Senate Amendment 5278
PAG LIN
1 1 Amend Senate File 2311 as follows:
1 2 #1. By striking everything after the enacting clause
1 3 and inserting:
1 4 <Section 1. Section 85.36, subsection 9, paragraph
1 5 a, Code 2009, is amended to read as follows:
1 6 a. In computing the compensation to be allowed
1 7 a volunteer fire fighter, emergency medical care
1 8 provider, reserve peace officer, volunteer ambulance
1 9 driver, volunteer emergency rescue technician as
1 10 defined in section 147A.1, or emergency medical
1 11 technician trainee, the earnings as a fire fighter,
1 12 emergency medical care provider, reserve peace officer,
1 13 or volunteer ambulance driver, volunteer emergency
1 14 rescue technician, or emergency medical technician
1 15 trainee shall be disregarded and the volunteer fire
1 16 fighter, emergency medical care provider, reserve peace
1 17 officer, or volunteer ambulance driver, volunteer
1 18 emergency rescue technician, or emergency medical
1 19 technician trainee shall be paid an amount equal
1 20 to the compensation the volunteer fire fighter,
1 21 emergency medical care provider, reserve peace officer,
1 22 or volunteer ambulance driver, volunteer emergency
1 23 rescue technician, or emergency medical technician
1 24 trainee would be paid if injured in the normal
1 25 course of the volunteer fire fighter's, emergency
1 26 medical care provider's, reserve peace officer's,
1 27 or volunteer ambulance driver's, volunteer emergency
1 28 rescue technician's, or emergency medical technician
1 29 trainee's regular employment or an amount equal to one
1 30 hundred and forty percent of the statewide average
1 31 weekly wage, whichever is greater.
1 32 Sec. 2. Section 85.61, subsection 2, paragraph a,
1 33 Code 2009, is amended to read as follows:
1 34 a. A person, firm, association, or corporation,
1 35 state, county, municipal corporation, school
1 36 corporation, area education agency, township as
1 37 an employer of volunteer fire fighters, volunteer
1 38 emergency rescue technicians, and emergency medical
1 39 care providers only, benefited fire district, and the
1 40 legal representatives of a deceased employer.
1 41 Sec. 3. Section 85.61, subsection 7, paragraph b,
1 42 Code 2009, is amended to read as follows:
1 43 b. Personal injuries sustained by volunteer
1 44 emergency rescue technicians or emergency medical care
1 45 providers as defined in section 147A.1 arise in the
1 46 course of employment if the injuries are sustained at
1 47 any time from the time the volunteer emergency rescue
1 48 technicians or emergency medical care providers are
1 49 summoned to duty until the time those duties have been
1 50 fully discharged.
2 1 Sec. 4. Section 85.61, subsection 11, paragraph
2 2 a, subparagraph (2), Code 2009, is amended to read as
2 3 follows:
2 4 (2) An emergency medical care provider as defined
2 5 in section 147A.1, a volunteer emergency rescue
2 6 technician as defined in section 147A.1, or a volunteer
2 7 ambulance driver, or an emergency medical technician
2 8 trainee, only if an agreement is reached between
2 9 such worker or employee and the employer for whom
2 10 the volunteer services are provided that workers'
2 11 compensation coverage under this chapter and chapters
2 12 85A and 85B is to be provided by the employer. An
2 13 emergency medical care provider or volunteer emergency
2 14 rescue technician who is a worker or employee under
2 15 this subparagraph is not a casual employee. "Volunteer
2 16 ambulance driver" means a person performing services
2 17 as a volunteer ambulance driver at the request
2 18 of the person in charge of a fire department or
2 19 ambulance service of a municipality. "Emergency
2 20 medical technician trainee" means a person enrolled
2 21 in and training for emergency medical technician
2 22 certification.
