SB 71: "An Act relating to emergency medical services; and repealing obsolete references to the Statewide Health Coordinating Council and health systems agencies."
00SENATE BILL NO. 71 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 08 INTENSIVE CARE PARAMEDICS,] and the medical services that they [EACH] may 09 perform, including [BUT 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 a person who is licensed 09 as a mobile intensive care paramedic under AS 18.08; 10 * Sec. 7. AS 11.81.430(a)(5) is amended to read: 11 (5) A licensed physician, licensed mobile intensive care paramedic, 12 or registered nurse; or a person acting under the direction of a licensed physician, 13 licensed mobile intensive care paramedic, or registered nurse; or any person who 14 renders emergency care at the scene of an emergency, may use reasonable and 15 appropriate nondeadly force for the purpose of administering a recognized and lawful 16 form of treatment that [WHICH] is reasonably adapted to promoting the physical or 17 mental health of the patient if 18 (A) the treatment is administered with the consent of the patient 19 or, if the patient is a child under 18 years of age or an incompetent person, 20 with the consent of the parent, guardian, or other person entrusted with care 21 and supervision of the child or incompetent person; or 22 (B) the treatment is administered in an emergency if the person 23 administering the treatment reasonably believes that no one competent to 24 consent can be consulted under the circumstances and that a reasonable person, 25 wishing to safeguard the welfare of the patient, would consent. 26 * Sec. 8. AS 12.55.185 is amended by adding a new paragraph to read: 27 (13) "paramedic" means a mobile intensive care paramedic licensed 28 under AS 18.08. 29 * Sec. 9. AS 18.08.010 is amended to read: 30 Sec. 18.08.010. ADMINISTRATION. The department is responsible for the 31 development, implementation, and maintenance of a statewide comprehensive
01 emergency medical services system and, accordingly, shall 02 (1) coordinate public and private agencies engaged in the planning and 03 delivery of emergency medical services, including trauma care, to plan an emergency 04 medical services system; 05 (2) assist public and private agencies to deliver emergency medical 06 services, including trauma care, through the award of grants in aid; 07 (3) conduct, encourage, and approve programs of education and 08 training designed to upgrade the knowledge and skills of health personnel 09 involved in emergency medical services, including trauma care; 10 (4) establish and maintain a process under which hospitals and 11 clinics could represent themselves to be trauma centers because they voluntarily 12 meet criteria adopted by the department; criteria adopted by the department to 13 implement this paragraph must be based on an applicable national evaluation 14 system. 15 * Sec. 10. AS 18.08 is amended by adding a new section to read: 16 Sec. 18.08.015. PATIENT INFORMATION SYSTEM. (a) The department 17 shall establish an emergency medical services patient care information system. The 18 purpose of the system is to 19 (1) collect data on the incidence, severity, and causes of trauma 20 injuries; 21 (2) integrate this data on trauma injuries with information available 22 from other public and private sources on trauma injuries; and 23 (3) improve the delivery of prehospital and hospital emergency medical 24 services. 25 (b) A person, organization, or government agency that provides a prehospital 26 emergency medical service through a certificate issued under this chapter shall 27 participate in the system by making available to the department the minimum data 28 requested on forms developed by the department to implement (a) of this section. The 29 minimum data must include the 30 (1) type of medical emergency or nature of the call; 31 (2) response time; and
01 (3) prehospital treatment provided. 02 (c) A hospital that provides emergency medical services shall make available 03 to the department an abstract of the records of all patients admitted to the hospital's 04 trauma and general surgery services for trauma care. The abstracts must be on forms 05 developed by the department and must include the minimum data requested by the 06 department. 07 (d) The department shall consult with the Alaska Council on Emergency 08 Medical Services in designing, implementing, and revising the system. 09 (e) The department may delegate the responsibility for collecting data under 10 this section to other public agencies or to private persons on contract to the 11 department. 12 (f) In this section, "system" means the emergency medical services patient care 13 information system established under this section. 