79R4186 JTS-F
By: Solis H.B. No. 3368
A BILL TO BE ENTITLED
AN ACT
relating to establishing a State Emergency Medical Services
Commission.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 773, Health and Safety
Code, is amended by adding Section 773.0031 to read as follows:
Sec. 773.0031. TRANSFER OF AUTHORITY AND DUTIES. The
authority granted to and the duties of the board, the department,
and the bureau under this chapter are transferred to the State
Emergency Medical Services Commission under Subchapter H.
SECTION 2. Chapter 773, Health and Safety Code, is amended
by adding Subchapter H to read as follows:
SUBCHAPTER H. STATE EMERGENCY MEDICAL SERVICES COMMISSION
Sec. 773.201. DEFINITIONS. In this subchapter:
(1) "Advisory council" means the advisory council
established by Section 773.012.
(2) "Commission" means the State Emergency Medical
Services Commission established under this subchapter.
(3) "Director" means the state emergency medical
services director.
(4) "Medical board" means the Emergency Medical
Services Medical Board established by Section 773.206.
(5) "Medical director" means the state emergency
medical services medical director.
Sec. 773.202. COMMISSION MEMBERS. (a) The commission is
composed of the following nine members:
(1) the presiding officer of the advisory council; and
(2) eight members appointed by the governor as
follows:
(A) an officer or employee of a private provider
of emergency medical services, appointed from a list of names
recommended by a statewide association of private providers of
emergency medical services;
(B) a volunteer who provides emergency medical
services, appointed from a list of names recommended by a statewide
association of volunteers;
(C) an educator in the field of emergency medical
services;
(D) a representative of a fire department that
provides emergency medical services, appointed from a list of names
recommended by a statewide association of firefighters;
(E) a representative of hospitals who is
affiliated with a hospital that provides emergency medical
services, appointed from a list of names recommended by a statewide
association of hospitals;
(F) a representative of a county provider of
emergency medical services;
(G) a representative of a municipal provider of
emergency medical services; and
(H) one member of the advisory council.
(b) Appointed members of the commission serve staggered
six-year terms with one-third, or as near as one-third as possible,
of the members' terms expiring February 1 of each odd-numbered
year.
(c) A vacancy on the commission is filled for the unexpired
term in the same manner as the original appointment.
(d) A member of the commission may be removed if the member
is absent from more than 60 percent of the regularly scheduled
commission meetings that the member is eligible to attend during a
calendar year without an excuse approved by a majority vote of the
commission.
(e) The presiding officer of the commission shall notify the
governor if grounds for removal exist.
(f) The commission shall elect from among its members a
presiding officer, vice presiding officer, secretary, and
governor's liaison. Each officer serves in that capacity until the
person's term as a commission member expires.
(g) The commission shall meet at least six times a year on
the call of the presiding officer or any five members.
Sec. 773.203. COMMISSION DUTIES. The commission shall:
(1) every five years, adopt a statewide plan for the
coordinated delivery of emergency medical services and submit the
plan to the governor, lieutenant governor, and speaker of the house
of representatives;
(2) adopt rules to implement the licensing and
certification requirements of Subchapter C;
(3) annually inventory emergency medical services
resources within the state, including facilities, equipment, and
personnel, to determine:
(A) the need for additional services; and
(B) the effectiveness of existing services;
(4) report the results of the inventory under
Subdivision (3) to the legislature and county and city officials;
(5) review and evaluate all areawide plans developed
by the emergency medical services councils;
(6) review for conformity to policy guidelines all
grant and contract applications for federal or state funds
available for emergency medical services or related activities and
forward applications to the appropriate agency, when applicable;
(7) establish minimum standards and regulations to
develop the following components of an emergency medical services
system:
(A) communications;
(B) transportation services to and from medical
facilities;
(C) training, including training of emergency
medical technicians and communications personnel; and
(D) emergency medical services facilities;
(8) coordinate training of all personnel involved with
emergency medical services;
(9) develop or cause to be developed a data collection
system that follows a patient from initial entry into the emergency
medical services system to the patient's arrival at the emergency
department;
(10) establish an emergency medical services research
component to improve emergency medical services pre-hospital
patient care and approve a process for local emergency medical
services providers to perform research approved by the commission;
(11) establish emergency medical services service
areas for emergency medical services providers in the licensing
process;
(12) develop programs, including programs relating
to:
(A) public education and information;
(B) administration of emergency medical services
grants;
(C) planning;
(D) cost data and alternative funding sources for
commission duties and goals; and
(E) performance standards for the evaluation of
commission goals;
(13) with the advice of the regional advisory council
pre-hospital committees, develop model local emergency medical
services plans and performance agreements to guide municipalities
in the development of such plans and agreements;
(14) require all licensed emergency medical services
providers to provide their current charges or rates to the
commission;
(15) review Medicaid reimbursement rates to emergency
medical services providers and make recommendations to the
legislature on reimbursements to licensed emergency medical
services providers each legislative session; and
(16) conduct random audits for possible Medicare,
insurance, and Medicaid fraud.
