SB736: Bill Text

SB736,9,21 146.37 (1) (a) “Health care provider" includes an ambulance service provider, as defined in s. 256.01 (3), and an emergency medical services practitioner, as defined in s. 256.01 (5), an individual with a privilege to practice, as defined in s. 256.60 (2) (L), and an emergency medical responder, as defined in s. 256.01 (4p).

SB736,17 Section 17 . 146.37 (1) (a) of the statutes is amended to read:

SB736,9,24 146.37 (1) (a) “Health care provider" includes an ambulance service provider, as defined in s. 256.01 (3), and an emergency medical services practitioner, as defined in s. 256.01 (5), and an emergency medical responder, as defined in s. 256.01 (4p), and an individual with a privilege to practice, as defined in s. 256.60 (2) (L).

SB736,18 Section 18 . 146.38 (1) (b) 1. of the statutes is amended to read:

SB736,10,4 146.38 (1) (b) 1. A person specified in s. 146.81 (1) (a) to (hp), (r), or (s), or (t).

SB736,19 Section 19. 146.81 (1) (t) of the statutes is created to read:

SB736,10,7 146.81 (1) (t) An individual with a privilege to practice, as defined in s. 256.60 (2) (L).

SB736,20 Section 20. 146.81 (4) of the statutes is amended to read:

SB736,10,24 146.81 (4) “Patient health care records" means all records related to the health of a patient prepared by or under the supervision of a health care provider; and all records made by an ambulance service provider, as defined in s. 256.01 (3), an emergency medical services practitioner, as defined in s. 256.01 (5), or an emergency medical responder, as defined in s. 256.01 (4p), or an individual with a privilege to practice, as defined in s. 256.60 (2) (L), in administering emergency care procedures to and handling and transporting sick, disabled, or injured individuals. “ Patient health care records" includes billing statements and invoices for treatment or services provided by a health care provider and includes health summary forms prepared under s. 302.388 (2). “Patient health care records" does not include those records subject to s. 51.30, reports collected under s. 69.186, records of tests administered under s. 252.15 (5g) or (5j), 343.305, 938.296 (4) or (5) or 968.38 (4) or (5), records related to sales of pseudoephedrine products, as defined in s. 961.01 (20c), that are maintained by pharmacies under s. 961.235, fetal monitor tracings, as defined under s. 146.817 (1), or a pupil's physical health records maintained by a school under s. 118.125.

SB736,21 Section 21. 146.997 (1) (d) 14. of the statutes is amended to read:

SB736,11,3 146.997 (1) (d) 14. An emergency medical services practitioner licensed under s. 256.15 (5) or, an emergency medical responder, or an individual with a privilege to practice, as defined in s. 256.60 (2) (L).

SB736,22 Section 22 . 154.19 (3) (a) of the statutes is amended to read:

SB736,11,10 154.19 (3) (a) Except as provided in par. (b), emergency medical services practitioners, as defined in s. 256.01 (5), emergency medical responders, as defined in s. 256.01 (4p), individuals with a privilege to practice, as defined in s. 256.60 (2) (L), and emergency health care facilities personnel shall follow do-not-resuscitate orders. The procedures used in following a do-not-resuscitate order shall be in accordance with any procedures established by the department by rule.

SB736,23 Section 23 . 154.19 (3) (b) 3. of the statutes is amended to read:

SB736,11,14 154.19 (3) (b) 3. The emergency medical services practitioner, emergency medical responder, individual with a privilege to practice, or member of the emergency health care facility knows that the patient is pregnant.

SB736,24 Section 24 . 154.21 (1) (a) of the statutes is amended to read:

SB736,11,22 154.21 (1) (a) The patient expresses to an emergency medical services practitioner, to an emergency medical responder, to an individual with a privilege to practice, as defined in s. 256.60 (2) (L), or to a person who serves as a member of an emergency health care facility's personnel the desire to be resuscitated. The emergency medical services practitioner, emergency medical responder, individual with a privilege to practice, or the member of the emergency health care facility shall promptly remove the do-not-resuscitate bracelet.

SB736,25 Section 25 . 154.225 (2) (a) of the statutes is amended to read:

SB736,12,5 154.225 (2) (a) The guardian or health care agent directs an emergency medical services practitioner, an emergency medical responder, an individual with a privilege to practice, as defined in s. 256.60 (2) (L), or a person who serves as a member of an emergency health care facility's personnel to resuscitate the patient. The emergency medical services practitioner, the emergency medical responder, individual with a privilege to practice, or the member of the emergency health care facility shall promptly remove the do-not-resuscitate bracelet.

SB736,26 Section 26 . 154.25 (6) of the statutes is amended to read:

SB736,12,12 154.25 (6) Valid do-not-resuscitate bracelet. A do-not-resuscitate bracelet that has not been removed, altered, or tampered with in any way shall be presumed valid, unless the patient, the patient's guardian, or the patient's health care agent expresses to the emergency medical services practitioner, emergency medical responder, individual with a privilege to practice, as defined in s. 256.60 (2) (L), or emergency health care facility personnel the patient's desire to be resuscitated.

SB736,27 Section 27. 157.06 (12) (a) 1. of the statutes is amended to read:

SB736,12,16 157.06 (12) (a) 1. A law enforcement officer, fire fighter, emergency medical services practitioner, emergency medical responder, individual with a privilege to practice, as defined in s. 256.60 (2) (L), or ambulance service provider.

SB736,28 Section 28. 252.14 (1) (ar) 16. of the statutes is created to read:

SB736,12,19 252.14 (1) (ar) 16. An individual with a privilege to practice, as defined in s. 256.60 (2) (L).

SB736,29 Section 29. 252.15 (5g) (a) 1. of the statutes is amended to read:

SB736,13,3 252.15 (5g) (a) 1. The person is an emergency medical services practitioner; emergency medical responder; individual with a privilege to practice, as defined in s. 256.60 (2) (L); fire fighter; peace officer; correctional officer; person who is employed at a juvenile correctional facility, as defined in s. 938.02 (10p), or a secured residential care center for children and youth, as defined in s. 938.02 (15g); state patrol officer; jailer, keeper of a jail, or person designated with custodial authority by the jailer or keeper and the contact occurred during the course of the person providing care or services to the individual.

SB736,30 Section 30. Subchapter I (title) of chapter 256 [precedes 256.01] of the statutes is created to read:

SB736,13,6 chapter 256

SB736,13,7 SUBCHAPTER I

SB736,13,9 EMERGENCY MEDICAL SERVICES IN GENERAL

SB736,31 Section 31. 256.01 (intro.) of the statutes is amended to read:

SB736,13,11 256.01 Definitions. (intro.) In this chapter subchapter:

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.