CHAPTER 368d*

EMERGENCY MEDICAL SERVICES

*See Sec. 19a-88b re renewal of certain professional and occupational licenses, certificates, permits or registrations which become void while the holder is on active duty in the armed forces of the United States.

Former Sec. 19-73u et seq. cited. 35 CS 136; 37 CS 124.

Table of Contents


Note: Readers should refer to the 2024 Supplement, revised to January 1, 2024, for updated versions of statutes amended, repealed or added during the 2023 legislative sessions.


Sec. 19a-175. (Formerly Sec. 19-73u). Definitions.

Sec. 19a-176. (Formerly Sec. 19-73v). Department of Public Health to administer emergency medical services program.

Sec. 19a-177. (Formerly Sec. 19-73w). Duties of commissioner.

Sec. 19a-177a. Waiver of regulations.

Sec. 19a-177b. Adjustment of rates for conveyance and treatment of patients by licensed ambulance services and invalid coaches.

Sec. 19a-178. (Formerly Sec. 19-73z). Office of Emergency Medical Services. State-wide coordinated delivery plan. Model local emergency medical services plans and performance agreements.

Sec. 19a-178a. Emergency Medical Services Advisory Board established; appointment; responsibilities.

Sec. 19a-178b. Grants for enhancing emergency medical services and equipment.

Sec. 19a-178c. Plan to mobilize emergency medical services during state of emergency. Rates.

Sec. 19a-179. (Formerly Sec. 19-73aa). Regulations.

Sec. 19a-179a. Scope of practice of emergency medical responder, emergency medical technician, emergency medical services instructor or paramedic.

Sec. 19a-179b. Emergency medical technicians and paramedics engaged in civil preparedness duty or training. Chain of command.

Sec. 19a-179c. Interfacility critical care transport. Emergency interfacility transport.

Sec. 19a-179d. Implementation of policies and procedures re training, recertification and reinstatement of certification or licensure of emergency medical service personnel.

Sec. 19a-179e. Department of Public Health to compile list of training programs. Provision of lists.

Sec. 19a-179f. Transport of patient to an alternate destination.

Sec. 19a-180. (Formerly Sec. 19-73bb). Licensure and certification of ambulance service, paramedic intercept service or rescue service. Exception. Establishment of mobile integrated health care programs. Suspension or revocation of licensure or certification. Penalty. Duties of emergency medical service organization. Additional emergency vehicles. Change of address of principal or branch location or addition of branch location. Authorization as mobile integrated health care program for primary service area.

Sec. 19a-180a. Emergency medical service organization filing of strike contingency plan. Penalty. Regulations.

Sec. 19a-180b. Certificate of authorization for supplemental first responder. Suspension or revocation.

Sec. 19a-180c. Authority of primary service area responder at certain scenes.

Sec. 19a-180d. Responsibility for decision-making on scene of emergency medical call.

Sec. 19a-181. (Formerly Sec. 19-73cc). Inspection and registration of ambulance, invalid coach and authorized emergency medical services vehicle. Suspension or revocation of registration certificate.

Sec. 19a-181a. Indemnification of emergency medical services instructors.

Sec. 19a-181b. Local emergency medical services plan.

Sec. 19a-181c. Removal of responder. Revocation of responder's primary service area assignment.

Sec. 19a-181d. Hearing re performance standards.

Sec. 19a-181e. Pilot program for municipal selection of emergency medical services provider based on issuance of requests for proposals.

Sec. 19a-181f. Change in primary service area responder. Submission of alternative local emergency medical services plan.

Sec. 19a-181g. Primary service area responder sale or transfer of ownership.

Sec. 19a-182. (Formerly Sec. 19-73dd). Emergency medical services councils. Plans for delivery of services.

Sec. 19a-183. (Formerly Sec. 19-73ee). Regional emergency medical services councils.

Sec. 19a-184. (Formerly Sec. 19-73ff). Functions of regional emergency medical services councils.

Sec. 19a-185. (Formerly Sec. 19-73gg). Regional emergency medical services coordinators; appointment.

Sec. 19a-186. (Formerly Sec. 19-73hh). Functions of regional emergency medical services coordinators.

Sec. 19a-186a. Regional emergency medical services coordinators. Employment with Department of Public Health.

Sec. 19a-187. (Formerly Sec. 19-73ii). Cooperation of state agencies. Advice and consultation by The University of Connecticut Health Center.

Sec. 19a-188. (Formerly Sec. 19-73jj). Transfer of staff and funds.

Secs. 19a-189 to 19a-192. (Formerly Secs. 19-73kk to 19-73nn). Definitions. Municipal contracts with volunteer ambulance companies; residence requirements. Volunteer ambulance personnel compensated under chapter 568; hypertension or heart disease presumptions. Benefits for volunteers serving another ambulance company.

Sec. 19a-192a. Transferred

Sec. 19a-193. Transferred

Sec. 19a-193a. Liability for emergency medical treatment services or transportation services provided by an ambulance service or paramedic intercept service. Liability for medical services or transport services under nonemergency conditions from mobile integrated health care program.

Sec. 19a-193b. Collection of payment by an ambulance service.

Sec. 19a-194. (Formerly Sec. 19-73pp). Motorcycle rescue vehicles.

Sec. 19a-195. Regulations re staffing of ambulances.

Secs. 19a-195a and 19a-195b. Regulations re recertification and state-wide standardization of certification. Reinstatement of expired certification; validity of expired certificate.

Sec. 19a-196. Complaints against emergency medical services councils, hearings and appeals.

Sec. 19a-196a. Termination of services to municipalities restricted.

Sec. 19a-196b. Response to calls from other municipalities. Transporting patients to the state's mobile field hospital.

Sec. 19a-197. Automatic external defibrillators. Registry established. Regulations. Simultaneous communication with physician not required.

Sec. 19a-197a. Administration of epinephrine.

Sec. 19a-197b. Training standards for the use of automatic external defibrillators.

Sec. 19a-197c. Automatic external defibrillators required on public golf courses.

