HB1446: HB1446 Health; transfer responsibility for oversight of emergency medical services from Department of Public Health to Georgia Emergency Medical Services and Trauma Council

26 LC 60 0331S The House Committee on Regulated Industries offers the following substitute to HB 1446: A BILL TO BE ENTITLED AN ACT To amend Chapter 11 of Title 31 of the Official Code of Georgia Annotated, relating to1 emergency medical services, so as to transfer responsibility for the oversight of emergency2 medical services from the Department of Public Health to the Georgia Emergency Medical3 Services and Trauma Council; to transfer agreements, employees, and property to such4 council; to establish such council and provide for its membersh ip, powers, and duties; to5 provide certain minimum requirements for such council in transacting business; to provide6 for the appointment of an executive director of such council; to provide for the establishment7 of emergency medical services regions; to transfer responsibili ty for designating and8 contracting with regional emergency medical services from the Board of Public Health to the9 Board of Community Health; to provide for rules and regulations; to provide for licensure10 of ambulance providers and emergency medical services personnel by the Georgia11 Emergency Medical Services and Trauma Council; to revise provisions relating to automated12 external defibrillators; to revise procedures for licensing and appeals related thereto; to13 transfer responsibility for designating and certifying stroke centers from the Department of14 Public Health to the Georgia Emergency Medical Services and Trauma Council; to transfer15 the Office of Cardiac Care and its employees to such council; t o revise and provide for16 definitions; to provide for legislative findings; to update ter minology and provide for17 conforming changes; to provide for construction; to amend various titles of the Official Code18 H. B. 1446 (SUB) - 1 - 26 LC 60 0331S of Georgia Annotated, so as to make conforming changes; to provide for related matters; to19 provide for effective dates; to repeal conflicting laws; and for other purposes.20 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:21 PART I22 Emergency Medical Services Generally23 SECTION 1-1.24 Chapter 11 of Title 31 of the Official Code of Georgia Annotate d, relating to emergency25 medical services, is amended by repealing Article 1, relating t o general provisions, and26 enacting a new Article 1 to read as follows:27 "ARTICLE 128 31-11-1.29 (a) The General Assembly finds and determines that:30 (1) The provision of emergency medical services is a matter of substantial importance31 to the people of this state;32 (2) The cost and quality of emergency medical services are mat ters within the public33 interest;34 (3) It is highly desirable for the state to participate in eme rgency medical systems35 communications programs established pursuant to Public Law 93-1 54, entitled the36 Emergency Medical Services Systems Act of 1973;37 (4) The administration of an emergency medical systems communi cations program38 should be the responsibility of the Georgia Emergency Medical S ervices and Trauma39 Council, acting upon the recommendations of regional emergency medical services40 H. B. 1446 (SUB) - 2 - 26 LC 60 0331S advisory councils which coordinate the program; all ambulance services shall be a part41 of this system even if this system is the 9-1-1 emergency telephone number;42 (5) An emergency medical systems communications program in each emergency medical43 services region should be operated as economically and efficiently as possible to serve44 the public welfare and, to achieve this goal, should involve th e designation of45 geographical territories to be serviced by participating ambulance providers and should46 involve an economic and efficient procedure to distribute emerg ency calls among47 participating ambulance providers serving the same emergency medical services region;48 and49 (6) First responders should fall under the Georgia Emergency M edical Services and50 Trauma Council's rules and regulations governing ambulances and should transport only51 in life-threatening situations or by orders of a licensed physician or in situations where52 an ambulance provider cannot respond.53 (b) The General Assembly therefore declares that, in the exercise of the sovereign powers54 of the state to safeguard and protect the public health and general well-being of its citizens,55 it is the public policy of this state to encourage, foster, and promote emergency medical56 systems communications programs and that such programs shall be accomplished in a57 manner that is coordinated, orderly, economical, and without unnecessary duplication of58 services and facilities.59 31-11-2.60 As used in this chapter, the term:61 (1) 'Air ambulance' means any rotary-wing aircraft used or intended to be used for hire62 for transportation of a patient who may need medical attention during transport.63 (2) 'Air ambulance services' means the for-hire provision of e mergency care and64 transportation by means of an air ambulance for a patient to or from a place where65 medical or hospital care is furnished.66 H. B. 1446 (SUB) - 3 - 26 LC 60 0331S (3) 'Ambulance' means a motor vehicle that is specially constructed and equipped or an67 air ambulance and is intended to be used for the emergency tran sportation of patients,68 including dual purpose police patrol cars and funeral coaches or hearses which otherwise69 comply with the provisions of this chapter.70 (4) 'Ambulance attendant' means an individual responsible for the care of patients being71 transported in an ambulance.72 (5) 'Ambulance provider' means an agency or entity providing ambulance services which73 has been duly licensed under this chapter by a predecessor agen c y p r i o r t o74 January 1, 2028, or by the council on or after such date.75 (6) 'Ambulance services' means the provision of:76 (A) Emergency care and transportation on the public streets and highways of this state77 for a wounded, injured, sick, invalid, or incapacitated human being to or from a place78 where medical or hospital care is furnished;79 (B) Any air ambulance services;80 (C) Transportation services by an emergency organ transport ve hicle on the public81 streets and highways of this state for the transport of necessa ry personnel, organs,82 tissue, or medical supplies to a time-critical organ transplant procedure; or83 (D) Services specified in subparagraphs (A) and (B) of this paragraph.84 (7) 'Board' means the Board of Community Health established pu rsuant to Code85 Section 31-2-3.86 (8) 'Cardiac technician' means an individual who has been duly certified as such under87 this chapter by a predecessor agency prior to January 1, 2028, or by the council on or88 after such date.89 (9) 'Composite board' means the Georgia Composite Medical Board established pursuant90 to Code Section 43-34-2.91 (10) 'Council' means the Georgia Emergency Medical Services an d Trauma Council92 established pursuant to Code Section 31-11-5.93 H. B. 1446 (SUB) - 4 - 26 LC 60 0331S (11) 'Department' means the Department of Community Health established pursuant to94 Code Section 31-2-4.95 (12) 'Emergency medical services region' or 'EMS region' means any geographical96 district used as a basis for coordinating and administrating the EMSC Program and duly97 designated by a predecessor agency prior to January 1, 2028, or by the council on or after98 such date provided for pursuant to Code Section 31-11-9.99 (13) 'Emergency medical services system' means a system which provides for the100 arrangement of personnel, facilities, and equipment for the eff ective and coordinated101 delivery in an appropriate geographical area of healthcare serv ices under emergency102 conditions, occurring either as a result of the patient's condition or as a result of natural103 disasters or similar situations, and which is administered by a public or private nonprofit104 entity which has the authority and the resources to provide effective administration of the105 system.106 (14) 'Emergency Medical Systems Communications Program' or 'EMSC Program' means107 any program established pursuant to Public Law 93-154, entitled the Emergency Medical108 Services Systems Act of 1973, which serves as a central communi cations system to109 coordinate the personnel, facilities, and equipment of an emerg ency medical services110 system and which:111 (A) Utilizes emergency medical telephonic screening;112 (B) Utilizes a publicized emergency telephone number; and113 (C) Has direct communication connections and interconnections with the personnel,114 facilities, and equipment of an emergency medical services system.115 (15) 'Emergency medical technician' means an individual who has been duly certified as116 such under this chapter by a predecessor agency prior to Januar y 1, 2028, or by the117 council on or after such date.118 H. B. 1446 (SUB) - 5 - 26 LC 60 0331S (16) 'Emergency organ transport vehicle' means a motor vehicle that is intended to be119 used for the transport of necessary personnel, organs, tissue, or medical supplies to a120 time-critical organ transplant procedure.121 (17) 'First responder' means any person or agency who provides on-site care until the122 arrival of an ambulance provider, including, but not limited to , those individuals who123 routinely respond to calls for assistance through an affiliatio n with law enforcement124 agencies, fire departments, and rescue agencies.125 (18) 'Invalid car' means a motor vehicle not used for emergency purposes but used only126 to transport individuals who are convalescent, sick, or otherwise nonambulatory.127 (19) 'License' means, when issued to an ambulance provider, th at its facilities and128 operations comply with this chapter and any rules and regulations duly established by a129 predecessor agency prior to January 1, 2028, or by the council on or after such date.130 (20) 'License officer' means a predecessor agency prior to January 1, 2028, or the council131 or its designee on or after such date.132 (21) 'Paramedic' means an in dividual who has b een duly certifi ed as such under this133 chapter by a predecessor agency prior to January 1, 2028, or by the council on or after134 such date.135 (22) 'Paramedic clinical preceptor' means a paramedic certifie d in this state with a136 minimum of two years of emergency medical services experience who meets the standard137 requirements for paramedic preceptor training as established by a predecessor agency138 prior to January 1, 2028, or by the council on or after such date.139 (23) 'Patient' means an individual who is sick, injured, wound ed, or otherwise140 incapacitated or helpless.141 (24) 'Person' means any individual, firm, partnership, association, corporation, company,142 group of individuals acting together for a common purpose, or organization of any kind,143 including any governmental agency other than of the United States.144 H. B. 1446 (SUB) - 6 - 26 LC 60 0331S (25) 'Predecessor agency' means the Department of Public Health; provided, however,145 that such term shall mean the Georgia Composite Medical Board f or the purposes of146 rules, regulations, policies, procedures, and administrative orders relating to the licensing147 of emergency medical services personnel under Article 2 of this chapter prior to148 January 1, 2002.149 (26) 'Provisional license' means, when issued to an ambulance provider, a license issued150 on a conditional basis to allow a newly established ambulance p rovider a period of 30151 days to demonstrate that its facilities and operations comply with this chapter and rules152 and regulations issued under this chapter by a predecessor agen c y p r i o r t o153 January 1, 2028, or by the council on or after such date.154 (27) 'Regional emergency medical services advisory council' or 'REMSAC' means a155 public or private nonprofit local entity designated, pursuant to Code Section 31-11-10,156 to administer and coordinate the EMSC Program in an EMS region provided for pursuant157 to Code Section 31-11-9.158 31-11-3.159 Except as otherwise expressly provided, all powers, functions, duties, and obligations of160 the Department of Public Health under this chapter, as they exist on December 31, 2027,161 with the exception of subsections (a) and (b) of Code Section 3 1-11-10, relating to the162 designation of REMSACs, are transferred to the Georgia Emergency Medical Services and163 Trauma Council, effective January 1, 2028.164 31-11-4.165 (a) The Georgia Emergency Medical Services and Trauma Council shall succeed to all166 rules, regulations, policies, standards, programs, procedures, and administrative orders of167 a predecessor agency that are in effect on December 31, 2027, o r scheduled to go into168 effect on or after January 1, 2028, and which relate to the fun ctions transferred to the169 H. B. 1446 (SUB) - 7 - 26 LC 60 0331S council pursuant to Code Section 31-11-3 and shall further succ eed to any rights,170 privileges, entitlements, obligations, and duties of the Department of Public Health that are171 in effect on December 31, 2027, which relate to the functions t ransferred to the Georgia172 Emergency Medical Services and Trauma Council pursuant to Code Section 31-11-3. Such173 rules, regulations, policies, standards, programs, procedures, and administrative orders shall174 remain in effect until amended, repealed, superseded, or nullif ied by the Georgia175 Emergency Medical Services and Trauma Council by proper authori ty or as otherwise176 provided by law.177 (b) Except as otherwise expressly provided, the rights, privil eges, entitlements,178 obligations, and duties of parties to contracts, leases, agreem ents, and other transactions179 entered into prior to January 1, 2028, by the Department of Public Health which relate to180 the functions transferred to the Georgia Emergency Medical Services and Trauma Council181 pursuant to Code Section 31-11-3 shall continue to exist; and n one of such rights,182 privileges, entitlements, obligations, and duties are impaired or diminished by reason of the183 transfer of the functions to the Georgia Emergency Medical Services and Trauma Council. 