0001| SENATE BILL 825 | 0002| 43rd legislature - STATE OF NEW MEXICO - first session, 1997 | 0003| INTRODUCED BY | 0004| CARLOS R. CISNEROS | 0005| | 0006| | 0007| | 0008| FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE | 0009| | 0010| AN ACT | 0011| RELATING TO HEALTH; PROVIDING AUTHORITY FOR OVERSIGHT AND | 0012| QUALITY ASSURANCE OF EXPANDED EMERGENCY MEDICAL SERVICES. | 0013| | 0014| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: | 0015| Section 1. Section 24-10B-3 NMSA 1978 (being Laws 1993, | 0016| Chapter 161, Section 2) is amended to read: | 0017| "24-10B-3. DEFINITIONS.--As used in the Emergency Medical | 0018| Services Act: | 0019| A. "academy" means a separately funded emergency | 0020| medical services training program administered through the | 0021| department of emergency medicine of the university of New | 0022| Mexico school of medicine; | 0023| B. "advance directive" means a written instruction, | 0024| such as a living will or durable power of attorney for health | 0025| care, recognizable under state law and relating to the | 0001| provision of health care when an individual is incapacitated; | 0002| C. "advanced life support" means advanced pre- | 0003| hospital and interfacility care and treatment, including basic | 0004| and intermediate life support, as prescribed by regulation, | 0005| which may be performed only by an individual licensed as a | 0006| paramedic by the bureau and operating under medical direction; | 0007| D. "air ambulance service" means any governmental | 0008| or private service that provides air transportation | 0009| specifically designed to accommodate the medical needs of a | 0010| person who is ill, injured or otherwise mentally or physically | 0011| incapacitated and who requires in-flight medical supervision; | 0012| E. "approved emergency medical services training | 0013| program" means an emergency medical services training program | 0014| that is sponsored by a post-secondary educational institution, | 0015| is accredited by the joint review committee on educational | 0016| programs or active in the accreditation process, as verified by | 0017| the chair of the joint review committee on educational | 0018| programs, or is approved by the joint organization on education | 0019| and participates in the joint organization on education; | 0020| F. "basic life support" means pre-hospital and | 0021| interfacility care and treatment, as prescribed by regulation, | 0022| which can be performed by all licensed emergency medical | 0023| technicians; | 0024| G. "bureau" means the primary care and emergency | 0025| medical services bureau of the public health division of the | 0001| department of health; | 0002| H. "certified emergency medical services first | 0003| responder" means a person who is certified by the bureau and | 0004| who functions within the emergency medical services system to | 0005| provide initial emergency aid, but not basic, intermediate or | 0006| advanced life support, to a person in need of medical | 0007| assistance; | 0008| I. "critical incident stress debriefing program" | 0009| means a program of preventive education and crisis intervention | 0010| intended to reduce the negative effects of critical stress on | 0011| emergency responders; | 0012| J. "curricula" means programs of study, the minimum | 0013| content of which has been developed by the joint organization | 0014| on education, for the initial and mandatory refresher training | 0015| of emergency medical technicians and certified emergency | 0016| medical services first responders; | 0017| K. "department" means the department of health; | 0018| L. "emergency medical dispatcher" means a person | 0019| who is trained and certified pursuant to Subsection [F] G | 0020| of Section 24-10B-4 NMSA 1978 to receive calls for emergency | 0021| medical assistance, provide pre-arrival medical instructions, | 0022| dispatch emergency medical assistance and coordinate its | 0023| response; | 0024| M. "emergency medical services" means the services | 0025| rendered by emergency medical technicians, certified emergency | 0001| medical services first responders or emergency medical | 0002| dispatchers in response to an individual's need for immediate | 0003| medical care to prevent loss of life or aggravation of physical | 0004| or psychological illness or injury; | 0005| N. "emergency medical services system" means a | 0006| coordinated system of health care delivery that includes | 0007| community education and prevention programs, centralized access | 0008| and emergency medical dispatch, trained first responders, | 0009| medical-rescue services, ambulance services, hospital