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Regular Session, 2012
SENATE BILL NO. 500
BY SENATORS BUFFINGTON AND MILLS
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 and4
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 licensure of emergency9
medical personnel and continuing education requirements for certification licensure.10
The commission shall retain the authority to approve requirements and standard of11
practice for emergency medical personnel; conduct disciplinary hearings for12
emergency medical personnel; and cause the prosecution of any individual who13
violates the provisions of Subpart B of Part VII of Chapter 5 of Title 40 of the14
Louisiana Revised Statutes 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),18
1232.7(D) and (E), 1232.9, 1232.11, 1233, 1234, 1235(A)(1), (2)(a), (c), and (d), 1235.1(A),19
1236, 1236.1, 1236.13(B) and (F), 1299.58.2(4), 1299.64.2(3) are hereby amended and20
reenacted 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 a licensed emergency medical10
responder or who is nationally registered, who has successfully completed an11
emergency medical services practitioner education program based on national12
EMS education standards, and who is licensed as 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 approved by the bureau and who9
is licensed by the bureau.10
(10) (7) "Commission" means the Louisiana Emergency Medical Services11
Certification Commission.12
(11) (8) "Department" means the Department of Health and Hospitals.13
(12)"Emergency medical personnel" or "emergency service person(s)" means14
individuals who are certified first responders or certified emergency medical15
technicians.16
(13) (9) "Emergency medical response vehicle" means a marked emergency17
vehicle with fully visual and audible warning signals operated by a certified18
ambulance service, the primary purpose of which is to respond to the scene of a19
medical emergency to provide emergency medical stabilization or support, or20
command, control, and communications, but which is not an ambulance designed or21
intended for the purpose of transporting a victim from the scene to a medical facility22
regardless of its designation. Included are such vehicles referred to but not limited23
to the designation as "sprint car", "quick response vehicle", "special response24
vehicle", "triage trucks", "staff cars", "supervisor units", and other similar25
designations. Emergency medical response vehicles shall not include fire apparatus26
and law enforcement patrol vehicles which carry first aid or emergency medical27
supplies and which respond to medical emergencies as part of their routine duties.28
(14) (10) "Emergency medical services" or "EMS" means a system that29 SB NO. 500
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represents the combined efforts of several professionals and agencies to provide1
prehospital emergency care to the sick and injured.2
(14.1) (11) "EMS professional" means an individual who is a certified first3
responder or certified emergency medical technician. "EMS practitioner" means4
an individual who is a licensed emergency medical responder, licensed5
emergency medical technician, licensed advanced emergency medical6
technician, or a licensed paramedic.7
(15) (12) "EMS task force" means the Emergency Medical Services Task8
Force, composed of individuals appointed by the assistant secretary of the office of9
public health, subject to the approval of the secretary of the department, which10
advises and makes recommendations to the office bureau of emergency medical11
services and the department on matters related to emergency medical services.12
(16) "First aid certificate" means a certificate in the Emergency Response13
Course issued by the American Red Cross or other certificate in a first aid course14
approved by the bureau and issued to any individual who has successfully completed15
the required training and met the established standards of such organizations.16
(17) (13) "Industrial ambulance" means any vehicle owned and operated by17
an industrial facility and used for transporting any employee who becomes sick,18
injured, or otherwise incapacitated in the course and scope of his employment from19
a job site to an appropriate medical facility.20
(18) (14) "Moral turpitude" means an act of baseness, vileness, or depravity21
in the duties which one person owes another, or to society in general, which is22
contrary to the usual, accepted, and customary rule of right and duty which a person23
should follow.24
(19) (15) "Municipal nonprofit organization" means an organization owned25
by a parish, municipality, or entity of a parish or municipality which in its regular26
course of business responds to a call for help and renders medical treatment and27
whose attendants are emergency medical personnel, a registered nurse, or a28
physician.29 SB NO. 500
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(20) (16) "Physician" means a physician licensed to practice medicine by the1
Louisiana State Board of Medical Examiners.2
(21) (17) "Volunteer nonprofit organization" means an organization which3
in its regular course of business responds to a call for help and renders medical4
treatment and whose attendants are emergency medical personnel, a registered nurse,5
or a physician and which is chartered as a nonprofit organization under Section 501c6
of the United States Internal Revenue Code, as a volunteer fire department by the7
Louisiana state fire marshal's office, or as a nonprofit organization by the Louisiana8
secretary of state.9
(18) "EMS medical director" means a physician licensed by the10
Louisiana State Board of Medical Examiners who has responsibility and11
authority to ensure quality of care and provide guidance for all medical aspects12
of EMS.13
(19) "National EMS education standards" means the document that14
outlines current nationally recognized EMS education standards, has been15
adopted by the bureau, and defines terminal objective for each nationally16
defined EMS licensing level.17