184 In all such instances, the Georgia Emergency Medical Services and Trauma Council shall185 be substituted for the Department of Public Health, and the Georgia Emergency Medical186 Services and Trauma Council shall succeed to the rights, privil eges, entitlements,187 obligations, and duties under such contracts, leases, agreements, and other transactions.188 (c) All individuals employed by the Department of Public Health in capacities which relate189 t o t h e f u n c t i o n s t r a n s f e r r e d t o t h e G e o r g i a E m e r g e n c y M e d i c a l Services and Trauma190 Council pursuant to Code Section 31-11-3 on December 31, 2027, including, but not191 limited to, the Office of Cardiac Care established pursuant to Code Section 31-11-132,192 shall, on January 1, 2028, become employees of the Georgia Emergency Medical Services193 and Trauma Council in similar capacities, as determined by the executive director194 appointed pursuant to Code Section 31-11-8.195 H. B. 1446 (SUB) - 8 - 26 LC 60 0331S (d) Notwithstanding any provision to the contrary in this chapter, any license, provisional196 license, certificate, permit, registration, or other authorization required under this chapter197 to engage in the practice of any profession or the provision of any service that was duly198 issued by a predecessor agency to any person prior to January 1, 2028, shall be valid until199 such license, provisional license, certificate, permit, registr ation, or other authorization200 expires, is revoked by the Georgia Emergency Medical Services and Trauma Council, is201 surrendered by the holder, or is otherwise terminated under this chapter.202 (e) The Georgia Emergency Medical Services and Trauma Council shall receive custody203 of any state owned real property in the custody of the Departme nt of Public Health on204 December 31, 2027, and which pertains to the functions transfer red to the Georgia205 Emergency Medical Services and Trauma Council pursuant to Code Section 31-11-3.206 31-11-5.207 (a) There is established the Georgia Emergency Medical Service s and Trauma Council,208 which shall be assigned to the department for administrative purposes only, as provided in209 Code Section 50-4-3.210 (b) The council shall be composed of the following members:211 (1) One member from each REMSAC, with preference given to the chairperson of each212 such REMSAC, to be appointed by the Governor;213 (2) One member who is an employee or representative of a privately owned ambulance214 provider, to be appointed by the Governor;215 (3) One member knowledgeable of the EMSC Program, to be appoin ted by the216 Governor;217 (4) One member knowledgeable of the EMSC Program, to be appointed by the Speaker218 of the House of Representatives; and219 (5) One member knowledgeable of the EMSC Program, to be appointed by the President220 of the Senate.221 H. B. 1446 (SUB) - 9 - 26 LC 60 0331S (c)(1) On or before August 1, 2027, the Governor, Speaker of t he House of222 Representatives, and President of the Senate shall appoint the initial members of the223 council, in accordance with subsection (b) of this Code section . Each member of the224 council shall be appointed for a term of two years.225 (2) Each member of the council shall serve until his or her su ccessor is appointed and226 qualified. In the event of a vacancy in the council for any reason, such vacancy shall be227 filled for the remainder of the unexpired term in the same mann er as the original228 appointment. Each member of the council shall be eligible to succeed himself or herself;229 provided, however, that no member shall serve more than two consecutive terms on the230 council.231 (3) Members of the council may be removed from office under the same conditions for232 removal from office of members of professional licensing boards as provided in Code233 Section 43-1-17.234 (d) At its first regular meeting, the council shall elect a chairperson and such other officers235 from among its membership as it deems necessary.236 (e)(1) Each REMSAC shall promptly notify the council of any change in chairperson of237 such REMSAC.238 (2) Upon request by the Governor, each REMSAC shall promptly notify the Governor239 of the name and contact information for the chairperson of such REMSAC.240 (f) The council may, from time to time, designate advisory com mittees of such241 composition as the council may prescribe to assist and advise the council in carrying out242 its duties under this chapter. The members of any such advisory committee shall serve at243 the pleasure of the council.244 (g) Members of the council shall serve without compensation but shall be allowed actual245 and necessary expenses in the performance of their duties. Mem bers of the commission246 shall receive a daily expense allowance in the amount specified in subsection (b) of Code247 Section 45-7-21, as well as the mileage or transportation allow ance authorized for state248 H. B. 1446 (SUB) - 10 - 26 LC 60 0331S employees. The funds necessary for the reimbursement of expenses and allowances of any249 member of the council shall be paid from funds appropriated to or otherwise available to250 the department.251 31-11-6.252 (a) The council is vested with the following functions and powers:253 (1) To provide rules of procedure for its internal management and control;254 (2) To establish an internal code of conduct which shall contain member disclosure and255 conflict of interest policies;256 (3) To enter into contracts or do such things as may be necessary and incidental to the257 administration of its authority pursuant to this chapter, inclu ding, but not limited to,258 employing professional, technical, and clerical personnel;259 (4) To oversee the EMSC Program and the provision of emergency medical services260 within each EMS region, as provided under this chapter;261 (5) To make all necessary modifications to the territorial zones within each EMS region262 and methods of distributing calls among ambulance providers participating in the EMSC263 Program, in accordance with the procedures set forth in Code Section 31-11-10;264 (6) To prescribe reasonable health, sanitation, and safety sta ndards for transporting265 patients in ambulances;266 (7) To prescribe reasonable conditions under which ambulance attendants are required;267 (8) To establish uniform minimum standards consistent with thi s chapter for the268 employment and training of first responders, emergency medical technicians, paramedics,269 paramedic clinical preceptors, ambulance attendants, cardiac technicians, and such other270 emergency medical service personnel as determined by the counci l, including271 qualifications, certifications, recertifications, decertifications, and probations for certified272 individuals and suspensions for noncertified individuals;273 H. B. 1446 (SUB) - 11 - 26 LC 60 0331S (9) To establish minimum curriculum requirements for schools operated by or for any274 employing agency for the speci fic purpose of training first res ponders, emergency275 medical technicians, paramedics, paramedic clinical preceptors, ambulance attendants,276 cardiac technicians, and such other emergency medical service personnel as determined277 by the council;278 (10) To approve institutions and facilities for school operation by or for any employing279 agency for the specific purpose of training first responders, e mergency medical280 technicians, paramedics, paramedic clinical preceptors, ambulan ce attendants, cardiac281 technicians, and such other emergency medical service personnel as determined by the282 council;283 (11) To permit the emergency medical technician course to be offered at area hospitals284 and area vocational technical schools in conjunction with their emergency patient care285 and personnel training programs;286 (12) To make or support studies on any aspect of the education and training or287 recruitment of first responders, emergency medical technicians, paramedics, paramedic288 clinical preceptors, ambulance attendants, cardiac technicians, and such other emergency289 medical service personnel as determined by the council;290 (13) To make recommendations concerning any matter within its purview;291 (14) To establish basic training requirements for first respon ders, emergency medical292 technicians, paramedics, paramedic clinical preceptors, ambulan ce attendants, cardiac293 technicians, and such other emergency medical service personnel as determined by the294 council;295 (15) To certify any individual satisfactorily complying with t he training program296 established in accordance with paragraph (13) of this subsectio n and the qualifications297 for employment under this chapter;298 (16) To issue a certificate to any individual who has received training in another state as299 or who has received training by the United States government as a first responder,300 H. B. 1446 (SUB) - 12 - 26 LC 60 0331S emergency medical technician, paramedic, paramedic clinical pre ceptor, ambulance301 attendant, cardiac technician, or such other emergency medical service personnel as302 determined by the council, when the council has determined that the training was at least303 equivalent to that required by the council for approved education and training programs304 in this state for such profession and when the individual has satisfactorily complied with305 all other requirements of this chapter;306 (17) To accept donations, gifts, property, and other contributions and to use the same for307 carrying out the purposes of this chapter; and308 (18) To promulgate rules and regulations as reasonably necessa ry to administer and309 implement the provisions of this chapter.310 (b) Nothing in this Code section shall authorize the council to adopt and promulgate rules311 or regulations which prevent the continued use of dual purpose funeral coaches or hearses312 currently being used as ambulances if the vehicles otherwise conform in all respects to the313 requirements of Code Section 31-11-34 except for their size and shape.314 31-11-7.315 (a) The council shall transact business in the following manner:316 (1) The council shall hold at least four regular meetings each year at the call of the317 chairperson or upon the written request of a majority of the members of the council;318 (2) A majority of the members of the council shall constitute a quorum necessary for the319 transaction of business and shall be sufficient to do and perform any action permitted the320 council by this chapter. No vacancy on the council shall impair the right of a quorum to321 transact any and all business of the council; and322 (3) The council shall adopt such rules for the transaction of its business as it shall desire.323 (b) The council shall be subject to Chapter 14 of Title 50, relating to open meetings, and324 Article 4 of Chapter 18 of Title 50, relating to open records.325 H. B. 1446 (SUB) - 13 - 26 LC 60 0331S (c) The council shall make an annual report of its activities to the Governor and to the326 General Assembly and shall include in such report any recommendations for appropriate327 legislation. The council shall not be required to distribute c opies of such report to the328 members of the General Assembly but shall notify the members of the availability of the329 report in the manner it deems to be most effective and efficient.330 31-11-8.331 (a) The council shall appoint an executive director and establish the executive director's332 duties and compensation. Such executive director shall serve at the pleasure of the council.333 (b) The executive director may contract for such services and employ such other334 professional, technical, and clerical personnel as may be reasonably necessary to carry out335 the purposes of this chapter.336 31-11-9.337 On or after January 1, 2028, the council shall establish as a b asis for coordinating and338 administering the EMSC Program one or more EMS regions composed of one or more339 counties. Each such EMS region shall, for purposes of coordinating and administering the340 EMSC Program, succeed to any health districts established by th e Department of Public341 Health that are in effect on December 31, 2027, or scheduled to go into effect on or after342 January 1, 2028. Such health districts shall remain in effect until amended, superseded, or343 nullified by the council or as otherwise provided by law.344 31-11-10.345 (a)(1) Subject to paragraph (2) of this subsection, the board shall as soon as practicable346 designate and contract with a public or private nonprofit local entity to administer and347 coordinate the EMSC Program for each EMS region provided for pu rsuant to Code348 H. B. 1446 (SUB) - 14 - 26 LC 60 0331S Section 31-11-9. Any such local entity designated or contracted with shall be known as349 a regional emergency medical services advisory council or REMSAC.350 (2) Any public or private nonprofit local entity that is administering and coordinating the351 EMSC Program for a designated territory on January 1, 2028, or is scheduled to352 administer and coordinate the EMSC Program for a designated territory after such date,353 pursuant to a contract with, agreement with, or other designation by the Department of354 Public Health duly entered into or agreed to prior to January 1, 2028, shall serve out the355 remainder of the term of such contract, agreement, or designati on; provided, however,356 that this shall not be construed to impair either party's rights, privileges, entitlements, or357 duties under any such contract, agreement, or designation. In all such instances, the358 Board of Community Health shall be substituted for the Board of Public Health; the board359 shall succeed to the rights, privileges, entitlements, and duties under any such contract,360 agreement, or designation; and, upon the expiration of such con tract, agreement, or361 designation, the board shall designate and contract with a succ essor REMSAC in362 accordance with paragraph (1) of this subsection.363 (3) In designating and contracting with a REMSAC pursuant to this subsection, the board364 shall take all steps necessary to ensure that each REMSAC condu cts its business in365 accordance with Chapter 14 of Title 50, relating to open meetin gs, and Article 4 of366 Chapter 18 of Title 50, relating to open records.367 (b) Each REMSAC shall be composed of between 25 to 50 members who are368 knowledgeable of the EMSC Program and meet such other requirements as the board may369 prescribe, one of whom shall serve as chairperson of such REMSAC.370 (c) At such times as the council shall prescribe, each REMSAC shall recommend to the371 council or its designee the manner in which the EMSC Program is to be conducted. In372 making its recommendations, the REMSAC shall give priority to m aking the EMSC373 Program function as efficiently and economically as possible.374 H. B. 1446 (SUB) - 15 - 26 LC 60 0331S (d)(1) Each ambulance provider in an EMS region shall have the opportunity to375 participate in the EMSC Program.376 (2) Each REMSAC designated by the board pursuant to subsection (a) of this Code377 section shall request from each ambulance provider in its EMS r egion a written378 description of the territory in which it can respond to emergency calls. Each ambulance379 provider shall submit such written description to a REMSAC with in ten days of any380 request by such REMSAC.381 (3) Within ten days of receiving the written descriptions of t erritory provided by the382 ambulance providers in accordance with paragraph (2) of this subsection, each REMSAC383 shall recommend in writing to the council or its designee the territories within the EMS384 region to be serviced by each ambulance provider and the method for distributing385 emergency calls among the ambulance