as approved by the 
 16.21  board, specific to the EMT, EMT-I, or EMT-P classification; 
 16.22     (2) pass the written and practical examinations approved by 
 16.23  the board, specific to the EMT, EMT-I, or EMT-P classification; 
 16.24  and 
 16.25     (3) submit the appropriate fee as required under section 
 16.26  144E.29. 
 16.27     Subd. 2.  [EXPIRATION DATES.] Certification expiration 
 16.28  dates are as follows: 
 16.29     (1) for initial certification granted between January 1 and 
 16.30  June 30 of an even-numbered year, the expiration date is March 
 16.31  31 of the next even-numbered year; 
 16.32     (2) for initial certification granted between July 1 and 
 16.33  December 31 of an even-numbered year, the expiration date is 
 16.34  March 31 of the second odd-numbered year; 
 16.35     (3) for initial certification granted between January 1 and 
 16.36  June 30 of an odd-numbered year, the expiration date is March 31 
 17.1   of the next odd-numbered year; and 
 17.2      (4) for initial certification granted between July 1 and 
 17.3   December 31 of an odd-numbered year, the expiration date is 
 17.4   March 31 of the second even-numbered year. 
 17.5      Subd. 3.  [RECIPROCITY.] The board may certify an 
 17.6   individual who possesses a current National Registry of 
 17.7   Emergency Medical Technicians registration from another 
 17.8   jurisdiction and who meets the requirements under subdivision 1. 
 17.9   The board certification classification shall be the same as the 
 17.10  National Registry's classification.  Certification shall be for 
 17.11  the duration of the applicant's registration period in another 
 17.12  jurisdiction, not to exceed two years. 
 17.13     Subd. 4.  [DENIAL, SUSPENSION, REVOCATION.] (a) The board 
 17.14  may initiate a contested case hearing under chapter 14 upon 
 17.15  reasonable notice to deny, suspend, revoke, place conditions on, 
 17.16  or refuse to renew the certification of an individual who the 
 17.17  board determines: 
 17.18     (1) violates sections 144E.001 to 144E.33 or the rules 
 17.19  adopted under those sections; 
 17.20     (2) misrepresents or falsifies information on an 
 17.21  application form for board certification; 
 17.22     (3) is convicted or pleads guilty or nolo contendere to a 
 17.23  felony, gross misdemeanor, or misdemeanor; 
 17.24     (4) uses drugs or intoxicating liquors to an extent that 
 17.25  affects professional competence; 
 17.26     (5) engages in unethical conduct, including conduct likely 
 17.27  to deceive, defraud, or harm the public, or demonstrating a 
 17.28  willful or careless disregard for the health, welfare, or safety 
 17.29  of the public; 
 17.30     (6) is afflicted with a mental, emotional, or physical 
 17.31  disability or addiction that adversely affects the individual's 
 17.32  ability to provide emergency medical services; or 
 17.33     (7) mistreats or abandons a patient. 
 17.34     (b) The board shall render a final decision in the case 
 17.35  according to sections 14.61 and 14.62. 
 17.36     (c) An individual whose certification is denied, suspended, 
 18.1   or revoked; has conditions placed on it; or is refused renewal 
 18.2   shall be notified of the decision by certified mail.  The notice 
 18.3   shall be mailed to the address shown on the application or the 
 18.4   last known address of the individual.  The notice shall state 
 18.5   the reasons why the certification was denied, suspended, or 
 18.6   revoked; had conditions placed on it; or was refused renewal and 
 18.7   shall inform the individual of the right to a contested case 
 18.8   hearing under chapter 14. 
 18.9      (d) Denial, suspension, revocation, placing conditions on, 
 18.10  or refusal to renew the certification shall be reviewed by the 
 18.11  board at the request of the individual against whom the 
 18.12  disciplinary action was taken. 
 18.13     (e) Six months after the board's decision to deny, revoke, 
 18.14  place conditions on, or refuse renewal of an individual's 
 18.15  certification for disciplinary action, the individual shall have 
 18.16  the opportunity to apply to the board for reinstatement. 
 18.17     Subd. 5.  [TEMPORARY SUSPENSION.] (a) In addition to any 
 18.18  other remedy provided by law, the board may temporarily suspend 
 18.19  the certification of an individual after conducting a 
 18.20  preliminary inquiry to determine if the board believes that the 
 18.21  individual has violated a statute or rule that the board is 
 18.22  empowered to enforce and that the continued provision of service 
 18.23  by the individual would create an imminent risk to public health 
 18.24  or harm to others.  
