HCS CSSSSB 71(HES): "An Act relating to emergency medical services; and repealing obsolete references to the Statewide Health Coordinating Council and health systems agencies."
00HOUSE CS FOR CS FOR SS FOR SENATE BILL NO. 71(HES) 01 "An Act relating to emergency medical services; and repealing obsolete references 02 to the Statewide Health Coordinating Council and health systems agencies." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.64.107 is amended to read: 05 Sec. 08.64.107. REGULATION OF PHYSICIAN ASSISTANTS AND 06 INTENSIVE CARE PARAMEDICS. The board shall adopt regulations regarding the 07 registration of physician assistants and [PHYSICIAN-TRAINED] mobile intensive care 08 paramedics, and the medical services that they [EACH] may perform, including [BUT 09 NOT LIMITED TO] 10 (1) the educational and other qualifications, 11 (2) the application and registration procedures, 12 (3) the scope of activities authorized, and 13 (4) the responsibilities of the supervising or training physician. 14 * Sec. 2. AS 08.64.170(a) is amended to read:
01 (a) A person may not practice medicine, podiatry, or osteopathy in the state 02 unless the person is licensed under this chapter, except that 03 (1) a physician assistant may examine, diagnose, or treat persons under 04 the supervision, control, and responsibility of either a physician licensed under this 05 chapter or a physician exempted from licensing under AS 08.64.370; 06 (2) a [PHYSICIAN-TRAINED] mobile intensive care paramedic may 07 render emergency lifesaving service; and 08 (3) a person who is licensed or authorized under another chapter of this 09 title may engage in a practice that is authorized under that chapter. 10 * Sec. 3. AS 08.64.360 is amended to read: 11 Sec. 08.64.360. PENALTY FOR PRACTICING WITHOUT A LICENSE OR 12 IN VIOLATION OF CHAPTER. Except for a physician assistant, a 13 [PHYSICIAN-TRAINED] mobile intensive care paramedic [UNDER AS 08.64.170], 14 or a person licensed or authorized under another chapter of this title who engages in 15 practices for which that person is licensed or authorized under that chapter, a person 16 practicing medicine or osteopathy in the state without a valid license or permit is guilty 17 of a class A misdemeanor. Each day of illegal practice is a separate offense. 18 * Sec. 4. AS 08.64.366 is amended to read: 19 Sec. 08.64.366. LIABILITY FOR SERVICES RENDERED BY A 20 [PHYSICIAN-TRAINED] MOBILE INTENSIVE CARE PARAMEDIC. An act or 21 omission of a [PHYSICIAN-TRAINED] mobile intensive care paramedic done or 22 omitted in good faith while rendering emergency service to a person who is in need 23 of immediate aid in order to avoid serious harm or loss of life does not impose any 24 liability upon the [PHYSICIAN-TRAINED] mobile intensive care paramedic, the 25 supervising physician, a hospital, the officers, members of the staff, nurses, or other 26 employees of a hospital or upon a federal, state, borough, city or other local 27 governmental unit or upon other employees of a governmental unit; however, this 28 section does not relieve a physician or a hospital of a duty otherwise imposed by law 29 upon the physician or hospital for the designation or training of a 30 [PHYSICIAN-TRAINED] mobile intensive care paramedic or for the provision or 31 maintenance of equipment to be used by the [PHYSICIAN-TRAINED] mobile
01 intensive care paramedic. 02 * Sec. 5. AS 08.64.369(d) is amended to read: 03 (d) In this section, "health care professional" includes an emergency medical 04 technician certified under AS 18.08, health aide, physician, nurse, mobile intensive 05 care paramedic, and physician's assistant, but does not include a practitioner of 06 religious healing. 07 * Sec. 6. AS 08.64.380(4) is repealed and reenacted to read: 08 (4) "mobile intensive care paramedic" means an individual licensed by 09 the board who has successfully completed a paramedic training program certified under 10 AS 18.08 and is authorized by law to provide advanced life support under the direct 11 or indirect supervision of a physician; 12 * Sec. 7. AS 11.81.430(a)(5) is amended to read: 13 (5) A licensed physician, licensed mobile intensive care paramedic, 14 or registered nurse; or a person acting under the direction of a licensed physician, 15 licensed mobile intensive care paramedic, or registered nurse; or any person who 16 renders emergency care at the scene of an emergency, may use reasonable and 17 appropriate nondeadly force for the purpose of administering a recognized and lawful 18 form of treatment that [WHICH] is reasonably adapted to promoting the physical or 19 mental health of the patient if 20 (A) the treatment is administered with the consent of the patient 21 or, if the patient is a child under 18 years of age or an incompetent person, 22 with the consent of the parent, guardian, or other person entrusted with care 23 and supervision of the child or incompetent person; or 24 (B) the treatment is administered in an emergency if the person 25 administering the treatment reasonably believes that no one competent to 26 consent can be consulted under the circumstances and that a reasonable person, 27 wishing to safeguard the welfare of the patient, would consent. 28 * Sec. 8. AS 12.55.185 is amended by adding a new paragraph to read: 29 (13) "paramedic" means a mobile intensive care paramedic licensed 30 under AS 08.64. 31 * Sec. 9. AS 18.08.010 is amended to read:
