SB 1005 — AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING REVISIONS TO EMERGENCY MEDICAL SERVICES DEFINITIONS, CERTIFICATION AND CONTINUING EDUCATION REQUIREMENTS.

Upon determination by the commissioner that an applicant is qualified to be aLCO supplemental{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0114 first responder, the commissioner shall issue a certificate of authorization29 effectiveR01-SB.docx for} twoSubstitute yearsBill toNo. such applicant.

1005 a supplemental first responder, the commissioner shall issue a certificate of authorization effective for two years to such applicant.

If the commissioner determines that an applicant for such license is not so qualified, the commissioner shall provide such applicant with written LCOnotice No.of the denial of the application with a statement of the reasons for such denial.

5308 14 of 29 Raised Bill No.1005 notice of the denial of the application with a statement of the reasons for such denial.

[A provider] An emergency medical service organization on the scene of an emergency medical call who has undertaken decision- making responsibility for patient care shall transfer patient care to a provider with a higher classification of licensure or certification upon suchLCO provider's{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0115 arrivalof on29 theR01-SB.docx scene.} Substitute Bill No.

1005 such provider's arrival on the scene.

Paramedic, advanced emergency medical technician, emergency medical technician and emergency LCOmedical No.responder.

5308 15 of 29 Raised Bill No.1005 medical responder.

(3) The establishment of performance standards, including, but not limitedLCO to,{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0116 standards for responding to a certain percentage of initial29 responseR01-SB.docx notifications,} responseSubstitute times,Bill qualityNo. assurance and service area coverage patterns, for each segment of the municipality's emergency medical services system;

and1005 (4)limited Anyto, subcontracts,standards writtenfor agreementsresponding orto mutuala aidcertain callpercentage agreementsof thatinitial emergencyresponse medicalnotifications, [servicesresponse providers]times, quality assurance and service LCOarea No.coverage patterns, for each segment of the municipality's emergency medical services system;

5308and 16(4) ofAny 29subcontracts, Raisedwritten Billagreements No.1005or mutual aid call agreements that emergency medical [services providers] service organizations may have with other entities to provide services identified in the plan.

(3) a communications system thatLCO includes{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0117 aof central29 dispatchR01-SB.docx center,} two-waySubstitute radioBill communicationNo. between the ambulance and the receiving hospital and a universal emergency telephone number;

1005 that includes a central dispatch center, two-way radio communication between the ambulance and the receiving hospital and a universal emergency telephone number;

LCOSec. No.

5308 17 of 29 Raised Bill No.1005 Sec.

(c) No license as a paramedic or certificate as an emergency medical responder, emergency medical technician, advanced emergency medicalLCO technician{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0118 or emergency medical services instructor shall be required of (1)29 aR01-SB.docx person} performingSubstitute servicesBill within the scope of practice for which he or she is licensed or certified by any agency of this state, or (2) a student, intern or trainee pursuing a course of study in emergency medical services in an accredited institution of education or within an emergency medical services program approved by the commissioner, provided the activities that would otherwise require a license or certificate as an emergency medical services [provider] LCO No.

53081005 18medical technician or emergency medical services instructor shall be required of 29(1) Raiseda Billperson No.1005performing services within the scope of practice for which he or she is licensed or certified by any agency of this state, or (2) a student, intern or trainee pursuing a course of study in emergency medical services in an accredited institution of education or within an emergency medical services program approved by the commissioner, provided the activities that would otherwise require a license or certificate as an emergency medical services [provider] personnel are performed under supervision and constitute a part of a supervised course of study.

(5) "Emergency medical services personnel" means an individual certified to practice as an emergency medical responder, emergency medical technician, advanced emergency medical technician, emergency medical services instructor or an individual licensed as a paramedic;LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0119 of 29 R01-SB.docx } Substitute Bill No.

1005 paramedic;

(7) "National organization for emergency medical certification" means a national organization approved by the Department of Public Health and identified on the department's Internet web site, or itssuch LCOnational No.organization's successor organization, that tests and provides certification to emergency medical responders, emergency medical technicians, advanced medical technicians and paramedics;

5308 19 of 29 Raised Bill No.1005 successor organization, that tests and provides certification to emergency medical responders, emergency medical technicians, advanced medical technicians and paramedics;

and[and] [(9)] (10) "Paramedic" means a person licensed to practice as a paramedic under the provisions of section 20-206ll20-206ll; (11) "Continuing education platform Internet web site" means a database, approved by the Commissioner of Public Health, for emergency medical services personnel to enter, track and reconcile the hours and topics of continuing education completed by such personnel.

and (11) "Continuing education platform Internet web site" means an online database, approved by the Commissioner of Public Health, for emergency medical services personnel to enter, track and reconcile the hours and topics of continuing education completed by such personnel.

