Specialty care transports

AN ACT Relating to personnel for ambulance service interfacility 1
specialty care transports; amending RCW 18.73.030 and 18.73.150; and 2
creating a new section. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. The legislature finds that a statewide 5
program of emergency medical care is necessary to promote the health, 6
safety, and welfare of the citizens of this state. The intent of the 7
legislature is to assure minimum standards and training for first 8
responders and emergency medical technicians, and minimum standards 9
for ambulance services, ambulances, aid vehicles, aid services, and 10
emergency medical equipment. It is further the intent of the 11
legislature to improve timely and safe interfacility specialty care 12
transfers of patients to the appropriate level of care when workforce 13
limitations would otherwise inhibit the transport.14
Sec. 2. RCW 18.73.030 and 2023 c 290 s 11 are each amended to 15
read as follows: 16
The definitions in this section apply throughout this chapter 17
unless the context clearly requires otherwise. 18
H-2470.1
HOUSE BILL 2110
State of Washington 69th Legislature 2026 Regular Session
By Representatives Schmick, Tharinger, Engell, Parshley, Davis,
Stuebe, Marshall, Simmons, Barnard, Zahn, Griffey, Graham, and
Bernbaum
Prefiled 12/08/25. Read first time 01/12/26. Referred to Committee
on Health Care & Wellness.
p. 1 HB 2110
(1) "Advanced life support" means invasive emergency medical 1
services requiring advanced medical treatment skills as defined by 2
chapter 18.71 RCW. 3
(2) "Aid service" means an organization that operates one or more 4
aid vehicles. 5
(3) "Aid vehicle" means a vehicle used to carry aid equipment and 6
individuals trained in first aid or emergency medical procedure.7
(4) "Ambulance" means a ground or air vehicle designed and used 8
to transport the ill and injured and to provide personnel, 9
facilities, and equipment to treat patients before and during 10
transportation. 11
(5) "Ambulance service" means an organization that operates one 12
or more ambulances. 13
(6) "Basic life support" means noninvasive emergency medical 14
services requiring basic medical treatment skills as defined in this 15
chapter. 16
(7) "Collaborative medical care" means medical treatment and care 17
provided pursuant to agreements with local, regional, or state public 18
health agencies to control and prevent the spread of communicable 19
diseases which is rendered separately from emergency medical service.20
(8) "Communications system" means a radio and landline network 21
which provides rapid public access, coordinated central dispatching 22
of services, and coordination of personnel, equipment, and facilities 23
in an emergency medical services and trauma care system.24
(9) "Council" means the local or regional emergency medical 25
services and trauma care council as authorized under chapter 70.168 26
RCW. 27
(10) "Department" means the department of health.28
(11) "Emergency medical service" means medical treatment and care 29
which may be rendered at the scene of any medical emergency or while 30
transporting any patient in an ambulance to an appropriate medical 31
facility, including ambulance transportation between medical 32
facilities. 33
(12) "Emergency medical services medical program director" means 34
a person who is an approved medical program director as defined by 35
RCW 18.71.205(4). 36
(13) "Emergency medical technician" means a person who is 37
authorized by the secretary to render emergency medical care pursuant 38
to RCW 18.73.081, under the responsible supervision and direction of 39
an approved medical program director, which may include participating 40
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in an emergency services supervisory organization or a community 1
assistance referral and education services program established under 2
RCW 35.21.930, or providing collaborative medical care if the 3
participation or provision of collaborative medical care does not 4
exceed the participant's training and certification.5
(14) "Emergency services supervisory organization" means an 6
entity that is authorized by the secretary to use certified emergency 7
medical services personnel to provide medical evaluation or initial 8
treatment, or both, to sick or injured people, while in the course of 9
duties with the organization for on-site medical care prior to any 10
necessary activation of emergency medical services. Emergency 11
services supervisory organizations include law enforcement agencies, 12
disaster management organizations, search and rescue operations, 13
diversion centers, and businesses with organized industrial safety 14
teams. 15
(15) "First responder" means a person who is authorized by the 16
secretary to render emergency medical care as defined by RCW 17
18.73.081. 18
(16) "Interfacility transport" means medical transport of a 19
patient between recognized medical treatment facilities requested by 20
a licensed health care provider.21
(17) "Organ transport service" means an organization that 22
operates one or more organ transport vehicles. 23
(((17))) (18) "Organ transport vehicle" has the same meaning as 24
in RCW 46.04.371. 25
(((18))) (19) "Patient care procedures" means written operating 26
