Bill Text: IL HB5085 | 2023-2024 | 103rd General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Reinserts the provisions of the introduced bill with the following changes. Removes changes to provisions concerning the EMT Training, Recruitment, and Retention Task Force; Emergency Medical Services personnel licensure levels; and vehicle service providers. Removes language providing that an education plan within a resource hospital may include classes performed outside of the region in which the resource hospital is located. Provides that an EMS System may coordinate education outside of the region of which it is located with valid justification and Department of Public Health approval. Provides that the didactic portion of education may be conducted through an online platform with EMS System and Department approval. Sets forth provisions concerning Department approval. Provides that an EMS Lead Instructor may oversee a paramedic with at least 3 years of experience to teach EMT classes, with a licensed teacher, in high schools. Provides that high school students electing to not take the National Registry of Emergency Medical Technicians (NREMT) Certification exam shall not be accounted for in calculating the course pass rate by the EMS System or Department.

Spectrum: Slight Partisan Bill (Democrat 14-7)

Status: (Enrolled) 2024-05-26 - Added as Alternate Co-Sponsor Sen. Meg Loughran Cappel [HB5085 Detail]

Download: Illinois-2023-HB5085-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5085 Introduced , by Rep. William "Will" Davis SYNOPSIS AS INTRODUCED:
210 ILCS 50/3.5
210 ILCS 50/3.22
210 ILCS 50/3.35
210 ILCS 50/3.50
210 ILCS 50/3.65
210 ILCS 50/3.85
Amends the Emergency Medical Services (EMS) Systems Act. Provides that "clinical observation" means the ongoing observation of a patient's medical or mental health condition by a licensed health care professional utilizing a medical skill set while continuing assessment and care. Provides that the EMS Medical Directors on the EMT Training, Recruitment, and Retention Task Force may be active or retired. Provides that an education plan within a resource hospital may include classes performed outside of the region in which the resource hospital is located. Provides that "paramedic" means a person who has successfully completed a course in advanced life support care as approved by the Department of Public Health or accredited by the Committee on Accreditation for the EMS Professions (CoAEMSP), is licensed by the Department, and practices with an Advanced Life Support EMS System. Provides that the Department shall have the authority to adopt rules governing the curriculum, practice, and necessary equipment applicable to emergency medical responders and shall allow curriculum in addition to the National Registry curriculum. Provides that a fee for EMS personnel examination, licensure, and license renewal shall be reasonable. Provides that a lead instructor is permitted to oversee a paramedic with at least 3 years of experience to teach EMT classes in high schools with a licensed teacher. Provides that pass rates for classes taught in high schools shall not adversely impact the lead instructor or affiliated EMS system, resource hospital, or provider. Provides that the Department may not include any additional criteria for approval of a staffing waiver utilizing an EMR other than the criteria outlined. Provides that the EMR pilot program shall not be implemented before Department approval which must be granted upon EMS System Medical Director approval.
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A BILL FOR
HB5085 LRB103 38312 CES 68447 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Emergency Medical Services (EMS) Systems
Act is amended by changing Sections 3.5, 3.22, 3.35, 3.50,
3.65, and 3.85 as follows:
(210 ILCS 50/3.5)
Sec. 3.5. Definitions. As used in this Act:
"Clinical observation" means the ongoing observation of a
patient's medical or mental health condition by a licensed
health care professional utilizing a medical skill set while
continuing assessment and care.
"Department" means the Illinois Department of Public
Health.
"Director" means the Director of the Illinois Department
of Public Health.
"Emergency" means a medical condition of recent onset and
severity that would lead a prudent layperson, possessing an
average knowledge of medicine and health, to believe that
urgent or unscheduled medical care is required.
"Emergency Medical Services personnel" or "EMS personnel"
means persons licensed as an Emergency Medical Responder (EMR)
(First Responder), Emergency Medical Dispatcher (EMD),

