As Reported by the House Transportation, Public Safety and Homeland Security Committee

129th General Assembly
Regular Session
2011-2012
Sub. H. B. No. 128


Representatives Carey, Peterson 

Cosponsors: Representatives Balderson, Combs, Kozlowski, Slaby, Hollington, Maag, Antonio, Boose, Grossman, Derickson, Amstutz, DeGeeter, Ruhl 

A BILL
To amend sections 505.44, 505.84, 4765.07, 4765.43, 1
and 4766.03, to enact sections 505.441 and 2
4765.011, and to repeal section 4765.431 of the 3
Revised Code to revise the requirements for 4
staffing ambulances and the priorities for 5
distributing grants for emergency medical 6
services, and to specify additional titles to be 7
used by emergency medical service personnel.8


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1.  That sections 505.44, 505.84, 4765.07, 4765.43, 9
and 4766.03 be amended and sections 505.441 and 4765.011 of the 10
Revised Code be enacted to read as follows:11

       Sec. 505.44.  As used in this section:12

       (A) "Emergency medical service organization" has the same 13
meaning as in section 4765.01 of the Revised Code.14

       (B) "State agency" means all departments, boards, offices, 15
commissions, agencies, colleges, universities, institutions, and 16
other instrumentalities of this or another state.17

       In order to obtain the services of ambulance service 18
organizations, to obtain additional services from ambulance 19
service organizations in times of emergency, to obtain the 20
services of emergency medical service organizations, or, if the 21
township is located in a county with a population of forty 22
thousand or less, to obtain the services of nonemergency patient 23
transport service organizations, a township may enter into a 24
contract with one or more state agencies, townships, municipal 25
corporations, counties, nonprofit corporations, joint emergency 26
medical services districts, fire and ambulance districts, or 27
private ambulance owners, regardless of whether such state 28
agencies, townships, municipal corporations, counties, nonprofit 29
corporations, joint emergency medical services districts, fire and 30
ambulance districts, or private ambulance owners are located 31
within or outside the state, upon such terms as are agreed to by 32
them, to furnish or receive services from ambulance or emergency 33
medical service organizations or, if the township is located in a 34
county with a population of forty thousand or less, to furnish or 35
receive services from nonemergency patient transport service 36
organizations, or may enter into a contract for the interchange of 37
services from ambulance or emergency medical service organizations 38
or, if the township is located in a county with a population of 39
forty thousand or less, the interchange of services from 40
nonemergency patient transport service organizations, within the 41
several territories of the contracting parties, if the contract is 42
first authorized by the respective boards of township trustees, 43
the other legislative bodies, or the officer or body authorized to 44
contract on behalf of the state agency. Such contracts shall not 45
be entered into with a state agency or nonprofit corporation that 46
receives more than half of its operating funds from governmental 47
entities with the intention of directly competing with the 48
operation of other ambulance, emergency medical, or nonemergency 49
patient transport service organizations in the township unless the 50
state agency or nonprofit corporation is awarded the contract 51
after submitting the lowest and best bid to the board of township 52
trustees.53

       The contract may provide for a fixed annual charge to be paid 54
at the times agreed upon and stipulated in the contract, or for55
compensation based upon a stipulated price for each run, call, or 56
emergency, orsuch terms as the elapsed time of service required 57
in such run, call, or emergency, or any combination thereof58
parties may agree.59

       Any township wishing to commence providing or wishing to 60
enter into a contract for the first time to furnish or obtain 61
services from nonemergency patient transport service organizations 62
on or after March 1, 1993, including a township in which a private 63
provider has been providing the service, shall demonstrate the 64
need for public funding for the service to, and obtain approval 65
from, the state board of emergency medical services or its 66
immediate successor board prior to the establishment of a 67
township-operated or township-funded service.68

       Sec. 505.441.  (A) As used in this section, "run" includes a 69
call and an emergency to which a contracting party responds under 70
a contract executed pursuant to section 505.44 of the Revised 71
Code.72

       (B) A township that enters into a contract with another party 73
for services pursuant to section 505.44 of the Revised Code may 74
provide in the contract that the contracting party shall collect 75
and retain any fee that the township may charge for each run 76
involving ambulance service, emergency medical service, or 77
nonemergency patient transport service. The contract shall require 78
that once each month, the contracting party shall provide the 79
township with a written report that shall include for the previous 80
month the number of runs the contracting party made in the 81
township, the amount that was billed for each run, and the amount 82
received for each run from the person that was billed for that 83
particular run. The report also shall include the total amount 84
collected that calendar year to date and the total amount 85
outstanding that calendar year to date.86

