OK
Oklahoma Senate Bill SB536

Oklahoma 2023 Regular Session

Oklahoma Senate Bill SB536 Compare Versions

OldNewDifferences
11
22
3-ENGR. H. A. to ENGR. S. B. NO. 536 Page 1 1
3+SB536 HFLR Page 1
4+BOLD FACE denotes Committee Amendments. 1
45 2
56 3
67 4
78 5
89 6
910 7
1011 8
1112 9
1213 10
1314 11
1415 12
1516 13
1617 14
1718 15
1819 16
1920 17
2021 18
2122 19
2223 20
2324 21
2425 22
2526 23
2627 24
2728
28-ENGROSSED HOUSE AMENDME NT
29- TO
30-ENGROSSED SENATE BILL NO . 536 By: Rosino of the Senate
29+HOUSE OF REPRESENTATIVES - FLOOR VERSION
30+
31+STATE OF OKLAHOMA
32+
33+1st Session of the 59th Legislature (2023)
34+
35+COMMITTEE SUBSTITUTE
36+FOR ENGROSSED
37+SENATE BILL NO. 536 By: Rosino of the Senate
3138
3239 and
3340
3441 Hill of the House
3542
3643
3744
38-
45+COMMITTEE SUBSTITUTE
3946
4047 An Act relating to emergency medical services;
4148 amending 63 O.S. 2021, Section 1 -2503, as amended by
4249 Section 1, Chapter 276, O.S.L. 2 022 (63 O.S. Supp.
4350 2022, Section 1-2503), which relates to definitions
4451 used in the Oklahoma Emergency Res ponse Systems
4552 Development Act; adding and modifying defin itions;
4653 repealing 63 O.S. 2021, Section 1-2503, as amended by
4754 Section 1, Chapter 246, O.S.L. 2016, which relates to
4855 definitions used in the Oklahoma Emergency Response
4956 Systems Development Act; and providing an effective
5057 date.
5158
5259
5360
61+BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
62+SECTION 1. AMENDATORY 63 O.S. 2021, Section 1-2503, as
63+amended by Section 1, Chapter 276, O.S.L. 2022 (63 O.S. Supp. 2022,
64+Section 1-2503), is amended to read as follows:
65+Section 1-2503. As used in the Oklahoma Emergency Response
66+Systems Development Act:
67+1. “Ambulance” means any ground, air or water vehicle whi ch is
68+or should be approved by the State Commissioner of Health, designed
5469
55-
56-AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill
57-and insert:
58-
59-
60-"An Act relating to emergency medical services;
61-amending 63 O.S. 2021, Section 1 -2503, as amended by
62-Section 1, Chapter 276, O.S.L. 2 022 (63 O.S. Supp.
63-2022, Section 1-2503), which relates to definitions
64-used in the Oklahoma Emergency Res ponse Systems
65-Development Act; adding and modifying definitions;
66-repealing 63 O.S. 2021, Section 1-2503, as amended by
67-Section 1, Chapter 246, O.S.L. 2016, which relates to
68-definitions used in the Oklahoma Emergency Response
69-Systems Development Act; and providing an effective
70-date.
71-
72-
73-
74-BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
75-
76-ENGR. H. A. to ENGR. S. B. NO. 536 Page 2 1
70+SB536 HFLR Page 2
71+BOLD FACE denotes Committee Amendments. 1
7772 2
7873 3
7974 4
8075 5
8176 6
8277 7
8378 8
8479 9
8580 10
8681 11
8782 12
8883 13
8984 14
9085 15
9186 16
9287 17
9388 18
9489 19
9590 20
9691 21
9792 22
9893 23
9994 24
10095
101-SECTION 1. AMENDATORY 63 O.S. 2021, Section 1-2503, as
102-amended by Section 1, Chapter 276, O.S.L. 2022 (63 O.S. Supp. 2022,
103-Section 1-2503), is amended to read as follows:
104-Section 1-2503. As used in the Oklahoma Emergency Response
105-Systems Development Act:
106-1. “Ambulance” means any ground, air or water vehicle whi ch is
107-or should be approved by the State Commissioner of Health, designed
10896 and equipped to transport a patient or patients an d to provide
10997 appropriate on-scene and en route patient stabilization and care as
11098 required. Vehicles used as am bulances shall meet s uch standards as
11199 may be required by the Commissioner for approval, and shall display
112100 evidence of such approval at all times;
113101 2. “Ambulance authority” means any public trust or nonprofit
114102 corporation established by the state or any unit of local government
115103 or combination of units of government for the express purpose of
116104 providing, directly o r by contract, emergency medical servi ces in a
117105 specified area of the state;
118106 3. “Ambulance patient” or “patient” means any person who is or
119107 will be transported in a recli ning position to or from a health care
120108 facility in an ambulance;
121109 4. “Ambulance service” means any private firm or governmen tal
122110 agency that owns or operates ambulances and which is or should shall
123111 be licensed by the State D epartment of Health to provide levels of
124-medical care, including, but not limited to, comprehensive
112+medical care, including but not lim ited to, comprehensive integrated
113+medical care in emergency and nonemergency sett ings under the
114+supervision of a physician based on certification standards
115+promulgated by the Commis sioner;
116+5. “Ambulance service district ” means any county, group of
