OLR Bill Analysis
AN ACT CONCERNING EMERGENCY MEDICAL SERVICES DATA COLLECTION AND EMERGENCY MEDICAL DISPATCH.
This bill makes a number of changes IN the state's emergency medical services (EMS) system including: (1) requiring the Department of Public Health (DPH) to collect specific EMS data from licensed and certified ambulance services on a quarterly basis and prepare an annual report based on this data; (2) allowing DPH to impose penalties on ambulance services not submitting the required data; (3) requiring each public safety answering point (PSAP) to submit information quarterly to the Office of State-Wide Emergency Telecommunications on EMS calls received and requiring the office to provide DPH with this information annually; (4) requiring each PSAP, by July 1, 2004, to provide emergency medical dispatch (EMD) or arrange for it to be provided by a public or private safety agency or regional telecommunications center, for 9-1-1 calls the PSAP receives that require emergency medical services; (5) requiring the office to provide or approve an EMD training course and to reimburse PSAPs or centers for certain EMD training costs; and (6) providing funding, through the enhanced emergency 9-1-1 program funding mechanism, for the DPH data collection activities and certain EMD costs.
EFFECTIVE DATE: July 1, 2000
DATA COLLECTION SYSTEM
By law, the DPH commissioner must develop a data collection system that follows a patient from initial entry into the system through discharge from the emergency room. The bill, instead, directs DPH to develop the EMS data collection system by October 1, 2001 and follow the patient from initial EMS entry through emergency room arrival. The bill requires DPH to collect the following on a quarterly basis from each licensed or certified ambulance service providing EMS:
1. the total number of calls for EMS service received during the reporting period;
2. the level of EMS required for each call;
3. the response time for each level of EMS given during that period;
4. the number of passed, cancelled, and mutual aid calls during that period ("a mutual aid call" is a call for EMS that, according to a written agreement, a secondary or alternate EMS provider responds to because the primary or designated provider cannot because it is responding to another call or the vehicle is out of service); and
5. the prehospital data for the unscheduled transport of patients for that period.
This information can be submitted in any DPH-approved written or electronic form the service chooses. DPH must consider the services' needs in approving the form. DPH can audit the service as necessary to verify the reported information's accuracy.
DPH Report
The bill directs DPH to prepare a report for the year that includes:
1. the total number of calls for EMS received during the reporting year by each licensed or certified ambulance service;
2. the level of EMS required for each call;
3. the name of the provider of each level of EMS given during the reporting year;
4. the response time (in time ranges or fractile response times) for each level of EMS using a common definition of response time; and
5. the number of passed, cancelled, and mutual aid calls.
This report must be in a format that categorizes the information for each town in which the EMS was provided, grouped according to urban, suburban, and rural categories. By March 31, 2002 and annually thereafter, DPH must submit this report to the Public Health Committee, make it publicly available, and post it on the Internet.
Penalties
Under the bill, the commissioner can impose certain penalties on a licensed or certified ambulance service that fails to submit the required information. DPH must issue a written order directing the service to comply with the reporting requirement if (1) the service does not submit information for six consecutive months or (2) if DPH believes the service knowingly or intentionally submitted incomplete or false information.
If the service does not fully comply with the order within three months from its issuance, DPH (1) must hold a hearing at which the service must show cause why its primary service area assignment should not be revoked and (2) can take a variety of disciplinary actions against the service (e.g. license revocation or suspension, censure, letter of reprimand, probation, civil penalties) as it deems appropriate.
PSAP REPORTING
Beginning January 1, 2001, the bill requires each PSAP to submit quarterly reports to the Office of State-wide Emergency Telecommunications of the calls it received for EMS. A "PSAP" is a facility operated 24 hours a day to receive 9-1-1 calls and, as appropriate, directly dispatch emergency response services or transfer or relay emergency 9-1-1 calls to other public safety agencies.
