1-1 By: Glaze (Senate Sponsor - Patterson) H.B. No. 1604
1-2 (In the Senate - Received from the House May 11, 1995;
1-3 May 12, 1995, read first time and referred to Committee on Health
1-4 and Human Services; May 17, 1995, reported favorably by the
1-5 following vote: Yeas 9, Nays 0; May 17, 1995, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to the regulation of emergency medical services providers
1-9 and of training programs for those providers.
1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11 SECTION 1. Section 773.003(11), Health and Safety Code, is
1-12 amended to read as follows:
1-13 (11) "Emergency medical services provider" means a
1-14 person who uses or maintains emergency medical services vehicles,
1-15 medical equipment, and emergency medical services personnel to
1-16 provide emergency medical services.
1-17 SECTION 2. Sections 773.011(c) and (d), Health and Safety
1-18 Code, are amended to read as follows:
1-19 (c) The board shall adopt a rule that requires an emergency
1-20 medical services provider to secure a surety bond in the amount of
1-21 sums to be subscribed before soliciting subscriptions and <or to
1-22 purchase and maintain contractual liability insurance before>
1-23 creating and operating a subscription program. The surety bond
1-24 must be issued by a company that is licensed by or eligible to do
1-25 business in this state.
1-26 (d) The board may adopt rules for waiver of the <contractual
1-27 liability insurance or> surety bond.
1-28 SECTION 3. Section 773.042, Health and Safety Code, is
1-29 amended to read as follows:
1-30 Sec. 773.042. BASIC LIFE-SUPPORT EMERGENCY MEDICAL SERVICES
1-31 PROVIDER <VEHICLE> QUALIFICATIONS. A provider <vehicle> qualifies
1-32 as a basic life-support emergency medical services provider
1-33 <vehicle> if it provides a vehicle that is designed for
1-34 transporting the sick or injured and has personnel and sufficient
1-35 equipment and supplies for providing basic life support.
1-36 SECTION 4. Section 773.043, Health and Safety Code, is
1-37 amended to read as follows:
1-38 Sec. 773.043. ADVANCED LIFE-SUPPORT EMERGENCY MEDICAL
1-39 SERVICES PROVIDER <VEHICLE> QUALIFICATIONS. A provider <vehicle>
1-40 qualifies as an advanced life-support emergency medical services
1-41 provider <vehicle> if it:
1-42 (1) meets the requirements of a basic life-support
1-43 emergency medical services provider <vehicle>; and
1-44 (2) has personnel and sufficient equipment and
1-45 supplies for providing intravenous therapy and endotracheal or
1-46 esophageal intubation.
1-47 SECTION 5. Section 773.044, Health and Safety Code, is
1-48 amended to read as follows:
1-49 Sec. 773.044. MOBILE INTENSIVE-CARE PROVIDER <UNIT>
1-50 QUALIFICATIONS. A provider <vehicle> qualifies as a mobile
1-51 intensive-care provider <unit> if it:
1-52 (1) meets the requirements of an advanced life-support
1-53 emergency medical services provider <vehicle>; and
1-54 (2) has personnel and sufficient equipment and
1-55 supplies to provide cardiac monitoring, defibrillation,
1-56 cardioversion, drug therapy, and two-way radio communication.
1-57 SECTION 6. Section 773.045, Health and Safety Code, is
1-58 amended to read as follows:
1-59 Sec. 773.045. SPECIALIZED EMERGENCY MEDICAL SERVICES
1-60 PROVIDER <VEHICLE> QUALIFICATIONS. (a) A provider using a
1-61 vehicle, including a helicopter, boat, fixed-wing aircraft, or
1-62 ground vehicle, qualifies as a specialized emergency medical
1-63 services provider <vehicle> if <it>:
1-64 (1) the vehicle is designed for transporting the sick
1-65 or injured by air, water, or ground transportation; and
1-66 (2) the provider has personnel and sufficient
1-67 equipment and supplies to provide for the specialized needs of the
1-68 patient transported.