§1231.1. Emergency medical services program; cooperation of other state18
departments19
A. The department shall establish and maintain a program for the20
improvement and regulation of emergency medical services in the state. The21
responsibility for implementation and conduct of this program shall be vested in the22
office of public health, bureau of emergency medical services.23
* * *24
SUBPART B. EMERGENCY MEDI CAL PERSONNEL25
§1232. Emergency medical personnel training; certification26
A. The bureau shall promulgate rules and regulations in accordance with the27
Administrative Procedure Act for the following:28
(1) To define and authorize appropriate functions and pre-certification and29 SB NO. 500
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post-certification training programs for emergency medical personnel. All such1
training programs shall meet or exceed the performance requirements developed by2
the United States Department of Transportation. education programs based on3
national EMS education standards for emergency medical services4
practitioners. All such education programs shall meet or exceed national EMS5
education standards.6
(2) To specify minimum operational requirements which will assure ensure7
medical direction, supervision, and control over emergency medical services.8
(3) To specify minimum testing examination and continuing education9
requirements for all emergency medical personnel services practitioners.10
(4) To provide for the issuance of certificates and licenses, renewals of11
certificates licenses, and requirements for emergency medical personnel services12
practitioners.13
(5) To specify initial certification and certification renewal requirements14
consistent with the National Registry of Emergency Medical Technicians for each15
level of emergency medical personnel.16
(6) (5) To establish fees for certification and certification license and license17
renewal.18
B. An individual petitioning for certification or certification license or19
license renewal as a certified emergency medical technician or a certified first20
responder an emergency medical services practitioner shall submit an application21
to the bureau on forms provided by the bureau. The application shall be accompanied22
by the appropriate fee.23
* * *24
§1232.1. Fee schedule; fees for certification license prohibited25
A.(1) The bureau shall not require or collect any fee or charges for26
certification or recertification license or license renewal of emergency medical27
personnel services practitioners who serve as such on a voluntary basis and who28
receive no compensation of any kind for such services.29 SB NO. 500
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(2) The bureau shall not set the fee for certification license of an emergency1
medical technician-basic to exceed fifteen dollars for any individual who is an2
employee or volunteer of the state of Louisiana or another public entity, a municipal3
fire department, a fire protection district, a volunteer fire department, or a municipal4
law enforcement agency who does not perform emergency medical services outside5
of the individual's official governmental responsibilities for any form of6
compensation.7
(3) The bureau shall not set the fee for recertification license renewal of an8
emergency medical technician-basic to exceed ten dollars for any individual who is9
an employee or volunteer of the state of Louisiana or another public entity, a10
municipal fire department, a fire protection district, a volunteer fire department, or11
a municipal law enforcement agency who does not perform emergency medical12
services outside of the individual's official governmental responsibilities for any13
form of compensation.14
B. Except as provided in Subsection A of this Section, the bureau shall assess15
fees for testing and certification based on the following schedule:16
(1) Test fees: Fee17
(a) First responder- Emergency medical responder - written only $ 15.0018
(b) First responder- Emergency medical responder - written only19
(out of state) 15.0020
(c) Basic Emergency medical technician initial written & practical60.0021
(d) Basic Emergency medical technician entire practical exam 30.0022
(e) Basic Emergency medical technician partial practical 15.0023
(f) Basic Emergency medical technician testing/retesting-written only15.0024
(g) Basic Emergency medical technician testing/retesting-written only25
(out of state) 15.0026
(h) Intermediate Advanced emergency medical technician initial27
written & practical 75.0028
(i) Intermediate Advanced emergency medical technician initial written 29 SB NO. 500
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& practical (out of state) 100.001
(j) Intermediate Advanced emergency medical technician retest entire2
practical 50.003
(k) Intermediate Advanced emergency medical technician retest entire4
practical (out of state) 65.005
(l) Intermediate Advanced emergency medical technician retest partial6
practical 30.007
(m) Intermediate Advanced emergency medical technician retest partial8
practical (out of state) 30.009
(n) Intermediate Advanced emergency medical technician testing/retesting-10
written only (exam only) 15.0011
(o) Intermediate Advanced emergency medical technician testing/retesting-12
written only (exam only) (out of state) 15.0013
(p) Paramedic initial written & practical 90.0014
(q) Paramedic initial written & practical (out of state) 125.0015
(r) Paramedic retesting-entire practical 60.0016
(s) Paramedic retesting-entire practical (out of state) 75.0017
(t) Paramedic retesting-partial practical 35.0018
(u) Paramedic retesting-partial practical (out of state) 40.0019
(v) Paramedic testing/retesting written 15.0020
(w) Paramedic testing/retesting written (out of state) 15.0021
(2) Certification fees22
(a) First responder Emergency medical responder 10.0023
(b) Basic EMT Emergency medical technician 30.0024
(c) Intermediate Advanced emergency medical technician 40.0025
(d) Paramedic 50.0026
(3) Recertification27
(a) First responder Emergency medical responder 5.0028
(b) Basic EMT Emergency medical technician 25.0029 SB NO. 500
