SECONDREGULARSESSION
HOUSECOMMITTEESUBSTITUTEFOR
HOUSEBILLNO.2381
101STGENERALASSEMBLY
5094H.02C DANARADEMANMILLER,ChiefClerk
ANACT
Torepealsections67.145,70.631,170.310,190.091,190.100,190.134,650.320,650.330,
and650.340,RSMo,andtoenactinlieuthereofeightnewsectionsrelatingto
emergencymedicaldispatchers.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Sections67.145,70.631,170.310,190.091,190.100,190.134,650.320,
2650.330,and650.340,RSMo,arerepealedandeightnewsectionsenactedinlieuthereof,to
3beknownassections67.145,70.631,170.310,190.091,190.100,650.320,650.330,and
4650.340,toreadasfollows:
67.145.1.Nopoliticalsubdivisionofthisstateshallprohibitanyfirstresponderfrom
2engaginginanypoliticalactivitywhileoffdutyandnotinuniform,beingacandidatefor
3electedorappointedpublicoffice,orholdingsuchofficeunlesssuchpoliticalactivityor
4candidacyisotherwiseprohibitedbystateorfederallaw.
5 2.Asusedinthissection,"firstresponder"meansanypersontrainedandauthorized
6bylaworruletorenderemergencymedicalassistanceortreatment.Suchpersonsmay
7include,butshallnotbelimitedto,emergencyfirstresponders,telecommunicatorfirst
8responders,policeofficers,sheriffs,deputysheriffs,firefighters,ambulanceattendantsand
9attendantdrivers,emergencymedicaltechnicians,mobileemergencymedicaltechnicians,
10emergencymedicaltechnician-paramedics,registerednurses,orphysicians.
70.631.1.Eachpoliticalsubdivisionmay,bymajorityvoteofitsgoverningbody,
2electtocoveremergency[telecommunicators] telecommunicatorfirstresponders, jailors,
3andemergencymedicalservicepersonnelaspublicsafetypersonnelmembersofthesystem.
4Theclerkorsecretaryofthepoliticalsubdivisionshallcertifyanelectionconcerningthe
5coverageofemergency[telecommunicators] telecommunicatorfirstresponders, jailors,
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 6andemergencymedicalservicepersonnelaspublicsafetypersonnelmembersofthesystem
7totheboardwithintendaysaftersuchvote.Thedateinwhichthepoliticalsubdivision's
8electionbecomeseffectiveshallbethefirstdayofthecalendarmonthspecifiedbysuch
9governingbody,thefirstdayofthecalendarmonthnextfollowingreceiptbytheboardofthe
10certificationoftheelection,ortheeffectivedateofthepoliticalsubdivision'sbecomingan
11employer,whicheveristhelatestdate.Suchelectionshallnotbechangedaftertheeffective
12date.Iftheelectionismade,thecoverageprovisionsshallbeapplicabletoallpastandfuture
13employmentwiththeemployerbypresentandfutureemployees.Ifapoliticalsubdivision
14makesnoelectionunderthissection,noemergencytelecommunicatorfirstresponder, jailor,
15oremergencymedicalservicepersonnelofthepoliticalsubdivisionshallbeconsideredpublic
16safetypersonnelforpurposesdeterminingaminimumserviceretirementageasdefinedin
17section70.600.
18 2.Ifanemployerelectstocoveremergency[telecommunicators] telecommunicator
19firstresponders, jailors,andemergencymedicalservicepersonnelaspublicsafetypersonnel
20membersofthesystem,theemployer'scontributionsshallbecorrespondinglychanged
21effectivethesamedateastheeffectivedateofthepoliticalsubdivision'selection.
22 3.Thelimitationonincreasesinanemployer'scontributionsprovidedbysubsection
236ofsection70.730shallnotapplytoanycontributionincreaseresultingfromanemployer
24makinganelectionundertheprovisionsofthissection.
25 4.Theprovisionsofthissectionshallonlyapplytocountiesofthethirdclassification
26andanycountyofthefirstclassificationwithmorethanseventythousandbutfewerthan
27eighty-threethousandinhabitantsandwithacityofthefourthclassificationwithmorethan
28thirteenthousandfivehundredbutfewerthansixteenthousandinhabitantsasthecountyseat,
29andanypoliticalsubdivisionslocated,inwholeorinpart,withinsuchcounties.
170.310.1.Forschoolyear2017-18andeachschoolyearthereafter,upon
2graduationfromhighschool,pupilsinpublicschoolsandcharterschoolsshallhavereceived
3thirtyminutesofcardiopulmonaryresuscitationinstructionandtrainingintheproper
4performanceoftheHeimlichmaneuverorotherfirstaidforchokinggivenanytimeduringa
5pupil'sfouryearsofhighschool.