2-1 (b) A fixed-wing aircraft and staff used to transport a
2-2 patient by stretcher and that advertises as an air ambulance
2-3 service is required to be licensed by the department.
2-4 SECTION 7. Sections 773.050(b), (c), and (d), Health and
2-5 Safety Code, are amended to read as follows:
2-6 (b) The board by rule shall establish minimum standards for:
2-7 (1) staffing an advanced life-support emergency
2-8 medical services vehicle, a mobile intensive-care unit, or a
2-9 specialized emergency medical services vehicle;
2-10 (2) emergency medical services personnel certification
2-11 and performance, including provisional certification,
2-12 certification, decertification, recertification, suspension,
2-13 emergency suspension, and probation;
2-14 (3) the approval of courses and training programs, the
2-15 certification of program instructors, examiners, and course
2-16 coordinators for emergency medical services personnel training, and
2-17 the revocation and probation of an approval or certification;
2-18 (4) continuing education programs and examinations of
2-19 emergency medical services personnel;
2-20 (5) medical supervision of basic and advanced
2-21 life-support systems;
2-22 (6) granting, suspending, and revoking a license for
2-23 emergency medical services providers; and
2-24 (7) emergency medical services vehicles.
2-25 (c) The board shall consider the education, training, and
2-26 experience of allied health professionals in adopting the minimum
2-27 standards for emergency medical services personnel certification
2-28 and may establish criteria for interstate reciprocity of emergency
2-29 medical services personnel. Each out-of-state application for
2-30 certification must be accompanied by a nonrefundable fee of $100.
2-31 The board may also establish criteria for out-of-country emergency
2-32 medical services personnel certification. Each out-of-country
2-33 application for certification must be accompanied by a
2-34 nonrefundable fee of $150.
2-35 (d) The board may not adopt a rule that requires any system,
2-36 service, or agency to provide advanced life-support or staffing
2-37 beyond basic life-support levels except for providers <the
2-38 operation> of:
2-39 (1) <an> advanced life-support emergency medical
2-40 services <vehicle>;
2-41 (2) <a> mobile intensive care <intensive-care unit>;
2-42 or
2-43 (3) <a> specialized emergency medical services
2-44 <vehicle that provides advanced life support>.
2-45 SECTION 8. Section 773.051, Health and Safety Code, is
2-46 amended to read as follows:
2-47 Sec. 773.051. MUNICIPAL REGULATION. A municipality may
2-48 establish standards for <staffing or equipping> an emergency
2-49 medical services provider <vehicle> that are stricter than the
2-50 minimum standards of this chapter and department rules adopted
2-51 under this chapter.
2-52 SECTION 9. Section 773.054, Health and Safety Code, is
2-53 amended by amending Subsection (c) and adding Subsection (d) to
2-54 read as follows:
2-55 (c) Each application under Subsection (a)(3) must be
2-56 accompanied by a nonrefundable fee of $25 for a program instructor
2-57 or examiner or $50 for a course coordinator. The department may
2-58 not require a fee for a certification from an instructor, examiner,
2-59 or coordinator who does not receive compensation for providing
2-60 services.
2-61 (d) Each application under Subsection (a)(2) must be
2-62 accompanied by a nonrefundable fee of $25 for a basic course or
2-63 training program or $50 for an advanced course or training program.
2-64 The department may not require a fee for approval of a course or
2-65 training program if the course coordinator or sponsoring agency
2-66 does not receive compensation for providing the course or training
2-67 program.
2-68 SECTION 10. Section 773.055(a), Health and Safety Code, is
2-69 amended to read as follows:
2-70 (a) A nonrefundable fee must accompany each application for
3-1 emergency medical services personnel certification. The fee may
3-2 not exceed:
3-3 (1) $75 for <examination for certification of> an
3-4 emergency medical technician-paramedic or emergency medical
3-5 technician-intermediate;
3-6 (2) $50 for <examination for certification of> an
3-7 emergency medical technician or emergency care attendant;
3-8 (3) $75 for recertification of an emergency medical
3-9 technician-paramedic or emergency medical technician-intermediate;
3-10 or
3-11 (4) $50 for recertification of an emergency medical
3-12 technician or emergency care attendant.
