US Emergency Medical Services Resources

US Emergency Medical Services Resources in United States

US Emergency Medical Services  Resources

State Description
Alabama Ala. Code § 04-374 (2004) provides further for the service charge of fire dues of a fire district in the same manner as ad valorem taxes. Relates to districts for fire protection, emergency medical services, garbage, and other services.Ala. Code § 04-421 (2004) creates the Emergency Response Commission to address the health care crisis in Alabama.
Alaska Alaska Stat. § 09.65.090 (1998) limits the immunity provided to an emergency services volunteer who provides manual electric cardiac defibrillation and specifies that advanced life support includes manual electric cardiac defibrillation.
American
Samoa
Arizona Ariz. Rev. Stat. § 36-2225 (2005) Concerns emergency medical services and designation as a trauma unit by a national verification organization of surgeons or other qualified organizations who verify health care institutions to provide trauma care. (SB 1134)2005 Ariz. Sess. Laws, Chap. 1228 Adds a position for a military emergency medical technician to the Emergency Medical Services Advisory Council.Ariz. Rev. Stat. § 9-500.02 (2004, 2005)  sets limitations on liability for emergency medical technicians and paramedics providing aid to vulnerable and incapacitated adults. (HB 2195) Amended in 2005 to add emergency medical technician and other minor changes to language. (SB 1138)

Ariz. Rev. Stat. § 36-2222 (2004) requires a representative of tribal health organization to sit on the Trauma Advisory Board. (HB 2197)

Ariz. Rev. Stat. § 36-2232 (2004) provides regulations for ambulances and ambulance services.(HB 2568)

Ariz. Rev. Stat. § 20-2801, 20-2803 (2000) amends definitions to include “Emergency Ambulance Services,” which means services provided by an ambulance service following the onset of a medical condition that manifests itself by symptoms of pain, illness or injury that the absence of access an ambulance or emergency response by calling 911 or a designated telephone number to reach public safety answering point and receiving time sensitive medical attention could reasonably be expected to result in any of the following: placing the health of the individual, or with respect to a pregnant woman, the health of her unborn child in serious jeopardy; serious impairment to bodily functions; serious dysfunction of any bodily organ or part. A health care services plan shall provide coverage for emergency ambulance services without prior authorization, subject to applicable copayment, coinsurance and deductibles.

Ariz. Rev. Stat. § 36-1162 (1999) requires the Arizona Poison Control System to establish a teratogen (a substance that causes developmental malformations) information and education program, effective until July 1, 2009. The act appropriates $92,000 from the poison control fund to the University of Arizona in both FY 1999-2000 and FY 2000-2001 to establish the program.

Ariz. Rev. Stat. § 36-2205 (1998) allows the director of the Department of Health Services (DHS), in consultation with the medical director of Emergency Medical Services, the Emergency Medical Council and the Medical Direction Commission, to establish protocols relating to transportation of patients to the appropriate medical service provider based on the patient’s condition. The act allows an ambulance service to provide gratuitous services if the patient subsequently declines to be treated or transported.

Ariz. Rev. Stat. § 20-821 and 1068 (1996) requires health plans to provide coverage for an initial medical screening examination and any immediately necessary stabilizing treatment required by the Emergency Medical Treatment and Active Labor Act without prior authorization by the plan, subject to applicable copayments, coinsurance and deductibles. A provider may not deny, limit or otherwise restrict a patient’s access to medically necessary emergency services based upon the patient’s enrollment in a health plan. The act allows a health plan to require, as a condition of coverage, prior authorization for health care services arising after the initial screening and stabilizing treatment. In such cases, the health plan must provide enrollees 24-hour access by telephone or facsimile.

Ariz. Rev. Stat. § 11-251.02 (2004) requires a certificate of necessity to provide ambulance service in the rural or wilderness service areas in counties with a population of less than five hundred thousand people. (HB 2671)

Arkansas Ark. Stat. § 20-16-507 (1997) amends the fire protection district laws to allow qualified districts to offer additional services to their members in addition to fire protection services, such as emergency medical, ambulance, and patient transport services.
California Cal. Education Code § 49414.5 (2003)  authorizes each school district to provide voluntary emergency medical training to school personnel to administer emergency medical assistance to pupils with diabetes and provides immunity from civil liability.Cal. Health and Safety Code § 1374.34 (2003) requires that all health care services plans provide reimbursement if the urgent care or emergency services are determined to be medically necessary.  The law authorizes that each administering agency to maintain a reserve in specified portions of its emergency medical services fund, revises the formula for distribution of the fund, requires each county establishing an emergency medical services fund to report to the legislature annually on April 15th, and  authorizes that any surplus beyond the amount designated for the reserve  be reimbursed to physicians and surgeons at the end of the fiscal year.  Finally, the law requires the administering officer to solicit input from physicians and surgeons and hospitals to review payment distribution methodologies to ensure fair and timely payments.Cal. Government Code § 76104.1, Health and Safety Code § 1797.98e and Vehicle Code § 42007.5 (2003) Eliminates restrictions of County Emergency Medical Services Fund and provides that Santa Barbara may apply funds to medical services rendered after a 48-hour period for continued stay. (SB 635)

Cal. Health & Safety Code § 1345 (1998) revises the definition of “basic health services” to provide that it includes ambulance and ambulance transport services provided through the “911” emergency response system.

Cal. Health & Safety Code § 1797.254 (1996) establishes the Emergency Medical Services for Children Program within the Emergency Medical Services Authority and states that no more than $120,000 per fiscal year be expended for the program.

Cal. Health & Safety Code § 124900, 124930 (1996) extends the several programs funded by Cigarette and Tobacco Products Surtax Fund money including emergency treatment of county indigent patients. The act also revises reporting and maintenance of effort requirements under the California Health Care for the Indigent.

Cal. Health and Safety Code § 1797.98a, 1797.98b, 1797.98c, and 1797.98e (2003) Existing law authorizes each county to establish an emergency medical services fund, and makes money in the fund available for the reimbursement of physicians and surgeons and hospitals for losses incurred in the provision of emergency medical services when payment is not otherwise made for those services. (SB 476)

Colorado Colo. Rev. Stat. § 29-11-101, 102 and 104 (2004) Provides that governing body incur costs pertaining to continued operation of emergency telephone services; provides that funds from charges assigned by governing body be applied to all related costs of continued operation. (SB 111)Colo. Rev. Stat. § 25-3.5-703 and 704 (1999) defines a Regional Pediatric Trauma Center as a facility that provides comprehensive pediatric trauma care, including acute management of the most severely injured pediatric trauma patients. It may serve as an ultimate resource for lower level facilities on pediatric trauma care, and as a facility that performs pediatric trauma research and provides pediatric trauma education for health care professionals. The law also authorizes Department of Public Health and Environment to designate a facility as a regional pediatric trauma center. (SB 1214)Colo. Rev. Stat. § 10-16-102, 107, 116 and 10-16-705 (1999) prohibits a managed care plan from denying benefits for emergency services previously rendered, based upon the covered person’s failure to provide subsequent notification in accordance with the plan provision, where the covered person’s medical condition prevented timely notification. (SB141)
Connecticut Conn. Gen. Stat § 19a-436 (2004) requires the Commissioner of Public Health to evaluate emergency medical services in the state and conduct a needs assessment to identify placement and use of automatic external defibrillators within the emergency medical services system, establish guidelines for providing emergency medical services during mass gatherings, and review existing laws and regulations to identify conflicting and ambiguous issues, including the meaning of public access defibrillation. (HB 5631)Conn. Gen. Stat. § 19a-490h(a) et seq. (1998) requires each hospital licensed by the Department of Public Health as a short-term general hospital, outpatient surgical facility or outpatient clinic to include in the record of each trauma patient a notation indicating the extent and outcome of screening for alcohol and substance abuse.Conn. Gen. Stat. § 52-227b and 19a-175 (1998) exempts people trained to use automatic external defibrillators from civil liability for ordinary negligence for any emergency medical assistance given free and outside their ordinary course of employment. They must be trained in accordance with the American Red Cross or the American Heart Association standards and are not protected for acts of gross, willful, or wanton negligence. It requires anyone possessing a defibrillator to provide its location to the Office of Emergency Medical Services, which must establish a registry of defibrillator locations and share that information with the enhanced 911 services.

Conn. Gen. Stat. § 19a-195a (1997) requires the Department of Public Health commissioner to adopt regulations for certifying intermediate level emergency medical technicians and requires the certification standards to be uniform statewide. The regulations must also allow applicants to take required courses statewide and for certified EMT-intermediates to work throughout the state.

Conn. Gen. Stat. § 19a-180 (1997) requires licensure of paramedics by the Department of Public Health.

Conn. Gen. Stat. § 17a-450 and 38a-175 et seq. (1997) requires that presenting symptoms, as coded by the provider and recorded by the hospital, will be the basis for reimbursement or coverage, provided such symptoms reasonably indicated an emergency medical condition. For the purposes of this section, an emergency medical condition is a condition such that a prudent layperson, acting reasonably, would have believed that emergency medical treatment is needed. The law also requires that managed care organizations provide enrollees with a description of emergency services and the appropriate use of those services.

Delaware Del. Code Ann. tit. 16 § 10005, 10103, 10104, 10105 and tit. 30 § 501 (2003) correct some defects in the enactment of the funding provisions of the integrated wireline and wireless E-911 system. (HB 143)Del. Code Ann. tit. 16 § 9806 (2003) clarifies the definition and role of the State EMS Directors in the statewide paramedic system and their role in providing on patient care during emergency situations.  The law also identifies them clearly as EMS providers entitled to liability protection. (HB 197)Del. Code Ann. tit. 16 § 9701 et seq. (1996) establishes a voluntary and inclusive statewide trauma care system and provides for the creation of a statewide trauma plan addressing pre-hospital care, prevention, hospital care, rehabilitative care, continuing education and trauma system evaluation. The act also permits representation of the Trauma Systems Committee on the Delaware Emergency Medical Services Advisory Council to safeguard against fragmentation of the Delaware EMS System. The act also protects the confidentiality of all quality management proceedings related to the trauma care system.
District of Columbia D.C. Code § 35-4811 (1998) requires health insurers to reimburse for emergency services provided due to a medical emergency. Medical emergency is defined using the prudent layperson standards. Emergency services include emergency medical services transportation in addition to the usual health care and ancillary services provided in or available to a hospital emergency department.
Florida 1996 Fla. Laws, Chap. 509 (HB 2005) clarifies that the Palm Beach County Health Care District’s authority includes the ability to plan, set policy and fund from its revenue sources the establishment and implementation of cooperative agreements with other government authorities and public and private entities within and outside of Palm Beach County which promote the efficiencies of local and regional trauma agencies, rural health networks and cooperative health care delivery systems, provided that any agreements with entities outside of Palm Beach County ensure that the costs associated with trauma services are the responsibility of that entity. The district also has the authority to reorganize any of the hospitals it owns in accordance with state law.Fla. Chap. 329 (2005) Relates to the Key Largo Fire Rescue and Emergency Medical Services District in Monroe County; creates Key Largo Fire Rescue and Emergency Medical Services District; provides for creation, status, charter amendments, boundaries, and purposes; provides for board of commissioners; provides for employment of district personnel; provides for election of board officers; provides for powers, duties, and responsibilities of board; provides for ad valorem taxes and impact fees. (HB 1291)Fla. Stat. § 212.055 (2003)  authorizes certain counties to levy surtax to fund trauma.  The law requires the Department of Health to promote the development of trauma centers and agencies and to perform assessment of the trauma system and report its findings to the governor and the legislature.  The law also sets boundaries for state trauma system plan. (SB 1762)

Fla. Stat. § 768.1335 (2003) creates the Emergency Medical Dispatch Act and provides a presumption of nonnegligence for certain individuals who use emergency dispatch protocols. The law also provides for grants to local agencies to support emergency medical dispatch. (HB 195)

Fla. Chap. 357 (2003) establishes the Lee County Trauma Services District for the purpose of financially supporting trauma services in Lee County. (HB 1055)

Fla. Stat. § 401.252 (1997) requires infants less than 28 days old or infants weighing less than five kilograms, who require critical care interfacility transport to a neonatal intensive care unit, to be transported in a permitted advance life support or basic life support transport ambulance, or in a permitted advanced life support or basic life support ambulance that is recognized by the Department of Health as meeting designated criteria for neonatal interfacility criteria care transport.