6 2.Beginninginschoolyear2017-18,anypublicschoolorcharterschoolserving
7gradesninethroughtwelveshallprovideenrolledstudentsinstructionincardiopulmonary
8resuscitation.Studentswithdisabilitiesmayparticipatetotheextentappropriateas
9determinedbytheprovisionsoftheIndividualswithDisabilitiesEducationActorSection
10504oftheRehabilitationAct.Instructionshallbeincludedinthedistrict'sexistinghealthor
11physicaleducationcurriculum.Instructionshallbebasedonaprogramestablishedbythe
12AmericanHeartAssociationortheAmericanRedCross,orthroughanationallyrecognized
13programbasedonthemostcurrentnationalevidence-basedemergencycardiovascularcare
HCSHB2381 2 14guidelines,andpsychomotorskillsdevelopmentshallbeincorporatedintotheinstruction.
15Forpurposesofthissection,"psychomotorskills"meanstheuseofhands-onpracticingand
16skillstestingtosupportcognitivelearning.
17 3.Theteacherofthecardiopulmonaryresuscitationcourseorunitshallnotbe
18requiredtobeacertifiedtrainerofcardiopulmonaryresuscitationiftheinstructionisnot
19designedtoresultincertificationofstudents.Instructionthatisdesignedtoresultin
20certificationbeingearnedshallberequiredtobetaughtbyanauthorizedcardiopulmonary
21instructor.Schoolsmaydevelopagreementswithanylocalchapterofavoluntary
22organizationoffirstresponderstoprovidetherequiredhands-onpracticeandskillstesting.
23Forpurposesofthissubsection,firstrespondersshallincludetelecommunicatorfirst
24respondersasdefinedinsection650.320.
25 4.Thedepartmentofelementaryandsecondaryeducationmaypromulgaterulesto
26implementthissection.Anyruleorportionofarule,asthattermisdefinedinsection
27536.010,thatiscreatedundertheauthoritydelegatedinthissectionshallbecomeeffective
28onlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,
29section536.028.Thissectionandchapter536arenonseverableandifanyofthepowers
30vestedwiththegeneralassemblypursuanttochapter536toreview,todelaytheeffective
31date,ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrant
32ofrulemakingauthorityandanyruleproposedoradoptedafterAugust28,2012,shallbe
33invalidandvoid.
190.091.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Bioterrorism",theintentionaluseofanymicroorganism,virus,infectious
3substance,orbiologicalproductthatmaybeengineeredasaresultofbiotechnologyorany
4naturallyoccurringorbioengineeredcomponentofanymicroorganism,virus,infectious
5substance,orbiologicalproducttocausedeath,disease,orotherbiologicalmalfunctionina
6human,ananimal,aplant,oranyotherlivingorganismtoinfluencetheconductof
7governmentortointimidateorcoerceacivilianpopulation;
8 (2)"Department",theMissouridepartmentofhealthandseniorservices;
9 (3)"Director",thedirectorofthedepartmentofhealthandseniorservices;
10 (4)"Disasterlocations",anygeographicallocationwhereabioterrorismattack,
11terroristattack,catastrophicornaturaldisaster,oremergencyoccurs;
12 (5)"Firstresponders",stateandlocallawenforcementpersonnel,telecommunicator
13firstresponders,firedepartmentpersonnel,andemergencymedicalpersonnelwhowillbe
14deployedtorespondtopandemics,bioterrorismattacks,terroristattacks,catastrophicor
15naturaldisasters,andemergencies.
16 2.Thedepartmentshallofferavaccinationprogramforfirstresponderswhomaybe
17exposedtoinfectiousdiseaseswhendeployedtorespondtoapandemicortodisaster
HCSHB2381 3 18locationsasaresultofabioterrorismeventorasuspectedbioterrorismevent.The
19vaccinationsshallinclude,butarenotlimitedto,smallpox,anthrax,andothervaccinations
20whenrecommendedbythefederalCentersforDiseaseControlandPrevention'sAdvisory
21CommitteeonImmunizationPractices.
22 3.Participationinthevaccinationprogramshallbevoluntarybythefirstresponders,
23exceptforfirstresponderswho,asdeterminedbytheiremployer,cannotsafelyperform
24[emergency] theirresponsibilitieswhenrespondingtoapandemic,bioterrorismevent, or
25suspectedbioterrorismeventwithoutbeingvaccinated.TherecommendationsoftheCenters
26forDiseaseControlandPrevention'sAdvisoryCommitteeonImmunizationPracticesshallbe
27followedwhenprovidingappropriatescreeningforcontraindicationstovaccinationforfirst
28responders.Afirstrespondershallbeexemptfromvaccinations[whenawrittenstatement
29fromalicensedphysicianispresentedtotheiremployerindicatingthatavaccineismedically
30contraindicatedforsuchperson] uponobjectingtohisorheremployeronthebasisof
31religiousbeliefsormedicalcontraindications.Theemployershallnotrequirethefirst
32respondertofurnishanyexplanationorsubmitanydocumentationsupportingthe
33objection.
34 4.Ifashortageofthevaccinesreferredtoinsubsection2ofthissectionexistsduring
35apandemicorfollowingabioterrorismeventorsuspectedbioterrorismevent,thedirector,in
36consultationwiththegovernorandthefederalCentersforDiseaseControlandPrevention,
37shallgivepriorityforsuchvaccinationstopersonsexposedtothediseaseandtofirst
38responderswhoaredeployedtorespondtothepandemicortothedisasterlocation.
