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28	28	STATE OF OKLAHOMA
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30	30	2nd Session of the 58th Legislature (2022)
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32	32	HOUSE BILL 3428 By: Osburn
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38	38	AS INTRODUCED
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40	40	An Act relating to emergency medical services ;
41	41	amending 63 O.S. 2021, Section 1 -2503, which relates
42	42	to definitions used in the Oklahoma Emergency
43	43	Response Systems Development Act ; modifying
44	44	definitions; allowing certified emergency medical
45	45	response agency to provide limited transport under
46	46	certain conditions; modifying transport protocol; and
47	47	providing an effective date.
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54	54	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
55	55	SECTION 1. AMENDATORY 63 O.S. 2021, Section 1 -2503, is
56	56	amended to read as follows:
57	57	Section 1-2503. As used in the Oklahoma Emergenc y Response
58	58	Systems Development Act:
59	59	1. "Ambulance" means any ground, air or water vehicle which is
60	60	or should be approved by the State Commissioner of Heal th, designed
61	61	and equipped to transp ort a patient or patients and to p rovide
62	62	appropriate on-scene and en route patient stabilization and care as
63	63	required. Vehicles used as ambulances shall meet such standards as
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90	90	may be required by the Commissioner for appr oval, and shall display
91	91	evidence of such approval at all times;
92	92	2. "Ambulance authority" means any public trust or nonprofit
93	93	corporation established by the state or any unit of local government
94	94	or combination of units of government for the express purpose of
95	95	providing, directly or by contr act, emergency medical services in a
96	96	specified area of the state;
97	97	3. "Ambulance patient" or "patient" means any person who is or
98	98	will be transported in a reclining position to or from a health care
99	99	facility in an ambulan ce;
100	100	4. "Ambulance service" means any private firm or governmental
101	101	agency which is or should be licen sed by the State Department of
102	102	Health to provide levels of medical care based on certification
103	103	standards promulgated by the Commissioner;
104	104	5. "Ambulance service district" means any county, group of
105	105	counties or parts of count ies formed together to provide, operate
106	106	and finance emergency medical services as provided by Section 9C of
107	107	Article X of the Oklahoma Consti tution or Sections 1201 through 1221
108	108	of Title 19 of the Oklahoma Statutes;
109	109	6. "Board" means the State Board of Heal th;
110	110	7. "Certified emergency med ical responder" means an individual
111	111	certified by the Department to perform emergency medical services in
112	112	accordance with the Oklahoma Emergency Response Sy stems Development
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139	139	Act and in accordance with the rules and standards promulgated by
140	140	the Commissioner;
141	141	8. "Certified emergency medical response agency " means an
142	142	organization of any type certified by the Depart ment to provide
143	143	emergency medical care , but not transport and limited transport. A
144	144	certified emergency medical response agency shall only provide
145	145	transport upon approval by the appropriate me dical control at the
146	146	time of transport. Certified emergency med ical response agencies
147	147	may utilize certified em ergency medical responders or licensed
148	148	emergency medical personnel; provided, however, that all perso nnel
149	149	so utilized shall function under the directi on of and consistent
150	150	with guidelines for medical control;
151	151	9. "Classification" means an inclusive standard ized
152	152	identification of stabilizing and definitive emergency services
153	153	provided by each hospital that t reats emergency patients;
154	154	10. "CoAEMSP" means the Committee on Accreditation of
155	155	Educational Programs for th e Emergency Medical Services Professions;
156	156	11. "Commissioner" means the State Commissioner of Health;
157	157	12. "Council" means the Trauma and Emergency Response Advisory
158	158	Council created in Section 1 -103a.1 of this title;
159	159	13. "Critical care paramedic " or "CCP" means a licensed
160	160	paramedic who has successfull y completed critical care training and
161	161	testing requirements in accordance with the Oklahoma Emergency
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188	188	Response Systems Development Act and in accordan ce with the rules
189	189	and standards promulgated by the Commissi oner;
190	190	14. "Department" means the State Departm ent of Health;
191	191	15. "Emergency medical services system" means a system which
192	192	provides for the organiz ation and appropriate designation of