2 23 Sec. 5. Section 100B.31, subsection 3, paragraph b,
2 24 Code Supplement 2009, is amended to read as follows:
2 25 b. A person performing the functions of an
2 26 emergency medical care provider or emergency rescue
2 27 technician as defined in section 147A.1 who was not
2 28 paid full=time by the entity for which such services
2 29 were being performed at the time the incident giving
2 30 rise to the death occurred.
2 31 Sec. 6. Section 147A.1, subsection 4, Code
2 32 Supplement 2009, is amended to read as follows:
2 33 4. "Emergency medical care provider" means
2 34 an individual trained to provide emergency and
2 35 nonemergency medical care at the first=responder,
2 36 EMT=basic, EMT=intermediate, EMT=paramedic
2 37 level, emergency medical responder, emergency medical
2 38 technician, advanced emergency medical technician,
2 39 paramedic, or other certification levels adopted
2 40 by rule by the department, who has been issued a
2 41 certificate by the department.
2 42 Sec. 7. Section 147A.1, subsections 6, 8, and
2 43 9, Code Supplement 2009, are amended by striking the
2 44 subsections.
2 45 Sec. 8. Section 147A.1, Code Supplement 2009, is
2 46 amended by adding the following new subsections:
2 47 NEW SUBSECTION. 11. "Service program" or
2 48 "service" means any medical care ambulance service or
2 49 nontransport service that has received authorization
2 50 from the department under section 147A.5.
3 1 NEW SUBSECTION. 12. "Training program" means an
3 2 Iowa college approved by the north central association
3 3 of colleges and schools or an Iowa hospital authorized
3 4 by the department to conduct emergency medical care
3 5 services training.
3 6 Sec. 9. Section 147A.2, Code 2009, is amended to
3 7 read as follows:
3 8 147A.2 Council established == terms of office.
3 9 1. An EMS advisory council shall be appointed
3 10 by the director. Membership of the council shall
3 11 be comprised of individuals nominated from, but
3 12 not limited to, the following state or national
3 13 organizations: Iowa osteopathic medical association,
3 14 Iowa medical society, American college of emergency
3 15 physicians, Iowa physician assistant society, Iowa
3 16 academy of family physicians, university of Iowa
3 17 hospitals and clinics, American academy of emergency
3 18 medicine, American academy of pediatrics, Iowa
3 19 EMS association, Iowa firemen's association, Iowa
3 20 professional firefighters, EMS education programs
3 21 committee, EMS regional council, Iowa nurses
3 22 association, Iowa hospital association, and the Iowa
3 23 state association of counties. The council shall also
3 24 include a member=at=large who is an emergency medical
3 25 care provider.
3 26 2. The EMS advisory council shall advise the
3 27 director and develop policy recommendations concerning
3 28 the regulation, administration, and coordination of
3 29 emergency medical services in the state.
3 30 Sec. 10. Section 147A.4, Code Supplement 2009, is
3 31 amended to read as follows:
3 32 147A.4 Rulemaking authority.
3 33 1. a. The department shall adopt rules required
3 34 or authorized by this subchapter pertaining to the
3 35 operation of ambulance, rescue, and first response
3 36 services service programs which have received
3 37 authorization under section 147A.5 to utilize the
3 38 services of certified emergency medical care providers.
3 39 These rules shall include but need not be limited
3 40 to requirements concerning physician supervision,
3 41 necessary equipment and staffing, and reporting by
3 42 ambulance, rescue, and first response services service
3 43 programs which have received the authorization pursuant
3 44 to section 147A.5.
3 45 b. The director, pursuant to rule, may grant
3 46 exceptions and variances from the requirements of
3 47 rules adopted under this subchapter for any ambulance,
3 48 rescue, or first response service program. Exceptions
3 49 or variations shall be reasonably related to undue
3 50 hardships which existing services experience in
4 1 complying with this subchapter or the rules adopted
4 2 pursuant to this subchapter. However, no exception or
4 3 variance may be granted unless the service adopted a
4 4 plan approved by the department prior to July 1, 1996,
4 5 to achieve compliance during a period not to exceed
4 6 seven years with this subchapter and rules adopted
4 7 pursuant to this subchapter. Services requesting
4 8 exceptions and variances shall be subject to other
4 9 applicable rules adopted pursuant to this subchapter.
