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Senate Study Bill 55

Conference Committee Text

PAG LIN
  1  1    Section 1.  Section 68B.2A, subsection 1, paragraph a, Code
  1  2 1995, is amended to read as follows:
  1  3    a.  The outside employment or activity involves the use of
  1  4 the state's or the political subdivision's time, facilities,
  1  5 equipment, and supplies or the use of the state or political
  1  6 subdivision badge, uniform, business card, or other evidences
  1  7 of office or employment to give the person or member of the
  1  8 person's immediate family an advantage or pecuniary benefit
  1  9 that is not available to other similarly situated members or
  1 10 classes of members of the general public.  This paragraph does
  1 11 not apply to off-duty peace officers who provide private duty
  1 12 security or fire fighters or basic or advanced emergency
  1 13 medical care providers certified under chapter 147 or 147A who
  1 14 provide private duty fire safety or emergency medical services
  1 15 while carrying their badge or wearing their official uniform,
  1 16 provided that the person has secured the prior approval of the
  1 17 agency or political subdivision in which the person is
  1 18 regularly employed to engage in the activity.  For purposes of
  1 19 this subsection, a person is not "similarly situated" merely
  1 20 by being or being related to a person who serves or is
  1 21 employed by the state or a political subdivision of the state.
  1 22    Sec. 2.  Section 85.36, subsection 10, paragraph a, Code
  1 23 1995, is amended to read as follows:
  1 24    a.  In computing the compensation to be allowed a volunteer
  1 25 fire fighter, basic or advanced emergency medical care
  1 26 provider, or reserve peace officer, the earnings as a fire
  1 27 fighter, basic or advanced emergency medical care provider, or
  1 28 reserve peace officer shall be disregarded and the volunteer
  1 29 fire fighter, basic or advanced emergency medical care
  1 30 provider, or reserve peace officer shall be paid an amount
  1 31 equal to the compensation the volunteer fire fighter, basic or
  1 32 advanced emergency medical care provider, or reserve peace
  1 33 officer would be paid if injured in the normal course of the
  1 34 volunteer fire fighter's, basic or advanced emergency medical
  1 35 care provider's, or reserve peace officer's regular employment
  2  1 or an amount equal to one hundred and forty percent of the
  2  2 statewide average weekly wage, whichever is greater.
  2  3    Sec. 3.  Section 85.61, subsection 2, Code 1995, is amended
  2  4 to read as follows:
  2  5    2.  "Employer" includes and applies to a person, firm,
  2  6 association, or corporation, state, county, municipal
  2  7 corporation, school corporation, area education agency,
  2  8 township as an employer of volunteer fire fighters and basic
  2  9 or advanced emergency medical care providers only, benefited
  2 10 fire district, and the legal representatives of a deceased
  2 11 employer.  "Employer" includes and applies to a rehabilitation
  2 12 facility approved for purchase-of-service contracts or for
  2 13 referrals by the department of human services or the
  2 14 department of education.
  2 15    Sec. 4.  Section 85.61, subsection 7, unnumbered paragraph
  2 16 3, Code 1995, is amended to read as follows:
  2 17    Personal injuries sustained by basic emergency medical care
  2 18 providers, as defined in section 147.1, or by advanced
  2 19 emergency medical care providers as defined in section 147A.1,
  2 20 arise in the course of employment if the injuries are
  2 21 sustained at any time from the time the emergency medical care
  2 22 providers are summoned to duty until the time those duties
  2 23 have been fully discharged.
  2 24    Sec. 5.  Section 85.61, subsection 11, unnumbered paragraph
  2 25 3, Code 1995, is amended to read as follows:
  2 26    "Worker" or "employee" includes a basic an emergency
  2 27 medical care provider as defined in section 147.1, an advanced
  2 28 emergency medical care provider as defined in section 147A.1,
  2 29 a volunteer ambulance driver, or an emergency medical
  2 30 technician trainee, only if an agreement is reached between
  2 31 such worker or employee and the employer for whom the
  2 32 volunteer services are provided that workers' compensation
  2 33 coverage under chapters 85, 85A, and 85B is to be provided by
  2 34 the employer.  A basic or advanced An emergency medical care
  2 35 provider who is a worker or employee under this paragraph is
  3  1 not a casual employee.  "Volunteer ambulance driver" means a
  3  2 person performing services as a volunteer ambulance driver at
  3  3 the request of the person in charge of a fire department or
  3  4 ambulance service of a municipality.  "Emergency medical
  3  5 technician trainee" means a person enrolled in and training
  3  6 for emergency medical technician certification.
