Senate Bill sb2136c1

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    Florida Senate - 2004                           CS for SB 2136

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




    317-2196-04

  1                      A bill to be entitled

  2         An act relating to emergency medical services;

  3         amending s. 401.113, F.S.; requiring that a

  4         recipient of funds from the Emergency Medical

  5         Services Trust Fund return unexpended funds to

  6         the Department of Health at the end of the

  7         grant period; authorizing the expenditure of

  8         interest generated from grant funds under

  9         certain circumstances; amending s. 401.27,

10         F.S.; authorizing the electronic submission of

11         an application for certification as an

12         emergency medical technician or paramedic;

13         requiring that rules of the department provide

14         for the approval of certain equivalent courses

15         for purposes of certification; deleting

16         provisions authorizing the department to issue

17         a temporary certification; creating s.

18         401.27001, F.S.; providing requirements for

19         background screening for applicants for initial

20         certification as an emergency medical

21         technician or paramedic and for renewal of

22         certification; requiring an applicant to pay

23         the costs of screening; requiring that

24         fingerprints be submitted to the Department of

25         Law Enforcement and forwarded to the Federal

26         Bureau of Investigation; specifying the

27         offenses that are grounds for denial of

28         certification; authorizing the department to

29         grant an exemption to an applicant,

30         notwithstanding certain convictions; requiring

31         the department to adopt rules; amending s.

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 1         401.2701, F.S.; requiring that a training

 2         program for emergency medical technicians and

 3         paramedics include information concerning the

 4         requirements for background screening;

 5         providing an effective date.

 6  

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

 8  

 9         Section 1.  Subsection (2) of section 401.113, Florida

10  Statutes, is amended to read:

11         401.113  Department; powers and duties.--

12         (2)(a)  The department shall annually dispense funds

13  contained in the Emergency Medical Services Trust Fund as

14  follows:

15         1.(a)  Forty-five percent of such moneys must be

16  divided among the counties according to the proportion of the

17  combined amount deposited in the trust fund from the county.

18  These funds may not be used to match grant funds as identified

19  in subparagraph 2. paragraph (b). An individual board of

20  county commissioners may distribute these funds to emergency

21  medical service organizations within the county, as it deems

22  appropriate.

23         2.(b)  Forty percent of such moneys must be used by the

24  department for making matching grants to local agencies,

25  municipalities, and emergency medical services organizations

26  for the purpose of conducting research, increasing existing

27  levels of emergency medical services, evaluation, community

28  education, injury prevention programs, and training in

29  cardiopulmonary resuscitation and other lifesaving and first

30  aid techniques.

31  

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    Florida Senate - 2004                           CS for SB 2136
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 1         a.1.  At least 90 percent of these moneys must be made

 2  available on a cash matching basis.  A grant made under this

 3  sub-subparagraph subparagraph must be contingent upon the

 4  recipient providing a cash sum equal to 25 percent of the

 5  total department-approved grant amount.

 6         b.2.  No more than 10 percent of these moneys must be

 7  made available to rural emergency medical services, and

 8  notwithstanding the restrictions specified in subsection (1),

 9  these moneys may be used for improvement, expansion, or

10  continuation of services provided.  A grant made under this

11  sub-subparagraph subparagraph must be contingent upon the

12  recipient providing a cash sum equal to no more than 10

13  percent of the total department-approved grant amount.

14  

15  The department shall develop procedures and standards for

16  grant disbursement under this subparagraph paragraph based on

17  the need for emergency medical services, the requirements of

18  the population to be served, and the objectives of the state

19  emergency medical services plan.

20         3.(c)  Fifteen percent of such moneys must be used by

21  the department for capital equipment outlay, personnel,

22  community education, evaluation, and other costs associated

23  with the administration of this chapter. Any moneys not

24  annually used for this purpose must be used for making

25  additional rural grant funds available.

26         (b)  Notwithstanding any other provision of law to the

27  contrary, interest generated from grant funds may be expended

28  by the grantee on the budget items approved by the department.

