Substitute House Bill No. 5328
          Substitute House Bill No. 5328

              PUBLIC ACT NO. 98-195


AN ACT CONCERNING  THE OFFICE OF EMERGENCY MEDICAL
SERVICES.


    Be it enacted  by  the  Senate  and  House  of
Representatives in General Assembly convened:
    Section  1. (NEW)  (a)  There  is  established
within  the  Department   of   Public   Health  an
Emergency Medical Services Advisory Board.
    (b)  The  advisory   board  shall  consist  of
forty-one members, including  the  Commissioner of
Public Health and  the  state medical director, or
their designees. The  Governor  shall  appoint the
following members: One  person  from  each  of the
regional emergency medical  services councils; one
person  from  the   Connecticut   Association   of
Directors  of  Health;   three  persons  from  the
Connecticut College of  Emergency  Physicians; one
person from the Connecticut Committee on Trauma of
the American College  of Surgeons; one person from
the Connecticut Medical  Advisory  Committee;  one
person  from  the   Emergency   Department  Nurses
Association;  one  person   from  the  Connecticut
Association   of   Emergency    Medical   Services
Instructors;  one  person   from  the  Connecticut
Hospital  Association;  two  persons  representing
commercial ambulance providers;  one  person  from
the  Connecticut  Firefighters   Association;  one
person   from   the    Connecticut   Fire   Chiefs
Association;  one  person   from  the  Connecticut
Chiefs of Police  Association; one person from the
Connecticut State Police;  and one person from the
Connecticut  Commission  on  Fire  Prevention  and
Control. An additional  eighteen  members shall be
appointed as follows:  Three  by the president pro
tempore  of the  Senate;  three  by  the  majority
leader of the  Senate; four by the minority leader
of the Senate;  three  by the speaker of the House
of Representatives; two  by the majority leader of
the House of  Representatives  and  three  by  the
minority leader of  the  House of Representatives.
The  appointees  shall   include   a  person  with
experience  in  municipal  ambulance  services;  a
person  with experience  in  for-profit  ambulance
services;  three  persons   with   experience   in
volunteer ambulance services; an emergency medical
technician   paramedic;   an   emergency   medical
technician;   an  emergency   medical   technician
intermediate;  three consumers  and  four  persons
from state-wide organizations  with  interests  in
emergency medical services  as  well  as any other
areas of expertise  that  may  be deemed necessary
for the proper functioning of the advisory board.
    (c) The Commissioner  of  Public  Health shall
appoint a chairperson  from  among  the members of
the advisory board  who  shall serve for a term of
one year. The  advisory  board  shall elect a vice
chairperson  and  secretary.  The  advisory  board
shall have committees  made  up of such members as
the  chairperson  shall  appoint  and  such  other
interested persons as  the committee members shall
elect to membership.  The advisory board may, from
time to time,  appoint nonmembers to serve on such
ad hoc committees  as it deems necessary to assist
with  its  functions.  The  advisory  board  shall
develop bylaws. The advisory board shall establish
a Connecticut Emergency  Medical  Services Medical
Advisory Committee as  a  standing  committee. The
standing committee shall provide the commissioner,
the advisory board  and  other  ad  hoc committees
with  advice and  comment  regarding  the  medical
aspects of their  projects. The standing committee
may submit reports  directly  to  the commissioner
regarding  medically-related  concerns  that  have
not, in the  standing  committee's  opinion,  been
satisfactorily addressed by the advisory board.
    (d) The term  for each appointed member of the
advisory  board  shall  be  coterminous  with  the
appointing  authority.  Appointees   shall   serve
without compensation.
    (e) The advisory  board,  in addition to other
power conferred and  in addition to functioning in
a  general  advisory  capacity,  shall  assist  in
coordinating  the  efforts   of  all  persons  and
agencies in the state concerned with the emergency
medical service system, and shall render advice on
the development of  the  emergency medical service
system where needed. The advisory board shall make
an annual report to the commissioner.
    (f) The advisory  board  shall  be  provided a
reasonable   opportunity  to   review   and   make
recommendations   on  all   regulations,   medical
guidelines   and  policies   affecting   emergency
medical services before the department establishes
such regulations, medical  guidelines or policies.
The advisory board  shall  make recommendations to
the  Governor  and   to   the   General   Assembly
concerning  legislation  which,  in  the  advisory
board's judgment, will  improve  the  delivery  of
emergency medical services.
    Sec. 2. (NEW)  (a)  The Commissioner of Public
Health  shall  establish   an   Emergency  Medical
Services Equipment and  Local  System  Development
grant program. The program shall provide incentive
grants for enhancing  emergency  medical  services
and equipment. The  commissioner  shall define the
nature, description and systems designed for grant
proposals.
    (b) The commissioner  shall adopt regulations,
in accordance with the provisions of chapter 54 of
the general statutes,  to  determine  the entities
eligible to receive grants under the grant program
established pursuant to  subsection  (a)  of  this
section.   In   determining    eligibility,    the
commissioner shall consider:  (1) The demonstrated
need within the community; (2) the degree to which
the proposal serves the emergency medical services
system plan; and  (3) the extent to which there is
available adequate trained  staff to carry out the
proposal.
