HBA-NRS C.S.H.B. 2446 77(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 2446 By: Glaze Public Health 4/11/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE In its interim report to the 77th Texas Legislature, the House Committee on Public Health (committee) examined the requirements imposed on emergency medical service (EMS) providers in rural areas and determined whether individual requirements encourage or hinder the provision of services. The committee outlined several policy options including allowing an advisory council to advise the Texas Board of Health (board) on emergency medical services, allowing counties to reimburse EMS providers under the Indigent Health Care and Treatment Act at Medicaid rates, and considering the standardization and simplification of EMS terminology and classification of providers. The committee also met with the Texas Department of Health (TDH), which recommended establishing a peer assistance program and providing confidentiality for the regional advisory council's quality improvement and data process. C.S.H.B. 2446 addresses the recommendations outlined in the interim report along with recommendations by TDH. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 2446 amends the Health and Safety Code to require the governor to ensure that approximately one half of the members of the advisory council that advises the Texas Board of Health (board) regarding matters related to the responsibilities of the board, the commissioner of health (commissioner), and the Texas Department of Health (TDH) under the Emergency Medical Services Act are residents of rural areas of the state. The bill requires the advisory council to assess the need for emergency medical services in rural areas and to develop a strategic plan for refining the educational requirements for certification and maintaining certification as emergency medical services personnel and for developing emergency medical services and trauma care systems (Sec. 773.012). The bill authorizes TDH to establish, approve, and fund a peer assistance program in accordance with minimum criteria established by the Texas Commission on Alcohol and Drug Abuse and in accordance with board rules (Sec. 773.013). The bill authorizes a governmental entity or nongovernmental organization that sponsors or wishes to sponsor an emergency medical services provider or first responder organization in a rural or underserved area to request TDH's bureau of emergency management (bureau) to provide or facilitate the provision of initial training for emergency care attendants, if the training is not available locally. The bill requires the bureau to ensure that the training is provided, and requires the bureau to provide services free of charge to students who agree to perform emergency care attendant services for at least one year with the local emergency medical services provider or first responder organizations. The bill requires the bureau to consult with experienced emergency medical service personnel to facilitate all levels of emergency medical services training (Sec. 773.025). The bill provides that the proceedings and records of organized committees of emergency medical services and trauma care systems relating to the review, evaluation, or improvement of such systems are confidential and not subject to disclosure by court subpoena or otherwise (Sec. 773.095). The bill requires a trauma care facility to be designated by the bureau according to the level of trauma care and services provided in accordance with the American College of Surgeons guidelines for level I and level II trauma facilities and rules adopted by the board for level III and IV trauma facilities. The bill removes the level V trauma designation (Sec. 773.115). C.S.H.B. 2446 amends the Government Code to include survivors of an emergency services volunteer, an emergency care attendant, and a licensed paramedic in the list of those eligible for financial assistance through the Employees Retirement System of Texas (Sec. 615.003). The bill amends the Health and Safety Code to authorize a county, in accordance with TDH rules, to receive payments through Medicaid for emergency medical services provided under the Indigent Health Care and Treatment Act (Sec. 61.0285). The bill modifies the composition of the advisory committee for the executive committee of the Center for Rural Health Initiatives to include an individual who provides emergency medical services in a rural area who is certified or licensed as an emergency care attendant or at a higher level of training. EFFECTIVE DATE September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 2446 modifies the original bill by establishing training programs for emergency care attendants in rural areas through the Texas Department of Health's bureau of emergency management.