01 Sec. 18.08.010. ADMINISTRATION. The department is responsible for the 02 development, implementation, and maintenance of a statewide comprehensive 03 emergency medical services system and, accordingly, shall 04 (1) coordinate public and private agencies engaged in the planning and 05 delivery of emergency medical services, including trauma care, to plan an emergency 06 medical services system; 07 (2) assist public and private agencies to deliver emergency medical 08 services, including trauma care, through the award of grants in aid; 09 (3) conduct, encourage, and approve programs of education and 10 training designed to upgrade the knowledge and skills of health personnel 11 involved in emergency medical services, including trauma care; 12 (4) establish and maintain a process under which hospitals and 13 clinics could represent themselves to be trauma centers because they voluntarily 14 meet criteria adopted by the department; criteria adopted by the department to 15 implement this paragraph must be based on an applicable national evaluation 16 system. 17 * Sec. 10. AS 18.08 is amended by adding a new section to read: 18 Sec. 18.08.015. PATIENT INFORMATION SYSTEM. (a) The department 19 may establish an emergency medical services patient care information system. If the 20 department collects information on emergency medical services patient care, the 21 department shall establish a format for the data collection. The purpose of the system 22 is to 23 (1) collect data on the incidence, severity, and causes of trauma 24 injuries; 25 (2) integrate this data on trauma injuries with information available 26 from other public and private sources on trauma injuries; and 27 (3) improve the delivery of prehospital and hospital emergency medical 28 services. 29 (b) A person, organization, or government agency that provides a prehospital 30 emergency medical service through a certificate issued under this chapter shall 31 participate in the system by making available to the department the minimum data
01 requested in a format that is compatible with the format developed by the department 02 to implement (a) of this section. The minimum data must include the 03 (1) type of medical emergency or nature of the call; 04 (2) response time; and 05 (3) prehospital treatment provided. 06 (c) A hospital that provides emergency medical services shall make available 07 to the department an abstract of the records of all patients admitted to the hospital's 08 trauma and general surgery services for trauma care. The abstracts must be in a 09 format that is compatible with the format developed by the department under (a) of 10 this section. 11 (d) The department shall consult with the Alaska Council on Emergency 12 Medical Services in designing, implementing, and revising the system. 13 (e) The department may delegate the responsibility for collecting data under 14 this section to other public agencies or to private persons on contract to the 15 department. 16 (f) In this section, "system" means the emergency medical services patient care 17 information system established under this section. 18 * Sec. 11. AS 18.08.020 is amended to read: 19 Sec. 18.08.020. ALASKA [ADVISORY] COUNCIL ON EMERGENCY 20 MEDICAL SERVICES. There is established in the department the Alaska [AN 21 ADVISORY] Council on Emergency Medical Services. The council shall 22 [(1)] advise the commissioner and the governor with regard to the 23 planning and implementation of a statewide emergency medical services system [; 24 (2) ASSIST THE STATEWIDE HEALTH COORDINATING 25 COUNCIL IN PERFORMING ITS DUTIES UNDER AS 18.07.011 RELATING TO 26 EMERGENCY MEDICAL SERVICES]. 27 * Sec. 12. AS 18.08.030 is amended to read: 28 Sec. 18.08.030. COMPOSITION. The council consists of 11 members 29 appointed by the governor. The governor shall provide for appropriate 30 geographical distribution in the appointments and shall appoint 31 (1) two members who are physicians with experience in emergency
