Bill Text: MI SB0885 | 2013-2014 | 97th Legislature | Introduced

---

Bill Title: Health; emergency services; medical control authority oversight of emergency medical services personnel; authorize development of enhanced protocols, require the department to convene a rural task force, and provide other general amendments. Amends secs. 20910 & 20919 of 1978 PA 368 (MCL 333.20910 & 333.20919).

Spectrum: Partisan Bill (Republican 3-0)

Status: (Introduced - Dead) 2014-12-02 - Referred To Committee Of The Whole [SB0885 Detail]

Download: Michigan-2013-SB0885-Introduced.html

---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SENATE BILL No. 885

 

 

March 20, 2014, Introduced by Senators CASPERSON, HANSEN and PAPPAGEORGE and referred to the Committee on Health Policy.

 

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 20910 and 20919 (MCL 333.20910 and 333.20919),

 

as amended by 2006 PA 582.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 20910. (1) The department shall do all of the following:

 

     (a) Be responsible for the development, coordination, and

 

administration of Develop, coordinate, and administer a statewide

 

emergency medical services system.

 

     (b) Facilitate and promote programs of public information and

 

education concerning emergency medical services.

 

     (c) In case of During actual disasters and disaster training

 

drills and exercises, provide emergency medical services resources

 

pursuant to applicable provisions of as prescribed in the Michigan

 

emergency preparedness management plan , or as prescribed by the

 

state director of emergency services pursuant to management under

 

the emergency management act, 1976 PA 390, MCL 30.401 to 30.421.

 

     (d) Consistent with the rules of the federal communications

 

commission, plan, develop, coordinate, and administer a statewide

 

emergency medical services communications system.

 

     (e) Develop and maintain standards of emergency medical

 

services and personnel as follows:

 

     (i) License emergency medical services personnel in accordance

 

with under this part.

 

     (ii) License ambulance operations, nontransport prehospital

 

life support operations, and medical first response services in

 

accordance with under this part.

 

     (iii) At least annually, inspect or provide for the inspection

 

of each life support agency, except medical first response

 

services. As part of that inspection, the department shall conduct

 

random inspections of life support vehicles. If a life support

 

vehicle is determined by the department to be out of compliance,

 

the department shall give the life support agency 24 hours to bring

 

the life support vehicle into compliance. If the life support

 

vehicle is not brought into compliance in that time period, the

 

department shall order the life support vehicle taken out of

 

service until the life support agency demonstrates to the

 

department, in writing, that the life support vehicle has been

 

brought into compliance.

 

     (iv) Promulgate rules to establish the requirements for

 

licensure of life support agencies, vehicles, and individuals

 

licensed under this part to provide emergency medical services and

 

other rules necessary to implement this part. The department shall

 

submit all proposed rules and changes to the state emergency

 

medical services coordination committee and provide a reasonable

 

time for the committee's review and recommendations before

 

submitting the rules for public hearing under the administrative

 

procedures act of 1969.

 

     (f) Promulgate rules to establish and maintain standards for

 

and regulate the use of descriptive words, phrases, symbols, or

 

emblems that represent or denote that an ambulance operation,

 

nontransport prehospital life support operation, or medical first

 

response service is or may be provided. The department's authority

 

to regulate use of the descriptive devices includes use for the

 

purposes of advertising, promoting, or selling the services

 

rendered by an ambulance operation, nontransport prehospital life

 

support operation, or medical first response service , or by

 

emergency medical services personnel.

 

     (g) Designate a medical control authority as the medical

 

control for emergency medical services for a particular geographic

 

region as provided for under this part.

 

     (h) Develop and implement field studies involving the use of

 

skills, techniques, procedures, or equipment that are not included

 

as part of the standard education for medical first responders,

 

emergency medical technicians, emergency medical technician

 

specialists, or paramedics, if all of the following conditions are

 

met:

 

     (i) The state emergency medical services coordination committee

 

reviews the field study prior to before implementation.

 

     (ii) The field study is conducted in an area a region for which

 

a medical control authority has been approved pursuant to

 

designated under subdivision (g).

 

     (iii) The medical first responders, emergency medical

 

technicians, emergency medical technician specialists, and

 

paramedics participating in the field study receive training for

 

the new skill, technique, procedure, or equipment.

 

     (i) Collect data as necessary to assess the need for and

 

quality of emergency medical services throughout the this state

 

pursuant to 1967 PA 270, MCL 331.531 to 331.533.331.534.

