GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2001
H	1
HOUSE BILL 452

 
 
Short Title:	Emergency Medical Services Act Update-AB.	()	
Sponsors:	Representatives Wright; and Wainwright.	
Referred to:	Health.	
March 1, 2001

A BILL TO BE ENTITLED
AN ACT TO REVISE AND UPDATE THE EMERGENCY MEDICAL SERVICES ACT OF 1973.

The General Assembly of North Carolina enacts:
SECTION 1.  Article 56 of Chapter 143 reads as rewritten:
"Article 56.
"Emergency Medical Services Act of 1973.
"§ 143‑507.  Establishment of emergency medical services program.
(a)	There is established a comprehensive emergency medical services program in the Department of Health and Human Services. All responsibility for this program shall be vested in the Secretary of the Department of Health and Human Services and other officers, boards, and commissions specified by law or regulation.
(b)	This Article is to enable and assist providers of emergency medical services in the delivery of emergency medical services for all the people of North Carolina and the provision of medical care during a disaster.
(c)	Emergency medical services referred to in this Article include all services rendered in responding to improve the health and wellness of the community and to address the individual's need for  emergency medical care in order to prevent loss of life or further aggravation of physiological or psychological illness or injury. The Statewide Emergency Medical Services System  also includes first aid by members of the community; public knowledge and easy access into the system; prompt emergency medical dispatch of well designed, equipped, and staffed ambulances; effective care by credentialed personnel with appropriate disposition at the scene of the emergency; communications with the treatment center while at the scene and while in transit; routing and referral to the appropriate treatment facility; definitive care at the emergency treatment facility; injury prevention initiatives; wellness initiatives within the community and the public health system; and follow‑up lifesaving and restorative care.
"§ 143-508. Department of Health and Human Services to establish program; rules and regulations of North Carolina Medical Care Commission.
(a)	The State Department of Health and Human Services shall establish and maintain a program for the improvement and upgrading of emergency medical services throughout the State. The Department shall consolidate all State functions relating to emergency medical services, both regulatory and developmental, under the auspices of this program.
(b)	The North Carolina Medical Care Commission  shall adopt, amend, and rescind rules to carry out the purpose of this Article and  Articles 7 and 7A of Chapter  131E of the General Statutes regardless of other provisions of rule or law. These rules shall be adopted with the advice of the Emergency Medical Services Advisory Council. The Department of Health and Human Services shall enforce all rules adopted by the Commission.
(c)	The North Carolina Medical Care Commission may adopt rules with regard to emergency medical services, not inconsistent with the laws of this State, that may be required by the federal government for grants-in-aid for emergency medical services and licensure which may be made available to the State by the federal government. This section is to be liberally construed in order that the State and its citizens may benefit from such grants-in-aid.
(d)	The North Carolina Medical Care Commission shall adopt rules to do all of the following: (1)	Establish standards and criteria for the credentialing of emergency medical services agencies to carry out the purpose of Article 7 of Chapter 131E of the General Statutes of North Carolina.
(2)	Establish standards and criteria for the credentialing of trauma centers to carry out the purpose of Article 7A of Chapter 131E of the General Statutes of North Carolina.
(3)	Establish standards and criteria for the education and credentialing of emergency medical services personnel to carry out the purpose of Article 7 of Chapter 131E of the General Statutes of North Carolina.
(4)	Establish standards and criteria for the credentialing of EMS educational institutions to carry out the purpose of Article 7 of Chapter 131E of the General Statutes of North Carolina.
(5)	Establish standards and criteria for data collection as part of the statewide emergency medical services information system to carry out the purpose of G.S. 143-509(5).
(6)	Define the scope of practice of credentialed emergency medical services personnel.
(7)	Define the practice settings of credentialed emergency medical services personnel.
(8)	Establish standards for vehicles and equipment used within the emergency medical services system.
(9)	Establish standards for a statewide EMS communications system.
(10)	Establish standards and criteria for the denial, suspension, or revocation of emergency medical services credentials for emergency medical services agencies, educational institutions, and personnel including the establishment of fines for credentialing violations.
(11)	Establish standards and criteria for the education and credentialing of persons trained to administer lifesaving treatment to a person who suffers a severe adverse reaction to insect stings.
 
"§ 143‑509.  Powers and duties of Secretary.
The Secretary of the Department of Health and Human Services has full responsibilities for supervision and direction of the emergency medical services program and, to that end, shall accomplish all of the following:
(1)	After consulting with the Emergency Medical Services Advisory Council and with any local governments that may be involved, seek the establishment of a statewide, emergency medical services system, integrated with other health care providers and networks including, but not limited to, public health, community health monitoring activities, and special needs populations.
(2)	Repealed by Session Laws 1989, c. 74.
(3)	 Establish and maintain a comprehensive statewide trauma system in accordance with the provisions of Article 7A of Chapter 131E of the General Statutes of North Carolina and the rules of the North Carolina Medical Care Commission.
(4)	Establish and maintain a statewide emergency medical services communications system including designation of EMS radio frequencies and coordination of EMS radio communications networks within FCC rules and regulations.
(5)	Establish and maintain a statewide emergency medical services  information that provides information linkage between various public safety services and other health care providers.
(6)	Credential emergency medical services providers, vehicles, EMS educational institutions, and personnel after documenting that the requirements of the North Carolina Medical Care Commission are met.