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(c) Intermediate Advanced emergency medical technician 35.001
(d) Paramedic 45.002
(4) Reciprocity3
(a) Basic EMT Emergency medical technician 60.004
(b) Intermediate Advanced emergency medical technician 80.005
(c) Paramedic 100.006
* * *7
§1232.2. Louisiana Emergency Medical Services Certification Commission;8
creation; membership; qualifications; terms; vacancies; meetings;9
officers; compensation; domicile10
* * *11
B.(1) The commission shall be composed of eleven voting members12
appointed by the governor as follows:13
* * *14
(b) Two certified emergency medical technician- licensed paramedics and15
one licensed emergency medical technician-basic who are certified approved as16
emergency medical services instructors educators by the bureau. Until November17
6, 2011, or the member's resignation from the commission, whichever is earlier, at18
least one of the members as provided in this Subparagraph shall be a full-time19
employee of a fire department. After November 6, 2011, or the member's resignation20
from the commission, at At least one of the members as provided in this21
Subparagraph shall be appointed by the Louisiana Fire Chiefs Association.22
* * *23
(d) One member who is, at a minimum, a state-certified emergency medical24
technician-basic nominated by the Louisiana Municipal Association.25
* * *26
(2) The commission shall also have one nonvoting member appointed by the27
governor who is a registered nurse and who is a state-certified licensed paramedic28
to be nominated by the Louisiana State Nurses Association from a list of two names29 SB NO. 500
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submitted by the Louisiana Emergency Nurses Association.1
* * *2
G.(1) Subsequent to the appointment of the initial members, the voting3
members shall be appointed from a list of two nominees for each appointment4
submitted by the task force. No later than thirty days prior to the termination date of5
a member's term, the task force or, for the nonvoting member, the Louisiana State6
Nurses Association, shall submit a list of nominees to the governor. If the Louisiana7
State Nurses Association or the task force fails to submit the required list of8
nominees to the governor within thirty days, the governor shall appoint the9
respective member to fill the vacancy without the nomination list required.10
(2) A vacancy on the commission prior to the expiration of a term shall be11
filled for the remainder of the term. No later than thirty days after the occurrence of12
a vacancy prior to the expiration of a term, the task force or, for the nonvoting13
member, the Louisiana State Nurses Association, shall submit a list of nominees to14
the governor. If the Louisiana State Nurses Association or the task force fails to15
submit the required list of nominees to the governor within thirty days, the governor16
shall appoint the respective member to fill the vacancy without the nomination list17
required.18
* * *19
§1232.3. Powers and duties of the commission; exceptions20
A. The commission shall:21
(1) Recommend to the bureau requirements and standards of practice scope22
of practice for individuals seeking to be certified under this Subpart.23
(2) Approve requirements and standards of practice scope of practice24
submitted by the bureau for emergency medical personnel services practitioners25
consistent with this Subpart.26
(3) Recommend continuing education requirements and standards to the27
bureau in accordance with criteria established by the National Registry of28
Emergency Medical Technicians for individuals seeking to renew a certificate29 SB NO. 500
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license.1
* * *2
B. Except as they relate to scope of practice or patient care issues, Paragraphs3
(A)(4), (5), and (6) of this Section shall not apply to anyone who is a volunteer of or4
employed by the state of Louisiana or another public entity, a municipal fire5
department, a fire protection district, or a volunteer fire department who has6
successfully completed an emergency medical technician-basic, emergency medical7
technician-intermediate, emergency medical technician-paramedic, or first responder8
training program developed and promulgated by the United States Department of9
Transportation an education program based on national EMS education10
standards and who possesses a current national and state certification and state11
license, until the commission has forwarded the nonmedical practice complaint to12
the local governing body and received a response with investigative results and any13
disciplinary disposition. In the event that the local governing body does not send a14
response or request for extension to the commission within sixty days after receipt15
of the complaint, the commission may proceed with the powers and duties as defined16
in Subsection A of this Section. Notwithstanding any law to the contrary, in the event17
the commission determines by a two-thirds vote of the membership of the18
commission that public health and safety would be jeopardized by waiting for a19
response from the local governing authority, the commission shall have the right to20
exercise its powers and duties as provided in Subsection A of this Section without21
receipt of an investigative report from the local governing authority or the expiration22
of the sixty-day period as provided in this Subsection.23
§1232.4. Powers and duties of the bureau24
The bureau shall:25
(1) Issue a certificate license and renew a certificate license to any duly26
qualified applicant for certification or for certification license and license renewal27
as a certified first responder or certified emergency medical technician. an28
emergency medical services practitioner.29 SB NO. 500
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* * *1
(3) Adopt requirements and standards of practice scope of practice approved2
by the commission for emergency medical personnel services practitioners.3
* * *4
(5) Deny, withhold, revoke, restrict, probate, or suspend a certificate license5
