By: Patterson S.B. No. 998
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the regulation of emergency medical services providers
1-2 and of training programs for those providers.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 773.003(11), Health and Safety Code, is
1-5 amended to read as follows:
1-6 (11) "Emergency medical services provider" means a
1-7 person who uses or maintains emergency medical services vehicles,
1-8 medical equipment, and emergency medical services personnel to
1-9 provide emergency medical services.
1-10 SECTION 2. Sections 773.011(c) and (d), Health and Safety
1-11 Code, are amended to read as follows:
1-12 (c) The board shall adopt a rule that requires an emergency
1-13 medical services provider to secure a surety bond in the amount of
1-14 sums to be subscribed before soliciting subscriptions and <or to
1-15 purchase and maintain contractual liability insurance before>
1-16 creating and operating a subscription program. The surety bond
1-17 must be issued by a company that is licensed by or eligible to do
1-18 business in this state.
1-19 (d) The board may adopt rules for waiver of the <contractual
1-20 liability insurance or> surety bond.
1-21 SECTION 3. Section 773.042, Health and Safety Code, is
1-22 amended to read as follows:
1-23 Sec. 773.042. BASIC LIFE-SUPPORT EMERGENCY MEDICAL SERVICES
2-1 PROVIDER <VEHICLE> QUALIFICATIONS. A provider <vehicle> qualifies
2-2 as a basic life-support emergency medical services provider
2-3 <vehicle> if it provides a vehicle that is designed for
2-4 transporting the sick or injured and has personnel and sufficient
2-5 equipment and supplies for providing basic life support.
2-6 SECTION 4. Section 773.043, Health and Safety Code, is
2-7 amended to read as follows:
2-8 Sec. 773.043. ADVANCED LIFE-SUPPORT EMERGENCY MEDICAL
2-9 SERVICES PROVIDER <VEHICLE> QUALIFICATIONS. A provider <vehicle>
2-10 qualifies as an advanced life-support emergency medical services
2-11 provider <vehicle> if it:
2-12 (1) meets the requirements of a basic life-support
2-13 emergency medical services provider <vehicle>; and
2-14 (2) has personnel and sufficient equipment and
2-15 supplies for providing intravenous therapy and endotracheal or
2-16 esophageal intubation.
2-17 SECTION 5. Section 773.044, Health and Safety Code, is
2-18 amended to read as follows:
2-19 Sec. 773.044. MOBILE INTENSIVE-CARE PROVIDER <UNIT>
2-20 QUALIFICATIONS. A provider <vehicle> qualifies as a mobile
2-21 intensive-care provider <unit> if it:
2-22 (1) meets the requirements of an advanced life-support
2-23 emergency medical services provider <vehicle>; and
2-24 (2) has personnel and sufficient equipment and
2-25 supplies to provide cardiac monitoring, defibrillation,
3-1 cardioversion, drug therapy, and two-way radio communication.
3-2 SECTION 6. Section 773.045, Health and Safety Code, is
3-3 amended to read as follows:
3-4 Sec. 773.045. SPECIALIZED EMERGENCY MEDICAL SERVICES
3-5 PROVIDER <VEHICLE> QUALIFICATIONS. (a) A provider using a
3-6 vehicle, including a helicopter, boat, fixed-wing aircraft, or
3-7 ground vehicle, qualifies as a specialized emergency medical
3-8 services provider <vehicle> if <it>:
3-9 (1) the vehicle is designed for transporting the sick
3-10 or injured by air, water, or ground transportation; and
3-11 (2) the provider has personnel and sufficient
3-12 equipment and supplies to provide for the specialized needs of the
3-13 patient transported.
3-14 (b) A fixed-wing aircraft and staff used to transport a
3-15 patient by stretcher and that advertises as an air ambulance
3-16 service is required to be licensed by the department.
3-17 SECTION 7. Sections 773.050(b), (c), and (d), Health and
3-18 Safety Code, are amended to read as follows:
3-19 (b) The board by rule shall establish minimum standards for:
3-20 (1) staffing an advanced life-support emergency
3-21 medical services vehicle, a mobile intensive-care unit, or a
3-22 specialized emergency medical services vehicle;
3-23 (2) emergency medical services personnel certification
3-24 and performance, including provisional certification,
3-25 certification, decertification, recertification, suspension,
4-1 emergency suspension, and probation;
4-2 (3) the approval of courses and training programs, the
4-3 certification of program instructors, examiners, and course
4-4 coordinators for emergency medical services personnel training, and
4-5 the revocation and probation of an approval or certification;
4-6 (4) continuing education programs and examinations of
4-7 emergency medical services personnel;
4-8 (5) medical supervision of basic and advanced
4-9 life-support systems;
4-10 (6) granting, suspending, and revoking a license for
4-11 emergency medical services providers; <and>
4-12 (7) emergency medical services vehicles; and
4-13 (8) the scope of practice of emergency medical
4-14 services personnel.