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Emergency Medical Technician (EMT), Emergency Medical
Technician-Intermediate (EMT-I), Advanced Emergency Medical
Technician (A-EMT), Paramedic (EMT-P), Emergency
Communications Registered Nurse (ECRN), Pre-Hospital
Registered Nurse (PHRN), Pre-Hospital Advanced Practice
Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant
(PHPA).
"Exclusive representative" has the same meaning as defined
in Section 3 of the Illinois Public Labor Relations Act.
"Health care facility" means a hospital, nursing home,
physician's office or other fixed location at which medical
and health care services are performed. It does not include
"pre-hospital emergency care settings" which utilize EMS
personnel to render pre-hospital emergency care prior to the
arrival of a transport vehicle, as defined in this Act.
"Hospital" has the meaning ascribed to that term in the
Hospital Licensing Act.
"Labor organization" has the same meaning as defined in
Section 3 of the Illinois Public Labor Relations Act.
"Medical monitoring" means the performance of medical
tests and physical exams to evaluate an individual's ongoing
exposure to a factor that could negatively impact that
person's health. "Medical monitoring" includes close
surveillance or supervision of patients liable to suffer
deterioration in physical or mental health and checks of
various parameters such as pulse rate, temperature,

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respiration rate, the condition of the pupils, the level of
consciousness and awareness, the degree of appreciation of
pain, and blood gas concentrations such as oxygen and carbon
dioxide.
"Silver spanner program" means a program in which a member
under a fire department's or fire protection district's
collective bargaining agreement works on or at the EMS System
under another fire department's or fire protection district's
collective bargaining agreement and (i) the other fire
department or fire protection district is not the member's
full-time employer and (ii) any EMS services not included
under the original fire department's or fire protection
district's collective bargaining agreement are included in the
other fire department's or fire protection district's
collective bargaining agreement.
"Trauma" means any significant injury which involves
single or multiple organ systems.
(Source: P.A. 103-521, eff. 1-1-24.)
(210 ILCS 50/3.22)
Sec. 3.22. EMT Training, Recruitment, and Retention Task
Force.
(a) The EMT Training, Recruitment, and Retention Task
Force is created to address the following:
(1) the impact that the EMT and Paramedic shortage is
having on this State's EMS System and health care system;

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(2) barriers to the training, recruitment, and
retention of Emergency Medical Technicians throughout this
State;
(3) steps that the State of Illinois can take,
including coordination and identification of State and
federal funding sources, to assist Illinois high schools,
community colleges, and ground ambulance providers to
train, recruit, and retain emergency medical technicians;
(4) the examination of current testing mechanisms for
EMRs, EMTs, and Paramedics and the utilization of the
National Registry of Emergency Medical Technicians,
including current pass rates by licensure level, national
utilization, and test preparation strategies;
(5) how apprenticeship programs, local, regional, and
statewide, can be utilized to recruit and retain EMRs,
EMTs, and Paramedics;
(6) how ground ambulance reimbursement affects the
recruitment and retention of EMTs and Paramedics; and
(7) all other areas that the Task Force deems
necessary to examine and assist in the recruitment and
retention of EMTs and Paramedics.
(b) The Task Force shall be comprised of the following
members:
(1) one member of the Illinois General Assembly,
appointed by the President of the Senate, who shall serve
as co-chair;

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(2) one member of the Illinois General Assembly,
appointed by the Speaker of the House of Representatives;
(3) one member of the Illinois General Assembly,
appointed by the Senate Minority Leader;
(4) one member of the Illinois General Assembly,
appointed by the House Minority Leader, who shall serve as
co-chair;
(5) 9 members representing private ground ambulance
providers throughout this State representing for-profit
and non-profit rural and urban ground ambulance providers,
appointed by the President of the Senate;
(6) 3 members representing hospitals, appointed by the
Speaker of the House of Representatives, with one member
representing safety-net hospitals and one member
representing rural hospitals;
(7) 3 members representing a statewide association of
nursing homes, appointed by the President of the Senate;
(8) one member representing the State Board of
Education, appointed by the House Minority Leader;
(9) 2 active or retired EMS Medical Directors from a
Regional EMS Medical Directors Committee, appointed by the
Governor; and
(10) one member representing the Illinois Community
College Systems, appointed by the Minority Leader of the
Senate.
(c) Members of the Task Force shall serve without