as directed by the commission under the provisions of R.S. 40:1232.6.6
* * *7
(10) Adopt and amend the title and the definition of licensed emergency8
medical services practitioners.9
§1232.5. Certification License; requirements; renewal10
A. Applicants for initial certification license as emergency personnel11
medical services practitioners shall submit the following evidence to the bureau:12
(1) Completion of the required approved educational program.13
(2) Documentation that the applicant meets the qualifications and14
requirements as established by the bureau.15
B. In lieu of the evidence required by Subsection A of this Section, an16
applicant may submit evidence that he has been duly licensed or certified in another17
state, territory, or country or has received military training and certification or18
license as emergency medical personnel services practitioner as defined in R.S.19
40:1231, and meets the qualifications and requirements established by the bureau.20
C.(1) The certificate license shall be renewed every two years provided the21
applicant seeking renewal completes the application and meets the requirements for22
renewal established by the bureau prior to the expiration date on his current23
certificate license.24
(2) An individual whose certificate license expires by his failure to renew25
as provided may be reinstated provided the applicant submits a completed26
application and meets any additional requirements established by the bureau for an27
individual who has failed to timely renew his certificate license.28
§1232.6. Grounds for disciplinary proceedings29 SB NO. 500
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The commission may discipline emergency medical services professionals1
practitioners by directing the bureau to deny, withhold, revoke, restrict, probate, or2
suspend a certificate license to practice as a certified emergency medical technician3
or certified first responder an emergency medical services practitioner, impose4
fines and assess costs, or otherwise discipline an emergency medical services5
practitioner, and the commission may direct the bureau to limit, restrict, or deny a6
student EMS professional emergency medical services practitioner from entering7
or continuing the clinical phase of EMS education for the following causes:8
(1) Conviction of selling or attempting to sell, falsely obtaining, or furnishing9
to a person a certified emergency medical technician or certified first responder10
certification licensed emergency medical services practitioner document.11
(2) Conviction of a crime or offense which reflects the inability of an12
emergency medical services practitioner to provide emergency medical services13
with due regard for the health and safety of clients or patients or enters a plea of14
guilty or nolo contendere to a criminal charge regardless of final disposition of the15
criminal proceeding, including but not limited to expungement or nonadjudication.16
* * *17
(12) Has had a certification or license to practice as an EMS professional18
emergency medical services practitioner or to practice as another health care19
provider denied, revoked, suspended, or otherwise restricted.20
* * *21
(15) Intentional falsification of any document related to license,22
emergency medical services education, or related to the care of the patient.23
§1232.7. Hearings of the commission; appeal of decision24
* * *25
D. Notice of the commission's decision to revoke, restrict, suspend, or deny26
a certificate license shall be sent to the individual under investigation by registered27
mail, return receipt requested, at his last known address as it appears on the records28
of the bureau.29 SB NO. 500
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E. An individual whose certification license has been revoked, restricted,1
suspended, placed in probation, or denied may have the proceedings of the2
commission reviewed by a court of competent jurisdiction, provided that an appeal3
is made no later than thirty days after the date indicated on the registered mail receipt4
of the notice required by Subsection D of this Section. The decision of the5
commission shall remain in force until an appeal is granted unless the court orders6
a stay. If an appeal is granted, the decision of the commission shall be suspended7
until a final disposition of the matter is ultimately rendered by the court affirming the8
decision of the commission.9
* * *10
§1232.9. Violations11
No person or individual shall engage in any of the following activities:12
(1) Sell, or attempt to sell, falsely obtain, or furnish to any person any13
emergency medical personnel services practitioner diploma, certification license14
document, or record, or aid or abet therein.15
(2) Practice as a certified an emergency medical technician or certified first16
responder services practitioner under any diploma or certificate illegally obtained17
or signed or issued unlawfully.18
(3) Practice as a certified an emergency medical technician or certified first19
responder services practitioner unless certified licensed to do so under the20
provisions of this Subpart.21
(4) Use in connection with his name any designation tending to imply that22
he is a certified an emergency medical technician or certified first responder services23
practitioner unless duly authorized to practice under the provisions of this Subpart.24
(5) Practice as a certified an emergency medical technician or certified first25
responder services practitioner during the time the certification license issued under26
the provisions of this Subpart is suspended or revoked.27
(6) Practice as a certified an emergency medical technician or certified first28
responder services practitioner during the time his certification license has lapsed29 SB NO. 500
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by reason of his intentional failure to renew the certification license.1
(7) Conduct or serve as an assistant instructor educator in conducting any2
course claiming to prepare students for certification license as emergency medical3