4-15 (c) The board shall consider the education, training, and
4-16 experience of allied health professionals in adopting the minimum
4-17 standards for emergency medical services personnel certification
4-18 and may establish criteria for interstate reciprocity of emergency
4-19 medical services personnel. Each out-of-state application for
4-20 certification must be accompanied by a nonrefundable fee of $100.
4-21 The board may also establish criteria for out-of-country emergency
4-22 medical services personnel certification. Each out-of-country
4-23 application for certification must be accompanied by a
4-24 nonrefundable fee of $150.
4-25 (d) The board may not adopt a rule that requires any system,
5-1 service, or agency to provide advanced life-support or staffing
5-2 beyond basic life-support levels except for providers <the
5-3 operation> of:
5-4 (1) <an> advanced life-support emergency medical
5-5 services <vehicle>;
5-6 (2) <a> mobile intensive care <intensive-care unit>;
5-7 or
5-8 (3) <a> specialized emergency medical services
5-9 <vehicle that provides advanced life support>.
5-10 SECTION 8. Section 773.051, Health and Safety Code, is
5-11 amended to read as follows:
5-12 Sec. 773.051. MUNICIPAL REGULATION. A municipality may
5-13 establish standards for <staffing or equipping> an emergency
5-14 medical services provider <vehicle> that are stricter than the
5-15 minimum standards of this chapter and department rules adopted
5-16 under this chapter.
5-17 SECTION 9. Section 773.054, Health and Safety Code, is
5-18 amended by amending Subsection (c) and adding Subsection (d) to
5-19 read as follows:
5-20 (c) Each application under Subsection (a)(3) must be
5-21 accompanied by a nonrefundable fee of $25 for a program instructor
5-22 or examiner or $50 for a course coordinator. The department may
5-23 not require a fee for a certification from an instructor, examiner,
5-24 or coordinator who does not receive compensation for providing
5-25 services.
6-1 (d) Each application under Subsection (a)(2) must be
6-2 accompanied by a nonrefundable fee of $25 for a basic course or
6-3 training program or $50 for an advanced course or training program.
6-4 The department may not require a fee for approval of a course or
6-5 training program if the course coordinator or sponsoring agency
6-6 does not receive compensation for providing the course or training
6-7 program.
6-8 SECTION 10. Section 773.055(a), Health and Safety Code, is
6-9 amended to read as follows:
6-10 (a) A nonrefundable fee must accompany each application for
6-11 emergency medical services personnel certification. The fee may
6-12 not exceed:
6-13 (1) $75 for <examination for certification of> an
6-14 emergency medical technician-paramedic or emergency medical
6-15 technician-intermediate;
6-16 (2) $50 for <examination for certification of> an
6-17 emergency medical technician or emergency care attendant;
6-18 (3) $75 for recertification of an emergency medical
6-19 technician-paramedic or emergency medical technician-intermediate;
6-20 or
6-21 (4) $50 for recertification of an emergency medical
6-22 technician or emergency care attendant.
6-23 SECTION 11. Section 773.056(b), Health and Safety Code, is
6-24 amended to read as follows:
6-25 (b) The department shall issue a certificate to each program
7-1 instructor, examiner, or course coordinator who meets the minimum
7-2 standards adopted under Section 773.050. The certificate is valid
7-3 for two years. The department shall charge a fee of $5 to replace
7-4 a lost or stolen certificate.
7-5 SECTION 12. Sections 773.057(b) and (c), Health and Safety
7-6 Code, are amended to read as follows:
7-7 (b) A nonrefundable fee of $150 for each emergency medical
7-8 services patient transport vehicle owned by the provider and
7-9 operating in this state <determined by the board> must accompany
7-10 each application. <The fee may not exceed:>
7-11 <(1) $100 for each emergency medical services vehicle
7-12 operated by the provider; or>
7-13 <(2) $2,000 for a fleet of emergency medical services
7-14 vehicles operated by the provider.>
7-15 (c) The department may delegate vehicle inspections to the
7-16 commissioners court of a county or the governing body of a
7-17 municipality. The delegation must be made:
7-18 (1) at the request of the commissioners court or
7-19 governing body; and
7-20 (2) in accordance with criteria and procedures adopted
7-21 by the board.
