CHAPTER 231
HB 257 – FINAL VERSION
09Mar2005… 0226h
13Apr2005… 0951h
06/02/05 1611s
15Jun2005… 1912eba
2005 SESSION
05/09
HOUSE BILL 257
AN ACT relative to emergency medical and trauma service protocols and quality assurance program.
SPONSORS: Rep. S. L’Heureux, Merr 9; Rep. Palangas, Hills 12; Sen. Clegg, Dist 14
COMMITTEE: Health, Human Services and Elderly Affairs
This bill:
I. Requires the commissioner of the department of safety to adopt rules under RSA 541-A relative to protocols for emergency medical care.
II. Removes the reference in current law to the provision of local options under medical control and repeals the definition of “local option.”
III. Establishes a quality management program for emergency and trauma service providers.
This bill is a request of the department of safety.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
09Mar2005… 0226h
13Apr2005… 0951h
06/02/05 1611s
15Jun2005… 1912eba
05-0453
05/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Five
AN ACT relative to emergency medical and trauma service protocols and quality assurance program.
Be it Enacted by the Senate and House of Representatives in General Court convened:
231:1 Emergency Medical and Trauma Services; Definition of Off-Line Medical Control. Amend RSA 153-A:2, XV(a) to read as follows:
(a) “Off-line” medical control which includes [education, protocol development, critique, leadership, advice, and quality control] collaborative oversight of education, advice, critiques, medications, treatment modalities, and performance improvement with the head of the unit.
231:2 New Paragraph; Emergency Medical and Trauma Services; Definition of Prerequisites Added. Amend RSA 153-A:2 by inserting after paragraph XVI the following new paragraph:
XVI-a. “Prerequisite” means the education or demonstrated proficiency required as a prior condition to performing select skills or procedures contained in the standardized protocols issued by the emergency medical services medical control board.
231:3 Emergency Medical Services Medical Control Board; Adoption of Protocols Concerning Patient Care. RSA 153-A:5, III(d) is repealed and reenacted to read as follows:
(d) Submitting to the commissioner standardized protocols concerning patient care to consider for adoption as rules, which shall address prerequisites within protocols governing their use by providers, living wills established under RSA 137-H, durable powers of attorney for health care established under RSA 137-J, and patient-requested, physician generated orders relative to resuscitation.
231:4 Emergency Medical and Trauma Services; Duties of Commissioner. Amend RSA 153-A:7, II to read as follows:
II. The commissioner shall:
(a) Adopt rules, under RSA 541-A, with the advice and assistance of the coordinating board, the emergency medical services medical control board, and the trauma medical review committee, in accordance with RSA 153-A:20.
(b) Oversee the administration of the division by the director.
231:5 New Paragraph; Rulemaking; Quality Management Program. Amend RSA 153-A:20 by inserting after paragraph XXII the following new paragraph:
XXIII. The administration of the quality management program established under RSA 153-A:34.
231:6 New Subdivision; Quality Management Program. Amend RSA 153-A by inserting after section 33 the following new subdivision:
153-A:34 Quality Management Program
I. In this section:
(a) “Quality management program” means a comprehensive, continuous, and organization-wide evaluation and measurement system established in accordance with the rules and definitions adopted by the division of fire standards and training and emergency medical services. The system shall be used to evaluate and monitor the quality and appropriateness of system operation and the care provided to patients in order to identify sentinel events and trends so that corrective action may be taken by the local provider agency.
(b) “Records” means records of interviews, internal review and investigations, and all reports, statements, minutes, memoranda, charts, statistics, and other documentation generated during the activities of a quality management program. “Records” shall not mean original medical records or other records kept relative to any patient in the course of the business of operating as an emergency medical services unit.
II. Records of a quality management program shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such civil or administrative action merely because they were presented to a quality management program, and any person who supplies information or testifies as part of a quality management program, or who is a member of a quality management program committee, may not be prevented from testifying as to matters within his or her knowledge, but such witness may not be asked about his or her testimony before such program, or opinions formed by him or her, as a result of committee participation. Further, a program’s records shall be discoverable in either of the following cases:
(a) A judicial or administrative proceeding brought by the commissioner to revoke or restrict the license or certification of an emergency medical care provider or other person licensed under this chapter; or
(b) A proceeding alleging repetitive malicious action and personal injury brought against an emergency medical care provider or other person licensed under this chapter.
III. No person or entity shall be held liable in any action for damages or other relief arising from their good faith participation in a quality management program, or from the providing of information to a quality management program or in any judicial or administrative proceeding.
231:7 Emergency Medical and Trauma Services; Rulemaking. Amend RSA 153-A:20, II to read as follows:
II. Protocols [recommended] approved and issued by the emergency medical services medical control board for provision of emergency medical care, which shall [provide for the provision of local options under medical control. The protocols shall] address living wills established under RSA 137-H, durable powers of attorney for health care established under RSA 137-J, and patient-requested, physician generated orders relative to resuscitation. Notwithstanding RSA 541-A:12, III, the department may incorporate by reference into such rules protocols pertaining solely to medical and pharmaceutical patient care processes issued by the emergency medical services board and approved by the commissioner.
231:8 Repeal. RSA 153-A:2, XII, relative to the definition of a local option, is repealed.
231:9 Effective Date. This act shall take effect January 1, 2006.
(Approved: July 11, 2005)
(Effective Date: January 1, 2006)