(a)LCO Except{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0120 as provided in subsections (b) and (c) of this29 section,R01-SB.docx an} applicantSubstitute forBill aNo. license as a paramedic shall submit evidence satisfactory to the Commissioner of Public Health that the applicant has successfully (1) completed a paramedic training program approved by the commissioner, and (2) passed an examination prescribed by the commissioner.

1005 (a) Except as provided in subsections (b) Anand (c) of this section, an applicant for licensurea bylicense endorsementas a paramedic shall presentsubmit LCOevidence No.satisfactory to the Commissioner of Public Health that the applicant has successfully (1) completed a paramedic training program approved by the commissioner, and (2) passed an examination prescribed by the commissioner.

5308(b) 20An ofapplicant 29for Raisedlicensure Billby No.1005endorsement shall present evidence satisfactory to the commissioner that the applicant (1) is licensed or certified as a paramedic in another state or jurisdiction whose requirements for practicing in such capacity are substantially similar to or higher than those of this state and that the applicant has no pending disciplinary action or unresolved complaint against him or her, or (2) (A) is currently licensed or certified as a paramedic in good standing in any New England state, New York or New Jersey, (B) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the paramedic scope of practice model conducted by an organization offering a program that is recognized by the national emergency medical services program accrediting organization, and (C) has no pending disciplinary action or unresolved complaint against him or her.

(1) For initial certification, an applicant shall presentLCO evidence{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0121 satisfactoryof to29 theR01-SB.docx commissioner} thatSubstitute theBill applicant [(1) is currently certified as an emergency medical technician, emergency medical responder, or advanced emergency medical technician in good standing in any New England state, New York or New Jersey, (2)] (A) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the [emergency medical technician,] emergency LCO No.

53081005 21present ofevidence 29satisfactory Raisedto Billthe No.1005commissioner that the applicant [(1) is currently certified as an emergency medical technician, emergency medical responder, or advanced emergency medical technician in good standing in any New England state, New York or New Jersey, (2)] (A) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the [emergency medical technician,] emergency medical responder curriculum, [or advanced emergency medical technician, and (3) has no pending disciplinary action or unresolved complaint against him or her] and (B) has passed the emergency medical responder examination administered by the national organization for emergency medical certification or an examination approved by the department, (2) for renewal certification, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) has successfully completed continuing education for an emergency medical responder as required by the national organization for emergency medical certification or as approved by the department, or (B) presents a current certification as an emergency medical responder from the national organization for emergency medical certification, or (3) for certification by endorsement from another state, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) is currently certified as an emergency medical responder in good standing by a state that maintains certification or licensing requirements that the commissioner determines are equal to or greater than those in this state, or (B) holds a current certification as an emergency medical responder from the national organization for emergency medical certification.

For the purpose of maintaining an acceptable level of proficiency, each emergency medical technician who is recertified for a three-year period shall complete thirty hours of refresher training approved by theLCO commissioner{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0122 orof meet29 suchR01-SB.docx other} requirementsSubstitute asBill mayNo. be prescribed by the commissioner.

1005 the commissioner or meet such other requirements as may be prescribed by the commissioner.

(1) For initial certification, an applicant shall LCOpresent No.evidence satisfactory to the commissioner that the applicant (A) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the emergency medical technician curriculum, and (B) has passed the emergency medical technician examination administered by the national organization for emergency medical certification or an examination approved by the department, (2) for renewal certification, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) has successfully completed continuing education for an emergency medical technician as required by the national organization for emergency medical certification or as approved by the department, or (B) presents a current certification as an emergency medical technician from the national organization for emergency medical certification, or (3) for certification by endorsement from another state, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) is currently certified as an emergency medical technician in good standing by a state that maintains certification or licensing requirements that the commissioner determines are equal to or greater than those in this state, or (B) holds a current certification as an emergency medical technician from the national organization for emergency medical certification.

