New Jersey-2024-S3563-Introduced

An Act concerning the regulation of paramedicine, revising various parts of the statutory law, and supplementing Title 45 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. The following sections are repealed:

Sections 1 through 5 of P.L.1984, c.146 (C.26:2K-7 through C.26:2K-11);

Sections 3 through 5 and 12 of P.L.2022, c.118 (C.26:2K-8.1. through C.26:2K-8.3 and C.26:2K-9.1);

Sections 10 through 13 of P.L.1984, c.146 (C.26:2K-16 through C.26:2K-19);

Section 1 of P.L.1985, c.351 (C.26:2K-21);

Sections 3 through 15 of P.L.1985, c.351 (C.26:2K-22 through C.26:2K-34);

Sections 1 through 8 and 10 of P.L.2003, c.1 (C.26:2K-47.1 through C.26:2K-47.9);

Section 1 of P.L.2013, c.101 (C.26:2K-65);

P.L.1989, c.314 (C.26:2K-39 through C.26:2K-47);

P.L.1992, c.96 (C.26:2K-48 through C.26:2K-53);

P.L.1992, c.143 (C.26:2K-54 through C.26:2K-59);

P.L.2009, c.174 (C.26:2K-63 through C.26:2K-64);

P.L.2023, c.229 (C.26:2K-65.1 through C.26:2K-65.3);

P.L.2017, c.116 (C.26:2K-66 through C.26:2K-69); and

P.L.2021, c.153 (C.26:2K-71).

2. (New section) As used in P.L. , c. (C. ) (pending before the Legislature as this bill):

"Advanced life support" means an advanced level of emergency medical care, including specialty care transport and air medical ambulances, which includes the use of procedures, medications, and equipment established by the National Highway Traffic Safety Administration's National EMS Scope of Practice Model for paramedics, and any other such procedures, therapies, medications, and as otherwise authorized in rules or regulations promulgated by the board.

"Basic life support" or "basic life support services" means a basic level of pre-hospital care which includes the use of procedures, medications, and equipment established by the National EMS Scope of Practice Model from the National Highway Traffic Safety Administration and other techniques, therapies, and procedures authorized by the board.

"Board" means the New Jersey Board of Paramedicine.

"Emergency medical technician" or "EMT" means a person trained in basic life support services and who is certified by the board to perform these services.

"Flight nurse" means a licensed mobile intensive care nurse with the proper additional training who responds via air ambulance to emergency requests or for transfers of patients.

"Flight paramedic" means a licensed paramedic with the proper additional training who responds via air ambulance to emergency requests or for transfers of patients.

"Interfacility" means between two healthcare facilities, primarily involving the transportation of a patient between the healthcare facilities that requires no more than basic life support services rendered to patients before and during transportation between licensed facilities, during retrieval from those facilities, and upon arrival within those facilities.

"Mobile intensive care nurse" means a registered professional nurse licensed by the New Jersey Board of Nursing and who is authorized to provide advanced life support services in a mobile intensive care unit by the New Jersey Board of Paramedicine.

"Mobile intensive care paramedic" means a person trained in advanced life support services and licensed by the board to render advanced life support services as part of a mobile intensive care unit.

"Mobile intensive care unit" means a specialized emergency medical service unit staffed in accordance with P.L. , c. (C. ) (pending before the Legislature as this bill) and operated for the provision of advanced life support services under the direction of an authorized provider.

"Paramedicine" means the practice of basic life support and advanced life support performed by a licensee of the New Jersey Board of Paramedicine established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill).

"Pre-hospital care" means those emergency medical services rendered to patients before and during transportation to treatment facilities, and upon arrival within those facilities.

"Professional emergency medical service" means non-volunteer emergency medical services.

"Specialty care transport" means services that are above basic life support services rendered to patients before and during transportation between licensed facilities, during retrieval from those facilities, and upon arrival within those facilities.

3. (New section) The New Jersey Board of Paramedicine shall consist of 15 members, five of whom shall be actively practicing as New Jersey-licensed mobile intensive care paramedics; three of whom shall be New Jersey-licensed emergency medical technicians; one of whom shall be a board-certified emergency medical services physician; one of whom shall be a board-certified trauma surgeon; one of whom shall be a board-certified pediatric emergency medicine physician; one of whom shall be a representative from the New Jersey Emergency Nurses Association; and three of whom shall be public members. Except for public members, members of the board shall be appointed by the Governor. The public members shall be appointed by the Governor with the advice and consent of the Senate. Appointments to the board shall be for terms of three years or for the unexpired portion of a term in the case of a vacancy for any cause within a term, and until a successor shall be appointed and qualified. Except for the public members, in making appointments, the Governor shall give due consideration to, but not be bound by, recommendations submitted by the various emergency medical services professional organizations of this State. Upon notice and hearing, the Governor may remove from office any member of the board for neglect of duty, incompetency, unprofessional or dishonorable conduct. The members first appointed shall be appointed no later than the first day of the second month following enactment of P.L. , c. (C. ) (pending before the Legislature as this bill).

4. (New section) a. No member of the board may be appointed if the individual was employed by a State executive branch entity at any time in the five years prior.

b. Each mobile intensive care paramedic member of the board shall:

(1) be a resident of New Jersey and a citizen of the United States;

(2) be a graduate of an accredited school of paramedicine;

(3) have at least five years of experience in advanced life support and professional emergency medical services;

(4) at the time of appointment, be actively working as a mobile intensive care paramedic; and

(5) except for the members first appointed, hold a license from the New Jersey Board of Paramedicine.

c. Each emergency medical technician member of the board shall:

(1) be a resident of New Jersey and a citizen of the United States;

(2) hold a valid license as an emergency medical technician in this State;

(3) have at least five years of experience in professional emergency medical services; and

(4) at the time of appointment, be actively working as an EMT in professional emergency medical services.

d. At the time of appointment:

(1) the board-certified trauma surgeon shall be actively practicing as a trauma surgeon at a level one or level two trauma center in New Jersey;

(2) the board-certified pediatric emergency physician shall be actively practicing as a pediatric emergency physician; and

(3) the representative from the New Jersey Emergency Nurses Association shall have at least two years of experience practicing as an emergency nurse in New Jersey and, while preferred but not required, be licensed as a mobile intensive care nurse.

5. (New section) a. Within 30 days after receipt of appointment, the board shall organize and each board member shall take and subscribe to an oath before an officer authorized to administer oaths in this State for the faithful performance of their duties and file the oath with the Secretary of State.

b. A majority of the board, including one officer, shall constitute a quorum.

c. Each member of the board shall receive $15.00 per day for each day in which such member is actually engaged in the discharge of duties and traveling and other expenses necessarily incurred in the discharge of duties.

6. (New section) The board shall:

a. hold quarterly meetings and other meetings as it may deem necessary at such times and places as the board shall prescribe;

b. elect from its members and prescribe the duties of a president and secretary-treasurer, each of whom shall serve for one year and until a successor is elected;

c. appoint and prescribe the duties of an executive secretary, who shall hold office at the will and pleasure of the board, who need not be a member thereof but who shall be:

(1) a citizen of the United States;

(2) a graduate of a college or university with a bachelor's degree; and

(3) a New Jersey-licensed mobile intensive care paramedic;

d. employ and prescribe the duties of persons as in its judgment shall be necessary for the proper performance and execution of the duties and powers of the board;

e. determine and pay reasonable compensation and necessary expenses of the executive secretary and all employees of the board;

f. pay to each member of the board the compensation hereinafter provided;

g. have a common seal, keep an official record of all its meetings, and, through its secretary-treasurer, report annually to the Governor the work of the board;

h. prescribe standards and requirements for:

(1) an individual to apply for licensure as a mobile intensive care paramedic, mobile intensive care nurse, flight paramedic, flight nurse, or emergency medical technician; and

