(3) Establish licensing standards and requirements for Vehicle Service Providers, through rules adopted pursuant to this Act, including but not limited to: (A) Vehicle design, specification, operation and maintenance standards, including standards for the use of reserve ambulances;(B) Equipment requirements;(C) Staffing requirements; and(D) License renewal at intervals determined by the Department, which shall be not less than every 4 years. The Department's standards and requirements with respect to vehicle staffing for private, nonpublic local government employers must allow for alternative staffing models that include an EMR with a licensed EMT, EMT-I, A-EMT, Paramedic, or PHRN, as appropriate, pursuant to the approval of the EMS System Program Plan developed and approved by the EMS Medical Director for an EMS System. The EMS personnel licensed at the highest level shall provide the initial assessment of the patient to determine the level of care required for transport to the receiving health care facility, and this assessment shall be documented in the patient care report and documented with online medical control. The EMS personnel licensed at or above the level of care required by the specific patient as directed by the EMS Medical Director shall be the primary care provider en route to the destination facility or patient's residence. The Department shall monitor the implementation and performance of alternative staffing models and may issue a notice of termination of an alternative staffing model only upon evidence that an EMS System Program Plan is not being adhered to. Adoption of an alternative staffing model shall not result in a Vehicle Service Provider being prohibited or limited in the utilization of its staff or equipment from providing any of the services authorized by this Act or as otherwise outlined in the approved EMS System Program Plan, including, without limitation, the deployment of resources to provide out-of-state disaster response. EMS System Program Plans must address a process for out-of-state disaster response deployments that must meet the following:
(A) All deployments to provide out-of-state disaster response must first be approved by the EMS Medical Director and submitted to the Department.(B) The submission must include the number of units being deployed, vehicle identification numbers, length of deployment, and names of personnel and their licensure level.(C) Ensure that all necessary in-state requests for services will be covered during the duration of the deployment. An EMS System Program Plan for a Basic Life Support, advanced life support, and critical care transport utilizing an EMR and an EMT shall include the following:
(A) Alternative staffing models for a Basic Life Support transport utilizing an EMR shall only be utilized for interfacility Basic Life Support transports as specified by the EMS System Program Plan as determined by the EMS System Medical Director .(B) Protocols that shall include dispatch procedures to properly screen and assess patients for EMR-staffed transports .(C) A requirement that a provider and EMS System shall implement a quality assurance plan that shall include for the initial waiver period the review of at least 5% of total interfacility transports utilizing an EMR with mechanisms outlined to audit dispatch screening, reason for transport, patient diagnosis, level of care, and the outcome of transports performed. Quality assurance reports must be submitted and reviewed by the provider and EMS System monthly and made available to the Department upon request. The percentage of transports reviewed under quality assurance plans for renewal periods shall be determined by the EMS Medical Director, however, it shall not be less than 3%.(D) The EMS System Medical Director shall develop a minimum set of requirements for individuals based on level of licensure that includes education, training, and credentialing for all team members identified to participate in an alternative staffing plan. The EMT, Paramedic, PHRN, PHPA, PHAPRN, and critical care transport staff shall have the minimum experience in performance of pre-hospital and inter-hospital care, as determined by the EMS Medical Director in accordance with the EMS System Program Plan, but at a minimum of 6 months of prehospital experience or at least 50 documented patient care interventions during transport as the primary care provider and approved by the Department.(E) The licensed EMR must complete a defensive driving course prior to participation in the Department's alternative staffing model.(F) The length of the EMS System Program Plan for a Basic Life Support transport utilizing an EMR shall be for one year, and must be renewed annually if proof of the criteria being met is submitted, validated, and approved by the EMS Medical Director for the EMS System and the Department.(G) Beginning July 1, 2023, the utilization of EMRs for advanced life support transports and Tier III Critical Care Transports shall be allowed for periods not to exceed 3 years under a pilot program. The pilot program shall not be implemented before Department approval. Agencies requesting to utilize this staffing model for the time period of the pilot program must complete the following: (i) Submit a waiver request to the Department requesting to participate in the pilot program with specific details of how quality assurance and improvement will be gathered, measured, reported to the Department, and reviewed and utilized internally by the participating agency.(ii) Submit a signed approval letter from the EMS System Medical Director approving participation in the pilot program.(iii) Submit updated EMS System plans, additional education, and training of the EMR and protocols related to the pilot program.(iv) Submit agency policies and procedures related to the pilot program.(v) Submit the number of individuals currently participating and committed to participating in education programs to achieve a higher level of licensure at the time of submission.(vi) Submit an explanation of how the provider will support individuals obtaining a higher level of licensure and encourage a higher level of licensure during the year of the alternative staffing plan and specific examples of recruitment and retention activities or initiatives. Upon submission of a renewal application and recruitment and retention plan, the provider shall include additional data regarding current employment numbers, attrition rates over the year, and activities and initiatives over the previous year to address recruitment and retention. The information required under this subparagraph (G) shall be provided to and retained by the EMS System upon initial application and renewal and shall be provided to the Department upon request.
The Department must allow for an alternative rural staffing model for those vehicle service providers that serve a rural or semi-rural population of 10,000 or fewer inhabitants and exclusively uses volunteers, paid-on-call, or a combination thereof.