emergency | 0010| departments and specialty care hospitals that respond to the | 0011| needs of the acutely sick and injured; | 0012| O. "emergency medical technician" means a health | 0013| care provider who has been licensed to practice by the bureau; | 0014| P. "expanded emergency medical services" means | 0015| those specifically approved special skills, including | 0016| preventive, public health and primary care outreach and triage | 0017| services, employed only under close medical direction by | 0018| specially trained and licensed emergency medical technicians, | 0019| in order to enhance access to the health care system in rural | 0020| and medically underserved areas; | 0021| [P.] Q. "intermediate life support" means | 0022| certain advanced pre-hospital and interfacility care and | 0023| treatment, including basic life support, as prescribed by | 0024| regulation, which may be performed only by an individual | 0025| licensed by the bureau and operating under medical direction; | 0001| [Q.] R. "joint review committee" means the | 0002| joint review committee on educational programs for the | 0003| emergency medical technician-paramedic, a nonprofit | 0004| organization incorporated in the state of Massachusetts; | 0005| [R.] S. "medical control" means supervision | 0006| provided by or under the direction of physicians to providers | 0007| by written protocol or direct communications; | 0008| [S.] T. "medical direction" means guidance or | 0009| supervision provided by a physician to a provider or emergency | 0010| medical services system and which includes authority over and | 0011| responsibility for emergency medical dispatch, direct patient | 0012| care and transport of patients, arrangements for medical | 0013| control and all other aspects of patient care delivered by a | 0014| provider; | 0015| [T.] U. "medical-rescue service" means a | 0016| provider that is part of the emergency medical services system, | 0017| but not subject to the authority of the state corporation | 0018| commission under the Ambulance Standards Act, and [which] | 0019| that may be dispatched to the scene of an emergency to | 0020| provide rescue or medical care; | 0021| [U.] V. "physician" means a doctor of medicine | 0022| or doctor of osteopathy who is licensed or otherwise authorized | 0023| to practice medicine or osteopathic medicine in New Mexico; | 0024| [V.] W. "protocol" means a predetermined, | 0025| written medical care plan and includes standing orders; | 0001| [W.] X. "provider" means a person or entity | 0002| delivering emergency medical services; | 0003| [X.] Y. "regional office" means a regional | 0004| emergency medical services planning and development agency | 0005| formally recognized and supported by the bureau; | 0006| [Y.] Z. "secretary" means the secretary of | 0007| health; | 0008| [Z.] AA. "special skills" means a set of | 0009| procedures or therapies that are beyond the usual scope of | 0010| practice of a given level of life support and that have been | 0011| approved by the medical direction committee for use by a | 0012| specified provider; and | 0013| [AA.] BB. "state emergency medical services | 0014| medical director" means a physician employed by the bureau to | 0015| provide overall medical direction to the statewide emergency | 0016| medical services program, whose duties include serving as a | 0017| liaison to the medical community and chairing the medical | 0018| direction committee." | 0019| Section 2. Section 24-10B-4 NMSA 1978 (being Laws 1983, | 0020| Chapter 190, Section 4, as amended) is amended to read: | 0021| "24-10B-4. BUREAU--DUTIES.--The bureau is designated as | 0022| the lead agency for the emergency medical services system and | 0023| shall establish and maintain a program for regional planning | 0024| and development, improvement, expansion, [and] direction, | 0025| review, oversight and quality assurance of emergency medical | 0001| services, including expanded emergency medical services, | 0002| throughout the state, including: | 0003| A. design, development, implementation and | 0004| coordination of communications systems to join the personnel, | 0005| facilities and equipment of a given region or system that will | 0006| allow for medical control of pre-hospital or interfacility | 0007| care; | 0008| B. provision of technical assistance to the state | 0009| corporation commission for further development and | 0010| implementation of standards for certification of ambulance | 0011| services, vehicles and equipment; | 0012| C. development of requirements for the collection | 0013| of data and statistics to evaluate the availability, operation | 0014| and quality