Read 1st time January 12, 2000, and 1000 copies ordered printed.
ANNE C. WALKER, Chief Clerk
AN ACT
To repeal section 190.101, RSMo Supp. 1999, relating to emergency medical services, and to enact in lieu thereof eight new sections relating to the regulation of stretcher vans.
Section A. Section 190.101, RSMo Supp. 1999, is repealed and eight new sections enacted in lieu thereof, to be known as sections 190.101, 190.181, 190.525, 190.528, 190.531, 190.534, 190.537 and 190.540, to read as follows:
190.101. 1. There is hereby established a "State Advisory Council on Emergency Medical Services" which shall consist of fifteen members. The members of the council shall be appointed by the governor with the advice and consent of the senate and shall serve terms of four years. The governor shall designate one of the members as chairperson. The chairperson may appoint subcommittees that include noncouncil members.
2. The state EMS medical directors advisory committee and the regional EMS advisory committees will be recognized as subcommittees of the state advisory council on emergency medical services.
3. The council shall have geographical representation and representation from appropriate areas of expertise in emergency medical services including volunteers, professional organizations involved in emergency medical services, EMT's, paramedics, nurses, firefighters, physicians, ambulance service administrators, hospital administrators, stretcher van operators, a statewide transportation broker and other health care providers concerned with emergency medical services. The regional EMS advisory committees shall serve as a resource for the identification of potential members of the state advisory council on emergency medical services.
4. The members of the council and subcommittees shall serve without compensation except that the department of health shall budget for reasonable travel expenses and meeting expenses related to the functions of the council.
5. The purpose of the council is to make recommendations to the governor, the general assembly, and the department on policies, plans, procedures and proposed regulations on how to improve the statewide emergency medical services system. The council shall advise the governor, the general assembly, and the department on all aspects of the emergency medical services system.
190.181. Any ambulance service that has been found guilty, or enters a plea of guilty or nolo contendere to Medicaid or Medicare fraud shall, for a period of five years, be prohibited from providing ambulance services to public entities which receive any local, state or federal funds.
190.525. As used in sections 190.525 to 190.540, the following terms mean:
(1) "Department", the department of health;
(2) "Director", the director of the department of health or the director's duly authorized representative;
(3) "Patient", an individual who is sick, injured, wounded, diseased, or otherwise incapacitated or helpless, and requires medical monitoring, aid, care or treatment during transport;
(4) "Person", as such term is defined in section 190.100;
(5) "Stretcher van", a vehicle designed and equipped to transport a person in a supine position;
(6) "Stretcher van operator", any person who operates one or more stretcher vans.
190.528. 1. Any person or governmental entity who owns or acts as an agent for the owner of any business or service that furnishes, operates, conducts, maintains, advertises, engages in, proposes to engage in, or professes to engage in the business or service of transportation of persons who are confined to stretchers and whose conditions are such that such persons do not need and are not likely to need medical attention during transport shall be licensed by the department of health.
2. The department shall issue service licenses for a period of no more than five years for each service meeting the established criteria.
3. Application for a stretcher van license shall be made upon such forms as prescribed by rule by the department.
4. A city or county may promulgate rules to establish reasonable standards in addition to the minimum state standards. Such rules shall not have the effect of constructively eliminating or prohibiting the use of stretcher vans in a city or county.
5. The provisions of this section shall not apply to regulations in effect prior to January 1, 2000, by any city having a charter form of government with a population of not less than three hundred thousand or more than six hundred and fifty thousand inhabitants located wholly or partially within a county of the first classification having a charter form of government.
190.531. 1. A stretcher van operator may transport a passenger when such passenger needs routine transportation to or from a medical appointment or service if such person does not require medical monitoring, aid, care or treatment during transport.
2. A stretcher van operator shall not transport patients.
190.534. 1. A stretcher van shall always be operated with the following, including but not limited to:
(1) A two-person crew, each of whom is currently certified:
(a) To provide basic first aid and cardiopulmonary resuscitation;
(b) To move supine persons;
(c) To communicate with emergency medical services systems; and
(d) On stretcher mechanics;
(2) Communication devices that allow crew members to immediately contact emergency medical services systems if a passenger's medical condition deteriorates;
(3) Stretchers and mountings that meet or exceed current manufacturer's KKK-A-1822 specifications, or subsequent industry-recognized replacement specifications, at the time of manufacture;
(4) Vehicles specifically designed, manufactured and equipped for use as a stretcher van that meet current federal safety standards at the date of vehicle manufacture;
(5) Policies that provide for the effective maintenance and cleanliness of the vehicle and stretchers; and
(6) A basic first aid kit and supplies necessary to provide bloodborne pathogen protection, but shall not contain medical equipment.
2. A stretcher van crew shall immediately contact the area's emergency medical services system if a passenger's medical condition deteriorates.
3. A stretcher van agency shall provide proof of public liability insurance that meets or exceeds:
(1) Two hundred fifty thousand dollars for bodily injury to, or the death of, one person;
(2) Five hundred thousand dollars for bodily injury to, or the death of, all persons injured or killed in any one accident, subject to a maximum of two hundred fifty thousand dollars per person; and
(3) One hundred thousand dollars for loss or damage to property, except cargo, of persons in one accident.
4. In the event of ambiguity in the provisions of this section, the department may promulgate rules to clarify such ambiguities.
190.537. 1. In accordance with sections 190.525 to 190.540, a licensed ambulance service may be a stretcher van operator.
2. A licensed ambulance service that receives any portion of its funding from local, state or federal sources shall not use such funds in competition against a for-profit stretcher van operator. All revenue and costs, both fixed and variable, shall be accounted for separately. All records related to the operation shall be deemed a public record.
190.540. No rule or portion of a rule promulgated under the authority of sections 190.525 to 190.540 shall become
effective unless it has been promulgated pursuant to chapter 536, RSMo.
Missouri House of Representatives