74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 623
Senate Bill 162
Printed pursuant to Senate Interim Rule 213.28 by order of the
President of the Senate in conformance with presession filing
rules, indicating neither advocacy nor opposition on the part
of the President (at the request of Governor Theodore R.
Kulongoski for Department of Human Services)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Modifies organization and duties of Emergency Medical Services
and Trauma Systems Program. Establishes and specifies duties of
State Critical Illness and Serious Injury Steering Committee.
Establishes and specifies duties of Oregon State Board of
Emergency Responders. Authorizes Governor to take certain actions
when emergency medical situation overwhelms local emergency
medical service resources.
A BILL FOR AN ACT
Relating to medical services provided in emergencies; creating
new provisions; amending ORS 146.015, 353.450, 431.607,
431.611, 431.623, 431.671, 442.507, 682.025, 682.028, 682.031,
682.051, 682.068, 682.075, 682.079, 682.204, 682.208, 682.212,
682.216, 682.220, 682.224, 682.245 and 682.991; and repealing
ORS 431.609, 431.613, 431.617, 431.619, 431.627, 431.633 and
682.039.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 431.607 is amended to read:
431.607. In cooperation with representatives of the emergency
medical services professions, the Department of Human Services
shall develop { - a - } comprehensive emergency medical
services and trauma { - system - } { + systems + }. The
department shall report progress on the { - system - }
{ + systems + } to the Legislative Assembly.
SECTION 2. ORS 431.623 is amended to read:
431.623. (1) The Emergency Medical Services and Trauma Systems
Program is created within the Department of Human Services for
the purpose of { - administering and regulating ambulances,
training and certifying emergency medical technicians,
establishing and maintaining emergency medical systems including
trauma systems and obtaining appropriate data from the Oregon
Injury Registry as necessary for trauma reimbursement, system
quality assurance and assuring cost efficiency. - } { +
organizing and coordinating efforts across the state to ensure
that a full range of care is delivered to critically or seriously
ill and injured patients. The activities organized and
coordinated by the program shall include, but are not limited to:
(a) Injury prevention.
(b) Designation and certification of trauma hospitals,
equipment and resources and critical care hospitals.
(c) Incident and injury identification.
(d) Prompt response to medical emergencies and transport of
patients to appropriate trauma hospitals or critical care
hospitals.
(e) Emergency room resuscitation and evaluation of patients.
(f) Interfacility transfer of patients to high level of trauma
care or critical care facilities when appropriate.
(g) Hospital-based multidisciplinary definitive management of
patient care.
(h) Physical and occupational therapy.
(i) Rehabilitation, reintroduction to society and follow-up
care of patients.
(j) Development and implementation of evidence-based patient
evaluation and statewide treatment guidelines for trauma and
emergency medical services systems.
(k) Continuous statewide case review and quality of care
improvement. + }
(2) For purposes of ORS 431.607 to { - 431.619 - } { +
431.671 + } and ORS chapter 682, the duties vested in the
department shall be performed by the Emergency Medical Services
and Trauma Systems Program.
{ - (3) The program shall be administered by a director. - }
{ - (4) - } { + (3) + } With moneys transferred to the
program by ORS 442.625 { + and from other sources + }, the
program { - shall apply those moneys - } { + is
authorized + } to:
{ - (a) Developing state and regional standards of care; - }
{ - (b) Developing a statewide educational curriculum to
teach standards of care; - }
{ - (c) Implementing quality improvement programs; - }
{ - (d) Creating a statewide data system for prehospital
care; and - }
{ - (e) Providing ancillary services to enhance Oregon's
emergency medical service system. - }
{ + (a)(A) Develop a statewide emergency medical and trauma
services plan and adopt rules necessary for implementation and
operation of the plan. The plan shall include both trauma and
critical illness care components and cover normal operations and
disaster response. Rules adopted to implement the plan must
specify critical illness and trauma care objectives and
standards, hospital categorization criteria and criteria and
procedures to be utilized in designating critical illness care
system hospitals;
(B) Revise the plan every four years; and
(C) Report biennially by January 31 of each odd-numbered year
to the Legislative Assembly in the manner provided in ORS 192.245
about the plan and any revisions that have been made to the plan;
(b) Create a regionalized system to deal with the care and
transport of patients experiencing life-threatening illness;
(c) Regulate emergency medical services agencies, ambulances,
medical emergency response vehicles and designated trauma
hospitals;
(d) Develop educational standards and curricula for the
training of emergency medical technicians and first responders;
(e) Provide training in rural areas of the state;
(f) Assist the Oregon State Board of Emergency Responders in
the regulation of emergency medical technicians and first
responders in:
(A) Establishing minimum qualifications for certification and
recertification;
(B) Providing for reciprocal certification and recertification
for qualified providers coming from outside this state who meet
standards established by this state; and
(C) Investigating the conduct of, and disciplining, emergency
medical technicians and first responders;
(g) Establish a process for designating and regulating trauma
hospitals that conform to standards established by the program
that includes:
(A) Investigating a designated trauma hospital; and
(B) Placing a designated trauma hospital on probation or
restricting, suspending or revoking a trauma hospital designation
for violations of program standards;
(h) Design, establish and maintain systems for the optimal
delivery of emergency medical services and trauma care, including
but not limited to the development of state and regional
standards of care;
(i) Evaluate the adequacy of care provided within the emergency
medical services and trauma care systems, including the
inspection of facilities, equipment and patient records;
(j) Design, establish and maintain a system for obtaining and
receiving appropriate data from emergency medical services
agencies and hospitals;
(k) Utilize data obtained pursuant to this section for agency
or hospital evaluation, system evaluation, quality improvement
and assuring cost efficiency;
(L) Implement measures to ensure the confidentiality of data
obtained pursuant to this section, in accordance with ORS 41.675,
41.685 and 192.501 to 192.505;
(m) Identify quality improvement needs and develop emergency
medical services system quality improvement initiatives;
(n) Develop an emergency medical services emergency response
plan that addresses the ability of the state to respond to
emergencies that exceed the response capability of local or
regional resources, and modify the plan at least every three
years; and
(o) Adopt rules as necessary for the administration of ORS
431.607 to 431.671 and ORS chapter 682.
(4) The program shall be administered by a State Emergency
Medical Services Director who shall be appointed by the Public
Health Officer. The director shall be responsible for all
administrative and managerial aspects of the Emergency Medical
Services and Trauma Systems Program.
(5) The Public Health Officer shall appoint an individual to be
responsible for medical and paramedical aspects of the Emergency
Medical Services and Trauma Systems Program. The individual
appointed shall provide support and technical assistance for
local emergency medical services medical directors and hospital
trauma directors to coordinate and standardize prehospital care
and trauma medical care throughout the state. The individual
appointed shall report to the State Emergency Medical Services
Director.
(6) The State Emergency Medical Services Director may adopt
rules necessary for the administration of ORS 431.607 to 431.671
and ORS chapter 682. + }
SECTION 3. { + ORS 431.607, 431.611, 431.623 and 431.671 and
sections 4 to 12 of this 2007 Act are added to and made a part of
ORS 431.607 to 431.671. + }
SECTION 4. { + As used in ORS 431.607 to 431.671:
(1) 'Ambulance' means any privately or publicly owned motor
vehicle, aircraft or marine craft that is licensed by the
Department of Human Services, operated by an emergency medical
services agency or an ambulance service and that is regularly
provided or offered to be provided for the emergency and
nonemergency transportation of persons who are ill or injured or
who have disabilities.
(2) 'Ambulance service' means any individual, partnership,
corporation, association, governmental agency or unit or other
entity that holds a license issued by the Department of Human
Services to provide emergency care and nonemergency care and
transportation to persons who are ill or injured or who have
disabilities.
(3) 'Ambulance service area' means an area that is served by
one or more ambulance services providing ground ambulance service
in all or a portion of a county or in all or portions of two or
more contiguous counties.
(4) 'Critical illness care system hospital' means a hospital
that has been granted a speciality designation for providing care
for a specific patient population, illness or injury by the
Department of Human Services.
(5) 'Emergency care' means the performance of acts or
procedures under emergency conditions relating to the
observation, care and counsel of persons who are ill or injured
or who have disabilities, and the administration of care or
medications as prescribed by a licensed physician, insofar as any
of these acts is based upon knowledge and application of the
principles of biological, physical and social science as required
by a completed course utilizing an approved curriculum in
prehospital emergency care. However, 'emergency care' does not
mean acts of medical diagnosis or prescription of therapeutic or
corrective measures.
(6) 'Emergency medical services agency' means any person,
partnership, corporation, governmental agency or unit, sole
proprietorship or other entity that utilizes emergency medical
technicians or first responders to provide prehospital emergency
or nonemergency care. An emergency medical services agency may be
either an ambulance service or a nontransporting service.
(7) 'Emergency medical services director' means a medical or
osteopathic physician actively licensed under ORS chapter 677,
and in good standing with the Board of Medical Examiners, who
provides direction of emergency care or nonemergency care
provided by emergency medical technicians, registered nurses or
physician assistants associated with a licensed emergency medical
services agency.
(8) 'Emergency medical technician' means a person who has
received formal training in prehospital care and emergency care
and is state certified to attend any person who is ill or injured
or who has a disability. Police officers, fire fighters, funeral
home employees and other personnel serving in a dual capacity,
one of which meets the definition of 'emergency medical
technician, ' are 'emergency medical technicians' within the
meaning of ORS chapter 682.
