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
4-6 agency 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. Subchapter A, Chapter 773, Health and Safety
5-5 Code, is amended by adding Section 773.014 to read as follows:
5-6 Sec. 773.014. ADMINISTRATION OF EPINEPHRINE. (a) An
5-7 emergency medical services provider and a first responder
5-8 organization may acquire and possess epinephrine auto-injector
5-9 devices in accordance with this section. Emergency medical
5-10 services personnel certified as emergency medical technicians or at
5-11 a higher level of training may carry and administer epinephrine
5-12 auto-injector devices in accordance with this section.
5-13 (b) The department shall adopt rules designed to protect the
5-14 public health and safety to implement this section. The rules must
5-15 provide that emergency medical services personnel certified as
5-16 emergency medical technicians or at a higher level of training may
5-17 administer an epinephrine auto-injector device to another only if
5-18 the person has successfully completed a training course, approved
5-19 by the department, in the use of the device that is consistent with
5-20 the national standard training curriculum for emergency medical
5-21 technicians.
5-22 (c) An emergency medical services provider or first
5-23 responder organization may acquire, possess, maintain, and dispose
5-24 of epinephrine auto-injector devices, and emergency medical
5-25 services personnel certified as emergency medical technicians or at
5-26 a higher level of training may carry, maintain, administer, and
5-27 dispose of epinephrine auto-injector devices, only in accordance
6-1 with:
6-2 (1) rules adopted by the department under this
6-3 section; and
6-4 (2) a delegated practice agreement that provides for
6-5 medical supervision by a licensed physician who either:
6-6 (A) acts as a medical director for an emergency
6-7 medical services system or a licensed hospital; or
6-8 (B) has knowledge and experience in the delivery
6-9 of emergency care.
6-10 (d) Emergency medical services personnel who administer
6-11 epinephrine auto-injector devices to others shall immediately
6-12 report the use to the physician supervising the activities of the
6-13 emergency medical services personnel.
6-14 (e) The administration of an epinephrine auto-injector
6-15 device to another under this section is considered to be the
6-16 administration of emergency care for the purposes of any statute
6-17 relating to liability for the provision of emergency care. The
6-18 administration of an epinephrine auto-injector device to another in
6-19 accordance with the requirements of this section does not
6-20 constitute the unlawful practice of any health care profession.
6-21 (f) A person otherwise authorized to sell or provide an
6-22 epinephrine auto-injector device to another may sell or provide the
6-23 devices to an emergency medical services provider or a first
6-24 responder organization authorized to acquire and possess the
6-25 devices under this section.
6-26 (g) This section does not prevent emergency medical services
6-27 personnel who are also licensed health care professionals under
7-1 another health care licensing law and who are authorized to
7-2 acquire, possess, and administer an epinephrine auto-injector
7-3 device under the other health care licensing law from acting under
7-4 the other law.
7-5 (h) This section does not impose a standard of care not
7-6 otherwise required by law.
7-7 SECTION 5. Section 773.025, Health and Safety Code, is
7-8 amended by adding Subsections (d) and (e) to read as follows:
7-9 (d) A governmental entity or nongovernmental organization
7-10 that sponsors or wishes to sponsor an emergency medical services
7-11 provider or first responder organization in a rural or underserved
7-12 area may request the bureau to provide or facilitate the provision
7-13 of initial training for emergency care attendants, if the training
7-14 is not available locally. The bureau shall ensure that the
7-15 training is provided. The bureau shall provide the training without
7-16 charge, or contract with qualified instructors to provide the
7-17 training without charge, to students who agree to perform emergency
7-18 care attendant services for at least one year with the local
7-19 emergency medical services provider or first responder
7-20 organization. The training must be provided at times and places
7-21 that are convenient to the students. The bureau shall require that
7-22 at least three students are scheduled to take any class offered
7-23 under this subsection.
7-24 (e) To facilitate all levels of emergency medical services
7-25 training, the bureau shall consult with and solicit comment from
7-26 emergency medical services providers, first responder
7-27 organizations, persons who provide emergency medical services
8-1 training, and other entities interested in emergency medical
8-2 services training programs.