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compensation.
(d) The Task Force shall convene at the call of the
co-chairs and shall hold at least 6 meetings.
(e) The Task Force shall submit its final report to the
General Assembly and the Governor no later than September 1,
2024, and upon the submission of its final report, the Task
Force shall be dissolved.
(Source: P.A. 103-547, eff. 8-11-23; 103-563, eff. 11-17-23.)
(210 ILCS 50/3.35)
Sec. 3.35. Emergency Medical Services (EMS) Resource
Hospital; Functions. The Resource Hospital of an EMS System
shall:
(a) Prepare a Program Plan in accordance with the
provisions of this Act and minimum standards and criteria
established in rules adopted by the Department pursuant to
this Act, and submit such Program Plan to the Department
for approval.
(b) Appoint an EMS Medical Director, who will
continually monitor and supervise the System and who will
have the responsibility and authority for total management
of the System as delegated by the EMS Resource Hospital.
The Program Plan shall require the EMS Medical
Director to appoint an alternate EMS Medical Director and
establish a written protocol addressing the functions to
be carried out in his or her absence.

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(c) Appoint an EMS System Coordinator and EMS
Administrative Director in consultation with the EMS
Medical Director and in accordance with rules adopted by
the Department pursuant to this Act.
(d) Identify potential EMS System participants and
obtain commitments from them for the provision of
services.
(e) Educate or coordinate the education of EMS
personnel and all other license holders in accordance with
the requirements of this Act, rules adopted by the
Department pursuant to this Act, and the EMS System
Program Plan. An education plan within a resource hospital
may include classes performed outside of the region in
which the resource hospital is located.
(f) Notify the Department of EMS personnel who have
successfully completed the requirements as provided by law
for initial licensure, license renewal, and license
reinstatement by the Department.
(g) Educate or coordinate the education of Emergency
Medical Dispatcher candidates, in accordance with the
requirements of this Act, rules adopted by the Department
pursuant to this Act, and the EMS System Program Plan.
(h) Establish or approve protocols for prearrival
medical instructions to callers by System Emergency
Medical Dispatchers who provide such instructions.
(i) Educate or coordinate the education of

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Pre-Hospital Registered Nurse, Pre-Hospital Advanced
Practice Registered Nurse, Pre-Hospital Physician
Assistant, and ECRN candidates, in accordance with the
requirements of this Act, rules adopted by the Department
pursuant to this Act, and the EMS System Program Plan.
(j) Approve Pre-Hospital Registered Nurse,
Pre-Hospital Advanced Practice Registered Nurse,
Pre-Hospital Physician Assistant, and ECRN candidates to
practice within the System, and reapprove Pre-Hospital
Registered Nurses, Pre-Hospital Advanced Practice
Registered Nurses, Pre-Hospital Physician Assistants, and
ECRNs every 4 years in accordance with the requirements of
the Department and the System Program Plan.
(k) Establish protocols for the use of Pre-Hospital
Registered Nurses, Pre-Hospital Advanced Practice
Registered Nurses, and Pre-Hospital Physician Assistants
within the System.
(l) Establish protocols for utilizing ECRNs and
physicians licensed to practice medicine in all of its
branches to monitor telecommunications from, and give
voice orders to, EMS personnel, under the authority of the
EMS Medical Director.
(m) Monitor emergency and non-emergency medical
transports within the System, in accordance with rules
adopted by the Department pursuant to this Act.
(n) Utilize levels of personnel required by the

