House Bill 1431c1

CODING: Words stricken are deletions; words underlined are additions.







    Florida House of Representatives - 1999             CS/HB 1431

        By the Committee on Health Care Licensing & Regulation and
    Representatives Casey and Fiorentino





  1                      A bill to be entitled

  2         An act relating to emergency medical services;

  3         amending s. 401.25, F.S.; providing

  4         qualifications for licensure as basic or

  5         advanced life support service; amending s.

  6         401.27, F.S.; providing standards for

  7         certification of emergency medical technicians

  8         and paramedics; creating s. 401.2701, F.S.;

  9         establishing criteria for emergency medical

10         services training programs; creating s.

11         401.2715, F.S.; providing for recertification

12         training of emergency medical technicians and

13         paramedics; providing for fees; amending s.

14         401.30, F.S.; providing for use and maintenance

15         of records; amending s. 401.35, F.S.; providing

16         rulemaking authority; providing an effective

17         date.

18

19  Be It Enacted by the Legislature of the State of Florida:

20

21         Section 1.  Subsection (7) of section 401.25, Florida

22  Statutes, is added to read:

23         401.25  Licensure as a basic life support or an

24  advanced life support service.--

25         (7)(a)  Each permitted basic life support ambulance not

26  specifically exempted from this part, when transporting a

27  person who is sick, injured, wounded, incapacitated, or

28  helpless, must be occupied by at least two persons: one

29  patient attendant who is a certified emergency medical

30  technician, certified paramedic, or licensed physician; and

31  one ambulance driver who meets the requirements of s. 401.281.

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1  This paragraph does not apply to interfacility transfers

  2  governed by s. 401.252(1).

  3         (b)  Each permitted advanced life support ambulance not

  4  specifically exempted from this part, when transporting a

  5  person who is sick, injured, wounded, incapacitated, or

  6  helpless must be occupied by at least two persons: one who is

  7  a certified paramedic or licensed physician; and one who is a

  8  certified emergency medical technician, certified paramedic,

  9  or licensed physician who also meets the requirements of s.

10  401.281 for drivers. The person with the highest medical

11  certifications shall be in charge of patient care. This

12  paragraph does not apply to interfacility transfers governed

13  by s. 401.252(1).

14         Section 2.  Subsection (3) of section 401.27, Florida

15  Statutes, is amended to read:

16         401.27  Personnel; standards and certification.--

17         (3)  Any person who desires to be certified or

18  recertified as an emergency medical technician or paramedic

19  must apply to the department under oath on forms provided by

20  the department which shall contain such information as the

21  department reasonably requires, which may include affirmative

22  evidence of ability to comply with applicable laws and rules.

23  The department shall determine whether the applicant meets the

24  requirements specified in this section and in rules of the

25  department and shall issue a certificate to any person who

26  meets such requirements.

27         Section 3.  Section 401.2701, Florida Statutes, is

28  created to read:

29         401.2701  Emergency medical services training

30  programs.--

31

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1         (1)  Any private or public institution in Florida

  2  desiring to conduct an approved program for the education of

  3  emergency medical technicians and paramedics shall:

  4         (a)  Submit a completed application on a form provided

  5  by the department, which must include:

  6         1.  Evidence that the institution is in compliance with

  7  all applicable requirements of the Department of Education.

  8         2.  Evidence of an affiliation agreement with a

  9  hospital that has an emergency department staffed by at least

10  one physician and one registered nurse.

11         3.  Evidence of an affiliation agreement with a current

12  Florida-licensed emergency medical services provider. Such

13  agreement shall include, at a minimum, a commitment by the

14  provider to conduct the field experience portion of the

15  education program.

16         4.  Documentation verifying faculty, including:

17         a.  A medical director who is a licensed physician

18  meeting the applicable requirements for emergency medical

19  services medical directors as outlined in this chapter and

20  rules of the department. The medical director shall have the

21  duty and responsibility of certifying that graduates have

22  successfully completed all phases of the education program and

23  are proficient in basic or advanced life support techniques,

24  as applicable.

25         b.  A program director responsible for the operation,

26  organization, periodic review, administration, development,

27  and approval of the program.

