PA EMS System Act Regulations –
Act 37
Overview
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Future of EMS
Regulations Update
Continuing Education
EMS Agencies
Patient Care Reports
Bureau Priorities
Question/Answer
Regulations Update
• Submitted to Attorney General’s Office – August 27,
2013
• Promulgated in PA Bulletin on Oct. 10, 2013
• The regulations will be phased-in over a six month
period. The outgoing regulations will be phased-out over
the same time period
• EMS System Act – The remainder of the Act will go into
effect April 10, 2014
• The Department is not able to implement any of the new
features created under the Act or the new regulations
until April 10, 2014
Regulations Update (Continued)
• CMP – EMS Providers – including non-certified providers
(≤$1000); EMS Agencies – including unlicensed
agencies & PCR Vendors (≤$5000)
• The Department can issue conditional temporary
licenses (provisional licenses) indefinitely if the
Department determines it is in the public interest to do
so. Previously, the Department could only issue these
licenses for up to 18 months
Regulation Update (Continued)
• Even when some sections take effect, specific
subsections within a section have their own phase-in
periods
– Example - EMS Agency Dispatch Centers
• Use County EMD Program within 270 days after publication
in PA Bulletin, which is 90 days after effective date of §
1027.4.
• Use PEMA-certified Call-takers and Dispatchers within 2
years after publication in PA Bulletin, which is one and a half
years after effective date of § 1027.4
Continuing Education
• Lapse of Certification
– Expired 1 Day to 2 Years
• Con-Ed (All required CEU’s for 3 years prior to
date of lapse AND up to time of reinstatement)
• NREMT Cognitive Exam
– 2 Years or Greater
• Con-Ed (All required CEU’s for 3 years prior to
date of lapse AND up to time of reinstatement)
• NREMT Psychomotor Exam
• NREMT Cognitive Exam
Continuing Education
• Testing Written (Cognitive) Testing
• January 1, 2014 – ALL testing done via Pearson
Vue system
• Regardless of where you are in your attempts
• Practical (Psychomotor Skills) Testing
– Follow NREMT guidelines
– Statewide testing calendar
– Regions will work with Educational Institutes to
develop planning and schedules
Continuing Education
• Scope of practice for EMS providers follows the EMS
Scope of Practice Model that the National Association
of State EMS Officials has developed for the National
Highway Traffic Safety Administration
• Licenses and certifications of EMS providers are
permanent (subject to discipline), but continued
practice is conditioned upon biennial or triennial reregistration and meeting Con-Ed requirements
• Ambulance vehicle operators will now be certified,
regulated, and required to meet Con-Ed requirements
Continuing Education
• The Act provides for the establishment of three new EMS providers
– the Emergency Medical Responder (EMR), the Advanced
Emergency Medical Technician (AEMT), and the Pre-hospital
Physician Extender (PHPE)
• The EMR replaces Ambulance Attendants and First Responders (§
1023.23)
– Current First Responders will be converted to EMRs
automatically
– Current Ambulance Attendants will be converted to EMRs
automatically. There is a “grandfather” provision that permits
Ambulance Attendants to remain as EMRs without full EMR
certification for 2 years after the 6 month phase-in period for the
regulations (April 10th, 2014)
CONTINUING EDUCATION
EMS
PROVIDER
OLD REQUIREMENTS + NEW REQUIREMENTS + CPR
CPR
EMSVO alone
EMSVO & BLS
EMSVO & ALS
N/A
N/A
N/A
2 hours/2 years
3 hours/3 years
2 hours/2 years
EMR
FR – 16/3 years*
12 Med/Trauma, 4 Other/3 years*
EMT
24/3 years*
18 Med/Trauma, 6 Other/3 years*
AEMT
N/A
27 Med/Trauma, 9 Other/2 years*
Paramedic
18/1 year*
27 Med/Trauma, 9 Other/2 years*
PHRN
18/1 year*
27 Med/Trauma, 9 Other/2 years*
PHPE & PHP
N/A
27 Med/Trauma, 9 Other/2 years*
**ANY AMOUNT OF CEU’S, EITHER MED/TRAUMA OR
OTHER, MAY BE DONE ONLINE**
Continuing Education Credits
• 1 Credit for every 60 minutes
• Credits will be within 30 minutes blocks of time
• If a student misses more then 15% of the time
assigned for program, receives no credit
**ANY AMOUNT OF CEU’S, EITHER
MED/TRAUMA OR OTHER, MAY BE DONE
ONLINE**
Continuing Education
• Con-Ed Tracking
– PERSONAL responsibility
– Get a completion certificate for ALL classes
attended
– Maintain Class completion certificates for a
possible audit at time of re-registration
Re-Registration Dates
ALL Providers at ALS levels will now have re-registration dates. For
initial renewal period, ALS providers will receive pro rated CEU’s to
“balance” Con Ed requirements as follows:
REMEMBER: It is the responsibility of each Provider to track completed
and required CEU’s, and to have all required CEU’s completed by the
renewal date on their card to remain “Command Eligible”. This
information is readily available in each Providers individual EMSRS
Account. There will be NO reminder notification sent.