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Department to provide emergency care to the sick and
injured at the scene of an emergency, during transport to
a hospital or during inter-hospital transport and within
the hospital emergency department until the responsibility
for the care of the patient is assumed by the medical
personnel of a hospital emergency department or other
facility within the hospital to which the patient is first
delivered by System personnel.
(o) Utilize levels of personnel required by the
Department to provide non-emergency medical services
during transport to a health care facility and within the
health care facility until the responsibility for the care
of the patient is assumed by the medical personnel of the
health care facility to which the patient is delivered by
System personnel.
(p) Establish and implement a program for System
participant information and education, in accordance with
rules adopted by the Department pursuant to this Act.
(q) Establish and implement a program for public
information and education, in accordance with rules
adopted by the Department pursuant to this Act.
(r) Operate in compliance with the EMS Region Plan.
(Source: P.A. 100-1082, eff. 8-24-19.)
(210 ILCS 50/3.50)
Sec. 3.50. Emergency Medical Services personnel licensure

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levels.
(a) "Emergency Medical Technician" or "EMT" means a person
who has successfully completed a course in basic life support
as approved by the Department, is currently licensed by the
Department in accordance with standards prescribed by this Act
and rules adopted by the Department pursuant to this Act, and
practices within an EMS System. A valid Emergency Medical
Technician-Basic (EMT-B) license issued under this Act shall
continue to be valid and shall be recognized as an Emergency
Medical Technician (EMT) license until the Emergency Medical
Technician-Basic (EMT-B) license expires.
(b) "Emergency Medical Technician-Intermediate" or "EMT-I"
means a person who has successfully completed a course in
intermediate life support as approved by the Department, is
currently licensed by the Department in accordance with
standards prescribed by this Act and rules adopted by the
Department pursuant to this Act, and practices within an
Intermediate or Advanced Life Support EMS System.
(b-5) "Advanced Emergency Medical Technician" or "A-EMT"
means a person who has successfully completed a course in
basic and limited advanced emergency medical care as approved
by the Department, is currently licensed by the Department in
accordance with standards prescribed by this Act and rules
adopted by the Department pursuant to this Act, and practices
within an Intermediate or Advanced Life Support EMS System.
(c) "Paramedic (EMT-P)" means a person who has

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successfully completed a course in advanced life support care
as approved by the Department or accredited by the Committee
on Accreditation for the EMS Professions (CoAEMSP), is
licensed by the Department in accordance with standards
prescribed by this Act and rules adopted by the Department
pursuant to this Act, and practices within an Advanced Life
Support EMS System. A valid Emergency Medical
Technician-Paramedic (EMT-P) license issued under this Act
shall continue to be valid and shall be recognized as a
Paramedic license until the Emergency Medical
Technician-Paramedic (EMT-P) license expires.
(c-5) "Emergency Medical Responder" or "EMR (First
Responder)" means a person who has successfully completed a
course in emergency medical response as approved by the
Department and provides emergency medical response services in
accordance with the level of care established by the National
EMS Educational Standards Emergency Medical Responder course
as modified by the Department, or who provides services as
part of an EMS System response plan, as approved by the
Department, of that EMS System. The Department shall have the
authority to adopt rules governing the curriculum, practice,
and necessary equipment applicable to Emergency Medical
Responders and shall allow curriculum in addition to the
National Registry curriculum.
On August 15, 2014 (the effective date of Public Act
98-973), a person who is licensed by the Department as a First

