HB 2446 Enrolled- Today --5-27-01-waiting Gov's Signature

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77® HB 2446 Enrolled version - Bill Text

1-1 AN ACT

1-2 relating to emergency medical services.

1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-4 SECTION 1. Chapter 771, Health and Safety Code, is amended

1-5 by adding Subchapter E to read as follows:

1-6 SUBCHAPTER E. STATE EMERGENCY MEDICAL DISPATCH RESOURCE CENTER

1-7 Sec. 771.101. ESTABLISHMENT OF PILOT PROGRAM. (a) The Texas

1-8 Department of Health, with the assistance of the advisory council

1-9 appointed under Section 773.012, shall establish a pilot program to

1-10 test the efficacy of using emergency medical dispatchers located in

1-11 a regional emergency medical dispatch resource center to provide

1-12 lifesaving and other emergency medical instructions to persons who

1-13 need guidance while awaiting the arrival of emergency medical

1-14 personnel. The purpose of a regional emergency medical dispatch

1-15 resource center is not to dispatch personnel or equipment resources

1-16 but to serve as a resource to provide pre-arrival instructions that

1-17 may be accessed by selected public safety answering points that are

1-18 not adequately staffed or funded to provide those services.

1-19 ( The commission shall provide technical assistance to the

1-20 department to facilitate the implementation of the pilot program.

1-21 © The department, with the cooperation of the advisory

1-22 council, shall:

1-23 (1) design criteria and protocols and provide

1-24 oversight as needed to conduct the pilot program;

2-1 (2) collect the necessary data to evaluate the outcome

2-2 of the pilot program; and

2-3 (3) report its findings to the legislature.

2-4 Sec. 771.102. PARTICIPATION IN PILOT PROGRAM. (a) The Texas

2-5 Department of Health shall determine which public safety answering

2-6 points are interested in participating in the pilot program.

2-7 ( The department shall establish criteria for selecting

2-8 qualified public safety answering points to participate in the

2-9 pilot program.

2-10 © Participating public safety answering points must agree

2-11 to participate in any required training and to provide regular

2-12 reports required by the department for the pilot program.

2-13 Sec. 771.103. SELECTION OF REGIONAL EMERGENCY MEDICAL

2-14 DISPATCH RESOURCE CENTER. (a) The Texas Department of Health, with

2-15 the assistance of the advisory council, shall select one public

2-16 safety answering point to serve as the regional emergency medical

2-17 dispatch resource center. The public safety answering point

2-18 selected as the resource center for the pilot program must:

2-19 (1) have a fully functional quality assurance program

2-20 that measures each emergency medical dispatcher's compliance with

2-21 the medical protocol;

2-22 (2) have dispatch personnel who meet the requirements

2-23 for emergency medical dispatcher certification or the equivalent as

2-24 determined by the Texas Department of Health;

2-25 (3) use emergency medical dispatch protocols approved

2-26 by a physician medical director knowledgeable in emergency medical

2-27 dispatch;

3-1 (4) have sufficient experience in providing

3-2 pre-arrival instructions; and

3-3 (5) have sufficient resources to handle the additional

3-4 workload and responsibilities of the pilot program.

3-5 ( In selecting an existing public safety answering point

3-6 to act as the resource center, the department and the advisory

3-7 council shall consider a public safety answering point's ability to

3-8 keep records and produce reports to measure the effectiveness of

3-9 the pilot program.

3-10 Sec. 771.104. CRITERIA FOR EMERGENCY MEDICAL DISPATCH

3-11 INTERVENTION. The department and the advisory council shall define

3-12 criteria that establish the need for emergency medical dispatch

3-13 intervention to be used by participating public safety answering

3-14 points to determine which calls are to be transferred to the

3-15 regional emergency medical dispatch resource center for emergency

3-16 medical dispatch intervention.

3-17 Sec. 771.105. FUNDING OF PILOT PROGRAM. Money in the 9-1-1

3-18 services fee fund may be appropriated to the Texas Department of

3-19 Health to fund the pilot program. The department is also

3-20 authorized to seek grant funding for the pilot program. The

3-21 provisions in this subchapter that require the department to

3-22 establish, conduct, and evaluate the pilot program are contingent

3-23 on the department receiving funding in accordance with this

3-24 section.

3-25 Sec. 771.106. REPORT TO LEGISLATURE. The department shall

3-26 report its findings to the presiding officer of each house of the

3-27 legislature no later than December 1, 2002.

4-1 Sec. 771.107. LIABILITY. The operations of the regional

4-2 emergency medical dispatch resource center are considered to be the

4-3 provision of 9-1-1 services for purposes of Section 771.053.

