1 SB115
2 204385-1
3 By Senator Butler
4 RFD: Healthcare
5 First Read: 02-FEB-21
6 PFD: 01/28/2021
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1 204385-1:n:02/06/2020:PMG/bm LSA2020-321
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8 SYNOPSIS: Under existing law, emergency medical
9 services personnel are subject to regulation by the
10 State Board of Health.
11 This bill would authorize the State Board of
12 Health to establish and administer a community
13 paramedicine program that authorizes paramedics to
14 provide certain services to patients in certain
15 circumstances.
16 This bill would require the State Board of
17 Health to adopt rules.
18 This bill would also revise definitions,
19 including definitions for services provided by
20 emergency medical services personnel.
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22 A BILL
23 TO BE ENTITLED
24 AN ACT
25
26 Relating to emergency medical services; to amend
27 Section 22-18-1, Code of Alabama 1975, and to add Section
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1 22-18-10 to the Code of Alabama 1975; to authorize the State
2 Board of Health to establish and administer a community
3 paramedicine program that allows paramedics to provide certain
4 services to patients; to authorize rulemaking; and to revise
5 definitions.
6 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
7 Section 1. Section 22-18-1, Code of Alabama 1975, is
8 amended to read as follows:
9 "22-18-1.
10 "For the purposes of this article, the following
11 terms shall have the meanings respectively ascribed to them by
12 this section:
13 "(1) ADVANCED EMERGENCY MEDICAL TECHNICIAN. Any
14 person individual 18 years of age or older who satisfies all
15 of the following:
16 "a. Has successfully completed the advanced
17 emergency medical technician course of instruction, or its
18 equivalent, as approved by the State Board of Health board.
19 "b. Has passed the state Advanced EMT examination,
20 as well as having met the requirements for becoming a licensed
21 emergency medical technician.
22 "c. Has been granted a license by the State Board of
23 Health board.
24 "(2) ADVANCED LIFE SUPPORT (ALS). The treatment of
25 potentially life-threatening medical emergencies through the
26 use of invasive medical techniques specified as advanced life
27 support techniques by the Board of Health board, which
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1 ordinarily would be performed or provided by licensed
2 physicians, but which may be performed by emergency medical
3 service personnel during emergencies under constraints
4 specified by rule of the board.
5 "(3) AIR AMBULANCE. An aircraft that is intended to
6 be used for and is maintained or operated for transportation
7 to a medical care facility of persons who are sick or injured.
8 For the purposes of this chapter, fixed-wing aircraft that do
9 not conduct scene flights shall not be considered air
10 ambulances.
11 "(4) BASIC LIFE SUPPORT (BLS). Prehospital care
12 involving non-invasive life support measures as specified by
13 the board.
14 "(5) BOARD or BOARD OF HEALTH. The State Board of
15 Health.
16 "(6) COMMUNITY PARAMEDIC. An individual 18 years of
17 age or older who satisfies all of the following:
18 "a. Is currently licensed as a paramedic.
19 "b. Has two years of full-time service as a
20 paramedic.
21 "c. Has successfully completed a community paramedic
22 training program from an accredited college or university
23 approved by the board.
24 "d. Has passed the state community paramedic
25 examination, as well as having met the requirements for
26 becoming a licensed community paramedic.
27 "e. Has been granted a license by the board.
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1 "(7) COMMUNITY PARAMEDICINE PROGRAM. The provision
2 of certain medical services, as determined by rule, that a
3 community paramedic may provide.
4 "(6)(8) DEPARTMENT. The Alabama Department of Public
5 Health.
6 "(7)(9) EMERGENCY MEDICAL SERVICES (EMS). A system
7 of coordinated response to provide prehospital emergency aid
8 and medical assistance from primary response to definitive
9 care, involving personnel trained in the rescue,
10 stabilization, transportation, and treatment of sick or
11 injured persons A system that consists of all of the
12 following:
13 "a. The transportation and medical care provided to
14 sick or injured individuals before arrival at a medical
15 facility by licensed emergency medical services personnel.
16 "b. Continuation of care within a medical facility
17 subject to the approval of the medical staff and governing
18 board of that facility.
19 "c. Integrated medical care in emergency and
20 nonurgent settings with the oversight of a physician.
21 (8)(10) EMERGENCY MEDICAL SERVICES PERSONNEL (EMSP).
