(b)(4) AnApprove EMR,individuals EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic may practice as anEMS EMR,Lead EMT,Instructors EMT-I,who A-EMT,have ormet Paramedic or utilize his or her EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic license in pre-hospital or inter-hospital emergency care settings or non-emergency medical transport situations, under the writtenDepartment's oreducation verbaland directiontesting ofrequirements. the EMS Medical Director.

For(5) purposesRequire ofthat thisall Section,education, atraining "pre-hospitaland emergencycontinuing careeducation setting"courses mayfor includeEMT, aEMT-I, location,A-EMT, thatParamedic, isPHRN, notPHPA, aPHAPRN, healthECRN, careEMR, facility,and whichEmergency utilizesMedical EMSDispatcher personnelbe tocoordinated renderby pre-hospitalat emergencyleast careone priorapproved toEMS theLead arrivalInstructor. of a transport vehicle.

TheA locationprogram shallwhich includeincludes communicationeducation, equipmenttraining andor allcontinuing ofeducation the portable equipment and drugs appropriate for themore EMR,than EMT,one EMT-I,type A-EMT, or Paramedic's level of care,personnel asmay requireduse byone thisEMS Act,Lead rulesInstructor adoptedto bycoordinate the Departmentprogram, pursuant to this Act, and thea protocolssingle of the EMS Systems,Lead andInstructor shallmay operatesimultaneously onlycoordinate withmore thethan approvalone andprogram underor thecourse. direction of the EMS Medical Director.

SB0761(6) EnrolledProvide -standards 11and -procedures LRB103for 03215awarding CPFEMS 48221Lead bInstructor Thisapproval Sectionto shallpersons notpreviously prohibitapproved anby EMR,the EMT,Department EMT-I,to A-EMT,coordinate PHRN,such PHAPRN,courses, PHPA,based oron Paramedicqualifications fromprescribed practicingby withinthe anDepartment emergencythrough departmentrules or10300SB0761sam001 other-11- healthLRB103 care03215 settingBMS for59916 thea purposeadopted ofpursuant receivingto continuingthis educationAct. or training approved by the EMS Medical Director.

This(7) SectionSuspend, shallrevoke, also not prohibit an EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedicrefuse fromto seekingissue credentials other than his or herrenew EMT,the EMT-I,approval A-EMT,of PHRN,an PHAPRN,EMS PHPA,Lead orInstructor, Paramedicafter licensean andopportunity utilizingfor sucha credentialshearing, towhen workfindings inshow emergencyone departments or othermore healthof care settings under the jurisdictionfollowing: of that employer.

(c)(A) AnThe EMT,EMS EMT-I,Lead A-EMT,Instructor PHRN,has PHAPRN,failed PHPA,to orconduct Paramedica maycourse honorin Doaccordance Notwith Resuscitatethe (DNR)curriculum ordersprescribed andby powersthis ofAct attorneyand for health care only in accordance with rules adopted by the Department pursuant to this ActAct; and protocols of the EMS System in which he or she practices.

(d)or A(B) studentThe enrolled in a Department approved EMS personnelLead program,Instructor whilehas fulfillingfailed theto clinicalcomply trainingwith andprotocols in-fieldprescribed supervised experience requirements mandated for licensure or approval by the SystemDepartment andthrough therules Department,adopted maypursuant perform prescribed procedures under the direct supervision of a physician licensed to practicethis medicineAct. in all of its branches, a qualified registered professional nurse, or qualified EMS personnel, only when authorized by the EMS Medical Director.

(e) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or SB0761 Enrolled - 12 - LRB103 03215 CPF 48221 b Paramedic may transport a police dog injured in the line of duty to a veterinary clinic or similar facility if there are no persons requiring medical attention or transport at that time.

For the purposes of this subsection, "police dog" means a dog owned or used by a law enforcement department or agency in the course of the department or agency's work, including a search and rescue dog, service dog, accelerant detection canine, or other dog that is in use by a county, municipal, or State law enforcement agency.

