By Glaze, et al.                                      H.B. No. 2446
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to emergency medical services.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Chapter 771, Health and Safety Code, is amended
 1-5     by adding Subchapter E to read as follows:
 1-6       SUBCHAPTER E.  STATE EMERGENCY MEDICAL DISPATCH RESOURCE CENTER
 1-7           Sec. 771.101.  ESTABLISHMENT OF PILOT PROGRAM. (a)  The Texas
 1-8     Department of Health, with the assistance of the advisory council
 1-9     appointed under Section 773.012, shall establish a pilot program to
1-10     test the efficacy of using emergency medical dispatchers located in
1-11     a regional emergency medical dispatch resource center to provide
1-12     lifesaving and other emergency medical instructions to persons who
1-13     need guidance while awaiting the arrival of emergency medical
1-14     personnel.  The purpose of a regional emergency medical dispatch
1-15     resource center is not to dispatch personnel or equipment resources
1-16     but to serve as a resource to provide pre-arrival instructions that
1-17     may be accessed by selected public safety answering points that are
1-18     not adequately staffed or funded to provide those services.
1-19           (b)  The commission shall provide technical assistance to the
1-20     department to facilitate the implementation of the pilot program.
1-21           (c)  The department, with the cooperation of the advisory
1-22     council, shall:
1-23                 (1)  design criteria and protocols and provide
1-24     oversight as needed to conduct the pilot program;
 2-1                 (2)  collect the necessary data to evaluate the outcome
 2-2     of the pilot program; and
 2-3                 (3)  report its findings to the legislature.
 2-4           Sec. 771.102.  PARTICIPATION IN PILOT PROGRAM. (a)  The Texas
 2-5     Department of Health shall determine which public safety answering
 2-6     points are interested in participating in the pilot program.
 2-7           (b)  The department shall establish criteria for selecting
 2-8     qualified public safety answering points to participate in the
 2-9     pilot program.
2-10           (c)  Participating public safety answering points must agree
2-11     to participate in any required training and to provide regular
2-12     reports required by the department for the pilot program.
2-13           Sec. 771.103.  SELECTION OF REGIONAL EMERGENCY MEDICAL
2-14     DISPATCH RESOURCE CENTER. (a)  The Texas Department of Health, with
2-15     the assistance of the advisory council, shall select one public
2-16     safety answering point to serve as the regional emergency medical
2-17     dispatch resource center.  The public safety answering point
2-18     selected as the resource center for the pilot program must:
2-19                 (1)  have a fully functional quality assurance program
2-20     that measures each emergency medical dispatcher's compliance with
2-21     the medical protocol;
2-22                 (2)  have dispatch personnel who meet the requirements
2-23     for emergency medical dispatcher certification or the equivalent as
2-24     determined by the Texas Department of Health;
2-25                 (3)  use emergency medical dispatch protocols approved
2-26     by a physician medical director knowledgeable in emergency medical
2-27     dispatch;
 3-1                 (4)  have sufficient experience in providing
 3-2     pre-arrival instructions; and
 3-3                 (5)  have sufficient resources to handle the additional
 3-4     workload and responsibilities of the pilot program.
 3-5           (b)  In selecting an existing public safety answering point
 3-6     to act as the resource center, the department and the advisory
 3-7     council shall consider a public safety answering point's ability to
 3-8     keep records and produce reports to measure the effectiveness of
 3-9     the pilot program.
3-10           Sec. 771.104.  CRITERIA FOR EMERGENCY MEDICAL DISPATCH
3-11     INTERVENTION. The department and the advisory council shall define
3-12     criteria that establish the need for emergency medical dispatch
3-13     intervention to be used by participating public safety answering
3-14     points to determine which calls are to be transferred to the
3-15     regional emergency medical dispatch resource center for emergency
3-16     medical dispatch intervention.
3-17           Sec. 771.105.  FUNDING OF PILOT PROGRAM. Money in the 9-1-1
3-18     services fee fund may be appropriated to the Texas Department of
3-19     Health to fund the pilot program.  The department is also
3-20     authorized to seek grant funding for the pilot program.  The
3-21     provisions in this subchapter that require the department to
3-22     establish, conduct, and evaluate the pilot program are contingent
3-23     on the department receiving funding in accordance with this
3-24     section.
3-25           Sec. 771.106.  REPORT TO LEGISLATURE. The department shall
3-26     report its findings to the presiding officer of each house of the
3-27     legislature no later than December 1, 2002.
 4-1           Sec. 771.107.  LIABILITY. The operations of the regional
 4-2     emergency medical dispatch resource center are considered to be the
 4-3     provision of 9-1-1 services for purposes of Section 771.053.
 4-4     Employees of and volunteers at the center have the same protection
 4-5     from liability as a member of the governing body of a public agency
 4-6     under Section 771.053.
 4-7           Sec. 771.108.  EXPIRATION.  This subchapter expires September
 4-8     1, 2003.