Fla. Stat. § 381.0408 (1997) creates the Public Health Partnership Council on Stroke to be responsible for making available state-of-the-art information on stroke education, prevention, and treatment to the public and to health care providers, including primary care physicians, emergency health care workers, long-term care providers, and rehabilitation providers.

Fla. Stat. § 768.13 (1997) provides legislative intent that an automatic external defibrillator may be used by any person for the purpose of saving the life of another person in cardiac arrest. The law requires persons who have access to or use an automatic external defibrillator to obtain appropriate training, register the defibrillator with the local emergency medical services medical director and activate the emergency medical services system as soon as possible upon use of the automatic external defibrillator. The law provides for immunity.

Fla. Stat. § 641.47 (1996) prohibits certain misrepresentations by HMOs on the availability of providers and specifies requirements for HMOs in providing emergency services and care. The act specifies an emergency medical condition with respect to a pregnant woman to mean there is inadequate time to effect safe transfer to another hospital before delivery, a transfer may pose a threat to the health and safety of the patient or fetus, or there is evidence of the onset and persistence of uterine contractions or rupture of the membranes.

Georgia Ga. Code Ann. § 31-11-2 (2003) provides for the licensure and regulation of air ambulance services.  Ga. Code Ann. § 31-11-53.1 (1998) authorizes appropriately trained people to use automated external defibrillators to save the life of a person in cardiac arrest. The law also states that any person, including those licensed to practice medicine, who gratuitously and in good faith render emergency care or treatment by the use of or provision of an automated external defibrillator, without objection of the injured victim or victims thereof, is not liable for any civil damages as a result of such care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment.Ga. Code Ann. § 31-11-9 (1997) provides for enforcement powers regarding the emergency medical services program and provides for certain enforcement powers regarding the Emergency Medical Services for Children Program.

Ga. Code Ann. § 31-11-82 (1997) prohibits insurance plans from denying payment for certain medical interventions for emergency conditions or when prospective authorization has been given.

Ga. Code Ann. § 33-20A-1, et seq. and § 33-21-1,13,18 (1996) enacts the Patient Protection Act, with provisions for the certification and regulation of managed health care plans by the commissioner of insurance. Among other provisions, the act uses the prudent layperson test to define emergency care services as services that are provided for a condition of recent onset and sufficient severity, that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that failure to obtain immediate medical care could result in placing the patient’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part. The act specifies that prior authorization is not required for the reimbursement of these services.

Guam 1996 Guam Laws, P.L. 23-77 designates the Guam Fire Department as the central agency for the overall operation of the island’s 911 emergency medical services system; requires the commission to adopt rules and regulations for the operation and implementation of the EMS System, the administration of the commission and the standards for certification of emergency medical services.
Hawaii Hawaii Rev. Stat. § 710 1014.5 (2005) Establishes the offense of misuse of 911 telephone service for accessing 911 and knowingly causing a false alarm or making a false complaint or report. Makes the offense of misuse of 911 telephone service a misdemeanor. (HB 313)2005 Session Law. Act No. 42 Makes an emergency appropriation for public safety answering points from the Wireless Enhanced 911 Fund. (HB 556)Hawaii Rev. Stat. § 321-226 (2003) requires ambulance service providers to establish and maintain alcohol and substance abuse policy for employees that the Department of Health deems is equivalent to, or exceeds the provisions of, the safety and health standards established by the federal Department of Transportation for holders of commercial driver’s licenses. (SB 1163)

Hawaii Rev. Stat. § 321-235 (2004) State shall not be liable for any claim of injury or death based on a failure to establish or continue emergency aeromedical services. (SB 3156)

Hawaii Rev. Stat. § 321-222, 224, 228 and 230 (2003) requires the Department of Health to integrate emergency aeromedical services into statewide emergency medical services.  This law also establishes the emergency aeromedical system and quality improvement committee and appropriates funds for aeromedical services for Maui county. (SB 745)

Hawaii Rev. Stat. § 321-221 et seq. (1999) establishes within the Department of Health the emergency medical service system for children, and defines “emergency medical services for children” as comprehensive emergency medical services including preventive, pre-hospital, hospital, rehabilitative, and other post-hospital care for children. The act establishes a state comprehensive emergency medical services system throughout the state to include but not be limited to emergency medical services for children. The system provides for personnel, personnel training, communications, emergency transportation, facilities, coordination with emergency services, coordination and use of available public safety agencies, promotion of consumer participation, accessibility to care, mandatory, standard medical record-keeping, consumer information and education, independent review and evaluation, disaster linkage, mutual aid agreements, and other.

Hawaii Rev. Stat. § 321-224 (1998) requires the Department of Health to plan and develop a statewide emergency aeromedical service system. A report to the Legislature is also required.

Hawaii Rev. Stat. § 453-2 and 663-1.5 (1998) allows any first responder personnel certified by the Department of Health and under the oversight of a licensed physician or any person who establishes or successfully completes an automatic external defibrillator training program administered by a physician to provide automatic external defibrillation. The law provides immunity from liability to any person who successfully completes a training program, uses an automatic external defibrillator in good faith, without remuneration or expectation of remuneration, to resuscitate a person in immediate danger and provides immunity from liability to any person, including an employer, who establishes an automatic external defibrillator program, from any act or omission of their trained people or employees acting in good faith.

Hawaii Rev. Stat. § 431:10A, 432:1 and 432D (1998) establishes that certain insurers and HMOs will cover emergency services provided 24 hours a day, seven days a week to members with emergency medical conditions without regard to whether the member, or an emergency provider treating the member, obtained prior authorization for these services. The law requires health plans to cover emergency services provided to a member at a nonparticipating emergency department up to the point of stabilization if the member presents oneself with an emergency medical condition; and due to circumstances beyond the member’s control, the member was unable to arrive at a participating emergency department without serious threat to life or health-based on the prudent layperson standard. The law also provides that health plans reimburse an emergency provider and an emergency department for any items or service not necessary to stabilize the patient but that are determined to be medically necessary to treat the illness that lead the patient to believe that he or she had an emergency medical condition, and that a reasonable patient would expect to receive from a physician at the time of presentation.

Hawaii Rev. Stat. § 321-224 (12) (1994) recognizes the need to develop emergency medical services for children whose needs are from those of adults, by establishing an emergency service system for children and requiring the different State Medical Services Advisory Committee to include a pediatrician.

Idaho Idaho Chapter No. 347 (2005) Appropriates funds to the Department of Health and Welfare for the Physical Health Services Program for fiscal year 2006, and limits the authorized full- time equivalent positions for the Physical Health Services Program; appropriates funds to the Department of Health and Welfare for the Emergency Medical Services Program for fiscal year 2006, and limits the authorized full-time equivalent positions; includes the laboratory services program. (HB 382)Idaho Code § 67-8801 et seq. (2005) Amends existing law to provide for Law Enforcement, Firefighting and EMS Medal of Honor Commission, and to provide for membership of the Department of Health and Welfare Bureau of Emergency Medical Services on the commission; defines terms. (SB 1119)Idaho Code § 46-1007, 1009 (2004) amends exisiting law to clarify jurisdiction of licensed emergency medical service agencies and to provide an exception to jurisdiction of the sheriff over certain search and rescue situations. (SB 1317)

Idaho Code § 39-1392a, 1392b, 1392e and 1393 (2004) amends exisiting law to revise definitions of “emergency medical services personnel” and “licensed emergency medical service” to provide that no disciplinary order of a certification for emergency medical services personnel shall be admissible in a civil proceeding seeking damages or other civil relief. (SB 1320)

Idaho Code § 56-1017 (2004)  amends existing law to provide for the adoption of rules and standards concerning the criteria for certified EMS personnels’ use of air medical services in emergency situations.

Idaho Code § 56-1021 (2004) amends existing law to provide that EMS personnel comply with DNR protocol.

Idaho Code § 31-3503 and 31-3503A (1997) amends existing law to provide for payment by county commissioners for emergency medical services for a nonresident to a certain level unless the nonresident is from a state which has a reciprocal agreement and qualifies for necessary medical services under that agreement. In addition, the law requires payment by the administrator of the catastrophic fund for emergency medical services for a nonresident unless the nonresident is from a state which has a reciprocal agreement.

Idaho Code § 41-3901 et seq. (1997) prohibits a Managed Care Organization (MCO) from requiring prior authorization for emergency services, and requires an MCO to respond to a member or provider’s request for prior authorization of a nonemergency service within two business days after complete member medical information is provided to the MCO, under most circumstances.

Idaho Code § 39-139 (1996) amends, adds to and repeals existing law to bring advanced life support and emergency medical services into a consistent program administered by the Board of Health and Welfare with medical oversight by the Board of Medicine.

Idaho Code § 39-167 (1996) requires the director of the Department of Health and Welfare to establish a statewide poison control center that provides 24-hour emergency telephone service determining whether treatment can be accomplished at the scene of the incident or transport to an emergency room or other facility is required and carrying out telephone follow-up to families and other individuals to assure that adequate care is provided. The act also provides 24-hour emergency telephone referral of poison victims, information to health professionals involved in management of poisoning and overdose victims and community poison prevention education programs. The director must establish a system for consulting with other state agency programs concerned with poisons and poisonings to develop the most coordinated and consistent response possible.

Illinois Ill. Rev. Stat. ch. 410 § 70/5 (2005) amends the Sexual Assault Survivors Emergency Treatment Act to allow alleged sexual assault survivors under the age of 18 to recieve medication such as HIV prophylaxis without parental consent. (S.B. 1878)Ill. Rev. Stat. ch. 210 § 85/6.14f, ch. 410 § 535/18 (2005) requires all hospitals to report any accident involving persons under 18 years of age being backed over or caught in the window of a motor vehicle. (H.B. 1350)Ill. Rev. Stat. ch. 30 § 105/5.625, 805/8.28 and ch. 410 § 4/30 (2003) creates the Physical Fitness Facility Medical Emergency Preparedness Act. Requires public and private indoor physical fitness facilities to develop and implement a plan for responding to medical emergencies. Requires each such facility to have at least one automated external defibrillator (AED) on the facility premises and to have trained AED users on staff. (HB 4232)

Ill. Rev. Stat. ch. 20 § 2310/2310-543 (2003) amends the Emergency Medical Treatment Act by providing that no person, facility, or entity call itself an “urgent”, “urgi-“, “emergi-“, or “emergent” care center or utilize any other term giving the impression that emergency medical treatment is provided by the person, facility, or entity unless it is the emergency room of a facility licensed as a hospital as a stand-alone emergency center.  The law also provides for penalties.