(f) Nothing in this Act shall be construed to prohibit an EMT, EMT-I, A-EMT, Paramedic, or PHRN from completing an initial Occupational Safety and Health Administration Respirator Medical Evaluation Questionnaire on behalf of fire service personnel, as permitted by his or her EMS System Medical Director.

(g) An EMT, EMT-I, A-EMT, Paramedic, PHRN, PHAPRN, or PHPA shall be eligible to work for another EMS System for a period not to exceed 2 weeks if the individual is under the direct supervision of another licensed individual operating at the same or higher level as the EMT, EMT-I, A-EMT, Paramedic, PHRN, PHAPRN, or PHPA;

obtained approval in writing from the EMS System's Medical Director;

and tests into the EMS System based upon appropriate standards as outlined in the EMS System Program Plan.

The EMS System within which the EMT, EMT-I, A-EMT, Paramedic, PHRN, PHAPRN, or PHPA is seeking to join must make all required testing available to the EMT, EMT-I, SB0761 Enrolled - 13 - LRB103 03215 CPF 48221 b A-EMT, Paramedic, PHRN, PHAPRN, or PHPA within 2 weeks after the written request.

Failure to do so by the EMS System shall allow the EMT, EMT-I, A-EMT, Paramedic, PHRN, PHAPRN, or PHPA to continue working for another EMS System until all required testing becomes available.

102-79,100-1082, eff.

1-1-22.)8-24-19.) (210 ILCS 50/3.85) Sec.

(1) "Ambulance" means any publicly or privately owned on-road vehicle that is specifically designed, constructed or modified and equipped, and is intended to be used for, and is maintained or operated for the emergency 10300SB0761sam001 -12- LRB103 03215 BMS 59916 a transportation of persons who are sick, injured, wounded or otherwise incapacitated or helpless, or the non-emergency medical transportation of persons who require the presence of medical personnel to monitor the individual's condition or medical apparatus being used on such individuals.

(2) "Specialized Emergency Medical Services Vehicle" SB0761 Enrolled - 14 - LRB103 03215 CPF 48221 b or "SEMSV" means a vehicle or conveyance, other than those owned or operated by the federal government, that is primarily intended for use in transporting the sick or injured by means of air, water, or ground transportation, that is not an ambulance as defined in this Act.

(B) "Special-Use Vehicle" means any publicly or privately owned vehicle that is specifically designed, constructed or modified and equipped, and is intended to be used for, and is maintained or operated solely 10300SB0761sam001 -13- LRB103 03215 BMS 59916 a for the emergency or non-emergency transportation of a specific medical class or category of persons who are sick, injured, wounded or otherwise incapacitated or helpless (e.g.

(C) "Reserve Ambulance" means a vehicle that meets all criteria set forth in this Section and all SB0761 Enrolled - 15 - LRB103 03215 CPF 48221 b Department rules, except for the required inventory of medical supplies and durable medical equipment, which may be rapidly transferred from a fully functional ambulance to a reserve ambulance without the use of tools or special mechanical expertise.

(3) Establish licensing standards and requirements for 10300SB0761sam001 -14- LRB103 03215 BMS 59916 a Vehicle Service Providers, through rules adopted pursuant to this Act, including but not limited to:

and SB0761 Enrolled - 16 - LRB103 03215 CPF 48221 b (D) License renewal at intervals determined by the Department, which shall be not less than every 4 years.

The EMS personnel licensed at the highest level shall provide the initial assessment of the patient to determine the level of care required for transport to the receiving health care facility, and this assessment shall be documented in the patient care report and documented with online medical control.

The EMS personnel licensed at or above the level of care required by the specific patient as directed by the EMS Medical Director shall be the primary care provider en route to the destination facility or patient's residence.

