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





                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4

                            CHAMBER ACTION
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10                                                                

11  The Committee on Governmental Oversight and Productivity

12  recommended the following amendment:

13

14         Senate Amendment (with title amendment) 

15         On page 49, line 11, through

16            page 54, line 29, delete those lines

17

18  and insert:

19         Section 28.  Subsection (7) is added to section 401.25,

20  Florida Statutes, to read:

21         401.25  Licensure as a basic life support or an

22  advanced life support service.--

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

24  specifically exempted from this part, when transporting a

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

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

27  patient attendant who is a certified emergency medical

28  technician, certified paramedic, or licensed physician; and

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

30  This paragraph does not apply to interfacility transfers

31  governed by s. 401.252(1).

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





 1         (b)  Each permitted advanced life support ambulance not

 2  specifically exempted from this part, when transporting a

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

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

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

 6  certified emergency medical technician, certified paramedic,

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

 8  401.281 for drivers. The person with the highest medical

 9  certifications shall be in charge of patient care. This

10  paragraph does not apply to interfacility transfers governed

11  by s. 401.252(1).

12         Section 29.  Subsection (3) of section 401.27, Florida

13  Statutes, is amended to read:

14         401.27  Personnel; standards and certification.--

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

16  recertified as an emergency medical technician or paramedic

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

18  the department which shall contain such information as the

19  department reasonably requires, which may include affirmative

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

21  The department shall determine whether the applicant meets the

22  requirements specified in this section and in rules of the

23  department and shall issue a certificate to any person who

24  meets such requirements.

25         Section 30.  Section 401.2701, Florida Statutes, is

26  created to read:

27         401.2701  Emergency medical services training

28  programs.--

29         (1)  Any private or public institution in Florida

30  desiring to conduct an approved program for the education of

31  emergency medical technicians and paramedics shall:

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





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

 2  by the department, which must include:

 3         1.  Evidence that the institution is in compliance with

 4  all applicable requirements of the Department of Education.

 5         2.  Evidence of an affiliation agreement with a

 6  hospital that has an emergency department staffed by at least

 7  one physician and one registered nurse.

 8         3.  Evidence of an affiliation agreement with a current

 9  Florida-licensed emergency medical services provider. Such

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

11  provider to conduct the field experience portion of the

12  education program.

13         4.  Documentation verifying faculty, including:

14         a.  A medical director who is a licensed physician

15  meeting the applicable requirements for emergency medical

16  services medical directors as outlined in this chapter and

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

18  duty and responsibility of certifying that graduates have

19  successfully completed all phases of the education program and

20  are proficient in basic or advanced life support techniques,

21  as applicable.

22         b.  A program director responsible for the operation,

23  organization, periodic review, administration, development,

24  and approval of the program.

25         5.  Documentation verifying that the curriculum:

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

27  plans in the most recent Emergency Medical Technician-Basic

28  National Standard Curricula for emergency medical technician

29  programs and Emergency Medical Technician-Paramedic National

30  Standard Curricula for paramedic programs.

31         b.  Includes 2 hours of instruction on the trauma

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





 1  scorecard methodologies for assessment of adult trauma

 2  patients and pediatric trauma patients as specified by the

 3  department by rule.

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

 5  training consistent with the requirements of chapter 381.

 6         6.  Evidence of sufficient medical and educational

 7  equipment to meet emergency medical services training program

 8  needs.

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

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

11  conducted within 30 days after notification to the institution

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

13  department must determine the applicant's compliance with the

14  following criteria:

15         1.  Emergency medical technician programs must be a

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

17  clinical supervision, including 10 hours in a hospital

18  emergency department.

19         2.  Paramedic programs must be available only to

20  Florida-certified emergency medical technicians or an

21  emergency medical technician applicant who will obtain Florida

22  certification prior to completion of phase one of the

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

24  hours of didactic and skills practice components, with the

25  skills laboratory student-to-instructor ratio not exceeding

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

27  experience aboard an advanced life support permitted

28  ambulance.

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

30  shall prepare a report which shall be provided to the

31  institution. Upon completion of the report, the application

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





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

 2  shall apply.

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

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

 5  emergency medical technician training program or a paramedic

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

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

 8  needing improvement, and any suggested means of improvement of

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

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

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

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

13  plan of correction. Such intent notification shall provide the

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

15  correction must be submitted to the department within 30 days

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

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

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

19  denial of the application may be reviewed as provided in

20  chapter 120.

