H.B. No. 1604
1-1 AN ACT
1-2 relating to the regulation of emergency medical services providers
1-3 and of training programs for those providers.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 773.003(11), Health and Safety Code, is
1-6 amended to read as follows:
1-7 (11) "Emergency medical services provider" means a
1-8 person who uses or maintains emergency medical services vehicles,
1-9 medical equipment, and emergency medical services personnel to
1-10 provide emergency medical services.
1-11 SECTION 2. Sections 773.011(c) and (d), Health and Safety
1-12 Code, are amended to read as follows:
1-13 (c) The board shall adopt a rule that requires an emergency
1-14 medical services provider to secure a surety bond in the amount of
1-15 sums to be subscribed before soliciting subscriptions and <or to
1-16 purchase and maintain contractual liability insurance before>
1-17 creating and operating a subscription program. The surety bond
1-18 must be issued by a company that is licensed by or eligible to do
1-19 business in this state.
1-20 (d) The board may adopt rules for waiver of the <contractual
1-21 liability insurance or> surety bond.
1-22 SECTION 3. Section 773.042, Health and Safety Code, is
1-23 amended to read as follows:
2-1 Sec. 773.042. BASIC LIFE-SUPPORT EMERGENCY MEDICAL SERVICES
2-2 PROVIDER <VEHICLE> QUALIFICATIONS. A provider <vehicle> qualifies
2-3 as a basic life-support emergency medical services provider
2-4 <vehicle> if it provides a vehicle that is designed for
2-5 transporting the sick or injured and has personnel and sufficient
2-6 equipment and supplies for providing basic life support.
2-7 SECTION 4. Section 773.043, Health and Safety Code, is
2-8 amended to read as follows:
2-9 Sec. 773.043. ADVANCED LIFE-SUPPORT EMERGENCY MEDICAL
2-10 SERVICES PROVIDER <VEHICLE> QUALIFICATIONS. A provider <vehicle>
2-11 qualifies as an advanced life-support emergency medical services
2-12 provider <vehicle> if it:
2-13 (1) meets the requirements of a basic life-support
2-14 emergency medical services provider <vehicle>; and
2-15 (2) has personnel and sufficient equipment and
2-16 supplies for providing intravenous therapy and endotracheal or
2-17 esophageal intubation.
2-18 SECTION 5. Section 773.044, Health and Safety Code, is
2-19 amended to read as follows:
2-20 Sec. 773.044. MOBILE INTENSIVE-CARE PROVIDER <UNIT>
2-21 QUALIFICATIONS. A provider <vehicle> qualifies as a mobile
2-22 intensive-care provider <unit> if it:
2-23 (1) meets the requirements of an advanced life-support
2-24 emergency medical services provider <vehicle>; and
2-25 (2) has personnel and sufficient equipment and
3-1 supplies to provide cardiac monitoring, defibrillation,
3-2 cardioversion, drug therapy, and two-way radio communication.
3-3 SECTION 6. Section 773.045, Health and Safety Code, is
3-4 amended to read as follows:
3-5 Sec. 773.045. SPECIALIZED EMERGENCY MEDICAL SERVICES
3-6 PROVIDER <VEHICLE> QUALIFICATIONS. (a) A provider using a
3-7 vehicle, including a helicopter, boat, fixed-wing aircraft, or
3-8 ground vehicle, qualifies as a specialized emergency medical
3-9 services provider <vehicle> if <it>:
3-10 (1) the vehicle is designed for transporting the sick
3-11 or injured by air, water, or ground transportation; and
3-12 (2) the provider has personnel and sufficient
3-13 equipment and supplies to provide for the specialized needs of the
3-14 patient transported.
3-15 (b) A fixed-wing aircraft and staff used to transport a
3-16 patient by stretcher and that advertises as an air ambulance
3-17 service is required to be licensed by the department.
3-18 SECTION 7. Sections 773.050(b), (c), and (d), Health and
3-19 Safety Code, are amended to read as follows:
3-20 (b) The board by rule shall establish minimum standards for:
3-21 (1) staffing an advanced life-support emergency
3-22 medical services vehicle, a mobile intensive-care unit, or a
3-23 specialized emergency medical services vehicle;
3-24 (2) emergency medical services personnel certification
3-25 and performance, including provisional certification,
4-1 certification, decertification, recertification, suspension,
4-2 emergency suspension, and probation;
4-3 (3) the approval of courses and training programs, the
4-4 certification of program instructors, examiners, and course
4-5 coordinators for emergency medical services personnel training, and
4-6 the revocation and probation of an approval or certification;
4-7 (4) continuing education programs and examinations of
4-8 emergency medical services personnel;
4-9 (5) medical supervision of basic and advanced
4-10 life-support systems;
4-11 (6) granting, suspending, and revoking a license for
4-12 emergency medical services providers; and
4-13 (7) emergency medical services vehicles.