Ill. Rev. Stat. ch. 745 § 49/12 (1998) exempts from civil liability a person who takes a course under American Heart Association standards on emergency care of people in cardiac arrest, including the use of automatic external defibrillators for giving emergency aid.

Ill. Rev. Stat. ch. 730 § 5/5-9, ch. 705 § 105/27.6 and ch. 20 § 3960/6.01 (1996) allows the Illinois Department of Public Health to issue an annual Freestanding Emergency Center Demonstration License to a facility meeting several criteria. The center must have at least one board-certified emergency physician and a crew of paramedics present and must offer comprehensive emergency treatment 24 hours a day. The demonstration program will last until September 1998 but may be extended two more years. People convicted of firearm or drug crimes must pay a $100 “fee” to go to the Trauma Center Fund in the state treasury for distribution to hospitals designated as trauma centers.

Ill. Rev. Stat. ch. 305 § 5/6-1 et seq. (1996) amends the Public Aid Code to provide that a local governmental unit in any county may elect to provide, at a minimum, under the General Assistance Program, financial aid for emergency medical treatment, care and supplies only, deleting the term “necessary treatment, care and supplies required because of illness or disability.” The act requires that the General Assistance rules of the local governmental unit must specify the emergency treatment for which financial aid is provided and must include medical treatment, care and supplies necessitated by a condition that is life-threatening, will result in significant and permanent physical impairment, or requires immediate attention to relieve significant present physical pain and suffering. The act provides that a township, township supervisor, or township employee is not liable for injury caused by a decision to grant or deny aid under the Article on General Assistance.

Ill. Rev. Stat. ch. 210 § 50/1 et seq. (1996) allows the Illinois Department of Public Health to investigate a hospital in an Emergency Medical Services (EMS) system that goes on “bypass status” to determine whether that action was reasonable and to fine a hospital for unreasonably going on this status. The act also requires each EMS system and its trauma center medical directors’ committee to send the department, within 90 days after enactment, an internal disaster plan describing contingency plans to transfer patients to other facilities in a catastrophe.

Indiana Ind. Code § 12-17.6-1-2.6 and 12-17.6-4-3 (2000) defines emergency as a medical condition that arises suddenly and unexpectedly and manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent layperson who possesses an average knowledge of health and medicine to: place an individual’s health in serious jeopardy; result in serious impairment to the individual’s bodily functions; or result in serious dysfunction of a bodily organ or part of the individual. Deductibles, coinsurance, or other cost sharing is not permitted with respect to services for treatment of an emergency in an emergency department of a hospital. (SB 504)Ind. Code § 9-18-45, § 10-4-1-29 and § 10-9 (1999) specifies that the emergency management foundation will administer funds to the emergency medical services fund to pay for emergency medical services projects of the Public Safety institute. (HB 1448)Ind. Code § 16-31-6, 6.5 (1998) requires a person or entity who is not a health care provider or entity and who acquires an automatic external defibrillator (AED) to: ensure that AED users successfully complete an American Heart Association AED course or the equivalent and an American Heart Association cardiopulmonary resuscitation course or the equivalent, taught by a national or state approved instructor; ensure that the AED is maintained and tested according to the manufacturer’s operational guidelines; and enlist medical direction by a licensed physician in the use of the AED and cardiopulmonary resuscitation. It also requires a person or entity in possession of an AED to notify the ambulance service provider that serves the area where the person or entity is located, or the emergency medical services commission, of the acquisition and location of the AED. The law also requires that a person who uses an AED contact the ambulance service provider or a fire department that provides ambulance service to the area as soon as practicable and is immune from civil liability for any damages resulting from an act or omission not amounting to gross negligence or willful or wanton misconduct. It also provides that an individual, business or organization that allows a person who is trained to use the AED of the individual, business or organization to render emergency medical care, is immune from civil liability for damages resulting from an act or omission not amounting to gross negligence or willful or wanton misconduct by the user, or for acquiring or providing the AED to the user for the purpose of rendering the care.

Ind. Code § 27-13-36-9 (1998) requires HMOs to provide coverage for emergency services under a prudent layperson standard and access to medically necessary nonformulary drugs without prior approval. (HB 1309)

Ind. Code § 36-8-16.5 (1998) creates the wireless 911 advisory board and requires the board to levy a monthly fee on each commercial mobile radio service telephone number (other than a government telephone number) that has a billing address in the state. It also requires the board to create the Wireless Emergency Telephone System Fund for the purpose of creating and maintaining an enhanced wireless 911 system. The law makes using wireless emergency telephone service for a purpose other than obtaining public safety assistance a Class A misdemeanor.

Iowa Iowa Code § 331.385 and § 331.424C (2005) Relates to emergency services provided to residents of certain townships; includes effective date and retroactive applicability date provisions; relates to fire protection and emergency medical services; provides for a township levy. (HB 607)Iowa Code § 147A.6 (1997) provides that certification fees currently paid to the Iowa Department of Public Health by emergency medical care providers are to be deposited in the Emergency Medical Services Fund. This fund is to be used to assist counties by matching, on a dollar-for-dollar basis, moneys spent by a county for the acquisition of emergency medical services equipment and to provide grants to counties for education and training in the delivery of emergency medical services.Iowa Code § 80B.11C (1995) requires the director of the Iowa Law Enforcement Academy to adopt rules establishing minimum standards for the training of telecommunicators, which are people who receive requests for, or dispatch requests to, emergency response agencies that include law enforcement, fire, rescue, emergency medical services and other similar agencies.
Kansas Kan. Stat. Ann. § 12-4117(3), 20-367 and 28-172a (1999) creates a new act that develops a statewide trauma system plan, an advisory committee on trauma, and a trauma registry. The Secretary of Health and Environment will develop a statewide trauma system plan, using the1998 Kansas EMS-Trauma Systems Plan Study as a guide and including the establishment of regional trauma councils. The secretary is to plan, develop and administer a trauma registry to collect and analyze data on the incidence, severity and causes of trauma; provide technical assistance to regional councils; collect data elements for the trauma registry; develop a phased-in implementation schedule for each component of the trauma system; develop standard reports to be utilized by the regional trauma councils; assess the fiscal impact of and recommend funding sources for the trauma system and trauma registry; and prepare and submit an annual budget.Kan. Stat. Ann. § 65-6102 and 65-6110 et seq. (1998) adds to the types of emergency care some emergency medical services personnel may provide, creates new categories of certification, adds new grounds for disciplinary action and authorizes a physician assistant to give directions to certified emergency services personnel when authorized to do so by the physician who is responsible for the physician assistant. The act also creates a new statute to regulate the use of automatic external defibrillators. The law gives the Emergency Medical Services Board authority to set the qualifications of, approve training for and establish fees applicable to training officers. The new law also states that any qualified person may use an automated external defibrillator. A qualified person is defined as a person who has completed a course in cardiopulmonary resuscitation or a basic first aid course that includes cardiopulmonary resuscitation training, and has completed a course of training in the use of automated external defibrillators and has demonstrated proficiency in the use of an automated external defibrillator. Any qualified person who gratuitously and in good faith renders emergency care or treatment by the use of or the provision of an automated external defibrillator is not to be liable for civil damages as the result of such care or treatment or a failure to act in providing or arranging further medical treatment when the person acts as an ordinary reasonably prudent person would have acted under the same or similar circumstances.Kan. Stat. Ann. § 40-460 and 4603 (1997) requires health plans to cover emergency services according to the presenting symptoms as defined by the provider and to cover an emergency medical examination and stabilizing treatment regardless of whether prior authorization was obtained.
Kentucky Ky. Rev. Stat. § 211.953c and 211.950a (1998) requires the lead agency for emergency medical services in the Department for Health Services to engage in data collection specifically related to emergency medical services and trauma care of children and establishes the Emergency Medical Services for Children Program. The act also establishes the Emergency Medical Services for Children Advisory Committee.Ky. Rev. Stat. § 304.17A-005, 304-17A-200 and 304.17A-220 et seq. (1998) requires health benefit plans to educate enrollees on the availability of emergency and other medical services and requires health benefit plans to cover emergency department screening and stabilization services both in and out of network. The act also requires that emergency department personnel contact the patient’s primary care provider or health benefit plan as quickly as possible for follow-up and post-stabilization services to promote the continuity of care.Ky. Rev. Stat. § 311.660c, 314.181c, 216B-0415 and 216B.0417 (1998) specifies that the State Board of Medical Licensure has sole jurisdiction relating to complaints against a physician serving as medical director of an ambulance service and provides that the nursing board has sole jurisdiction relating to complaints against a nurse serving in a prehospital setting for an ambulance service.
Louisiana La. Rev. Stat. § 22:657(D)(2) (1997) requires an insurer to provide coverage and subsequently pay providers for emergency care, including screening, evaluation and stabilization of insureds who present themselves with an emergency medical condition. The act prohibits an insurer from retrospectively denying or reducing payments to providers for emergency care services except in the case where a provider falsifies information.La. Rev. Stat. § 36:259(M) (1997) requires the Department of Health and Hospitals to promulgate rules and regulations establishing a list of required medical and safety equipment that must be carried in every ambulance. The act also requires that the list to be consistent with the scope of practice for emergency medical technicians and to be based upon the recommendations of an advisory committee known as the Ambulance Standards Committee of the Emergency Medical Services Task Force as established by the assistant secretary of the Office of Public Health. The committee must include a representative from the American Academy of Pediatrics.La. Rev. Stat. § 45:816(9) and 840-844 (1997) requires telephone companies to provide all listed and unlisted numbers with emergency alert services.

La. Rev. Stat. §40:1231 et seq. and 1232 et seq. (1997) creates the Emergency Medical Services Certification Commission and establishes requirements for certification and grounds for disciplinary action. This act also addresses the scope of practice of emergency medical technicians.

La. Rev. Stat. §40:1300.101 et seq. (1995) creates the Emergency Medical Services for Children Program and requires the secretary of the Department of Health and Hospitals to hire a coordinator of program. The coordinator’s duties are delineated in the act, which also provides for program functions. In addition, the act creates an advisory council and allows the governor to appoint a minimum of 17 public members including a board certified pediatric surgeon, a pediatric critical care physician, a board-certified pediatric emergency physician, a pediatric psychiatrist, an emergency physician, an emergency medical technician, a paramedic, a family practice physician, two registered emergency nurses, a person representing the nursing schools, a person representing vocational technical emergency medical services education, an administrator of an ambulance service company, and three members with a non-medical background, two of whom are parents of children under the age of 18.

La. Rev. Stat. § 40:2109.3 (1993) requires, by January 1, 1995, registered nurses working primarily in hospital emergency rooms and pediatric wards to have trained in pediatric advanced life support and an emergency nursing pediatric course that includes training in pediatric trauma. Training taken in compliance with this requirement may be used to satisfy continuing education requirements.