7-22 SECTION 13. Section 773.0571, Health and Safety Code, is
7-23 amended to read as follows:
7-24 Sec. 773.0571. REQUIREMENTS <INSPECTION REQUIRED> FOR
7-25 PROVIDER LICENSE. The department shall issue to an emergency
8-1 medical services provider a license that is valid for two years if
8-2 the department <conducts an inspection and> is satisfied that:
8-3 (1) the emergency medical services provider has
8-4 adequate staff to meet the staffing standards prescribed by this
8-5 chapter and the rules adopted under this chapter;
8-6 (2) each emergency medical services vehicle is
8-7 adequately constructed, equipped, maintained, and operated to
8-8 render basic or advanced life support services safely and
8-9 efficiently;
8-10 (3) the emergency medical services provider offers
8-11 safe and efficient services for emergency prehospital care and
8-12 transportation of patients; and
8-13 (4) the emergency medical services provider complies
8-14 with the rules adopted by the board under this chapter.
8-15 SECTION 14. Section 773.0572, Health and Safety Code, is
8-16 amended to read as follows:
8-17 Sec. 773.0572. PROVISIONAL LICENSES. The board by rule
8-18 shall establish conditions under which an emergency medical
8-19 services provider who fails to meet the minimum standards
8-20 prescribed by this chapter may be issued a provisional license.
8-21 The department may issue a provisional license to an emergency
8-22 medical services provider under this chapter if the department
8-23 finds that issuing the license would serve the public interest and
8-24 that the provider meets the requirements of the rules adopted under
8-25 this section. A nonrefundable fee of $25 must accompany each
9-1 application for a provisional license.
9-2 SECTION 15. Section 773.0611(c), Health and Safety Code, is
9-3 amended to read as follows:
9-4 (c) The board shall adopt rules for unannounced inspections
9-5 authorized under this section. The department or its
9-6 representative shall perform unannounced inspections in accordance
9-7 with those rules. An emergency medical services provider shall pay
9-8 to the department a nonrefundable fee of $25 if reinspection is
9-9 necessary to determine compliance with this chapter and the rules
9-10 adopted under this chapter.
9-11 SECTION 16. Section 773.065, Health and Safety Code, is
9-12 amended to read as follows:
9-13 Sec. 773.065. ADMINISTRATIVE PENALTY. (a) The commissioner
9-14 <of health> may assess an administrative penalty against an
9-15 emergency medical services provider or a course coordinator who
9-16 violates this chapter or a rule adopted or an order issued under
9-17 this chapter.
9-18 (b) In determining the amount of the penalty, the
9-19 commissioner shall consider:
9-20 (1) the emergency medical services provider's or
9-21 course coordinator's previous violations;
9-22 (2) the seriousness of the violation;
9-23 (3) any hazard to the health and safety of the public;
9-24 (4) the emergency medical services provider's or
9-25 course coordinator's demonstrated good faith; and
10-1 (5) any other matter as justice may require.
10-2 (c) The penalty may not exceed $250 for each violation.
10-3 (d) Each day a violation continues may be considered a
10-4 separate violation.
10-5 SECTION 17. Section 773.066, Health and Safety Code, is
10-6 amended to read as follows:
10-7 Sec. 773.066. ASSESSMENT OF ADMINISTRATIVE PENALTY. (a) An
10-8 administrative penalty may be assessed only after an emergency
10-9 medical services provider or course coordinator charged with a
10-10 violation is provided notice and given an opportunity to request a
10-11 hearing.
10-12 (b) If a hearing is held, the commissioner shall make
10-13 findings of fact and shall issue a written decision regarding
10-14 whether the emergency medical services provider or course
10-15 coordinator committed a violation and the amount of any penalty to
10-16 be assessed.
10-17 (c) If the emergency medical services provider or course
10-18 coordinator charged with the violation does not request a hearing,
10-19 the commissioner shall determine whether the provider or course
10-20 coordinator committed a violation and the amount of any penalty to
10-21 be assessed.
10-22 (d) After making a determination under Subsection (b) or (c)
10-23 that a penalty is to be assessed against an emergency medical
10-24 services provider or a course coordinator, the commissioner shall
10-25 issue an order requiring that the emergency medical services
11-1 provider or course coordinator pay the penalty.
11-2 (e) Not later than the 30th day after the date an order is
11-3 issued under Subsection (d), the commissioner shall give written
11-4 notice of the order to the emergency medical services provider or
11-5 course coordinator.
11-6 (f) The commissioner may consolidate a hearing held under
11-7 this section with another proceeding.