 

     (j) Develop, with the advice of the state emergency medical

 

services coordination committee, an emergency medical services plan

 

that includes rural issues.

 

     (k) Develop recommendations for territorial boundaries of

 

medical control authorities that are designed to assure that there

 

exists reasonable emergency medical services capacity within the

 

boundaries for the estimated demand for emergency medical services.

 

     (l) Within 1 year after the statewide trauma care advisory

 

subcommittee is established under section 20917a and in In

 

consultation with the statewide trauma care advisory subcommittee

 

established under section 20917a, develop, implement, and

 

promulgate rules for the implementation and operation of a

 

statewide trauma care system within the emergency medical services

 

system consistent with the document entitled "Michigan Trauma

 

Systems Plan" prepared by the Michigan trauma coalition, dated

 

November 2003. The implementation and operation of the statewide

 

trauma care system, including the rules promulgated in accordance

 

with under this subdivision, are subject to review by the state

 

emergency medical services coordination committee and the statewide

 

trauma care advisory subcommittee. The rules promulgated under this

 

subdivision shall must not require a hospital to be designated as

 

providing a certain level of trauma care. Upon implementation of a

 

statewide trauma care system, the department shall review and

 

identify potential funding mechanisms and sources for the statewide

 

trauma care system.

 

     (m) Authorize a medical control authority to establish

 

enhanced protocols for the use of skills, techniques, procedures,

 

or equipment that are not included as part of the standard

 

education for medical first responders, emergency medical

 

technicians, emergency medical technician specialists, or

 

paramedics, if all of the following conditions are met:

 

     (i) The department reviews the medical control authority's

 

enhanced protocols before implementation.

 

     (ii) The enhanced protocols are used in a region for which a

 

medical control authority has been designated under subdivision

 

(g).

 

     (iii) The medical first responders, emergency medical

 

technicians, emergency medical technician specialists, and

 

paramedics subject to the enhanced protocols receive training for

 

the new skill, technique, procedure, or equipment.

 

     (iv) The medical control authority monitors the events when

 

enhanced protocols are used.

 

     (v) The medical control authority collects data as necessary

 

and submits the data to the department to be included in a

 

repository of enhanced protocols.

 

     (n) Convene and support a rural emergency medical services

 

task force to evaluate the status, resources, needs, and forecasts

 

of the provision of prehospital emergency medical services in the

 

rural areas of this state. The rural emergency medical services

 

task force shall advise the department on emergency medical

 

services issues specific to the rural areas of this state and shall

 

provide a comprehensive rural emergency medical services status and

 

recommendation report to the department within 14 months after the

 

effective date of the amendatory act that added this subdivision.

 

The department shall appoint all of the following to the rural

 

emergency medical services task force:

 

     (i) Two members who represent life support agencies from each

 

of the 8 regions described below:

 

     (A) Region one, which consists of the counties of Baraga,

 

Dickinson, Gogebic, Houghton, Iron, Keweenaw, Marquette, and

 

Ontonagon.

 

     (B) Region two, which consists of the counties of Alger,

 

Chippewa, Delta, Luce, Mackinac, Menominee, and Schoolcraft.

 

     (C) Region three, which consists of the counties of Alcona,

 

Alpena, Antrim, Charlevoix, Cheboygen, Crawford, Emmet,

 

Montmorency, Oscoda, Otsego, and Presque Isle.

 

     (D) Region four, which consists of the counties of Benzie,

 

Clare, Grand Traverse, Kalkaska, Lake, Leelanau, Manistee, Mason,

 

Missaukee, Oceana, Osceola, and Wexford.

 

     (E) Region five, which consists of the counties of Arenac,

 

Bay, Gladwin, Huron, Iosco, Lapeer, Midland, Ogemaw, Saginaw,

 

Sanilac, Roscommon, and Tuscola.

 

     (F) Region six, which consists of the counties of Clinton,

 

Gratiot, Ingham, Ionia, Isabella, Kent, Mecosta, Montcalm,

 

Muskegon, Newaygo, Ottawa, and Shiawassee.

 

     (G) Region seven, which consists of the counties of Allegan,

 

Barry, Berrien, Branch, Cass, Calhoun, Eaton, Hillsdale, Jackson,

 

Kalamazoo, St. Joseph, and Vanburen.