39 5.Thedepartmentshallnotifyfirstrespondersconcerningtheavailabilityofthe
40vaccinationprogramdescribedinsubsection2ofthissectionandshallprovideeducationto
41suchfirstrespondersandtheiremployersconcerningthevaccinationsofferedandthe
42associateddiseases.
43 6.Thedepartmentmaycontractfortheadministrationofthevaccinationprogram
44describedinsubsection2ofthissectionwithhealthcareproviders,includingbutnotlimited
45tolocalpublichealthagencies,hospitals,federallyqualifiedhealthcenters,andphysicians.
46 7.Theprovisionsofthissectionshallbecomeeffectiveuponreceiptoffederal
47fundingorfederalgrantswhichdesignatethatthefundingisrequiredtoimplement
48vaccinationsforfirstrespondersinaccordancewiththerecommendationsofthefederal
49CentersforDiseaseControlandPrevention'sAdvisoryCommitteeonImmunization
50Practices.Uponreceiptofsuchfunding,thedepartmentshallmakeavailablethevaccinesto
51firstrespondersasprovidedinthissection.
190.100.Asusedinsections190.001to190.245,thefollowingwordsandterms
2mean:
HCSHB2381 4 3 (1)"Advancedemergencymedicaltechnician"or"AEMT",apersonwhohas
4successfullycompletedacourseofinstructionincertainaspectsofadvancedlifesupportcare
5asprescribedbythedepartmentandislicensedbythedepartmentinaccordancewithsections
6190.001to190.245andrulesandregulationsadoptedbythedepartmentpursuanttosections
7190.001to190.245;
8 (2)"Advancedlifesupport(ALS)",anadvancedlevelofcareasprovidedtotheadult
9andpediatricpatientsuchasdefinedbynationalcurricula,andanymodificationstothat
10curriculaspecifiedinrulesadoptedbythedepartmentpursuanttosections190.001to
11190.245;
12 (3)"Ambulance",anyprivatelyorpubliclyownedvehicleorcraftthatisspecially
13designed,constructedormodified,staffedorequippedfor,andisintendedorused,
14maintainedoroperatedforthetransportationofpersonswhoaresick,injured,woundedor
15otherwiseincapacitatedorhelpless,orwhorequirethepresenceofmedicalequipmentbeing
16usedonsuchindividuals,butthetermdoesnotincludeanymotorvehiclespeciallydesigned,
17constructedorconvertedfortheregulartransportationofpersonswhoaredisabled,
18handicapped,normallyusingawheelchair,orotherwisenotacutelyill,oremergencyvehicles
19usedwithinairports;
20 (4)"Ambulanceservice",apersonorentitythatprovidesemergencyor
21nonemergencyambulancetransportationandservices,orboth,incompliancewithsections
22190.001to190.245,andtherulespromulgatedbythedepartmentpursuanttosections
23190.001to190.245;
24 (5)"Ambulanceservicearea",aspecificgeographicareainwhichanambulance
25servicehasbeenauthorizedtooperate;
26 (6)"Basiclifesupport(BLS)",abasiclevelofcare,asprovidedtotheadultand
27pediatricpatientasdefinedbynationalcurricula,andanymodificationstothatcurricula
28specifiedinrulesadoptedbythedepartmentpursuanttosections190.001to190.245;
29 (7)"Council",thestateadvisorycouncilonemergencymedicalservices;
30 (8)"Department",thedepartmentofhealthandseniorservices,stateofMissouri;
31 (9)"Director",thedirectorofthedepartmentofhealthandseniorservicesorthe
32director'sdulyauthorizedrepresentative;
33 (10)["Dispatchagency",anypersonororganizationthatreceivesrequestsfor
34emergencymedicalservicesfromthepublic,bytelephoneorothermeans,andisresponsible
35fordispatchingemergencymedicalservices;
36 (11)]"Emergency",thesuddenand,atthetime,unexpectedonsetofahealth
37conditionthatmanifestsitselfbysymptomsofsufficientseveritythatwouldleadaprudent
38layperson,possessinganaverageknowledgeofhealthandmedicine,tobelievethatthe
39absenceofimmediatemedicalcarecouldresultin:
HCSHB2381 5 40 (a)Placingtheperson'shealth,orwithrespecttoapregnantwoman,thehealthofthe
41womanorherunbornchild,insignificantjeopardy;
42 (b)Seriousimpairmenttoabodilyfunction;
43 (c)Seriousdysfunctionofanybodilyorganorpart;
44 (d)Inadequatelycontrolledpain;
45 [(12)] (11)"Emergencymedicaldispatcher",apersonwhoreceivesemergencycalls
46fromthepublicandhassuccessfullycompletedanemergencymedicaldispatchercourse[,
47meetingorexceedingthenationalcurriculumoftheUnitedStatesDepartmentof
48Transportationandanymodificationstosuchcurriculaspecifiedbythedepartment
49throughrulesadoptedpursuanttosections190.001to190.245] andanyongoingtraining
50requirementsundersection650.340;
51 [(13)] (12)"Emergencymedicalresponder",apersonwhohassuccessfullycompleted
52anemergencyfirstresponsecoursemeetingorexceedingthenationalcurriculumoftheU.S.
