Florida Senate - 2022                             CS for SB 1144
       By the Committee on Health Policy; and Senator Brodeur
       588-02670-22                                          20221144c1
    1                        A bill to be entitled                      
    2         An act relating to advanced life support nontransport
    3         services and medical countermeasures; amending s.
    4         401.25, F.S.; exempting certain governmental entities
    5         from the requirement to obtain a certificate of public
    6         convenience and necessity for a license to provide
    7         advanced life support nontransport services; providing
    8         requirements for, and limitations on, the provision of
    9         advanced life support nontransport services by such
   10         entities; defining the term “countywide common medical
   11         protocol”; providing applicability; prohibiting
   12         counties from limiting, prohibiting, or preventing
   13         such entities from providing advanced life support
   14         nontransport services; providing construction;
   15         amending s. 401.26, F.S.; conforming a provision to
   16         changes made by the act; amending s. 401.265, F.S.;
   17         providing that a medical director is liable for any
   18         act or omission of a paramedic under his or her
   19         supervision who administers medical countermeasures in
   20         a nonemergency environment; providing for a State
   21         Emergency Medical Services Medical Director appointed
   22         by the State Surgeon General; requiring the medical
   23         director to meet certain minimum qualifications and
   24         perform certain duties; amending s. 401.272, F.S.;
   25         defining the terms “health promotion and wellness
   26         activities” and “medical countermeasures”; authorizing
   27         paramedics to administer medical countermeasures in a
   28         nonemergency environment under the direction of a
   29         medical director; providing that a paramedic’s medical
   30         director may have a certain required written agreement
   31         with the Department of Health, rather than only with a
   32         county health department; requiring medical directors
   33         to verify and document that paramedics under their
   34         direction have received sufficient training and
   35         experience to administer medical countermeasures;
   36         authorizing independent special fire control districts
   37         to allow their paramedics and emergency medical
   38         technicians to perform certain activities and
   39         administer certain services in accordance with
   40         specified provisions; providing an effective date.
   42  Be It Enacted by the Legislature of the State of Florida:
   44         Section 1. Subsection (8) is added to section 401.25,
   45  Florida Statutes, to read:
   46         401.25 Licensure as a basic life support or an advanced
   47  life support service.—
   48         (8)(a)Notwithstanding paragraph (2)(d) or any general law,
   49  special act, or local ordinance to the contrary, and except as
   50  provided in paragraph (b), the department shall issue a
   51  governmental entity a license to provide advanced life support
   52  nontransport services without requiring it to obtain a
   53  certificate of public convenience and necessity if the
   54  governmental entity maintains a fire rescue infrastructure that
   55  dispatches first responders as defined in s. 112.1815(1) and
   56  meets all other licensure requirements of this section. A
   57  governmental entity issued a license under this subsection is
   58  subject to all of the following requirements and limitations:
   59         1.The governmental entity must require its medical
   60  director to issue standing orders or protocols to implement the
   61  medical standards of any countywide common medical protocol
   62  applicable to the entity, if such protocol is instituted. An
   63  entity must submit an affidavit with its licensure application
   64  certifying that its medical director has issued such standing
   65  orders or protocols. As used in this subparagraph, the term
   66  “countywide common medical protocol” means medical standards
   67  issued by a county’s medical director or a council created by
   68  county ordinance which specify protocols for the provision of
   69  basic and advanced life support services in that county. Such
   70  standards must be based on whether the procedures are being
   71  performed by an emergency medical technician or a paramedic and
   72  not based on the employer of, or type of response vehicle used
   73  by, such emergency medical personnel.
   74         2.The governmental entity is eligible only for advanced
   75  life support nontransport vehicle permits issued under s.
   76  401.26.
   77         3.The governmental entity may provide only advanced life
   78  support nontransport services and is authorized to provide such
   79  services within its jurisdictional boundaries and areas that it
   80  serves in accordance with a closest unit response agreement or
   81  mutual or automatic aid agreement.
   82         (b)The exemption under this subsection does not apply to a
   83  governmental entity that:
   84         1.Is located within a county in which there is a
   85  countywide emergency medical services authority created by
   86  special act;
   87         2.Is located within a county that has more than 35
   88  municipalities; or
   89         3.Contracts with a private entity licensed by the
   90  department to provide emergency medical services.
   91         (c)A county may not limit, prohibit, or prevent a
   92  governmental entity that has been issued a license under this
   93  subsection from providing advanced life support nontransport
   94  services, including, but not limited to, requiring the
   95  governmental entity to obtain a license, certificate, or vehicle
   96  permit or to pay a fee to provide such services in that county.
   97         (d)This subsection may not be construed to exempt an
   98  applicant from any other requirement for licensure under state
   99  law or to exempt a licensee from otherwise complying with this
  100  part or department rules.