(9)	Promote a means of training individuals to administer life‑saving treatment to persons who suffer a severe adverse reaction to insect stings. Individuals, upon successful completion of this training program, may be approved by the North Carolina Medical Care Commission to administer epinephrine to these persons, in the absence of the availability of physicians or other practitioners who are authorized to administer the treatment. This training may also be offered as part of the emergency medical services training program.
(10)	Establish and maintain a collaborative effort with other community resources and agencies to educate the public regarding EMS systems and issues.
(11)	Collaborate with community agencies and other health care providers to integrate the principles of injury prevention into the statewide EMS system to improve community health. 
(12)	Establish and maintain a means of medical direction and control for the statewide EMS system.
"§ 143‑510.  North Carolina Emergency Medical Services Advisory Council.
(a)	There is created an Emergency Medical Services Advisory Council to consult with the Secretary of the Department of Health and Human Services in the administration of this Article. 									
The North Carolina Emergency Medical Services Advisory Council shall consist of 21 members appointed by the Secretary of the Department of Health and Human Services to serve four-year terms. Three of the members shall represent the North Carolina Medical Society, and include one licensed pediatrician, surgeon, and public health physician. Three members shall represent the North Carolina College of Emergency Physicians, two of whom shall be current local EMS Medical Directors. Two members shall represent the North Carolina Committee on Trauma. One member each shall represent the North Carolina Association of Rescue and Emergency Medical Services, the North Carolina Association of EMS Administrators, the North Carolina Hospital Association, the North Carolina Nurses Association, and the North Carolina Association of County Commissioners. The remaining eight members shall be appointed so as to fairly represent the general public, credentialed and practicing EMS personnel, EMS educators, local public health officials, and other EMS interest groups in North Carolina.
(b)	The initial membership of the Council shall be the current 21 members of the North Carolina Emergency Medical Services Advisory Council. These persons shall serve as members of the Council for a period equal to the remainder of their current terms. Upon the expiration of these terms, the Secretary shall make appointments as hereinabove provided. The two Council members appointed by the General Assembly upon the recommendation of the President Pro Tempore of the Senate and the two Council members appointed by the General Assembly upon the recommendation of the Speaker of the House of Representatives shall not be reappointed at the end of their current terms on the Council.
(c)	Any appointment to fill a vacancy on the Council created by the resignation, dismissal, death, or disability of a member shall be for the balance of the unexpired term. Vacancies on the Council among the membership nominated by a society, association, or foundation as provided in subsection (a) of this section shall be filled by appointment of the Secretary upon consideration of a nomination by the Executive Committee or other authorized agent of the society, association, or foundation until the next meeting of the society, association, or foundation at which time the society, association, or foundation shall nominate a member to fill the vacancy for the unexpired term.
(d)	The members of the Council shall receive per diem and necessary travel and subsistence expenses in accordance with the provisions of G.S. 138-5.
(e)	A majority of the Council shall constitute a quorum for the transaction of business. All clerical and other services required by the Council shall be supplied by the Department of Health and Human Services, Division of Facility Services, Office of Emergency Medical Services.
"§ 143‑511.  Powers and duties of the Council.
The Emergency Medical Services Advisory Council  may advise the Secretary of the Department of Health and Human Services on personnel and policy issues regarding the statewide Emergency Medical Services program, including all rules proposed to be adopted by the North Carolina Medical Care Commission.
			
"§ 143‑512.  Regional demonstration plans.
The Secretary of the Department of Health and Human Services may develop and implement, in conjunction with any local sponsors that may agree to participate, regional emergency medical services systems in order to demonstrate the desirability of comprehensive regional emergency medical services systems and to determine the optimum characteristics of such plans. The Secretary may make special grants‑in‑aid to participants.
"§ 143‑513.  Regional emergency medical services councils.
The Secretary of the Department of Health and Human Services may establish emergency medical services regional councils to implement and coordinate emergency medical services programs within regions.

"§ 143‑515.  Establishment of regions.
The Secretary is authorized to establish an appropriate number of multicounty emergency medical services regions.
"§ 143‑516.  Single State agency.
The Department of Health and Human Services is hereby designated as the single agency for North Carolina for the purposes of all federal emergency medical services legislation as has or may be hereafter enacted to assist in development of emergency medical services plans and programs.
"§ 143‑517.  Ambulance support; free enterprise.
Each county shall ensure that emergency medical services are provided to its citizens. Nothing in this Article affects the power of local governments to finance ambulance operations or to support rescue squads. Nothing in this Article shall be construed to allow infringement on the private practice of medicine or the lawful operation of health care facilities.
"§ 143-518.  Confidentiality of patient information.
(a)	Medical records compiled and maintained by the Department or EMS providers in connection with dispatch, response, treatment, or transport of individual patients or in connection with the statewide trauma system pursuant to Article 7 of   Chapter 131E of the General Statutes may contain identifiable data which will allow linkage to other health care-based data systems for the purposes of quality management, peer review, and public health initiatives. 
This data shall be strictly confidential and shall not be released or made public except under any of the following conditions:
(1)	Release is made of specific medical or epidemiological information for statistical purposes in a way that no person can be identified.
(2)	Release is made of all or part of the medical record with the written consent of the person or persons identified or their guardians.
(3)	Release is made to health care personnel providing medical care to the patient.
(4)	Release is made pursuant to subpoena or court order. Upon request of the person identified in the record, the record shall be reviewed in camera. In the trial, the trial judge may, during the taking of testimony concerning such information, exclude from the courtroom all persons except the officers of the court, the parties, and those engaged in the trial of the case.
(5)	Release is made for the purposes of bona fide research purposes. The North Carolina Medical Care Commission shall adopt rules to establish standards and criteria providing for the use of the information for research purposes.
(b)	Charges, accounts, credit histories, and other personal financial records compiled and maintained by the Department or EMS providers in connection with the admission, treatment, and discharge of individual patients are strictly confidential and shall not be released.
"§§  143-519 through 143‑520:  Reserved for future codification purposes."
SECTION 2.  This act is effective when it becomes law.