    (c) The commissioner shall maintain a priority
list of eligible  proposals  and shall establish a
system setting the  priority  of grant funding. In
establishing  such a  priority  list  and  ranking
system,  the  commissioner   shall   consider  all
relevant factors including,  but  not  limited to:
(1)  The  public   health   and  safety;  (2)  the
population affected; (3)  the  attainment of state
emergency medical services  goals  and  standards;
and  (4)  consistency  with  the  state  plan  for
emergency medical services.
    (d) The commissioner  shall  consult  with the
appropriate  regional  council   by  sending  such
council a copy of any grant proposal. The regional
emergency medical services  council  shall  review
and comment upon  any proposal. Each council shall
indicate  how the  grant  proposal  addresses  the
regional   emergency   medical    services    plan
established  priorities.  The  commissioner  shall
consider  the  recommendation   of   the  regional
council when making a final grant determination.
    Sec.  3.  Section   19a-175   of  the  general
statutes, as amended  by  section 15 of public act
97-311,  is  repealed   and   the   following   is
substituted in lieu thereof:
    As used in this chapter:
    (1) "Emergency medical service system" means a
system  which  provides  for  the  arrangement  of
personnel,  facilities  and   equipment   for  the
efficient, effective and  coordinated  delivery of
health care services under emergency conditions;
    (2) "Patient" means  an injured, ill, crippled
or   physically   handicapped   person   requiring
assistance and transportation;
    (3)   "Ambulance"  means   a   motor   vehicle
specifically designed to carry patients;
    (4) "Ambulance service"  means an organization
which transports patients;
    (5) "Emergency medical  technician"  means  an
individual  who  has  successfully  completed  the
training   requirements   established    by    the
Commissioner  of  Public   Health   and  has  been
certified by the Department of Public Health;
    (6) "Ambulance driver"  means  a  person whose
primary function is driving an ambulance;
    (7) "Emergency medical  technician instructor"
means a person  who is certified by the Department
of Public Health  to teach courses, the completion
of  which are  required  in  order  to  become  an
emergency medical technician;
    (8)   "Communications  facility"   means   any
facility housing the  personnel  and equipment for
handling the emergency  communications  needs of a
particular geographic area;
    (9) "Life saving  equipment"  means  equipment
used  by  emergency   medical  personnel  for  the
stabilization and treatment of patients;
    (10) "Emergency medical  service organization"
means any organization  whether public, private or
voluntary which offers transportation or treatment
services to patients under emergency conditions;
    (11)  "Invalid coach"  means  a  vehicle  used
exclusively    for    the     transportation    of
nonambulatory patients, who  are  not  confined to
stretchers, to or  from  either a medical facility
or the patient's  home  in nonemergency situations
or utilized in  emergency  situations  as a backup
vehicle  when  insufficient   emergency   vehicles
exist;
    (12) "Rescue service"  means any organization,
whether profit or nonprofit, whose primary purpose
is to search  for  persons who have become lost or
to render emergency  service to persons who are in
dangerous or perilous circumstances;
    (13) "Provider" means  any person, corporation
or  organization,  whether  profit  or  nonprofit,
whose primary purpose  is  to deliver medical care
or services, including  such  related medical care
services as ambulance transportation;
    (14) "Commissioner" means  the Commissioner of
Public  Health;  [acting  through  the  Office  of
Emergency Medical Services;]
    (15)  "Paramedic"  means   a  person  licensed
pursuant to section  11  of  [this act] PUBLIC ACT
97-311;
    (16) "Commercial ambulance  service"  means an
ambulance  service which  primarily  operates  for
profit;
    (17)  "Licensed  ambulance  service"  means  a
commercial ambulance service  [issued a license by
the Office of  Emergency  Medical Services or any]
OR  A volunteer  or  municipal  ambulance  service
issued  a license  by  the  [Office  of  Emergency
Medical   Services  prior   to   July   1,   1981]
COMMISSIONER;
    (18) "Certified ambulance  services"  means  a
municipal or volunteer  ambulance service issued a
certificate by the  [Office  of  Emergency Medical
Services] COMMISSIONER; and
    (19)    "Management    service"    means    an
organization  which  provides   emergency  medical
technicians or paramedics  to any entity including
an  ambulance  service  but  does  not  include  a
commercial ambulance service  or  a  volunteer  or
municipal ambulance service.
    Sec.  4.  Section   19a-176   of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    The Department of  Public  Health shall be the
[state  agency]  LEAD   AGENCY   FOR  THE  STATE'S
EMERGENCY MEDICAL SERVICES  PROGRAM  AND  SHALL BE
responsible  for the  planning,  coordination  and
administration of a  state-wide  emergency medical
care service system.  The  Commissioner  of Public
Health shall set  policy  and establish state-wide
priorities   for   emergency    medical   services
utilizing the services  of the state Department of
Public Health and  the  emergency medical services
councils, as established by section 19a-183.