29  However, a grantee that receives funds requiring a match may

30  not expend interest earnings until all match requirements have

31  been met. The grantee shall return to the department any

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    Florida Senate - 2004                           CS for SB 2136
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 1  interest earned and grant funds not expended at the conclusion

 2  of the grant period. All such returned funds shall be used by

 3  the department for additional awards of matching grants.

 4         Section 2.  Section 401.27, Florida Statutes, is

 5  amended to read:

 6         401.27  Personnel; standards and certification.--

 7         (1)  Each permitted ambulance not specifically exempted

 8  from this part, when transporting a person who is sick,

 9  injured, wounded, incapacitated, or helpless, must be occupied

10  by at least two persons, one of whom must be a certified

11  emergency medical technician, certified paramedic, or licensed

12  physician and one of whom must be a driver who meets the

13  requirements for ambulance drivers.  This subsection does not

14  apply to interfacility transfers governed by s. 401.252(1).

15         (2)  The department shall establish by rule educational

16  and training criteria and examinations for the certification

17  and recertification of emergency medical technicians and

18  paramedics. Such rules must require, but need not be limited

19  to:

20         (a)  For emergency medical technicians, proficiency in

21  techniques identified in s. 401.23(7) and in rules of the

22  department.

23         (b)  For paramedics, proficiency in techniques

24  identified in s. 401.23(1) and in rules of the department.

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

26  recertified as an emergency medical technician or paramedic

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

28  the department which shall contain such information as the

29  department reasonably requires, which may include affirmative

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

31  The department may accept electronically submitted

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    Florida Senate - 2004                           CS for SB 2136
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 1  applications. If an application is submitted electronically,

 2  the department may require that supplemental materials be

 3  submitted in a nonelectronic format, including an original

 4  signature of the applicant and documentation verifying

 5  eligibility for certification. The department shall determine

 6  whether the applicant meets the requirements specified in this

 7  section and in rules of the department and shall issue a

 8  certificate to any person who meets such requirements.

 9         (4)  An applicant for certification or recertification

10  as an emergency medical technician or paramedic must:

11         (a)  Have completed an appropriate training course as

12  follows:

13         1.  For an emergency medical technician, an emergency

14  medical technician training course equivalent to the most

15  recent emergency medical technician basic training course of

16  the United States Department of Transportation as approved by

17  the department;

18         2.  For a paramedic, a paramedic training program

19  equivalent to the most recent paramedic course of the United

20  States Department of Transportation as approved by the

21  department;

22         (b)  Certify under oath that he or she is not addicted

23  to alcohol or any controlled substance;

24         (c)  Certify under oath that he or she is free from any

25  physical or mental defect or disease that might impair the

26  applicant's ability to perform his or her duties;

27         (d)  Within 1 year after course completion have passed

28  an examination developed or required by the department;

29         (e)1.  For an emergency medical technician, hold either

30  a current American Heart Association cardiopulmonary

31  resuscitation course card or an American Red Cross

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 1  cardiopulmonary resuscitation course card or its equivalent as

 2  defined by department rule. The rules must include, but need

 3  not be limited to, the procedure for recognizing

 4  cardiopulmonary resuscitation course equivalency, as

 5  determined by the Continuing Education Coordinating Board for

 6  Emergency Medical Services;

 7         2.  For a paramedic, hold a certificate of successful

 8  course completion in advanced cardiac life support from the

 9  American Heart Association or its equivalent as defined by

10  department rule. The rules must include, but need not be

11  limited to, the procedure for recognizing advanced cardiac

12  life support course equivalency, as determined by the

13  Continuing Education Coordinating Board for Emergency Medical

14  Services;

15         (f)  Submit the certification fee and the nonrefundable

16  examination fee prescribed in s. 401.34, which examination fee

17  will be required for each examination administered to an

18  applicant; and

19         (g)  Submit a completed application to the department,

20  which application documents compliance with paragraphs (a),

21  (b), (c), (e), (f), (g), and, if applicable, (d). The

22  application must be submitted so as to be received by the

23  department at least 30 calendar days before the next regularly

24  scheduled examination for which the applicant desires to be

25  scheduled.

26         (5)  The certification examination must be offered

27  monthly.  The department shall issue an examination admission

28  notice to the applicant advising him or her of the time and

29  place of the examination for which he or she is scheduled.