  3  7    Sec. 6.  Section 139B.1, subsection 1, paragraph d, Code
  3  8 1995, is amended to read as follows:
  3  9    d.  "Emergency care provider" means a person who is trained
  3 10 and authorized by federal or state law to provide emergency
  3 11 medical assistance or treatment, for compensation or in a
  3 12 voluntary capacity, including but not limited to, all of the
  3 13 following:
  3 14    (1)  A basic emergency care provider as defined in section
  3 15 147.1.
  3 16    (2) (1)  An advanced emergency medical care provider as
  3 17 defined in section 147A.1.
  3 18    (3) (2)  A health care provider as defined in this section.
  3 19    (4) (3)  A fire fighter.
  3 20    (5) (4)  A peace officer.
  3 21    "Emergency care provider" also includes a person who
  3 22 renders direct emergency aid without compensation.
  3 23    Sec. 7.  Section 141.22A, subsection 1, paragraph a, Code
  3 24 1995, is amended to read as follows:
  3 25    a.  "Emergency care provider" means a person who is trained
  3 26 and authorized by federal or state law to provide emergency
  3 27 medical assistance or treatment, for compensation or in a
  3 28 voluntary capacity, including but not limited to all of the
  3 29 following:
  3 30    (1)  A basic emergency medical care provider as defined in
  3 31 section 147.1.
  3 32    (2) (1)  An advanced emergency medical care provider as
  3 33 defined in section 147A.1.
  3 34    (3) (2)  A health care provider as defined in this section.
  3 35    (4) (3)  A fire fighter.
  4  1    (5) (4) A peace officer.
  4  2    "Emergency care provider" also includes a person who
  4  3 renders emergency aid without compensation.
  4  4    Sec. 8.  Section 147.1, Code 1995, is amended by striking
  4  5 subsections 1, 3, 4, and 6.
  4  6    Sec. 9.  Section 147A.1, Code 1995, is amended by striking
  4  7 the section and inserting in lieu thereof the following:
  4  8    147A.1  DEFINITIONS.
  4  9    As used in this chapter, unless the context otherwise
  4 10 requires:
  4 11    1.  "Board" means the board of medical examiners appointed
  4 12 pursuant to section 147.14, subsection 2.
  4 13    2.  "Department" means the Iowa department of public
  4 14 health.
  4 15    3.  "Director" means the director of the Iowa department of
  4 16 public health.
  4 17    4.  "Emergency medical care" means such medical procedures
  4 18 as:
  4 19    a.  Administration of intravenous solutions.
  4 20    b.  Intubation.
  4 21    c.  Performance of cardiac defibrillation and synchronized
  4 22 cardioversion.
  4 23    d.  Administration of emergency drugs as provided by rule
  4 24 by the department.
  4 25    e.  Any other medical procedure approved by the department,
  4 26 by rule, as appropriate to be performed by emergency medical
  4 27 care providers who have been trained in that procedure.
  4 28    5.  "Emergency medical care provider" means an individual
  4 29 trained to provide emergency and nonemergency medical care at
  4 30 the first-responder, EMT-basic, EMT-intermediate, EMT-
  4 31 paramedic level, or other certification levels adopted by rule
  4 32 by the department, who has been issued a certificate by the
  4 33 department.
  4 34    6.  "Emergency medical services" or "EMS" means an
  4 35 integrated medical care delivery system to provide emergency
  5  1 and nonemergency medical care at the scene or during out-of-
  5  2 hospital patient transportation in an ambulance.
  5  3    7.  "Emergency medical services instructor" means an
  5  4 individual who has successfully completed an EMS curriculum
  5  5 approved by the department and is currently certified by the
  5  6 department as an EMS instructor.
  5  7    8.  "Emergency rescue technician" or "EMT" means an
  5  8 individual trained in various rescue techniques including, but
  5  9 not limited to, extrication from vehicles and agricultural
  5 10 rescue, and who has successfully completed a curriculum
  5 11 approved by the department in cooperation with the Iowa fire
  5 12 service institute.