3-13 SECTION 11. Section 773.056(b), Health and Safety Code, is
3-14 amended to read as follows:
3-15 (b) The department shall issue a certificate to each program
3-16 instructor, examiner, or course coordinator who meets the minimum
3-17 standards adopted under Section 773.050. The certificate is valid
3-18 for two years. The department shall charge a fee of $5 to replace
3-19 a lost or stolen certificate.
3-20 SECTION 12. Sections 773.057(b) and (c), Health and Safety
3-21 Code, are amended to read as follows:
3-22 (b) A nonrefundable fee determined by the board must
3-23 accompany each application. The fee may not exceed $150<:>
3-24 <(1) $100> for each emergency medical services vehicle
3-25 operated by the provider<; or>
3-26 <(2) $2,000 for a fleet of emergency medical services
3-27 vehicles operated by the provider>.
3-28 (c) The department may delegate vehicle inspections to the
3-29 commissioners court of a county or the governing body of a
3-30 municipality. The delegation must be made:
3-31 (1) at the request of the commissioners court or
3-32 governing body; and
3-33 (2) in accordance with criteria and procedures adopted
3-34 by the board.
3-35 SECTION 13. Section 773.0571, Health and Safety Code, is
3-36 amended to read as follows:
3-37 Sec. 773.0571. REQUIREMENTS <INSPECTION REQUIRED> FOR
3-38 PROVIDER LICENSE. The department shall issue to an emergency
3-39 medical services provider a license that is valid for two years if
3-40 the department <conducts an inspection and> is satisfied that:
3-41 (1) the emergency medical services provider has
3-42 adequate staff to meet the staffing standards prescribed by this
3-43 chapter and the rules adopted under this chapter;
3-44 (2) each emergency medical services vehicle is
3-45 adequately constructed, equipped, maintained, and operated to
3-46 render basic or advanced life support services safely and
3-47 efficiently;
3-48 (3) the emergency medical services provider offers
3-49 safe and efficient services for emergency prehospital care and
3-50 transportation of patients; and
3-51 (4) the emergency medical services provider complies
3-52 with the rules adopted by the board under this chapter.
3-53 SECTION 14. Section 773.0572, Health and Safety Code, is
3-54 amended to read as follows:
3-55 Sec. 773.0572. PROVISIONAL LICENSES. The board by rule
3-56 shall establish conditions under which an emergency medical
3-57 services provider who fails to meet the minimum standards
3-58 prescribed by this chapter may be issued a provisional license.
3-59 The department may issue a provisional license to an emergency
3-60 medical services provider under this chapter if the department
3-61 finds that issuing the license would serve the public interest and
3-62 that the provider meets the requirements of the rules adopted under
3-63 this section. A nonrefundable fee of $25 must accompany each
3-64 application for a provisional license.
3-65 SECTION 15. Section 773.0611(c), Health and Safety Code, is
3-66 amended to read as follows:
3-67 (c) The board shall adopt rules for unannounced inspections
3-68 authorized under this section. The department or its
3-69 representative shall perform unannounced inspections in accordance
3-70 with those rules. An emergency medical services provider shall pay
4-1 to the department a nonrefundable fee of $25 if reinspection is
4-2 necessary to determine compliance with this chapter and the rules
4-3 adopted under this chapter.
4-4 SECTION 16. Section 773.065, Health and Safety Code, is
4-5 amended to read as follows:
4-6 Sec. 773.065. ADMINISTRATIVE PENALTY. (a) The commissioner
4-7 <of health> may assess an administrative penalty against an
4-8 emergency medical services provider or a course coordinator who
4-9 violates this chapter or a rule adopted or an order issued under
4-10 this chapter.
