Full Text of HB5187 103rd General Assembly
HB5187 103RD GENERAL ASSEMBLY | | | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 HB5187 Introduced 2/9/2024, by Rep. Christopher "C.D." Davidsmeyer SYNOPSIS AS INTRODUCED: | | | Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Department of Public Health shall allow for an alternative rural staffing model for vehicle service providers that serve a rural or semi-rural population of 10,000 or fewer inhabitants and exclusively use volunteers, paid-on-call, or part-time employees, or a combination thereof (now, the use of part-time employees is not an option). Effective immediately. |
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| | A BILL FOR |
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| 1 | | AN ACT concerning regulation. | 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly: | 4 | | Section 5. The Emergency Medical Services (EMS) Systems | 5 | | Act is amended by changing Section 3.85 as follows: | 6 | | (210 ILCS 50/3.85) | 7 | | Sec. 3.85. Vehicle Service Providers. | 8 | | (a) "Vehicle Service Provider" means an entity licensed by | 9 | | the Department to provide emergency or non-emergency medical | 10 | | services in compliance with this Act, the rules promulgated by | 11 | | the Department pursuant to this Act, and an operational plan | 12 | | approved by its EMS System(s), utilizing at least ambulances | 13 | | or specialized emergency medical service vehicles (SEMSV). | 14 | | (1) "Ambulance" means any publicly or privately owned | 15 | | on-road vehicle that is specifically designed, constructed | 16 | | or modified and equipped, and is intended to be used for, | 17 | | and is maintained or operated for the emergency | 18 | | transportation of persons who are sick, injured, wounded | 19 | | or otherwise incapacitated or helpless, or the | 20 | | non-emergency medical transportation of persons who | 21 | | require the presence of medical personnel to monitor the | 22 | | individual's condition or medical apparatus being used on | 23 | | such individuals. |
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| 1 | | (2) "Specialized Emergency Medical Services Vehicle" | 2 | | or "SEMSV" means a vehicle or conveyance, other than those | 3 | | owned or operated by the federal government, that is | 4 | | primarily intended for use in transporting the sick or | 5 | | injured by means of air, water, or ground transportation, | 6 | | that is not an ambulance as defined in this Act. The term | 7 | | includes watercraft, aircraft and special purpose ground | 8 | | transport vehicles or conveyances not intended for use on | 9 | | public roads. | 10 | | (3) An ambulance or SEMSV may also be designated as a | 11 | | Limited Operation Vehicle or Special-Use Vehicle: | 12 | | (A) "Limited Operation Vehicle" means a vehicle | 13 | | which is licensed by the Department to provide basic, | 14 | | intermediate or advanced life support emergency or | 15 | | non-emergency medical services that are exclusively | 16 | | limited to specific events or locales. | 17 | | (B) "Special-Use Vehicle" means any publicly or | 18 | | privately owned vehicle that is specifically designed, | 19 | | constructed or modified and equipped, and is intended | 20 | | to be used for, and is maintained or operated solely | 21 | | for the emergency or non-emergency transportation of a | 22 | | specific medical class or category of persons who are | 23 | | sick, injured, wounded or otherwise incapacitated or | 24 | | helpless (e.g. high-risk obstetrical patients, | 25 | | neonatal patients). | 26 | | (C) "Reserve Ambulance" means a vehicle that meets |
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| 1 | | all criteria set forth in this Section and all | 2 | | Department rules, except for the required inventory of | 3 | | medical supplies and durable medical equipment, which | 4 | | may be rapidly transferred from a fully functional | 5 | | ambulance to a reserve ambulance without the use of | 6 | | tools or special mechanical expertise. | 7 | | (b) The Department shall have the authority and | 8 | | responsibility to: | 9 | | (1) Require all Vehicle Service Providers, both | 10 | | publicly and privately owned, to function within an EMS | 11 | | System. | 12 | | (2) Require a Vehicle Service Provider utilizing | 13 | | ambulances to have a primary affiliation with an EMS | 14 | | System within the EMS Region in which its Primary Service | 15 | | Area is located, which is the geographic areas in which | 16 | | the provider renders the majority of its emergency | 17 | | responses. This requirement shall not apply to Vehicle | 18 | | Service Providers which exclusively utilize Limited | 19 | | Operation Vehicles. | 20 | | (3) Establish licensing standards and requirements for | 21 | | Vehicle Service Providers, through rules adopted pursuant | 22 | | to this Act, including but not limited to: | 23 | | (A) Vehicle design, specification, operation and | 24 | | maintenance standards, including standards for the use | 25 | | of reserve ambulances; | 26 | | (B) Equipment requirements; |