of providers in the state; | 0015| D. adoption of regulations for medical direction of | 0016| a provider or emergency medical services system upon the | 0017| recommendation of the medical direction committee, including: | 0018| (1) development of model guidelines for | 0019| medical direction of all components of an emergency medical | 0020| services system, including expanded emergency medical | 0021| services; | 0022| (2) a process for notifying the bureau of the | 0023| withdrawal of medical control by a physician from a provider; | 0024| and | 0025| (3) specific requirements for medical | 0001| direction of intermediate and advanced life support personnel | 0002| and basic life support personnel with special skills approval; | 0003| E. maintenance of a list of approved emergency | 0004| medical services training programs, the graduates of which | 0005| shall be the only New Mexico emergency medical services | 0006| students eligible to apply for emergency medical technician | 0007| licensure or certified emergency medical services first | 0008| responder certification; | 0009| F. approval of continuing education programs for | 0010| emergency medical services personnel; | 0011| G. adoption of regulations pertaining to the | 0012| training and certification of emergency medical dispatchers and | 0013| their instructors; | 0014| H. adoption of regulations, based upon the | 0015| recommendations of the trauma advisory committee, for | 0016| implementation and monitoring of a statewide, comprehensive | 0017| trauma care system, including: | 0018| (1) minimum standards for designation or | 0019| retention of designation as a trauma center or a participating | 0020| trauma facility; | 0021| (2) pre-hospital care management guidelines | 0022| for the triage and transportation of traumatized persons; | 0023| (3) establishment [for] of interfacility | 0024| transfer criteria and transfer agreements; | 0025| (4) standards for collection of data relating | 0001| to trauma system operation, patient outcome and trauma | 0002| prevention; and | 0003| (5) creation of a state trauma care plan; | 0004| I. adoption of regulations, based upon the | 0005| recommendations of the air transport advisory committee, for | 0006| the certification of air ambulance services; | 0007| J. adoption of regulations pertaining to | 0008| authorization of providers to honor advance directives to | 0009| withhold or terminate care in certain pre-hospital or | 0010| interfacility circumstances, as guided by local medical | 0011| protocols; | 0012| K. development of guidelines, with consultation | 0013| from the state fire marshal, pertaining to the operation of | 0014| medical-rescue services within the emergency medical services | 0015| system; and | 0016| L. operation of a critical incident stress | 0017| debriefing program for emergency responders utilizing | 0018| specifically trained volunteers who shall be considered public | 0019| employees for the purposes of the Tort Claims Act when called | 0020| upon to perform a debriefing." | 0021| Section 3. Section 24-10B-7 NMSA 1978 (being Laws 1983, | 0022| Chapter 190, Section 7, as amended) is amended to read: | 0023| "24-10B-7. COMMITTEES ESTABLISHED.-- | 0024| A. The secretary shall appoint a statewide | 0025| emergency medical services advisory committee to advise the | 0001| bureau in carrying out the provisions of the Emergency Medical | 0002| Services Act. The advisory committee shall include | 0003| representatives from the state medical society, the state | 0004| emergency medical technicians' association, the state | 0005| firefighters' association, emergency medical service regional | 0006| offices and other interested provider and consumer groups. The | 0007| advisory committee shall establish appropriate subcommittees, | 0008| including a trauma advisory committee and an air transport | 0009| advisory committee. | 0010| B. The joint organization on education in emergency | 0011| medical services shall be composed of the directors and medical | 0012| directors of the academy and each approved emergency medical | 0013| services training program, the state emergency medical services | 0014| medical director and the bureau chief or his designee, who | 0015| shall serve without vote, and three persons who instruct | 0016| emergency medical technicians, one at each level of life | 0017| support, who are appointed by the secretary from a list | 0018| proposed by the statewide emergency medical services advisory | 0019| committee. The duties of the joint organization on education | 0020| include: | 0021| (1) developing minimum curricula content for | 0022| approved emergency medical