(9) 'First responder' means a person who has received formal
training and state certification in the on-scene stabilization of
any person who is ill or injured or who has a disability prior to
the arrival of an individual who can provide prehospital care and
emergency care. Police officers, fire fighters, funeral home
employees and other personnel serving in a dual capacity, one of
which meets the definition of a 'first responder,' are 'first
responders' within the meaning of ORS chapter 682.
(10) 'Medical emergency response vehicle' means any privately
or publicly owned motor vehicle, aircraft or marine craft
operated by an emergency medical services agency that is licensed
by the Department of Human Services and that is regularly
provided or offered to be provided for the emergency care and
nonemergency care, excluding transportation, of persons who are
ill or injured or who have disabilities.
(11) 'Nonemergency care' means the performance of acts or
procedures on a patient who is not expected to die, become
permanently disabled or suffer permanent harm within the next 24
hours, including but not limited to observation, care and counsel
of a patient and the administration of medications prescribed by
a physician licensed under ORS chapter 677, insofar as any of
those acts are based upon knowledge and application of the
principles of biological, physical and social science and are
performed in accordance with scope of practice rules adopted by
the Board of Medical Examiners in the course of providing
prehospital care as defined by this section.
(12) 'Nontransporting service' means any individual,
partnership, corporation, association, governmental agency or
unit or other entity that holds an emergency medical services
agency license to provide emergency care and nonemergency care,
excluding transportation, to persons who are ill or injured or
who have disabilities.
(13) 'Patient' means a person who is ill or injured or who has
a disability who is cared for through an emergency medical
services agency or hospital trauma service.
(14) 'Patient care report form' means a form approved by the
Department of Human Services that is completed for all patients
receiving prehospital assessment, care or transportation to a
medical facility.
(15) 'Prehospital care' means patient care that is rendered
through a licensed emergency medical services agency that
includes both emergency care and nonemergency care, and that may
involve an ambulance or a medical emergency response vehicle.
(16) 'Provider' means a person who provides medical care to a
patient.
(17) 'Public Health Officer' means the administrator appointed
by the Director of Human Services under ORS 431.045 to be
responsible for state public health activities.
(18) 'State Emergency Medical Services Director' means the
director appointed under ORS 431.623.
(19) 'Teaching institution' means a two-year community college,
a four-year degree-granting college or university or a career
school licensed by the Department of Education under ORS 345.010
to 345.450. + }
SECTION 5. { + (1) The Public Health Officer shall appoint a
State Critical Illness and Serious Injury Steering Committee
composed of 17 members as follows:
(a) Five physicians licensed under ORS chapter 677. Of the
five:
(A) One must specialize in the surgical care of trauma
patients;
(B) One must specialize in emergency medicine;
(C) One must specialize in the care of patients under 18 years
of age;
(D) One must specialize in the treatment of cardiovascular and
cerebrovascular illness; and
(E) One must be a local emergency medical services director.
(b) A trauma coordinator responsible for a trauma program in a
designated trauma hospital.
(c) A nurse specializing in emergency department nursing.
(d) An emergency medical technician or nurse specializing in
interfacility or speciality air transport services.
(e) A person who specializes in injury prevention.
(f) A representative of a community college or career school
that provides emergency medical technician education.
(g) A person who specializes in the care of patients with
special needs.
(h) A person specializing in health advocacy.
(i) An ambulance operator representing a volunteer,
governmental or private ambulance company.
(j) A hospital administrator.
(k) An emergency department administrator responsible for
overseeing the treatment of acutely ill and injured patients.
(L) An emergency medical technician whose practice consists of
routinely dealing with emergencies.
(m) A member of the public.
(2) The committee shall include at least one resident but no
more than five residents from each region served by one area
trauma advisory board at the time of appointment.
(3) The term of members appointed under subsection (1) of this
section is four years. Members may be reappointed to additional
terms. Vacancies shall be filled for any unexpired term as soon
as the Public Health Officer can make such appointments. Members
serve at the pleasure of the Public Health Officer.
(4) The committee shall choose its own chairperson and shall
meet at the call of the chairperson or the Public Health Officer.
(5) Members are entitled to compensation as provided in ORS
292.495.
(6) The State Critical Illness and Serious Injury Steering
Committee shall assist the Emergency Medical Services and Trauma
Systems Program in its efforts to:
(a) Develop and annually review a statewide emergency medical
services plan and to present a report to the Legislative Assembly
in January of every odd-numbered year;
(b) Identify quality improvement needs and develop emergency
medical services system quality improvement initiatives;
(c) Develop an emergency medical services emergency response
plan that addresses the ability of the state to respond to
emergencies that exceed the response capability of local or
regional resources, and modify the plan at least every three
years;
(d) Review and prioritize rural community emergency medical
service funding and training requests;
(e) Provide input to the Rural Health Coordinating Council, the
Area Health Education Center program, the Office of Rural Health
and other agencies dealing with rural health issues;
(f) Develop budget recommendations and present them to the
program in March of every even-numbered year;
(g) Develop a prioritized list of emergency medical services
and trauma services clinical concerns, present the list to the
program in June of every even-numbered year and work with the
State Emergency Medical Services Director to address these
concerns with emergency medical services agencies and medical
directors; and
(h) Participate in emergency preparedness planning, conduct
exercises based on the plans developed and enlist the
participation of appropriate emergency medical services agencies,
medical directors and hospitals in these activities.
(7) The State Critical Illness and Serious Injury Steering
Committee shall appoint and convene subcommittees that may be
comprised of members and nonmembers of the steering committee.
The chairperson of each subcommittee must be a member of the
steering committee. Subcommittees shall include, but are not
limited to:
(a) An emergency medical services subcommittee;
(b) A trauma advisory subcommittee;
(c) An emergency medical services for children subcommittee;
and
(d) Other medical specialty subcommittees.
(8) The emergency medical services subcommittee shall:
(a) Approve ambulance service area plans;
(b) Approve regional plans that include the designation level
of health care facilities within the region;
(c) Make the final determination on designation surveys; and
(d) Identify quality improvement needs through the analysis of
emergency medical services data collected from emergency medical
services agencies and hospitals by the Emergency Medical Services
and Trauma Systems Program as authorized under section 10 of this
2007 Act.
(9) The trauma advisory subcommittee shall, in accordance with
section 8 of this 2007 Act:
(a) Approve area trauma advisory board plans and plan
modifications;
(b) Make the final determination on trauma designation surveys;
and
(c) Identify trauma system quality improvement needs through
the analysis of data collected as authorized by section 10 of
this 2007 Act.
(10) The State Critical Illness and Serious Injury Steering
Committee is prohibited from discussing confidential data during
an open meeting, and from using or disclosing confidential data
for any purpose other than to carry out the duties established in
this section.
(11) Subcommittees established under this section may share
data collected by the program with other subcommittees of the
program.
(12) The program may assign other specific duties for the
subcommittees by rule after consultation with the State Critical
Illness and Serious Injury Steering Committee.
(13) Members of the subcommittees established as authorized by
this section are entitled to compensation as provided in ORS
292.495. + }
SECTION 6. { + Notwithstanding the term of office specified
for members of the State Critical Illness and Serious Injury
Steering Committee specified in section 5 of this 2007 Act, of
the members first appointed to the board:
(1) Five shall serve for a term ending on January 1, 2009.
(2) Six shall serve for a term ending on January 1, 2010.
(3) Six shall serve for a term ending on January 1, 2011. + }
SECTION 7. { + (1) After consultation with the trauma advisory
subcommittee established in section 5 of this 2007 Act, the
Emergency Services and Trauma Systems Program shall:
(a) Develop and monitor a statewide trauma system; and
(b) Designate trauma areas within the state consistent with
local resources, geography and current patient referral patterns.
(2) Each trauma area shall include two or more hospitals
designated or categorized according to trauma care capabilities
using standards modeled after the American College of Surgeons
Committee on Trauma standards that have been adopted by the
program by rule.
(3) The trauma advisory subcommittee shall establish area
trauma advisory boards in accordance with section 8 of this 2007
Act to:
(a) Develop trauma systems plans;
(b) Oversee regional quality improvement activities;
(c) Implement central medical control for all field care and
transportation consistent with geographic limitations and current
communications capability; and
(d) Develop regional triage protocols.
(4) Prior to approval and implementation of area trauma plans
submitted by area trauma advisory boards, the program shall adopt
rules pursuant to ORS chapter 183 that specify state trauma
objectives and standards, hospital categorization criteria and
criteria and procedures to be utilized in designating trauma
system hospitals. + }
SECTION 8. { + (1) The Emergency Services and Trauma Systems
Program shall designate trauma centers in areas that are within
the jurisdiction of trauma advisory boards.
(2) The program shall adopt rules pursuant to ORS chapter 183
that specify state trauma objectives and standards, hospital
categorization criteria, triage criteria, procedures to be
utilized in designating trauma system hospitals and procedures
for data collection, evaluation and quality improvement.