  5 13    9.  "First responder" or "FR" means an individual trained
  5 14 in patient-stabilizing techniques, through the use of initial
  5 15 basic emergency medical care procedures and skills prior to
  5 16 the arrival of an ambulance, pursuant to rules established by
  5 17 the department and who is currently certified as a first
  5 18 responder by the department.
  5 19    10.  "Physician" means an individual licensed under chapter
  5 20 148, 150, or 150A.
  5 21    Sec. 10.  NEW SECTION.  147A.2  COUNCIL ESTABLISHED &endash;
  5 22 TERMS OF OFFICE.
  5 23    An EMS advisory council shall be appointed by the director.
  5 24 Membership of the council shall be comprised of individuals
  5 25 nominated from, but not limited to, the following state or
  5 26 national organizations:  Iowa osteopathic medical association,
  5 27 Iowa medical society, American college of emergency
  5 28 physicians, university of Iowa hospitals and clinics, Iowa EMS
  5 29 association, Iowa firemen's association, EMS education
  5 30 programs committee, EMS regional council, Iowa nurses
  5 31 association, Iowa hospital association, and the Iowa state
  5 32 association of counties.
  5 33    The EMS advisory council shall advise the director and
  5 34 develop policy recommendations concerning the regulation,
  5 35 administration, and coordination of emergency medical services
  6  1 in the state.
  6  2    Sec. 11.  NEW SECTION.  147A.3  MEETINGS OF THE COUNCIL &endash;
  6  3 QUORUM &endash; EXPENSES.
  6  4    Membership, terms of office, quorum, and expenses shall be
  6  5 determined by the director pursuant to chapter 135.
  6  6    Sec. 12.  Section 147A.4, Code 1995, is amended to read as
  6  7 follows:
  6  8    147A.4  RULEMAKING AUTHORITY.
  6  9    1.  The department shall adopt rules required or authorized
  6 10 by this chapter pertaining to the operation of ambulance,
  6 11 rescue, and first response services which have received
  6 12 authorization under section 147A.5 to utilize the services of
  6 13 certified advanced emergency medical care providers.  These
  6 14 rules shall include, but need not be limited to, requirements
  6 15 concerning physician supervision, necessary equipment and
  6 16 staffing, and reporting by ambulance, rescue, and first
  6 17 response services which have received the authorization
  6 18 pursuant to section 147A.5.
  6 19    The director, pursuant to rule, may grant exceptions and
  6 20 variances from the requirements of rules adopted under this
  6 21 chapter for any ambulance, rescue, or first response service.
  6 22 Exceptions or variations shall be reasonably related to undue
  6 23 hardships which existing services experience in complying with
  6 24 this chapter or the rules adopted pursuant to this chapter.
  6 25 However, no exception or variance may be granted unless the
  6 26 service has adopted a plan approved by the department prior to
  6 27 January 1, 1996, to achieve compliance with this chapter and
  6 28 rules adopted pursuant to this chapter.  Services requesting
  6 29 exceptions and variances shall be subject to other applicable
  6 30 rules adopted pursuant to this chapter.
  6 31    2.  The department shall adopt rules required or authorized
  6 32 by this chapter pertaining to the examination and
  6 33 certification of advanced emergency medical care providers.
  6 34 These rules shall include, but need not be limited to,
  6 35 requirements concerning prerequisites, training, and
  7  1 experience for advanced emergency medical care providers and
  7  2 procedures for determining when individuals have met these
  7  3 requirements.  The department shall consult with the board
  7  4 concerning these rules.
  7  5    3.  The department shall establish the fee for the
  7  6 examination of the advanced emergency medical care providers
  7  7 to cover the administrative costs of the examination program.
  7  8    Sec. 13.  Section 147A.5, subsections 1 and 3, Code 1995,
  7  9 are amended to read as follows:
  7 10    1.  An ambulance, rescue, or first response service in this
  7 11 state, that desires to provide advanced emergency medical care
  7 12 in the prehospital out-of-hospital setting, shall apply to the
  7 13 department for authorization to establish a program utilizing
  7 14 certified advanced emergency medical care providers for
  7 15 delivery of the care at the scene of an emergency, during
  7 16 transportation to a hospital, during transfer from one medical
  7 17 care facility to another or to a private residence, or while
  7 18 in the hospital emergency department, and until care is
  7 19 directly assumed by a physician or by authorized hospital
  7 20 personnel.
