Senate Bill sb2060

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    Florida Senate - 2002                                  SB 2060

    By Senator Peaden





    1-1154-02

  1                      A bill to be entitled

  2         An act relating to emergency medical dispatch;

  3         amending s. 401.111, F.S.; providing for grants

  4         to local agencies to support emergency medical

  5         dispatch; amending s. 401.23, F.S.; defining

  6         terms relating to emergency medical dispatcher

  7         operations; creating s. 401.434, F.S., the

  8         "Emergency Medical Dispatch Act"; establishing

  9         requirements for training; requiring the

10         Department of Health to monitor compliance with

11         training requirements; establishing

12         requirements for certification; establishing

13         requirements for emergency medical dispatch

14         agencies; requiring medical oversight for such

15         agencies; providing for liability protections

16         for emergency medical dispatchers and agencies;

17         providing an effective date.

18

19         WHEREAS, emergency medical dispatch programs promote

20  appropriate standards that result in more effective dispatch

21  of emergency services and the saving of lives, and

22         WHEREAS, the 911 dispatcher is the first responder to a

23  medical emergency when someone calls 911, and those

24  dispatchers are being recognized nationally as the true first

25  responders to the scene of the emergency, and

26         WHEREAS, patients' access to emergency medical services

27  is frequently delayed due to myriad reasons, such as traffic,

28  waiting for the elevator, and equipment retrieval, and

29         WHEREAS, a certified emergency medical dispatcher has

30  an immediate response time to offer basic instructions to the

31  caller regardless of the emergency-medical-services response

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  1  time, and such a dispatcher is a pivotal component for the

  2  delivery and receipt of information to

  3  emergency-medical-service units, and

  4         WHEREAS, emergency medical dispatch is a key component

  5  of a quality emergency-medical-services system, and

  6         WHEREAS, in many parts of the state, emergency medical

  7  dispatch is the weakest link in the emergency-medical-services

  8  system, and

  9         WHEREAS, lifesaving pre-arrival instructions by 911

10  dispatchers are not always available throughout the state, and

11         WHEREAS, in many 911 centers, dispatchers are

12  performing critical dispatch functions with little training in

13  emergency medical dispatch, and

14         WHEREAS, there is a lack of consistency in the delivery

15  of dispatch life support and medically approved lifesaving

16  pre-arrival instructions by 911 dispatch offices across the

17  state, and

18         WHEREAS, organizations such as the American Heart

19  Association, American College of Emergency Physicians,

20  National Association of Emergency Medical Services Physicians,

21  the National Institutes of Health, the National Highway

22  Traffic Safety Administration, and the American Society of

23  Testing Materials have endorsed the development and adoption

24  of standards for emergency medical dispatch, and

25         WHEREAS, a properly trained emergency medical

26  dispatcher significantly improves the quality of care provided

27  by an emergency-medical-services system because the dispatcher

28  is able to identify the level of need of the caller, including

29  resource allocations and response modes, thus enabling more

30  effective and efficient dispatch, to identify situations that

31  might require pre-arrival instructions, to gather information

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    Florida Senate - 2002                                  SB 2060
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  1  to be relayed to the responding crews to help them better

  2  manage and respond to the emergency situation upon arrival,

  3  and to obtain information regarding emergency-scene safety for

  4  the patient, bystanders, and responding personnel, and

  5         WHEREAS, as a result of inconsistencies in 911 centers,

  6  many states are now adopting a standard

  7  emergency-medical-dispatch program, and

  8         WHEREAS, there is an expectation by the public that

  9  when they call for emergency medical help, a properly trained

10  dispatcher will handle their call regardless of where they are

11  located in Florida, and

12         WHEREAS, the most successful emergency-medical-services

13  systems are those that have strong field-response times

14  coupled with well-trained 911 dispatchers, and

15         WHEREAS, emergency medical dispatch has become a clear

16  standard of care for dispatching emergency medical services,

17  and

18         WHEREAS, it is the intent of the Legislature that all

19  emergency-medical-services dispatch agencies in this state

20  implement this standard of care, NOW, THEREFORE,

21

22  Be It Enacted by the Legislature of the State of Florida:

23

24         Section 1.  Section 401.111, Florida Statutes, is

25  amended to read:

26         401.111  Emergency medical services grant program;

27  authority.--The department is hereby authorized to make grants

28  to local agencies, and emergency medical services

29  organizations, and emergency medical dispatch agencies in

30  accordance with any agreement entered into pursuant to this

31  part. These grants shall be designed to assist said agencies

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  1  and organizations in providing emergency medical services,

  2  including emergency medical dispatch. The cost of

  3  administering this program shall be paid by the department

  4  from funds appropriated to it.

  5         Section 2.  Section 401.23, Florida Statutes, is

  6  amended to read:

  7         401.23  Definitions.--As used in this part, the term:

  8         (1)  "Advanced life support" means treatment of

  9  life-threatening medical emergencies through the use of

10  techniques such as endotracheal intubation, the administration

11  of drugs or intravenous fluids, telemetry, cardiac monitoring,

12  and cardiac defibrillation by a qualified person, pursuant to

13  rules of the department.

14         (2)  "Advanced life support service" means any

15  emergency medical transport or nontransport service which uses

16  advanced life support techniques.

17         (3)  "Air ambulance" means any fixed-wing or

18  rotary-wing aircraft used for, or intended to be used for, air

19  transportation of sick or injured persons requiring or likely

20  to require medical attention during transport.

21         (4)  "Air ambulance service" means any publicly or

22  privately owned service, licensed in accordance with the

23  provisions of this part, which operates air ambulances to

24  transport persons requiring or likely to require medical

25  attention during transport.

26         (5)  "Ambulance" or "emergency medical services

27  vehicle" means any privately or publicly owned land or water

28  vehicle that is designed, constructed, reconstructed,

29  maintained, equipped, or operated for, and is used for, or

30  intended to be used for, land or water transportation of sick

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    Florida Senate - 2002                                  SB 2060
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  1  or injured persons requiring or likely to require medical

  2  attention during transport.

  3         (6)  "Ambulance driver" means any person who meets the

  4  requirements of s. 401.281.

  5         (7)  "Basic life support" means treatment of medical

  6  emergencies by a qualified person through the use of

  7  techniques such as patient assessment, cardiopulmonary

  8  resuscitation (CPR), splinting, obstetrical assistance,

  9  bandaging, administration of oxygen, application of medical

10  antishock trousers, administration of a subcutaneous injection

11  using a premeasured autoinjector of epinephrine to a person

12  suffering an anaphylactic reaction, and other techniques

13  described in the Emergency Medical Technician Basic Training

14  Course Curriculum of the United States Department of

15  Transportation.  The term "basic life support" also includes

16  other techniques which have been approved and are performed

17  under conditions specified by rules of the department.

18         (8)  "Basic life support service" means any emergency

19  medical service which uses only basic life support techniques.

20         (9)  "Certification" means any authorization issued

21  pursuant to this part to a person to act as an emergency

22  medical technician or a paramedic.

23         (10)  "Department" means the Department of Health.

24         (11)  "Emergency medical dispatch agency" means any

25  private or public safety entity that has a responsibility in

26  the processing of calls for emergency assistance or the

27  dispatching of emergency medical services by emergency medical

28  dispatchers. The agency's emergency medical dispatch program

29  must consist of public safety telecommunicators, post-dispatch

30  instructions, and a quality-assurance program that meets or

31  exceeds standards set by the medical director.

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    Florida Senate - 2002                                  SB 2060
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  1         (12)  "Emergency medical dispatcher" means any public

  2  safety telecommunicator who is trained and certified in the

  3  efficient management of emergency medical communications under

  4  this part.

  5         (13)  "Emergency medical dispatch training entity"

  6  means a program recognized or approved by the department to

  7  provide emergency medical dispatch training under this part.

  8         (14)(11)  "Emergency medical technician" means a person

  9  who is certified by the department to perform basic life

10  support pursuant to this part.

11         (15)(12)  "Interfacility transfer" means the

12  transportation by ambulance of a patient between two

13  facilities licensed under chapter 393, chapter 395, or chapter

14  400, pursuant to this part.

15         (16)(13)  "Licensee" means any basic life support

16  service, advanced life support service, or air ambulance

17  service licensed pursuant to this part.

18         (17)(14)  "Medical direction" means direct supervision

19  by a physician through two-way voice communication or, when

20  such voice communication is unavailable, through established

21  standing orders, pursuant to rules of the department.

22         (18)(15)  "Medical director" means a physician who is

23  employed or contracted by a licensee and who provides medical

24  supervision, including appropriate quality assurance but not

25  including administrative and managerial functions, for daily

26  operations and training pursuant to this part.

27         (19)(16)  "Mutual aid agreement" means a written

28  agreement between two or more entities whereby the signing

29  parties agree to lend aid to one another under conditions

30  specified in the agreement and as sanctioned by the governing

31  body of each affected county.

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    Florida Senate - 2002                                  SB 2060
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  1         (20)(17)  "Paramedic" means a person who is certified

  2  by the department to perform basic and advanced life support

  3  pursuant to this part.

  4         (21)(18)  "Permit" means any authorization issued

  5  pursuant to this part for a vehicle to be operated as a basic

  6  life support or advanced life support transport vehicle or an

  7  advanced life support nontransport vehicle providing basic or

  8  advanced life support.

  9         (22)(19)  "Physician" means a practitioner who is

10  licensed under the provisions of chapter 458 or chapter 459.

11  For the purpose of providing "medical direction" as defined in

12  subsection (17) (14) for the treatment of patients immediately

13  prior to or during transportation to a United States

14  Department of Veterans Affairs medical facility, "physician"

15  also means a practitioner employed by the United States

16  Department of Veterans Affairs.

17         (23)  "Post-dispatch instructions," also known as

18  "pre-arrival instructions" or "dispatcher life support," means

19  instructions that have been approved by the medical director

20  of the local emergency medical services agency to be given by

21  an emergency medical dispatcher to a caller who is reporting a

22  life-threatening medical emergency, before the arrival at the

23  emergency scene of the emergency medical services or other

24  assistance dispatched in response to the call.

25         (24)  "Public-safety telecommunicator" means an

26  individual who has been trained to communicate by electronic

27  means with persons who are seeking emergency assistance and

28  with agencies and individuals who provide such assistance.

29         (25)  "Quality-assurance program" means a prospective

30  and retrospective method used by the administrator and the

31  medical director of a public-safety agency to review and

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  1  evaluate certified emergency-medical-dispatcher

  2  telecommunicators' use of post-dispatch instructions and

  3  medical-emergency-handling training, to ensure that they are

  4  followed and are in compliance with standards set by the

  5  medical director.

  6         (26)(20)  "Registered nurse" means a practitioner who

  7  is licensed to practice professional nursing pursuant to part

  8  I of chapter 464.

  9         (27)(21)  "Secretary" means the Secretary of Health.

10         (28)(22)  "Service location" means any permanent

11  location in or from which a licensee solicits, accepts, or

12  conducts business under this part.

13         Section 3.  Subsection (4) of section 401.265, Florida

14  Statutes, is amended to read:

15         401.265  Medical directors.--

16         (4)  Each emergency medical dispatch agency must employ

17  or contract for a medical director to advise, consult, train,

18  counsel, and oversee emergency medical dispatch, including

19  appropriate quality assurance but not including administrative

20  managerial functions. Each medical director who uses a

21  paramedic or emergency medical technician to perform blood

22  pressure screening, health promotion, and wellness activities,

23  or to administer immunization on any patient under a protocol

24  as specified in s. 401.272, which is not in the provision of

25  emergency care, is liable for any act or omission of any

26  paramedic or emergency medical technician acting under his or

27  her supervision and control when performing such services.

28         Section 4.  Section 401.434, Florida Statutes, is

29  created to read:

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  1         401.434  Emergency Medical Dispatch Act; emergency

  2  medical dispatchers, emergency medical dispatch agencies, and

  3  training entities.--

  4         (1)  This section may be cited as the "Emergency

  5  Medical Dispatch Act."

  6         (2)  Each agency or entity that provides emergency

  7  medical dispatch services in this state must implement an

  8  emergency medical dispatch program by September 11, 2004.

  9         (3)  In order to comply with this section, the

10  emergency medical dispatch program must be approved by the

11  department.

12         (4)  The department must implement a procedure that

13  provides for a timely review of all emergency medical dispatch

14  programs, including currently available programs and those

15  customized by local jurisdictions.

16         (5)  The department's approval procedure must be an

17  informal one intended to ensure that all programs meet

18  standards for staffing, training, and quality-assurance which

19  are at least equivalent to those provided for in programs

20  currently available from APCO, Powerphone, or Medical Priority

21  Consultants.

22         (6)  Currently available emergency dispatch programs

23  maintained by APCO, Powerphone, or Medical Priority

24  Consultants must be found by the department to meet its

25  standards for approval.

26         (7)  The department shall monitor all emergency medical

27  services dispatch points to ensure that they have implemented

28  departmentally approved emergency medical dispatch programs.

29         (8)  Any individual who works as an emergency medical

30  dispatcher before September 11, 2002, must attain

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  1  certification as an emergency medical dispatcher by September

  2  11, 2004.

  3         (9)  Any private or public emergency medical dispatch

  4  agency and any emergency medical dispatcher providing

  5  post-dispatch instructions, as approved by their medical

  6  director, within the scope of their employment and meeting the

  7  requirements of this section and applicable rules are not

  8  subject to criminal prosecution or civil liability; are not

  9  considered to have engaged in negligent or unprofessional

10  conduct that might otherwise be incurred or imposed by reason

11  of the employee's or agency's actions; and are considered to

12  be providing emergency medical care or treatment for the

13  purpose of s. 768.12(2)(b). Any emergency medical dispatcher,

14  as a result of providing medically approved post-dispatch

15  instructions, may be found liable in a civil action only for

16  acts or omissions performed in a grossly negligent manner. A

17  public or private agency that employs such an emergency

18  medical dispatcher in an approved emergency medical dispatch

19  program is not liable for civil damages if the emergency

20  medical dispatcher is not liable. The medical director

21  providing oversight, including appropriate quality-assurance

22  to the emergency medical dispatch agency, is not liable for

23  civil damages if the emergency medical dispatch agency is not

24  liable.

25         Section 5.  This act shall take effect September 11,

26  2002.

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  2                          SENATE SUMMARY

  3    Establishes a statewide minimum standard for the practice
      of emergency medical dispatch. Provides legislative
  4    intent. Requires individuals who are providing such
      service to be certified and establishes the criteria for
  5    training programs. Establishes a standard for dispatcher
      training and provides for dispatcher certification of
  6    those individuals that successfully complete the course.
      Authorizes the Department of Health to provide minimum
  7    standards governing facilities, instructors'
      qualifications, instructor roles and responsibilities,
  8    and course content. Provides for the department to review
      and approve training programs. Provides for the
  9    department to award grants to emergency medical dispatch
      agencies.
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