Secs. 19a-198 and 19a-199. Reserved


Sec. 19a-175. (Formerly Sec. 19-73u). Definitions. As used in this chapter and section 19a-906, unless the context otherwise requires:

(1) “Emergency medical service system” means a system which provides for (A) the arrangement of personnel, facilities and equipment for the efficient, effective and coordinated delivery of health care services under emergency conditions, and (B) mobile integrated health care;

(2) “Patient” means an injured or ill person or a person with a physical disability requiring assistance and transportation;

(3) “Ambulance” means a motor vehicle specifically designed to carry patients;

(4) “Ambulance service” means an organization which transports patients;

(5) “Emergency medical technician” means a person who is certified pursuant to chapter 384d;

(6) “Emergency medical services instructor” means a person who is certified pursuant to chapter 384d;

(7) “Communications facility” means any facility housing the personnel and equipment for handling the emergency communications needs of a particular geographic area;

(8) “Life saving equipment” means equipment used by emergency medical personnel for the stabilization and treatment of patients;

(9) “Emergency medical service organization” means any corporation or organization whether public, private or voluntary that (A) is licensed or certified by the Department of Public Health's Office of Emergency Medical Services, and (B) offers ambulance transportation or treatment services to patients primarily under emergency conditions or a mobile integrated health care program;

(10) “Invalid coach” means a vehicle used exclusively for the transportation of nonambulatory patients, who are not confined to stretchers, to or from either a medical facility or the patient's home in nonemergency situations or utilized in emergency situations as a backup vehicle when insufficient emergency vehicles exist;

(11) “Rescue service” means any organization, whether for-profit or nonprofit, whose primary purpose is to search for persons who have become lost or to render emergency service to persons who are in dangerous or perilous circumstances;

(12) “Commissioner” means the Commissioner of Public Health;

(13) “Paramedic” means a person licensed pursuant to chapter 384d;

(14) “Commercial ambulance service” means an ambulance service which primarily operates for profit;

(15) “Licensed ambulance service” means a commercial ambulance service or a volunteer or municipal ambulance service issued a license by the commissioner;

(16) “Certified ambulance service” means a municipal, volunteer or nonprofit ambulance service issued a certificate by the commissioner;

(17) “Automatic external defibrillator” means a device that: (A) Is used to administer an electric shock through the chest wall to the heart; (B) contains internal decision-making electronics, microcomputers or special software that allows it to interpret physiologic signals, make medical diagnosis and, if necessary, apply therapy; (C) guides the user through the process of using the device by audible or visual prompts; and (D) does not require the user to employ any discretion or judgment in its use;

(18) “Mutual aid call” means a call for emergency medical services that, pursuant to the terms of a written agreement, is responded to by a secondary or alternate emergency medical service organization if the primary or designated emergency medical service organization is unable to respond because such primary or designated emergency medical service organization is responding to another call for emergency medical services or the ambulance or nontransport emergency vehicle operated by such primary or designated emergency medical service organization is out of service. For purposes of this subdivision, “nontransport emergency vehicle” means a vehicle used by emergency medical technicians or paramedics in responding to emergency calls that is not used to carry patients;

(19) “Municipality” means the legislative body of a municipality or the board of selectmen in the case of a municipality in which the legislative body is a town meeting;

(20) “Primary service area” means a specific geographic area to which one designated emergency medical service organization is assigned for each category of emergency medical response services;

(21) “Primary service area responder” means an emergency medical service organization who is designated to respond to a victim of sudden illness or injury in a primary service area;

(22) “Interfacility critical care transport” means the interfacility transport of a patient between licensed health care institutions;

(23) “Advanced emergency medical technician” means an individual who is certified as an advanced emergency medical technician pursuant to chapter 384d;

(24) “Emergency medical responder” means an individual who is certified pursuant to chapter 384d;

(25) “Medical oversight” means the active surveillance by physicians of the provision of emergency medical services sufficient for the assessment of overall emergency medical service practice levels, as defined by state-wide protocols;

(26) “Office of Emergency Medical Services” means the office established within the Department of Public Health pursuant to section 19a-178;

(27) “Sponsor hospital” means a hospital that has agreed to maintain staff for the provision of medical oversight, supervision and direction to an emergency medical service organization and its personnel and has been approved for such activity by the Department of Public Health;

(28) “Paramedic intercept service” means paramedic treatment services provided by an entity that does not provide the ground ambulance transport;

(29) “Authorized emergency medical services vehicle” means an ambulance, invalid coach or advanced emergency technician-staffed intercept vehicle or a paramedic-staffed intercept vehicle licensed or certified by the Department of Public Health for purposes of providing emergency medical care to patients;

(30) “Emergency medical services personnel” means an individual certified to practice as an emergency medical responder, emergency medical technician, advanced emergency medical technician, emergency medical services instructor or an individual licensed as a paramedic;

(31) “Mobile integrated health care program” means a program approved by the commissioner in which a licensed or certified ambulance service or paramedic intercept service provides services, including clinically appropriate medical evaluations, treatment, transport or referrals to other health care providers under nonemergency conditions by a paramedic acting within the scope of his or her practice as part of an emergency medical services organization within the emergency medical services system; and

(32) “Alternate destination” means a destination other than an emergency department that is a medically appropriate facility.

(P.A. 74-305, S. 1, 19; P.A. 75-112, S. 1, 18; P.A. 77-268, S. 1; 77-349, S. 1; 77-614, S. 323, 587, 610; P.A. 78-303, S. 85, 136; P.A. 81-259, S. 1, 3; P.A. 87-79; 87-420, S. 2, 14; P.A. 90-172, S. 1; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 96-180, S. 56, 166; P.A. 97-311, S. 15; P.A. 98-62, S. 2; 98-195, S. 3; P.A. 00-151, S. 1, 14; P.A. 06-195, S. 34; P.A. 09-16, S. 2; P.A. 10-18, S. 6; 10-117, S. 24; P.A. 14-231, S. 16; P.A. 15-109, S. 5; 15-223, S. 3; 15-242, S. 11; P.A. 17-202, S. 70; P.A. 19-118, S. 46, 64; P.A. 21-121, S. 90.)