 18.25     (b) A temporary suspension order prohibiting the individual 
 18.26  from providing emergency medical care shall give notice of the 
 18.27  right to a hearing according to subdivision 4 and shall state 
 18.28  the reasons for the entry of the temporary suspension order. 
 18.29     (c) Service of a temporary suspension order is effective 
 18.30  when the order is served on the individual personally or by 
 18.31  certified mail, which is complete upon receipt, refusal, or 
 18.32  return for nondelivery to the most recent address provided to 
 18.33  the board for the individual. 
 18.34     (d) At the time the board issues a temporary suspension 
 18.35  order, the board shall schedule a hearing, to be held before a 
 18.36  group of its members designated by the board, that shall begin 
 19.1   within 60 days after issuance of the temporary suspension order 
 19.2   or within 15 working days of the date of the board's receipt of 
 19.3   a request for a hearing from the individual, whichever is 
 19.4   sooner.  The hearing shall be on the sole issue of whether there 
 19.5   is a reasonable basis to continue, modify, or lift the temporary 
 19.6   suspension.  A hearing under this paragraph is not subject to 
 19.7   chapter 14. 
 19.8      (e) Evidence presented by the board or the individual shall 
 19.9   be in the form of an affidavit.  The individual or counsel of 
 19.10  record may appear for oral argument. 
 19.11     (f) Within five working days of the hearing, the board 
 19.12  shall issue its order and, if the suspension is continued, 
 19.13  schedule a contested case hearing under chapter 14 within 30 
 19.14  days of the issuance of the order.  The administrative law judge 
 19.15  shall issue a report and recommendation within 30 days after the 
 19.16  closing of the contested case hearing record.  The board shall 
 19.17  issue a final order within 30 days after receipt of the 
 19.18  administrative law judge's report.  
 19.19     Subd. 6.  [RENEWAL.] (a) Prior to the expiration date but 
 19.20  within the current certification period, an applicant for 
 19.21  renewal of certification as an EMT shall:  
 19.22     (1) successfully complete a course in cardiopulmonary 
 19.23  resuscitation that is approved by the board or the licensee's 
 19.24  medical director; and 
 19.25     (2) take the United States Department of Transportation EMT 
 19.26  refresher course and successfully pass the practical skills test 
 19.27  portion of the course, or successfully complete 48 hours of 
 19.28  continuing education in EMT programs that is consistent with the 
 19.29  United States Department of Transportation National Standard 
 19.30  Curriculum or its equivalent as approved by the board or as 
 19.31  approved by the licensee's medical director.  Twenty-four of the 
 19.32  48 hours must include at least four hours of instruction in each 
 19.33  of the following six categories: 
 19.34     (i) airway management and resuscitation procedures; 
 19.35     (ii) circulation, bleeding control, and shock; 
 19.36     (iii) human anatomy and physiology, patient assessment, and 
 20.1   medical emergencies; 
 20.2      (iv) injuries involving musculoskeletal, nervous, 
 20.3   digestive, and genito-urinary systems; 
 20.4      (v) environmental emergencies and rescue techniques; and 
 20.5      (vi) emergency childbirth and other special situations. 
 20.6      (b) Prior to the expiration date but within the current 
 20.7   certification period, an applicant for renewal of certification 
 20.8   as an EMT-I or EMT-P shall:  
 20.9      (1) for an EMT-I, successfully complete a course in 
 20.10  cardiopulmonary resuscitation that is approved by the board or 
 20.11  the licensee's medical director and for an EMT-P, successfully 
 20.12  complete a course in advanced cardiac life support that is 
 20.13  approved by the board or the licensee's medical director; and 
 20.14     (2) successfully complete 48 hours of continuing education 
 20.15  in emergency medical training programs, appropriate to the level 
 20.16  of the applicant's EMT-I or EMT-P certification, that is 
 20.17  consistent with the United States Department of Transportation 
 20.18  National Standard Curriculum or its equivalent as approved by 
 20.19  the board or as approved by the licensee's medical director.  An 
 20.20  applicant may take the United States Department of 
 20.21  Transportation Emergency Medical Technician refresher course or 
 20.22  its equivalent without the written or practical test as approved 
 20.23  by the board, and as appropriate to the applicant's level of 
 20.24  certification, as part of the 48 hours of continuing education.  
 20.25  Each hour of the refresher course counts toward the 48-hour 
 20.26  continuing education requirement. 
