Bill Summary – FastDemocracy

0748.01000
     Sixty-sixth
     Legislative Assembly                     HOUSE BILL NO. 1337
     of North Dakota
     Introduced by
       Representatives Heinert, Guggisberg, Meier, Porter
       Senators Burckhard, Dever, Meyer
  A BILL for an Act to create and enact chapter 23-27.1 of the North Dakota Century Code,
  relating to the emergency medical services personnel licensure interstate compact.
  BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
      SECTION 1. Chapter 23-27.1 of the North Dakota Century Code is created and enacted as
  follows:
      23-27.1-01. Purpose.
      To protect the public through verification of competency and ensure accountability for
  patient care-related activities all states license emergency medical services personnel, such as
  emergency medical technicians, advanced emergency medical technicians, and paramedics.
 This compact is intended to facilitate the day-to-day movement of emergency medical services
 personnel across state boundaries in the performance of their emergency medical services
 duties as assigned by an appropriate authority and authorize state emergency medical services
 offices to afford immediate legal recognition to emergency medical services personnel licensed
 in a member state. This compact recognizes states have a vested interest in protecting the
 public's health and safety through their licensing and regulation of emergency medical services
 personnel and state regulation shared among the member states will best protect public health
 and safety. This compact is designed to achieve the following purposes and objectives:
     1.     Increase public access to emergency medical services personnel;
     2.     Enhance the states' ability to protect the public's health and safety, especially patient
            safety;
     3.     Encourage the cooperation of member states in the areas of emergency medical
            services personnel licensure and regulation;
     4.     Support licensing of military members who are separating from an active duty tour and
            their spouses;
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      5.   Facilitate the exchange of information between member states regarding emergency
           medical services personnel licensure, adverse action, and significant investigatory
           information;
      6.   Promote compliance with the laws governing emergency medical services personnel
           practice in each member state; and
      7.   Invest all member states with the authority to hold emergency medical services
           personnel accountable through the mutual recognition of member state licenses.
     23-27.1-02. Definitions.
     In this chapter:
     1.   "Advanced emergency medical technician" means an individual licensed with cognitive
          knowledge and a scope of practice that corresponds to that level in the national
          emergency medical services education standards and national emergency medical
          services scope of practice model.
     2.   "Adverse action" means any administrative, civil, equitable, or criminal action
          permitted by law which may be imposed against licensed emergency medical services
          personnel by a state emergency medical services authority or state court, including
          actions against an individual's license such as revocation, suspension, probation,
          consent agreement, monitoring, or other limitation or encumbrance on the individual's
          practice, letters of reprimand or admonition, fines, criminal convictions, and state court
          judgments enforcing adverse actions by the state emergency medical services
          authority.
     3.   "Alternative program" means a voluntary, nondisciplinary substance abuse recovery
          program approved by a state emergency medical services authority.
     4.   "Certification" means the successful verification of entry-level cognitive and
          psychomotor competency using a reliable, validated, and legally defensible
          examination.
     5.   "Commission" means the national administrative body of which all states that have
          enacted the compact are members.
     6.   "Emergency medical technician" means an individual licensed with cognitive
          knowledge and a scope of practice that corresponds to that level in the national
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           emergency medical services education standards and national emergency medical
           services scope of practice model.
      7.   "Home state" means a member state where an individual is licensed to practice
           emergency medical services.
      8.   "License" means the authorization by a state for an individual to practice as an
           emergency medical technician, advanced emergency medical technician, paramedic,
           or a level in between an emergency medical technician and paramedic.
      9.   "Medical director" means a physician licensed in a member state who is accountable
           for the care delivered by emergency medical services personnel.
    10.   "Member state" means a state that has enacted this compact.
    11.   "Paramedic" means an individual licensed with cognitive knowledge and a scope of
          practice that corresponds to that level in the national emergency medical services
          education standards and national emergency medical services scope of practice
          model.
    12.   "Privilege to practice" means an individual's authority to deliver emergency medical
          services in remote states as authorized under this compact.
    13.   "Remote state" means a member state in which an individual is not licensed.
    14.   "Restricted" means the outcome of an adverse action that limits a license or the
          privilege to practice.
    15.   "Rule" means a written statement by the interstate commission promulgated pursuant
          to section 23-27.1-12 which is of general applicability; implements, interprets, or
          prescribes a policy or provision of the compact; or is an organizational, procedural, or
          practice requirement of the commission and has the force and effect of statutory law in
          a member state and includes the amendment, repeal, or suspension of an existing
          rule.
    16.   "Scope of practice" means defined parameters of various duties or services that may
          be provided by an individual with specific credentials. Whether regulated by rule,
          statute, or court decision, it tends to represent the limits of services an individual may
          perform.
    17.   "Significant investigatory information" means:
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           a.   Investigative information that a state emergency medical services authority, after
                a preliminary inquiry that includes notification and an opportunity to respond if
                required by state law, has reason to believe, if proved true, would result in the
                imposition of an adverse action on a license or privilege to practice; or
           b.   Investigative information that indicates an individual represents an immediate
                threat to public health and safety regardless of whether the individual has been
                notified and had an opportunity to respond.
     18.   "State" means any state, commonwealth, district, or territory of the United States.
     19.   "State emergency medical services authority" means the board, office, or other agency
          with the legislative mandate to license emergency medical services personnel.
    23-27.1-03. Home state licensure.
     1.   Any member state in which an individual holds a current license is deemed a home
          state for purposes of this compact.
     2.   Any member state may require an individual to obtain and retain a license to be
          authorized to practice in the member state under circumstances not authorized by the
          privilege to practice under the terms of this compact.