Adoption of an alternative staffing SB0761 Enrolled - 17 - LRB103 03215 CPF 48221 b model shall not result in a Vehicle Service Provider being prohibited or limited in the utilization of its staff or equipment from providing 10300SB0761sam001 -15- LRB103 03215 BMS 59916 a any of the services authorized by this Act or as otherwise outlined in the approved EMS System Program Plan, including, without limitation, the deployment of resources to provide out-of-state disaster response.

An EMS System Program PlansPlan mustfor address a processBasic forLife out-of-stateSupport, disasteradvanced responselife deploymentssupport, thatand mustcritical meetcare transport services transport utilizing an EMR and an EMT, Paramedic, or appropriate critical care transport staff shall include the following:

(A) AllAlternative deploymentsstaffing tomodels providefor out-of-statea disasterBasic responseLife mustSupport firsttransport utilizing an EMR and an EMT shall only be approvedutilized for interfacility Basic Life Support transports specified by the EMS System Program Plan as determined by the EMS System Medical Director and submittedmedical appointments, excluding any transport to theor Department.from a dialysis center.

(B) The submission must include the number of units being deployed, vehicle identification numbers, length of deployment, and names of personnel and their licensure level.

(C) Ensure that all necessary in-state requests for services will be covered during the duration of the deployment.

An EMS System Program Plan for a Basic Life Support, advanced life support, and critical care transport utilizing an EMR and an EMT shall include the following:

(A) Alternative staffing models for a Basic Life Support transport utilizing an EMR and an EMT shall only be utilized for interfacility Basic Life Support transports as specified by the EMS System Program Plan SB0761 Enrolled - 18 - LRB103 03215 CPF 48221 b as determined by the EMS System Medical Director and medical appointments, excluding any transport to or from a dialysis center.

(C) A requirement that a provider and EMS System shall implement a quality assurance plan that shall include for the initial waiver period the review of at least 5% of total interfacility transports utilizing an EMR with mechanisms outlined to audit dispatch screening,screening reason for transport, patient diagnosis, level of care, and the outcome of transports performed.

Quality(D) assuranceThe reportsEMT, mustParamedic, beand submittedcritical andcare reviewedtransport bystaff shall have the providerminimum andat EMSleast Systemone monthly10300SB0761sam001 -16- LRB103 03215 BMS 59916 a year of experience in performance of pre-hospital, inter-hospital emergency care and madeother availablehealth tocare experience as a clinician, as determined by the DepartmentEMS uponMedical request.Director in accordance with the EMS System Program Plan.

The percentage of transports reviewed under quality assurance plans for renewal periods shall be determined by the EMS Medical Director, however, it shall not be less than 3%.

(D) The EMS System Medical Director shall develop a minimum set of requirements for individuals based on level of licensure that includes education, training, and credentialing for all team members identified to participate in an alternative staffing plan.

The EMT, SB0761 Enrolled - 19 - LRB103 03215 CPF 48221 b Paramedic, PHRN, PHPA, PHAPRN, and critical care transport staff shall have the minimum at least one year of experience in performance of pre-hospital and inter-hospital emergency care, as determined by the EMS Medical Director in accordance with the EMS System Program Plan, but at a minimum of 6 months of prehospital experience or at least 50 documented patient care interventions during transport as the primary care provider and approved by the Department.

(G) Beginning July 1, 2023, the utilization of EMRs for advanced life support transports and Tier III Critical Care Transports shall be allowed for periods not to exceed 3 years under a pilot program.

The pilot program shall not be implemented before Department approval.

Agencies requesting to utilize this staffing model for the time period of the pilot program must complete the following:

SB0761 Enrolled - 20 - LRB103 03215 CPF 48221 b (i) Submit a waiver request to the Department requesting to participate in the pilot program with specific details of how quality assurance and improvement will be gathered, measured, reported to the Department, and reviewed and utilized internally by the participating agency.

(ii) Submit a signed approval letter from the EMS System Medical Director approving participation in the pilot program.

