Bill Text: MI HB5404 | 2013-2014 | 97th Legislature | Introduced
Bill Title: Health; emergency services; protocols that require emergency response vehicles to carry opioid antagonists and require emergency services personnel to be trained; require medical control authority to develop. Amends secs. 20919 & 20965 of 1978 PA 368 (MCL 333.20919 & 333.20965).
Spectrum: Slight Partisan Bill (Republican 6-2)
Status: (Passed) 2014-10-22 - Assigned Pa 312'14 With Immediate Effect [HB5404 Detail]
Download: Michigan-2013-HB5404-Introduced.html
HOUSE BILL No. 5404
March 11, 2014, Introduced by Reps. Crawford, Forlini, Graves, Lane, Yanez, Zorn, Lauwers and Kowall and referred to the Committee on Judiciary.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 20919 and 20965 (MCL 333.20919 and 333.20965),
section 20919 as amended by 2006 PA 582 and section 20965 as
amended by 2000 PA 375.
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, 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 opioid antagonists and that
each emergency services personnel is properly trained to administer
opioid antagonists.
(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.
Sec. 20965. (1) Unless an act or omission is the result of
gross negligence or willful misconduct, the acts or omissions of a
medical first responder, emergency medical technician, emergency
medical technician specialist, paramedic, medical director of a
medical control authority or his or her designee, or, subject to
subsection (5), an individual acting as a clinical preceptor of a
department-approved education program sponsor while providing
services to a patient outside a hospital, in a hospital before
transferring patient care to hospital personnel, or in a clinical
setting that are consistent with the individual's licensure or
additional training required by the medical control authority
including, but not limited to, services described in subsection
(2), or consistent with an approved procedure for that particular
education program do not impose liability in the treatment of a
patient on those individuals or any of the following persons:
(a) The authorizing physician or physician's designee.
(b) The medical director and individuals serving on the
governing board, advisory body, or committee of the medical control
authority and an employee of the medical control authority.
(c) The person providing communications services or lawfully
operating or utilizing supportive electronic communications
devices.
(d) The life support agency or an officer, member of the
staff, or other employee of the life support agency.
(e) The hospital or an officer, member of the staff, nurse, or
other employee of the hospital.
(f) The authoritative governmental unit or units.
(g) Emergency personnel from outside the state.
(h) The education program medical director.
(i) The education program instructor-coordinator.
(j) The education program sponsor and education program
sponsor advisory committee.
(k) The student of a department-approved education program who
is participating in an education program-approved clinical setting.
(l) An instructor or other staff employed by or under contract
to a department-approved education program for the purpose of
providing training or instruction for the department-approved
education program.
(m) The life support agency or an officer, member of the
staff, or other employee of the life support agency providing the
clinical setting described in subdivision (k).
(n) The hospital or an officer, member of the medical staff,
or other employee of the hospital providing the clinical setting
described in subdivision (k).
(2) Subsection (1) applies to services consisting of any of
the following:
(a) The use of an automated external defibrillator on an
individual who is in or is exhibiting symptoms of cardiac distress.
(b) The administration of an opioid antagonist to an
individual who is suffering or is exhibiting symptoms of an opioid-
related overdose.
(3) Unless an act or omission is the result of gross
negligence or willful misconduct, the acts or omissions of any of
the persons named below, while participating in the development of
protocols under this part, implementation of protocols under this
part, or holding a participant in the emergency medical services
system accountable for department-approved protocols under this
part, does not impose liability in the performance of those
functions:
(a) The medical director and individuals serving on the
governing board, advisory body, or committees of the medical
control authority or employees of the medical control authority.
(b) A participating hospital or freestanding surgical
outpatient facility in the medical control authority or an officer,
member of the medical staff, or other employee of the hospital or
freestanding surgical outpatient facility.
(c) A participating agency in the medical control authority or
an officer, member of the medical staff, or other employee of the
participating agency.
(d) A nonprofit corporation that performs the functions of a
medical control authority.
(4) Subsections (1) and (3) do not limit immunity from
liability otherwise provided by law for any of the persons listed
in subsections (1) and (3).
(5) The limitation on liability granted to a clinical
preceptor under subsection (1) applies only to an act or omission
of the clinical preceptor relating directly to a student's clinical
training activity or responsibility while the clinical preceptor is
physically present with the student during the clinical training
activity, and does not apply to an act or omission of the clinical
preceptor during that time that indirectly relates or does not
relate to the student's clinical training activity or
responsibility.
Enacting section 1. This amendatory act does not take effect
unless all of the following bills of the 97th Legislature are
enacted into law:
(a) Senate Bill No. 721.
(b) Senate Bill No. ____ or House Bill No. 5407 (request no.
04233'13 *).
(c) Senate Bill No. ____ or House Bill No. 5405 (request no.
04998'14).