  101         Section 2. Subsection (1) of section 401.26, Florida
  102  Statutes, is amended to read:
  103         401.26 Vehicle permits for basic life support and advanced
  104  life support services.—
  105         (1) Every licensee shall possess a valid permit for each
  106  transport vehicle, advanced life support nontransport vehicle,
  107  and aircraft in use. Applications for such permits must shall be
  108  made upon forms prescribed by the department. The licensee shall
  109  provide documentation that each vehicle for which a permit is
  110  sought meets the appropriate requirements for a basic life
  111  support or advanced life support service vehicle, whichever is
  112  applicable, as specified by rule of the department. A permit is
  113  not required for an advanced life support nontransport vehicle
  114  that is intended to be used for scene supervision, incident
  115  command, or the augmentation of supplies. A governmental entity
  116  issued a license under s. 401.25(8) is eligible only for an
  117  advanced life support nontransport vehicle permit.
  118         Section 3. Present subsection (5) of section 401.265,
  119  Florida Statutes, is redesignated as subsection (6), a new
  120  subsection (5) is added to that section, and subsection (4) of
  121  that section is amended, to read:
  122         401.265 Medical directors.—
  123         (4) Each medical director who uses a paramedic or emergency
  124  medical technician to perform blood pressure screenings or
  125  screening, health promotion, and wellness activities, or to
  126  administer immunizations or medical countermeasures in a
  127  nonemergency environment immunization on any patient under a
  128  protocol as specified in s. 401.272, which is not in the
  129  provision of emergency care, is liable for any act or omission
  130  of any paramedic or emergency medical technician acting under
  131  his or her supervision and control when performing such
  132  activities and services.
  133         (5)A State Emergency Medical Services (EMS) Medical
  134  Director shall be appointed by and report to the State Surgeon
  135  General. The State EMS Medical Director must be a physician
  136  licensed under chapter 458 or chapter 459 who has specialized
  137  training and experience in the provision of emergency medical
  138  services and who has recognized skills in leadership and the
  139  promotion of emergency medical services programs. The State EMS
  140  Medical Director shall perform such duties as directed by the
  141  State Surgeon General and serve on the Emergency Medical
  142  Services Advisory Council created under s. 401.245.
  143         Section 4. Section 401.272, Florida Statutes, is amended to
  144  read:
  145         401.272 Emergency medical services community health care.—
  146         (1) As used in this section, the term:
  147         (a)“Health promotion and wellness activities” means the
  148  provision of public health programs relating to the prevention
  149  or reduction of illness or injury.
  150         (b)“Medical countermeasures” means lifesaving medication
  151  or medical supplies regulated by the United States Food and Drug
  152  Administration which can be used to diagnose, prevent, protect
  153  from, or treat conditions associated with chemical, biological,
  154  radiological, or nuclear threats, emerging infectious diseases,
  155  or natural disasters.
  156         (2) The purpose of this section is to encourage more
  157  effective utilization of the skills of emergency medical
  158  technicians and paramedics by enabling them to perform, in
  159  partnership with local county health departments, specific
  160  additional health care tasks that are consistent with the public
  161  health and welfare.
  162         (3)(2) Notwithstanding any other provision of law to the
  163  contrary:
  164         (a) Paramedics or emergency medical technicians may perform
  165  health promotion and wellness activities and blood pressure
  166  screenings in a nonemergency environment, within the scope of
  167  their training, and under the direction of a medical director.
  168  As used in this paragraph, the term “health promotion and
  169  wellness” means the provision of public health programs
  170  pertaining to the prevention of illness and injury.
  171         (b) Paramedics may administer immunizations or medical
  172  countermeasures in a nonemergency environment, within the scope
  173  of their training, and under the direction of a medical
  174  director. There must be a written agreement between the
  175  paramedic’s medical director and the department or the county
  176  health department located in each county in which the paramedic
  177  administers immunizations or medical countermeasures. This
  178  agreement must establish the protocols, policies, and procedures
  179  under which the paramedic must operate.
  180         (4)(3) Each medical director under whose direction a
  181  paramedic administers immunizations or medical countermeasures
  182  must verify and document that the paramedic has received
  183  sufficient training and experience to administer immunizations
  184  or medical countermeasures, as applicable. The verification must
  185  be documented on forms developed by the department, and the
  186  completed forms must be maintained at the service location of
  187  the licensee and made available to the department upon request.
  188         (5)An independent special fire control district as defined
  189  in s. 191.003 may allow its paramedics and emergency medical
  190  technicians to perform blood pressure screenings or health
  191  promotion and wellness activities or administer immunizations or
  192  medical countermeasures in accordance with this section.
  193         (6)(4) The department may adopt and enforce all rules
  194  necessary to enforce the provisions relating to a paramedic’s
  195  administration of immunizations and medical countermeasures and
  196  the performance of health promotion and wellness activities and
  197  blood pressure screenings by a paramedic or emergency medical
  198  technician in a nonemergency environment.
  199         Section 5. This act shall take effect upon becoming a law.