    Sec.  5.  Section   19a-177   of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    The commissioner shall:
    [(a)] (1) With  the  advice  of  THE OFFICE OF
EMERGENCY MEDICAL SERVICES ESTABLISHED PURSUANT TO
SECTION 19a-178, AS AMENDED BY THIS ACT, AND OF an
advisory committee on  emergency  medical services
and with the  benefit  of  [the] meetings [,] held
pursuant to subsection  (b) of section 19a-184, AS
AMENDED BY THIS ACT, [develop and annually update]
ADOPT EVERY FIVE  YEARS  a state-wide plan for the
coordinated   delivery   of    emergency   medical
services; [, which  plan  shall  take into account
the  needs  of   the  emergency  medical  services
councils. The plan  shall  contain:  (1)  Specific
goals for the  delivery  of such emergency medical
services; (2) a time frame for achievement of such
goals;  (3)  cost  data  and  alternative  funding
sources for the development of such goals; and (4)
performance standards for  the  evaluation of such
goals;]
    (2)  LICENSE OR  CERTIFY  THE  FOLLOWING:  (A)
AMBULANCE OPERATIONS, AMBULANCE DRIVERS, EMERGENCY
MEDICAL TECHNICIANS AND  COMMUNICATIONS PERSONNEL;
(B) EMERGENCY ROOM  FACILITIES  AND COMMUNICATIONS
FACILITIES;  AND  (C)   TRANSPORTATION  EQUIPMENT,
INCLUDING LAND, SEA  AND  AIR  VEHICLES  USED  FOR
TRANSPORTATION OF PATIENTS TO EMERGENCY FACILITIES
AND PERIODICALLY INSPECT  LIFE  SAVING  EQUIPMENT,
EMERGENCY FACILITIES AND  EMERGENCY TRANSPORTATION
VEHICLES  TO  INSURE   THAT  STATE  STANDARDS  ARE
MAINTAINED;
    [(b)] (3) Annually  inventory  [or cause to be
inventoried] emergency medical  services resources
within the state, including facilities, equipment,
and personnel, for the purposes of determining the
need for additional services and the effectiveness
of existing services;
    [(c)] (4) Review  and  evaluate  all area-wide
plans developed by  the emergency medical services
councils pursuant to  section  19a-182, AS AMENDED
BY THIS ACT,  in  order  to insure conformity with
standards issued by said commissioner;
    [(d)] (5) Within thirty days of their receipt,
review all grant  and  contract  applications  for
federal  or  state   funds   concerning  emergency
medical  services  or   related   activities   for
conformity to policy  guidelines  and forward such
application  to  the   appropriate   agency,  when
required;
    [(e)] (6) Establish such minimum standards and
adopt  such regulations  in  accordance  with  the
provisions of chapter  54,  as may be necessary to
develop the following  components  of an emergency
medical service system:  [(1)] (A) Communications,
which  shall  include,  but  not  be  limited  to,
equipment,  radio  frequencies   and   operational
procedures;  [(2)]  (B)  transportation  services,
which  shall  include,  but  not  be  limited  to,
vehicle type, design,  condition  and maintenance,
life saving equipment  and  operational procedure;
[(3)] (C) training,  which  shall include, but not
be  limited  to,  emergency  medical  technicians,
communications     personnel,    paraprofessionals
associated   with  emergency   medical   services,
firefighters and state and local police; and [(4)]
(D) emergency medical  service  facilities,  which
shall   include,   but    not   be   limited   to,
categorization  of  emergency  departments  as  to
their   treatment   capabilities   and   ancillary
services;
    [(f)] (7) Coordinate training of all personnel
related to emergency medical services;
    [(g)] (8) Develop  or  cause to be developed a
data  collection  system  which  shall  include  a
method of uniform  patient  record  keeping  which
will follow a  patient from initial entry into the
emergency medical service system through discharge
from the emergency room; AND
    [(h) Develop a  program  for  public education
and information which takes into account the needs
of visitors to as well as residents of the state;]
    [(i)] (9) Establish  rates  for the conveyance
of patients by  licensed  ambulance  services  and
invalid coaches and establish an emergency service
rate for certified ambulance services provided the
present rates established  by the Public Utilities
Commission for such  services  and  vehicles shall
remain  in  effect   until   such   time   as  the
commissioner establishes a  new  rate  schedule as
provided   herein,  and   adopt   regulations   in
accordance  with  the  provisions  of  chapter  54
establishing  methods  for   setting   rates   and
conditions for charging such rates. [;]
    [(j) No later  than  December  31,  1975,  and
annually  thereafter  submit   a   report  to  the
Governor and General Assembly which shall include,
but not be  limited  to,  the  following:  (1)  An
accounting of all federal and state funds expended
for emergency medical services in the state; (2) a
statement and evaluation of the accomplishments of
the Office of  Emergency  Medical  Services during
the preceding year  together with a description of
goals   for   the    upcoming    year;   and   (3)
recommendations  for any  legislation  which  said
commissioner  feels  will  facilitate  a  complete
coordinated emergency medical services system; and
    (k) If no  emergency  medical services council
exists within a  region,  develop  in  conjunction
with the regional  coordinator,  as established by
section  19a-185, an  emergency  medical  services
plan for such  region,  such  plan to conform with
the requirements of section 19a-182.]