5308 22 of 29 Raised Bill No.1005 present evidence satisfactory to the commissioner that the applicant (A) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the emergency medical technician curriculum, and (B) has passed the emergency medical technician examination administered by the national organization for emergency medical certification or an examination approved by the department, (2) for renewal certification, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) has successfully completed continuing education for an emergency medical technician as required by the national organization for emergency medical certification or as approved by the department, or (B) presents a current certification as an emergency medical technician from the national organization for emergency medical certification, or (3) for certification by endorsement from another state, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) is currently certified as an emergency medical technician in good standing by a state that maintains certification or licensing requirements that the commissioner determines are equal to or greater than those in this state, or (B) holds a current certification as an emergency medical technician from the national organization for emergency medical certification.

(1) For initialLCO certification,{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0123 anof applicant29 shallR01-SB.docx present} evidenceSubstitute satisfactoryBill to the commissioner that the applicant (A) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the advanced emergency medical technician curriculum, and (B) has passed the advanced emergency medical technician examination administered by the national organization for emergency medical certification or an LCO No.

53081005 23initial ofcertification, 29an Raisedapplicant Billshall No.1005present evidence satisfactory to the commissioner that the applicant (A) has completed an initial training program consistent with the National Emergency Medical Services Education Standards, as promulgated by the National Highway Traffic Safety Administration for the advanced emergency medical technician curriculum, and (B) has passed the advanced emergency medical technician examination administered by the national organization for emergency medical certification or an examination approved by the department, (2) for renewal certification, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) has successfully completed continuing education for an advanced emergency medical technician as required by the national organization for emergency medical certification or as approved by the department, or (B) presents a current certification as an advanced emergency medical technician from the national organization for emergency medical certification, or (3) for certification by endorsement from another state, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) is currently certified as an advanced emergency medical technician in good standing by a state that maintains certification or licensing requirements that the commissioner determines are equal to or greater than those in this state, or (B) holds a current certification as an advanced emergency medical technician from the national organization for emergency medical certification.

(1) For initial certification, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) is currently certified by the department as an emergency medical technician or advanced emergency medical technician or licensed by the department as a paramedic, (B) has completed a program of training as an emergency medical instructor based on current national education standards withinLCO the{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0124 prior two years, (C) has completed twenty-five hours of teaching29 activityR01-SB.docx under} theSubstitute supervisionBill of a currently certified emergency medical services instructor, (D) has completed written and practical examinations as prescribed by the commissioner, (E) has no pending disciplinary action or unresolved complaints against the applicant, and (F) effective on a date prescribed by the commissioner, presents documentation satisfactory to the commissioner that the applicant is currently certified as an emergency medical technician, LCO No.

53081005 24within the prior two years, (C) has completed twenty-five hours of 29teaching Raisedactivity Billunder No.1005the supervision of a currently certified emergency medical services instructor, (D) has completed written and practical examinations as prescribed by the commissioner, (E) has no pending disciplinary action or unresolved complaints against the applicant, and (F) effective on a date prescribed by the commissioner, presents documentation satisfactory to the commissioner that the applicant is currently certified as an emergency medical technician, advanced emergency medical technician or paramedic by the national organization for emergency medical certification, or (2) for renewal certification, an applicant shall present evidence satisfactory to the commissioner that the applicant (A) has successfully completed continuing education and teaching activity as required by the department, (B) maintains current certification by the department as an emergency medical technician, advanced emergency medical technician or licensure by the department as a paramedic, and (C) effective on a date as prescribed by the commissioner, presents documentation satisfactory to the commissioner that the applicant is currently certified as an emergency medical technician, advanced emergency medical technician or paramedic by the national organization for emergency medical certification.

[(f)] (i) The commissioner may issue a temporary emergency medical technician certificate to an applicant who presents evidence satisfactory to the commissioner that (1) the applicant was certified by the department as an emergency medical technician prior to becoming licensed as a paramedic pursuant to section 20-206ll, or (2) the applicant's certification as an emergency medical technician has expired and the applicant's license as a paramedic has become void pursuantLCO to{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0125 sectionof 19a-88.29 R01-SB.docx } Substitute Bill No.

1005 pursuant to section 19a-88.