providers, based primarily on considerations of386 economy, efficiency, and benefit to the public welfare. The council or its designee shall387 approve or modify the territorial zones and method of distributing calls among ambulance388 providers participating in the EMSC Program in the EMS region b ased on such389 recommendations.390 (e)(1) The council or its designee shall be empowered to condu ct a hearing into the391 recommendations made by any REMSAC, and such hearing shall be conducted according392 to the procedures set forth in Code Section 31-11-15. The reco mmendations of any393 REMSAC shall not be modified unless the council or its designee finds, after a hearing,394 that the determination of such REMSAC is inconsistent with oper ation of the EMSC395 Program in an efficient and economical manner that benefits the public welfare. No396 hearing shall be required if the council adopts the recommendat ions of the REMSAC397 without modification. The final decision of the council or its designee shall be rendered398 as soon as possible and shall be final and conclusive concernin g the operation of the399 EMSC Program. An appeal from such final decision shall be purs uant to Code400 Section 31-11-17.401 H. B. 1446 (SUB) - 16 - 26 LC 60 0331S (2) The REMSAC shall begin administering the EMSC Program in accordance with a402 final decision of the council or its designee immediately after issuance of the final403 decision by the council or its designee regarding the approval or modification of the404 recommendations made by the REMSAC, and the EMSC Program shall be operated in405 such manner pending the resolution of any appeals filed pursuan t to Code406 Section 31-11-17, except as otherwise provided in such Code section.407 (f) This Code section shall not apply to air ambulances, air a mbulance services, or408 emergency organ transport vehicles.409 31-11-11.410 Records of each ambulance trip shall be made by the ambulance provider in such manner411 and on such forms as may be prescribed by the council through rules and regulations. Such412 records shall be available for inspection by the council at any time, and a summary of413 ambulance services shall be prepared on specific cases and furnished to the council upon414 request.415 31-11-12.416 (a) The driver of an ambulance on the public streets, highways, and private access roads417 of this state, when responding to an emergency call or while tr ansporting a patient, shall418 be authorized to operate the ambulance as an emergency vehicle pursuant to Code419 Section 40-6-6.420 (b) The driver of an emergency organ transport vehicle on the public streets, highways,421 and private access roads of this state, when transporting neces sary personnel, organs,422 tissue, or medical supplies to a time-critical organ transplant procedure, shall be authorized423 to operate the emergency organ transport vehicle as an emergenc y vehicle pursuant to424 Code Section 40-6-6.425 H. B. 1446 (SUB) - 17 - 26 LC 60 0331S 31-11-13.426 (a) Any person, including an agent or employee, that is licens ed to furnish ambulance427 services and in good faith renders emergency care to an individ ual who is a victim of an428 accident or emergency shall not be liable for any civil damages to such victim as a result429 of any act or omission by such person in rendering emergency care to such victim.430 (b) A physician shall not be civilly liable for damages result ing from that physician's431 acting as medical adviser to an ambulance provider, pursuant to Code Section 31-11-50,432 if those damages are not a result of that physician's willful and wanton negligence.433 (c) The immunity provided in this Code section shall apply onl y to those persons that434 perform the aforesaid emergency services for no remuneration.435 31-11-14.436 (a) The council and its duly authorized agents are authorized to enforce compliance with437 this chapter and rules and regulations promulgated under this chapter in the same manner438 as provided in Article 1 of Chapter 5 of this title and, in connection therewith during the439 reasonable business hours of the day, to enter upon and inspect in a reasonable manner the440 premises of an ambulance provider. All inspections under this Code section shall be in441 compliance with the provisions of Article 2 of Chapter 5 of this title.442 (b) The council is authorized to enforce compliance with this chapter, including, but not443 limited to, compliance with the EMSC Program and the provision of emergency medical444 services within designated territories, by imposing fines in the same manner as provided445 in paragraph (6) of subsection (c) of Code Section 31-2-8; this enforcement action shall be446 a contested case under Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'447 31-11-15.448 Hearings shall be required for any and all quasi-judicial actio ns and in any other449 proceeding required by this title or the Constitution of Georgia. All such hearings shall be450 H. B. 1446 (SUB) - 18 - 26 LC 60 0331S conducted in accordance with Chapter 13 of Title 50, the 'Georg ia Administrative451 Procedure Act.'452 31-11-16.453 All rules and regulations of the council shall be adopted after due notice to and hearing by454 persons and parties affected thereby; and such rules and regulations shall be maintained in455 a book kept for that purpose, orderly arranged and indexed and subject to inspection by the456 public during regular business hours. The council shall make copies thereof available for457 distribution to persons interested in or affected thereby. No rule or regulation shall become458 effective as law until 30 days after its adoption, except in cases of emergencies constituting459 an imminent threat to the public, in which event such rules or regulations shall become460 effective upon adoption; but, in all such cases, the council shall as a part thereof state the461 conditions found by it to justify such immediate effectiveness. Where deemed desirable462 by the council, hearing and notice in the same manner as provid ed in Code463 Section 31-11-15 may be conducted by it prior to adoption of any rule or regulation.464 31-11-17.465 (a) Any person or party to a proceeding who is aggrieved or adversely affected by a final466 order or action of the council, including, but not limited to, an order or action involving a467 dispute concerning the designation, application, or administration of an ambulance provider468 territory, may have review thereof by appeal to the superior court in the county in which469 the action arose. If an appeal concerns a final order or actio n involving the designation,470 application, or administration of an ambulance provider territory which includes portions471 of more than one county, such an appeal may be filed in the sup erior court of any such472 county.473 (b) Appeal to the superior court shall be by petition which sh all be filed in the clerk's474 office of such court within 30 days after the final order or ac tion of the council. The475 H. B. 1446 (SUB) - 19 - 26 LC 60 0331S petition shall set forth the names of the parties taking the appeal; the order, rule, regulation,476 or decision appealed from; and the reason it is claimed to be erroneous. The enforcement477 of the order or action appealed from shall not be stayed until and unless so ordered and478 directed by the superior court. A superior court may order a stay only if the court makes479 a finding that the public health, safety, and welfare will not be harmed by the issuance of480 the stay. Upon the filing of such petition, the petitioner shall serve on the council a copy481 thereof in a manner prescribed by law for the service of proces s, unless such service of482 process is waived. The review shall be conducted by the superior court without a jury and483 shall be confined to the record. In cases of alleged irregularities in procedure before the484 council, not shown in the record, proof thereon may be taken in the court. The superior485 court, upon request, shall hear oral argument and receive written briefs.486 (c) The superior court shall not substitute its judgment for t hat of the council as to the487 weight of the evidence on questions of fact. The court may aff irm the decision of the488 council or remand the case for further proceedings. The court may reverse or modify the489 decision if substantial rights of the appellant have been preju diced because the490 administrative findings, inferences, conclusions, or decisions are:491 (1) In violation of constitutional or statutory provisions;492 (2) In excess of the statutory authority of the council;493 (3) Made upon unlawful procedure;494 (4) Affected by other error of law;495 (5) Clearly erroneous in view of the reliable, probative, and substantial evidence on the496 whole record; or497 (6) Arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted498 exercise of discretion.499 H. B. 1446 (SUB) - 20 - 26 LC 60 0331S 31-11-18.500 Notwithstanding any provision to the contrary in this chapter, the council shall cooperate501 with and take all steps necessary to share information with, at such frequency and as502 required by, the Department of Public Health related to the Department of Public Health's503 performance of its duties under this title; provided, however, that any information released504 shall comply with the requirements of the federal Health Insura nce Portability and505 Accountability Act of 1996, P.L. 104-191. 506 31-11-19.507 Nothing in this chapter shall be construed as prohibiting or preventing a municipality from508 fixing, charging, or assessing any license fee or registration fee on any business or509 profession covered by this chapter or upon any related profession or any person engaged510 in any profession governed by this chapter or collecting any fe e so imposed or from511 establishing additional regulations regarding ambulance services.512 31-11-20.513 This chapter shall not apply to:514 (1) An ambulance or any provision of ambulance services operated by an agency of the515 United States government;516 (2) A vehicle or aircraft operated by an individual who is not licensed to furnish517 ambulance services when rendering assistance temporarily in the case of a major518 catastrophe or emergency because the ambulance providers of the state are insufficient519 or unable to meet the demands thereof;520 (3) An ambulance which is operated from a location outside of the state in order to521 transport patients from without the state's limits to locations within the state; or522 (4) An invalid car or the operator thereof, except as provided in subsection (b) of Code523 Section 31-11-30.524 H. B. 1446 (SUB) - 21 - 26 LC 60 0331S 31-11-21.525 Medical directors of ambulance providers, first responders, or neonatal services are526 authorized to contract with licensed pharmacies to furnish dangerous drugs and controlled527 substances for the vehicles of their particular services. Such dangerous drugs and528 controlled substances shall be furnished, secured, and stored in the manner provided for in529 Code Section 26-4-116."530 PART II531 Licenses532 SECTION 2-1.533 Said chapter is further amended in Article 2, relating to licen ses, by revising Code534 Section 31-11-30, relating to license requirement, as follows:535 "31-11-30.536 (a) No person shall operate as an ambulance service provider in this state without having537 a valid license or provisional license issued by the license officer pursuant to this chapter.538 (b) No person shall make use of the word 'ambulance' to descri be any ground or air539 transportation or facility or service associated therewith which such person provides or to540 otherwise hold oneself out to be an ambulance service provider unless such person has a541 valid license or provisional license issued pursuant to the provisions of this chapter or is542 exempt from licensing under this chapter and is not the operator of an invalid car.543 (c) Any person who violates the provisions of this Code sectio n shall be guilty of a544 misdemeanor."545 SECTION 2-2.546 Said chapter is further amended in said article by revising par agraphs (1) and (7) of Code547 Section 31-11-31, relating to application for license, as follows:548 H. B. 1446 (SUB) - 22 - 26 LC 60 0331S "(1) The name and address of the owner of the ambulance service provider or proposed549 ambulance service provider;"550 "(7) The location and description of the place or places from w hich the ambulance551 service provider is intended to operate."552 SECTION 2-3.553 Said chapter is further amended in said article by revising Code Section 31-11-31.2, relating554 to ambulance service provider matching payment, segregated account, appropriations from555 segregated account, audits, and rules and regulations, as follows:556 "(a) As used in this Code section, the term:557 (1) 'Ambulance service' means an entity licensed by the Depart ment of Public Health558 pursuant to this chapter.559 (2) 'Board' means the Board of Community Health.560 (3) 'Department' means the Department of Community Health.561 (4) 'Provider matching payment' 'provider matching payment' means a payment assessed562 by the board pursuant to this Code section on providers which o perate an ambulance563 service provider.564 (b)(1) The board shall be authorized to establish and assess, by board rule, one or more565 provider matching payments on a subclass of ambulance services providers, as defined566 by the board; provided, however, that, if any such provider matching payment is567 established and assessed, the provider matching payment shall c omply with the568 requirements of 42 C.F.R. 433.68. Any provider matching paymen t assessed pursuant569 to this Code section shall not exceed the amount necessary to o btain federal financial570 participation allowable under Title XIX of the federal Social Security Act.571 (2) The board shall be authorized to discontinue any provider matching payment572 assessed pursuant to this Code section. The board shall cease to impose any such573 provider matching payment if:574 H. B. 1446 (SUB) - 23 - 26 LC 60 0331S (A) The provider matching payments are not eligible for federal matching funds under575 Title XIX of the federal Social Security Act; or576 (B) The department, as a direct result of the enactment of this Code section, reduces577 or supplants Medicaid payment rates to ambulance providers as such rates are in effect578 on June 30, 2021, or reduces or supplants the provider matching payment rate579 adjustment factors utilized in developing the state Fiscal Year 2021 capitated rates for580 Medicaid managed care organizations.581 (c)(1) Any provider matching payments assessed pursuant to this Code section shall be582 deposited into a segregated account within the Indigent Care Trust Fund created pursuant583 to Code Section 31-8-152 and used solely for the purpose of obtaining federal financial584 participation for medical assistance payments to providers on b ehalf of Medicaid585 recipients pursuant to Article 7 of Chapter 4 of Title 49. Any funds deposited into such586 segregated account pursuant to this Code section shall be subject to appropriation by the587 General Assembly.588 (2) The department shall be authorized to impose a penalty of up to 6 percent on the589 amount of any owed provider matching payments for any ambulance service provider that590 fails to pay a provider matching payment within the time required by the department for591 each month, or fraction thereof, that such provider matching pa yment is overdue. If a592 required provider matching payment has not been received by the department in593 accordance with department timelines, the department shall withhold an amount equal to594 the provider matching payment and penalty owed from any medical assistance payment595 due such ambulance service provider under the Medicaid program. Any provider596 matching payment assessed pursuant to this Code section shall constitute a debt due the597 state and may be collected by civil action and the filing of ta x liens in addition to such598 methods provided for in this Code section. Any penalty that ac crues pursuant to this599 subsection shall be credited to the applicable segregated account.600 H. B. 1446 (SUB) - 24 - 26 LC 60 0331S (d)(1) Notwithstanding any other provision of Chapter 8 of thi s title, the General601 Assembly is authorized to appropriate as state funds to the dep artment for use in any602 fiscal year all revenues dedicated and deposited into one or mo re segregated accounts. 