The report must include (1) the number of 9-1-1 calls during the quarter involving a medical emergency and (2) for each call, the elapsed time between the time the call was received and the time it was answered, and the elapsed time between when the call was answered and the time emergency response services were dispatched or the call was transferred or relayed to another public or private safety agency (this must be reported in time ranges or fractile response times). Annually, the office must give this information to DPH and make it available to the public, including Internet posting.
EMERGENCY MEDICAL DISPATCH
Under the bill, by July 1, 2004, each PSAP must itself provide or arrange for emergency medical dispatch (EMD) to be provided by a public or private safety agency or a regional emergency telecommunications center, concerning all 9-1-1 calls received by the PSAP that require EMS. "Emergency Medical Dispatch" means the management of requests for emergency medical assistance using a system of (1) tiered response or priority dispatching of emergency medical resources based on the level of assistance needed and (2) prearrival first aid or other medical instructions given by trained personnel who are responsible for receiving 9-1-1 calls and directly dispatching emergency response services. Any PSAP arranging for EMD from a public or private agency or regional center must file with the office documentation demonstrating that the agency or center satisfies the bill's requirements.
An EMD program must include:
1. medical interrogation, dispatch prioritization, and prearrival instructions for 9-1-1 calls requiring EMS that are provided only by personnel who have satisfactorily completed an EMD training course offered or approved by the office;
2. a medically approved EMD priority system used by the personnel;
3. EMD continuing education;
4. a mechanism to detect and correct discrepancies between established EMD protocols and actual practice; and
5. a quality assurance component to monitor EMD time intervals, use of EMD program components, and appropriateness of EMD instructions and protocols. (There must be an ongoing review of the EMD program's effectiveness by an emergency medicine physician.)
EMD Training Course
By July 1, 2001, the bill requires the office to provide an EMD training course or approve one offered by others, if the course meets requirements of the U.S. Department of Transportation, National Highway Traffic Safety Administration, EMD: National Standard Curriculum.
Reimbursement
The bill requires the office to reimburse each PSAP or regional center doing EMD for (1) start-up costs for the initial training of EMD personnel and purchase of an EMD priority reference card set and (2) costs related to ongoing training of personnel. Before approving any reimbursement, the office must get satisfactory proof that the PSAP or center has established an EMD program complying with the law.
FUNDING FOR ENHANCED EMERGENCY 9-1-1
Existing law requires the public safety commissioner to determine and specify the funding needed for development and administration of the enhanced Emergency 9-1-1 (E 9-1-1) program. This includes (1) purchasing and maintaining new PSAP terminal equipment, (2) subsidizing regional public safety emergency centers, (3) establishing a transition grant program to encourage regionalization of public safety communication, (4) establishing a regional emergency telecommunications service credit to support regional dispatch services, (5) necessary personnel training, (6) recurring expenses and future capital costs of the telecommunications network used to provide E 9-1-1 services, and (7) administrative expenses of the office.
To pay for the expenses of the E 9-1-1 program, the Department of Public Utility Control (DPUC) establishes a monthly assessment on each subscriber of local telephone and commercial mobile radio service as defined by federal law.
This bill adds, for FY 2000-01, the expenses of developing the data collection system and reporting by DPH to the items that determine the amount of funding the E 9-1-1 system needs. The bill specifies that the expenses for the data collection and reporting activities cannot exceed $250,000. It specifies that, for FY 2000-01 and afterwards, the regional emergency telecommunication service credit for coordinated EMS must be based on a factor of 30 cents per capita and cannot be reduced each year.
The bill also adds, beginning FY 2000-2001 and afterwards, the reimbursement of EMD costs for start-up and training.
BACKGROUND
Related Bill
sSB 164, favorably reported by the Program Review and Investigations Committee, makes a number of changes to the EMS system, some similar to those in this bill.
COMMITTEE ACTION
Public Health Committee
Joint Favorable Substitute
Yea |
22 |
Nay |
0 |