28         5.  Documentation verifying that the curriculum:

29         a.  Meets the course guides and instructor's lesson

30  plans in the most recent Emergency Medical Technician-Basic

31  National Standard Curricula for emergency medical technician

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1  programs and Emergency Medical Technician-Paramedic National

  2  Standard Curricula for paramedic programs.

  3         b.  Includes 2 hours of instruction on the trauma

  4  scorecard methodologies for assessment of adult trauma

  5  patients and pediatric trauma patients as specified by the

  6  department by rule.

  7         c.  Includes 4 hours of instruction on HIV/AIDS

  8  training consistent with the requirements of chapter 381.

  9         6.  Evidence of sufficient medical and educational

10  equipment to meet emergency medical services training program

11  needs.

12         (b)  Receive a scheduled site visit from the department

13  to the applicant's institution. Such site visit shall be

14  conducted within 30 days after notification to the institution

15  that the application was accepted. During the site visit, the

16  department must determine the applicant's compliance with the

17  following criteria:

18         1.  Emergency medical technician programs must be a

19  minimum of 110 hours, with at least 20 hours of supervised

20  clinical supervision, including 10 hours in a hospital

21  emergency department.

22         2.  Paramedic programs must be available only to

23  Florida-certified emergency medical technicians or an

24  emergency medical technician applicant who will obtain Florida

25  certification prior to completion of phase one of the

26  paramedic program. Paramedic programs must be a minimum of 700

27  hours of didactic and skills practice components, with the

28  skills laboratory student-to-instructor ratio not exceeding

29  six to one. Paramedic programs must provide a field internship

30  experience aboard an advanced life support permitted

31  ambulance.

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1         (2)  After completion of the site visit, the department

  2  shall prepare a report which shall be provided to the

  3  institution. Upon completion of the report, the application

  4  shall be deemed complete and the provisions of s. 120.60,

  5  shall apply.

  6         (3)  If the program is approved, the department must

  7  issue the institution a 2-year certificate of approval as an

  8  emergency medical technician training program or a paramedic

  9  training program. If the application is denied, the department

10  must notify the applicant of any areas of strength, areas

11  needing improvement, and any suggested means of improvement of

12  the program. A denial notification shall be provided to the

13  applicant so as to allow the applicant 5 days prior to the

14  expiration of the application processing time in s. 120.60 to

15  advise the department in writing of its intent to submit a

16  plan of correction. Such intent notification shall provide the

17  time for application processing in s. 120.60. The plan of

18  correction must be submitted to the department within 30 days

19  of the notice. The department shall advise the applicant of

20  its approval or denial of the plan of correction within 30

21  days of receipt. The denial of the plan of correction or

22  denial of the application may be reviewed as provided in

23  chapter 120.

24         (4)  Approved emergency medical services training

25  programs must maintain records and reports that must be made

26  available to the department, upon written request. Such

27  records must include student applications, records of

28  attendance, records of participation in hospital clinic and

29  field training, medical records, course objectives and

30  outlines, class schedules, learning objectives, lesson plans,

31  number of applicants, number of students accepted, admission

                                  5

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1  requirements, description of qualifications, duties and

  2  responsibilities of faculty, and correspondence.

  3         (5)  Each approved program must notify the department

  4  within 30 days of any change in the professional or employment

  5  status of faculty. Each approved program must require its

  6  students to pass a comprehensive final written and practical

  7  examination evaluating the skills described in the current

  8  United States Department of Transportation EMT-Basic or

  9  EMT-Paramedic, National Standard Curriculum. Each approved

10  program must issue a certificate of completion to program

11  graduates within 14 days of completion.

12         Section 4.  Section 401.2715, Florida Statutes, is

13  created to read:

14         401.2715  Recertification training of emergency medical

15  technicians and paramedics.--

16         (1)  The department shall establish by rule criteria

17  for all emergency medical technician and paramedic

18  recertification training. The rules shall provide that all

19  recertification training equals at least 30 hours, includes

20  the performance parameters for adult and pediatric emergency

21  medical clinical care, and is documented through a system of

22  recordkeeping.