4-11 (b) In determining the amount of the penalty, the
4-12 commissioner shall consider:
4-13 (1) the emergency medical services provider's or
4-14 course coordinator's previous violations;
4-15 (2) the seriousness of the violation;
4-16 (3) any hazard to the health and safety of the public;
4-17 (4) the emergency medical services provider's or
4-18 course coordinator's demonstrated good faith; and
4-19 (5) any other matter as justice may require.
4-20 (c) The penalty may not exceed $250 for each violation.
4-21 (d) Each day a violation continues may be considered a
4-22 separate violation.
4-23 SECTION 17. Section 773.066, Health and Safety Code, is
4-24 amended to read as follows:
4-25 Sec. 773.066. ASSESSMENT OF ADMINISTRATIVE PENALTY. (a) An
4-26 administrative penalty may be assessed only after an emergency
4-27 medical services provider or course coordinator charged with a
4-28 violation is provided notice and given an opportunity to request a
4-29 hearing.
4-30 (b) If a hearing is held, the commissioner shall make
4-31 findings of fact and shall issue a written decision regarding
4-32 whether the emergency medical services provider or course
4-33 coordinator committed a violation and the amount of any penalty to
4-34 be assessed.
4-35 (c) If the emergency medical services provider or course
4-36 coordinator charged with the violation does not request a hearing,
4-37 the commissioner shall determine whether the provider or course
4-38 coordinator committed a violation and the amount of any penalty to
4-39 be assessed.
4-40 (d) After making a determination under Subsection (b) or (c)
4-41 that a penalty is to be assessed against an emergency medical
4-42 services provider or a course coordinator, the commissioner shall
4-43 issue an order requiring that the emergency medical services
4-44 provider or course coordinator pay the penalty.
4-45 (e) Not later than the 30th day after the date an order is
4-46 issued under Subsection (d), the commissioner shall give written
4-47 notice of the order to the emergency medical services provider or
4-48 course coordinator.
4-49 (f) The commissioner may consolidate a hearing held under
4-50 this section with another proceeding.
4-51 SECTION 18. Section 773.067, Health and Safety Code, is
4-52 amended to read as follows:
4-53 Sec. 773.067. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
4-54 later than the 30th day after the date on which an order charging
4-55 the emergency medical services provider or course coordinator with
4-56 a penalty is final as provided by Chapter 2001, Government Code,
4-57 the person charged shall:
4-58 (1) pay the penalty in full;
4-59 (2) pay the penalty and file a petition for judicial
4-60 review contesting the occurrence of the violation, the amount of
4-61 the penalty, or both the occurrence of the violation and the amount
4-62 of the penalty; or
4-63 (3) without paying the penalty, file a petition for
4-64 judicial review contesting the occurrence of the violation, the
4-65 amount of the penalty, or both the occurrence of the violation and
4-66 the amount of the penalty.
4-67 (b) Within the 30-day period, a person who acts under
4-68 Subsection (a)(3) may:
4-69 (1) stay enforcement of the penalty by:
4-70 (A) paying the amount of the penalty to the
5-1 court for placement in an escrow account; or
5-2 (B) giving to the court a supersedeas bond that
5-3 is approved by the court for the amount of the penalty and that is
5-4 effective until all judicial review of the commissioner's order is
5-5 final; or
5-6 (2) request the court to stay enforcement of the
5-7 penalty by:
5-8 (A) filing with the court a sworn affidavit of
5-9 the person stating that the person is financially unable to pay the
5-10 amount of the penalty and is financially unable to give the
5-11 supersedeas bond; and
5-12 (B) giving a copy of the affidavit to the
5-13 commissioner by certified mail.