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| 1 | | (C) Staffing requirements; and | 2 | | (D) License renewal at intervals determined by the | 3 | | Department, which shall be not less than every 4 | 4 | | years. | 5 | | The Department's standards and requirements with | 6 | | respect to vehicle staffing for private, nonpublic local | 7 | | government employers must allow for alternative staffing | 8 | | models that include an EMR with a licensed EMT, EMT-I, | 9 | | A-EMT, Paramedic, or PHRN, as appropriate, pursuant to the | 10 | | approval of the EMS System Program Plan developed and | 11 | | approved by the EMS Medical Director for an EMS System. | 12 | | The EMS personnel licensed at the highest level shall | 13 | | provide the initial assessment of the patient to determine | 14 | | the level of care required for transport to the receiving | 15 | | health care facility, and this assessment shall be | 16 | | documented in the patient care report and documented with | 17 | | online medical control. The EMS personnel licensed at or | 18 | | above the level of care required by the specific patient | 19 | | as directed by the EMS Medical Director shall be the | 20 | | primary care provider en route to the destination facility | 21 | | or patient's residence. The Department shall monitor the | 22 | | implementation and performance of alternative staffing | 23 | | models and may issue a notice of termination of an | 24 | | alternative staffing model only upon evidence that an EMS | 25 | | System Program Plan is not being adhered to. Adoption of | 26 | | an alternative staffing model shall not result in a |
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| 1 | | Vehicle Service Provider being prohibited or limited in | 2 | | the utilization of its staff or equipment from providing | 3 | | any of the services authorized by this Act or as otherwise | 4 | | outlined in the approved EMS System Program Plan, | 5 | | including, without limitation, the deployment of resources | 6 | | to provide out-of-state disaster response. EMS System | 7 | | Program Plans must address a process for out-of-state | 8 | | disaster response deployments that must meet the | 9 | | following: | 10 | | (A) All deployments to provide out-of-state | 11 | | disaster response must first be approved by the EMS | 12 | | Medical Director and submitted to the Department. | 13 | | (B) The submission must include the number of | 14 | | units being deployed, vehicle identification numbers, | 15 | | length of deployment, and names of personnel and their | 16 | | licensure level. | 17 | | (C) Ensure that all necessary in-state requests | 18 | | for services will be covered during the duration of | 19 | | the deployment. | 20 | | An EMS System Program Plan for a Basic Life Support, | 21 | | advanced life support, and critical care transport | 22 | | utilizing an EMR and an EMT shall include the following: | 23 | | (A) Alternative staffing models for a Basic Life | 24 | | Support transport utilizing an EMR shall only be | 25 | | utilized for interfacility Basic Life Support | 26 | | transports as specified by the EMS System Program Plan |
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| 1 | | as determined by the EMS System Medical Director. | 2 | | (B) Protocols that shall include dispatch | 3 | | procedures to properly screen and assess patients for | 4 | | EMR-staffed transports. | 5 | | (C) A requirement that a provider and EMS System | 6 | | shall implement a quality assurance plan that shall | 7 | | include for the initial waiver period the review of at | 8 | | least 5% of total interfacility transports utilizing | 9 | | an EMR with mechanisms outlined to audit dispatch | 10 | | screening, reason for transport, patient diagnosis, | 11 | | level of care, and the outcome of transports | 12 | | performed. Quality assurance reports must be submitted | 13 | | and reviewed by the provider and EMS System monthly | 14 | | and made available to the Department upon request. The | 15 | | percentage of transports reviewed under quality | 16 | | assurance plans for renewal periods shall be | 17 | | determined by the EMS Medical Director, however, it | 18 | | shall not be less than 3%. | 19 | | (D) The EMS System Medical Director shall develop | 20 | | a minimum set of requirements for individuals based on | 21 | | level of licensure that includes education, training, | 22 | | and credentialing for all team members identified to | 23 | | participate in an alternative staffing plan. The EMT, | 24 | | Paramedic, PHRN, PHPA, PHAPRN, and critical care | 25 | | transport staff shall have the minimum experience in | 26 | | performance of pre-hospital and inter-hospital care, |
