BILL ANALYSIS C.S.H.B. 235 By: Driver March 2, 1995 Committee Report (Substituted) BACKGROUND Under current state law, many emergency communication centers do not provide pre-arrival emergency medical information because of civil liability concerns and the cost and lack of availability of appropriate training for their employees and volunteers. PURPOSE This bill encourages emergency communication centers to provide pre-arrival emergency medical information to callers by providing for training and protocols to be offered by the Texas Department of Health and by granting immunity from civil liability for damages resulting from emergency medical information given by trained employees or volunteers of an emergency communication center following rules established by the Board of Health. RULEMAKING AUTHORITY This bill delegates rulemaking authority to Texas Board of Health in Sections 1 and 4. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subtitle B, Title 9, Health and Safety Code, by adding a new Chapter 778, "Emergency Medical Information Services" with the following sections: Sec. 778.001. Defines terms. Sec. 778.002 Permits trained employees and volunteers of an emergency communication center to provide emergency medical information of a type easily communicated by telephone to a person not trained in emergency care. Sec. 778.003. Requires the Texas Board of Health ("the board") to adopt minimum standards for emergency medical information training programs, the form and content of information to be provided, and the protocol for delivery of the information, and for maintaining records of calls. Requires the board to consider nationally recognized training programs and training programs offered in this state. Sec. 778.004. Requires that the employee or volunteer providing emergency medical information services under this chapter must have completed a training program approved by the Department of Health ("the department"). Prohibits the department from charging a fee for approval of a program. Permits the department to require a trained employee or volunteer to demonstrate competence in providing emergency medical information or to require that the training program include a demonstration of competence. Permits department to charge fee for reasonable expenses relating to the demonstration of competence. Sec. 778.005. Requires the department to approve a protocol for the delivery of emergency medical information if the protocol meets the minimum standards set by the board. Prohibits the department from charging a fee for approval of a protocol. Sec. 778.006. Requires the department to assist emergency communication centers, local governmental units, and other entities that provide emergency medical information and to develop a model training program and materials that these entities may use. Permits department to charge a reasonable fee for materials and services provided under this section. Sec. 778.007. Provides that an emergency communication center is not required to provide emergency medical information. Sec. 778.008. Grants immunity from liability under the Tort Claims Act for an emergency communication center and an employee or volunteer of an emergency communication center for property damage, personal injury, or death arising in connection with the provision of or failure to provide emergency medical information under the provisions of this chapter. SECTION 2. Amends Section 84.007, Civil Practice and Remedies Code, in the Charitable Immunity and Liability Act of 1987, to exclude claims governed by Section 778.008, Health and Safety Code. SECTION 3. Amends Section 101.062, Civil Practice and Remedies Code, in the Tort Claims Act, to exclude claims against an emergency communication center governed by Section 778.008, Health and Safety Code. SECTION 4. Effective September 1, 1995. Permits local governmental unit or other entity to submit a training program and protocol and to identify emergency communication centers to the department on or after the effective date. Provides that a training program or protocol submitted between September 1 and December 31, 1995 is approved on the date it is submitted to the department, and approval continues until withdrawn by the department. Provides that an emergency communication center identified for the provision of emergency medical information between September 1 and December 31, 1995 is considered to be of a type designated by board rule until that designation is withdrawn by the department. Requires that not later than January 1, 1996, the board must adopt minimum standards and rules required by this chapter. SECTION 5. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE Original applied to a public safety answering point providing emergency medical information through a 9-1-1 service. Substitute applies to an emergency communication center, defined as a location staffed and equipped to receive and either transmit or dispatch emergency calls. Original required employee to complete a training program approved by the Board of Health, permitted board to require employee to pass an examination, and required board to adopt a manual and a protocol for the delivery of emergency medical information. Substitute requires board to adopt minimum standards for emergency medical information training programs, the form and content of information that may be provided, and the protocol of delivery of the information. Substitute requires board to consider nationally recognized training programs and training programs offered in this state. Substitute requires that employee or volunteer providing emergency medical information under this chapter must be trained in a program approved by the Department of Health. Substitute prohibits the department from charging a fee for approval of a program. Substitute permits department to require employee to show competence in providing emergency medical information. Substitute requires department to approve a protocol for delivery of emergency medical information, and the department is prohibited from charging a fee for approval of a protocol. Substitute requires department to assist emergency communication centers and to develop a model training program and materials for which they can charge a fee not to exceed the actual cost. Original excluded claims under Section 771.053, Health and Safety Code, pertaining to liability of 9-1-1 service providers and officers of the providers. Substitute excludes claims under Section 84.007, Civil Practice and Remedies Code, the Charitable Immunity and Liability Act of 1987. Original required the Board of Health to approve a program and adopt a manual and protocol by January 1, 1996. Substitute requires the Board of Health to adopt minimum standards and rules by January 1, 1996. It permits an entity to submit to the Department of Health a training program and protocol and to identify one or more emergency communication centers beginning September 1, 1995. Any program, protocol, and center submitted for approval between September 1 and December 31, 1995 is automatically approved on the date submitted until approval is withdrawn by the department. SUMMARY OF COMMITTEE ACTION Pursuant to notice posted on February 23, 1995, the Committee on Public Safety convened in a public hearing on February 28, 1995 to consider H.B. 235. The chairman laid out H.B. 235 and recognized the author, Representative Driver, to lay out the substitute to H.B 235. The committee considered a complete substitute for the bill. The following persons testified in favor of the substitute bill: Mike Pedigo representing the Denco Area 911 District; and Norman Hood representing Independent Colleges and Universities of Texas; and Lavergne Schwender representing Greater Harris County 911 Emergency Network; and Ann Muzalewski representing herself; and Craig Hooser representing the Texas College of Emergency; and Craig Pardue representing Dallas County. The following persons testified neutrally on the substitute bill: Mary Boyd representing the Advisory Commission on State Emergency Communications; and Gene Weatherall representing the Texas Department of Health. The substitute was adopted without objection. The bill was reported favorably as substituted with the recommendation that it do pass and be printed, by a record vote of 7 ayes, 0 nays, 0 PNV, and 2 absent.