Text: HF00391 Text: HF00393 Text: HF00300 - HF00399 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 139B.1, subsection 2, paragraph b, Code 1 2 1999, is amended to read as follows: 1 3 b. If an individual is diagnosed or confirmed as having a 1 4 contagious or infectious disease, the hospital shall notify 1 5 the designated officer of an emergency care provider service 1 6 who shall notify persons involved in attending or transporting 1 7 the individual. For blood-borne contagious or infectious 1 8 diseases, notification shall only take place upon filing of an 1 9 exposure report form with the hospital. The exposure report 1 10 form may be incorporated into the Iowa prehospital care 1 11 report, the Iowa prehospital advanced care report, or a 1 12 similar report used by an ambulance, rescue,orfirst response1 13 nontransport service or law enforcement agency. 1 14 Sec. 2. Section 147A.1, Code 1999, is amended by adding 1 15 the following new subsections: 1 16 NEW SUBSECTION. 0A. "Ambulance service" means a privately 1 17 or publicly owned service program which utilizes ambulances, 1 18 or nontransport service vehicles to supplement the use of 1 19 ambulances, in order to provide patient transportation and 1 20 emergency medical care at the scene of an emergency or while 1 21 en route to a hospital or during transfer from one medical 1 22 care facility to another or to a private home. 1 23 NEW SUBSECTION. 9A. "Nontransport service" means a 1 24 privately or publicly owned rescue or first response service 1 25 program which does not provide patient transportation, except 1 26 when no ambulance is available or in a disaster situation, and 1 27 utilizes only rescue or first response vehicles to provide 1 28 emergency medical care at the scene of an emergency. 1 29 NEW SUBSECTION. 11. "Physician designee" means a 1 30 registered nurse licensed pursuant to chapter 152, or a 1 31 physician assistant licensed and approved pursuant to chapter 1 32 148C by the board of physician assistant examiners, who holds 1 33 a current course completion card in advanced cardiac life 1 34 support and is acting as an intermediary for a supervising 1 35 physician in directing the actions of emergency medical care 2 1 personnel in accordance with written policies and protocols. 2 2 Sec. 3. Section 147A.4, subsection 1, Code 1999, is 2 3 amended to read as follows: 2 4 1. The department shall adopt rules required or authorized 2 5 by this subchapter pertaining to the operation of ambulance,2 6rescue,andfirst responsenontransport services which have 2 7 received authorization under section 147A.5 to utilize the 2 8 services of certified emergency medical care providers. These 2 9 rules shall include, but need not be limited to, requirements 2 10 concerning physician supervision, necessary equipment and 2 11 staffing, and reporting by ambulance, rescue,andfirst2 12responsenontransport services which have received the 2 13 authorization pursuant to section 147A.5. 2 14 The director, pursuant to rule, may grant exceptions and 2 15 variances from the requirements of rules adopted under this 2 16 subchapter for any ambulance, rescue,orfirst response2 17 nontransport service. Exceptions or variations shall be 2 18 reasonably related to undue hardships which existing services 2 19 experience in complying with this subchapter or the rules 2 20 adopted pursuant to this subchapter. However, no exception or 2 21 variance may be granted unless the service has adopted a plan 2 22 approved by the department prior to July 1, 1996, to achieve 2 23 compliance during a period not to exceed seven years with this 2 24 subchapter and rules adopted pursuant to this subchapter. 2 25 Services requesting exceptions and variances shall be subject 2 26 to other applicable rules adopted pursuant to this subchapter. 2 27 Sec. 4. Section 147A.5, subsection 1, Code 1999, is 2 28 amended to read as follows: 2 29 1. An ambulance, rescue,orfirst responsenontransport 2 30 service in this state that desires to provide emergency and 2 31 nonemergency medical care in the out-of-hospital setting shall 2 32 apply to the department for authorization to establish a 2 33 program for delivery of the careat the scene of an emergency,2 34during transportation to a hospital, during transfer from one2 35medical care facility to another or to a private residence, or3 1while in the hospital emergency department, and until care is3 2directly assumed by a physician or by authorized hospital3 3personnelin accordance with rules established by the 3 4 department. 3 5 Sec. 5. Section 147A.8, Code 1999, is amended to read as 3 6 follows: 3 7 147A.8 AUTHORITY OF CERTIFIED EMERGENCY MEDICAL CARE 3 8 PROVIDER. 