5-14 (c) If the commissioner receives a copy of an affidavit
5-15 under Subsection (b)(2), the commissioner may file with the court,
5-16 within five days after the date the copy is received, a contest to
5-17 the affidavit. The court shall hold a hearing on the facts alleged
5-18 in the affidavit as soon as practicable and shall stay the
5-19 enforcement of the penalty on finding that the alleged facts are
5-20 true. The person who files an affidavit has the burden of proving
5-21 that the person is financially unable to pay the amount of the
5-22 penalty and to give a supersedeas bond.
5-23 (d) If the person does not pay the amount of the penalty and
5-24 the enforcement of the penalty is not stayed, the commissioner may
5-25 refer the matter to the attorney general for collection of the
5-26 amount of the penalty.
5-27 (e) Judicial review of the order of the commissioner:
5-28 (1) is instituted by filing a petition as provided by
5-29 Subchapter G, Chapter 2001, Government Code; and
5-30 (2) is under the substantial evidence rule.
5-31 (f) If the court sustains the occurrence of the violation,
5-32 the court may uphold or reduce the amount of the penalty and order
5-33 the person to pay the full or reduced amount of the penalty. If
5-34 the court does not sustain the occurrence of the violation, the
5-35 court shall order that no penalty is owed.
5-36 (g) When the judgment of the court becomes final, the court
5-37 shall proceed under this subsection. If the person paid the
5-38 penalty and if the amount of the penalty is reduced or the penalty
5-39 is not upheld by the court, the court shall order that the
5-40 appropriate amount plus accrued interest be remitted to the person.
5-41 The rate of the interest is the rate charged on loans to depository
5-42 institutions by the New York Federal Reserve Bank, and the interest
5-43 shall be paid for the period beginning on the date the penalty was
5-44 paid and ending on the date the penalty is remitted. If the person
5-45 gave a supersedeas bond and if the penalty is not upheld by the
5-46 court, the court shall order the release of the bond. If the
5-47 person gave a supersedeas bond and if the amount of the penalty is
5-48 reduced, the court shall order the release of the bond after the
5-49 person pays the amount. <mailed or otherwise transmitted to the
5-50 provider, the provider shall:>
5-51 <(1) pay the penalty in full; or>
5-52 <(2) if the provider seeks judicial review of the
5-53 amount of the penalty, the fact of the violation, or both:>
5-54 <(A) send the amount of the penalty to the
5-55 commissioner for placement in an escrow account; or>
5-56 <(B) post with the commissioner a bond for the
5-57 amount of the penalty.>
5-58 <(b) A bond posted under this section must be in a form
5-59 approved by the commissioner and must be effective until judicial
5-60 review of the order is final.>
5-61 <(c) An emergency medical services provider who does not
5-62 send the amount of the penalty to the commissioner or post the bond
5-63 within the period prescribed by Subsection (a) may not contest the
5-64 violation or the amount of the penalty.>
5-65 SECTION 19. Sections 773.010, 773.053, and 773.068, Health
5-66 and Safety Code, are repealed.
5-67 SECTION 20. Section 774.003(b), Health and Safety Code, is
5-68 amended to read as follows:
5-69 (b) In providing for the services authorized by Subsection
5-70 (a), a commissioners court may enter into exclusive agreements with
6-1 any municipality, hospital district, sheriff's office, fire
6-2 department, private ambulance service, or other agency or entity
6-3 that the commissioners court finds to be suitably organized to
6-4 provide efficient emergency ambulance service in the county. The
6-5 governing body of a municipality or hospital district in which
6-6 emergency ambulance service is to be rendered must approve an
6-7 agreement made with the commissioners court to provide that service
6-8 in the municipality or hospital district.
6-9 SECTION 21. The importance of this legislation and the
6-10 crowded condition of the calendars in both houses create an
6-11 emergency and an imperative public necessity that the
6-12 constitutional rule requiring bills to be read on three several
6-13 days in each house be suspended, and this rule is hereby suspended,
6-14 and that this Act take effect and be in force from and after its
6-15 passage, and it is so enacted.
6-16 * * * * *