  7 21    3.  The department may deny an application for
  7 22 authorization to establish a program utilizing the services of
  7 23 certified advanced emergency medical care providers, or may
  7 24 place on probation, suspend, or revoke existing authorization
  7 25 if the department finds reason to believe the program has not
  7 26 been or will not be operated in compliance with this chapter
  7 27 and the rules adopted pursuant to this chapter, or that there
  7 28 is insufficient assurance of adequate protection for the
  7 29 public.  The denial or period of probation, suspension, or
  7 30 revocation shall be effected and may be appealed as provided
  7 31 by section 17A.12.
  7 32    Sec. 14.  Section 147A.6, Code 1995, is amended to read as
  7 33 follows:
  7 34    147A.6  ADVANCED EMERGENCY MEDICAL CARE PROVIDER
  7 35 CERTIFICATES &endash; RENEWAL.
  8  1    1.  The department, upon application and receipt of the
  8  2 prescribed fee, shall issue a certificate attesting to the
  8  3 qualifications of to an individual who has met all of the
  8  4 requirements for advanced emergency medical care provider
  8  5 certification established by the rules adopted under section
  8  6 147A.4, subsection 2.
  8  7    2.  Advanced emergency Emergency medical care provider
  8  8 certificates are valid for the multiyear period determined by
  8  9 the department, unless sooner suspended or revoked.  The
  8 10 certificate shall be renewed upon application of the holder
  8 11 and receipt of the prescribed fee if the holder has
  8 12 satisfactorily completed continuing medical education programs
  8 13 as required by rule.
  8 14    Sec. 15.  Section 147A.7, subsection 1, unnumbered
  8 15 paragraph 1, Code 1995, is amended to read as follows:
  8 16    The board department may deny an application for issuance
  8 17 or renewal of an advanced emergency medical care provider
  8 18 certificate, or suspend or revoke the certificate when it
  8 19 finds that the applicant or certificate holder is guilty of
  8 20 any of the following acts or offenses:
  8 21    Sec. 16.  Section 147A.7, subsection 1, paragraphs j and k,
  8 22 Code 1995, are amended to read as follows:
  8 23    j.  Violating a statute of this state, another state, or
  8 24 the United States, without regard to its designation as either
  8 25 a felony or misdemeanor, which relates to the practice of an
  8 26 advanced emergency medical care provider.  A copy of the
  8 27 record of conviction or plea of guilty is conclusive evidence
  8 28 of the violation.
  8 29    k.  Having certification to practice as an advanced
  8 30 emergency medical care provider revoked or suspended, or
  8 31 having other disciplinary action taken by a licensing or
  8 32 certifying authority of another state, territory, or country.
  8 33 A certified copy of the record or order of suspension,
  8 34 revocation, or disciplinary action is conclusive or prima
  8 35 facie evidence.
  9  1    Sec. 17.  Section 147A.8, Code 1995, is amended to read as
  9  2 follows:
  9  3    147A.8  AUTHORITY OF CERTIFIED ADVANCED EMERGENCY MEDICAL
  9  4 CARE PROVIDER.
  9  5    An advanced emergency medical care provider properly
  9  6 certified under this chapter may:
  9  7    1.  Render advanced emergency and nonemergency medical
  9  8 care, rescue, and lifesaving services in those areas for which
  9  9 the advanced emergency medical care provider is certified, as
  9 10 defined and approved in accordance with the rules of the
  9 11 department, at the scene of an emergency, during
  9 12 transportation to a hospital or while in the hospital
  9 13 emergency department, and until care is directly assumed by a
  9 14 physician or by authorized hospital personnel.