21         (4)  Approved emergency medical services training

22  programs must maintain records and reports that must be made

23  available to the department, upon written request. Such

24  records must include student applications, records of

25  attendance, records of participation in hospital clinic and

26  field training, medical records, course objectives and

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

28  number of applicants, number of students accepted, admission

29  requirements, description of qualifications, duties and

30  responsibilities of faculty, and correspondence.

31         (5)  Each approved program must notify the department

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





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

 2  status of faculty. Each approved program must require its

 3  students to pass a comprehensive final written and practical

 4  examination evaluating the skills described in the current

 5  United States Department of Transportation EMT-Basic or

 6  EMT-Paramedic, National Standard Curriculum. Each approved

 7  program must issue a certificate of completion to program

 8  graduates within 14 days of completion.

 9         Section 31.  Section 401.2715, Florida Statutes, is

10  created to read:

11         401.2715  Recertification training of emergency medical

12  technicians and paramedics.--

13         (1)  The department shall establish by rule criteria

14  for all emergency medical technician and paramedic

15  recertification training. The rules shall provide that all

16  recertification training equals at least 30 hours, includes

17  the performance parameters for adult and pediatric emergency

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

19  recordkeeping.

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

21  or governmental entity may conduct emergency medical

22  technician or paramedic recertification training upon

23  application to the department and payment of a nonrefundable

24  fee to be deposited into the Emergency Medical Services Trust

25  Fund. Institutions conducting department-approved educational

26  programs as provided in this chapter and licensed ambulance

27  services are exempt from the application process and payment

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

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

30  administering this approval process.

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





 1  s. 401.27, certified emergency medical technicians and

 2  paramedics must provide proof of completion of training

 3  conducted pursuant to this section. The department shall

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

 5  department-approved educational program's medical director as

 6  documentation that the certificateholder has completed a

 7  minimum of 30 hours of recertification training as provided

 8  herein.

 9         Section 32.  Present subsections (2), (3), and (4) of

10  section 401.30, Florida Statutes, 1998 Supplement, are

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

12  a new subsection (2) is added to that section, to read:

13         401.30  Records.--

14         (2)  Each licensee must provide the receiving hospital

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

16  patient who is transported to the hospital. The information

17  contained in the record and the method and timeframe for

18  providing the record shall be prescribed by rule of the

19  department.

20         (3)(2)  Reports to the department from licensees which

21  cover statistical data are public records, except that the

22  names of patients and other patient-identifying information

23  contained in such reports are confidential and exempt from the

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

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

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

27  or have information deleted.

28         (4)(3)  Records of emergency calls which contain

29  patient examination or treatment information are confidential

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

31  disclosed without the consent of the person to whom they

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





 1  pertain, but appropriate limited disclosure may be made

 2  without such consent:

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

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

 5  minor;

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

 7  the treatment of the patient;

 8         (c)  To the department;

 9         (d)  To the service medical director;

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

11  Any such discussions during a critical incident stress

12  debriefing shall be considered privileged communication under

13  s. 90.503;

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

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

16  court of competent jurisdiction and proper notice by the party

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

18  representative; or

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

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

21  assist the agency in performing quality assurance activities

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

23  obtained under this paragraph are confidential and exempt from

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

25

26  This subsection does not prohibit the department or a licensee

27  from providing information to any law enforcement agency or

28  any other regulatory agency responsible for the regulation or

29  supervision of emergency medical services and personnel.

30         (5)(4)  The department shall adopt and enforce all

31  rules necessary to administer this section.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





 1         Section 33.  Paragraph (l) is added to subsection (1)

 2  of section 401.35, Florida Statutes, and paragraph (i) is

 3  added to subsection (2) of that section, 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, not inconsistent with the

10  provisions of chapter 499.

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

18  which shall contain such information as the department

19  reasonably requires, which may include affirmative evidence of

20  ability to comply with applicable laws and rules.

21

22

23  ================ T I T L E   A M E N D M E N T ===============

24  And the title is amended as follows:

25         On page 3, lines 16-30, delete those lines

26

27  and insert:

28         s. 401.25, F.S.; providing qualifications for

29         licensure as basic or advanced life support

30         service; amending s. 401.27, F.S.; providing

31         standards for certification of emergency

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No. 4





 1         medical technicians and paramedics; creating s.

 2         401.2701, F.S.; establishing criteria for

 3         emergency medical services training programs;

 4         creating s. 401.2715, F.S.; providing for

 5         recertification training of emergency medical

 6         technicians and paramedics; providing for fees;

 7         amending s. 401.30, F.S.; providing for use and

 8         maintenance of records; amending s. 401.35,

 9         F.S.; providing rulemaking authority; amending

10         s. 409.9126, F.S.; revising

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