(3) A designated hospital must:
(a) Provide and maintain the resources, services and standards
adopted by the program by rule for the designation level of the
hospital; and
(b) Notify the program if resources, services and standards are
not maintained. + }
SECTION 9. { + (1) In consultation with the trauma advisory
subcommittee established by section 5 of this 2007 Act, the
Public Health Officer shall select a minimum of seven members for
each area trauma advisory board from lists submitted by regional
emergency medical technicians, emergency nurses, emergency
physicians, surgeons, hospital administrators, emergency medical
services agencies and citizens at large. Members of each advisory
board shall be representative of the trauma area as a whole.
(2) Area trauma advisory boards established in section 7 of
this 2007 Act shall meet as often as necessary to identify
specific trauma area needs and problems and to propose to the
Emergency Medical Services and Trauma System Program area trauma
system plans and changes to plans that meet state standards and
objectives. A trauma area advisory board must implement the area
trauma system plan following approval of the plans by the
program. + }
SECTION 10. { + (1) The Emergency Medical Services and Trauma
Systems Program shall develop and maintain reporting systems,
including the Emergency Medical Services and Trauma Systems
Database, to collect and analyze information on patient care and
outcomes as part of a quality improvement process and to allow
for appropriate research as defined by the program by rule.
(2) A designated trauma hospital must report data on each
patient presented to the hospital who is determined by the
hospital to exceed the injury severity score specified by the
program by rule.
(3) An emergency medical services agency may report data on
each patient served by using the patient care report form.
(4) A hospital must report data on each patient presented to
the hospital who is determined by the hospital to meet trauma
inclusion criteria specified by the program by rule.
(5) All data collected or developed by the program under this
section that identifies or may be used to identify a patient,
provider or facility is confidential and not subject to civil or
administrative subpoena or to discovery in a civil action,
including but not limited to a judicial, administrative,
arbitration or mediation proceeding.
(6) The program shall publish a biennial report that includes
an analysis of available aggregate data in the Emergency Medical
Services and Trauma Systems Database.
(7) Notwithstanding the confidentiality provisions in
subsection (5) of this section, the program may provide data to
subcommittees established under section 5 of this 2007 Act and to
researchers who meet the criteria for access to collected data
established by the program by rule in a manner that ensures
information on individual patients, providers or facilities
remains confidential.
(8) The program, in collaboration with the State Critical
Illness and Serious Injury Steering Committee, shall continuously
identify the causes of trauma and critical illness in Oregon, and
propose programs to prevent trauma and critical illness for
consideration by the Legislative Assembly or others.
(9) The Emergency Medical Services and Trauma System Program
shall adopt rules establishing:
(a) The data elements to be reported;
(b) Injury and illness severity criteria;
(c) Objectives, standards, criteria and procedures to be
utilized in administering the reporting and data systems, and to
the extent possible establish standards that are consistent with
nationally recognized guidelines; and
(d) Procedures for maintaining the confidentiality of the data
collected. + }
SECTION 11. { + (1) Area trauma advisory boards shall conduct
peer review of individual cases to monitor and assure quality of
care for trauma patients.
(2) Designated trauma centers, other hospitals and emergency
medical services agencies may conduct peer review on individual
cases to monitor and assure quality of care for trauma patients
and critically ill patients.
(3) Any information regarding patient care quality assurance
activities that identifies or may be used to identify a patient,
provider or facility collected or received by the Emergency
Medical Services and Trauma Systems Program, an area trauma
advisory board or the State Critical Illness and Serious Injury
Steering Committee or its subcommittees shall be confidential and
not subject to civil or administrative subpoena or to discovery
in a civil action, including but not limited to a judicial,
administrative, arbitration or mediation proceeding.
(4)(a) A person communicating information to the program or
serving on or communicating information to the State Critical
Illness and Serious Injury Steering Committee or its
subcommittees or an area trauma advisory board may not be
examined in any civil action, including but not limited to a
judicial, administrative, arbitration or mediation proceeding as
to whether a communication of any kind, including oral or written
communication, has been made or shared with the program, the
State Critical Illness and Serious Injury Steering Committee or
its subcommittees or an area trauma advisory board regarding
patient care quality assurance activities.
(b) A person communicating information to the program or
serving on or communicating information to the State Critical
Illness and Serious Injury Steering Committee or its
subcommittees or an area trauma advisory board shall not be
subject to an action for civil damages for actions taken or
statements made in good faith.
(5) Nothing in this section affects the admissibility in
evidence of a party's medical records not otherwise confidential
or privileged concerning the party's medical care.
(6) As used in this section, 'information' includes but is not
limited to written reports, notes, records, findings and
recommendations.
(7) Final reports developed by the program, the State Critical
Illness and Serious Injury Steering Committee or its
subcommittees or an area trauma advisory board on peer-reviewed
cases may be available to the public if the report does not
identify or cannot be used to identify any patient, provider or
facility. + }
SECTION 12. { + (1) Subject to the availability of funds, the
Emergency Medical Services and Trauma Systems Program may
reimburse designated trauma centers, emergency services
providers, trauma care providers, hospitals, emergency
departments, emergency medical services agencies and physical
rehabilitation centers for unsponsored or inadequately insured
trauma patients.
(2) In order to be eligible for reimbursement, designated
trauma centers, emergency services providers and trauma care
providers must:
(a) Provide data to the program as required by section 10 of
this 2007 Act;
(b) Comply with other reporting requirements established by the
program by rule; and
(c) Participate in quality improvement activities as required
by the program by rule.
(3) Reimbursement may not be made until:
(a) All data required by program rules is submitted;
(b) The program confirms that the care provided meets
reimbursement criteria established by the program by rule; and
(c) Funds are made available for distribution.
(4) Reimbursement may be made in a manner prescribed by
rule. + }
SECTION 13. ORS 431.611 is amended to read:
431.611. { - (1) Prior to approval and implementation of area
trauma plans submitted to the Department of Human Services by
area trauma advisory boards, the department shall adopt rules
pursuant to ORS chapter 183 which specify state trauma objectives
and standards, hospital categorization criteria and criteria and
procedures to be utilized in designating trauma system
hospitals. - }
{ - (2) For approved area trauma plans recommending
designation of trauma system hospitals, the department rules
shall provide for: - } { + For approved area trauma plans with
designated trauma system hospitals, rules adopted by the
Emergency Medical Services and Trauma Systems Program shall
provide for: + }
{ - (a) - } { + (1) + } The transport of a member of a
health maintenance organization, or other managed health care
system, as defined by rule, to a hospital that contracts with the
health maintenance organization when central medical control
determines that the condition of the member permits such
transport; and
{ - (b) - } { + (2) + } The development and utilization of
protocols between designated trauma hospitals and health
maintenance organizations, or other managed health care systems,
as defined by rule, including notification of admission of a
member to a designated trauma hospital within 48 hours of
admission, and coordinated discharge planning between a
designated trauma hospital and a hospital that contracts with a
health maintenance organization to facilitate transfer of the
member when the medical condition of the member permits.
SECTION 14. { + ORS 682.204, 682.208, 682.212, 682.216,
682.220, 682.224, 682.245 and 682.265 and sections 15, 17 and 18
of this 2007 Act are added to and made a part of ORS 682.204 to
682.265. + }
SECTION 15. { + (1) There is created within the Department of
Human Services an Oregon State Board of Emergency Responders
appointed by the Governor and composed of 11 members as follows:
(a) Five physicians licensed under ORS chapter 677 whose
practice consists of emergency medicine, at least two of whom are
local emergency medical services directors and at least one of
whom is a member of the emergency medical services subcommittee
established under section 5 of this 2007 Act.
(b) One emergency medical technician with a valid Oregon
paramedic certification.
(c) One emergency medical technician with a valid Oregon
intermediate paramedic certification.
(d) One emergency medical technician with a valid Oregon basic
paramedic certification.
(e) One first responder.
(f) One nurse who provides air medical response service.
(g) One member of the public with an interest in emergency
medical services who is not employed as a health professional or
in any health-related industry.
(2) In making appointments to the board, the Governor shall
give consideration to representation of the different geographic
regions of the state.
(3)(a) The members of the board shall be appointed by the
Governor for terms of four years, beginning on January 1. Members
of the board serve at the pleasure of the Governor. Members of
the board may be reappointed, but a member may not serve for more
than three consecutive terms. At the time of appointment, the
appointee to the board must be a citizen of the United States and
a resident of Oregon. Each professional member must be currently
licensed or certified and not under disciplinary status with the
professional regulatory board that regulates the member's
profession. If a vacancy on the Oregon State Board of Emergency
Responders occurs, a member shall be appointed in the same manner
as the original appointee to complete the unexpired term.
(b) All appointments of members of the board by the Governor
are subject to confirmation by the Senate pursuant to section 4,
Article III of the Oregon Constitution.
(4) Members are entitled to compensation as provided in ORS
292.495. + }
SECTION 16. { + Notwithstanding the term of office specified
for members of the Oregon State Board of Emergency Responders in
section 15 of this 2007 Act, of the members first appointed to
the board:
(1) Three shall serve for a term ending on January 1, 2009.
(2) Four shall serve for a term ending on January 1, 2010.
(3) Four shall serve for a term ending on January 1, 2011. + }
SECTION 17. { + (1) The Oregon State Board of Emergency
Responders shall elect annually from its number a chairperson, a
vice chairperson and a secretary, each of whom shall serve until
a successor is elected and qualified. The board shall meet at the
call of the chairperson or as the board may require. Special
meetings of the board may be called by the secretary at the
request of any three members of the board. Six members of the
board constitutes a quorum for the transaction of business.