53DepartmentofTransportationandanymodificationstosuchcurriculaspecifiedbythe
54departmentthroughrulesadoptedundersections190.001to190.245andwhoprovides
55emergencymedicalcarethroughemploymentbyorinassociationwithanemergencymedical
56responseagency;
57 [(14)] (13)"Emergencymedicalresponseagency",anypersonthatregularlyprovides
58alevelofcarethatincludesfirstresponse,basiclifesupportoradvancedlifesupport,
59exclusiveofpatienttransportation;
60 [(15)] (14)"Emergencymedicalservicesforchildren(EMS-C)system",the
61arrangementofpersonnel,facilitiesandequipmentforeffectiveandcoordinateddeliveryof
62pediatricemergencymedicalservicesrequiredinpreventionandmanagementofincidents
63whichoccurasaresultofamedicalemergencyorofaninjuryevent,naturaldisasteror
64similarsituation;
65 [(16)] (15)"Emergencymedicalservices(EMS)system",thearrangementof
66personnel,facilitiesandequipmentfortheeffectiveandcoordinateddeliveryofemergency
67medicalservicesrequiredinpreventionandmanagementofincidentsoccurringasaresultof
68anillness,injury,naturaldisasterorsimilarsituation;
69 [(17)] (16)"Emergencymedicaltechnician",apersonlicensedinemergencymedical
70careinaccordancewithstandardsprescribedbysections190.001to190.245,andbyrules
71adoptedbythedepartmentpursuanttosections190.001to190.245;
72 [(18)] (17)"Emergencymedicaltechnician-basic"or"EMT-B",apersonwhohas
73successfullycompletedacourseofinstructioninbasiclifesupportasprescribedbythe
74departmentandislicensedbythedepartmentinaccordancewithstandardsprescribedby
75sections190.001to190.245andrulesadoptedbythedepartmentpursuanttosections190.001
76to190.245;
HCSHB2381 6 77 [(19)] (18)"Emergencymedicaltechnician-communityparamedic","community
78paramedic",or"EMT-CP",apersonwhoiscertifiedasanemergencymedicaltechnician-
79paramedicandiscertifiedbythedepartmentinaccordancewithstandardsprescribedin
80section190.098;
81 [(20)] (19)"Emergencymedicaltechnician-paramedic"or"EMT-P",apersonwho
82hassuccessfullycompletedacourseofinstructioninadvancedlifesupportcareasprescribed
83bythedepartmentandislicensedbythedepartmentinaccordancewithsections190.001to
84190.245andrulesadoptedbythedepartmentpursuanttosections190.001to190.245;
85 [(21)] (20)"Emergencyservices",healthcareitemsandservicesfurnishedor
86requiredtoscreenandstabilizeanemergencywhichmayinclude,butshallnotbelimitedto,
87healthcareservicesthatareprovidedinalicensedhospital'semergencyfacilitybyan
88appropriateproviderorbyanambulanceserviceoremergencymedicalresponseagency;
89 [(22)] (21)"Healthcarefacility",ahospital,nursinghome,physician'sofficeorother
90fixedlocationatwhichmedicalandhealthcareservicesareperformed;
91 [(23)] (22)"Hospital",anestablishmentasdefinedinthehospitallicensinglaw,
92subsection2ofsection197.020,orahospitaloperatedbythestate;
93 [(24)] (23)"Medicalcontrol",supervisionprovidedbyorunderthedirectionof
94physicians,ortheirdesignatedregisterednurse,includingbothonlinemedicalcontrol,
95instructionsbyradio,telephone,orothermeansofdirectcommunications,andoffline
96medicalcontrolthroughsupervisionbytreatmentprotocols,casereview,training,and
97standingordersfortreatment;
98 [(25)] (24)"Medicaldirection",medicalguidanceandsupervisionprovidedbya
99physiciantoanemergencyservicesprovideroremergencymedicalservicessystem;
100 [(26)] (25)"Medicaldirector",aphysicianlicensedpursuanttochapter334
101designatedbytheambulanceservice, dispatchagency,oremergencymedicalresponse
102agencyandwhomeetscriteriaspecifiedbythedepartmentbyrulespursuanttosections
103190.001to190.245;
104 [(27)] (26)"Memorandumofunderstanding",anagreementbetweenanemergency
105medicalresponseagencyordispatchagencyandanambulanceserviceorserviceswithin
106whoseterritorytheagencyoperates,inordertocoordinateemergencymedicalservices;
107 [(28)] (27)"Patient",anindividualwhoissick,injured,wounded,diseased,or
108otherwiseincapacitatedorhelpless,ordead,excludingdeceasedindividualsbeingtransported
109fromorbetweenprivateorpublicinstitutions,homesorcemeteries,andindividualsdeclared
110deadpriortothetimeanambulanceiscalledforassistance;
111 [(29)] (28)"Person",asusedinthesedefinitionsandelsewhereinsections190.001to
112190.245,anyindividual,firm,partnership,copartnership,jointventure,association,
113cooperativeorganization,corporation,municipalorprivate,andwhetherorganizedfor
HCSHB2381 7 114profitornot,state,county,politicalsubdivision,statedepartment,commission,board,bureau
115orfraternalorganization,estate,publictrust,businessorcommonlawtrust,receiver,assignee