(2) a competency evaluation program resulting in licensure for an individual pursuant to paragraph (1) of this subsection;

i. review applications for mobile intensive care paramedic, mobile intensive care nurse, flight paramedic, flight nurse, or emergency medical technician licensure; renew licensure every two years; conduct investigations pursuant to the provisions of subsection j. of this section; and issue, deny renewal of, or suspend or revoke licensure;

j. in its discretion, investigate and prosecute all violations of the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill);

k. keep an official record which shall show the name, age, nativity and permanent place of residence of each applicant and licensee and such further information concerning each applicant and licensee as the board shall deem advisable. The record shall show also whether the applicant was examined, licensed, or rejected under this and any prior act. Copies of any of the entries of the record or of any certificate issued by the board may be authenticated by any member of the board under its seal and when so authenticated shall be evidence in all courts of this State of the same weight and force as the original thereof. For authenticating a copy of any entry or entries contained in its record the board shall be paid a fee of $3.00, but such authentication, if made at the request of any public agency of this or any other jurisdiction, may be without fee;

l. in its discretion, publish, at times as it shall determine, a list of mobile intensive care paramedics, emergency medical technicians, flight paramedics, flight nurses, and mobile intensive care nurses licensed under P.L. , c. (C. ) (pending before the Legislature as this bill), a list of schools accredited or approved under P.L. , c. (C. ) (pending before the Legislature as this bill), and such other information as it shall deem advisable;

m. prescribe the scope of practice of emergency medical technicians, mobile intensive care paramedics, flight paramedics, flight nurses, and mobile intensive care nurses, which shall include, for all professionals, the use of procedures, medications, and equipment established by National EMS Scope of Practice Model of the National Highway Traffic Safety Administration, and other techniques, therapies, and procedures authorized by the board.

n. prescribe standards and curricula for schools to train for licensure, or another credential, of mobile intensive care paramedics; mobile intensive care nurses; flight paramedics; flight nurses; and emergency medical technicians, and evaluate and approve courses for affiliation;

o. review and determine status of applications for accreditation of schools; conduct investigations before and after accreditation of schools and institutions with which schools are affiliated; and issue, suspend or revoke certificates of accreditation as hereinafter provided;

p. approve schools which shall conform to standards, curricula, and requirements prescribed by the board, and suspend or revoke approval for violations thereof; except that this power shall not extend to schools operated by any board of education in this State;

q. issue subpoenas for the attendance of witnesses and production of documents at any hearing before the board authorized by P.L. , c. (C. ) (pending before the Legislature as this bill) and any member of the board shall administer an oath or affirmation to persons appearing to give testimony at such hearings;

r. conduct, at its discretion, any investigations and studies of paramedicine and paramedicine education and related matters, and prepare and issue such publications as, in the judgment of the board, will advance the profession of paramedicine and its service to the public;

s. establish and maintain a registry of all individuals who have successfully completed training and a competency evaluation program to become a mobile intensive care paramedic, mobile intensive care nurse, flight paramedic, flight nurse, or emergency medical technician. The board shall provide for the inclusion in the registry of information about the disqualification of any person from licensure including the specific documented findings constituting the basis for that disqualification, except that the information shall indicate that the person was convicted of a crime or disorderly persons offense as described in section 8 of P.L. , c. (C. ) (pending before the Legislature as this bill) but shall not identify the conviction or convictions which constitute the basis for the disqualification;

t. require, at its discretion, licensees to meet continuing education requirements as a condition of renewal;

u. promulgate rules and regulations not inconsistent with P.L. , c. (C. ) (pending before the Legislature as this bill); and

v. perform all other functions which are provided in P.L. , c. (C. ) (pending before the Legislature as this bill) to be performed by it or which, in the judgment of the board, are necessary or proper for the administration of P.L. , c. (C. ) (pending before the Legislature as this bill).

7. (New section) a. An applicant for licensure as a mobile intensive care paramedic, mobile intensive care nurse, flight paramedic, flight nurse, or an emergency medical technician shall pay a fee as prescribed by the board at the time of application and at the time of each application, if necessary, for re-examination.

b. The board shall provide that a person may satisfy the examination requirement for licensure as an emergency medical technician, mobile intensive care paramedic, mobile intensive care nurse, flight paramedic, or flight nurse by passing a written and practical competency evaluation in English.

8. (New section) a. An emergency medical technician, mobile intensive care paramedic, or mobile intensive care nurse licensed by the board prior to the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill) and upon whom a criminal history record background check has not been conducted shall be required to undergo that criminal history record background check as a condition of that individual's initial re-licensure following the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill).

b. A criminal history record background check of federal records shall be conducted at least once every two years as a condition of licensure renewal for each licensee; except that the board, in lieu of conducting a follow-up criminal history record background checks for purposes of renewal, may provide for an alternative means of determining whether the licensee has been convicted of a crime or disorderly persons offense which would disqualify that individual from licensure, including, but not limited to, a match of an individual's Social Security number or other identifying information with records of criminal proceedings in this and other states. If the board elects to implement this alternative means of determining whether the licensee has been convicted of a crime or disorderly persons offense which would disqualify that individual from licensure, the board shall report to the Governor and the Legislature prior to its implementation on the projected costs and procedures to be followed with respect to its implementation and setting forth the rationale therefor.

c. An individual shall be disqualified from licensure if a criminal history record background check reveals a record of conviction of any of the following crimes and offenses:

(1) in New Jersey, any crime or disorderly persons offense:

(a) involving danger to the individual, meaning those crimes and disorderly persons offenses set forth in chapters 11, 12, 13, 14, or 15 of Title 26 of the New Jersey Statutes; or

(b) against the family, children or incompetents, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:24-1 et seq.; or

(d) involving any controlled dangerous substance or controlled substance analog as set forth in chapter 35 of Title 2C of the New Jersey Statutes except paragraph (4) of subsection a. of N.J.S.2C:35-10; or

(2) in any other state or jurisdiction, of conduct which, if committed in New Jersey, would constitute any of the crimes or disorderly persons offenses described in paragraph (1) of this subsection.

d. Notwithstanding the provisions of subsection a. of this section, no individual shall be disqualified from licensure solely because the individual has been convicted of or engaged in acts constituting any crime or offense, unless the crime or offense has a direct or substantial relationship to the activity regulated by P.L. , c. (C. ) (pending before the Legislature as this bill) or is of a nature such that licensure of the individual would be inconsistent with the public's health, safety, or welfare. For the purposes of this section, a judgment of conviction or a plea of guilty, non vult, nolo contendere or any other such disposition of alleged criminal activity shall be deemed a conviction. In making this determination, the board shall consider the following:

(1) the nature and seriousness of the crime or offense and the passage of time since its commission;

(2) the relationship of the crime or offense to the purposes of regulating the profession or occupation regulated by the board;

(3) any evidence of rehabilitation of the individual in the period of time following the prior conviction that may be made available to the board; and

(4) the relationship of the crime or offense to the ability, capacity, and fitness required to perform the duties and discharge the responsibilities of the profession or occupation regulated by the board.

e. An arrest of an individual licensed by the board for an act that would have otherwise disqualified the individual from licensure shall be reported by the individual to the board within 30 days of occurrence. A conviction of the individual shall also be reported by the individual to the board within 30 days of occurrence.

9. (New section) Any individual submitting a false sworn statement pursuant to section 8 of P.L. , c. (C. ) (pending before the Legislature) shall be subject to a fine of not more than $1,000, which may be assessed by the board.

10. (New section) There shall be established a "Board of Paramedicine Fund." The fund shall be the repository for moneys provided pursuant to subsection j. of R.S.39:5-41 and shall be split across the following:

a. support of the operations of the board;

b. training for providers of paramedicine throughout New Jersey;

c. research related to paramedicine; and

d. defraying the costs to apply to the board for licensure, including the cost of a criminal background check.

11. (New section) a. The board shall establish an Alternative to Discipline Program for licensees who are suffering from a chemical dependency or other impairment.

b. The program shall permit these licensees to disclose their dependency or impairment status to an intervention program designated by the board, which shall provide confidential oversight of the licensee during the period that the licensee seeks treatment for, and follows a plan for recovery from, the dependency or impairment.

c. The board shall designate at least one intervention program to provide services under P.L. , c. (C. ) (pending before the Legislature as this bill) and shall delineate, in a formal agreement, the responsibilities of the intervention program and its relationship to the board.

d. The board shall establish a five-member Alternative to Discipline Committee to review matters involving licensees suffering from a chemical dependency or other impairment:

(1) The committee shall be comprised of two members of the board, to be appointed by the president of the board, at least one of whom is a mobile intensive care paramedic; two registered professional nurses with expertise in addiction recommended by the New Jersey State Nurses Association who represent a designated intervention program, to be appointed by the president of the board with the advice of the board; and one individual designated by the Commissioner of Health.