3 9 1. An emergency medical care provider properly certified 3 10 under this subchapter, acting under the direct or indirect 3 11 supervision of a physician or physician designee, may:3 121. Renderrender emergency and nonemergency medical care, 3 13 rescue, and lifesaving services in those areas for which the 3 14 emergency medical care provider is certified, under 3 15 circumstances as defined and approved in accordance with the 3 16 rules of the department, at the scene of an emergency, during3 17transportation to a hospital or while in the hospital3 18emergency department, and until care is directly assumed by a3 19physician or by authorized hospital personnel. 3 202. Function in any hospital when:3 21a. Enrolled as a student or participating as a preceptor3 22in a training program approved by the department; or3 23b. Fulfilling continuing education requirements as defined3 24by rule; or3 25c. Employed by or assigned to a hospital as a member of an3 26authorized ambulance, rescue, or first response service, by3 27rendering lifesaving services in the facility in which3 28employed or assigned pursuant to the emergency medical care3 29provider's certification and under the direct supervision of a3 30physician, physician assistant, or registered nurse. An3 31emergency medical care provider shall not routinely function3 32without the direct supervision of a physician, physician3 33assistant, or registered nurse. However, when the physician,3 34physician assistant, or registered nurse cannot directly3 35assume emergency care of the patient, the emergency medical4 1care provider may perform without direct supervision emergency4 2medical care procedures for which that individual is certified4 3if the life of the patient is in immediate danger and such4 4care is required to preserve the patient's life; or4 5d. Employed by or assigned to a hospital as a member of an4 6authorized ambulance, rescue, or first response service to4 7perform nonlifesaving procedures for which those individuals4 8have been trained and are designated in a written job4 9description. Such procedures may be performed after the4 10patient is observed by and when the emergency medical care4 11provider is under the supervision of the physician, physician4 12assistant, or registered nurse and where the procedure may be4 13immediately abandoned without risk to the patient.4 14The department shall consult with the board concerning4 15rules and training requirements related to this section.4 16 2.Nothing in thisThis subchapter shall not be construed 4 17 to require any voluntary ambulance, rescue,orfirst response4 18 nontransport service to provide a level of care beyond minimum 4 19 basic care standards. 4 20 Sec. 6. Section 147A.11, subsections 2 and 3, Code 1999, 4 21 are amended to read as follows: 4 22 2. An owner of an unauthorized ambulance, rescue,orfirst4 23responsenontransport service in this state who operates or 4 24 purports to operate an ambulance, rescue,orfirst response4 25 nontransport service, or who uses any term to indicate or 4 26 imply authorization without having obtained the appropriate 4 27 authorization under this subchapter, is guilty of a class "D" 4 28 felony. 4 29 3. Any person who imparts or conveys, or causes to be 4 30 imparted or conveyed, or attempts to impart or convey false 4 31 information concerning the need for assistance of an 4 32 ambulance, rescue,orfirst responsenontransport service or 4 33 of any personnel or equipment thereof, knowing such 4 34 information to be false, is guilty of a serious misdemeanor. 4 35 Sec. 7. Section 147A.12, subsection 1, Code 1999, is 5 1 amended to read as follows: 5 2 1. This subchapter does not restrict a registered nurse, 5 3 licensed pursuant to chapter 152, from staffing an authorized 5 4 ambulance, rescue,orfirst responsenontransport service 5 5 provided the registered nurse can document equivalency through 5 6 education and additional skills training essential in the 5 7 delivery of out-of-hospital emergency care. The equivalency 5 8 shall be accepted when: 5 9 a. Documentation has been reviewed and approved at the 5 10 local level by the medical director of the ambulance, rescue,5 11 orfirst responsenontransport service in accordance with the 5 12 rules of the board of nursing developed jointly with the 5 13 department. 5 14 b. Authorization has been granted to that ambulance,5 15rescue,orfirst responsenontransport service by the 5 16 department. 5 17 Sec. 8. Section 147A.13, Code 1999, is amended to read as 5 18 follows: 5 19 147A.13 PHYSICIAN ASSISTANT EXCEPTION. 