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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (2022)
HOUSE BILL 3428 By: Osburn
AS INTRODUCED
An Act relating to emergency medical services ;
amending 63 O.S. 2021, Section 1 -2503, which relates
to definitions used in the Oklahoma Emergency
Response Systems Development Act ; modifying
definitions; allowing certified emergency medical
response agency to provide limited transport under
certain conditions; modifying transport protocol; and
providing an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Section 1 -2503, is
amended to read as follows:
Section 1-2503. As used in the Oklahoma Emergenc y Response
Systems Development Act:
1. "Ambulance" means any ground, air or water vehicle which is
or should be approved by the State Commissioner of Heal th, designed
and equipped to transp ort a patient or patients and to p rovide
appropriate on-scene and en route patient stabilization and care as
required. Vehicles used as ambulances shall meet such standards as
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may be required by the Commissioner for appr oval, and shall display
evidence of such approval at all times;
2. "Ambulance authority" means any public trust or nonprofit
corporation established by the state or any unit of local government
or combination of units of government for the express purpose of
providing, directly or by contr act, emergency medical services in a
specified area of the state;
3. "Ambulance patient" or "patient" means any person who is or
will be transported in a reclining position to or from a health care
facility in an ambulan ce;
4. "Ambulance service" means any private firm or governmental
agency which is or should be licen sed by the State Department of
Health to provide levels of medical care based on certification
standards promulgated by the Commissioner;
5. "Ambulance service district" means any county, group of
counties or parts of count ies formed together to provide, operate
and finance emergency medical services as provided by Section 9C of
Article X of the Oklahoma Consti tution or Sections 1201 through 1221
of Title 19 of the Oklahoma Statutes;
6. "Board" means the State Board of Heal th;
7. "Certified emergency med ical responder" means an individual
certified by the Department to perform emergency medical services in
accordance with the Oklahoma Emergency Response Sy stems Development
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Act and in accordance with the rules and standards promulgated by
the Commissioner;
8. "Certified emergency medical response agency " means an
organization of any type certified by the Depart ment to provide
emergency medical care , but not transport and limited transport. A
certified emergency medical response agency shall only provide
transport upon approval by the appropriate me dical control at the
time of transport. Certified emergency med ical response agencies
may utilize certified em ergency medical responders or licensed
emergency medical personnel; provided, however, that all perso nnel
so utilized shall function under the directi on of and consistent
with guidelines for medical control;
9. "Classification" means an inclusive standard ized
identification of stabilizing and definitive emergency services
provided by each hospital that t reats emergency patients;
10. "CoAEMSP" means the Committee on Accreditation of
Educational Programs for th e Emergency Medical Services Professions;
11. "Commissioner" means the State Commissioner of Health;
12. "Council" means the Trauma and Emergency Response Advisory
Council created in Section 1 -103a.1 of this title;
13. "Critical care paramedic " or "CCP" means a licensed
paramedic who has successfull y completed critical care training and
testing requirements in accordance with the Oklahoma Emergency
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Response Systems Development Act and in accordan ce with the rules
and standards promulgated by the Commissi oner;
14. "Department" means the State Departm ent of Health;
15. "Emergency medical services system" means a system which
provides for the organiz ation and appropriate designation of
personnel, facilities and equipment for the effective and
coordinated local, regional and statewide delivery of health care
services primarily under emergency conditions;
16. "Letter of review" means the official desig nation from
CoAEMSP to a paramedic program that i s in the "becoming accredited"
process;
17. "Licensed emergency medical personnel " means an emergency
medical technician (EMT), an intermediate, an advanced emergency
medical technician (AEMT), or a paramed ic licensed by the Department
to perform emergency medical services in accordance with the
Oklahoma Emergency Response Systems Development Act and the rule s
and standards promulgated by the Commissioner;
18. "Licensure" means the licensing of emergency me dical care
providers and ambulance services pursu ant to rules and standards
promulgated by the Commissioner at one or more of the following
levels:
a. Basic basic life support,
b. Intermediate intermediate life support,
c. Paramedic paramedic life support,
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d. Advanced advanced life support,
e. Stretcher stretcher van, and
f. Specialty specialty care, which shall be used solely
for interhospital transport of patients requiring
specialized en route medical monitoring and advanced
life support which exceed the capabilities of the
equipment and personnel prov ided by paramedic life
support.
Requirements for each level of care shall be established by the
Commissioner. Licensure at any level of care includes a license to
operate at any lower level, with the exception of licensure for
specialty care; provided, ho wever, that the highest level of care
offered by an ambulan ce service shall be available twenty -four (24)
hours each day, three hundred sixty -five (365) days per year.
