This document includes House Floor Amendments incorporated into the bill on Mon, Feb 28, 2022 at 10:28 AM by lfindlay.



Chief Sponsor: Dan N. Johnson

Senate Sponsor: Curtis S. Bramble


8     General Description:
9          This bill authorizes the creation of community paramedicine programs.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms;
13          ▸     authorizes the creation of community paramedicine programs; and
14          ▸     makes technical changes.
15     Money Appropriated in this Bill:
16          None
17     Other Special Clauses:
18          None
19     Utah Code Sections Affected:
20     AMENDS:
21          26-8a-102, as last amended by Laws of Utah 2021, Chapters 208, 237, and 265
22     ENACTS:
23          26-8a-212, Utah Code Annotated 1953

25     Be it enacted by the Legislature of the state of Utah:
26          Section 1. Section 26-8a-102 is amended to read:
27          26-8a-102. Definitions.

28          As used in this chapter:
29          (1) (a) "911 ambulance or paramedic services" means:
30          (i) either:
31          (A) 911 ambulance service;
32          (B) 911 paramedic service; or
33          (C) both 911 ambulance and paramedic service; and
34          (ii) a response to a 911 call received by a designated dispatch center that receives 911
35     or E911 calls.
36          (b) "911 ambulance or paramedic services" does not mean a seven or ten digit
37     telephone call received directly by an ambulance provider licensed under this chapter.
38          (2) "Ambulance" means a ground, air, or water vehicle that:
39          (a) transports patients and is used to provide emergency medical services; and
40          (b) is required to obtain a permit under Section 26-8a-304 to operate in the state.
41          (3) "Ambulance provider" means an emergency medical service provider that:
42          (a) transports and provides emergency medical care to patients; and
43          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
44          (4) (a) "Behavioral emergency services" means delivering a behavioral health
45     intervention to a patient in an emergency context within a scope and in accordance with
46     guidelines established by the department.
47          (b) "Behavioral emergency services" does not include engaging in the:
48          (i) practice of mental health therapy as defined in Section 58-60-102;
49          (ii) practice of psychology as defined in Section 58-61-102;
50          (iii) practice of clinical social work as defined in Section 58-60-202;
51          (iv) practice of certified social work as defined in Section 58-60-202;
52          (v) practice of marriage and family therapy as defined in Section 58-60-302; or
53          (vi) practice of clinical mental health counseling as defined in Section 58-60-402; and
54          (vii) practice as a substance use disorder counselor as defined in Section 58-60-502.
55          (5) "Committee" means the State Emergency Medical Services Committee created by
56     Section 26-1-7.
57          (6) "Community paramedicine" means medical care:
58          (a) provided by emergency medical service personnel; and

59          (b) provided to a patient who is not:
60          (i) in need of ambulance transportation; or
61          (ii) located in a health care facility as defined in Section 26-21-2.
62          [(6)] (7) "Direct medical observation" means in-person observation of a patient by a
63     physician, registered nurse, physician's assistant, or individual licensed under Section
64     26-8a-302.
65          [(7)] (8) "Emergency medical condition" means:
66          (a) a medical condition that manifests itself by symptoms of sufficient severity,
67     including severe pain, that a prudent layperson, who possesses an average knowledge of health
68     and medicine, could reasonably expect the absence of immediate medical attention to result in:
69          (i) placing the individual's health in serious jeopardy;
70          (ii) serious impairment to bodily functions; or
71          (iii) serious dysfunction of any bodily organ or part; or
72          (b) a medical condition that in the opinion of a physician or the physician's designee
73     requires direct medical observation during transport or may require the intervention of an
74     individual licensed under Section 26-8a-302 during transport.
75          [(8)] (9) (a) "Emergency medical service personnel" means an individual who provides
76     emergency medical services or behavioral emergency services to a patient and is required to be
77     licensed or certified under Section 26-8a-302.
78          (b) "Emergency medical service personnel" includes a paramedic, medical director of a
79     licensed emergency medical service provider, emergency medical service instructor, behavioral
80     emergency services technician, other categories established by the committee, and a certified
81     emergency medical dispatcher.
82          [(9)] (10) "Emergency medical service providers" means:
83          (a) licensed ambulance providers and paramedic providers;
84          (b) a facility or provider that is required to be designated under Subsection
85     26-8a-303(1)(a); and
86          (c) emergency medical service personnel.
87          [(10)] (11) "Emergency medical services" means:
88          (a) medical services;
89          (b) transportation services;

