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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (2022)
HOUSE BILL 3920 By: Pfeiffer
AS INTRODUCED
An Act relating to emergency medical services;
amending 63 O.S. 2021, Section 1-2503, which relates
to definitions; modifying definition; 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 Emergen cy Response
Systems Development Act:
1. "Ambulance" means any ground, air or water vehicle which is
or should be approved by the Commissioner of Health, designed and
equipped to transport a patient or patients and to provide
appropriate on-scene and en route patient stabilization and care as
required. Vehicles used as ambulances shall meet such standards as
may be required by the State Board of Health for approval, 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
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or combination of units of government for the express purpose of
providing, directly or by contract, emergency medical services in a
specified area of the sta te;
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 ambulance;
4. "Ambulance service" means any private firm or governmental
agency which is or should be l icensed by the State Department of
Health to provide lev els of medical care, including but not limited
to comprehensive integrated medical care in emergency and
nonemergency settings under the supervision of a physician, base d on
certification standards pr omulgated by the Board;
5. "Ambulance service district " means any county, group of
counties or parts of counties formed together to provide, operate
and finance emergency medical services as provided by Section 9C of
Article X of the Oklahoma Constitution or Sections 1201 through 1221
of Title 19 of the Oklaho ma Statutes;
6. "Board" means the State Board of Health;
7. "Certified emergency medical responder " means an individual
certified by the Department to perform emergenc y medical services in
accordance with the Oklahoma Emergency Response Systems Developme nt
Act and in accordance with the rules and standards promulgated by
the Board;
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8. "Certified emergency medical response agency " means an
organization of any type certified by the Department to provi de
emergency medical care, but not transport. Certified emergency
medical response agencies may utilize certified emergency medical
responders or licensed emergency medical personnel; provided,
however, that all personnel so utilized shall function under the
direction of and consistent with guidelines for medi cal control;
9. "Classification" means an inclusive standardized
identification of stabilizing and definitive emergency services
provided by each hospital that treats emergency patients;
10. "CoAEMSP" means the Committee on Accreditation of
Educational Programs for the Emergency Medical Services Professions;
11. "Commissioner" means the State Commissioner of Health;
12. "Community paramedic" means a licensed paramedic who meets
the requirements of Section 1-2505 of this title;
13. "Community paramedic services" means services that include
interventions intended to prevent unnecessary a mbulance
transportation or hospital emergency department use.
a. Community paramedic services must be part of a car e
plan ordered by a primary health care provider or a
hospital provider in consultation with the medical
director of an ambulance service. S uch care plan must
ensure that the services provided by a community
paramedic do not duplicate services already pro vided
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to the patient, including home health and waiver
services.
b. Community paramedic services shall include health
assessment, chronic dis ease monitoring and education,
medication compliance, immunizations and vaccinations,
laboratory specimen collectio n, hospital discharge
follow-up care and minor medical p rocedures compliant
with the community paramedic 's scope of practice and
approved by the ambulance medical director;
14. "Council" means the Trauma and Emergency Response Advisory
Council created in Section 1-103a.1 of this title;
15. "Critical care paramedic" or "CCP" means a licensed
paramedic who has successfully completed critical care training and
testing requirements in accordance with the Oklahoma Emergency
Response Systems Development Act and in accordance with the rules
and standards promulgated by the Board;
16. "Department" means the State Department of Health;
17. "Emergency medical services system " means a system which
provides for the organization 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;
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18. "Letter of review" means the official designation from
CoAEMSP to a paramedic program t hat is in the "becoming accredited"
process;
19. "Licensed emergency medical personnel" means an emergency
medical technician (EMT), an intermediate emergency medical
technician (IEMT), an advanced emergency medical technician (AEMT),
or a paramedic licen sed by the Department to perform emergency
medical services in accordance with the Oklahoma Emergency Response
Systems Development Act and the rules and standards promulgated by
the Board;
20. "Licensure" means the licensing of emergency medical care
providers and ambulance services pursuant to rules and stand ards
promulgated by the Board at one or more of the following levels:
a. basic life support,
b. intermediate life support,
c. paramedic life support,
d. advanced life support,
e. stretcher aid van, an d
f. 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 provided by paramedic life
support.