116forthebenefitofcreditors,trusteeortrusteeinbankruptcy,oranyotherserviceuseror
117provider;
118 [(30)] (29)"Physician",apersonlicensedasaphysicianpursuanttochapter334;
119 [(31)] (30)"Politicalsubdivision",anymunicipality,city,county,citynotwithina
120county,ambulancedistrictorfireprotectiondistrictlocatedinthisstatewhichprovidesorhas
121authoritytoprovideambulanceservice;
122 [(32)] (31)"Professionalorganization",anyorganizedgrouporassociationwithan
123ongoinginterestregardingemergencymedicalservices.Suchgroupsandassociationscould
124includethoserepresentingvolunteers,labor,management,firefighters,EMT-B's,nurses,
125EMT-P's,physicians,communicationsspecialistsandinstructors.Organizationscouldalso
126representtheinterestsofgroundambulanceservices,airambulanceservices,fireservice
127organizations,lawenforcement,hospitals,traumacenters,communicationcenters,pediatric
128services,laborunionsandpoisoncontrolservices;
129 [(33)] (32)"Proofoffinancialresponsibility",proofofabilitytorespondtodamages
130forliability,onaccountofaccidentsoccurringsubsequenttotheeffectivedateofsuchproof,
131arisingoutoftheownership,maintenanceoruseofamotorvehicleinthefinancialamount
132setinrulespromulgatedbythedepartment,butinnoeventlessthanthestatutoryminimum
133requiredformotorvehicles.Proofoffinancialresponsibilityshallbeusedasproofofself-
134insurance;
135 [(34)] (33)"Protocol",apredetermined,writtenmedicalcareguideline,whichmay
136includestandingorders;
137 [(35)] (34)"RegionalEMSadvisorycommittee",acommitteeformedwithinan
138emergencymedicalservices(EMS)regiontoadviseambulanceservices,thestateadvisory
139councilonEMSandthedepartment;
140 [(36)] (35)"Specialtycaretransportation",thetransportationofapatientrequiringthe
141servicesofanemergencymedicaltechnician-paramedicwhohasreceivedadditionaltraining
142beyondthetrainingprescribedbythedepartment.Specialtycaretransportationservicesshall
143bedefinedinwritingintheappropriatelocalprotocolsforgroundandairambulanceservices
144andapprovedbythelocalphysicianmedicaldirector.Theprotocolsshallbemaintainedby
145thelocalambulanceserviceandshalldefinetheadditionaltrainingrequiredoftheemergency
146medicaltechnician-paramedic;
147 [(37)] (36)"Stabilize",withrespecttoanemergency,theprovisionofsuchmedical
148treatmentasmaybenecessarytoattempttoassurewithinreasonablemedicalprobabilitythat
149nomaterialdeteriorationofanindividual'smedicalconditionislikelytoresultfromoroccur
HCSHB2381 8 150duringambulancetransportationunlessthelikelybenefitsofsuchtransportationoutweighthe
151risks;
152 [(38)] (37)"Stateadvisorycouncilonemergencymedicalservices",acommittee
153formedtoadvisethedepartmentonpolicyaffectingemergencymedicalservicethroughout
154thestate;
155 [(39)] (38)"StateEMSmedicaldirectorsadvisorycommittee",asubcommitteeofthe
156stateadvisorycouncilonemergencymedicalservicesformedtoadvisethestateadvisory
157councilonemergencymedicalservicesandthedepartmentonmedicalissues;
158 [(40)] (39)"STEMI"or"ST-elevationmyocardialinfarction",atypeofheartattackin
159whichimpairedbloodflowtothepatient'sheartmuscleisevidencedbyST-segmentelevation
160inelectrocardiogramanalysis,andasfurtherdefinedinrulespromulgatedbythedepartment
161undersections190.001to190.250;
162 [(41)] (40)"STEMIcare",includeseducationandprevention,emergencytransport,
163triage,andacutecareandrehabilitativeservicesforSTEMIthatrequiresimmediatemedical
164orsurgicalinterventionortreatment;
165 [(42)] (41)"STEMIcenter",ahospitalthatiscurrentlydesignatedassuchbythe
166departmenttocareforpatientswithST-segmentelevationmyocardialinfarctions;
167 [(43)] (42)"Stroke",aconditionofimpairedbloodflowtoapatient'sbrainasdefined
168bythedepartment;
169 [(44)] (43)"Strokecare",includesemergencytransport,triage,andacuteintervention
170andotheracutecareservicesforstrokethatpotentiallyrequireimmediatemedicalorsurgical
171interventionortreatment,andmayincludeeducation,primaryprevention,acuteintervention,
172acuteandsubacutemanagement,preventionofcomplications,secondarystrokeprevention,
173andrehabilitativeservices;
174 [(45)] (44)"Strokecenter",ahospitalthatiscurrentlydesignatedassuchbythe
175department;
176 [(46)] (45)"Trauma",aninjurytohumantissuesandorgansresultingfromthe
177transferofenergyfromtheenvironment;
178 [(47)] (46)"Traumacare"includesinjuryprevention,triage,acutecareand
179rehabilitativeservicesformajorsinglesystemormultisysteminjuriesthatpotentiallyrequire
180immediatemedicalorsurgicalinterventionortreatment;
181 [(48)] (47)"Traumacenter",ahospitalthatiscurrentlydesignatedassuchbythe
182department.