  9 15    2.  Function in any hospital when:
  9 16    a.  Enrolled as a student or participating as a preceptor
  9 17 in a training program approved by the department; or
  9 18    b.  Fulfilling continuing education requirements as defined
  9 19 by rule; or
  9 20    c.  Employed by or assigned to a hospital as a member of an
  9 21 authorized ambulance, rescue, or first response service, by
  9 22 rendering lifesaving services in the facility in which
  9 23 employed or assigned pursuant to the advanced emergency
  9 24 medical care provider's certification and under the direct
  9 25 supervision of a physician, physician assistant, or registered
  9 26 nurse.  An advanced emergency medical care provider shall not
  9 27 routinely function without the direct supervision of a
  9 28 physician, physician assistant, or registered nurse.  However,
  9 29 when the physician, physician assistant, or registered nurse
  9 30 cannot directly assume emergency care of the patient, the
  9 31 advanced emergency medical care provider may perform without
  9 32 direct supervision advanced emergency medical care procedures
  9 33 for which that individual is certified if the life of the
  9 34 patient is in immediate danger and such care is required to
  9 35 preserve the patient's life; or
 10  1    d.  Employed by or assigned to a hospital as a member of an
 10  2 authorized ambulance, rescue, or first response service to
 10  3 perform nonlifesaving procedures for which those individuals
 10  4 have been trained and are designated in a written job
 10  5 description.  Such procedures may be performed after the
 10  6 patient is observed by and when the advanced emergency medical
 10  7 care provider is under the supervision of the physician,
 10  8 physician assistant, or registered nurse and where the
 10  9 procedure may be immediately abandoned without risk to the
 10 10 patient.
 10 11    The department shall consult with the board concerning
 10 12 rules and training requirements related to this section.
 10 13    Sec. 18.  Section 147A.9, Code 1995, is amended to read as
 10 14 follows:
 10 15    147A.9  REMOTE SUPERVISION OF ADVANCED EMERGENCY MEDICAL
 10 16 CARE PROVIDERS &endash; EMERGENCY COMMUNICATION FAILURE &endash;
 10 17 AUTHORIZATION OF IMMEDIATE LIFESAVING TO INITIATE EMERGENCY
 10 18 MEDICAL CARE PROCEDURES.
 10 19    1.  When voice contact or a telemetered electrocardiogram
 10 20 is monitored by a physician, physician's designee, or
 10 21 physician assistant, and direct communication is maintained,
 10 22 an advanced emergency medical care provider may upon order of
 10 23 the monitoring physician or upon standing orders of a
 10 24 physician transmitted by the monitoring physician's designee
 10 25 or physician assistant perform any advanced emergency medical
 10 26 care procedure for which that advanced emergency medical care
 10 27 provider is certified.
 10 28    2.  If communications fail during an emergency or
 10 29 nonemergency situation, the advanced emergency medical care
 10 30 provider may perform any advanced emergency medical care
 10 31 procedure for which that individual is certified and which is
 10 32 included in written protocols if in the judgment of the
 10 33 advanced emergency medical care provider the life of the
 10 34 patient is in immediate danger and such care is required to
 10 35 preserve the patient's life.
 11  1    3.  The department shall adopt rules to authorize the
 11  2 institution of lifesaving medical care procedures which can be
 11  3 initiated in accordance with written protocols in instances
 11  4 where prior to the establishment of communication in lieu of
 11  5 immediate action may cause patient harm or death.
 11  6    4.  The department shall consult with the board concerning
 11  7 rules related to this section.
 11  8    Sec. 19.  Section 147A.10, Code 1995, is amended to read as
 11  9 follows:
 11 10    147A.10  EXEMPTIONS FROM LIABILITY IN CERTAIN
 11 11 CIRCUMSTANCES.
 11 12    1.  A physician, physician's designee, or physician
 11 13 assistant, who gives orders, either directly or via
 11 14 communications equipment from some other point, or via
 11 15 standing protocols to an appropriately certified advanced
 11 16 emergency medical care provider or registered nurse at the
 11 17 scene of an emergency, and an appropriately certified advanced
 11 18 emergency medical care provider or registered nurse following
 11 19 the orders, are not subject to criminal liability by reason of
 11 20 having issued or executed the orders, and are not liable for
 11 21 civil damages for acts or omissions relating to the issuance
 11 22 or execution of the orders unless the acts or omissions
 11 23 constitute recklessness.
 11 24    2.  A physician, physician's designee, physician assistant,
 11 25 registered nurse, or advanced emergency medical care provider
 11 26 shall not be subject to civil liability solely by reason of
 11 27 failure to obtain consent before rendering emergency medical,
 11 28 surgical, hospital or health services to any individual,
 11 29 regardless of age, when the patient is unable to give consent
 11 30 for any reason and there is no other person reasonably
 11 31 available who is legally authorized to consent to the
 11 32 providing of such care.