4-14 (c) The board shall consider the education, training, and
4-15 experience of allied health professionals in adopting the minimum
4-16 standards for emergency medical services personnel certification
4-17 and may establish criteria for interstate reciprocity of emergency
4-18 medical services personnel. Each out-of-state application for
4-19 certification must be accompanied by a nonrefundable fee of $100.
4-20 The board may also establish criteria for out-of-country emergency
4-21 medical services personnel certification. Each out-of-country
4-22 application for certification must be accompanied by a
4-23 nonrefundable fee of $150.
4-24 (d) The board may not adopt a rule that requires any system,
4-25 service, or agency to provide advanced life-support or staffing
5-1 beyond basic life-support levels except for providers <the
5-2 operation> of:
5-3 (1) <an> advanced life-support emergency medical
5-4 services <vehicle>;
5-5 (2) <a> mobile intensive care <intensive-care unit>;
5-6 or
5-7 (3) <a> specialized emergency medical services
5-8 <vehicle that provides advanced life support>.
5-9 SECTION 8. Section 773.051, Health and Safety Code, is
5-10 amended to read as follows:
5-11 Sec. 773.051. MUNICIPAL REGULATION. A municipality may
5-12 establish standards for <staffing or equipping> an emergency
5-13 medical services provider <vehicle> that are stricter than the
5-14 minimum standards of this chapter and department rules adopted
5-15 under this chapter.
5-16 SECTION 9. Section 773.054, Health and Safety Code, is
5-17 amended by amending Subsection (c) and adding Subsection (d) to
5-18 read as follows:
5-19 (c) Each application under Subsection (a)(3) must be
5-20 accompanied by a nonrefundable fee of $25 for a program instructor
5-21 or examiner or $50 for a course coordinator. The department may
5-22 not require a fee for a certification from an instructor, examiner,
5-23 or coordinator who does not receive compensation for providing
5-24 services.
5-25 (d) Each application under Subsection (a)(2) must be
6-1 accompanied by a nonrefundable fee of $25 for a basic course or
6-2 training program or $50 for an advanced course or training program.
6-3 The department may not require a fee for approval of a course or
6-4 training program if the course coordinator or sponsoring agency
6-5 does not receive compensation for providing the course or training
6-6 program.
6-7 SECTION 10. Section 773.055(a), Health and Safety Code, is
6-8 amended to read as follows:
6-9 (a) A nonrefundable fee must accompany each application for
6-10 emergency medical services personnel certification. The fee may
6-11 not exceed:
6-12 (1) $75 for <examination for certification of> an
6-13 emergency medical technician-paramedic or emergency medical
6-14 technician-intermediate;
6-15 (2) $50 for <examination for certification of> an
6-16 emergency medical technician or emergency care attendant;
6-17 (3) $75 for recertification of an emergency medical
6-18 technician-paramedic or emergency medical technician-intermediate;
6-19 or
6-20 (4) $50 for recertification of an emergency medical
6-21 technician or emergency care attendant.
6-22 SECTION 11. Section 773.056(b), Health and Safety Code, is
6-23 amended to read as follows:
6-24 (b) The department shall issue a certificate to each program
6-25 instructor, examiner, or course coordinator who meets the minimum
7-1 standards adopted under Section 773.050. The certificate is valid
7-2 for two years. The department shall charge a fee of $5 to replace
7-3 a lost or stolen certificate.
7-4 SECTION 12. Sections 773.057(b) and (c), Health and Safety
7-5 Code, are amended to read as follows:
7-6 (b) A nonrefundable fee determined by the board must
7-7 accompany each application. The fee may not exceed $150<:>
7-8 <(1) $100> for each emergency medical services vehicle
7-9 operated by the provider<; or>
7-10 <(2) $2,000 for a fleet of emergency medical services
7-11 vehicles operated by the provider>.
7-12 (c) The department may delegate vehicle inspections to the
7-13 commissioners court of a county or the governing body of a
7-14 municipality. The delegation must be made:
7-15 (1) at the request of the commissioners court or
7-16 governing body; and
7-17 (2) in accordance with criteria and procedures adopted
7-18 by the board.
7-19 SECTION 13. Section 773.0571, Health and Safety Code, is
7-20 amended to read as follows:
7-21 Sec. 773.0571. REQUIREMENTS <INSPECTION REQUIRED> FOR
7-22 PROVIDER LICENSE. The department shall issue to an emergency
7-23 medical services provider a license that is valid for two years if
7-24 the department <conducts an inspection and> is satisfied that:
7-25 (1) the emergency medical services provider has
8-1 adequate staff to meet the staffing standards prescribed by this
8-2 chapter and the rules adopted under this chapter;
8-3 (2) each emergency medical services vehicle is
8-4 adequately constructed, equipped, maintained, and operated to
8-5 render basic or advanced life support services safely and
8-6 efficiently;
8-7 (3) the emergency medical services provider offers
8-8 safe and efficient services for emergency prehospital care and
8-9 transportation of patients; and
8-10 (4) the emergency medical services provider complies
8-11 with the rules adopted by the board under this chapter.