650.320.Forthepurposesofsections650.320to650.340,thefollowingtermsmean:
2 (1)"Ambulanceservice",thesamemeaninggiventotheterminsection190.100;
3 (2)"Board",theMissouri911serviceboardestablishedinsection650.325;
HCSHB2381 9 4 [(2)](3)"Dispatchagency",anypersonororganizationthatreceivesrequests
5foremergencymedicalservicesfromthepublic,bytelephoneorothermeans,andis
6responsiblefordispatchingemergencymedicalservices;
7 (4)"Medicaldirector",thesamemeaninggiventotheterminsection190.100;
8 (5)"Memorandumofunderstanding",thesamemeaninggiventothetermin
9section190.100;
10 (6)"Publicsafetyansweringpoint",thelocationatwhich911callsareanswered;
11 [(3)](7)"Telecommunicatorfirstresponder", anypersonemployedasanemergency
12[telephoneworker,]calltakerorpublicsafetydispatcherwhosedutiesincludereceiving,
13processingortransmittingpublicsafetyinformationreceivedthrougha911publicsafety
14answeringpoint.
650.330.1.Theboardshallconsistoffifteenmembers,oneofwhichshallbechosen
2fromthedepartmentofpublicsafety,andtheothermembersshallbeselectedasfollows:
3 (1)Onememberchosentorepresentanassociationdomiciledinthisstatewhose
4primaryinterestrelatestomunicipalities;
5 (2)OnememberchosentorepresenttheMissouri911DirectorsAssociation;
6 (3)Onememberchosentorepresentemergencymedicalservicesandphysicians;
7 (4)Onememberchosentorepresentanassociationwithachapterdomiciledinthis
8statewhoseprimaryinterestrelatestoanationalemergencynumber;
9 (5)Onememberchosentorepresentanassociationwhoseprimaryinterestrelatesto
10issuespertainingtofirechiefs;
11 (6)Onememberchosentorepresentanassociationwithachapterdomiciledinthis
12statewhoseprimaryinterestrelatestoissuespertainingtopublicsafetycommunications
13officers;
14 (7)Onememberchosentorepresentanassociationwhoseprimaryinterestrelatesto
15issuespertainingtopolicechiefs;
16 (8)Onememberchosentorepresentanassociationdomiciledinthisstatewhose
17primaryinterestrelatestoissuespertainingtosheriffs;
18 (9)Onememberchosentorepresentcountiesofthesecond,third,andfourth
19classification;
20 (10)Onememberchosentorepresentcountiesofthefirstclassification,countieswith
21acharterformofgovernment,andcitiesnotwithinacounty;
22 (11)Onememberchosentorepresenttelecommunicationsserviceproviders;
23 (12)Onememberchosentorepresentwirelesstelecommunicationsserviceproviders;
24 (13)Onememberchosentorepresentvoiceoverinternetprotocolserviceproviders;
25and
HCSHB2381 10 26 (14)Onememberchosentorepresentthegovernor'scouncilondisabilityestablished
27undersection37.735.
28 2.Eachofthemembersoftheboardshallbeappointedbythegovernorwiththe
29adviceandconsentofthesenateforatermoffouryears.Membersofthecommitteemay
30servemultipleterms.Nocorporationoritsaffiliateshallhavemorethanoneofficer,
31employee,assign,agent,orotherrepresentativeservingasamemberoftheboard.
32Notwithstandingsubsection1ofthissectiontothecontrary,allmembersappointedasof
33August28,2017,shallcontinuetoservetheremainderoftheirterms.
34 3.Theboardshallmeetatleastquarterlyataplaceandtimespecifiedbythe
35chairpersonoftheboardanditshallkeepandmaintainrecordsofsuchmeetings,aswellas
36theotheractivitiesoftheboard.Membersshallnotbecompensatedbutshallreceiveactual
37andnecessaryexpensesforattendingmeetingsoftheboard.