       Sec. 505.84.  As used in this section, "authorized medicare 87
reimbursement rate" means such rate established for the locality 88
under Title XVIII of the "Social Security Act," 49 Stat. 620 89
(1935), 42 U.S.C.A. 301, as amended.90

       A board of township trustees may establish reasonable charges 91
for the use of fire and rescue services, ambulance services, or 92
emergency medical services. The board may establish different 93
charges for township residents and nonresidents, and may, in its 94
discretion, waive all or part of the charge for any resident. The 95
charge for ambulance transportation for nonresidents shall be an 96
amount not less than the authorized medicare reimbursement rate, 97
except that, if prior to September 9, 1988, the board had 98
different charges for residents and nonresidents and the charge 99
for nonresidents was less than the authorized medicare 100
reimbursement rate, the board may charge nonresidents less than 101
the authorized medicare reimbursement rate.102

       ChargesExcept as provided in section 505.441 of the Revised 103
Code, charges collected under this section shall be kept in a 104
separate fund designated as "the fire and rescue services, 105
ambulance services, and emergency medical services fund," and 106
shall be appropriated and administered by the board. The fund 107
shall be used for the payment of the costs of the management, 108
maintenance, and operation of fire and rescue services, ambulance 109
services, and emergency medical services in the township. If the 110
fire and rescue services, ambulance services, and emergency 111
medical services are discontinued in the township, any balance 112
remaining in the fund shall be paid into the general fund of the 113
township.114

       Sec. 4765.011. (A) With respect to the following individuals 115
who receive certificates to practice issued under this chapter, 116
all of the following apply:117

        (1) A first responder shall be also known as an emergency 118
medical responder or EMR;119

        (2) An emergency medical technician-basic or EMT-basic shall 120
be also known as an emergency medical technician or EMT, 121
respectively;122

        (3) An emergency medical technician-intermediate or EMT-I 123
shall be also known as an advanced emergency medical technician or 124
AEMT, respectively.125

        (B) With respect to the provisions of this chapter and all 126
other provisions of the Revised Code that refer to the individuals 127
specified in division (A) of this section, all of the following 128
apply:129

        (1) A reference to a first responder is deemed to be a 130
reference to an emergency medical responder or EMR;131

        (2) A reference to an emergency medical technician-basic or 132
EMT-basic is deemed to be a reference to an emergency medical 133
technician or EMT, respectively;134

        (3) A reference to an emergency medical 135
technician-intermediate or EMT-I is deemed to be a reference to an 136
advanced emergency medical technician or AEMT, respectively.137

       Sec. 4765.07.  (A) The state board of emergency medical 138
services shall adopt rules under section 4765.11 of the Revised 139
Code to establish and administer a grant program under which 140
grants are distributed according to the following priorities:141

       (1) First priority shall be given to emergency medical 142
service organizations for the training of personnel, for the 143
purchase of equipment and vehicles, and to improve the 144
availability, accessibility, and quality of emergency medical 145
services in this state. In this category, the board shall give 146
priority to grants that fund training and equipping of emergency 147
medical service personnel.148

       (2) Second priority shall be given to entities that research, 149
test, and evaluate medical procedures and systems related to adult 150
and pediatric trauma care.151

       (3) Third priority shall be given to entities that research 152
the causes, nature, and effects of traumatic injuries, educate the 153
public about injury prevention, and implement, test, and evaluate 154
injury prevention strategies.155

       (3) Third(4) Fourth priority shall be given to entities that 156
research, test, and evaluate procedures that promote the 157
rehabilitation, retraining, and reemployment of adult or pediatric 158
trauma victims and social service support mechanisms for adult or 159
pediatric trauma victims and their families.160

       (4) Fourth(5) Fifth priority shall be given to entities that 161
research, test, and evaluate medical procedures related to adult 162
and pediatric trauma careconduct research on, test, or evaluate 163
one or more of the following:164

       (a) Procedures governing the performance of emergency medical 165
services in this state;166