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Responder and has completed a Department-approved course in
first responder defibrillator training based on, or equivalent
to, the National EMS Educational Standards or other standards
previously recognized by the Department shall be eligible for
licensure as an Emergency Medical Responder upon meeting the
licensure requirements and submitting an application to the
Department. A valid First Responder license issued under this
Act shall continue to be valid and shall be recognized as an
Emergency Medical Responder license until the First Responder
license expires.
(c-10) All EMS Systems and licensees shall be fully
compliant with the National EMS Education Standards, as
modified by the Department in administrative rules, within 24
months after the adoption of the administrative rules.
(d) The Department shall have the authority and
responsibility to:
(1) Prescribe education and training requirements,
which includes training in the use of epinephrine, for all
levels of EMS personnel except for EMRs, based on the
National EMS Educational Standards and any modifications
to those curricula specified by the Department through
rules adopted pursuant to this Act.
(2) Prescribe licensure testing requirements for all
levels of EMS personnel, which shall include a requirement
that all phases of instruction, training, and field
experience be completed before taking the appropriate

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licensure examination. Candidates may elect to take the
appropriate National Registry examination in lieu of the
Department's examination, but are responsible for making
their own arrangements for taking the National Registry
examination. In prescribing licensure testing requirements
for honorably discharged members of the armed forces of
the United States under this paragraph (2), the Department
shall ensure that a candidate's military emergency medical
training, emergency medical curriculum completed, and
clinical experience, as described in paragraph (2.5), are
recognized.
(2.5) Review applications for EMS personnel licensure
from honorably discharged members of the armed forces of
the United States with military emergency medical
training. Applications shall be filed with the Department
within one year after military discharge and shall
contain: (i) proof of successful completion of military
emergency medical training; (ii) a detailed description of
the emergency medical curriculum completed; and (iii) a
detailed description of the applicant's clinical
experience. The Department may request additional and
clarifying information. The Department shall evaluate the
application, including the applicant's training and
experience, consistent with the standards set forth under
subsections (a), (b), (c), and (d) of Section 3.10. If the
application clearly demonstrates that the training and

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experience meet such standards, the Department shall offer
the applicant the opportunity to successfully complete a
Department-approved EMS personnel examination for the
level of license for which the applicant is qualified.
Upon passage of an examination, the Department shall issue
a license, which shall be subject to all provisions of
this Act that are otherwise applicable to the level of EMS
personnel license issued.
(3) License individuals as an EMR, EMT, EMT-I, A-EMT,
or Paramedic who have met the Department's education,
training and examination requirements.
(4) Prescribe annual continuing education and
relicensure requirements for all EMS personnel licensure
levels.
(5) Relicense individuals as an EMD, EMR, EMT, EMT-I,
A-EMT, PHRN, PHAPRN, PHPA, or Paramedic every 4 years,
based on their compliance with continuing education and
relicensure requirements as required by the Department
pursuant to this Act. Every 4 years, a Paramedic shall
have 100 hours of approved continuing education, an EMT-I
and an advanced EMT shall have 80 hours of approved
continuing education, and an EMT shall have 60 hours of
approved continuing education. An Illinois licensed EMR,
EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHPA, PHAPRN, or
PHRN whose license has been expired for less than 36
months may apply for reinstatement by the Department.

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Reinstatement shall require that the applicant (i) submit
satisfactory proof of completion of continuing medical
education and clinical requirements to be prescribed by
the Department in an administrative rule; (ii) submit a
positive recommendation from an Illinois EMS Medical
Director attesting to the applicant's qualifications for
retesting; and (iii) pass a Department approved test for
the level of EMS personnel license sought to be
reinstated.
(6) Grant inactive status to any EMR, EMD, EMT, EMT-I,
A-EMT, Paramedic, ECRN, PHAPRN, PHPA, or PHRN who
qualifies, based on standards and procedures established
by the Department in rules adopted pursuant to this Act.
(7) Charge a reasonable fee for EMS personnel
examination, licensure, and license renewal.
(8) Suspend, revoke, or refuse to issue or renew the
license of any licensee, after an opportunity for an
impartial hearing before a neutral administrative law
judge appointed by the Director, where the preponderance
of the evidence shows one or more of the following:
(A) The licensee has not met continuing education
or relicensure requirements as prescribed by the
Department;
(B) The licensee has failed to maintain
proficiency in the level of skills for which he or she
is licensed;

