By: Zaffirini S.B. No. 1263
A BILL TO BE ENTITLED
AN ACT
1-1 concerning the provision of emergency medical services for
1-2 children; establishing the Emergency Medical Services for Children
1-3 Program.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. LEGISLATIVE FINDINGS. The legislature finds and
1-6 declares that:
1-7 (1) traumatic injuries, such as automobile accidents,
1-8 bicycle accidents, drownings, and poisonings, are the most common
1-9 cause of death in children over the age of one, and children have a
1-10 high death rate in these emergency situations;
1-11 (2) children react differently than adults to stress,
1-12 metabolize drugs differently, and suffer different illnesses and
1-13 injuries, and, because of these differences, children's emergency
1-14 medical needs should be recognized;
1-15 (3) emergency medical services training programs focus
1-16 on adults and therefore offer fewer hours of pediatric training; in
1-17 addition, many emergency medical services personnel have no
1-18 clinical experience with children, indicating the need to improve
1-19 training of those personnel in pediatric emergencies; and
1-20 (4) it is the public policy of this state that
1-21 children are entitled to comprehensive emergency medical services,
1-22 including prehospital, hospital, and rehabilitative care.
1-23 SECTION 2. DEFINITIONS. In this Act:
2-1 (1) "Advanced life support" means an advanced level of
2-2 prehospital, interhospital, and emergency service care which
2-3 includes basic life support functions, cardiac monitoring, cardiac
2-4 defibrillation, telemetered electrocardiography, administration of
2-5 antiarrhythmic agents, intravenous therapy, administration of
2-6 specific medications, drugs, and solutions, use of adjunctive
2-7 ventilation devices, trauma care, and other techniques and
2-8 procedures authorized in writing by the commissioner pursuant to
2-9 department regulations and the Administrative Procedure and Texas
2-10 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes).
2-11 (2) "Advisory council" means the Emergency Medical
2-12 Services for Children Advisory Council established pursuant to
2-13 Section 5 of this Act.
2-14 (3) "Basic life support" means a basic level of
2-15 prehospital care which includes patient stabilization, airway
2-16 clearance, cardiopulmonary resuscitation, hemorrhage control,
2-17 initial wound care and fracture stabilization, and other techniques
2-18 and procedures authorized by the commissioner.
2-19 (4) "Commissioner" means the commissioner of health.
2-20 (5) "Coordinator" means the person coordinating the
2-21 program within the Office of Emergency Medical Services in the
2-22 department.
2-23 (6) "Department" means the Texas Department of Health.
2-24 (7) "Emergency medical services personnel" means
2-25 persons trained and certified or licensed to provide emergency
3-1 medical care, whether on a paid or volunteer basis, as part of a
3-2 basic life support or advanced life support prehospital emergency
3-3 care service or in an emergency department or pediatric critical
3-4 care or specialty unit in a licensed hospital.
3-5 (8) "Prehospital care" means the provision of
3-6 emergency medical care or transportation by trained and certified
3-7 or licensed emergency medical services personnel at the scene of an
3-8 emergency and while transporting sick or injured persons to a
3-9 medical care facility or provider.
3-10 (9) "Program" means the Emergency Medical Services for
3-11 Children Program established pursuant to Section 3 of this Act and
3-12 other relevant activities conducted by the Office of Emergency
3-13 Medical Services of the department in support of appropriate
3-14 treatment, transport, and triage of ill or injured children in the
3-15 State of Texas.
3-16 SECTION 3. ESTABLISHMENT. (a) The Emergency Medical
3-17 Services for Children Program is established within the Office of
3-18 Emergency Medical Services of the department.
3-19 (b) The commissioner shall hire a full-time coordinator for
3-20 the program in consultation with and on the recommendation of the
3-21 advisory council.
3-22 (c) The coordinator shall implement the program following
3-23 consultation with and on the recommendation of the advisory
3-24 council. The coordinator shall serve as a liaison to the advisory
3-25 council.
4-1 (d) The coordinator may employ professional, technical,
4-2 research, and clerical staff as necessary within the limits of
4-3 available appropriations. The provisions of Title 9, Health and
4-4 Safety Code, apply to all personnel so employed.
4-5 (e) The coordinator may solicit and accept grants of funds
4-6 from the federal government and from other public and private
4-7 sources.