    Sec.  6.  Section   19a-178   of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a)  There shall  be  established  within  the
Department of Public Health an Office of Emergency
Medical Services. The  office shall be responsible
for [(a) the  licensure  or  certification  of the
following:  (1)  Ambulance  operations,  ambulance
drivers,   emergency  medical   technicians,   and
communications  personnel;  (2)   emergency   room
facilities and communications  facilities  and (3)
transportation equipment, including  land, sea and
air vehicles used  for  transportation of patients
to emergency facilities;  (b) periodic inspections
of life saving  equipment, of emergency facilities
and of emergency transportation vehicles to insure
that  state  standards  are  maintained;  and  (c)
perform such other  duties  and  functions  as are
assigned to said  office  by  the  Commissioner of
Public  Health]  PROGRAM  DEVELOPMENT  ACTIVITIES,
INCLUDING,  BUT  NOT   LIMITED   TO:   (1)  PUBLIC
EDUCATION    AND   INFORMATION    PROGRAMS;    (2)
ADMINISTERING  THE  EMERGENCY   MEDICAL   SERVICES
EQUIPMENT  AND  LOCAL   SYSTEM  DEVELOPMENT  GRANT
PROGRAM;  (3)  PLANNING;   (4)   REGIONAL  COUNCIL
OVERSIGHT; (5) TRAINING;  AND  (6) PROVIDING STAFF
SUPPORT TO THE ADVISORY BOARD.
    (b) THE OFFICE  OF  EMERGENCY MEDICAL SERVICES
SHALL ADOPT A  FIVE-YEAR  PLANNING  CYCLE  FOR THE
STATE-WIDE PLAN FOR  THE  COORDINATED  DELIVERY OF
MEDICAL EMERGENCY SERVICES  REQUIRED BY SUBSECTION
(a) OF THIS  SECTION.  THE PLAN SHALL CONTAIN: (1)
SPECIFIC GOALS FOR  THE DELIVERY OF SUCH EMERGENCY
MEDICAL SERVICES; (2) A TIME FRAME FOR ACHIEVEMENT
OF  SUCH GOALS;  (3)  COST  DATA  AND  ALTERNATIVE
FUNDING SOURCES FOR THE DEVELOPMENT OF SUCH GOALS;
AND (4) PERFORMANCE  STANDARDS  FOR THE EVALUATION
OF SUCH GOALS.
    Sec.  7.  Section   19a-179   of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    [(a) There shall  be  a director of the Office
of Emergency Medical  Services  as  established in
section 19a-178 who  shall  be  appointed  by  and
responsible to the  Commissioner of Public Health.
The director shall  carry  out  the  duties of the
Office of Emergency  Medical  Services as provided
in  said  section.   The   commissioner  shall  be
responsible  for  adopting]  THE  COMMISSIONER  OF
PUBLIC HEALTH SHALL  ADOPT  regulations concerning
the  methods  and  conditions  for  licensure  and
certification of the  operations,  facilities  and
equipment enumerated in [said] section 19a-177, AS
AMENDED BY THIS  ACT,  and  regulations  regarding
complaint  procedures  for   the  public  and  any
emergency  medical  service   organization.   Such
regulations shall be  adopted  in  accordance with
the provisions of  chapter  54  and  shall  be  in
conformity  with  the   policies   and   standards
established by the  commissioner. [All regulations
adopted by the  Ambulance  Commission and in force
on June 30,  1974,  shall  remain  in effect until
such time as  new  regulations which repeal, amend
or  replace specific  regulations  concerning  the
methods   and   conditions   for   licensure   and
certification of the  operations,  facilities  and
equipment   enumerated   in   said   section   and
regulations regarding complaint procedures for the
public   and   any   emergency   medical   service
organization are adopted  by  the  commissioner in
accordance with the provisions of this section.
    (b) (1) The  assignment  or transfer of any of
the functions, powers  or  duties of the Ambulance
Commission under any  of  the  provisions  of this
chapter shall not affect any action or proceeding,
civil or criminal,  pending  at  the  time of such
assignment  or  transfer,   and   the   Office  of
Emergency  Medical  Services   shall   be   deemed
substituted in such  action  by  operation of this
subsection without motion  or order. (2) Any right
of action or matter undertaken or commenced by the
Ambulance  Commission, the  functions,  powers  or
duties of which  are  assigned or transferred, may
be  conducted  and  completed  by  the  Office  of
Emergency Medical Services  in the same manner and
under the same  terms  and conditions and with the
same effect as  if  undertaken  or  commenced  and
conducted   and   completed   by   the   Ambulance
Commission.  (3) The  chairman  of  the  Ambulance
Commission  shall  deliver   to   the   Office  of
Emergency Medical Services,  all contracts, books,
maps,   plans,  papers,   records   and   property
pertaining  to or  used  in  connection  with  the
functions,   powers   or    duties   assigned   or
transferred, to said office.
    (c) The director  of  the  Office of Emergency
Medical  Services  may   employ,  subject  to  the
provisions to chapter 67, with the approval of the
Commissioner of Public  Health,  such  staff as is
necessary to carry out the responsibilities of the
office provided for in this chapter.]
