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Regular Session, 2012 ENROLLED
SENATE BILL NO. 500
BY SENATORS BUFFINGTON AND MILLS
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)(2), (3), and3
(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, 1236.13(B) and (F),1299.58.2(3),6
1299.58.7(E), 1299.58.8(D), 1299.64.2(2), 1299.64.4(D), and 1299.64.5(B); to enact7
R.S. 40:1232.4(10) and 1232.6(15), and to repeal R.S. 40:1236.3, 1299.58.2(4), and8
1299.64.2(3), relative to changes within the emergency medical services provisions;9
to provide for changes in references to emergency medical personnel; to provide with10
respect to title designations for certain licensees providing emergency medical11
services; to provide with respect to grounds for disciplinary proceedings relative to12
intentional falsification of documents; to provide relative to the duties of emergency13
medical personnel; to provide relative to the permissible functions which an14
emergency medical services practitioner student may perform and under what15
conditions those functions may be performed; to provide with respect to the16
certifications necessary for an emergency medical services practitioner to hold; and17
to provide for related matters.18
Be it enacted by the Legislature of Louisiana:19
Section 1. R.S. 36:919.4 is hereby amended and reenacted to read as follows:20
§919.4. Transfer; Louisiana Emergency Medical Services Certification Commission21
ACT No. 789 SB NO. 500 ENROLLED
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The Louisiana Emergency Medical Services Certification Commission,1
placed in the Department of Health and Hospitals by the provisions of R.S.2
36:259(GG), shall exercise and perform its powers, duties, functions, and3
responsibilities as provided for agencies transferred pursuant to this Part. However,4
the commission shall advise the bureau of emergency medical services , office of5
public health, on requirements and standards for certification licensure of emergency6
medical personnel and continuing education requirements for certification licensure.7
The commission shall retain the authority to approve requirements and standard of8
practice for emergency medical personnel; conduct disciplinary hearings for9
emergency medical personnel; and cause the prosecution of any individual who10
violates the provisions of Subpart B of Part VII of Chapter 5 of Title 40 of the11
Louisiana Revised Statutes of 1950.12
Section 2. R.S. 40:1231, 1231.1(A), 1232(A) and (B), 1232.1(A) and (B),13
1232.2(B)(1)(b) and (d), (B)(2), and (G), 1232.3(A)(2), (3), and (B), 1232.4 (1), (3), and (5),14
1232.5, the introductory paragraph of 1232.6 and 1232.6(1), (2), and (12), 1232.7(D) and15
(E), 1232.9, 1232.11, 1233, 1234, 1235(A)(1), (2)(a), (c), and (d), 1235.1(A), 1236,16
1236.13(B) and (F), 1299.58.2(3), 1299.58.7(E), 1299.58.8(D), 1299.64.2(2), 1299.64.4(D),17
and 1299.64.5(B) are hereby amended and reenacted and R.S. 40:1232.4 (10) and 1232.618
(15) are hereby enacted to read as follows:19
PART VII. EMERGENCY MEDICAL SERVICES20
SUBPART A. GENERAL PROVISIONS21
§1231. Definitions22
For purposes of this Part:23
(1) "Ambulance" means any authorized emergency vehicle, equipped with24
warning devices, designed and operated as a part of a regular course of conduct or25
business to transport a sick or injured individual or which is advertised or otherwise26
held out to the public as such. "Ambulance" shall not mean a hearse or other funeral27
home vehicle utilized for the transportation of the dead.28
(2) "Ambulance service" or "ambulance provider" means any person, firm,29
association, or government entity owning, controlling, or operating any business or30 SB NO. 500 ENROLLED
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service which furnishes, operates, conducts, maintains, advertises, engages in,1
proposes to engage in, or professes to engage in the business or service of2
transporting, in ambulances, individuals who may need medical attention during3
transport. However, "ambulance service" and "ambulance provider" shall not include4
any of the following:5
(a) An agency of the federal government.6
(b) A volunteer nonprofit organization or municipal nonprofit organization7
operating an invalid coach or coaches.8
(c) An entity rendering assistance to a licensed ambulance or ambulances in9
the case of a major disaster.10
(d) A licensed hospital providing nonemergency, noncritical interhospital11
transfer and patient transportation for diagnostic and therapeutic purposes when such12
transportation originates at a licensed hospital.13
(e) An entity operating an ambulance or ambulances from a location outside14
of the state to transport patients from a location outside of the state to a location15
inside the state or to transport a patient or patients from a medical facility inside of16
the state to a location outside of the state.17
(f) An entity providing transportation to employees who become sick or18
injured during the course of their employment from a job site to the nearest19
appropriate medical facility.20
(3) "Air ambulance" means any aircraft, either fixed-wing or rotary-winged,21
designed and operated as a part of a regular course of conduct or business to22
transport a sick or injured individual or which is advertised or otherwise held out to23
the public as such.24
(3.1) "Air ambulance service" means any person, firm, association, or25
government entity owning, controlling, or operating any business or service which26
furnishes, operates, conducts, maintains, advertises, engages in, proposes to engage27
in, or professes to engage in the business or service of transporting, in air28
ambulances, individuals who may need medical attention during transport.29
(3.2) "Auto-injector" means a spring-loaded needle and syringe with a single30 SB NO. 500 ENROLLED
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dose of epinephrine that will automatically release and inject the medicine.1
(4) "Bureau" means the Department of Health and Hospitals, office of public2
health, bureau of emergency medical services.3
(5) "Certified emergency medical technician" means an individual who is4
certified as any one of the following: "Licensed emergency medical services5
practitioner" means an individual who is a licensed emergency medical6
responder or who is nationally registered, who has successfully completed an7
emergency medical services practitioner education program based on national8
EMS education standards, and who is licensed as any one of the following:9
(a) A certified licensed emergency medical technician -basic.10
(b) A certified licensed advanced emergency medical technician-11
intermediate.12
(c) A certified emergency medical technician-licensed paramedic.13
(6) "Certified emergency medical technician-basic" means an individual who14
has successfully completed an emergency medical technician-basic training program15
developed and promulgated by the United States Department of Transportation and16
