Bill Text: IL HB5187 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Department of Public Health shall allow for an alternative rural staffing model for vehicle service providers that serve a rural or semi-rural population of 10,000 or fewer inhabitants and exclusively use volunteers, paid-on-call, or part-time employees, or a combination thereof (now, the use of part-time employees is not an option). Effective immediately.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2024-04-05 - Rule 19(a) / Re-referred to Rules Committee [HB5187 Detail]

Download: Illinois-2023-HB5187-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5187 Introduced , by Rep. Christopher "C.D." Davidsmeyer SYNOPSIS AS INTRODUCED:
210 ILCS 50/3.85
Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Department of Public Health shall allow for an alternative rural staffing model for vehicle service providers that serve a rural or semi-rural population of 10,000 or fewer inhabitants and exclusively use volunteers, paid-on-call, or part-time employees, or a combination thereof (now, the use of part-time employees is not an option). Effective immediately.
LRB103 38523 CES 68659 b
A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Emergency Medical Services (EMS) Systems
Act is amended by changing Section 3.85 as follows:
(210 ILCS 50/3.85)
Sec. 3.85. Vehicle Service Providers.
(a) "Vehicle Service Provider" means an entity licensed by
the Department to provide emergency or non-emergency medical
services in compliance with this Act, the rules promulgated by
the Department pursuant to this Act, and an operational plan
approved by its EMS System(s), utilizing at least ambulances
or specialized emergency medical service vehicles (SEMSV).
(1) "Ambulance" means any publicly or privately owned
on-road vehicle that is specifically designed, constructed
or modified and equipped, and is intended to be used for,
and is maintained or operated for the emergency
transportation of persons who are sick, injured, wounded
or otherwise incapacitated or helpless, or the
non-emergency medical transportation of persons who
require the presence of medical personnel to monitor the
individual's condition or medical apparatus being used on
such individuals.

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(2) "Specialized Emergency Medical Services Vehicle"
or "SEMSV" means a vehicle or conveyance, other than those
owned or operated by the federal government, that is
primarily intended for use in transporting the sick or
injured by means of air, water, or ground transportation,
that is not an ambulance as defined in this Act. The term
includes watercraft, aircraft and special purpose ground
transport vehicles or conveyances not intended for use on
public roads.
(3) An ambulance or SEMSV may also be designated as a
Limited Operation Vehicle or Special-Use Vehicle:
(A) "Limited Operation Vehicle" means a vehicle
which is licensed by the Department to provide basic,
intermediate or advanced life support emergency or
non-emergency medical services that are exclusively
limited to specific events or locales.
(B) "Special-Use Vehicle" means any publicly or
privately owned vehicle that is specifically designed,
constructed or modified and equipped, and is intended
to be used for, and is maintained or operated solely
for the emergency or non-emergency transportation of a
specific medical class or category of persons who are
sick, injured, wounded or otherwise incapacitated or
helpless (e.g. high-risk obstetrical patients,
neonatal patients).
(C) "Reserve Ambulance" means a vehicle that meets

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all criteria set forth in this Section and all
Department rules, except for the required inventory of
medical supplies and durable medical equipment, which
may be rapidly transferred from a fully functional
ambulance to a reserve ambulance without the use of
tools or special mechanical expertise.
(b) The Department shall have the authority and
responsibility to:
(1) Require all Vehicle Service Providers, both
publicly and privately owned, to function within an EMS
System.
(2) Require a Vehicle Service Provider utilizing
ambulances to have a primary affiliation with an EMS
System within the EMS Region in which its Primary Service
Area is located, which is the geographic areas in which
the provider renders the majority of its emergency
responses. This requirement shall not apply to Vehicle
Service Providers which exclusively utilize Limited
Operation Vehicles.
(3) Establish licensing standards and requirements for
Vehicle Service Providers, through rules adopted pursuant
to this Act, including but not limited to:
(A) Vehicle design, specification, operation and
maintenance standards, including standards for the use
of reserve ambulances;
(B) Equipment requirements;

