SB-0282, As Passed House, June 13, 2019
HOUSE SUBSTITUTE FOR
SENATE BILL NO. 282
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 20919 (MCL 333.20919), as amended by 2018 PA
383.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 20919. (1) A medical control authority shall establish
written protocols for the practice of life support agencies and
licensed emergency medical services personnel within its region.
The medical control authority shall develop and adopt the protocols
required under this section in accordance with procedures
established by the department and shall include all of the
following:
(a) The acts, tasks, or functions that may be performed by
each type of emergency medical services personnel licensed under
this part.
(b) Medical protocols to ensure the appropriate dispatching of
a life support agency based upon medical need and the capability of
the emergency medical services system.
(c) Protocols for complying with the Michigan do-not-
resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067.
(d) Protocols defining the process, actions, and sanctions a
medical control authority may use in holding a life support agency
or emergency medical services personnel accountable.
(e) Protocols to ensure that if the medical control authority
determines that an immediate threat to the public health, safety,
or welfare exists, appropriate action to remove medical control can
immediately be taken until the medical control authority has had
the opportunity to review the matter at a medical control authority
hearing. The protocols must require that the hearing is held within
3 business days after the medical control authority's
determination.
(f) Protocols to ensure that if medical control has been
removed from a participant in an emergency medical services system,
the participant does not provide prehospital care until medical
control is reinstated and that the medical control authority that
removed the medical control notifies the department of the removal
within 1 business day.
(g) Protocols to ensure that a quality improvement program is
in place within a medical control authority and provides data
protection as provided in 1967 PA 270, MCL 331.531 to 331.534.
(h) Protocols to ensure that an appropriate appeals process is
in place.
(i) Protocols to ensure that each life support agency that
provides basic life support, limited advanced life support, or
advanced life support is equipped with epinephrine or epinephrine
auto-injectors and that each emergency medical services personnel
authorized to provide those services is properly trained to
recognize an anaphylactic reaction, to administer the epinephrine,
and to dispose of the epinephrine auto-injector or vial.
(j) Protocols to ensure that each life support vehicle that is
dispatched and responding to provide medical first response life
support, basic life support, or limited advanced life support is
equipped with an automated external defibrillator and that each
emergency medical services personnel is properly trained to utilize
the automated external defibrillator.
(k) Except as otherwise provided in this subdivision, before
October 15, 2015, protocols Protocols to ensure that each life
support vehicle that is dispatched and responding to provide
medical first response life support, basic life support, or limited
advanced life support is equipped with opioid antagonists and that
each emergency medical services personnel is properly trained to
administer opioid antagonists. Beginning October 14, 2017, a
However, a medical control authority, at its discretion, may
rescind or continue the protocol adopted under this subdivision.
(l) Protocols for complying with part 56B.
(2) A medical control authority shall not establish a protocol
under this section that conflicts with the Michigan do-not-
resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067,
or part 56B.
(3) The department shall establish procedures for the
development and adoption of written protocols under this section.
The procedures must include at least all of the following
requirements:
(a) At least 60 days before the adoption of a protocol, the
medical control authority shall circulate a written draft of the
proposed protocol to all significantly affected persons within the
emergency medical services system served by the medical control
authority and submit the written draft to the department for
approval.
(b) The department shall review a proposed protocol for
consistency with other protocols concerning similar subject matter
that have already been established in this state and shall consider
any written comments received from interested persons in its
review.
(c) Within 60 days after receiving a written draft of a
proposed protocol from a medical control authority, the department
shall provide a written recommendation to the medical control
authority with any comments or suggested changes on the proposed
protocol. If the department does not respond within 60 days after
receiving the written draft, the proposed protocol is considered to
be approved by the department.
(d) After department approval of a proposed protocol, the
medical control authority may formally adopt and implement the
protocol.
(e) A medical control authority may establish an emergency
protocol necessary to preserve the health or safety of individuals
within its region in response to a present medical emergency or
disaster without following the procedures established by the
department under this subsection for an ordinary protocol. An
emergency protocol established under this subdivision is effective
only for a limited period and does not take permanent effect unless
it is approved according to the procedures established by the
department under this subsection.
(4) A medical control authority shall provide an opportunity
for an affected participant in an emergency medical services system
to appeal a decision of the medical control authority. Following
appeal, the medical control authority may affirm, suspend, or
revoke its original decision. After appeals to the medical control
authority have been exhausted, the affected participant in an
emergency medical services system may appeal the medical control
authority's decision to the state emergency medical services
coordination committee created in section 20915. The state
emergency medical services coordination committee shall issue an
opinion on whether the actions or decisions of the medical control
authority are in accordance with the department-approved protocols
of the medical control authority and state law. If the state
emergency medical services coordination committee determines in its
opinion that the actions or decisions of the medical control
authority are not in accordance with the medical control
authority's department-approved protocols or with state law, the
state emergency medical services coordination committee shall
recommend that the department take any enforcement action
authorized under this code.
(5) If adopted in protocols approved by the department, a
medical control authority may require life support agencies within
its region to meet reasonable additional standards for equipment
and personnel, other than medical first responders, that may be
more stringent than are otherwise required under this part. If a
medical control authority proposes a protocol that establishes
additional standards for equipment and personnel, the medical
control authority and the department shall consider the medical and
economic impact on the local community, the need for communities to
do long-term planning, and the availability of personnel. If either
the medical control authority or the department determines that
negative medical or economic impacts outweigh the benefits of those
additional standards as they affect public health, safety, and
welfare, the medical control authority shall not adopt and the
department shall not approve protocols containing those additional
standards.
(6) If adopted in protocols approved by the department, a
medical control authority may require medical first response
services and licensed medical first responders within its region to
meet additional standards for equipment and personnel to ensure
that each medical first response service is equipped with an
epinephrine auto-injector, and that each licensed medical first
responder is properly trained to recognize an anaphylactic reaction
and to administer and dispose of the epinephrine auto-injector, if
a life support agency that provides basic life support, limited
advanced life support, or advanced life support is not readily
available in that location.
(7) If a decision of the medical control authority under
subsection (5) or (6) is appealed by an affected person, the
medical control authority shall make available, in writing, the
medical and economic information it considered in making its
decision. On appeal, the state emergency medical services
coordination committee created in section 20915 shall review this
information under subsection (4) and shall issue its findings in
writing.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.
Enacting section 2. This amendatory act does not take effect
unless all of the following bills of the 100th Legislature are
enacted into law:
(a) Senate Bill No. 200.
(b) House Bill No. 4367.