8-12 SECTION 14. Section 773.0572, Health and Safety Code, is
8-13 amended to read as follows:
8-14 Sec. 773.0572. PROVISIONAL LICENSES. The board by rule
8-15 shall establish conditions under which an emergency medical
8-16 services provider who fails to meet the minimum standards
8-17 prescribed by this chapter may be issued a provisional license.
8-18 The department may issue a provisional license to an emergency
8-19 medical services provider under this chapter if the department
8-20 finds that issuing the license would serve the public interest and
8-21 that the provider meets the requirements of the rules adopted under
8-22 this section. A nonrefundable fee of $25 must accompany each
8-23 application for a provisional license.
8-24 SECTION 15. Section 773.0611(c), Health and Safety Code, is
8-25 amended to read as follows:
9-1 (c) The board shall adopt rules for unannounced inspections
9-2 authorized under this section. The department or its
9-3 representative shall perform unannounced inspections in accordance
9-4 with those rules. An emergency medical services provider shall pay
9-5 to the department a nonrefundable fee of $25 if reinspection is
9-6 necessary to determine compliance with this chapter and the rules
9-7 adopted under this chapter.
9-8 SECTION 16. Section 773.065, Health and Safety Code, is
9-9 amended to read as follows:
9-10 Sec. 773.065. ADMINISTRATIVE PENALTY. (a) The commissioner
9-11 <of health> may assess an administrative penalty against an
9-12 emergency medical services provider or a course coordinator who
9-13 violates this chapter or a rule adopted or an order issued under
9-14 this chapter.
9-15 (b) In determining the amount of the penalty, the
9-16 commissioner shall consider:
9-17 (1) the emergency medical services provider's or
9-18 course coordinator's previous violations;
9-19 (2) the seriousness of the violation;
9-20 (3) any hazard to the health and safety of the public;
9-21 (4) the emergency medical services provider's or
9-22 course coordinator's demonstrated good faith; and
9-23 (5) any other matter as justice may require.
9-24 (c) The penalty may not exceed $250 for each violation.
9-25 (d) Each day a violation continues may be considered a
10-1 separate violation.
10-2 SECTION 17. Section 773.066, Health and Safety Code, is
10-3 amended to read as follows:
10-4 Sec. 773.066. ASSESSMENT OF ADMINISTRATIVE PENALTY. (a) An
10-5 administrative penalty may be assessed only after an emergency
10-6 medical services provider or course coordinator charged with a
10-7 violation is provided notice and given an opportunity to request a
10-8 hearing.
10-9 (b) If a hearing is held, the commissioner shall make
10-10 findings of fact and shall issue a written decision regarding
10-11 whether the emergency medical services provider or course
10-12 coordinator committed a violation and the amount of any penalty to
10-13 be assessed.
10-14 (c) If the emergency medical services provider or course
10-15 coordinator charged with the violation does not request a hearing,
10-16 the commissioner shall determine whether the provider or course
10-17 coordinator committed a violation and the amount of any penalty to
10-18 be assessed.
10-19 (d) After making a determination under Subsection (b) or (c)
10-20 that a penalty is to be assessed against an emergency medical
10-21 services provider or a course coordinator, the commissioner shall
10-22 issue an order requiring that the emergency medical services
10-23 provider or course coordinator pay the penalty.
10-24 (e) Not later than the 30th day after the date an order is
10-25 issued under Subsection (d), the commissioner shall give written
11-1 notice of the order to the emergency medical services provider or
11-2 course coordinator.
11-3 (f) The commissioner may consolidate a hearing held under
11-4 this section with another proceeding.
11-5 SECTION 18. Section 773.067, Health and Safety Code, is
11-6 amended to read as follows:
11-7 Sec. 773.067. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
11-8 later than the 30th day after the date on which an order charging
11-9 the emergency medical services provider or course coordinator with
11-10 a penalty is final as provided by Chapter 2001, Government Code,
11-11 the person charged shall:
11-12 (1) pay the penalty in full;
11-13 (2) pay the penalty and file a petition for judicial
11-14 review contesting the occurrence of the violation, the amount of
11-15 the penalty, or both the occurrence of the violation and the amount
11-16 of the penalty; or
11-17 (3) without paying the penalty, file a petition for
11-18 judicial review contesting the occurrence of the violation, the
11-19 amount of the penalty, or both the occurrence of the violation and
11-20 the amount of the penalty.