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| 1 | | as determined by the EMS Medical Director in | 2 | | accordance with the EMS System Program Plan, but at a | 3 | | minimum of 6 months of prehospital experience or at | 4 | | least 50 documented patient care interventions during | 5 | | transport as the primary care provider and approved by | 6 | | the Department. | 7 | | (E) The licensed EMR must complete a defensive | 8 | | driving course prior to participation in the | 9 | | Department's alternative staffing model. | 10 | | (F) The length of the EMS System Program Plan for a | 11 | | Basic Life Support transport utilizing an EMR shall be | 12 | | for one year, and must be renewed annually if proof of | 13 | | the criteria being met is submitted, validated, and | 14 | | approved by the EMS Medical Director for the EMS | 15 | | System and the Department. | 16 | | (G) Beginning July 1, 2023, the utilization of | 17 | | EMRs for advanced life support transports and Tier III | 18 | | Critical Care Transports shall be allowed for periods | 19 | | not to exceed 3 years under a pilot program. The pilot | 20 | | program shall not be implemented before Department | 21 | | approval. Agencies requesting to utilize this staffing | 22 | | model for the time period of the pilot program must | 23 | | complete the following: | 24 | | (i) Submit a waiver request to the Department | 25 | | requesting to participate in the pilot program | 26 | | with specific details of how quality assurance and |
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| 1 | | improvement will be gathered, measured, reported | 2 | | to the Department, and reviewed and utilized | 3 | | internally by the participating agency. | 4 | | (ii) Submit a signed approval letter from the | 5 | | EMS System Medical Director approving | 6 | | participation in the pilot program. | 7 | | (iii) Submit updated EMS System plans, | 8 | | additional education, and training of the EMR and | 9 | | protocols related to the pilot program. | 10 | | (iv) Submit agency policies and procedures | 11 | | related to the pilot program. | 12 | | (v) Submit the number of individuals currently | 13 | | participating and committed to participating in | 14 | | education programs to achieve a higher level of | 15 | | licensure at the time of submission. | 16 | | (vi) Submit an explanation of how the provider | 17 | | will support individuals obtaining a higher level | 18 | | of licensure and encourage a higher level of | 19 | | licensure during the year of the alternative | 20 | | staffing plan and specific examples of recruitment | 21 | | and retention activities or initiatives. | 22 | | Upon submission of a renewal application and | 23 | | recruitment and retention plan, the provider shall | 24 | | include additional data regarding current employment | 25 | | numbers, attrition rates over the year, and activities | 26 | | and initiatives over the previous year to address |
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| 1 | | recruitment and retention. | 2 | | The information required under this subparagraph | 3 | | (G) shall be provided to and retained by the EMS System | 4 | | upon initial application and renewal and shall be | 5 | | provided to the Department upon request. | 6 | | The Department must allow for an alternative rural | 7 | | staffing model for those vehicle service providers that | 8 | | serve a rural or semi-rural population of 10,000 or fewer | 9 | | inhabitants and exclusively uses volunteers, paid-on-call, | 10 | | or part-time employees, or a combination thereof. | 11 | | (4) License all Vehicle Service Providers that have | 12 | | met the Department's requirements for licensure, unless | 13 | | such Provider is owned or licensed by the federal | 14 | | government. All Provider licenses issued by the Department | 15 | | shall specify the level and type of each vehicle covered | 16 | | by the license (BLS, ILS, ALS, ambulance, critical care | 17 | | transport, SEMSV, limited operation vehicle, special use | 18 | | vehicle, reserve ambulance). | 19 | | (5) Annually inspect all licensed vehicles operated by | 20 | | Vehicle Service Providers. | 21 | | (6) Suspend, revoke, refuse to issue or refuse to | 22 | | renew the license of any Vehicle Service Provider, or that | 23 | | portion of a license pertaining to a specific vehicle | 24 | | operated by the Provider, after an opportunity for a | 25 | | hearing, when findings show that the Provider or one or | 26 | | more of its vehicles has failed to comply with the |
