Florida Senate - 2022 CS for SB 1144
By the Committee on Health Policy; and Senator Brodeur
588-02670-22 20221144c1
1 A bill to be entitled
2 An act relating to advanced life support nontransport
3 services and medical countermeasures; amending s.
4 401.25, F.S.; exempting certain governmental entities
5 from the requirement to obtain a certificate of public
6 convenience and necessity for a license to provide
7 advanced life support nontransport services; providing
8 requirements for, and limitations on, the provision of
9 advanced life support nontransport services by such
10 entities; defining the term “countywide common medical
11 protocol”; providing applicability; prohibiting
12 counties from limiting, prohibiting, or preventing
13 such entities from providing advanced life support
14 nontransport services; providing construction;
15 amending s. 401.26, F.S.; conforming a provision to
16 changes made by the act; amending s. 401.265, F.S.;
17 providing that a medical director is liable for any
18 act or omission of a paramedic under his or her
19 supervision who administers medical countermeasures in
20 a nonemergency environment; providing for a State
21 Emergency Medical Services Medical Director appointed
22 by the State Surgeon General; requiring the medical
23 director to meet certain minimum qualifications and
24 perform certain duties; amending s. 401.272, F.S.;
25 defining the terms “health promotion and wellness
26 activities” and “medical countermeasures”; authorizing
27 paramedics to administer medical countermeasures in a
28 nonemergency environment under the direction of a
29 medical director; providing that a paramedic’s medical
30 director may have a certain required written agreement
31 with the Department of Health, rather than only with a
32 county health department; requiring medical directors
33 to verify and document that paramedics under their
34 direction have received sufficient training and
35 experience to administer medical countermeasures;
36 authorizing independent special fire control districts
37 to allow their paramedics and emergency medical
38 technicians to perform certain activities and
39 administer certain services in accordance with
40 specified provisions; providing an effective date.
41
42 Be It Enacted by the Legislature of the State of Florida:
43
44 Section 1. Subsection (8) is added to section 401.25,
45 Florida Statutes, to read:
46 401.25 Licensure as a basic life support or an advanced
47 life support service.—
48 (8)(a) Notwithstanding paragraph (2)(d) or any general law,
49 special act, or local ordinance to the contrary, and except as
50 provided in paragraph (b), the department shall issue a
51 governmental entity a license to provide advanced life support
52 nontransport services without requiring it to obtain a
53 certificate of public convenience and necessity if the
54 governmental entity maintains a fire rescue infrastructure that
55 dispatches first responders as defined in s. 112.1815(1) and
56 meets all other licensure requirements of this section. A
57 governmental entity issued a license under this subsection is
58 subject to all of the following requirements and limitations:
59 1. The governmental entity must require its medical
60 director to issue standing orders or protocols to implement the
61 medical standards of any countywide common medical protocol
62 applicable to the entity, if such protocol is instituted. An
63 entity must submit an affidavit with its licensure application
64 certifying that its medical director has issued such standing
65 orders or protocols. As used in this subparagraph, the term
66 “countywide common medical protocol” means medical standards
67 issued by a county’s medical director or a council created by
68 county ordinance which specify protocols for the provision of
69 basic and advanced life support services in that county. Such
70 standards must be based on whether the procedures are being
71 performed by an emergency medical technician or a paramedic and
72 not based on the employer of, or type of response vehicle used
73 by, such emergency medical personnel.
74 2. The governmental entity is eligible only for advanced
75 life support nontransport vehicle permits issued under s.
76 401.26.
77 3. The governmental entity may provide only advanced life
78 support nontransport services and is authorized to provide such
79 services within its jurisdictional boundaries and areas that it
80 serves in accordance with a closest unit response agreement or
81 mutual or automatic aid agreement.
82 (b) The exemption under this subsection does not apply to a
83 governmental entity that:
84 1. Is located within a county in which there is a
85 countywide emergency medical services authority created by
86 special act;
87 2. Is located within a county that has more than 35
88 municipalities; or
89 3. Contracts with a private entity licensed by the
90 department to provide emergency medical services.
91 (c) A county may not limit, prohibit, or prevent a
92 governmental entity that has been issued a license under this
93 subsection from providing advanced life support nontransport
94 services, including, but not limited to, requiring the
95 governmental entity to obtain a license, certificate, or vehicle
96 permit or to pay a fee to provide such services in that county.
97 (d) This subsection may not be construed to exempt an
98 applicant from any other requirement for licensure under state
99 law or to exempt a licensee from otherwise complying with this
100 part or department rules.