(2) The State Emergency Medical Services Director appointed
under ORS 431.623 shall serve as the executive director of the
board. The executive director may employ and define the duties of
persons necessary to carry out the responsibilities of the board
as required by ORS 682.204 to 682.265 and sections 15, 17 and 18
of this 2007 Act. The executive director, with approval of the
board, may also contract with special consultants. All salaries,
compensation and expenses incurred or allowed shall be paid out
of funds received by the Emergency Medical Services and Trauma
Systems Program.
(3) The board shall:
(a) Monitor the practice of emergency medical technicians and
first responders.
(b) Prescribe standards and approve curricula for emergency
medical technician and first responder programs preparing persons
for licensing under ORS 682.204 to 682.265.
(c) Provide for surveys of nursing education programs at such
times as may be necessary.
(d) Approve emergency medical technician and first responder
programs that meet the requirements established by the board by
rule.
(e) Deny or withdraw approval of emergency medical technician
and first responder programs for failure to meet prescribed
standards.
(f) Examine, certify and renew the certifications of qualified
applicants for certification as emergency medical technicians or
first responders as provided in ORS 682.204 to 682.265.
(g) Provide a process for reciprocal certification for
qualified emergency medical technicians and first responders
coming from outside the state who meet the standards established
by the board by rule.
(h) Undertake investigations as authorized by ORS 682.220.
(i) Deny certification to applicants or discipline certified
emergency medical technicians and first responders as provided in
ORS 682.204 to 682.265.
(j) Enforce the provisions of ORS 682.204 to 682.265 and
sections 15, 17 and 18 of this 2007 Act and incur necessary
expenses therefor.
(k) Notify certificate holders at least annually of changes in
legislative or board rules that affect the certificate holders.
Notice may be by newsletter or other appropriate means.
(4) The board may require applicants and certificate holders to
provide to the board data concerning the individual's employment
and education.
(5) For the purpose of requesting a state or nationwide
criminal records check under ORS 181.534, the board may require
the fingerprints of a person who is:
(a) Applying for a certificate that is issued by the board;
(b) Applying for renewal of a certificate that is issued by the
board; or
(c) Under investigation by the board.
(6) The board shall keep a record of all its proceedings and of
all persons certified and schools or programs approved under this
section.
(7) The board may enter into executive session to consider
information obtained as part of an investigation of an applicant
or certificate holder as provided in ORS 192.660 (2)(k).
(8) The board must accept the scope of practice for emergency
medical technicians and first responders as established by the
Board of Medical Examiners.
(9) The board shall accept the accreditation status of teaching
institutions provided by the Department of Education.
(10) Pursuant to ORS chapter 183, the board shall adopt rules
necessary to carry out the provisions of ORS 682.204 to 682.265
and sections 15, 17 and 18 of this 2007 Act. + }
SECTION 18. { + The lapse, suspension or revocation of a
certificate by the operation of law, by order of the Oregon State
Board of Emergency Responders or by the decision of a court of
law, or the voluntary surrender of a certificate by a certificate
holder, does not deprive the board of jurisdiction to proceed
with any investigation of, or any action or disciplinary
proceeding against, the certificate holder or to revise or render
null and void an order of disciplinary action against the
certificate holder. + }
SECTION 19. ORS 682.025 is amended to read:
682.025. As used in this chapter, unless the context requires
otherwise:
(1) 'Ambulance' or 'ambulance vehicle' means any privately or
publicly owned motor vehicle, aircraft or watercraft that is
regularly provided or offered to be provided for the emergency
transportation of persons { - suffering from illness, injury or
disability - } { + who are ill or injured or who have
disabilities + }.
(2) 'Ambulance service' means any person, governmental unit,
corporation, partnership, sole proprietorship or other entity
that operates ambulances and that holds itself out as providing
prehospital care or medical transportation to { - sick, injured
or disabled persons - } { + persons who are ill or injured or
who have disabilities + }.
{ - (3) 'Board' means the Board of Medical Examiners for the
State of Oregon. - }
{ - (4) 'Department' means the Department of Human
Services. - }
{ - (5) - } { + (3) + } 'Emergency care' means the
performance of acts or procedures under emergency conditions
{ - in - } { + relating to + } the observation, care and
counsel of { - the ill, injured or disabled; in - }
{ + persons who are ill or injured or who have disabilities,
and + } the administration of care or medications as prescribed
by a licensed physician, insofar as any of these acts is based
upon knowledge and application of the principles of biological,
physical and social science as required by a completed course
utilizing an approved curriculum in prehospital emergency care.
However, 'emergency care' does not { - include - }
{ + mean + } acts of medical diagnosis or prescription of
therapeutic or corrective measures.
{ - (6) - } { + (4) + } 'Emergency medical technician' or
'EMT' means a person who has received formal training in
prehospital { - and emergency - } { + care, emergency care
and nonemergency + } care, and is state certified to attend any
{ - ill, injured or disabled - } person { + who is ill or
injured or who has a disability + }. Police officers,
firefighters, funeral home employees and other personnel serving
in a dual capacity one of which meets the definition of '
emergency medical technician' are 'emergency medical technicians'
within the meaning of this chapter.
{ + (5) 'Emergency responder' means a person certified by the
Oregon State Board of Emergency Responders to provide medical
care and who responds to emergencies. + }
{ - (7) - } { + (6) + } 'First responder' means a person
who has successfully completed a first responder training course
approved by the { - department - } { + Oregon State Board of
Emergency Responders + } and { - : - }
{ - (a) - } has been examined and certified as a first
responder by
{ - an authorized representative of the department - }
{ + the board + } to perform basic emergency { + care + } and
nonemergency care procedures { - ; or - }
{ - (b) Has been otherwise designated as a first responder by
an authorized representative of the department to perform basic
emergency and nonemergency care procedures - } .
{ - (8) - } { + (7) + } 'Fraud or deception' means the
intentional misrepresentation or misstatement of a material fact,
concealment of or failure to make known any material fact, or any
other means by which misinformation or false impression knowingly
is given.
{ - (9) - } { + (8) + } 'Governmental unit' means the state
or any county, municipality or other political subdivision or any
department, board or other agency of any of them.
{ - (10) - } { + (9) + } 'Highway' means every public way,
thoroughfare and place, including bridges, viaducts and other
structures within the boundaries of this state, used or intended
for the use of the general public for vehicles.
{ - (11) - } { + (10) + } 'Nonemergency care' means the
performance of acts or procedures on a patient who is not
expected to die, become permanently disabled or suffer permanent
harm within the next 24 hours, including but not limited to
observation, care and counsel of a patient and the administration
of medications prescribed by a physician licensed under ORS
chapter 677, insofar as any of those acts are based upon
knowledge and application of the principles of biological,
physical and social science and are performed in accordance with
scope of practice rules adopted by the Board of Medical Examiners
in the course of providing prehospital care as defined by this
section.
{ - (12) - } { + (11) + } 'Owner' means the person having
all the incidents of ownership in an ambulance service or an
ambulance vehicle or where the incidents of ownership are in
different persons, the person, other than a security interest
holder or lessor, entitled to the possession of an ambulance
vehicle or operation of an ambulance service under a security
agreement or a lease for a term of 10 or more successive days.
{ + (12) 'Paramedic' means a certified emergency medical
technician who has reached a level of competency established by
the Oregon State Board of Emergency Responders. + }
(13) 'Patient' means { - an ill, injured or disabled
person - } { + a person who is ill or injured or who has a
disability and who is + } transported in an ambulance.
(14) 'Person' means any individual, corporation, association,
firm, partnership, joint stock company, group of individuals
acting together for a common purpose or organization of any kind
and includes any receiver, trustee, assignee or other similar
representative thereof.
(15) 'Prehospital care' means that care rendered by emergency
medical technicians as an incident of the operation of an
ambulance as defined by this chapter and that care rendered by
emergency medical technicians as incidents of other public or
private safety duties, and includes, but is not limited to, '
emergency care' as defined by this section.
(16) 'Scope of practice' means the maximum level of emergency
{ + care + } or nonemergency care that an emergency medical
technician may provide { + as established by the Board of
Medical Examiners + }.
(17) 'Standing orders' means the written protocols that an
emergency medical technician follows to treat patients when
direct contact with a physician is not maintained.
(18) 'Supervising physician' means a medical or osteopathic
physician licensed under ORS chapter 677, actively registered and
in good standing with the board, who provides direction of
emergency { + care + } or nonemergency care provided by
emergency medical technicians.
(19) 'Unprofessional conduct' means conduct unbecoming a person
{ + applying to become or a person + } certified in emergency
care { + or nonemergency care + }, or { + conduct + }
detrimental to the best interests of the public { + , + } and
includes:
(a) Any conduct or practice contrary to recognized standards of
ethics of the medical profession or any conduct or practice
{ - which - } { + that + } does or might constitute a danger
to the health or safety of a patient or the public or any
conduct, practice or condition { - which - } { + that + }
does or might impair an emergency medical technician's ability
safely and skillfully to practice emergency { + care + } or
nonemergency care;
(b) Willful performance of any medical treatment
{ - which - } { + that + } is contrary to acceptable medical
standards; and
(c) Willful and consistent utilization of medical service for
treatment { - which - } { + that + } is or may be considered
inappropriate or unnecessary.