Maine Me. Rev. Stat. tit. 29A, § 2054 (2) (2005) Permits municipal and volunteer firefighters and emergency medical services personnel to use any combination of 2 flashing red or white lights on personal vehicles while en route to or at the scene of fires or other emergencies; provides that such vehicles are covered by the rules of operation applying to authorized emergency vehicles. (Public Law No. 299)Me. Rev. Stat. tit. 14 § 8102 (1A); 32 § 93C (2005) Provides a limitation on the tort liability of ambulance services. It also prohibits anyone from requiring an ambulance service to maintain liability insurance coverage in excess of these limits. (Public Law No. 398)Me. Rev. Stat. tit. 25, § 2927 (3), (3A), tit. 32 § 85A (2005) Requires the Emergency Services Communication Bureau within the Public Utilities Commission, in consultation with the Emergency Medical Services Board, to adopt rules governing qualifications for and standards to be observed by providers of emergency medical dispatch services; requires transfer of funds to the Other Special Revenue Funds, Emergency Medical Services and the Emergency Services’ Board; provides for payment of emergency medical dispatch training costs. (Public Law No. 303)

Me. Resolve No. 63 (2005) Requires that the Emergency Services Communication Bureau ensures that all public safety answering points accept calls generated from automated emergency response telephones; Ensures that all dispatchers at public safety answering points are trained on telecommunications devices for the deaf and voice carry-over, hearing carry-over and captioned telephone equipment as well as any newly developed related equipment; conducts monthly, unannounced call tests.

2003 Me. H.B 632 protects health care practitioners responding to public health threats. Provides limited immunity from civil liability for health care practitioners and emergency medical service personnel who provide services in response to a public health threat.

Me. Rev. Stat. tit. 32, § 85 (6), § 90A, § 91A, and § 92 (2004) requires persons operating an ambulance to obtain certification of successful completion of a basic ambulance vehicle operator course by January 1, 2007.  (Public Law No. 559)

2004 Me. Resolve, Chap. 112 requires that schools ensure that all school personnel be trained in cardiopulmonary resuscitation.

2003 Me. Resolve, Chap. 23 directs the Commissioner of Public Safety to study the Emergency Medical Services System, including an independent assessment of the needs, design and structure of the organization and administration of the system at the regional and state levels and of the fiscal resources necessary to deliver emergency medical services at the regional and state levels. (HB 783)

Me. Rev. Stat. tit. 859, § 401 (1998) appropriates $25,000 for the Department of Public Safety to develop a training program for law enforcement and emergency medical services personnel to cover sudden infant death syndrome, critical incident stress management and interpersonal skills dealing with notification of death or serious injury.

Me. Rev. Stat. tit. 24, 83 § 7, 88 § 1, 9A (1998) requires that the basic emergency medical technician must complete a defined course.

Maryland Md. Education § 13-517 (2005) Establishes an Automated External Defibrillator (AED) Program Fund; repeals age limitations on operation of AEDs at authorized facilities; alters qualifications for EMS Board certificates for facilities that desire to make AEDs available. (HB 1054)Md. Public Local Laws of Prince George’s County, MD § 10-192.11 (2005) Requires the County Council of Prince George’s County to impose a public safety surcharge on new residential construction for which a preliminary plan has been approved after a certain date; specifies that payment of the surcharge does not eliminate any authority to apply certain tests concerning the adequacy of public safety facilities; requires distributions from the surcharge revenue to the Prince George’s County Police and Fire/EMS Departments to be used for specified purposes.Md. Health – General § 19-131, 19-706(ddd), 19-3A et seq. (2005) Relates to freestanding medical facilities for emergency services that are physically separate from a hospital; provides for a pilot project that does not require a certificate of need; provides for payment of claims by health maintenance organizations and the Medical Assistance Program; provides for review.(SB 231)

Md. State Personnel and Pensions § 26-201 (2005) Provides for aviators who operate an aircraft for the State Emergency Medical System and who are employed by the Department of State Police with membership in the Law Enforcement Officers’ Pension System; makes membership optional for specified aviators. (SB 510)

Md. Health – General §17-601 et seq. (2004) requires the Department of Health and Mental Hygiene to adopt regulations that require local jurisdictions to be informed of the location and nature of certain biological agents in the Biological Agents Registry. (HB 666)

Md. Transportation § 12-120, 13-912 et seq. and 16-111.2 (2004) repeals the termination of the Maryland Trauma Physician Services Fund. (HB 1467)

Md. Health – General Code § 4-301, 5-601 and 5-608 (1998) clarifies the meanings of “health care provider,” “health care practitioner” and “health practitioner” to include specified emergency medical services personnel and provides a penalty for unauthorized provision of emergency medical services.

Md. Health – General Code § 1-101, 15-101 and 15-114.1 (1998) requires the Department of Health and Mental Hygiene to reimburse public emergency service transporters for the costs of transportation and medical services provided to a Medicaid recipient during transport to specified facilities in response to a 911 call if the emergency service transporter charges for its services and requests reimbursement from the program.

Md. Health – General Code § 19-712.5 and 19-729 et seq. (1998) requires an HMO to reimburse a hospital emergency facility and provider, less any applicable copayments, for medical assessment and stabilization services rendered to meet the requirements of the federal Emergency Medical Treatment and Active Labor Act.

Md. Health – General Code § 5-608 et seq. (1997) provides immunity from criminal or civil liability for emergency medical services personnel for the provision of health care by these personnel under specified circumstances.

Md. Health – General Code § 19-705.1, 710, 712.5, 716 (1996) requires HMOs to reimburse hospital emergency facilities and providers (minus the applicable copayment) for medically necessary services provided to an HMO enrollee, if the HMO authorized, directed, referred, or allowed the use of the emergency facility and the services are related to the condition for which the member was allowed to use the emergency facility. The act stipulates that a provider is not required to obtain prior authorization or approval for payment from an HMO in order to obtain reimbursement. The act authorizes the hospital, provider, or insurer that has reimbursed a provider to collect or attempt to collect payment from an enrollee for a medical condition that is determined not to be an emergency. The act requires HMOs to provide to members a statement of the potential responsibility of the member to pay for services the member seeks to obtain from a provider, including a physician or hospital, that does not have a written contract with the HMO. In addition, HMOs must provide members with a description of procedures to be followed for emergency services, including the appropriate use of hospital emergency facilities; the appropriate use, location and hours of operation of any urgent care facilities operated by the HMO; and the potential responsibility of subscribers and enrollees for payment for emergency services or nonemergency services rendered in a hospital emergency facility.

Massachusetts Mass. Gen Laws ch. 111C § 3 (2003) regulates the color of emergency medical service vehicles operated by fire departments. (H.B. 1914)Mass. Gen. Laws ch. 29 § 6D and 7A § 13 (1999) dedicates $150,000 for the purposes of a federally funded grant entitled EMS for children.Mass. Gen. Laws ch. 111C § 14 and 112 § 12V (1998) provides that any person who is trained according to the standards and guidelines of the American Heart Association or the American National Red Cross in cardiopulmonary resuscitation (CPR) or the use of semi-automatic or automatic external defibrillators or any person who has successfully met the training requirements of a course in basic cardiac life support, conducted according to the standards established by the American Heart Association, who in good faith and without compensation renders emergency cardiopulmonary resuscitation or defibrillation in accordance with his training, other than in the course of his regular professional or business activity, to any person who apparently requires cardiopulmonary resuscitation or defibrillation, shall not be liable for acts or omissions, other than gross negligence or willful or wanton misconduct, resulting from the rendering of such emergency cardiopulmonary resuscitation or defibrillation.
Michigan Mich. Comp. Laws Ann. § 333.20919 (2003) amends the public health code to allow a pharmacist to dispense epinephrine to licensed medical responders. (Pub. Act 233)Mich. Comp. Laws Ann. § 550.1418 and 500.3406K (1998) requires health plans that provide coverage for emergency health services to provide coverage for medically necessary services provided to an insured for the sudden onset of a medical condition that manifests itself by signs and symptoms of sufficient severity including: severe pain such, that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to the individual’s health or to a pregnancy in the case of a pregnant woman; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part. An insurer may not deny payment for emergency health services up to the point of stabilization provided to an insured under this subsection because of either of the following: final diagnosis, or because prior authorization was not given by the health care corporation before emergency health services were provided.
Minnesota Minn. Stat. § 144E.01 (2003, 2004) modifies provisions relating to emergency medical services. Relates to the membership of the Emergency Medical Services Regulatory Board. Relates to the licensure of the emergency medical services personnel including training. (SB 1748)Minn. Stat. § 169A.52 (2003) modifies emergency 911 telephone system provisions to require multiline telephone systems to provide caller location. (SB 653)Minn. Stat. § 415.01 (2003) authorizes a city to collect unpaid emergency service charges.

Minn. Stat. § 604A.01 (1998) provides that volunteers and others who provide emergency medical care with an automatic external defibrillator without expectation of compensation are not liable for civil damages effective August 1, 1998. The new law broadens the existing “Good Samaritan statute,” which provides immunity to volunteers or others who give emergency care, unless a patient objects.

Mississippi Miss. Code Ann. § 41-59-3 et seq. (2004) prescribes certain requirements regarding the operation of ambulances and special use emergency medical service vehicles. Revises the definition of authorized emergency vehicle, provides the minimum distance from ambulances that other vehicles must maintain in certain situations, specifies the color of lights with which ambulances and 911 emergency communications district vehicles may be marked. Amended in 2004, revises the definition of first responder in the emergency medical services law by deleting the requirement for certification by they state department of health. Requires responders to be certified by the state department ofhealth, repeals sections authorizing certain emergency medical personnel to carry and administer ephinephrine. (HB 445)Miss. Code Ann. § 41-49-3 et seq. (1998) directs the State Department of Health to develop and administer a uniform statewide trauma care system to reduce death and disability resulting from traumatic injury. The act increases the assessment collected on traffic violations and implied consent law violations to help fund the trauma care system.Miss. Laws, Chap. 605 (1997) creates a Trauma Care Task Force to assist the State Department of Health in developing the Mississippi Trauma Care Plan. The task force will research financial mechanisms for offsetting uncompensated trauma care and present the findings of its study and the revised Trauma Care Plan to the Legislature during the 1998 Regular Session. (SB 2861)
Missouri Mo. Ann. Stat. § 190.375 (1998) allows any county, municipality or fire protection district to establish a program to allow the use of an automatic external defibrillator (AED) by emergency personnel or any person who has completed a course certified by the American Red Cross or American Heart Association that includes cardiopulmonary resuscitation training. The law states that people trained to use an AED and who render emergency care when appropriate by use of an AED without objection of the injured victim are not liable in tort.Mo. Ann. Stat. § 19.001 et seq. (1998) authorizes the continued operation of ambulance districts operating before August 1, 1998, in counties with a population of less than 400,000 and allows for a property tax to fund ambulance district pension programs. The law also establishes the State Advisory Council on Emergency Medical Services (EMS) to advise the governor, General Assembly and Department of Health on matters related to improving all aspects of emergency medical service and requires the selection of one physician from each EMS region to serve as regional EMS medical director. In addition, it authorizes the Department of Health to establish a pediatric EMS system, requires the department to license and regulate all ambulance services; requires the department to certify the various levels of technicians and regulate and accredit institutions that train EMS personnel; and requires the department to license and regulate all levels of emergency medical technicians. The law provides that health carriers and managed care plans pay benefits directly to ambulance services and prohibits them from discouraging the use of 911 systems when emergency service is needed. The Department of Health must collect data on all ambulance runs and injured patients and designate a hospital as an adult, pediatric or adult/pediatric trauma center. Finally, the law requires severely injured patients to be transported to a trauma center or the nearest appropriate facility for stabilization. Patients who are not severely injured will be transported to the hospital of choice.Mo. Ann. Stat. § 354.400 and 354.603 (1997) defines an emergency medical condition to include those conditions that would lead a prudent layperson to believe that immediate medical care is required. The law also requires health carriers to cover emergency services necessary to screen and stabilize an enrollee without prior authorization and directs them to deny post-stabilization services within 60 minutes of a request for authorization. The law also requires that enrollees have access to emergency care 24 hours per day, seven days per week.
Montana
Nebraska Neb. Rev. Stat. § 86-420 et seq. (2005) Relates to telecommunications service; provides powers and immunity from liability for the Public Service Commission; provides that the Public Services Commission may apply for or assist any political subdivision in applying for federal or other funds available for 911 or E911 services.Neb. Rev. Stat. § 71-51-102 (2005) Relates to emergency medical services; changes provisions relating to automated external defibrillator useNeb. Rev. Stat. § 20-127, 20-129 (2003) relates to rights of disabled persons, the licensing of pharmacists and mail service pharmacies, the licensing of respiratory care practitioners, the release of patient data under the Emergency Medical Services Act and automated external defibrillators. Redefines infectious diseases, opts out of federal food stamp provisions, eliminates provisions of Parkinson’s Disease Registry Act.