(2) The committee shall meet on a regular basis as necessary. The executive director of the board and the director of the designated intervention program shall serve as staff to the committee and shall be available to assist the committee at its meetings.

(3) The committee shall perform the following duties, as well as such others as the board may require:

(a) accept, from licensees and from members of the public, reports, which include the identity of the individual, concerning licensees who may be suffering from chemical dependencies or other impairments;

(b) accept referrals, which include the identity of the individual, from the board;

(c) accept coded summary reports from the designated intervention program, without any information from which the identity of the licensee can be discerned;

(d) promptly review each referral to determine if participation in the program is appropriate, giving due consideration to factors for participation, as specified by regulation of the board;

(e) accept confidential reports from the intervention program regarding participating licensees and ensure that the identity of the licensee is maintained in a limited-access file of the committee with disclosure provided only to those individuals whom the committee determines have a need to know the identity of the licensee;

(f) require the program to conduct such supplemental inquiry concerning a licensee as may be directed by the committee, and authorize the program to request, through the committee, that further investigation be conducted by committee staff, investigative personnel or the Attorney General, as appropriate;

(g) require the program to immediately disclose to the committee the identity of a participating licensee in the event of noncompliance by the licensee with the conditions for participation or any other change in circumstances that may render the licensee inappropriate for participation in the program, as specified by regulation of the board; and

(h) transmit such reports as required by the board.

e. The executive director of the board shall advise the committee of any information concerning a concurrent investigation or consumer complaints, as may be necessary to enable the committee to assess whether participation of a licensee in the program is appropriate.

f. Upon receipt of disclosure of the identity of a participating licensee pursuant to subparagraph (g) of paragraph (3) of subsection d. of this section, the committee shall notify the board of the identity of the licensee.

g. Any information concerning the conduct of a licensee provided to the board pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill), is confidential and shall not be considered a public or government record under P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.), pending final disposition of the inquiry or investigation by the board, except for information required to be shared with the Bureau of Fraud Deterrence in the Department of Banking and Insurance and the Office of the Insurance Fraud Prosecutor in the Department of Law and Public Safety to comply with the provisions of section 9 of P.L.1983, c.320 (C.17:33A-9) or with any other law enforcement agency. If the result of the inquiry or investigation is a finding of no basis for disciplinary action by the board, the information shall remain confidential and shall not be considered a public or government record under P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.), except that the board may release the information to a government agency, for good cause shown, upon an order of the Superior Court after notice to the licensee who is the subject of the information and an opportunity to be heard. The application for the court order shall be placed under seal.

h. A licensee who files a report with the committee pursuant to subparagraph (a) of paragraph (3) of subsection d. of this section, shall be deemed to have discharged the duty to report an impairment to the board or division pursuant to regulation or law.

i. The board may, by regulation, revise the fees charged pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill) or establish a surcharge to these fees for costs related to the administration of the Alternative to Discipline Program and the committee established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill).

j. Nothing in P.L. , c. (C. ) (pending before the Legislature as this bill) shall be construed to require the board to fund the testing, specimen monitoring or treatment of a licensee who participates in the Alternative to Discipline Program pursuant to section.

k. As used in this section:

"Chemical dependency" means a condition involving the continued misuse of chemical substances.

"Chemical substances" includes alcohol, drugs or medications, including those taken pursuant to a valid prescription for legitimate medical purposes and in accordance with the prescriber's direction, as well as those used illegally.

"Impairment" means an inability to function at an acceptable level of competency, or an incapacity to continue to practice with the requisite skill, safety and judgment, as a result of alcohol or chemical dependency, a psychiatric or emotional disorder, senility or a disabling physical disorder.

12. (New section) The secretary-treasurer, before taking office, and the executive secretary, before entering upon the executive secretary's duties, shall each give to the State of New Jersey a bond with surety, in a penal sum to be determined by the board, conditioned for the faithful performance of duties. The secretary-treasurer shall keep an account of all moneys received and expended and shall render a detailed statement thereof to the State Comptroller on June 30th of each year or as soon thereafter as practicable and shall also submit to the Governor on June 30th of each year or as soon thereafter as practicable a general statement of the work of the board, including therein a statement of the number of applications received, approved and rejected during the year reported upon.

13. (New section) a. Any person, partnership, association, corporation or public educational institution desiring to conduct a school of paramedicine; an emergency medical technician school; school of mobile intensive care nursing; flight nurse school; or flight paramedic school shall submit to the board evidence in such form as the board may require that the applicant:

(1) is equipped to give the course of instruction and practice set forth in the curriculum prescribed by the board, part of which instruction and practice may, with the approval of the board, be given by arrangement with one or more agencies or institutions approved by the board for that purpose;

(2) is affiliated with a hospital of such size and facilities as the board may prescribe; and

(3) meets any other standards and requirements as the board may prescribe. In any case other than an application by a public educational institution, the board may require evidence of good moral character of all persons directly or indirectly interested in the operation of a school of paramedicine; an emergency medical technician school; school of mobile intensive care nursing; flight nurse school; or flight paramedic school. Upon approval of the application the board shall issue a certificate of accreditation, which may be conditional during the first year.

b. The holder of a certificate of accreditation shall have the right during the effective period of the certificate of accreditation to conduct a school of paramedicine; an emergency medical technician school; school of mobile intensive care nursing; flight nurse school; or flight paramedic school. The effective period of a certificate or a renewal thereof shall commence on the date of issuance and shall terminate at the end of the fiscal year, July 1st to June 30th, in which it is issued, and shall not include any period of suspension ordered by the board as hereinafter provided. An accredited school of paramedicine; emergency medical technician school; school of mobile intensive care nursing; flight nursing school; or flight paramedic school shall:

(1) admit as students only persons possessing the preliminary educational requirements determined pursuant to section 6 of P.L. , c. (C. ) (pending before the Legislature as this bill);

(2) abide by and conform to the curriculum and standards of operation prescribed from time to time by the board;

(3) make reports to the board as the board may require; and

(4) submit to investigations by representatives of the board as the board may require.

c. Applications for renewal of certificates of accreditation issued under P.L. , c. (C. ) (pending before the Legislature as this bill) shall be made at times and in a form and manner as the board shall prescribe.

14. (New section) It shall be unlawful for any individual, corporation, partnership, or association to:

a. practice or offer to practice paramedicine as defined by P.L. , c. (C. ) (pending before the Legislature as this bill), unless the individual holds an effective, unsuspended license as a mobile intensive care paramedic, mobile intensive care nurse, emergency medical technician, flight paramedic, or flight nurse issued pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill);

b. represent in any way that the individual is a mobile intensive care paramedic, mobile intensive care nurse, emergency medical technician, flight paramedic, or flight nurse or to use after his or her name the abbreviation "MICP," "MICN," "EMT," "Flight Nurse," or "Flight Paramedic," unless the individual holds an effective, unsuspended license as a mobile intensive care paramedic, mobile intensive care nurse, emergency medical technician, flight paramedic, or flight nurse under P.L. , c. (C. ) (pending before the Legislature as this bill);

c. conduct or to represent in any way that the individual conducts a school for paramedicine, unless the individual holds an effective, unsuspended certificate of accreditation under P.L. , c. (C. ) (pending before the Legislature as this bill) and subsisting, unsuspended approval of the board;

d. obtain or attempt to obtain by fraud a license or renewal thereof or a certificate of accreditation or a renewal thereof under P.L. , c. (C. ) (pending before the Legislature as this bill);

e. represent in any way that the individual is authorized to issue a license for the practice of paramedicine or a certificate of accreditation for a school of paramedicine;

f. transfer, offer to transfer, or permit the use by another of any license issued under P.L. , c. (C. ) (pending before the Legislature as this bill);

g. without the approval of the board, transfer, offer to transfer, or permit the use by another of a certificate of accreditation issued under P.L. , c. (C. ) (pending before the Legislature as this bill); or

h. otherwise to violate or to aid or abet any individual to violate any provision of P.L. , c. (C. ) (pending before the Legislature as this bill).