    Sec.  8.  Section   19a-180   of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a)  No person  shall  operate  any  ambulance
service,  rescue  service  or  management  service
without either a  license  or a certificate issued
by  the [Office  of  Emergency  Medical  Services]
COMMISSIONER OF PUBLIC  HEALTH.  No  person  shall
operate  a  commercial   ambulance  or  commercial
rescue service or  a  management service without a
license issued by the [Office of Emergency Medical
Services]  COMMISSIONER. A  certificate  shall  be
issued to any  volunteer  or  municipal  ambulance
service  which shows  proof  satisfactory  to  the
commissioner that it  meets  the minimum standards
of the commissioner  in  the  areas  of  training,
equipment and personnel.  Applicants for a license
shall use the  forms  prescribed by the [Office of
Emergency Medical Services] COMMISSIONER and shall
submit  such  application   to   the   [Office  of
Emergency    Medical    Services]     COMMISSIONER
accompanied  by  an  annual  fee  of  one  hundred
dollars. In considering  requests  for approval of
permits  for new  or  expanded  emergency  medical
services in any  region,  THE  COMMISSIONER  SHALL
CONSULT  WITH  the  Office  of  Emergency  Medical
Services [shall consult  with]  AND  the emergency
medical services council  of such region and shall
hold a public  hearing  to determine the necessity
for such services.  Written notice of such hearing
shall  be  given   to  current  providers  in  the
geographic  region  where  such  new  or  expanded
services would be  implemented,  provided that any
volunteer ambulance service  which  elects  not to
levy  charges for  services  rendered  under  this
chapter  shall  be   exempt  from  the  provisions
concerning requests for  approval  of  permits for
new or expanded  emergency  medical  services, set
forth above. Each  applicant  for  licensure shall
furnish proof of  financial  responsibility  which
the  [office]  COMMISSIONER  deems  sufficient  to
satisfy any claim.  The  [Commissioner  of  Public
Health shall establish by regulation] COMMISSIONER
MAY  ADOPT  REGULATIONS  IN  ACCORDANCE  WITH  THE
PROVISIONS OF CHAPTER 54 TO ESTABLISH satisfactory
kinds of coverage and limits of insurance for each
applicant for either  licensure  or certification.
[,  provided  until   such  time  as]  UNTIL  such
regulations   are   [promulgated]   ADOPTED,   the
following  shall  be   the   required  limits  for
licensure: (1) For  damages  by reason of personal
injury to, or  the death of, one person on account
of any accident,  at  least  five hundred thousand
dollars, and more  than  one  person on account of
any accident, at  least  one  million dollars, (2)
for damage to  property  at  least  fifty thousand
dollars and (3) for malpractice in the care of one
passenger  at least  two  hundred  fifty  thousand
dollars, and for  more than one passenger at least
five hundred thousand  dollars.  In  lieu  of  the
foregoing, a single  limit  of  liability shall be
allowed as follows:  (A)  For damages by reason of
personal injury to,  or  death  of,  one  or  more
persons  and damage  to  property,  at  least  one
million dollars; and  (B)  for  malpractice in the
care of one  or  more  passengers,  at  least five
hundred thousand dollars.  A  certificate  of such
proof shall be filed with the [Office of Emergency
Medical Services] COMMISSIONER. Upon determination
by  the [Office  of  Emergency  Medical  Services]
COMMISSIONER  that  an  applicant  is  financially
responsible,  properly  certified   and  otherwise
qualified  to  operate   a   commercial  ambulance
service,   the  [Office   of   Emergency   Medical
Services]  COMMISSIONER  shall   issue  a  license
effective for one  year  to such applicant. If the
[Office    of    Emergency    Medical    Services]
COMMISSIONER  determines  that  an  applicant  for
either  a  certificate   or   license  is  not  so
qualified, [it] THE COMMISSIONER shall notify such
applicant of the  denial of his application with a
statement of the  reasons  for  such  denial. Such
applicant shall have  thirty  days  to  request  a
hearing on the denial of said application.
    (b) Any person  or  emergency medical services
organization which does  not maintain standards or
violates regulations [promulgated]  ADOPTED  under
any section of  this  chapter  applicable  to such
person or organization may have his or its license
or certification suspended  or  revoked  or may be
subject to any other disciplinary action specified
in section 19a-17  after  notice by certified mail
to such person  or  organization  of  the facts or
conduct which warrant  the  intended  action. Such
person or emergency  medical services organization
shall have an  opportunity to show compliance with
all  requirements  for   the   retention  of  such
certificate or license.  In  the  conduct  of  any
investigation by the  [Office of Emergency Medical
Services] COMMISSIONER of  alleged  violations  of
the standards or regulations [promulgated] ADOPTED
under  the  provisions   of   this   chapter,  the
commissioner  may issue  subpoenas  requiring  the
attendance of witnesses  and the production by any
medical  services  organization   or   person   of
reports, records, tapes  or  other documents which
concern the allegations  under  investigation. All
records obtained by the commissioner in connection
with any such  investigation  shall not be subject
to the provisions  of section 1-16 for a period of
six months from  the date of the petition or other
event initiating such investigation, or until such
time as the  investigation  is terminated pursuant
to a withdrawal  or  other informal disposition or
until a hearing  is  convened  pursuant to chapter
54, whichever is  earlier. A complaint, as defined
in subdivision (6)  of  section  19a-13,  shall be
subject to the provisions of section 1-16 from the
time  that  it   is   served   or  mailed  to  the
respondent.  Records which  are  otherwise  public
records shall not  be  deemed  confidential merely
because they have been obtained in connection with
an investigation under this chapter.
