| 1 | 1 | | 23 LC 39 3601 |
|---|
| 2 | 2 | | S. B. 16 |
|---|
| 3 | 3 | | - 1 - |
|---|
| 4 | 4 | | Senate Bill 16 |
|---|
| 5 | 5 | | By: Senators Albers of the 56th, Watson of the 1st, Hufstetler of the 52nd, Still of the 48th, |
|---|
| 6 | 6 | | Kirkpatrick of the 32nd and others |
|---|
| 7 | 7 | | A BILL TO BE ENTITLED |
|---|
| 8 | 8 | | AN ACT |
|---|
| 9 | 9 | | To amend Chapter 11 of Title 31 of the Official Code of Georgia Annotated, relating to |
|---|
| 10 | 10 | | 1 |
|---|
| 11 | 11 | | emergency medical services, so as to amend provisions relative to the Emergency Medical2 |
|---|
| 12 | 12 | | Systems Communications Program administered by the Department of Public Health; to3 |
|---|
| 13 | 13 | | provide for legislative findings, determinations, and declarations; to authorize local entities4 |
|---|
| 14 | 14 | | to establish boundaries for the provision of emergency medical services; to provide for5 |
|---|
| 15 | 15 | | definitions; to provide for a short title; to provide for related matters; to provide for an6 |
|---|
| 16 | 16 | | effective date; to repeal conflicting laws; and for other purposes.7 |
|---|
| 17 | 17 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:8 |
|---|
| 18 | 18 | | SECTION 1.9 |
|---|
| 19 | 19 | | This Act shall be known and may be cited as the "Georgia EMS Reform Act."10 |
|---|
| 20 | 20 | | SECTION 2.11 |
|---|
| 21 | 21 | | Chapter 11 of Title 31 of the Official Code of Georgia Annotated, relating to emergency12 |
|---|
| 22 | 22 | | medical services, is amended by revising Code Section 31-11-1, relating to findings and13 |
|---|
| 23 | 23 | | declaration of policy, as follows:14 23 LC 39 3601 |
|---|
| 24 | 24 | | S. B. 16 |
|---|
| 25 | 25 | | - 2 - |
|---|
| 26 | 26 | | "31-11-1. |
|---|
| 27 | 27 | | 15 |
|---|
| 28 | 28 | | (a) The General Assembly finds and determines:16 |
|---|
| 29 | 29 | | (1) That the furnishing of emergency medical services is a matter of substantial17 |
|---|
| 30 | 30 | | importance to the people of this state;18 |
|---|
| 31 | 31 | | (2) That the cost and quality of emergency medical services are matters within the public19 |
|---|
| 32 | 32 | | interest;20 |
|---|
| 33 | 33 | | (3) That it is highly desirable for the state to participate in emergency medical systems21 |
|---|
| 34 | 34 | | communications programs established pursuant to Public Law 93-154, entitled the22 |
|---|
| 35 | 35 | | Emergency Medical Services Systems Act of 1973;23 |
|---|
| 36 | 36 | | (4) That the administration of an emergency medical systems communications program24 |
|---|
| 37 | 37 | | should be the responsibility of the Department of Public Health, acting upon the25 |
|---|
| 38 | 38 | | recommendations of the local entity which coordinates the program; all |
|---|
| 39 | 39 | | ambulance26 |
|---|
| 40 | 40 | | services shall be a part of this system even if this system is the 9-1-1 emergency27 |
|---|
| 41 | 41 | | telephone number; provided, however, that local governing bodies capable of28 |
|---|
| 42 | 42 | | coordinating ambulance services and related communications should be empowered to29 |
|---|
| 43 | 43 | | do so;30 |
|---|
| 44 | 44 | | (5) That an emergency medical systems communications program in a health district or31 |
|---|
| 45 | 45 | | a service area established by local governing bodies through contract, memorandum of32 |
|---|
| 46 | 46 | | understanding, or other appropriate instrument should be operated as economically and33 |
|---|
| 47 | 47 | | efficiently as possible to serve the public welfare and, to achieve this goal, should involve34 |
|---|
| 48 | 48 | | the designation of geographical territories to be serviced by participating ambulance35 |
|---|
| 49 | 49 | | providers and should involve an economic and efficient procedure to distribute36 |
|---|
| 50 | 50 | | emergency calls among participating ambulance providers serving the same health district37 |
|---|
| 51 | 51 | | or locally established service area; and38 |
|---|
| 52 | 52 | | (6) Any first responder falls under the department's rules and regulations governing39 |
|---|
