SB736: Bill Text

SB736,32 Section 32 . 256.12 (2) (a) of the statutes is amended to read:

SB736,14,11 256.12 (2) (a) Any county, city, town, village, hospital, ambulance service provider, or combination thereof may, after submission of a plan approved by the department, conduct an emergency medical services program using emergency medical services practitioners or individuals with a privilege to practice, as defined in s. 256.60 (2) (L), for the delivery of emergency medical care to sick, disabled, or injured individuals at the scene of an emergency and during transport to a hospital, while in the hospital emergency department until responsibility for care is assumed by the regular hospital staff, and during transfer of a patient between health care facilities. An ambulance service provider may, after submission of a plan approved by the department, conduct an emergency medical services program using emergency medical services practitioners or individuals with a privilege to practice for the delivery of emergency medical care to sick, disabled, or injured individuals during transfer of the individuals between health care facilities. Nothing in this section prohibits an emergency medical services program from using community paramedics and community emergency medical services practitioners for services described in ss. 256.205 (6) and 256.21 (6) or from providing nonemergency services in accordance with s. 256.15 (6p). Nothing in this section shall be construed to prohibit the operation of fire department, police department, for-profit ambulance service provider, or other emergency vehicles using the services of emergency medical services practitioners or individuals with a privilege to practice in conjunction with a program approved by the department. Hospitals that offer approved training courses for emergency medical services practitioners should, if feasible, serve as the base of operation for approved programs using emergency medical services practitioners.

SB736,33 Section 33. Subchapter II of chapter 256 [precedes 256.60] of the statutes is created to read:

SB736,14,14 chapter 256

SB736,14,15 SUBCHAPTER II

SB736,14,18 EMERGENCY MEDICAL SERVICES PERSONNEL LICENSURE INTERSTATE COMPACT

SB736,15,7 256.60 Emergency medical services personnel licensure interstate compact. (1) Purpose. (a) In order to protect the public through verification of competency and ensure accountability for patient care related activities, all states license emergency medical services personnel, such as emergency medical technicians, advanced emergency medical technicians, and paramedics. This compact is intended to facilitate the day-to-day movement of emergency medical services personnel across state boundaries in the performance of their emergency medical services duties as assigned by an appropriate authority and authorize state emergency medical services offices to afford immediate legal recognition to emergency medical services personnel licensed in a member state. This compact recognizes that states have a vested interest in protecting the public's health and safety through their licensing and regulation of emergency medical services personnel and that such state regulation shared among the member states will best protect public health and safety.

SB736,15,8 (b) This compact is designed to achieve the following purposes and objectives:

SB736,15,9 1. Increase public access to emergency medical services personnel.

SB736,15,11 2. Enhance the states' ability to protect the public's health and safety, especially patient safety.

SB736,15,13 3. Encourage the cooperation of member states in the areas of emergency medical services personnel licensure and regulation.

SB736,15,15 4. Support licensing of military members who are separating from an active duty tour and their spouses.

SB736,15,18 5. Facilitate the exchange of information between member states regarding emergency medical services personnel licensure, adverse action, and significant investigatory information.

SB736,15,20 6. Promote compliance with the laws governing emergency medical services personnel practice in each member state.

SB736,15,23 7. Invest all member states with the authority to hold emergency medical services personnel accountable through the mutual recognition of member state licenses.

SB736,15,24 (2) Definitions. In this section:

SB736,16,4 (a) “Advanced emergency medical technician” or “AEMT” means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National Emergency Medical Services Education Standards and National Emergency Medical Services Scope of Practice Model.

SB736,16,11 (b) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state's laws that may be imposed against licensed emergency medical services personnel by a state EMS authority or state court, including, but not limited to, actions against an individual's license such as revocation, suspension, probation, consent agreement, monitoring or other limitation or encumbrance on the individual's practice, letters of reprimand or admonition, fines, criminal convictions, and state court judgments enforcing adverse actions by the state EMS authority.

SB736,16,13 (c) “Alternative program” means a voluntary, nondisciplinary substance abuse recovery program approved by a state EMS authority.

SB736,16,16 (d) “Certification” means the successful verification of entry-level cognitive and psychomotor competency using a reliable, validated, and legally defensible examination.

SB736,16,18 (e) “Commission” means the national administrative body of which all states that have enacted the compact are members.

SB736,16,22 (f) “Emergency medical technician” or “EMT” means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National Emergency Medical Services Education Standards and National Emergency Medical Services Scope of Practice Model.

SB736,16,24 (g) “Home state” means a member state where an individual is licensed to practice emergency medical services.

SB736,17,2 (h) “License” means the authorization by a state for an individual to practice as an EMT, AEMT, paramedic, or a level in between EMT and paramedic.

SB736,17,4 (i) “Medical director” means a physician licensed in a member state who is accountable for the care delivered by emergency medical services personnel.

SB736,17,5 (j) “Member state” means a state that has enacted this compact.

SB736,17,9 (k) “Paramedic” means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National Emergency Medical Services Education Standards and National Emergency Medical Services Scope of Practice Model.