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(C) The licensee, during the provision of medical
services, engaged in dishonorable, unethical, or
unprofessional conduct of a character likely to
deceive, defraud, or harm the public;
(D) The licensee has failed to maintain or has
violated standards of performance and conduct as
prescribed by the Department in rules adopted pursuant
to this Act or his or her EMS System's Program Plan;
(E) The licensee is physically impaired to the
extent that he or she cannot physically perform the
skills and functions for which he or she is licensed,
as verified by a physician, unless the person is on
inactive status pursuant to Department regulations;
(F) The licensee is mentally impaired to the
extent that he or she cannot exercise the appropriate
judgment, skill and safety for performing the
functions for which he or she is licensed, as verified
by a physician, unless the person is on inactive
status pursuant to Department regulations;
(G) The licensee has violated this Act or any rule
adopted by the Department pursuant to this Act; or
(H) The licensee has been convicted (or entered a
plea of guilty or nolo contendere) by a court of
competent jurisdiction of a Class X, Class 1, or Class
2 felony in this State or an out-of-state equivalent
offense.

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(9) Prescribe education and training requirements in
the administration and use of opioid antagonists for all
levels of EMS personnel based on the National EMS
Educational Standards and any modifications to those
curricula specified by the Department through rules
adopted pursuant to this Act.
(d-5) An EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN,
PHAPRN, PHPA, or PHRN who is a member of the Illinois National
Guard or an Illinois State Trooper or who exclusively serves
as a volunteer for units of local government with a population
base of less than 5,000 or as a volunteer for a not-for-profit
organization that serves a service area with a population base
of less than 5,000 may submit an application to the Department
for a waiver of the fees described under paragraph (7) of
subsection (d) of this Section on a form prescribed by the
Department.
The education requirements prescribed by the Department
under this Section must allow for the suspension of those
requirements in the case of a member of the armed services or
reserve forces of the United States or a member of the Illinois
National Guard who is on active duty pursuant to an executive
order of the President of the United States, an act of the
Congress of the United States, or an order of the Governor at
the time that the member would otherwise be required to
fulfill a particular education requirement. Such a person must
fulfill the education requirement within 6 months after his or

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her release from active duty.
(e) In the event that any rule of the Department or an EMS
Medical Director that requires testing for drug use as a
condition of the applicable EMS personnel license conflicts
with or duplicates a provision of a collective bargaining
agreement that requires testing for drug use, that rule shall
not apply to any person covered by the collective bargaining
agreement.
(f) At the time of applying for or renewing his or her
license, an applicant for a license or license renewal may
submit an email address to the Department. The Department
shall keep the email address on file as a form of contact for
the individual. The Department shall send license renewal
notices electronically and by mail to a licensee who provides
the Department with his or her email address. The notices
shall be sent at least 60 days prior to the expiration date of
the license.
(Source: P.A. 101-81, eff. 7-12-19; 101-153, eff. 1-1-20;
102-558, eff. 8-20-21; 102-623, eff. 8-27-21.)
(210 ILCS 50/3.65)
Sec. 3.65. EMS Lead Instructor.
(a) "EMS Lead Instructor" means a person who has
successfully completed a course of education as approved by
the Department, and who is currently approved by the
Department to coordinate or teach education, training and