30  Individuals achieving a passing score on the certification

31  examination may be issued a temporary certificate with their

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 1  examination grade report.  The department must issue an

 2  original certification within 45 days after the examination.

 3  Examination questions and answers are not subject to discovery

 4  but may be introduced into evidence and considered only in

 5  camera in any administrative proceeding under chapter 120. If

 6  an administrative hearing is held, the department shall

 7  provide challenged examination questions and answers to the

 8  administrative law judge. The department shall establish by

 9  rule the procedure by which an applicant, and the applicant's

10  attorney, may review examination questions and answers in

11  accordance with s. 119.07(3)(a).

12         (6)(a)  The department shall establish by rule a

13  procedure for biennial renewal certification of emergency

14  medical technicians and paramedics.

15         (a)  For emergency medical technicians, such rules must

16  require a United States Department of Transportation refresher

17  training program of at least 30 hours as approved by the

18  department every 2 years.  The refresher program may be

19  offered in multiple presentations spread over the 2-year

20  period.  The rules must also provide that the refresher course

21  requirement may be satisfied by passing a challenge

22  examination.

23         (b)  The department shall establish by rule a procedure

24  For biennial renewal certification of paramedics,. such rules

25  must require candidates for renewal to have taken at least 30

26  hours of continuing education units during the 2-year period.

27  The rules must provide that the continuing education

28  requirement may be satisfied by passing a challenge

29  examination.

30         (7)  A physician, dentist, or registered nurse may be

31  certified as a paramedic if the physician, dentist, or

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 1  registered nurse is certified in this state as an emergency

 2  medical technician, has passed the required emergency medical

 3  technician curriculum, has successfully completed an advanced

 4  cardiac life support course, has passed the examination for

 5  certification as a paramedic, and has met other certification

 6  requirements specified by rule of the department.  A

 7  physician, dentist, or registered nurse so certified must be

 8  recertified under this section.

 9         (8)  Each emergency medical technician certificate and

10  each paramedic certificate will expire automatically and may

11  be renewed if the holder meets the qualifications for renewal

12  as established by the department. A certificate that is not

13  renewed at the end of the 2-year period will automatically

14  revert to an inactive status for a period not to exceed 180

15  days. Such certificate may be reactivated and renewed within

16  the 180 days if the certificateholder meets all other

17  qualifications for renewal and pays a $25 late fee.

18  Reactivation shall be in a manner and on forms prescribed by

19  department rule. The holder of a certificate that expired on

20  December 1, 1996, has until September 30, 1997, to reactivate

21  the certificate in accordance with this subsection.

22         (9)  The department may suspend or revoke a certificate

23  at any time if it determines that the holder does not meet the

24  applicable qualifications.

25         (10)  The department may provide by rule for physically

26  disabled persons to take and be provided with the results of

27  the written portion of the emergency medical technician

28  certification examination or paramedic certification

29  examination.  However, such persons may not receive any

30  special assistance in completing the examination.  A

31  physically disabled An individual who achieves a passing grade

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 1  on the emergency medical technician certification examination

 2  or paramedic certification examination may be issued a limited

 3  emergency medical technician certificate or a limited

 4  paramedic certificate. An individual issued a limited

 5  certificate may not perform patient care or treatment

 6  activities.

 7         (11)(a)  A certificateholder may request that his or

 8  her emergency medical technician certificate or paramedic

 9  certificate be placed on inactive status by applying to the

10  department before his or her current certification expires and

11  paying a fee set by the department not to exceed $50.

12         (a)(b)1.  A certificateholder whose certificate has

13  been on inactive status for 1 year or less following the date

14  his or her emergency medical technician certificate or

15  paramedic certificate expired may renew his or her certificate

16  pursuant to the rules adopted by the department and upon

17  payment of a late renewal fee set by the department not to

18  exceed $100.

19         (b)2.  A certificateholder whose certificate has been

20  on inactive status for more than 1 year may renew his or her

21  certificate pursuant to rules adopted by the department.  To

22  renew, the certificateholder must pass the certification

23  examination and complete continuing education requirements and

24  a field internship.

25         (c)  A certificate that which has been inactive for

26  more than 6 years automatically expires and may not be

27  reinstated.

