The next order of business was SSSB 71 (EMERGENCY MEDICAL SERVICES SYSTEM), sponsored by Senator Leman. SENATOR LEMAN said after seeing the assessment of Emergency Medical Services in Alaska completed by the National Highway Traffic Safety Administration Technical Assistance Team he concluded that there were some good recommendations on updating statutes. He said he worked with people from Emergency Medical Services as well as the Departments of Health and Social Services and Commerce and Economic Development in writing SSSB 71. He said Alaska is fortunate to have over 3,000 volunteers and paramedics who provide a valuable service, in many cases, at a reduced cost. MARK JOHNSON, Chief, Emergency Medical Services Section, Department of Health and Social Services, testified in support of SSSB 71. He informed the committee that the legislation the Emergency Medical Services Section functions under was initially passed by the legislature in 1977 and was amended in 1978. It has not been amended since. The National Highway Traffic and Safety Administration started a program a few years ago to make it possible for states to have an outside comprehensive evaluation of their systems. About 38 states have taken advantage of that process which uses federal funds. He said in September, 1992, the National Traffic Highway Safety Administration brought a team of experts to Alaska from around the U.S. Mr. Johnson said he has been working with Senator Leman's staff to identify areas that need changes and to address the various components of a comprehensive emergency medical services system. Mr. Johnson continued to review his position paper as to what the legislation would do. This legislation would: (1) Expand authority of the EMS Section, Department of Health and Social Services to set standards for Mobile Intensive Care Paramedic training programs; (2) Expand the authority of the Department of Health and Social Services to address statewide trauma care system development and to establish standards for the certification of trauma centers; (3) Require the Department of Health and Social Services to establish an EMS patient care information system and require EMS organizations and hospital to provide data; Mr. Johnson noted that currently there is a statewide trauma registry data system that every acute care hospital in Alaska is participating in on a voluntary basis. The bill would put that system in statute. He noted the department also does surveys of pre-hospital emergency medical services every year. Approximately 75 percent of the ambulance services are already providing data. (4) Change the name of the State Advisory Council on Emergency Medical Services to the Alaska Council on Emergency Medical Services, provide that the Council advise the governor and the commissioner of Health and Social Services on EMS issues, and specify the types of EMS system providers to be appointed by the governor; (5) Expand the authority of the department to adopt regulations to charge fees for certification and licensing of organizations; (6) Provide for certification of emergency medical dispatchers; (7) Provide for the disclosure of medical records information to pre-hospital EMS providers for quality of care review and education; and (8) Include state certified EMT instructors in the immunity from liability protection listed in AS 18.08.086. Other provisions of this bill would delete references to the Statewide Health Coordinating Council and health systems agencies, which no longer exist, and delete the words "physician trained" in statutory references to mobile intensive care paramedics (MICP's), to more accurately reflect that MICP's are trained by a combination of physicians, nurses and other paramedics. Number 298 CHAIRMAN RIEGER questioned whether the department is already doing the patient information system. Mr. Johnson said the answer is "yes" and it is being done under a federal grant. Chairman Rieger said the fiscal note is $200 thousand. Mr. Johnson explained that if the federal money runs out, there is no money currently to replace it. If the bill passes along with the fiscal note, that would give the department the money to continue the system. It started as a pilot program in 1988 and it is a very good data system. Chairman Rieger asked what benefits are coming from the system. Mr. Johnson said the system has two major purposes. One purpose is provide data for quality of care review so that the department can give reports back to hospitals. Very soon they will be giving reports to the pre-hospital ambulance services on trauma patients. Mr. Johnson said it is a very sophisticated piece of software that was developed by the former chairman of the American College of Emergency Physicians, Committee on Trauma. Included in the software are some parameters that came out of the Major Trauma Outcome Study, which was a nationwide study done by trauma centers throughout the U.S. in the mid 1980s. Mr. Johnson referred to the other major piece of the data the department gets information on which relates to the causes and severity of the injuries. Injuries are like diseases as they tend to show up in clusters. When those clusters can be identified, you can begin to look at ways to prevent those injuries. He said they are beginning to review the data and isolate those circumstances which resulted in injuries. TODD HUTTENLOCHER, Medical Director, Emergency Medical Services Section, Department of Health and Social Services, testified in support of SSSB 71. He said the enabling legislation for the EMS Section is 15 years old. Over that time period, the department has identified a need for the designation of paramedic training programs and certification of those programs within the state. They have identified a need for emergency medical dispatch certification standardization. Neither of those currently exist and the legislation will allow the department to do that in a formulated, well thought out pre-planned system. Number 354 There being no further testimony on the measure, SENATOR LEMAN moved to pass SSSB 71 out of the Senate HESS Committee with individual recommendations and accompanying fiscal notes. There being no objection, the motion passed.