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Regular Session, 2012
SENATE BILL NO. 500
BY SENATOR BUFFINGTON
HEALTH SERVICES. Amends the emergency medical services provisions. (gov sig)
AN ACT1
To amend and reenact R.S. 36:919.4 and R.S. 40:1231, 1231.1(A), 1232(A) and (B),2
1232.1(A) and (B), 1232.2(B)(1)(b) and (d), (B)(2), and (G), 1232.3(A)(1) through3
(3) and (B), 1232.4(1), (3), and (5), 1232.5, the introductory paragraph of 1232.6,4
and 1232.6 (1), (2), and (12), 1232.7 (D) and (E), 1232.9, 1232.11, 1233, 1234,5
1235(A)(1), (2)(a), (c), and (d), 1235.1(A), 1236, 1236.1, 1236.13(B) and (F),6
1299.58.2(4), 1299.64.2(3); to enact R.S. 40:1232.4(10) and 1232.6(15), and to7
repeal R.S. 40:1236.3, relative to the changes within the emergency medical services8
provisions; to provide for changes in references to emergency medical personnel; to9
provide with respect to title designations for certain licensee providing emergency10
medical services; to provide with respect to grounds for disciplinary proceedings11
relative to intentional falsification of documents; to provide relative to the duties of12
emergency medical personnel; to provide relative to the permissible functions which13
an emergency medical services practitioner student may perform and under what14
conditions they may be performed; to provide with respect to the certifications15
necessary for an emergency medical services practitioner to hold; and to provide for16
related matters.17 SB NO. 500
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Be it enacted by the Legislature of Louisiana:1
Section 1. R.S. 36:919.4 is hereby amended and reenacted to read as follows:2
§919.4. Transfer; Louisiana Emergency Medical Services Certification Commission3
The Louisiana Emergency Medical Services Certification Commission,4
placed in the Department of Health and Hospitals by the provisions of R.S.5
36:259(GG), shall exercise and perform its powers, duties, functions, and6
responsibilities as provided for agencies transferred pursuant to this Part. However,7
the commission shall advise the bureau of emergency medical services, office of8
public health, on requirements and standards for certification of emergency medical9
personnel and continuing education requirements for certification. The commission10
shall retain the authority to approve requirements and standard of practice for11
emergency medical personnel; conduct disciplinary hearings for emergency medical12
personnel; and cause the prosecution of any individual who violates the provisions13
of Subpart B of Part VII of Chapter 5 of Title 40 of the Louisiana Revised Statutes14
of 1950.15
Section 2. R.S. 40:1231, 1231.1(A), 1232(A) and (B), 1232.1(A) and (B),16
1232.2(B)(1)(b) and (d), (B)(2), and (G), 1232.3(A)(1) through (3) and (B), 1232.4 (1), (3),17
and (5), 1232.5, the introductory paragraph of 1232.6 and 1232.6 (1), (2), and (12), 1232.718
(D) and (E), 1232.9, 1232.11, 1233, 1234, 1235(A)(1), (2)(a), (c), and (d), 1235.1(A), 1236,19
1236.1, 1236.13(B) and (F), 1299.58.2(4), 1299.64.2(3) are hereby amended and reeancted20
and R.S. 40:1232.4 (10) and 1232.6 (15) are hereby enacted to read as follows:21
PART VII. EMERGENCY MEDICAL SERVICES22
SUBPART A. GENERAL PROVISIONS23
§1231. Definitions24
For purposes of this Part:25
(1) "Ambulance" means any authorized emergency vehicle, equipped with26
warning devices, designed and operated as a part of a regular course of conduct or27
business to transport a sick or injured individual or which is advertised or otherwise28
held out to the public as such. "Ambulance" shall not mean a hearse or other funeral29 SB NO. 500
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home vehicle utilized for the transportation of the dead.1
(2) "Ambulance service" or "ambulance provider" means any person, firm,2
association, or government entity owning, controlling, or operating any business or3
service which furnishes, operates, conducts, maintains, advertises, engages in,4
proposes to engage in, or professes to engage in the business or service of5
transporting, in ambulances, individuals who may need medical attention during6
transport. However, "ambulance service" and "ambulance provider" shall not include7
any of the following:8
(a) An agency of the federal government.9
(b) A volunteer nonprofit organization or municipal nonprofit organization10
operating an invalid coach or coaches.11
(c) An entity rendering assistance to a licensed ambulance or ambulances in12
the case of a major disaster.13
(d) A licensed hospital providing nonemergency, noncritical interhospital14
transfer and patient transportation for diagnostic and therapeutic purposes when such15
transportation originates at a licensed hospital.16
(e) An entity operating an ambulance or ambulances from a location outside17
of the state to transport patients from a location outside of the state to a location18
inside the state or to transport a patient or patients from a medical facility inside of19
the state to a location outside of the state.20
(f) An entity providing transportation to employees who become sick or21
injured during the course of their employment from a job site to the nearest22
appropriate medical facility.23
(3) "Air ambulance" means any aircraft, either fixed-wing or rotary-winged,24
designed and operated as a part of a regular course of conduct or business to25
transport a sick or injured individual or which is advertised or otherwise held out to26
the public as such.27
(3.1) "Air ambulance service" means any person, firm, association, or28
government entity owning, controlling, or operating any business or service which29 SB NO. 500
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furnishes, operates, conducts, maintains, advertises, engages in, proposes to engage1
in, or professes to engage in the business or service of transporting, in air2
ambulances, individuals who may need medical attention during transport.3
(3.2) "Auto-injector" means a spring-loaded needle and syringe with a single4
dose of epinephrine that will automatically release and inject the medicine.5
(4) "Bureau" means the Department of Health and Hospitals, office of public6
health, bureau of emergency medical services.7
(5) "Certified emergency medical technician" means an individual who is8
certified as any one of the following: "Licensed emergency medical services9
practitioner" means an individual who is nationally registered, who has10
successfully completed an emergency medical services practitioner education11
program based on national EMS education standards, and who is licensed as12
any one of the following:13
(a) A certified licensed emergency medical technician -basic.14
(b) A certified licensed advanced emergency medical technician-15
intermediate.16
(c) A certified emergency medical technician-licensed paramedic.17
(6) "Certified emergency medical technician-basic" means an individual who18