22 The collective term used to refer to licensed emergency
23 medical technicians, emergency medical technicians
24 intermediate, advanced emergency medical technicians,
25 paramedics, and any level of licensure as recognized by the
26 National Highway Traffic Safety Administration for individuals
27 who provide emergency medical services or who initiate
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1 immediate lifesaving care An individual licensed by the board
2 at any level established by law or by rules adopted by the
3 board under this article and authorized to perform these
4 limited services set forth in the rules.
5 "(9)(11) EMERGENCY MEDICAL TECHNICIAN (EMT). Any
6 person An individual 18 years of age or older who satisfies
7 all of the following:
8 "a. Has successfully completed the basic emergency
9 medical technician course of instruction, or its equivalent,
10 as approved by the Board of Health board.
11 "b. Has passed the state EMT examination.
12 "c. Has been granted a license by the Board of
13 Health board.
14 "(10)(12) GROUND AMBULANCE. A motor vehicle that is
15 intended to be used for and is maintained or operated for
16 transportation to a medical care facility of persons
17 individuals who are sick or injured.
18 "(11)(13) LICENSED EMERGENCY MEDICAL
19 TECHNICIAN-INTERMEDIATE. Any person An individual 18 years of
20 age or older who, prior to December 31, 2002, satisfies all of
21 the following:
22 "a. Has successfully completed the intermediate
23 emergency medical technician course of instruction, or its
24 equivalent, as approved by the Board of Health board.
25 "b. Has passed the state EMT Intermediate
26 examination, as well as having met the requirements for
27 becoming a licensed emergency medical technician.
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1 "c. has been granted a license by the Board of
2 Health board.
3 "(14) MEDICAL FACILITY. Any hospital, medical
4 clinic, physician's office, nursing home, or other health care
5 facility.
6 "(12)(15) NON-TRANSPORT VEHICLE. A vehicle operated
7 with the intent to provide BLS or ALS stabilization on scene,
8 but not intended to transport a patient to a medical care
9 facility.
10 "(13)(16) PARAMEDIC. Any person individual 18 years
11 of age or older who has successfully completed the paramedic
12 course of instruction, or its equivalent, as approved by the
13 Board of Health board, and passed the state EMT-paramedic
14 examination, and who has been granted a license by the Board
15 of Health board.
16 "(14)(17) PATIENT. An individual who receives or
17 requests medical care, or for whom medical care is requested,
18 because the individual is sick or injured.
19 "(15)(18) PHYSICIAN. An individual licensed to
20 practice medicine by the Medical Licensure Commission of
21 Alabama.
22 "(16)(19) PROVIDER SERVICE. An organization, whether
23 public or private, which provides transport or non-transport
24 emergency medical services.
25 "(17)(20) SCENE FLIGHT. The flight of an air
26 ambulance to the physical location of a sick or injured person
27 individual.
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1 "(18)(21) TRANSPORT VEHICLE. An air or ground
2 ambulance."
3 Section 2. Section 22-18-10 is added to the Code of
4 Alabama 1975, to read as follows:
5 22-18-10.
6 (a) The board may establish and administer a
7 community paramedicine program to authorize paramedics to
8 provide community paramedic services, as further provided in
9 this section.
10 (b) An individual is eligible as a patient for a
11 community paramedicine program if the individual meets any of
12 the following criteria:
13 (1) The individual has been discharged from a
14 medical facility, and has declined or is not eligible for home
15 health or hospice services.
16 (2) The individual has been identified by his or her
17 treating physician as an individual for whom community
18 paramedic services would likely prevent admission or
19 readmission to, or allow discharge from, a medical facility.
20 (3) The individual has been referred to the
21 community paramedicine program to receive preventive services.
22 (c) Community paramedic services are limited to all
23 of the following:
24 (1) Coordination of community services.
25 (2) Chronic disease monitoring and education.
26 (3) Health assessment.
27 (4) Hospital discharge follow-up care.
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1 (5) Laboratory specimen collection.
2 (6) Medication compliance.
3 (7) Continuation of care within a medical facility.
4 (8) Integrated medical care with the oversight of a
5 physician.
6 (d) A community paramedic shall document all
7 community paramedic services provided, and shall forward a
8 copy of the documentation to the attending or treating
9 physician, as prescribed by rules adopted by the board.
10 (e) Nothing in this section shall be construed to
11 allow a community paramedic to make a diagnosis or prescribe
12 drugs.
13 (f) The board shall adopt rules to implement this
14 section, including, but not limited to, the length of time
15 after discharge a patient is eligible for community paramedic
16 services.
17 Section 3. This act shall become effective on the
18 first day of the third month following its passage and
19 approval by the Governor, or its otherwise becoming law.
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Statutes affected:
Introduced: 22-18-1