 

     (H) Region eight, which consists of the counties of Genesee,

 

Lenawee, Livingston, Macomb, Monroe, Oakland, St. Clair, Washtenaw,

 

and Wayne.

 

     (ii) One member who represents the UP-EMS corporation.

 

     (iii) One member who represents the Michigan center for rural

 

health.

 

     (iv) One member who represents the state emergency medical

 

services coordination committee.

 

     (o) (m) Promulgate other rules to implement this part.

 

     (p) (n) Perform other duties as set forth in this part.

 

     (2) The department may do all any of the following:

 

     (a) In consultation with the state emergency medical services

 

coordination committee, promulgate rules to require an ambulance

 

operation, nontransport prehospital life support operation, or

 

medical first response service to periodically submit designated

 

records and data for evaluation by the department.

 

     (b) Establish a grant program or contract with a public or

 

private agency, emergency medical services professional

 

association, or emergency medical services coalition to provide

 

training, public information, and assistance to medical control

 

authorities and emergency medical services systems or to conduct

 

other activities as specified in this part.

 

     Sec. 20919. (1) A local medical control authority shall

 

establish written protocols for the practice of life support

 

agencies and licensed emergency medical services personnel within

 

its region. The medical control authority shall develop and adopt

 

the protocols shall be developed and adopted required under this

 

section in accordance with procedures established by the department

 

and shall include all of the following:

 

     (a) The acts, tasks, or functions that may be performed by

 

each type of emergency medical services personnel licensed under

 

this part.

 

     (b) Medical protocols to ensure the appropriate dispatching of

 

a life support agency based upon medical need and the capability of

 

the emergency medical services system.

 

     (c) Protocols for complying with the Michigan do-not-

 

resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067.

 

     (d) Protocols defining the process, actions, and sanctions a

 

medical control authority may use in holding a life support agency

 

or emergency medical services personnel accountable.

 

     (e) Protocols to ensure that, if the medical control authority

 

determines that an immediate threat to the public health, safety,

 

or welfare exists, appropriate action to remove medical control can

 

immediately be taken until the medical control authority has had

 

the opportunity to review the matter at a medical control authority

 

hearing. The protocols shall must require that the hearing is held

 

within 3 business days after the medical control authority's

 

determination.

 

     (f) Protocols to ensure that, if medical control has been

 

removed from a participant in an emergency medical services system,

 

the participant does not provide prehospital care until medical

 

control is reinstated , and that the medical control authority that

 

removed the medical control notifies the department within 1

 

business day of the removal.

 

     (g) Protocols that to ensure that a quality improvement

 

program is in place within a medical control authority and provides

 

data protection as provided in 1967 PA 270, MCL 331.531 to

 

331.533.331.534.

 

     (h) Protocols to ensure that an appropriate appeals process is

 

in place.

 

     (i) Within 1 year after December 23, 2003, protocols Protocols

 

to ensure that each life support agency that provides basic life

 

support, limited advanced life support, or advanced life support is

 

equipped with epinephrine or epinephrine auto-injectors and that

 

each emergency services personnel authorized to provide those

 

services is properly trained to recognize an anaphylactic reaction,

 

to administer the epinephrine, and to dispose of the epinephrine

 

auto-injector or vial.

 

     (j) Within 6 months after the effective date of the amendatory

 

act that added this subdivision, protocols Protocols to ensure that

 

each life support vehicle that is dispatched and responding to

 

provide medical first response life support, basic life support, or

 

limited advanced life support is equipped with an automated

 

external defibrillator and that each emergency medical services

 

personnel is properly trained to utilize the automated external

 

defibrillator.

 

     (2) A medical control authority shall not establish a protocol

 

established under this section shall not conflict that conflicts

 

with the Michigan do-not-resuscitate procedure act, 1996 PA 193,

 

MCL 333.1051 to 333.1067.

 

     (3) The department shall establish procedures established by

 

the department for the development and adoption of written

 

protocols under this section. shall comply with The procedures must

 

include at least all of the following requirements:

 

     (a) At least 60 days before adoption of a protocol, the

 

medical control authority shall circulate a written draft of the

 

proposed protocol to all significantly affected persons within the

 

emergency medical services system served by the medical control

 

authority and submit the written draft to the department for

 

approval.

 

     (b) The department shall review a proposed protocol for

 

consistency with other protocols concerning similar subject matter

 

that have already been established in this state and shall consider

 

any written comments received from interested persons in its

 

review.