Gone Are The Days
Revised, further defined use of Lights
and Sirens policy - protocols
When transporting or responding to a
call involving a patient who presents or
is in good faith perceived to present a
combination of circumstances that may
lead to worsened patient outcomes if
additional medical interventions were
delayed by the amount of time
estimated to be saved by the use of
emergency lights or audible warning
devices. Lights and sirens may be used
on an ambulance when transporting a
patient ONLY when medical
interventions is BEYOND the
capabilities of the ambulance crew
using available supplies and equipment
Disciplinary Action
• REINSTATEMENT OF REVOKED EMS PROVIDERS
– Five (5) years prior to requesting
– If request denied, applicant would wait one (1) year prior
to secondary request.
• DISCIPLINE OF EMSVO
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Emergency Suspension
– Clear and immediate danger to public
– Department would need credible evidence
– Hearing within 30 days
The BEMS has the authority to….
Automatically Suspend a certification
Agencies, Con-Ed/Education Institutes
Command Facilities, PCR Software Vendors
Civil money penalty for providers now in place. For Agency after
April 10th, 2014
Impose civil money penalties against entities that conduct EMS
operations without being licensed as an EMS agency.
Accessing Your EMSR
Accessing Your EMSR
Accessing Your EMSR
EMS Agencies
• Ambulance Services Classified as EMS
Agencies
– Capabilities Licensed Under One License
• Safety Committee
 Quarterly Meeting of Committee required
• QI/PI Committee
 Quarterly Meeting of Committee required
Peer Review – Peer Protection
Members and employees of a peer review committee
and persons who furnish professional services to a peer
review committee. An individual who is a member or
employee of a peer review committee or who provides
professional services to a peer review committee conducting
peer review under this section has the same protections
from civil and criminal liability for the performance
of any duty, function or activity required of the peer
review committee as a person who performs the duty,
function or activity under the Peer Review Protection Act.
EMS Agencies
• Staffing Plan
EMS Agencies
• Command Forms
EMS Agencies (Continued)
1. Ground Ambulance Services – BLS; Intermediate ALS;
and ALS (includes critical care transport ambulance
services)
2. Air Ambulance Services
3. Water Ambulance Services – BLS; Intermediate ALS; and
ALS
4. Squad Services – BLS; Intermediate ALS; and ALS
5. QRS
6. Special Operations EMS Services – Tactical EMS;
Wilderness EMS; Mass-gathering EMS; and Urban Search
& Rescue EMS
7. EMS Agency Dispatch Centers
EMS Agencies (Continued)
• EMS Agency Dispatch Centers (§ 1027.4)
– Certification Required. Effective October 13, 2015, an
EMS agency that operates an EMS agency dispatch
center shall use call-takers and dispatchers who are
certified and maintain certification as call-takers and
dispatchers by the Pennsylvania Emergency Management
Agency under 35 Pa.C.S. § 5303(a)(6) (relating to
telecommunications management)
• Must obtain an EMS agency license to
operate an EMS agency dispatch center
EMS Agencies (Continued)
• Subject to certain exceptions, EMS agencies are required to operate
24-7-365
• Exceptions:
– Conditional Temporary Licenses (§ 1027.12) A.K.A. Provisional
Licenses
– County or Broader Level EMS plan approved by the Department
(§ 1027.6)
– Tactical EMS response services except when their affiliated law
enforcement service requests their assistance
– Water Ambulances
– Air Ambulances
– Intermediate ALS Ambulance Services provided the EMS agency
also operates a BLS or ALS Service at the same location
EMS Agencies (Continued)
• Special Operations EMS (§ 1027.41)
– Tactical EMS
• Provides EMS support to law enforcement during a tactical law
enforcement operation
– Wilderness EMS
• Provides EMS in the wilderness, backcountry, or other wild,
uncultivated area
– Mass-Gathering EMS
• Provides EMS where there is a large gathering of people under
circumstances illustrated in the regulation
– Urban Search & Rescue EMS
• Provides EMS at an incident in which there patients entrapped
by a structural collapse or other entrapment for an
extended period of time
EMS Agencies (Continued)
• Stretcher and Wheelchair Vehicles
 An entity may not operate a stretcher or wheelchair
vehicle to transport a person who the entity knows, or
should reasonably know, requires:
 Medical Assessment
 Monitoring
 Treatment
 And/or observation during Transport
Patient Care Reports
• EMS Agencies shall collect, maintain, and electronically report
complete, accurate and reliable patient data
• Report should be complete no later than 72 hours after the EMS
Agency concludes patient care
• EMS Agency must submit, within 30 days, all PCR data to their
‘home’ Regional EMS Council
• Upon transfer of care, the provider must provide, verbally and in
writing or other means by which information is recorded, report to
the individual at the receiving facility assuming patient care
• Within 24 hours, the receiving facility shall receive a completed
EMS PCR
• PCR’s shall be retained by the EMS Agency for a minimum of 7
years
Bureau Priorities
• Safety
– Providers
• Wellness
• Vehicle Operations
– Patients’
• Error Reduction
• Decision Making
– Public
• Vehicle Operations
Bureau Priorities (Continued)
• Personal Accountability
• System Development
– Advancement
– Education vs Re-Education
• Efficiencies & Effectiveness
• Capacity Building & Preparedness
Bureau Priorities (Continued)
• Mass Casualty Incidents
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Event Planning
Event Coordination
Regional Initiatives
Asset Management
Thank you