History: P.A. 75-112 deleted Subdiv. (f) defining “commission”, relettering remaining Subsecs. accordingly, added Subdiv. (o) defining “commissioner” and substituted commissioner of health for commission on hospitals and health care where necessary; P.A. 77-268 defined “health systems agency” rather than “comprehensive health planning agency” in Subdiv. (b); P.A. 77-349 added Subdiv. (p) defining “paramedic”; P.A. 77-614 and P.A. 78-303 replaced commissioner and department of health with commissioner and department of health services, effective January 1, 1979; P.A. 81-259 added Subdivs. (q) to (s) defining “commercial ambulance service”, “licensed ambulance service” and “certified ambulance service”; Sec. 19-73u transferred to Sec. 19a-175 in 1983; P.A. 87-79 redefined “invalid coach” to specify applicability re transportation of nonambulatory patients not confined to stretchers; P.A. 87-420 deleted Subdiv. (b) defining “health systems agency”, relettering remaining Subdivs. accordingly; P.A. 90-172 added the definition of “management service”; P.A. 93-381 replaced department and commissioner of health services with department and commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 96-180 replaced alphabetic Subdiv. indicators with numeric indicators, effective June 3, 1996; P.A. 97-311 redefined “paramedic”; P.A. 98-62 added Subdiv. (20) defining “automatic external defibrillator”; P.A. 98-195 amended Subdiv. (14) by deleting “acting through the Office of Emergency Medical Services” and amended Subdivs. (17) and (18), replacing Office of Emergency Medical Services with “commissioner” (Revisor's note: In Subdiv. (7) the phrase “... to teach courses, the completion of which are required ...” was changed editorially by the Revisors to “... to teach courses, the completion of which is required ...”); P.A. 00-151 made technical changes and added new Subdivs. (21) to (24) defining “mutual aid call”, “municipality”, “primary service area” and “primary service area responder”, effective July 1, 2000; P.A. 06-195 redefined “management service” in Subdiv. (19), effective June 7, 2006; P.A. 09-16 added Subdiv. (25) defining “interfacility critical care transport”, effective April 30, 2009; P.A. 10-18 amended Subdiv. (7) by replacing “emergency medical technician instructor” with “emergency medical services instructor”; P.A. 10-117 applied definitions to Sec. 19a-179d, amended Subdiv. (7) by replacing “emergency medical technician instructor” with “emergency medical services instructor” and added Subdivs. (26) to (31) defining “advanced emergency medical technician”, “emergency medical responder”, “medical oversight”, “mobile intensive care”, “Office of Emergency Medical Services” and “sponsor hospital”; P.A. 14-231 amended Subdiv. (5) by redefining “emergency medical technician”, amended Subdiv. (7) by redefining “emergency medical services instructor”, amended Subdiv. (10) by redefining “emergency medical service organization”, amended Subdiv. (12) by replacing “profit” with “for-profit”, amended Subdiv. (18) by adding “or nonprofit”, deleted former Subdiv. (19) re definition of “management service”, redesignated existing Subdivs. (20) to (28) as Subdivs. (19) to (27), amended redesignated Subdiv. (24) by replacing “hospitals” with “health care institutions”, amended redesignated Subdiv. (26) by replacing provision re certification by department with provision re certification pursuant to chapter, amended redesignated Subdiv. (27) by replacing “mobile intensive care” with “the provision of emergency medical services” and adding “emergency medical service”, deleted former Subdiv. (29) re definition of “mobile intensive care”, redesignated existing Subdiv. (30) as Subdiv. (28) and amended same by deleting “Services”, redesignated existing Subdiv. (31) as Subdiv. (29) and amended same by replacing “Office of Emergency Medical Services” with “Department of Public Health”, added new Subdiv. (30) defining “paramedic intercept service” and made technical changes; P.A. 15-109 amended Subdiv. (2) by deleting “crippled”; P.A. 15-223 amended Subdiv. (2) by deleting “crippled”, amended Subdivs. (5), (7) and (26) by replacing “this chapter” with “chapter 384d”, amended Subdiv. (15) by replacing “section 20-206ll” with “chapter 384d”, and amended Subdiv. (25) by replacing “by the Department of Public Health” with “pursuant to chapter 384d”; P.A. 15-242 added Subdiv. (31) defining “authorized emergency medical services vehicle”; P.A. 17-202 amended Subdiv. (2) by replacing “, ill or physically handicapped person” with “or ill person or a person with a physical disability”; P.A. 19-118 added references to Secs. 19a-177, 19a-179f, 19a-180, 19a-193a and 19a-906 in introductory language, redefined “emergency medical service system” in Subdiv. (1), redefined “emergency medical service organization” in Subdiv. (10), redefined “emergency medical service organization” in Subdiv. (10), deleted Subdiv. (13) defining “provider”, redesignated existing Subdivs. (14) to (19) as new Subdivs. (13) to (18), redesignated existing Subdiv. (20) as new Subdiv. (19) and amended same by redefining “mutual aid call”, redesignated existing Subdiv. (21) as new Subdiv. (20), redesignated existing Subdiv. (22) as new Subdiv. (21) and amended same by redefining “primary service area”, redesignated existing Subdiv. (23) as new Subdiv. (22) and amended same by redefining “primary service area responder”, redesignated existing Subdivs. (24) to (31) as new Subdivs. (23) to (30), added new Subdiv. (31) defining “emergency medical services personnel”, added Subdiv. (32) defining “mobile integrated health care program”, added Subdiv. (33) defining “alternate destination”, and made technical changes, effective July 1, 2019 (Revisor's note: References to Secs. 19a-177, 19a-179f, 19a-180 and 19a-193a in the introductory language were deleted for clarity because all sections are included in “this chapter”); P.A. 21-121 deleted Subdiv. (6) re definition of “ambulance driver”, redesignated existing Subdivs. (7) to (33) as Subdivs. (6) to (32) and made technical changes, effective July 6, 2021.

Annotations to former section 19-73u:

Cited. 35 CS 136; 37 CS 124.

Sec. 19a-176. (Formerly Sec. 19-73v). Department of Public Health to administer emergency medical services program. The Department of Public Health shall be the lead agency for the state's emergency medical services program and shall be responsible for the planning, coordination and administration of a state-wide emergency medical care service system. The commissioner shall set policy and establish state-wide priorities for emergency medical services utilizing the services of the Department of Public Health and the emergency medical services councils, as established by section 19a-183.

(P.A. 74-305, S. 2, 19; P.A. 75-112, S. 2, 18; P.A. 77-268, S. 2; 77-614, S. 323, 610; P.A. 78-303, S. 94, 136; P.A. 87-420, S. 3, 14; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 98-195, S. 4; P.A. 01-195, S. 139, 181.)

History: P.A. 75-112 replaced commission on hospitals and health care with commissioner and department of health; P.A. 77-268 replaced “b” agencies with “health systems agencies”; P.A. 77-614 replaced commissioner and department of health with commissioner and department of health services, effective January 1, 1979; P.A. 78-303 removed provision re advice of advisory committee on emergency medical services in establishing policy and priorities; Sec. 19-73v transferred to Sec. 19a-176 in 1983; P.A. 87-420 deleted reference to health systems agencies and their associates and made a technical correction; P.A. 93-381 replaced department and commissioner of health services with department and commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 98-195 added that department shall be the lead agency for the state's emergency medical services program; P.A. 01-195 deleted “state” re the Department of Public Health and substituted “commissioner” for “Commissioner of Public Health”, effective July 11, 2001.

Annotation to former section 19-73v:

Cited. 35 CS 136.