603 Such appropriations shall be authorized to be made for the sole purpose of obtaining604 federal financial participation for medical assistance payments to providers on behalf of605 Medicaid recipients pursuant to Article 7 of Chapter 4 of Title 49. Any appropriation606 from a segregated account for any purpose other than such medical assistance payments607 shall be void.608 (2) Revenues appropriated to the department pursuant to this Code section shall be used609 to match federal funds that are available for the purpose for which such funds have been610 appropriated.611 (3) Appropriations from a segregated account to the department shall not lapse to the612 general fund at the end of the fiscal year.613 (e) The department shall have the authority to inspect and cop y the records of an614 ambulance service provider for purposes of auditing the calculation of the provider615 matching payment. All information obtained by the department p ursuant to this Code616 section shall be confidential and shall not constitute a public record.617 (f) The board shall be authorized to establish rules and regul ations to assess and collect618 any such provider matching payments, including, but not limited to, payment frequency619 and schedules, required information to be submitted, and record retention."620 SECTION 2-4.621 Said chapter is further amended in said article by revising sub sections (c) and (d) of Code622 Section 31-11-32, relating to duties of license officer, as follows:623 "(c) The license officer shall issue provisional licenses for 3 0 days for the purpose624 specified in paragraph (19) of Code Section 31-11-2 to allow a newly established625 ambulance provider a period of 30 days to demonstrate that its facilities and operations626 H. B. 1446 (SUB) - 25 - 26 LC 60 0331S comply with this chapter and any rules and regulations issued u nder this chapter by a627 predecessor agency prior to January 1, 2028, or by the council on or after such date.628 (d) Before issuing a license to a government or governmental agency for a new ambulance629 service provider, the license officer shall establish that, due to inadequate private service,630 the public's convenience and necessity require the proposed ambulance service provider."631 SECTION 2-5.632 Said chapter is further amended in said article by revising sub section (b) of Code633 Section 31-11-35, relating to renewal of license and change of ownership of ambulance634 service, as follows:635 "(b) Change of ownership of an ambulance service provider shall require a new application636 and a new license issued in conformance with the requirements o f this article as upon637 original licensing."638 SECTION 2-6.639 Said chapter is further amended in said article by revising Code Section 31-11-36, relating640 to suspension or revocation of license and appeal to superior court, as follows:641 "31-11-36.642 (a) Any license issued under this article may be suspended or revoked for a failure of a643 licensee to comply and to maintain compliance with this article or rules and regulations644 issued under this article, but only after an opportunity for a hearing as provided in Article 1645 of Chapter 5 of this title Code Section 31-11-15.646 (b) Any person who has exhausted all administrative remedies a vailable within the647 department and who is substantially aggrieved by a final order or final action of the license648 officer is entitled to judicial review in the manner provided by Article 1 of Chapter 5 of this649 title and, notwithstanding Code Section 31-5-3, shall be entitled to an appeal to superior650 court as provided in subsection (c) of this Code section Code Section 31-11-17.651 H. B. 1446 (SUB) - 26 - 26 LC 60 0331S (c) Appeal to the superior court shall be by petition which shall be filed in the clerk's office652 of such court within 30 days after the final order or action of the department; the petition653 shall set forth the names of the parties taking the appeal, the order, rule, regulation, or654 decision appealed from, and the reason it is claimed to be erroneous. The enforcement of655 the order or action appealed from shall be automatically stayed upon the filing of such656 petition unless the commissioner of public health in his final order certifies that his657 decision if stayed will harm the public health and safety, in which case a reviewing court658 may order a stay only if the court makes a finding that the public health and safety will not659 be harmed by the issuance of the stay. Upon the filing of such petition, the petitioner shall660 serve on the commissioner a copy thereof in the manner prescribed by law for the service661 of process, unless such service of process is waived. The appeal shall be an appeal de novo662 to the superior court and the appealing party shall have a right to a jury trial and all rights663 provided under Chapter 11 of Title 9, the 'Georgia Civil Practice Act.' The superior court664 shall render a decision approving, setting aside, or modifying the order or action appealed665 from."666 PART III667 Personnel668 SECTION 3-1.669 Said chapter is further amended in Article 3, relating to personnel, by revising paragraph (3)670 of Code Section 31-11-49, relating to definitions, as follows:671 "(3) 'Emergency medical services personnel' means all individuals duly licensed by the672 department under this article by a predecessor agency prior to January 1, 2028, or by the673 council on or after such date."674 H. B. 1446 (SUB) - 27 - 26 LC 60 0331S SECTION 3-2.675 Said chapter is further amended in said article by revising Code Section 31-11-50, relating676 to medical adviser, as follows:677 "31-11-50.678 (a) To enhance the provision of emergency medical care, each ambulance service provider679 shall be required to have a medical adviser. The adviser shall be a physician licensed to680 practice medicine in this state and subject to approval by the medical consultant of the681 Emergency Health Section of the Department of Public Health council . Ambulance682 services providers unable to obtain a medical adviser, due to unavailability or r efusal of683 physicians to act as medical advisers, may request the district health director or his or her684 designee to act as assistance from the council in identifying an individual to ac t as a685 medical adviser until the services of a physician are available.686 (b) The duties of the medical adviser shall be to provide medical direction and training for687 the ambulance service provider personnel in conformance with acceptable emergency688 medical practices and procedures.689 (c) This Code section shall not apply to any ambulance service provider which solely690 provides transportation for necessary personnel, organs, tissue , or medical supplies to a691 time-critical organ transplant procedure by emergency organ tra nsport vehicles or any692 county having a population under 12,000 according to the United States decennial census693 of 1970 2020 or any such future census."694 SECTION 3-3.695 Said chapter is further amended in said article by revising Code Section 31-11-51, relating696 to licensing of emergency medical services personnel, rules and regulations, use of697 conviction data in licensing decisions, and retention of fingerprints, as follows:698 H. B. 1446 (SUB) - 28 - 26 LC 60 0331S "31-11-51.699 (a) As used in this Code section, the term 'conviction data' means a record of a finding or700 verdict of guilty or plea of guilty or plea of nolo contendere with regard to any crime,701 regardless of whether an appeal of the conviction has been sought.702 (b) Except as otherwise provided for in this chapter, the boar d council shall, by rule or703 regulation, authorize the department to establish procedures and standards for the licensing704 of emergency medical services personnel. The department council shall succeed to all705 rules and regulations, policies, standards, programs, procedures, and administrative orders706 of the composite board which were in effect on December 31, 2001, and which relate to the707 functions transferred to the department by this chapter. Such rules, regulations, policies,708 procedures, and administrative orders shall remain in effect un til amended, repealed,709 superseded, or nullified by proper authority or as otherwise provided by law a predecessor710 agency, in accordance with Code Section 31-11-4.711 (c) In reviewing applicants for initial licensure of emergency medical services personnel,712 the department council shall be authorized pursuant to this Code section to obtain713 conviction data with respect to such applicants for the purpose s of determining the714 suitability of the applicant for licensure.715 (d) The department council shall, by rule or regulation, consistent with the requirements716 of this subsection, establish a procedure for requesting a fingerprint based criminal history717 records check from the center and the Federal Bureau of Investigation. Fingerprints shall718 be in such form and of such quality as prescribed by the center and under standards adopted719 by the Federal Bureau of Investigation. Fees may be charged as necessary to cover the cost720 of the records search. An applicant may request that a criminal history records check be721 conducted by a state or local law enforcement agency or by a private vendor approved by722 the department council. Fees for criminal history records checks shall be paid by th e723 applicant to the entity processing the request at the time such request is made. The state724 or local law enforcement agency or private vendor shall remit payment to the center in such725 H. B. 1446 (SUB) - 29 - 26 LC 60 0331S amount as required by the center for conducting a criminal hist ory records check. The726 department council shall accept a criminal history records check whether such request is727 made through a state or local law enforcement agency or through a private vendor728 approved by the department council. Upon receipt of an authorized request, the center729 shall promptly cause such criminal records search to be conducted. The center shall notify730 the department council in writing of any finding of disqualifying information, including,731 but not limited to, any conviction data regarding the fingerprint records check, or if there732 is no such finding.733 (e) An applicant with conviction data which indicates a conviction of a felony more than734 five but less than ten years prior to application shall not be disqualified for licensure,735 provided that such applicant has:736 (1) Successfully completed a training program duly approved by a predecessor agency737 prior to January 1, 2028, or by the department council on or after such date and sponsored738 by the Department of Corrections pursuant to Code Section 42-5-57; and739 (2) Met all other requirements as set forth in this chapter.740 (f) Conviction data received by the department council o r a a n y state or local law741 enforcement agency shall be privileged and shall not be a public record or disclosed to any742 person. Conviction data shall be maintained by the department council and the any state743 or local law enforcement agency pursuant to laws regarding such records and the rules and744 regulations of the center and the Federal Bureau of Investigati on. Penalties for the745 unauthorized release or disclosure of conviction data shall be as prescribed by law or rule746 or regulation of the center or Federal Bureau of Investigation.747 (g) The center, the department council, or any law enforcement agency, or the employees748 of any such entities, shall neither be responsible for the accuracy of information provided749 pursuant to this Code section nor be liable for defamation, invasion of privacy, negligence,750 or any other claim relating to or arising from the dissemination of information pursuant to751 this Code section.752 H. B. 1446 (SUB) - 30 - 26 LC 60 0331S (h) If the department council is participating in the program described in753 subparagraph (a)(1)(F) of Code Section 35-3-33, the Georgia Bureau of Investigation and754 the Federal Bureau of Investigation shall be authorized to reta in fingerprints obtained755 pursuant to this Code section for such program, and the department council shall notify the756 individual whose fingerprints were taken of the parameters of such retention."757 SECTION 3-4.758 Said chapter is further amended in said article by revising Code Section 31-11-52, relating759 to certification of paramedics and cardiac technicians and prov isional practice by military760 medical personnel, as follows:761 "31-11-52.762 (a) As used in this Code section, the term 'military medical personnel' means an individual763 who has, within 12 months of seeking certification pursuant to this Code section, served764 as a medic in the United States Army, medical technician in the United States Air Force,765 or corpsman in the United States Navy or Coast Guard and who was discharged or released766 from such service under conditions other than dishonorable.767 (b) The department council shall establish procedures and standards for certifying and768 recertifying first responders, emergency medical technicians, paramedics, and cardiac769 technicians. An applicant for initial certification as a param edic or a cardiac technician770 shall:771 (1) Submit a completed application on a form to be prescribed by the department council,772 which shall include evidence that the applicant is 18 years of age or older and is of good773 moral character;774 (2) Submit from the department council a notarized statement that the applicant has775 completed a training course approved by the department council;776 ( 3 ) S u b m i t t o t h e d e p a r t m e n t council a f e e a s s e t f o r t h i n t h e r e g u l a t i o n s o f t h e777 department council; and778 H. B. 1446 (SUB) - 31 - 26 LC 60 0331S (4) Meet such other requirements as are set forth in the rules and regulations of the779 department council.780 (b)(c) The department council shall also adopt procedures and standards for its approval781 of paramedic training courses and cardiac technician training courses for first responders,782 emergency medical technicians, paramedics, and cardiac technici ans. The department783 council shall adopt such regulations after consultation with appropriate public and private784 agencies and organizations concerned with medical education and the practice of medicine. 