Scope of Study
REGULATION OF EMERGENCY MEDICAL SERVICES
The state’s role in the emergency medical system is to assure citizens that safe, effective, and suitable emergency medical services are available and being delivered. The emergency medical system in Connecticut is regulated at the state level by the Department of Public Health. The regulation takes the form of both economic and quality assurance elements. The delivery of services happens in a multitude of organizational structures -- commercial, nonprofit, and volunteer, and in some cases, combinations of those – depending on location and, sometimes, time of day.
There have been recent newspaper accounts of situations where ambulances took too long to respond to calls, or did not come at all. Also, issues have been raised about the reimbursement for these services. There is interest in determining if any legislative change is needed and can be identified so that this session of the General Assembly can act. Thus, this scope sets out a short-term review. If further study is deemed warranted at that time, the committee could take action on another scope.
Area of Focus
The review would focus on the three cornerstones of business regulation of emergency medical services:
assignment of exclusive service areas for service providers -- called Primary Service Areas (PSAs);
maximum allowable rate-setting for service providers; and
determination of need for licensing and certification.
The study would assess the impact these regulatory tools have on the delivery of emergency medical services in Connecticut, and how the regulatory structure ensures accountability.
Areas of Analysis
Explore the original purpose of the business regulation elements, and assess whether purpose is being served.
Examine Connecticut’s regulatory structure, describing its component parts and processes, focusing on PSA designation, rate-setting, and determination of need elements.
Compare Connecticut’s system with national and other state models for regulating emergency medical services.
Describe the current emergency medical services landscape in Connecticut, including PSAs, PSA responders, licensed and certified providers, and rates for services.
Identify performance accountability points including entities involved and measures used.
Focusing on towns with populations greater than 50,000, examine role of municipalities in assuring service delivery including contracting and oversight, and relationship with state regulatory structure.
Review the effect the regulatory structure has on service delivery.
Areas Not Included in Analysis
Organization of DPH and Regional Councils to implement functions
Standards, training and certification, and scope of practice of individuals involved in emergency medical services
Adequacy of resources in DPH to implement functions
Other areas covered in the committee’s 1997 study of the Office of Emergency Medical Services.