 20.27     (c) Continuing education credit may be given for the 
 20.28  following programs that comply with the requirements of 
 20.29  paragraph (d): 
 20.30     (1) emergency medical training courses; 
 20.31     (2) conventions; 
 20.32     (3) workshops and seminars; 
 20.33     (4) lectures; 
 20.34     (5) correspondence work; and 
 20.35     (6) self-study. 
 20.36     (d) No program shall be given credit that involves 
 21.1   television viewing in the home, correspondence work, or 
 21.2   self-study unless approved by the Continuing Education 
 21.3   Coordinating Board for Emergency Medical Services. 
 21.4      (e) Certification shall be renewed every two years. 
 21.5      (f) If the applicant does not meet the renewal requirements 
 21.6   under this section, the applicant's certification shall be 
 21.7   immediately revoked. 
 21.8      Subd. 7.  [REINSTATEMENT.] (a) Within four years of the 
 21.9   certification expiration date, a person whose certification has 
 21.10  been revoked under subdivision 6, paragraph (f), may have the 
 21.11  certification reinstated upon submission of evidence to the 
 21.12  board of training equivalent to the continuing education 
 21.13  requirements of this section and upon payment of the 
 21.14  certification fee. 
 21.15     (b) If more than four years have passed since the 
 21.16  certificate expiration date, the applicant must complete the 
 21.17  initial certification process including passing the written and 
 21.18  practical examinations. 
 21.19     Sec. 32.  [144E.281] [REPORTING MISCONDUCT.] 
 21.20     Subdivision 1.  [VOLUNTARY REPORTING.] A person who has 
 21.21  knowledge of any conduct constituting grounds for discipline 
 21.22  under section 144E.28, subdivision 4, may report the alleged 
 21.23  violation to the board. 
 21.24     Subd. 2.  [MANDATORY REPORTING.] (a) A licensee or medical 
 21.25  response unit shall report to the board conduct by an EMT, 
 21.26  EMT-I, or EMT-P that it reasonably believes constitutes grounds 
 21.27  for disciplinary action under section 144E.28, subdivision 4.  
 21.28     (b) A licensee or medical response unit shall report to the 
 21.29  board any disciplinary action it takes to limit the scope of 
 21.30  practice of an EMT, EMT-I, or EMT-P including dismissal from 
 21.31  employment.  A licensee or medical response unit shall report 
 21.32  the resignation of an EMT, EMT-I, or EMT-P before the conclusion 
 21.33  of any disciplinary proceeding or before commencement of formal 
 21.34  charges but after the EMT, EMT-I, or EMT-P has knowledge that 
 21.35  formal charges are contemplated or in preparation.  The 
 21.36  reporting described by this paragraph is required only if the 
 22.1   action pertains to grounds for disciplinary action under section 
 22.2   144E.28, subdivision 4.  
 22.3      (c) A person certified by the board under section 144E.28 
 22.4   shall report to the board personal knowledge of conduct by an 
 22.5   EMT, EMT-I, or EMT-P the person reasonably believes constitutes 
 22.6   grounds for disciplinary action under section 144E.28, 
 22.7   subdivision 4. 
 22.8      Subd. 3.  [IMMUNITY.] (a) An individual, licensee, medical 
 22.9   response unit, health care facility, business, or organization 
 22.10  is immune from civil liability or criminal prosecution for 
 22.11  submitting in good faith a report to the board under subdivision 
 22.12  1 or 2 or for otherwise reporting in good faith to the board 
 22.13  violations or alleged violations of sections 144E.001 to 144E.33.
 22.14  Reports are classified as confidential data on individuals or 
 22.15  protected nonpublic data under section 13.02 while an 
 22.16  investigation is active.  Inactive investigative data is public 
 22.17  data under section 13.03. 
 22.18     (b) Members of the board and persons employed by the board 
 22.19  or engaged in the investigation of violations and in the 
 22.20  preparation and management of charges of violations of sections 
 22.21  144E.001 to 144E.33 on behalf of the board or persons 
 22.22  participating in the investigation regarding charges of 
 22.23  violations are immune from civil liability and criminal 
 22.24  prosecution for any actions, transactions, or publications, made 
 22.25  in good faith, in the execution of, or relating to, their duties 
 22.26  under sections 144E.001 to 144E.33. 
 22.27     (c) For purposes of this section, a member of the board is 
 22.28  considered a state employee under section 3.736, subdivision 9.  