| 53 | 53 | | ambulances and can transport only in life-threatening situations or by orders of a licensed40 |
|---|
| 54 | 54 | | physician or when a licensed ambulance cannot respond.41 23 LC 39 3601 |
|---|
| 55 | 55 | | S. B. 16 |
|---|
| 56 | 56 | | - 3 - |
|---|
| 57 | 57 | | (b) The General Assembly therefore declares that, in the exercise of the sovereign powers |
|---|
| 58 | 58 | | 42 |
|---|
| 59 | 59 | | of the state to safeguard and protect the public health and general well-being of its citizens,43 |
|---|
| 60 | 60 | | it is the public policy of this state to encourage, foster, and promote emergency medical44 |
|---|
| 61 | 61 | | systems communications programs and that such programs shall be accomplished |
|---|
| 62 | 62 | | in a45 |
|---|
| 63 | 63 | | manner that is coordinated, orderly, economical, and without unnecessary duplication of46 |
|---|
| 64 | 64 | | services and facilities. The General Assembly recognizes the importance of local control47 |
|---|
| 65 | 65 | | relating to the provision of timely and adequate emergency medical services to residents."48 |
|---|
| 66 | 66 | | SECTION 3.49 |
|---|
| 67 | 67 | | Said title is further amended in Code Section 31-11-2, relating to definitions relating to50 |
|---|
| 68 | 68 | | emergency medical services, by revising paragraphs (7) and (15) and adding a new paragraph51 |
|---|
| 69 | 69 | | to read as follows:52 |
|---|
| 70 | 70 | | "(7) 'Emergency medical services system' means a system within territories designated53 |
|---|
| 71 | 71 | | by the department or in locally established service areas which provides for the54 |
|---|
| 72 | 72 | | arrangement of personnel, facilities, and equipment for the effective and coordinated55 |
|---|
| 73 | 73 | | delivery in an appropriate geographical area of health care services under emergency56 |
|---|
| 74 | 74 | | conditions, occurring either as a result of the patient's condition or as a result of natural57 |
|---|
| 75 | 75 | | disasters or similar situations, and which is administered by a public or nonprofit private58 |
|---|
| 76 | 76 | | entity which has the authority and the resources to provide effective administration of the59 |
|---|
| 77 | 77 | | system."60 |
|---|
| 78 | 78 | | "(15) 'Local coordinating entity' means the public or nonprofit private entity designated61 |
|---|
| 79 | 79 | | by the Board of Public Health or its designee or local governing bodies of a locally62 |
|---|
| 80 | 80 | | established service area to administer and coordinate the EMSC Program in a health63 |
|---|
| 81 | 81 | | district established in accord with Code Section 31-3-15 or a locally established service64 |
|---|
| 82 | 82 | | area.65 |
|---|
| 83 | 83 | | (15.1) 'Locally established service area' means an area established by local entities66 |
|---|
| 84 | 84 | | through contract, memorandum of understanding, or other appropriate instrument for the67 23 LC 39 3601 |
|---|
| 85 | 85 | | S. B. 16 |
|---|
| 86 | 86 | | - 4 - |
|---|
| 87 | 87 | | provision of emergency medical services; provided, however, that the creation of which68 |
|---|
| 88 | 88 | | has been approved by the department pursuant to Code Section 31-11-31."69 |
|---|
| 89 | 89 | | SECTION 4.70 |
|---|
| 90 | 90 | | Said title is further amended by revising Code Section 31-11-3, relating to recommendations71 |
|---|
| 91 | 91 | | by local coordinating entity as to administration of EMSC Program and hearing and appeal,72 |
|---|
| 92 | 92 | | as follows:73 |
|---|
| 93 | 93 | | "31-11-3.74 |
|---|
| 94 | 94 | | (a) The Board of Public Health shall have the authority on behalf of the state to designate75 |
|---|
| 95 | 95 | | and contract with a public or nonprofit local entity to coordinate and administer the EMSC76 |
|---|
| 96 | 96 | | Program for each health district the territories designated by the Department of Public77 |
|---|
| 97 | 97 | | Health department. The local coordinating entity thus designated shall be responsible for78 |
|---|
| 98 | 98 | | recommending to the board or its designee the manner in which the EMSC Program is to79 |
|---|