SECTION 20. ORS 682.028 is amended to read:
682.028. (1) It is unlawful for any person or governmental unit
to:
(a) Intentionally make any false statement on an application
for an ambulance service license, ambulance vehicle license or
for certification as an emergency medical technician or first
responder or on any other documents required by the Department of
Human Services { + , the Emergency Medical Services and Trauma
Systems Program or the Oregon State Board of Emergency
Responders + }; or
(b) Make any misrepresentation in seeking to obtain or retain a
certification or license.
(2) Any violation described in subsection (1) of this section
is also grounds for denial, suspension or revocation of a
certification or license under ORS 682.220.
SECTION 21. ORS 682.075 is amended to read:
682.075. (1) Subject to any law or rule pursuant thereto
relating to the construction or equipment of ambulances, the
Department of Human Services shall, with the advice of the State
{ - Emergency Medical Service - } { + Critical Illness and
Serious Injury Steering + } Committee appointed under { - ORS
682.039 - } { + section 5 of this 2007 Act + } and in
accordance with ORS chapter 183, adopt and when necessary amend
or repeal rules relating to the construction, maintenance,
capacity, sanitation, emergency medical supplies and equipment of
ambulances.
(2) In order for an owner to secure and retain a license for an
ambulance under this chapter, it shall meet the requirements
imposed by rules of the department. The requirements may relate
to construction, maintenance, capacity, sanitation and emergency
medical supplies and equipment on ambulances. Such requirements
shall include, but are not limited to, requirements relating to
space in patient compartments, access to patient compartments,
storage facilities, operating condition, cots, mattresses,
stretchers, cot and stretcher fasteners, bedding, oxygen and
resuscitation equipment, splints, tape, bandages, tourniquets,
patient convenience accessories, cleanliness of vehicle and
laundering of bedding.
SECTION 22. ORS 682.079 is amended to read:
682.079. (1) The Department of Human Services may grant
exemptions or variances from one or more of the requirements of
ORS 820.330 to 820.380 or this chapter or the rules adopted
thereunder to any class of vehicles if it finds that compliance
with such requirement or requirements is inappropriate because of
special circumstances which { + that + } would render compliance
unreasonable, burdensome or impractical due to special conditions
or cause, or because compliance would result in substantial
curtailment of necessary ambulance service. { - Such - }
Exemptions or variances may be limited in time or may be
conditioned as the department considers necessary to protect the
public welfare.
(2) In determining whether or not a variance shall be granted,
the advice of the State { - Emergency Medical Service - }
{ + Critical Illness and Serious Injury Steering + } Committee
shall be received and in all cases the equities involved and the
advantages and disadvantages to the welfare of patients and the
owners of vehicles shall be weighed by the department.
(3) Rules under this section shall be adopted, amended or
repealed in accordance with ORS 183.330.
SECTION 23. ORS 682.204 is amended to read:
682.204. (1) { - On and after September 13, 1975, - } It
shall be unlawful:
(a) For any person to act as an emergency medical technician
without being certified under this chapter.
(b) For any person or governmental unit { - which - }
{ + that + } operates an ambulance to authorize a person to act
for it as an emergency medical technician without being certified
under this chapter.
(c) For any person or governmental unit to operate or allow to
be operated in this state any ambulance unless it is operated
with at least one certified emergency medical technician.
(2) It is a defense to any charge under this section that there
was a reasonable basis for believing that the performance of
services contrary to this section was necessary to preserve human
life, that diligent effort was made to obtain the services of a
certified emergency medical technician and that the services of a
certified emergency medical technician were not available or were
not available in time as under the circumstances appeared
necessary to preserve such human life.
(3) Subsection (1) of this section is not applicable to any
individual, group of individuals, partnership, entity,
association or other organization otherwise subject thereto
providing a service to the public exclusively by volunteer unpaid
workers, nor to any person who acts as an ambulance attendant
therefor, provided that in the particular county in which the
service is rendered, the county court or board of county
commissioners has by order, after public hearing, granted
exemption from such subsection to the individual, group,
partnership, entity, association or organization. When exemption
is granted under this section, any person who attends an
{ - ill, injured or disabled person - } { + individual who is
ill or injured or who has a disability + } in an ambulance may
not purport to be an emergency medical technician or use the
designation 'EMT. '
SECTION 24. ORS 682.208 is amended to read:
682.208. (1) For any person to be certified as an emergency
medical technician or first responder, an application for
certification shall be made to the { - Department of Human
Services - } { + Oregon State Board of Emergency Responders + }.
The application shall be upon forms prescribed by the
{ - department - } { + board + } and shall contain:
(a) The name and address of the applicant.
(b) The name and location of the training course successfully
completed by the applicant and the date of completion.
(c) Certification that to the best of the applicant's knowledge
the applicant is physically and mentally qualified to act as an
emergency medical technician or first responder, is free from
addiction to controlled substances or alcoholic beverages, or if
not so free, has been and is currently rehabilitated and is free
from epilepsy or diabetes, or if not so free, has been free from
any lapses of consciousness or control occasioned thereby for a
period of time as prescribed by rule of the { - department - }
{ + board + }.
(d) { - Such - } Other information { - as - }
{ + that + } the { - department - } { + board + } may
reasonably require to determine compliance with applicable
provisions of this chapter and the rules adopted thereunder.
(2) The application shall be accompanied by proof as prescribed
by rule of the { - department - } { + board + } of the
applicant's successful completion of a training course approved
by the
{ - department - } { + board + }, and if an extended period
of time has elapsed since the completion of the course, of a
satisfactory amount of continuing education.
(3) The { - department - } { + board + } shall adopt a
schedule of minimum educational requirements in emergency
{ + care + } and nonemergency care for emergency medical
technicians and first responders. The
{ - department, with the advice of the State Emergency Medical
Service Committee, - } { + board + } may establish levels of
emergency medical technician certification as may be necessary to
serve the public interest. A course approved by the
{ - department - } { + board + } shall be designed to protect
the welfare of out-of-hospital patients, to promote the health,
well-being and saving of the lives of such patients and to reduce
their pain and suffering.
SECTION 25. ORS 682.212 is amended to read:
682.212. (1) A nonrefundable initial application fee shall be
submitted with the initial application for emergency medical
technician and first responder certification. In addition, a
nonrefundable examination fee shall be submitted for the
following purposes:
(a) First responder written examination;
(b) Emergency medical technician written examination;
(c) Emergency medical technician practical examination; and
(d) A fee deemed necessary by the { - Department of Human
Services - } { + Oregon State Board of Emergency Responders + }
to cover the fee charged by the national examination agency or
other examination service utilized by the department for the
purpose of examining candidates for emergency medical technician
certification.
{ + (2) The board shall establish by rule a fee for:
(a) Renewal of a certificate.
(b) Late renewal of a certificate.
(c) Certification by indorsement.
(d) Issuance of a duplicate certificate. + }
{ - (2) - } { + (3) + } Subject to the review of the Oregon
Department of Administrative Services, the fees and charges
established under this section shall not exceed the cost of
administering the regulatory program of the { - Department of
Human Services - } { + board + } pertaining to the purpose for
which the fee or charge is established, as authorized by the
Legislative Assembly for the
{ - department's - } { + board's + } budget, as the budget
may be modified by the Emergency Board.
{ - (3) - } { + (4) + } All moneys received by the
{ - department - } { + board + } under this chapter shall be
paid into the General Fund in the State Treasury and placed to
the credit of the { - department account and such moneys
hereby - } { + Oregon State Board of Emergency Responders
Account, which is established. Moneys in the account + } are
appropriated continuously { + to the board + } and shall be used
only for the administration and enforcement of this chapter.
SECTION 26. ORS 682.216 is amended to read:
682.216. (1) When application has been made as required under
ORS 682.208, the { - Department of Human Services - }
{ + Oregon State Board of Emergency Responders + } shall certify
the applicant as an emergency medical technician or as a first
responder if it finds:
(a) The applicant has successfully completed a training course
approved by the { - department - } { + board + }.
(b) The applicant's physical and mental qualifications have
been certified as required under ORS 682.208.
(c) No matter has been brought to the attention of the
{ - department which - } { + board that + } would disqualify
the applicant.
(d) A nonrefundable fee has been paid to the department
pursuant to ORS 682.212.
(e) The applicant for emergency medical technician
certification is 18 years of age or older and the applicant for
first responder is 16 years of age or older.
(f) The applicant has successfully completed examination as
prescribed by the { - department - } { + board + }.
(g) The applicant meets other requirements prescribed { + by
the board + } by rule { - of the department - } .
(2) The { - department - } { + board + } may provide for
the issuance of a provisional certification for emergency medical
technicians.
(3) The { - department - } { + board + } may issue by
indorsement certification for emergency medical technician
without proof of completion of an approved training course to an
emergency medical technician who is licensed { + or
certified + } to practice emergency care in another state of the
United States or a foreign country if, in the opinion of the
{ - department - } { + board + }, the applicant meets the
requirements of certification in this state and can demonstrate
to the satisfaction of the { - department - } { + board + }
competency to practice emergency care. The { - department - }
{ + board + } shall be the sole judge of credentials of any
emergency medical technician applying for certification without
proof of completion of an approved training course.
