Senate Bill 1476c1

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    Florida Senate - 1999                           CS for SB 1476

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Campbell




    317-1913A-99

  1                      A bill to be entitled

  2         An act relating to emergency medical services;

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

  4         qualifications for licensure as basic or

  5         advanced life support service; amending s.

  6         401.27, F.S.; requiring applications to be made

  7         under oath by emergency medical technicians or

  8         paramedics; amending s. 401.30, F.S.; providing

  9         the department with rule authority for patient

10         care records of licensed ambulance services;

11         amending s. 401.35, F.S.; authorizing the

12         department to prescribe by rule requirements

13         for storage, and security of medications

14         maintained by licensed support services;

15         creating s. 401.49, F.S.; authorizing the

16         department's approval of emergency medical

17         technician and paramedic programs; creating s.

18         401.50, F.S.; providing recertification

19         requirements for paramedics and emergency

20         medical technicians; providing an effective

21         date.

22

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

24

25         Section 1.  Subsection (7) is added to section 401.25,

26  Florida Statutes, to read:

27         401.25  Licensure as a basic life support or an

28  advanced life support service.--

29         (7)(a)  Each permitted basic-life-support ambulance of

30  a licensee not specifically exempted from this part, when

31  transporting a person who is sick, injured, wounded,

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    Florida Senate - 1999                           CS for SB 1476
    317-1913A-99




  1  incapacitated, or helpless, must be occupied by at least two

  2  persons: one patient attendant who is a certified emergency

  3  medical technician, certified paramedic, or licensed physician

  4  and one ambulance driver who meets the requirements of s.

  5  401.281. This subsection does not apply to interfacility

  6  transfers governed by s. 401.252(1).

  7         (b)  Each permitted advanced-life-support ambulance of

  8  a licensee not specifically exempted from this part, when

  9  transporting a person who is sick, injured, wounded,

10  incapacitated, or helpless must be occupied by at least two

11  persons: one who is a certified paramedic or licensed

12  physician and one who is a certified emergency medical

13  technician, certified paramedic, or licensed physician who

14  also meets the requirements of s. 401.281 for drivers. The

15  person with the highest medical certifications shall be in

16  charge of patient care. This subsection does not apply to

17  interfacility transfers governed by s. 401.252(1).

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

19  Statutes, is amended to read:

20         401.27  Personnel; standards and certification.--

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

22  recertified as an emergency medical technician or paramedic

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

24  the department which shall contain such information as the

25  department reasonably requires and which may include

26  affirmative evidence of ability to comply with applicable laws

27  and rules. The department shall determine whether the

28  applicant meets the requirements specified in this section and

29  in rules of the department and shall issue a certificate to

30  any person who meets such requirements.

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    Florida Senate - 1999                           CS for SB 1476
    317-1913A-99




  1         Section 3.  Present subsection (2) of section 401.30,

  2  Florida Statutes, 1998 Supplement, is redesignated as

  3  subsection (3), and a new subsection (2) is added to that

  4  section, to read:

  5         401.30  Records.--

  6         (2)  Each licensee must provide the receiving hospital

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

  8  patient who is transported to the hospital. The information

  9  contained on the record and the method and timeframe for

10  providing the record shall be prescribed by rule of the

11  department.

12         Section 4.  Paragraph (l) is added to subsection (1)

13  and paragraph (h) of subsection (2) of section 401.35, Florida

14  Statutes, is amended to read:

15         401.35  Rules.--The department shall adopt rules

16  necessary to carry out the purposes of this part.

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

18  governing:

19         (l)  Licensees' security and storage of controlled

20  substances, medications, and fluids that are not inconsistent

21  with the requirements of chapter 499 or chapter 893.

22         (2)  The rules must establish application requirements

23  for licensure and certification.  Pursuant thereto, the

24  department must develop application forms for basic life

25  support services and advanced life support services.  An

26  application for each respective service license must include,

27  but is not limited to:

28         (h)  Such other information as the department

29  determines reasonable and necessary and an oath, upon forms

30  provided by the department which shall contain such

31  information as the department reasonably requires and which

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    Florida Senate - 1999                           CS for SB 1476
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  1  may include affirmative evidence of the ability to comply with

  2  applicable laws and rules.

  3         Section 5.  Section 401.49, Florida Statutes, is

  4  created to read:

  5         401.49  Approval of emergency medical technicians and

  6  paramedic programs.--

  7         (1)  Any private or public institution in this state

  8  which desires to conduct an approved program for educating

  9  emergency medical technicians and paramedics must submit to

10  the department a completed application on a form provided by

11  the department which includes:

12         (a)  Evidence that the institution is in compliance

13  with all applicable requirements of the Department of

14  Education.

15         (b)  Evidence that the institution has an agreement of

16  affiliation with a hospital that has an emergency department

17  staffed by at least one physician and one registered nurse.

18         (c)  Evidence that the institution has an agreement of

19  affiliation with an emergency medical service provider that

20  holds a current license in this state. Such agreement must

21  include, at a minimum, a commitment by the provider to conduct

22  the field-experience portion of the education program.

23         (d)  Documentation verifying that the institution's

24  faculty includes:

25         1.  A medical director who is a licensed physician who

26  meets the applicable requirements for an EMS medical director,

27  as outlined in this chapter and rules of the department. The

28  medical director shall certify that graduates have

29  successfully completed all phases of the education program and

30  are proficient in basic or advanced life-support techniques,

31  as applicable.

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    Florida Senate - 1999                           CS for SB 1476
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  1         2.  A program director who is responsible for the

  2  operation, organization, periodic review, administration,

  3  development, and approval of the program.