| 99 | 99 | | be conducted. In making its recommendations, the local coordinating entity shall give80 |
|---|
| 100 | 100 | | priority to making the EMSC Program function as efficiently and economically as possible.81 |
|---|
| 101 | 101 | | Each licensed ambulance provider in the health district territories designated by the82 |
|---|
| 102 | 102 | | department and the locally established service areas shall have the opportunity to83 |
|---|
| 103 | 103 | | participate in the EMSC Program.84 |
|---|
| 104 | 104 | | (b) The local coordinating entity shall request from each licensed ambulance provider in85 |
|---|
| 105 | 105 | | its health district or locally established service area a written description of the territory in86 |
|---|
| 106 | 106 | | which it can respond to emergency calls, based upon the provider's average response time87 |
|---|
| 107 | 107 | | from its base location within such territory; and such written description shall be due within88 |
|---|
| 108 | 108 | | ten days of the request by the local coordinating entity.89 |
|---|
| 109 | 109 | | (c)(1) After receipt of the written descriptions of territory in which where the ambulance90 |
|---|
| 110 | 110 | | providers propose to respond to emergency calls, the local coordinating entity shall91 |
|---|
| 111 | 111 | | within ten days recommend in writing: to92 23 LC 39 3601 |
|---|
| 112 | 112 | | S. B. 16 |
|---|
| 113 | 113 | | - 5 - |
|---|
| 114 | 114 | | (A) To the board or its designee, the territories within the health district to be serviced93 |
|---|
| 115 | 115 | | by the ambulance providers; and at this same time the local coordinating entity shall94 |
|---|
| 116 | 116 | | also recommend the and a recommended method for distributing emergency calls95 |
|---|
| 117 | 117 | | among the providers, based primarily on the considerations of economy, efficiency, and96 |
|---|
| 118 | 118 | | benefit to the public welfare; and97 |
|---|
| 119 | 119 | | (B) To the governing bodies of any locally established service area, the ambulance98 |
|---|
| 120 | 120 | | providers authorized to provide service within the locally established service area and99 |
|---|
| 121 | 121 | | a recommended method for distributing emergency calls among the providers, based100 |
|---|
| 122 | 122 | | primarily on the considerations of economy, efficiency, and benefit to the public101 |
|---|
| 123 | 123 | | welfare.102 |
|---|
| 124 | 124 | | (2) The recommendation recommendations of the local coordinating entity provided for103 |
|---|
| 125 | 125 | | in subparagraph (1)(A) of this subsection shall be forwarded immediately to the board or104 |
|---|
| 126 | 126 | | its designee for approval or modification of the territorial zones and method of105 |
|---|
| 127 | 127 | | distributing calls among ambulance providers participating in the EMSC Program in the106 |
|---|
| 128 | 128 | | health district.107 |
|---|
| 129 | 129 | | (d) The board, or its designee, is empowered to conduct a hearing into the108 |
|---|
| 130 | 130 | | recommendations made by the local coordinating entity pursuant to subparagraph (c)(1)(A)109 |
|---|
| 131 | 131 | | of this Code Section, and such hearing shall be conducted according to the procedures set110 |
|---|
| 132 | 132 | | forth in Code Section 31-5-2.111 |
|---|
| 133 | 133 | | (e) The recommendations of the local coordinating entity made pursuant to subparagraph112 |
|---|
| 134 | 134 | | (c)(1)(A) of this Code Section shall not be modified unless the board or its designee shall113 |
|---|
| 135 | 135 | | find, after a hearing, that the determination of the district health director is not consistent114 |
|---|
| 136 | 136 | | with operation of the EMSC Program in an efficient, economical manner that benefits the115 |
|---|
| 137 | 137 | | public welfare. The decision of the board or its designee shall be rendered as soon as116 |
|---|
| 138 | 138 | | possible and shall be final and conclusive concerning the operation of the EMSC Program;117 |
|---|
| 139 | 139 | | and appeal from such decision shall be pursuant to Code Section 31-5-3.118 23 LC 39 3601 |
|---|