Sec. 19a-177. (Formerly Sec. 19-73w). Duties of commissioner. The commissioner shall:

(1) With the advice of the Office of Emergency Medical Services established pursuant to section 19a-178 and of an advisory committee on emergency medical services and with the benefit of meetings held pursuant to subsection (b) of section 19a-184, adopt every five years a state-wide plan for the coordinated delivery of emergency medical services;

(2) License or certify the following: (A) Ambulance operations, emergency medical services personnel and communications personnel; (B) emergency room facilities and communications facilities; and (C) transportation equipment, including land, sea and air vehicles used for transportation of patients to emergency facilities and periodically inspect life saving equipment, emergency facilities and emergency transportation vehicles to ensure state standards are maintained;

(3) Annually inventory emergency medical services resources within the state, including facilities, equipment, and personnel, for the purposes of determining the need for additional services and the effectiveness of existing services;

(4) Review and evaluate all area-wide plans developed by the emergency medical services councils pursuant to section 19a-182 in order to insure conformity with standards issued by the commissioner;

(5) Not later than thirty days after their receipt, review all grant and contract applications for federal or state funds concerning emergency medical services or related activities for conformity to policy guidelines and forward such application to the appropriate agency, when required;

(6) Establish such minimum standards and adopt such regulations in accordance with the provisions of chapter 54, as may be necessary to develop the following components of an emergency medical service system: (A) Communications, which shall include, but not be limited to, equipment, radio frequencies and operational procedures; (B) transportation services, which shall include, but not be limited to, vehicle type, design, condition and maintenance, and operational procedures; (C) training, which shall include, but not be limited to, emergency medical services personnel, communications personnel, paraprofessionals associated with emergency medical services, firefighters and state and local police; (D) emergency medical service facilities, which shall include, but not be limited to, categorization of emergency departments as to their treatment capabilities and ancillary services; and (E) mobile integrated health care programs, which shall include, but not be limited to, the standards to ensure the health, safety and welfare of the patients being served by such programs and data collection and reporting requirements to ensure and measure quality outcomes of such programs;

(7) Coordinate training of all emergency medical services personnel;

(8) (A) Develop an emergency medical services data collection system. Each emergency medical service organization licensed or certified pursuant to this chapter shall submit data to the commissioner, on a quarterly basis, from each licensed ambulance service, certified ambulance service or paramedic intercept service that provides emergency medical services. Such submitted data shall include, but not be limited to: (i) The total number of calls for emergency medical services received by such licensed ambulance service, certified ambulance service or paramedic intercept service through the 9-1-1 system during the reporting period; (ii) each level of emergency medical services, as defined in regulations adopted pursuant to section 19a-179, required for each such call; (iii) the response time for each licensed ambulance service, certified ambulance service or paramedic intercept service during the reporting period; (iv) the number of passed calls, cancelled calls and mutual aid calls, both made and received, during the reporting period; and (v) for the reporting period, the prehospital data for the nonscheduled transport of patients required by regulations adopted pursuant to subdivision (6) of this section. The data required under this subdivision may be submitted in any electronic form selected by such licensed ambulance service, certified ambulance service or paramedic intercept service and approved by the commissioner, provided the commissioner shall take into consideration the needs of such licensed ambulance service, certified ambulance service or paramedic intercept service in approving such electronic form. The commissioner may conduct an audit of any such licensed ambulance service, certified ambulance service or paramedic intercept service as the commissioner deems necessary in order to verify the accuracy of such reported data.

(B) On or before June 1, 2023, and annually thereafter, the commissioner shall prepare a report to the Emergency Medical Services Advisory Board, established pursuant to section 19a-178a, that shall include, but not be limited to, the following data: (i) The total number of calls for emergency medical services received during the reporting year by each licensed ambulance service, certified ambulance service or paramedic intercept service; (ii) the level of emergency medical services required for each such call; (iii) the name of the emergency medical service organization that provided each such level of emergency medical services furnished during the reporting year; (iv) the response time, by time ranges or fractile response times, for each licensed ambulance service, certified ambulance service or paramedic intercept service, using a common definition of response time, as provided in regulations adopted pursuant to section 19a-179; and (v) the number of passed calls, cancelled calls and mutual aid calls during the reporting year. The commissioner shall prepare such report in a format that categorizes such data for each municipality in which the emergency medical services were provided, with each such municipality grouped according to urban, suburban and rural classifications.

(C) If any licensed ambulance service, certified ambulance service or paramedic intercept service does not submit the data required under subparagraph (A) of this subdivision for a period of six consecutive months, or if the commissioner believes that such licensed ambulance service, certified ambulance service or paramedic intercept service knowingly or intentionally submitted incomplete or false data, the commissioner shall issue a written order directing such licensed ambulance service, certified ambulance service or paramedic intercept service to comply with the provisions of subparagraph (A) of this subdivision and submit all missing data or such corrected data as the commissioner may require. If such licensed ambulance service, certified ambulance service or paramedic intercept service fails to fully comply with such order not later than three months from the date such order is issued, the commissioner (i) shall conduct a hearing, in accordance with chapter 54, at which such licensed ambulance service, certified ambulance service or paramedic intercept service shall be required to show cause why the primary service area assignment of such licensed ambulance service, certified ambulance service or paramedic intercept service should not be revoked, and (ii) may take such disciplinary action under section 19a-17 as the commissioner deems appropriate.

(D) The commissioner shall collect the data required by subparagraph (A) of this subdivision, in the manner provided in said subparagraph, from each emergency medical service organization licensed or certified pursuant to this chapter. Any such emergency medical service organization that fails to comply with the provisions of this section shall be liable for a civil penalty not to exceed one hundred dollars per day for each failure to report the required data regarding emergency medical services provided to a patient, as determined by the commissioner. The civil penalties set forth in this subparagraph shall be assessed only after the department provides a written notice of deficiency and the organization is afforded the opportunity to respond to such notice. An organization shall have not more than fifteen business days after the date of receiving such notice to provide a written response to the department. The commissioner may adopt regulations, in accordance with chapter 54, concerning the development, implementation, monitoring and collection of emergency medical service system data. All state agencies licensed or certified as emergency medical service organizations shall be exempt from the civil penalties set forth in this subparagraph.

(E) The commissioner shall, with the recommendation of the Connecticut Emergency Medical Services Advisory Board established pursuant to section 19a-178a, adopt for use in trauma data collection the most recent version of the National Trauma Data Bank's National Trauma Data Standards and Data Dictionary and nationally recognized guidelines for field triage of injured patients;

(9) (A) Establish rates for the conveyance and treatment of patients by licensed ambulance services and invalid coaches and establish emergency service rates for certified ambulance services and paramedic intercept services, provided (i) the present rates established for such services and vehicles shall remain in effect until such time as the commissioner establishes a new rate schedule as provided in this subdivision, and (ii) any rate increase not in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, filed in accordance with subparagraph (B)(iii) of this subdivision shall be deemed approved by the commissioner. For purposes of this subdivision, licensed ambulance services and paramedic intercept services shall not include emergency air transport services or mobile integrated health care programs.