guidelines adopted by the regional emergency medical services and 27
trauma care council, in consultation with the local emergency medical 28
services and trauma care councils, emergency communication centers, 29
and the emergency medical services medical program director, in 30
accordance with statewide minimum standards. The patient care 31
procedures shall identify the level of medical care personnel to be 32
dispatched to an emergency scene, procedures for triage of patients, 33
the level of trauma care facility to first receive the patient, and 34
the name and location of other trauma care facilities to receive the 35
patient should an interfacility transfer be necessary. Procedures on 36
interfacility transfer of patients shall be consistent with the 37
transfer procedures in chapter 70.170 RCW. 38
(((19))) (20) "Prehospital patient care protocols" means the 39
written procedure adopted by the emergency medical services medical 40
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program director which direct the out-of-hospital emergency care of 1
the emergency patient which includes the trauma care patient. These 2
procedures shall be based upon the assessment of the patient's 3
medical needs and what treatment will be provided for emergency 4
conditions. The protocols shall meet or exceed statewide minimum 5
standards developed by the department in rule as authorized in 6
chapter 70.168 RCW. 7
(((20))) (21) "Secretary" means the secretary of the department 8
of health. 9
(((21))) (22) "Specialty care transport" means the level of care 10
or service needed during an interfacility transport for a patient who 11
is critically injured or ill and whose condition requires care by a 12
physician, registered nurse with appropriate competencies, or a 13
paramedic who has received special training and approval of the 14
medical program director.15
(23) "Stretcher" means a cart designed to serve as a litter for 16
the transportation of a patient in a prone or supine position as is 17
commonly used in the ambulance industry, such as wheeled stretchers, 18
portable stretchers, stair chairs, solid backboards, scoop 19
stretchers, basket stretchers, or flexible stretchers. The term does 20
not include personal mobility aids that recline at an angle or remain 21
at a flat position, that are owned or leased for a period of at least 22
one week by the individual using the equipment or the individual's 23
guardian or representative, such as wheelchairs, personal gurneys, or 24
banana carts. 25
Sec. 3. RCW 18.73.150 and 2021 c 17 s 1 are each amended to read 26
as follows: 27
(1)(a) Any ambulance operated as such shall operate with 28
sufficient personnel for adequate patient care, at least one of whom 29
shall be an emergency medical technician under standards promulgated 30
by the secretary. The emergency medical technician shall have 31
responsibility for its operation and for the care of patients both 32
before they are placed aboard the vehicle and during transit. If 33
there are two or more emergency medical technicians operating the 34
ambulance, a nondriving medical technician shall be in command of the 35
vehicle. The emergency medical technician in command of the vehicle 36
shall be in the patient compartment and in attendance to the patient.37
(b) Except as provided in ((subsection)) subsections (2) and (3) 38
of this section, the driver of the ambulance shall have at least a 39
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certificate of advance first aid qualification recognized by the 1
secretary pursuant to RCW 18.73.120 unless there are at least two 2
certified emergency medical technicians in attendance of the patient, 3
in which case the driver shall not be required to have such 4
certificate. 5
(2) With approval from the department, an ambulance service 6
established by volunteer or municipal corporations, or by an 7
association made up entirely of two or more municipalities, in a 8
rural area with insufficient personnel may use a driver without any 9
medical or first aid training so long as the driver is at least 10
eighteen years old, successfully passes a background check issued or 11
approved by the department, possesses a valid driver's license with 12
no restrictions, is accompanied by a nondriving emergency medical 13
technician while operating the ambulance during a response or 14
transport of a patient, and only provides medical care to patients to 15
the level that they are trained. 16
(3) A registered nurse without an emergency medical technician 17
certification is sufficient personnel for an ambulance service 18
providing an interfacility specialty care transport if:19
(a) There is at least one certified emergency medical service 20
provider within the ambulance;21
(b) The registered nurse has the appropriate competencies to 22
provide patient care during the interfacility specialty care 23
transport;24
(c) The ambulance service providing interfacility specialty care 25
transport does not have a paramedic on an employed or volunteer basis 26
available to respond to the call for service; and27
(d) The sending hospital does not have a registered nurse with an 28
emergency medical technician certification available to respond to 29
the call for service.30
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