adopted by the bureau, who is nationally registered, and who is certified by the17
bureau.18
(7) "Certified emergency medical technician-intermediate" means any19
individual who has successfully completed an emergency medical technician-20
intermediate training program developed and promulgated by the United States21
Department of Transportation and adopted by the bureau, who is nationally22
registered, and who is certified by the bureau.23
(8) "Certified emergency medical technician-paramedic" means any24
individual who has successfully completed an emergency medical technician-25
paramedic training program developed and promulgated by the United States26
Department of Transportation and adopted by the bureau, who is nationally27
registered, and who is certified by the bureau.28
(9) (6) "Certified first responder" means any individual who has successfully29
completed a training course developed and promulgated by the United States30 SB NO. 500 ENROLLED
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Department of Transportation and adopted by the bureau and who is certified by the1
bureau. "Licensed emergency medical responder" means any individual who has2
successfully completed an emergency medical responder education program3
based on National EMS Education Standards approved by the bureau and who4
is licensed by the bureau.5
(10) (7) "Commission" means the Louisiana Emergency Medical Services6
Certification Commission.7
(11) (8) "Department" means the Department of Health and Hospitals.8
(12)"Emergency medical personnel" or "emergency service person(s)" means9
individuals who are certified first responders or certified emergency medical10
technicians.11
(13) (9) "Emergency medical response vehicle" means a marked emergency12
vehicle with fully visual and audible warning signals operated by a certified13
ambulance service, the primary purpose of which is to respond to the scene of a14
medical emergency to provide emergency medical stabilization or support, or15
command, control, and communications, but which is not an ambulance designed or16
intended for the purpose of transporting a victim from the scene to a medical facility17
regardless of its designation. Included are such vehicles referred to but not limited18
to the designation as "sprint car", "quick response vehicle", "special response19
vehicle", "triage trucks", "staff cars", "supervisor units", and other similar20
designations. Emergency medical response vehicles shall not include fire apparatus21
and law enforcement patrol vehicles which carry first aid or emergency medical22
supplies and which respond to medical emergencies as part of their routine duties.23
(14) (10) "Emergency medical services" or "EMS" means a system that24
represents the combined efforts of several professionals and agencies to provide25
prehospital emergency care to the sick and injured.26
(14.1) (11) "EMS professional" means an individual who is a certified first27
responder or certified emergency medical technician. "EMS practitioner" means28
an individual who is a licensed emergency medical responder, licensed29
emergency medical technician, licensed advanced emergency medical30 SB NO. 500 ENROLLED
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technician, or a licensed paramedic.1
(15) (12) "EMS task force" means the Emergency Medical Services Task2
Force, composed of individuals appointed by the assistant secretary of the office of3
public health, subject to the approval of the secretary of the department, which4
advises and makes recommendations to the office bureau of emergency medical5
services and the department on matters related to emergency medical services.6
(16) "First aid certificate" means a certificate in the Emergency Response7
Course issued by the American Red Cross or other certificate in a first aid course8
approved by the bureau and issued to any individual who has successfully completed9
the required training and met the established standards of such organizations.10
(17) (13) "Industrial ambulance" means any vehicle owned and operated by11
an industrial facility and used for transporting any employee who becomes sick,12
injured, or otherwise incapacitated in the course and scope of his employment from13
a job site to an appropriate medical facility.14
(18) (14) "Moral turpitude" means an act of baseness, vileness, or depravity15
in the duties which one person owes another, or to society in general, which is16
contrary to the usual, accepted, and customary rule of right and duty which a person17
should follow.18
(19) (15) "Municipal nonprofit organization" means an organization owned19
by a parish, municipality, or entity of a parish or municipality which in its regular20
course of business responds to a call for help and renders medical treatment and21
whose attendants are emergency medical personnel, a registered nurse, or a22
physician.23
(20) (16) "Physician" means a physician licensed to practice medicine by the24
Louisiana State Board of Medical Examiners.25
(21) (17) "Volunteer nonprofit organization" means an organization which26
in its regular course of business responds to a call for help and renders medical27
treatment and whose attendants are emergency medical personnel, a registered nurse,28
or a physician and which is chartered as a nonprofit organization under Section 501c29
of the United States Internal Revenue Code, as a volunteer fire department by the30 SB NO. 500 ENROLLED
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Louisiana state fire marshal's office, or as a nonprofit organization by the Louisiana1
secretary of state.2
(18) "EMS medical director" means a physician licensed by the3
Louisiana State Board of Medical Examiners who has responsibility and4
authority to ensure quality of care and provide guidance for all medical aspects5
of EMS.6
(19) "National EMS education standards" means the document that7
outlines current nationally recognized EMS education standards, has been8
adopted by the bureau, and defines terminal objectives for each nationally9
defined EMS licensing level.10
§1231.1. Emergency medical services program; cooperation of other state11
departments12
A. The department shall establish and maintain a program for the13
improvement and regulation of emergency medical services in the state. The14
responsibility for implementation and conduct of this program shall be vested in the15
office of public health, bureau of emergency medical services.16
* * *17
SUBPART B. EMERGENCY MEDI CAL PERSONNEL18
§1232. Emergency medical personnel training; certification19
A. The bureau shall promulgate rules and regulations in accordance with the20
Administrative Procedure Act for the following:21
(1) To define and authorize appropriate functions and pre-certification and22
post-certification training programs for emergency medical personnel. All such23
training programs shall meet or exceed the performance requirements developed by24