       (b) The training of emergency medical service personnel;167

       (c) The staffing of emergency medical service organizations.168

       (6) For grants distributed for the grant award years 169
occurring not later than the award year ending June 30, 2017, 170
sixth priority shall be given to entities that operate paramedic 171
training programs and are seeking national accreditation of the 172
programs.173

       (B) To be eligible for a grant distributed pursuant to 174
division (A)(6) of this section, an applicant for the grant shall 175
meet all of the following conditions:176

       (1) Hold a certificate of accreditation issued by the board 177
under section 4765.17 of the Revised Code to operate a paramedic 178
training program;179

       (2) Be seeking initial national accreditation of the program 180
from an accrediting organization approved by the board;181

       (3) Apply for the national accreditation on or after February 182
25, 2010.183

       (C) The grant program shall be funded from the trauma and 184
emergency medical services grants fund created by section 4513.263 185
of the Revised Code. 186

       Sec. 4765.43.  (A) A person who drives an ambulance that is 187
equipped for emergency medical services, is not required by this 188
chapter to be certified as an emergency medical technician-basic, 189
emergency medical technician-intermediate, or emergency medical 190
technician-paramedic.191

       (B)(1) During each emergency run made by an ambulance that is 192
equipped for emergency medical services and is operated by an 193
emergency medical service organization that does not utilize any 194
volunteer emergency medical service providers or does not 195
substantially utilize those providersDuring each emergency run 196
made by an ambulance that is equipped for emergency medical 197
services, the emergency medical service organization operating the 198
ambulance shall staff the ambulance in accordance with this 199
section.200

       For purposes of determining the applicable staffing 201
requirements, both of the following apply:202

       (1) An emergency run consists of components that are 203
distinguished between the period during which the ambulance is 204
traveling to the scene of an emergency and, if applicable, the 205
period during which the ambulance is transporting a patient from 206
the scene of the emergency.207

       (2) In the case of an emergency medical service organization 208
that utilizes a combination of volunteer and paid first 209
responders, emergency medical service technicians-basic, emergency 210
medical service technicians-intermediate, or emergency medical 211
service technicians-paramedic, the organization is considered to 212
be substantially utilizing volunteers in a particular week when 213
the paid individuals, taken as a whole, are scheduled for a total 214
of not more than one hundred ninety-two hours in that week.215

       (B) With respect to the driver of an ambulance during an 216
emergency run, both of the following apply:217

       (1) The driver must be at least eighteen years of age.218

       (2) The driver must hold a certificate issued under section 219
4765.30 of the Revised Code to practice as a first responder, 220
EMT-basic, EMT-I, or paramedic or a fire training certificate 221
issued pursuant to section 4765.55 of the Revised Code to provide 222
services as a firefighter.223

       (C) With respect to the component of an emergency run during 224
which the ambulance is traveling to the scene of the emergency, 225
the ambulance shall be staffed by at least one EMT-basic, EMT-I, 226
or paramedic. This individual may serve as the driver.227

       (D) With respect to the component of an emergency run during 228
which a patient is being transported, the ambulance shall be 229
staffed as follows:230

       (1) If the emergency medical service organization utilizes 231
only paid individuals or utilizes volunteers on a basis that is 232
not considered to be substantially utilizing volunteers, the 233
ambulance shall be staffed by at least two EMTs-basic, EMTs-I, or 234
paramedics. When an ambulance is so staffed, it may be driven by a 235
person who is not certified as an EMT-basic, EMT-I, or paramedic236
One of these individuals may serve as the driver.237

       (2) During each emergency run made by an ambulance that is 238
equipped for emergency medical services and is operated by anIf 239
the emergency medical service organization thatis substantially 240
utilizes volunteer emergency medical service providersutilizing 241
volunteers or utilizes only volunteers, the ambulance shall be 242
staffed by at least two EMTs-basic, EMTs-I, or paramedics or by at 243
least one first responder and one EMT-basic, EMT-I, or paramedic. 244
When an ambulance is so staffed, it may be driven by a person who 245
is not certified as a first responder, EMT-basic, EMT-I, or 246
paramedic. If circumstances so require, an ambulance that is 247
staffed by only one first responder and one EMT-basic, EMT-I, or 248
paramedic may be driven by the first responder who is staffing the 249
ambulance with the EMT-basic, EMT-I, or paramedicOne of these 250
individuals may serve as the driver, but if the staffing 251
requirement is being met by utilizing a first responder, the first 252
responder shall serve as the driver.253