785 Procedures and standards adopted by the department council shall be consistent with the786 purposes and provisions of this chapter.787 (c)(d) An applicant convicted of a felony more than five but less th an ten years prior to788 application shall not be disqualified for certification, provided that such applicant has:789 (1) Successfully completed a training program approved by the department council and790 sponsored by the Department of Corrections pursuant to Code Section 42-5-57; and791 (2) Met all other requirements as set forth in this chapter.792 (d)(e) The department council, in collaboration with the Department of Veterans Service,793 shall establish a program through which military medical person nel may provisionally794 operate within their scope of practice and training for a perio d of 12 months without795 meeting the requirements provided for in paragraphs (2) and (4) of subsection (a) (b) of this796 Code section. The program established pursuant to this subsection shall not conflict with797 or supplant Code Section 38-3-71 or Georgia's status as a member of the EMS Interstate798 Compact.799 (e) As used in this Code section, the term 'military medical personnel' means an individual800 who has, within 12 months of seeking certification pursuant to this Code section, served801 as a medic in the United States Army, medical technician in the United States Air Force,802 or corpsman in the United States Navy or Coast Guard and who was discharged or released803 from such service under conditions other than dishonorable.804 H. B. 1446 (SUB) - 32 - 26 LC 60 0331S (f) Any rules, regulations, policies, standards, programs, pro cedures, or administrative805 orders issued by the council under this Code section shall succeed to the rules, regulations,806 policies, standards, programs, procedures, or administrative orders of a predecessor agency,807 in accordance with Code Section 31-11-4."808 SECTION 3-5.809 Said chapter is further amended in said article by revising Code Section 31-11-53, relating810 to services which may be rendered by certified emergency medical technicians and trainees811 and provisional practice by military medical personnel, as follows:812 "31-11-53.813 (a) As used in this Code section, the term 'military medical personnel' means an individual814 who has, within 12 months of seeking certification pursuant to this Code section, served815 as a medic in the United States Army, medical technician in the United States Air Force,816 or corpsman in the United States Navy or Coast Guard and who was discharged or released817 from such service under conditions other than dishonorable.818 (b) Emergency Upon certification by the department, emergency medical technicians may819 do any of the following:820 (1) Render first-aid and resuscitation services as taught in the United States Department821 of Transportation basic training courses for emergency medical technicians or an822 equivalent course approved by the department council;823 (2) Upon the order of a duly licensed physician, administer ap proved intravenous824 solutions and opioid antagonists; and825 (3) Upon the order of a duly licensed physician during a publi c health emergency, as826 defined in Code Section 31-12-1.1, administer vaccines.827 H. B. 1446 (SUB) - 33 - 26 LC 60 0331S (b)(c) While in training preparatory to becoming certified, emergency medical technician828 trainees may perform any of the functions specified in this Code section under the direct829 supervision of a duly licensed physician or a registered nurse.830 (c)(d) The department council, in collaboration with the Department of Veterans Service,831 shall establish a program through which military medical person nel may provisionally832 operate within their scope of practice and training without additional training, experience,833 or examination for a period of up to 12 months. During such 12 month period, such834 individual may apply for certification at the appropriate level . The program established835 pursuant to this subsection shall not conflict with or supplant Code Section 38-3-71 or836 Georgia's status as a member of the EMS Interstate Compact.837 (d) As used in this Code section, the term 'military medical personnel' means an individual838 who has, within 12 months of seeking certification pursuant to this Code section, served839 as a medic in the United States Army, medical technician in the United States Air Force,840 or corpsman in the United States Navy or Coast Guard and who was discharged or released841 from such service under conditions other than dishonorable.842 (e) Any rules, regulations, policies, standards, programs, pro cedures, or administrative843 orders issued by the council under this Code section shall succeed to the rules, regulations,844 policies, standards, programs, procedures, or administrative orders of a predecessor agency,845 in accordance with Code Section 31-11-4."846 SECTION 3-6.847 Said chapter is further amended in said article by revising Code Section 31-11-53.1, relating848 to automated external defibrillator program, establishment, reg ulations, and liability, as849 follows:850 "31-11-53.1.851 (a) As used in this Code section, the term:852 H. B. 1446 (SUB) - 34 - 26 LC 60 0331S (1) 'Agencies' means every state department, agency, division, board, bureau,853 commission, or entity, including without limitation the Board o f Regents of the854 University System of Georgia.855 (1)(2) 'Automated external defibrillator' means a defibrillator which:856 (A) Is capable of cardiac rhythm analysis;857 (B) Will charge and be capable of being activated to deliver a countershock after858 electrically detecting the presence of certain cardiac dysrhythmias; and859 (C) Is capable of continuous recording of the cardiac dysrhythmia at the scene with a860 mechanism for transfer and storage or for printing for review subsequent to use.861 (2)(3) 'Defibrillation' means to terminate ventricular fibrillation.862 (3) 'First responder' means any person or agency who provides on-site care until the863 arrival of a duly licensed ambulance service. This shall inclu de, but not be limited to,864 persons who routinely respond to calls for assistance through a n affiliation with law865 enforcement agencies, fire suppression agencies, rescue agencies, and others.866 (4) 'Person' means any firm, partnership, association, corporation, or other private entity,867 including without limitation any private postsecondary school, college, or university in868 this state.869 (5) 'Public safety answering point' shall have the same meanin g as set forth in Code870 Section 46-5-122.871 (b) It is the intent of the General Assembly that an automated external defibrillator may872 be used by any person for the purpose of saving the life of another person an individual in873 cardiac arrest. In order to ensure public health and safety:874 (1) It is recommended that all persons who have access to or use an automated external875 defibrillator obtain appropriate training as set forth in the r ules and regulations of the876 Department of Public Health from the American Red Cross, the American Heart877 Association, or another nationally recognized training. It is further recommended that878 such training include at a minimum the successful completion of:879 H. B. 1446 (SUB) - 35 - 26 LC 60 0331S (A) A nationally recognized health care provider/professional healthcare provider or880 professional rescuer level cardiopulmonary resuscitation course; and881 (B) A department established or approved nationally recognized course which includes882 demonstrated proficiency in the use of an automated external defibrillator;883 (2) All persons and agencies possessing and maintaining an aut omated external884 defibrillator shall notify the appropriate emergency medical services system public safety885 answering point of the existence and location of the automated external defibrillator prior886 to said defibrillator being placed in use;. The council is authorized to promulgate rules887 and regulations to implement this provision; and888 (3) All persons who use an automated external defibrillator shall activate the emergency889 medical services system as soon as reasonably possible by calli ng 9-1-1 or the890 appropriate emergency telephone number upon use of the automate d external891 defibrillator; and892 (4) Within a reasonable period of time, all persons who use an automated external893 defibrillator shall make available a printed or electronically stored report to the licensed894 emergency medical services provider which transports the patient.895 (c) With the exception of communications officers under Code Section 35-8-23, who shall896 complete training as set forth in such Code section, all All persons who provide instruction897 to others in the use of the automated external defibrillator sh all have completed an a898 nationally recognized instructor course established or approved by the department.899 (d) The department shall establish an automated external defibrillator program for use by900 emergency medical technicians. Such program shall be subject to the direct supervision901 of a medical adviser approved under Code Section 31-11-50. No emergency medical902 technician shall be authorized to use an automated external def ibrillator to defibrillate a903 person unless that defibrillator is a properly maintained automated external defibrillator and904 that emergency medical technician:905 H. B. 1446 (SUB) - 36 - 26 LC 60 0331S (1) Submits to and has approved by the department an application for such use, and in906 considering that application the department may obtain and use the recommendation of907 the local coordinating entity for the health district in which the applicant will use such908 defibrillator;909 (2) Successfully completes an automated external defibrillator training program910 established or approved by the department;911 (3) Is subject to protocols requiring that both the emergency physician who receives a912 patient defibrillated by that emergency medical technician and the medical adviser for the913 defibrillator program review the department required prehospita l care report and any914 other documentation of the defibrillation of any person by that emergency medical915 technician and send a written report of such review to the district EMS medical director916 of the health district in which the defibrillation occurred; and917 (4) Obtains a passing score on an annual automated external de fibrillator proficiency918 exam given in connection with that program.919 (e) It shall not be necessary for a licensed emergency medical service, licensed neonatal920 transport service, or other services licensed by the department which provide care921 administered by cardiac technicians or paramedics to obtain department approval for the922 use of an automated external defibrillator on licensed vehicles.923 (f) Any emergency medical technician who violates the provisio ns of this Code section924 shall be subject to having revoked by the department that perso n's authority to use an925 automated external defibrillator. Such a violation shall also be grounds for any entity926 which issues a license or certificate authorizing such emergenc y medical technician to927 perform emergency medical services to take disciplinary action against such person,928 including but not limited to suspension or revocation of that license or certificate. Such a929 violation shall also be grounds for the employer of such emergency medical technician to930 impose any sanction available thereto, including but not limited to dismissal.931 H. B. 1446 (SUB) - 37 - 26 LC 60 0331S (g)(d) Any first responder who gratuitously and in good faith renders emergency care or932 treatment by the use of or provision of an automated external d efibrillator, without933 objection of the injured victim or victims thereof, shall not b e held liable for any civil934 damages as a result of such care or treatment or as a result of any act or failure to act in935 providing or arranging further medical treatment where the pers on first responder acts936 without gross negligence or intent to harm or as an ordinary re asonably prudent person937 would have acted under the same or similar circumstances, even if such individual does so938 without benefit of the appropriate training. This provision in cludes paid persons939 individuals who extend care or treatment without expectation of remunerati on from the940 patient or victim for receiving the defibrillation care or treatment.941 (e) Any rules, regulations, policies, standards, programs, pro cedures, or administrative942 orders issued by the council under this Code section shall succeed to the rules, regulations,943 policies, standards, programs, procedures, or administrative orders of a predecessor agency,944 in accordance with Code Section 31-11-4."945 SECTION 3-7.946 Said chapter is further amended in said article by revising sub section (a) of Code Section947 31-11-54, relating to services which may be rendered by paramedics and paramedic trainees,948 as follows:949 "(a) Paramedics Upon certification by the department, paramedics may perform any950 service that a cardiac technician is permitted to perform. In addition, upon the order of a951 duly licensed physician and subject to the conditions set forth in paragraph (2) of952 subsection (a) of Code Section 31-11-55, paramedics may perform any other procedures953 which they have been both trained and certified to perform, including, but not limited to:954 (1) Administration of parenteral injections of diuretics, anti convulsants, hypertonic955 glucose, antihistamines, bronchodilators, emetics, narcotic antagonists, and others, and956 administration of opioid antagonists;957 H. B. 1446 (SUB) - 38 - 26 LC 60 0331S (2) Cardioversion; and958 (3) Endotracheal suction."959 SECTION 3-8.960 Said chapter is further amended in said article by revising sub section (a) of Code961 Section 31-11-55, relating to services which may be rendered by certified cardiac