    (c) Any person  or  emergency  medical service
organization aggrieved by  an  act  or decision of
the  [Office  of   Emergency   Medical   Services]
COMMISSIONER regarding certification  or licensure
may appeal in the manner provided by chapter 54.
    [(d)  On or  before  December  31,  1975,  the
Office of Emergency Medical Services shall issue a
temporary ambulance or  rescue operation permit to
any    service    organization    which    submits
satisfactory evidence to  the  Office of Emergency
Medical Services that  it  was actively engaged in
operating  an  ambulance   or  rescue  service  on
January 1, 1974.  Such  temporary  licenses  shall
expire one year from the date of issuance.]
    [(e)] (d) Any  person  guilty  of  any  of the
following acts shall  be  fined  not more than two
hundred fifty dollars, or imprisoned not more than
three months, or be both fined and imprisoned: (1)
In any application  to  the  [Office  of Emergency
Medical   Services]   COMMISSIONER   or   in   any
proceeding before [it, or in any] OR investigation
made by [it or on its authority] THE COMMISSIONER,
knowingly [makes] MAKING  any  false  statement or
representation, or, with knowledge of its falsity,
[files or causes]  FILING  OR  CAUSING to be filed
[with the Office  of  Emergency  Medical Services]
any  false  statement   or   representation  in  a
required application or  statement;  (2)  [issues,
circulates  or  publishes,   or  causes]  ISSUING,
CIRCULATING OR PUBLISHING OR CAUSING to be issued,
circulated or published  any form of advertisement
or circular for the purpose of soliciting business
which contains any  statement  that  is  false  or
misleading,  or  otherwise  likely  to  deceive  a
reader thereof, with  knowledge  that  it contains
such false, misleading or deceptive statement; (3)
[gives  or offers]  GIVING  OR  OFFERING  to  give
anything of value to any person for the purpose of
promoting or securing  ambulance or rescue service
business or obtaining favors relating thereto; (4)
[administers, or causes]  ADMINISTERING OR CAUSING
to be administered,  while serving in the capacity
of an employee of any licensed ambulance or rescue
service, any alcoholic  liquor  to  any patient in
his  care,  except   under   the  supervision  and
direction of a  licensed  physician;  (5)  in  any
respect wilfully [violates  or fails] VIOLATING OR
FAILING  to comply  with  any  provision  of  this
chapter or wilfully  [violates  or fails, omits or
neglects]   VIOLATING,   FAILING,    OMITTING   OR
NEGLECTING to obey  or comply with any regulation,
order,  decision  or   license,  or  any  part  or
provisions thereof; (6)  with  one  or  more other
persons,  [conspires] CONSPIRING  to  violate  any
license  or  order   issued   by  the  [Office  of
Emergency Medical Services]  COMMISSIONER  or  any
provision of this chapter.
    [(f)]   (e)  No   person   shall   place   any
advertisement or produce  any  printed matter that
holds that person  out  to be an ambulance service
unless he is  licensed  or  certified  pursuant to
this section. Any  such  advertisement  or printed
matter shall include  the  license  or certificate
number issued by  the [Office of Emergency Medical
Services] COMMISSIONER.
    Sec.  9.  Section   19a-181   of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a) Each ambulance  or  rescue vehicle used by
an ambulance or rescue service shall be registered
with the Department  of Motor Vehicles pursuant to
chapter 246. Said  Department  of  Motor  Vehicles
shall not issue  a certificate of registration for
any such ambulance  or  rescue  vehicle unless the
applicant  for such  certificate  of  registration
presents to said  department  a safety certificate
from the [Office  of  Emergency  Medical Services]
COMMISSIONER OF PUBLIC HEALTH certifying that said
ambulance or rescue vehicle has been inspected [by
said office] and  has  met  the  minimum standards
prescribed by the  commissioner.  Each  vehicle so
registered with [said  department]  THE DEPARTMENT
OF MOTOR VEHICLES  shall  be  inspected [annually]
ONCE EVERY TWO  YEARS  thereafter by [said office]
THE COMMISSIONER OF PUBLIC HEALTH on or before the
anniversary   date  of   the   issuance   of   the
certificate of registration.  Each inspector, upon
determining that such  ambulance or rescue vehicle
meets  the  standards   of  safety  and  equipment
prescribed by [said  office]  THE  COMMISSIONER OF
PUBLIC HEALTH, shall affix a safety certificate to
such vehicle in  such  manner  and  form  as [said
office   shall   designate]    THE    COMMISSIONER
DESIGNATES, and such sticker shall be so placed as
to be readily  visible  to  any person in the rear
compartment of such vehicle.
    (b) The Department  of  Motor  Vehicles  shall
suspend or revoke  the certificate of registration
of any vehicle  inspected  under the provisions of
this section upon  certification from [said Office
of Emergency Medical Services] THE COMMISSIONER OF
PUBLIC  HEALTH  that   such  ambulance  or  rescue
vehicle has failed  to  meet the minimum standards
prescribed by said commissioner.