117+counties or parts of counties formed together to p rovide, operate
118+and finance emergency medical services as provided by Section 9C of
125119
126-ENGR. H. A. to ENGR. S. B. NO. 536 Page 3 1
120+SB536 HFLR Page 3
121+BOLD FACE denotes Committee Amendments. 1
127122 2
128123 3
129124 4
130125 5
131126 6
132127 7
133128 8
134129 9
135130 10
136131 11
137132 12
138133 13
139134 14
140135 15
141136 16
142137 17
143138 18
144139 19
145140 20
146141 21
147142 22
148143 23
149144 24
150145
151-integrated medical c are in emergency and nonemergency sett ings under
152-the supervision of a physician based on certification standards
153-promulgated by the Commis sioner;
154-5. “Ambulance service district ” means any county, group of
155-counties or parts of counties formed together to p rovide, operate
156-and finance emergency medical services as provided by Section 9C of
157146 Article X of the Oklahoma Constitution or Sections 120 1 through 1221
158147 of Title 19 of the Oklahoma Statutes;
159148 6. “Board” means the State Board of Health;
160149 7. “Certified emergency medical responder” means an individual
161150 certified by the Department to perform emergency medical services in
162151 accordance with the Oklah oma Emergency Response Systems Development
163152 Act and in accordance with the ru les and standards promulgated by
164153 the Commissioner;
165154 8. “Certified emergency medical response agency” means an
166155 organization of any type certified by the Department to provide
167156 emergency medical care and limited transport in an emergency vehicle
168157 as defined in Section 1-103 of Title 47 of the Oklahoma Statutes. A
169158 certified emergency medical response agency shall only provide
170159 transport upon approval by the appropriate online medical con trol at
171160 the time of transport. Certified emergency med ical response
172161 agencies may utilize certified emergency medical responders or
173162 licensed emergency m edical personnel; provided, however, that all
163+personnel so utilized shall function under the direction o f and
164+consistent with guidelines for medical control;
165+9. “Classification” means an inclusive standardized
166+identification of stabilizing and definitive emergency services
167+provided by each hospital that treats emergency patients;
168+10. “CoAEMSP” means the Committee on Accreditation of
169+Educational Programs for th e Emergency Medical S ervices Professions;
174170
175-ENGR. H. A. to ENGR. S. B. NO. 536 Page 4 1
171+SB536 HFLR Page 4
172+BOLD FACE denotes Committee Amendments. 1
176173 2
177174 3
178175 4
179176 5
180177 6
181178 7
182179 8
183180 9
184181 10
185182 11
186183 12
187184 13
188185 14
189186 15
190187 16
191188 17
192189 18
193190 19
194191 20
195192 21
196193 22
197194 23
198195 24
199196
200-personnel so utilized shall function under the direction o f and
201-consistent with guidelines for medical control;
202-9. “Classification” means an inclusive standardized
203-identification of stabilizing and definitive emergency services
204-provided by each hospital that treats emergency patients;
205-10. “CoAEMSP” means the Committee on Accreditation of
206-Educational Programs for th e Emergency Medical S ervices Professions;
207197 11. “Commissioner” means the State Commissioner of Health;
208198 12. “Community paramedic” means a licensed paramedic who meets
209199 the requirements of Section 1-2505 of this title;
210200 13. “Community paramedic ser vices” means services that inclu de
211201 interventions intended to prevent unnecessary ambulance
212202 transportation or hospital emergency department use, or are provided
213203 as part of in-home inpatient or outpatient hospital services .
214204 Community paramedic services:
215205 a. must be part of a care plan orde red by a primary
216206 health care provider or h ospital provider in
217207 consultation with the medical director of an ambulance
218208 service. Such care plan must ensure that the services
219209 provided by a community paramedic do not duplicate
220210 services already provided to the patient, including
221211 home health and waiver services, and
222212 b. shall include health assessment, chronic disease
223213 monitoring and education, medication compliance,
214+immunizations and vaccinations, laboratory specimen
215+collection, hospital discharge follow -up care, and
216+minor medical procedures compliant wit h the community
217+paramedic’s scope of practice and approved by the
218+ambulance medical director;
219+14. “Council” means the Trauma and Emergency Response Advisory
220+Council created in Section 1 -103a.1 of this title;
224221
225-ENGR. H. A. to ENGR. S. B. NO. 536 Page 5 1