28         (12)  An applicant for certification who is an

29  out-of-state certified or military-trained trained emergency

30  medical technician or paramedic must provide proof of current

31  emergency medical technician or paramedic certification or

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 1  registration based upon successful completion of the United

 2  States Department of Transportation emergency medical

 3  technician or paramedic training curriculum and hold a current

 4  certificate of successful course completion in cardiopulmonary

 5  resuscitation (CPR) or advanced cardiac life support for

 6  emergency medical technicians or paramedics, respectively, to

 7  be eligible for the certification examination. The applicant

 8  must successfully complete the certification examination

 9  within 1 year after the date of the receipt of his or her

10  application by the department.  After 1 year, the applicant

11  must submit a new application, meet all eligibility

12  requirements, and submit all fees to reestablish eligibility

13  to take the certification examination.

14         (13)  The department shall adopt a standard state

15  insignia for emergency medical technicians and paramedics. The

16  department shall establish by rule the requirements to display

17  the state emergency medical technician and paramedic insignia.

18  The rules may not require a person to wear the standard

19  insignia but must require that if a person wears any insignia

20  that identifies the person as a certified emergency medical

21  technician or paramedic in this state, the insignia must be

22  the standard state insignia adopted under this section. The

23  insignia must denote the individual's level of certification

24  at which he or she is functioning.

25         Section 3.  Section 401.27001, Florida Statutes, is

26  created to read:

27         401.27001  Background screening required for

28  certification.--

29         (1)  An applicant for initial certification under s.

30  401.27 must submit information and a set of fingerprints to

31  the Department of Health on a form and according to procedures

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 1  specified by the department, along with payment in an amount

 2  equal to the costs incurred by the Department of Health for a

 3  statewide criminal history check and a national criminal

 4  history check of the applicant.

 5         (2)  An applicant for initial renewal of certification

 6  on or after July 1, 2004, who has not previously submitted a

 7  set of fingerprints to the Department of Health must submit

 8  information required to perform a statewide criminal

 9  background check and a set of fingerprints required to perform

10  a national criminal history check. The applicant must submit

11  the fingerprints on a form and under procedures specified by

12  the department for a national criminal history check, along

13  with payment in an amount equal to the costs incurred by the

14  department. For subsequent renewals, the department shall, by

15  rule, adopt an application form that includes an oath or

16  affirmation attesting to the existence of any criminal

17  convictions, regardless of plea or adjudication, which have

18  occurred since the previous certification. If there has been a

19  criminal conviction, the provisions of this section apply. The

20  department shall notify each current certificateholder of the

21  requirement to undergo a criminal history background screening

22  sufficiently in advance of the 2004 biennial expiration for

23  the certificateholder to provide the required information

24  prior to submission of the renewal certification application.

25  The department may not deny eligibility for renewal of the

26  first renewal application subsequent to July 1, 2004, due to a

27  delay in obtaining the criminal history from the Department of

28  Law Enforcement, the Federal Bureau of Investigation, or the

29  Division of State Fire Marshal if the applicant has submitted

30  the required criminal background screening information or

31  affidavit and fees with the renewal certification application.

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 1  A certificate that expires on December 1, 2004, may be renewed

 2  subject to withdrawal of certification pending the

 3  department's determination of whether the certificateholder

 4  will be granted an exemption as provided in subsection (8).

 5  The applicant must make timely application for renewal and

 6  request the exemption from denial prior to expiration of the

 7  certificate.

 8         (3)  Pursuant to the requirements of s. 120.60, an

 9  application for certification must be processed within 90 days

10  after receipt of the completed application. An application for

11  certification is not complete until the criminal history and

12  certified copies of all court documents for an applicant

13  having a prior criminal conviction, pursuant to this section,

14  have been received by the department.

15         (4)  The department shall submit the fingerprints and

16  information required for a statewide criminal history check to

17  the Department of Law Enforcement, and the Department of Law

18  Enforcement shall forward the fingerprints to the Federal

19  Bureau of Investigation for a national criminal history check

20  of the applicant.