SB736,17,11 (L) “Privilege to practice” means an individual's authority to deliver emergency medical services in remote states as authorized under this compact.

SB736,17,13 (m) “Remote state” means a member state in which an individual is not licensed.

SB736,17,15 (n) “Restricted” means the outcome of an adverse action that limits a license or the privilege to practice.

SB736,17,21 (o) “Rule” means a written statement by the interstate commission promulgated pursuant to sub. (12) that is of general applicability; implements, interprets, or prescribes a policy or provision of the compact; or is an organizational, procedural, or practice requirement of the commission and has the force and effect of statutory law in a member state and includes the amendment, repeal, or suspension of an existing rule.

SB736,17,25 (p) “Scope of practice” means defined parameters of various duties or services that may be provided by an individual with specific credentials. Whether regulated by rule, statute, or court decision, it tends to represent the limits of services an individual may perform.

SB736,18,1 (q) “Significant investigatory information” means any of the following:

SB736,18,5 1. Investigative information that a state EMS authority, after a preliminary inquiry that includes notification and an opportunity to respond if required by state law, has reason to believe, if proven true, would result in the imposition of an adverse action on a license or privilege to practice.

SB736,18,8 2. Investigative information that indicates that the individual represents an immediate threat to public health and safety regardless of whether the individual has been notified and had an opportunity to respond.

SB736,18,10 (r) “State” means any state, commonwealth, district, or territory of the United States.

SB736,18,12 (s) “State EMS authority” means the board, office, or other agency with the legislative mandate to license emergency medical services personnel.

SB736,18,14 (3) Home state licensure. (a) Any member state in which an individual holds a current license shall be deemed a home state for purposes of this compact.

SB736,18,17 (b) Any member state may require an individual to obtain and retain a license to be authorized to practice in the member state under circumstances not authorized by the privilege to practice under the terms of this compact.

SB736,18,19 (c) A home state's license authorizes an individual to practice in a remote state under the privilege to practice only if the home state does all of the following:

SB736,18,22 1. Currently requires the use of the National Registry of Emergency Medical Technicians examination as a condition of issuing initial licenses at the EMT and paramedic levels.

SB736,18,24 2. Has a mechanism in place for receiving and investigating complaints about individuals.

SB736,19,2 3. Notifies the commission, in compliance with the terms herein, of any adverse action or significant investigatory information regarding an individual.

SB736,19,8 4. No later than 5 years after activation of the compact, requires a criminal background check of all applicants for initial licensure, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the federal bureau of investigation with the exception of federal employees who have suitability determination in accordance with 5 CFR 731.202 and submit documentation of such as promulgated in the rules of the commission.

SB736,19,9 5. Complies with the rules of the commission.

SB736,19,12 (4) Compact privilege to practice. (a) Member states shall recognize the privilege to practice of an individual licensed in another member state that is in conformance with sub. (3).

SB736,19,14 (b) To exercise the privilege to practice under the terms and provisions of this compact, an individual must satisfy all of the following requirements:

SB736,19,15 1. Be at least 18 years of age.

SB736,19,18 2. Possess a current unrestricted license in a member state as an EMT, AEMT, paramedic, or state recognized and licensed level with a scope of practice and authority between EMT and paramedic.

SB736,19,19 3. Practice under the supervision of a medical director.

SB736,19,23 (c) An individual providing patient care in a remote state under the privilege to practice shall function within the scope of practice authorized by the home state unless and until modified by an appropriate authority in the remote state as may be defined in the rules of the commission.

SB736,20,4 (d) Except as provided in par. (c), an individual practicing in a remote state will be subject to the remote state's authority and laws. A remote state may, in accordance with due process and that state's laws, restrict, suspend, or revoke an individual's privilege to practice in the remote state and may take any other necessary actions to protect the health and safety of its citizens. If a remote state takes action, it shall promptly notify the home state and the commission.

SB736,20,7 (e) If an individual's license in any home state is restricted or suspended, the individual shall not be eligible to practice in a remote state under the privilege to practice until the individual's home state license is restored.

SB736,20,10 (f) If an individual's privilege to practice in any remote state is restricted, suspended, or revoked, the individual shall not be eligible to practice in any remote state until the individual's privilege to practice is restored.

SB736,20,15 (5) Conditions of practice in a remote state. An individual may practice in a remote state under a privilege to practice only in the performance of the individual's emergency medical services duties as assigned by an appropriate authority, as defined in the rules of the commission, and under all of the following circumstances:

SB736,20,17 (a) The individual originates in the home state and transports the patient to a remote state.

SB736,20,19 (b) The individual originates in the home state and enters a remote state to pick up a patient and provide care and transport of the patient to the home state.

SB736,20,21 (c) The individual enters a remote state to provide patient care or transport within that remote state.

SB736,20,23 (d) The individual enters a remote state to pick up a patient and provide care and transport to a 3rd member state.

SB736,20,24 (e) Other conditions as determined by rules promulgated by the commission.