222+SB536 HFLR Page 5
223+BOLD FACE denotes Committee Amendments. 1
226224 2
227225 3
228226 4
229227 5
230228 6
231229 7
232230 8
233231 9
234232 10
235233 11
236234 12
237235 13
238236 14
239237 15
240238 16
241239 17
242240 18
243241 19
244242 20
245243 21
246244 22
247245 23
248246 24
249247
250-immunizations and vaccinations, laboratory specimen
251-collection, hospital discharge follow -up care, and
252-minor medical procedures compliant wit h the community
253-paramedic’s scope of practice and approved by the
254-ambulance medical director;
255-14. “Council” means the Trauma and Emergency Response Advisory
256-Council created in Section 1 -103a.1 of this title;
257248 13. 15. “Critical care paramedic” or “CCP” means a licensed
258249 paramedic who has succ essfully completed critical care training and
259250 testing requirements in accorda nce with the Oklahoma Emergency
260251 Response Systems Development Act and in accordance with the rules
261252 and standards promulgated by the Commissioner ;
262253 14. 16. “Department” means the State Department of Health;
263254 15. 17. “Emergency medical services sy stem” means a system
264255 which provides for the organization and appropriate designation of
265256 personnel, facilities and e quipment for the effective and
266257 coordinated local, regional and statewide del ivery of health care
267258 services primarily under emergency condition s;
268259 16. 18. “Letter of review” means the official designation from
269260 CoAEMSP to a paramedic program that is in the “becoming accredited”
270261 process;
271262 17. 19. “Licensed emergency medical personnel ” means an
272263 emergency medical technician (EMT), an intermediate emergency
273264 medical technician (IEMT) , an advanced emergency medical technician
265+(AEMT), or a paramedic licensed by the D epartment to perform
266+emergency medical services in accordance with the Oklah oma Emergency
267+Response Systems Development Act and the rules and standards
268+promulgated by the Commissioner;
269+18. 20. “Licensure” means the licensing of emergency medical
270+care providers and ambulance services pursuant to rules and
274271
275-ENGR. H. A. to ENGR. S. B. NO. 536 Page 6 1
272+SB536 HFLR Page 6
273+BOLD FACE denotes Committee Amendments. 1
276274 2
277275 3
278276 4
279277 5
280278 6
281279 7
282280 8
283281 9
284282 10
285283 11
286284 12
287285 13
288286 14
289287 15
290288 16
291289 17
292290 18
293291 19
294292 20
295293 21
296294 22
297295 23
298296 24
299297
300-(AEMT), or a paramedic licensed by the D epartment to perform
301-emergency medical services in accordance with the Oklah oma Emergency
302-Response Systems Development Act and the rules and standards
303-promulgated by the Commissioner;
304-18. 20. “Licensure” means the licensing of emergency medical
305-care providers and ambulance services pursuant to rules and
306298 standards promulgated by t he Commissioner at one or more of the
307299 following levels:
308300 a. basic life support,
309301 b. intermediate life support,
310302 c. paramedic life support,
311303 d. advanced life support,
312304 e. stretcher van, and
313305 f. specialty care, which shall be us ed solely for
314306 interhospital transpor t of patients requiring
315307 specialized en route medical monitoring and advanced
316308 life support which exceed the capabi lities of the
317309 equipment and personnel provided by paramedic life
318310 support.
319311 Requirements for each level of ca re shall be established by the
320312 Commissioner. Licensure at any level of care includes a license to
321313 operate at any lower level, with the exception of licensure for
322314 specialty care; provided, however, that the highest l evel of care
315+offered by an ambulance ser vice shall be available twenty-four (24)
316+hours each day, three hundred sixty-five (365) days per year.
317+Licensure shall be granted or renewed for such periods and under
318+such terms and conditions as may be promulgated by the Commissioner;
319+19. 21. “Medical control” means local, regional or sta tewide
320+medical direction and quality assurance of health care delivery in
321+an emergency medical service system. O nline medical control is the
323322
324-ENGR. H. A. to ENGR. S. B. NO. 536 Page 7 1
323+SB536 HFLR Page 7
324+BOLD FACE denotes Committee Amendments. 1
325325 2
326326 3
327327 4
328328 5
329329 6
330330 7
331331 8
332332 9
333333 10
334334 11
335335 12
336336 13
337337 14
338338 15
339339 16
340340 17
341341 18
342342 19
343343 20
344344 21
345345 22
346346 23
347347 24
348348
349-offered by an ambulance ser vice shall be available twenty-four (24)
350-hours each day, three hundred sixty-five (365) days per year.