(4) Each person holding a certificate under ORS 682.208 and
this section shall submit, at the time of application for renewal
of the certificate to the { - department - } { + board + },
evidence of the applicant's satisfactory completion of a
{ - department - } { + board + } approved program of
continuing education and other requirements prescribed by rule by
the { - department - } { + board + }.
(5) The { - department - } { + board + } shall prescribe
{ + by rule + } criteria and approve programs of continuing
education in emergency { + care + } and nonemergency care to
meet the requirements of this section.
(6) The { - department - } { + board + } shall include a
fee pursuant to ORS 682.212 for late renewal and for issuance of
any duplicate certificate. Each certification issued under this
section, unless sooner suspended or revoked, shall expire and be
renewable after a period of two years. Each certificate must be
renewed on or before June 30 of every second year. The
{ - department - } { + board + } by rule shall establish a
schedule of certificate renewals under this subsection and shall
prorate the fees to reflect any shorter certificate period.
(7) Nothing in this chapter authorizes an emergency medical
technician or first responder to operate an ambulance without a
driver license as required under the Oregon Vehicle Code.
SECTION 27. ORS 682.220 is amended to read:
682.220. (1) The Department of Human Services may deny, suspend
or revoke licenses for ambulances and ambulance services in
accordance with the provisions of ORS chapter 183 for a failure
to comply with any of the requirements of ORS 820.350 to 820.380
and this chapter or the rules adopted thereunder.
(2) The { + Oregon State Board of Emergency Responders may
deny, suspend or revoke the + } certification of an emergency
medical technician { - may be denied, suspended or revoked - }
{ + or first responder + } in accordance with { - the
provisions of - } ORS chapter 183 { + and ORS 682.224 + } for
any of the following reasons:
(a) A failure to have completed successfully a
{ - department - } { + board + } approved course.
(b) In the case of provisional certifications, failure to have
completed successfully a { - department - } { + board + }
approved course.
(c) Failure to meet or continue to meet the physical and mental
qualifications required to be certified under ORS 682.208.
(d) The use of fraud or deception in receiving a certificate.
(e) Practicing skills beyond the scope of practice established
by the Board of Medical Examiners for the State of Oregon under
ORS 682.245.
(f) Rendering emergency { + care + } or nonemergency care
under an assumed name.
(g) The impersonation of another EMT { + or first
responder + }.
(h) Unprofessional conduct.
(i) Obtaining a fee by fraud or misrepresentation.
(j) Habitual or excessive use of intoxicants or { + use of
illegal + } drugs.
(k) The presence of a mental disorder that demonstrably affects
an EMT's { + or first responder's + } performance, as certified
by two psychiatrists retained by the { - department - } { +
board + }.
(L) Subject to ORS 670.280, conviction of any criminal offense
that reasonably raises questions about the ability of the EMT
{ + or first responder + } to perform the duties of an EMT
{ + or first responder + } in accordance with the standards
established by this chapter. A copy of the record of conviction,
certified to by the clerk of the court entering the conviction,
shall be conclusive evidence of the conviction.
(m) Suspension or revocation of an emergency medical technician
{ + or first responder + } certificate issued by another state:
(A) For a reason that would permit the { - department - }
{ + board + } to suspend or revoke a certificate issued under
this chapter; and
(B) Evidenced by a certified copy of the order of suspension or
revocation.
(n) Gross negligence or repeated negligence in rendering
emergency medical assistance.
(o) Rendering emergency { + care + } or nonemergency care
without being certified except as provided in ORS 30.800.
(p) Rendering emergency { + care + } or nonemergency care as
an EMT { + or first responder + } without written authorization
and standing orders from a supervising physician who has been
approved by the board in accordance with ORS 682.245.
(q) { + Failing to cooperate with a board investigation,
including but not limited to + } refusing an invitation for an
interview with the { - department - } { + board + } as
specified in this section. { +
(r) Violating an order of the board. + }
(3) { + (a) + } The { - department - } { + board + } may
investigate any evidence that appears to show that an
{ + applicant for certification or an + } EMT { + or + }
{ + first responder + } certified by the { - department - }
{ + board + } is or may be medically incompetent, guilty of
unprofessional or dishonorable conduct or mentally or physically
unable to safely function as an EMT { + or first responder + }.
{ + (b) The board may require a certificate holder or
applicant for certification to undergo a psychological, physical,
psychiatric or alcohol or chemical dependency assessment if the
board has reasonable cause to believe that a certificate holder
or applicant has a psychological, physical, psychiatric or
alcohol or chemical dependency problem that may effect the
ability of the certificate holder or applicant to perform the
duties of an EMT or first responder.
(c) + } The { - department - } { + board + } may
investigate the off-duty conduct of an EMT { + or first
responder + } to the extent that such conduct may reasonably
raise questions about the ability of the EMT { + or first
responder + } to perform the duties of an EMT { + or first
responder + } in accordance with the standards established by
this chapter.
{ + (d) + } Upon receipt of a complaint about an EMT { + ,
first responder + } or applicant, the { - department - }
{ + board + } shall conduct an investigation as described under
ORS 676.165. An investigation shall be conducted in accordance
with ORS 676.175.
(4) Any health care facility licensed under ORS 441.015 to
441.087 and 441.820, any medical or osteopathic physician
licensed under ORS chapter 677, any owner of an ambulance
licensed under this chapter or any EMT certified under this
chapter shall report to the { - department - } { + board + }
any information the person may have that appears to show that an
EMT { + or first responder + } is or may be medically
incompetent, guilty of unprofessional or dishonorable conduct or
mentally or physically unable to safely function as an EMT
{ + or first responder + }.
(5) If, in the opinion of the { - department - }
{ + board + }, it appears that the information provided to
{ - it - } { + the board + } under provisions of this section
is or may be true, the { - department - } { + board + } may
request an interview with the EMT { + or first responder + }. At
the time the { - department - } { + board + } requests an
interview, the EMT { + or first responder + } shall be provided
with a general statement of the issue or issues of concern to the
{ - department - } { + board + }. The request shall include a
statement of the procedural safeguards available to the EMT
{ + or first responder + }, including the right to end the
interview on request, the right to have counsel present and the
following statement: 'Any action proposed by the { - Department
of Human Services - } { + Oregon State Board + } { + of
Emergency Responders + } shall provide for a contested case
hearing. '
(6) Information regarding an ambulance service provided to the
{ + board or + } Department { + of Human Services + } pursuant
to this section is confidential and shall not be subject to
public disclosure, nor shall it be admissible as evidence in any
judicial proceeding. Information that the { + board or + }
department obtains as part of an investigation into emergency
medical technician { + , first responder + } or applicant conduct
or as part of a contested case proceeding, consent order or
stipulated agreement involving emergency medical technician { + ,
first responder + } or applicant conduct is confidential as
provided under ORS 676.175. Information regarding an ambulance
service does not become confidential due to its use in a
disciplinary proceeding against an emergency medical
technician { + or first responder + }.
(7) Any person who reports or provides information to the { +
board or + } Department { + of Human Services + } under this
section and who provides information in good faith shall not be
subject to an action for civil damage as a result thereof.
(8) In conducting an investigation under subsection (3) of this
section, the { - department - } { + board + } may:
(a) Take evidence;
(b) Take depositions of witnesses, including the person under
investigation, in the manner provided by law in civil cases;
(c) Compel the appearance of witnesses, including the person
under investigation, in the manner provided by law in civil
cases;
(d) Require answers to interrogatories; { - and - }
(e) Compel the production of books, papers, accounts, documents
and testimony pertaining to the matter under investigation
{ - . - } { + ; and
(f) Require physical, mental or other evaluations at the
applicant's or certificate holder's expense. + }
(9) The { - department - } { + board + } may issue
subpoenas to compel compliance with the provisions of subsection
(8) of this section. If any person fails to comply with a
subpoena issued under this subsection, or refuses to testify on
matters on which the person may lawfully be interrogated, a court
may compel obedience as provided in ORS 183.440.
{ + (10) Failure to cooperate with an Oregon State Board of
Emergency Responders investigation may be considered
unprofessional conduct. + }
SECTION 28. ORS 682.224 is amended to read:
682.224. (1) The Department of Human Services may discipline
{ - , as provided in this section, - } an ambulance service
{ - or - } { + and the Oregon State Board of Emergency
Responders may discipline + } any person certified as an
emergency medical technician or first responder in this state who
has:
(a) Admitted the facts of a complaint which alleges facts which
establish that such person is guilty of violation of one or more
of the grounds for suspension or revocation of a certificate as
set forth in ORS 682.220 or that an ambulance service has
violated the provisions of this chapter or the rules adopted
thereunder.
(b) { - Been found guilty - } In accordance with ORS chapter
183 { + , + }
{ - of violation of - } { + been found to have violated + }
one or more of the grounds for suspension or revocation of
certification as set forth in ORS 682.220 or that an ambulance
service has violated the provisions of this chapter or the rules
adopted thereunder.
(2) The purpose of disciplining an EMT { + or first
responder + } under this section is to ensure that the EMT
{ + or first responder + } will provide services that are
consistent with the obligations of this chapter. Prior to taking
final disciplinary action, the
{ - department - } { + board + } shall determine if the EMT
{ + or first responder + } has been disciplined for the
questioned conduct by the EMT's { + or first responder's + }
employer or supervising physician. The
{ - department - } { + board + } shall consider any such
discipline or any other corrective action in deciding whether
additional discipline or corrective action by the
{ - department - } { + board + } is appropriate.