4 10 2. The department shall adopt rules required
4 11 or authorized by this subchapter pertaining to the
4 12 examination and certification of emergency medical
4 13 care providers. These rules shall include, but
4 14 need not be limited to, requirements concerning
4 15 prerequisites, training, and experience for emergency
4 16 medical care providers and procedures for determining
4 17 when individuals have met these requirements. The
4 18 department shall adopt rules to recognize the
4 19 previous EMS training and experience of first
4 20 responders and emergency medical technicians to
4 21 provide for an equitable transition to the EMT=basic
4 22 certification emergency medical care providers
4 23 transitioning to the emergency medical responder,
4 24 emergency medical technician, advanced emergency
4 25 medical technician, and paramedic levels. The
4 26 department may require additional training and
4 27 examinations as necessary and appropriate to ensure
4 28 that individuals seeking certification transition to
4 29 another level have met the EMT=basic knowledge and
4 30 skill requirements. All requirements for transition
4 31 to another level, including fees, shall be adopted by
4 32 rule.
4 33 3. The department shall establish the fee for the
4 34 examination of the emergency medical care providers
4 35 to cover the administrative costs of the examination
4 36 program.
4 37 4. The department shall adopt rules required
4 38 or authorized by this subchapter pertaining to the
4 39 operation of training programs. These rules shall
4 40 include but need not be limited to requirements
4 41 concerning curricula, resources, facilities, and staff.
4 42 Sec. 11. Section 147A.5, subsections 1 and 3, Code
4 43 2009, are amended to read as follows:
4 44 1. An ambulance, rescue, or first
4 45 response A service program in this state that
4 46 desires to provide emergency medical care in the
4 47 out=of=hospital setting shall apply to the department
4 48 for authorization to establish a program for delivery
4 49 of the care at the scene of an emergency, during
4 50 transportation to a hospital, during transfer from
5 1 one medical care facility to another or to a private
5 2 residence, or while in the hospital emergency
5 3 department, and until care is directly assumed by a
5 4 physician or by authorized hospital personnel.
5 5 3. The department may deny an application for
5 6 authorization, or may impose a civil penalty not to
5 7 exceed one thousand dollars upon, place on probation,
5 8 suspend, or revoke the authorization of, or otherwise
5 9 discipline a service program with an existing
5 10 authorization if the department finds reason to
5 11 believe the service program has not been or will not
5 12 be operated in compliance with this subchapter and the
5 13 rules adopted pursuant to this subchapter, or that
5 14 there is insufficient assurance of adequate protection
5 15 for the public. The authorization, denial, or civil
5 16 penalty, period of probation, suspension, or
5 17 revocation, or other disciplinary action shall be
5 18 effected and may be appealed as provided by section
5 19 17A.12.
5 20 Sec. 12. Section 147A.6, Code 2009, is amended to
5 21 read as follows:
5 22 147A.6 Emergency medical care provider certificates
5 23 == renewal.
5 24 1. The department, upon application and receipt
5 25 of the prescribed fee, shall issue a certificate to
5 26 an individual who has met all of the requirements
5 27 for emergency medical care provider certification
5 28 established by the rules adopted under section 147A.4,
5 29 subsection 2. All fees and civil penalties received
5 30 pursuant to this section and sections 147A.5, 147A.7,
5 31 and 147A.17 shall be deposited in the emergency medical
5 32 services fund established in section 135.25.
5 33 2. Emergency medical care provider certificates
5 34 are valid for the multiyear period determined by the
5 35 department, unless sooner suspended or revoked. The
5 36 certificate shall be renewed upon application of
5 37 the holder and receipt of the prescribed fee if the
5 38 holder has satisfactorily completed continuing medical
5 39 education programs as required by rule.