351-Licensure shall be granted or renewed for such periods and under
352-such terms and conditions as may be promulgated by the Commissioner;
353-19. 21. “Medical control” means local, regional or sta tewide
354-medical direction and quality assurance of health care delivery in
355-an emergency medical service system. O nline medical control is the
356349 medical direction given to licensed em ergency medical personnel,
357350 certified emergency medical responders and stretc her van personnel
358351 by a physician via radio or telephone. Off -line medical control is
359352 the establishment and monit oring of all medical components of an
360353 emergency medical service sys tem, which is to include stretcher van
361354 service including, but not limited to , protocols, standing orders,
362355 educational programs, and the quality and delivery of onli ne
363356 control;
364357 20. 22. “Medical director” means a physician, fully licensed
365358 without restriction, who acts as a paid or volunteer medic al advisor
366359 to a licensed ambulance s ervice and who monitors and directs the
367360 care so provided. Such physicians shall meet such q ualifications
368361 and requirements as may be promulgated by the Commissioner;
369362 21. 23. “Region” or “emergency medical service region ” means
370363 two or more municipalities, counties, ambulance districts or other
371364 political subdivisions exercising joint control over one or more
365+providers of emergency medical services and stretcher van service
366+through common ordinances, authorities, boards or other means;
367+22. 24. “Regional emergency medical services system” means a
368+network of organizations, individuals, facilities and equipme nt
369+which serves a region, subject to a unified set of regional rules
370+and standards which may exceed, but may not be in c ontravention of,
371+those required by the state, which is under the medical direction of
372372
373-ENGR. H. A. to ENGR. S. B. NO. 536 Page 8 1
373+SB536 HFLR Page 8
374+BOLD FACE denotes Committee Amendments. 1
374375 2
375376 3
376377 4
377378 5
378379 6
379380 7
380381 8
381382 9
382383 10
383384 11
384385 12
385386 13
386387 14
387388 15
388389 16
389390 17
390391 18
391392 19
392393 20
393394 21
394395 22
395396 23
396397 24
397398
398-providers of emergency medical services and stretcher van service
399-through common ordinances, authorities, boards or other means;
400-22. 24. “Regional emergency medical services system” means a
401-network of organizations, individuals, facilities and equipme nt
402-which serves a region, subject to a unified set of regional rules
403-and standards which may exceed, but may not be in c ontravention of,
404-those required by the state, which is under the medical direction of
405399 a single regional medical director, and which part icipates directly
406400 in the delivery of the following services:
407401 a. medical call-taking and emergency medical services
408402 dispatching, emergency and routine includ ing priority
409403 dispatching of first response agencies, stretcher van
410404 and ambulances,
411405 b. emergency medical responder services provided by
412406 emergency medical response agencies,
413407 c. ambulance services, both emergency, routine a nd
414408 stretcher van including, but not limited to, the
415409 transport of patients in accordance with transport
416410 protocols approved by the regional medical dir ector,
417411 and
418412 d. directions given by physicians directly via radio or
419413 telephone, or by written protocol, to em ergency
420414 medical response agencies, s tretcher van or ambulance
415+personnel at the scene of an emergency or while en
416+route to a hospital;
417+23. 25. “Regional medical director ” means a licensed physician,
418+who meets or exceeds the qualifications of a medical dire ctor as
419+defined by the Oklahoma Emer gency Response Systems Development Act,
420+chosen by an emergency medical service region to p rovide external
421+medical oversight, quality control and related services to that
422+region;
421423
422-ENGR. H. A. to ENGR. S. B. NO. 536 Page 9 1
424+SB536 HFLR Page 9
425+BOLD FACE denotes Committee Amendments. 1
423426 2
424427 3
425428 4
426429 5
427430 6
428431 7
429432 8
430433 9
431434 10
432435 11
433436 12
434437 13
435438 14
436439 15
437440 16
438441 17
439442 18
440443 19
441444 20
442445 21
443446 22
444447 23
445448 24
446449
447-personnel at the scene of an emergency or while en
448-route to a hospital;
449-23. 25. “Regional medical director ” means a licensed physician,
450-who meets or exceeds the qualifications of a medical dire ctor as
451-defined by the Oklahoma Emer gency Response Systems Development Act,
452-chosen by an emergency medical service region to p rovide external
453-medical oversight, quality control and related services to that
454-region;
455450 24. 26. “Registration” means the listing of an ambulance
456451 service in a registr y maintained by the Department; provided,
457452 however, registration shall not be deemed to be a li cense;
458453 25. 27. “Stretcher van” means any ground vehicle which is or
459454 should shall be approved by the State Commissioner of Health, which
460455 is designed and equipped to transport individuals on a stretcher or
461456 gurney type apparatus. Vehicles used as stretcher vans shall meet
462457 such standards as may be required by the Commissioner for approval
463458 and shall display evidence of licensure at all times. The
464459 Commissioner shall not establish Federal Specification KKK-A-1822
465460 ambulance standards for stretcher vans; provided, a stretc her van
466461 shall meet Ambulance Manufacturers Division (AMD) Standards 004, 012
467462 and 013, and shall pass corresponding safety tests. Stretcher van
468463 services shall only be permitted and approved by the Commissioner in
469464 emergency medical service regions, ambulanc e service districts, or
470465 counties with populations in excess of five hundred thousa nd
466+(500,000) people. Notwithstanding the provisions of this paragraph,
467+stretcher van transports may be made to and from any federal or
468+state veterans facility. Stretcher va ns may carry and provide
469+oxygen and may carry and utilize any equipment necessary for the
470+provision of oxygen;
471+26. 28. “Stretcher van passenger” means any person who is or
472+will be transported in a reclining position on a stretcher or
473+gurney, who is medically stable, nonemergent and does not require
471474
472-ENGR. H. A. to ENGR. S. B. NO. 536 Page 10 1
475+SB536 HFLR Page 10
476+BOLD FACE denotes Committee Amendments. 1
473477 2
474478 3
475479 4
476480 5
477481 6
478482 7
479483 8
480484 9
481485 10
482486 11
483487 12
484488 13
485489 14
486490 15
487491 16
488492 17
489493 18
490494 19
491495 20
492496 21
493497 22
494498 23
495499 24
496500
497-(500,000) people. Notwithstanding the provisions of this paragraph,
498-stretcher van transports may be made to and from any federal or
499-state veterans facility. Stretcher va ns may carry and provide
500-oxygen and may carry and utilize any equipment necessary for the
501-provision of oxygen;
502-26. 28. “Stretcher van passenger” means any person who is or
503-will be transported in a reclining position on a stretcher or
504-gurney, who is medically stable, nonemergent and does not require
505501 any medical monitoring equipment or a ssistance during transport
506502 except oxygen. Passengers must be authorized as qualified to be
507503 transported by stretcher van. Passengers shall be authorized
508504 through screening provid ed by a certified medical dispatching
509505 protocol approved made available for review by the Department during
510506 inspection. All patients being transported to or from any medically
511507 licensed facility shall be screened before transport. Any patient
512508 transported without screening shall be a violation of Commissioner
513509 rule by the transporting company and subject to administra tive
514510 procedures of the Department; and
515511 27. 29. “Transport protocol” means the written instructions
516512 governing decision-making at the scene of a medical emergency by
517513 ambulance personnel regardi ng the selection of the hospital to which
518514 the patient shall be t ransported. Transport protocols shall be
519515 developed by the regional medical director for a regional emergency
520516 medical services system or by the Department if no regional
517+emergency medical serv ices system has been established. Such
518+transport protocols shal l adhere to, at a minimum, the following
519+guidelines:
520+a. nonemergency, routine transport shall be to the
521+facility of the patient ’s choice,
522+b. urgent or emergency transport not involving life -
523+threatening medical illness or injury shall b e to the
524+nearest facility, or, subject to transport
521525
522-ENGR. H. A. to ENGR. S. B. NO. 536 Page 11 1
526+SB536 HFLR Page 11
527+BOLD FACE denotes Committee Amendments. 1
523528 2
524529 3
525530 4
526531 5
527532 6
528533 7
529534 8
530535 9
531536 10
532537 11
533538 12
534539 13
535540 14
536541 15
537542 16
538543 17
539544 18
540545 19
541546 20
542547 21
543548 22
544549 23
545550 24
546551
547-emergency medical serv ices system has been established. Such
548-transport protocols shal l adhere to, at a minimum, the following
549-guidelines:
550-a. nonemergency, routine transport shall be to the
551-facility of the patient ’s choice,
552-b. urgent or emergency transport not involving life -
553-threatening medical illness or injury shall b e to the
554-nearest facility, or, subject to transport
555552 availability and system area coverage, to the facility
556553 of the patient’s choice,
557554 c. life-threatening medical illness or injury shall
558555 require transport to the near est health care facility
559556 appropriate to the needs of the patient as established
560557 by regional or state guidelines, and
561558 d. emergency ambulance transportation is not required
562559 when a patient’s apparent clinical condition, as
563560 defined by applicable medical treatm ent protocols,
564561 does not warrant emergency a mbulance transport, a nd
565562 nontransport of patients is authorized pursuant to
566563 applicable medical treatment protocols established by
567564 the regional medical director.
568565 SECTION 2. REPEALER 63 O.S. 2021, Section 1-2503, as
569566 amended by Section 1, Chapter 246, O.S. L. 2016, is hereby repealed.
570-SECTION 3. This act shall become effective November 1, 2023."
567+SECTION 3. This act shall become effective November 1, 2023.
571568
572-ENGR. H. A. to ENGR. S. B. NO. 536 Page 12 1
573-2
574-3
575-4
576-5
577-6
578-7
579-8
580-9
581-10
582-11
583-12
584-13
585-14
586-15
587-16
588-17
589-18
590-19
591-20
592-21
593-22
594-23
595-24
596-
597-Passed the House of Representatives the 20th day of April, 2023.
598-
599-
600-
601-
602-
603-Presiding Officer of the House of
604- Representatives
605-
606-
607-Passed the Senate the ____ day of _______ ___, 2023.
608-
609-
610-
611-
612-
613-Presiding Officer of the Senate
614-
615-
616-ENGR. S. B. NO. 536 Page 1 1
617-2
618-3
619-4
620-5
621-6
622-7
623-8
624-9
625-10
626-11
627-12
628-13
629-14
630-15
631-16
632-17
633-18
634-19
635-20
636-21
637-22
638-23
639-24
640-
641-ENGROSSED SENATE
642-BILL NO. 536 By: Rosino of the Senate
643-
644- and
645-
646- Hill of the House
647-
648-
649-
650-
651-An Act relating to emergency medical services;
652-amending 63 O.S. 2021, Section 1 -2503, as amended by
653-Section 1, Chapter 276, O.S.L. 2 022 (63 O.S. Supp.
654-2022, Section 1-2503), which relates to definitions
655-used in the Oklahoma Emergency Response Systems
656-Development Act; adding and modifying definitions;
657-repealing 63 O.S. 2021, Section 1-2503, as amended by
658-Section 1, Chapter 246, O.S.L. 2016, which relates to
659-definitions used in the Oklahoma Emergency Response
660-Systems Development Act; and providing an effec tive
661-date.
662-
663-
664-
665-
666-
667-BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
668-SECTION 4. AMENDATORY 63 O.S. 2021, Section 1-2503, as
669-amended by Section 1, Chapter 276, O.S.L. 2022 (63 O.S. Supp. 2022,
670-Section 1-2503), is amended to read as follows:
671-Section 1-2503. As used in the Oklahoma Emergency Response
672-Systems Development Act:
673-1. “Ambulance” means any ground, air or water vehicle whi ch is
674-or should be approved by the State Commissioner of Health, designed
675-and equipped to transport a patient or patients and to provide
676-appropriate on-scene and en route patient s tabilization and care as
677-required. Vehicles used as am bulances shall meet s uch standards as
678-
679-ENGR. S. B. NO. 536 Page 2 1
680-2
681-3
682-4
683-5
684-6
685-7
686-8
687-9
688-10
689-11
690-12
691-13
692-14
693-15
694-16
695-17
696-18
697-19
698-20
699-21
700-22
701-23
702-24
703-
704-may be required by the Commissioner for approval, and shall display
705-evidence of such approval at all times;
706-2. “Ambulance authority” means any public trust or non profit
707-corporation established by the state or any unit of local government
708-or combination of units of government for the express purpose of
709-providing, directly or by contract, emergency medical services in a
710-specified area of the state;
711-3. “Ambulance patient” or “patient” means any person who is or
712-will be transported in a recli ning position to or from a health care
713-facility in an ambulance;
714-4. “Ambulance service” means any private firm or governmental
715-agency which is or should be licensed by the State D epartment of
716-Health to provide levels of medical care , including but not lim ited
717-to comprehensive integrated medical care in emergency and
718-nonemergency settings under the supervision of a physician based on
719-certification standards promulgated by the Commis sioner;
720-5. “Ambulance service district ” means any county, group of
721-counties or parts of counties formed together to provide, operate
722-and finance emergency medical services as p rovided by Section 9C of
723-Article X of the Oklahoma Constitution or Sections 120 1 through 1221
724-of Title 19 of the Oklahoma Statutes;
725-6. “Board” means the State Board of Health;
726-7. “Certified emergency medical responder ” means an individual
727-certified by the Department to perform emergency medical services in
728-
729-ENGR. S. B. NO. 536 Page 3 1
730-2
731-3
732-4
733-5
734-6
735-7
736-8
737-9
738-10
739-11
740-12
741-13
742-14
743-15
744-16
745-17
746-18
747-19
748-20
749-21
750-22
751-23
752-24
753-
754-accordance with the Oklah oma Emergency Response Systems Development
755-Act and in accordance with the ru les and standards promulgated by
756-the Commissioner;
757-8. “Certified emergency medical response agency ” means an
758-organization of any type certified by the Department to provide
759-emergency medical care and limited transport in an emergency vehicle
760-as defined in Section 1-103 of Title 47 of the Oklahoma Statutes. A
761-certified emergency medical response agency shall only provide
762-transport upon approval by the appropriate online medical con trol at
763-the time of transport. Certified emergency med ical response
764-agencies may utilize certified emergency medical responders or
765-licensed emergency m edical personnel; provided, however, that all
766-personnel so utilized shall function under the direction o f and
767-consistent with guidelines for medical control;
768-9. “Classification” means an inclusive standardized
769-identification of stabili zing and definitive emergency services
770-provided by each hospital that treats emergency patients;
771-10. “CoAEMSP” means the Committee on Accreditation of
772-Educational Programs for th e Emergency Medical S ervices Professions;
773-11. “Commissioner” means the State Commissioner of Health;
774-12. “Community paramedic” means a licensed para medic who meets
775-the requirements of Section 1-2505 of this title;
776-13. “Community paramedic ser vices” means services that inclu de
777-interventions intended to prevent unnecessary ambulance
778-
779-ENGR. S. B. NO. 536 Page 4 1
780-2
781-3
782-4
783-5
784-6
785-7
786-8
787-9
788-10
789-11
790-12
791-13
792-14
793-15
794-16
795-17
796-18
797-19
798-20
799-21
800-22
801-23
802-24
803-
804-transportation or hospital emergency department use. Community
805-paramedic services:
806-a. must be part of a care plan orde red by a primary
807-health care provider or hospit al provider in
808-consultation with the medical director of an ambulance
809-service. Such care plan must ensure that the services
810-provided by a community paramedic do not duplicate
811-services already provided to the patient, including
812-home health and waiver servi ces, and
813-b. shall include health assessment, chronic disease
814-monitoring and education, medication compliance,
815-immunizations and vaccinations, laboratory specimen
816-collection, hospital discharge follow -up care, and
817-minor medical procedures compliant with the community
818-paramedic’s scope of practice and approved by the
819-ambulance medical director;
820-14. “Council” means the Trauma and Emergency Response Advisory
821-Council created in Section 1 -103a.1 of this title;
822-13. 15. “Critical care paramedic” or “CCP” means a licensed
823-paramedic who has succ essfully completed critical care trai ning and
824-testing requirements in accorda nce with the Oklahoma Emergency
825-Response Systems Development Act and in accordance with the rules
826-and standards promulgated by the Commissioner;
827-14. 16. “Department” means the State Department of Health;
828-
829-ENGR. S. B. NO. 536 Page 5 1
830-2
831-3
832-4
833-5
834-6
835-7
836-8
837-9
838-10
839-11
840-12
841-13
842-14
843-15
844-16
845-17
846-18
847-19
848-20
849-21
850-22
851-23
852-24
853-
854-15. 17. “Emergency medical services sy stem” means a system
855-which provides for the organization and appropriate designation of
856-personnel, facilities and e quipment for the effective and
857-coordinated local, regio nal and statewide del ivery of health care
858-services primarily under emergency condition s;
859-16. 18. “Letter of review” means the official designation from
860-CoAEMSP to a paramedic program that is in the “becoming accredited”
861-process;
862-17. 19. “Licensed emergency medical personnel ” means an
863-emergency medical technician (EMT) , an intermediate emergency
864-medical technician (IEMT) , an advanced emergency medical technician
865-(AEMT), or a paramedic licensed by the D epartment to perform
866-emergency medical services in acco rdance with the Oklah oma Emergency
867-Response Systems Development Act and the rules and standards
868-promulgated by the Commissioner;
869-18. 20. “Licensure” means the licensing of emergency medical
870-care providers and ambulance services pursuant to rules and
871-standards promulgated by t he Commissioner at one or more of the
872-following levels:
873-a. basic life support,
874-b. intermediate life support,
875-c. paramedic life support,
876-d. advanced life support,
877-e. stretcher van, and
878-
879-ENGR. S. B. NO. 536 Page 6 1
880-2
881-3
882-4
883-5
884-6
885-7
886-8
887-9
888-10
889-11
890-12
891-13
892-14
893-15
894-16
895-17
896-18
897-19
898-20
899-21
900-22
901-23
902-24
903-
904-f. specialty care, which shall be used solely for
905-interhospital transpor t of patients requiring
906-specialized en route medical monitoring and advanced
907-life support which exceed the capabi lities of the
908-equipment and personnel provided by paramedic life
909-support.
910-Requirements for each level of care shall be est ablished by the
911-Commissioner. Licensure at any level of care includes a license to
912-operate at any lower level, with the exception of licensure for
913-specialty care; provided, however, that the highest l evel of care
914-offered by an ambulance service shall be a vailable twenty-four (24)
915-hours each day, three hundred sixty -five (365) days per year.
916-Licensure shall be granted or renewed for such periods and under
917-such terms and conditions as may be promulgated by the Commissioner;
918-19. 21. “Medical control” means local, regional or sta tewide
919-medical direction and quality assurance of health care delivery in
920-an emergency medical service system. O nline medical control is the
921-medical direction given to licensed em ergency medical personnel,
922-certified emergency medical responders and stretc her van personnel
923-by a physician via radio or telephone. Off -line medical control is
924-the establishment and monit oring of all medical components of an
925-emergency medical service sys tem, which is to include stretcher van
926-service including, but not limited to , protocols, standing orders,
927-
928-ENGR. S. B. NO. 536 Page 7 1
929-2
930-3
931-4
932-5
933-6
934-7
935-8
936-9
937-10
938-11
939-12
940-13
941-14
942-15
943-16
944-17
945-18
946-19
947-20
948-21
949-22
950-23
951-24
952-
953-educational programs, and the quality and delivery of onli ne
954-control;
955-20. 22. “Medical director” means a physician, fully licensed
956-without restriction, who acts as a paid or volunteer medical advisor
957-to a licensed ambulance s ervice and who monitors and directs the
958-care so provided. Such physicians shall meet such q ualifications
959-and requirements as may be promulgated by the Commissioner;
960-21. 23. “Region” or “emergency medical service region ” means
961-two or more municipalities, counties, ambulance districts or other
962-political subdivisions exercising joint control over one or more
963-providers of emergency medical services and stretcher van service
964-through common ordinances, authorities, boards or other means;
965-22. 24. “Regional emergency medical services system” means a
966-network of organizations, individuals, facilities and equipme nt
967-which serves a region, subject to a unified set of regional rules
968-and standards which may exceed, but may not be in contravention of ,
969-those required by the state, which is under the medical direction of
970-a single regional medical director, and which part icipates directly
971-in the delivery of the following services:
972-a. medical call-taking and emergency medical services
973-dispatching, emergen cy and routine includ ing priority
974-dispatching of first response agencies, stretcher van
975-and ambulances,
976-
977-ENGR. S. B. NO. 536 Page 8 1
978-2
979-3
980-4
981-5
982-6
983-7
984-8
985-9
986-10
987-11
988-12
989-13
990-14
991-15
992-16
993-17
994-18
995-19
996-20
997-21
998-22
999-23
1000-24
1001-
1002-b. emergency medical responder services provided by
1003-emergency medical response agencies,
1004-c. ambulance services, both emergency, routine and
1005-stretcher van including, but not limited to, the
1006-transport of patients in accordance with transport
1007-protocols approved by the regional medical dir ector,
1008-and
1009-d. directions given by physicians directly via radio or
1010-telephone, or by written protocol, to emergency
1011-medical response agencies, s tretcher van or ambulance
1012-personnel at the scene of an emergency or while en
1013-route to a hospital;
1014-23. 25. “Regional medical director ” means a licensed physician,
1015-who meets or exceeds the qualifications of a medical director as
1016-defined by the Oklahoma Emer gency Response Systems Development Act,
1017-chosen by an emergency medical service region to p rovide external
1018-medical oversight, quality control and related services to that
1019-region;
1020-24. 26. “Registration” means the listing of an ambulance
1021-service in a registr y maintained by the Department; provided,
1022-however, registration shall not be deemed to be a li cense;
1023-25. 27. “Stretcher van” means any ground vehicle which is or
1024-should be approved by the State Commissioner of Health, which is
1025-designed and equipped to tra nsport individuals on a stretcher or
1026-
1027-ENGR. S. B. NO. 536 Page 9 1
1028-2
1029-3
1030-4
1031-5
1032-6
1033-7
1034-8
1035-9
1036-10
1037-11
1038-12
1039-13
1040-14
1041-15
1042-16
1043-17
1044-18
1045-19
1046-20
1047-21
1048-22
1049-23
1050-24
1051-
1052-gurney type apparatus. Vehicles used as stretcher vans shall meet
1053-such standards as may be required by the Commissioner for approval
1054-and shall display evidence of licensure at all times. The
1055-Commissioner shall not est ablish Federal Specification KKK-A-1822
1056-ambulance standards for stretcher vans; provided, a stretc her van
1057-shall meet Ambulance Manufacturers Division (AMD) Standards 004, 012
1058-and 013, and shall pass corresponding safety tests. Stretch er van
1059-services shall only be permitted and approved by the Commissioner in
1060-emergency medical service regions, ambulanc e service districts, or
1061-counties with populations in excess of five hundred thousa nd
1062-(500,000) people. Notwithstanding the provisions of this paragraph,
1063-stretcher van transports may be made to and from any federal or
1064-state veterans facility. Stretcher va ns may carry and provide
1065-oxygen and may carry and utilize any equipment necessary for the
1066-provision of oxygen;
1067-26. 28. “Stretcher van passenger” means any person who is or
1068-will be transported in a reclining position on a stretcher or
1069-gurney, who is medically stable, nonemergent and does not require
1070-any medical monitoring equipment or a ssistance during transport
1071-except oxygen. Passengers m ust be authorized as qualified to be
1072-transported by stretcher van. Passengers shall be authorized
1073-through screening provid ed by a certified medical dispatching
1074-protocol approved by the Department. Al l patients being transported
1075-to or from any medically l icensed facility shal l be screened before
1076-
1077-ENGR. S. B. NO. 536 Page 10 1
1078-2
1079-3
1080-4
1081-5
1082-6
1083-7
1084-8
1085-9
1086-10
1087-11
1088-12
1089-13
1090-14
1091-15
1092-16
1093-17
1094-18
1095-19
1096-20
1097-21
1098-22
1099-23
1100-24
1101-
1102-transport. Any patient transported without screening shall be a
1103-violation of Commissioner rule by the transporting company and
1104-subject to administrative proce dures of the Department; and
1105-27. 29. “Transport protocol” means the written instructions
1106-governing decision-making at the scene of a medical emergency by
1107-ambulance personnel regardi ng the selection of the hospital to which
1108-the patient shall be transported . Transport protocols shall be
1109-developed by the region al medical director f or a regional emergency
1110-medical services system or by the Department if no regional
1111-emergency medical serv ices system has been established. Such
1112-transport protocols shall adhere t o, at a minimum, the following
1113-guidelines:
1114-a. nonemergency, routine transpor t shall be to the
1115-facility of the patient ’s choice,
1116-b. urgent or emergency transport not involving life -
1117-threatening medical illness or injury shall b e to the
1118-nearest facility, or, subject to transport
1119-availability and system area cover age, to the facility
1120-of the patient’s choice,
1121-c. life-threatening medical illness or injury shall
1122-require transport to the near est health care facility
1123-appropriate to the needs of the patient as establ ished
1124-by regional or state guidelines, and
1125-
1126-ENGR. S. B. NO. 536 Page 11 1
1127-2
1128-3
1129-4
1130-5
1131-6
1132-7
1133-8
1134-9
1135-10
1136-11
1137-12
1138-13
1139-14
1140-15
1141-16
1142-17
1143-18
1144-19
1145-20
1146-21
1147-22
1148-23
1149-24
1150-
1151-d. emergency ambulance transporta tion is not required
1152-when a patient’s apparent clinical condition, as
1153-defined by applicable medical treatm ent protocols,
1154-does not warrant emergency a mbulance transport, and
1155-nontransport of patients is authorized pursuant to
1156-applicable medical treatment pro tocols established by
1157-the regional medical director.
1158-SECTION 5. REPEALER 63 O.S. 2021, Section 1-2503, as
1159-amended by Section 1, Chapter 246, O.S. L. 2016, is hereby repealed.
1160-SECTION 6. This act shall become effectiv e November 1, 2023.
1161-Passed the Senate the 9th day of March, 2023.
1162-
1163-
1164-
1165- Presiding Officer of the Senate
1166-
1167-
1168-Passed the House of Representatives the ____ day of __________,
1169-2023.
1170-
1171-
1172-
1173- Presiding Officer of the House
1174- of Representatives
1175-
1176-
569+COMMITTEE REPORT BY: COMMITTEE ON COUNTY AND MUNICIPAL GOVERNMENT,
570+dated 04/11/2023 - DO PASS, As Amended.