(1) Renewal of such person's paramedic license, giving such person's name in full, such person's residence and business address and such other information as the department requests, LCOprovided No.the application for license renewal is accompanied by evidence satisfactory to the commissioner that the applicant was under the medical oversight of a sponsor hospital, as those terms are defined in section 19a-175, as amended by this act, on the date the applicant's paramedic license became void for nonrenewal;

5308 25 of 29 Raised Bill No.1005 provided the application for license renewal is accompanied by evidence satisfactory to the commissioner that the applicant was under the medical oversight of a sponsor hospital, as those terms are defined in section 19a-175, as amended by this act, on the date the applicant's paramedic license became void for nonrenewal;

[(h) The commissioner may issue an emergency medical responder, emergency medical technician or advanced emergency medical technician certificate to an applicant for certification by endorsement who presents evidence satisfactory to the commissioner that the applicant (1) is currently certified as an emergency medical responder, emergency medical technician or advanced emergency medical technician in good standing by a state that maintains licensing requirements that the commissioner determines are equal to, or greater than, those in this state, (2) has completed an initial department- approved emergency medical responder, emergency medical technician or advanced emergency medical technician training programLCO that{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0126 includes written and practical examinations at the completion of the29 course,R01-SB.docx or} aSubstitute programBill outsideNo. the state that adheres to national education standards for the emergency medical responder, emergency medical technician or advanced emergency medical technician scope of practice and that includes an examination, and (3) has no pending disciplinary action or unresolved complaint against him or her.

(i)1005 Theprogram commissionerthat mayincludes issuewritten anand practical examinations at the completion of the course, or a program outside the state that adheres to national education standards for the emergency medical serviceresponder, instructoremergency certificatemedical totechnician or advanced emergency medical technician scope of practice and that includes an applicantexamination, whoand presents(3) (1)has evidenceno LCOpending No.disciplinary action or unresolved complaint against him or her.

5308(i) 26The ofcommissioner 29may Raisedissue Billan No.1005emergency medical service instructor certificate to an applicant who presents (1) evidence satisfactory to the commissioner that the applicant is currently certified as an emergency medical technician in good standing, (2) documentation satisfactory to the commissioner, with reference to national education standards, regarding qualifications as an emergency medical service instructor, (3) a letter of endorsement signed by two instructors holding current emergency medical service instructor certification, (4) documentation of having completed written and practical examinations as prescribed by the commissioner, and (5) evidence satisfactory to the commissioner that the applicant has no pending disciplinary action or unresolved complaints against him or her.] [(j)] (k) Any person certified as an emergency medical responder, emergency medical technician, advanced emergency medical technician or emergency medical services instructor pursuant to this chapter and the regulations adopted pursuant to section 20-206oo whose certification has expired may apply to the Department of Public Health for reinstatement of such certification as follows:

or (2) [if such recertification expired more than one year but less than three years from the date of application for reinstatement, such person shall complete the training required for recertification and the examination required for initial certificationLCO specified{\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0127 inof regulations29 adoptedR01-SB.docx pursuant} toSubstitute sectionBill 20-No. 206oo;

1005 certification specified in regulations adopted pursuant to section 20- 206oo;

[(k)] (l) The Commissioner of Public Health shall issue an emergency medical technician certification to an applicant who is a LCOmember No.of the armed forces or the National Guard or a veteran and who (1) presents evidence satisfactory to the commissioner that such applicant holds a current certification as a person entitled to perform similar services under a different designation by the National Registry of Emergency Medical Technicians, or (2) satisfies the regulations promulgated pursuant to subdivision [(4)] (3) of subsection (a) of section 19a-179.

5308 27 of 29 Raised Bill No.1005 member of the armed forces or the National Guard or a veteran and who (1) presents evidence satisfactory to the commissioner that such applicant holds a current certification as a person entitled to perform similar services under a different designation by the National Registry of Emergency Medical Technicians, or (2) satisfies the regulations promulgated pursuant to subdivision [(4)] (3) of subsection (a) of section 19a-179.

Sec.LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-0128 of 29 R01-SB.docx } Substitute Bill No.

1005 Sec.

LCOThis No.act shall take effect as follows and shall amend the following sections:

5308 28 of 29 Raised Bill No.

1005 This act shall take effect as follows and shall amend the following sections:

4 July 1, 2019 19a-180(a) July 1, 2019 Sec.

5 July 1, 2019 19a-180(i) to (l) Sec.

15 July 1, 2019 20-9(14) Statement of Purpose:Legislative Commissioners:

ToIn (1)Section make12(9), technical"and" revisionswas tobracketed, distinguish references to emergency medical service organizations and personnel,in (2)Section allow12(10), ambulance"; services to add a branch location, and (3) require emergency medical services personnel to initiate, renew and maintain certifications through national curriculum and testing requirements.

exceptand" thatwas whenadded thefor entiregrammatical textcorrectness. of a bill or resolution or a section of a bill or resolution is new, it is not underlined.] LCO No.

5308PH 29Joint ofFavorable 29Subst.

-LCO LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-01005- 29 of 29 R01-SB.docx }