personnel services practitioner under the provisions of this Subpart, unless both the4
course and the instructor educator have been approved by the bureau.5
(8) Knowingly aid or abet another person in the violation of this Subpart.6
* * *7
§1232.11. Exceptions8
This Subpart shall not apply to the practice of emergency medical services9
by a legally qualified emergency medical technician services practitioner who is10
employed by the United States government, or by any bureau, division, or agency11
thereof, while in the discharge of his official duties.12
* * *13
§1233. Civil immunity14
A.(1) Any emergency medical person certified services practitioner15
pursuant to the provisions of this Subpart who renders emergency medical care to an16
individual while in the performance of his medical duties and following the17
instructions of a physician shall not be individually liable to such an individual for18
civil damages as a result of acts or omissions in rendering the emergency medical19
care, except for acts or omissions intentionally designed to harm, or for grossly20
negligent acts or omissions which result in harm to such an individual. Nothing21
herein shall relieve the driver of the emergency vehicle from liability arising from22
the operation or use of such vehicle.23
(2) The immunity granted to emergency medical personnel services24
practitioners by the provisions of this Subpart shall extend to parish governing25
authorities, police departments, sheriffs' offices, fire departments, or other public26
agencies engaged in rendering emergency medical services and its insurers with27
respect to such emergency medical services unless the emergency medical personnel28
services practitioner employed by such agencies would be personally liable under29 SB NO. 500
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the provisions of Paragraph (1) of this Subsection.1
B. Any physician who provides instructions to any emergency medical2
personnel services practitioner by use of electronic or other means of transmission3
in connection with the rendering of emergency medical services to an individual4
shall not be liable unto such personnel practitioner or to an individual or both for5
civil damages arising from his opinion, judgments, actions, or duties, except for acts6
or omissions intentionally designed to harm, or for grossly negligent acts or7
omissions which result in harm to the individual, while exercising that degree of skill8
and care ordinarily employed by members of his profession in good standing.9
C. No hospital facility which allows the use of telemetry or other equipment10
to maintain contact between a certified emergency medical technician an emergency11
medical services practitioner and a physician shall be liable for any civil damages12
arising out of the use of such equipment except for acts or omissions by hospital13
personnel that are grossly negligent which result in harm to an individual.14
D. No registered nurse, certified emergency medical technician licensed15
emergency medical services practitioner, or other health professional licensed in16
Louisiana who supervises, instructs, or trains emergency medical personnel services17
practitioners in accordance with curricula developed or adopted by the bureau shall18
be liable for any civil damages arising out of the actions or negligence of the19
emergency medical personnel whom he supervised, instructed educated, or trained.20
E. There shall be no cause of action or civil liability, and no certificate21
license holder or applicant shall have any cause of action or any claim for damages22
against any individual, person, or institution providing information to the23
commission or its agents or employees when that individual, person, or institution24
acts without malice and when there is a reasonable belief that such information is25
accurate.26
§1234. Duties of emergency medical personnel27
A.(1) A certified licensed emergency medical technician-basic services28
practitioner may perform any of the following functions:29 SB NO. 500
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(a) Rescue, first aid, resuscitation, and other services Services, treatment,1
and procedures consistent with national EMS education standards that have2
been approved and adopted by the bureau, and to the extent that he has been3
trained to perform such services under the provisions of the National Standard EMT-4
Basic training curriculum developed and promulgated by the United States5
Department of Transportation that are adopted by the bureau.6
(b) When authorized by medical direction, an emergency medical technician-7
basic or an emergency medical technician-intermediate may administer or aid the8
patient in the administration of a dose of epinephrine from an auto-injector to treat9
allergic reaction and anaphylaxis. Administration of other drugs or procedures10
for which the licensed emergency medical services practitioner has received11
training, license, and approval by the commission and which may be considered12
necessary by the ordering physician.13
(c) Services which may be performed by a certified emergency medical14
technician-intermediate as provided in Subsection B of this Section, but only while15
he is enrolled in good standing in an approved emergency medical technician-16
intermediate clinical or field internship program and while he is under the direct17
supervision of a physician, registered nurse, certified emergency18
technician-paramedic, or other preceptor approved by the bureau.19
(d) Services which may be performed by a certified emergency medical20
technician-paramedic, as provided in Subsection C of this Section, but only while he21
is enrolled in good standing in an approved emergency medical technician-paramedic22
clinical or field internship program and while he is under the direct supervision of23
a physician, registered nurse, certified emergency technician-paramedic, or other24
preceptor approved by the bureau.25
(2) The functions authorized by Paragraph (1) of this Subsection may be26
performed by the certified licensed emergency medical technician-basic services27