193	193	personnel, facilities and equipment for the effective and
194	194	coordinated local, regional and statewide delivery of health care
195	195	services primarily under emergency conditions;
196	196	16. "Letter of review" means the official desig nation from
197	197	CoAEMSP to a paramedic program that i s in the "becoming accredited"
198	198	process;
199	199	17. "Licensed emergency medical personnel " means an emergency
200	200	medical technician (EMT), an intermediate, an advanced emergency
201	201	medical technician (AEMT), or a paramed ic licensed by the Department
202	202	to perform emergency medical services in accordance with the
203	203	Oklahoma Emergency Response Systems Development Act and the rule s
204	204	and standards promulgated by the Commissioner;
205	205	18. "Licensure" means the licensing of emergency me dical care
206	206	providers and ambulance services pursu ant to rules and standards
207	207	promulgated by the Commissioner at one or more of the following
208	208	levels:
209	209	a. Basic basic life support,
210	210	b. Intermediate intermediate life support,
211	211	c. Paramedic paramedic life support,
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238	238	d. Advanced advanced life support,
239	239	e. Stretcher stretcher van, and
240	240	f. Specialty specialty care, which shall be used solely
241	241	for interhospital transport of patients requiring
242	242	specialized en route medical monitoring and advanced
243	243	life support which exceed the capabilities of the
244	244	equipment and personnel prov ided by paramedic life
245	245	support.
246	246	Requirements for each level of care shall be established by the
247	247	Commissioner. Licensure at any level of care includes a license to
248	248	operate at any lower level, with the exception of licensure for
249	249	specialty care; provided, ho wever, that the highest level of care
250	250	offered by an ambulan ce service shall be available twenty -four (24)
251	251	hours each day, three hundred sixty -five (365) days per year.
252	252	Licensure shall be granted or renewed for such periods and under
253	253	such terms and conditio ns as may be promulgated by the Commissioner;
254	254	19. "Medical control" means local, regional or statewide
255	255	medical direction and quality assurance of health care delivery in
256	256	an emergency medical service system. On-line medical control is the
257	257	medical direction given to licensed emergency medical personnel,
258	258	certified emergency medical responders and stretcher van personnel
259	259	by a physician via radio or telephone. Off -line medical control is
260	260	the establishment and monitoring of all medical components of an
261	261	emergency medical service system, which is to include stretcher va n
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288	288	service including, but not limited to, protoc ols, standing orders,
289	289	educational programs, and the quality and delivery of o n-line
290	290	control;
291	291	20. "Medical director" means a physician, fully licensed
292	292	without restriction, who acts as a paid or volunteer medic al advisor
293	293	to a licensed ambulance service and who monitors and directs the
294	294	care so provided. Such physicians shall meet su ch qualifications
295	295	and requirements as may be promulgated by the Commissio ner;
296	296	21. "Region" or "emergency medical service region " means two or
297	297	more municipalities, counties, ambul ance districts or other
298	298	political subdivisions exercising joint control over one or more
299	299	providers of emergency medical services and stretcher van ser vice
300	300	through common ordinances, authorities, boards or othe r means;
301	301	22. "Regional emergency medical servi ces system" means a
302	302	network of organizations, individuals, facilities and equ ipment
303	303	which serves a region, subject to a unified set of regional rules
304	304	and standards which may exceed, but may not be in contraven tion of,
305	305	those required by the state, which is under the medical direction of
306	306	a single regional medical director, and which participates directly
307	307	in the delivery of the following services:
308	308	a. medical call-taking and emergency medical services
309	309	dispatching, emergency and routine , including priority
310	310	dispatching of first response agencies, stretcher van
311	311	and ambulances,
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338	338	b. emergency medical respond er services provided by
339	339	emergency medical response agenci es,
340	340	c. ambulance services, both emergency, routine and
341	341	stretcher van including, but not limited to, the
342	342	transport of patients in accordance with transport
343	343	protocols approved by the regional medical d irector,
344	344	and
345	345	d. directions given by physicians directly v ia radio or
346	346	telephone, or by written protocol, to emergency
347	347	medical response agencies, stretcher van or am bulance
348	348	personnel at the scene of an emergency or while en