5 40 3. If the certificate holder fails to complete
5 41 the required continuing education prior to the time
5 42 of renewal, the certificate holder may request a
5 43 forty=five day extension. Request for extension must
5 44 be submitted to the department prior to the expiration
5 45 date and include a fifty dollar extension fee. The
5 46 certificate may be renewed only during that forty=five
5 47 day period on submission of a completed renewal
5 48 application, and payment of applicable renewal fee.
5 49 Sec. 13. Section 147A.7, Code 2009, is amended to
5 50 read as follows:
6 1 147A.7 Denial, suspension, or revocation of
6 2 certificates == other disciplinary action == hearing ==
6 3 appeal.
6 4 1. The department may deny an application for
6 5 issuance or renewal of an emergency medical care
6 6 provider certificate or may impose a civil penalty
6 7 not to exceed one thousand dollars upon, place on
6 8 probation, or suspend or revoke the certificate of,
6 9 or otherwise discipline the certificate holder when
6 10 it finds that the applicant or certificate holder is
6 11 guilty of any of the following acts or offenses:
6 12 a. Negligence in performing authorized services.
6 13 b. Failure to follow the directions of the
6 14 supervising physician.
6 15 c. Rendering treatment not authorized under this
6 16 subchapter.
6 17 d. Fraud in procuring certification.
6 18 e. Professional incompetency.
6 19 f. Knowingly making misleading, deceptive, untrue
6 20 or fraudulent representation in the practice of a
6 21 profession or engaging in unethical conduct or practice
6 22 harmful or detrimental to the public. Proof of actual
6 23 injury need not be established.
6 24 g. Habitual intoxication or addiction to the use of
6 25 drugs.
6 26 h. Fraud in representations as to skill or ability.
6 27 i. Willful or repeated violations of this
6 28 subchapter or of rules adopted pursuant to this
6 29 subchapter.
6 30 j. Violating a statute of this state, another
6 31 state, or the United States, without regard to its
6 32 designation as either a felony or misdemeanor, which
6 33 relates to the practice of an emergency medical care
6 34 provider. A copy of the record of conviction or plea
6 35 of guilty is conclusive evidence of the violation.
6 36 k. Having certification to practice as an emergency
6 37 medical care provider revoked or suspended, or having
6 38 other disciplinary action taken by a licensing or
6 39 certifying authority of another state, territory, or
6 40 country. A certified copy of the record or order of
6 41 suspension, revocation, or disciplinary action is
6 42 conclusive or prima facie evidence.
6 43 l. Other acts or offenses as specified by rule.
6 44 2. A determination of mental incompetence by a
6 45 court of competent jurisdiction automatically suspends
6 46 a certificate for the duration of the certificate
6 47 unless the department orders otherwise.
6 48 3. A denial, civil penalty, period of
6 49 probation, suspension, or revocation under this
6 50 section shall be effected, and may be appealed in
7 1 accordance with the rules of the department established
7 2 pursuant to chapter 272C.
7 3 Sec. 14. Section 147A.8, Code Supplement 2009, is
7 4 amended to read as follows:
7 5 147A.8 Authority of certified emergency medical care
7 6 provider.
7 7 1. An emergency medical care provider properly
7 8 certified under this subchapter may:
7 9 a. 1. Render emergency and nonemergency medical
7 10 care, rescue, and lifesaving services in those areas
7 11 for which the emergency medical care provider is
7 12 certified, as defined and approved in accordance
7 13 with the rules of the department, at the scene of an
7 14 emergency, during transportation to a hospital or while
7 15 in the hospital emergency department, and until care
7 16 is directly assumed by a physician or by authorized
7 17 hospital personnel.