 22.29     Sec. 33.  [144E.283] [EMT INSTRUCTOR CERTIFICATION.] 
 22.30     Subdivision 1.  [QUALIFICATIONS.] The board shall grant 
 22.31  certification as an emergency medical technician instructor to 
 22.32  an applicant who files a completed application and furnishes 
 22.33  evidence satisfactory to the board that the applicant:  
 22.34     (1) possesses a current certification, registration, or 
 22.35  license as an EMT, EMT-I, EMT-P, physician, physician's 
 22.36  assistant, or registered nurse; 
 23.1      (2) has two years of active practical experience; 
 23.2      (3) is recommended by a medical director of a licensed 
 23.3   hospital or ambulance service; 
 23.4      (4) successfully completes the United States Department of 
 23.5   Transportation Emergency Medical Services Instructor Training 
 23.6   Program or its equivalent as approved by the board; and 
 23.7      (5) submits the appropriate fee as required under section 
 23.8   144E.29. 
 23.9      Subd. 2.  [EXPIRATION.] Certification expires two years 
 23.10  from the date of the initial certification and must be renewed 
 23.11  every two years. 
 23.12     Subd. 3.  [RENEWAL.] (a) An applicant shall submit an 
 23.13  application to the board for renewal at least three months prior 
 23.14  to the expiration date of the current certification and must 
 23.15  furnish evidence satisfactory to the board that the applicant: 
 23.16     (1) complies with the requirements of subdivision 1; 
 23.17     (2) has at least 40 hours of experience as an instructor in 
 23.18  an emergency medical technician course approved by the board 
 23.19  under section 144E.285; and 
 23.20     (3) has attended at least eight hours of continuing 
 23.21  education encompassing the course topics of the United States 
 23.22  Department of Transportation national standard curriculum for an 
 23.23  Emergency Medical Services Instructor Training Program or its 
 23.24  equivalent as approved by the board. 
 23.25     (b) An emergency medical technician instructor whose 
 23.26  certification is revoked for nonrenewal must obtain a new 
 23.27  certification by applying to the board and meeting the 
 23.28  requirements of subdivision 1. 
 23.29     Sec. 34.  [144E.285] [TRAINING PROGRAMS.] 
 23.30     Subdivision 1.  [APPROVAL REQUIRED.] (a) All training 
 23.31  programs for a first responder, EMT, EMT-I, or EMT-P must be 
 23.32  approved by the board. 
 23.33     (b) To be approved by the board, a training program must: 
 23.34     (1) submit an application prescribed by the board that 
 23.35  includes: 
 23.36     (i) type and length of course to be offered; 
 24.1      (ii) names, addresses, and qualifications of the program 
 24.2   medical director, program training coordinator, and certified 
 24.3   instructors; 
 24.4      (iii) names and addresses of clinical sites, including a 
 24.5   contact person and telephone number; 
 24.6      (iv) admission criteria for students; and 
 24.7      (v) materials and equipment to be used; 
 24.8      (2) for each course, implement the most current version of 
 24.9   the United States Department of Transportation curriculum or its 
 24.10  equivalent as determined by the board applicable to first 
 24.11  responder, EMT, EMT-I, or EMT-P training; 
 24.12     (3) have a medical director, as provided under section 
 24.13  144E.265, and a program coordinator; 
 24.14     (4) utilize instructors certified under section 144E.283 
 24.15  for teaching at least 50 percent of the course content.  The 
 24.16  remaining 50 percent of the course may be taught by guest 
 24.17  lecturers approved by the training program coordinator or 
 24.18  medical director; 
 24.19     (5) maintain a written agreement with a licensed hospital 
 24.20  or licensed ambulance service designating a clinical training 
 24.21  site; 
 24.22     (6) retain documentation of program approval by the board, 
 24.23  course outline, and student information; and 
 24.24     (7) notify the board of the starting date of a course at 
 24.25  least two weeks prior to the beginning of a course. 
 24.26     Subd. 2.  [EMT-P REQUIREMENTS.] (a) In addition to the 
 24.27  requirements under subdivision 1, paragraph (b), a training 
 24.28  program applying for approval to teach EMT-P curriculum must be 
 24.29  administered by an educational institution accredited by the 
 24.30  Commission of Accreditation of Allied Health Education Programs 
 24.31  (CAAHEP). 
 24.32     (b) An EMT-P training program that is administered by an 
 24.33  educational institution not currently accredited by CAAHEP, but 
 24.34  that is in the process of completing the accreditation process, 
 24.35  may be granted provisional approval by the board upon 
 24.36  verification of submission of its self-study report and the 
 25.1   appropriate review fee to CAAHEP. 
 25.2      (c) An educational institution that discontinues its 
 25.3   participation in the accreditation process must notify the board 
 25.4   immediately and provisional approval shall be withdrawn. 
