1 HB141
2 211142-3
3 By Representative Sells
4 RFD: Health
5 First Read: 02-FEB-21
6 PFD: 01/26/2021
Page 0
 HB141
1
2 ENROLLED, An Act,
3 Relating to emergency medical services; to amend
4 Section 22-18-1, Code of Alabama 1975, and to add Section
5 22-18-10 to the Code of Alabama 1975; to authorize the State
6 Board of Health to establish and administer a community
7 paramedicine program that allows paramedics to provide certain
8 services to patients; to authorize rulemaking; and to revise
9 definitions.
10 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
11 Section 1. Section 22-18-1, Code of Alabama 1975, is
12 amended to read as follows:
13 "22-18-1.
14 "For the purposes of this article, the following
15 terms shall have the meanings respectively ascribed to them by
16 this section:
17 "(1) ADVANCED EMERGENCY MEDICAL TECHNICIAN. Any
18 person individual who is an emergency medical services
19 personnel and is 18 years of age or older, and who satisfies
20 all of the following:
21 "a. Has successfully completed the advanced
22 emergency medical technician course of instruction, or its
23 equivalent, as approved by the State Board of Health board.
Page 1
 HB141
1 "b. Has passed the state Advanced EMT examination,
2 as well as having met the requirements for becoming a licensed
3 emergency medical technician.
4 "c. Has been granted a license by the State Board of
5 Health board.
6 "(2) ADVANCED LIFE SUPPORT (ALS). The treatment of
7 potentially life-threatening medical emergencies through the
8 use of invasive medical techniques specified as advanced life
9 support techniques by the Board of Health board, which
10 ordinarily would be performed or provided by licensed
11 physicians, but which may be performed by emergency medical
12 service personnel during emergencies under constraints
13 specified by rule of the board.
14 "(3) AIR AMBULANCE. An aircraft that is intended to
15 be used for and is maintained or operated for transportation
16 to a medical care facility of persons who are sick or injured.
17 For the purposes of this chapter, fixed-wing aircraft that do
18 not conduct scene flights shall not be considered air
19 ambulances.
20 "(4) BASIC LIFE SUPPORT (BLS). Prehospital care
21 involving non-invasive life support measures as specified by
22 the board.
23 "(5) BOARD or BOARD OF HEALTH. The State Board of
24 Health.
Page 2
 HB141
1 "(6) COMMUNITY PARAMEDIC. An individual who is an
2 emergency medical services personnel and is 18 years of age or
3 older, and who satisfies all of the following:
4 "a. Is currently licensed as a paramedic.
5 "b. Has at least two years of full-time service as a
6 paramedic.
7 "c. Has successfully completed a community paramedic
8 training program from an accredited college or university
9 approved by the board.
10 "d. Has passed the state community paramedic
11 examination and has met the requirements for becoming a
12 licensed community paramedic.
13 "e. Has been granted a license by the board.
14 "(7) COMMUNITY PARAMEDICINE PROGRAM. The provision
15 of episodic care, patient evaluation, advice, and treatment
16 directed at preventing or improving a particular medical
17 condition, within the scope of practice of the emergency
18 medical services personnel.
19 "(8) DEFINITIVE CARE FACILITY. A facility that has
20 the capability to render care to conclusively manage a
21 patient's current medical condition. The term includes, but is
22 not limited to, urgent care facilities, family practice
23 facilities, doctor's offices, and emergency departments.
24 "(6)(9) DEPARTMENT. The Alabama Department of Public
25 Health.
Page 3
 HB141
1 "(7)(10) EMERGENCY MEDICAL SERVICES (EMS). A system
2 of coordinated response to provide prehospital emergency aid
3 and medical assistance from primary response to definitive
4 care, involving personnel trained in the rescue,
5 stabilization, transportation, and treatment of sick or
6 injured persons medical assistance and care provided by
7 emergency medical services personnel, including:
8 "a. The transportation and medical care provided to
9 sick or injured individuals before arrival at a definitive
10 care facility.
11 "b. Continuation of care within a definitive care
12 facility subject to the approval from that facility.
13 "c. Integrated medical care with the oversight of a
14 medical director.
15 (8)(11) EMERGENCY MEDICAL SERVICES PERSONNEL (EMSP).
16 The collective term used to refer to licensed emergency
17 medical technicians, emergency medical technicians
18 intermediate, advanced emergency medical technicians,
19 paramedics, and any level of licensure as recognized by the
20 all recognized National Highway Traffic Safety Administration
21 for individuals levels of personnel licensed by the board, who
22 have met all primary and renewal educational requirements, and
23 who provide emergency or non-emergency medical services or who
24 initiate immediate lifesaving care within the level of their
Page 4
 HB141
1 scope of practice and in accordance with the applicable EMS
2 Patient Care Protocols.
3 "(9)(12) EMERGENCY MEDICAL TECHNICIAN (EMT). Any
4 person An individual who is an emergency medical services
5 personnel and is 18 years of age or older, and who satisfies
6 all of the following:
7 "a. Has successfully completed the basic emergency
8 medical technician course of instruction, or its equivalent,
9 as approved by the Board of Health board.