01 medicine or trauma care; 02 (2) one member who is a registered nurse with experience in 03 emergency nursing; 04 (3) three members who are active as prehospital emergency care 05 providers, at least one of whom resides in a community that is not connected by 06 land or marine highway, or a combination of land and marine highway, to a 07 community in which a hospital is located; in this paragraph, "highway" has the 08 meaning given in AS 28.40.100; 09 (4) one member who is an emergency medical services 10 administrator; 11 (5) one member who is an administrator of a hospital or Native 12 health care organization; and 13 (6) three members who are consumers [FOUR OF THE MEMBERS 14 MUST BE CONSUMERS] of emergency medical services who each reside in a 15 different [, AND ONE FROM EACH] judicial district in the state. 16 * Sec. 13. AS 18.08.080 is amended by adding a new subsection to read: 17 (b) The department may charge fees set by regulation for the certification of 18 individuals and organizations under this chapter. 19 * Sec. 14. AS 18.08.082(a) is amended to read: 20 (a) The department shall prescribe by regulation a course of training or other 21 requirements prerequisite to the issuance of certificates that provide for the following: 22 (1) certification of [CERTIFIES THAT] a person who meets the 23 training and other requirements as an emergency medical technician, emergency 24 medical technician instructor, or emergency medical dispatcher; 25 (2) authorization for [AUTHORIZES] an emergency medical 26 technician certified under this chapter to provide under the written or oral direction of 27 a physician the advanced life support services enumerated on the certificate or 28 enumerated on a written document filed with the department by the technician's 29 medical director and approved by the department under its regulations; 30 (3) certification [CERTIFIES] that a person, organization, or 31 government agency that provides an emergency medical service, conducts a training
01 course for a mobile intensive care paramedic, or represents itself as a trauma 02 center meets the minimum [OPERATING] standards prescribed by the department for 03 that service, course, or designation; and 04 (4) authorization for [AUTHORIZES] an emergency medical service 05 certified under this chapter to provide under the written or oral direction of a physician 06 the advanced life support services enumerated on the certificate or enumerated on a 07 written document filed with the department by the medical director for the 08 emergency medical service and approved by the department under its regulations. 09 * Sec. 15. AS 18.08.084(a) is amended to read: 10 (a) One may not represent oneself, nor may an agency or business represent 11 an agent or employee of that agency or business, as an emergency medical 12 dispatcher, emergency medical technician, or emergency medical technician 13 instructor certified by the state unless the person represented is certified for that 14 occupation [AS AN EMERGENCY MEDICAL TECHNICIAN] under AS 18.08.082. 15 * Sec. 16. AS 18.08.084 is amended by adding new subsections to read: 16 (e) A hospital, clinic, or other entity may not represent itself as being a trauma 17 center unless it is certified under AS 18.08.082 as meeting the criteria established for 18 a trauma center. 19 (f) A person, organization, or government agency may not offer or conduct a 20 training course that is represented as a course for mobile intensive care paramedics 21 unless the person, organization, or agency is certified under AS 18.08.082 to offer or 22 conduct that course. 23 * Sec. 17. AS 18.08.086(a) is amended to read: 24 (a) A person certified under AS 18.08.082 who administers emergency 25 medical services to an injured or sick person, [OR] a person or public agency that 26 employs, sponsors, directs, or controls the activities of persons certified under 27 AS 18.08.082 [,] who administer [ADMINISTERS] emergency medical services to 28 an injured or sick person, or a health care professional or emergency medical 29 dispatcher acting within the scope of the person's certification who directs or 30 advises a person to administer emergency medical services to an injured or sick 31 person is not liable for civil damages as a result of an act or omission in administering
