Bill Summary – FastDemocracy

67th Legislature                                                                                               SB 377.1
                                                   SENATE BILL NO. 377
   INTRODUCED BY E. MCCLAFFERTY, B. BENNETT, E. BOLDMAN, M. FOX, S. MORIGEAU, S. O'BRIEN, M.
                                            SWEENEY, S. WEBBER, R. LYNCH
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   A BILL FOR AN ACT ENTITLED: “AN ACT GENERALLY REVISING LAWS RELATED TO EMERGENCY
   CARE PROVIDERS AND EMERGENCY MEDICAL SERVICES; ESTABLISHING A MEDICAL CARE
   COUNCIL TO OVERSEE EMERGENCY MEDICAL SERVICES IN MONTANA; TRANSFERRING LICENSING
   AND OTHER ADMINISTRATIVE REQUIREMENTS FOR EMERGENCY MEDICAL SERVICES AND
   EMERGENCY CARE PROVIDERS FROM THE BOARD OF MEDICAL EXAMINERS TO THE DEPARTMENT
   OF PUBLIC HEALTH AND HUMAN SERVICES; REVISING DEFINITIONS; PROVIDING FOR LICENSING
   FEES; REVISING DEFINITIONS; PROVIDING RULEMAKING AUTHORITY; AMENDING SECTIONS 37-1-
   138, 37-3-102, 37-3-203, 50-6-102, 50-6-103, 50-6-105, 50-6-201, 50-6-202, 50-6-203, 50-6-302, 50-6-317, 50-
   6-322, 50-6-323, 50-32-603, 53-21-1208, AND 61-2-502, MCA; AND REPEALING SECTIONS 50-6-104, 50-6-
   207, 50-6-307, AND 50-6-324, MCA.”
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   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
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              NEW SECTION. Section 1.        Emergency medical care council. (1) There is an emergency medical
   care council.
              (2)   The council consists of members appointed by the governor as follows:
              (a)   a physician representative of the American college of emergency physicians, Montana chapter;
              (b)   a physician member of the Montana committee on trauma of the American college of surgeons;
              (c)   a physician member of the Montana academy of pediatrics;
              (d)   three members who are emergency medical services medical directors;
              (e)   a representative of the Montana hospital association;
              (f)   a member of the Montana medical association;
              (g)   a member representing the Montana board of medical examiners;
              (h)   an emergency care provider who represents volunteer providers;
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              (i)   an emergency care provider who represents career providers; and
              (j)   an individual who represents the public.
              (3)   Members must be appointed for 4-year terms, except that seven of the members initially
   appointed shall serve terms of 2 years. Members serve at the pleasure of the governor. If a vacancy occurs, the
   governor shall appoint a replacement to fill the unexpired term. A member may be reappointed.
              (4)   A member of the council may not receive compensation for performing the member's duties but
   must be reimbursed for expenses.
              (5)   The council is attached to the department of public health and human services for administrative
   purposes only as provided in 2-15-121.
              (6)   The council has the duties provided in [section 2].
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              NEW SECTION. Section 2.         Duties of emergency medical care council. The emergency medical
   care council provided for in [section 1] shall provide recommendations and guidance to the department
   concerning:
              (1)   emergency medical care, including suggestions for changes to the statewide emergency care
   system;
              (2)   the implementation of a prehospital data collection system;
              (3)   standards for scope of practice and medical supervision for emergency care providers and
   emergency medical services licensed by the department;
              (4)   disciplinary recommendations for personnel and emergency medical services licensed by the
   department;
              (5)   the design and implementation of a statewide quality improvement system for emergency medical
   care that considers the standards provided by the national highway traffic safety administration office of
   emergency medical services and other national organizations; and
              (6)   assisting the department in conducting statewide quality improvement and peer review functions
   by regularly analyzing the effect of the statewide emergency care system on patient care, morbidity, and
   mortality.
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67th Legislature                                                                                                   SB 377.1
              NEW SECTION. Section 3.        Licensure fees -- department costs. (1) The department shall set fees
   related to emergency care provider licensing that provide the amount of money usually needed for the
   operation of the department for services, including but not limited to licensing, reciprocity, renewals,
   applications, inspections, investigations, compliance, discipline, and audits.
              (2)   There is a special revenue account in the state special revenue fund established in 17-2-102 to
   the credit of the department for the purposes of this section, and the department shall deposit fees collected
   under this section.
