SB 21: "An Act relating to mobile intensive care paramedics; relating to duties of the State Medical Board and the Department of Health and Social Services; and providing for an effective date."
00 SENATE BILL NO. 21 01 "An Act relating to mobile intensive care paramedics; relating to duties of the State 02 Medical Board and the Department of Health and Social Services; and providing for an 03 effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 08.64.107 is amended to read: 06 Sec. 08.64.107. Regulation of physician assistants [AND INTENSIVE 07 CARE PARAMEDICS]. The board shall adopt regulations regarding the licensure of 08 physician assistants [AND REGISTRATION OF MOBILE INTENSIVE CARE 09 PARAMEDICS,] and the medical services that they may perform, including the 10 (1) educational and other qualifications, including education in pain 11 management and opioid use and addiction; 12 (2) application and licensing [REGISTRATION] procedures; 13 (3) scope of activities authorized; and 14 (4) responsibilities of the supervising or training physician.
01 * Sec. 2. AS 08.64.170(a) is amended to read: 02 (a) A person may not practice medicine, podiatry, or osteopathy in the state 03 unless the person is licensed under this chapter, except that 04 (1) a physician assistant may examine, diagnose, or treat persons under 05 the supervision, control, and responsibility of either a physician licensed under this 06 chapter or a physician exempted from licensing under AS 08.64.370; 07 (2) [A MOBILE INTENSIVE CARE PARAMEDIC MAY RENDER 08 EMERGENCY LIFESAVING SERVICE; 09 (3)] a person who is licensed or authorized under another law of the 10 state [CHAPTER OF THIS TITLE] may engage in a practice that is authorized under 11 that law [CHAPTER]; and 12 (3) [(4)] a person may perform routine medical duties delegated under 13 AS 08.64.106. 14 * Sec. 3. AS 08.64.360 is amended to read: 15 Sec. 08.64.360. Penalty for practicing without a license or in violation of 16 chapter. Except for a physician assistant [, A MOBILE INTENSIVE CARE 17 PARAMEDIC,] or a person licensed or authorized under another law of the state 18 [CHAPTER OF THIS TITLE] who engages in practices for which that person is 19 licensed or authorized under that law [CHAPTER], a person practicing medicine or 20 osteopathy in the state without a valid license or permit is guilty of a class A 21 misdemeanor. Each day of illegal practice is a separate offense. 22 * Sec. 4. AS 08.64.369(d) is amended to read: 23 (d) In this section, "health care professional" includes an emergency medical 24 technician certified under AS 18.08, health aide, physician, nurse, mobile intensive 25 care paramedic licensed under AS 18.08, and physician assistant, but does not include 26 a practitioner of religious healing. 27 * Sec. 5. AS 12.55.185(11) is amended to read: 28 (11) "paramedic" means a mobile intensive care paramedic licensed 29 under AS 18.08 [AS 08.64]; 30 * Sec. 6. AS 18.08.075 is amended to read: 31 Sec. 18.08.075. Authority of emergency medical technician and mobile
01 intensive care paramedic. (a) An emergency medical technician or mobile intensive 02 care paramedic who responds to an emergency with an ambulance service or first 03 responder service, who has in the technician's or mobile intensive care paramedic's 04 possession a current emergency medical technician or mobile intensive care 05 paramedic identification card [,] and who provides emergency medical care or other 06 emergency medical service, has the authority to 07 (1) control and direct activities at the accident site or emergency until 08 the arrival of law enforcement personnel; 09 (2) order a person other than the owner to leave a building or place in 10 the vicinity of the accident or other emergency for the purpose of protecting the person 11 from injury; 12 (3) temporarily block a public highway, street, or private right-of-way 13 while at the scene of an accident, illness, or emergency; 14 (4) trespass upon property at or near the scene of an accident, illness, 15 or emergency at any time of day or night; 16 (5) enter a building, including a private dwelling, or premises where a 17 report of an injury or illness has taken place or where there is a reasonable cause to 18 believe an individual has been injured or is ill to render emergency medical care; and 19 (6) direct the removal or destruction of a motor vehicle or other thing 20 that the emergency medical technician or mobile intensive care paramedic 21 determines is necessary to prevent further harm to injured or ill individuals. 22 (b) A person who knowingly refuses to comply with an order of an emergency 23 medical technician or mobile intensive care paramedic authorized under (a) of this 24 section is, upon conviction, guilty of a class B misdemeanor. In this subsection, 25 "knowingly" has the meaning given in AS 11.81.900(a). 26 * Sec. 7. AS 18.08.080 is amended to read: 27 Sec. 18.08.080. Regulations. (a) The department shall adopt, with the 28 concurrence of the Department of Public Safety, regulations establishing standards and 29 procedures for the issuance, renewal, reissuance, revocation, and suspension of 30 certificates or licenses required under AS 18.08.084, as well as other regulations 31 necessary to carry out the purposes of this chapter.