practitioner under any of the following conditions:28
(a) While while he is caring for a patient or at the scene of a medical or29 SB NO. 500
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other emergency where voice contact is established with a physician and under the1
physician's order; or under a protocol that has been approved by the local parish2
medical society or the emergency medical services practitioner's medical3
director, until voice communication with the physician is established.4
(b) While he is at the scene of a life threatening emergency and under a5
protocol that has been approved by the local parish medical society, or its designee,6
until voice communication with the physician is established at the earliest possible7
time.8
B.(1) A certified emergency medical technician-intermediate may perform9
any of the following functions An emergency medical services practitioner10
student may, while he is enrolled in good standing in a state approved clinical11
or field internship program under the direct supervision of a physician,12
registered nurse, paramedic, or other preceptor recognized by the bureau:13
(a)(1)Any services to the extent that he has been trained to perform such14
services under the provisions of the National Standard EMT-Intermediate training15
curriculum developed and promulgated by the United States Department of16
Transportation that are adopted by the bureau Perform services, treatments, and17
procedures consistent with national EMS education standards that have been18
approved and adopted by the bureau, and to the extent that he has been trained19
to perform such services.20
(b) Services which may be performed by a certified emergency medical21
technician-paramedic, as provided in Subsection C of this Section, but only while he22
is enrolled in good standing in an approved emergency medical technician-paramedic23
clinical or field internship program and while under the direct supervision of a24
physician, registered nurse, certified emergency technician-paramedic, or other25
preceptor approved by the bureau.26
(2) The functions authorized by Paragraph (1) of this Subsection may be27
performed by the certified emergency medical technician-intermediate under any of28
the following conditions:29 SB NO. 500
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(a) While caring for a patient in a participating hospital under the direct1
supervision of a physician.2
(b) While he is at the scene of a medical or other emergency where voice3
contact is established with a physician and under the physician's orders.4
(c) While he is at the scene of a life threatening emergency and under a5
protocol that has been approved by the local parish medical society, or its designee,6
until voice communication with the physician is established at the earliest possible7
time.8
C.(1) A certified emergency medical technician-paramedic may perform any9
of the following functions:10
(a) Any services to the extent that he has been trained to perform such service11
under the provisions of the National Standard EMT-Paramedic training curriculum12
developed and promulgated by the United States Department of Transportation that13
are adopted by the bureau.14
(b) Administration of other drugs or procedures for which the certified15
emergency medical technician-paramedic has received training, certification, and16
approval by the commission and which may be considered necessary by the ordering17
physician.18
(2) The functions authorized by Paragraph (1) of this Subsection may be19
performed by a certified emergency medical technician-paramedic under any of the20
following conditions:21
(a) While his caring for a patient in a participating hospital under the direct22
supervision of a physician.23
(b) While he is at the scene of a medical or other emergency where voice24
contact is established with a physician and under the physician's orders.25
(c) While he is at the scene of a life threatening emergency and under a26
protocol that has been approved by the local parish medical society, or its designee,27
until voice communication with the physician is established at the earliest possible28
time.29 SB NO. 500
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D. A certified first responder may perform any of the following functions:1
(1) Rescue, first aid, resuscitation, and other services to the extent that he has2
been trained to perform such services under the provisions of the first responder3
training curriculum developed and adopted by the bureau.4
(2) Administration of Administer automated cardiac defibrillation in5
accordance with rules and regulations promulgated by the bureau in accordance with6
the Administrative Procedure Act and a protocol that shall be approved by the local7
parish medical society, or its designee, and the local physician medical director.8
EC.(1) In a case of a life-threatening situation as determined by a certified9
licensed emergency medical technician-intermediate or an emergency medical10
technician-paramedic services practitioner, when voice contact with a physician or11
when telemetered electrocardiogram communication is delayed, not possible, or12
when the delay in treatment could endanger the life of the patient, such a person may13
render services, in accordance with a protocol that shall be established by the14
emergency medical services committee or the executive committee of the parish or15
component medical society, or its designee, until voice or telemetered16
electrocardiogram communication can be established at the earliest possible time.17
(2) Such services may be rendered for the following conditions: 18
(a) Cardiac arrest.19
(b) Ventricular tachycardia.20
(c) Supraventricular tachycardia.21
(d) Premature ventricular ectopy when greater than six per minute,22
multifocal, bigeminal, occurring in bursts of two or more, falling on or close to the23
T wave.24
(e) Severe, unrelieved, suspected cardiogenic chest pain, or suspected25
myocardial infarction.26
(f) Bradydysrhythmias.27
(g) Hypoglycemia.28