| 140 | 140 | | S. B. 16 |
|---|
| 141 | 141 | | - 6 - |
|---|
| 142 | 142 | | (f)(1) The local coordinating entity shall begin administering the EMSC Program in119 |
|---|
| 143 | 143 | | accord with the decision by the board or its designee immediately after the decision by120 |
|---|
| 144 | 144 | | the board or its designee regarding the approval or modification of the recommendations121 |
|---|
| 145 | 145 | | made by the local coordinating entity; and the EMSC Program shall be operated in such122 |
|---|
| 146 | 146 | | manner pending the resolution of any appeals filed pursuant to Code Section 31-5-3.123 |
|---|
| 147 | 147 | | (2) The local coordinating entity shall begin administering the EMSC Program within124 |
|---|
| 148 | 148 | | a locally established service area upon approval or modification made by the governing125 |
|---|
| 149 | 149 | | bodies of any locally established service area.126 |
|---|
| 150 | 150 | | (g) This Code section shall not apply to air ambulances or air ambulance services."127 |
|---|
| 151 | 151 | | SECTION 5.128 |
|---|
| 152 | 152 | | Said chapter is further amended by adding a new Code section to read as follows:129 |
|---|
| 153 | 153 | | "31-11-3.1.130 |
|---|
| 154 | 154 | | On and after January 1, 2024, any local governing body may elect to be removed from the131 |
|---|
| 155 | 155 | | territories designated by the department for service of emergency medical services pursuant132 |
|---|
| 156 | 156 | | to Code Section 31-11-3. At least two months prior to any such election, such local133 |
|---|
| 157 | 157 | | governing body shall submit to the local coordinating entity the geographic location to be134 |
|---|
| 158 | 158 | | removed, a proposed plan for providing adequate emergency medical services, and copies135 |
|---|
| 159 | 159 | | of any contract, memorandum of understanding, or other appropriate instrument executed136 |
|---|
| 160 | 160 | | between local governing bodies when the proposed locally established service area is to137 |
|---|
| 161 | 161 | | provide services to more than one local subdivision of this state. The local coordinating138 |
|---|
| 162 | 162 | | entity shall immediately forward the information required by this Code section to the139 |
|---|
| 163 | 163 | | department. The department shall approve within 30 days any proposal submitted pursuant140 |
|---|
| 164 | 164 | | to this Code section unless it is found that such proposal would harm the public welfare.141 |
|---|
| 165 | 165 | | Any denial by the department of a proposal submitted pursuant to this Code section shall142 |
|---|
| 166 | 166 | | be subject to hearing and review in accordance with Chapter 13 of Title 50, the 'Georgia143 |
|---|
| 167 | 167 | | Administrative Procedure Act.' The department shall modify the territorial zones and144 23 LC 39 3601 |
|---|
| 168 | 168 | | S. B. 16 |
|---|
| 169 | 169 | | - 7 - |
|---|
| 170 | 170 | | method of distributing calls among ambulance providers participating in the EMSC145 |
|---|
| 171 | 171 | | Program in any health district where a local service area has been approved."146 |
|---|
| 172 | 172 | | SECTION 6.147 |
|---|
| 173 | 173 | | Said title is further amended by revising Code Section 31-11-4, relating to supervision and148 |
|---|
| 174 | 174 | | modifications of EMSC Program, as follows:149 |
|---|
| 175 | 175 | | "31-11-4.150 |
|---|
| 176 | 176 | | The board or its designee shall exercise continuing supervision over the operations of the151 |
|---|
| 177 | 177 | | EMSC Program in each the areas of any health district outside of locally established152 |
|---|
| 178 | 178 | | service areas and shall make all necessary modifications in accord with the procedures set153 |
|---|
| 179 | 179 | | forth in Code Section 31-11-3."154 |
|---|
| 180 | 180 | | SECTION 7.155 |
|---|
| 181 | 181 | | Said title is further amended by revising Code Section 31-11-9, relating to enforcement and156 |
|---|
| 182 | 182 | | inspections, as follows:157 |
|---|
| 183 | 183 | | "31-11-9.158 |
|---|
| 184 | 184 | | The department and its duly authorized agents are authorized to enforce compliance with159 |
