Emergency medical services sustainability trust.

WORKING DRAFT

ORIGINAL HOUSE

BILL

NO.
0146

ENROLLED ACT NO. 94, HOUSE OF REPRESENTATIVES

SIXTIETH LEGISLATURE OF THE STATE OF
WYOMING
2009 GENERAL SESSION

AN ACT relating to
emergency medical services;

creating an emergency medical services
sustainability
trust account and income account;
providing for
needs
assessment
grants as specified; providing for emergency medical services master plan

implementation grants as specified;
providing for a local match as specified
; requiring report
s
; providing appropriations;
and providing for an effective date.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.

W.S. 33
‑
36
‑
115 is created to read:

33
‑
36
‑
115.

E
mergency medical services
sustainability

trust account
;
account
established;
planning grants; implementation grants
.

(a)

A trust account is created to be known as the
emergency medical services
sustainability
trust account. The trust account shall consist of those funds designated to the account by law and all monies received from federal grants and other contributions, grants, gifts, transfers, bequests and donations to the trust account. The trust account is specifically empowered to accept grants, gifts, transfers, bequests and donations including those which are limited in their purposes by the grantor. Funds deposited within the trust account are intended to be inviolate and constitute a perpetual trust account which shall be invested by the state treasurer as authorized under W.S. 9
‑
4
‑
715(a), (d) and (e) and in a manner to obtain the highest return possible consistent with preservation of the account corpus.

(b)

The state treasurer shall credit annually to a
n

emergency medical services
sustainability
trust income account
earnings
from investment of the trust account corpus. The legislature may, from time to time, appropriate funds directly to the income account for distribution in accordance with the terms of this
section
. Such specially appropriated funds shall be credited directly by the state treasurer to the income account and are available to the
division
for award of grants as otherwise permitted by this
section
.

(c)

Individuals and other entities may also grant, give, transfer, beque
ath
or donate funds to the trust account or the income account.
These
funds shall be credited by the state treasurer to either the trust account or the income account, as appropriate, in a manner consistent with the conditions attached to their receipt.

(d)

Funds in the
trust income
account are continuously appropriated to the department
for purposes of providing
grants to
improve the delivery and quality of emergency medical services
as provided in this section.

(e
)

The department shall establish by rule and regulation
a grant application calendar and procedure
for
needs
assessment
grants
,
which shall include the
follow
ing provisio
n
s
:

(i)

An assessment of emergency medical services in a service area and an analysis of the current emergency medical services system including:

(A)

The level of volunteerism;

(B)

The level and period of certification;

(C)

Response times;

(D)

Billing practices;

(E)

Funding sources and budget sustainability; and

(F)

Call volume.

(i
i
)

Needs
assessment
grants shall be for the purpose of assessing the provision of emergency medical services in a service area
and preparing a
master
plan for an efficient, coordinated system of emergency medical service deliver
y
, subject to the following:

(A)

Grant applications may be submitted by persons
,
entities
or groups interested in improving emergency medical services
in a
proposed
service area which shall correspond to a
rural urban commuting area as defined by the
United States
department of agriculture
. The grant application shall be signed by
authorized representatives of
all
involved
political subdivisions
within the proposed service area
;

(
B
)

The
department
shall review applications and
,
if
it determines that further
detailed
assessment
of emergency medical services in the proposed service area is appropriate
and following consultation with the affected entities described in subparagraph (A) of this paragraph
, shall
contract for

an assessment
in the service area of emergency medical services strengths, weaknesses and coverage gaps. The contractor conducting the
assessment
shall prepare a written report that shall include a master plan for a coordinated, efficient emergency medical service delivery system
within the service area
.
T
he master plan shall identify the
governmental
or private
entity that will oversee and coordinate implementation of the plan, the areas and entities included in the plan, an estimate of funds available to implement the plan and continuing revenue sources, the approximate number of volunteer and paid emergency medical technicians available to provide services in the area and
include provision
, if necessary,
for
transition from an all volunteer service model to one combining volunteer and paid technicians
. The master plan shall identify major problems and opportunities concerning emergency medical services, and provide for a desired sequence of events for implementation of the plan
;

(
C
)

Any
needs
assessment
shall include
consultation
with
the affected entities described in subparagraph (A) of this paragraph,

representatives of
public,
private and volunteer ambulance services in the
proposed service area
, county and local government organizations, hospitals furnishing emergency medical services and
other appropriate stakeholders;

(
D
)

Any needs
assessment
shall provide for the collection of data by service area using a common benchmark, indicator and scoring format on emergency medical service workforce shortfalls, strengths and weaknesses of current service delivery models. The needs
assessment
shall b
uild upon but avoid duplication of the study completed by the rural policy research institute for the
Wyoming
health care commission in June, 2007;

(
E
)

Grant applications shall include a commitment of local matching funds of at least five thousand dollars ($5,000.00).

(
iii
)

Following complet
ion
of a needs
assessment
as provided in paragraph (i
i
) of this subsection, a county, joint powers board or emergency medical services special district may apply for a grant
to assist in the
development and implementation of a
master plan, subject to the following:

(
A
)

Grants shall be documented in writing signed by the department and an authorized representative of the grantee. The
document
shall specify the intended use of the funds to improve emergency medical service delivery
by assisting with the
cost of implementing
the master plan
;

(
B
)

Award of grants shall be based on demonstrable need. Those service areas demonstrating the greatest need,
at
the discretion of the department, shall be given the highest priority in receiving grants pursuant to this section;

(C)

Implementation grant applications shall include a working budget to demonstrate how the grant will be used to address revenue gaps on a temporary basis while transitioning to a defined time when revenue is expected to be sufficient to sustain services in the master plan service area
not to exceed two (2) years
.

(f)

The department

is authorized to enter into contracts it deems appropriate to conduct and coordinate needs analyses and implementation grants authorized by this section, including contracts with local providers or other stakeholders to report on service needs in the respective service areas.

(g)

The department
shall
provide a report by November 1 of each year on the emergency medical services trust account
to the joint
labor, health and social services
interim committee. The reports shall include
the status of the account, a description of all grants from the income account and
any recommendations for
providing more cost effective and accessible delivery of emergency medical services, including recommendations regarding regional approaches to providing those services, and any recommended
statutory or rule
changes
.

Section 2.

W.S. 33
‑
36
‑
102(a)(xi)
is
amended to read:

33
‑
36
‑
102.

Definitions.

(a)

As used in this act:

(xi)

"This act" means W.S. 33
‑
36
‑
101 through
33
‑
36
‑
113

33
‑
36
‑
115
.

Section
3
.

(a)

There is appropriated
five hundred thousand
dollars ($
5
00,000.00) from the
tobacco trust fund income account
to the
emergency medical services
sustainability
trust account
. This appropriation shall be
used

only
for the purpose
s of W.S. 33
‑
36
‑
115 created by this act.
Notwithstanding any other provision of law, this appropriation shall not be
expended and shall not be
transferred for any other purpose
.

(b)

There is appropriated
fifty
thousand dollars ($
50
,000.00) from the general fund to
the
emergency medical services sustainability
trust income account
. This appropriation shall only be expended for the purposes of W.S. 33
‑
36
‑
115 created by this act. Notwithstanding any other provision of law, this appropriation shall not be transferred or expended for any other purpose.
Any unexpended monies in the
income
account shall not revert but shall remain in the account to be expended for the purposes specified in this act.

(
c
)

None of the
appropriation
s in this section
shall be included in the department's 2011-2012 standard biennial budget request.

Section
4
.

This act is effective immediately upon co
m
pletion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constit
u
tion.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the House.

Chief Clerk

1