September 17, 2013, Introduced by Reps. Tlaib, Townsend, Switalski, Darany, Kandrevas, Hobbs and Cavanagh and referred to the Committee on Local Government.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 20919 (MCL 333.20919), as amended by 2006 PA
582.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec.
20919. (1) A local medical control authority shall
establish written protocols for the practice of life support
agencies and licensed emergency medical services personnel within
its region. The medical control authority shall develop and adopt
the
protocols shall be developed and
adopted required under this
section in accordance with procedures established by the department
and shall include all of the following:
(a) The acts, tasks, or functions that may be performed by
each type of emergency medical services personnel licensed under
this part.
(b) Medical protocols to ensure the appropriate dispatching of
a life support agency based upon medical need and the capability of
the emergency medical services system.
(c) Protocols for complying with the Michigan do-not-
resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067.
(d) Protocols defining the process, actions, and sanctions a
medical control authority may use in holding a life support agency
or personnel accountable.
(e) Protocols to ensure that if the medical control authority
determines that an immediate threat to the public health, safety,
or welfare exists, appropriate action to remove medical control can
immediately be taken until the medical control authority has had
the opportunity to review the matter at a medical control authority
hearing.
The protocols shall must require that the hearing is held
within 3 business days after the medical control authority's
determination.
(f) Protocols to ensure that if medical control has been
removed from a participant in an emergency medical services system,
the participant does not provide prehospital care until medical
control is reinstated, and that the medical control authority that
removed the medical control notifies the department within 1
business day of the removal.
(g)
Protocols that to ensure that
a quality improvement
program is in place within a medical control authority and provides
data protection as provided in 1967 PA 270, MCL 331.531 to
331.533.331.534.
(h) Protocols to ensure that an appropriate appeals process is
in place.
(i)
Within 1 year after December 23, 2003, protocols Protocols
to ensure that each life support agency that provides basic life
support, limited advanced life support, or advanced life support is
equipped with epinephrine or epinephrine auto-injectors and that
each emergency services personnel authorized to provide those
services is properly trained to recognize an anaphylactic reaction,
to administer the epinephrine, and to dispose of the epinephrine
auto-injector or vial.
(j)
Within 6 months after the effective date of the amendatory
act
that added this subdivision, protocols Protocols to ensure that
each life support vehicle that is dispatched and responding to
provide medical first response life support, basic life support, or
limited advanced life support is equipped with an automated
external defibrillator and that each emergency services personnel
is properly trained to utilize the automated external
defibrillator.
(k) Within 6 months after the effective date of the amendatory
act that added this subdivision, for a medical control authority
that has more than 500,000 residents within its region, protocols
to ensure that each life support vehicle that is dispatched and
responding to provide basic life support, limited advanced life
support, or advanced life support is dispatched and responding in a
reasonable time within that region.
(2) A medical control authority shall not establish a protocol
established
under this section shall not
conflict that conflicts
with the Michigan do-not-resuscitate procedure act, 1996 PA 193,
MCL 333.1051 to 333.1067.
(3)
The department shall establish procedures established by
the
department for the development
and adoption of written
protocols
under this section. shall comply with The procedures must
include at least all of the following requirements:
(a) At least 60 days before adoption of a protocol, the
medical control authority shall circulate a written draft of the
proposed protocol to all significantly affected persons within the
emergency medical services system served by the medical control
authority and submit the written draft to the department for
approval.
(b) The department shall review a proposed protocol for
consistency with other protocols concerning similar subject matter
that have already been established in this state and shall consider
any written comments received from interested persons in its
review.
(c) Within 60 days after receiving a written draft of a
proposed protocol from a medical control authority, the department
shall provide a written recommendation to the medical control
authority with any comments or suggested changes on the proposed
protocol. If the department does not respond within 60 days after
receiving
the written draft, the proposed protocol shall be is
considered to be approved by the department.
(d) After department approval of a proposed protocol, the
medical control authority may formally adopt and implement the
protocol.
(e) A medical control authority may establish an emergency
protocol necessary to preserve the health or safety of individuals
within
its jurisdiction region in response to a present medical
emergency or disaster without following the procedures established
by
the department under this section subsection for an ordinary
protocol. An emergency protocol established under this subdivision
is
effective only for a limited time period and does not take
permanent effect unless it is approved according to the procedures
established by the department under this subsection.
(4) A medical control authority shall provide an opportunity
for an affected participant in an emergency medical services system
to appeal a decision of the medical control authority. Following
appeal, the medical control authority may affirm, suspend, or
revoke its original decision. After appeals to the medical control
authority have been exhausted, the affected participant in an
emergency medical services system may appeal the medical control
authority's
decision to the statewide state
emergency medical
services coordination committee created in section 20915. The
statewide
state emergency medical services coordination committee
shall issue an opinion on whether the actions or decisions of the
medical control authority are in accordance with the department-
approved protocols of the medical control authority and state law.
If
the statewide state emergency medical services coordination
committee determines in its opinion that the actions or decisions
of the medical control authority are not in accordance with the
medical control authority's department-approved protocols or with
state law, the state emergency medical services coordination
committee shall recommend that the department take any enforcement
action authorized under this code.
(5) If adopted in protocols approved by the department, a
medical control authority may require life support agencies within
its region to meet reasonable additional standards for equipment
and personnel, other than medical first responders, that may be
more stringent than are otherwise required under this part. If a
medical control authority proposes a protocol that establishes
additional standards for equipment and personnel, the medical
control authority and the department shall consider the medical and
economic impact on the local community, the need for communities to
do long-term planning, and the availability of personnel. If either
the medical control authority or the department determines that
negative medical or economic impacts outweigh the benefits of those
additional standards as they affect public health, safety, and
welfare, the medical control authority shall not adopt and the
department shall not approve protocols containing those additional
standards. shall
not be adopted.
(6) If adopted in protocols approved by the department, a
local
medical control authority may
require medical first response
services and licensed medical first responders within its region to
meet additional standards for equipment and personnel to ensure
that each medical first response service is equipped with an
epinephrine auto-injector, and that each licensed medical first
responder is properly trained to recognize an anaphylactic reaction
and to administer and dispose of the epinephrine auto-injector, if
a life support agency that provides basic life support, limited
advanced life support, or advanced life support is not readily
available in that location.
(7) If a decision of the medical control authority under
subsection (5) or (6) is appealed by an affected person, the
medical control authority shall make available, in writing, the
medical and economic information it considered in making its
decision.
On appeal, the statewide state
emergency medical services
coordination committee shall review this information under
subsection (4) and shall issue its findings in writing.