       (C) For purposes of division (B) of this section, an 254
emergency medical service organization substantially utilizes 255
volunteer emergency medical service providers if, on any given 256
date, for the six-month period immediately prior to that date, the 257
organization's daily average number of hours during which the 258
organization used only volunteer first responders, volunteer 259
EMTs-basic, volunteer EMTs-I, or volunteer paramedics, or a 260
combination of such volunteers, was fifty per cent or more of the 261
daily average number of hours that the organization made emergency 262
medical services available to the public.263

       Sec. 4766.03.  (A) The Ohio medical transportation board 264
shall adopt rules, in accordance with Chapter 119. of the Revised 265
Code, implementing the requirements of this chapter. The rules 266
shall include provisions relating to the following:267

       (1) Requirements for an emergency medical service 268
organization to receive a permit for an ambulance or nontransport 269
vehicle;270

       (2) Requirements for an emergency medical service 271
organization to receive a license as a basic life-support, 272
intermediate life-support, advanced life-support, or mobile 273
intensive care unit organization;274

       (3) Requirements for a nonemergency medical service 275
organization to receive a permit for an ambulette vehicle;276

       (4) Requirements for a nonemergency medical service 277
organization to receive a license for an ambulette service;278

       (5) Requirements for an air medical service organization to 279
receive a permit for a rotorcraft air ambulance or fixed wing air 280
ambulance;281

       (6) Requirements for licensure of air medical service 282
organizations;283

       (7) Forms for applications and renewals of licenses and 284
permits;285

       (8) Requirements for record keeping of service responses made 286
by licensed emergency medical service organizations;287

       (9) Fee amounts for licenses and permits, and their renewals;288

       (10) Inspection requirements for licensees' vehicles or 289
aircraft, records, and physical facilities;290

       (11) Fee amounts for inspections of ambulances, ambulettes, 291
rotorcraft air ambulances, fixed wing air ambulances, and 292
nontransport vehicles;293

       (12) Requirements for ambulances and nontransport vehicles 294
used by licensed emergency medical service organizations, for 295
ambulette vehicles used by licensed nonemergency medical service 296
organizations, and for rotorcraft air ambulances or fixed wing air 297
ambulances used by licensed air medical service organizations that 298
specify for each type of vehicle or aircraft the types of 299
equipment that must be carried, the communication systems that 300
must be maintained, and the personnel who must staff the vehicle 301
or aircraft;302

       (13) The level of care each type of emergency medical service 303
organization, nonemergency medical service organization, and air 304
medical service organization is authorized to provide;305

       (14) Eligibility requirements for employment as an ambulette 306
driver, including grounds for disqualification due to the results 307
of a motor vehicle law violation check, chemical test, or criminal 308
records check. The rule may require that an applicant for 309
employment as an ambulette driver provide a set of fingerprints to 310
law enforcement authorities if the applicant comes under final 311
consideration for employment.312

       (15) Any other rules that the board determines necessary for 313
the implementation and enforcement of this chapter.314

       (B) In the rules for ambulances and nontransport vehicles 315
adopted under division (A)(12) of this section, the board may 316
establish requirements that vary according to whether the 317
emergency medical service organization using the vehicles is 318
licensed as a basic life-support, intermediate life-support, 319
advanced life-support, or mobile intensive care unit organization.320

       (C) A mobile intensive care unit that is not dually certified 321
to provide advanced life-support and meets the requirements of the 322
rules adopted under this section is not required to carry 323
immobilization equipment, including board splint kits, traction 324
splints, backboards, backboard straps, cervical immobilization 325
devices, cervical collars, stair chairs, folding cots, or other 326
types of immobilization equipment determined by the board to be 327
unnecessary for mobile intensive care units.328

       A mobile intensive care unit is exempt from the emergency 329
medical technician staffing requirements of division (B) of330
section 4765.43 of the Revised Code when it is staffed by at least 331
one physician or registered nurse and another person, designated 332
by a physician, who holds a valid license or certificate to 333
practice in a health care profession, and when at least one of the 334
persons staffing the mobile intensive care unit is a registered 335
nurse whose training meets or exceeds the training required for a 336
paramedic.337

       Section 2.  That existing sections 505.44, 505.84, 4765.07, 338
4765.43, and 4766.03 and section 4765.431 of the Revised Code are 339
hereby repealed.340