 25.5      Subd. 3.  [EXPIRATION.] Training program approval shall 
 25.6   expire two years from the date of approval. 
 25.7      Subd. 4.  [REAPPROVAL.] A training program shall apply to 
 25.8   the board for reapproval at least three months prior to the 
 25.9   expiration date of its approval and must: 
 25.10     (1) submit an application prescribed by the board 
 25.11  specifying any changes from the information provided for prior 
 25.12  approval and any other information requested by the board to 
 25.13  clarify incomplete or ambiguous information presented in the 
 25.14  application; and 
 25.15     (2) comply with the requirements under subdivision 1, 
 25.16  paragraph (b), clauses (2) to (7). 
 25.17     Subd. 5.  [DISCIPLINARY ACTION.] (a) The board may initiate 
 25.18  a contested case hearing under chapter 14 upon reasonable notice 
 25.19  to deny, suspend, revoke, place conditions on, or refuse to 
 25.20  renew approval of a training program which the board determines: 
 25.21     (1) violated subdivisions 1 to 4 or rules adopted under 
 25.22  sections 144E.001 to 144E.33; or 
 25.23     (2) misrepresented or falsified information on an 
 25.24  application form provided by the board. 
 25.25     (b) The board shall render a final decision in the case 
 25.26  according to sections 14.61 and 14.62.  
 25.27     (c) A training program whose approval is denied, suspended, 
 25.28  or revoked; has conditions placed on it; or is refused renewal 
 25.29  shall be notified of the decision by certified mail.  The notice 
 25.30  shall be mailed to the address shown on the application or the 
 25.31  last known address of the training program.  The notice must 
 25.32  state the reasons why the approval was denied, suspended, or 
 25.33  revoked; had conditions placed on it; or was refused renewal and 
 25.34  must inform the training program of the right to a contested 
 25.35  case hearing under chapter 14. 
 25.36     (d) Denial, suspension, revocation, placing conditions on, 
 26.1   or refusal to renew the approval must be reviewed by the board 
 26.2   at the request of the training program against which the 
 26.3   disciplinary action was taken. 
 26.4      (e) Six months after the board's decision to deny, revoke, 
 26.5   place conditions on, or refuse approval of a training program 
 26.6   for disciplinary action, the training program shall have the 
 26.7   opportunity to apply to the board for reapproval.  
 26.8      Subd. 6.  [TEMPORARY SUSPENSION.] (a) In addition to any 
 26.9   other remedy provided by law, the board may temporarily suspend 
 26.10  approval of the training program after conducting a preliminary 
 26.11  inquiry to determine if the board believes that the training 
 26.12  program has violated a statute or rule that the board is 
 26.13  empowered to enforce and that the continued provision of service 
 26.14  by the training program would create an imminent risk to public 
 26.15  health or harm to others. 
 26.16     (b) A temporary suspension order prohibiting the training 
 26.17  program from providing emergency medical care training shall 
 26.18  give notice of the right to a hearing according to subdivision 5 
 26.19  and shall state the reasons for the entry of the temporary 
 26.20  suspension order. 
 26.21     (c) Service of a temporary suspension order is effective 
 26.22  when the order is served on the training program personally or 
 26.23  by certified mail, which is complete upon receipt, refusal, or 
 26.24  return for nondelivery to the most recent address provided to 
 26.25  the board for the training program. 
 26.26     (d) At the time the board issues a temporary suspension 
 26.27  order, the board shall schedule a hearing, to be held before a 
 26.28  group of its members designated by the board, that shall begin 
 26.29  within 60 days after issuance of the temporary suspension order 
 26.30  or within 15 working days of the date of the board's receipt of 
 26.31  a request for a hearing from the training program, whichever is 
 26.32  sooner.  The hearing shall be on the sole issue of whether there 
 26.33  is a reasonable basis to continue, modify, or lift the temporary 
 26.34  suspension.  A hearing under this paragraph is not subject to 
 26.35  chapter 14. 
 26.36     (e) Evidence presented by the board or the individual shall 
 27.1   be in the form of an affidavit.  The training program or counsel 
 27.2   of record may appear for oral argument. 
 27.3      (f) Within five working days of the hearing, the board 
 27.4   shall issue its order and, if the suspension is continued, 
 27.5   schedule a contested case hearing under chapter 14 within 30 
 27.6   days of the issuance of the order.  The administrative law judge 
 27.7   shall issue a report and recommendation within 30 days after the 
 27.8   closing of the contested case hearing record.  The board shall 
 27.9   issue a final order within 30 days after receipt of the 
 27.10  administrative law judge's report. 