11-8 SECTION 18. Section 773.067, Health and Safety Code, is
11-9 amended to read as follows:
11-10 Sec. 773.067. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
11-11 later than the 30th day after the date on which an order charging
11-12 the emergency medical services provider or course coordinator with
11-13 a penalty is final as provided by Chapter 2001, Government Code,
11-14 the person charged shall:
11-15 (1) pay the penalty in full;
11-16 (2) pay the penalty and file a petition for judicial
11-17 review contesting the occurrence of the violation, the amount of
11-18 the penalty, or both the occurrence of the violation and the amount
11-19 of the penalty; or
11-20 (3) without paying the penalty, file a petition for
11-21 judicial review contesting the occurrence of the violation, the
11-22 amount of the penalty, or both the occurrence of the violation and
11-23 the amount of the penalty.
11-24 (b) Within the 30-day period, a person who acts under
11-25 Subsection (a)(3) may:
12-1 (1) stay enforcement of the penalty by:
12-2 (A) paying the amount of the penalty to the
12-3 court for placement in an escrow account; or
12-4 (B) giving to the court a supersedeas bond that
12-5 is approved by the court for the amount of the penalty and that is
12-6 effective until all judicial review of the commissioner's order is
12-7 final; or
12-8 (2) request the court to stay enforcement of the
12-9 penalty by:
12-10 (A) filing with the court a sworn affidavit of
12-11 the person stating that the person is financially unable to pay the
12-12 amount of the penalty and is financially unable to give the
12-13 supersedeas bond; and
12-14 (B) giving a copy of the affidavit to the
12-15 commissioner by certified mail.
12-16 (c) If the commissioner receives a copy of an affidavit
12-17 under Subsection (b)(2), the commissioner may file with the court,
12-18 within five days after the date the copy is received, a contest to
12-19 the affidavit. The court shall hold a hearing on the facts alleged
12-20 in the affidavit as soon as practicable and shall stay the
12-21 enforcement of the penalty on finding that the alleged facts are
12-22 true. The person who files an affidavit has the burden of proving
12-23 that the person is financially unable to pay the amount of the
12-24 penalty and to give a supersedeas bond.
12-25 (d) If the person does not pay the amount of the penalty and
13-1 the enforcement of the penalty is not stayed, the commissioner may
13-2 refer the matter to the attorney general for collection of the
13-3 amount of the penalty.
13-4 (e) Judicial review of the order of the commissioner:
13-5 (1) is instituted by filing a petition as provided by
13-6 Subchapter G, Chapter 2001, Government Code; and
13-7 (2) is under the substantial evidence rule.
13-8 (f) If the court sustains the occurrence of the violation,
13-9 the court may uphold or reduce the amount of the penalty and order
13-10 the person to pay the full or reduced amount of the penalty. If
13-11 the court does not sustain the occurrence of the violation, the
13-12 court shall order that no penalty is owed.
13-13 (g) When the judgment of the court becomes final, the court
13-14 shall proceed under this subsection. If the person paid the
13-15 penalty and if the amount of the penalty is reduced or the penalty
13-16 is not upheld by the court, the court shall order that the
13-17 appropriate amount plus accrued interest be remitted to the person.
13-18 The rate of the interest is the rate charged on loans to depository
13-19 institutions by the New York Federal Reserve Bank, and the interest
13-20 shall be paid for the period beginning on the date the penalty was
13-21 paid and ending on the date the penalty is remitted. If the person
13-22 gave a supersedeas bond and if the penalty is not upheld by the
13-23 court, the court shall order the release of the bond. If the
13-24 person gave a supersedeas bond and if the amount of the penalty is
13-25 reduced, the court shall order the release of the bond after the
14-1 person pays the amount. <mailed or otherwise transmitted to the
14-2 provider, the provider shall:>
14-3 <(1) pay the penalty in full; or>
14-4 <(2) if the provider seeks judicial review of the
14-5 amount of the penalty, the fact of the violation, or both:>
14-6 <(A) send the amount of the penalty to the
14-7 commissioner for placement in an escrow account; or>
14-8 <(B) post with the commissioner a bond for the
14-9 amount of the penalty.>
14-10 <(b) A bond posted under this section must be in a form
14-11 approved by the commissioner and must be effective until judicial
14-12 review of the order is final.>
14-13 <(c) An emergency medical services provider who does not
14-14 send the amount of the penalty to the commissioner or post the bond
14-15 within the period prescribed by Subsection (a) may not contest the
14-16 violation or the amount of the penalty.>
14-17 SECTION 19. Sections 773.010, 773.053, and 773.068, Health
14-18 and Safety Code, are repealed.
14-19 SECTION 20. The importance of this legislation and the
14-20 crowded condition of the calendars in both houses create an
14-21 emergency and an imperative public necessity that the
14-22 constitutional rule requiring bills to be read on three several
14-23 days in each house be suspended, and this rule is hereby suspended,
14-24 and that this Act take effect and be in force from and after its
14-25 passage, and it is so enacted.