     3.   A home state's license authorizes an individual to practice in a remote state under the
          privilege to practice only if the home state:
          a.   Currently requires the use of the national registry of emergency medical
               technicians examination as a condition of issuing initial licenses at the
               emergency medical technician and paramedic levels;
          b.   Has a mechanism in place for receiving and investigating complaints about
               individuals;
          c.   Notifies the commission, in compliance with the terms herein, of any adverse
               action or significant investigatory information regarding an individual;
          d.   No later than five years after activation of the compact, requires a criminal
               background check of all applicants for initial licensure, including the use of the
               results of fingerprint or other biometric data checks compliant with the
               requirements of the federal bureau of investigation with the exception of federal
               employees who have suitability determination in accordance with title 5, Code of
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                Federal Regulations, section 731, part 202 and submit documentation of such as
                promulgated in the rules of the commission; and
           e.   Complies with the rules of the commission.
     23-27.1-04. Compact privilege to practice.
      1.   Member states shall recognize the privilege to practice of an individual licensed in
           another member state that is in conformance with section 23-27.1-03.
      2.   To exercise the privilege to practice under the terms and provisions of this compact, an
           individual must:
           a.   Be at least 18 years of age;
          b.   Possess a current unrestricted license in a member state as an emergency
               medical technician, advanced emergency medical technician, paramedic, or state
               recognized and licensed level with a scope of practice and authority between
               emergency medical technician and paramedic; and
          c.   Practice under the supervision of a medical director.
     3.   An individual providing patient care in a remote state under the privilege to practice
          shall function within the scope of practice authorized by the home state unless and
          until modified by an appropriate authority in the remote state as may be defined in the
          rules of the commission.
     4.   Except as provided in subsection 3, an individual practicing in a remote state is subject
          to the remote state's authority and laws. A remote state may, in accordance with due
          process and that state's laws, restrict, suspend, or revoke an individual's privilege to
          practice in the remote state and may take any other necessary actions to protect the
          health and safety of its citizens. If a remote state takes action, that remote state shall
          promptly notify the home state and the commission.
     5.   If an individual's license in any home state is restricted or suspended, the individual is
          not eligible to practice in a remote state under the privilege to practice until the
          individual's home state license is restored.
     6.   If an individual's privilege to practice in any remote state is restricted, suspended, or
          revoked, the individual is not eligible to practice in any remote state until the
          individual's privilege to practice is restored.
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      23-27.1-05. Conditions of practice in a remote state.
      An individual may practice in a remote state under a privilege to practice only in the
  performance of the individual's emergency medical services duties as assigned by an
  appropriate authority, as defined in the rules of the commission, and under the following
  circumstances:
      1.   The individual originates a patient transport in a home state and transports the patient
           to a remote state;
      2.   The individual originates in the home state and enters a remote state to pick up a
           patient and provide care and transport of the patient to the home state;
     3.   The individual enters a remote state to provide patient care or transport within that
          remote state;
     4.   The individual enters a remote state to pick up a patient and provide care and
          transport to a third member state; and
     5.   Other conditions as determined by rules promulgated by the commission.
     23-27.1-06. Relationship to emergency management assistance compact.
     Upon a member state's governor's declaration of a state of emergency or disaster that
 activates the emergency management assistance compact, all relevant terms and provisions of
 the emergency management assistance compact apply and to the extent any terms or
 provisions of this compact conflict with the emergency management assistance compact, the
 terms of the emergency management assistance compact prevails with respect to any
 individual practicing in the remote state in response to such declaration.
     23-27.1-07. Veterans, service members separating from active duty military, and their
 spouses.
     1.   Member states shall consider a veteran, active military service member, and member
          of the national guard and reserves separating from an active duty tour, and a spouse
          thereof, who holds a current valid and unrestricted national registry of emergency
          medical technicians certification at or above the level of the state license being sought
          as satisfying the minimum training and examination requirements for such licensure.
     2.   Member states shall expedite the processing of licensure applications submitted by
          veterans, active military service members, and members of the national guard and
          reserves separating from an active duty tour, and their spouses.
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      3.   All individuals functioning with a privilege to practice under this section remain subject
           to the adverse actions provisions of section 23-27.1-08.
     23-27.1-08. Adverse actions.
      1.   A home state shall have exclusive power to impose adverse action against an
           individual's license issued by the home state.
      2.   If an individual's license in any home state is restricted or suspended, the individual is
           not eligible to practice in a remote state under the privilege to practice until the
           individual's home state license is restored.
           a.   All home state adverse action orders must include a statement that the
               individual's compact privileges are inactive. The order may allow the individual to
               practice in remote states with prior written authorization from both the home state
               and remote state's emergency medical services authority.
          b.   An individual currently subject to adverse action in the home state may not
               practice in any remote state without prior written authorization from both the
               home state and remote state's emergency medical services authority.
     3.   A member state shall report adverse actions and any occurrences that the individual's
          compact privileges are restricted, suspended, or revoked to the commission in
          accordance with the rules of the commission.
     4.   A remote state may take adverse action on an individual's privilege to practice within
          that state.
     5.   Any member state may take adverse action against an individual's privilege to practice
          in the member state based on the factual findings of another member state, so long as
          each state follows its own procedures for imposing such adverse action.
     6.   A home state's emergency medical services authority shall investigate and take
          appropriate action with respect to reported conduct in a remote state as it would if
          such conduct had occurred within the home state. In such cases, the home state's law
          shall control in determining the appropriate adverse action.
     7.   Nothing in this compact may override a member state's decision that participation in
          an alternative program may be used in lieu of adverse action and that such
          participation must remain nonpublic if required by the member state's laws. Member
          states must require individuals who enter any alternative programs to agree not to
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           practice in any other member state during the term of the alternative program without
           prior authorization from such other member state.
      23-27.1-09. Additional powers invested in a member state's emergency medical
  services authority.
      A member sta