Read the full stored bill text
SECOND REGULAR SESSION
HOUSE BILL NO. 1979
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE COOK.
4829H.02I JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal section 190.098, RSMo, and to enact in lieu thereof one new section relating to
community paramedic services.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 190.098, RSMo, is repealed and one new section enacted in lieu
2 thereof, to be known as section 190.098, to read as follows:
190.098. 1. As used in this section, the term "community paramedic services"
2 means services that are:
3 (1) Pr ovided by any entity that:
4 (a) Employs licensed paramedics who are certified as community paramedics by
5 the department; and
6 (b) Has receiv ed an endorsement by the department as a community paramedic
7 service entity;
8 (2) Pr ovided in a nonemergent setting, independent of a 91 1 system or
9 emergency summons;
10 (3) Consistent with the training and education, as well as within the scope of skill
11 and practice, of the personnel and with the supervisory standard appr oved by the
12 medical director; and
13 (4) Reflected and documented in the entity's patient care plans or protocols
14 appr oved by the medical dir ector in accordance with section 190.142.
15 2. In order for a person to be eligible for certification by the department as a
16 community paramedic, an individual shall:
17 (1) Be currently [ certified ] licensed as a paramedic;
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
18 (2) Successfully complete or have successfully completed a community paramedic
19 certification program from a college, university , or educational institution that has been
20 approved by the department or accredited by a national accreditation or ganization approved
21 by the department; and
22 (3) Complete an application form approved by the department.
23 [ 2. ] 3. A community paramedic shall practice in accordance with protocols and
24 supervisory standards established by the medical director in collaboration with the
25 ambulance service administrator . [ A community paramedic shall provide services of a
26 health care plan if the plan has been developed by the patient's physician or by an advanced
27 practice registered nurse through a collaborative practice arrangement with a physician or a
28 physician assistant through a collaborative practice arrangement with a physician and there is
29 no duplication of services to the patient from another provider ] Patient car e plans that ar e
30 developed by the patient's physician, advanced practice regist ered nurse, or physician
31 assistant shall be implemented thr ough a collaboration with the medical dir ector and
32 emergency medical res ponse agency .
33 [ 3. Any ambulance service shall enter into a written contract to provide community
34 paramedic services in another ambulance service area, as that term is defined in section
35 190.100 . The contract that is agreed upon may be for an indefinite period of time, as long as
36 it includes at least a sixty-day cancellation notice by either ambulance service ] 4. (1) (a)
37 Any ambulance service that seeks to pro vide community paramedic services outside of
38 its ambulance service area, as described in section 190.105 and administere d by the
39 department, and in the service ar ea of another ambulance service that curr ently
40 pr ovides community paramedic services shall be req uired to have a memorandum of
41 understanding with that ambulance service reg arding the pr ovision of such community
42 paramedic services. An ambulance service that pr ovides community paramedic services
43 may pro vide community paramedic services without a memorandum of understanding
44 in the ambulance service are a of an ambulance service that is not pr oviding community
45 paramedic services, but the ambulance service pr oviding community paramedic
46 services shall prov ide notification to the ambulance service with emergency service
47 r esponsibilities in the service ar ea of the general community paramedic activities being
48 performed.
49 (b) An ambulance service that prov ides sustained community paramedic
50 services in an area outside the county of the ambulance service's primary 91 1 res ponse
51 territory and where another ambulance service also offers community paramedic
52 services shall coordinate its community paramedic services with the local ambulance
53 service offering community paramedic services in that area.
HB 1979 2
54 (c) Nothing in this subdivision shall preven t an ambulance service that pro vides
55 community paramedic services fro m honoring any formal contract or agre ement with a
56 health car e institution, hospital licensed under chapter 197, health clinic, or insurance
57 company for the pr ovision of community paramedic services.
58 (2) Any emergency medical r esponse agency seeking to pr ovide community
59 paramedic services within its designated res ponse service area may do so if the groun d
60 ambulance service covering the area within which the emergency medical res ponse
61 agency is located does not pr ovide community paramedic services. If such groun d
62 ambulance service does pr ovide community paramedic services, the gro und ambulance
63 service may establish, at its sole discr etion, a memorandum of understanding with the
64 emergency medical res ponse agency planning to offer community paramedic services in
65 order to coordinate progr ams and avoid service duplication. If an emergency medical
66 r esponse agency is pr oviding community paramedic services in a service area before the
67 gr ound ambulance service in that service ar ea begins offering community paramedic
68 services, the emergency medical res ponse agency and the grou nd ambulance service
69 shall establish a memorandum of understanding for the coordination of services.
70 (3) A community paramedic pr ogram shall notify the appr opriate local
71 ambulance service when prov iding services within the service area of an ambulance
72 service.
73 (4) The department shall establish r egulations for the purpose of rec ognizing
74 community paramedic service entities that have met the standards necessary to provi de
75 community paramedic services, including physician medical oversight, training, patient
76 r ecordkeeping, formal rel ationships with primary care services where necessary , and
77 quality improvement policies. The department shall issue an endorsement to any
78 community paramedic service entity that meets such standards that allows the entity to
79 pr ovide community paramedic services for a period of five years .
80 [ 4. ] 5. A community paramedic is subject to the provisions of sections 190.001 to
81 190.245 and rules promulgated under sections 190.001 to 190.245.
82 [ 5. ] 6. No person shall hold himself or herself out as a community paramedic or
83 provide the services of a community paramedic unless such person is certified by the
84 department.
85 [ 6. ] 7. The medical director shall approve the implementation of the community
86 paramedic program.
87 [ 7. ] 8. Any rule or portion of a rule, as that term is defined in section 536.010, that is
88 created under the authority delegated in this section shall become ef fective only if it complies
89 with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.
90 This section and chapter 536 are nonseverable and if any of the powers vested with the
HB 1979 3
91 general assembly pursuant to chapter 536 to review , to delay the ef fective date, or to
92 disapprove and annul a rule are subsequently held unconstitutional, then the grant of
93 rulemaking authority and any rule proposed or adopted after August 28, 2013, shall be invalid
94 and void.
✔
HB 1979 4