has successfully completed an emergency medical technician-basic training program19
developed and promulgated by the United States Department of Transportation and20
adopted by the bureau, who is nationally registered, and who is certified by the21
bureau.22
(7) "Certified emergency medical technician-intermediate" means any23
individual who has successfully completed an emergency medical technician-24
intermediate training program developed and promulgated by the United States25
Department of Transportation and adopted by the bureau, who is nationally26
registered, and who is certified by the bureau.27
(8) "Certified emergency medical technician-paramedic" means any28
individual who has successfully completed an emergency medical technician-29 SB NO. 500
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paramedic training program developed and promulgated by the United States1
Department of Transportation and adopted by the bureau, who is nationally2
registered, and who is certified by the bureau.3
(9) (6) "Certified first responder" means any individual who has successfully4
completed a training course developed and promulgated by the United States5
Department of Transportation and adopted by the bureau and who is certified by the6
bureau. "Licensed emergency medical responder" means any individual who has7
successfully completed an emergency medical responder education program8
based on National EMS Education Standards.9
(10) (7) "Commission" means the Louisiana Emergency Medical Services10
Certification Commission.11
(11) (8) "Department" means the Department of Health and Hospitals.12
(12)"Emergency medical personnel" or "emergency service person(s)" means13
individuals who are certified first responders or certified emergency medical14
technicians.15
(13) (9) "Emergency medical response vehicle" means a marked emergency16
vehicle with fully visual and audible warning signals operated by a certified17
ambulance service, the primary purpose of which is to respond to the scene of a18
medical emergency to provide emergency medical stabilization or support, or19
command, control, and communications, but which is not an ambulance designed or20
intended for the purpose of transporting a victim from the scene to a medical facility21
regardless of its designation. Included are such vehicles referred to but not limited22
to the designation as "sprint car", "quick response vehicle", "special response23
vehicle", "triage trucks", "staff cars", "supervisor units", and other similar24
designations. Emergency medical response vehicles shall not include fire apparatus25
and law enforcement patrol vehicles which carry first aid or emergency medical26
supplies and which respond to medical emergencies as part of their routine duties.27
(14) (10) "Emergency medical services" or "EMS" means a system that28
represents the combined efforts of several professionals and agencies to provide29 SB NO. 500
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prehospital emergency care to the sick and injured.1
(14.1) (11) "EMS professional" means an individual who is a certified first2
responder or certified emergency medical technician. "EMS practitioner" means3
an individual who is a licensed emergency medical technician, licensed advanced4
emergency medical technician, or a licensed paramedic.5
(15) (12) "EMS task force" means the Emergency Medical Services Task6
Force, composed of individuals appointed by the assistant secretary of the office of7
public health, subject to the approval of the secretary of the department, which8
advises and makes recommendations to the office Bureau of Emergency Medical9
Services and the department on matters related to emergency medical services.10
(16) "First aid certificate" means a certificate in the Emergency Response11
Course issued by the American Red Cross or other certificate in a first aid course12
approved by the bureau and issued to any individual who has successfully completed13
the required training and met the established standards of such organizations.14
(17) (13) "Industrial ambulance" means any vehicle owned and operated by15
an industrial facility and used for transporting any employee who becomes sick,16
injured, or otherwise incapacitated in the course and scope of his employment from17
a job site to an appropriate medical facility.18
(18) (14) "Moral turpitude" means an act of baseness, vileness, or depravity19
in the duties which one person owes another, or to society in general, which is20
contrary to the usual, accepted, and customary rule of right and duty which a person21
should follow.22
(19) (15) "Municipal nonprofit organization" means an organization owned23
by a parish, municipality, or entity of a parish or municipality which in its regular24
course of business responds to a call for help and renders medical treatment and25
whose attendants are emergency medical personnel, a registered nurse, or a26
physician.27
(20) (16) "Physician" means a physician licensed to practice medicine by the28
Louisiana State Board of Medical Examiners.29 SB NO. 500
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(21) (17) "Volunteer nonprofit organization" means an organization which1
in its regular course of business responds to a call for help and renders medical2
treatment and whose attendants are emergency medical personnel, a registered nurse,3
or a physician and which is chartered as a nonprofit organization under Section 501c4
of the United States Internal Revenue Code, as a volunteer fire department by the5
Louisiana state fire marshal's office, or as a nonprofit organization by the Louisiana6
secretary of state.7
(18) "EMS medical director" means a physician licensed by the8
Louisiana State Board of Medical Examiners who has ultimate responsibility9
and authority to assure quality of care and provide management, supervision,10
and guidance for all medical aspects of EMS.11
(19) "National EMS education standards" means the document that12
outlines current nationally recognized EMS education standards, has been13
adopted by the bureau, and defines terminal objective for each nationally14
defined EMS licensing level.15
§1231.1. Emergency medical services program; cooperation of other state16
departments17
A. The department shall establish and maintain a program for the18
improvement and regulation of emergency medical services in the state. The19
responsibility for implementation and conduct of this program shall be vested in the20
office of public health, bureau of emergency medical services.21
* * *22
SUBPART B. EMERGENCY MEDI CAL PERSONNEL23
§1232. Emergency medical personnel training; certification24
A. The bureau shall promulgate rules and regulations in accordance with the25
Administrative Procedure Act for the following:26
(1) To define and authorize appropriate functions and pre-certification and27
post-certification training programs for emergency medical personnel. All such28