7 18 b. 2. Function in any hospital or any other entity
7 19 in which health care is ordinarily provided only when
7 20 under the direct supervision, as defined by rules
7 21 adopted pursuant to chapter 17A, of a physician, when
7 22 the emergency care provider is any of the following:
7 23 (1) a. Enrolled as a student or participating
7 24 as a preceptor in a training program approved by the
7 25 department; or or an agency authorized in another state
7 26 to provide initial EMS education and approved by the
7 27 department.
7 28 (2) b. Fulfilling continuing education
7 29 requirements as defined by rule; or.
7 30 (3) c. Employed by or assigned to a hospital
7 31 or other entity in which health care is ordinarily
7 32 provided only when under the direct supervision of a
7 33 physician, as a member of an authorized ambulance,
7 34 rescue, or first response service program, or in
7 35 an individual capacity, by rendering lifesaving
7 36 services in the facility in which employed or assigned
7 37 pursuant to the emergency medical care provider's
7 38 certification and under the direct supervision of a
7 39 physician, physician assistant, or registered nurse.
7 40 An emergency medical care provider shall not routinely
7 41 function without the direct supervision of a physician,
7 42 physician assistant, or registered nurse. However,
7 43 when the physician, physician assistant, or registered
7 44 nurse cannot directly assume emergency care of the
7 45 patient, the emergency medical care provider may
7 46 perform without direct supervision emergency medical
7 47 care procedures for which that individual is certified
7 48 if the life of the patient is in immediate danger and
7 49 such care is required to preserve the patient's life;
7 50 or.
8 1 (4) d. Employed by or assigned to a hospital
8 2 or other entity in which health care is ordinarily
8 3 provided only when under the direct supervision of a
8 4 physician, as a member of an authorized ambulance,
8 5 rescue, or first response service program, or in
8 6 an individual capacity, to perform nonlifesaving
8 7 procedures for which those individuals have been
8 8 certified and are designated in a written job
8 9 description. Such procedures may be performed after
8 10 the patient is observed by and when the emergency
8 11 medical care provider is under the supervision of the
8 12 physician, physician assistant, or registered nurse,
8 13 including when the registered nurse is not acting in
8 14 the capacity of a physician designee, and where the
8 15 procedure may be immediately abandoned without risk to
8 16 the patient.
8 17 2. Nothing in this subchapter shall be construed
8 18 to require any voluntary ambulance, rescue, or first
8 19 response service to provide a level of care beyond
8 20 minimum basic care standards.
8 21 Sec. 15. Section 147A.11, Code 2009, is amended to
8 22 read as follows:
8 23 147A.11 Prohibited acts.
8 24 1. Any person not certified as required by this
8 25 subchapter who claims to be an emergency medical care
8 26 provider, or who uses any other term to indicate or
8 27 imply that the person is an emergency medical care
8 28 provider, or who acts as an emergency medical care
8 29 provider without having obtained the appropriate
8 30 certificate under this subchapter, is guilty of a class
8 31 "D" felony.
8 32 2. An owner of an unauthorized ambulance, rescue,
8 33 or first response service program in this state who
8 34 operates or purports to operate an ambulance, rescue,
8 35 or first response a service program, or who uses any
8 36 term to indicate or imply authorization without having
8 37 obtained the appropriate authorization under this
8 38 subchapter, is guilty of a class "D" felony.
8 39 3. Any person who imparts or conveys, or causes
8 40 to be imparted or conveyed, or attempts to impart
8 41 or convey false information concerning the need
8 42 for assistance of an ambulance, rescue, or first
8 43 response a service program or of any personnel or
8 44 equipment thereof, knowing such information to be
8 45 false, is guilty of a serious misdemeanor.