4-4 Employees of and volunteers at the center have the same protection

4-5 from liability as a member of the governing body of a public

4-6 agency under Section 771.053.

4-7 Sec. 771.108. EXPIRATION. This subchapter expires September

4-8 1, 2003.

4-9 SECTION 2. Section 773.012, Health and Safety Code, is

4-10 amended by amending Subsection (a) and adding Subsections (k) and

4-11 (l) to read as follows:

4-12 (a) The governor shall appoint an advisory council to advise

4-13 the board regarding matters related to the responsibilities of the

4-14 board, commissioner, and department under this chapter. In making

4-15 appointments to the advisory council, the governor shall ensure

4-16 that approximately one-half of the members of the advisory council

4-17 are residents of rural areas of the state.

4-18 (k) The advisory council shall assess the need for emergency

4-19 medical services in the rural areas of the state.

4-20 (l) The advisory council shall develop a strategic plan for:

4-21 (1) refining the educational requirements for

4-22 certification and maintaining certification as emergency medical

4-23 services personnel; and

4-24 (2) developing emergency medical services and trauma

4-25 care systems.

4-26 SECTION 3. Subchapter A, Chapter 773, Health and Safety Code,

4-27 is amended by adding Section 773.013 to read as follows:

5-1 Sec. 773.013. PEER ASSISTANCE PROGRAM. The department may

5-2 establish, approve, and fund a peer assistance program in

5-3 accordance with Section 467.003 and board rules.

5-4 SECTION 4. Subchapter A, Chapter 773, Health and Safety

5-5 Code, is amended by adding Section 773.014 to read as follows:

5-6 Sec. 773.014. ADMINISTRATION OF EPINEPHRINE. (a) An

5-7 emergency medical services provider and a first responder

5-8 organization may acquire and possess epinephrine auto-injector

5-9 devices in accordance with this section. Emergency medical

5-10 services personnel certified as emergency medical technicians or at

5-11 a higher level of training may carry and administer epinephrine

5-12 auto-injector devices in accordance with this section.

5-13 ( The department shall adopt rules designed to protect the

5-14 public health and safety to implement this section. The rules must

5-15 provide that emergency medical services personnel certified as

5-16 emergency medical technicians or at a higher level of training may

5-17 administer an epinephrine auto-injector device to another only if

5-18 the person has successfully completed a training course, approved

5-19 by the department, in the use of the device that is consistent with

5-20 the national standard training curriculum for emergency medical

5-21 technicians.

5-22 © An emergency medical services provider or first

5-23 responder organization may acquire, possess, maintain, and dispose

5-24 of epinephrine auto-injector devices, and emergency medical

5-25 services personnel certified as emergency medical technicians or at

5-26 a higher level of training may carry, maintain, administer, and

5-27 dispose of epinephrine auto-injector devices, only in accordance

6-1 with:

6-2 (1) rules adopted by the department under this

6-3 section; and

6-4 (2) a delegated practice agreement that provides for

6-5 medical supervision by a licensed physician who either:

6-6 (A) acts as a medical director for an emergency

6-7 medical services system or a licensed hospital; or

6-8 ( has knowledge and experience in the delivery

6-9 of emergency care.

6-10 (d) Emergency medical services personnel who administer

6-11 epinephrine auto-injector devices to others shall immediately

6-12 report the use to the physician supervising the activities of the

6-13 emergency medical services personnel.

6-14 (e) The administration of an epinephrine auto-injector

6-15 device to another under this section is considered to be the

6-16 administration of emergency care for the purposes of any statute

6-17 relating to liability for the provision of emergency care. The

6-18 administration of an epinephrine auto-injector device to another in

6-19 accordance with the requirements of this section does not

6-20 constitute the unlawful practice of any health care profession.

6-21 (f) A person otherwise authorized to sell or provide an

6-22 epinephrine auto-injector device to another may sell or provide the

6-23 devices to an emergency medical services provider or a first

6-24 responder organization authorized to acquire and possess the

6-25 devices under this section.

6-26 (g) This section does not prevent emergency medical services

6-27 personnel who are also licensed health care professionals under

7-1 another health care licensing law and who are authorized to

7-2 acquire, possess, and administer an epinephrine auto-injector

7-3 device under the other health care licensing law from acting under

7-4 the other law.

7-5 (h) This section does not impose a standard of care not

7-6 otherwise required by law.

