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| Montana Administrative Register Notice 37-655 | No. 21 11/14/2013 | |
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BEFORE THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On December 4, 2013, at 1:30 p.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, at Helena, Montana, to consider the proposed amendment of the above-stated rules.
2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on November 27, 2013, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail [email protected].
3. The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:
37.104.101 DEFINITIONS The following definitions apply in subchapters 1 through 4: (1) "Advanced emergency medical technician (ECP-AEMT)" means an individual who is licensed by the board as an advanced emergency medical technician as defined in ARM 24.156.2701. (2) "Advanced emergency medical technician (ECP-AEMT) equivalent" means one of the following: (a) an ECP-AEMT; (b) any licensed ECP provider above ECP-AEMT, including endorsements; or (c ) a registered nurse with supplemental training. (3) remains the same, but is renumbered (4). (4) remains the same, but is renumbered (6). (7) "AEMT life support EMS service" means an ambulance service or nontransporting medical unit that has the capacity and is licensed by the department to provide care at the ECP-AEMT equivalent level 24 hours a day, seven days a week. (5) through (8) remain the same, but are renumbered (8) through (11). (11) remains the same, but is renumbered (14). (15) "Emergency care provider (ECP)" means any out-of-hospital provider licensed by the board. (16) "Emergency medical responder (ECP-EMR)" means an individual who is licensed by the board as an emergency medical responder as defined in ARM 24.156.2701. (17) "Emergency medical responder (ECP-EMR) equivalent" means one of the following: (a) an ECP-EMR; (b) any licensed ECP above ECP-EMR; or (c) a registered nurse with supplemental training. (a) An ECP-EMT is equivalent to the emergency medical technician-basic as required in 50-6-322, MCA. (a) an (b) any licensed (c) remains the same. (20) and (21) remain the same. (25) remains the same, but is renumbered (23). (24) "Paramedic (ECP-paramedic)" means an individual who is licensed by the board as a paramedic as defined in ARM 24.156.2701. (25) "Paramedic equivalent" means one of the following: (a) a paramedic (ECP-paramedic); (b) an ECP provider with an endorsement above paramedic; or (c) a registered nurse with supplemental training. (26) through (32) remain the same. (33) "Supplemental training" means a training program for registered nurses utilized by an emergency medical service that complements their existing education and experience and results in knowledge and skill objectives comparable to the level of (34) and (35) remain the same. (36) "Type of EMS service" means either an air ambulance fixed wing, air ambulance rotor wing, ground ambulance, or nontransporting medical unit.
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.102 PERSONNEL: (a) remains the same. (b) when transporting a patient at the
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.105 LICENSE TYPES AND LEVELS (1) A license will be issued for, and authorize performance of, emergency medical services of a specific type and at a basic, (2) Except as specifically provided in this chapter, an emergency medical service may be licensed at an
AUTH: 50-6-323, MCA
37.104.109 BASIC LIFE SUPPORT SERVICE LICENSING (1) An ambulance service or nontransporting medical unit (NTU) capable of providing service only at the basic life support level will be licensed at the basic life support level. (a) An ambulance service or NTU that provides advanced life support with (b) An ambulance service or NTU that provides advanced life support with (2) Ambulance services or NTUs requesting authorization for (1)(a) or (b) (a) remains the same. (b) submit documentation of the level and endorsement(s) each
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.316 PERSONNEL REQUIREMENTS: BASIC LIFE SUPPORT GROUND AMBULANCE SERVICE (1) Except as provided for in 50-6-322, MCA, a basic life support ground ambulance service must ensure that at least two of the following individuals are on board the ambulance when a patient is loaded or transported, with the proviso that having only two (a) (c) remains the same, but is renumbered (b). (2) remains the same. (3) Persons utilized as drivers of ambulances
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.319 PERSONNEL: ADVANCED LIFE SUPPORT GROUND AMBULANCE SERVICE (1) An advanced life support ground ambulance service must: (a) remains the same. (b) when transporting a patient at the advanced life support level, ensure that one of the required personnel is an
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.321 PERSONNEL:
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.329 PERSONNEL: ADVANCED LIFE SUPPORT AIR AMBULANCE SERVICE (1) In addition to the pilot, one
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.330
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.401 PERSONNEL: BASIC LIFE SUPPORT NONTRANSPORTING UNIT (1) At least one of the following individuals must be on each call: (d) remains the same, but is renumbered (b).