training programs shall meet or exceed the performance requirements developed by29 SB NO. 500
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the United States Department of Transportation. education programs based on1
national EMS education standards for emergency medical services2
practitioners. All such education programs shall meet or exceed national EMS3
education standards.4
(2) To specify minimum operational requirements which will assure medical5
direction, supervision, and control over emergency medical services.6
(3) To specify minimum testing examination and continuing education7
requirements for all emergency medical personnel services practitioners.8
(4) To provide for the issuance of certificates and licenses, renewals of9
certificates licenses, and requirements for emergency medical personnel services10
practitioners.11
(5) To specify initial certification and certification renewal requirements12
consistent with the National Registry of Emergency Medical Technicians for each13
level of emergency medical personnel.14
(6) (5) To establish fees for certification and certification license and license15
renewal.16
B. An individual petitioning for certification or certification license or17
license renewal as a certified emergency medical technician or a certified first18
responder an emergency medical services practitioner shall submit an application19
to the bureau on forms provided by the bureau. The application shall be accompanied20
by the appropriate fee.21
* * *22
§1232.1. Fee schedule; fees for certification license prohibited23
A.(1) The bureau shall not require or collect any fee or charges for24
certification or recertification license or license renewal of emergency medical25
personnel services practitioners who serve as such on a voluntary basis and who26
receive no compensation of any kind for such services.27
(2) The bureau shall not set the fee for certification license of an emergency28
medical technician-basic to exceed fifteen dollars for any individual who is an29 SB NO. 500
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employee or volunteer of the state of Louisiana or another public entity, a municipal1
fire department, a fire protection district, a volunteer fire department, or a municipal2
law enforcement agency who does not perform emergency medical services outside3
of the individual's official governmental responsibilities for any form of4
compensation.5
(3) The bureau shall not set the fee for recertification license renewal of an6
emergency medical technician-basic to exceed ten dollars for any individual who is7
an employee or volunteer of the state of Louisiana or another public entity, a8
municipal fire department, a fire protection district, a volunteer fire department, or9
a municipal law enforcement agency who does not perform emergency medical10
services outside of the individual's official governmental responsibilities for any11
form of compensation.12
B. Except as provided in Subsection A of this Section, the bureau shall assess13
fees for testing and certification based on the following schedule:14
(1) Test fees: Fee15
(a) First responder- Emergency medical responder - written only $ 15.0016
(b) First responder- Emergency medical responder - written only17
(out of state) 15.0018
(c) Basic Emergency medical technician initial written & practical60.0019
(d) Basic Emergency medical technician entire practical exam 30.0020
(e) Basic Emergency medical technician partial practical 15.0021
(f) Basic Emergency medical technician testing/retesting-written only15.0022
(g) Basic Emergency medical technician testing/retesting-written only23
(out of state) 15.0024
(h) Intermediate Advanced emergency medical technician initial25
written & practical 75.0026
(i) Intermediate Advanced emergency medical technician initial written 27
& practical (out of state) 100.0028
(j) Intermediate Advanced emergency medical technician retest entire29 SB NO. 500
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practical 50.001
(k) Intermediate Advanced emergency medical technician retest entire2
practical (out of state) 65.003
(l) Intermediate Advanced emergency medical technician retest partial4
practical 30.005
(m) Intermediate Advanced emergency medical technician retest partial6
practical (out of state) 30.007
(n) Intermediate Advanced emergency medical technician testing/retesting-8
written only (exam only) 15.009
(o) Intermediate Advanced emergency medical technician testing/retesting-10
written only (exam only) (out of state) 15.0011
(p) Paramedic initial written & practical 90.0012
(q) Paramedic initial written & practical (out of state) 125.0013
(r) Paramedic retesting-entire practical 60.0014
(s) Paramedic retesting-entire practical (out of state) 75.0015
(t) Paramedic retesting-partial practical 35.0016
(u) Paramedic retesting-partial practical (out of state) 40.0017
(v) Paramedic testing/retesting written 15.0018
(w) Paramedic testing/retesting written (out of state) 15.0019
(2) Certification fees20
(a) First responder Emergency medical responder 10.0021
(b) Basic EMT Emergency medical technician 30.0022
(c) Intermediate Advanced emergency medical technician 40.0023
(d) Paramedic 50.0024
(3) Recertification25
(a) First responder Emergency medical responder 5.0026
(b) Basic EMT Emergency medical technician 25.0027
(c) Intermediate Advanced emergency medical technician 35.0028
(d) Paramedic 45.0029 SB NO. 500
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(4) Reciprocity1
(a) Basic EMT Emergency medical technician 60.002
(b) Intermediate Advanced emergency medical technician 80.003
(c) Paramedic 100.004
* * *5
§1232.2. Louisiana Emergency Medical Services Certification Commission;6
creation; membership; qualifications; terms; vacancies; meetings;7
officers; compensation; domicile8
* * *9
B.(1) The commission shall be composed of eleven voting members10
appointed by the governor as follows:11
* * *12
(b) Two certified emergency medical technician- licensed paramedics and13
one licensed emergency medical technician-basic who are certified approved as14
emergency medical services instructors educators by the bureau. Until November15
6, 2011, or the member's resignation from the commission, whichever is earlier, at16
least one of the members as provided in this Subparagraph shall be a full-time17
employee of a fire department. After November 6, 2011, or the member's resignation18
from the commission, at least one of the members as provided in this Subparagraph19
shall be appointed by the Louisiana Fire Chiefs Association.20
* * *21
(d) One member who is, at a minimum, a state-certified emergency medical22
technician-basic nominated by the Louisiana Municipal Association.23
* * *24
(2) The commission shall also have one nonvoting member appointed by the25
governor who is a registered nurse and who is a state-certified licensed paramedic26