01 (b) The department may charge fees set by regulation for the certification or 02 licensure of individuals and organizations under this chapter. 03 * Sec. 8. AS 18.08.082(a) is amended to read: 04 (a) The department shall prescribe by regulation a course of training or other 05 requirements prerequisite to the issuance of certificates or licenses that provide for the 06 following: 07 (1) certification of a person who meets the training and other 08 requirements as an emergency medical technician, emergency medical technician 09 instructor, or emergency medical dispatcher; 10 (2) authorization for an emergency medical technician certified under 11 this chapter to provide under the written or oral direction of a physician the advanced 12 life support services enumerated on the certificate or enumerated on a written 13 document filed with the department by the technician's medical director and approved 14 by the department under its regulations; 15 (3) certification that a person, organization, or government agency that 16 provides an emergency medical service, conducts a training course for a mobile 17 intensive care paramedic, or represents itself as a trauma center meets the minimum 18 standards prescribed by the department for that service, course, or designation; [AND] 19 (4) authorization for an emergency medical service certified under this 20 chapter to provide under the written or oral direction of a physician the advanced life 21 support services enumerated on the certificate or enumerated on a written document 22 filed with the department by the medical director for the emergency medical service 23 and approved by the department under its regulations; and 24 (5) licensure of a mobile intensive care paramedic and the medical 25 services that a mobile intensive care paramedic may perform, including the 26 (A) educational and other qualifications, including 27 education in pain management and opioid use and addiction; 28 (B) application and licensing procedures; 29 (C) scope of activities authorized; and 30 (D) responsibilities of a supervising or training physician. 31 * Sec. 9. AS 18.08.082(b) is amended to read:
01 (b) The department is the central certifying and licensing agency for persons, 02 organizations, or governmental agencies that are [PERSONNEL] certified or 03 licensed under (a) [(a)(1) AND (2)] of this section and under regulations adopted 04 under AS 18.08.080. 05 * Sec. 10. AS 18.08.084(a) is amended to read: 06 (a) One may not represent oneself, nor may an agency or business represent an 07 agent or employee of that agency or business, as an emergency medical dispatcher, 08 emergency medical technician, mobile intensive care paramedic, or emergency 09 medical technician instructor certified or licensed by the state unless the person 10 represented is certified or licensed for that occupation under AS 18.08.082. 11 * Sec. 11. AS 18.08.086(a) is amended to read: 12 (a) A person certified or licensed under AS 18.08.082 who administers 13 emergency medical services to an injured or sick person, a person or public agency 14 that employs, sponsors, directs, or controls the activities of persons certified or 15 licensed under AS 18.08.082 who administer emergency medical services to an 16 injured or sick person, or a health care professional or emergency medical dispatcher 17 acting within the scope of the person's certification who directs or advises a person to 18 administer emergency medical services to an injured or sick person is not liable for 19 civil damages as a result of an act or omission in administering those services or 20 giving that advice or those directions if the administering, advising, and directing are 21 done in good faith and the injured or sick person reasonably seems to be in immediate 22 danger of serious harm or death. This subsection does not preclude liability for civil 23 damages that are the proximate result of gross negligence or intentional misconduct, 24 nor preclude imposition of liability on a person or public agency that employs, 25 sponsors, directs, or controls the activities of persons certified or licensed under 26 AS 18.08.082 if the act or omission is a proximate result of a breach of duty to act 27 created under this chapter. In [FOR THE PURPOSES OF] this subsection, "gross 28 negligence" means reckless, wilful, or wanton misconduct. 29 * Sec. 12. AS 18.08.089(a) is amended to read: 30 (a) A mobile intensive care paramedic licensed under this chapter, a [OR] 31 physician assistant registered or licensed under AS 08.64.107, or an emergency