the United States Department of Transportation. education programs based on25
national EMS education standards for emergency medical services26
practitioners. All such education programs shall meet or exceed national EMS27
education standards.28
(2) To specify minimum operational requirements which will assure ensure29
medical direction, supervision, and control over emergency medical services.30 SB NO. 500 ENROLLED
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(3) To specify minimum testing examination and continuing education1
requirements for all emergency medical personnel services practitioners.2
(4) To provide for the issuance of certificates and licenses, renewals of3
certificates licenses, and requirements for emergency medical personnel services4
practitioners.5
(5) To specify initial certification and certification renewal requirements6
consistent with the National Registry of Emergency Medical Technicians for each7
level of emergency medical personnel.8
(6) (5) To establish fees for certification and certification licensure and9
license renewal.10
B. An individual petitioning for certification or certification licensure or11
license renewal as a certified emergency medical technician or a certified first12
responder an emergency medical services practitioner shall submit an application13
to the bureau on forms provided by the bureau. The application shall be accompanied14
by the appropriate fee.15
* * *16
§1232.1. Fee schedule; fees for certification license prohibited17
A.(1) The bureau shall not require or collect any fee or charges for18
certification or recertification licensure or license renewal of emergency medical19
personnel services practitioners who serve as such on a voluntary basis and who20
receive no compensation of any kind for such services.21
(2) The bureau shall not set the fee for certification licensure of an22
emergency medical technician-basic to exceed fifteen dollars for any individual who23
is an employee or volunteer of the state of Louisiana or another public entity, a24
municipal fire department, a fire protection district, a volunteer fire department, or25
a municipal law enforcement agency who does not perform emergency medical26
services outside of the individual's official governmental responsibilities for any27
form of compensation.28
(3) The bureau shall not set the fee for recertification license renewal of an29
emergency medical technician-basic to exceed ten dollars for any individual who is30 SB NO. 500 ENROLLED
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an employee or volunteer of the state of Louisiana or another public entity, a1
municipal fire department, a fire protection district, a volunteer fire department, or2
a municipal law enforcement agency who does not perform emergency medical3
services outside of the individual's official governmental responsibilities for any4
form of compensation.5
B. Except as provided in Subsection A of this Section, the bureau shall assess6
fees for testing and certification licenses based on the following schedule:7
(1) Test fees: Fee8
(a) First responder- Emergency medical responder - written only $ 15.009
(b) First responder- Emergency medical responder - written only10
(out of state) 15.0011
(c) Basic Emergency medical technician initial written & practical60.0012
(d) Basic Emergency medical technician entire practical exam 30.0013
(e) Basic Emergency medical technician partial practical 15.0014
(f) Basic Emergency medical technician testing/retesting-written only15.0015
(g) Basic Emergency medical technician testing/retesting-written only16
(out of state) 15.0017
(h) Intermediate Advanced emergency medical technician initial18
written & practical 75.0019
(i) Intermediate Advanced emergency medical technician initial written 20
& practical (out of state) 100.0021
(j) Intermediate Advanced emergency medical technician retest entire22
practical 50.0023
(k) Intermediate Advanced emergency medical technician retest entire24
practical (out of state) 65.0025
(l) Intermediate Advanced emergency medical technician retest partial26
practical 30.0027
(m) Intermediate Advanced emergency medical technician retest partial28
practical (out of state) 30.0029
(n) Intermediate Advanced emergency medical technician testing/retesting-30 SB NO. 500 ENROLLED
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written only (exam only) 15.001
(o) Intermediate Advanced emergency medical technician testing/retesting-2
written only (exam only) (out of state) 15.003
(p) Paramedic initial written & practical 90.004
(q) Paramedic initial written & practical (out of state) 125.005
(r) Paramedic retesting-entire practical 60.006
(s) Paramedic retesting-entire practical (out of state) 75.007
(t) Paramedic retesting-partial practical 35.008
(u) Paramedic retesting-partial practical (out of state) 40.009
(v) Paramedic testing/retesting written 15.0010
(w) Paramedic testing/retesting written (out of state) 15.0011
(2) Certification License fees12
(a) First responder Emergency medical responder 10.0013
(b) Basic EMT Emergency medical technician 30.0014
(c) Intermediate Advanced emergency medical technician 40.0015
(d) Paramedic 50.0016
(3) Recertification17
(a) First responder Emergency medical responder 5.0018
(b) Basic EMT Emergency medical technician 25.0019
(c) Intermediate Advanced emergency medical technician 35.0020
(d) Paramedic 45.0021
(4) Reciprocity22
(a) Basic EMT Emergency medical technician 60.0023
(b) Intermediate Advanced emergency medical technician 80.0024
(c) Paramedic 100.0025
* * *26
§1232.2. Louisiana Emergency Medical Services Certification Commission;27
creation; membership; qualifications; terms; vacancies; meetings;28
officers; compensation; domicile29
* * *30 SB NO. 500 ENROLLED
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B.(1) The commission shall be composed of eleven voting members1
appointed by the governor as follows:2
* * *3
(b) Two certified emergency medical technician- licensed paramedics and4
one licensed emergency medical technician-basic who are certified approved as5
emergency medical services instructors educators by the bureau. Until November6
6, 2011, or the member's resignation from the commission, whichever is earlier, at7
least one of the members as provided in this Subparagraph shall be a full-time8
employee of a fire department. After November 6, 2011, or the member's resignation9
from the commission, at At least one of the members as provided in this10
Subparagraph shall be appointed by the Louisiana Fire Chiefs Association.11
* * *12
(d) One member who is, at a minimum, a state-certified emergency medical13
technician-basic nominated by the Louisiana Municipal Association.14
* * *15
(2) The commission shall also have one nonvoting member appointed by the16
governor who is a registered nurse and who is a state-certified licensed paramedic17
to be nominated by the Louisiana State Nurses Association from a list of two names18