to be nominated by the Louisiana State Nurses Association from a list of two names27
submitted by the Louisiana Emergency Nurses Association.28
* * *29 SB NO. 500
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G.(1) Subsequent to the appointment of the initial members, the voting1
members shall be appointed from a list of two nominees for each appointment2
submitted by the task force. No later than thirty days prior to the termination date of3
a member's term, the task force or, for the nonvoting member, the Louisiana State4
Nurses Association, shall submit a list of nominees to the governor. If the Louisiana5
State Nurses Association or the task force fails to submit the required list of6
nominees to the governor within thirty days, the governor shall appoint the7
respective member to fill the vacancy without the nomination list required.8
(2) A vacancy on the commission prior to the expiration of a term shall be9
filled for the remainder of the term. No later than thirty days after the occurrence of10
a vacancy prior to the expiration of a term, the task force or, for the nonvoting11
member, the Louisiana State Nurses Association, shall submit a list of nominees to12
the governor. If the Louisiana State Nurses Association or the task force fails to13
submit the required list of nominees to the governor within thirty days, the governor14
shall appoint the respective member to fill the vacancy without the nomination list15
required.16
* * *17
§1232.3. Powers and duties of the commission; exceptions18
A. The commission shall:19
(1) Recommend to the bureau requirements and standards of practice scope20
of practice for individuals seeking to be certified under this Subpart.21
(2) Approve requirements and standards of practice scope of practice22
submitted by the bureau for emergency medical personnel services practitioners23
consistent with this Subpart.24
(3) Recommend continuing education requirements and standards to the25
bureau in accordance with criteria established by the National Registry of26
Emergency Medical Technicians for individuals seeking to renew a certificate27
license.28
* * *29 SB NO. 500
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B. Except as they relate to scope of practice or patient care issues, Paragraphs1
(A)(4), (5), and (6) of this Section shall not apply to anyone who is a volunteer of or2
employed by the state of Louisiana or another public entity, a municipal fire3
department, a fire protection district, or a volunteer fire department who has4
successfully completed an emergency medical technician-basic, emergency medical5
technician-intermediate, emergency medical technician-paramedic, or first responder6
training program developed and promulgated by the United States Department of7
Transportation education program based on national EMS education standards8
and who possesses a current national and state certification and state license, until9
the commission has forwarded the nonmedical practice complaint to the local10
governing body and received a response with investigative results and any11
disciplinary disposition. In the event that the local governing body does not send a12
response or request for extension to the commission within sixty days after receipt13
of the complaint, the commission may proceed with the powers and duties as defined14
in Subsection A of this Section. Notwithstanding any law to the contrary, in the event15
the commission determines by a two-thirds vote of the membership of the16
commission that public health and safety would be jeopardized by waiting for a17
response from the local governing authority, the commission shall have the right to18
exercise its powers and duties as provided in Subsection A of this Section without19
receipt of an investigative report from the local governing authority or the expiration20
of the sixty-day period as provided in this Subsection.21
§1232.4. Powers and duties of the bureau22
The bureau shall:23
(1) Issue a certificate license and renew a certificate license to any duly24
qualified applicant for certification or for certification license and license renewal25
as a certified first responder or certified emergency medical technician.26
* * *27
(3) Adopt requirements and standards of practice scope of practice approved28
by the commission for emergency medical personnel services practitioners.29 SB NO. 500
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* * *1
(5) Deny, withhold, revoke, restrict, probate, or suspend a certificate license2
as directed by the commission under the provisions of R.S. 40:1232.6.3
* * *4
(10) Adopt and amend the title and the definition of licensed emergency5
medical services practitioners.6
§1232.5. Certification License; requirements; renewal7
A. Applicants for initial certification license as emergency personnel8
medical services practitioners shall submit the following evidence to the bureau:9
(1) Completion of the required approved educational program.10
(2) Documentation that the applicant meets the qualifications and11
requirements as established by the bureau.12
B. In lieu of the evidence required by Subsection A of this Section, an13
applicant may submit evidence that he has been duly licensed or certified in another14
state, territory, or country or has received military training and certification or15
license as emergency medical personnel services practitioner as defined in R.S.16
40:1231, and meets the qualifications and requirements established by the bureau.17
C.(1) The certificate license shall be renewed every two years provided the18
applicant seeking renewal completes the application and meets the requirements for19
renewal established by the bureau prior to the expiration date on his current20
certificate license.21
(2) An individual whose certificate license expires by his failure to renew22
as provided may be reinstated provided the applicant submits a completed23
application and meets any additional requirements established by the bureau for an24
individual who has failed to timely renew his certificate license.25
§1232.6. Grounds for disciplinary proceedings26
The commission may discipline emergency medical services professionals27
practitioners by directing the bureau to deny, withhold, revoke, restrict, probate, or28
suspend a certificate license to practice as a certified emergency medical technician29 SB NO. 500
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or certified first responder an emergency medical services practitioner, impose1
fines and assess costs, or otherwise discipline an emergency medical services2
practitioner, and the commission may direct the bureau to limit, restrict, or deny a3
student EMS professional emergency medical services practitioner from entering4
or continuing the clinical phase of EMS education for the following causes:5
(1) Conviction of selling or attempting to sell, falsely obtaining, or furnishing6
to a person a certified emergency medical technician or certified first responder7