5 20 This subchapter does not restrict a physician assistant, 5 21 licensed pursuant to chapter 148C, from staffing an authorized 5 22 ambulance, rescue,orfirst responsenontransport service if 5 23 the physician assistant can document equivalency through 5 24 education and additional skills training essential in the 5 25 delivery of out-of-hospital emergency care. The equivalency 5 26 shall be accepted when: 5 27 1. Documentation has been reviewed and approved at the 5 28 local level by the medical director of the ambulance, rescue,5 29 orfirst responsenontransport service in accordance with the 5 30 rules of the board of physician assistant examiners developed 5 31 after consultation with the department. 5 32 2. Authorization has been granted to that ambulance,5 33rescue,orfirst responsenontransport service by the 5 34 department. 5 35 Sec. 9. Section 321.423, subsection 1, paragraph c, Code 6 1 1999, is amended to read as follows: 6 2 c. "Member" means a person who is a member in good 6 3 standing of a fire department or a person who is an emergency 6 4 medical care provider employed by an ambulance, rescue,or 6 5first responsenontransport service. 6 6 Sec. 10. Section 321.423, subsection 4, Code 1999, is 6 7 amended to read as follows: 6 8 4. EXPIRATION OF AUTHORITY. The authorization shall 6 9 expire at midnight on the thirty-first day of December five 6 10 years from the year in which it was issued, or when the 6 11 vehicle is no longer owned by the member, or when the member 6 12 has ceased to be an active member of the fire department or of 6 13 an ambulance, rescue,orfirst responsenontransport service, 6 14 or when the member has used the blue or white light beyond the 6 15 scope of its authorized use. A person issued an authorization 6 16 under subsection 3, paragraph "b", shall return the 6 17 authorization to the fire chief upon expiration or upon a 6 18 determination by the fire chief or the department that the 6 19 authorization should be revoked. 6 20 Sec. 11. Section 321.423, subsection 7, paragraph a, Code 6 21 1999, is amended to read as follows: 6 22 a. On a vehicle owned or exclusively operated by an 6 23 ambulance, rescue,orfirst responsenontransport service. 6 24 Sec. 12. Section 321.423, subsection 7, paragraph b, 6 25 subparagraphs (1) and (4), Code 1999, are amended to read as 6 26 follows: 6 27 (1) The vehicle is owned by a member of an ambulance,6 28rescue,orfirst responsenontransport service. 6 29 (4) The head of an ambulance, rescue,orfirst response6 30 nontransport service certifies that the member is in good 6 31 standing and recommends that the authorization be granted. 6 32 Sec. 13. Section 422D.6, subsection 3, paragraph e, Code 6 33 1999, is amended to read as follows: 6 34 e. Vehicles including, but not limited to, ambulances, 6 35 fire apparatus, boats,rescue/first responsenontransport 7 1 service vehicles as defined in section 147A.1, and 7 2 snowmobiles. 7 3 EXPLANATION 7 4 This bill provides for changes in terminology regarding 7 5 emergency and nonemergency medical care services performed or 7 6 provided utilizing nontransport service vehicles. Previously, 7 7 nontransport service vehicles were referred to in most 7 8 instances as rescue or first response vehicles in the Code. 7 9 The bill changes these references to the term "nontransport 7 10 service", consistent with administrative rules prescribed by 7 11 the Iowa department of public health in 641 Iowa 7 12 Administrative Code chapter 132. The bill adds the terms 7 13 "ambulance service", "nontransport service", and "physician 7 14 designee" to the definitions contained in Code section 147A.1. 7 15 The bill additionally provides that applications to the 7 16 department by an ambulance or nontransport service desiring to 7 17 provide emergency and nonemergency medical care services in an 7 18 out-of-hospital setting shall be authorized, and authority of 7 19 a certified emergency medical care provider acting under the 7 20 direct or indirect supervision of a physician or physician 7 21 designee to render emergency and nonemergency medical care 7 22 shall be granted, as prescribed by the department by rule. 7 23 Previously, the locations or circumstances under which such 7 24 authorization was granted were specifically set forth in 7 25 statute. 7 26 LSB 1078YH 78 7 27 rn/gg/8.3
Text: HF00391 Text: HF00393 Text: HF00300 - HF00399 Text: HF Index Bills and Amendments: General Index Bill History: General Index
© 1999 Cornell College and League of Women Voters of Iowa
Comments about this site or page?
webmaster@legis.iowa.gov.
Please remember that the person listed above does not vote on bills. Direct all comments concerning legislation to State Legislators.
Last update: Wed Feb 9 03:35:15 CST 2000
URL: /DOCS/GA/78GA/Legislation/HF/00300/HF00392/990224.html
jhf