technicians962 and trainees, as follows:963 "(a) Cardiac Upon certification by the department, cardiac technicians may do any of the964 following:965 (1) Render first-aid and resuscitation services;966 (2) Upon the order of a duly licensed physician and as recomme nded by the Georgia967 Emergency Medical Services Advisory Council and duly approved by the department a968 predecessor agency prior to January 1, 2028, or by the council on or after such date:969 (A) Perform cardiopulmonary resuscitation and defibrillation in a hemodynamically970 unstable patient;971 (B) Administer approved intravenous solutions;972 (C) Administer parenteral injections of antiarrhythmic agents, vagolytic agents,973 chronotropic agents, alkalizing agents, analgesic agents, and v asopressor agents or974 administer opioid antagonists;975 (D) Perform pulmonary ventilation by esophageal airway and endotracheal intubation;976 and977 (E) Upon the order of a duly licensed physician during a public health emergency, as978 defined in Code Section 31-12-1.1, administer vaccines."979 H. B. 1446 (SUB) - 39 - 26 LC 60 0331S SECTION 3-9.980 Said chapter is further amended in said article by revising sub sections (a) and (b) of Code981 Section 31-11-55.1, relating to administration of opioid antagonists by first responders and982 issuance by pharmacies, as follows:983 "(a) As used in this Code section, the term:984 (1) 'First responder' means any person or agency who provides on-site care until the985 arrival of a duly licensed ambulance service. This shall inclu de, but not be limited to,986 persons who routinely respond to calls for assistance through a n affiliation with law987 enforcement agencies, fire departments, and rescue agencies.988 (2)(1) 'Opioid antagonist' means any drug that binds to opioid recep tors and blocks or989 inhibits the effects of opioids acting on those receptors and that is approved by the federal990 Food and Drug Administration for the treatment of an opioid related overdose.991 (3)(2) 'Opioid related overdose' means an acute condition, including, but not limited to,992 extreme physical illness, decreased level of consciousness, respiratory depression, coma,993 mania, or death, resulting from the consumption or use of an opioid or another substance994 with which an opioid was combined or that a layperson would reasonably believe to be995 resulting from the consumption or use of an opioid or another substance with which an996 opioid was combined.997 (b) An opioid antagonist may be administered or provided by any first responder for the998 purpose of saving the life of a person an individual experiencing an opioid related999 overdose. In order to ensure public health and safety:1000 (1) All first responders who have access to or maintain an opioid antagonist shall obtain1001 appropriate training as set forth in the any rules and regulations of the Department of1002 Public Health duly established under this chapter;1003 (2) All law enforcement agencies, fire departments, rescue agencies, and other similar1004 entities shall notify the appropriate emergency medical services system of the possession1005 and maintenance of opioid antagonists by its personnel; and1006 H. B. 1446 (SUB) - 40 - 26 LC 60 0331S (3) Within a reasonable period of time, all first responders who administer or provide an1007 opioid antagonist shall make available a printed or electronica lly stored report to the1008 licensed ambulance service ambulance provider which transports the patient."1009 SECTION 3-10.1010 Said chapter is further amended in said article by revising sub sections (c) and (d) of Code1011 Section 31-11-55.2, rela ting to administration of hydrocortison e sodium succinate and1012 training, and adding a new subsection to read as follows:1013 "(c) In order to ensure public health and safety:1014 (1) All emergency medical services personnel shall obtain appr opriate training on1015 congenital adrenal hyperplasia, and all paramedics shall obtain appropriate training1016 regarding administration of hydrocortisone sodium succinate as set forth in the rules and1017 regulations of the Department of Public Health council; and1018 (2) Within a reasonable period of time, all paramedics who adm inister hydrocortisone1019 sodium succinate shall make available a printed or electronical ly stored report to the1020 licensed ambulance service ambulance provider which transports the patient.1021 (d) The immunity provided in Code Section 31-11-8 31-11-13 shall apply to any1022 paramedic who in good faith renders emergency care pursuant to this Code section.1023 (e) Any rules, regulations, policies, standards, programs, pro cedures, or administrative1024 orders issued by the council under this Code section shall succeed to the rules, regulations,1025 policies, standards, programs, procedures, or administrative orders of a predecessor agency,1026 in accordance with Code Section 31-11-4."1027 SECTION 3-11.1028 Said chapter is further amended in said article by revising Code Section 31-11-56, relating1029 to revocation of certificates issued to emergency medical technicians, as follows:1030 H. B. 1446 (SUB) - 41 - 26 LC 60 0331S "31-11-56.1031 Certificates issued to emergency medical technicians pursuant t o this chapter may be1032 revoked by the council for good cause, as set forth in the in accordance with any rules and1033 regulations, by the department duly established under this chapter, after notice to the1034 certificate holder of the charges and an opportunity for hearing. Such proceedings shall be1035 conducted in accordance with Chapter 13 of Title 50, the 'Georg ia Administrative1036 Procedure Act.', in accordance with the procedures set forth in Code Section 31-11-15."1037 SECTION 3-12.1038 Said chapter is further amended in said article by revising Code Section 31-11-57, relating1039 to revocation of certificates issued to paramedics and cardiac technicians, as follows:1040 "31-11-57.1041 Certificates issued to paramedics and cardiac technicians pursuant to this chapter may be1042 revoked for good cause by the department council in accordance with established any rules1043 and regulations duly established under this chapter, after notice to the certificate holder of1044 the charges and an opportunity for hearing. Such proceedings s hall be conducted in1045 accordance with Chapter 13 of Title 50, the 'Georgia Administra tive Procedure Act.', in1046 accordance with the procedures set forth in Code Section 31-11- 15. The department1047 council shall have the authority to conduct investigations and subpoen a any documents1048 relating to the fitness of paramedics and cardiac technicians. Such documents may be used1049 in any hearing conducted by the department council."1050 SECTION 3-13.1051 Said chapter is further amended in said article by revising Code Section 31-11-58, relating1052 to recertification of emergency medical technicians and continuing education requirements,1053 as follows:1054 H. B. 1446 (SUB) - 42 - 26 LC 60 0331S "31-11-58.1055 (a) The department council shall be authorized to require emergency medical technicians1056 seeking recertification under this chapter to complete departme nt council approved1057 continuing education. The department council shall be authorized to approve courses,1058 including, but not limited to, courses offered by the department council, the number of1059 hours required, and the category in which these hours should be earned.1060 (b) The department council shall be authorized to waive the continuing education1061 requirement in cases of hardship, disability, illness, or under such other circumstances as1062 the department council deems appropriate.1063 (c) The department council shall be authorized to promulgate rules and regulations to1064 implement and ensure compliance with the requirements of this Code section.1065 (d) This Code section shall apply to each certification and re certification cycle which1066 begins after the 1992-1993 renewal January 1, 2028."1067 SECTION 3-14.1068 Said chapter is further amended in said article by revising Code Section 31-11-58.1, relating1069 to recertification of paramedics and cardiac technicians and co ntinuing education1070 requirements, as follows:1071 "31-11-58.1.1072 (a) The department council shall be authorized to require paramedics and cardiac1073 technicians seeking recertification under this chapter to compl ete department council1074 approved continuing education of not less than 40 hours biennia lly. The department1075 council shall be authorized to approve courses, including but not limited to courses offered1076 by the department council, the number of hours required, and the category in which these1077 hours should be earned.1078 H. B. 1446 (SUB) - 43 - 26 LC 60 0331S (b) The department council shall be authorized to waive the continuing education1079 requirement in cases of hardship, disability, illness, or under such other circumstances as1080 the department council deems appropriate.1081 (c) The department council shall be authorized to promulgate rules and regulations to1082 implement and ensure compliance with the requirements of this Code section.1083 (d) This Code section shall apply to each certification and recertification cycle which1084 begins after the renewal deadline in 2000 January 1, 2028."1085 SECTION 3-15.1086 Said chapter is further amended in said article by revising Code Section 31-11-60, relating1087 to obtaining and administering drugs by certified employees of counties or municipalities,1088 as follows:1089 "31-11-60.1090 (a) Any emergency medical technician, paramedic, or cardiac technician who is certified1091 under this article and who work s for a county or municipal poli ce department, fire1092 department, or rescue unit is authorized to obtain any substanc e which such person1093 technician or paramedic is authorized to administer by virtue of his such certification. Any1094 such unit to which the emergency medical technician, paramedic, or cardiac technician is1095 attached must be duly licensed by the department as a medical first responder unit by a1096 predecessor agency prior to January 1, 2028, or by the council on or after such date. Such1097 unit may then obtain from a hospital pharmacy those legend drug s listed and legally1098 permitted to be used by paramedics, emergency medical technicians, paramedics, o r1099 cardiac technicians. The first responder unit shall have a sig ned agreement with the1100 hospital in order for the hospital to furnish such drugs, and a copy of this agreement must1101 be filed with the Georgia Drugs and Narcotics Agency. The requ irements for1102 administering, controlling, and storing these drugs shall be the same as the requirements1103 for a standard ward inventory in a hospital.1104 H. B. 1446 (SUB) - 44 - 26 LC 60 0331S (b) Any substance obtained under subsection (a) of this Code section shall be used only1105 in connection with the emergency medical technician's, paramedic's, or cardiac technician's1106 employment with the county or municipality, as such, and only w hile on duty as an1107 emergency medical technician, paramedic, or cardiac technician.1108 (c) It shall not be necessary for an emergency medical technician, paramedic, or cardiac1109 technician to be assigned to a licensed an ambulance service provider in order to obtain any1110 substance under subsection (a) of this Code section."1111 SECTION 3-16.1112 Said chapter is further amended in said article by revising Code Section 31-11-60.1, relating1113 to program for physician control over emergency medical services to nonhospital patients,1114 as follows:1115 "31-11-60.1.1116 (a) As used in this Code section, the term:1117 (1) 'Ambulance provider medical director' 'Ambulance service medical director' means1118 a physician licensed to practice in this state and subject to t he approval of the local1119 coordinating entity and the department REMSAC and the council who has agreed, in1120 writing, to provide medical direction to a specific ambulance service ambulance provider.1121 (2) 'Base station facility' means any facility responsible for providing direct physician1122 control of emergency medical services.1123 (3) 'District emergency medical services medical director' means a person an individual1124 who is:1125 (A) A physician licensed to practice medicine in this state;1126 (B) Familiar with the design and operation of prehospital emergency services systems;1127 (C) Experienced in the prehospital emergency care of acutely i ll or injured patients;1128 and1129 H. B. 1446 (SUB) - 45 - 26 LC 60 0331S (D) Experienced in the administrative processes affecting regional and state prehospital1130 emergency medical services systems.1131 (4) 'Emergency medical services personnel' means any emergency medical technician,1132 paramedic, cardiac technician, or designated first responder who is certified under this1133 article.1134 (b) The department council and the district emergency medical services medical directors1135 shall develop and implement a program to ensure appropriate phy sician control over the1136 rendering of emergency medical services by emergency medical se rvices personnel to1137 patients who are not in a hospital, which program shall succeed to any program developed1138 and implemented by a predecessor agency and the district emerge ncy medical services1139 medical directors prior to January 1, 2028. Such program shall include but not be limited1140 to the following:1141 (1) Medical protocols regarding permissible and appropriate emergency medical services1142 which may be rendered by emergency medical services personnel t o a patient not in a1143 hospital;1144 (2) Communication protocols regarding which medical situations require direct voice1145 communication between emergency medical services personnel and a physician or a1146 nurse or a paramedic or a physician assistant in direct communication with a physician1147 prior to those emergency medical services personnel's rendering specified emergency1148 medical services to a patient not in a hospital;1149 (3) Record-keeping and accountability requirements for emergen cy medical services1150 personnel and base station facility personnel in order to monit or compliance with this1151 subsection; and1152 (4) Base station facility standards.1153 (c) The ambulance service provider medical director shall serve as the medical authority1154 for the ambulance service provider , performing liaison activities with the medical1155 community, medical facilities, and governmental agencies. The ambulance service1156 H. B. 1446 (SUB) - 46 - 26 LC 60 0331S provider medical director shall be responsible for the provision of med ical direction and1157 training for the emergency medical services personnel providing ambulance service1158 services for the ambulance provider for which he or she is responsible in conformance with1159 acceptable emergency medical practices and procedures. These r esponsibilities shall1160 include the duties