7-7 SECTION 5. Section 773.025, Health and Safety Code, is

7-8 amended by adding Subsections (d) and (e) to read as follows:

7-9 (d) A governmental entity or nongovernmental organization

7-10 that sponsors or wishes to sponsor an emergency medical services

7-11 provider or first responder organization in a rural or underserved

7-12 area may request the bureau to provide or facilitate the provision

7-13 of initial training for emergency care attendants, if the training

7-14 is not available locally. The bureau shall ensure that the

7-15 training is provided. The bureau shall provide the training without

7-16 charge, or contract with qualified instructors to provide the

7-17 training without charge, to students who agree to perform emergency

7-18 care attendant services for at least one year with the local

7-19 emergency medical services provider or first responder

7-20 organization. The training must be provided at times and places

7-21 that are convenient to the students. The bureau shall require that

7-22 at least three students are scheduled to take any class offered

7-23 under this subsection.

7-24 (e) To facilitate all levels of emergency medical services

7-25 training, the bureau shall consult with and solicit comment from

7-26 emergency medical services providers, first responder

7-27 organizations, persons who provide emergency medical services

8-1 training, and other entities interested in emergency medical

8-2 services training programs.

8-3 SECTION 6. Section 773.095(a), Health and Safety Code, is

8-4 amended to read as follows:

8-5 (a) The proceedings and records of organized committees of

8-6 hospitals, medical societies, emergency medical services providers,

8-7 emergency medical services and trauma care systems, or first

8-8 responder organizations relating to the review, evaluation, or

8-9 improvement of an emergency medical services provider, a first

8-10 responder organization, an emergency medical services and trauma

8-11 care system, or emergency medical services personnel are

8-12 confidential and not subject to disclosure by court subpoena or

8-13 otherwise.

8-14 SECTION 7. Section 773.115(a), Health and Safety Code, is

8-15 amended to read as follows:

8-16 (a) The bureau may designate trauma facilities that are a

8-17 part of an emergency medical services and trauma care system. A

8-18 trauma facility shall be designated by the level of trauma care and

8-19 services provided in accordance with the American College of

8-20 Surgeons guidelines for level I and [,] II[, and III] trauma

8-21 facilities [centers] and rules adopted by the board for level III

8-22 and IV [and V] trauma facilities [centers]. In adopting rules

8-23 under this section, the board may consider trauma caseloads,

8-24 geographic boundaries, or minimum population requirements, but the

8-25 bureau may not deny designation solely on these criteria. The

8-26 board may not set an arbitrary limit on the number of facilities

8-27 designated as trauma facilities.

9-1 SECTION 8. Section 615.003, Government Code, is amended to

9-2 read as follows:

9-3 Sec. 615.003. APPLICABILITY. This chapter applies only to

9-4 eligible survivors of the following individuals:

9-5 (1) an individual elected, appointed, or employed as a

9-6 peace officer by the state or a political subdivision of the state

9-7 under Article 2.12, Code of Criminal Procedure, or other law;

9-8 (2) a paid probation officer appointed by the director

9-9 of a community supervision and corrections department who has the

9-10 duties set out in Section 76.002 and the qualifications set out in

9-11 Section 76.005, or who was appointed in accordance with prior law;

9-12 (3) a parole officer employed by the pardons and

9-13 paroles division of the Texas Department of Criminal Justice who

9-14 has the duties set out in Section 508.001 and the qualifications

9-15 set out in Section 508.113 or in prior law;

9-16 (4) a paid jailer;

9-17 (5) a member of an organized police reserve or

9-18 auxiliary unit who regularly assists peace officers in enforcing

9-19 criminal laws;

9-20 (6) a member of the class of employees of the

9-21 institutional division or the state jail division of the Texas

9-22 Department of Criminal Justice formally designated as custodial

9-23 personnel under Section 615.006 by the Texas Board of Criminal

9-24 Justice or its predecessor in function;

9-25 (7) a jailer or guard of a county jail who is

9-26 appointed by the sheriff and who:

9-27 (A) performs a security, custodial, or

10-1 supervisory function over the admittance, confinement, or discharge

10-2 of prisoners; and

10-3 ( is certified by the [Texas] Commission on

10-4 Law Enforcement Officer Standards and Education;

10-5 (8) a juvenile correctional employee of the Texas

10-6 Youth Commission;

10-7 (9) an employee of the Texas Department of Mental

10-8 Health and Mental Retardation who:

10-9 (A) works at the department's maximum security

10-10 unit; or

10-11 ( performs on-site services for the Texas

10-12 Department of Criminal Justice;

10-13 (10) an individual who is employed by the state or a

10-14 political or legal subdivision and is subject to certification by

10-15 the Texas Commission on Fire Protection;

10-16 (11) an individual employed by the state or a

10-17 political or legal subdivision whose principal duties are aircraft

10-18 crash and rescue fire fighting;

10-19 (12) a member of an organized volunteer fire-fighting

10-20 unit that:

10-21 (A) renders fire-fighting services without

10-22 remuneration;

10-23 ( consists of not fewer than 20 active

10-24 members, a majority of whom are present at each meeting; and

10-25 © conducts a minimum of two drills each month,

10-26 each two hours long; or

10-27 (13) an individual who:

11-1 (A) performs emergency medical services or

11-2 operates an ambulance;

11-3 ( is employed by a political subdivision of

11-4 the state or is an emergency medical services volunteer as defined

11-5 by Section 773.003, Health and Safety Code; and

11-6 © is qualified as an emergency care attendant

11-7 [medical technician] or at a higher level of training under Section

11-8 773.046, 773.047, 773.048, [or] 773.049, or 773.0495, Health and

11-9 Safety Code.

11-10 SECTION 9. Section 61.0285(a), Health and Safety Code, is

11-11 amended to read as follows:

11-12 (a) In addition to basic health care services provided under

11-13 Section 61.028, a county may, in accordance with department rules

11-14 adopted under Section 61.006, provide other medically necessary

11-15 services or supplies that the county determines to be

11-16 cost-effective, including:

11-17 (1) ambulatory surgical center services;

11-18 (2) diabetic and colostomy medical supplies and

11-19 equipment;

11-20 (3) durable medical equipment;

11-21 (4) home and community health care services;

11-22 (5) services provided by licensed master medical

11-23 social workers--advanced clinical practitioners;

11-24 (6) psychological counseling services;

11-25 (7) services provided by physician assistants, nurse

11-26 practitioners, certified nurse midwives, clinical nurse

11-27 specialists, and certified registered nurse anesthetists;

12-1 (8) dental care;

12-2 (9) vision care, including eyeglasses;

12-3 (10) services provided by federally qualified health

12-4 centers, as defined by 42 U.S.C. Section 1396d(l)(2)(; [and]

12-5 (11) emergency medical services; and

12-6 (12) any other appropriate health care service

12-7 identified by board rule that may be determined to be

12-8 cost-effective.

12-9 SECTION 10. Section 106.043(, Health and Safety Code, is

12-10 amended to read as follows:

12-11 ( The advisory committee is composed of 13 [12] members

12-12 appointed by the executive committee and must include:

12-13 (1) a rural practicing family practice physician;

12-14 (2) a rural hospital administrator;

12-15 (3) a rural practicing registered professional nurse;

12-16 (4) a rural practicing allied health professional;

12-17 (5) a dean of a medical school;

12-18 (6) a dean of a nursing school;

12-19 (7) a dean of a school of allied health science;

12-20 (8) a head of a vocational/technical institution;

12-21 (9) a community college administrator;

12-22 (10) an individual knowledgeable in student financial

12-23 assistance programs;

12-24 (11) a rural public school superintendent; [and]

12-25 (12) a rural resident; and

12-26 (13) an individual who provides emergency medical

12-27 services in a rural area and who is certified or licensed as an

13-1 emergency care attendant or at a higher level of training under

13-2 Section 773.046, 773.047, 773.048, 773.049, or 773.0495.

13-3 SECTION 11. (a) Except as provided by Subsection ( of

13-4 this section, this Act takes effect September 1, 2001.

13-5 ( Section 773.014, Health and Safety Code, as added by

13-6 this Act, takes effect January 1, 2002, except that Section 773.014

13-7 takes effect September 1, 2001, for the limited purpose of allowing

13-8 the Texas Department of Health to adopt rules under that law that

13-9 may take effect before January 1, 2002.

13-10 © Before January 1, 2002, epinephrine auto-injector

13-11 devices may be carried and administered by certain emergency

13-12 medical services personnel to the extent allowed under the law that

13-13 exists before September 1, 2001.

_______________________________ _______________________________

President of the Senate Speaker of the House

I certify that H.B. No. 2446 was passed by the House on April

26, 2001, by a non-record vote; that the House refused to concur in

Senate amendments to H.B. No. 2446 on May 21, 2001, and requested

the appointment of a conference committee to consider the

differences between the two houses; and that the House adopted the

conference committee report on H.B. No. 2446 on May 26, 2001, by a

non-record vote.

_______________________________

Chief Clerk of the House

I certify that H.B. No. 2446 was passed by the Senate, with

amendments, on May 17, 2001, by a viva-voce vote; at the request of

the House, the Senate appointed a conference committee to consider

the differences between the two houses; and that the Senate adopted

the conference committee report on H.B. No. 2446 on May 26, 2001,

by a viva-voce vote.

_______________________________

Secretary of the Senate

APPROVED: __________________________

Date

__________________________

Governor