HB279: relative to the licensure of emergency medical dispatchers.

HB 279 - AS INTRODUCED

2003 SESSION

03-0337

08/10

HOUSE BILL 279

AN ACT relative to the licensure of emergency medical dispatchers.

SPONSORS: Rep. S. L'Heureux, Merr 37; Rep. Palangas, Hills 52; Sen. Clegg, Dist 14

COMMITTEE: Executive Departments and Administration

ANALYSIS

This bill establishes emergency medical dispatch licensing and regulation.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03-0337

08/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Three

AN ACT relative to the licensure of emergency medical dispatchers.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Subdivision; Emergency Medical Dispatch. Amend RSA 153-A by inserting after section 33 the following new subdivision:

Emergency Medical Dispatch

153-A:34 Definitions. In this subdivision:

I. "Board" means the coordinating board established in RSA 153-A:3.

II. "Continuing dispatcher education" means medical dispatch relevant educational experiences in accordance with standards set forth in national standards established for the practice for emergency medical dispatching, as adopted in rules by the board.

III. "Dispatch life support" means the knowledge, procedures, and skills used by trained EMDs in providing care and advice through pre-arrival instructions and post-dispatch instructions to callers requesting emergency medical assistance.

IV. "Emergency medical dispatch medical direction" means the management and accountability for the medical care aspects of an emergency medical dispatch agency including: responsibility for the medical decision and care advice rendered by the emergency medical dispatcher and emergency medical dispatch agency; approval and medical control of the operational emergency medical dispatch priority reference system; evaluation of the medical care and pre-arrival instructions rendered by the emergency medical dispatch personnel; direct participation in the emergency medical dispatch system evaluation and continuous quality improvement process; and, the medical oversight of the training of the emergency medical dispatch personnel.

V. "Emergency medical dispatch medical director" means a licensed physician approved by the board who provides emergency medical dispatch medical direction to the emergency medical dispatch agency and works with the local emergency medical system medical director if not the same person.

VI. "Emergency medical dispatcher" or "EMD" means a person trained to provide emergency medical dispatch services and who is licensed in accordance with this subdivision.

VII. "Emergency medical dispatching" means the reception, evaluation, processing, provision of dispatch life support, management of requests for emergency medical assistance, and participation in ongoing evaluation and improvement of the emergency medical dispatch process. This process includes identifying the nature of the request, prioritizing the severity of the request, dispatching the necessary resources, providing medical aid and safety instructions to the callers and coordinating the responding resources as needed but does not include call routing per se.

VIII. "Emergency medical dispatch agency" or "agency" means any company, organization, or government agency that provides emergency medical dispatch services for emergency medical assistance, and is licensed in accordance with this subdivision.

IX. "Emergency medical dispatch priority reference system" means a board approved and emergency medical dispatch medical director approved system that includes the protocol used by an emergency medical dispatcher in an emergency medical dispatch agency to dispatch aid to medical emergencies that include: systematized caller interrogation questions; systematized dispatch life support instructions; and, systematized coding protocols that match the dispatcher's evaluation of the injury or illness severity with the vehicle response mode and vehicle response configuration; continuous quality improvement program that measures compliance to protocol through ongoing random case review for each emergency medical dispatcher; and a training curriculum and testing process consistent with the specific emergency medical dispatch priority reference system protocol used by the emergency medical dispatch agency. An emergency medical dispatch priority reference system shall be used as a whole and may not be implemented in part.

X. "National emergency medical dispatch standard-setting and certification organization" means an organization that provides and maintains a comprehensive emergency medical dispatch protocol and training system development process including a scientific methods-based standards improvement methodology. Such organizations must maintain current and up-to-date emergency medical dispatch priority reference system, curriculum, training, testing, licensing, relicensing, instructor, quality improvement, and accreditation programs and standards.

XI. "Pre-arrival instructions" means the current, scripted medical instructions given in life threatening situations whenever possible and appropriate, where correct evaluation, verification, and advice given by emergency medical dispatcher is essential to provide necessary assistance and control of the situation prior to arrival of emergency medical services personnel.

XII. "Post-dispatch instructions" means case-specific advice, warnings, and treatments given by trained emergency medical dispatchers whenever possible and appropriate after dispatching field responders. These protocols are part of an emergency medical dispatch priority reference system.

XIII. "Quality assurance and improvement program" means a program approved by the medical director and administered by the emergency medical dispatch agency for the purpose of insuring safe, efficient, and effective performance of emergency medical dispatchers in regard to their use of the emergency medical dispatch priority reference system and patient care advice provided. This program shall include at a minimum, the random case review evaluating emergency medical dispatcher performance, feedback of emergency medical dispatch priority reference system compliance levels to emergency medical dispatchers, related continuing dispatcher education retraining and remediation, and submission of compliance data to the medical director and the board.

XIV. "Vehicle response mode" means the use of emergency driving techniques, such as warning lights-and-siren or routine driving response as assigned by the emergency medical system agency and approved by the emergency medical system medical director.

