AMBULANCE OPERATIONS H.B. 5232 (S-2): FIRST ANALYSIS


House Bill 5232 (Substitute S-2 as reported)
Sponsor: Representative John Stakoe
House Committee: Health Policy
Senate Committee: Health Policy


Date Completed: 6-15-04

RATIONALE


Ambulances are licensed to operate at basic life support, limited advanced life support, or advanced life support levels. Under the Public Health Code, all must be operated within the limits of their licenses. Thus, an ambulance licensed at the basic life support level may not operate at a higher level even if appropriately trained and licensed personnel are available to staff it. Some people believe that this is an inefficient use of available trained personnel and that the public would be better served if ambulances could be operated at a higher level of life support than they are licensed to provide.

CONTENT The bill would amend the Public Health Code to allow an ambulance operation to operate an ambulance at a higher level of life support than the ambulance was licensed to provide, if certain criteria were met.

The Code requires an ambulance operation license to state the level of life support the ambulance operation is licensed to provide, and prohibits an ambulance operation from providing life support at a level that exceeds its license. The bill would require the license to state the highest level of life support the operation was licensed to provide; and would prohibit an ambulance operation from providing life support at a level that exceeded its license or available licensed personnel.


The Code prohibits an ambulance operation from operating, attending, or permitting an ambulance to be operated while transporting a patient unless the ambulance is, at a minimum, staffed as follows:

-- If designated as providing basic life support, with at least one emergency medical technician (EMT) and one medical first responder.
-- If designated as providing limited advanced life support, with at least one EMT specialist and one EMT.
-- If designated as providing advanced life support, with at least one paramedic and one EMT.


The bill would make an exception to this provision. Under the bill, if an ambulance operation that was licensed to provide advanced life support had more than one ambulance licensed under its operation, the ambulance operation could operate an ambulance licensed to provide basic life support or limited advanced life support at a higher level of life support if all of the following conditions were met:

-- The ambulance operation had at least one ambulance under its operation that was properly staffed and available to provide advanced life support on a 24-hour-a-day, seven-day-a-week basis.
-- The licensed personnel required to operate at the higher level of life support were available at the scene and in the ambulance during the patient transport to provide life support at the higher level.
-- The ambulance met all equipment and communication requirements to operate at the higher level of life support.
-- An ambulance operation that was unable respond to a request for emergency assistance immediately requested assistance pursuant to protocols established by the local medical control authority and approved by the Department of Community Health under the Code.




An ambulance operation that maintained patient care equipment and medications necessary to upgrade from providing basic or limited advanced life support to providing a higher level of life support in accordance with the bill would have to secure the equipment and medications in a way such that they could be used only by the appropriately licensed personnel.


MCL 333.20920 et al.

ARGUMENTS (Please note: The arguments contained in this analysis originate from sources outside the Senate Fiscal Agency. The Senate Fiscal Agency neither supports nor opposes legislation.)

Supporting Argument Municipal emergency medical services (EMS) providers face a problem when they receive two calls necessitating advanced life support services at the same time but have only one unit licensed to operate at that level. Sometimes, there are properly trained and licensed EMTs present to operate a higher-level unit; however, they cannot operate the remaining basic life support or limited advanced life support unit at the level appropriate to responding to the call. When this happens, EMTs must seek another advanced life support unit from a neighboring municipality; however, this practice is undesirable because it temporarily removes a critical service from that community. Some local communities cannot afford to purchase additional advanced life support-licensed ambulances. By allowing for multiple-use units, the bill would enhance EMS providers' ability to use their available resources to bring life-saving services to the public more quickly.


Legislative Analyst: Julie Koval

FISCAL IMPACT
The bill would have no fiscal impact on State or local government.


Fiscal Analyst: Dana Patterson

Analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent. hb5232/0304