              (3)   The department shall adopt rules regarding all fees.
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              NEW SECTION. Section 4.        Licensure fees -- department costs. (1) The department shall set fees
   related to emergency medical services licensing that provide the amount of money usually needed for the
   operation of the department for services, including but not limited to licensing, reciprocity, renewals,
   applications, inspections, investigations, compliance, discipline, and audits.
              (2)   There is a special revenue account in the state special revenue fund established in 17-2-102 to
   the credit of the department for the purposes of this section, and the department shall deposit fees collected
   under this section.
              (3)   The department shall adopt rules regarding all fees.
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              Section 5. Section 37-1-138, MCA, is amended to read:
              "37-1-138.   Protection of professional licenses for activated military reservists -- rulemaking
   authority -- definitions. (1) For the purposes of this section, the following definitions apply:
              (a)   "Activated reservist" means a member of a reserve component who has received federal military
   orders to report for federal active duty for at least 90 consecutive days.
              (b)   "License" has the meaning provided in 37-1-302 and includes a license required in Title 50,
   chapter 6, parts 2 and 3.
              (c)   "Reserve component" means the Montana national guard or the military reserves of the United
   States armed forces.
              (2)   An activated reservist who holds an occupational or professional license may report the reservist's
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   activation to the appropriate professional licensing board or to the department of labor and industry if the
   licensing requirements are administered by the department. The report must, at a minimum, include a copy of
   the reservist's orders to federal active duty. The report may request that the reservist's professional license
   revert to an inactive status.
              (3)   If an activated reservist has requested that the reservist's license revert to inactive status pursuant
   to subsection (2), then for the duration of the reservist's active duty service under the orders submitted, the
   department or licensing board may not:
              (a)   require the collection of professional licensing fees or continuing education fees from the activated
   reservist;
              (b)   require that the activated reservist take continuing education classes or file a report of continuing
   education classes completed; or
              (c)   revoke or suspend the activated reservist's professional license, require the license to be forfeited,
   or allow the license to lapse for failure to pay licensing fees or continuing education fees or for failure to take or
   report continuing education classes.
              (4)   (a) Upon release from federal active duty service, the reservist shall send a copy of the reservist's
   discharge documents to the appropriate professional licensing board or to the department.
              (b)   The board or department shall evaluate the discharge documents, consider the military position
   held by the reservist and the duties performed by the reservist during the active duty, and compare the position
   and duties to the licensing requirements for the profession. The board or department shall also consider the
   reservist's length of time on federal active duty.
              (c)   Based on the considerations pursuant to subsection (4)(b) and subject to subsection (5):
              (i)   the license must be fully restored;
              (ii) conditions must be attached to the reservist's continued retention of the license; or
              (iii) the license must be suspended or revoked.
              (5)   (a) A licensing board or the department may adopt rules concerning what conditions may be
   attached to a reservist's professional license pursuant to subsection (4)(c)(ii).
              (b)   If conditions are attached pursuant to subsection (4)(c)(ii) or the license is suspended or revoked
   pursuant to subsection (4)(c)(iii), the affected reservist may, within 90 days of the decision to take the action,
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   request a hearing by writing a letter to the board or department. The board or department shall conduct a
   requested hearing within 30 days of receiving the written request."
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              Section 6. Section 37-3-102, MCA, is amended to read:
              "37-3-102.   Definitions. Unless the context requires otherwise, in this chapter, the following definitions
   apply:
              (1)   "ACGME" means the accreditation council for graduate medical education.
              (2)   "AOA" means the American osteopathic association.
              (3)   "Approved internship" means an internship training program of at least 1 year in a program that
   either is approved for intern training by the AOA or conforms to the standards for intern training established by
   the ACGME or successors. However, the board may, upon investigation, approve any other internship.
              (4)   "Approved medical school" means a school that either is accredited by the AOA or conforms to the
   education standards established by the LCME or the world health organization or successors for medical
   schools that meet standards established by the board by rule.
              (5)   "Approved residency" means a residency training program conforming to the standards for
   residency training established by the ACGME or successors or approved for residency training by the AOA.
              (6)   "Board" means the Montana state board of medical examiners provided for in 2-15-1731.
              (7)   "Community-integrated health care" means the provision of out-of-hospital medical services that
   an emergency care provider with an endorsement may provide as determined by board rule.