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(C) Staffing requirements; and
(D) License renewal at intervals determined by the
Department, which shall be not less than every 4
years.
The Department's standards and requirements with
respect to vehicle staffing for private, nonpublic local
government employers must allow for alternative staffing
models that include an EMR with a licensed EMT, EMT-I,
A-EMT, Paramedic, or PHRN, as appropriate, pursuant to the
approval of the EMS System Program Plan developed and
approved by the EMS Medical Director for an EMS System.
The EMS personnel licensed at the highest level shall
provide the initial assessment of the patient to determine
the level of care required for transport to the receiving
health care facility, and this assessment shall be
documented in the patient care report and documented with
online medical control. The EMS personnel licensed at or
above the level of care required by the specific patient
as directed by the EMS Medical Director shall be the
primary care provider en route to the destination facility
or patient's residence. The Department shall monitor the
implementation and performance of alternative staffing
models and may issue a notice of termination of an
alternative staffing model only upon evidence that an EMS
System Program Plan is not being adhered to. Adoption of
an alternative staffing model shall not result in a

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Vehicle Service Provider being prohibited or limited in
the utilization of its staff or equipment from providing
any of the services authorized by this Act or as otherwise
outlined in the approved EMS System Program Plan,
including, without limitation, the deployment of resources
to provide out-of-state disaster response. EMS System
Program Plans must address a process for out-of-state
disaster response deployments that must meet the
following:
(A) All deployments to provide out-of-state
disaster response must first be approved by the EMS
Medical Director and submitted to the Department.
(B) The submission must include the number of
units being deployed, vehicle identification numbers,
length of deployment, and names of personnel and their
licensure level.
(C) Ensure that all necessary in-state requests
for services will be covered during the duration of
the deployment.
An EMS System Program Plan for a Basic Life Support,
advanced life support, and critical care transport
utilizing an EMR and an EMT shall include the following:
(A) Alternative staffing models for a Basic Life
Support transport utilizing an EMR shall only be
utilized for interfacility Basic Life Support
transports as specified by the EMS System Program Plan

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as determined by the EMS System Medical Director.
(B) Protocols that shall include dispatch
procedures to properly screen and assess patients for
EMR-staffed transports.
(C) A requirement that a provider and EMS System
shall implement a quality assurance plan that shall
include for the initial waiver period the review of at
least 5% of total interfacility transports utilizing
an EMR with mechanisms outlined to audit dispatch
screening, reason for transport, patient diagnosis,
level of care, and the outcome of transports
performed. Quality assurance reports must be submitted
and reviewed by the provider and EMS System monthly
and made available to the Department upon request. The
percentage of transports reviewed under quality
assurance plans for renewal periods shall be
determined by the EMS Medical Director, however, it
shall not be less than 3%.
(D) The EMS System Medical Director shall develop
a minimum set of requirements for individuals based on
level of licensure that includes education, training,
and credentialing for all team members identified to
participate in an alternative staffing plan. The EMT,
Paramedic, PHRN, PHPA, PHAPRN, and critical care
transport staff shall have the minimum experience in
performance of pre-hospital and inter-hospital care,

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as determined by the EMS Medical Director in
accordance with the EMS System Program Plan, but at a
minimum of 6 months of prehospital experience or at
least 50 documented patient care interventions during
transport as the primary care provider and approved by
the Department.
(E) The licensed EMR must complete a defensive
driving course prior to participation in the
Department's alternative staffing model.
(F) The length of the EMS System Program Plan for a
Basic Life Support transport utilizing an EMR shall be
for one year, and must be renewed annually if proof of
the criteria being met is submitted, validated, and
approved by the EMS Medical Director for the EMS
System and the Department.
(G) Beginning July 1, 2023, the utilization of
EMRs for advanced life support transports and Tier III
Critical Care Transports shall be allowed for periods
not to exceed 3 years under a pilot program. The pilot
program shall not be implemented before Department
approval. Agencies requesting to utilize this staffing
model for the time period of the pilot program must
complete the following:
(i) Submit a waiver request to the Department
requesting to participate in the pilot program
with specific details of how quality assurance and

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improvement will be gathered, measured, reported
to the Department, and reviewed and utilized
internally by the participating agency.
(ii) Submit a signed approval letter from the
EMS System Medical Director approving
participation in the pilot program.
(iii) Submit updated EMS System plans,
additional education, and training of the EMR and
protocols related to the pilot program.
(iv) Submit agency policies and procedures
related to the pilot program.
(v) Submit the number of individuals currently
participating and committed to participating in
education programs to achieve a higher level of
licensure at the time of submission.
(vi) Submit an explanation of how the provider
will support individuals obtaining a higher level
of licensure and encourage a higher level of
licensure during the year of the alternative
staffing plan and specific examples of recruitment
and retention activities or initiatives.
Upon submission of a renewal application and
recruitment and retention plan, the provider shall
include additional data regarding current employment
numbers, attrition rates over the year, and activities
and initiatives over the previous year to address