 27.11     Subd. 7.  [AUDIT.] The board may audit training programs 
 27.12  approved by the board.  The audit may include investigation of 
 27.13  complaints, course inspection, classroom observation, review of 
 27.14  instructor qualifications, and student interviews. 
 27.15     Sec. 35.  [144E.29] [FEES.] 
 27.16     (a) The board shall charge the following fees: 
 27.17     (1) initial application for and renewal of an ambulance 
 27.18  service license, $150; 
 27.19     (2) each ambulance operated by a licensee, $96.  The 
 27.20  licensee shall pay an additional $96 fee for the full licensing 
 27.21  period or $4 per month for any fraction of the period for each 
 27.22  ambulance added to the ambulance service during the licensing 
 27.23  period; 
 27.24     (3) initial application for and renewal of certification as 
 27.25  an EMT, EMT-I, or EMT-P, $10; 
 27.26     (4) initial application for and renewal of certification as 
 27.27  a medical response unit, $20; 
 27.28     (5) initial application for and renewal of certification as 
 27.29  an EMT instructor, $10; 
 27.30     (6) initial application for and renewal of approval for a 
 27.31  training program, $100; and 
 27.32     (7) duplicate of an original license, certification, or 
 27.33  approval, $25.  
 27.34     (b) With the exception of paragraph (a), clause (7), all 
 27.35  fees are for a two-year period.  All fees are nonrefundable.  
 27.36     (c) Fees collected by the board shall be deposited as 
 28.1   nondedicated receipts in the trunk highway fund. 
 28.2      Sec. 36.  [144E.31] [CORRECTION ORDER AND FINES.] 
 28.3      Subdivision 1.  [CORRECTION ORDER.] (a) If the board finds 
 28.4   that a licensee or training program has failed to comply with an 
 28.5   applicable law or rule and the violation does not imminently 
 28.6   endanger the public health or safety, the board may issue a 
 28.7   correction order to the licensee or training program. 
 28.8      (b) The correction order shall state: 
 28.9      (1) the conditions that constitute a violation of the law 
 28.10  or rule; 
 28.11     (2) the specific law or rule violated; and 
 28.12     (3) the time allowed to correct the violation. 
 28.13     Subd. 2.  [RECONSIDERATION.] (a) If the licensee or 
 28.14  training program believes that the contents of the board's 
 28.15  correction order are in error, the licensee or training program 
 28.16  may ask the board to reconsider the parts of the correction 
 28.17  order that are alleged to be in error. 
 28.18     (b) The request for reconsideration must: 
 28.19     (1) be in writing; 
 28.20     (2) be delivered by certified mail; 
 28.21     (3) specify the parts of the correction order that are 
 28.22  alleged to be in error; 
 28.23     (4) explain why they are in error; and 
 28.24     (5) include documentation to support the allegation of 
 28.25  error. 
 28.26     (c) A request for reconsideration does not stay any 
 28.27  provision or requirement of the correction order.  The board's 
 28.28  disposition of a request for reconsideration is final and not 
 28.29  subject to appeal under chapter 14. 
 28.30     Subd. 3.  [FINE.] (a) The board may order a fine 
 28.31  concurrently with the issuance of a correction order, or after 
 28.32  the licensee or training program has not corrected the violation 
 28.33  within the time specified in the correction order. 
 28.34     (b) A licensee or training program that is ordered to pay a 
 28.35  fine shall be notified of the order by certified mail.  The 
 28.36  notice shall be mailed to the address shown on the application 
 29.1   or the last known address of the licensee or training program.  
 29.2   The notice shall state the reasons the fine was ordered and 
 29.3   shall inform the licensee or training program of the right to a 
 29.4   contested case hearing under chapter 14.  
 29.5      (c) A licensee or training program may appeal the order to 
 29.6   pay a fine by notifying the board by certified mail within 15 
 29.7   calendar days after receiving the order.  A timely appeal shall 
 29.8   stay payment of the fine until the board issues a final order. 
 29.9      (d) A licensee or training program shall pay the fine 
 29.10  assessed on or before the payment date specified in the board's 
 29.11  order.  If a licensee or training program fails to fully comply 
 29.12  with the order, the board shall suspend the license or cancel 
 29.13  approval until there is full compliance with the order. 