  4         (e)  Documentation verifying that the curriculum:

  5         1.  Meets the course guides and instructor's lesson

  6  plans in the most recent Emergency Medical Technician Basic

  7  National Standard Curricula for emergency medical technician

  8  programs and the Emergency Medical Technician Paramedic

  9  National Standard Curricula for paramedic programs.

10         2.  Includes 2 hours of instruction on the trauma

11  scorecard methodologies for assessment of adult trauma

12  patients and pediatric trauma patients, as specified by the

13  department by rule.

14         3.  Includes 4 hours of instruction on HIV and AIDS,

15  which is consistent with the requirements of chapter 381.

16         (f)  Evidence that the institution has sufficient

17  medical and educational equipment to meet the program needs

18  for training in emergency medical services.

19         (2)  The department must schedule a site visit to the

20  applicant's institution within 30 days after notifying the

21  institution that the application is accepted. During the site

22  visit, the department must determine the applicant's

23  compliance with the following criteria:

24         (a)  The program for emergency medical technicians must

25  require a minimum of 110 hours, with at least 20 hours of

26  supervised clinical supervision that includes 10 hours in a

27  hospital emergency department.

28         (b)  The program for paramedics must be available only

29  to an emergency medical technician who is certified in this

30  state or to an applicant for certification in this state as an

31  emergency medical technician who obtains such certification

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    Florida Senate - 1999                           CS for SB 1476
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  1  prior to completing phase one of the paramedic program. The

  2  paramedic program must require a minimum of 700 hours of

  3  didactic and skills-practice components, with a

  4  student-to-instructor ratio for the skills laboratory which

  5  does not exceed six to one. A paramedic program must provide

  6  field-internship experience aboard an ALS permitted ambulance.

  7         (3)  After completing the site visit, the department

  8  shall provide a report to the institution. Upon completion of

  9  the report, the application is complete and s. 120.60 applies.

10         (4)  If the program is approved, the department shall

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

12  emergency medical technician training program or a paramedic

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

14  must notify the applicant of areas of strength, areas that

15  need improvement, and suggested means of improving the

16  program. A notice of denial must be provided to the applicant

17  so that the applicant has at least 5 days prior to the

18  expiration of the application-processing time provided under

19  s. 120.60 in which to advise the department in writing of its

20  intent to submit a plan of correction. Notice of such intent

21  tolls the time for processing the application s. 120.60. The

22  plan of correction must be submitted to the department within

23  30 days after the notice. The department shall advise the

24  applicants of its approval or denial of the plan of correction

25  within 30 days after receipt of the plan of correction. The

26  denial of a plan of correction or an application is subject to

27  review under chapter 120.

28         (5)  Each approved emergency medical services training

29  program shall maintain records and reports that must be made

30  available to the department upon written request. Such records

31  must include student applications, records of attendance,

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    Florida Senate - 1999                           CS for SB 1476
    317-1913A-99




  1  records of participation in hospital clinic and field

  2  training, medical records, course objectives and outlines,

  3  class schedules, learning objectives, lesson plans, the number

  4  of applicants, the number of students accepted, admission

  5  requirements, descriptions of qualifications, duties and

  6  responsibilities of the institution's faculty, and

  7  correspondence.

  8         (6)  Each approved program must notify the department

  9  within 30 days following any change in the professional or

10  employment status of a faculty member. Each approved program

11  must require its students to pass a comprehensive final

12  written and practical examination that evaluates the skills

13  described in the most current Emergency Medical Technician

14  Basic or Emergency Medical Technician Paramedic National

15  Standard Curriculum of the United States Department of

16  Transportation. Each approved program must issue a

17  certification of completion to a graduate within 14 days after

18  successful completion of the program.

19         Section 6.  Section 401.50, Florida Statutes, is

20  created to read:

21         401.50  Recertification training of emergency medical

22  technicians and paramedics.--

23         (1)  The department shall establish by rule criteria

24  for all emergency medical technician and paramedic

25  recertification training. The rules must require at least 30

26  hours of recertification training and must include the

27  performance parameters for adult and pediatric emergency

28  medical clinical care, which are documented through a system

29  of recordkeeping.

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

31  or governmental entity may conduct emergency medical

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    Florida Senate - 1999                           CS for SB 1476
    317-1913A-99




  1  technician or paramedic recertification training upon

  2  application to the department and payment of a nonrefundable

  3  fee to be deposited into the Emergency Medical Services Trust

  4  Fund. Institutions conducting department-approved educational

  5  programs as provided in this part and licensed ambulance

  6  services are exempt from the application process and payment

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

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

  9  administration of the requirements of this subsection.

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

11  s. 401.27, a certified medical technician or paramedic must

12  provide evidence to the department that the applicant has

13  completed the training required for recertification under this

14  section. The department shall accept the written affirmation

15  of a licensee's medical director or a medical director of a

16  department-approved educational program as documentation that

17  the certified emergency medical technician or paramedic has

18  completed the recertification training required by this

19  section.

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

21

22          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
23                         Senate Bill 1476

24

25  The committee substitute substantially revises the original
    bill to only provide for the Department of Health's authority:
26  to approve training programs for emergency medical technicians
    and paramedics; to require recertification training for
27  emergency medical technicians and paramedics that must include
    performance parameters for adult and pediatric emergency
28  medical clinical care; to impose minimum requirements on
    permitted emergency medical vehicles; and to require documents
29  and other information to be submitted under oath by emergency
    medical services licensees, emergency medical services
30  certificate holders, or applicants to the department.

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