38 4.Theboardshall:
39 (1)Organizeandadoptstandardsgoverningtheboard'sformalandinformal
40procedures;
41 (2)Providerecommendationsforprimaryansweringpointsandsecondaryanswering
42pointsontechnicalandoperationalstandardsfor911services;
43 (3)Providerecommendationstopublicagenciesconcerningmodelsystemstobe
44consideredinpreparinga911serviceplan;
45 (4)Providerequestedmediationservicestopoliticalsubdivisionsinvolvedin
46jurisdictionaldisputesregardingtheprovisionof911services,exceptthattheboardshallnot
47supersededecision-makingauthorityoflocalpoliticalsubdivisionsinregardto911services;
48 (5)Provideassistancetothegovernorandthegeneralassemblyregarding911
49services;
50 (6)Reviewexistingandproposedlegislationandmakerecommendationsasto
51changesthatwouldimprovesuchlegislation;
52 (7)Aidandassistinthetimelycollectionanddisseminationofinformationrelatingto
53theuseofauniversalemergencytelephonenumber;
54 (8)Performotherdutiesasnecessarytopromotesuccessfuldevelopment,
55implementationandoperationof911systemsacrossthestate,includingmonitoringfederal
56andindustrystandardsbeingdevelopedfornext-generation911systems;
57 (9)Designateastate911coordinatorwhoshallberesponsibleforoverseeing
58statewide911operationsandensuringcompliancewithfederalgrantsfor911funding;
59 (10)Electthechairfromitsmembership;
60 (11)Applyforandreceivegrantsfromfederal,private,andothersources;
HCSHB2381 11 61 (12)Reporttothegovernorandthegeneralassemblyatleasteverythreeyearsonthe
62statusof911servicesstatewide,aswellasspecificeffortstoimproveefficiency,cost-
63effectiveness,andlevelsofservice;
64 (13)Conductandreviewanannualsurveyofpublicsafetyansweringpointsin
65Missouritoevaluatepotentialforimprovedservices,coordination,andfeasibilityof
66consolidation;
67 (14)Makeandexecutecontractsoranyotherinstrumentsandagreementsnecessary
68orconvenientfortheexerciseofitspowersandfunctions,includingforthedevelopmentand
69implementationofanemergencyservicesinternetprotocolnetworkthatcanbesharedbyall
70publicsafetyagencies;
71 (15)Developaplanandtimelineoftargetdatesforthetesting,implementation,and
72operationofanext-generation911systemthroughoutMissouri.Thenext-generation911
73systemshallallowfortheprocessingofelectronicmessagesincluding,butnotlimitedto,
74electronicmessagescontainingtext,images,video,ordata;
75 (16)Administerandauthorizegrantsandloansundersection650.335tothose
76countiesandanyhomerulecitywithmorethanfifteenthousandbutfewerthanseventeen
77thousandinhabitantsandpartiallylocatedinanycountyofthethirdclassificationwithouta
78townshipformofgovernmentandwithmorethanthirty-seventhousandbutfewerthanforty-
79onethousandinhabitantsthatcandemonstrateafinancialcommitmenttoimproving911
80servicesbyprovidingatleastafiftypercentmatchanddemonstratetheabilitytooperateand
81maintainongoing911services.Thepurposeofgrantsandloansfromthe911servicetrust
82fundshallinclude:
83 (a)Implementationof911servicesincountiesofthestatewhereservicesdonotexist
84ortoimproveexisting911systems;
85 (b)Promotionofconsolidationwhereappropriate;
86 (c)Mappingandaddressingallcountylocations;
87 (d)Ensuringprimaryaccessandtextingabilitiesto911servicesfordisabled
88residents;
89 (e)Implementationofinitialemergencymedicaldispatchservices,including
90prearrivalmedicalinstructionsincountieswherethoseservicesarenotofferedasofJuly1,
912019;and
92 (f)Developmentandimplementationofanemergencyservicesinternetprotocol
93networkthatcanbesharedbyallpublicsafetyagencies;
94 (17)Developanapplicationprocessincludingreportingandaccountability
95requirements,withholdingaportionofthegrantuntilcompletionofaproject,andother
96measurestoensurefundsareusedinaccordancewiththelawandpurposeofthegrant,and
97conductauditsasdeemednecessary;
HCSHB2381 12 98 (18)Setthepercentagerateoftheprepaidwirelessemergencytelephoneservice
99chargestoberemittedtoacountyorcityasprovidedundersubdivision(5)ofsubsection3of
100section190.460;
101 (19)Retaininitsrecordsproposedcountyplansdevelopedundersubsection11of
102section190.455andnotifythedepartmentofrevenuethatthecountyhasfiledaplanthatis
103readyforimplementation;
104 (20)Notifyanycommunicationsserviceprovider,asdefinedinsection190.400,that
105hasvoluntarilysubmitteditscontactinformationwhenanyupdateismadetothecentralized
106databaseestablishedundersection190.475asaresultofacountyorcityestablishingor
107modifyingataxormonthlyfeenolessthanninetydayspriortotheeffectivedateofthe
108establishmentormodificationofthetaxormonthlyfee;
109 (21)Establishcriteriaforconsolidationprioritizationofpublicsafetyanswering
110points;
111 (22)Incoordinationwithexistingpublicsafetyansweringpoints,byDecember31,
1122018,designatenomorethanelevenregional911coordinationcenterswhichshallcoordinate
113statewideinteroperabilityamongpublicsafetyansweringpointswithintheirregionthrough
114theuseofastatewide911emergencyservicesnetwork;[and]
115 (23)Establishanannualbudget,retainrecordsofallrevenueandexpendituresmade,
116retainminutesofallmeetingsandsubcommittees,postrecords,minutes,andreportsonthe
117board'swebpageonthedepartmentofpublicsafetywebsite; and
118 (24)Promoteandeducatethepublicaboutthecriticalroleoftelecommunicator
119firstrespondersinprotectingthepublicandensuringpublicsafety.