(h) Anaphylactic reactions.29 SB NO. 500
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(i) Hypovolemic shock.1
(j) Unconsciousness, altered mental status, or respiratory depression from2
suspected drug overdose.3
(k) Treatment induced unconsciousness, altered mental status, hypotension,4
or respiratory depression from physician ordered or protocol appropriate paramedic5
administered narcotics.6
(l) Respiratory failure or respiratory arrest.7
(m) Active seizure.8
(3) Nothing in this Subsection shall be construed to authorize a certified9
emergency medical technician-paramedic to administer any Schedule II narcotic10
without a direct order by a physician licensed to practice medicine by the Louisiana11
State Board of Medical Examiners or in accordance with an approved protocol12
adopted pursuant to Subsection E(1) and (2).13
F.(1) The bureau shall adopt rules and regulations to allow emergency14
medical personnel to institute a program for the delivery of automated cardiac15
defibrillation in the pre-hospital setting.16
(2) The bureau shall adopt rules and regulations for training to allow all17
levels of certified medical technicians to carry and administer epinephrine by auto-18
injectors to patients experiencing allergic reactions or anaphylaxis.19
GD. Any individual, training education organization, organization, or other20
entity violating the provisions of this Section shall be guilty of a misdemeanor,21
conviction of which shall subject the offender to a fine of not less than five hundred22
dollars nor more than one thousand dollars for each separate offense.23
H E. In the event that there is no organized or functional local parish medical24
society in a parish of the state, the provisions of this Section which require the25
approval of an emergency medical service protocol by the local parish medical26
society or its designee may be performed by a parish or multiparish medical society27
which is adjacent or contiguous to the parish without an organized or functional local28
parish medical society. In the absence of such adjacent or contiguous parish or29 SB NO. 500
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multiparish medical society, the district medical society shall approve an emergency1
medical service protocol for the parish without an organized or functional local2
parish medical society. In the event the district medical society does not approve an3
emergency medical service protocol for the parish without an organized or functional4
local parish medical society, the disaster and emergency medical services committee5
of the Louisiana State Medical Society shall approve an emergency medical service6
protocol for the parish without an organized or functional local parish medical7
society.8
I F. The department shall promulgate rules and regulations establishing basic9
guidelines for statewide emergency medical service protocols. Such rules and10
regulations shall be based on the recommendations of the Louisiana State Medical11
Society's disaster and emergency medical services committee, which shall serve as12
an advisory committee to the department for this purpose.13
* * *14
SUBPART C. EMERGENCY MEDI CAL TRANSPORTATION15
§1235. Qualifications to operate ambulances; equipment; penalty16
A.(1) No person or individual shall conduct, maintain, or operate an17
ambulance on any street, alley, or public way or place in the state unless the18
ambulance is staffed with a minimum of two persons, one of whom shall be a19
certified licensed emergency medical technician.20
(2)(a) No person or individual shall provide services in any capacity on any21
ambulance unless he is a certified first responder, a certified emergency medical22
technician, licensed emergency medical responder, a licensed emergency medical23
technician, a licensed advance emergency medical technician, a licensed24
paramedic, a licensed respiratory therapist, a licensed nurse practitioner, a25
licensed physician assistant, a licensed occupational therapist, a licensed26
registered or practical nurse, or a physician.27
* * *28
(c) No individual shall provide services in any capacity on any ambulance29 SB NO. 500
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unless he holds a cardiopulmonary resuscitation provider card issued by the1
American Heart Association or the American Red Cross without holding an2
American Heart Association Health Care Provider, or American Red Cross3
Professional Rescuer, or the equivalent cardio-pulmonary resuscitation4
certification that has been approved by the Ambulance Standards Committee.5
(d) No individual shall transport any ill or injured person by ambulance6
unless the sick or injured person is attended by a certified emergency medical7
technician licensed emergency medical technician, a licensed advance emergency8
medical technician, a licensed paramedic, a registered nurse, or a physician in the9
patient compartment.10
* * *11
§1235.1. Qualifications to operate emergency medical response vehicles; vehicle12
requirements; equipment; penalties13
A.(1) No person shall conduct, maintain, or operate an emergency medical14
response vehicle as an emergency vehicle on any street, alley, or public way or place15
in the state unless the vehicle is staffed with at least one individual who is a16
Louisiana state-certified nationally registered licensed emergency medical technician17
responder.18
(2) No person shall provide services in any capacity on an emergency19
medical response vehicle unless he is the holder of a certification by the Department20
of Health and Hospitals or its agent as a first responder; or a certification of an21
emergency medical technician issued by the National Registry of Emergency22
Medical Technicians at least a licensed emergency medical responder;, or a23
holder of a certificate of licensure as a registered nurse or licensed practical nurse;,24
or is a physician or surgeon licensed to practice medicine by the Louisiana State25
Board of Medical Examiners, a licensed respiratory therapist, a licensed nurse26
practitioner, a licensed physician assistant, or a licensed occupational therapist.27