              (8)(7)   "Department" means the department of labor and industry provided for in Title 2, chapter 15,
   part 17.
              (9)   "Emergency care provider" or "ECP" means a person licensed by the board, including but not
   limited to an emergency medical responder, an emergency medical technician, an advanced emergency
   medical technician, or a paramedic. An emergency care provider with an endorsement may provide community-
   integrated health care.
              (10)(8) "LCME" means the liaison committee on medical education.
              (11)(9) "Medical assistant" means an unlicensed allied health care worker who functions under the
   supervision of a physician, physician assistant, or podiatrist in a physician's or podiatrist's office and who
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   performs administrative and clinical tasks.
              (12)(10) "Physician" means a person who holds a degree as a doctor of medicine or doctor of
   osteopathy and who has a valid license to practice medicine or osteopathic medicine in this state.
              (13)(11) "Practice of medicine" means the diagnosis, treatment, or correction of or the attempt to or the
   holding of oneself out as being able to diagnose, treat, or correct human conditions, ailments, diseases,
   injuries, or infirmities, whether physical or mental, by any means, methods, devices, or instrumentalities,
   including electronic and technological means such as telemedicine. If a person who does not possess a license
   to practice medicine in this state under this chapter and who is not exempt from the licensing requirements of
   this chapter performs acts constituting the practice of medicine, the person is practicing medicine in violation of
   this chapter.
              (14)(12) (a) "Telemedicine" means the practice of medicine using interactive electronic
   communications, information technology, or other means between a licensee in one location and a patient in
   another location with or without an intervening health care provider. Telemedicine typically involves the
   application of secure videoconferencing or store-and-forward technology, as defined in 33-22-138.
              (b)   The term does not mean an audio-only telephone conversation, an e-mail or instant messaging
   conversation, or a message sent by facsimile transmission."
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              Section 7. Section 37-3-203, MCA, is amended to read:
              "37-3-203.    Powers and duties -- rulemaking authority. (1) The board may:
              (a)   adopt rules necessary or proper to carry out the requirements in Title 37, chapter 3, parts 1
   through 4, and of chapters covering podiatry, acupuncture, physician assistants, and nutritionists, and
   emergency care providers as set forth in Title 37, chapters 6, 13, 20, and 25, and 50-6-203, respectively. Rules
   adopted for emergency care providers with an endorsement to provide community-integrated health care must
   address the scope of practice, competency requirements, and educational requirements.
              (b)   hold hearings and take evidence in matters relating to the exercise and performance of the powers
   and duties vested in the board;
              (c)   aid the county attorneys of this state in the enforcement of parts 1 through 4 and 8 of this chapter
   as well as Title 37, chapters 6, 13, 20, and 25, and Title 50, chapter 6, regarding emergency care providers
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   licensed by the board. The board also may assist the county attorneys of this state in the prosecution of
   persons, firms, associations, or corporations charged with violations of the provisions listed in this subsection
   (1)(c).
              (d)   review certifications of disability and determinations of eligibility for a permit to hunt from a vehicle
   as provided in 87-2-803(11); and
              (e)   fund additional staff, hired by the department, to administer the provisions of this chapter, by
   increasing license fees as necessary.
              (2)   (a) The board shall establish a medical assistance program to assist and rehabilitate licensees
   who are subject to the jurisdiction of the board and who are found to be physically or mentally impaired by
   habitual intemperance or the excessive use of addictive drugs, alcohol, or any other drug or substance or by
   mental illness or chronic physical illness.
              (b)   The board shall ensure that a licensee who is required or volunteers to participate in the medical
   assistance program as a condition of continued licensure or reinstatement of licensure must be allowed to
   enroll in a qualified medical assistance program within this state and may not require a licensee to enroll in a
   qualified treatment program outside the state unless the board finds that there is no qualified treatment program
   in this state.
              (3)   (a) The board shall report annually on the number and types of complaints it has received
   involving physician practices in providing written certification, as defined in 50-46-302, for the use of marijuana
   for a debilitating medical condition provided for in Title 50, chapter 46. The report must contain:
              (i)   the number of complaints received by the board pursuant to 37-1-308;
              (ii) the number of complaints for which a reasonable cause determination was made pursuant to 37-1-
   307;
              (iii) the general nature of t