Sec. 773.204. LICENSE OR CERTIFICATION REQUIREMENTS. (a)
Rules adopted under Section 773.203(2) must:
(1) require an emergency medical services provider to:
(A) have written approval by the local
governmental entity the provider serves;
(B) follow all ordinances applicable in each
municipality in which the provider transports patients;
(C) follow all county policies approved by a
commissioners court to operate in each county in which the provider
operates;
(D) be an active member in good standing of at
least one regional advisory council for a region in which the
provider provides services;
(E) report required data run information to the
commission; and
(F) comply with the data run information set by
the commission;
(2) require an emergency medical services licensed
ambulance provider to have written approval from each governing
body of a municipality and county commissioners court in the area in
which the provider operates, and submit the approval to the
commission; and
(3) require an emergency medical services medical
director to complete and pass a continuing education course once
every two years.
(b) The governing body of a municipality or county
commissioners court may set its own fines and fees applicable to the
operation of a medical transportation service within its
jurisdiction, not to exceed the fines and fees set by the state.
Sec. 773.205. REPORT BY STATE MEDICAID CONTRACTOR. The
executive commissioner of the Health and Human Services Commission
shall require the state's Medicaid contractor to provide semiannual
reports to the commission on reimbursements made to emergency
medical services licensed providers and to work closely with the
commission to:
(1) ensure that emergency medical services providers
are reimbursed within 45 days of the claim;
(2) reduce denials of emergency medical services
provider claims; and
(3) adopt the Medicare methodology for emergency
medical services provider reimbursements.
Sec. 773.206. MEDICAL BOARD. (a) The medical board is
composed of 15 members appointed by the commission as follows:
(1) five chairs of regional medical advisory councils;
(2) a member of the American College of Emergency
Physicians;
(3) a member of the Texas College of Emergency
Physicians;
(4) a member of an emergency medical services medical
directors association;
(5) a paramedic who is licensed or certified, as
required;
(6) an emergency medical technician-intermediate who
is licensed or certified, as required;
(7) an emergency medical technician who is licensed or
certified, as required;
(8) two emergency medical services administrators of
licensed emergency medical services providers in an urban area; and
(9) two emergency medical services administrators of
licensed emergency medical services providers in a rural area.
(b) Nonvoting members may be added to the medical board at
the discretion of the medical board.
(c) Appointed members of the medical board serve staggered
six-year terms, with five of the members' terms expiring February 1
of each odd-numbered year. A vacancy on the medical board is filled
for the unexpired term in the same manner as the original
appointment.
(d) The medical board may remove a member if the member is
absent from more than 60 percent of the regularly scheduled
meetings that the member is eligible to attend during a calendar
year without an excuse approved by a majority vote of the medical
board.
(e) The medical board shall notify by certified mail a
member removed under Subsection (d).
(f) The medical board shall elect from among its members a
presiding officer, vice presiding officer, secretary, and
commission liaison. Each officer serves in that capacity until the
person's term as a medical board member expires.
(g) The medical board shall meet during the same dates that
the commission meets.
Sec. 773.207. MEDICAL BOARD DUTIES. The medical board may
advise the commission to:
(1) coordinate the medical aspects of the commission's
planning and administration for the statewide emergency medical
services system;
(2) develop and approve statewide recommended
treatment protocols, guidelines, and policies relating to medical
care delivered by emergency medical services providers;
(3) ensure that all elements of the statewide
emergency medical services system are medically current and valid,
including training, patient care, protocols, telecommunications,
medical equipment, regulations, and performance standards;
(4) establish and revise biannually adult and
pediatric patient care protocols;
(5) oversee medical content of dispatching and
pre-arrival instructions;
(6) review and approve emergency medical services
research proposals;
(7) review and disseminate research results and
follow-up information;
(8) assess regional medical issues as presented by
regional medical directors;
(9) review disciplinary actions from any emergency
medical services segment as requested and comment on medical issues
involved; and
(10) develop the curriculum, course, and hours for an
emergency medical services medical directors course and required
continuing education.
Sec. 773.208. ADVISORY COUNCIL AS POLICY ARM. (a) The
advisory council shall advise the commission on commission policy.
The advisory council shall review and comment on all emergency
medical services issues, including finances, policies, guidelines,
legislation, regulations, and procedures necessary to operate the
statewide emergency medical services system. The advisory council
will assist the commission in developing and implementing the
statewide emergency medical services plan.
(b) The advisory council shall establish:
(1) an air medical committee;
(2) an education committee;
(3) an injury prevention committee;
(4) a pediatric committee;
(5) a rural emergency medical services committee;
(6) a trauma committee;
(7) a medical transportation providers task force; and
(8) other committees and task forces the advisory
council considers necessary or appropriate.
(c) The advisory council shall appoint committee members to
its committees and task forces.
