SENATE  No. 1650


with committee amendments




DATED:  JUNE 18, 2012


      The Senate Health, Human Services and Senior Citizens Committee reports favorably and with committee amendments Senate Bill No. 1650.

      As amended by the committee, this bill provides a new statutory approach to the regulation of emergency medical services that encompasses basic and advanced life support services, and governs the qualifications, training, and operations of paramedics, emergency medical technicians (EMTs), and emergency medical responders.

      The bill provides specifically as follows:

     Under the direction of the Commissioner of Health and Senior Services, the Office of Emergency Medical Services in the Department of Health and Senior Services (DHSS) is to serve as the lead State agency for the oversight of emergency medical services delivery in the State.

     The commissioner is to appoint a physician with relevant experience as State Medical Director for Emergency Medical Services, and the State Medical Director may appoint up to three regional medical directors to oversee their respective geographic areas. 

     The commissioner is to ensure or arrange for the provision of advanced life support pre-hospital care in response to 9-1-1 calls within the State.

      Paramedics who staff mobile intensive care units, EMTs who staff licensed ambulances, and emergency medical responders to 9-1-1 calls are to be licensed and to undergo criminal history record background checks; however, an EMT who is a member of a volunteer first aid, ambulance, or rescue squad is exempt from having to assume any costs for licensure or having to undergo a criminal history record background check.

      The commissioner is authorized, after notice and hearing, to revoke the license of a paramedic, EMT, or emergency medical responder for violation of any provision of applicable laws and regulations.

      DHSS is to make available to the public a current list of licensed paramedics and EMTs on its Internet website.

     A paramedic is authorized to perform advanced life support services if the paramedic:  maintains direct voice communication with and is taking orders from a licensed physician or physician-directed registered professional nurse, both of whom are affiliated with a mobile intensive care program; or is operating under standing orders from a licensed physician that were developed or approved by a mobile intensive care program.

      A hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) is:  authorized to develop and maintain a mobile intensive care program if it is licensed to do so pursuant to this bill; and, at a minimum, is required to maintain an accredited emergency department.  The commissioner is to establish, by regulation, criteria which a hospital must meet in order to obtain licensure to operate a mobile intensive care program.

     The commissioner is to establish an Emergency Medical Care Advisory Board (EMCAB), which is to advise the commissioner on all matters of mobile intensive care services, basic life support services, advanced life support services, and pre-hospital and inter-facility care.  EMCAB replaces the State mobile intensive care advisory council; and section 10 of P.L.1984, c.146 (C.26:2K-16), which established the council, is repealed.  EMCAB is to include 16 members, as follows:  the commissioner and the Director of the Office of Emergency Medical Services in DHSS, and the State Medical Director for Emergency Medical Services, or their designees, as ex officio, nonvoting members; and 13 public members, to be initially appointed by the commissioner and thereafter appointed in a manner specified by regulation of the commissioner, including one representative from each of the following:  volunteer basic life support services providers; paid basic life support services providers; emergency medical service helicopter response units; mobile intensive care programs; emergency physicians; general hospitals; emergency care nurses; municipal government; emergency telecommunications services; county offices of emergency management; trauma services or burn treatment providers; the Emergency Medical Services for Children program; and a member of the general public who is not involved with the provision of health care or emergency medical services.  EMCAB is to provide ongoing review of regulations governing emergency medical services, recommend to the commissioner such revisions as it determines are needed to achieve the goals of evidence-based medical care and protecting the public health, and submit an annual report to the commissioner on the state of pre-hospital and inter-facility care in New Jersey, including evaluations and recommendations from each of its standing committees.

     The commissioner, in consultation with EMCAB, is to establish by regulation requirements for:  the collection of data that each agency providing pre-hospital or inter-facility care is to obtain for each patient encounter; the creation and use of a patient care report by the agency to provide this data to the receiving facility in a timely manner; and the electronic reporting of this data to DHSS.

      The commissioner, in consultation with EMCAB, is to establish minimum standards for training, response times, equipment, and quality of care with respect to basic life support pre-hospital care and advanced life support pre-hospital care.

     The commissioner is to establish, maintain, and coordinate the activities of a New Jersey Emergency Medical Services Task Force, which will include emergency medical services providers from all regions of the State.  The purpose of the task force is to support and enhance the provision of specialized response services for both pre-planned and emergency events in order to reduce morbidity and mortality through appropriate triage, incident management, and coordinated pre-hospital care and transportation.

     The bill repeals the following sections of law that are obviated by its provisions:  section 5 of P.L.1984, c.146 (C.26:2K-11), concerning the performance of advanced life support procedures by a paramedic who is not in direct voice communication with a physician; section 12 of P.L.1984, c.146 (C.26:2K-18), concerning a paramedic performing the duties or filling the position of another health care professional employed by a hospital; and section 4 of P.L.1986, c.106 (C.26:2K-38), concerning immunity from liability for persons training for or rendering advanced life support services.  In addition, the bill repeals P.L.1989, c.314 (C.26:2K-39 et seq.), concerning certification of EMT-Ds by the commissioner to perform cardiac defibrillation, which is obviated by the training in cardiac defibrillation provided to EMTs and First Responders to meet American Heart Association CPR certification requirements.

     The commissioner is to report to the Governor and the Legislature, no later than December 31 of each year, on the adequacy of emergency medical services, and to identify funding needed for the succeeding fiscal year for infrastructure and research to encourage continued improvement of emergency medical services.

     The bill takes effect on the first day of the seventh month after its enactment, but authorizes the commissioner to take prior administrative action as necessary for its implementation.

      The committee amendments to the bill remove the President of the New Jersey State First Aid Council or his proxy as an ex officio member of EMCAB and provide instead for an additional public member to represent volunteer basic life support services providers; delete the requirement that the standards established by the  commissioner to approve and monitor dispatch agencies include requirements for global positioning tracking of emergency medical services vehicles; delete the proposed increase in the surcharge imposed on motor vehicle violations for deposit into the "Emergency Medical Technician Training Fund” (from $.50, as currently provided in N.J.S.22A:3-4, to $5); provide that when an ambulance operated by a basic life support first aid, rescue, or ambulance squad is transporting a patient, it is to be staffed by at least one EMT, who is to attend to the patient in the patient compartment; and revise the effective date of the bill from the 180th day after enactment to the first day of the seventh month next following the date of enactment.