8-3 SECTION 6. Section 773.095(a), Health and Safety Code, is
8-4 amended to read as follows:
8-5 (a) The proceedings and records of organized committees of
8-6 hospitals, medical societies, emergency medical services providers,
8-7 emergency medical services and trauma care systems, or first
8-8 responder organizations relating to the review, evaluation, or
8-9 improvement of an emergency medical services provider, a first
8-10 responder organization, an emergency medical services and trauma
8-11 care system, or emergency medical services personnel are
8-12 confidential and not subject to disclosure by court subpoena or
8-13 otherwise.
8-14 SECTION 7. Section 773.115(a), Health and Safety Code, is
8-15 amended to read as follows:
8-16 (a) The bureau may designate trauma facilities that are a
8-17 part of an emergency medical services and trauma care system. A
8-18 trauma facility shall be designated by the level of trauma care and
8-19 services provided in accordance with the American College of
8-20 Surgeons guidelines for level I and [,] II[, and III] trauma
8-21 facilities [centers] and rules adopted by the board for level III
8-22 and IV [and V] trauma facilities [centers]. In adopting rules
8-23 under this section, the board may consider trauma caseloads,
8-24 geographic boundaries, or minimum population requirements, but the
8-25 bureau may not deny designation solely on these criteria. The
8-26 board may not set an arbitrary limit on the number of facilities
8-27 designated as trauma facilities.
9-1 SECTION 8. Section 615.003, Government Code, is amended to
9-2 read as follows:
9-3 Sec. 615.003. APPLICABILITY. This chapter applies only to
9-4 eligible survivors of the following individuals:
9-5 (1) an individual elected, appointed, or employed as a
9-6 peace officer by the state or a political subdivision of the state
9-7 under Article 2.12, Code of Criminal Procedure, or other law;
9-8 (2) a paid probation officer appointed by the director
9-9 of a community supervision and corrections department who has the
9-10 duties set out in Section 76.002 and the qualifications set out in
9-11 Section 76.005, or who was appointed in accordance with prior law;
9-12 (3) a parole officer employed by the pardons and
9-13 paroles division of the Texas Department of Criminal Justice who
9-14 has the duties set out in Section 508.001 and the qualifications
9-15 set out in Section 508.113 or in prior law;
9-16 (4) a paid jailer;
9-17 (5) a member of an organized police reserve or
9-18 auxiliary unit who regularly assists peace officers in enforcing
9-19 criminal laws;
9-20 (6) a member of the class of employees of the
9-21 institutional division or the state jail division of the Texas
9-22 Department of Criminal Justice formally designated as custodial
9-23 personnel under Section 615.006 by the Texas Board of Criminal
9-24 Justice or its predecessor in function;
9-25 (7) a jailer or guard of a county jail who is
9-26 appointed by the sheriff and who:
9-27 (A) performs a security, custodial, or
10-1 supervisory function over the admittance, confinement, or discharge
10-2 of prisoners; and
10-3 (B) is certified by the [Texas] Commission on
10-4 Law Enforcement Officer Standards and Education;
10-5 (8) a juvenile correctional employee of the Texas
10-6 Youth Commission;
10-7 (9) an employee of the Texas Department of Mental
10-8 Health and Mental Retardation who:
10-9 (A) works at the department's maximum security
10-10 unit; or
10-11 (B) performs on-site services for the Texas
10-12 Department of Criminal Justice;
10-13 (10) an individual who is employed by the state or a
10-14 political or legal subdivision and is subject to certification by
10-15 the Texas Commission on Fire Protection;
10-16 (11) an individual employed by the state or a
10-17 political or legal subdivision whose principal duties are aircraft
10-18 crash and rescue fire fighting;
10-19 (12) a member of an organized volunteer fire-fighting
10-20 unit that:
10-21 (A) renders fire-fighting services without
10-22 remuneration;
10-23 (B) consists of not fewer than 20 active
10-24 members, a majority of whom are present at each meeting; and
10-25 (C) conducts a minimum of two drills each month,
10-26 each two hours long; or
10-27 (13) an individual who:
11-1 (A) performs emergency medical services or
11-2 operates an ambulance;
11-3 (B) is employed by a political subdivision of
11-4 the state or is an emergency medical services volunteer as defined
11-5 by Section 773.003, Health and Safety Code; and
11-6 (C) is qualified as an emergency care attendant
11-7 [medical technician] or at a higher level of training under Section
11-8 773.046, 773.047, 773.048, [or] 773.049, or 773.0495, Health and
11-9 Safety Code.