Neb. Rev. Stat. § 71-7605 et seq. (1998) creates the Excellence in Health Care Trust Fund which will be used for awarding grants for activities related to the design, maintenance, or enhancement of the statewide trauma system, support of emergency medical services programs and support for the emergency medical services programs for children.

Neb. Rev. Stat. § 71-2017 and 71-2029 (1997) establishes a statewide trauma system that is intended to identify facilities with specific capabilities to provide trauma care, so that trauma patients can be treated at a designated trauma center based on level of injury. The act creates the State Trauma Advisory Board, appointed by the director of the Department of Health and Human Services Regulation and Licensure, to advise on issues concerning trauma care, including the review of regional trauma plans and proposed departmental rules and regulations concerning trauma care. The act creates a trauma registry for data collection and allows for state and regional medical centers to provide oversight of the trauma system.

Neb. Rev. Stat. § 71-5108 (1997) rewrites and simplifies Nebraska law dealing with the provision of out-of-hospital emergency medical services and combines two existing oversight boards into one. The act establishes the Emergency Medical Services Act, replacing the First Responders Emergency Rescue Act and the Emergency Medical Technician-Paramedic Act. It also creates the Board of Emergency Medical Services, a 15-member board appointed by the governor, to replace the Board of Ambulance Advisors and the Board of Advance Emergency Medical Care. The act also collapses 28 categories of EMS providers into four: first responder, emergency medical technician, emergency medical technician-intermediate, and emergency medical technician-paramedic, and adopts the U.S. Department of Transportation’s curricula for emergency medical personnel training and permitted practices and procedures for certification.

Neb. Rev. Stat. § 44-5408 (1997) establishes standards for access to and delivery of emergency medical services, including services furnished outside the managed care network.

Nevada Nev. Rev. Stat. § 244A. 7641 et seq. (2005) Authorizes certain cities to establish wireless enhanced 911 service and impose surcharges for certain telephone services to pay for such service; requires a city council which imposes such a surcharge to create an advisory committee to develop a plan for the enhancement of the city’s telephone service for reporting emergencies.Nev. Rev. Stat. § 57.2 through 57.27 (1997) requires Managed Care Organizations (MCOs) to provide coverage for medically necessary emergency services without prior authorization.
New Hampshire N.H. Rev. Stat. § 21-P:12-d (2003) relates to relative fees for copies of motor vehicle records, relative to the fire standards, training and emergency medical services fund. Also relates to the relative fire standards, training and emergency medical services report and budget.2004 N.H. Laws, Chap. #171 establishes a division of emergency services, communications, and management, a division of fire standards and training and emergency medical services, and a division of fire safety in the department of safety.N.H. Rev. Stat. § 417-F (1997) establishes a definition of emergency services for health care insurance purposes to ensure consistent interpretation of those services covered. The act also requires that a participating provider or other authorized representative of the plan that gives prior authorization shall not rescind or modify the authorization after the health care provider has rendered the authorized emergency services care in good faith and the enrollee’s, insured’s, or subscriber’s coverage was effective on the date of service.

N.H. Rev. Stat. § 58-570A-2 (1996) allows the state police, county sheriffs, the office of emergency management, or the bureau of emergency communications to intercept, record, or disclose emergency telecommunications when necessary for the rendition of service or the protection of life or property.

New Jersey N.J. Stat.§ 52:17C-17 et seq. (2004) Imposes a fee on mobile telecommunications and telecommunications exchange customers for funding certain costs of the 9-1-1 system and emergency response.N.J. Stat. § 30:6D-5.1 et seq. and § 45:1-21.3 (2003) “Danielle’s Law”; requires certain staff working with persons with developmental disabilities or traumatic brain injury to call 911 emergency telephone service in life-threatening emergencies.N.J. Stat. § 2A:62A-1 et seq. (1998) supplements the “Good Samaritan Act,” and clarifies that the immunity from liability for civil damages afforded under that act extends to include municipal, county and state firefighters, both paid or volunteer, who render emergency assistance at the scene of an accident.

N.J. Stat. § 26:2K-39 (1996) expands the number of people who may provide cardiac defibrillation services to traffic accident victims or victims of other emergency situations by allowing police and fire personnel to be able to use automated external defibrillators.

New Mexico N.M. Stat. § 63-9D-3 et. seq (2005) Relates to 911 Fund; creates a surcharge and fund for financing emergency 911 service; provides for enhanced 911 services by local governing bodies and payment of costs.N.M. Stat. § 59A-57-1 et seq., 59a-1-16 and 59A-46-30 (1998) requires managed care organizations to provide emergency care without prior authorization requirements and appropriate out-of-network emergency care must not be subject to additional costs.1996 N.M. Laws, Sen. Jt. Mem. 32 requests that the Human Services Department include expanded emergency medical services for reimbursement under Medicaid or its successor program.

1996 N.M. Laws, Sen. Jt. Res. 31 resolves that the Department of Health study the feasibility of expanded emergency medical services in rural, medically underserved communities throughout the state as one major asset to be included in any managed care plans for the area. The department is requested to report its findings to the interim legislative health and human services committee at its October 1996 meeting.

New York 2005 N.Y. Laws, Chap. 516 creates the Child Abuse Medical Provider (CHAMP) program to better provide quality emergency medical services to children suspected of maltreatment. The program also provides education for mandated reporters of abuse and neglect. (S.B. 7643)2005 N.Y. Laws, Chap. 614 establishes the Emergency Medical Services for Children Act which provides emergency medical, trauma, and disaster care for all children. (A.B. 10690)2004 N.Y. Laws, Chap. 67  amends chapter 572 of the laws of 1994 by extending its provisions relating to emergency medical service in Suffolk county.

2003 N.Y. Laws, Chap. 217 Authorizes the county of Washington to impose a wireless communications service surcharge of not more than thirty cents per month on every wireless communication device with a primary place of use in such county; provides such surcharge moneys may be used for the payment of eligible wireless 911 service costs in such county. (SB 3206)

2003 N.Y. Laws, Chap 646 Increases the limit on loans from the emergency services revolving loan account from fifty to seventy-five percent of the project cost where such percentage is the lesser of such amount or $150,000 and removes prohibition of such loans where applicants seek or receive other loans or aid from the state for the same purpose. (SB 1444)

2003 N.Y. Laws, Chap. 600 Provides that a person shall be guilty of obstructing emergency medical services when he intentionally obstructs the efforts of emergency medical technicians in the performance of their duties; classifies such crime as a class A misdemeanor. (SB 1235)

2003 N.Y. Laws, Chap. 446 Designates county emergency medical services vehicles as emergency vehicles;defines county emergency medical services vehicle as a vehicle operated by a county emergency medical services coordinator or deputy county emergency medical services coordinator when operated in official capacity engaged in an emergency operation.

N.Y. Public Health Law § S 3000-b and S 300-9 (1998) authorizes a person, firm, organization, or other entity to possess and operate an automated external defibrillator (AED) pursuant to a collaborative agreement with an emergency health care provider. The law requires the collaborative agreement to contain a written agreement and written practice protocols. The law also specifies that the possession and operation of an AED must comply with specified requirements.

N.Y. General Municipal Law § 11-AA, 219-i, 11-AAA, 219-j and 219-p (1998) creates a defined benefit service award program for volunteer ambulance workers which authorizes certain political subdivisions to provide municipally funded, pension-like benefits based upon years of service in order to encourage the recruitment and retention of volunteers into emergency medical services.

N.Y. Public Health Law § S3003-b (1998) establishes a pilot project in the county of Orange under the control and supervision of the Hudson Valley Emergency Medical Service Council for the purpose of providing training to emergency medical service field providers by means of cable television or other broadcast medium with programming produced by a group such as the Fire Training Education Network. The council will prepare a report with recommendations concerning, among other things, the effectiveness of such programming in training emergency medical service field providers.

North Carolina N.C. Gen. Stat. § 143-135 (2005) Increases the force account limit of Davie County as to an emergency medical services station. (HB 997)N.C Gen. Stat. § 153A.225 (2003) Provides that when a local confinement facility transfers a prisoner to another local confinement facility the transferring facility shall provide health information about the prisoner. Amends the emergency medical services act, increases the criminal penalty for damaging a public building with an explosive or incendiary device.N.C Gen. Stat. § 110-102.1A (2003) prohibits the administration of medication to a child in a licensed or unlicensed child care facility without proper authorization from the child’s parent or guardian, except in the event of a medical emergency and the child’s parent cannot be reached.

N.C. Gen. Stat. § 62-B-1 et seq. (1998) establishes a system for charging cellular telephone users for enhanced 911 service and establishes a method of administering and distributing the collected funds. In December 1997, the Federal Communications Commission adopted an order requiring enhanced 911 capabilities for cellular telephones so that the physical location of the person using a cell phone to call for 911 services can be pinpointed when the 911 call is connected. In order to implement the enhanced 911 capabilities, there must be a mechanism for recovering the costs of the services.

N.C. Gen. Stat. § 58-3-176, 58-67-50(c) and 58-3-190 (1997) requires that coverage for emergency services must be provided to the extent necessary to screen and stabilize the person covered under the plan. If the emergency services are obtained from a hospital or other provider outside the managed care plan’s network, they must still be covered if a prudent layperson would have believed that a delay in seeking treatment would have worsened the emergency or if the patient went outside the plan network for emergency treatment for reasons beyond his or her control. The law also bans prior approval of emergency treatment if a prudent layperson acting reasonably would have believed an emergency existed. If prior approval has been given by the health benefit plan for emergency treatment, that approval cannot be retracted after the services have been rendered unless the provider or the patient materially misrepresented the patient’s condition. It requires that a managed care plan impose deductibles and copayments on emergency treatment equal to other treatment. The law states that managed care plans provide information to their enrollees on coverage of emergency medical services, the use of those services, cost-sharing provisions for emergency medical services, and accessibility and availability of those services.