 

     (c) Within 60 days after receiving a written draft of a

 

proposed protocol from a medical control authority, the department

 

shall provide a written recommendation to the medical control

 

authority with any comments or suggested changes on the proposed

 

protocol. If the department does not respond within 60 days after

 

receiving the written draft, the proposed protocol shall be is

 

considered to be approved by the department.

 

     (d) After department approval of a proposed protocol, the

 

medical control authority may formally adopt and implement the

 

protocol.

 

     (4) (e) A medical control authority may establish an emergency

 

protocol necessary to preserve the health or safety of individuals

 

within its jurisdiction region in response to a present medical

 

emergency or disaster without following the procedures established

 

by the department under this section subsection (3) for an ordinary

 

protocol. An emergency protocol established under this subdivision

 

subsection is effective only for a limited time period and does not

 

take permanent effect unless it is approved according to this the

 

procedures established by the department under subsection (3).

 

     (5) (4) A medical control authority shall provide an

 

opportunity for an affected participant in an emergency medical

 

services system to appeal a decision of the medical control

 

authority. Following appeal, the medical control authority may

 

affirm, suspend, or revoke its original decision. After appeals to

 

the medical control authority have been exhausted, the affected

 

participant in an emergency medical services system may appeal the

 

medical control authority's decision to the statewide state

 

emergency medical services coordination committee. The statewide

 

state emergency medical services coordination committee shall issue

 

an opinion on whether the actions or decisions of the medical

 

control authority are in accordance compliance with the department-

 

approved its protocols of the medical control authority and state

 

law. If the statewide state emergency medical services coordination

 

committee determines in its opinion that the actions or decisions

 

of the medical control authority are not in accordance compliance

 

with the medical control authority's department-approved protocols

 

or with state law, the state emergency medical services

 

coordination committee shall recommend that the department take any

 

enforcement action authorized under this code.

 

     (6) (5) If adopted in protocols approved by the department, a

 

protocol under this section, a medical control authority may

 

require life support agencies within its region to meet reasonable

 

additional standards for equipment and personnel , other than

 

medical first responders, that may be more stringent than are

 

otherwise required under this part. If a medical control authority

 

proposes a protocol that establishes additional standards for

 

equipment and personnel, the medical control authority and the

 

department shall consider the medical and economic impact on the

 

local community, the need for communities to do long-term planning,

 

and the availability of personnel. If either the medical control

 

authority or the department determines that negative medical or

 

economic impacts outweigh the benefits of those additional

 

standards as they affect public health, safety, and welfare, the

 

medical control authority shall not adopt protocols containing

 

those additional standards. shall not be adopted.

 

     (7) (6) If adopted in protocols approved by the department,a

 

protocol under this section, a local medical control authority may

 

require medical first response services and licensed medical first

 

responders within its region to meet additional standards for

 

equipment and personnel to ensure that each medical first response

 

service is equipped with an epinephrine auto-injector , and that

 

each licensed medical first responder is properly trained to

 

recognize an anaphylactic reaction and to administer and dispose of

 

the epinephrine auto-injector, if a life support agency that

 

provides basic life support, limited advanced life support, or

 

advanced life support is not readily available in that location.

 

     (8) As authorized in section 20910(1)(m), a medical control

 

authority may establish an enhanced protocol for the use of skills,

 

techniques, procedures, or equipment that is not included as part

 

of the standard education for medical first responders, emergency

 

medical technicians, emergency medical technician specialists, or

 

paramedics without following the procedures established by the

 

department under subsection (3) for an ordinary protocol. An

 

enhanced protocol established in the manner prescribed in section

 

20910(1)(m) is effective for the period prescribed in the protocol.

 

     (9) (7) If a decision of the medical control authority under

 

subsection (5) or (6), (7), or (8) is appealed by an affected

 

person, the medical control authority shall make available, in

 

writing, the medical and economic information it considered in

 

making its decision. On appeal, the statewide state emergency

 

medical services coordination committee shall review this

 

information under subsection (4) (5) and shall issue its findings

 

in writing.

 

     (10) A medical control authority may allow a life support

 

agency within its region to utilize all types of licensed emergency

 

medical services personnel and allow the personnel to perform

 

emergency medical services within its region based on his or her

 

license type. A medical control authority described in this

 

subsection shall develop written protocols under this section for

 

the utilization of personnel under this subsection that include

 

situations, personnel, equipment, supplies, pharmaceutical

 

security, training, quality improvement, and competency.