 4-9           SECTION 2. Section 773.012, Health and Safety Code, is
4-10     amended by amending Subsection (a) and adding Subsections (k) and
4-11     (l) to read as follows:
4-12           (a)  The governor shall appoint an advisory council to advise
4-13     the board regarding matters related to the responsibilities of the
4-14     board, commissioner, and department under this chapter.  In making
4-15     appointments to the advisory council, the governor shall ensure
4-16     that approximately one-half of the members of the advisory council
4-17     are residents of rural areas of the state.
4-18           (k)  The advisory council shall assess the need for emergency
4-19     medical services in the rural areas of the state.
4-20           (l)  The advisory council shall develop a strategic plan for:
4-21                 (1)  refining the educational requirements for
4-22     certification and maintaining certification as emergency medical
4-23     services personnel; and
4-24                 (2)  developing emergency medical services and trauma
4-25     care systems.
4-26           SECTION 3. Subchapter A, Chapter 773, Health and Safety Code,
4-27     is amended by adding Section 773.013 to read as follows:
 5-1           Sec. 773.013.  PEER ASSISTANCE PROGRAM. The department may
 5-2     establish, approve, and fund a peer assistance program in
 5-3     accordance with Section 467.003 and board rules.
 5-4           SECTION 4. Section 773.025, Health and Safety Code, is
 5-5     amended by adding Subsections (d) and (e) to read as follows:
 5-6           (d)  A governmental entity or nongovernmental organization
 5-7     that sponsors or wishes to sponsor an emergency medical services
 5-8     provider or first responder organization in a rural or underserved
 5-9     area may request the bureau to provide or facilitate the provision
5-10     of initial training for emergency care attendants, if the training
5-11     is not available locally.  The bureau shall ensure that the
5-12     training is provided. The bureau shall provide the training without
5-13     charge, or contract with qualified instructors to provide the
5-14     training without charge, to students who agree to perform emergency
5-15     care attendant services for at least one year with the local
5-16     emergency medical services provider or first responder
5-17     organization. The training must be provided at times and places
5-18     that are convenient to the students. The bureau shall require that
5-19     at least three students are scheduled to take any class offered
5-20     under this subsection.
5-21           (e)  To facilitate all levels of emergency medical services
5-22     training, the bureau shall consult with and solicit comment from
5-23     emergency medical services providers, first responder
5-24     organizations, persons who provide emergency medical services
5-25     training, and other entities interested in emergency medical
5-26     services training programs.
5-27           SECTION 5. Section 773.095(a), Health and Safety Code, is
 6-1     amended to read as follows:
 6-2           (a)  The proceedings and records of organized committees of
 6-3     hospitals, medical societies, emergency medical services providers,
 6-4     emergency medical services and trauma care systems, or first
 6-5     responder organizations relating to the review, evaluation, or
 6-6     improvement of an emergency medical services provider, a first
 6-7     responder organization, an emergency medical services and trauma
 6-8     care system, or emergency medical services personnel are
 6-9     confidential and not subject to disclosure by court subpoena or
6-10     otherwise.
6-11           SECTION 6. Section 773.115(a), Health and Safety Code, is
6-12     amended to read as follows:
6-13           (a)  The bureau may designate trauma facilities that are a
6-14     part of an emergency medical services and trauma care system.  A
6-15     trauma facility shall be designated by the level of trauma care and
6-16     services provided in accordance with the American College of
6-17     Surgeons guidelines for level I and [,] II[, and III] trauma
6-18     facilities [centers] and rules adopted by the board for level III
6-19     and IV [and V] trauma facilities [centers].  In adopting rules
6-20     under this section, the board may consider trauma caseloads,
6-21     geographic boundaries, or minimum population requirements, but the
6-22     bureau may not deny designation solely on these criteria.  The
6-23     board may not set an arbitrary limit on the number of facilities
6-24     designated as trauma facilities.
