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AN ACT to amend the public health law and the county law, in relation to

emergency medical services; to amend the state finance' law, in rela-
tion to creating the New York state emergency medical services train-
ing, account; and repealing subdivision 3 of section 3003 and sections
3004 and 3006 of the public health law relating to emergency medical
services
Became a law August 7, 1992, with the approval of the Governor.

Passed by a majority vote, three-fifths being present.
The People of the State of New York, represented in Senate and Assen-
bly, do enact as follows:

Section 1. Section 3000 of the public health law, as added by chapter 1053 of the laws of 1974, the second unnumbered paragraph as amended by chapter 252 of the laws of 1981, is amended to read as follows:

$ 3000. Declaration of policy and statement of purpose. The furnishing of medical assistance in an emergency is a matter of vital concern affecting the public health, safety and welfare. [Emergency] Prehospital emergency medical care, the provision of prompt and effective communication among ambulances and hospitals and safe [handling, and effec; tive care and transportation of the sick[.] and injured [and disabled] are essential public health services.

It is the purpose of this article to promote the public health, safety and welfare by providing for [registration or] certification of all advanced life support first response services and ambulance services( , ); the creation of regional emergency medical services.councils; and a New York state emergency medical services council (which would) to develop minimum training standards for certified first responders, emergency medical technicians and advanced emergency medical technicians and minimum equipment and communication standards for [certain

emergency medical] advanced life support first response services and ambulance services.

§ 2. Section 3001 of the public health law, as added by chapter 1053 of the laws of 1974, subdivision 7 as separately added by chapters 338 and 742 of the laws of 1977, subdivisions 6 and 7 as renumbered by chap; ter 252 of the laws of 1981 and subdivisions 11, 12, 13 and 14 as

added by chapter 439 of the laws of 1979, is amended to read as follows:

§ 3001. Definitions. As used in this article, unless the context otherwise requires:

1. "Emergency medical service" means ça service engaged in providing] initial emergency medical assistance including, but not limited to, the treatment trauma, burns, respiratory, circulatory and obstetrical emergencies.

2.°"'Ambulance service" means an individual, partnership, association, corporation, municipality or any legal or public entity subdivision thereof engaged in providing emergency medical (services] care and the transportation of sicky, disabled] or injured persons by motor vehicle, aircraft other [form] forms of transportation to (or), from, or between general hospitals or other health

facilities (providing hospital services].

3. "Voluntary ambulance service" means an ambulance service (i) oper: ating not for pecuniary profit or financial gain, and (ii) no the assets

income of which is distributable to, or enures to the benefit of, its members, directors or officers except to the extent permitted under this article.

4. ["Municipal ambulance service" means an ambulance service operated by a municipality or agency thereof and staffed by municipal employees

ambulance service operated by a county or agency thereof and staffed by county employees] ' "Voluntary advanced life support first response service" means advanced life support first response service (i) operating not for pecuniary profit or financial gain, and (ii) no part of the assets or income of which is distributable to, or enures to the benefit of, its members, directors or officers except to the extent permitted under this article.

5. ["Hospital ambulance service" means an ambulance service owned or operated by a hospital as defined in article twenty-eight of this law] "Certified first responder" means an individual who meets the minimum requirements established by regulations

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thousand two of this article and who is responsible for administration
of initial life saving care of sick and in jured persons.

6. "Emergency medical technician" means an individual who meets the
minimum requirements established by regulations pursuant to section
three thousand two of this article and who is responsible for adminis-
tration or supervision of initial emergency, medical [assistance and
handling] care and transportation of

sick[, disabled] injured persons.

7. "Advanced emergency medical technician" means an emergency medical technician who has satisfactorily completed an advanced course of training approved by the state council under regulations pursuant to section three thousand two of this [chapter] article.

8. "State council" means the New York state emergency medical services council established pursuant to this article.

9. "Regional council" means a regional emergency medical services
council established pursuant to this article.

10. "Enrolled member" means [an active] any member of a voluntary am-
bulance service or voluntary advanced life support first response
vice who provides emergency medical care or transportation of sick or
injured persons without expectation of monetary compensation.