 11 33    3.  An act of commission or omission of any appropriately
 11 34 certified advanced emergency medical care provider, registered
 11 35 nurse, or physician assistant while rendering advanced
 12  1 emergency medical care under the responsible supervision and
 12  2 control of a physician to a person who is deemed by them to be
 12  3 in immediate danger of serious injury or loss of life, shall
 12  4 not impose any liability upon the certified advanced emergency
 12  5 medical care provider, registered nurse, or physician
 12  6 assistant, the supervising physician, physician designee, or
 12  7 any hospital, or upon the state, or any county, city or other
 12  8 political subdivision, or the employees of any of these
 12  9 entities; provided that this section shall not relieve any
 12 10 person of liability for civil damages for any act of
 12 11 commission or omission which constitutes recklessness.
 12 12    Sec. 20.  Section 147A.11, subsections 1 and 2, Code 1995,
 12 13 are amended to read as follows:
 12 14    1.  Any person not certified as required by this chapter
 12 15 who claims to be an advanced emergency medical care provider,
 12 16 or who uses any other term to indicate or imply that the
 12 17 person is an advanced emergency medical care provider, or who
 12 18 acts as an advanced emergency medical care provider without
 12 19 having obtained the appropriate certificate under this
 12 20 chapter, is guilty of a class "D" felony.
 12 21    2.  An owner of an unauthorized ambulance, rescue, or first
 12 22 response service in this state who operates or purports to
 12 23 operate an authorized ambulance, rescue, or first response
 12 24 service, or who uses any term to indicate or imply such
 12 25 authorization without having obtained the appropriate
 12 26 authorization under this chapter, is guilty of a class "D"
 12 27 felony.
 12 28    Sec. 21.  Section 147A.12, subsection 1, Code 1995, is
 12 29 amended to read as follows:
 12 30    1.  This chapter does not restrict a registered nurse,
 12 31 licensed pursuant to chapter 152, from staffing an authorized
 12 32 ambulance, rescue, or first response service provided the
 12 33 registered nurse can document equivalency through education
 12 34 and additional skills training essential in the delivery of
 12 35 prehospital out-of-hospital emergency care.  The equivalency
 13  1 shall be accepted when:
 13  2    a.  Documentation has been reviewed and approved at the
 13  3 local level by the medical director of the ambulance, rescue,
 13  4 or first response service in accordance with the rules of the
 13  5 board of nursing developed jointly with the board of medical
 13  6 examiners department.
 13  7    b.  Authorization has been granted to that ambulance,
 13  8 rescue, or first response service by the department.
 13  9    Sec. 22.  Section 147A.13, Code 1995, is amended to read as
 13 10 follows:
 13 11    147A.13  PHYSICIAN ASSISTANT EXCEPTION.
 13 12    This chapter does not restrict a physician assistant,
 13 13 licensed pursuant to chapter 148C, from staffing an authorized
 13 14 ambulance, rescue, or first response service if the physician
 13 15 assistant can document equivalency through education and
 13 16 additional skills training essential in the delivery of
 13 17 prehospital out-of-hospital emergency care.  The equivalency
 13 18 shall be accepted when:
 13 19    1.  Documentation has been reviewed and approved at the
 13 20 local level by the medical director of the ambulance, rescue,
 13 21 or first response service in accordance with the rules of the
 13 22 board of physician assistant examiners developed jointly with
 13 23 the department.
 13 24    2.  Authorization has been granted to that ambulance,
 13 25 rescue, or first response service by the department.
 13 26    Sec. 23.  Section 152B.11, unnumbered paragraph 3, Code
 13 27 1995, is amended to read as follows:
 13 28    This section does not apply to persons who are licensed to
 13 29 practice a health profession covered by chapter 147 or to any
 13 30 person who performs respiratory care procedures as a first
 13 31 responder, emergency rescue technician, emergency medical
 13 32 technician-ambulance, advanced emergency medical care
 13 33 provider, or other person functioning as part of a rescue unit
 13 34 or in a hospital as authorized by chapter 147A, or to persons
 13 35 whose function with respect to respiratory care is limited to
 14  1 the home delivery and connection of oxygen tanks.
 14  2    Sec. 24.  Section 232.68, subsection 5, Code 1995, is
 14  3 amended to read as follows:
 14  4    5.  "Health practitioner" includes a licensed physician and
 14  5 surgeon, osteopath, osteopathic physician and surgeon,
 14  6 dentist, optometrist, podiatrist or chiropractor; a resident
 14  7 or intern in any of such professions; a licensed dental
 14  8 hygienist, a registered nurse or licensed practical nurse; and
 14  9 a basic an emergency medical care provider certified under
 14 10 section 147.161 or an advanced emergency medical care provider
 14 11 certified under section 147A.6.