(3) In disciplining an EMT { + , first responder + } or
ambulance service as authorized by subsection (1) of this
section, the { + board or + } department may use any or all of
the following methods:
(a) Suspend judgment.
(b) Issue a letter of reprimand.
(c) Issue a letter of instruction.
(d) Place the EMT { + , first responder + } or ambulance
service on probation.
(e) Suspend the EMT { + or first responder + } certificate or
{ + the + } ambulance service license.
(f) Revoke the EMT { + or first responder + } certificate or
{ + the + } ambulance service license.
(g) Place limitations on the certificate of the EMT { + or
first responder + } to practice emergency { + care + } or
nonemergency care in this state or place limitations on the
license of the ambulance service.
(h) Take such other disciplinary action as the { + board
or + } department in its discretion finds proper, including
assessment of the costs of the disciplinary proceedings as a
civil penalty or assessment of a civil penalty not to exceed
$5,000, or both.
(4) In addition to the action authorized by subsection (3) of
this section, the { + board or + } department may temporarily
suspend a certificate or license without a hearing,
simultaneously with the commencement of proceedings under ORS
chapter 183 if the { + board or + } department finds that
evidence in its possession indicates that a continuation in
practice of the EMT { + or first responder + } or operation of
the ambulance service constitutes an immediate danger to the
public.
(5) If { + , as set forth in subsection (3)(d) of this
section, + } the { - department - } { + board + } places any
EMT { + or first responder on probation + } or { + the
department places an + } ambulance service on probation { - as
set forth in subsection (3)(d) of this section - } , the { +
board or + } department may determine, and may at any time
modify, the conditions of the probation and may include among
them any reasonable condition for the purpose of protection of
the public and for the purpose of the rehabilitation of the
EMT { + , first responder + } or ambulance service, or both. Upon
expiration of the term of probation, further proceedings shall be
abated if the EMT { + , first responder + } or ambulance service
has complied with the terms of the probation.
(6) If an EMT { + or first responder + } certified in this
state is suspended, the holder of the certificate may not
practice during the term of suspension.
(7) If an ambulance service licensed in this state is
suspended, the ambulance service may not operate in this state
during the term of the suspension, provided that the department
shall condition such suspension upon such arrangements as may be
necessary to assure the continued availability of ambulance
service in the area served by that ambulance service. Upon
expiration of the term of suspension, the certificate or license
shall be reinstated by the department if the conditions for which
the certificate or license was suspended no longer exist.
(8) Whenever an EMT { + or first responder + } certificate or
ambulance service license is denied or revoked for any cause, the
{ + board or + } department may, in { - its - } { + the
board's or department's + } discretion, after the lapse of two
years from the date of such { + denial or + } revocation, upon
written application by the person { + denied, + } formerly
certified or licensed and after a hearing, issue or restore the
EMT { + or first responder + } certificate or ambulance service
license.
(9) Civil penalties under this section shall be imposed as
provided in ORS 183.745.
SECTION 29. ORS 682.245 is amended to read:
682.245. (1) The Board of Medical Examiners for the State of
Oregon shall adopt by rule a scope of practice for emergency
medical technicians { + and first responders + } at such levels
as may be established by the { - Department of Human Services
and for first responders - } { + Oregon State Board + } { +
of Emergency Responders + }.
(2) The Board { + of Medical Examiners + } shall adopt by rule
standards for the qualifications and responsibilities of
supervising physicians.
(3) The standing orders for emergency medical technicians and
first responders may not exceed the scope of practice defined by
the Board { + of Medical Examiners + }.
(4) No emergency medical technician shall provide patient care
or treatment without written authorization and standing orders
from a supervising physician who has been approved by the
Board { + of Medical Examiners + }.
(5) The policies and procedures for applying and enforcing this
section may be delegated in whole or in part to the
{ - department - } { + Oregon State Board of Emergency
Responders + }.
SECTION 30. ORS 682.991 is amended to read:
682.991. (1) Violation of any provision of ORS 682.028, 682.047
(5) or 682.204 is a Class A misdemeanor. Each day of continuing
violation shall be considered a separate offense.
(2) Violation of any provision of this chapter is a
misdemeanor. In any prosecution for such violation it shall be
sufficient to sustain a conviction to show a single act of
conduct in violation of any of the provisions of this chapter and
it shall not be necessary to show a general course of such
conduct.
(3) In addition to the penalties under this section, the { +
Oregon State Board of Emergency Responders or the + } Department
of Human Services may assess civil penalties of up to $5,000 per
violation against any entity or person licensed under this
chapter or subject to licensure under this chapter.
SECTION 31. ORS 146.015 is amended to read:
146.015. (1) There is hereby established the State Medical
Examiner Advisory Board.
(2) The advisory board shall make policies for the
administration of ORS 146.003 to 146.165 and the Department of
State Police shall make rules to effectuate such policies.
(3) The advisory board shall recommend the name or names of
pathologists to the Superintendent of State Police from which the
superintendent shall appoint the State Medical Examiner.
(4) The State Medical Examiner Advisory Board shall consist of
10 members appointed by the Governor and shall include:
(a) The Chairman of the Department of Anatomic Pathology at the
Oregon Health and Science University, who shall be the
chairperson of the board;
(b) The State Health Officer;
(c) A sheriff;
(d) A trauma physician recommended by the { - State Trauma
Advisory Board - } { + Emergency Medical Services and Trauma
Systems Program + };
(e) A pathologist;
(f) A district attorney;
(g) A funeral service practitioner and embalmer licensed by the
State Mortuary and Cemetery Board;
(h) A chief of police;
(i) A member of the defense bar; and
(j) A member of the public at large.
(5) The persons described in subsection (4)(a) and (b) of this
section shall serve as long as they hold their respective
positions. The terms of the persons described in subsection
(4)(c), (f) and (h) of this section shall be for four years,
except that they shall become vacant if the person ceases to be a
sheriff, district attorney or chief of police, respectively. The
terms of the other members of the board shall be four years.
(6) A member of the advisory board is entitled to compensation
and expenses as provided in ORS 292.495.
(7) The advisory board shall meet annually at a time and place
determined by the chairperson. The chairperson or any four
members of the board may call a special meeting upon not less
than one week's notice to the members of the board.
(8) Six members of the board shall constitute a quorum.
SECTION 32. ORS 353.450 is amended to read:
353.450. (1) It is the finding of the Legislative Assembly that
there is need to provide programs that will assist a rural
community to recruit and retain physicians, physician assistants
and nurse practitioners. For that purpose:
(a) The Legislative Assembly supports the development at the
Oregon Health and Science University of an Area Health Education
Center program as provided for under the United States Public
Health Service Act, Section 781.
(b) The university shall provide continuing education
opportunities for persons licensed to practice medicine under ORS
chapter 677 who practice in rural areas of this state in
cooperation with the respective professional organizations,
including the Oregon Medical Association and the Oregon Society
of Physician Assistants.
(c) The university shall seek funding through grants and other
means to implement and operate a fellowship program for
physicians, physician assistants and nurse practitioners
intending to practice in rural areas.
(2) With the moneys transferred to the Area Health Education
Center program by ORS 442.625, the program shall:
(a) Establish educational opportunities for emergency medical
technicians in rural counties;
(b) Contract with educational facilities qualified to conduct
emergency medical training programs using a curriculum approved
by the Emergency Medical Services and Trauma Systems Program; and
(c) Review requests for training funds with input from the
{ - State Emergency Medical Service Committee - }
{ + Emergency Medical Services and Trauma Systems Program + }
and other individuals with expertise in emergency medical
services.
SECTION 33. ORS 431.671 is amended to read:
431.671. (1) Subject to available funding from gifts, grants or
donations, the Emergency Medical Services for Children Program is
established in the Department of Human Services. The Emergency
Medical Services for Children Program shall operate in
cooperation with the Emergency Medical Services and Trauma
Systems Program to promote the delivery of emergency medical and
trauma services to the children of Oregon.
(2) The Department of Human Services shall:
(a) Employ or contract with professional, technical, research
and clerical staff as required to implement this section.
(b) Provide technical assistance to the { - State Trauma
Advisory Board - } { + emergency medical services for children
subcommittee of the State Critical Illness and Serious Injury
Steering Committee + } on the integration of an emergency medical
services for children program into the statewide emergency
medical services and trauma { - system - } { + systems + }.
(c) Provide advice and technical assistance to { - area
trauma advisory boards - } { + the emergency medical services
for children subcommittee of the State Critical Illness and
Serious Injury Steering Committee + } on the integration of an
emergency medical services for children program into area trauma
system plans.
(d) Establish an Emergency Medical Services for Children
Advisory Committee.
(e) Establish guidelines for:
(A) The approval of emergency and critical care medical service
facilities for pediatric care, and for the designation of
specialized regional pediatric critical care centers and
pediatric trauma care centers.
(B) Referring children to appropriate emergency or critical
care medical facilities.
(C) Necessary prehospital and other pediatric emergency and
critical care medical service equipment.
(D) Developing a coordinated system that will allow children to
receive appropriate initial stabilization and treatment with
timely provision of, or referral to, the appropriate level of
care, including critical care, trauma care or pediatric
subspecialty care.
(E) Protocols for prehospital and hospital facilities
encompassing all levels of pediatric emergency services,
pediatric critical care and pediatric trauma care.