11. "Advanced life support.[services] care" means definitive acute
medical care (services] provided, under medical (supervision and direc-
tion] control, by advanced emergency medical technicians within an ad-
vanced life support system.

12. "Advanced life support system" means an organized acute medical care system to provide advanced life support [services] care on site

route to ta hospital], from, or between general hospitals or other health care facilities.

13. "Advanced life support mobile unit" means an ambulance approved to provide advanced life support services pursuant to this article.

14. "Qualified medical and health personnel" means physicians, registered professional nurses and advanced emergency medical [personnel] technicians competent in the management of patients requiring advanced life support (services) care.

15. "Medical control" means advice and direction provided by a physician or under the direction of a physician to certified first responders, emergency medical technicians or advanced emergency medical technicians who are providing medical care at the scene of an emergency or route to a health care facility. Medical control shall also include the written policies, procedures, and protocols for prehospital emergency medical care and transportation developed by the state emergency medical advisory committee, approved by the state emergency medical services council and the commissioner, and implemented by regional medical advisory committees.

16. "Regional medical advisory Committee" means a group of five or more physicians, and one or more non-voting individuals

representative of each of the following: hospitals, basic life support providers, advanced life support providers and emergency

medical services training sponsor medical directors approved by the affected regional emergency medical services councils.

17. "Advanced life support first response service" means an organiza-
tion which provides advanced life support care, but does not transport
patients.

18. "EMS program agency" means a not-for-profit corporation or munici-
pality designated by the state council and approved by the affected
regional council or councils to facilitate the development and operation
of an emergency medical services system within a region as directed by
the regional council under this article.

19. "Operator" means any person who by reason of a direct or indirect
ownership interest (whether of record or beneficial) has the ability,
acting either alone or in concert with others with ownership interests,
to direct or cause the direction of the management or policies of an am-
bulance service or advanced life support first response service.

20. "Mutual aid agreement" means a written agreement, entered into by two or more ambulance services or advanced life support first response services possessing valid ambulance service or advanced life support first response service certificates or statements of registration, for the organized, coordinated, and cooperative reciprocal mobilization of personnel, equipment, services, or facilities for back-up or support EXPLANATION—Matter in italics is new; matter in brackets [ ] is old law

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upon request as required pursuant to a written mutual aid plan.. An ambulance service and advanced life support first response

service may participate in one or more mutual aid agreements.

21. "Primary territory" means the geographic area or subdivisions listed on an ambulance service certificate or statement of registration within which the ambulance service may receive patients for transport.

§ 3. Section 3002 of the public health law, as added by chapter 1053 of the laws of 1974, subdivisions 1 and 4 as amended by, chapter 1054 of the laws of 1974, subdivisions 2 and 3 as amended by chapter 252 of the laws of 1981 and subdivision 2-a as amended by chapter 176 of the laws of 1988, is amended to read as follows:

§ 3002. New York state emergency medical services council. 1. There is hereby created in the department of health the New York state emergency medical services council. The state council shall consist of [no less than thirteen but no more than thirty-one members. (Thirteen). Fourteen members

to

the state council shall be appointed by the commissioner[, prior to the first day of August, nineteen hundred seventy-five,) and shall be representative of each geographic area of the state. [of those members first appointed, ) At least one member shall be representative of the interests of the general public [and the others). Other members shall be knowledgeable in various aspects of emergency medical services and shall include, but not be limited to, representatives of voluntary ambulance services, 'advanced life support first response services, ambulance services operating for profit, municipal ambulance services, hospitals [and], a statewide organization representing volunteer fire services, municipal tax districts providing ambulance services, physicians, and nurses. The commissioner shall also appoint a representative from each regional council, from nominations received from the appropriate regional councill, upon establishment thereof pursuant to the provisions of section three thousand three). The members of the state council shall elect a [chairman] chairperson from among the members of the state council by a majority vote of those present, who shall serve for a term of one year and until [his] a successor is elected.