North Dakota N.D. Cent. Code § 14-10-17.1 (2007) Directs the Interim State Health Council to study reasonable emergency medical services, including response times.  Directs the board of county comissioners in each county to review EMS coverage and report to the state department of health yearly, and directs that all districts that are taxed to pay for EMS actually receive those services. (HB 1162)N.D. Cent. Code § 50-24.1-15 (2005) Relates to provider appeals of medical assistance reimbursement denials; relates to prehospital emergency medical services. (HB 1206)N.D. Cent. Code § 57-39.2-04 (24) (2005) Relates to a sales and use tax exemption for sales made to an emergency medical services provider; provides an effective date. (HB 1368)

N.D. Cent. Code § 23-27-04.3 (2005) Relates to emergency medical services personnel training (HB1243)

Ohio Ohio Rev. Code § 5739.026 (2005) Permits the levy by a board of county commissioners of a sales and use tax for the purpose of providing emergency medical services of ambulance, paramedic and other medical services. (HB 13)Ohio Rev. Code § 2305.235 and 3701.85 (1998) provides that a person who has obtained appropriate training on how to perform automated external defibrillation (AED) and has successfully completed a course in cardiopulmonary resuscitation may perform AED. The law also provides civil and criminal immunity to a person who performs AED in good faith regardless of whether the person has appropriate training as long as the person does not commit willful or wanton misconduct or fail to activate an emergency medial service system. The law provides civil immunity to a physician who provides a prescription for an AED or consults with a person regarding the use and maintenance of a defibrillator and to a person who provides training in AED as long as the physician or person does not commit willful or wanton misconduct.Ohio Rev. Code § 9.60, 307.05, 505.37, 505.72, 2909.01, 4503.49, 4765.09, 4765.37 and 4766.13(1998) authorizes the Ohio Ambulance Licensing Board to adopt rules pertaining to the level of care each type of emergency medical service organization is authorized to provide and adds joint ambulance districts and joint emergency medical service districts to the list of entities that may subject emergency medical service organizations they operate to the Ambulance Licensing Law. The law also permits the board to license by endorsement, and issue vehicle permits to an emergency medical service organization that is regulated by another state.Ohio Rev. Code § 1753.28 (1997) defines emergency medical condition and requires a health insuring corporation to provide coverage for emergency health care services. The law also provides for coverage from nonparticipating providers and facilities under certain circumstances.

Ohio Rev. Code § 145.012, 307.052 et seq., 505.371, 505.38, 737.08, 737.22,  and 4765.01 et seq. (1996) requires the State Board of Emergency Medical Services to certify as a “first responder” an applicant who is a volunteer for a nonprofit emergency medical service organization or nonprofit fire department, unless this requirement is waived by the board, holds a certificate of completion of an accredited training program, passes a board-administered examination for first responders and meets other specified requirements. The act establishes the scope of practice of a first responder as one who is authorized to provide limited emergency medical services to patients until the arrival of an emergency medical technician and who must receive, unless communications fail, authorization before performing other services specified in the board’s rules. The act extends civil immunity to first responders similar to the immunity of other emergency medical technicians.

Oklahoma Okla. Stat. tit. 19 § 1710.1 (2005) Relates to counties and county officers; requires certain proceeds of emergency medical service districts to be used for specific purposes; provides for ownership or contracting of certain ambulance services; provides for retention of revenues for administrative expenses; provides for codification; provides an effective date. (HB 1926)Okla. Stat. tit. 63 § 1-2506, 2509, 2511 and 2516 (2005) Relates to public health and safety; relate to performance of medical procedures, ambulance service operations, the Emergency Medical Services Improvement Program and the Emergency Response Systems Development Advisory Council; authorizes complaint investigation; relates to Emergency Medical Technician Licensing. (SB 539)Okla. Stat. tit. 63 § 1-2503 (2005) Relates to emergency response systems; amends the Emergency Response Systems Development Act to provide that stretcher aid van transports may be made to and from any state veterans center. (SB 1012)

Okla. Stat. tit. 63 § 330.97 (2004) provides for a special assessment truama care fee for persons convicted of controlled substances-related offenses. The fee collected will be deposited into teh Trauma Care Assistance Revolving Fund. (HB 2600)

Okla. Stat. tit. 47 § 6-101 (2004)  requires that certain motor vehicle-related fines that are collected be deposited in the Trauma Care Assistance Revolving Fund.

Okla. Stat. tit. 21 § 1220 (2004) creates the Trauma Care Assistance Revolving Fund for the Department of Health within the State Treasury.  The law also provides details about the administration of the fund. (HB 2250)

Okla. Stat. tit. 63 § 1-2530 (2003) creates the Oklahoma Trauma Systems Improvement and Development Act. Provides for reimbursements, defines terms, provides promulgation of rules by the State Board of Health, specifies contents of rules, ect. (SB 1554)

Okla. Stat. tit. 63 § 1-2522 (2003) modifies methods of disbursement of certain funds. Creates the Task Force on Hospital Emergency Services and Trauma Care to study and assess date on availability and delivery of hospital emergency services and trauma care in the State. (SB 621)

Okla. Stat. tit. 63 § 330.95 (1997) provides for the continued orderly development of a statewide system of emergency medical care. The act establishes a fee, of not more than $5 per bed, for hospitals applying to the state Department of Health for recognition as a trauma facility and prohibits facilities from calling themselves trauma centers unless they meet the standards for recognition promulgated by the state Board of Health.

Okla. Stat. tit. 63 § 330.94, .95, .96 and 63 § 63-465.20, .21 (1997) funds emergency medical services. It dedicates 1/10 of one mill of the three-mill levy for emergency medical service district audits. Any funds remaining after the completion of the required audits will be applied to operating expenses of the district. It provides an additional $170,390 to the state Department of Health for the continued development of the trauma system.

Okla. Stat. tit. 63 § 1-706.11, .12 (1995) establishes the Oklahoma Medical Services for Children Resource Center within the pediatrics section of the University of Oklahoma College of Medicine to develop uniform statewide guidelines and protocols for the improvement of emergency pediatric services and to provide education and training for health care professionals and emergency services personnel in emergency pediatric medicine. The center will be operated under a contract between the College of Medicine and the State Department of Health, which has received federal funds for the improvement of emergency services.

Oregon Or. Rev. Stat. § 137.290A, 137.303, 353.450, 431.623, 442.505, 682.195 (1999) creates the Emergency Medical Services Enhancement Account which will fund the Emergency Medical Services and Trauma Systems Program. The law directs the Office of Rural Health to establish a grant program to disburse funds for purchase of equipment and improvement of existing emergency systems in rural communities and increases the Unitary Assessment by $3.00.Or. Rev. Stat. § 343, 743, 750.333A (1997) requires insurers offering a health benefit plan to provide coverage, without prior authorization, for emergency medical screening and stabilization of an emergency medical condition. The act requires coverage of services provided by a nonparticipating provider if a prudent layperson possessing an average knowledge of health and medicine would reasonably believe that the time required to go to a participating provider would put his or her health in serious jeopardy. The act also requires insurers to provide information to enrollees regarding emergency medical services. The measure prohibits an insurer from discouraging the appropriate use of 9-1-1 and from denying coverage for emergency services solely because 9-1-1 was used.Or. Rev. Stat. § 682.051 and 682.025 (1997) allows the emergency medical services system authority to provide patient information to a designated official of an ambulance service. The information, related to a patient’s admission, location, and diagnosis, is treated as confidential and a fee may be charged.
Pennsylvania Pa. Laws, Act 56 (2003) establishes a Statewide integrated wireless
E-911 State plan; establishing a Wireless E-911 Emergency Services Fund and
disbursements. Further provides for collection of an E-911 surcharge from wireless customers and for annual reporting. Also establishes a wireless E-911 Emergency Services Advisory Committee providing for rules and regulations.Pa. Cons. Stat. tit. 40 § 991.2001 et seq., 40 § 991.2111 et seq. (1998) adopts the prudent layperson standard for emergency services. The law states that a managed care plan shall ensure that emergency services are provided 24 hours a day, seven days a week and provide reasonable payment or reimbursement for those services.Pa. Laws, Act 112 (1996) requires insurers to provide reimbursement for “medically necessary” treatment received in an emergency room. The act defines “medical emergency” as a medical condition with acute symptoms of severity or severe pain for which care is sought as soon as possible after the medical condition becomes evident to the patient or the patient’s parent or guardian; and the absence of immediate medical attention could result in placing health in serious jeopardy, serious impairment to bodily functions, serious dysfunction of any body part, or other serious medical consequences. The act requires a hospital emergency room to provide an insurer with any claim for reimbursement of services information on the presenting symptoms of the insured as well as the services provided. An insurer must consider both the presenting symptoms and the services provided in processing a claim or reimbursement of emergency services (H.B 1415).
Puerto Rico Puerto Rico Laws, P. del S. § 240, Law Num 127 (1998) amends existing law to include people who have completed their first year of medical school on the list of people who are excluded from civil damages when performing emergency services.Puerto Rico Laws, P. de la C. 1375, Law Num 152 (1998) amends existing law to require the Department of Health to certify all people using electronic equipment to sustain life.
Rhode Island R.I. Gen. Laws § 42-12.3-4 (1999) requires the Department of Human Services to ensure that managed care organizations comply with the “prudent layperson” emergency care coverage standard.R.I. Gen. Laws § 23-4.1-16 (1997, 2005) establishes an Emergency Medical Services for Children (EMSC) program to facilitate the provision of emergency medical services to children. The objective and directive of the EMSC program shall be to continue, to the extent that funds through the federal government or private sources are available for this purpose, the growth and development of those programs already in effect pursuant to the federal grant received under the Maternal and Child Health Bureau. The law outlines program goals and objectives including the development and implementation of new statewide EMS treatment protocols that emphasize pediatric emergency care, along with supporting EMT education and training programs; the development of programs for parents and communities, which shall identify and reduce barriers to emergency care for children, provide information relating to health promotion and injury prevention, and focus on recognition of emergencies and improving access to and appropriate use of the local EMS systems; and the provision of periodic case reviews and follow-up to EMS personnel in pediatric cases. Amended in 2005 continues the Emergency Medical Services for Children program through several funding sources. The role of the program is to develop and implement protocols for EMS and pediatric care, develop a program for providers and families to eliminate barriers to emergency care for children and provide information on injury prevention, and complete periodic case reviews on EMS providers. (H.B. 5280)
South Carolina S.C. Code Ann. § 44-61-300 et. seq (1998) provides for the Emergency Medical Services for Children Program within the Department of Health and Environmental Control. The law outlines the program’s duties, which include the establishment of education programs in infant and children emergency care for emergency medical services personnel, and the development of guidelines for pediatric equipment for emergency departments and others. Working with the Data Oversight Council, the program will collect and analyze statewide pediatric emergency and critical care data from such medical services for the purpose of quality improvement by the facilities and services. In addition, the law provides for the confidentiality of the identities of patients, emergency and critical care medical services personnel and emergency and critical care medical services facilities referenced in information in connection with the program.S.C. Code Ann. § 38-71 (1998) requires that a patient at an emergency department must be screened, according to the federal Social Security Act, to determine if an emergency medical condition exists. A managed care organization must inform its insureds, enrollees, patients and affiliated providers about all policies related to emergency medical care access, coverage, payment and grievance procedures. A managed care organization which includes emergency medical care services as part of its policy or contract must provide coverage and must subsequently pay providers for emergency medical care services provided to an insured, enrollee, or patient who presents an emergency medical condition and may not retrospectively deny or reduce payments to providers even if the emergency medical condition is later determined not to have been an actual emergency. Exceptions to this include fraud and payment reduction due to deductibles. No managed care organization may engage in any practice to prohibit or discourage the appropriate use of the 911 emergency telephone system that may adversely affect the health of its enrollees.
South Dakota
Tennessee Tenn. Chapter No. 234 (2005) Concerns health care; authorizes all boards under division of health related boards and Tennessee emergency medical services board to use screening panels to assure that complaints against licensees have merit.Tenn. Code § 7-86-102 (2003) authorizes emergency communications districts to meet homeland security requirements and be self-supporting. Allows board of directors to determine emergency telephone service charge to fund 911 service. (SB 3115)Tenn. Code § 68-140-506 (2003) relates to emergency medical services. Provides that a separate license shall be required for each service and a separate permit required for each vehicle authorized for operation thereof. Provides that license permits issued in 2004 shall expire on June 30, 2005, and thereafter, licenses and permits shall expire on June 30 of the year after issuance. (HB 3192)