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.404 PERSONNEL: ADVANCED LIFE SUPPORT NONTRANSPORTING UNIT (1) An advanced life support nontransporting unit must: (a) remains the same. (b) when responding at the advanced life support level, ensure that at least one
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
37.104.405 PERSONNEL: (a) remains the same. (b) when responding at the
AUTH: 50-6-323, MCA IMP: 50-6-323, MCA
4. STATEMENT OF REASONABLE NECESSITY
The Department of Public Health and Human Services (the department) is proposing amendments to ARM 37.104.101, 37.104.102, 37.104.105, 37.104.109, 37.104.316, 37.104.319, 37.104.321, 37.104.329, 37.104.330, 37.104.401, 37.104.404, and 37.104.405 pertaining to emergency medical services (EMS).
Nationally, states and territory EMS offices have been adopting concepts of an EMS Education Agenda which describes a job-analysis process for EMT providers, new scopes of practice, and new names for various levels of EMT providers. Last year, the Montana Board of Medical Examiners (BOME) and the Montana Department of Labor and Industry (DLI) began a rule process to adopt these new levels of EMS providers and the new terms. Those rules were adopted this last summer, and the BOME adopted protocols defining their scope of practice in their September meeting. As of January 1, 2014, the old licensing levels of First Responder, EMT-Basic, Intermediate, and Paramedic will no longer exist. Several sections of the department's EMS service licensing rule reference these old terms for EMT providers. These rules must be changed to reflect the new terms of Emergency Medical Responder, Emergency Medical Technician, Advanced Emergency Medical Technician, and Paramedic. Also, amendments to terminology for levels of licensed EMS and level of care are being proposed in order to reduce confusion.
ARM 37.104.101
The proposed amendments to these rule definitions reflect changes to BOME rules regulating EMTs that will go into effect in January of 2014. This provides consistency in terms between EMS and EMT rules.
ARM 37.104.102 and 37.104.105
The department is proposing amendments to these rules to change terminology related to EMT intermediate to the newer term "advanced emergency medical technician or AEMT" to reflect industry usage.
ARM 37.104.109
The department is proposing amendments to this rule to change terminology related to EMT intermediate and EMT paramedic to the newer terms of "advanced emergency medical technician or AEMT" and "paramedic." An amendment to (2) is also proposed to clarify that each case in (1) requires approval and documentation about the ECPs and the levels of care that will be provided by the EMS.
ARM 37.104.316, 37.104.319, 37.104.321, 37.104.329, 37.104.330, 37.104.404, and 37.104.405
The department is proposing amendments to these sections to change names of EMT providers to the newer ECP names.
ARM 37.104.401
The department is proposing amendments to this section to change names of EMT providers to the newer ECP names. The department is also proposing deletion of the "grandfathered advanced first aid training" level as it refers to a provider that likely no longer exists on any licensed EMS.
5. The department intends to apply these rules retroactively to January 1, 2014. A retroactive application of the proposed rules does not result in a negative impact to any affected party.
6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail [email protected], and must be received no later than 5:00 p.m., December 12, 2013.
7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.
8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.
9. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register. The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered. In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.
10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.
11. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rules will not significantly and directly impact small businesses.
/s/ Shannon L. McDonald /s/ Richard H. Opper Shannon L. McDonald Richard H. Opper, Director Rule Reviewer Public Health and Human Services
Certified to the Secretary of State November 4, 2013.
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A directory of state agencies is available online at http://www.mt.gov/govt/agencylisting.asp.
For questions about the organization of the ARM or this web site, contact [email protected].