certification licensed emergency medical services practitioner document.8
(2) Conviction of a crime or offense which reflects the inability of an9
emergency medical services practitioner to provide emergency medical services10
with due regard for the health and safety of clients or patients or enters a plea of11
guilty or nolo contendere to a criminal charge regardless of final disposition of the12
criminal proceeding, including but not limited to expungement or nonadjudication.13
* * *14
(12) Has had a certification or license to practice as an EMS professional15
emergency medical services practitioner or to practice as another health care16
provider denied, revoked, suspended, or otherwise restricted.17
* * *18
(15) Intentional falsification of any document related to license,19
emergency medical services education, or related to the care of the patient.20
§1232.7. Hearings of the commission; appeal of decision21
* * *22
D. Notice of the commission's decision to revoke, restrict, suspend, or deny23
a certificate license shall be sent to the individual under investigation by registered24
mail, return receipt requested, at his last known address as it appears on the records25
of the bureau.26
E. An individual whose certification license has been revoked, restricted,27
suspended, placed in probation, or denied may have the proceedings of the28
commission reviewed by a court of competent jurisdiction, provided that an appeal29 SB NO. 500
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is made no later than thirty days after the date indicated on the registered mail receipt1
of the notice required by Subsection D of this Section. The decision of the2
commission shall remain in force until an appeal is granted unless the court orders3
a stay. If an appeal is granted, the decision of the commission shall be suspended4
until a final disposition of the matter is ultimately rendered by the court affirming the5
decision of the commission.6
* * *7
§1232.9. Violations8
No person or individual shall engage in any of the following activities:9
(1) Sell, or attempt to sell, falsely obtain, or furnish to any person any10
emergency medical personnel services practitioner diploma, certification license11
document, or record, or aid or abet therein.12
(2) Practice as a certified an emergency medical technician or certified first13
responder services practitioner under any diploma or certificate illegally obtained14
or signed or issued unlawfully.15
(3) Practice as a certified an emergency medical technician or certified first16
responder services practitioner unless certified license to do so under the provisions17
of this Subpart.18
(4) Use in connection with his name any designation tending to imply that19
he is a certified an emergency medical technician or certified first responder services20
practitioner unless duly authorized to practice under the provisions of this Subpart.21
(5) Practice as a certified an emergency medical technician or certified first22
responder services practitioner during the time the certification license issued under23
the provisions of this Subpart is suspended or revoked.24
(6) Practice as a certified an emergency medical technician or certified first25
responder services practitioner during the time his certification license has lapsed26
by reason of his intentional failure to renew the certification license.27
(7) Conduct or serve as an assistant instructor educator in conducting any28
course claiming to prepare students for certification license as emergency medical29 SB NO. 500
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personnel services practitioner under the provisions of this Subpart, unless both the1
course and the instructor educator have been approved by the bureau.2
(8) Knowingly aid or abet another person in the violation of this Subpart.3
* * *4
§1232.11. Exceptions5
This Subpart shall not apply to the practice of emergency medical services6
by a legally qualified emergency medical technician services practitioner who is7
employed by the United States government, or by any bureau, division, or agency8
thereof, while in the discharge of his official duties.9
* * *10
§1233. Civil immunity11
A.(1) Any emergency medical person certified services practitioner12
pursuant to the provisions of this Subpart who renders emergency medical care to an13
individual while in the performance of his medical duties and following the14
instructions of a physician shall not be individually liable to such an individual for15
civil damages as a result of acts or omissions in rendering the emergency medical16
care, except for acts or omissions intentionally designed to harm, or for grossly17
negligent acts or omissions which result in harm to such an individual. Nothing18
herein shall relieve the driver of the emergency vehicle from liability arising from19
the operation or use of such vehicle.20
(2) The immunity granted to emergency medical personnel services21
practitioner by the provisions of this Subpart shall extend to parish governing22
authorities, police departments, sheriffs' offices, fire department, or other public23
agencies engaged in rendering emergency medical services and its insurers with24
respect to such emergency medical services unless the emergency medical personnel25
services practitioner employed by such agencies would be personally liable under26
the provisions of Paragraph (1) of this Subsection.27
B. Any physician who provides instructions to any emergency medical28
personnel services practitioner by use of electronic or other means of transmission29 SB NO. 500
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in connection with the rendering of emergency medical services to an individual1
shall not be liable unto such personnel practitioner or to an individual or both for2
civil damages arising from his opinion, judgments, actions, or duties, except for acts3
or omissions intentionally designed to harm, or for grossly negligent acts or4
omissions which result in harm to the individual, while exercising that degree of skill5
and care ordinarily employed by members of his profession in good standing.6
C. No hospital facility which allows the use of telemetry or other equipment7
to maintain contact between a certified emergency medical technician an emergency8
medical services practitioner and a physician shall be liable for any civil damages9
arising out of the use of such equipment except for acts or omissions by hospital10
personnel that are grossly negligent which result in harm to an individual.11
D. No registered nurse, certified emergency medical technician licensed12
emergency medical services practitioner, or other health professional licensed in13
Louisiana who supervises, instructs, or trains emergency medical personnel services14
practitioner in accordance with curricula developed or adopted by the bureau shall15
