Senate Bill 1476e1

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    CS for SB 1476                           First Engrossed (ntc)



  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.

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

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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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    CS for SB 1476                           First Engrossed (ntc)



  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         (c)  Each advanced-life-support-permitted nontransport

19  vehicle of a licensee not specifically exempted from this part

20  must be occupied by at least two persons: one patient

21  attendant who is a certified paramedic or licensed physician

22  and one who is a certified emergency medical technician,

23  certified paramedic, or licensed physician. An

24  advanced-life-support-permitted nontransport vehicle may

25  operate as a basic-life-support nontransport vehicle if the

26  paramedic is temporarily providing patient care on another

27  vehicle for a maximum of 4 hours in a 24-hour period when

28  deemed by the licensee to be necessary to the operation of the

29  service as a result of unplanned events. This action may only

30  be taken in lieu of placing the unit completely out of

31  service. The licensee will ensure that the advanced life


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    CS for SB 1476                           First Engrossed (ntc)



  1  support service level is not routinely, intentionally, or

  2  repeatedly compromised as the result of this type of action.

  3  The licensee will ensure that the closest available

  4  advanced-life-support-permitted unit is dispatched to the

  5  incident with the basic life support nontransport unit.

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

  7  Statutes, is amended to read:

  8         401.27  Personnel; standards and certification.--

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

10  recertified as an emergency medical technician or paramedic

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

12  the department which shall contain such information as the

13  department reasonably requires and which may include

14  affirmative evidence of ability to comply with applicable laws

15  and rules. The department shall determine whether the

16  applicant meets the requirements specified in this section and

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

18  any person who meets such requirements.

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

20  Florida Statutes, 1998 Supplement, is redesignated as

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

22  section, to read:

23         401.30  Records.--

24         (2)  Each licensee must provide the receiving hospital

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

26  patient who is transported to the hospital. The information

27  contained on the record and the method and timeframe for

28  providing the record shall be prescribed by rule of the

29  department.

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

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

  3  Statutes, is amended to read:

  4         401.35  Rules.--The department shall adopt rules

  5  necessary to carry out the purposes of this part.

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

  7  governing:

  8         (l)  Licensees' security and storage of controlled

  9  substances, medications, and fluids that are not inconsistent

10  with the requirements of chapter 499 or chapter 893.

11         (2)  The rules must establish application requirements

12  for licensure and certification.  Pursuant thereto, the

13  department must develop application forms for basic life

14  support services and advanced life support services.  An

15  application for each respective service license must include,

16  but is not limited to:

17         (h)  Such other information as the department

18  determines reasonable and necessary and an oath, upon forms

19  provided by the department which shall contain such

20  information as the department reasonably requires and which

21  may include affirmative evidence of the ability to comply with

22  applicable laws and rules.

23         Section 5.  Section 401.49, Florida Statutes, is

24  created to read:

25         401.49  Approval of emergency medical technicians and

26  paramedic programs.--

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

28  which desires to conduct an approved program for educating

29  emergency medical technicians and paramedics must submit to

30  the department a completed application on a form provided by

31  the department which includes:


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    CS for SB 1476                           First Engrossed (ntc)



  1         (a)  Evidence that the institution is in compliance

  2  with all applicable requirements of the Department of

  3  Education.

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

  5  affiliation with a hospital that has an emergency department

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

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

  8  affiliation with an emergency medical service provider that

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

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

11  the field-experience portion of the education program.

12         (d)  Documentation verifying that the institution's

13  faculty includes:

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

15  meets the applicable requirements for an EMS medical director,

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

17  medical director shall certify that graduates have

18  successfully completed all phases of the education program and

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

20  as applicable.

21         2.  A program director who is responsible for the

22  operation, organization, periodic review, administration,

23  development, and approval of the program.