Tenn. Code § 68-140-525 (2003) authorizes employers to conduct criminal background checks on EMTs and EMT-Ps at the expense of the employer

Tenn. Code § 68-140-503 (2003) requires that one member of emergency medical services board, be a person with certification as EMT-P, EMT, or registered nurse, who may be from the list of nominees presented by the state professional fire fighters association.

Tenn. Code § 68-14-524 (2003) relates to the licensing of emergency medical services personnel. (HB 1069)

Tenn. Code § 7-61-104 (1998) authorizes certain counties and municipalities to enter into agreements with each other and other people providing countywide ambulance service to provide for joint emergency and non-emergency ambulance service.

Tenn. Code § 63-6-218 and 68-140 (1998) establishes procedures and protections for use of automatic external defibrillators to save the life of a person in cardiac arrest. Any person or entity who acquires an automatic external defibrillator is encouraged to register the existence and occasion of the defibrillator with the emergency communications district or the ambulance dispatch center of the primary provider of emergency medical services where the automatic external defibrillator is to be located. Any person, who in good faith and without compensation renders emergency care or treatment by the use of an automatic external defibrillator shall be immune from civil liability for any personal injury as a result of such care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment where the person acts as an ordinary reasonably prudent person would have acted under the same or similar circumstances.

Tenn. Code § 68-11-2 and 68-140-520 (1998) authorizes the Board for Licensing Health Care Facilities to promulgate regulatory standards to ensure the adequacy of emergency medical services for children. In developing the rules, the board is to be guided by national standards and will collaborate with, and draw upon the expertise of the committee on pediatric emergency care. The rules are to ensure the adequacy of emergency medical care for children relative to facility equipment standards, qualifications of facility personnel and continuing professional education of facility personnel. On or before July 1, 1999, and annually thereafter, a report on the current status of emergency medical services for children and on continuing efforts to improve such services will be submitted to specified committees of the legislature.

Tenn. Code § 56-7-2355 (1997) prohibits a health benefit plan from denying coverage for emergency services if the symptoms presented by an enrollee of a health benefit plan and recorded by the attending provider indicate that an emergency medical condition could exist, regardless of whether or not prior authorization was obtained to provide those services, and regardless of whether or not the provider furnishing the services has a contractual agreement with the health benefit plan for the provision of such services to such enrollee. Once an enrollee is stabilized, a health benefit plan may require as a condition of further coverage that a provider promptly contact the health insurer for prior authorization for continuing treatment, specialty consultations, transfer arrangements or other medically necessary and appropriate care for an enrollee. However, coverage of emergency services is subject to applicable copayments, coinsurance and deductibles.

Texas Texas Health and Safety Code § 773.015 (2005) Relates to allowing a law enforcement officer to take the fingerprints of people who receive emergency medical services in certain counties.(HB 805)Texas Loc. Gov. Code § 143.005 and Health and Safety Code § 104.042(e), 104.044, 191.008, 773.004, 773.042, 773.057(2005) Relates to exemptions from the law governing emergency medical services for certain transfer vehicles and staff and to the minimum qualifications for obtaining an emergency medical services provider license. (HB 1126)Texas Occupations Code § 204.2045 (2005) Relates to the authority of an emergency services district to obtain information to determine whether the district’s 9-1-1 emergency service fee is correctly billed, collected, and remitted. (HB 1577)

Texas Health and Safety Code § 780.001(2), (3) (2005) Relates to the operations of and the funding mechanisms for emergency medical services and trauma facility care in this state. (HB 2470)

Texas Health and Safety Code § 772.214 (2005) Relates to the emergency service fee rate in certain 9-1-1 emergency service districts. (SB 171)

Texas Health and Safety Code § 772.114 (2005) Relates to the emergency service fee rate in certain 9-1-1 emergency service districts. (SB 314)

Texas Health and Safety Code §241.153 (2005) Relates to allowing a hospital to release protected health information of a patient to emergency medical services providers for treatment, payment, and health care operations. (SB 1113)

Tex. Health & Safety Code § 773.003(10) and 773.0495 et seq (1997) establishes a “licensed paramedic” as a new level of emergency services personnel. The act provides for certification and qualifications for certification. The act extends confidentiality provisions to an organized committee of emergency services trauma systems. The act also allows a level 5 trauma center designation for trauma care facilities.

Tex. Health & Safety Code § 773.045(b)-(f) (1997) requires air ambulance companies based in this state or companies based in other states which transport patients on flights originating in this state to be licensed by the Texas Department of Health as emergency medical services providers. A licensed company is required to include information regarding the location of the company’s base operations in any advertising by the company in this state and is not prohibited from listing those locations in advertising, provided that all statutory requirements have been met. A company that is not located in this state but advertises within the state is required to have at least one physical location in the state. The act clarifies that an air transportation provider is not required to be licensed if, in addition to its normal service, it provides only voluntary, mercy-flight transportation at the company’s own expense.

Tex. Health & Safety Code § 777.010 et seq. (1997) authorizes the Texas Department of Health and the Advisory Commission on State Emergency Communications to jointly adopt rules permitting a poison control center to provide services for a health and human services region served by another poison control center. In coordination with the governor, the agencies are further authorized to enter into a contract and charge a fee to provide poison control services to individuals in another state or county, provided that the contract would not result in a decrease in services provided within the region served by a poison control center.

Tex. Health & Safety Code § 771.071(g) and 773.121 et seq. (1997) creates the emergency medical services and trauma care system fund, composed of money appropriated to the credit of the fund, including 9-1-1 emergency service fee revenue. From the fund, the Legislature may appropriate money to the Texas Department of Health for specific purposes, except that the commissioner of health must maintain a reserve of $250,000 for emergencies. Of the remainder after reserve subtraction, at least 70 percent is used to fund supplies, operational expenses, education and training, equipment, vehicles, and communications systems for local emergency medical services.

Tex. Health & Safety Code § 773.171 (1993) directs the Department of Health to develop a statewide pediatric emergency services system based on recommendations from a seven member advisory board appointed by the commissioner of health.

U.S. Virgin Islands
Utah Utah Code Ann. § 26-8a-405.1, 405.2, and 405.3 (2005) Amends the Emergency Medical Services System Act to clarify the procurement procedures that must be followed by a political subdivision issuing a request for proposal for emergency 911 ambulance services. (SB 216)Utah Code Ann. § 26-8a-405.1 and 405.2 (2004) This bill amends the definition of political subdivision in the Utah Emergency Medical Services System Act. (SB 91)Utah Code Ann. § 10-2-425 and 26-8a-414 (2004) modifies the Municipal Code and the Health Code by amending provisions related to emergency medical services provided by municipalities. (HB 225)

Utah Code Ann. § 26-8-7.5 (1998) permits a trained person to perform CPR and use a fully automatic external defibrillator without a license or certificate.

Utah Code Ann. § 26-8a-205 (1994) requires the State Medical Services Committee to establish a pediatric care quality improvement program and increase its membership from 13 to 14, adding one pediatrician.

Vermont Vt. Acts, Act 141 (1999) requires the Department of Health to establish a pediatric quality improvement resource program under the Emergency Medical Services Systems Act. (SB 54)
Virginia Va. Code 8.01-581.1 (2005) Provides that the Commissioner of Health shall issue permits for licenses for emergency medical services agencies and vehicles as needed to ensure compliance relating to reimbursement of ambulance services pursuant to Medicare and Medicaid. (Chapter 139)Va. Code 15.2-2307.1 (2005) Relates to the distribution of the Four For Life Fund of the funds collected from registration of commercial and personal motor vehicles; provides funding for emergency medical services, emergency medical personnel training, and recruitment of volunteer emergency medical personnel. (Chapter 194)2005 Va. Acts, Chap. 999  Provides for a Trauma Center fee charged to individuals for a DUI violation if they have been convicted previously of one or more such violation; establishes in the state treasury a special nonreverting fund to be known as the Trauma Center Fund; provides for grants from the Fund to appropriate trauma centers that routinely provide emergency medical care to victims of automobile accidents attributable to alcohol or drug use.

Va. Code 32.1-111.3 (2005) Adds several new requirements to the Statewide Emergency Medical Services Plan including a process for crisis intervention and peer support services for personnel; a statewide medical services for children program; emergency response teams and improvement of dispatching of emergency medical services; requires life support training.(Chapter 632)

Va. Code 46.2-411 (2005) Imposes an additional fee for reinstatement of suspended or revoked driver’s licenses; provides that the fees shall be paid into the Trauma Center Fund to defray costs of emergency medical care to victims of automobile accidents attributable to alcohol or drug use. (Chapter 886)

Va. Code 32.1-111.10 (2005) Increases the State Emergency Medical Services Advisory Board from 25 to 27 members appointed by the Governor. (Chapter 506)

Va. Code 15.2-995 (2005) States that each locality shall seek to ensure that emergency medical services are maintained throughout the entire locality. (HB 2521)

Va. Code § 32.1-111.10 (2005) Increases Board membership from 25 to 28 by including one representative from each of the regional emergency medical services councils. Current law states that each of the “eight” regional councils shall be represented, but 11 such councils actually exist. The bill also deletes an obsolete cross-reference regarding the automated external defibrillator registry, which no longer exists.(HB 2522)

Va. Code § 32.1-111.3 (2005) Amends the objectives of the Statewide Emergency Medical Services Plan by striking the now defunct registration program for automated external defibrillators and establishing new objectives including the identification and establishment of best practices for managing and operating agencies and improving and managing emergency medical response times as well as the establishment of a process for crisis intervention and peer support services for emergency medical services and public safety personnel; a statewide emergency medical services for children program; a statewide system of health and medical emergency response teams; and a program to improve dispatching of emergency medical services.  The bill further provides that the Board of Health’s Statewide Emergency Medical Services Plan may be posted on the Department of Health’s website to satisfy the publication requirement. (SB 1146)

Va. Code § 32.1-111.10 (2005) Increases the State Emergency Medical Services Advisory Board from 25 to 28 members appointed by the Governor. The change reflects the increase in the number of regional emergency medical services councils. (SB 1145)

Va. Code § 32.1-116.1 and 32.1-127.1:03 (2003) Authorizes licensed emergency medical services agencies to disclose prehospital patient care reports to law-enforcement officials upon request (i) when the patient is the victim of a crime or (ii) when the patient is in the custody of the law-enforcement officials and has received emergency medical services or has refused emergency medical services. This bill also includes technical amendments.