Licensure shall be granted or renewed for such periods and under
such terms and conditio ns as may be promulgated by the Commissioner;
19. "Medical control" means local, regional or statewide
medical direction and quality assurance of health care delivery in
an emergency medical service system. On-line medical control is the
medical direction given to licensed emergency medical personnel,
certified emergency medical responders and stretcher van personnel
by a physician via radio or telephone. Off -line medical control is
the establishment and monitoring of all medical components of an
emergency medical service system, which is to include stretcher va n
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service including, but not limited to, protoc ols, standing orders,
educational programs, and the quality and delivery of o n-line
control;
20. "Medical director" means a physician, fully licensed
without restriction, who acts as a paid or volunteer medic al advisor
to a licensed ambulance service and who monitors and directs the
care so provided. Such physicians shall meet su ch qualifications
and requirements as may be promulgated by the Commissio ner;
21. "Region" or "emergency medical service region " means two or
more municipalities, counties, ambul ance districts or other
political subdivisions exercising joint control over one or more
providers of emergency medical services and stretcher van ser vice
through common ordinances, authorities, boards or othe r means;
22. "Regional emergency medical servi ces system" means a
network of organizations, individuals, facilities and equ ipment
which serves a region, subject to a unified set of regional rules
and standards which may exceed, but may not be in contraven tion of,
those required by the state, which is under the medical direction of
a single regional medical director, and which participates directly
in the delivery of the following services:
a. medical call-taking and emergency medical services
dispatching, emergency and routine , including priority
dispatching of first response agencies, stretcher van
and ambulances,
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b. emergency medical respond er services provided by
emergency medical response agenci es,
c. ambulance services, both emergency, routine and
stretcher van including, but not limited to, the
transport of patients in accordance with transport
protocols approved by the regional medical d irector,
and
d. directions given by physicians directly v ia radio or
telephone, or by written protocol, to emergency
medical response agencies, stretcher van or am bulance
personnel at the scene of an emergency or while en
route to a hospital;
23. "Regional medical director" means a licensed physician, who
meets or exceeds the qualifications of a medical director as def ined
by the Oklahoma Emergency Response Systems Development Act, chosen
by an emergency medical service region to p rovide external medical
oversight, quality control and related services to that re gion;
24. "Registration" means the listing of an ambulance service in
a registry maintained by the Depart ment; provided, however,
registration shall not be deemed to be a li cense;
25. "Stretcher van" means any ground vehicle which is or should
be approved by the State Commissioner of Health, which is designed
and equipped to transport individuals on a stretc her or gurney type
apparatus. Vehicles used as stretcher vans shall meet such
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standards as may be required by the Commissioner for approval and
shall display evidence of licensure at all times. The Commissio ner
shall not establish Federal Specification K KK-A-1822 ambulance
standards for stretcher vans; provided, a stretc her van shall meet
Ambulance Manufacturers Division (AMD) Standards 004, 012 and 0 13,
and shall pass corresponding safety tests. Stretcher v an services
shall only be permitted and approve d by the Commissioner in
emergency medical service regions, ambulanc e service districts, or
counties with populations in excess of five hundred thousa nd
(500,000) people. Notwithstanding the provisions of thi s paragraph,
stretcher van transports may be ma de to and from any federal or
state veterans facility. Stretcher va ns may carry and provide
oxygen and may carry and utilize any equipment necessary for the
provision of oxygen;
26. "Stretcher van passenger " means any person who is or will
be transported in a reclining position on a stretcher or gurney, who
is medically stable, nonemergent and d oes not require any medical
monitoring equipment or assis tance during transport except oxygen.
Passengers must be a uthorized as qualified to be transported by
stretcher van. Passengers shall be authorized through screening
provided by a certified medical dispatching protocol approved by the
Department. All patients being transported to or from any medically
licensed facility shall be screened before transport. A ny patient
transported without screening shall be a violation of Com missioner
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rule by the transporting company and subject to administrative
procedures of the Department; and
27. "Transport protocol" means the written instructions
governing decision-making at the scene of a medical emergency by
ambulance personnel regardi ng the selection of the h ospital to which
the patient shall be transported. Trans port protocols shall be
developed by the regional medical d irector for a regional emergency
medical services system or by the Department if no regional
emergency medical serv ices system has been esta blished. Such
transport protocols shall adhere to, at a minimum, the following
guidelines:
a. nonemergency, routine transport shall be to the
facility of the pati ent's choice, except during an
event identified by the appropriate medical control as
a local, regional, or national emergency including,
but not limited to, a natural or manmade disaster, a
pandemic, or civil unrest, in which case the patient
shall be transported to the nearest appropriate
facility,
b. urgent or emergency transport not involving li fe-
threatening medical illness or injury shall be to th e
nearest facility, or, subject to transport
availability and system area coverage, to the facility
of the patient's choice, and
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c. life-threatening medical illness or injury shall
require transport to the nearest health care facility
appropriate to the ne eds of the patient as established
by regional or state guid elines, and
d. emergency ambulance transportation is not required
when a patient's apparent clinical condition, as
defined by applicable medic al treatment protocols,
does not warrant emergency ambu lance transport, and
nontransport of patients is authorized pursuant to
applicable medical treatment protoc ols established by
the regional medical director .
SECTION 2. This act shall become e ffective November 1, 2022.
58-2-8580 KN 01/16/22