HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS  3:33:50 PM CHAIR WILSON announced the consideration of HOUSE BILL NO. 57 "An Act relating to review organizations and permitting an emergency medical services provider to establish a review organization; and relating to patient records." 3:34:14 PM REPRESENTATIVE STANLEY WRIGHT, District 22, Alaska State Legislature, Juneau, Alaska, Sponsor of HB 57 stated the bill corrects an inequity affecting emergency medical services (EMS) in Alaska by extending quality assurance program protections to EMS workers, which fixed healthcare facilities have had for years. He noted that several states have already recognized the need for such protections for EMS systems. Alaska's EMS system, especially in rural areas, relies heavily on volunteers, including medical directors who are often physicians ensuring communities have access to state-certified emergency services. He emphasized a discrepancy where these physicians have quality assurance protections in their primary roles at clinics and hospitals but lose those protections when serving as EMS medical directors, threatening the health and safety of Alaskans and the sustainability of rural EMS systems. 3:36:05 PM RACHEL GUNN, Staff, Representative Stanley Wright, Alaska State Legislature, Juneau, Alaska, said EMS represents a vital intersection of transportation, safety, medical, and public health disciplines, with emergency physicians playing a critical role. She explained that these physicians extend their expertise beyond hospital walls, guiding EMTs and paramedics through medical control, issuing treatment orders, and establishing prehospital protocols to direct patient care before hospital arrival. EMS professionals, including Emergency Trauma Technicians (ETTs), Mobile Intensive Care Technicians (TMTs), paramedics, and medical directors, engage in critical self- reflection to assess what went well, what could improve, and factors contributing to poor outcomes. She emphasized that while peer review boards and quality assurance programs encourage continuous evaluation, the legal protections for hospital-based medical directors do not extend to EMS review processes. She argued that HB 57 is necessary to protect peer review discussions from legal exploitation, ensuring that EMS professionals can openly discuss improvements without fear of litigation, which is crucial for continuous EMS advancement and safety. 3:38:13 PM MS. GUNN provided the following sectional analysis for HB 57: [Original punctuation provided.] SECTIONAL ANALYSIS  HB 57  Emergency Medical Services Quality  Assurance Program Protections  SECTIONAL ANALYSIS HB 57 Emergency Medical Services Quality Assurance Program Protections Section I:    Amends AS 18.23.070(1) to Include EMT's, dispatchers, and paramedics in the definition of "health care provider" for the purpose of peer review protection. Section II:    Amends the definition of "healthcare provider" in AS 18.23.070(3) to include EMS agencies and employees who are conducting peer review activities. Section III:    AS 18.23.070(5) is amended to include emergency medical services agencies and employees under the definition of a "review organization" 3:39:17 PM CHAIR WILSON announced invited testimony on HB 57. 3:39:28 PM BRIAN WEBB, representing self, Anchorage, Alaska, stated SB 57 aims to address the omission of EMS in the original statute by extending the same protections that fixed healthcare facilities have to Alaska EMS services. He explained that Alaska EMS requests an amendment to AS 18.23.070 to broaden the definitions of covered entities, as the current wording does not include EMS personnel or activities. He noted that EMS providers are aware that what is discussed or documented in review processes is legally discoverable, leading to hesitation in sharing information, which hinders education and patient care improvements. The lack of protections impacts EMS retention, with valuable volunteers, clinicians, and critical medical directors leaving the system due to the absence of legal safeguards. He emphasized that rural towns in Alaska rely on volunteer medical directors, who have legal protections in their day jobs but not when volunteering, making HB 57 crucial. He cited a tenfold increase in EMS medical director litigation since COVID-19, mostly related to administrative duties, and noted that other states, including California, Arizona, Florida, and Washington, have already enacted similar protections. 3:43:00 PM MS. GUNN stated Dr. Livengood was on a medical emergency but provided a written testimony. 3:43:11 PM CHAIR WILSON opened public testimony on HB 57; finding none, he closed public testimony. 3:43:41 PM SENATOR KAUFMAN opined that HB 57 is sensible as it provides protection and opens communication channels to include EMS personnel in discussions about continuous improvement and quality management. 3:44:22 PM REPRESENTATIVE WRIGHT thanked the committee for hearing HB 57. 3:44:41 PM CHAIR WILSON held HB 57 in committee.