01 those services or giving that advice or those directions [,] if the administering, 02 advising, and directing are done in good faith and [IF] the injured or sick person 03 reasonably seems to be [IS] in immediate danger of serious harm or death. This 04 subsection does not preclude liability for civil damages that are the proximate result 05 of gross negligence or intentional misconduct, nor preclude imposition of liability on 06 a person or public agency that employs, sponsors, directs, or controls the activities of 07 persons certified under AS 18.08.082 if the act or omission is a proximate result of a 08 breach of duty to act created under this chapter. For the purposes of this subsection, 09 "gross negligence" means reckless, wilful, or wanton misconduct. 10 * Sec. 18. AS 18.08.086 is amended by adding a new subsection to read: 11 (d) A person certified as an emergency medical technician instructor, a person 12 or entity certified to conduct a training course for mobile intensive care paramedics, 13 and a person who employs or contracts with a certified emergency medical technician 14 instructor or with a person or entity certified to conduct a training course for mobile 15 intensive care paramedics is not liable for civil damages as a result of a negligent act 16 or omission during a training course that injures the person or property of a person 17 participating in the training course. 18 * Sec. 19. AS 18.08 is amended by adding a new section to read: 19 Sec. 18.08.087. DISCLOSURE OF MEDICAL RECORDS. When requested 20 for the purpose of evaluating the performance of an emergency medical technician, 21 mobile intensive care paramedic, or physician who provided emergency medical care 22 or other assistance to a sick or injured person, a licensed physician, advanced nurse 23 practitioner, or physician assistant may disclose to an emergency medical technician, 24 a mobile intensive care paramedic, or physician the medical or hospital records of a 25 sick or injured person to whom the paramedic, technician, or physician is providing 26 or has rendered emergency medical care or assistance. However, the disclosing 27 physician, nurse practitioner, or physician assistant shall limit disclosure under this 28 subsection to the records that are considered necessary by the discloser for evaluation 29 of the paramedic's, technician's, or physician's performance in providing the 30 emergency medical care or assistance. A mobile intensive care paramedic, emergency 31 medical care technician, or physician to whom confidential records are disclosed under
01 this section may not further disclose the information to a person not entitled to receive 02 that information under this section or another law. 03 * Sec. 20. AS 18.08.090(8) is amended to read: 04 (8) "emergency medical services system" means a system that provides 05 for the arrangement of personnel, facilities, and equipment for the effective and 06 coordinated delivery of health care services, including trauma care, under emergency 07 conditions, occurring either as a result of the patient's condition or of natural disasters 08 or similar situations, and that is administered by a statewide network that has the 09 authority and resources to provide effective administration of the system; 10 * Sec. 21. AS 18.08.090 is amended by adding new paragraphs to read: 11 (12) "emergency medical dispatcher" means a trained public safety 12 telecommunicator with additional training and specific emergency medical knowledge 13 essential for the efficient management of emergency medical communications; 14 (13) "paramedic training program" means a training program prescribed 15 in regulations of the department that includes classroom, clinical, and field internship 16 components designed to provide an individual with the knowledge and skills necessary 17 to function as a mobile intensive care paramedic; 18 (14) "trauma care" includes injury prevention, triage, prehospital care, 19 hospital care, and rehabilitative services for major single system or multisystem 20 injuries that require immediate medical or surgical intervention or treatment to prevent 21 death or permanent disability. 22 * Sec. 22. AS 18.15.250(d)(1) is amended to read: 23 (1) "emergency medical and rescue personnel" means a trauma 24 technician, emergency medical technician, rescuer, or mobile intensive care 25 paramedic; 26 * Sec. 23. AS 18.26.030(a) is amended to read: 27 (a) The authority shall be managed and controlled by a seven-person board of 28 directors, who serve at the pleasure of the governor, consisting of 29 (1) the commissioner of revenue, who shall also chair the board; 30 (2) the commissioner of health and social services; 31 (3) the commissioner of community and regional affairs;