(B) Adopt regulations, in accordance with the provisions of chapter 54, establishing methods for setting rates and conditions for charging such rates. Such regulations shall include, but not be limited to, provisions requiring that on and after July 1, 2000: (i) Requests for rate increases may be filed no more frequently than once a year, except that, in any case where an agency's schedule of maximum allowable rates falls below that of the Medicare allowable rates for that agency, the commissioner shall immediately amend such schedule so that the rates are at or above the Medicare allowable rates; (ii) only licensed ambulance services, certified ambulance services and paramedic intercept services that apply for a rate increase in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, and do not accept the maximum allowable rates contained in any voluntary state-wide rate schedule established by the commissioner for the rate application year shall be required to file detailed financial information with the commissioner, provided any hearing that the commissioner may hold concerning such application shall be conducted as a contested case in accordance with chapter 54; (iii) licensed ambulance services, certified ambulance services and paramedic intercept services that do not apply for a rate increase in any year in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, or that accept the maximum allowable rates contained in any voluntary state-wide rate schedule established by the commissioner for the rate application year shall, not later than the last business day in August of such year, file with the commissioner a statement of emergency and nonemergency call volume, and, in the case of a licensed ambulance service, certified ambulance service or paramedic intercept service that is not applying for a rate increase, a written declaration by such licensed ambulance service, certified ambulance service or paramedic intercept service that no change in its currently approved maximum allowable rates will occur for the rate application year; and (iv) detailed financial and operational information filed by licensed ambulance services, certified ambulance services and paramedic intercept services to support a request for a rate increase in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, shall cover the time period pertaining to the most recently completed fiscal year and the rate application year of the licensed ambulance service, certified ambulance service or paramedic intercept service.

(C) Establish rates for licensed ambulance services, certified ambulance services or paramedic intercept services for the following services and conditions: (i) “Advanced life support assessment” and “specialty care transports”, which terms have the meanings provided in 42 CFR 414.605; and (ii) mileage, which may include mileage for an ambulance transport when the point of origin and final destination for a transport is within the boundaries of the same municipality. The rates established by the commissioner for each such service or condition shall be equal to (I) the ambulance service's base rate plus its established advanced life support/paramedic surcharge when advanced life support assessment services are performed; (II) two hundred twenty-five per cent of the ambulance service's established base rate for specialty care transports; and (III) “loaded mileage”, as the term is defined in 42 CFR 414.605, multiplied by the ambulance service's established rate for mileage. Such rates shall remain in effect until such time as the commissioner establishes a new rate schedule as provided in this subdivision.

(D) Establish rates for the treatment and release of patients by a licensed or certified emergency medical services organization or a provider who does not transport such patients to an emergency department and who is operating within the scope of such organization's or provider's practice and following protocols approved by the sponsor hospital. The rates established pursuant to this subparagraph shall not apply to the treatment provided to patients through mobile integrated health care programs;

(10) Establish primary service areas and assign in writing a primary service area responder for each primary service area. Each state-owned campus having an acute care hospital on the premises shall be designated as the primary service area responder for that campus;

(11) Revoke primary service area assignments upon determination by the commissioner that it is in the best interests of patient care to do so; and

(12) Annually issue a list of minimum equipment requirements for authorized emergency medical services vehicles based upon current national standards. The commissioner shall distribute such list to all emergency medical service organizations and sponsor hospital medical directors and make such list available to other interested stakeholders. Emergency medical service organizations shall have one year from the date of issuance of such list to comply with the minimum equipment requirements.

(P.A. 74-305, S. 3, 19; P.A. 75-112, S. 3, 18; P.A. 77-268, S. 3; P.A. 78-331, S. 12, 58; P.A. 80-480, S. 1, 3; P.A. 87-420, S. 4, 14; P.A. 98-195, S. 5; P.A. 00-151, S. 2, 14; June Sp. Sess. P.A. 01-4, S. 51, 58; May 9 Sp. Sess. P.A. 02-7, S. 47; P.A. 03-46, S. 1; P.A. 04-221, S. 39; P.A. 05-272, S. 17; P.A. 09-232, S. 26, 27; P.A. 10-18, S. 7; P.A. 11-242, S. 30; P.A. 14-122, S. 118; 14-217, S. 162; 14-231, S. 17; P.A. 15-223, S. 2; 15-242, S. 10, 37; P.A. 16-66, S. 1; P.A. 18-168, S. 17; P.A. 19-56, S. 6; 19-118, S. 19, 47, 65; P.A. 21-121, S. 10; P.A. 22-58, S. 21.)