(F) Rehabilitation services for critically ill or injured
children.
(G) An interfacility transfer system for critically ill or
injured children.
(H) Initial and continuing professional education programs for
emergency medical services personnel, including training in the
emergency care of infants and children.
(I) A public education program concerning the Emergency Medical
Services for Children Program including information on emergency
access telephone numbers.
(J) The collection and analysis of statewide pediatric
emergency and critical care medical services data from emergency
and critical care medical service facilities for the purpose of
quality improvement by such facilities, subject to relevant
confidentiality requirements.
(K) The establishment of cooperative interstate relationships
to facilitate the provision of appropriate care for pediatric
patients who must cross state borders to receive emergency and
critical care services.
(L) Coordination and cooperation between the Emergency Medical
Services for Children Program and other public and private
organizations interested or involved in emergency and critical
care for children.
SECTION 34. ORS 442.507 is amended to read:
442.507. (1) With the moneys transferred to the Office of Rural
Health by ORS 442.625, the office shall establish a dedicated
grant program for the purpose of providing assistance to rural
communities to enhance emergency medical service systems.
(2) Communities, as well as nonprofit or governmental agencies
serving those communities, may apply to the office for grants on
forms developed by the office.
(3) The office shall make the final decision concerning which
entities receive grants, but the office may seek advice from the
Rural Health Coordinating Council, the { - State Emergency
Medical Service Committee - } { + Emergency Medical Services
and Trauma Systems Program + } and other appropriate individuals
experienced with emergency medical services.
(4) The office may make grants to entities for the purchase of
equipment, the establishment of new rural emergency medical
service systems or the improvement of existing rural emergency
medical service systems.
(5) With the exception of printing and mailing expenses
associated with the grant program, the Office of Rural Health
shall pay for administrative costs of the program with funds
other than those transferred under ORS 442.625.
SECTION 35. ORS 682.031 is amended to read:
682.031. (1) As used in this section, 'political subdivision'
includes counties, cities, districts, authorities and other
public corporations and entities organized and existing under
statute or charter.
(2) An ordinance of any political subdivision regulating
ambulance services or emergency medical technicians shall not
require less than is required under ORS 820.300 to 820.380, or
this chapter or the rules adopted by the Department of Human
Services { + or the Oregon State Board of Emergency
Responders + } under this chapter.
(3) When a political subdivision enacts an ordinance regulating
ambulance services or emergency medical technicians, the
ordinance must comply with the county plan for ambulance services
and ambulance service areas adopted under ORS 682.062 by the
county in which the political subdivision is situated and with
the rules of the department relating to such services and service
areas. The determination of whether the ordinance is in
compliance with the county plan shall be made by the county
governing body.
SECTION 36. ORS 682.051 is amended to read:
682.051. (1) A person or governmental unit commits the offense
of unlawful operation of an unlicensed ambulance if, on and after
July 1, 1983, or the offense of unlawful operation of an
unlicensed ambulance service if, on and after July 1, 1994, the
person or governmental unit advertises or operates in this state
a motor vehicle, aircraft or watercraft ambulance that:
(a) Is not operated by an ambulance service licensed under this
chapter;
(b) Is not licensed under this chapter; and
(c) Does not meet the minimum requirements established under
this chapter by the Department of Human Services in consultation
with the { - State Emergency Medical Service Committee - }
{ + Emergency Medical Services and Trauma Systems Program + }
for that type of ambulance.
(2) As used in this section, 'governmental unit' and ' person'
have the meaning given those terms in ORS 682.025.
(3) This section does not apply to any ambulance or any person
if the ambulance or person is exempted by ORS 682.035 or 682.079
from regulation by the Department of Human Services.
(4) Authority of political subdivisions to regulate ambulance
services or to regulate or allow the use of ambulances is limited
under ORS 682.031.
(5) The offense described in this section, unlawful operation
of an unlicensed ambulance or ambulance service, is a Class A
misdemeanor. Each day of continuing violation shall be considered
a separate offense.
(6) In addition to the penalties prescribed by subsection (5)
of this section, the Department of Human Services may impose upon
a licensed ambulance service a civil penalty not to exceed $5,000
for each violation of this chapter and the rules adopted
thereunder. Each day of continuing violation shall be considered
a separate violation for purposes of this subsection.
SECTION 37. ORS 682.068 is amended to read:
682.068. (1) The Department of Human Services, in consultation
with the { - State Emergency Medical Service Committee - }
{ + Emergency Medical Services and Trauma Systems Program + },
shall adopt rules specifying minimum requirements for ambulance
services, and for staffing and medical and communications
equipment requirements for all types of ambulances. The rules
shall define the requirements for advanced life support and basic
life support units of emergency vehicles, including equipment and
emergency medical technician staffing of the passenger
compartment when a patient is being transported in emergency
circumstances.
(2) The department may waive any of the requirements imposed by
this chapter in medically disadvantaged areas as determined by
the Director of Human Services, or upon a showing that a severe
hardship would result from enforcing a particular requirement.
(3) The department shall exempt from rules adopted under this
section air ambulances that do not charge for the provision of
ambulance services.
SECTION 38. { + Sections 39 to 46 of this 2007 Act are added
to and made a part of ORS 431.607 to 431.671. + }
SECTION 39. { + If the Governor is unavailable to exercise in
a timely manner the authority granted under section 40 of this
2007 Act, the Director of Human Services may exercise that
authority, and if the director is unavailable a designee of the
director within the Department of Human Services may exercise the
authority. Any orders, rules or regulations issued by the
director or the designee of the director have the same force and
effect as if issued by the Governor. + }
SECTION 40. { + The Governor may assign and make available for
use and duty, in any county, city or political subdivision, under
the direction and command of an officer designated by the
Governor, any emergency medical care provider staff or equipment
of an emergency medical services agency in this state, other than
staff or equipment of an agency that possesses only one ambulance
or one medical emergency response vehicle. The Governor may make
any emergency medical care provider staff or an emergency medical
services agency, or any equipment of an emergency medical
services agency, available under this section in response to a
request for aid from a county, city or other political
subdivision that indicates there is an emergency medical
situation that overwhelms local emergency medical service
resources of the jurisdiction making the request for aid. + }
SECTION 41. { + When any equipment is used pursuant to section
40 of this 2007 Act, the state shall be liable for any loss of or
damage to the equipment and shall pay any expense incurred in the
operation or maintenance of the equipment. No claim for any loss,
damage or expense shall be allowed unless, within 60 days after
the loss, damage or expense has been sustained or incurred, or
within an extension of time as may have been obtained from the
Department of Human Services, an itemized notice of the claim,
under oath, is served by mail or in person upon the Department of
Human Services. The loss, damage or expense shall be payable from
the Emergency Fund of the state. + }
SECTION 42. { + Whenever aid is supplied pursuant to section
40 of this 2007 Act, the state shall reimburse the emergency
medical services agency supplying the aid for the compensation
paid to employees supplied under section 40 of this 2007 Act
while the rendering of the aid prevents the employees from
performing their duties for the agency by which they are employed
and shall defray the actual traveling and maintenance expenses of
the employees while they are rendering the aid. The provisions of
sections 40 to 42 of this 2007 Act apply with equal effect to all
employees who are rendering aid under those provisions. As used
in this section, ' employees' means all emergency medical care
providers, whether paid, volunteer or on call. + }
SECTION 43. { + The Governor may make, amend and rescind any
orders, rules and regulations as are necessary or advisable to
carry out the provisions of sections 40 to 42 of this 2007 Act.
Any order issued by the Governor in relation to carrying out the
provisions of sections 40 to 42 of this 2007 Act may be either
written or oral. If written, a copy of an order shall be filed in
the office of the Secretary of State and another copy dispatched
as soon as possible to the emergency medical services agency
affected. Immediately thereafter the order, rule or regulation
shall be in effect. Oral orders may be made by the Governor when,
in the opinion of the Governor, the emergency is such that delay
in issuing a written order would be dangerous to the welfare of
the people of the state. Written copies of the oral order shall
be filed and dispatched as soon after issuing the oral order as
is conveniently possible in the manner provided in this section
for written orders. + }
SECTION 44. { + The Department of Human Services shall prepare
plans for effectively carrying out sections 40 to 42 of this 2007
Act and provide advice and counsel to the Governor for the most
practical utilization of the emergency medical services of this
state as authorized under section 40 of this 2007 Act. + }
SECTION 45. { + Neither the state nor any county, city, other
political subdivision or emergency medical services agency, or
any emergency medical care provider acting as the agent of any of
the foregoing is liable for any injury to person or property
resulting from the performance of any duty imposed by the
authority of sections 40 to 42 of this 2007 Act. A person
carrying out the provisions of sections 40 to 42 of this 2007
Act, or acting within the scope of any duty imposed by authority
of the provisions of sections 40 to 42 of this 2007 Act, is not
subject to civil liability for those actions. However, a person
may be liable for injury to person or property resulting from the
willful misconduct or gross negligence of the person. + }
SECTION 46. { + The state shall draw warrants on the State
Treasurer for the payment of all duly approved claims lawfully
incurred pursuant to sections 40 to 42 of this 2007 Act. + }
SECTION 47. { + ORS 431.609, 431.613, 431.617, 431.619,
431.627, 431.633 and 682.039 are repealed. + }
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