01 (4) four public members, appointed by the governor [FROM AMONG 02 THE NOMINEES SUBMITTED BY THE FOLLOWING: 03 (A) EACH HEALTH SYSTEMS AGENCY IN THE STATE, 04 ORGANIZED AND OPERATED IN ACCORDANCE WITH 42 U.S.C. 300l-1, 05 WHICH SHALL SUBMIT THREE NOMINEES FROM AMONG THE 06 MEMBERS OF THAT AGENCY; 07 (B) THE STATEWIDE HEALTH COORDINATING 08 COUNCIL, ESTABLISHED BY AS 18.07.011, WHICH SHALL SUBMIT 09 TWO NOMINEES FROM AMONG THE MEMBERS]. 10 * Sec. 24. AS 47.24.010(a) is amended to read: 11 (a) The following persons who, in the performance of their professional duties, 12 have reasonable cause to believe that an elderly person has suffered harm shall, not 13 later than 24 hours after first having cause for the belief, report the harm to the 14 Department of Health and Social Services: 15 (1) a physician or other licensed health care provider; 16 (2) a mental health professional as defined in AS 47.30.915(11) and 17 including a marital and family therapist licensed under AS 08.63; 18 (3) a pharmacist; 19 (4) an administrator of a nursing home, residential care or health care 20 facility; 21 (5) a guardian or conservator; 22 (6) a police officer; 23 (7) a village public safety officer; 24 (8) a village health aide; 25 (9) a social worker; 26 (10) a member of the clergy; 27 (11) a staff employee of a project funded by the Older Alaskans 28 Commission; 29 (12) an employee of a homemaker program or home health aide 30 program; 31 (13) an emergency medical technician or a mobile intensive care
01 paramedic [IN THE MOBILE INTENSIVE CARE PROGRAM]. 02 * Sec. 25. AS 47.24.110(a) is amended to read: 03 (a) The following persons who, in the performance of their professional duties, 04 have reasonable cause to believe that a disabled adult is a victim of assault under 05 AS 11.41.200 - 11.41.230 or sexual assault under AS 11.41.410 - 11.41.420, and that 06 the disabled adult is unable to report the crime, shall promptly report the crime to the 07 nearest law enforcement agency: 08 (1) a physician or other licensed health care provider; 09 (2) a mental health professional as defined in AS 47.30.915 and 10 including a marital and family therapist licensed under AS 08.63; 11 (3) a pharmacist; 12 (4) an administrator or employee of a nursing home, residential care, 13 or health care facility; 14 (5) a caretaker of the disabled adult; 15 (6) a guardian or conservator of the disabled adult; 16 (7) a police officer as defined in AS 18.65.290; 17 (8) a village public safety officer; 18 (9) a village health aide; 19 (10) a social worker; 20 (11) a member of the clergy; 21 (12) a staff employee of a program or project serving disabled adults; 22 (13) a licensed foster care provider; 23 (14) a paid employee of a domestic violence and sexual assault 24 program or a crisis intervention and prevention program as defined in AS 18.66.900; 25 (15) an employee of a homemaker program or home health aide 26 program; 27 (16) an emergency medical technician or mobile intensive care 28 paramedic [IN THE MOBILE INTENSIVE CARE PROGRAM]. 29 * Sec. 26. AS 47.30.475(b) is amended to read: 30 (b) Money available under this section shall be awarded by the department to 31 applicants on the basis of community need, but only [IF THE AWARD IS
01 CONSISTENT WITH THE ANNUAL IMPLEMENTATION PLAN DEVELOPED 02 UNDER 42 U.S.C. 300l-2(b)(2) (NATIONAL HEALTH RESOURCES PLANNING 03 AND DEVELOPMENT ACT OF 1974) BY THE HEALTH SYSTEMS AGENCY 04 FOR THE HEALTH SYSTEM AREA IN WHICH THE APPLICANT IS LOCATED 05 AND THE STATE HEALTH PLAN DEVELOPED BY THE STATEWIDE HEALTH 06 COORDINATING COUNCIL UNDER 42 U.S.C. 300m-3(c)(2)(A), AND ONLY] after 07 consideration of comment and advice of the Advisory Board on Alcoholism and Drug 08 Abuse. In awarding grants, the department shall further consider the amount of money 09 that is available for all applications and whether an application would contribute to the 10 wise development of a comprehensive program of alcoholic and drug abuse 11 rehabilitation and prevention. 12 * Sec. 27. AS 18.07.011, 18.07.111(7), 18.07.111(10); AS 18.08.040(b), 18.08.090(11); and 13 AS 47.30.475(e)(4) are repealed. 14 * Sec. 28. TRANSITIONAL PROVISIONS. (a) Notwithstanding AS 18.08.020, as 15 amended by sec. 11 of this Act, and AS 18.08.030, as amended by sec. 12 of this Act, the 16 terms of the members of the Advisory Council on Emergency Medical Services who are 17 serving on the council on the day before the effective date of this Act do not expire, for 18 purposes of remaining on the Alaska Council on Emergency Medical Services, until the 19 termination date previously set for their membership on the Advisory Council on Emergency 20 Medical Services. 21 (b) For all legal purposes, the Alaska Council on Emergency Medical Services 22 established under this Act shall be considered to be a continuation of the Advisory Council 23 on Emergency Medical Services. 24 (c) Notwithstanding secs. 6 and 14 of this Act, the license of a mobile intensive care 25 paramedic licensed by the State Medical Board before the effective date of this Act remains 26 valid even though the licensee has not completed a certified training course as required under 27 those sections.