services training programs; | 0023| (2) establishing minimum standards for | 0024| approved emergency medical services training programs; | 0025| (3) reviewing and approving the applications | 0001| of organizations seeking to become approved emergency medical | 0002| services training programs; and | 0003| (4) developing minimum qualifications for and | 0004| maintaining a list of instructors for each of the approved | 0005| emergency medical services training programs. | 0006| C. The secretary shall appoint a medical direction | 0007| committee to advise the bureau on matters relating to medical | 0008| control and medical direction. The state emergency medical | 0009| services medical director shall be a member of the committee | 0010| and shall act as its chairman. The medical direction committee | 0011| shall include a physician representative experienced in pre- | 0012| hospital medical care selected from a list proposed by the New | 0013| Mexico chapter of the American college of emergency physicians, | 0014| a physician representative from the academy, one physician from | 0015| each of the emergency medical services geographic regions and | 0016| one emergency medical technician at each level of life support. | 0017| Members shall be selected to represent both public and private | 0018| interests. The duties of the medical direction committee | 0019| include: | 0020| (1) reviewing the medical appropriateness of | 0021| all regulations proposed by the bureau; | 0022| (2) reviewing and approving the applications | 0023| of providers for special skills authorizations, including | 0024| those related to expanded emergency medical services; | 0025| (3) assisting in the development of | 0001| regulations pertaining to medical direction; and | 0002| (4) updating at least annually a list of | 0003| skills, techniques and medications approved for use at each | 0004| level of life support that [will] shall be approved by the | 0005| secretary and [that will be] issued by the bureau. | 0006| D. The committees created in this section [shall | 0007| be] are subject to the provisions of the Per Diem and | 0008| Mileage Act, to the extent that funds are available for that | 0009| purpose. | 0010| E. Any decision that the bureau proposes to make | 0011| contrary to the recommendation of any committee created in this | 0012| section shall be communicated in writing to that committee. | 0013| Upon the request of that committee, the decision shall be | 0014| submitted for reconsideration to the director of the public | 0015| health division of the department and subsequently to the | 0016| secretary. Any decision made pursuant to a request for | 0017| reconsideration shall be communicated in writing by the | 0018| department to the appropriate committee." | 0019|  | 0020| | 0021| | 0022| | 0023| | 0024| | 0025| | 0001| | 0002| | 0003| FORTY-THIRD LEGISLATURE | 0004| FIRST SESSION, 1997 | 0005| | 0006| | 0007| March 16, 1997 | 0008| | 0009| Mr. President: | 0010| | 0011| Your PUBLIC AFFAIRS COMMITTEE, to whom has been | 0012| referred | 0013| | 0014| SENATE BILL 825 | 0015| | 0016| has had it under consideration and reports same with | 0017| recommendation that it DO PASS. | 0018| | 0019| Respectfully submitted, | 0020| | 0021| | 0022| | 0023| | 0024| __________________________________ | 0025| Shannon Robinson, Chairman | 0001| | 0002| | 0003| | 0004| Adopted_______________________ Not | 0005| Adopted_______________________ | 0006| (Chief Clerk) (Chief Clerk) | 0007| | 0008| | 0009| Date ________________________ | 0010| | 0011| | 0012| The roll call vote was 5 For 0 Against | 0013| Yes: 5 | 0014| No: 0 | 0015| Excused: Adair, Boitano, Vernon, Smith | 0016| Absent: None | 0017| | 0018| | 0019| | 0020| | 0021| S0825PA1 | 0022| | 0023| FORTY-THIRD LEGISLATURE | 0024| FIRST SESSION, 1997 | 0025| | 0001| | 0002| March 16, 1997 | 0003| | 0004| Mr. President: | 0005| | 0006| Your PUBLIC AFFAIRS COMMITTEE, to whom has been | 0007| referred | 0008| | 0009| SENATE BILL 825 | 0010| | 0011| has had it under consideration and reports same with | 0012| recommendation that it DO PASS. | 0013| | 0014| Respectfully submitted, | 0015| | 0016| | 0017| | 0018| | 0019| __________________________________ | 0020| Shannon Robinson, Chairman | 0021| | 0022| | 0023| | 0024| Adopted_______________________ Not | 0025| Adopted_______________________ | 0001| (Chief Clerk) (Chief Clerk) | 0002| | 0003| | 0004| Date ________________________ | 0005| | 0006| | 0007| The roll call vote was 5 For 0 Against | 0008| Yes: 5 | 0009| No: 0 | 0010| Excused: Adair, Boitano, Vernon, Smith | 0011| Absent: None | 0012| | 0013| | 0014| | 0015| | 0016| S0825PA1 |