History: P.A. 75-112 replaced “commission”, i.e. commission on hospitals and health care, with “commissioner”, i.e. commissioner of health; P.A. 77-268 replaced “b” agencies with “health systems” agencies and added reference to “benefit of meetings held pursuant to subsection (b) of section 19-73ee” in development and update of state-wide plan; P.A. 78-331 replaced reference to Sec. 19-73ee with reference to Sec. 19-73ff; P.A. 80-480 amended Subsec. (i) to replace conveyance “in commercial ambulance vehicles” with more specific reference to conveyance “by licensed ambulance services” and added provisions re establishment of emergency service rate for certified ambulance services and re adoption of regulations concerning rates; Sec. 19-73w transferred to Sec. 19a-177 in 1983; P.A. 87-420 substituted “emergency medical services councils” for “health systems agencies” in Subdivs. (a), (c) and (k); P.A. 98-195 changed Subsec. designations to Subdivs., amended Subdiv. (1) by adding advice of the Office of Emergency Medical Services and changing annually updated plan to one adopted every five years, deleted specified contents of the plan, added new Subdiv. (2) re licensure, certification and inspections, deleted former Subsec. (h) re education programs, deleted former Subsec. (j) re annual reports to the General Assembly and Governor and Subsec. (k) re plans for regions without an emergency medical services council and made technical changes; P.A. 00-151 made technical changes, amended Subdiv. (8) by revising and adding provisions re the collection and reporting of information, amended Subdiv. (9) by adding requirements for regulations re rate increases and schedules applicable on and after July 1, 2000, and added new Subdivs. (10) to (12) re outcome measures and the establishment, assignment and revocation of primary service areas, effective July 1, 2000; June Sp. Sess. P.A. 01-4 amended Subdiv. (9) by adding provision re rate increase not in excess of the National Health Care Inflation Rate Index in Subpara. (A) and provisions re rate increase in excess of the National Health Care Inflation Rate Index and re hearing conducted as contested case in Subpara. (B), effective July 1, 2001; May 9 Sp. Sess. P.A. 02-7 amended Subdiv. (9) by replacing references to “National Health Care Inflation Rate Index” with “Medical Care Services Consumer Price Index”, and added new Subpara. (C) re the establishment of rates for licensed ambulance services and certified ambulance services for “advanced life support assessment” and “specialty care transports”, as defined, and intramunicipality mileage, as defined, and set out the factors to be considered by the commissioner in establishing the rates for each such service or condition and specified that the rates shall remain in effect until the commissioner establishes a new rate schedule, effective August 15, 2002; P.A. 03-46 amended Subdiv. (9)(B)(iii) by deleting requirement re submission of audited financial statement or accountant's review report by certain ambulance services; P.A. 04-221 amended Subdiv. (8)(A) by adding authority to expand data collection system to include clinical treatment and patient outcome data; P.A. 05-272 amended Subdiv. (9) by making technical changes and by amending Subpara. (B)(i) to authorize the commissioner to amend an agency's schedule of maximum allowable rates whenever such rates fall below that of the Medicare allowable rates for that agency, effective July 13, 2005; P.A. 09-232 amended Subdiv. (6)(B) by deleting “life saving equipment” and added Subdiv. (13) re commissioner's issuance of annual list of minimum equipment requirements for ambulances and rescue vehicles, effective January 1, 2010; P.A. 10-18 made a technical change in Subdiv. (13); P.A. 11-242 amended Subdiv. (8)(B) by requiring commissioner to provide report to Emergency Medical Services Advisory Board and by eliminating requirements re annual report, amended Subdiv. (8)(D) by eliminating provision re information to be included in annual report and amended Subdiv. (9)(A) by adding provision re licensed ambulance service shall not include emergency air transport services, effective July 13, 2011; P.A. 14-122 made technical changes in Subdiv. (9)(C); P.A. 14-217 made technical changes in Subdivs. (2), (5), (6) and (12) and amended Subdiv. (11) to add provision re each state-owned campus having an acute care hospital on the premises to be designated as primary service area responder for that campus; P.A. 14-231 amended Subdiv. (2) by replacing “emergency medical technicians” with “emergency medical services personnel”, amended Subdiv. (8) by adding “or paramedic intercept service”, amended Subdiv. (9) by adding “and treatment” in Subpara. (A) and by adding references to paramedic intercept services, and made technical changes; P.A. 15-223 amended Subdiv. (8) by replacing provision re development of data collection system with provisions re development of emergency medical services data collection system, submission of data to commissioner by each emergency medical service organization and inclusion of number of calls both made and received in Subpara. (A), adding provisions re civil penalty and exemption and permitting commissioner to adopt regulations and replacing reference to each person or organization licensed or certified under Sec. 19a-180 that provides emergency medical services with reference to each organization licensed or certified pursuant to Ch. 386d in Subpara. (D), and replacing “information” with “data”; P.A. 15-242 amended Subdiv. (9)(B) by replacing “July fifteenth of such year” with “the last business day in August of such year” and amended Subdiv. (9)(C) to delete “intramunicipality” and replace “means” with “may include” re mileage and amended Subdivs. (10) and (13) to replace “services” with “service”; P.A. 16-66 made a technical change in Subdiv. (8)(D), effective May 27, 2016; P.A. 18-168 amended Subdiv. (8) by inserting “On or before December 31, 2018, and annually thereafter,” in Subpara. (B) and adding Subpara. (E) re adopting most recent version of National Trauma Data Bank's National Trauma Data Standards and Data Dictionary and nationally recognized guidelines for field triage; P.A. 19-56 amended Subdiv. (8) by making technical changes in Subparas. (D) and (E), effective June 28, 2019; P.A. 19-118 amended Subdiv. (6) by replacing “emergency medical technicians” with “emergency medical services personnel” in Subpara. (C) and adding Subpara. (E) re mobile integrated health care programs, amended Subdiv. (7) by replacing “personnel related to emergency medical services” with “emergency medical services personnel”, amended Subdiv. (8) by replacing “chapter 386d” with “this chapter”, deleting “written or” in Subpara. (A) and replacing “provider of” with “emergency medical service organization that provided” in Subpara. (B), amended Subdiv. (9) by replacing “licensed ambulance service” with “licensed ambulance services and paramedic intercept services” and adding “or mobile integrated health care programs” in Subpara. (A) and adding Subpara. (D) re establishing rates for treatment and release of patients, deleted Subdiv. (10) re quantifiable outcome measures for state's emergency medical service system, redesignated Subdivs. (11) to (13) as Subdivs. (10) to (12), and made technical changes, effective July 1, 2019; P.A. 21-121 amended Subdiv. (2) by deleting “ambulance drivers,” and amended Subdiv. (12) by replacing “ambulances and rescue vehicles” with “authorized emergency medical services vehicles”; P.A. 22-58 amended Subdiv. (8)(B) by replacing “December 31, 2018” with “June 1, 2023”, effective May 23, 2022.

Annotation to former section 19-73w:

Cited. 35 CS 136.

Sec. 19a-177a. Waiver of regulations. The Commissioner of Public Health may waive any provisions of the regulations applying to an emergency medical service organization or emergency medical services personnel, as such terms are defined in section 19a-175, if the commissioner determines that such waiver (1) would not endanger the health, safety or welfare of any patient or resident, and (2) does not affect the maximum allowable rates for each emergency medical service organization or primary service area assignments. The commissioner may impose conditions, upon granting the waiver, that assure the health, safety or welfare of patients or residents and may terminate the waiver upon a finding that the health, safety or welfare of any patient or resident has been jeopardized. The commissioner may adopt regulations, in accordance with the provisions of chapter 54, establishing procedures for an application for a waiver pursuant to this section.

(P.A. 21-121, S. 11; P.A. 22-92, S. 16.)

History: P.A. 21-121 effective July 1, 2021; P.A. 22-92 made a technical change, effective May 24, 2022.

Sec. 19a-177b. Adjustment of rates for conveyance and treatment of patients by licensed ambulance services and invalid coaches. (a) For the fiscal year ending June 30, 2023, the Commissioner of Public Health shall increase the rates for the conveyance and treatment of patients by licensed ambulance services and invalid coaches and the rates for certified ambulance services and paramedic intercept services established pursuant to subparagraph (A) of subdivision (9) of section 19a-177 in proportion to the appropriations made available to the Department of Public Health for the administration of the provisions of said section.

(b) Not later than January 1, 2023, the commissioner shall report, in accordance with the provisions of section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to public safety and appropriations and the budgets of state agencies regarding the amount of such rates for the preceding ten fiscal years.