2. The state council shall have the power, by, an affirmative vote of a majority of those present, subject to approval by the commissioner, to enact, and from time to time, amend and repeal, rules and regulations establishing minimum standards for [emergency medical services, certified] ambulance services, ambulance service certification, advanced life support first response services, the provision of prehospital emergency medical care, public education, the development of a statewide emergency medical [service] services system, the provision of ambulance services outside the primary territory specified in the ambulance services' cer; tificate and the training, examination, and certification of certified first responders, emergency medical technicians, and advanced emergency medical technicians; provided, however, that such minimum standards must be consistent with the staffing standards established by section three thousand five-a of this article. [No] Until January first, nineteen hundred ninety-seven, minimum standards shall be established for services provided by a voluntary ambulance service operating solely pursuant to a statement of registration issued under section three thousand four. The curriculum for certified first responder training shall not exceed fifty-one hours including prerequisites. The state council shall have the same powers granted to regional councils by this article in any region of the state in which a regional council has not been established.

2-a. In furtherance of the powers set forth in subdivision two of this section, the state council shall provide to the trustees of the state university of New York such information and recommendations as may be requested by such trustees to assist such trustees' study of the

feasibility of community colleges! and state university of New York agricultural and technical colleges' offering credit and noncredit courses which would satisfy the educational requirements for certification and recertification of emergency medical technicians and advanced emergency medical technicians.

3. Upon appeal from the appropriate regional council, the state council shall have the power, by an affirmative vote of a majority of those present, to amend, modify and reverse determinations of the regional councils made pursuant to subdivision five of section three thousand three and section three thousand eight of this article. All determinations of the state council respecting applications for ambulance service certificates or statements of registration or respecting the revocation, suspension (except temporary suspension), limitation or annulment of an

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ambulance service certificate (or statement of registration) shall be subject to review as provided in article seventy-eight of the civil practice law and rules. Application for such review must be made within sixty days after service in person or by registered or certified mail of a copy of the determination upon the applicant or holder of the certificate (or statement of registration).

3-a. Upon appeal from the applicant, the department, or any concerned party, the state council shall have the power,' by an affirmative vote of a majority of those present, to amend, modify and reverse determinations of the regional councils made pursuant to subdivision five-a of section three thousand three of this article, All determinations of the state council with respect to

exemptions shall be subject to review as provided

article seventy-eight of the civil practice law and rules. Application for such review must be made within sixty days after service in person or by registered or certified mail. 4. The

term of office of each member shall be two years, provided, however, that of the members first appointed, seven shall be appointed for terms which shall expire on December thirty-first, nineteen hundred seventy-seven and six shall be appointed for terms which shall expire on December thirty-first, nineteen hundred seventy-eight). Vacancies shall be filled by appointment for the remainder of unexpired term. The members shall continue in office until the expiration of their terms and until their successors are appointed and have qualified. No member shall be appointed to the state council for more than [two] four consecutive terms.

5. The state council shall meet as frequently as its business may require. The presence of a majority of the members shall constitute a quorum.

The members of the state council shall receive no compensation for their services as members, but each shall be allowed the necessary and actual expenses [which he shall incur] incurred in the performance of his or her duties under this section.

6. The commissioner, upon request of the state council, shall designate an officer or employee of the department to act as secretary of the state council, and shall assign from time to time such other employees as the state council may require.

7. No civil action shall be brought in any court against any member, officer or employee of the state council for any act done, failure to act, statement or opinion made, while discharging his or her duties as a member, officer or employee of the state council, without leave from a justice of the supreme court, first had and obtained. In [any] no event shall such member, officer or employee (shall not] bę liable for damages in any such action if he or she shall have acted in good faith, with reasonable care and upon probable cause.

8. The state council shall, after consultation with the department and the regional councils, forward to the commissioner not later than December first an estimate of the amounts needed to provide adequate funding for emergency medical services training including advanced life support at the local level, regional medical emergency services councils, emergency medical services program agencies, the state emergency medical services council or other emergency medical services training programs to carry out the purposes of this article and article thirty-A of this chapter. Such estimate shall be transmitted without change by the commissioner to the governor, the division of the budget, the temporary president of the senate, the speaker of the assembly, and the fiscal and health committees of each house of the legislature.