120 5.Thedepartmentofpublicsafetyshallprovidestaffassistancetotheboardas
121necessaryinorderfortheboardtoperformitsdutiespursuanttosections650.320to650.340.
122Theboardshallhavetheauthoritytohireconsultantstoadministertheprovisionsofsections
123650.320to650.340.
124 6.Theboardshallpromulgaterulesandregulationsthatarereasonableandnecessary
125toimplementandadministertheprovisionsofsections190.455,190.460,190.465,190.470,
126190.475,andsections650.320to650.340.Anyruleorportionofarule,asthattermis
127definedinsection536.010,shallbecomeeffectiveonlyifithasbeenpromulgatedpursuantto
128theprovisionsofchapter536.Thissectionandchapter536arenonseverableandifanyofthe
129powersvestedwiththegeneralassemblypursuanttochapter536toreview,todelaythe
130effectivedateortodisapproveandannularulearesubsequentlyheldunconstitutional,then
131thegrantofrulemakingauthorityandanyruleproposedoradoptedafterAugust28,2017,
132shallbeinvalidandvoid.
650.340.1.Theprovisionsofthissectionmaybecitedandshallbeknownasthe
2"911TrainingandStandardsAct".
HCSHB2381 13 3 2.Initialtrainingrequirementsfor[telecommunicators] telecommunicatorfirst
4responderswhoanswer911callsthatcometopublicsafetyansweringpointsshallbeas
5follows:
6 (1)Policetelecommunicatorfirstresponder, 16hours;
7 (2)Firetelecommunicatorfirstresponder, 16hours;
8 (3)Emergencymedicalservicestelecommunicatorfirstresponder, 16hours;
9 (4)Jointcommunicationcentertelecommunicatorfirstresponder, 40hours.
10 3.Allpersonsemployedasatelecommunicatorfirstresponderinthisstateshallbe
11requiredtocompleteongoingtrainingsolongassuchpersonengagesintheoccupationasa
12telecommunicatorfirstresponder. Suchpersonsshallcompleteatleasttwenty-fourhoursof
13ongoingtrainingeverythreeyearsbysuchpersonsororganizationsasprovidedinsubsection
146ofthissection.
15 4.AnypersonemployedasatelecommunicatoronAugust28,1999,shallnotbe
16requiredtocompletethetrainingrequirementasprovidedinsubsection2ofthissection.Any
17personhiredasatelecommunicatororatelecommunicatorfirstresponderafterAugust28,
181999,shallcompletethetrainingrequirementsasprovidedinsubsection2ofthissection
19withintwelvemonthsofthedatesuchpersonisemployedasatelecommunicatoror
20telecommunicatorfirstresponder.
21 5.Thetrainingrequirementsasprovidedinsubsection2ofthissectionshallbe
22waivedforanypersonwhofurnishesprooftothecommitteethatsuchpersonhascompleted
23traininginanotherstatewhichisatleastasstringentasthetrainingrequirementsof
24subsection2ofthissection.
25 6.Theboardshalldeterminebyadministrativerulethepersonsororganizations
26authorizedtoconductthetrainingasrequiredbysubsection2ofthissection.
27 7.[Thissectionshallnotapplytoanemergencymedicaldispatcheroragencyas
28definedinsection190.100,orapersontrainedbyanentityaccreditedorcertifiedunder
29section190.131,orapersonwhoprovidesprearrivalmedicalinstructionswhoworksforan
30agencywhichmeetstherequirementssetforthinsection190.134] Theboardshallbe
31responsiblefortheapprovaloftrainingcoursesforemergencymedicaldispatchers.
32Theboardshalldevelopnecessaryrulesandregulationsincollaborationwiththestate
33EMSmedicaldirectorsadvisorycommittee,asdescribedinsection190.103,whichmay
34providerecommendationsrelatingtothemedicalaspectsofprearrivalmedical
35instructions.
36 8.Adispatchagencyisrequiredtohaveamemorandumofunderstandingwith
37allambulanceservicesthatitdispatches.Ifadispatchagencyprovidesprearrival
38medicalinstructions,itisrequiredtohaveamedicaldirectorwhosedutiesincludethe
39maintenanceofstandardsandapprovalofprotocolsorguidelines.
HCSHB2381 14 [190.134.Adispatchagencyisrequiredtohaveamemorandumof
2 understandingwithallambulanceservicesthatitdispatches.Ifadispatch
3 agencyprovidesprearrivalmedicalinstructions,itisrequiredtohavea
4 medicaldirector,whosedutiesincludethemaintenanceofstandardsand
5 protocolapproval.]
âś”
HCSHB2381 15