Analysis

Topic: Emergency Medical Services
Sponsor: Bennett

Position: The Department of Consumer and Industry Services supports the bill.

Background: There have reportedly been situations in Michigan where properly trained emergency medical service personnel have not been able to use advanced life support skills and equipment because the ambulance operation was not licensed at that level. These situations pose a threat to the lives of those needing advanced life support who are unable to receive it on the scene of an accident, natural disaster or other emergency because the ambulance at the scene did not happen to be licensed at that level.

Description of the Bill: The bill amends the Public Health Code to permit certain ambulance operations to apply for an ambulance operation upgrade license. Such a license would allow an ambulance to operate at the limited advanced life support or advanced life support level if properly trained emergency medical staff are available on a shift. The upgrade license is for a period of two years and may be renewed for one additional period of two years. An applicant for an upgrade license is required to provide a plan for permanently upgrading its service from the basic life support level to the higher level. Recommendations from the appropriate medical control authority and the Statewide Emergency Medical Services Coordinating Committee would be required before the department issues the license. The department is required to file a written report with the Legislature within three years after the effective date of the bill.

Arguments:
Pro: By permitting highly trained emergency medical service personnel to use their skills in emergency situations the bill will save lives.

The bill will make it easier for local ambulance services to attract and retain highly trained personnel by providing a mechanism by which their skills can be used to the fullest extent.

The limit of one two-year renewal assures that an increased level of care can be provided in communities wishing to do so without damaging the current three-tier licensure system for ambulance operations. The limit will provide a significant incentive for communities seeking to upgrade their service level to actually do so.

Con: The bill will reduce the incentive to upgrade ambulance services from basic life support to limited advanced life support or advanced life support by providing an easy to obtain intermediate step. Although the legislation provides for only one two-year renewal, a subsequent Legislature may be asked by the proponents of this legislation to provide for additional renewals.

Supporters/Opponents: Although they had reservations about the one renewal limit, emergency medical service personnel from Flat Rock and Woodhaven supported the bill in Senate and House committee. The American Red Cross and the Michigan Association of Ambulance Services testified in support of the substitute. Right to Life testified against the substitute in committee because of the one renewal limit. The Tri-County Medical Control Authority supported more flexible licensing, but didn't like the limit on renewals, either.

Fiscal Information: The bill creates a new licensure category for ambulance operators. Those applying for the upgrade license would still be required to obtain an operating license at the basic life support level. The fee for the upgrade license is $100 and is valid for a period of two years. The upgrade license may be renewed for a period of two years. It is not possible to estimate the number of applications which are likely to be received for the new license.

The Department of Consumer and Industry Services would be required to compile and submit a report on the experience of ambulance operators who seek to upgrade their level of service during the three years after the bill's effective date. The department would also be required to address the impact of the bill on the delivery of emergency medical services in the state in that report.