6-25           SECTION 7. Section 615.003, Government Code, is amended to
6-26     read as follows:
6-27           Sec. 615.003.  APPLICABILITY. This chapter applies only to
 7-1     eligible survivors of the following individuals:
 7-2                 (1)  an individual elected, appointed, or employed as a
 7-3     peace officer by the state or a political subdivision of the state
 7-4     under  Article 2.12, Code of Criminal Procedure, or other law;
 7-5                 (2)  a paid probation officer appointed by the director
 7-6     of a community supervision and corrections department who has the
 7-7     duties set out in Section 76.002 and the qualifications set out in
 7-8     Section 76.005, or who was appointed in accordance with prior law;
 7-9                 (3)  a parole officer employed by the pardons and
7-10     paroles division of the Texas Department of Criminal Justice who
7-11     has the duties set out in Section 508.001 and the qualifications
7-12     set out in Section 508.113 or in prior law;
7-13                 (4)  a paid jailer;
7-14                 (5)  a member of an organized police reserve or
7-15     auxiliary unit who regularly assists peace officers in enforcing
7-16     criminal laws;
7-17                 (6)  a member of the class of employees of the
7-18     institutional division or the state jail division of the Texas
7-19     Department of Criminal Justice formally designated as custodial
7-20     personnel under Section 615.006 by the Texas Board of Criminal
7-21     Justice or its predecessor in function;
7-22                 (7)  a jailer or guard of a county jail who is
7-23     appointed by the sheriff and who:
7-24                       (A)  performs a security, custodial, or
7-25     supervisory function over the admittance, confinement, or discharge
7-26     of prisoners; and
7-27                       (B)  is certified by the [Texas] Commission on
 8-1     Law Enforcement Officer Standards and Education;
 8-2                 (8)  a juvenile correctional employee of the Texas
 8-3     Youth Commission;
 8-4                 (9)  an employee of the Texas Department of Mental
 8-5     Health and Mental Retardation who:
 8-6                       (A)  works at the department's maximum security
 8-7     unit; or
 8-8                       (B)  performs on-site services for the Texas
 8-9     Department of Criminal Justice;
8-10                 (10)  an individual who is employed by the state or a
8-11     political or legal subdivision and is subject to certification by
8-12     the Texas Commission on Fire Protection;
8-13                 (11)  an individual employed by the state or a
8-14     political or legal subdivision whose principal duties are aircraft
8-15     crash and rescue fire fighting;
8-16                 (12)  a member of an organized volunteer fire-fighting
8-17     unit that:
8-18                       (A)  renders fire-fighting services without
8-19     remuneration;
8-20                       (B)  consists of not fewer than 20 active
8-21     members, a majority of whom are present at each meeting; and
8-22                       (C)  conducts a minimum of two drills each month,
8-23     each two hours long; or
8-24                 (13)  an individual who:
8-25                       (A)  performs emergency medical services or
8-26     operates an ambulance;
8-27                       (B)  is employed by a political subdivision of
 9-1     the state or is an emergency medical services volunteer as defined
 9-2     by Section 773.003, Health and Safety Code; and
 9-3                       (C)  is qualified as an emergency care attendant
 9-4     [medical technician] or at a higher level of training under Section
 9-5     773.046, 773.047, 773.048, [or]  773.049, or 773.0495, Health and
 9-6     Safety Code.
 9-7           SECTION 8. Section 61.0285(a), Health and Safety Code, is
 9-8     amended to read as follows:
 9-9           (a)  In addition to basic health care services provided under
9-10     Section 61.028, a county may, in accordance with department rules
9-11     adopted under Section 61.006, provide other medically necessary
9-12     services or supplies that the county determines to be
9-13     cost-effective, including:
9-14                 (1)  ambulatory surgical center services;
9-15                 (2)  diabetic and colostomy medical supplies and
9-16     equipment;
9-17                 (3)  durable medical equipment;
9-18                 (4)  home and community health care services;
9-19                 (5)  services provided by licensed master medical
9-20     social workers--advanced clinical practitioners;
9-21                 (6)  psychological counseling services;
9-22                 (7)  services provided by physician assistants, nurse
9-23     practitioners, certified nurse midwives, clinical nurse
9-24     specialists, and certified registered nurse anesthetists;
9-25                 (8)  dental care;
9-26                 (9)  vision care, including eyeglasses;
9-27                 (10)  services provided by federally qualified health
 10-1    centers, as defined by 42 U.S.C. Section 1396d(l)(2)(B);  [and]
 10-2                (11)  emergency medical services; and
 10-3                (12)  any other appropriate health care service
 10-4    identified by board rule that may be determined to be
 10-5    cost-effective.
 10-6          SECTION 9. Section 106.043(b), Health and Safety Code, is
 10-7    amended to read as follows:
 10-8          (b)  The advisory committee is composed of 13 [12] members
 10-9    appointed by the executive committee and must include:
10-10                (1)  a rural practicing family practice physician;
10-11                (2)  a rural hospital administrator;
10-12                (3)  a rural practicing registered professional nurse;
10-13                (4)  a rural practicing allied health professional;
10-14                (5)  a dean of a medical school;
10-15                (6)  a dean of a nursing school;
10-16                (7)  a dean of a school of allied health science;
10-17                (8)  a head of a vocational/technical institution;
10-18                (9)  a community college administrator;
10-19                (10)  an individual knowledgeable in student financial
10-20    assistance programs;
10-21                (11)  a rural public school superintendent; [and]
10-22                (12)  a rural resident; and
10-23                (13)  an individual who provides emergency medical
10-24    services in a rural area and who is certified or licensed as an
10-25    emergency care attendant or at a higher level of training under
10-26    Section 773.046, 773.047, 773.048, 773.049, or 773.0495.
10-27          SECTION 10.  This Act takes effect September 1, 2001.