 14 12    Sec. 25.  Section 321.423, subsection 1, Code 1995, is
 14 13 amended to read as follows:
 14 14    1.  DEFINITIONS.  As used in this section, unless the
 14 15 context otherwise requires:
 14 16    a.  "Advanced emergency Emergency medical care provider"
 14 17 means as defined in section 147A.1.
 14 18    b.  "Basic emergency medical care provider" means as
 14 19 defined in section 147.1.
 14 20    c. b.  "Fire department" means a paid or volunteer fire
 14 21 protection service provided by a benefited fire district under
 14 22 chapter 357B or by a county, municipality or township, or a
 14 23 private corporate organization that has a valid contract to
 14 24 provide fire protection service for a benefited fire district,
 14 25 county, municipality, township or governmental agency.
 14 26    d. c.  "Member" means a person who is a member in good
 14 27 standing of a fire department or a person who is an advanced
 14 28 or basic emergency medical care provider employed by an
 14 29 ambulance, rescue, or first responder service.
 14 30    Sec. 26.  Section 724.6, subsection 2, Code 1995, is
 14 31 amended to read as follows:
 14 32    2.  Notwithstanding subsection 1, fire fighters, as defined
 14 33 in section 411.1, subsection 9, airport fire fighters included
 14 34 under section 97B.49, subsection 16, paragraph "b",
 14 35 subparagraph (2), emergency medical technicians-ambulance and
 15  1 emergency rescue technicians, as defined in section 147.1, and
 15  2 advanced emergency medical care providers, as defined in
 15  3 section 147A.1, shall not, as a condition of employment, be
 15  4 required to obtain a permit under this section.  However, the
 15  5 provisions of this subsection shall not apply to a person
 15  6 designated as an arson investigator by the chief fire officer
 15  7 of a political subdivision.
 15  8    Sec. 27.  Section 147.161, Code 1995, is repealed.  
 15  9                           EXPLANATION
 15 10    This bill consolidates Code regulation of emergency medical
 15 11 services (EMS) into chapter 147A, eliminating previous
 15 12 references to basic EMS providers in chapter 147 and other
 15 13 sections of the Code.  An EMS advisory council is established
 15 14 to advise the director on policy and administration.  The bill
 15 15 requires the department to inspect and license all EMS
 15 16 services.  Those services previously not regulated which
 15 17 experience undue hardship with immediately complying with
 15 18 these regulations may be granted variances by the director.
 15 19 The bill allows the department to define by rule the skills of
 15 20 the three levels of EMS providers and clarifies the role of
 15 21 the EMS provider.
 15 22    Sections 1, 2, 3, 4, 5, 6, 7, 8, 13, 14, 16, 17, 20, 23,
 15 23 24, 25, 26, and 27 make necessary terminology changes
 15 24 consistent with the bill.
 15 25    Section 9 amends definitions.  The term "EMS provider" is
 15 26 expanded to include all levels of provider.  The emergency
 15 27 rescue technician and instructor certification is added.
 15 28 Emergency medical services and nonemergency is defined.
 15 29    Sections 10 and 11 establish the EMS advisory council.
 15 30    Section 12 applies service regulations to all EMS service
 15 31 providers and allows the director to grant variances in cases
 15 32 of hardship.
 15 33    Section 15 allows the board to issue, deny, revoke, or
 15 34 suspend EMS provider certificates.
 15 35    Section 18 states that the department shall adopt medical
 16  1 care procedures which can be started by EMS personnel before
 16  2 remote supervision commences or in the failure of remote
 16  3 supervision.
 16  4    Section 19 adds registered nurses to EMS personnel who are
 16  5 exempt from liability if following orders from a physician,
 16  6 physician's designee, or physician assistant at the scene of
 16  7 an emergency and adds registered nurses to those individuals
 16  8 not subject to civil liability only for not obtaining consent
 16  9 before starting emergency aid.
 16 10    Sections 21 and 22 establish the department as being
 16 11 jointly responsible for developing rules governing nurses and
 16 12 physician assistants in emergency care roles.  
 16 13 LSB 1851SC 76
 16 14 cl/cf/24
     

Text: SSB00054                          Text: SSB00056
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