Bill Text: MI SB0859 | 2013-2014 | 97th Legislature | Engrossed

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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). TIE BAR WITH: SB 0721'13, SB 0858'14, SB 0860'14

Spectrum: Partisan Bill (Republican 10-0)

Status: (Engrossed - Dead) 2014-06-04 - Referred To Committee On Judiciary [SB0859 Detail]

Download: Michigan-2013-SB0859-Engrossed.html

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SB-0859, As Passed Senate, June 4, 2014

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SENATE BILL No. 859

 

 

March 11, 2014, Introduced by Senators SCHUITMAKER, NOFS, MEEKHOF, JONES, HUNE, HILDENBRAND, JANSEN, ROBERTSON, RICHARDVILLE and KAHN 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

 

Senate Bill No. 859 as amended June 4, 2014

 

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) <<At the medical control authority's discretion,

 

                                >> 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.

 

Senate Bill No. 859 as amended June 4, 2014

 

     (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.

 

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