21         (5)  If an applicant has undergone a criminal history

22  check as a condition of employment or certification as a

23  firefighter under s. 633.34, the Division of State Fire

24  Marshal of the Department of Financial Services shall provide

25  the criminal history information regarding the applicant

26  seeking certification or renewal of certification under s.

27  401.27 to the department. Any applicant for initial

28  certification or renewal of certification who has already

29  submitted a set of fingerprints and information to the

30  Division of State Fire Marshal of the Department of Financial

31  Services for the criminal history check required for

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 1  employment and certification of firefighters under s. 633.34

 2  within 2 years prior to application under s. 401.27 is not

 3  required to provide to the department a subsequent set of

 4  fingerprints or other duplicate information required for a

 5  criminal history check if the applicant submits an affidavit

 6  in a form prescribed by the department attesting that he or

 7  she has been a state resident for the previous 2 years.

 8         (6)  Notwithstanding the grounds for certification

 9  denial outlined in s. 401.411, an applicant must not have been

10  found guilty of, regardless of plea or adjudication, any

11  offense prohibited under any of the following provisions of

12  the Florida Statutes or under any similar statute of another

13  jurisdiction:

14         (a)  Section 415.111, relating to abuse, neglect, or

15  exploitation of a vulnerable adult.

16         (b)  Section 782.04, relating to murder.

17         (c)  Section 782.07, relating to manslaughter,

18  aggravated manslaughter of an elderly person or disabled

19  adult, or aggravated manslaughter of a child.

20         (d)  Section 782.071, relating to vehicular homicide.

21         (e)  Section 782.09, relating to killing of an unborn

22  child by injury to the mother.

23         (f)  Section 784.011, relating to assault, if the

24  victim of the offense was a minor.

25         (g)  Section 784.021, relating to aggravated assault.

26         (h)  Section 784.03, relating to battery, if the victim

27  of the offense was a minor.

28         (i)  Section 784.045, relating to aggravated battery.

29         (j)  Section 784.01, relating to kidnapping.

30         (k)  Section 787.02, relating to false imprisonment.

31         (l)  Section 794.011, relating to sexual battery.

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 1         (m)  Former s. 794.041, relating to prohibited acts of

 2  persons in familial or custodial authority.

 3         (n)  Chapter 796, relating to prostitution.

 4         (o)  Section 798.02, relating to lewd and lascivious

 5  behavior.

 6         (p)  Chapter 800, relating to lewdness and indecent

 7  exposure.

 8         (q)  Section 806.01, relating to arson.

 9         (r)  Chapter 812, relating to theft, robbery, and

10  related crimes, if the offense was a felony.

11         (s)  Section 817.563, relating to the fraudulent sale

12  of controlled substances, if the offense was a felony.

13         (t)  Section 825.102, relating to abuse, aggravated

14  abuse, or neglect of an elderly person or disabled adult.

15         (u)  Section 825.1025, relating to lewd or lascivious

16  offenses committed upon or in the presence of an elderly

17  person or disabled adult.

18         (v)  Section 825.103, relating to exploitation of an

19  elderly person or disabled adult, if the offense was a felony.

20         (w)  Section 826.04, relating to incest.

21         (x)  Section 827.03, relating to child abuse,

22  aggravated child abuse, or neglect of a child.

23         (y)  Section 827.04, relating to contributing to the

24  delinquency or dependency of a child.

25         (z)  Former s. 827.05, relating to negligent treatment

26  of children.

27         (aa)  Section 827.071, relating to sexual performance

28  by a child.

29         (bb)  Chapter 847, relating to obscene literature.

30  

31  

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 1         (cc)  Chapter 893, relating to drug abuse prevention

 2  and control, if the offense was a felony or if any other

 3  person involved in the offense was a minor.

 4         (dd)  An act that constitutes domestic violence, as

 5  defined in s. 741.28.

 6         (7)  The department may grant to any applicant who

 7  would otherwise be denied certification or recertification

 8  under this subsection an exemption from that denial for:

 9         (a)  A felony committed more than 3 years prior to the

10  date of disqualification;

11         (b)  A misdemeanor prohibited under any of the Florida

12  Statutes cited in this subsection or under similar statutes of

13  other jurisdictions;

14         (c)  An offense that was a felony when committed but

15  that is currently a misdemeanor;

16         (d)  A finding of delinquency; or

17         (e)  The commission of an act of domestic violence as

18  defined in s. 741.28.