be liable for any civil damages arising out of the actions or negligence of the16
emergency medical personnel whom he supervised, instructed educated, or trained.17
E. There shall be no cause of action or civil liability, and no certificate18
license holder or applicant shall have any cause of action or any claim for damages19
against any individual, person, or institution providing information to the20
commission or its agents or employees when that individual, person, or institution21
acts without malice and when there is a reasonable belief that such information is22
accurate.23
§1234. Duties of emergency medical personnel24
A.(1) A certified license emergency medical technician-basic services25
practitioner may perform any of the following functions:26
(a) Rescue, first aid, resuscitation, and other services Services, treatment,27
and procedures consistent with national EMS education standards that have28
been approved and adopted by the bureau, and to the extent that he has been29 SB NO. 500
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trained to perform such services under the provisions of the National Standard EMT-1
Basic training curriculum developed and promulgated by the United States2
Department of Transportation that are adopted by the bureau.3
(b) When authorized by medical direction, an emergency medical technician-4
basic or an emergency medical technician-intermediate may administer or aid the5
patient in the administration of a dose of epinephrine from an auto-injector to treat6
allergic reaction and anaphylaxis. Administration of other drugs or procedures7
for which the licensed emergency medical services practitioner has received8
training, license, and approval by the commission and which may be considered9
necessary by the ordering physician.10
(c) Services which may be performed by a certified emergency medical11
technician-intermediate as provided in Subsection B of this Section, but only while12
he is enrolled in good standing in an approved emergency medical technician-13
intermediate clinical or field internship program and while he is under the direct14
supervision of a physician, registered nurse, certified emergency15
technician-paramedic, or other preceptor approved by the bureau.16
(d) Services which may be performed by a certified emergency medical17
technician-paramedic, as provided in Subsection C of this Section, but only while he18
is enrolled in good standing in an approved emergency medical technician-paramedic19
clinical or field internship program and while he is under the direct supervision of20
a physician, registered nurse, certified emergency technician-paramedic, or other21
preceptor approved by the bureau.22
(2) The functions authorized by Paragraph (1) of this Subsection may be23
performed by the certified license emergency medical technician-basic services24
practitioner under any of the following conditions:25
(a) While he is caring for a patient or at the scene of a medical or other26
emergency where voice contact is established with a physician and under the27
physician's order; or under a protocol that has been approved by the local parish28
medical society or the emergency medical services practitioner's medical29 SB NO. 500
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director, until voice communication with the physician is established.1
(b) While he is at the scene of a life threatening emergency and under a2
protocol that has been approved by the local parish medical society, or its designee,3
until voice communication with the physician is established at the earliest possible4
time.5
B.(1) A certified emergency medical technician-intermediate may perform6
any of the following functions: An emergency medical services practitioner7
student may perform any of the following functions while he is enrolled in good8
standing in a state approved clinical or field internship program under the9
direct supervision of a physician, registered nurse, paramedic, or other10
preceptor recognized by the bureau:11
(a) Any services to the extent that he has been trained to perform such12
services under the provisions of the National Standard EMT-Intermediate training13
curriculum developed and promulgated by the United States Department of14
Transportation that are adopted by the bureau. Services, treatments, and15
procedures consistent with national EMS education standards that have been16
approved and adopted by the bureau, and to the extent that he has been trained17
to perform such services.18
(b) Services which may be performed by a certified emergency medical19
technician-paramedic, as provided in Subsection C of this Section, but only while he20
is enrolled in good standing in an approved emergency medical technician-paramedic21
clinical or field internship program and while under the direct supervision of a22
physician, registered nurse, certified emergency technician-paramedic, or other23
preceptor approved by the bureau.24
(2) The functions authorized by Paragraph (1) of this Subsection may be25
performed by the certified emergency medical technician-intermediate under any of26
the following conditions:27
(a) While caring for a patient in a participating hospital under the direct28
supervision of a physician.29 SB NO. 500
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(b) While he is at the scene of a medical or other emergency where voice1
contact is established with a physician and under the physician's orders.2
(c) While he is at the scene of a life threatening emergency and under a3
protocol that has been approved by the local parish medical society, or its designee,4
until voice communication with the physician is established at the earliest possible5
time.6
C.(1) A certified emergency medical technician-paramedic may perform any7
of the following functions:8
(a) Any services to the extent that he has been trained to perform such service9
under the provisions of the National Standard EMT-Paramedic training curriculum10
developed and promulgated by the United States Department of Transportation that11
are adopted by the bureau.12
(b) Administration of other drugs or procedures for which the certified13
emergency medical technician-paramedic has received training, certification, and14
approval by the commission and which may be considered necessary by the ordering15
physician.16
(2) The functions authorized by Paragraph (1) of this Subsection may be17
performed by a certified emergency medical technician-paramedic under any of the18
following conditions:19
(a) While his caring for a patient in a participating hospital under the direct20
supervision of a physician.21
(b) While he is at the scene of a medical or other emergency where voice22
contact is established with a physician and under the physician's orders.23
(c) While he is at the scene of a life threatening emergency and under a24
protocol that has been approved by the local parish medical society, or its designee,25