submitted by the Louisiana Emergency Nurses Association.19
* * *20
G.(1) Subsequent to the appointment of the initial members, the voting21
members shall be appointed from a list of two nominees for each appointment22
submitted by the task force. No later than thirty days prior to the termination date of23
a member's term, the task force or, for the nonvoting member, the Louisiana State24
Nurses Association, shall submit a list of nominees to the governor. If the Louisiana25
State Nurses Association or the task force fails to submit the required list of26
nominees to the governor within thirty days, the governor shall appoint the27
respective member to fill the vacancy without the nomination list required.28
(2) A vacancy on the commission prior to the expiration of a term shall be29
filled for the remainder of the term. No later than thirty days after the occurrence of30 SB NO. 500 ENROLLED
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a vacancy prior to the expiration of a term, the task force or, for the nonvoting1
member, the Louisiana State Nurses Association, shall submit a list of nominees to2
the governor. If the Louisiana State Nurses Association or the task force fails to3
submit the required list of nominees to the governor within thirty days, the governor4
shall appoint the respective member to fill the vacancy without the nomination list5
required.6
* * *7
§1232.3. Powers and duties of the commission; exceptions8
A. The commission shall:9
* * *10
(2) Approve requirements and standards of practice submitted by the bureau11
for emergency medical personnel services practitioners consistent with this12
Subpart.13
(3) Recommend continuing education requirements and standards to the14
bureau in accordance with criteria established by the National Registry of15
Emergency Medical Technicians for individuals seeking to renew a certificate16
license.17
* * *18
B. Except as they relate to scope of practice or patient care issues, Paragraphs19
(A)(4), (5), and (6) of this Section shall not apply to anyone who is a volunteer of or20
employed by the state of Louisiana or another public entity, a municipal fire21
department, a fire protection district, or a volunteer fire department who has22
successfully completed an emergency medical technician-basic, emergency medical23
technician-intermediate, emergency medical technician-paramedic, or first responder24
training program developed and promulgated by the United States Department of25
Transportation an education program based on national EMS education26
standards and who possesses a current national and state certification and state27
license, until the commission has forwarded the nonmedical practice complaint to28
the local governing body and received a response with investigative results and any29
disciplinary disposition. In the event that the local governing body does not send a30 SB NO. 500 ENROLLED
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response or request for extension to the commission within sixty days after receipt1
of the complaint, the commission may proceed with the powers and duties as defined2
in Subsection A of this Section. Notwithstanding any law to the contrary, in the event3
the commission determines by a two-thirds vote of the membership of the4
commission that public health and safety would be jeopardized by waiting for a5
response from the local governing authority, the commission shall have the right to6
exercise its powers and duties as provided in Subsection A of this Section without7
receipt of an investigative report from the local governing authority or the expiration8
of the sixty-day period as provided in this Subsection.9
§1232.4. Powers and duties of the bureau10
The bureau shall:11
(1) Issue a certificate license and renew a certificate license to any duly12
qualified applicant for certification or for certification licensure and license renewal13
as a certified first responder or certified emergency medical technician. an14
emergency medical services practitioner.15
* * *16
(3) Adopt requirements and standards of practice approved by the17
commission for emergency medical personnel services practitioners.18
* * *19
(5) Deny, withhold, revoke, restrict, probate, or suspend a certificate license20
as directed by the commission under the provisions of R.S. 40:1232.6.21
* * *22
(10) Adopt and amend the title and the definition of licensed emergency23
medical services practitioners.24
§1232.5. Certification License; requirements; renewal25
A. Applicants for initial certification licensure as emergency personnel26
medical services practitioners shall submit the following evidence to the bureau:27
(1) Completion of the required approved educational program.28
(2) Documentation that the applicant meets the qualifications and29
requirements as established by the bureau.30 SB NO. 500 ENROLLED
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B. In lieu of the evidence required by Subsection A of this Section, an1
applicant may submit evidence that he has been duly licensed or certified in another2
state, territory, or country or has received military training and certification or3
license as emergency medical personnel services practitioner as defined in R.S.4
40:1231, and meets the qualifications and requirements established by the bureau.5
C.(1) The certificate license shall be renewed every two years provided the6
applicant seeking renewal completes the application and meets the requirements for7
renewal established by the bureau prior to the expiration date on his current8
certificate license.9
(2) An individual whose certificate license expires by his failure to renew10
as provided may be reinstated provided the applicant submits a completed11
application and meets any additional requirements established by the bureau for an12
individual who has failed to timely renew his certificate license.13
§1232.6. Grounds for disciplinary proceedings14
The commission may discipline emergency medical services professionals15
practitioners by directing the bureau to deny, withhold, revoke, restrict, probate, or16
suspend a certificate license to practice as a certified emergency medical technician17
or certified first responder an emergency medical services practitioner, impose18
fines and assess costs, or otherwise discipline an EMS professional emergency19
medical services practitioner, and the commission may direct the bureau to limit,20
restrict, or deny a student EMS professional emergency medical services21
practitioner from entering or continuing the clinical phase of EMS education for the22
following causes:23
(1) Conviction of selling or attempting to sell, falsely obtaining, or furnishing24
to a person a certified emergency medical technician or certified first responder25
certification licensed emergency medical services practitioner document.26
(2) Conviction of a crime or offense which reflects the inability of an27
emergency medical services practitioner to provide emergency medical services28