15. (New section) Every individual violating any of the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill) shall be subject to a penalty of $200 for each violation, and if after conviction as hereinafter provided the individual shall again violate any provision of P.L. , c. (C. ) (pending before the Legislature as this bill), the individual shall be subject to a penalty of $500 for each subsequent offense. A voluntary payment of a penalty for a violation of any provision of P.L. , c. (C. ) (pending before the Legislature as this bill) shall be deemed to be a conviction rendering the individual liable for the greater penalty for subsequent violations, and the continuation of an offense after conviction shall be deemed to be a subsequent offense.

16. (New section) a. There is created an Emergency Medical Services for Children Advisory Council to advise the board on all matters concerning emergency medical services for minors. The council shall serve as an advisory entity under the board and assist the board in the formulation of policy and regulations to effectuate the purposes of this section

b. The advisory council shall consist of a minimum of 15 public members to be appointed by the Governor, with the advice and consent of the Senate, for a term of three years. Membership of the advisory council shall include: one practicing pediatrician, one pediatric critical care physician, one board certified pediatric emergency physician and one pediatric physiatrist, to be appointed upon the recommendation of the New Jersey chapter of the American Academy of Pediatrics; one pediatric surgeon, to be appointed upon the recommendation of the New Jersey chapter of the American College of Surgeons; one emergency physician, to be appointed upon the recommendation of the New Jersey chapter of the American College of Emergency Physicians; one emergency medical technician and one mobile intensive care paramedic, to each be appointed upon the recommendation of the Board of Paramedicine; one family practice physician, to be appointed upon the recommendation of the New Jersey chapter of the Academy of Family Practice; two registered emergency nurses, one to be appointed upon the recommendation of the New Jersey State Nurses Association and one to be appointed upon the recommendation of the New Jersey Chapter of the Emergency Nurses Association; and three members, each with a non-medical background, two of whom are parents with children under the age of 18, to be appointed upon the joint recommendation of the Association for Children of New Jersey and the Junior Leagues of New Jersey.

c. Vacancies on the advisory council shall be filled for the unexpired term by appointment of the Governor in the same manner as originally filled. The members of the advisory council shall serve without compensation. The pediatric emergency physician appointed to the board shall serve as chairperson. Members of the advisory council may select from among the members a vice-chairperson and other officers or subcommittees which are deemed necessary or appropriate. The council may further organize itself in any manner it deems appropriate and enact bylaws as deemed necessary to carry out the responsibilities of the council.

17. (New section) a. Each emergency medical services provider shall report to the board, in the most recent National Emergency Medical Services Information System format, the following information concerning each incident in which the entity provides emergency medical services:

(1) the date, time, and location of the encounter;

(2) the nature of the medical emergency, including the number of individuals requiring emergency medical services and the condition of each individual requiring emergency medical services at the time the provider arrived at the scene of the encounter;

(3) any emergency medical treatment or other services provided, including any specific procedures performed, any medications administered including, but not limited to, an opioid antidote, and any modalities administered;

(4) the name and certification or professional licensure of each emergency medical service professional staffing the provider unit during the encounter, regardless of whether the professional provided direct treatment or services to any individual;

(5) whether any other emergency medical services provider responded to the request for emergency medical services, and, if so, whether emergency medical treatment or other services were given to any individual;

(6) the outcome of the encounter, including whether each individual receiving emergency medical services was treated, refused additional treatment, was transported to a hospital or other health care facility or transferred to another emergency medical services provider for further treatment, or died. In the case of an individual who was transported by a provider other than the reporting provider, the reporting provider shall identify the transporting provider and the receiving facility, if known. In the case of an individual who died, the provider shall indicate the cause of death, if known, and whether the individual died before, during, or after the provision of emergency medical services; and

(7) any other particulars of the encounter as may be relevant or as may be required by the board.

b. Each emergency medical services dispatch center shall report to the board, in a standardized format as the board shall prescribe by regulation, the following information concerning each request for emergency medical services received by the dispatch center:

(1) the date, time, and location of the request for emergency medical services;

(2) the nature and circumstances of the emergency, as provided to the dispatch center;

(3) the identity of each emergency medical services provider dispatched to the scene of the encounter; and

(4) any other particulars of the request as may be relevant or as may be required by the board.

18. (New section) a. There is established the "Emergency Medical Technician Training Fund" as a nonlapsing, revolving fund. The fund shall be administered by the board, and shall be credited with monies received pursuant to subsection b. of N.J.S.22A:3-4.

b. The State Treasurer is the custodian of the fund and all disbursements from the fund shall be made by the treasurer upon vouchers signed by the Director of the Division of Consumer Affairs or a designee. Monies in the fund shall be used to carry out the provisions of this section, except that no more than five percent of these monies shall be used for administration of the fund in each fiscal year. The fund shall consist of monies as provided for in this section and the interest which is earned on those monies. The monies in the fund shall be invested and reinvested by the Director of the Division of Investment in the Department of the Treasury as are other trust funds in the custody of the State Treasurer in the manner provided by law.

c. The board, within the limits of those monies in the fund, shall annually reimburse any private agency, organization or entity which is certified by the board to provide training and testing for volunteer ambulance, first aid and rescue squad personnel who are seeking emergency medical technician licensure or licensure renewal.

19. (New section) a. The board shall establish a mobile integrated health program, which is intended to operate as a coordinated, patient-centered, evidence-based holistic model of care using collaborative, interdisciplinary teams to serve patients' needs at the most appropriate level of care at a safe location of convenience for the patient. In establishing the program, the board shall consider relevant standards and criteria developed or adopted by nationally recognized agencies or organizations, as well as recommendations of interested stakeholders.

b. The board shall establish, in writing, criteria by which an entity may apply for and receive authorization from the board to participate in the mobile integrated health program, and criteria by which an entity may lose authorization to participate in the health program.

20. (New section) The board shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), adopt rules and regulations to effectuate the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill).

21. Section 1 of P.L.2002, c.104 (C.45:1-28) is amended to read as follows:

1. As used in this act:

"Applicant" means an applicant for the licensure or other authorization to engage in a health care profession.

"Board" means a professional and occupational licensing board within the Division of Consumer Affairs in the Department of Law and Public Safety.

"Director" means the Director of the Division of Consumer Affairs in the Department of Law and Public Safety.

"Division" means the Division of Consumer Affairs in the Department of Law and Public Safety.

"Health care professional" means a health care professional who is licensed or otherwise authorized, pursuant to Title 45 or Title 52 of the Revised Statutes, to practice a health care profession that is regulated by one of the following boards or by the Director of the Division of Consumer Affairs: the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Dentistry, the New Jersey State Board of Optometrists, the New Jersey State Board of Pharmacy, the State Board of Chiropractic Examiners, the Acupuncture Examining Board, the State Board of Physical Therapy, the State Board of Respiratory Care, the Orthotics and Prosthetics Board of Examiners, the State Board of Psychological Examiners, the State Board of Social Work Examiners, the State Board of Veterinary Medical Examiners, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Audiology and Speech-Language Pathology Advisory Committee, the State Board of Marriage and Family Therapy Examiners, the Occupational Therapy Advisory Council, the Certified Psychoanalysts Advisory Committee [or], the State Board of Polysomnography, or the New Jersey Board of Paramedicine.

Health care professional shall not include a nurse aide or personal care assistant who is required to undergo a criminal history record background check pursuant to section 2 of P.L.1997, c.100 (C.26:2H-83) or a homemaker-home health aide who is required to undergo a criminal history record background check pursuant to section 7 of P.L.1997, c.100 (C.45:11-24.3).

"Licensee" means an individual who has been issued a license or other authorization to practice a health care profession.

(cf: P.L.2005, c.244, s.17)

22. Section 6 of P.L.1984, c.146 (C.26:2K-12) is amended to read as follows:

6. a. (1) Only a hospital exclusively authorized to develop and maintain advanced life support services in the municipality in which the trauma center is located pursuant to section 1 of P.L.2015, c.70 (C.26:2K-12.1), or a hospital authorized by the commissioner with an accredited emergency department may develop and maintain a mobile intensive care unit, and provide advanced life support services utilizing licensed physicians, registered professional nurses trained in advanced life support nursing, and mobile intensive care paramedics.