4-8 SECTION 4. PROGRAM FUNCTIONS. The functions of the program
4-9 include but are not limited to establishing:
4-10 (1) training and continuing education programs for
4-11 emergency medical services personnel that include training in the
4-12 emergency care of infants and children;
4-13 (2) guidelines for referring children to the
4-14 appropriate emergency treatment facility;
4-15 (3) pediatric equipment guidelines for prehospital
4-16 care;
4-17 (4) guidelines for hospital-based emergency
4-18 departments appropriate for pediatric care to assess, stabilize,
4-19 and treat critically ill infants and children, either to resolve
4-20 the problem or to prepare the child for transfer to a pediatric
4-21 intensive care unit or a pediatric trauma center;
4-22 (5) guidelines for pediatric intensive care units,
4-23 pediatric trauma centers, and intermediate care units fully
4-24 equipped and staffed by appropriately trained critical care
4-25 pediatric physicians, surgeons, nurses, and therapists;
5-1 (6) an interhospital transfer system for critically
5-2 ill or injured children; and
5-3 (7) pediatric rehabilitation units staffed by
5-4 rehabilitation specialists and capable of providing any service
5-5 required to assure maximum recovery from the physical, emotional,
5-6 and cognitive effects of critical illness and severe trauma.
5-7 SECTION 5. EMERGENCY MEDICAL SERVICES FOR CHILDREN ADVISORY
5-8 COUNCIL. (a) The Emergency Medical Services for Children Advisory
5-9 Council is created to advise the Office of Emergency Medical
5-10 Services of the department and the coordinator of the program on
5-11 all matters concerning emergency medical services for children.
5-12 The advisory council shall assist in the formulation of policy and
5-13 regulations to effectuate the purposes of this Act.
5-14 (b) The advisory council consists of a minimum of 15 public
5-15 members to be appointed by the governor with the advice and consent
5-16 of the Senate for three-year terms. The membership of the advisory
5-17 council shall include: one practicing pediatrician, one pediatric
5-18 critical care physician, one board-certified pediatric emergency
5-19 physician, and one pediatric psychiatrist, to be appointed on the
5-20 recommendation of the Texas chapter of the American Academy of
5-21 Pediatrics; one pediatric surgeon, to be appointed on the
5-22 recommendation of the Texas chapter of the American College of
5-23 Surgeons; one emergency physician, to be appointed on the
5-24 recommendation of the Texas chapter of the American College of
5-25 Emergency Physicians; one emergency medical technician and one
6-1 paramedic, to be appointed on the recommendation of the Texas State
6-2 First Aid Council; one paramedic, to be appointed on the
6-3 recommendation of the state mobile intensive care advisory council;
6-4 one family practice physician, to be appointed on the
6-5 recommendation of the Texas chapter of the Academy of Family
6-6 Practice; two registered emergency nurses, one to be appointed on
6-7 the recommendation of the Texas State Nurses Association and one to
6-8 be appointed on the recommendation of the Texas chapter of the
6-9 Emergency Nurses Association; and three members, each with a
6-10 nonmedical background, two of whom are parents with children under
6-11 the age of 18, to be appointed on the joint recommendation of the
6-12 Association for Children of Texas and the Junior Leagues of Texas.
6-13 (c) Vacancies on the advisory council shall be filled for
6-14 the unexpired term by appointment of the governor in the same
6-15 manner as originally filled. The members of the advisory council
6-16 shall serve without compensation but shall be reimbursed for
6-17 necessary expenses incurred in the performance of their duties.
6-18 The advisory council shall elect a chairperson, who may select from
6-19 among the members a vice-chairperson and other officers and may
6-20 appoint subcommittees deemed necessary or appropriate. The
6-21 advisory council may further organize itself in any manner it deems
6-22 appropriate and enact bylaws deemed necessary to carry out the
6-23 responsibilities of the advisory council.
6-24 SECTION 6. RULE-MAKING AUTHORITY. The commissioner shall
6-25 adopt rules and regulations necessary to effectuate the purposes of
7-1 this Act, pursuant to the Administrative Procedure and Texas
7-2 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes).
7-3 SECTION 7. This Act takes effect September 1, 1993.
7-4 SECTION 8. The importance of this legislation and the
7-5 crowded condition of the calendars in both houses create an
7-6 emergency and an imperative public necessity that the
7-7 constitutional rule requiring bills to be read on three several
7-8 days in each house be suspended, and this rule is hereby suspended.