01 medical technician certified under this chapter may make a determination and 02 pronouncement of death of a person under the following circumstances: 03 (1) the mobile intensive care paramedic or emergency medical 04 technician is an active member of an emergency medical service certified under this 05 chapter; 06 (2) neither a physician licensed under AS 08.64 nor a physician 07 exempt from licensure under AS 08.64 is immediately available for consultation by 08 radio or telephone communications; 09 (3) the mobile intensive care paramedic, physician assistant, or 10 emergency medical technician has determined, based on acceptable medical standards, 11 that the person has sustained irreversible cessation of circulatory and respiratory 12 functions. 13 * Sec. 13. AS 18.08.200 is amended by adding a new paragraph to read: 14 (14) "mobile intensive care paramedic" means an individual licensed 15 by the department who has completed a paramedic training program approved by the 16 department and is authorized by law to provide advanced life support under the direct 17 or indirect supervision of a physician. 18 * Sec. 14. AS 29.45.050(r) is amended to read: 19 (r) A municipality may by ordinance exempt from taxation an amount not to 20 exceed $10,000 of the assessed value of real property owned and occupied as a 21 permanent place of abode by a resident who provides in the municipality volunteer (1) 22 fire fighting services and is certified as a firefighter by the Department of Public 23 Safety, or (2) emergency medical services or mobile intensive care paramedic 24 services and is certified or licensed under AS 18.08.082. If two or more individuals 25 are eligible for an exemption for the same property, not more than two exemptions 26 may be granted. 27 * Sec. 15. AS 37.05.146(c)(77) is amended to read: 28 (77) the following fees, receipts, income, and monetary recoveries 29 collected by the Department of Health and Social Services: 30 (A) receipts of the Department of Health and Social Services, 31 Bureau of Vital Statistics;
01 (B) monetary recoveries of Medicaid expenditures from 02 recipients, third parties, and providers under AS 47; 03 (C) the state's share of overpayments collected under 04 AS 47.05.080; 05 (D) income received from a state or federal agency for children 06 in foster care under AS 47.14.100; 07 (E) fees received or collected under AS 44.29.022 for nursing 08 and planning services provided at health centers, genetic screening clinics and 09 specialty clinics, the certification of x-ray machines, the alcohol safety action 10 program, and other public health programs and services; 11 (F) fees received under AS 18.08.080 for the certification or 12 licensure of emergency medical technicians, emergency medical dispatchers, 13 mobile intensive care paramedics, and emergency medical technician 14 instructors; 15 (G) fees received under AS 47.32; 16 (H) the state's share of child support collections for 17 reimbursement of the cost of the Alaska temporary assistance program as 18 provided under AS 25.27.120, 25.27.130, and AS 47.27.040; and 19 (I) monetary recoveries under AS 09.58 (Alaska Medical 20 Assistance False Claim and Reporting Act); 21 * Sec. 16. AS 08.64.366, 08.64.380(3), and 08.64.380(4) are repealed. 22 * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 23 read: 24 TRANSITION: EXISTING REGISTRATIONS; REGULATIONS. (a) 25 Notwithstanding the amendment to AS 08.64.107 made by sec. 1 of this Act, a registration of 26 a mobile intensive care paramedic issued before the effective date of sec. 1 of this Act is valid 27 until the registration 28 (1) expires under AS 08.64.107, as that section read on the day before the 29 effective date of sec. 1 of this Act; 30 (2) is suspended or revoked; or 31 (3) is converted to a license under AS 18.08.082(a) and (b), as amended by
01 secs. 8 and 9 of this Act. 02 (b) On January 1, 2022, the Department of Commerce, Community, and Economic 03 Development and the State Medical Board shall transfer the files of all pending records and 04 proceedings, including applications and disciplinary actions, relating to mobile intensive care 05 paramedics to the Department of Health and Social Services. 06 (c) The Department of Health and Social Services shall adopt regulations necessary to 07 implement this Act. The regulations must allow for the conversion of an unexpired 08 registration of a mobile intensive care paramedic issued under regulations authorized by 09 AS 08.64.107, as that section read on the day before the effective date of sec. 1 of this Act, to 10 a license under AS 18.08.082(a) and (b), as amended by secs. 8 and 9 of this Act. 11 * Sec. 18. Section 17(c) of this Act takes effect immediately under AS 01.10.070(c). 12 * Sec. 19. Except as provided in sec. 18 of this Act, this Act takes effect January 1, 2022.