14 * Sec. 11. AS 18.08.020 is amended to read: 15 Sec. 18.08.020. ALASKA [ADVISORY] COUNCIL ON EMERGENCY 16 MEDICAL SERVICES. There is established in the department the Alaska [AN 17 ADVISORY] Council on Emergency Medical Services. The council shall 18 [(1)] advise the commissioner and the governor with regard to the 19 planning and implementation of a statewide emergency medical services system [; 20 (2) ASSIST THE STATEWIDE HEALTH COORDINATING 21 COUNCIL IN PERFORMING ITS DUTIES UNDER AS 18.07.011 RELATING TO 22 EMERGENCY MEDICAL SERVICES]. 23 * Sec. 12. AS 18.08.030 is amended to read: 24 Sec. 18.08.030. COMPOSITION. The council consists of 11 members 25 appointed by the governor. The governor shall provide for appropriate 26 geographical distribution in the appointments and shall appoint 27 (1) two members who are physicians with experience in emergency 28 medicine or trauma care; 29 (2) one member who is a registered nurse with experience in 30 emergency nursing; 31 (3) three members who are active as prehospital emergency care
01 providers; 02 (4) one member who is an emergency medical services 03 administrator; 04 (5) one member who is an administrator of a hospital or Native 05 health care organization; and 06 (6) three members who are consumers [FOUR OF THE MEMBERS 07 MUST BE CONSUMERS] of emergency medical services [, AND ONE FROM EACH 08 JUDICIAL DISTRICT IN THE STATE]. 09 * Sec. 13. AS 18.08.080 is amended to read: 10 Sec. 18.08.080. REGULATIONS; FEES. The department shall adopt, with 11 the concurrence of the council [DEPARTMENT OF PUBLIC SAFETY], regulations 12 establishing standards and procedures for the issuance, renewal, reissuance, revocation, 13 and suspension of certificates and licenses required under this chapter 14 [AS 18.08.084], as well as other regulations necessary to carry out the purposes of this 15 chapter. 16 * Sec. 14. 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 and 18 licensure of personnel and organizations under this chapter. 19 * Sec. 15. AS 18.08.082 is amended to read: 20 Sec. 18.08.082. ISSUANCE OF CERTIFICATES AND LICENSES. (a) The 21 department shall prescribe by regulation a course of training or other requirements 22 prerequisite to the issuance of certificates or licenses that provide for the following: 23 (1) certification of [CERTIFIES THAT] a person who meets the 24 training and other requirements as an emergency medical technician, emergency 25 medical technician instructor, or emergency medical dispatcher; 26 (2) licensure of a person who meets the training and other 27 requirements as a mobile intensive care paramedic; 28 (3) authorization for [AUTHORIZES] an emergency medical 29 technician or a mobile intensive care paramedic certified or licensed under this 30 chapter to provide under the written or oral direction of a physician the advanced life 31 support services enumerated on the certificate or license or enumerated on a written
01 document filed with the department by the technician's or paramedic's medical 02 director and approved by the department under its regulations; 03 (4) certification [(3) CERTIFIES] that a person, organization, or 04 government agency that provides an emergency medical service, conducts a training 05 course for a mobile intensive care paramedic, or represents itself as a trauma 06 center meets the minimum [OPERATING] standards prescribed by the department for 07 that service, course, or designation; and 08 (5) authorization for [(4) AUTHORIZES] an emergency medical 09 service certified under this chapter to provide under the written or oral direction of a 10 physician the advanced life support services enumerated on the certificate or 11 enumerated on a written document filed with the department by the medical 12 director for the emergency medical service and approved by the department 13 under its regulations. 14 (b) The department is the central certifying and licensing agency for personnel 15 and organizations certified or licensed under (a)(1) - (3) [(a)(1) AND (2)] of this 16 section and under regulations adopted under AS 18.08.080. 17 * Sec. 16. AS 18.08.084(a) is amended to read: 18 (a) One may not represent oneself, nor may an agency or business represent 19 an agent or employee of that agency or business, as an emergency medical 20 dispatcher, emergency medical technician, mobile intensive care paramedic, or 21 emergency medical technician instructor certified or licensed by the state unless the 22 person represented is certified or licensed for that occupation [AS AN 23 EMERGENCY MEDICAL TECHNICIAN] under AS 18.08.082. 24 * Sec. 17. AS 18.08.084 is amended by adding new subsections to read: 25 (e) A hospital, clinic, or other entity may not represent itself as being a trauma 26 center unless it is certified under AS 18.08.082 as meeting the criteria established for 27 a trauma center. 28 (f) A person, organization, or government agency may not offer or conduct a 29 training course that is represented as a course for mobile intensive care paramedics 30 unless the person, organization, or agency is certified under AS 18.08.082 to offer or 31 conduct that course.
