HB269 By Representative Sells RFD Health Rd 1 18-FEB-20

SYNOPSIS: Under existing law, emergency medical services personnel are subject to regulation by the State Board of Health.

This bill would authorize the State Board of Health to establish and administer a community paramedicine program that authorizes paramedics to provide certain services to patients in certain circumstances.

This bill would require the State Board of Health to adopt rules.

This bill would also revise definitions, including definitions for services provided by emergency medical services personnel.

A BILL TO BE ENTITLED AN ACT

Relating to emergency medical services; to amend Section 22-18-1, Code of Alabama 1975, and to add Section 22-18-10 to the Code of Alabama 1975; to authorize the State Board of Health to establish and administer a community paramedicine program that allows paramedics to provide certain services to patients; to authorize rulemaking; and to revise definitions.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:Section 1. Section 22-18-1, Code of Alabama 1975, is amended to read as follows:

§22-18-1.

"For the purposes of this article, the following terms shall have the meanings respectively ascribed to them by this section:

"(1) ADVANCED EMERGENCY MEDICAL TECHNICIAN. Any person individual 18 years of age or older who satisfies all of the following:

"a. Has successfully completed the advanced emergency medical technician course of instruction, or its equivalent, as approved by the State Board of Health board.

"b. Has passed the state Advanced EMT examination, as well as having met the requirements for becoming a licensed emergency medical technician.

"c. Has been granted a license by the State Board of Health board.

"(2) ADVANCED LIFE SUPPORT (ALS). The treatment of potentially life-threatening medical emergencies through the use of invasive medical techniques specified as advanced life support techniques by the Board of Health board, which ordinarily would be performed or provided by licensed physicians, but which may be performed by emergency medical service personnel during emergencies under constraints specified by rule of the board.

"(3) AIR AMBULANCE. An aircraft that is intended to be used for and is maintained or operated for transportation to a medical care facility of persons who are sick or injured. For the purposes of this chapter, fixed-wing aircraft that do not conduct scene flights shall not be considered air ambulances.

"(4) BASIC LIFE SUPPORT (BLS). Prehospital care involving non-invasive life support measures as specified by the board.

"(5) BOARD or BOARD OF HEALTH. The State Board of Health.

"(6) COMMUNITY PARAMEDIC. An individual 18 years of age or older who satisfies all of the following:

"a. Is currently licensed as a paramedic.

"b. Has two years of full-time service as a paramedic.

"c. Has successfully completed a community paramedic training program from an accredited college or university approved by the board.

"d. Has passed the state community paramedic examination, as well as having met the requirements for becoming a licensed community paramedic.

"e. Has been granted a license by the board.

"(7) COMMUNITY PARAMEDICINE PROGRAM. The provision of certain medical services, as determined by rule, that a community paramedic may provide.

"(6)(8) DEPARTMENT. The Alabama Department of Public Health.

"(7)(9) EMERGENCY MEDICAL SERVICES (EMS). A system of coordinated response to provide prehospital emergency aid and medical assistance from primary response to definitive care, involving personnel trained in the rescue, stabilization, transportation, and treatment of sick or injured persons A system that consists of all of the following:

"a. The transportation and medical care provided to sick or injured individuals before arrival at a medical facility by licensed emergency medical services personnel.

"b. Continuation of care within a medical facility subject to the approval of the medical staff and governing board of that facility.

"c. Integrated medical care in emergency and nonurgent settings with the oversight of a physician.

(8)(10) EMERGENCY MEDICAL SERVICES PERSONNEL (EMSP). The collective term used to refer to licensed emergency medical technicians, emergency medical technicians intermediate, advanced emergency medical technicians, paramedics, and any level of licensure as recognized by the National Highway Traffic Safety Administration for individuals who provide emergency medical services or who initiate immediate lifesaving care An individual licensed by the board at any level established by law or by rules adopted by the board under this article and authorized to perform these limited services set forth in the rules.

"(9)(11) EMERGENCY MEDICAL TECHNICIAN (EMT). Any person An individual 18 years of age or older who satisfies all of the following:

"a. Has successfully completed the basic emergency medical technician course of instruction, or its equivalent, as approved by the Board of Health board.

"b. Has passed the state EMT examination.

"c. Has been granted a license by the Board of Health board.

"(10)(12) GROUND AMBULANCE. A motor vehicle that is intended to be used for and is maintained or operated for transportation to a medical care facility of persons individuals who are sick or injured.

"(11)(13) LICENSED EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE. Any person An individual 18 years of age or older who, prior to December 31, 2002, satisfies all of the following:

"a. Has successfully completed the intermediate emergency medical technician course of instruction, or its equivalent, as approved by the Board of Health board.

"b. Has passed the state EMT Intermediate examination, as well as having met the requirements for becoming a licensed emergency medical technician.

"c. has been granted a license by the Board of Health board.

"(14) MEDICAL FACILITY. Any hospital, medical clinic, physician's office, nursing home, or other health care facility.

"(12)(15) NON-TRANSPORT VEHICLE. A vehicle operated with the intent to provide BLS or ALS stabilization on scene, but not intended to transport a patient to a medical care facility.

"(13)(16) PARAMEDIC. Any person individual 18 years of age or older who has successfully completed the paramedic course of instruction, or its equivalent, as approved by the Board of Health board, and passed the state EMT-paramedic examination, and who has been granted a license by the Board of Health board.

"(14)(17) PATIENT. An individual who receives or requests medical care, or for whom medical care is requested, because the individual is sick or injured.

"(15)(18) PHYSICIAN. An individual licensed to practice medicine by the Medical Licensure Commission of Alabama.

"(16)(19) PROVIDER SERVICE. An organization, whether public or private, which provides transport or non-transport emergency medical services.

"(17)(20) SCENE FLIGHT. The flight of an air ambulance to the physical location of a sick or injured person individual.

"(18)(21) TRANSPORT VEHICLE. An air or ground ambulance."

Section 2. Section 22-18-10 is added to the Code of Alabama 1975, to read as follows:

§22-18-10.

(a) The board may establish and administer a community paramedicine program to authorize paramedics to provide community paramedic services, as further provided in this section.

(b) An individual is eligible as a patient for a community paramedicine program if the individual meets any of the following criteria:

(1) The individual has been discharged from a medical facility, and has declined or is not eligible for home health or hospice services.

(2) The individual has been identified by his or her treating physician as an individual for whom community paramedic services would likely prevent admission or readmission to, or allow discharge from, a medical facility.

(3) The individual has been referred to the community paramedicine program to receive preventive services.

(c) Community paramedic services are limited to all of the following:

(1) Coordination of community services.

(2) Chronic disease monitoring and education.

(3) Health assessment.

(4) Hospital discharge follow-up care.

(5) Laboratory specimen collection.

(6) Medication compliance.

(7) Continuation of care within a medical facility.

(8) Integrated medical care with the oversight of a physician.

(d) A community paramedic shall document all community paramedic services provided, and shall forward a copy of the documentation to the attending or treating physician, as prescribed by rules adopted by the board.

(e) Nothing in this section shall be construed to allow a community paramedic to make a diagnosis or prescribe drugs.

(f) The board shall adopt rules to implement this section, including, but not limited to, the length of time after discharge a patient is eligible for community paramedic services.

Section 3. This act shall become effective on the first day of the third month following its passage and approval by the Governor, or its otherwise becoming law.

Emergency Medical Services

Emergencies

Board of Health, State

Health Care

Code Added

Code Amended