(2) (a) A mobile intensive care unit, when in service, shall be staffed by a minimum of two persons[, which two persons may] who shall be [two] mobile intensive care paramedics[, two registered professional nurses trained in advanced life support nursing, or one mobile intensive care paramedic and one registered professional nurse trained in advanced life support nursing]. Any individual providing advanced life support as provided in this paragraph shall be authorized to render care within that individual's scope of practice, as determined by the [commissioner] New Jersey Board of Paramedicine and based on the agency EMS medical director's determination of competency.

(b) The Department of Health shall establish criteria for and a process by which a hospital may apply to the department for permission to operate a mobile intensive care unit that is staffed by one emergency medical technician and one mobile intensive care paramedic or registered professional nurse trained in advanced life support nursing, if the hospital is experiencing a staffing shortage.

(3) Agency EMS medical directors shall have the authority to establish advanced life support protocols, within the scope of practice for advanced life support providers established by [this act] P.L. , c. (C. ) (pending before the Legislature as this bill) and the [commissioner] New Jersey Board of Paramedicine, which protocols shall include, but shall not be limited to, protocols concerning medications, equipment, procedures, and clinical practice. Such advanced life support protocols shall be submitted to the [commissioner] New Jersey Board of Paramedicine for approval. The [commissioner] board may approve or deny advanced life support protocols submitted by an agency EMS medical director or may approve such protocols subject to amendments that the [commissioner] board deems to be necessary. Aspects of clinical practice that exceed the scope [established by commissioner] shall be submitted by an agency EMS medical director to [the mobile intensive care advisory council] the board for review and recommendation [to the commissioner], which shall be acted upon by the [commissioner] board within 90 days.

(4) The commissioner with the approval of the State Board of Medical Examiners shall establish education and competency requirements which a board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician assistant who is employed by a hospital with a mobile intensive care unit shall be required to meet in order to obtain authorization from the department to deliver care within the respective scope of practice of the board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician assistant, as the case may be, in pre-hospital care or an interfacility setting. An authorized board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician assistant may deliver such care if and to the extent approved by the agency EMS medical director.

b. A hospital authorized by the commissioner pursuant to subsection a. of this section shall provide mobile intensive care unit services on a seven-day-a-week basis.

c. The commissioner shall establish, in writing, criteria which a hospital shall meet in order to qualify for the authorization.

d. The commissioner may withdraw his authorization if the hospital or unit violates any provision of [this act] P.L.1984, c.146 (C.26:2K-7 et seq.) or rules or regulations promulgated pursuant thereto.

e. Nothing in this section shall be construed to alter the scope of practice of any licensed health care professional under Title 45 of the Revised Statutes or the scope or authority of any agency, board, department, or other entity in this State that is responsible for licensing health care workers.

(cf: P.L.2022, c.118, s.8)

23. R.S.39:5-41 is amended to read as follows:

39:5-41. a. All fines, penalties and forfeitures imposed and collected under authority of law for any violations of R.S.39:4-63 and R.S.39:4-64 shall be forwarded by the judge to whom the same have been paid to the proper financial officer of a county, if the violation occurred within the jurisdiction of that county's central municipal court, established pursuant to N.J.S.2B:12-1 et seq. or the municipality wherein the violation occurred, to be used by the county or municipality to help finance litter control activities in addition to or supplementing existing litter pickup and removal activities in the municipality.

b. Except as otherwise provided by subsection a. of this section, all fines, penalties and forfeitures imposed and collected under authority of law for any violations of the provisions of this Title, other than those violations in which the complaining witness is the chief administrator, a member of his staff, a member of the State Police, a member of a county police department and force, a county park police system, or a sheriff's office in a county that has established a central municipal court, an inspector of the Board of Public Utilities, or a law enforcement officer of any other State agency, shall be forwarded by the judge to whom the same have been paid as follows: one-half of the total amount collected to the financial officer, as designated by the local governing body, of the respective municipalities wherein the violations occurred, to be used by the municipality for general municipal use and to defray the cost of operating the municipal court; and one-half of the total amount collected to the proper financial officer of the county wherein they were collected, to be used by the county as a fund for the construction, reconstruction, maintenance and repair of roads and bridges, snow removal, the acquisition and purchase of rights-of-way, and the purchase, replacement and repair of equipment for use on said roads and bridges therein. Up to 25% of the money received by a municipality pursuant to this subsection, but not more than the actual amount budgeted for the municipal court, whichever is less, may be used to upgrade case processing.

All fines, penalties and forfeitures imposed and collected under authority of law for any violations of the provisions of this Title, in which the complaining witness is a member of a county police department and force, a county park police system, or a county sheriff's office in a county that has established a central municipal court, shall be forwarded by the judge to whom the same have been paid to the financial officer, designated by the governing body of the county, for all violations occurring within the jurisdiction of that court, to be used for general county use and to defray the cost of operating the central municipal court.

Whenever any county has deposited moneys collected pursuant to this section in a special trust fund in lieu of expending the same for the purposes authorized by this section, it may withdraw from said special trust fund in any year an amount which is not in excess of the amount expended by the county over the immediately preceding three-year period from general county revenues for said purposes. Such moneys withdrawn from the trust fund shall be accounted for and used as are other general county revenues.

c. (Deleted by amendment, P.L.1993, c.293.)

d. Notwithstanding the provisions of subsections a. and b. of this section, $1 shall be added to the amount of each fine and penalty imposed and collected through a court under authority of any law for any violation of the provisions of Title 39 of the Revised Statutes or any other motor vehicle or traffic violation in this State and shall be forwarded by the person to whom the same are paid to the State Treasurer. In addition, upon the forfeiture of bail, $1 of that forfeiture shall be forwarded to the State Treasurer. The State Treasurer shall annually deposit those moneys so forwarded in the "Body Armor Replacement" fund established pursuant to section 1 of P.L.1997, c.177 (C.52:17B-4.4). Beginning in the fiscal year next following the effective date of this act, the State Treasurer annually shall allocate from those moneys so forwarded an amount not to exceed $400,000 to the Department of the Treasury to be expended exclusively for the purposes of funding the operation of the "Law Enforcement Officer Crisis Intervention Services" telephone hotline established and maintained under the provisions of sections 115 and 116 of P.L.2008, c.29 (C.26:2NN-1 and C.26:2NN-2).

e. Notwithstanding the provisions of subsections a. and b. of this section, $1 shall be added to the amount of each fine and penalty imposed and collected through a court under authority of any law for any violation of the provisions of Title 39 of the Revised Statutes or any other motor vehicle or traffic violation in this State and shall be forwarded by the person to whom the same are paid to the State Treasurer. The State Treasurer shall annually deposit those moneys so forwarded in the "New Jersey Spinal Cord Research Fund" established pursuant to section 9 of P.L.1999, c.201 (C.52:9E-9). In order to comply with the provisions of Article VIII, Section II, paragraph 5 of the State Constitution, a municipal or county agency which forwards moneys to the State Treasurer pursuant to this subsection may retain an amount equal to 2% of the moneys which it collects pursuant to this subsection as compensation for its administrative costs associated with implementing the provisions of this subsection.

f. Notwithstanding the provisions of subsections a. and b. of this section, $1 shall be added to the amount of each fine and penalty imposed and collected through a court under authority of any law for any violation of the provisions of Title 39 of the Revised Statutes or any other motor vehicle or traffic violation in this State and shall be forwarded by the person to whom the same are paid to the State Treasurer. The State Treasurer shall annually deposit those moneys so forwarded in the "Autism Medical Research and Treatment Fund" established pursuant to section 1 of P.L.2003, c.144 (C.30:6D-62.2).

g. Notwithstanding the provisions of subsections a. and b. of this section, $3 shall be added to the amount of each fine and penalty imposed and collected by a court under authority of any law for any violation of the provisions of Title 39 of the Revised Statutes or any other motor vehicle or traffic violation in this State and shall be forwarded by the person to whom the same are paid to the State Treasurer. The State Treasurer shall annually deposit those moneys so forwarded in the "New Jersey Forensic DNA Laboratory Fund" established pursuant to P.L.2003, c.183. Prior to depositing the moneys into the fund, the State Treasurer shall forward to the Administrative Office of the Courts an amount not to exceed $475,000 from moneys initially collected pursuant to this subsection to be used exclusively to establish a collection mechanism and to provide funding to update the Automated Traffic System Fund created pursuant to N.J.S.2B:12-30 to implement the provisions of this subsection.

h. Notwithstanding the provisions of subsections a. and b. of this section, $1 shall be added to the amount of each fine and penalty imposed and collected under authority of any law for any violation of the provisions of Title 39 of the Revised Statutes or any other motor vehicle or traffic violation in this State and shall be forwarded by the person to whom the same are paid to the State Treasurer. The State Treasurer shall annually deposit those moneys so forwarded in the "New Jersey Brain Injury Research Fund" established pursuant to section 9 of P.L.2003, c.200 (C.52:9EE-9). The Administrative Office of the Courts may retain an amount equal to $475,000 from the moneys which it initially collects pursuant to this subsection, prior to depositing any moneys in the "New Jersey Brain Injury Research Fund," in order to meet the expenses associated with utilizing the Automated Traffic System Fund created pursuant to N.J.S.2B:12-30 to implement the provisions of this subsection and serve other statutory purposes.

i. Notwithstanding the provisions of subsections a. and b. of this section, all fines and penalties imposed and collected under authority of law for any violation related to the unlawful operation or the sale of a vehicle under section 1 of P.L.1955, c.53 (C.39:3-17.1) shall be forwarded by the judge to whom the same have been paid to the State Treasurer, if the complaining witness is the chief administrator, a member of his staff, a member of the State Police, an inspector of the Board of Public Utilities, or a law enforcement officer or other official of any other State agency; or, if the complaining witness is not one of the foregoing, one-half to the chief financial officer of the county and one-half to the chief financial officer of the municipality wherein the violation occurred.

j. Notwithstanding the provisions of subsections a. and b. of this section, $1 shall be added to the amount of each fine and penalty imposed and collected under authority of any law for any violation of the provisions of Title 39 of the Revised Statutes or any other motor vehicle or traffic violation in this State and shall be forwarded by the person to whom the same are paid to the State Treasurer. The State Treasurer shall annually deposit those moneys so forwarded in the "Board of Paramedicine Fund" established pursuant to section 10 of P.L. , c. (C. ) (pending before the Legislature as this bill).

(cf: P.L.2018, c.47 s.4)

24. Section 10 of P.L.2004, c.17 (C.2A:62A-1.3) is amended to read as follows:

10. a. If an individual's actual health care facility duty, including on-call duty, does not require a response to a patient emergency situation, a health care professional who, in good faith, responds to a life-threatening emergency or responds to a request for emergency assistance in a life-threatening emergency within a hospital or other health care facility, is not liable for civil damages as a result of an act or omission in the rendering of emergency care. The immunity granted pursuant to this section shall not apply to acts or omissions constituting gross negligence, recklessness, or willful misconduct.

b. The provisions of subsection a. of this section shall not apply to a health care professional if a provider-patient relationship existed before the emergency, or if consideration in any form is provided to the health care professional for the service rendered.

c. The provisions of subsection a. of this section do not diminish a general hospital's responsibility to comply with all Department of Health licensure requirements concerning medical staff availability at the hospital.

d. A health care professional shall not be liable for civil damages for injury or death caused in an emergency situation occurring in the health care professional's private practice or in a health care facility on account of a failure to inform a patient of the possible consequences of a medical procedure when the failure to inform is caused by any of the following:

(1) the patient was unconscious;

(2) the medical procedure was undertaken without the consent of the patient because the health care professional reasonably believed that the medical procedure should be undertaken immediately and that there was insufficient time to fully inform the patient; or

(3) the medical procedure was performed on a person legally incapable of giving informed consent, and the health care professional reasonably believed that the medical procedure should be undertaken immediately and that there was insufficient time to obtain the informed consent of the person authorized to give such consent for the patient.

The provisions of this subsection shall apply only to actions for damages for an injury or death arising as a result of a health care professional's failure to inform, and not to actions for damages arising as a result of a health care professional's negligence in rendering or failing to render treatment.

e. As used in this section:

(1) "Health care professional" means a physician, dentist, nurse, emergency medical technician, mobile intensive care paramedic, or other health care professional whose professional practice is regulated pursuant to Title 45 of the Revised Statutes [and an emergency medical technician or mobile intensive care paramedic certified by the Commissioner of Health licensed pursuant to Title 26 of the Revised Statutes]; and

(2) "Health care facility" means a health care facility licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and a psychiatric hospital operated by the Department of Human Services and listed in R.S.30:1-7.

(cf: P.L.2012, c.17, s.1)

25. Section 1 of P.L.1992, c.196 (C.2A:62A-19) is amended to read as follows:

1. a. Notwithstanding any other provision of law to the contrary, no emergency medical technician who, without compensation, trains or instructs other persons in basic life support services shall be liable in any action for damages as a result of his acts of commission or omission arising out of and in the course of that training or instruction.

b. (1) Nothing in this section shall be deemed to grant immunity to any person causing damage by his willful or wanton act of commission or omission.

(2) Nothing in this section shall be deemed to grant immunity to any person causing damage as the result of the person's operation of a motor vehicle.

c. As used in this section:

(1) "Basic life support services" shall include but not be limited to: patient stabilization, airway clearance, cardiopulmonary resuscitation, hemorrhage control, initial wound care and fracture stabilization.

(2) "Emergency medical technician" means a person who is trained in basic life support services and who is [certified] licensed by the [Department of Health] New Jersey Board of Paramedicine

to perform these services.

(cf: P.L.1992, c.196, s.1)

26. Section 2 of P.L.2008, c.80 (C.26:2-190) is amended to read as follows:

2. a. The Commissioner of Health [and], the Commissioner of Human Services, and the New Jersey Board of Paramedicine, in consultation with the New Jersey Fire and Emergency Medical Services Institute and the New Jersey State First Aid Council, shall develop a training curriculum with the purpose of informing emergency responders of the risks associated with autism or an intellectual or other developmental disability, as well as providing instruction in appropriate recognition and response techniques concerning these disabilities. The curriculum shall be incorporated into existing time requirements for training and continuing education of emergency responders.

b. Prior to [certification] licensure by the [Department of Health] New Jersey Board of Paramedicine, each emergency medical technician trained in basic life support services as defined in section [1] 2 of [P.L.1985, c.351 (C.26:2K-21)] P.L. , c. (C. ) (pending before the Legislature as this bill) shall be required to satisfactorily complete the training developed under subsection a. of this section. [Every emergency medical technician certified prior to the effective date of this act shall, within 36 months of the effective date of this act, satisfactorily complete the training in recognition and response techniques concerning these disabilities, through existing continuing education requirements.]

c. The Commissioner of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of [this act] P.L.2008, c.80 (C.26:2-190).

(cf: P.L.2012, c.17, s.143)

27. Section 1 of P.L.1994, c.29 (C.39:3-27.59) is amended to read as follows:

1. a. Upon application by a person who has been [certified] licensed by the [Commissioner of Health as an Emergency Medical Technician-Ambulance] New Jersey Board of Paramedicine, the Director of the Division of Motor Vehicles shall issue for the motor vehicle owned or leased by the applicant special vehicle registration plates bearing the letters "EMT-A." The plates shall also include the vehicle registration number and other markings or identification prescribed by law, including the "Tree of Life" insignia for an Emergency Medical Technician-Ambulance in a design approved by the director. Only one set of special registration plates shall be issued to an applicant. The special plates shall be displayed only on the vehicle for which they were issued.

b. The special vehicle registration plates authorized by this section shall be issued upon proof satisfactory to the director that the applicant meets the condition specified in subsection a. of this section. A person who has been issued special vehicle registration plates under this section shall return the special plates when that person no longer meets the qualification in subsection a. of this section.

c. The fee for the motor vehicle registration plates issued under this section shall be $25, in addition to the fees otherwise prescribed by law for the registration of motor vehicles.

d. A person who violates a provision of this section shall be fined $50.

e. The director may adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), governing the issuance and use of the special vehicle registration plates authorized by this section.

(cf: P.L.1994, c.29, s.1)

28. Section 1 of P.L.1973, c.307 (C.39:3C-1) is amended to read as follows:

1. As used in P.L.1973, c.307 (C.39:3C-1 et seq.):

"All-terrain vehicle" means a motor vehicle, designed and manufactured for off-road use only, of a type possessing between three and six non-highway tires, but shall not include golf carts or an all-terrain vehicle operated by an employee or agent of the State, a county, a municipality, or a fire district, or a member of an emergency service organization or an emergency medical technician which is used while in the performance of the employee's, agent's, member's or technician's official duties.