set forth in the department's council's rules and regulations for the1161 provision of ambulance services.1162 (d) The district emergency medical services medical director s hall not override those1163 policies or protocols of the ambulance service provider medical director if that ambulance1164 service provider medical director is documenting compliance with the department 's1165 council's rules and regulations for the provision of ambulance services.1166 (e) Every base station facility shall comply with the policies, protocols, requirements, and1167 standards provided for in subsection (b) of this Code section.1168 (f) All emergency medical services personnel shall comply with appropriate policies,1169 protocols, requirements, and standards of the ambulance service provider medical director1170 for that service or the policies, protocols, requirements, and standards provided for in1171 subsection (b) of this Code section.1172 (g) Conduct which would otherwise constitute a violation of subsection (f) of this Code1173 section shall not be such a violation if such conduct was carri ed out by any emergency1174 medical services personnel pursuant to an order from a physician, the ambulance service1175 provider medical director for such person personnel, or the protocol of that ambulance1176 service provider as approved by the ambulance service provider medical director for such1177 person personnel.1178 (h) Violation by any base station facility of subsection (e) o f this Code section may be1179 grounds for the removal of that base station facility's designa tion by the department1180 council.1181 (i) Enforcement of subsections (g) and (h) of this Code sectio n by the council shall1182 commence no earlier than 12 months after July 1, 1989 January 1, 2028."1183 H. B. 1446 (SUB) - 47 - 26 LC 60 0331S SECTION 3-17.1184 Said chapter is further amended in said article by revising sub sections (a) and (b) of Code1185 Section 31-11-60.2, relating to testing for illegal drug usage and requirements, as follows:1186 "(a) All persons licensed or certified based upon successful completion of training set forth1187 in paragraph (1) of subsection (e) of Code Section 31-11-51 or paragraph (1) of1188 subsection (c) (d) of Code Section 31-11-52 shall be subject to random testing for evidence1189 of use of illegal drugs. Such testing shall occur at least biannually for the first two years1190 of licensure or certification. Such testing shall be noninvasi ve and may be conducted at1191 any time during the calendar year, and the cost of all such tes ting shall be borne by the1192 employer. If the drug test shows the presence of drugs in the employee's system, the results1193 of the test will be confirmed with an alternative method by using the same urine sample.1194 (b) The department council shall adopt rules and regulations to establish for purposes of1195 testing and retesting for illegal drugs:1196 (1) Which illegal drugs will be the subject of testing;1197 (2) Methods for ensuring minimal privacy intrusions during col lection of body fluid1198 specimens for such testing;1199 (3) Methods for ensuring proper storage, transportation, and handling of such specimens1200 in order to maintain the integrity of the testing process;1201 (4) Which persons should be entitled to the results of such te sts and which methods1202 should be used for ensuring that only authorized persons are given access to such results;1203 (5) A list of laboratories qualified to conduct established drug tests; and1204 (6) Procedures through which emergency medical services person nel, paramedics, or1205 cardiac technicians, prior to the collection of body fluid specimens for such testing, may1206 provide information to their employers regarding use of any drug pursuant to a medical1207 prescription or, as otherwise authorized by law, any substance which could affect the1208 results of such test."1209 H. B. 1446 (SUB) - 48 - 26 LC 60 0331S PART IV1210 Emergency Services1211 SECTION 4-1.1212 Said chapter is further amended in Article 4, relating to emerg ency services, by revising1213 paragraph (2) of Code Section 31-11-81, relating to definitions, as follows:1214 "(2) 'Emergency medical provider' means any provider of emergen cy medical1215 transportation duly licensed or permitted by the Department of Public Health a1216 predecessor agency prior to January 1, 2028, or by the council on or after such date, any1217 hospital licensed or permitted by the Department of Community Health department, any1218 hospital based service, or any physician licensed by the Georgi a Composite Medical1219 Board composite board who provides emergency services."1220 SECTION 4-2.1221 Said chapter is further amended in said article by revising sub section (b) of Code1222 Section 31-11-82, relating to evaluation of emergency condition required, stabilization of1223 patient, and prospective authorization by insurer, as follows:1224 "(b) If in the opinion of the attending physician or licensed ambulance service ambulance1225 provider personnel acting under the medical direction of an ambulance s ervice provider1226 medical director, as defined in Code Section 31-11-60.1, the evaluation provided under1227 subsection (a) of this Code section warrants, he or she may initiate appropriate intervention1228 to stabilize the condition of the patient without seeking or re ceiving prospective1229 authorization by an insurer, a health maintenance organization, or a private health benefit1230 plan. No insurer, health maintenance organization, or private health benefit plan may1231 subsequently deny payment for an evaluation, diagnostic testing, or treatment provided as1232 part of such intervention for an emergency condition."1233 H. B. 1446 (SUB) - 49 - 26 LC 60 0331S PART V1234 Georgia Trauma Care Network Commission1235 SECTION 5-1.1236 Said chapter is further amended in Article 5, relating to Georg ia Trauma Care Network1237 Commission, by revising paragraphs (1) and (3) of Code Section 31-11-100, relating to1238 definitions, as follows:1239 "(1) 'Burn trauma center' means a facility that has been designated by the Department of1240 Public Health council as a burn center and that admits at least 300 patients annually with1241 the burn specific principal diagnosis codes as published by the International1242 Classification of Diseases."1243 "(3) 'Trauma center' means a facility designated by the Departm ent of Public Health1244 council as a Level I, II, III, or IV or burn trauma center. However, a burn trauma center1245 shall not be considered or treated as a trauma center for purpo ses of certificate of need1246 requirements under state law or regulations, including exceptio ns to need and adverse1247 impact standards allowed by the department council for trauma centers or for purposes1248 of identifying safety net hospitals."1249 SECTION 5-2.1250 Said chapter is further amended in said article by revising par agraphs (6), (7), and (10) of1251 subsection (a) of Code Section 31-11-102, relating to duties and responsibilities, as follows:1252 "(6) To reserve and disburse additional moneys to increase the number of participants in1253 the Georgia trauma system. These funds shall be disbursed thro ugh an application1254 process to cover partial start-up costs for nondesignated acute care facilities to enter the1255 system as Level II, III, or IV trauma centers. The application process developed by the1256 commission for start-up costs shall include, but is not limited to, the following:1257 (A) Criteria assuring that the trauma fund is a payor of last resort;1258 H. B. 1446 (SUB) - 50 - 26 LC 60 0331S (B) Criteria assuring that all other resources for start-up costs must be exhausted before1259 the trauma funds are allocated;1260 (C) Criteria assuring that the distribution of trauma funds will result in the applicant's1261 achieving a trauma designation as defined by the commission wit hin the time frame1262 specified on the application;1263 (D) Criteria assuring and verifying that the Department of Public Health council has1264 determined that there is a need for an additional trauma center with the designation that1265 the applicant is seeking; and1266 (E) Criteria assuring that no more than 15 percent of the total annual distribution from1267 the trauma fund total shall be distributed for new trauma center development;1268 (7)(A) To develop, implement, administer, and maintain a syste m to compensate1269 members of the emergency medical service transportation community for readiness and1270 uncompensated trauma care.1271 (B) The compensation for the cost of readiness shall be through an application process1272 adopted by the commission. The application process developed by the commission for1273 readiness costs shall include, but is not limited to, the following:1274 (i) Criteria assuring that the trauma fund is a payor of last resort;1275 (ii) Criteria assuring that all other resources for readiness costs must be exhausted1276 before the trauma funds are allocated;1277 (iii) Criteria assuring that the distribution of trauma funds will result in the applicant's1278 achieving certification as defined by the commission within the time frame specified1279 on the application; and1280 (iv) Criteria assuring and verifying that the Department of Public Health council has1281 determined that there is a need for additional emergency medica l services with the1282 certification that the applicant is seeking."1283 "(10) To coordinate its activities with the Department of Public Health council;"1284 H. B. 1446 (SUB) - 51 - 26 LC 60 0331S PART VI1285 System of Certified Stroke Centers1286 SECTION 6-1.1287 Said chapter is further amended in Article 6, relating to system of certified stroke centers, by1288 repealing in its entirety Code Section 31-11-111, relating to " department" defined, and1289 designating said Code section as reserved.1290 SECTION 6-2.1291 Said chapter is further amended in said article by revising Code Section 31-11-112, relating1292 to identification of stroke centers, as follows:1293 "31-11-112.1294 (a) The department council shall identify hospitals that meet the criteria set forth in t his1295 article as comprehensive, primary, or remote treatment stroke c enters. In addition, the1296 department council shall be authorized to establish one or more additional levels of stroke1297 centers, in consultation with the Georgia Coverdell Acute Strok e Registry, as necessary1298 based on advancements in medicine and patient care.1299 (b) A hospital shall apply to the department council for such identification and shall1300 demonstrate to the satisfaction of the department council that the hospital meets the1301 applicable criteria set forth in or established in accordance with Code Section 31-11-113.1302 (c) The department council shall identify as many hospitals as stroke centers as apply for1303 the identification, provided that each applicant meets the appl icable criteria set forth in1304 Code Section 31-11-113 or established by the department council.1305 (d) The department council may suspend or revoke a hospital's identification as a stroke1306 center, after notice and hearing, if the department council determines that the hospital is not1307 in compliance with the requirements of this article."1308 H. B. 1446 (SUB) - 52 - 26 LC 60 0331S SECTION 6-3.1309 Said chapter is further amended in said article by revising Code Section 31-11-113, relating1310 to certification, application process, and inspections, as follows:1311 "31-11-113.1312 (a) A hospital identified as a comprehensive or primary stroke center shall be certified as1313 such by a national health care healthcare accreditation body recognized by the department1314 council. Any hospital wishing to receive official identification under this subsection shall1315 submit a written application to the department council, providing adequate documentation1316 of the hospital's valid certification as a comprehensive or primary stroke center by any such1317 national health care healthcare accreditation body.1318 (b) Remote treatment stroke centers shall be certified and ide ntified by the department1319 council either by certification as an acute stroke-ready hospital by a national health care1320 healthcare accreditation body recognized by the department council or through an1321 application process to be determined by the department council. Said application process1322 shall contain, at minimum, the following requirements:1323 (1) Remote treatment stroke center certifications and identifications by the department1324 council are limited to those hospitals that utilize current and accept able telemedicine1325 protocols relative to acute stroke treatment as defined by the department council;1326 (2) Upon receipt of complete and proper application for certif ication as a remote1327 treatment stroke center, the department council shall schedule and conduct an inspection1328 of the applicant's facility no later than 90 days after receipt of application; and1329 (3) Any hospital, upon certification by the department council as a remote treatment1330 stroke center, shall automatically be identified as a remote tr eatment stroke center and1331 shall be added to the list of such hospitals maintained pursuant to subsection (a) of Code1332 Section 31-11-115.1333 (c) Any additional levels of stroke centers established by the department council pursuant1334 to subsection (a) of Code Section 31-11-112 shall be certified by the department council1335 H. B. 1446 (SUB) - 53 - 26 LC 60 0331S in accordance with any criteria and guidelines established by t he department council in1336 rules and regulations.1337 (d) Comprehensive and primary stroke centers are encouraged to coordinate, through1338 agreement, with remote treatment stroke centers throughout the state to provide appropriate1339 access to care for acute stroke patients. The coordinating stroke care agreements shall be1340 in writing and include at minimum:1341 (1) Transfer agreements for the transport and acceptance of al l stroke patients seen by1342 the remote treatment stroke center for stroke treatment therapi es which the remote1343 treatment stroke center is not capable of providing; and1344 (2) Communication criteria and protocols with the remote treatment stroke centers."1345 SECTION 6-4.1346 Said chapter is further amended in said article by revising Code Section 31-11-114, relating1347 to grants and reports, as follows:1348 "31-11-114.1349 (a) In order to encourage and ensure the establishment of stro ke centers throughout the1350 state, the department council shall award grants, subject to appropriations from the General1351 Assembly, to hospitals that seek identification as remote treat ment stroke centers and1352 demonstrate a need for financial assistance to develop the nece ssary infrastructure,1353 including personnel and equipment, in order to satisfy the crit eria for identification as a1354 remote treatment stroke center pursuant to subsection (b) of Code Section 31-11-113.1355 (b) A hospital seeking identification as a remote treatment stroke center pursuant to this1356 article may apply to the department council for a grant, in a manner and on a form required1357 by the department council, and provide such information as the department council deems1358 necessary to determine if the hospital is eligible for the grant.1359 H. B. 1446 (SUB) - 54 - 26 LC 60 0331S (c) The department council may provide grants to as many hospitals as it deems1360 appropriate, subject to appropriations, taking into considerati on adequate geographic1361 diversity with respect to locations.1362 (d) The department council shall annually prepare and submit to the Governor, the1363 President of the Senate, the Speaker of the House of Representatives, and the chairpersons1364 of the House Committee on Health and Human Services and the Senate Health and Human1365 Services Committee for distribution to its committee members a report indicating the total1366 number of hospitals that have applied for grants pursuant to this Code section, the number1367 of applicants that have been determined by the department council to be eligible for such1368 grants, the total number of grants to be awarded, the name and address of each grantee1369 hospital, the amount of the award to each grantee, and the amou nt of each award to be1370 disbursed to the grantee."1371 SECTION 6-5.1372 Said chapter is further amended in said article by revising Code Section 31-11-115, relating1373 to distribution of list of stroke centers, development of asses sment tool, and protocols for1374 emergency medical service providers, as follows:1375 "31-11-115.1376 (a) Beginning June 1, 2009 January 1, 2028 , and each year thereafter, the department1377 council shall send a list of comprehensive, primary, remote treatment, and other level1378 stroke centers identified pursuant to Code Section 31-11-113 to the medical director of1379 each licensed emergency medical services provider in this state, shall maintain a copy of1380 the list in the office designated with the department to oversee emergency medical services,1381 and shall coordinate with the department to post a list of comprehensive, primary, remote1382 treatment, and other level stroke centers on the department's website.1383 (b) The department council shall adopt or develop a sample stroke triage assessment tool. 1384 The department council shall coordinate with the department to post this sample1385 H. B. 1446 (SUB) - 55 - 26 LC 60 0331S assessment tool on its department's website and distribute a copy of the sample assessment1386 tool to each licensed emergency medical services provider no later than December 31, 20081387 as soon as practicable . Each licensed emergency medical services provider shall use a1388 stroke triage assessment tool that is substantially similar to the sample stroke triage1389 assessment tool provided by the department council.1390 (c) The office designated within the department to oversee eme rgency medical services1391 council shall establish protocols related to the assessment, treatment, triage, and transport1392 of stroke patients, including transport to the appropriate level stroke centers, by licensed1393 emergency medical services providers in this state.1394 (d) Any assessment tools or protocols of the council shall succeed to the assessment tools1395 or protocols of a predecessor agency, in accordance with Code Section 31-11-4."1396 SECTION 6-6.1397 Said chapter is further amended in said article by revising Code Section 31-11-116, relating1398 to annual reports, as follows:1399 "31-11-116.1400 (a) In order to assure that the patients are receiving the app ropriate level of care and1401 treatment at each level of stroke center in the state, each hos pital identified as a stroke1402 center shall annually report information, as specified by the department council in its rules1403 and regulations, to the department council.1404 (b) The department council shall collect the information reported pursuant to1405 subsection (a) of this Code section and shall coordinate with the department to post such1406 information in the form of a report card annually on the department's website and present1407 such report to the Office of Health Strategy and Coordination . The results of this report1408 card may be used by the department council to conduct training with the identified facilities1409 regarding best practices in the treatment of stroke.1410 H. B. 1446 (SUB) - 56 - 26 LC 60 0331S (c) In no way shall this article be construed to require discl osure of any confidential1411 information or other data in violation of the federal Health In surance Portability and1412 Accountability Act of 1996, P.L. 104-191."1413 SECTION 6-7.1414 Said chapter is further amended in said article by revising Code Section 31-11-118, relating1415 to advertising, as follows:1416 "31-11-118.1417 A hospital may not advertise to the public, by way of any mediu m whatsoever, that it is1418 identified by the state as a comprehensive, primary, remote treatment, or other level stroke1419 center unless the hospital has been identified as such by the department council pursuant1420 to this article."1421 SECTION 6-8.1422 Said chapter is further amended in said article by revising Code Section 31-11-119, relating1423 to rules and regulations, as follows:1424 "31-11-119.1425 The department council shall be authorized to promulgate rules and regulations to carry out1426 the purposes of this article. Such rules and regulations shall succeed to the rules and1427 regulations of a predecessor agency, in accordance with Code Section 31-11-4."1428 H. B. 1446 (SUB) - 57 - 26 LC 60 0331S PART VII1429 Emergency Cardiac Care Centers1430 SECTION 7-1.1431 Said chapter is further amended in Article 7, relating to emergency cardiac care centers, by1432 revising Code Section 31-11-132, relating to Office of Cardiac Care and level designations1433 and requirements, as follows:1434 "31-11-132.1435 (a) There shall be established the Office of Cardiac Care within the Department of Public1436 Health council. The office shall administer the designation process provided for in this1437 article, including, but not limited to, data collection, analysis and reporting, and site visits.1438 (b) The office shall designate hospitals that meet the criteri a set forth in this article as1439 emergency cardiac care centers. Each emergency cardiac care ce nter shall be further1440 designated as Level I, Level II, or Level III by the office. T he criteria for each level1441 designation shall be established by the office and shall includ e, at a minimum, the1442 following:1443 (1) Level I shall have:1444 (A) Cardiac catheterization and angioplasty facilities available 24 hours, seven days1445 per week, 365 days per year;1446 (B) On-site cardiothoracic surgery capability available 24 hou rs, seven days per1447 week, 365 days per year;1448 (C) Established protocols for therapeutic hypothermia for out-of-hospital cardiac arrest1449 patients;1450 (D) The ability to implant percutaneous left ventricular assis t devices for support of1451 hemodynamically unstable patients experiencing out-of-hospital cardiac arrest or heart1452 attack;1453 (E) Neurologic protocols to measure functional status at hospital discharge; and1454 H. B. 1446 (SUB) - 58 - 26 LC 60 0331S (F) The ability to implant automatic implantable cardioverter defibrillators;1455 (2) Level II shall have:1456 (A) Cardiac catheterization and angioplasty facilities available 24 hours, seven days1457 per week, 365 days per year, but no on-site cardiothoracic surgery capability;1458 (B) Established protocols for therapeutic hypothermia for out-of-hospital cardiac arrest1459 patients;1460 (C) Neurologic protocols to measure functional status at hospital discharge; and1461 (D) A written transfer plan with one or more Level I emergency cardiac care centers1462 for patients who need left ventricular assist devices or cardiothoracic surgery;1463 (3) Level III shall have:1464 (A) Established protocols for therapeutic hypothermia for out-of-hospital cardiac arrest1465 patients; and1466 (B) A written plan for systematic transfer to a Level I or Level II facility; and1467 (4) The department council shall be authorized to establish one or more additional levels1468 of cardiac care centers as necessary based upon advancements in medicine and patient1469 care."1470 PART VIII1471 Conforming Changes1472 SECTION 8-1.1473 Chapter 10 of Title 16 of the Official Code of Georgia Annotated, relating to offenses against1474 public administration, is amending by revising Code Section 16-10-29, relating to request for1475 ambulance service when not reasonably needed, as follows:1476 "16-10-29.1477 (a) It shall be unlawful for any person to transmit in any manner a request for ambulance1478 service services to any person, firm, or corporation furnishing ambulance service services,1479 H. B. 1446 (SUB) - 59 - 26 LC 60 0331S public or private, knowing at the time of making the request for ambulance service services1480 that there exists no reasonable need for such ambulance service services.1481 (b) Any person who violates subsection (a) of this Code sectio n shall be guilty of a1482 misdemeanor."1483 SECTION 8-2.1484 Chapter 11 of Title 16 of the Official Code of Georgia Annotated, relating to offenses against1485 public order and safety, is amending by revising subsection (a) of Code Section 16-11-42,1486 relating to refusal to relinquish telephone party line in case of emergency, false request on1487 party line as to emergency, and warning printed in telephone books, as follows:1488 "(a) A person is guilty of a misdemeanor when he or she fails to relinquish a telephone1489 party line consisting of subscriber line telephone circuit with two or more main telephone1490 stations connected therewith, each having a distinctive ring or telephone number, after he1491 such person has been requested to do so to permit another to place a call in an emergency,1492 in which property or human life is in jeopardy and the prompt s ummoning of aid is1493 essential, to a fire or police department or for medical aid or ambulance service services,1494 if the party line at the time of the request is not being used for any such other emergency1495 call. Any person who shall request the use of the party line by falsely stating that the same1496 is needed for any of such purposes, knowing the statement to be false, is guilty of a1497 misdemeanor."1498 SECTION 8-3.1499 Chapter 8 of Title 40 of the Official Code of Georgia Annotated, relating to equipment and1500 inspection of motor vehicles, is amending by revising subsectio n (a) of Code1501 Section 40-8-92, relating to designation of emergency vehicles, flashing or revolving lights,1502 permits, fee, and use of flashing or revolving green lights on public property, as follows:1503 H. B. 1446 (SUB) - 60 - 26 LC 60 0331S "(a) The commissioner of public safety shall be authorized to d esignate certain motor1504 vehicles as emergency vehicles. The commissioner of public safety shall so designate each1505 vehicle by issuing to such vehicle a permit to operate flashing or revolving emergency1506 lights of the appropriate color. Such permit shall be valid for five years from the date of1507 issuance. Any and all officially marked law enforcement vehicl es as specified in Code1508 Section 40-8-91 shall not be required to have a permit for the use of a blue light. Any and1509 all fire department vehicles which are distinctly marked on each side shall not be required1510 to have a permit for the use of a red light. Any and all motor vehicles which are operated1511 for ambulance services as ambulance providers, as defined in Code Section 31-11-2, under1512 a valid license from the Emergency Health Section of the Depart ment of Public Health1513 shall not be required to have a permit for the use of a red light."1514 SECTION 8-4.1515 The Official Code of Georgia Annotated is amended by replacing "ambulance service" with1516 "ambulance provider", "licensed ambulance services" with "ambulance providers", "a duly1517 licensed ambulance service" with "an ambulance provider", and " a licensed ambulance1518 service" with "an ambulance provider" wherever the terms or phrases occur in:1519 (1) Code Section 24-9-921, relating to identification of medical bills and expert witness1520 unnecessary;1521 (2) Code Section 26-4-5, relating to definitions relative to pharmacists and pharmacies;1522 (3) Code Section 26-4-116.2, relating to licensed health pract itioners authorized to1523 prescribe opioid antagonists, pharmacists authorized to fill pr escriptions, and immunity1524 from liability; 1525 (4) Code Section 33-20A-9, relating to emergency services requirements and restrictive1526 formulary requirements;1527 (5) Code Section 33-30-24, relating to health benefit plans pr oviding incentives to use1528 services of preferred providers and minimum requirements;1529 H. B. 1446 (SUB) - 61 - 26 LC 60 0331S (6) Code Section 37-3-101, relating to transportation of patie nts generally relative to1530 examination and treatment of mental illness; 1531 (7) Code Section 37-7-101, relating to transportation of patie nts generally relative to1532 hospitalization and treatment of alcoholics, drug dependent individuals, and drug abusers;1533 and1534 (8) Code Section 40-2-86.1, relating to license plates promoti ng or supporting certain1535 agencies, funds, or nonprofit corporations or issued to qualified motor vehicles or owners1536 with proceeds deposited in the general fund.1537 SECTION 8-5.1538 The Official Code of Georgia Annotated is amended by replacing "air ambulance service"1539 with "air ambulance services" and "Air ambulance service" with "Air ambulance services"1540 wherever the terms occur in:1541 (1) Code Section 33-1-21, relating to certain subscription agr eements for prepaid air1542 ambulance service not contract of insurance and definitions;1543 (2) Code Section 31-11-33, relating to insurance coverage requirements;1544 (3) Code Section 33-24-47.1, relating to notice prior to cance llation or nonrenewal of1545 individual or group accident and sickness policy;1546 (4) Code Section 33-29-1, relating to "accident and sickness p olicy" defined and1547 applicability of chapter;1548 (5) Code Section 33-29A-31, relating to relating to definition s relative to individual1549 accident and sickness insurance; and1550 (6) Code Section 43-25-8, relating to promulgation of rules and regulations by Safety Fire1551 Commissioner.1552 H. B. 1446 (SUB) - 62 - 26 LC 60 0331S PART IX1553 Effective Date and Repealer1554 SECTION 9-1.1555 (a) This Act shall become effective on January 1, 2028, except as provided otherwise in1556 subsection (b) of this section.1557 (b) Code Section 31-11-5 of this Act shall become effective on July 1, 2027.1558 SECTION 9-2.1559 All laws and parts of laws in conflict with this Act are repealed.1560 H. B. 1446 (SUB) - 63 -