XV. "Vehicle response configuration" means the specific vehicle or vehicles of varied types, capabilities, and numbers responding to render assistance as assigned by the emergency medical system agency and approved by the emergency medical system medical director.

153-A:35 Certificate Required.

I. No person may represent himself or herself as an emergency medical dispatcher unless licensed by the board.

II. No business, organization, or government agency may represent itself as an emergency medical dispatch agency unless the business, organization, or government agency is licensed by the board an emergency medical dispatch agency.

153-A:36 National Standards Required. The board shall use applicable national standards when developing the rules and requirements for emergency medical dispatchers and emergency medical dispatch agencies.

153-A:37 Authority and Responsibilities; Rulemaking.

I. The board shall adopt rules pursuant to RSA 541-A for the following:

(a) Licensure of a person who meets the training and other requirements as an emergency medical dispatcher.

(b) Licensure of a business, organization, or government agency that operates an emergency medical dispatch agency that meets the minimum standards prescribed by the board for an emergency medical dispatch agency.

(c) A biannual license renewal requirement that requires at least 12 hours of medical dispatch continuing education each year.

(d) Minimum education and continuing education requirements for the emergency medical dispatcher which meet national standards.

(e) Requirements for an emergency medical dispatcher to follow the questions and decision-making processes within their emergency medical dispatch priority reference system in compliance to the written policies and procedures of their emergency medical dispatch agency as approved by the board.

(f) Requirements for an emergency medical dispatcher to provide dispatch life support, including pre-arrival instructions, in compliance to the written text or scripts and other processes within the approved emergency medical dispatch priority reference system.

(g) Requirements for an emergency medical dispatch agency to have in place board approved polices and procedures for the safe and effective use of the emergency medical dispatch priority reference system.

(h) Requirements for an emergency medical dispatcher to keep the board currently informed as to the entity or agency that employs or supervises his/her activities as an emergency medical dispatcher.

(i) Approval of all emergency medical dispatch priority reference system protocols used by emergency medical dispatch agencies to assure compliance with national standards.

(j) Requirements that board approved emergency medical dispatch licensing training programs shall be conducted in accordance with national standards and shall include a written examination approved by the board that tests for competency in the specific emergency medical dispatch priority reference system taught in the approved licensing training program.

(k) Requirements that board approved emergency medical dispatcher licensing training programs shall be conducted by instructors that meet board approved qualifications.

(l) Requirements that the emergency medical dispatch agency be operated in a safe, efficient, and effective manner in accordance with national approved standards including but not limited to:

(1) All personnel providing emergency medical dispatch services must be certified by the board prior to working without supervision.

(2) The emergency medical dispatcher who speaks with the caller and who codes the incident must be the same emergency medical dispatcher who gives dispatch life support instructions.

(3) The emergency medical dispatcher who dispatches the response need not be the same person.

(4) Under the approval and supervision of the medical director, the establishment of a continuous quality assurance, improvement and management program that measures various areas of compliance to the emergency medical dispatch priority reference system through ongoing random case review for each emergency medical dispatcher and provides feed back to the individuals and management of the emergency medical system agency regarding the level of compliance and performance.

(5) A case review process evaluating the emergency medical dispatcher compliance to various board defined areas within the emergency medical dispatch priority reference system.

(6) Reporting requirements of emergency medical dispatch priority reference system performance and compliance data at board approved intervals.

(7) The appointment of a dispatch medical director to review and approve the emergency medical dispatch priority reference system, the emergency medical dispatcher training program, quality assurance/improvement program, medical dispatch oversight committee, continuing dispatch education program, and the medical aspects of the operation of the emergency medical dispatch agency.

(8) The agency shall have and use the most current version of the board approved emergency medical dispatch priority reference system selected for use by the agency as defined by the board.

(m) Requirements that a person, organization, or government agency may not offer or conduct a training course that is represented as a course for emergency medical dispatcher licensing unless the person, organization, or agency is approved by the board to offer or conduct that course.

(n) Recognition and reciprocity between the board and national standard-setting organizations having programs that meet the requirements contained in this subdivision and the rules established for it by the board.

(o) Requirements for each emergency medical dispatcher, emergency medical dispatch agency, or recognized national standard-setting organization to report to the board whenever an action has taken place that may require the revocation or suspension of a certificate issued by the board.

(p) Establish a schedule of administrative fines which may be imposed under RSA 153-A:38 for violations of this subdivision and procedures for notice and hearing prior to the imposition of an administrative fine consistent with RSA 541-A:16-21.

153-A:38 Penalties. The board, after notice and hearing pursuant to RSA 541-A, may impose an administrative fine not to exceed $250 for each offense upon any person who violates any provision of this subdivision, any rule adopted under this subdivision, or the terms or conditions of any license issued under the authority of this subdivision. Rehearings and appeals from a decision of the board under this paragraph shall be in accordance with RSA 541.

2 New Paragraph; Powers and Duties of the Coordinating Board. Amend RSA 153-A:4 by inserting after paragraph VII the following new paragraph:

VIII. Administer the provisions of RSA 153-A:34-38, relative to emergency medical dispatch.

3 Effective Date. This act shall take effect 60 days after its passage.