Sec. 773.209. COMMISSION EMPLOYEES. (a) The commission
shall appoint a state emergency medical services director. The
director must be a paramedic who is licensed or certified, as
required, with not less than 12 years experience, of which eight
years must have been in providing patient care for an emergency
medical services licensed provider as a paramedic in the field. The
director shall carry out the day-to-day functions of the commission
and carry out tasks delegated by the commission.
(b) The commission shall appoint a state emergency medical
services medical director. The medical director serves as a
nonvoting member of the medical board and carries out functions
related to medical care delegated by the commission. The medical
director may serve as medical director for emergency medical
services programs that apply with the commission for a medical
director due to financial hardship. The commission may set an
annual fee for the services provided by the medical director under
this subsection. The medical director shall attempt to keep all
protocols standard for each of the emergency medical services
programs served by the medical director under this subsection.
(c) The director shall hire and manage commission staff to
assist in carrying out the commission's duties.
Sec. 773.210. REGIONAL ADVISORY COUNCILS. (a) Regional
advisory councils shall present recommendations from their
emergency medical services medical directors committees and
pre-hospital provider committees to the advisory council or
commission as necessary.
(b) The regional advisory councils shall provide continuous
evaluation of emergency medical services for their respective
geographic areas.
(c) Regional advisory councils may charge licensed
emergency medical services providers dues in an amount considered
reasonable by the commission to support their role in emergency
medical services. Regional advisory councils may supplement any
state funds the council or an emergency medical services provider
receives for problematic issues in emergency medical services.
Sec. 773.211. REVENUE; ACCOUNT. (a) Subject to this
chapter, the commission may set fines, fees, dues, or any other
emergency medical services revenue source at an amount to cover the
expense of administering this chapter.
(b) The commission may apply for, accept, receive, and
administer gifts, grants, loans, and other funds available from any
source for the purposes of this chapter.
(c) The comptroller shall credit revenue collected under
this chapter to an account in the general revenue fund. Money in
the account may be appropriated only to the commission to
administer this chapter.
Sec. 773.212. CONFLICT WITH OTHER PROVISIONS. To the
extent that this subchapter conflicts with another provision of
this chapter, this subchapter prevails.
SECTION 3. (a) On the effective date of this Act:
(1) all of the rights, powers, duties, functions,
programs, and activities assigned to the executive commissioner of
the Health and Human Services Commission, the Department of State
Health Services, the Bureau of Emergency Management, or the
department's or bureau's officers or employees relating to
emergency medical services are transferred to the State Emergency
Medical Services Commission established under Subchapter H,
Chapter 773, Health and Safety Code, as added by this Act; and
(2) all appropriations, funds, obligations,
contracts, property, and records of the department and bureau
relating to emergency medical services are transferred to the State
Emergency Medical Services Commission.
(b) A rule or form adopted by the executive commissioner of
the Health and Human Services Commission, Department of State
Health Services, or Bureau of Emergency Management that relates to
emergency medical services is a rule or form of the State Emergency
Medical Services Commission and remains in effect until altered by
that commission. The secretary of state is authorized to adopt
rules as necessary to expedite the implementation of this
subsection.
(c) A reference in law to the executive commissioner of the
Health and Human Services Commission, the Department of State
Health Services, the Bureau of Emergency Management, the Texas
Department of Health, or the Texas Board of Health that relates to
emergency medical services means the State Emergency Medical
Services Commission.
(d) Not later than November 1, 2006, the presiding officer
and the state emergency medical services director of the State
Emergency Medical Services Commission shall report to the
lieutenant governor and the speaker of the house of representatives
on the transition under this section.
(e) The transfer of powers, duties, functions, programs,
and activities under this Act does not affect or impair any act
done, any obligation, right, order, license, permit, rule,
criterion, standard, or requirement existing, any investigation
begun, or any penalty accrued under former law, and that law remains
in effect for any action concerning those matters.
(f) An action brought or proceeding commenced before the
effective date of this Act, including a contested case or a remand
of an action or proceeding by a reviewing court, is governed by the
law and rules applicable to the action or proceeding before the
effective date of this Act.
SECTION 4. (a) Not later than January 1, 2006, the governor
shall appoint initial members of the State Emergency Medical
Services Commission as required by Section 773.202, Health and
Safety Code, as added by this Act. In appointing the initial
members of the commission, the governor shall appoint two members
to terms expiring February 1, 2007, three members to terms expiring
February 1, 2009, and three members to terms expiring February 1,
2011.
(b) Not later than February 1, 2006, the State Emergency
Medical Services Commission shall appoint initial members of the
Emergency Medical Services Medical Board as required by Section
773.206, Health and Safety Code, as added by this Act. In
appointing the initial members of the medical board, the commission
shall appoint five members to terms expiring February 1, 2007,
three members to terms expiring February 1, 2009, and three members
to terms expiring February 1, 2011.
SECTION 5. This Act takes effect September 1, 2005.