(iii) Submit updated EMS System plans, additional education, and training of the EMR and protocols related to the pilot program.

(iv) Submit agency policies and procedures related to the pilot program.

(v) Submit the number of individuals currently participating and committed to participating in education programs to achieve a higher level of licensure at the time of submission.

(vi) Submit an explanation of how the provider will support individuals obtaining a higher level of licensure and encourage a higher level of licensure during the year of the alternative staffing plan and specific examples of recruitment and retention activities or initiatives.

Upon submission of a renewal application and recruitment and retention plan, the provider shall SB0761 Enrolled - 21 - LRB103 03215 CPF 48221 b include additional data regarding current employment numbers, attrition rates over the year, and activities and initiatives over the previous year to address recruitment and retention.

The information required under this subparagraph (G) shall be provided to and retained by the EMS System upon initial application and renewal and shall be provided to the Department upon request.

All Provider licenses issued by the Department shall specify the level and type of each vehicle covered by the license (BLS, ILS, ALS, ambulance, critical care transport, SEMSV, limited operation vehicle, special use vehicle, ambulance assist 10300SB0761sam001 -17- LRB103 03215 BMS 59916 a vehicle, reserve ambulance).ambulance) and shall allow for ambulances to be immediately upgraded to a higher level of service when the Vehicle Service Provider sends an ambulance assist vehicle with appropriate equipment and licensed staff to intercept with the licensed ambulance in the field.

(6) Suspend, revoke, refuse to issue or refuse to renew the license of any Vehicle Service Provider, or that portion of a license pertaining to a specific vehicle SB0761 Enrolled - 22 - LRB103 03215 CPF 48221 b operated by the Provider, after an opportunity for a hearing, when findings show that the Provider or one or more of its vehicles has failed to comply with the standards and requirements of this Act or rules adopted by the Department pursuant to this Act.

(8) Exempt any licensed vehicle from subsequent vehicle design standards or specifications required by the 10300SB0761sam001 -18- LRB103 03215 BMS 59916 a Department, as long as said vehicle is continuously in compliance with the vehicle design standards and specifications originally applicable to that vehicle, or until said vehicle's title of ownership is transferred.

SB0761 Enrolled - 23 - LRB103 03215 CPF 48221 b (10) Prohibit any Vehicle Service Provider from advertising, identifying its vehicles, or disseminating information in a false or misleading manner concerning the Provider's type and level of vehicles, location, primary service area, response times, level of personnel, licensure status or System participation.

The fee per transport vehicle shall be set by administrative rule by the Department and shall not exceed 100 vehicles 10300SB0761sam001 -19- LRB103 03215 BMS 59916 a per provider.

(12) Beginning July 1, 2023, as part of a pilot program that shall not exceed a term of 3 years, an ambulance may be upgraded to a higher level of care for interfacility transports by an ambulance assistance vehicle with appropriate equipment and licensed personnel to intercept with the licensed ambulance at the sending facility before departure.

The pilot program shall not be implemented before Department approval.

To participate in the pilot program, an agency must:

(A) Submit a waiver request to the Department with SB0761 Enrolled - 24 - LRB103 03215 CPF 48221 b intercept vehicle vehicle identification numbers, calls signs, equipment detail, and a robust quality assurance plan that shall list, at minimum, detailed reasons each intercept had to be completed, barriers to initial dispatch of advanced life support services, and how this benefited the patient.

(B) Report to the Department quarterly additional data deemed meaningful by the providing agency along with the data required under subparagraph (A) of this paragraph (12).

(C) Obtain a signed letter of approval from the EMS Medical Director allowing for participation in the pilot program.

(D) Update EMS System plans and protocols from the pilot program.

(E) Update policies and procedures from the agencies participating in the pilot program.

8-27-21.)8-27-21.)". Section 99.

Effective date.

This Act takes effect upon becoming law.