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continuing education courses, in accordance with standards
prescribed by this Act and rules adopted by the Department
pursuant to this Act.
(b) The Department shall have the authority and
responsibility to:
(1) Prescribe education requirements for EMS Lead
Instructor candidates through rules adopted pursuant to
this Act.
(2) Prescribe testing requirements for EMS Lead
Instructor candidates through rules adopted pursuant to
this Act.
(3) Charge each candidate for EMS Lead Instructor a
fee to be submitted with an application for an
examination, an application for licensure, and an
application for relicensure.
(4) Approve individuals as EMS Lead Instructors who
have met the Department's education and testing
requirements.
(5) Require that all education, training and
continuing education courses for EMT, EMT-I, A-EMT,
Paramedic, PHRN, PHPA, PHAPRN, ECRN, EMR, and Emergency
Medical Dispatcher be coordinated by at least one approved
EMS Lead Instructor. A program which includes education,
training or continuing education for more than one type of
personnel may use one EMS Lead Instructor to coordinate
the program, and a single EMS Lead Instructor may

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simultaneously coordinate more than one program or course.
An EMS Lead Instructor may oversee a paramedic with at
least 3 years of experience to teach EMT classes in high
schools with a licensed teacher. Pass rates for classes
taught in high schools shall not adversely impact the EMS
Lead Instructor or affiliated EMS system/resource
hospital/provider.
(6) Provide standards and procedures for awarding EMS
Lead Instructor approval to persons previously approved by
the Department to coordinate such courses, based on
qualifications prescribed by the Department through rules
adopted pursuant to this Act.
(7) Suspend, revoke, or refuse to issue or renew the
approval of an EMS Lead Instructor, after an opportunity
for a hearing, when findings show one or more of the
following:
(A) The EMS Lead Instructor has failed to conduct
a course in accordance with the curriculum prescribed
by this Act and rules adopted by the Department
pursuant to this Act; or
(B) The EMS Lead Instructor has failed to comply
with protocols prescribed by the Department through
rules adopted pursuant to this Act.
(Source: P.A. 100-1082, eff. 8-24-19.)
(210 ILCS 50/3.85)

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Sec. 3.85. Vehicle Service Providers.
(a) "Vehicle Service Provider" means an entity licensed by
the Department to provide emergency or non-emergency medical
services in compliance with this Act, the rules promulgated by
the Department pursuant to this Act, and an operational plan
approved by its EMS System(s), utilizing at least ambulances
or specialized emergency medical service vehicles (SEMSV).
(1) "Ambulance" means any publicly or privately owned
on-road vehicle that is specifically designed, constructed
or modified and equipped, and is intended to be used for,
and is maintained or operated for the emergency
transportation of persons who are sick, injured, wounded
or otherwise incapacitated or helpless, or the
non-emergency medical transportation of persons who
require the presence of medical personnel to monitor the
individual's condition or medical apparatus being used on
such individuals.
(2) "Specialized Emergency Medical Services Vehicle"
or "SEMSV" means a vehicle or conveyance, other than those
owned or operated by the federal government, that is
primarily intended for use in transporting the sick or
injured by means of air, water, or ground transportation,
that is not an ambulance as defined in this Act. The term
includes watercraft, aircraft and special purpose ground
transport vehicles or conveyances not intended for use on
public roads.

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(3) An ambulance or SEMSV may also be designated as a
Limited Operation Vehicle or Special-Use Vehicle:
(A) "Limited Operation Vehicle" means a vehicle
which is licensed by the Department to provide basic,
intermediate or advanced life support emergency or
non-emergency medical services that are exclusively
limited to specific events or locales.
(B) "Special-Use Vehicle" means any publicly or
privately owned vehicle that is specifically designed,
constructed or modified and equipped, and is intended
to be used for, and is maintained or operated solely
for the emergency or non-emergency transportation of a
specific medical class or category of persons who are
sick, injured, wounded or otherwise incapacitated or
helpless (e.g. high-risk obstetrical patients,
neonatal patients).
(C) "Reserve Ambulance" means a vehicle that meets
all criteria set forth in this Section and all
Department rules, except for the required inventory of
medical supplies and durable medical equipment, which
may be rapidly transferred from a fully functional
ambulance to a reserve ambulance without the use of
tools or special mechanical expertise.
(b) The Department shall have the authority and
responsibility to:
(1) Require all Vehicle Service Providers, both

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publicly and privately owned, to function within an EMS
System.
(2) Require a Vehicle Service Provider utilizing
ambulances to have a primary affiliation with an EMS
System within the EMS Region in which its Primary Service
Area is located, which is the geographic areas in which
the provider renders the majority of its emergency
responses. This requirement shall not apply to Vehicle
Service Providers which exclusively utilize Limited
Operation Vehicles.
(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

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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:

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(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

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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.