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| 1 | | standards and requirements of this Act or rules adopted by | 2 | | the Department pursuant to this Act. | 3 | | (7) Issue an Emergency Suspension Order for any | 4 | | Provider or vehicle licensed under this Act, when the | 5 | | Director or his designee has determined that an immediate | 6 | | and serious danger to the public health, safety and | 7 | | welfare exists. Suspension or revocation proceedings which | 8 | | offer an opportunity for hearing shall be promptly | 9 | | initiated after the Emergency Suspension Order has been | 10 | | issued. | 11 | | (8) Exempt any licensed vehicle from subsequent | 12 | | vehicle design standards or specifications required by the | 13 | | Department, as long as said vehicle is continuously in | 14 | | compliance with the vehicle design standards and | 15 | | specifications originally applicable to that vehicle, or | 16 | | until said vehicle's title of ownership is transferred. | 17 | | (9) Exempt any vehicle (except an SEMSV) which was | 18 | | being used as an ambulance on or before December 15, 1980, | 19 | | from vehicle design standards and specifications required | 20 | | by the Department, until said vehicle's title of ownership | 21 | | is transferred. Such vehicles shall not be exempt from all | 22 | | other licensing standards and requirements prescribed by | 23 | | the Department. | 24 | | (10) Prohibit any Vehicle Service Provider from | 25 | | advertising, identifying its vehicles, or disseminating | 26 | | information in a false or misleading manner concerning the |
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| 1 | | Provider's type and level of vehicles, location, primary | 2 | | service area, response times, level of personnel, | 3 | | licensure status or System participation. | 4 | | (10.5) Prohibit any Vehicle Service Provider, whether | 5 | | municipal, private, or hospital-owned, from advertising | 6 | | itself as a critical care transport provider unless it | 7 | | participates in a Department-approved EMS System critical | 8 | | care transport plan. | 9 | | (11) Charge each Vehicle Service Provider a fee per | 10 | | transport vehicle, due annually at time of inspection. The | 11 | | fee per transport vehicle shall be set by administrative | 12 | | rule by the Department and shall not exceed 100 vehicles | 13 | | per provider. | 14 | | (12) Beginning July 1, 2023, as part of a pilot | 15 | | program that shall not exceed a term of 3 years, an | 16 | | ambulance may be upgraded to a higher level of care for | 17 | | interfacility transports by an ambulance assistance | 18 | | vehicle with appropriate equipment and licensed personnel | 19 | | to intercept with the licensed ambulance at the sending | 20 | | facility before departure. The pilot program shall not be | 21 | | implemented before Department approval. To participate in | 22 | | the pilot program, an agency must: | 23 | | (A) Submit a waiver request to the Department with | 24 | | intercept vehicle vehicle identification numbers, | 25 | | calls signs, equipment detail, and a robust quality | 26 | | assurance plan that shall list, at minimum, detailed |
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| 1 | | reasons each intercept had to be completed, barriers | 2 | | to initial dispatch of advanced life support services, | 3 | | and how this benefited the patient. | 4 | | (B) Report to the Department quarterly additional | 5 | | data deemed meaningful by the providing agency along | 6 | | with the data required under subparagraph (A) of this | 7 | | paragraph (12). | 8 | | (C) Obtain a signed letter of approval from the | 9 | | EMS Medical Director allowing for participation in the | 10 | | pilot program. | 11 | | (D) Update EMS System plans and protocols from the | 12 | | pilot program. | 13 | | (E) Update policies and procedures from the | 14 | | agencies participating in the pilot program. | 15 | | (Source: P.A. 102-623, eff. 8-27-21; 103-547, eff. 8-11-23.) | 16 | | Section 99. Effective date. This Act takes effect upon | 17 | | becoming law. |
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