24         (e)  Documentation verifying that the curriculum:

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

26  plans in the most recent Emergency Medical Technician Basic

27  National Standard Curricula for emergency medical technician

28  programs and the Emergency Medical Technician Paramedic

29  National Standard Curricula for paramedic programs.

30         2.  Includes 2 hours of instruction on the trauma

31  scorecard methodologies for assessment of adult trauma


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    CS for SB 1476                           First Engrossed (ntc)



  1  patients and pediatric trauma patients, as specified by the

  2  department by rule.

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

  4  which is consistent with the requirements of chapter 381.

  5         (f)  Evidence that the institution has sufficient

  6  medical and educational equipment to meet the program needs

  7  for training in emergency medical services.

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

  9  applicant's institution within 30 days after notifying the

10  institution that the application is accepted. During the site

11  visit, the department must determine the applicant's

12  compliance with the following criteria:

13         (a)  The program for emergency medical technicians must

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

15  supervised clinical supervision that includes 10 hours in a

16  hospital emergency department.

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

18  to an emergency medical technician who is certified in this

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

20  emergency medical technician who obtains such certification

21  prior to completing phase one of the paramedic program. The

22  paramedic program must require a minimum of 700 hours of

23  didactic and skills-practice components, with a

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

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

26  field-internship experience aboard an ALS permitted ambulance.

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

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

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

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

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


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    CS for SB 1476                           First Engrossed (ntc)



  1  emergency medical technician training program or a paramedic

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

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

  4  need improvement, and suggested means of improving the

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

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

  7  expiration of the application-processing time provided under

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

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

10  tolls the time for processing the application under s. 120.60.

11  The plan of correction must be submitted to the department

12  within 30 days after the notice. The department shall advise

13  the applicants of its approval or denial of the plan of

14  correction within 30 days after receipt of the plan of

15  correction. The denial of a plan of correction or an

16  application is subject to review under chapter 120.

17         (5)  Each approved emergency medical services training

18  program shall maintain records and reports that must be made

19  available to the department upon written request. Such records

20  must include student applications, records of attendance,

21  records of participation in hospital clinic and field

22  training, medical records, course objectives and outlines,

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

24  of applicants, the number of students accepted, admission

25  requirements, descriptions of qualifications, duties and

26  responsibilities of the institution's faculty, and

27  correspondence.

28         (6)  Each approved program must notify the department

29  within 30 days following any change in the professional or

30  employment status of a faculty member. Each approved program

31  must require its students to pass a comprehensive final


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  1  written and practical examination that evaluates the skills

  2  described in the most current Emergency Medical Technician

  3  Basic or Emergency Medical Technician Paramedic National

  4  Standard Curriculum of the United States Department of

  5  Transportation. Each approved program must issue a

  6  certification of completion to a graduate within 14 days after

  7  successful completion of the program.

  8         Section 6.  Section 401.50, Florida Statutes, is

  9  created to read:

10         401.50  Recertification training of emergency medical

11  technicians and paramedics.--

12         (1)  The department shall establish by rule criteria

13  for all emergency medical technician and paramedic

14  recertification training. The rules must require at least 30

15  hours of recertification training and must include the

16  performance parameters for adult and pediatric emergency

17  medical clinical care, which are documented through a system

18  of recordkeeping.

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

20  or governmental entity may conduct emergency medical

21  technician or paramedic recertification training upon

22  application to the department and payment of a nonrefundable

23  fee to be deposited into the Emergency Medical Services Trust

24  Fund. Institutions conducting department-approved educational

25  programs as provided in this part and licensed ambulance

26  services are exempt from the application process and payment

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

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

29  administration of the requirements of this subsection.

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

31  s. 401.27, a certified emergency medical technician or


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    CS for SB 1476                           First Engrossed (ntc)



  1  paramedic must provide evidence to the department that the

  2  applicant has completed the training required for

  3  recertification under this section. The department shall

  4  accept the written affirmation of a licensee's medical

  5  director or a medical director of a department-approved

  6  educational program as documentation that the certified

  7  emergency medical technician or paramedic has completed the

  8  recertification training required by this section.

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

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