19         (8)  For the department to grant an exemption to any

20  applicant under this section, the applicant must demonstrate

21  by clear and convincing evidence that the applicant should not

22  be disqualified from certification or renewed certification.

23  An applicant seeking an exemption has the burden of setting

24  forth sufficient evidence of rehabilitation, including, but

25  not limited to, the circumstances surrounding the criminal

26  incident for which an exemption is sought, the time period

27  that has elapsed since the incident, the nature of the harm

28  caused to the victim, and the history of the applicant since

29  the incident, or any other evidence or circumstances

30  indicating that the applicant will not present a danger if the

31  certification or renewed certification is granted. To make the

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 1  necessary demonstration, the applicant must request an

 2  exemption and submit the required information supporting that

 3  request at the time of application in order for the department

 4  to make a determination in accordance with this section.

 5         (9)  Denial of certification or renewed certification

 6  under subsection (6) may not be removed from, and an exemption

 7  may not be granted to, any applicant who is found guilty of,

 8  regardless of plea or adjudication, any felony covered by

 9  subsection (6), solely by reason of a pardon, executive

10  clemency, or restoration of civil rights.

11         (10)  The department shall adopt rules pursuant to

12  chapter 120 to administer this section.

13         Section 4.  Paragraph (a) of subsection (1) of section

14  401.2701, Florida Statutes, is amended to read:

15         401.2701  Emergency medical services training

16  programs.--

17         (1)  Any private or public institution in Florida

18  desiring to conduct an approved program for the education of

19  emergency medical technicians and paramedics shall:

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

21  by the department, which must include:

22         1.  Evidence that the institution is in compliance with

23  all applicable requirements of the Department of Education.

24         2.  Evidence of an affiliation agreement with a

25  hospital that has an emergency department staffed by at least

26  one physician and one registered nurse.

27         3.  Evidence of an affiliation agreement with a current

28  Florida-licensed emergency medical services provider. Such

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

30  provider to conduct the field experience portion of the

31  education program.

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 1         4.  Documentation verifying faculty, including:

 2         a.  A medical director who is a licensed physician

 3  meeting the applicable requirements for emergency medical

 4  services medical directors as outlined in this chapter and

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

 6  duty and responsibility of certifying that graduates have

 7  successfully completed all phases of the education program and

 8  are proficient in basic or advanced life support techniques,

 9  as applicable.

10         b.  A program director responsible for the operation,

11  organization, periodic review, administration, development,

12  and approval of the program.

13         5.  Documentation verifying that the curriculum:

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

15  plans in the most recent Emergency Medical Technician-Basic

16  National Standard Curricula for emergency medical technician

17  programs and Emergency Medical Technician-Paramedic National

18  Standard Curricula for paramedic programs.

19         b.  Includes 2 hours of instruction on the trauma

20  scorecard methodologies for assessment of adult trauma

21  patients and pediatric trauma patients as specified by the

22  department by rule.

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

24  training consistent with the requirements of chapter 381.

25         d.  Advises students at the initiation of the training

26  program of the certification and regulatory requirements of

27  this chapter, including, but not limited to, the criminal

28  history check required for initial and renewal certification

29  under s. 401.27001. The department shall prescribe by rule the

30  required content of this component of the training program.

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    Florida Senate - 2004                           CS for SB 2136
    317-2196-04




 1         6.  Evidence of sufficient medical and educational

 2  equipment to meet emergency medical services training program

 3  needs.

 4         Section 5.  This act shall take effect July 1, 2004.

 5  

 6          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 7                         Senate Bill 2136

 8                                 

 9  The bill no longer eliminates requirements for the Department
    of Health to adopt a standard state insignia for emergency
10  medical technicians and paramedics and requirements for the
    display of the insignia. Provisions are deleted that allowed
11  an applicant for certification as an emergency medical
    technician or paramedic who had undergone a criminal history
12  check for employment or licensing within 2 years prior to
    application, to submit, in lieu of fingerprints, a copy of a
13  previous official criminal history record.

14  

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