349	349	route to a hospital;
350	350	23. "Regional medical director" means a licensed physician, who
351	351	meets or exceeds the qualifications of a medical director as def ined
352	352	by the Oklahoma Emergency Response Systems Development Act, chosen
353	353	by an emergency medical service region to p rovide external medical
354	354	oversight, quality control and related services to that re gion;
355	355	24. "Registration" means the listing of an ambulance service in
356	356	a registry maintained by the Depart ment; provided, however,
357	357	registration shall not be deemed to be a li cense;
358	358	25. "Stretcher van" means any ground vehicle which is or should
359	359	be approved by the State Commissioner of Health, which is designed
360	360	and equipped to transport individuals on a stretc her or gurney type
361	361	apparatus. Vehicles used as stretcher vans shall meet such
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388	388	standards as may be required by the Commissioner for approval and
389	389	shall display evidence of licensure at all times. The Commissio ner
390	390	shall not establish Federal Specification K KK-A-1822 ambulance
391	391	standards for stretcher vans; provided, a stretc her van shall meet
392	392	Ambulance Manufacturers Division (AMD) Standards 004, 012 and 0 13,
393	393	and shall pass corresponding safety tests. Stretcher v an services
394	394	shall only be permitted and approve d by the Commissioner in
395	395	emergency medical service regions, ambulanc e service districts, or
396	396	counties with populations in excess of five hundred thousa nd
397	397	(500,000) people. Notwithstanding the provisions of thi s paragraph,
398	398	stretcher van transports may be ma de to and from any federal or
399	399	state veterans facility. Stretcher va ns may carry and provide
400	400	oxygen and may carry and utilize any equipment necessary for the
401	401	provision of oxygen;
402	402	26. "Stretcher van passenger " means any person who is or will
403	403	be transported in a reclining position on a stretcher or gurney, who
404	404	is medically stable, nonemergent and d oes not require any medical
405	405	monitoring equipment or assis tance during transport except oxygen.
406	406	Passengers must be a uthorized as qualified to be transported by
407	407	stretcher van. Passengers shall be authorized through screening
408	408	provided by a certified medical dispatching protocol approved by the
409	409	Department. All patients being transported to or from any medically
410	410	licensed facility shall be screened before transport. A ny patient
411	411	transported without screening shall be a violation of Com missioner
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438	438	rule by the transporting company and subject to administrative
439	439	procedures of the Department; and
440	440	27. "Transport protocol" means the written instructions
441	441	governing decision-making at the scene of a medical emergency by
442	442	ambulance personnel regardi ng the selection of the h ospital to which
443	443	the patient shall be transported. Trans port protocols shall be
444	444	developed by the regional medical d irector for a regional emergency
445	445	medical services system or by the Department if no regional
446	446	emergency medical serv ices system has been esta blished. Such
447	447	transport protocols shall adhere to, at a minimum, the following
448	448	guidelines:
449	449	a. nonemergency, routine transport shall be to the
450	450	facility of the pati ent's choice, except during an
451	451	event identified by the appropriate medical control as
452	452	a local, regional, or national emergency including,
453	453	but not limited to, a natural or manmade disaster, a
454	454	pandemic, or civil unrest, in which case the patient
455	455	shall be transported to the nearest appropriate
456	456	facility,
457	457	b. urgent or emergency transport not involving li fe-
458	458	threatening medical illness or injury shall be to th e
459	459	nearest facility, or, subject to transport
460	460	availability and system area coverage, to the facility
461	461	of the patient's choice, and
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488	488	c. life-threatening medical illness or injury shall
489	489	require transport to the nearest health care facility
490	490	appropriate to the ne eds of the patient as established
491	491	by regional or state guid elines, and
492	492	d. emergency ambulance transportation is not required
493	493	when a patient's apparent clinical condition, as
494	494	defined by applicable medic al treatment protocols,
495	495	does not warrant emergency ambu lance transport, and
496	496	nontransport of patients is authorized pursuant to
497	497	applicable medical treatment protoc ols established by
498	498	the regional medical director .
499	499	SECTION 2. This act shall become e ffective November 1, 2022.
500	500
501	501	58-2-8580 KN 01/16/22
502	502

Oklahoma 2022 Regular Session

Oklahoma House Bill HB3428 Compare Versions