(P.A. 22-118, S. 135; 22-146, S. 6.)

History: P.A. 22-118 effective May 7, 2022; P.A. 22-146 replaced existing provisions with Subsec. (a) re commissioner shall increase rates for conveyance and treatment of patients by licensed ambulance services and invalid coaches and rates for certified ambulance services and paramedic intercept services in proportion to the appropriations made available for the administration of the provisions of Sec. 19a-177(9)(A) and added Subsec. (b) re commissioner shall report rate amounts for preceding 10 fiscal years, effective May 7, 2022.

Sec. 19a-178. (Formerly Sec. 19-73z). Office of Emergency Medical Services. State-wide coordinated delivery plan. Model local emergency medical services plans and performance agreements. (a) There shall be established within the Department of Public Health an Office of Emergency Medical Services. The office shall be responsible for program development activities, including, but not limited to: (1) Public education and information programs; (2) administering the emergency medical services equipment and local system development grant program; (3) planning; (4) regional council oversight; (5) training; and (6) providing staff support to the advisory board.

(b) The Office of Emergency Medical Services shall adopt a five-year planning cycle for the state-wide plan for the coordinated delivery of medical emergency services required by subsection (a) of this section. The plan shall contain: (1) Specific goals for the delivery of such emergency medical services; (2) a time frame for achievement of such goals; (3) cost data and alternative funding sources for the development of such goals; and (4) performance standards for the evaluation of such goals.

(c) Not later than July 1, 2001, the Office of Emergency Medical Services shall, with the advice of the Emergency Medical Services Advisory Board established pursuant to section 19a-178a and the regional emergency medical services councils established pursuant to section 19a-183, develop model local emergency medical services plans and performance agreements to guide municipalities in the development of such plans and agreements. In developing the model plans and agreements, the office shall take into account (1) the differences in the delivery of emergency medical services in urban, suburban and rural settings, (2) the state-wide plan for the coordinated delivery of emergency medical services adopted pursuant to subdivision (1) of section 19a-177, and (3) guidelines or standards and contracts or written agreements in use by municipalities of similar population and characteristics.

(P.A. 74-305, S. 6, 19; P.A. 75-112, S. 5, 18; P.A. 77-614, S. 323, 610; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 98-195, S. 6; P.A. 00-151, S. 3, 14.)

History: P.A. 75-112 added Subdiv. (c) re performance of duties assigned by health commissioner and deleted provision requiring office to report findings to commission on hospitals and health care; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73z transferred to Sec. 19a-178 in 1983; P.A. 93-381 replaced department and commissioner of health services with department and commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 98-195 deleted office responsibilities re licensure, certification and inspectors, added Subdivs. (1) to (6) re program development activities and added new Subsec. (b) re five-year plan; P.A. 00-151 added new Subsec. (c) re model local emergency medical services plans and performance agreements, effective July 1, 2000.

Cited. 242 C. 152.

Sec. 19a-178a. Emergency Medical Services Advisory Board established; appointment; responsibilities. (a) There is established within the Department of Public Health an Emergency Medical Services Advisory Board.

(b) The advisory board shall consist of members appointed in accordance with the provisions of this subsection and shall include the Commissioner of Public Health, the department's emergency medical services medical director and the president of each of the regional emergency medical services councils, or their designees. The Governor shall appoint the following members: (1) One person from the Connecticut Association of Directors of Health; (2) three persons from the Connecticut College of Emergency Physicians; (3) one person from the Connecticut Committee on Trauma of the American College of Surgeons; (4) one person from the Connecticut Medical Advisory Committee; (5) one person from the Emergency Nurses Association; (6) one person from the Connecticut Association of Emergency Medical Services Instructors; (7) one person from the Connecticut Hospital Association; (8) two persons representing commercial ambulance services; (9) one person from the Connecticut State Firefighters Association; (10) one person from the Connecticut Fire Chiefs Association; (11) one person from the Connecticut Police Chiefs Association; (12) one person from the Connecticut State Police; and (13) one person from the Connecticut Commission on Fire Prevention and Control. An additional eighteen members shall be appointed as follows: (A) Three by the president pro tempore of the Senate; (B) three by the majority leader of the Senate; (C) four by the minority leader of the Senate; (D) three by the speaker of the House of Representatives; (E) two by the majority leader of the House of Representatives; and (F) three by the minority leader of the House of Representatives. The appointees shall include a person with experience in municipal ambulance services; a person with experience in for-profit ambulance services; three persons with experience in volunteer ambulance services; a paramedic; an emergency medical technician; an advanced emergency medical technician; three consumers and four persons from state-wide organizations with interests in emergency medical services as well as any other areas of expertise that may be deemed necessary for the proper functioning of the advisory board. Any appointment to the advisory board that is vacant for more than one year shall be filled by the Commissioner of Public Health. The commissioner shall notify the appointing authority of the identity of the commissioner's appointment not later than thirty days before making such appointment.

(c) The Commissioner of Public Health shall appoint a chairperson from among the members of the advisory board who shall serve for a term of one year. The advisory board shall elect a vice-chairperson and secretary. The advisory board shall have committees made up of such members as the chairperson shall appoint and such other interested persons as the committee members shall elect to membership. The advisory board may, from time to time, appoint nonmembers to serve on such ad hoc committees as it deems necessary to assist with its functions. The advisory board shall develop bylaws. The advisory board shall establish a Connecticut Emergency Medical Services Medical Advisory Committee as a standing committee. The standing committee shall provide the commissioner, the advisory board and other ad hoc committees with advice and comment regarding the medical aspects of their projects. The standing committee may submit reports directly to the commissioner regarding medically-related concerns that have not, in the standing committee's opinion, been satisfactorily addressed by the advisory board.

(d) The term for each appointed member of the advisory board shall be coterminous with the appointing authority. Appointees shall serve without compensation.

(e) The advisory board, in addition to other power conferred and in addition to functioning in a general advisory capacity, shall assist in coordinating the efforts of all persons and agencies in the state concerned with the emergency medical service system, and shall render advice on the development of the emergency medical service system where needed. The advisory board shall make an annual report to the commissioner.

(f) The advisory board shall be provided a reasonable opportunity to review and make recommendations on all regulations, medical guidelines and policies affecting emergency medical services before the department establishes such regulations, medical guidelines or policies. The advisory board shall make recommendations to the Governor and to the General Assembly concerning legislation which, in the advisory board's judgment, will improve the delivery of emergency medical services.

(P.A. 98-195, S. 1; P.A. 09-232, S. 29; P.A. 10-117, S. 54; P.A. 11-242, S. 34; P.A. 16-185, S. 10; P.A. 19-118, S. 48; P.A. 21-121, S. 60.)