No person shall provide services in any capacity on these vehicles without holding28
a valid certification of cardiopulmonary resuscitation issued by the American29 SB NO. 500
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National Red Cross or the American Heart Association an American Heart1
Association Health Care Provider, or American Red Cross Professional2
Rescuer, or the equivalent cardio-pulmonary resuscitation certification that has3
been approved by the Ambulance Standards Committee.4
* * *5
§1236. Advanced emergency medical technicians6
In addition to the requirements of R.S. 40:1235, any hospital, ancillary7
medical facility, or ambulance service, whether public or private, may conduct a8
program utilizing any certified emergency medical technician-intermediate or9
certified emergency medical technician-paramedic services practitioner to10
supervise and direct the delivery of emergency medical care to the sick and injured11
at the scene of an emergency during transport to a hospital, while in the hospital12
emergency department, and until care responsibility is assumed by the regular13
hospital staff.14
* * *15
§1236.13. Persons in possession of AED's; training, testing, and notification16
requirements; manufacturer responsibility; possession required17
* * *18
B. Any person or entity that possesses an AED shall notify the bureau of19
emergency medical services in the office of public health of the Department of20
Health and Hospitals and a local provider of emergency medical services, such as21
911 service, local ambulance service, or the fire department of the acquisition,22
location, and type of AED.23
* * *24
F. The office of public health within the Department of Health and Hospitals,25
through its center for community health, emergency medical services shall26
promulgate all necessary rules and regulations to implement the provisions of27
Subsections D and E of this Section. Such rules and regulations shall, at a minimum,28
provide for compliance, enforcement, and penalties.29 SB NO. 500
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* * *1
§1299.58.2. Definitions2
As used in this Part, the following words shall have the meanings ascribed3
to them unless the context clearly states otherwise:4
* * *5
(4) "Certified first responder" means any person who has successfully6
completed a training course developed and promulgated by the United States7
Department of Transportation and adopted by the bureau of emergency medical8
services of the Department of Health and Hospitals and who is certified by the9
bureau. "Licensed emergency medical responder" means any individual who has10
successfully completed an emergency medical responder education program11
based on National EMS Education Standards and adopted by the bureau of12
emergency medical services of the Department of Health and Hospitals and who13
is licensed by the bureau.14
* * *15
§1299.64.2. Definitions16
As used in this Part, the following terms shall have the meanings ascribed to17
them unless the context clearly states otherwise:18
* * *19
(3) "Certified first responder" means any person who has successfully20
completed a training course developed and promulgated by the United States21
Department of Transportation and adopted by the bureau of emergency medical22
services of the Department of Health and Hospitals and who is certified by the23
bureau. "Licensed emergency medical responder" means any individual who has24
successfully completed an emergency medical responder education program25
based on National EMS Education Standards and adopted by the bureau of26
emergency medical services of the Department of Health and Hospitals and who27
is licensed by the bureau.28
* * *29 SB NO. 500
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Section 3. R.S. 40:1236.3 is hereby repealed.1
Section 4. This Act shall become effective upon signature by the governor or, if not2
signed by the governor, upon expiration of the time for bills to become law without signature3
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If4
vetoed by the governor and subsequently approved by the legislature, this Act shall become5
effective on the day following such approval.6
The original instrument was prepared by Christopher D. Adams. The
following digest, which does not constitute a part of the legislative
instrument, was prepared by Tammy Crain-Waldrop.
DIGEST
Buffington (SB 500)
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 licensed 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.
Proposed law provides for additional health care professionals who may provide services on
an ambulance to include licensed respiratory therapist, a licensed nurse practitioner, a
licensed physician assistant, or a licensed occupational therapist.
Proposed law provides for additional health care professionals who may attend to a patient
on an ambulance to include licensed respiratory therapist, a licensed nurse practitioner, a
licensed physician assistant, or a licensed occupational therapist.
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), 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, 1236.13(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) SB NO. 500
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Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to
the original bill.
1. Provides for additional health care professionals who may provide services
on an ambulance to include licensed respiratory therapist, a licensed nurse
practitioner, a licensed physician assistant, or a licensed occupational
therapist.
2. Provides for additional health care professionals who may attend to a patient
on an ambulance to include licensed respiratory therapist, a licensed nurse
practitioner, a licensed physician assistant, or a licensed occupational
therapist.
3. Technical changes.
Senate Floor Amendments to engrossed bill
1. Removes provision that until November 6, 2011, or a resignation from the
commission, whichever is earlier, at least one member shall be a full-time
employee of a fire department.
2. Technical changes.