until voice communication with the physician is established at the earliest possible26
time.27
D C. A certified first responder may perform any of the following functions:28
(1) Rescue, first aid, resuscitation, and other services to the extent that he has29 SB NO. 500
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been trained to perform such services under the provisions of the first responder1
training curriculum developed and adopted by the bureau.2
(2) Administration of automated cardiac defibrillation in accordance with3
rules and regulations promulgated by the bureau in accordance with the4
Administrative Procedure Act and a protocol that shall be approved by the local5
parish medical society, or its designee, and the local physician medical director.6
ED.(1) In a case of a life-threatening situation as determined by a certified7
licensed emergency medical technician-intermediate or an emergency medical8
technician-paramedic services practitioner, when voice contact with a physician or9
when telemetered electrocardiogram communication is delayed, not possible, or10
when the delay in treatment could endanger the life of the patient, such a person may11
render services, in accordance with a protocol that shall be established by the12
emergency medical services committee or the executive committee of the parish or13
component medical society, or its designee, until voice or telemetered14
electrocardiogram communication can be established at the earliest possible time.15
(2) Such services may be rendered for the following conditions: 16
(a) Cardiac arrest.17
(b) Ventricular tachycardia.18
(c) Supraventricular tachycardia.19
(d) Premature ventricular ectopy when greater than six per minute,20
multifocal, bigeminal, occurring in bursts of two or more, falling on or close to the21
T wave.22
(e) Severe, unrelieved, suspected cardiogenic chest pain, or suspected23
myocardial infarction.24
(f) Bradydysrhythmias.25
(g) Hypoglycemia.26
(h) Anaphylactic reactions.27
(i) Hypovolemic shock.28
(j) Unconsciousness, altered mental status, or respiratory depression from29 SB NO. 500
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suspected drug overdose.1
(k) Treatment induced unconsciousness, altered mental status, hypotension,2
or respiratory depression from physician ordered or protocol appropriate paramedic3
administered narcotics.4
(l) Respiratory failure or respiratory arrest.5
(m) Active seizure.6
(3) Nothing in this Subsection shall be construed to authorize a certified7
emergency medical technician-paramedic to administer any Schedule II narcotic8
without a direct order by a physician licensed to practice medicine by the Louisiana9
State Board of Medical Examiners or in accordance with an approved protocol10
adopted pursuant to Subsection E(1) and (2).11
F.(1) The bureau shall adopt rules and regulations to allow emergency12
medical personnel to institute a program for the delivery of automated cardiac13
defibrillation in the pre-hospital setting.14
(2) The bureau shall adopt rules and regulations for training to allow all15
levels of certified medical technicians to carry and administer epinephrine by auto-16
injectors to patients experiencing allergic reactions or anaphylaxis.17
G E. Any individual, training education organization, organization, or other18
entity violating the provisions of this Section shall be guilty of a misdemeanor,19
conviction of which shall subject the offender to a fine of not less than five hundred20
dollars nor more than one thousand dollars for each separate offense.21
H F. In the event that there is no organized or functional local parish medical22
society in a parish of the state, the provisions of this Section which require the23
approval of an emergency medical service protocol by the local parish medical24
society or its designee may be performed by a parish or multiparish medical society25
which is adjacent or contiguous to the parish without an organized or functional local26
parish medical society. In the absence of such adjacent or contiguous parish or27
multiparish medical society, the district medical society shall approve an emergency28
medical service protocol for the parish without an organized or functional local29 SB NO. 500
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parish medical society. In the event the district medical society does not approve an1
emergency medical service protocol for the parish without an organized or functional2
local parish medical society, the disaster and emergency medical services committee3
of the Louisiana State Medical Society shall approve an emergency medical service4
protocol for the parish without an organized or functional local parish medical5
society.6
I G. The department shall promulgate rules and regulations establishing basic7
guidelines for statewide emergency medical service protocols. Such rules and8
regulations shall be based on the recommendations of the Louisiana State Medical9
Society's disaster and emergency medical services committee, which shall serve as10
an advisory committee to the department for this purpose.11
* * *12
SUBPART C. EMERGENCY MEDI CAL TRANSPORTATION13
§1235. Qualifications to operate ambulances; equipment; penalty14
A.(1) No person or individual shall conduct, maintain, or operate an15
ambulance on any street, alley, or public way or place in the state unless the16
ambulance is staffed with a minimum of two persons, one of whom shall be a17
certified licensed emergency medical technician.18
(2)(a) No person or individual shall provide services in any capacity on any19
ambulance unless he is a certified first responder, a certified emergency medical20
technician, licensed emergency medical responder, a licensed emergency medical21
technician, a licensed advance emergency medical technician, a licensed22
paramedic, a licensed registered or practical nurse, or a physician.23
* * *24
(c) No individual shall provide services in any capacity on any ambulance25
unless he holds a cardiopulmonary resuscitation provider card issued by the26
American Heart Association or the American Red Cross without holding an27
American Heart Association Health Care Provider, or American Red Cross28
Professional Rescuer, or the equivalent cardio-pulmonary resuscitation29 SB NO. 500
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certification that has been approved by the Ambulance Standards Committee.1
(d) No individual shall transport any ill or injured person by ambulance2
unless the sick or injured person is attended by a certified emergency medical3
technician license emergency medical technician, a licensed advance emergency4
medical technician, a licensed paramedic, a registered nurse, or a physician in the5
patient compartment.6
* * *7
§1235.1. Qualifications to operate emergency medical response vehicles; vehicle8
requirements; equipment; penalties9