10 "b. Has passed the state EMT examination.
11 "c. Has been granted a license by the Board of
12 Health board.
13 "(13) EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE. An
14 individual who is an emergency medical services personnel and
15 is 18 years of age or older, and who, prior to December 31,
16 2002, satisfies all of the following:
17 "a. Has successfully completed the intermediate
18 emergency medical technician course of instruction, or its
19 equivalent, as approved by the board.
20 "b. Has passed the state EMT Intermediate
21 examination and has met the requirements for becoming a
22 licensed emergency medical technician.
23 "c. Has been granted a license by the board.
24 "(10)(14) GROUND AMBULANCE. A motor vehicle that is
25 intended to be used for and is maintained or operated for
Page 5
 HB141
1 transportation to a medical care facility of persons
2 individuals who are sick or injured.
3 "(11) LICENSED EMERGENCY MEDICAL
4 TECHNICIAN-INTERMEDIATE. Any person 18 years of age or older
5 who, prior to December 31, 2002, satisfies all of the
6 following:
7 "a. Has successfully completed the intermediate
8 emergency medical technician course of instruction, or its
9 equivalent, as approved by the Board of Health.
10 "b. Has passed the state EMT Intermediate
11 examination, as well as having met the requirements for
12 becoming a licensed emergency medical technician.
13 "c. has been granted a license by the Board of
14 Health.
15 "(12)(15) NON-TRANSPORT VEHICLE. A vehicle operated
16 with the intent to provide BLS or ALS stabilization on scene,
17 but not intended to transport a patient to a medical care
18 facility.
19 "(13)(16) PARAMEDIC. Any person individual who is an
20 emergency medical services personnel and is 18 years of age or
21 older, and who has successfully completed the paramedic course
22 of instruction, or its equivalent, as approved by the Board of
23 Health board, and passed the state EMT-paramedic examination,
24 and who has been granted a license by the Board of Health
25 board.
Page 6
 HB141
1 "(14)(17) PATIENT. An individual who receives or
2 requests medical care, or for whom medical care is requested,
3 because the individual is sick or injured.
4 "(15)(18) PHYSICIAN. An individual licensed to
5 practice medicine or osteopathy by the Medical Licensure
6 Commission of Alabama.
7 "(19) PROGRAM MEDICAL DIRECTOR. A physician who has
8 completed the approved EMS Medical Director course and
9 provides medical direction and oversight to emergency medical
10 services personnel.
11 "(16)(20) PROVIDER SERVICE. An organization, whether
12 public or private, which provides transport or non-transport
13 emergency medical services.
14 "(17)(21) SCENE FLIGHT. The flight of an air
15 ambulance to the physical location of a sick or injured person
16 individual.
17 "(18)(22) TRANSPORT VEHICLE. An air or ground
18 ambulance."
19 Section 2. Section 22-18-10 is added to the Code of
20 Alabama 1975, to read as follows:
21 22-18-10.
22 (a) The board may establish and administer a
23 community paramedicine program to authorize paramedics to
24 provide community paramedic services under the direction and
Page 7
 HB141
1 oversight of the program medical director, as further provided
2 in this section.
3 (b) The criteria for which an individual is eligible
4 as a patient for a community paramedicine program includes,
5 but is not limited to, any of the following:
6 (1) The individual has been discharged from a
7 definitive care facility, and has declined or is not eligible
8 for home health or hospice services.
9 (2) The individual has been identified as a patient
10 for whom community paramedic services would likely prevent
11 admission or readmission to, or allow discharge from, a
12 definitive care facility.
13 (3) The individual has been referred to the
14 community paramedicine program to receive preventive services.
15 (c) Community paramedic services include, but are
16 not limited to:
17 (1) Coordination of community services.
18 (2) Chronic disease monitoring and education.
19 (3) Health assessment.
20 (4) Hospital discharge follow-up care.
21 (5) Laboratory specimen collection.
22 (6) Medication compliance.
23 (d) A community paramedic shall document and submit
24 all services provided in accordance with the applicable
Page 8
 HB141
1 patient care reporting rules or other rules as prescribed by
2 the board.
3 (e) Nothing in this section shall be construed to
4 allow a community paramedic to practice medicine or surgery,
5 to make a diagnosis, or to prescribe drugs.
6 (f) The board shall adopt rules to implement this
7 section, including, but not limited to, the length of time
8 after discharge a patient is eligible for community paramedic
9 services.
10 Section 3. This act shall become effective on the
11 first day of the third month following its passage and
12 approval by the Governor, or its otherwise becoming law.
Page 9
 HB141
1
2
3
4 Speaker of the House of Representatives
5
6 President and Presiding Officer of the Senate
7 House of Representatives
8 I hereby certify that the within Act originated in
9 and was passed by the House 16-MAR-21, as amended.
10
11 Jeff Woodard
12 Clerk
13
14
15
16 Senate 20-APR-21 Passed
17
Page 10


Statutes affected:
Introduced: 22-18-1
Engrossed: 22-18-1
Enrolled: 22-18-1