"Chief administrator" means the Chief Administrator of the New Jersey Motor Vehicle Commission.

"Commission" means the New Jersey Motor Vehicle Commission established by section 4 of P.L.2003, c.13 (C.39:2A-4).

"Commissioner" means the Commissioner of Environmental Protection.

"Department" means the Department of Environmental Protection.

"Dirt bike" means any two-wheeled motorcycle that is designed and manufactured for off-road use only and that does not comply with Federal Motor Vehicle Safety Standards or United States Environmental Protection Agency on-road emissions standards.

"Emergency medical technician" means a person trained in basic life support services [as defined in section 1 of P.L.1985, c.351 (C.26:2K-21)] and who is [certified] licensed by the [Department of Health] New Jersey Board of Paramedicine to perform these services.

"Emergency service organization" means a fire or first aid organization, whether organized as a volunteer fire company, volunteer fire department, fire district, or duly incorporated volunteer first aid, emergency, or volunteer ambulance or rescue squad association.

"Natural resource" means all land, fish, shellfish, wildlife, biota, air, waters, and other such resources owned, managed, held in trust, or otherwise controlled by the State.

"Public land" means all land owned, operated, managed, maintained, or under the jurisdiction of the Department of Environmental Protection, including any and all land owned, operated, managed, maintained, or purchased jointly by the Department of Environmental Protection with any other party and any land so designated by municipal or county ordinance. Public land shall also mean any land used for conservation purposes, including, but not limited to, beaches, forests, greenways, natural areas, water resources, wildlife preserves, land used for watershed protection, or biological or ecological studies, and land exempted from taxation pursuant to section 2 of P.L.1974, c.167 (C.54:4-3.64).

"Snowmobile" means any motor vehicle, designed primarily to travel over ice or snow, of a type which uses sled type runners, skis, an endless belt tread, cleats, or any combination of these or other similar means of contact with the surface upon which it is operated, but does not include any farm tractor, highway or other construction equipment, or any military vehicle.

"Special event" means an organized race, exhibition, or demonstration of limited duration which is conducted according to a prearranged schedule and in which general public interest is manifested.

(cf: P.L.2015, c.155, s.3)

29. Section 43 of P.L.1954, c.84 (C.43:15A-43) is amended to read as follows:

43. a. A member who has not attained age 65 shall, upon the application of the head of the department in which he is employed or upon his own application or the application of one acting in his behalf, be retired by the board of trustees, if said employee is permanently and totally disabled as a direct result of a traumatic event occurring during and as a result of the performance of his regular or assigned duties, on an accidental disability allowance. A traumatic event occurring during voluntary performance of regular or assigned duties at a place of employment before or after required hours of employment which is not in violation of any valid work rule of the employer or otherwise prohibited by the employer shall be deemed as occurring during the performance of regular or assigned duties.

The application to accomplish such retirement must be filed within five years of the original traumatic event, but the board of trustees may consider an application filed after the five-year period if it can be factually demonstrated to the satisfaction of the board of trustees that the disability is due to the accident and the filing was not accomplished within the five-year period due to a delayed manifestation of the disability or to circumstances beyond the control of the member.

Permanent and total disability resulting from a cardiovascular, pulmonary or musculo-skeletal condition which was not a direct result of a traumatic event occurring in the performance of duty shall be deemed an ordinary disability.

Before consideration of the application by the board of trustees, the physician or physicians designated by the board shall have first made a medical examination of the member at his residence or at any other place mutually agreed upon and shall have certified to the board that he is physically or mentally incapacitated for the performance of duty, and should be retired, and the appointing authority shall have certified to the board that the member is permanently and totally disabled as a direct result of a traumatic event occurring during and as a result of the performance of his regular or assigned duties, the time and place where the duty causing the disability was performed, that the disability was not the result of his willful negligence and that the member should be retired.

No person who becomes a member of the retirement system on or after the effective date of P.L.2010, c.3 shall be eligible for retirement pursuant to this section.

b. (1) For purposes of this subsection:

"Qualifying condition or impairment of health" includes:

diseases of the upper respiratory tract and mucosae, including conditions such as conjunctivitis, rhinitis, sinusitis, pharyngitis, laryngitis, vocal cord disease, upper airway hyper-reactivity and tracheo-bronchitis, or a combination of such conditions;

diseases of the lower respiratory tract, including but not limited to bronchitis, asthma, reactive airway dysfunction syndrome, and different types of pneumonitis, such as hypersensitivity, granulomatous, or eosinophilic;

diseases of the gastroesophageal tract, including esophagitis and reflux disease, either acute or chronic, caused by exposure or aggravated by exposure;

diseases of the psychological axis, including post-traumatic stress disorder, anxiety, depression, or any combination of such conditions;

diseases of the skin such as contact dermatitis or burns, either acute or chronic in nature, infectious, irritant, allergic, idiopathic or non-specific reactive in nature, caused by exposure or aggravated by exposure; and

new onset diseases resulting from exposure as such diseases occurring in the future including cancer, chronic obstructive pulmonary disease, asbestos-related disease, heavy metal poisoning, musculoskeletal disease and chronic psychological disease.

"World Trade Center rescue, recovery, or cleanup operations" means the rescue, recovery, or cleanup operations at the World Trade Center site between September 11, 2001 and October 11, 2001.

"World Trade Center site" means any location below a line starting from the Hudson River and Canal Street, east on Canal Street to Pike Street, south on Pike Street to the East River, and extending to the lower tip of Manhattan.

(2) Notwithstanding any provision of subsection a. of this section or any other law to the contrary, for a member who participated, whether or not under orders or instruction by an employer to so participate, in World Trade Center rescue, recovery, or cleanup operations for a minimum of eight hours, permanent and total disability resulting from a qualifying condition or impairment of health shall be presumed to have occurred during and as a result of the performance of the member's regular or assigned duties and not the result of the member's willful negligence, unless the contrary can be proved by competent evidence.

A member who did not participate in such operations for a minimum of eight hours shall be eligible for the presumption provided that:

the member participated in the rescue, recovery, or cleanup operations at the World Trade Center site between September 11, 2001 and September 12, 2001;

the member sustained a documented physical injury at the World Trade Center site between September 11, 2001 and September 12, 2001 that is a qualifying condition or impairment of health resulting in a disability to the member that prevented the member from continuing to participate in World Trade Center rescue, recovery, or cleanup operations for a minimum of eight hours; and

the documented physical injury that resulted in a disability to the member that prevented the member from continuing to participate in World Trade Center rescue, recovery, or cleanup operations for a minimum of eight hours is the qualifying condition or impairment of health for which the member seeks a presumption under this subsection.

In order to be eligible for the presumption provided under this subsection, a member shall have successfully passed a physical examination for entry into public service which failed to disclose evidence of the qualifying condition or impairment of health that formed the basis for the permanent and total disability.

(3) A member who participated in the World Trade Center rescue, recovery, or cleanup operations for a minimum of eight hours and subsequently retired on a service retirement or an ordinary disability retirement and thereafter incurred a disability caused by a qualifying condition or impairment of health which the medical board determines to be caused by participation in World Trade Center rescue, recovery, or cleanup operations shall be eligible to apply to the board of trustees to have the retiree's retirement allowance recalculated as an accidental disability retirement allowance for benefit payments on or after the date of the application, provided the retiree filed an application for such recalculation within 30 days of the date that the retiree knew or should have known of the existence of such disability and its relation to the rescue, recovery, or cleanup operations. In order to be eligible for such recalculation, the retiree shall have successfully passed a physical examination for entry into public service which failed to disclose evidence of the qualifying condition or impairment of health that formed the basis for the disability.

(4) The board of trustees shall promulgate rules and regulations necessary to implement the provisions of this subsection and shall notify members and retirants in the retirement system of the enactment of this act, P.L.2019, c.157, within 30 days of enactment.

A member or retiree shall not be eligible for the presumption or recalculation under this subsection unless within two years of the effective date of this act, P.L.2019, c.157, the member or retiree files a written and sworn statement with the retirement system on a form provided by the board of trustees thereof indicating the dates and locations of service.