8 46 Sec. 16. Section 147A.12, subsection 1, Code 2009,
8 47 is amended to read as follows:
8 48 1. This subchapter does not restrict a registered
8 49 nurse, licensed pursuant to chapter 152, from
8 50 staffing an authorized ambulance, rescue, or first
9 1 response service program provided the registered
9 2 nurse can document equivalency through education and
9 3 additional skills training essential in the delivery of
9 4 out=of=hospital emergency care. The equivalency shall
9 5 be accepted when:
9 6 a. Documentation has been reviewed and approved
9 7 at the local level by the medical director of the
9 8 ambulance, rescue, or first response service program in
9 9 accordance with the rules of the board of nursing
9 10 developed jointly with the department.
9 11 b. Authorization has been granted to that
9 12 ambulance, rescue, or first response service program by
9 13 the department.
9 14 Sec. 17. Section 147A.13, Code 2009, is amended to
9 15 read as follows:
9 16 147A.13 Physician assistant exception.
9 17 This subchapter does not restrict a physician
9 18 assistant, licensed pursuant to chapter 148C, from
9 19 staffing an authorized ambulance, rescue, or first
9 20 response service program if the physician assistant
9 21 can document equivalency through education and
9 22 additional skills training essential in the delivery of
9 23 out=of=hospital emergency care. The equivalency shall
9 24 be accepted when:
9 25 1. Documentation has been reviewed and approved
9 26 at the local level by the medical director of the
9 27 ambulance, rescue, or first response service program in
9 28 accordance with the rules of the board of physician
9 29 assistants developed after consultation with the
9 30 department.
9 31 2. Authorization has been granted to that
9 32 ambulance, rescue, or first response service program by
9 33 the department.
9 34 Sec. 18. NEW SECTION. 147A.17 Applications for
9 35 emergency medical care services training programs ==
9 36 approval or denial == disciplinary actions.
9 37 1. An Iowa college approved by the north central
9 38 association of colleges and schools or an Iowa hospital
9 39 in this state that desires to provide emergency medical
9 40 care services training leading to certification as an
9 41 emergency medical care provider shall apply to the
9 42 department for authorization to establish a training
9 43 program.
9 44 2. The department shall approve an application
9 45 submitted in accordance with subsection 1 when the
9 46 department is satisfied that the program proposed by
9 47 the application will be operated in compliance with
9 48 this subchapter and the rules adopted pursuant to this
9 49 subchapter.
9 50 3. The department may deny an application for
10 1 authorization or may impose a civil penalty not to
10 2 exceed one thousand dollars upon, place on probation,
10 3 suspend or revoke the authorization of, or otherwise
10 4 discipline a training program with an existing
10 5 authorization if the department finds reason to believe
10 6 the program has not been or will not be operated
10 7 in compliance with this subchapter and the rules
10 8 adopted pursuant to this subchapter, or that there
10 9 is insufficient assurance of adequate protection for
10 10 the public. The authorization denial, civil penalty,
10 11 period of probation, suspension, or revocation, or
10 12 other disciplinary action shall be effected and may be
10 13 appealed as provided by section 17A.12.
10 14 Sec. 19. Section 321.267A, subsection 5, Code 2009,
10 15 is amended to read as follows:
10 16 5. For the purposes of this section, "other
10 17 emergency responder" means a fire fighter certified
10 18 as a fire fighter I pursuant to rules adopted under
10 19 chapter 100B and trained in emergency driving or an
10 20 emergency medical responder care provider certified
10 21 under chapter 147A and trained in emergency driving.
10 22 Sec. 20. Section 724.6, subsection 2, Code
10 23 Supplement 2009, is amended to read as follows:
10 24 2. Notwithstanding subsection 1, fire fighters,
10 25 as defined in section 411.1, subsection 10, airport
10 26 fire fighters included under section 97B.49B, emergency
10 27 rescue technicians, and emergency medical care
10 28 providers, as defined in section 147A.1, shall not,
10 29 as a condition of employment, be required to obtain a
10 30 permit under this section. However, the provisions of
10 31 this subsection shall not apply to a person designated
10 32 as an arson investigator by the chief fire officer of
10 33 a political subdivision.>
JEFF DANIELSON
SF2311.2178 (1) 83
jr/nh
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