|---|
| 185 | 185 | | this chapter and rules and regulations promulgated under this chapter as provided in Article160 |
|---|
| 186 | 186 | | 1 of Chapter 5 of this title and, in connection therewith during the reasonable business161 |
|---|
| 187 | 187 | | hours of the day, to enter upon and inspect in a reasonable manner the premises of persons162 |
|---|
| 188 | 188 | | providing ambulance service. All inspections under this Code section shall be in163 |
|---|
| 189 | 189 | | compliance with the provisions of Article 2 of Chapter 5 of this title. The department is164 |
|---|
| 190 | 190 | | also authorized to enforce compliance with this chapter, including but not limited to165 |
|---|
| 191 | 191 | | compliance with the EMSC Program and furnishing of emergency services within166 |
|---|
| 192 | 192 | | designated territories outside the boundaries of any locally established service area, by167 |
|---|
| 193 | 193 | | imposing fines in the same manner as provided in paragraph (6) of subsection (c) of Code168 23 LC 39 3601 |
|---|
| 194 | 194 | | S. B. 16 |
|---|
| 195 | 195 | | - 8 - |
|---|
| 196 | 196 | | Section 31-2-8; this enforcement action shall be a contested case under Chapter 13 of Title |
|---|
| 197 | 197 | | 169 |
|---|
| 198 | 198 | | 50, the 'Georgia Administrative Procedure Act.'"170 |
|---|
| 199 | 199 | | SECTION 8.171 |
|---|
| 200 | 200 | | Said title is further amended in Code Section 31-11-53.1, relating to automated external172 |
|---|
| 201 | 201 | | defibrillator program, establishment, regulations, and liability, by revising subsection (d) as173 |
|---|
| 202 | 202 | | follows:174 |
|---|
| 203 | 203 | | "(d) The department shall establish an automated external defibrillator program for use by175 |
|---|
| 204 | 204 | | emergency medical technicians. Such program shall be subject to the direct supervision176 |
|---|
| 205 | 205 | | of a medical adviser approved under Code Section 31-11-50. No emergency medical177 |
|---|
| 206 | 206 | | technician shall be authorized to use an automated external defibrillator to defibrillate a178 |
|---|
| 207 | 207 | | person unless that defibrillator is a properly maintained automated external defibrillator and179 |
|---|
| 208 | 208 | | that emergency medical technician:180 |
|---|
| 209 | 209 | | (1) Submits to and has approved by the department an application for such use, and in |
|---|
| 210 | 210 | | 181 |
|---|
| 211 | 211 | | considering that application the department may obtain and use the recommendation of182 |
|---|
| 212 | 212 | | the local coordinating entity for the health district in which the applicant will use such183 |
|---|
| 213 | 213 | | defibrillator;184 |
|---|
| 214 | 214 | | (2) Successfully completes an automated external defibrillator training program185 |
|---|
| 215 | 215 | | established or approved by the department;186 |
|---|
| 216 | 216 | | (3) Is subject to protocols requiring that both the emergency physician who receives a187 |
|---|
| 217 | 217 | | patient defibrillated by that emergency medical technician and the medical adviser for the188 |
|---|
| 218 | 218 | | defibrillator program review the department required prehospital care report and any189 |
|---|
| 219 | 219 | | other documentation of the defibrillation of any person by that emergency medical190 |
|---|
| 220 | 220 | | technician and send a written report of such review to the district EMS medical director191 |
|---|
| 221 | 221 | | of the health district in which the defibrillation occurred; and192 |
|---|
| 222 | 222 | | (4) Obtains a passing score on an annual automated external defibrillator proficiency193 |
|---|
| 223 | 223 | | exam given in connection with that program."194 23 LC 39 3601 |
|---|
| 224 | 224 | | S. B. 16 |
|---|
| 225 | 225 | | - 9 - |
|---|
| 226 | 226 | | SECTION 9. |
|---|
| 227 | 227 | | 195 |
|---|
| 228 | 228 | | This Act shall become effective on January 1, 2024.196 |
|---|
| 229 | 229 | | SECTION 10.197 |
|---|
| 230 | 230 | | All laws and parts of laws in conflict with this Act are repealed.198 |
|---|