§ 4. The public health law is amended by adding a new section 3002-a to read as follows:

§ 3002-a. State emergency medical advisory committee. 1. There shall be a state emergency medical advisory Committee of the state emergency medical services council consisting of twenty-nine members. Twenty-one members shall be physicians appointed by the commissioner, including one from each regional emergency

medical advisory Committee and an additional physician from the city of New York and at least

pediatrician,

one trauma surgeon, and one psychiatrist. Each of the physicians shall have demonstrated knowledge and experience in emergency medical services, There shall be eight non-physician non-voting, members appointed by the chairperson of the state council, at least five of whom shall be members of the state emergency medical services council at the time of their appointment.

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emergency nurse, at least one shall be an advanced emergency medical technician, at least one shall be a basic emergency medical technician, and at least one shall be employed in a hospital setting with administrative responsibility for a hospital emergency department service. The commissioner shall appoint a physician to chair the committee.

2. The committee shall develop and recommend to the state council statewide minimum standards for: (a) medical control; (b) treatment, transportation and triage protocols, including protocols for invasive procedures and infection control; and (c) the use of regulated medical devices and drugs by emergency medical services, personnel certified pursuant to this article. The state emergency medical advisory Committee, with the consent of the commissioner, may issue advisory guidelines in any of these areas, which shall not have the force and effect of law unless adopted rules and regulations by the state emergency medical services council. The state emergency medical advisory Committee shall advise the

state emergency medical services council prior to the issuance of any guidelines. The committee shall also review protocols developed by regional

regional emergency medical advisory Committees for consistency with statewide standards.

3. Each member shall have a term of two years, except that five of those first appointed shall have a term of three years. Members may succeed themselves.

4. The committee shall meet as frequently as its business may require. The presence of a majority of the members shall constitute a quorum. The members of the committee shall receive no compensation for their services as members, but each shall be allowed the necessary and actual expenses incurred in the performance of his or her duties under this section.

5. No civil action shall be brought in any court against any member, officer or employee of the committee for any act done, failure to act, or statement or opinion made, while discharging his or her duties as a member, officer, or employee of the committee, without leave from a justice

of the supreme court, first had and obtained. In no event shall such member, officer, or employee be liable for damages in any such tion

if he or she shall have acted in good faith, with reasonable care and upon probable cause.

§ 5. Subdivision 2 of section 3003 of the public health law, as added by chapter 1053 of the laws of 1974, is amended to read as follows:

2. Each regional council shall be comprised of at least fifteen þut not more than thirty members to be initially appointed by the commissioner, with the approval of the state council, from nominations submit; ted by local organizations applying for establishment as the regional council. Not less than one-third of the membership of the regional councils shall be representatives of ambulance services and the remaining membership of the regional councils shall consist of, but not be limited to, representatives of existing local emergency medical care committees, physicians, hospitals, health planning agencies, fire department emergency and rescue squads, public health officers and the general public. The county EMS coordinator, established pursuant to section two hundred twenty-three-b of the county law, of any county within the region shall serve

ex officio member of the regional council; provided, however, nothing in this subdivision shall prevent a county EMS coordinator from serving as a voting member of a regional council. Members of each regional council shall be residents living within the geographic area to be served by the regional council. The presence of a majority of the members appointed shall constitute a quorum.

§ 6. Subdivision 3 of section 3003 of the public health law is repealed and a new subdivision 3 is added to read as follows: 3.

Each regional council shall have the power to: (a) have a seal and alter the same at pleasure;

(b) acquire, lease, hold, and dispose of real and personal property or any interest therein for its purposes; (c) make

and alter by-laws for its organization and internal manage; ment, and rules and regulations governing the exercise of its powers and the fulfillment of its purposes under this article; such rules and regula lations must be filed with the secretary of state and the state EMS council;

(d) enter into contracts for employment of such officers and employees as it may require for the performance of its duties; and to fix and determine their qualifications, duties, and compensation, and to retain and employ such personnel as may be required for its purposes; and pri

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