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Requirements for each level of care shall be establ ished by the
Board. Licensure at any level of care includes a license to operate
at any lower level, with the exception of licensure for specialty
care; provided, however, that the highest level of c are offered by
an ambulance service shall be available t wenty-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 conditions as may be promulgated by the Bo ard,
An applicant upon submitting his or her national ce rtification,
license fee and application to the Department, shall be granted a
temporary license which shall be valid for six (6) months. The
temporary license shall allow the applicant to immediatel y start
work as if the individual was in possession of his or her official
license and shall authorize the individ ual to conduct any actions as
the official license would authorize ;
21. "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 aid 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 aid van service including, but not limited to,
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protocols, standing orders, educational programs, and the quality
and delivery of on-line control;
22. "Medical director" means a physician, fully licensed
without restriction, who acts as a paid or volunt eer medical advisor
to a licensed ambulance service and who mo nitors and directs the
care so provided. Such physicians sha ll meet such qualifications
and requirements as may be p romulgated by the Board;
23. "Region" or "emergency medical service region " means two or
more municipalities, counties, ambulance district s or other
political subdivisions exercising joint control ov er one or more
providers of emergency medical services a nd stretcher aid van
service through common ordinances, authorities, boards o r other
means;
24. "Regional emergency medical services syste m" means a
network of organizations, individuals, facilities and equipment
which serves a region, subject to a unifie d set of regional rules
and standards which may exceed, but may not be in con travention 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 foll owing services:
a. medical call-taking and emergency medical services
dispatching, emergency and routine, including priority
dispatching of first response agencies, stretcher aid
van and ambulances,
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b. emergency medical responder services provided by
emergency medical response agencies,
c. ambulance services, both emergency, routin e and
stretcher aid van including, but not limited to, the
transport of patients in accordance with transport
protocols approved by the regional medical director,
and
d. directions given by physicians directly via radio or
telephone, or by written protocol , to emergency
medical response agencies, stretcher aid van or
ambulance personnel at the scene of an emergency or
while en route to a hospital;
25. "Regional medical director " means a licensed physician, who
meets or exceeds the qualifications of a medic al director as defined
by the Oklahoma Emergency Response Syst ems Development Act, chosen
by an emergency medical service r egion to provide external medical
oversight, quality con trol and related services to that region;
26. "Registration" means the listing of an ambulance service in
a registry maintained by the Dep artment; provided, however,
registration shall not be deemed to be a license;
27. "Stretcher aid 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 stretcher or
gurney type apparatus. Vehicles used as stretc her aid vans shall
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meet such standards as may be require d by the State Board of Health
for approval and shall display evidence of suc h approval at all
times. Stretcher aid van services shall onl y be permitted and
approved by the Commissioner in emergency medical service regions,
ambulance service districts, or counties with populations in excess
of four hundred thousand (400,000) peopl e. Notwithstanding the
provisions of this paragraph, stretche r aid van transports may be
made to and from any federal or s tate veterans facility;
28. "Stretcher aid van patient " means any person who is or will
be transported in a reclining position on a stretcher or gurney, who
is medically stable, nonemergent and does not require any medical
monitoring equipment or assistan ce during transport; and
29. "Transport protocol" means the written instructions
governing decision-making at the scene of a medical emergency by
ambulance personnel regarding the selection of t he hospital to which
the patient shall be transported. Trans port protocols shall be
developed by the regional medica l director for a regional emergency
medical services system or by the Departm ent if no regional
emergency medical services system has been established. Such
transport protocols shall adhere to, at a minimum, the following
guidelines:
a. nonemergency, routine transport shall be to the
facility of the patient 's choice,
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b. urgent or emergency transport not involving life -
threatening medical ill ness or injury shall be to the
nearest facility, or, subject to transport
availability and system area coverage, to t he facility
of the patient's choice, and
c. life-threatening medical illness or injury shall
require transport to the nearest health care f acility
appropriate to the needs of the patient as establishe d
by regional or state guidelines.
SECTION 2. This act shall become effective November 1, 2022.
58-2-9961 KN 01/14/22