(5) This subsection shall apply only to: any member or retiree who is or was enrolled in the Public Employees' Retirement System because the member or retiree did not meet the age or medical requirements for enrollment in the Police and Firemen's Retirement System on the basis of the position held; and to any emergency medical technician who is a member or retiree of the Public Employees' Retirement System. For the purposes of this paragraph, "emergency medical technician" means a person trained in basic life support services [as defined in section 1 of P.L.1985, c.351 (C.26:2K-21)] and who is [certified] licensed by the [Department of Health] New Jersey Board of Paramedicine to perform these services.

(6) This subsection shall apply regardless of whether the member or retiree, who is otherwise eligible, was enrolled in the retirement system at the time of participation in World Trade Center rescue, recovery, or cleanup operations as specified herein.

(cf: P.L.2019, c.157, s.4)

30. Section 1 of P.L.1998, c.16 (C.52:3-12) is amended to read as follows:

1. a. The Governor, upon timely notification and verification of the death of a federal, State or local law enforcement officer or firefighter who either works in New Jersey or is a citizen of New Jersey and who died in the line of duty, shall direct that the flag of the United States and the State flag be flown at half-staff for one week at the State House. The flags shall be flown upon an existing flagstaff or flagstaffs or, at the option of the Governor, a flagstaff or flagstaffs erected at an appropriate site, after consultation with organizations representing law enforcement officers and firefighters on the location and design of the flagstaff or flagstaffs.

The flags flown in honor of the deceased law enforcement officer or firefighter shall be presented to the family of that officer or firefighter.

b. The Governor, upon timely notification and verification of the death of a member of a duly incorporated first aid and emergency or volunteer ambulance or rescue squad or association rendering services in a county or municipality of this State or a duly [certified] licensed mobile intensive care paramedic or licensed emergency medical technician who either works in New Jersey or is a citizen of New Jersey and who died in the line of duty while rendering first aid, ambulance, rescue or emergency medical service, shall direct that the flag of the United States and the State flag be flown at half-staff for one week at the State House. The flags shall be flown upon an existing flagstaff or flagstaffs or, at the option of the Governor, a flagstaff or flagstaffs erected at an appropriate site, after consultation with organizations representing first aid, ambulance, rescue or emergency medical service providers on the location and design of the flagstaff or flagstaffs.

The flags flown in honor of the deceased member, paramedic or technician shall be presented to the family of that member, paramedic or technician.

(cf: P.L.1998, c.16, s.1)

31. Section 2 of P.L.1993, c.249 (C.52:27D-407) is amended to read as follows:

2. As used in this act:

"Abuse" means the willful infliction of physical pain, injury or mental anguish, unreasonable confinement, or the willful deprivation of services which are necessary to maintain a person's physical and mental health.

"Caretaker" means a person who has assumed the responsibility for the care of a vulnerable adult as a result of family relationship or who has assumed responsibility for the care of a vulnerable adult voluntarily, by contract, or by order of a court of competent jurisdiction, whether or not they reside together.

"Commissioner" means the Commissioner of Human Services.

"Community setting" means a private residence or any noninstitutional setting in which a person may reside alone or with others, but shall not include residential health care facilities, rooming houses or boarding homes or any other facility or living arrangement subject to licensure by, operated by, or under contract with, a State department or agency.

"County adult protective services provider" means a county Board of Social Services or other public or nonprofit agency with experience as a New Jersey provider of protective services for adults, designated by the county and approved by the commissioner. The county adult protective services provider receives reports made pursuant to this act, maintains pertinent records and provides, arranges, or recommends protective services.

"County director" means the director of a county adult protective services provider.

"Department" means the Department of Human Services.

"Exploitation" means the act or process of illegally or improperly using a person or his resources for another person's profit or advantage.

"Firefighter" means a paid or volunteer firefighter.

"Health care professional" means a health care professional who is licensed or otherwise authorized, pursuant to Title 45 or Title 52 of the Revised Statutes, to practice a health care profession that is regulated by one of the following boards or by the Director of the Division of Consumer Affairs: the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Dentistry, the New Jersey State Board of Optometrists, the New Jersey State Board of Pharmacy, the State Board of Chiropractic Examiners, the Acupuncture Examining Board, the State Board of Physical Therapy, the State Board of Respiratory Care, the Orthotics and Prosthetics Board of Examiners, the State Board of Psychological Examiners, the State Board of Social Work Examiners, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Audiology and Speech-Language Pathology Advisory Committee, the State Board of Marriage and Family Therapy Examiners, the Occupational Therapy Advisory Council, the Certified Psychoanalysts Advisory Committee, New Jersey Board of Paramedicine, and the State Board of Polysomnography. "Health care professional" also means a nurse aide or personal care assistant who is certified by the Department of Health.

"Neglect" means an act or failure to act by a vulnerable adult or his caretaker which results in the inadequate provision of care or services necessary to maintain the physical and mental health of the vulnerable adult, and which places the vulnerable adult in a situation which can result in serious injury or which is life-threatening.

"Protective services" means voluntary or court-ordered social, legal, financial, medical or psychiatric services necessary to safeguard a vulnerable adult's rights and resources, and to protect a vulnerable adult from abuse, neglect or exploitation. Protective services include, but are not limited to: evaluating the need for services, providing or arranging for appropriate services, obtaining financial benefits to which a person is entitled, and arranging for guardianship and other legal actions.

"Vulnerable adult" means a person 18 years of age or older who resides in a community setting and who, because of a physical or mental illness, disability or deficiency, lacks sufficient understanding or capacity to make, communicate, or carry out decisions concerning his well-being and is the subject of abuse, neglect or exploitation. A person shall not be deemed to be the subject of abuse, neglect or exploitation or in need of protective services for the sole reason that the person is being furnished nonmedical remedial treatment by spiritual means through prayer alone or in accordance with a recognized religious method of healing in lieu of medical treatment, and in accordance with the tenets and practices of the person's established religious tradition.

(cf: P.L.2012, c.17, s.424)

32. This act shall be effective immediately but sections 1, 2, 7 through 12, and 14 through 31 shall remain inoperative until the first day of the 12th month next following enactment. The director and the board may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.

STATEMENT

This bill establishes the New Jersey Board of Paramedicine. Current law governing mobile intensive care paramedics and emergency medical technicians are repealed and the board is assigned oversight of these professions, in addition to mobile intensive care nurses, flight paramedics, and flight nurses. "Paramedicine" is defined in the bill to mean the practice of basic life support and advanced life support. "Basic life support" or "basic life support services" means, in the bill, a basic level of pre-hospital care which includes the use of procedures, medications, and equipment established by the National EMS Scope of Practice Model from the National Highway Traffic Safety Administration and other techniques, therapies, and procedures authorized by the board. "Advanced life support" is defined, under the bill, to mean an advanced level of emergency medical care, including specialty care transport and air medical ambulances, which includes the use of procedures, medications, and equipment established by the National Highway Traffic Safety Administration's National EMS Scope of Practice Model for paramedics, and any other such procedures, therapies, medications, and as otherwise authorized in rules or regulations promulgated by the board.

The board is to consist of 15 members to include: (1) five actively practicing as New Jersey-licensed mobile intensive care paramedics; (2) three New Jersey-licensed emergency medical technicians; one of whom is to be a board-certified emergency medical services physician; (3) one board-certified trauma surgeon; (4) one board-certified pediatric emergency medicine physician; (5) one representative from the New Jersey Emergency Nurses Association; and (6) three public members.

The bill authorizes the board to, among other items: (1) prescribe standards and requirements for individuals seeking licensure as a mobile intensive care paramedic, mobile intensive care nurse, flight paramedic, flight nurse, or emergency medical technician; (2) establish standards for and accredit schools to train individuals overseen by the new board; (3) develop a registry of all individuals who have successfully completed training and a competency evaluation program; (4) conduct investigations and research to determine if new information will help advance the profession of paramedicine; and (5) establish an Alternative to Discipline Program for licensees dealing with a chemical dependency or other impairment.

The bill also establishes two separate funds - one a "Board of Paramedicine Fund" to, in part, fund research related to paramedicine and support operations of the board and the other an "Emergency Medical Technician Training Fund" to assist certain individuals training to be an emergency medical technician. The bill also creates an "Emergency Medical Services for Children Advisory Council" to advise the board on emergency medical services for minors. The bill also updates current laws to reflect the changes regarding the creation of the board.