with due regard for the health and safety of clients or patients or enters a plea of29
guilty or nolo contendere to a criminal charge regardless of final disposition of the30 SB NO. 500 ENROLLED
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criminal proceeding, including but not limited to expungement or nonadjudication.1
* * *2
(12) Has had a certification or license to practice as an EMS professional3
emergency medical services practitioner or to practice as another health care4
provider denied, revoked, suspended, or otherwise restricted.5
* * *6
(15) Intentional falsification of any document related to license,7
emergency medical services education, or related to the care of the patient.8
§1232.7. Hearings of the commission; appeal of decision9
* * *10
D. Notice of the commission's decision to revoke, restrict, suspend, or deny11
a certificate license shall be sent to the individual under investigation by registered12
mail, return receipt requested, at his last known address as it appears on the records13
of the bureau.14
E. An individual whose certification license has been revoked, restricted,15
suspended, placed in probation, or denied may have the proceedings of the16
commission reviewed by a court of competent jurisdiction, provided that an appeal17
is made no later than thirty days after the date indicated on the registered mail receipt18
of the notice required by Subsection D of this Section. The decision of the19
commission shall remain in force until an appeal is granted unless the court orders20
a stay. If an appeal is granted, the decision of the commission shall be suspended21
until a final disposition of the matter is ultimately rendered by the court affirming the22
decision of the commission.23
* * *24
§1232.9. Violations25
No person or individual shall engage in any of the following activities:26
(1) Sell, or attempt to sell, falsely obtain, or furnish to any person any27
emergency medical personnel services practitioner diploma, certification license28
document, or record, or aid or abet therein.29
(2) Practice as a certified an emergency medical technician or certified first30 SB NO. 500 ENROLLED
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responder services practitioner under any diploma or certificate illegally obtained1
or signed or issued unlawfully.2
(3) Practice as a certified an emergency medical technician or certified first3
responder services practitioner unless certified licensed to do so under the4
provisions of this Subpart.5
(4) Use in connection with his name any designation tending to imply that6
he is a certified an emergency medical technician or certified first responder services7
practitioner unless duly authorized to practice under the provisions of this Subpart.8
(5) Practice as a certified an emergency medical technician or certified first9
responder services practitioner during the time the certification license issued under10
the provisions of this Subpart is suspended or revoked.11
(6) Practice as a certified an emergency medical technician or certified first12
responder services practitioner during the time his certification license has lapsed13
by reason of his intentional failure to renew the certification license.14
(7) Conduct or serve as an assistant instructor educator in conducting any15
course claiming to prepare students for certification license as emergency medical16
personnel services practitioner under the provisions of this Subpart, unless both the17
course and the instructor educator have been approved by the bureau.18
(8) Knowingly aid or abet another person in the violation of this Subpart.19
* * *20
§1232.11. Exceptions21
This Subpart shall not apply to the practice of emergency medical services22
by a legally qualified emergency medical technician services practitioner who is23
employed by the United States government, or by any bureau, division, or agency24
thereof, while in the discharge of his official duties.25
§1233. Civil immunity26
A.(1) Any emergency medical person certified services practitioner,27
licensed pursuant to the provisions of this Subpart who renders emergency medical28
care to an individual while in the performance of his medical duties and following29
the instructions of a physician shall not be individually liable to such an individual30 SB NO. 500 ENROLLED
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for civil damages as a result of acts or omissions in rendering the emergency medical1
care, except for acts or omissions intentionally designed to harm, or for grossly2
negligent acts or omissions which result in harm to such an individual. Nothing3
herein shall relieve the driver of the emergency vehicle from liability arising from4
the operation or use of such vehicle.5
(2) The immunity granted to emergency medical personnel services6
practitioners by the provisions of this Subpart shall extend to parish governing7
authorities, police departments, sheriffs' offices, fire departments, or other public8
agencies engaged in rendering emergency medical services and its insurers with9
respect to such emergency medical services unless the emergency medical personnel10
services practitioner employed by such agencies would be personally liable under11
the provisions of Paragraph (1) of this Subsection.12
B. Any physician who provides instructions to any emergency medical13
personnel services practitioner by use of electronic or other means of transmission14
in connection with the rendering of emergency medical services to an individual15
shall not be liable unto such personnel practitioner or to an individual or both for16
civil damages arising from his opinion, judgments, actions, or duties, except for acts17
or omissions intentionally designed to harm, or for grossly negligent acts or18
omissions which result in harm to the individual, while exercising that degree of skill19
and care ordinarily employed by members of his profession in good standing.20
C. No hospital facility which allows the use of telemetry or other equipment21
to maintain contact between a certified emergency medical technician an emergency22
medical services practitioner and a physician shall be liable for any civil damages23
arising out of the use of such equipment except for acts or omissions by hospital24
personnel that are grossly negligent which result in harm to an individual.25
D. No registered nurse, certified emergency medical technician licensed26
emergency medical services practitioner, or other health professional licensed in27
Louisiana who supervises, instructs, or trains emergency medical personnel services28
practitioners in accordance with curricula developed or adopted by the bureau shall29
be liable for any civil damages arising out of the actions or negligence of the30 SB NO. 500 ENROLLED
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emergency medical personnel whom he supervised, instructed educated, or trained.1
E. There shall be no cause of action or civil liability, and no certificate2