A.(1) No person shall conduct, maintain, or operate an emergency medical10
response vehicle as an emergency vehicle on any street, alley, or public way or place11
in the state unless the vehicle is staffed with at least one individual who is a12
Louisiana state-certified nationally registered at least a licensed emergency medical13
technician responder.14
(2) No person shall provide services in any capacity on an emergency15
medical response vehicle unless he is the holder of a certification by the Department16
of Health and Hospitals or its agent as a first responder; or a certification of an17
emergency medical technician issued by the National Registry of Emergency18
Medical Technicians at least a licensed emergency medical responder; or a holder19
of a certificate of licensure as a registered nurse or licensed practical nurse; or is a20
physician or surgeon licensed to practice medicine by the Louisiana State Board of21
Medical Examiners. No person shall provide services in any capacity on these22
vehicles without holding a valid certification of cardiopulmonary resuscitation issued23
by the American National Red Cross or the American Heart Association. an24
American Heart Association Health Care Provider, or American Red Cross25
Professional Rescuer, or the equivalent cardio-pulmonary resuscitation26
certification that has been approved by the Ambulance Standards Committee.27
* * *28
§1236. Advanced emergency medical technicians29 SB NO. 500
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In addition to the requirements of R.S. 40:1235, any hospital, ancillary1
medical facility, or ambulance service, whether public or private, may conduct a2
program utilizing any certified emergency medical technician-intermediate or3
certified emergency medical technician-paramedic services practitioner to4
supervise and direct the delivery of emergency medical care to the sick and injured5
at the scene of an emergency during transport to a hospital, while in the hospital6
emergency department, and until care responsibility is assumed by the regular7
hospital staff.8
* * *9
§1236.13. Persons in possession of AED's; training, testing, and notification10
requirements; manufacturer responsibility; possession required11
* * *12
B. Any person or entity that possesses an AED shall notify the bureau of13
emergency medical services in the office of public health of the Department of14
Health and Hospitals and a local provider of emergency medical services, such as15
911 service, local ambulance service, or the fire department of the acquisition,16
location, and type of AED.17
* * *18
F. The office of public health within the Department of Health and Hospitals,19
through its center for community health, emergency medical services shall20
promulgate all necessary rules and regulations to implement the provisions of21
Subsections D and E of this Section. Such rules and regulations shall, at a minimum,22
provide for compliance, enforcement, and penalties.23
* * *24
§1299.58.2. Definitions25
As used in this Part, the following words shall have the meanings ascribed26
to them unless the context clearly states otherwise:27
* * *28
(4) "Certified first responder" means any person who has successfully29 SB NO. 500
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completed a training course developed and promulgated by the United States1
Department of Transportation and adopted by the bureau of emergency medical2
services of the Department of Health and Hospitals and who is certified by the3
bureau. "Licensed emergency medical responder" means any individual who has4
successfully completed an emergency medical responder education program5
based on National EMS Education Standards and adopted by the bureau of6
emergency medical services of the Department of Health and Hospitals and who7
is licensed by the bureau.8
* * *9
§1299.64.2. Definitions10
As used in this Part, the following terms shall have the meanings ascribed to11
them unless the context clearly states otherwise:12
* * *13
(3) "Certified first responder" means any person who has successfully14
completed a training course developed and promulgated by the United States15
Department of Transportation and adopted by the bureau of emergency medical16
services of the Department of Health and Hospitals and who is certified by the17
bureau. "Licensed emergency medical responder" means any individual who has18
successfully completed an emergency medical responder education program19
based on National EMS Education Standards and adopted by the bureau of20
emergency medical services of the Department of Health and Hospitals and who21
is licensed by the bureau.22
* * *23
Section 3. R.S. 40:1236.3 is hereby repealed.24
Section 4. This Act shall become effective upon signature by the governor or, if not25
signed by the governor, upon expiration of the time for bills to become law without signature26
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If27
vetoed by the governor and subsequently approved by the legislature, this Act shall become28
effective on the day following such approval.29 SB NO. 500
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The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christopher D. Adams.
DIGEST
Proposed law implements suggestions developed from the emergency medical services
professional working group created by SCR 40 of the 2011 Regular Session.
Proposed law makes changes within the present law to address the federally required
changes governing emergency medical services.
Present law provides for the duties of emergency personnel. Proposed law clarifies these
duties with respect to the administration of drugs or procedures by the licenced emergency
medical services practitioner. Further, proposed law provides for qualifying emergency
medical services practitioner students to perform specific functions.
Present law provides for the duties of emergency medical services practitioners when a life-
threatening situation is present and communication with a physician is not possible, and
present law provides for service by emergency medical services practitioners for specific
medical conditions.
Proposed law provides when a life-threatening situation is present and communication with
a physician is not possible, the emergency medical services practitioners may render service
in accordance with an established protocol, and the proposed law removes the specific list
of medical conditions.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 36:919.4 and R.S. 40:1231, 1231.1(A), 1232(A) and (B), 1232.1(A) and (B),
1232.2(B)(1)(b) and (d), (B)(2), and (G), 1232.3(A)(1) through (3) and (B), 1232.4(1), (3),
and (5), 1232.5, 1232.6 (intro para) and 1232.6(1), (2), and (12), 1232.7 (D) and (E), 1232.9,
1232.11, 1233, 1234, 1235(A)(1), (2)(a), (c), and (d), 1235.1(A), 1236, 1236.1, 1236.13(B)
and (F), 1299.58.2(4), and 1299.64.2(3); adds R.S. 40:1232.4(10) and 1232.6(15); repeals
R.S. 40:1236.3)