90          (c) behavioral emergency services; or
91          (d) any combination of the services described in Subsections [(10)] (11)(a) through (c).
92          [(11)] (12) "Emergency medical service vehicle" means a land, air, or water vehicle
93     that is:
94          (a) maintained and used for the transportation of emergency medical personnel,
95     equipment, and supplies to the scene of a medical emergency; and
96          (b) required to be permitted under Section 26-8a-304.
97          [(12)] (13) "Governing body":
98          (a) means the same as that term is defined in Section 11-42-102; and
99          (b) for purposes of a "special service district" under Section 11-42-102, means a
100     special service district that has been delegated the authority to select a provider under this
101     chapter by the special service district's legislative body or administrative control board.
102          [(13)] (14) "Interested party" means:
103          (a) a licensed or designated emergency medical services provider that provides
104     emergency medical services within or in an area that abuts an exclusive geographic service area
105     that is the subject of an application submitted pursuant to Part 4, Ambulance and Paramedic
106     Providers;
107          (b) any municipality, county, or fire district that lies within or abuts a geographic
108     service area that is the subject of an application submitted pursuant to Part 4, Ambulance and
109     Paramedic Providers; or
110          (c) the department when acting in the interest of the public.
111          [(14)] (15) "Medical control" means a person who provides medical supervision to an
112     emergency medical service provider.
113          [(15)] (16) "Non-911 service" means transport of a patient that is not 911 transport
114     under Subsection (1).
115          [(16)] (17) "Nonemergency secured behavioral health transport" means an entity that:
116          (a) provides nonemergency secure transportation services for an individual who:
117          (i) is not required to be transported by an ambulance under Section 26-8a-305; and
118          (ii) requires behavioral health observation during transport between any of the
119     following facilities:
120          (A) a licensed acute care hospital;

121          (B) an emergency patient receiving facility;
122          (C) a licensed mental health facility; and
123          (D) the office of a licensed health care provider; and
124          (b) is required to be designated under Section 26-8a-303.
125          [(17)] (18) "Paramedic provider" means an entity that:
126          (a) employs emergency medical service personnel; and
127          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
128          [(18)] (19) "Patient" means an individual who, as the result of illness, injury, or a
129     behavioral emergency condition, meets any of the criteria in Section 26-8a-305.
130          [(19)] (20) "Political subdivision" means:
131          (a) a city, town, or metro township;
132          (b) a county;
133          (c) a special service district created under Title 17D, Chapter 1, Special Service
134     District Act, for the purpose of providing fire protection services under Subsection
135     17D-1-201(9);
136          (d) a local district created under Title 17B, Limited Purpose Local Government Entities
137     - Local Districts, for the purpose of providing fire protection, paramedic, and emergency
138     services;
139          (e) areas coming together as described in Subsection 26-8a-405.2(2)(b)(ii); or
140          (f) an interlocal entity under Title 11, Chapter 13, Interlocal Cooperation Act.
141          [(20)] (21) "Trauma" means an injury requiring immediate medical or surgical
142     intervention.
143          [(21)] (22) "Trauma system" means a single, statewide system that:
144          (a) organizes and coordinates the delivery of trauma care within defined geographic
145     areas from the time of injury through transport and rehabilitative care; and
146          (b) is inclusive of all prehospital providers, hospitals, and rehabilitative facilities in
147     delivering care for trauma patients, regardless of severity.
148          [(22)] (23) "Triage" means the sorting of patients in terms of disposition, destination,
149     or priority. For prehospital trauma victims, triage requires a determination of injury severity to
150     assess the appropriate level of care according to established patient care protocols.
151          [(23)] (24) "Triage, treatment, transportation, and transfer guidelines" means written

152     procedures that:
153          (a) direct the care of patients; and
154          (b) are adopted by the medical staff of an emergency patient receiving facility, trauma
155     center, or an emergency medical service provider.
156          Section 2. Section 26-8a-212 is enacted to read:
157          26-8a-212. Community paramedicine program.
158          (1) A ground ambulance provider or a designated quick response provider, as
159     designated in accordance with Section 26-8a-303, may develop and implement a community
160     paramedicine program.
161          (2) (a) Before providing services, a community paramedicine program shall:
162          (i) implement training requirements as determined by the committee; and
163          (ii) submit a written community paramedicine operational plan to the department that
164     meets requirements established by the committee.
165          (b) A community paramedicine program shall report data, as determined by the
166     committee, related to community paramedicine to the department.
166a          Ĥ→ (3) A service provided as part of a community paramedicine program may not be
166b     billed to an individual or a health benefit plan as defined in Section 31A-1-301 unless:
166c          (a) the service is provided in partnership with a health care facility as defined in
166d     Section 26-21-2; and
166e          (b) the partnering health care facility is the person that bills the individual or health
166f     benefit plan.
166g          (4) Nothing in this section affects any billing authorized under Section 26-8a-403. ←Ĥ
167          Ĥ→ [
(3)] (5) ←Ĥ In accordance with Title 63G, Chapter 3, Utah Administrative
167a     Rulemaking Act, the
168     committee shall make rules to implement this section.