license holder or applicant shall have any cause of action or any claim for damages3
against any individual, person, or institution providing information to the4
commission or its agents or employees when that individual, person, or institution5
acts without malice and when there is a reasonable belief that such information is6
accurate.7
§1234. Duties of emergency medical personnel8
A.(1) A certified licensed emergency medical technician-basic services9
practitioner may perform any of the following functions:10
(a) Rescue, first aid, resuscitation, and other services Services, treatment,11
and procedures consistent with national EMS education standards that have12
been approved and adopted by the bureau, and to the extent that he has been13
trained to perform such services under the provisions of the National Standard EMT-14
Basic training curriculum developed and promulgated by the United States15
Department of Transportation that are adopted by the bureau.16
(b) When authorized by medical direction, an emergency medical technician-17
basic or an emergency medical technician-intermediate may administer or aid the18
patient in the administration of a dose of epinephrine from an auto-injector to treat19
allergic reaction and anaphylaxis. Administration of other drugs or procedures20
for which the licensed emergency medical services practitioner has received21
training, license, and approval by the commission and which may be considered22
necessary by the ordering physician.23
(c) Services which may be performed by a certified emergency medical24
technician-intermediate as provided in Subsection B of this Section, but only while25
he is enrolled in good standing in an approved emergency medical technician-26
intermediate clinical or field internship program and while he is under the direct27
supervision of a physician, registered nurse, certified emergency28
technician-paramedic, or other preceptor approved by the bureau.29
(d) Services which may be performed by a certified emergency medical30 SB NO. 500 ENROLLED
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technician-paramedic, as provided in Subsection C of this Section, but only while he1
is enrolled in good standing in an approved emergency medical technician-paramedic2
clinical or field internship program and while he is under the direct supervision of3
a physician, registered nurse, certified emergency technician-paramedic, or other4
preceptor approved by the bureau.5
(2) The functions authorized by Paragraph (1) of this Subsection may be6
performed by the certified licensed emergency medical technician-basic services7
practitioner under any of the following conditions:8
(a) While while he is caring for a patient or at the scene of a medical or9
other emergency where voice contact is established with a physician and under the10
physician's order; or under a protocol that has been approved by the local parish11
medical society or the emergency medical services practitioner's medical12
director, until voice communication with the physician is established.13
(b) While he is at the scene of a life threatening emergency and under a14
protocol that has been approved by the local parish medical society, or its designee,15
until voice communication with the physician is established at the earliest possible16
time.17
B.(1) A certified emergency medical technician-intermediate may perform18
any of the following functions An emergency medical services practitioner19
student may, while he is enrolled in good standing in a state approved clinical20
or field internship program under the direct supervision of a physician,21
registered nurse, paramedic, or other preceptor recognized by the bureau:22
(a)(1)Any services to the extent that he has been trained to perform such23
services under the provisions of the National Standard EMT-Intermediate training24
curriculum developed and promulgated by the United States Department of25
Transportation that are adopted by the bureau Perform services, treatments, and26
procedures consistent with national EMS education standards that have been27
approved and adopted by the bureau, and to the extent that he has been trained28
to perform such services.29
(b) Services which may be performed by a certified emergency medical30 SB NO. 500 ENROLLED
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technician-paramedic, as provided in Subsection C of this Section, but only while he1
is enrolled in good standing in an approved emergency medical technician-paramedic2
clinical or field internship program and while under the direct supervision of a3
physician, registered nurse, certified emergency technician-paramedic, or other4
preceptor approved by the bureau.5
(2) The functions authorized by Paragraph (1) of this Subsection may be6
performed by the certified emergency medical technician-intermediate under any of7
the following conditions:8
(a) While caring for a patient in a participating hospital under the direct9
supervision of a physician.10
(b) While he is at the scene of a medical or other emergency where voice11
contact is established with a physician and under the physician's orders.12
(c) While he is at the scene of a life threatening emergency and under a13
protocol that has been approved by the local parish medical society, or its designee,14
until voice communication with the physician is established at the earliest possible15
time.16
C.(1) A certified emergency medical technician-paramedic may perform any17
of the following functions:18
(a) Any services to the extent that he has been trained to perform such service19
under the provisions of the National Standard EMT-Paramedic training curriculum20
developed and promulgated by the United States Department of Transportation that21
are adopted by the bureau.22
(b) Administration of other drugs or procedures for which the certified23
emergency medical technician-paramedic has received training, certification, and24
approval by the commission and which may be considered necessary by the ordering25
physician.26
(2) The functions authorized by Paragraph (1) of this Subsection may be27
performed by a certified emergency medical technician-paramedic under any of the28
following conditions:29
(a) While his caring for a patient in a participating hospital under the direct30 SB NO. 500 ENROLLED
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supervision of a physician.1
(b) While he is at the scene of a medical or other emergency where voice2
contact is established with a physician and under the physician's orders.3
(c) While he is at the scene of a life threatening emergency and under a4
protocol that has been approved by the local parish medical society, or its designee,5
until voice communication with the physician is established at the earliest possible6
time.7
D. A certified first responder may perform any of the following functions:8
(1) Rescue, first aid, resuscitation, and other services to the extent that he has9