    Sec.  10.  Section   19a-182  of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a) The emergency  medical  services  councils
shall be the  area-wide  planning and coordinating
agencies for emergency  medical services and shall
provide continuous evaluation of emergency medical
services for their respective geographic areas.
    (b) Each emergency  medical  services  council
shall develop and  [annually]  revise  EVERY  FIVE
YEARS a plan for the delivery of emergency medical
services in its  area,  USING A FORMAT ESTABLISHED
BY THE OFFICE  OF EMERGENCY MEDICAL SERVICES. EACH
COUNCIL SHALL SUBMIT  AN  ANNUAL  UPDATE  FOR EACH
REGIONAL PLAN TO  THE  OFFICE OF EMERGENCY MEDICAL
SERVICES  DETAILING  ACCOMPLISHMENTS  MADE  TOWARD
PLAN IMPLEMENTATION. Such  plan  shall  include an
evaluation  of  the   current   effectiveness   of
emergency medical services  and  detail  the needs
for the future,  and  shall contain specific goals
for the delivery  of  emergency  medical  services
within their respective  geographic  areas, a time
frame for achievement of such goals, cost data for
the development of  such  goals,  and  performance
standards  for  the   evaluation  of  such  goals.
Special emphasis in such plan shall be placed upon
coordinating   the  existing   services   into   a
comprehensive  system.  Such  plan  shall  contain
provisions for, but  shall  not be limited to, the
following: (1) Clearly  defined geographic regions
to  be  serviced   by   each   provider  including
cooperative arrangements with  other providers and
backup services; (2) an adequate number of trained
personnel    for    staffing     of    ambulances,
communications facilities and  hospital  emergency
rooms, with emphasis  on former military personnel
trained   in   allied   health   fields;   (3)   a
communications  system  that  includes  a  central
dispatch  center,  two-way   radio   communication
between the ambulance  and  the receiving hospital
and a universal  emergency  telephone  number; and
(4) a public  education  program that stresses the
need for adequate  training  in  basic  lifesaving
techniques and cardiopulmonary resuscitation. Such
plan shall be  submitted  to  the  Commissioner of
Public Health no  later  than  June thirtieth [of]
each year THE PLAN IS DUE.
    Sec.  11.  Section   19a-184  of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a) Each emergency  medical  services  council
shall (1) forward  to  the  Commissioner of Public
Health the emergency medical services plan for its
region,  and (2)  review  and  within  sixty  days
forward to the  commissioner,  together  with  its
recommendations,    all   grant    and    contract
applications   for   federal   and   state   funds
pertaining to emergency  medical services from the
following entities within  its  region: (A) A unit
of  local  government,   (B)   a   public   entity
administering   a  compact   or   other   regional
arrangement or consortium, or (C) any other public
entity or any nonprofit private agency.
    (b) The chairpersons,  or  their designees, of
said councils shall  meet  as  a  group,  at least
bimonthly, with [the  director  of]  the Office of
Emergency   Medical  Services   to   discuss   the
planning, coordination and  implementation  of the
state-wide emergency medical care service system.
    Sec.  12.  Section   19a-194  of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a) A motorcycle  equipped  to  handle medical
emergencies shall be  deemed  a rescue vehicle for
the purposes of  section 19a-181. The [director of
the   Office  of   Emergency   Medical   Services]
COMMISSIONER shall issue  a  safety certificate to
such motorcycle upon  examination  of such vehicle
[by  said  director   or   his   designee]  and  a
determination  that  such  motorcycle  (1)  is  in
satisfactory mechanical condition,  (2) is as safe
to operate as  the  average motorcycle, and (3) is
equipped with such  emergency medical equipment as
may be required by subsection (b) of this section.
    (b) The [director  of  the Office of Emergency
Medical  Services shall  adopt  regulations  which
shall specify] COMMISSIONER  MAY ADOPT REGULATIONS
IN ACCORDANCE WITH  THE  PROVISIONS  OF CHAPTER 54
SPECIFYING the equipment  a  motorcycle must carry
to operate as  a  rescue  vehicle pursuant to this
section. Such equipment  shall include those items
that would enable an emergency medical technician,
paramedic or other individual similarly trained to
render to a  person  requiring  emergency  medical
assistance the maximum  benefit  possible from the
operation of such motorcycle rescue vehicle.
    Sec.  13.  Section   19a-196  of  the  general
statutes  is  repealed   and   the   following  is
substituted in lieu thereof:
    (a) For purposes  of this section and sections
19a-196a and 19a-196b,  "municipality"  means  any
town, city or  borough,  whether  consolidated  or
unconsolidated.
    (b)  For  purposes   of   this   section,  the
Commissioner of Public  Health may appoint hearing
officers to investigate  complaints filed pursuant
to this section.  [and to report their findings to
the director of  the  Office  of Emergency Medical
Services.]