 29.14     (e) Fines shall be assessed as follows: 
 29.15     (1) $150 for violation of section 144E.123; 
 29.16     (2) $400 for violation of sections 144E.06, 144E.07, 
 29.17  144E.101, 144E.103, 144E.121, 144E.125, 144E.265, 144E.281, and 
 29.18  144E.285; 
 29.19     (3) $750 for violation of rules adopted under section 
 29.20  144E.16, subdivision 4, paragraph (a), clause (8); and 
 29.21     (4) $50 for violation of all other sections under this 
 29.22  chapter or rules adopted under this chapter that are not 
 29.23  specifically enumerated in clauses (1) to (3). 
 29.24     (f) Fines collected by the board shall be deposited as 
 29.25  nondedicated receipts in the trunk highway fund. 
 29.26     Subd. 4.  [ADDITIONAL PENALTIES.] This section does not 
 29.27  prohibit the board from suspending, revoking, placing conditions 
 29.28  on, or refusing to renew the licensee's license or the training 
 29.29  program's approval in addition to ordering a fine. 
 29.30     Sec. 37.  [144E.33] [PENALTY.] 
 29.31     Any person who violates a provision of sections 144E.001 to 
 29.32  144E.33 is guilty of a misdemeanor.  
 29.33     Sec. 38.  Minnesota Statutes 1997 Supplement, section 
 29.34  144E.35, subdivision 1, is amended to read: 
 29.35     Subdivision 1.  [REPAYMENT FOR VOLUNTEER TRAINING.] Any 
 29.36  political subdivision, or nonprofit hospital or nonprofit 
 30.1   corporation operating a licensed ambulance service shall be 
 30.2   reimbursed by the board for the necessary expense of the initial 
 30.3   training of a volunteer ambulance attendant upon successful 
 30.4   completion by the attendant of a basic emergency care course, or 
 30.5   a continuing education course program for basic emergency care, 
 30.6   or both, which has been approved by the board, pursuant to 
 30.7   section 144E.16.  Reimbursement may include tuition, 
 30.8   transportation, food, lodging, hourly payment for the time spent 
 30.9   in the training course or program, and other necessary 
 30.10  expenditures, except that in no instance shall a volunteer 
 30.11  ambulance attendant be reimbursed more than $450 for successful 
 30.12  completion of a basic course, and $225 for successful completion 
 30.13  of a continuing education course program. 
 30.14     Sec. 39.  Minnesota Statutes 1997 Supplement, section 
 30.15  144E.41, is amended to read: 
 30.16     144E.41 [PROGRAM ELIGIBILITY; QUALIFIED AMBULANCE SERVICE 
 30.17  PERSONNEL.] 
 30.18     (a) Persons eligible to participate in the ambulance 
 30.19  service personnel longevity award and incentive program are 
 30.20  qualified ambulance service personnel. 
 30.21     (b) Qualified ambulance service personnel are ambulance 
 30.22  attendants EMTs, EMT-Is, EMT-Ps, ambulance drivers, and 
 30.23  ambulance service medical directors or medical advisors who meet 
 30.24  the following requirements: 
 30.25     (1) employment of the person by or provision by the person 
 30.26  of service to an ambulance service that is licensed as such by 
 30.27  the state of Minnesota and that provides ambulance services that 
 30.28  are generally available to the public and are free of unfair 
 30.29  discriminatory practices under chapter 363; 
 30.30     (2) performance by the person during the 12 months ending 
 30.31  as of the immediately previous June 30 of all or a predominant 
 30.32  portion of the person's services in the state of Minnesota or on 
 30.33  behalf of Minnesota residents, as verified by August 1 annually 
 30.34  in an affidavit from the chief administrative officer of the 
 30.35  ambulance service; 
 30.36     (3) current certification of the person during the 12 
 31.1   months ending as of the immediately previous June 30 by the 
 31.2   Minnesota department of health as an ambulance attendant EMT, 
 31.3   EMT-I, EMT-P, ambulance driver, or ambulance service medical 
 31.4   director or medical advisor under section 144E.16 144E.265 or 
 31.5   144E.28, and supporting rules, and current active ambulance 
 31.6   service employment or service provision status of the person, as 
 31.7   verified by August 1 annually in an affidavit from the chief 
 31.8   administrative officer of the ambulance service; and 
 31.9      (4) conformance by the person with the definition of the 
 31.10  phrase "volunteer ambulance attendant" under section 144E.35, 
 31.11  subdivision 2, except that for the salary limit specified in 
 31.12  that provision there must be substituted, for purposes of this 
 31.13  section only, a limit of $3,000 for calendar year 1993, and 
 31.14  $3,000 multiplied by the cumulative percentage increase in the 
 31.15  national Consumer Price Index, all items, for urban wage earners 
 31.16  and clerical workers, as published by the federal Department of 
 31.17  Labor, Bureau of Labor Statistics, since December 31, 1993, and 
 31.18  for an ambulance service medical director, conformance based 
 31.19  solely on the person's hourly stipends or salary for service as 
 31.20  a medical director.  