SB736,21,8 (6) Relationship to emergency management assistance compact. Upon a member state's governor's declaration of a state of emergency or disaster that activates the Emergency Management Assistance Compact, all relevant terms and provisions of the Emergency Management Assistance Compact shall apply and to the extent any terms or provisions of this compact conflicts with the Emergency Management Assistance Compact, the terms of the Emergency Management Assistance Compact shall prevail with respect to any individual practicing in the remote state in response to such declaration.

SB736,21,15 (7) Veterans, service members separating from active duty military, and their spouses. (a) Member states shall consider a veteran, active military service member, and member of the National Guard and Reserves separating from an active duty tour, and a spouse thereof, who holds a current valid and unrestricted certification by the National Registry of Emergency Medical Technicians at or above the level of the state license being sought as satisfying the minimum training and examination requirements for such licensure.

SB736,21,18 (b) Member states shall expedite the processing of licensure applications submitted by veterans, active military service members, and members of the National Guard and Reserves separating from an active duty tour, and their spouses.

SB736,21,20 (c) All individuals functioning with a privilege to practice under this subsection remain subject to the adverse actions provisions in sub. (8).

SB736,21,22 (8) Adverse actions. (a) A home state shall have exclusive power to impose adverse action against an individual's license issued by the home state.

SB736,21,25 (b) 1. If an individual's license in any home state is restricted or suspended, the individual shall not be eligible to practice in a remote state under the privilege to practice until the individual's home state license is restored.

SB736,22,4 2. All home state adverse action orders shall include a statement that the individual's compact privileges are inactive. The order may allow the individual to practice in remote states with prior authorization from the state EMS authority of both the home state and the remote state.

SB736,22,7 3. An individual currently subject to adverse action in the home state shall not practice in any remote state without prior written authorization from the state EMS authority of both the home state and the remote state.

SB736,22,10 (c) A member state shall report adverse actions and any occurrences that the individual's compact privileges are restricted, suspended, or revoked to the commission in accordance with the rules of the commission.

SB736,22,12 (d) A remote state may take adverse action on an individual's privilege to practice within that state.

SB736,22,15 (e) Any member state may take adverse action against an individual's privilege to practice in that state based on the factual findings of another member state, so long as each state follows its own procedures for imposing such adverse action.

SB736,22,19 (f) The state EMS authority of a home state shall investigate and take appropriate action with respect to reported conduct in a remote state as it would if such conduct had occurred within the home state. In such cases, the home state's law shall control in determining the appropriate adverse action.

SB736,22,25 (g) Nothing in this compact shall override a member state's decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain nonpublic if required by the member state's laws. Member states must require individuals who enter any alternative programs to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state.

SB736,23,3 (9) Additional powers invested in a state EMS authority of a member state. The state EMS authority of a member state, in addition to any other powers granted under state law, is authorized under this compact to do any of the following:

SB736,23,12 (a) Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses and the production of evidence. Subpoenas issued by the state EMS authority of a member state for the attendance and testimony of witnesses, or the production of evidence from another member state, shall be enforced in the remote state by any court of competent jurisdiction, according to that court's practice and procedure in considering subpoenas issued in its own proceedings. The issuing state EMS authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses or evidence are located.

SB736,23,14 (b) Issue cease and desist orders to restrict, suspend, or revoke an individual's privilege to practice in the state.

SB736,23,19 (10) Establishment of the Interstate Commission for Emergency Medical Services Personnel Practice. (a) Interstate Commission for Emergency Medical Services Personnel Practice. The compact states hereby create and establish a joint public agency known as the Interstate Commission for Emergency Medical Services Personnel Practice.

SB736,23,21 1. The commission is a body politic and an instrumentality of the compact states.

SB736,23,24 2. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located.

SB736,24,2 3. Nothing in this compact shall be construed to be a waiver of sovereign immunity.

SB736,24,12 (b) Membership, voting, and meetings. 1. Each member state shall have and be limited to one delegate. The responsible official of the state EMS authority or his or her designee shall be the delegate to this compact for each member state. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. Any vacancy occurring in the commission shall be filled in accordance with the laws of the member state in which the vacancy exists. In the event that more than one board, office, or other agency with the legislative mandate to license emergency medical services personnel at and above the level of EMT exists, the governor of the state will determine which entity will be responsible for assigning the delegate.

SB736,24,17 2. Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the commission. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates' participation in meetings by telephone or other means of communication.

SB736,24,19 3. The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.

SB736,24,22 4. All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rule-making provisions in sub. (12).

SB736,24,24 5. The commission may convene in a closed, nonpublic meeting if the commission must discuss any of the following:

SB736,24,25 a. Noncompliance of a member state with its obligations under the compact.

SB736,25,3 b. The employment, compensation, discipline, or other personnel matters, practices, or procedures related to specific employees, or other matters related to the commission's internal personnel practices and procedures.

SB736,25,4 c. Current, threatened, or reasonably anticipated litigation.

SB736,25,6 d. Negotiation of contracts for the purchase or sale of goods, services, or real estate.