01 * Sec. 18. AS 18.08.086(a) is amended to read: 02 (a) A person certified or licensed under AS 18.08.082 who administers 03 emergency medical services to an injured or sick person, [OR] a person or public 04 agency that employs, sponsors, directs, or controls the activities of persons certified 05 or licensed under AS 18.08.082 [,] who administer [ADMINISTERS] emergency 06 medical services to an injured or sick person, or a health care professional or 07 emergency medical dispatcher acting within the scope of the person's licensure or 08 certification who directs or advises a person to administer emergency medical 09 services to an injured or sick person is not liable for civil damages as a result of an 10 act or omission in administering those services or giving that advice or those 11 directions [,] if the administering, advising, and directing are done in good faith 12 and [IF] the injured or sick person reasonably seems to be [IS] in immediate danger 13 of serious harm or death. This subsection does not preclude liability for civil damages 14 that are the proximate result of gross negligence or intentional misconduct, nor 15 preclude imposition of liability on a person or public agency that employs, sponsors, 16 directs, or controls the activities of persons certified or licensed under AS 18.08.082 17 if the act or omission is a proximate result of a breach of duty to act created under this 18 chapter. For the purposes of this subsection, "gross negligence" means reckless, wilful, 19 or wanton misconduct. 20 * Sec. 19. AS 18.08 is amended by adding a new section to read: 21 Sec. 18.08.087. DISCLOSURE OF MEDICAL RECORDS. A licensed 22 physician or other health care provider may disclose to an emergency medical 23 technician, a mobile intensive care paramedic, or another physician the medical or 24 hospital records of a sick or injured person to whom the paramedic, technician, or 25 physician is providing or has rendered emergency medical care or assistance for the 26 purpose of promoting the medical education of the specific person who provided the 27 care or assistance. A mobile intensive care paramedic, emergency medical care 28 technician, or physician to whom confidential records are disclosed under this section 29 may not further disclose the information to a person not entitled to receive that 30 information under this section or another law. 31 * Sec. 20. AS 18.08.090(8) is amended to read:
01 (8) "emergency medical services system" means a system that provides 02 for the arrangement of personnel, facilities, and equipment for the effective and 03 coordinated delivery of health care services, including trauma care, under emergency 04 conditions, occurring either as a result of the patient's condition or of natural disasters 05 or similar situations, and that is administered by a statewide network that has the 06 authority and resources to provide effective administration of the system; 07 * Sec. 21. AS 18.08.090 is amended by adding new paragraphs to read: 08 (12) "emergency medical dispatcher" means a trained public safety 09 telecommunicator with additional training and specific emergency medical knowledge 10 essential for the efficient management of emergency medical communications; 11 (13) "mobile intensive care paramedic" means an individual who has 12 successfully completed a paramedic training program and is authorized by law to 13 provide advanced life support under the direct or indirect supervision of a physician; 14 (14) "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 (15) "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 sec. 1 of this Act, the regulations adopted by the State Medical 25 Board that govern licensure of mobile intense care paramedics remain in effect until new 26 regulations are adopted by the Department of Health and Social Services under AS 18.08, as 27 amended by this Act. However, the paramedic licensing regulations of the State Medical 28 Board that remain in effect under this subsection shall be administered by the Department of 29 Health and Social Services rather than the State Medical Board.