11-10 SECTION 9. Section 61.0285(a), Health and Safety Code, is
11-11 amended to read as follows:
11-12 (a) In addition to basic health care services provided under
11-13 Section 61.028, a county may, in accordance with department rules
11-14 adopted under Section 61.006, provide other medically necessary
11-15 services or supplies that the county determines to be
11-16 cost-effective, including:
11-17 (1) ambulatory surgical center services;
11-18 (2) diabetic and colostomy medical supplies and
11-19 equipment;
11-20 (3) durable medical equipment;
11-21 (4) home and community health care services;
11-22 (5) services provided by licensed master medical
11-23 social workers--advanced clinical practitioners;
11-24 (6) psychological counseling services;
11-25 (7) services provided by physician assistants, nurse
11-26 practitioners, certified nurse midwives, clinical nurse
11-27 specialists, and certified registered nurse anesthetists;
12-1 (8) dental care;
12-2 (9) vision care, including eyeglasses;
12-3 (10) services provided by federally qualified health
12-4 centers, as defined by 42 U.S.C. Section 1396d(l)(2)(B); [and]
12-5 (11) emergency medical services; and
12-6 (12) any other appropriate health care service
12-7 identified by board rule that may be determined to be
12-8 cost-effective.
12-9 SECTION 10. Section 106.043(b), Health and Safety Code, is
12-10 amended to read as follows:
12-11 (b) The advisory committee is composed of 13 [12] members
12-12 appointed by the executive committee and must include:
12-13 (1) a rural practicing family practice physician;
12-14 (2) a rural hospital administrator;
12-15 (3) a rural practicing registered professional nurse;
12-16 (4) a rural practicing allied health professional;
12-17 (5) a dean of a medical school;
12-18 (6) a dean of a nursing school;
12-19 (7) a dean of a school of allied health science;
12-20 (8) a head of a vocational/technical institution;
12-21 (9) a community college administrator;
12-22 (10) an individual knowledgeable in student financial
12-23 assistance programs;
12-24 (11) a rural public school superintendent; [and]
12-25 (12) a rural resident; and
12-26 (13) an individual who provides emergency medical
12-27 services in a rural area and who is certified or licensed as an
13-1 emergency care attendant or at a higher level of training under
13-2 Section 773.046, 773.047, 773.048, 773.049, or 773.0495.
13-3 SECTION 11. (a) Except as provided by Subsection (b) of
13-4 this section, this Act takes effect September 1, 2001.
13-5 (b) Section 773.014, Health and Safety Code, as added by
13-6 this Act, takes effect January 1, 2002, except that Section 773.014
13-7 takes effect September 1, 2001, for the limited purpose of allowing
13-8 the Texas Department of Health to adopt rules under that law that
13-9 may take effect before January 1, 2002.
13-10 (c) Before January 1, 2002, epinephrine auto-injector
13-11 devices may be carried and administered by certain emergency
13-12 medical services personnel to the extent allowed under the law that
13-13 exists before September 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 2446 was passed by the House on April
26, 2001, by a non-record vote; that the House refused to concur in
Senate amendments to H.B. No. 2446 on May 21, 2001, and requested
the appointment of a conference committee to consider the
differences between the two houses; and that the House adopted the
conference committee report on H.B. No. 2446 on May 26, 2001, by a
non-record vote.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 2446 was passed by the Senate, with
amendments, on May 17, 2001, by a viva-voce vote; at the request of
the House, the Senate appointed a conference committee to consider
the differences between the two houses; and that the Senate adopted
the conference committee report on H.B. No. 2446 on May 26, 2001,
by a viva-voce vote.
_______________________________
Secretary of the Senate
APPROVED: __________________________
Date
__________________________
Governor