    (c) Any municipality  aggrieved  by any action
of an emergency medical service council may file a
written complaint with the [director of the Office
of   Emergency  Medical   Services]   COMMISSIONER
describing such action  and  shall  mail a copy of
such complaint to the party that is the subject of
the complaint. Any  complaint  filed  pursuant  to
this section shall  be  filed  [within]  NOT LATER
THAN one hundred  eighty  days  after  the alleged
act. Upon receipt  of  a properly filed complaint,
the  [director]  COMMISSIONER   shall  refer  such
complaint to a  hearing  officer appointed [by the
Commissioner of Public Health] to investigate such
complaints.  The  hearing   officer  shall,  after
investigation and [within]  NOT  LATER THAN ninety
days after the  date  of such referral, either (1)
make  a  report  to  the  [director]  COMMISSIONER
recommending dismissal of  the  complaint  or  (2)
issue an official  written  complaint charging the
emergency  medical  service   council   with   the
appropriate  violation. Upon  receiving  a  report
from the officer  recommending  dismissal  of  the
complaint, the [director]  COMMISSIONER  may issue
an order dismissing  the  complaint or may order a
further investigation or  a  hearing thereon. Upon
receiving a complaint  issued  by the officer, the
[director] COMMISSIONER shall set a time and place
for the hearing.  The  hearing  shall  be  held in
accordance with the  provisions  of chapter 54. If
no  such  report   or  complaint  is  issued,  the
[director] COMMISSIONER may,  in  his  discretion,
proceed to a  hearing  upon  the  party's original
complaint in accordance  with  the  provisions  of
chapter 54.
    (d) A final  decision  shall be in writing and
shall include any findings of fact and conclusions
of    law   necessary    to    the    [director's]
COMMISSIONER'S decision. Findings of fact shall be
based exclusively on  the  evidence in the record.
The final decision  shall be delivered promptly to
each  party  or   his  authorized  representative,
personally  or  by   [U.S.]  UNITED  STATES  mail,
certified or registered,  postage  prepaid, return
receipt requested. The  final  decision  shall  be
effective when personally delivered or mailed.
    (e) A municipality  aggrieved by a decision of
the  [director]  COMMISSIONER   pursuant  to  this
section may appeal therefrom to the Superior Court
in  accordance  with  the  provisions  of  section
4-183.
    Sec. 14. The  Commissioner  of  Public  Health
shall submit a report on the implementation of the
emergency medical services  program development to
the  joint  standing   committee  of  the  General
Assembly having cognizance  of matters relating to
public health on or before January 1, 1999.
    Sec. 15. (a) There is established a task force
to  study  the   provision  of  emergency  medical
services, as well  as  a  method  of  funding  the
emergency medical services  system,  utilizing the
report  unanimously  adopted  by  the  Legislative
Program Review and  Investigations  Committee,  on
December 11, 1997.  The  study  shall include, but
not be limited to:
    (1) The economic  impact  and strengthening of
the volunteer emergency medical services system;
    (2)  The  need   for  permanent  and  adequate
funding  for  the   Office  of  Emergency  Medical
Services, the emergency  medical services regional
councils and the grant program, as outlined in the
Legislative  Program  Review   and  Investigations
Committee report; and
    (3) The management  of  costs  associated with
quality training and education.
    (b) The task force shall consist of:
    (1) One member appointed by the speaker of the
House  of  Representatives,   to   represent   the
Emergency   Medical   Services    Advisory   Board
established in section 1 of this act;
    (2) One member  appointed by the president pro
tempore of the  Senate, to represent the emergency
medical services commercial sector;
    (3)  One  member  appointed  by  the  minority
leader  of  the   House   of  Representatives,  to
represent the municipal sector;
    (4)  One  member  appointed  by  the  minority
leader of the  Senate,  to represent the nonprofit
sector;
    (5) One member  appointed  by  the  Council of
Small Towns;
    (6) One member  appointed  by  the  council of
regional chairpersons, to  represent  the regional
councils;
    (7)  One member  appointed  by  the  volunteer
committee  of  the   Emergency   Medical  Services
Advisory Board, to represent the volunteer sector;
    (8)  One  member   appointed   by   the  house
chairperson of the joint standing committee of the
General  Assembly  having  cognizance  of  matters
relating  to  public  health,  to  represent  that
committee;
    (9) One member  appointed  by  the Connecticut
College of Emergency Physicians, to represent that
agency;
    (10)  One member  appointed  by  the  American
College of Surgeons, to represent that agency; and
    (11) The Commissioner  of Public Health or the
commissioner's designee.
    (c) All appointments  to  the task force shall
be  made no  later  than  thirty  days  after  the
effective date of  this section. Any vacancy shall
be filled by the appointing agency.
    (d)  The appointee  from  the  joint  standing
committee   of   the   General   Assembly   having
cognizance of matters  relating  to  public health
shall be the  chairperson  of this task force. The
chairperson shall schedule  the  first  meeting of
the task force,  which shall be held no later than
sixty  days  after  the  effective  date  of  this
section.
    (e) The task  force  shall report its findings
and   recommendations,   which    shall    include
recommendations concerning funding,  to  the joint
standing committee of  the General Assembly having
cognizance of matters  relating  to  public health
not later than January 15, 1999.
    Sec. 16. This  act  shall take effect from its
passage, except that  sections 1 to 14, inclusive,
shall take effect October 1, 1998.

Approved June 4, 1998