11-21 (b) Within the 30-day period, a person who acts under
11-22 Subsection (a)(3) may:
11-23 (1) stay enforcement of the penalty by:
11-24 (A) paying the amount of the penalty to the
11-25 court for placement in an escrow account; or
12-1 (B) giving to the court a supersedeas bond that
12-2 is approved by the court for the amount of the penalty and that is
12-3 effective until all judicial review of the commissioner's order is
12-4 final; or
12-5 (2) request the court to stay enforcement of the
12-6 penalty by:
12-7 (A) filing with the court a sworn affidavit of
12-8 the person stating that the person is financially unable to pay the
12-9 amount of the penalty and is financially unable to give the
12-10 supersedeas bond; and
12-11 (B) giving a copy of the affidavit to the
12-12 commissioner by certified mail.
12-13 (c) If the commissioner receives a copy of an affidavit
12-14 under Subsection (b)(2), the commissioner may file with the court,
12-15 within five days after the date the copy is received, a contest to
12-16 the affidavit. The court shall hold a hearing on the facts alleged
12-17 in the affidavit as soon as practicable and shall stay the
12-18 enforcement of the penalty on finding that the alleged facts are
12-19 true. The person who files an affidavit has the burden of proving
12-20 that the person is financially unable to pay the amount of the
12-21 penalty and to give a supersedeas bond.
12-22 (d) If the person does not pay the amount of the penalty and
12-23 the enforcement of the penalty is not stayed, the commissioner may
12-24 refer the matter to the attorney general for collection of the
12-25 amount of the penalty.
13-1 (e) Judicial review of the order of the commissioner:
13-2 (1) is instituted by filing a petition as provided by
13-3 Subchapter G, Chapter 2001, Government Code; and
13-4 (2) is under the substantial evidence rule.
13-5 (f) If the court sustains the occurrence of the violation,
13-6 the court may uphold or reduce the amount of the penalty and order
13-7 the person to pay the full or reduced amount of the penalty. If
13-8 the court does not sustain the occurrence of the violation, the
13-9 court shall order that no penalty is owed.
13-10 (g) When the judgment of the court becomes final, the court
13-11 shall proceed under this subsection. If the person paid the
13-12 penalty and if the amount of the penalty is reduced or the penalty
13-13 is not upheld by the court, the court shall order that the
13-14 appropriate amount plus accrued interest be remitted to the person.
13-15 The rate of the interest is the rate charged on loans to depository
13-16 institutions by the New York Federal Reserve Bank, and the interest
13-17 shall be paid for the period beginning on the date the penalty was
13-18 paid and ending on the date the penalty is remitted. If the person
13-19 gave a supersedeas bond and if the penalty is not upheld by the
13-20 court, the court shall order the release of the bond. If the
13-21 person gave a supersedeas bond and if the amount of the penalty is
13-22 reduced, the court shall order the release of the bond after the
13-23 person pays the amount. <mailed or otherwise transmitted to the
13-24 provider, the provider shall:>
13-25 <(1) pay the penalty in full; or>
14-1 <(2) if the provider seeks judicial review of the
14-2 amount of the penalty, the fact of the violation, or both:>
14-3 <(A) send the amount of the penalty to the
14-4 commissioner for placement in an escrow account; or>
14-5 <(B) post with the commissioner a bond for the
14-6 amount of the penalty.>
14-7 <(b) A bond posted under this section must be in a form
14-8 approved by the commissioner and must be effective until judicial
14-9 review of the order is final.>
14-10 <(c) An emergency medical services provider who does not
14-11 send the amount of the penalty to the commissioner or post the bond
14-12 within the period prescribed by Subsection (a) may not contest the
14-13 violation or the amount of the penalty.>
14-14 SECTION 19. Sections 773.010, 773.053, and 773.068, Health
14-15 and Safety Code, are repealed.
14-16 SECTION 20. Section 774.003(b), Health and Safety Code, is
14-17 amended to read as follows:
14-18 (b) In providing for the services authorized by Subsection
14-19 (a), a commissioners court may enter into exclusive agreements with
14-20 any municipality, hospital district, sheriff's office, fire
14-21 department, private ambulance service, or other agency or entity
14-22 that the commissioners court finds to be suitably organized to
14-23 provide efficient emergency ambulance service in the county. The
14-24 governing body of a municipality or hospital district in which
14-25 emergency ambulance service is to be rendered must approve an
15-1 agreement made with the commissioners court to provide that service
15-2 in the municipality or hospital district.
15-3 SECTION 21. The importance of this legislation and the
15-4 crowded condition of the calendars in both houses create an
15-5 emergency and an imperative public necessity that the
15-6 constitutional rule requiring bills to be read on three several
15-7 days in each house be suspended, and this rule is hereby suspended,
15-8 and that this Act take effect and be in force from and after its
15-9 passage, and it is so enacted.