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(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 outlined in statute being met is
submitted, validated, and approved by the EMS Medical
Director for the EMS System and the Department. The
Department may not include any additional criteria for
approval of a staffing waiver utilizing an EMR other
than the criteria outlined in this Act.
(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 which must be granted upon EMS System Medical
Director 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

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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.

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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.
(4) License all Vehicle Service Providers that have
met the Department's requirements for licensure, unless
such Provider is owned or licensed by the federal
government. All Provider licenses issued by the Department
shall specify the level and type of each vehicle covered
by the license (BLS, ILS, ALS, ambulance, critical care
transport, SEMSV, limited operation vehicle, special use
vehicle, reserve ambulance).
(5) Annually inspect all licensed vehicles operated by
Vehicle Service Providers.
(6) Suspend, revoke, refuse to issue or refuse to
renew the license of any Vehicle Service Provider, or that
portion of a license pertaining to a specific vehicle
operated by the Provider, after an opportunity for a
hearing, when findings show that the Provider or one or
more of its vehicles has failed to comply with the
standards and requirements of this Act or rules adopted by
the Department pursuant to this Act.
(7) Issue an Emergency Suspension Order for any
Provider or vehicle licensed under this Act, when the
Director or his designee has determined that an immediate

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and serious danger to the public health, safety and
welfare exists. Suspension or revocation proceedings which
offer an opportunity for hearing shall be promptly
initiated after the Emergency Suspension Order has been
issued.
(8) Exempt any licensed vehicle from subsequent
vehicle design standards or specifications required by the
Department, as long as said vehicle is continuously in
compliance with the vehicle design standards and
specifications originally applicable to that vehicle, or
until said vehicle's title of ownership is transferred.
(9) Exempt any vehicle (except an SEMSV) which was
being used as an ambulance on or before December 15, 1980,
from vehicle design standards and specifications required
by the Department, until said vehicle's title of ownership
is transferred. Such vehicles shall not be exempt from all
other licensing standards and requirements prescribed by
the Department.
(10) Prohibit any Vehicle Service Provider from
advertising, identifying its vehicles, or disseminating
information in a false or misleading manner concerning the
Provider's type and level of vehicles, location, primary
service area, response times, level of personnel,
licensure status or System participation.
(10.5) Prohibit any Vehicle Service Provider, whether
municipal, private, or hospital-owned, from advertising

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itself as a critical care transport provider unless it
participates in a Department-approved EMS System critical
care transport plan.
(11) Charge each Vehicle Service Provider a fee per
transport vehicle, due annually at time of inspection. The
fee per transport vehicle shall be set by administrative
rule by the Department and shall not exceed 100 vehicles
per provider.
(12) Beginning July 1, 2023, as part of a pilot
program that shall not exceed a term of 3 years, an
ambulance may be upgraded to a higher level of care for
interfacility transports by an ambulance assistance
vehicle with appropriate equipment and licensed personnel
to intercept with the licensed ambulance at the sending
facility before departure. The pilot program shall not be
implemented before Department approval. To participate in
the pilot program, an agency must:
(A) Submit a waiver request to the Department with
intercept vehicle vehicle identification numbers,
calls signs, equipment detail, and a robust quality
assurance plan that shall list, at minimum, detailed
reasons each intercept had to be completed, barriers
to initial dispatch of advanced life support services,
and how this benefited the patient.
(B) Report to the Department quarterly additional
data deemed meaningful by the providing agency along

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