been trained to perform such services under the provisions of the first responder10
training curriculum developed and adopted by the bureau.11
(2) Administration of Administer automated cardiac defibrillation in12
accordance with rules and regulations promulgated by the bureau in accordance with13
the Administrative Procedure Act and a protocol that shall be approved by the local14
parish medical society, or its designee, and the local physician medical director.15
EC.(1) In a case of a life-threatening situation as determined by a certified16
licensed emergency medical technician-intermediate or an emergency medical17
technician-paramedic services practitioner, when voice contact with a physician or18
when telemetered electrocardiogram communication is delayed, not possible, or19
when the delay in treatment could endanger the life of the patient, such a person may20
render services, in accordance with a protocol that shall be established by the21
emergency medical services committee or the executive committee of the parish or22
component medical society, or its designee, until voice or telemetered23
electrocardiogram communication can be established at the earliest possible time.24
(2) Such services may be rendered for the following conditions: 25
(a) Cardiac arrest.26
(b) Ventricular tachycardia.27
(c) Supraventricular tachycardia.28
(d) Premature ventricular ectopy when greater than six per minute,29
multifocal, bigeminal, occurring in bursts of two or more, falling on or close to the30 SB NO. 500 ENROLLED
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T wave.1
(e) Severe, unrelieved, suspected cardiogenic chest pain, or suspected2
myocardial infarction.3
(f) Bradydysrhythmias.4
(g) Hypoglycemia.5
(h) Anaphylactic reactions.6
(i) Hypovolemic shock.7
(j) Unconsciousness, altered mental status, or respiratory depression from8
suspected drug overdose.9
(k) Treatment induced unconsciousness, altered mental status, hypotension,10
or respiratory depression from physician ordered or protocol appropriate paramedic11
administered narcotics.12
(l) Respiratory failure or respiratory arrest.13
(m) Active seizure.14
(3) Nothing in this Subsection shall be construed to authorize a certified15
emergency medical technician-paramedic to administer any Schedule II narcotic16
without a direct order by a physician licensed to practice medicine by the Louisiana17
State Board of Medical Examiners or in accordance with an approved protocol18
adopted pursuant to Subsection E(1) and (2).19
F.(1) The bureau shall adopt rules and regulations to allow emergency20
medical personnel to institute a program for the delivery of automated cardiac21
defibrillation in the pre-hospital setting.22
(2) The bureau shall adopt rules and regulations for training to allow all23
levels of certified medical technicians to carry and administer epinephrine by auto-24
injectors to patients experiencing allergic reactions or anaphylaxis.25
GD. Any individual, training education organization, organization, or other26
entity violating the provisions of this Section shall be guilty of a misdemeanor,27
conviction of which shall subject the offender to a fine of not less than five hundred28
dollars nor more than one thousand dollars for each separate offense.29
H E. In the event that there is no organized or functional local parish medical30 SB NO. 500 ENROLLED
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society in a parish of the state, the provisions of this Section which require the1
approval of an emergency medical service protocol by the local parish medical2
society or its designee may be performed by a parish or multiparish medical society3
which is adjacent or contiguous to the parish without an organized or functional local4
parish medical society. In the absence of such adjacent or contiguous parish or5
multiparish medical society, the district medical society shall approve an emergency6
medical service protocol for the parish without an organized or functional local7
parish medical society. In the event the district medical society does not approve an8
emergency medical service protocol for the parish without an organized or functional9
local parish medical society, the disaster and emergency medical services committee10
of the Louisiana State Medical Society shall approve an emergency medical service11
protocol for the parish without an organized or functional local parish medical12
society.13
I F. The department shall promulgate rules and regulations establishing basic14
guidelines for statewide emergency medical service protocols. Such rules and15
regulations shall be based on the recommendations of the Louisiana State Medical16
Society's disaster and emergency medical services committee, which shall serve as17
an advisory committee to the department for this purpose.18
* * *19
SUBPART C. EMERGENCY MEDI CAL TRANSPORTATION20
§1235. Qualifications to operate ambulances; equipment; penalty21
A.(1) No person or individual shall conduct, maintain, or operate an22
ambulance on any street, alley, or public way or place in the state unless the23
ambulance is staffed with a minimum of two persons, one of whom shall be a24
certified licensed emergency medical technician.25
(2)(a) No person or individual shall provide services in any capacity on any26
ambulance unless he is a certified first responder, a certified emergency medical27
technician, licensed emergency medical responder, a licensed emergency medical28
technician, a licensed advance emergency medical technician, a licensed29
paramedic, a licensed respiratory therapist, a licensed nurse practitioner, a30 SB NO. 500 ENROLLED
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licensed physician assistant, a licensed occupational therapist, a licensed1
registered or practical nurse, or a physician.2
* * *3
(c) No individual shall provide services in any capacity on any ambulance4
unless he holds a cardiopulmonary resuscitation provider card issued by the5
American Heart Association or the American Red Cross without holding an6
American Heart Association Health Care Provider, or American Red Cross7
Professional Rescuer, or the equivalent cardio-pulmonary resuscitation8
certification that has been approved by the Ambulance Standards Committee.9
(d) No individual shall transport any ill or injured person by ambulance10
unless the sick or injured person is attended by a certified emergency medical11
technician licensed emergency medical technician, a licensed advance emergency12
medical technician, a licensed paramedic, a registered nurse, or a physician in the13
patient compartment.14
* * *15
§1235.1. Qualifications to operate emergency medical response vehicles; vehicle16
requirements; equipment; penalties17
A.(1) No person shall conduct, maintain, or operate an emergency medical18
response vehicle as an emergency vehicle on any street, alley, or public way or place19
in the state unless the vehicle is staffed with at least one individual who is a20