Va. Code § 8.01-225, 32.1-111.4, and 54.1-3408 (2003) Requires the Board of Health’s regulations on certification of emergency medical services technicians to allow certain levels of EMTs to possess and administer epinephrine in emergency cases of anaphylactic shock. Clarifying amendments are added to the Good Samaritan law and to the Drug Control Act to reinforce this authorization. (SB 1224)

Va. Code § 8.01-66.2, 8.01-66.5, 8.01-66.7, and 8.01-66.8 (2003) Increases from $50 to $200 the maximum lien that an ambulance service may have on the personal injury claim of the person to whom the ambulance service was provided, and incorporates the lien provisions for ambulance service into Title 8.01, Chapter 3, Article 7.1. The lien amount for ambulance service has not been amended since it was enacted in 1956. (SB 841)

Va. Code § 56.484.12 and 56.484.17 (2003) Specifies how CMRS providers can collect the wireless E-911 surcharge. Under the current statute, the surcharge is defined as a monthly charge billed monthly. Because prepaid wireless is not billed monthly, the bill provides that the surcharge may be collected either through monthly billing, adding the surcharge at the point of sale, or deducting an equivalent number of minutes. (SB 942)

Va. Code § 56-484.17 (2004) Eliminates the requirement that the Wireless E-911 Board make qualifying payments to eligible operators and providers in four equal payments at the beginning of each calendar quarter, and authorizes the Board to make the payments on an alternate schedule approved by the Board.(SB 171)

Va. Code § 38.2-401 (2004) Requires the Executive Director of the Department of Fire Programs to establish written standards for determining the extent to which clients outside the Commonwealth shall be financially responsible for the cost of fire and emergency services training provided by the Department of Fire Programs. Revenues generated shall be retained in the Fire Programs Fund and used solely for providing additional training to members of Virginia’s fire and emergency services. (SB 154)

Va. Code § 32.1-127.1:03 and 40.1-8 (2004) Directs licensed emergency medical services agencies to release to the Commissioner of the Department of Labor and Industry, or his designee, certain prehospital patient care reports when such records are requested for a patient who has suffered an injury, disability, or death resulting from an accident or illness while engaged in his employment. The Commissioner shall only disclose such information in compliance with federal regulations and the Health Insurance Portability and Accountability Act of 1996. (SB 136)

Va. Code § 57-60 (2004) Provides an exemption for regional emergency medical services councils from the registration requirements that charitable organizations that solicit contributions must satisfy. Such organizations will still be subject to the remaining provisions concerning solicitation found in Chapter 5 of Title 57 of the Code of Virginia. (SB 61)

Va. Code § 46.2 -694 (2004) Relates to the distribution of the Four For Life Fund of the funds collected from registration of commercial and personal motor vehicles. Provides fudning for emergency medical services, emergency medical personnel training and recruitment of volunteer emergency medical personnel.

Va. Code § 32.1-111.1, 32.1-111.6, and 32.1-111.10 (2004) Requires the Commissioner of Health to issue permits or licenses for emergency medical services agencies and vehicles as needed to ensure compliance with federal regulations relating to reimbursement of ambulance services pursuant to Medicare and Medicaid. (HB 627)

Va. Code § 8.01-581.1 (2002) Adds emergency medical care attendants or technicians who provide fee-based emergency medical services to the definition of health care providers for purposes of the limitation on liability for medical malpractice actions.

Va. Code § 32.1-111.10 (2002) Expands the State Emergency Medical Services Advisory Board by one member and adds a Virginia professional firefighter.

Va. Code § 61.1-340 (2000) relates to the emergency admission of minors for inpatient treatment. A minor may be taken into custody and admitted for inpatient treatment. If the minor is admitted to a willing facility, the temporary detention order shall be effective until such time as the juvenile and domestic relations district court schedules a hearing.

Va. Code § 54.1-2969 (2000) mandates that whenever delay in providing medical or surgical treatment to a minor may adversely affect such minor’s recovery and no person authorized in this section to consent to such treatment for such minor is available within a reasonable time under the circumstances, no liability shall be imposed upon qualified emergency medical services personnel at the scene of an accident, fire or other emergency, a licensed health professional or a licensed hospital by reason of lack of consent to such medical or surgical treatment. However, in the case of a minor fourteen years of age or older who is physically capable of giving consent, such consent shall be obtained first. Whenever delay in providing transportation to a minor from the scene of an accident, fire or other emergency prior to hospital admission may adversly affect such minor’s recovery and no person authorized in this section to consent to such transportation for such minor is available within a reasonable time under the circumstances, no liability shall be imposed upon emergency medical services personnel by reason of lack of consent to such transportation. However, in the case of a minor fourteen years of age or older who is physically capable of giving consent, such consent shall be obtained first.

Va. Code § 32.1-111.3 (1998) requires the Board of Health to develop and maintain a statewide prehospital and interhospital trauma triage plan as a component of the Statewide Emergency Medical Services Plan to provide rapid access to appropriate trauma care for pediatric and adult trauma patients.

Va. Code § 38.2-4312.3 (1997) provides members of health maintenance organizations (HMOs) with access to a system of 24-hour emergency services. This act directs HMOs to provide either 24-hour access to medical care or 24-hour access by telephone to a physician or licensed health professional with appropriate medical training. HMOs must reimburse hospital emergency facilities for medical screening and stabilization rendered to meet the requirements of the Federal Emergency Medical Treatment and Active Labor Act under certain conditions.

Washington Wash. Laws of 1999, Chapter 160 requires foster parents to complete first aid/CPR and HIV/AIDS training to become licensed. The department of social and health services may waive the first aid/CPR and/or HIV/AIDS training if the foster parent has current certification or has professional or educational background in this area. The department shall provide all new and current foster parents with first aid/CPR and HIV/AIDS training.Wash. Rev. Code § 70.54 (1998) provides immunity from civil liability for entities that maintain and use semi-automatic defibrillators in accordance with specified guidelines as long as their actions do not constitute gross negligence or willful or wanton misconduct. In addition, immunity from civil liability is provided for individuals using a semi-automatic defibrillator in an emergency setting if the individual is acting under the good samaritan statute.Wash. Rev. Code § 70.168.135, 70.168.040, 46.63.110, 3.62.090, 46.12.042, 63.14.010 and 63.14.130 (1997) establishes a $6.50 fee collected from consumers at the time of title transactions on motor vehicles to fund the state trauma care system’s uncompensated trauma care. Car dealers keep $2.50 of the fee and the remainder is deposited into the emergency medical services and trauma care system trust account. A $5 surcharge is assessed on all traffic infractions. This fee cannot be waived or reduced. Money collected from this fee is transmitted to the emergency medical services and trauma care system trust account.
West Virginia W. Va. Act No. 247 (2005) Adjusts the formula by which the Public Service Commission distributes wireless enhanced 911 fee revenues to the counties; raises the fee; earmarks a percentage to the State Police; earmarks an amount for construction of wireless towers; creates the Enhanced 911 Wireless Tower Assistance Fund to be administered by the Public Service Commissions; allows counties which consolidate government services to receive one percent of fee for each county consolidated.W. Va. Act No. 122 (2005) Changes the name of the office of emergency services to the Division of Homeland Security and Emergency Management; specifies additional responsibilities; provides for coordination with the Department of Military Affairs and Public Safety.W. Va. Act No 213 (2005) Provides for continuation of the emergency medical services advisory council.

W. Va. Code § 5-16-8 (1998) provides a detailed and standardized definition of emergency services under the types of services that various health insurers and health care organizations are required to cover. The new definition includes services provided in or by an ambulance and other prehospital services to the extent necessary to screen and stabilize the covered person. The act provides detailed procedures for the coverage of emergency services, including a prudent layperson standard for use in determining if coverage should be provided.

W. Va. Code § 24-6-6b and 11 et seq. (1997) establishes a wireless enhanced 911 fee to help offset the cost to counties for their 911 emergency telephone systems. The fee is set at $.75 per month for each valid retail commercial mobile radio service subscription. The fee is to be recalculated every two years by the Public Service Commission after an audit is conducted.

W. Va. Code § 33-25-8d (1996) requires that health insurance policies include coverage for emergency services, with the same deductibles, coinsurance and other limitations as apply to other covered services. Preauthorization or precertification may not be required.

W. Va. Code § 33-25A-8d (1996) provides that when an HMO enrollee receives covered emergency health care services from a noncontracting provider, the HMO is responsible for payment of the provider’s normal charges for those health care services, exclusive of any applicable deductibles or copayments. In addition, the act expresses legislative intent that ambulance services in the state are performed by various volunteer emergency service squads, county operations and small businesses that may lack the sophistication and expertise required to negotiate a contract with an HMO for the provision of ambulance services and that the best interests of the state require the continued development and preservation of an emergency medical system to serve all the citizens of the state, including those who do not receive health care services through an HMO. The act directs the commissioner of insurance to promulgate legislative rules to regulate contracting for emergency medical services, including reimbursement for nonemergency transportation by non-participating providers and the appropriate use of 911 or community dispatching.

Wisconsin Wis. Stat. § 15.197(25) and 146.56 (1998) creates in the Department of Health and Family Services a trauma advisory council and provides that no later than July 1, 2001, the department shall develop and implement a statewide trauma care system. The law also states that the department shall seek the advice of the statewide trauma advisory council in developing and implementing the system and authorizes the department to promulgate rules to develop and implement the system. The law also requires the department and the council to prepare a joint report on the development and implementation of the statewide trauma care system.Wis. Stat. § 40.51(8), 40.51(8m), 60.23(25), 66.184, 120.13(2)(g), 185.981(4t), 185.983(1), 111.91(2)(o) and 632.85 (1998) states that if a health care plan or a self-insured health plan provides coverage of any emergency medical services, the plan shall provide coverage of emergency medical services that are provided in a hospital emergency facility and that are needed to evaluate or stabilize an emergency medical condition. A health care plan or a self-insured health plan that is required to provide such coverage may not require prior authorization for the provision or coverage of the emergency medical services.Wis. Stat. § 9426(1k)(1m), 90b-bq, 268f and 276bm (1998) states that if a managed care plan provides coverage of emergency services, the plan must cover emergency medical services that are obtained without prior authorization and that are provided to an individual who has coverage under the plan as a dependent child and who is a full-time student attending school outside of the geographic service area of the plan.
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