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recruitment and retention.
The information required under this subparagraph
(G) shall be provided to and retained by the EMS System
upon initial application and renewal and shall be
provided to the Department upon request.
The Department must allow for an alternative rural
staffing model for those vehicle service providers that
serve a rural or semi-rural population of 10,000 or fewer
inhabitants and exclusively uses volunteers, paid-on-call,
or part-time employees, or a combination thereof.
(4) License all Vehicle Service Providers that have
met the Department's requirements for licensure, unless
such Provider is owned or licensed by the federal
government. All Provider licenses issued by the Department
shall specify the level and type of each vehicle covered
by the license (BLS, ILS, ALS, ambulance, critical care
transport, SEMSV, limited operation vehicle, special use
vehicle, reserve ambulance).
(5) Annually inspect all licensed vehicles operated by
Vehicle Service Providers.
(6) Suspend, revoke, refuse to issue or refuse to
renew the license of any Vehicle Service Provider, or that
portion of a license pertaining to a specific vehicle
operated by the Provider, after an opportunity for a
hearing, when findings show that the Provider or one or
more of its vehicles has failed to comply with the

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standards and requirements of this Act or rules adopted by
the Department pursuant to this Act.
(7) Issue an Emergency Suspension Order for any
Provider or vehicle licensed under this Act, when the
Director or his designee has determined that an immediate
and serious danger to the public health, safety and
welfare exists. Suspension or revocation proceedings which
offer an opportunity for hearing shall be promptly
initiated after the Emergency Suspension Order has been
issued.
(8) Exempt any licensed vehicle from subsequent
vehicle design standards or specifications required by the
Department, as long as said vehicle is continuously in
compliance with the vehicle design standards and
specifications originally applicable to that vehicle, or
until said vehicle's title of ownership is transferred.
(9) Exempt any vehicle (except an SEMSV) which was
being used as an ambulance on or before December 15, 1980,
from vehicle design standards and specifications required
by the Department, until said vehicle's title of ownership
is transferred. Such vehicles shall not be exempt from all
other licensing standards and requirements prescribed by
the Department.
(10) Prohibit any Vehicle Service Provider from
advertising, identifying its vehicles, or disseminating
information in a false or misleading manner concerning the

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Provider's type and level of vehicles, location, primary
service area, response times, level of personnel,
licensure status or System participation.
(10.5) Prohibit any Vehicle Service Provider, whether
municipal, private, or hospital-owned, from advertising
itself as a critical care transport provider unless it
participates in a Department-approved EMS System critical
care transport plan.
(11) Charge each Vehicle Service Provider a fee per
transport vehicle, due annually at time of inspection. The
fee per transport vehicle shall be set by administrative
rule by the Department and shall not exceed 100 vehicles
per provider.
(12) Beginning July 1, 2023, as part of a pilot
program that shall not exceed a term of 3 years, an
ambulance may be upgraded to a higher level of care for
interfacility transports by an ambulance assistance
vehicle with appropriate equipment and licensed personnel
to intercept with the licensed ambulance at the sending
facility before departure. The pilot program shall not be
implemented before Department approval. To participate in
the pilot program, an agency must:
(A) Submit a waiver request to the Department with
intercept vehicle vehicle identification numbers,
calls signs, equipment detail, and a robust quality
assurance plan that shall list, at minimum, detailed

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reasons each intercept had to be completed, barriers
to initial dispatch of advanced life support services,
and how this benefited the patient.
(B) Report to the Department quarterly additional
data deemed meaningful by the providing agency along
with the data required under subparagraph (A) of this
paragraph (12).
(C) Obtain a signed letter of approval from the
EMS Medical Director allowing for participation in the
pilot program.
(D) Update EMS System plans and protocols from the
pilot program.
(E) Update policies and procedures from the
agencies participating in the pilot program.
(Source: P.A. 102-623, eff. 8-27-21; 103-547, eff. 8-11-23.)