Louisiana state-certified nationally registered licensed emergency medical technician21
responder.22
(2) No person shall provide services in any capacity on an emergency23
medical response vehicle unless he is the holder of a certification by the Department24
of Health and Hospitals or its agent as a first responder; or a certification of an25
emergency medical technician issued by the National Registry of Emergency26
Medical Technicians at least a licensed emergency medical responder;, or a27
holder of a certificate of licensure as a registered nurse or licensed practical nurse;,28
or is a physician or surgeon licensed to practice medicine by the Louisiana State29
Board of Medical Examiners, a licensed respiratory therapist, a licensed nurse30 SB NO. 500 ENROLLED
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practitioner, a licensed physician assistant, or a licensed occupational therapist.1
No person shall provide services in any capacity on these vehicles without holding2
a valid certification of cardiopulmonary resuscitation issued by the American3
National Red Cross or the American Heart Association an American Heart4
Association Health Care Provider, or American Red Cross Professional5
Rescuer, or the equivalent cardio-pulmonary resuscitation certification that has6
been approved by the Ambulance Standards Committee.7
* * *8
§1236. Advanced emergency medical technicians9
In addition to the requirements of R.S. 40:1235, any hospital, ancillary10
medical facility, or ambulance service, whether public or private, may conduct a11
program utilizing any certified emergency medical technician-intermediate or12
certified emergency medical technician-paramedic services practitioner to13
supervise and direct the delivery of emergency medical care to the sick and injured14
at the scene of an emergency during transport to a hospital, while in the hospital15
emergency department, and until care responsibility is assumed by the regular16
hospital staff.17
* * *18
§1236.13. Persons in possession of AED's; training, testing, and notification19
requirements; manufacturer responsibility; possession required20
* * *21
B. Any person or entity that possesses an AED shall notify the bureau of22
emergency medical services in the office of public health of the Department of23
Health and Hospitals and a local provider of emergency medical services, such as24
911 service, local ambulance service, or the fire department of the acquisition,25
location, and type of AED.26
* * *27
F. The office of public health within the Department of Health and Hospitals,28
through its center for community health, emergency medical services shall29
promulgate all necessary rules and regulations to implement the provisions of30 SB NO. 500 ENROLLED
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Subsections D and E of this Section. Such rules and regulations shall, at a minimum,1
provide for compliance, enforcement, and penalties.2
* * *3
§1299.58.2. Definitions4
As used in this Part, the following words shall have the meanings ascribed5
to them unless the context clearly states otherwise:6
* * *7
(3) "Certified emergency medical technician" "Licensed emergency8
medical services practitioner" means a certified emergency medical technician9
licensed emergency medical services practitioner as defined in R.S. 40:1231.10
* * *11
§1299.58.7. Physician, health care provider, certified emergency technician, and12
certified first responder and licensed emergency medical services13
practitioner responsibility14
* * *15
E. Certified emergency medical technicians and certified first responders16
Licensed emergency medical services practitioners shall make a reasonable effort17
to detect the presence of a do-not-resuscitate identification bracelet on the patient.18
§1299.58.8. Immunity from liability19
* * *20
D.(1) A certified emergency medical technician or a certified first responder21
licensed emergency medical services practitioner shall not be subject to criminal22
prosecution or civil liability for withholding life-sustaining procedures from a23
qualified patient who is wearing a do-not-resuscitate identification bracelet.24
(2) A certified emergency medical technician or a certified first responder25
licensed emergency medical services practitioner shall not be subject to criminal26
prosecution or civil liability for administering life-sustaining procedures to a27
qualified patient who is not wearing the do-not-resuscitate identification bracelet.28
* * *29
§1299.64.2. Definitions30 SB NO. 500 ENROLLED
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As used in this Part, the following terms shall have the meanings ascribed to1
them unless the context clearly states otherwise:2
* * *3
(2) "Certified emergency medical technician" "Licensed emergency4
medical services practitioner" means a certified emergency medical technician5
licensed emergency medical services practitioner as defined in R.S. 40:1231.6
* * *7
§1299.64.4. Physician, health care provider, certified emergency technician, and8
certified first responder and licensed emergency medical services9
practitioner responsibility10
* * *11
D. Certified emergency medical technicians and certified first responders12
Licensed emergency medical services practitioners shall make a reasonable effort13
to detect the presence of an executed LaPOST form.14
§1299.64.5. Immunity from liability15
* * *16
B.(1) A certified emergency medical technician or a certified first responder17
licensed emergency medical services practitioner shall not be subject to criminal18
prosecution or civil liability for withholding life-sustaining procedures from a19
patient who has duly executed a LaPOST form.20
(2) A certified emergency medical technician or a certified first responder21
licensed emergency medical services practitioner shall not be subject to criminal22
prosecution or civil liability for administering life-sustaining procedures to a patient23
who has duly executed a LaPOST form when there is no reasonable means by which24
the certified emergency medical technician or certified first responder licensed25
emergency medical services practitioner could know or should have known that26
the patient had executed such LaPOST form, or as a result of transferring a patient27
to a provider with which the provisions of this Part can be effectuated.28
Section 3. R.S. 40:1236.3, 1299.58.2(4), and 1299.64.2(3) are hereby repealed in29
their entirety.30 SB NO. 500 ENROLLED
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Section 4. This Act shall become effective upon signature by the governor or, if not1
signed by the governor, upon expiration of the time for bills to become law without signature2
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If3
vetoed by the governor and subsequently approved by the legislature, this Act shall become4
effective on the day following such approval.5
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: