Florida Senate - 2022                        COMMITTEE AMENDMENT
       Bill No. SB 1144
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/02/2022           .                                

       The Committee on Health Policy (Brodeur) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (8) is added to section 401.25,
    6  Florida Statutes, to read:
    7         401.25 Licensure as a basic life support or an advanced
    8  life support service.—
    9         (8)(a)Notwithstanding paragraph (2)(d) or any general law,
   10  special act, or local ordinance to the contrary, and except as
   11  provided in paragraph (b), the department shall issue a
   12  governmental entity a license to provide advanced life support
   13  nontransport services without requiring it to obtain a
   14  certificate of public convenience and necessity if the
   15  governmental entity maintains a fire rescue infrastructure that
   16  dispatches first responders as defined in s. 112.1815(1) and
   17  meets all other licensure requirements of this section. A
   18  governmental entity issued a license under this subsection is
   19  subject to all of the following requirements and limitations:
   20         1.The governmental entity must require its medical
   21  director to issue standing orders or protocols to implement the
   22  medical standards of any countywide common medical protocol
   23  applicable to the entity, if such protocol is instituted. An
   24  entity must submit an affidavit with its licensure application
   25  certifying that its medical director has issued such standing
   26  orders or protocols. As used in this subparagraph, the term
   27  “countywide common medical protocol” means medical standards
   28  issued by a county’s medical director or a council created by
   29  county ordinance which specify protocols for the provision of
   30  basic and advanced life support services in that county. Such
   31  standards must be based on whether the procedures are being
   32  performed by an emergency medical technician or a paramedic and
   33  not based on the employer of, or type of response vehicle used
   34  by, such emergency medical personnel.
   35         2.The governmental entity is eligible only for advanced
   36  life support nontransport vehicle permits issued under s.
   37  401.26.
   38         3.The governmental entity may provide only advanced life
   39  support nontransport services and is authorized to provide such
   40  services within its jurisdictional boundaries and areas that it
   41  serves in accordance with a closest unit response agreement or
   42  mutual or automatic aid agreement.
   43         (b)The exemption under this subsection does not apply to a
   44  governmental entity that:
   45         1.Is located within a county in which there is a
   46  countywide emergency medical services authority created by
   47  special act;
   48         2.Is located within a county that has more than 35
   49  municipalities; or
   50         3.Contracts with a private entity licensed by the
   51  department to provide emergency medical services.
   52         (c)A county may not limit, prohibit, or prevent a
   53  governmental entity that has been issued a license under this
   54  subsection from providing advanced life support nontransport
   55  services, including, but not limited to, requiring the
   56  governmental entity to obtain a license, certificate, or vehicle
   57  permit or to pay a fee to provide such services in that county.
   58         (d)This subsection may not be construed to exempt an
   59  applicant from any other requirement for licensure under state
   60  law or to exempt a licensee from otherwise complying with this
   61  part or department rules.
   62         Section 2. Subsection (1) of section 401.26, Florida
   63  Statutes, is amended to read:
   64         401.26 Vehicle permits for basic life support and advanced
   65  life support services.—
   66         (1) Every licensee shall possess a valid permit for each
   67  transport vehicle, advanced life support nontransport vehicle,
   68  and aircraft in use. Applications for such permits must shall be
   69  made upon forms prescribed by the department. The licensee shall
   70  provide documentation that each vehicle for which a permit is
   71  sought meets the appropriate requirements for a basic life
   72  support or advanced life support service vehicle, whichever is
   73  applicable, as specified by rule of the department. A permit is
   74  not required for an advanced life support nontransport vehicle
   75  that is intended to be used for scene supervision, incident
   76  command, or the augmentation of supplies. A governmental entity
   77  issued a license under s. 401.25(8) is eligible only for an
   78  advanced life support nontransport vehicle permit.
   79         Section 3. Present subsection (5) of section 401.265,
   80  Florida Statutes, is redesignated as subsection (6), a new
   81  subsection (5) is added to that section, and subsection (4) of
   82  that section is amended, to read:
   83         401.265 Medical directors.—
   84         (4) Each medical director who uses a paramedic or emergency
   85  medical technician to perform blood pressure screenings or
   86  screening, health promotion, and wellness activities, or to
   87  administer immunizations or medical countermeasures in a
   88  nonemergency environment immunization on any patient under a
   89  protocol as specified in s. 401.272, which is not in the
   90  provision of emergency care, is liable for any act or omission
   91  of any paramedic or emergency medical technician acting under
   92  his or her supervision and control when performing such
   93  activities and services.
   94         (5)A State Emergency Medical Services (EMS) Medical
   95  Director shall be appointed by and report to the State Surgeon
   96  General. The State EMS Medical Director must be a physician
   97  licensed under chapter 458 or chapter 459 who has specialized
   98  training and experience in the provision of emergency medical
   99  services and who has recognized skills in leadership and the
  100  promotion of emergency medical services programs. The State EMS
  101  Medical Director shall perform such duties as directed by the
  102  State Surgeon General and serve on the Emergency Medical
  103  Services Advisory Council created under s. 401.245.
  104         Section 4. Section 401.272, Florida Statutes, is amended to
  105  read:
  106         401.272 Emergency medical services community health care.—
  107         (1) As used in this section, the term:
  108         (a)“Health promotion and wellness activities” means the
  109  provision of public health programs relating to the prevention
  110  or reduction of illness or injury.
  111         (b)“Medical countermeasures” means lifesaving medication
  112  or medical supplies regulated by the United States Food and Drug
  113  Administration which can be used to diagnose, prevent, protect
  114  from, or treat conditions associated with chemical, biological,
  115  radiological, or nuclear threats, emerging infectious diseases,
  116  or natural disasters.
  117         (2) The purpose of this section is to encourage more
  118  effective utilization of the skills of emergency medical
  119  technicians and paramedics by enabling them to perform, in
  120  partnership with local county health departments, specific
  121  additional health care tasks that are consistent with the public
  122  health and welfare.
  123         (3)(2) Notwithstanding any other provision of law to the
  124  contrary:
  125         (a) Paramedics or emergency medical technicians may perform
  126  health promotion and wellness activities and blood pressure
  127  screenings in a nonemergency environment, within the scope of
  128  their training, and under the direction of a medical director.
  129  As used in this paragraph, the term “health promotion and
  130  wellness” means the provision of public health programs
  131  pertaining to the prevention of illness and injury.
  132         (b) Paramedics may administer immunizations or medical
  133  countermeasures in a nonemergency environment, within the scope
  134  of their training, and under the direction of a medical
  135  director. There must be a written agreement between the
  136  paramedic’s medical director and the department or the county
  137  health department located in each county in which the paramedic
  138  administers immunizations or medical countermeasures. This
  139  agreement must establish the protocols, policies, and procedures
  140  under which the paramedic must operate.
  141         (4)(3) Each medical director under whose direction a
  142  paramedic administers immunizations or medical countermeasures
  143  must verify and document that the paramedic has received
  144  sufficient training and experience to administer immunizations
  145  or medical countermeasures, as applicable. The verification must
  146  be documented on forms developed by the department, and the
  147  completed forms must be maintained at the service location of
  148  the licensee and made available to the department upon request.
  149         (5)An independent special fire control district as defined
  150  in s. 191.003 may allow its paramedics and emergency medical
  151  technicians to perform blood pressure screenings or health
  152  promotion and wellness activities or administer immunizations or
  153  medical countermeasures in accordance with this section.
  154         (6)(4) The department may adopt and enforce all rules
  155  necessary to enforce the provisions relating to a paramedic’s
  156  administration of immunizations and medical countermeasures and
  157  the performance of health promotion and wellness activities and
  158  blood pressure screenings by a paramedic or emergency medical
  159  technician in a nonemergency environment.
  160         Section 5. This act shall take effect upon becoming a law.
  162  ================= T I T L E  A M E N D M E N T ================
  163  And the title is amended as follows:
  164         Delete everything before the enacting clause
  165  and insert:
  166                        A bill to be entitled                      
  167         An act relating to advanced life support nontransport
  168         services and medical countermeasures; amending s.
  169         401.25, F.S.; exempting certain governmental entities
  170         from the requirement to obtain a certificate of public
  171         convenience and necessity for a license to provide
  172         advanced life support nontransport services; providing
  173         requirements for, and limitations on, the provision of
  174         advanced life support nontransport services by such
  175         entities; defining the term “countywide common medical
  176         protocol”; providing applicability; prohibiting
  177         counties from limiting, prohibiting, or preventing
  178         such entities from providing advanced life support
  179         nontransport services; providing construction;
  180         amending s. 401.26, F.S.; conforming a provision to
  181         changes made by the act; amending s. 401.265, F.S.;
  182         providing that a medical director is liable for any
  183         act or omission of a paramedic under his or her
  184         supervision who administers medical countermeasures in
  185         a nonemergency environment; providing for a State
  186         Emergency Medical Services Medical Director appointed
  187         by the State Surgeon General; requiring the medical
  188         director to meet certain minimum qualifications and
  189         perform certain duties; amending s. 401.272, F.S.;
  190         defining the terms “health promotion and wellness
  191         activities” and “medical countermeasures”; authorizing
  192         paramedics to administer medical countermeasures in a
  193         nonemergency environment under the direction of a
  194         medical director; providing that a paramedic’s medical
  195         director may have a certain required written agreement
  196         with the Department of Health, rather than only with a
  197         county health department; requiring medical directors
  198         to verify and document that paramedics under their
  199         direction have received sufficient training and
  200         experience to administer medical countermeasures;
  201         authorizing independent special fire control districts
  202         to allow their paramedics and emergency medical
  203         technicians to perform certain activities and
  204         administer certain services in accordance with
  205         specified provisions; providing an effective date.