ARIZONA STATE SENATE
Phoenix, Arizona
REVISED
EMTs; first responder; definition
Purpose
Makes numerous changes to
the statutes governing emergency medical services, including training standards
for first responders, centralized medical direction and oversight of emergency
medical technicians (EMTs) and paramedics.
In accordance with A.R.S. §
36-2201, a “first responder” is a person who is employed by an ambulance
service and whose primary responsibility is the driving of an ambulance. Statute also requires first responders to
comply with training and certification requirements that are recommended by the
medical director of the Division of Emergency Medical Services (EMS) and the
Emergency Medical Services Council and adopted by the Director of the
Department of Health Services (DHS).
However, DHS has not developed a training curriculum for first
responders; nor has it adopted the national standard curriculum prescribed by
the U.S. Department of Transportation.
A.R.S. § 36-2202 requires an
ambulance service provider operating in an area with a population of less than
10,000 persons to have a certified EMT and a first responder staffing an
ambulance while transporting a patient.
Due to the lack of training and certification regulations for first
responders, there are currently no certified first responders in the
state. Under these statutory
requirements, ambulance service providers in rural areas have been required to
staff their ambulances with two EMTs, which is more costly.
H.B. 2482 attempts to
address the lack of first responders by prescribing training requirements for
first responders, thus allowing DHS to recognize first responders who have completed
a national curriculum and examination while under the supervision of a
qualified first responder instructor.
DHS is also responsible for protecting the public’s health, safety and welfare through licensing and regulating ambulance service and emergency service providers, including the oversight of EMTs. Pursuant to A.R.S. §36-2202, the Director of DHS is required to adopt standards relating to certification for EMTs and ambulance attendants. Additionally, A.R.S. §6‑2211 authorizes the medical director of EMS to censure an EMT or ambulance attendant or suspend or revoke the certification of an EMT or ambulance attendant. H.B. 2482 authorizes ambulance service and emergency medical services providers to administer EMT certification and recertification tests and investigate and censure EMTs.
Centralized
Medical Direction
Pursuant to rules promulgated by DHS, administrative medical direction is physician development of procedures, protocols and programs related to the education and assessment of prehospital personnel. Prehospital personnel include EMTs and ambulance attendants. Currently, administrative medical direction can only be provided by a base hospital medical director or basic life support medical director. In recent years, the number of base hospitals has declined, reducing the availability of administrative medical direction for prehospital personnel. In particular, prehospital personnel in some rural areas do not have access to a base hospital to receive administrative medical direction.
H.B. 2482 increases access to administrative medical direction by allowing a centralized medical direction communications center to provide centralized medical direction to ambulance service and emergency medical services providers.
There is no fiscal impact to
the state general fund associated with the provisions of this bill.
1. Redefines “first responder” as a person who has been trained under the supervision of a person certified in accordance with American Red Cross standards, provides patient care and treatment and completes the first responder national standard curriculum course, the national registry first responder examination and, biennially, the first responder refresher national standard curriculum.
2. Allows the Director of DHS to waive compliance with a rule on a determination the rule is not in the public’s best interest or is inconsistent with contemporary medical practices.
3. Authorizes the Director to suspend a rule if:
a. it is not in the public’s best interest.
b. the Director initiates the administrative procedure.
c. all interested parties are notified of the action.
4. Requires ambulance service providers serving a certificate of necessity area with a population of more than 10,000 persons to have at least one certified EMT and one other ambulance attendant, excluding first responders, staffing ambulances while transporting patients. (Other ambulance attendants include licensed physicians and nurses.)
5. Authorizes emergency medical services providers and ambulance services providers with their own education and training sections to administer tests for the certification and recertification of EMTs and ambulance attendants.
6. Specifies qualifications for emergency medical services providers and ambulance service providers to administer the tests.
7. Increases, from four to six, the number of lay members who serve on the Emergency Medical Services Council.
8. Allows ambulance services and emergency medical services providers to provide centralized medical direction through a centralized medical direction communications center.
9. Authorizes, in lieu of DHS regulation, ambulance service and emergency medical services providers to investigate and discipline an employee, and censure and place on probation an EMT or paramedic certification if the employer:
a. has a separate investigative or supervisory staff to conduct investigations.
b. has an employee assistance program for counseling.
c. has drug testing policies.
d. has monitoring policies for personnel suspected or convicted of substance abuse.
e. uses an employee performance review system to make the final determination of an employee’s certification status.
10. Requires ambulance service and emergency medical services providers conducting disciplinary investigations to report specific information regarding investigations to the medical director of EMS.
11. Limits the disciplinary action authority of ambulance service and emergency ambulance services providers to grounds for disciplinary action authorized under DHS.
12. Specifies an employer’s decisions are appealable and subject to judicial review.
13. Prescribes definitions.
14. Makes conforming and technical changes.
15. Provides for a general effective date.
1.
Makes
clarifying changes.
1.
Adds
several provisions from H.B. 2479 (emergency medical services providers) with
the exception of provisions relating to the self-inspection of ambulances.
2.
Makes
conforming and technical changes.
House Action Senate
Action
HEALTH 2/2/00 DPA 8-0-0-1 HEALTH 3/7/00 DPA 7-0-2-0
3rd Read 2/28/00 53-0-7-0 3rd Read 3/29/00 29-0-1-0
Prepared by Senate Staff
April 6, 2000