 31.21     (c) The term "active ambulance service employment or 
 31.22  service provision status" means being in good standing with and 
 31.23  on the active roster of the ambulance service making the 
 31.24  certification. 
 31.25     (d) The maximum period of ambulance service employment or 
 31.26  service provision for which a person may receive credit towards 
 31.27  an award under this chapter, including prior service credit 
 31.28  under section 144E.45, subdivision 2, paragraph (c), is 20 years.
 31.29     (e) For a person who is employed by or provides service to 
 31.30  more than one ambulance service concurrently during any period 
 31.31  during the 12-month period, credit towards an award under this 
 31.32  chapter is limited to one ambulance service during any period.  
 31.33  The creditable period is with the ambulance service for which 
 31.34  the person undertakes the greatest portion of employment or 
 31.35  service hours. 
 31.36     Sec. 40.  Minnesota Statutes 1997 Supplement, section 
 32.1   145A.02, subdivision 10, is amended to read: 
 32.2      Subd. 10.  [EMERGENCY MEDICAL CARE.] "Emergency medical 
 32.3   care" means activities intended to protect the health of persons 
 32.4   suffering a medical emergency and to ensure rapid and effective 
 32.5   emergency medical treatment.  These activities include the 
 32.6   coordination or provision of training, cooperation with public 
 32.7   safety agencies, communications, life-support transportation as 
 32.8   defined under section 144E.16 sections 144E.06 to 144E.267, 
 32.9   public information and involvement, and system management. 
 32.10     Sec. 41.  [REVISOR'S INSTRUCTION.] 
 32.11     In each section of Minnesota Statutes referred to in column 
 32.12  A, the revisor of statutes shall delete the reference in column 
 32.13  B and insert the reference in column C. 
 32.14     Column A              Column B               Column C 
 32.15  144E.10, subd. 2      144E.16             144E.101 to 144E.127
 32.16  144E.12               144E.16             144E.121 to 144E.127 
 32.17  144E.13               144E.16             144E.101 to 144E.127 
 32.18  144E.14               144E.16             144E.101 to 144E.127 
 32.19  144E.35, subd. 1      144E.16             144E.285 
 32.20  353.64, subd. 10      144E.16             144E.28 
 32.21  144E.30, subds. 1     144E.30             144E.33 
 32.22   and 6 
 32.23  147A.09               144E.16, subd. 2,   144E.127 
 32.24                         para. (c) 
 32.25     Sec. 42.  [REPEALER.] 
 32.26     Minnesota Statutes 1997 Supplement, sections 144E.16, 
 32.27  subdivisions 1, 2, 3, and 6; 144E.17; 144E.25; and 144E.30, 
 32.28  subdivisions 1, 2, and 6, are repealed.  Minnesota Rules, parts 
 32.29  4690.0100, subparts 4, 13, 15, 19, 20, 21, 22, 23, 24, 26, 27, 
 32.30  28, and 29; 4690.0300; 4690.0400; 4690.0500; 4690.0600; 
 32.31  4690.0700; 4690.0800, subparts 1, 2, and 3; 4690.0900; 
 32.32  4690.1000; 4690.1100; 4690.1200; 4690.1300; 4690.1600; 
 32.33  4690.1700; 4690.2100; 4690.2200; 4690.2300; 4690.2400; 
 32.34  4690.2500; 4690.2900; 4690.3000; 4690.3100; 4690.3600; 
 32.35  4690.3700; 4690.3900; 4690.4000; 4690.4100; 4690.4200; 
 32.36  4690.4300; 4690.4400; 4690.4500; 4690.4600; 4690.4700; 
 33.1   4690.4800; 4690.4900; 4690.5000; 4690.5100; 4690.5200; 
 33.2   4690.5300; 4690.5400; 4690.5500; 4690.5700; 4690.5800; 
 33.3   4690.5900; 4690.6000; 4690.6100; 4690.6200; 4690.6300; 
 33.4   4690.6400; 4690.6500; 4690.6600; 4690.6700; 4690.6800; 
 33.5   4690.7000; 4690.7100; 4690.7200; 4690.7300; 4690.7400; 
 33.6   4690.7500; 4690.7600; 4690.7700; 4690.7800; 4690.8300, subparts 
 33.7   1, 2, 3, 4, and 5; and 4735.5000, are repealed.