23         (2)  Any individual, institution, school, corporation,

24  or governmental entity may conduct emergency medical

25  technician or paramedic recertification training upon

26  application to the department and payment of a nonrefundable

27  fee to be deposited into the Emergency Medical Services Trust

28  Fund. Institutions conducting department-approved educational

29  programs as provided in this chapter and licensed ambulance

30  services are exempt from the application process and payment

31  of fees. The department shall adopt rules for the application

                                  6

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1  and payment of a fee not to exceed the actual cost of

  2  administering this approval process.

  3         (3)  To be eligible for recertification as provided in

  4  s. 401.27, certified emergency medical technicians and

  5  paramedics must provide proof of completion of training

  6  conducted pursuant to this section. The department shall

  7  accept the written affirmation of a licensee's or a

  8  department-approved educational program's medical director as

  9  documentation that the certificateholder has completed a

10  minimum of 30 hours of recertification training as provided

11  herein.

12         Section 5.  Present subsections (2), (3), and (4) of

13  section 401.30, Florida Statutes, 1998 Supplement, are

14  renumbered as subsections (3), (4), and (5), respectively, and

15  a new subsection (2) is added to said section, to read:

16         401.30  Records.--

17         (2)  Each licensee must provide the receiving hospital

18  with a copy of an individual patient care record for each

19  patient who is transported to the hospital. The information

20  contained in the record and the method and timeframe for

21  providing the record shall be prescribed by rule of the

22  department.

23         (3)(2)  Reports to the department from licensees which

24  cover statistical data are public records, except that the

25  names of patients and other patient-identifying information

26  contained in such reports are confidential and exempt from the

27  provisions of s. 119.07(1).  Any record furnished by a

28  licensee at the request of the department must be a true and

29  certified copy of the original record and may not be altered

30  or have information deleted.

31

                                  7

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1         (4)(3)  Records of emergency calls which contain

  2  patient examination or treatment information are confidential

  3  and exempt from the provisions of s. 119.07(1) and may not be

  4  disclosed without the consent of the person to whom they

  5  pertain, but appropriate limited disclosure may be made

  6  without such consent:

  7         (a)  To the person's guardian, to the next of kin if

  8  the person is deceased, or to a parent if the person is a

  9  minor;

10         (b)  To hospital personnel for use in conjunction with

11  the treatment of the patient;

12         (c)  To the department;

13         (d)  To the service medical director;

14         (e)  For use in a critical incident stress debriefing.

15  Any such discussions during a critical incident stress

16  debriefing shall be considered privileged communication under

17  s. 90.503;

18         (f)  In any civil or criminal action, unless otherwise

19  prohibited by law, upon the issuance of a subpoena from a

20  court of competent jurisdiction and proper notice by the party

21  seeking such records, to the patient or his or her legal

22  representative; or

23         (g)  To a local trauma agency or a regional trauma

24  agency, or a panel or committee assembled by such an agency to

25  assist the agency in performing quality assurance activities

26  in accordance with a plan approved under s. 395.401. Records

27  obtained under this paragraph are confidential and exempt from

28  s. 119.07(1) and s. 24(a), Art. I of the State Constitution.

29

30  This subsection does not prohibit the department or a licensee

31  from providing information to any law enforcement agency or

                                  8

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999             CS/HB 1431

    601-154-99






  1  any other regulatory agency responsible for the regulation or

  2  supervision of emergency medical services and personnel.

  3         (5)(4)  The department shall adopt and enforce all

  4  rules necessary to administer this section.

  5         Section 6.  Paragraph (l) is added to subsection (1) of

  6  section 401.35, Florida Statutes, and paragraph (i) is added

  7  to subsection (2) of said section, to read:

  8         401.35  Rules.--The department shall adopt rules

  9  necessary to carry out the purposes of this part.

10         (1)  The rules must provide at least minimum standards

11  governing:

12         (l)  Licensees' security and storage of controlled

13  substances, medications, and fluids, not inconsistent with the

14  provisions of chapter 499.

15         (2)  The rules must establish application requirements

16  for licensure and certification.  Pursuant thereto, the

17  department must develop application forms for basic life

18  support services and advanced life support services.  An

19  application for each respective service license must include,

20  but is not limited to:

21         (i)  An oath, upon forms provided by the department

22  which shall contain such information as the department

23  reasonably requires, which may include affirmative evidence of

24  ability to comply with applicable laws and rules.

25         Section 7.  This act shall take effect July 1, 1999.

26

27

28

29

30

31

                                  9