101 Section 2. Subsection (1) of section 401.26, Florida
102 Statutes, is amended to read:
103 401.26 Vehicle permits for basic life support and advanced
104 life support services.—
105 (1) Every licensee shall possess a valid permit for each
106 transport vehicle, advanced life support nontransport vehicle,
107 and aircraft in use. Applications for such permits must shall be
108 made upon forms prescribed by the department. The licensee shall
109 provide documentation that each vehicle for which a permit is
110 sought meets the appropriate requirements for a basic life
111 support or advanced life support service vehicle, whichever is
112 applicable, as specified by rule of the department. A permit is
113 not required for an advanced life support nontransport vehicle
114 that is intended to be used for scene supervision, incident
115 command, or the augmentation of supplies. A governmental entity
116 issued a license under s. 401.25(8) is eligible only for an
117 advanced life support nontransport vehicle permit.
118 Section 3. Present subsection (5) of section 401.265,
119 Florida Statutes, is redesignated as subsection (6), a new
120 subsection (5) is added to that section, and subsection (4) of
121 that section is amended, to read:
122 401.265 Medical directors.—
123 (4) Each medical director who uses a paramedic or emergency
124 medical technician to perform blood pressure screenings or
125 screening, health promotion, and wellness activities, or to
126 administer immunizations or medical countermeasures in a
127 nonemergency environment immunization on any patient under a
128 protocol as specified in s. 401.272, which is not in the
129 provision of emergency care, is liable for any act or omission
130 of any paramedic or emergency medical technician acting under
131 his or her supervision and control when performing such
132 activities and services.
133 (5) A State Emergency Medical Services (EMS) Medical
134 Director shall be appointed by and report to the State Surgeon
135 General. The State EMS Medical Director must be a physician
136 licensed under chapter 458 or chapter 459 who has specialized
137 training and experience in the provision of emergency medical
138 services and who has recognized skills in leadership and the
139 promotion of emergency medical services programs. The State EMS
140 Medical Director shall perform such duties as directed by the
141 State Surgeon General and serve on the Emergency Medical
142 Services Advisory Council created under s. 401.245.
143 Section 4. Section 401.272, Florida Statutes, is amended to
144 read:
145 401.272 Emergency medical services community health care.—
146 (1) As used in this section, the term:
147 (a) “Health promotion and wellness activities” means the
148 provision of public health programs relating to the prevention
149 or reduction of illness or injury.
150 (b) “Medical countermeasures” means lifesaving medication
151 or medical supplies regulated by the United States Food and Drug
152 Administration which can be used to diagnose, prevent, protect
153 from, or treat conditions associated with chemical, biological,
154 radiological, or nuclear threats, emerging infectious diseases,
155 or natural disasters.
156 (2) The purpose of this section is to encourage more
157 effective utilization of the skills of emergency medical
158 technicians and paramedics by enabling them to perform, in
159 partnership with local county health departments, specific
160 additional health care tasks that are consistent with the public
161 health and welfare.
162 (3)(2) Notwithstanding any other provision of law to the
163 contrary:
164 (a) Paramedics or emergency medical technicians may perform
165 health promotion and wellness activities and blood pressure
166 screenings in a nonemergency environment, within the scope of
167 their training, and under the direction of a medical director.
168 As used in this paragraph, the term “health promotion and
169 wellness” means the provision of public health programs
170 pertaining to the prevention of illness and injury.
171 (b) Paramedics may administer immunizations or medical
172 countermeasures in a nonemergency environment, within the scope
173 of their training, and under the direction of a medical
174 director. There must be a written agreement between the
175 paramedic’s medical director and the department or the county
176 health department located in each county in which the paramedic
177 administers immunizations or medical countermeasures. This
178 agreement must establish the protocols, policies, and procedures
179 under which the paramedic must operate.
180 (4)(3) Each medical director under whose direction a
181 paramedic administers immunizations or medical countermeasures
182 must verify and document that the paramedic has received
183 sufficient training and experience to administer immunizations
184 or medical countermeasures, as applicable. The verification must
185 be documented on forms developed by the department, and the
186 completed forms must be maintained at the service location of
187 the licensee and made available to the department upon request.
188 (5) An independent special fire control district as defined
189 in s. 191.003 may allow its paramedics and emergency medical
190 technicians to perform blood pressure screenings or health
191 promotion and wellness activities or administer immunizations or
192 medical countermeasures in accordance with this section.
193 (6)(4) The department may adopt and enforce all rules
194 necessary to enforce the provisions relating to a paramedic’s
195 administration of immunizations and medical countermeasures and
196 the performance of health promotion and wellness activities and
197 blood pressure screenings by a paramedic or emergency medical
198 technician in a nonemergency environment.
199 Section 5. This act shall take effect upon becoming a law.