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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (2022)
COMMITTEE SUBSTITUTE
FOR ENGROSSED
SENATE BILL NO. 1515 By: Weaver, Matthews, and
Rogers of the Senate
and
Osburn of the House
COMMITTEE SUBSTITUTE
An Act relating to emergency medical services;
amending 63 O.S. 2021, Section 1 -2503, as amended by
Section 1, Chapter 93, O.S.L. 2019, 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, as
amended by Section 1, Chap ter 93, O.S.L. 2019, is amended to read as
follows:
Section 1-2503. As used in the Oklahoma Emergenc y Response
Systems Development Act:
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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 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 stan dards as
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 un it of local government
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 state;
3. "Ambulance patient" or "patient" means any person who is or
will be transported in a reclining pos ition 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 counties formed together to provide, operate
and finance emergency medical services as provided by Section 9 C of
Article X of the Oklahoma Constitution or Sections 1201 through 1221
of Title 19 of the Oklahoma Statutes;
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6. "Board" means the State Board of Health;
7. "Certified emergency med ical responder" means an individual
certified by the Department to perf orm emergency medical services in
accordance with the Oklahoma Emergency Response Sy stems Development
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 Department 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 online medical control at
the time of transport. Certified emergency medical response
agencies may utilize certified em ergency 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 medic al 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 Accredi tation of
Educational Programs for the 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;
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13. "Critical care parame dic" or "CCP" means a licensed
paramedic who has successfull y 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 Commissioner;
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 equipmen t 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 is 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 pursuant to rules and stand ards
promulgated by the Commissioner at one or more of the following
levels:
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a. Basic basic life support,
b. Intermediate intermediate life support,
c. Paramedic paramedic life support,
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 provided 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, however, that the highes t level of care
offered by an ambulance 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 conditions as may be promulgat ed 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. Online medical control is the
medical direction given to licensed em ergency medical personne l,
certified emergency medical responders and stretcher van personnel
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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 sys tem, which is to include stretcher van
service including, but not limited to, protoc ols, standing orders,
educational programs, and the quality and delivery of online
control;
20. "Medical director" means a physician, fully licensed
without restriction, who acts as a paid or vo lunteer medical advisor
to a licensed ambulance service and who monitors and directs the
care so provided. Such physicians shall meet such qualifications
and requirements as may be promulgated by the Commissioner;
21. "Region" or "emergency medical servi ce 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 service
through common ordinances, authorities, b oards or other means;
22. "Regional emergency medical servi ces system" means a
network of organizations, individuals, facilities and equipment
which serves a region, subject to a unified set of regional rules
and standards which ma y exceed, but may not be in contravention 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:
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a. medical call-taking and emergency medical services
dispatching, emergency and routine, including priority
dispatching of first response agencies, stretcher van
and ambulances,
b. emergency medical respond er services provided by
emergency medical response agencies,
c. ambulance services, both emergency, rou tine 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 via 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 qualif ications of a medical di rector as defined
by the Oklahoma Emergency Response Systems Development Act, chosen
by an emergency medical service region to provide external medical
oversight, quality control and related services to that region;
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 license;
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25. "Stretcher van" means any ground vehicle which is or should
be approved by the State Commiss ioner of Health, which i s designed
and equipped to transport individuals on a stretc her or gurney type
apparatus. Vehicles used as stretcher vans shall meet such
standards as may be required by the Commissioner for approval and
shall display evidence of l icensure at all times. The Commissioner
shall not establish Federal Specification K KK-A-1822 ambulance
standards for stretcher vans; provided, a stretcher van shall meet
Ambulance Manufacturers Division (AMD) Standards 004, 012 and 013,
and shall pass corresponding safety tests. Stretcher van services
shall only be permitted and approve d by the Commissioner in
emergency medical service regions, ambulance service districts, or
counties with populations in excess of five hundred thousand
(500,000) people. Notwithstanding the prov isions of this paragraph,
stretcher van transports may be ma de to and from any federal or
state veterans facility. Stretcher vans 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 assistance during transport except oxygen.
Passengers must be authorized as qualified to be transported by
stretcher van. Passengers shall be authorized through screening
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provided by a certified medical dispatching protocol approved by the
Department. All patients being transport ed to or from any medica lly
licensed facility shall be screened before transport. A ny patient
transported without screening shall be a violation of Commissioner
rule by the transporting company and subject to administrative
procedures of the Department; a nd
27. "Transport protocol" means the written instructions
governing decision-making at the scene of a medical emergency by
ambulance personnel regarding the selection of the h ospital to which
the patient shall be transported. Transport protocols shall b e
developed by the regio nal medical director for a regional emergency
medical services system or by the Department if no regional
emergency medical services 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,
b. urgent or emergency transport no t involving life-
threatening medical illness or injury shall be to the
nearest facility, or, subject to transport
availability and system area cove rage, to the facility
of the patient's choice, and
c. life-threatening medical illness or injury shall
require transport to the nearest health care facility
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appropriate to the needs of the patient as established
by regional or state guidelines, and
d. emergency ambulance transportation is not required
when a patient's apparent clinical condition, as
defined by applicable medical treatment protocols,
does not warrant emergency ambulance transport, and
nontransport of patients is auth orized pursuant to
applicable medical treatment protocols established by
the regional medical director.
SECTION 2. This act shall become effective November 1, 2022.
58-2-11345 GRS 04/12/22