History: P.A. 09-232 amended Subsec. (b) by substituting “department's emergency medical services medical director” for “state medical director”, “paramedic” for “emergency medical technician paramedic” and “advanced emergency medical technician” for “emergency medical technician intermediate”, effective January 1, 2010; P.A. 10-117 amended Subsec. (b) by deleting “forty-one” re number of board members, inserting provision re appointment in accordance with “this subsection” and adding regional medical service coordinators appointed pursuant to Sec. 19a-186a to advisory board, effective July 1, 2010; P.A. 11-242 amended Subsec. (b) by deleting provision re regional medical service coordinators appointed pursuant to Sec. 19a-186a being members of advisory board; P.A. 16-185 amended Subsec. (b) by deleting reference to representative from each regional emergency medical services council appointed by Governor and adding reference to president of each council, by adding Subdiv. designators (1) to (13) and Subpara. designators (A) to (F) and by making technical changes, effective June 7, 2016; P.A. 19-118 amended Subsec. (b)(8) by replacing “commercial ambulance providers” with “commercial ambulance services”, effective July 1, 2019; P.A. 21-121 amended Subsec. (b) by adding provision re Commissioner of Public Health to fill vacancy and notify appointing authority, effective July 6, 2021.

Sec. 19a-178b. Grants for enhancing emergency medical services and equipment. (a) The Commissioner of Public Health shall establish an Emergency Medical Services Equipment and Local System Development grant program. The program shall provide incentive grants for enhancing emergency medical services and equipment. The commissioner shall define the nature, description and systems designed for grant proposals.

(b) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to determine the entities eligible to receive grants under the grant program established pursuant to subsection (a) of this section. In determining eligibility, the commissioner shall consider: (1) The demonstrated need within the community; (2) the degree to which the proposal serves the emergency medical services system plan; and (3) the extent to which there is available adequate trained staff to carry out the proposal.

(c) The commissioner shall maintain a priority list of eligible proposals and shall establish a system setting the priority of grant funding. In establishing such a priority list and ranking system, the commissioner shall consider all relevant factors including, but not limited to: (1) The public health and safety; (2) the population affected; (3) the attainment of state emergency medical services goals and standards; and (4) consistency with the state plan for emergency medical services.

(d) The commissioner shall consult with the appropriate regional council by sending such council a copy of any grant proposal. The regional emergency medical services council shall review and comment upon any proposal. Each council shall indicate how the grant proposal addresses the regional emergency medical services plan established priorities. The commissioner shall consider the recommendation of the regional council when making a final grant determination.

(P.A. 98-195, S. 2.)

Sec. 19a-178c. Plan to mobilize emergency medical services during state of emergency. Rates. (a) The Commissioner of Public Health shall develop and implement a plan in circumstances where the Governor declares a state of emergency to mobilize state emergency medical service assets to aid areas where local emergency medical services and ordinary mutual aid resources are overwhelmed. Such plan shall be known as the Forward Movement of Patients Plan. Such plan shall include, but not be limited to, a procedure for the request of resources, authority for plan activation, the typing of resources, resource command and control and logistical considerations.

(b) Emergency rates established by the commissioner for certified emergency medical service, paramedic intercept service, invalid coach and temporary transportation needs for a specified event or incident shall apply when the emergency medical service organization is authorized by the commissioner to function as part of the Forward Movement of Patients Plan.

(P.A. 14-231, S. 26.)

Sec. 19a-179. (Formerly Sec. 19-73aa). Regulations. (a) The commissioner shall adopt regulations, in accordance with chapter 54, concerning (1) the methods and conditions for licensure and certification of the operations, facilities and equipment enumerated in section 19a-177, (2) complaint procedures for the public and any emergency medical service organization, and (3) exemption of members of the armed forces or the National Guard or veterans with appropriate military training, including, but not limited to, members of the armed forces or the National Guard or veterans with a designation by the National Registry of Emergency Medical Technicians and veterans or members of the United States Navy and Coast Guard, from training and testing requirements for emergency medical technician licensure and certification. Such regulations shall be in conformity with the policies and standards established by the commissioner. Such regulations shall require that, as an express condition of the purchase of any business holding a primary service area, the purchaser shall agree to abide by any performance standards to which the purchased business was obligated pursuant to its agreement with the municipality.

(b) For the purposes of this section, “veteran” and “armed forces” have the same meanings as provided in section 27-103.

(P.A. 74-305, S. 7, 8, 19; P.A. 75-112, S. 6, 18; P.A. 77-614, S. 323, 610; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 98-195, S. 7; P.A. 00-151, S. 4, 14; P.A. 01-1, S. 1, 3; P.A. 04-221, S. 38; P.A. 05-55, S. 1; 05-272, S. 4; P.A. 09-232, S. 30; P.A. 14-131, S. 13; 14-141, S. 3; 14-231, S. 19; P.A. 21-79, S. 27.)

History: P.A. 75-112 replaced commission on hospitals and health care with commissioner of health, qualified new regulations as ones “which repeal, amend or replace specific regulations” and transferred power to adopt regulations from director of office of emergency medical services to commissioner of health; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73aa transferred to Sec. 19a-179 in 1983; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 98-195 amended former Subsec. (a) to eliminate appointment of a director of Office of Emergency Medical Services and obsolete references to Ambulance Commission, deleted former Subsec. (b) re obsolete references to Ambulance Commission and deleted former Subsec. (c) re authority of director eliminated from Subsec. (a); P.A. 00-151 made technical changes and added provisions re condition of purchase of a business holding a primary service area, effective July 1, 2000; P.A. 01-1 added requirement for regulations re methods and conditions for the issuance, renewal and reinstatement of licensure and certification or recertification of emergency medical service personnel and made technical changes, effective February 7, 2001; P.A. 04-221 designated existing provisions as Subsec. (a) and added Subsec. (b) re issuance of certificate to applicants from New England states, New York or New Jersey, effective June 8, 2004; P.A. 05-55 added Subsecs. (c) to (e), inclusive, re temporary emergency medical technician certificate, renewal of lapsed paramedic license, recertification as emergency medical technician and definition of “medical control” and “sponsor hospital”; P.A. 05-272 amended Subsec. (b)(2) by replacing “paramedic curriculum” with “emergency medical technician curriculum”; P.A. 09-232 amended Subsecs. (d)(1) and (e) by substituting “medical oversight” for “medical control”, effective January 1, 2010; P.A. 14-131 amended Subsec. (a) by adding provision re regulations exempting certain members of the armed forces or the National Guard and veterans from emergency medical technician training and testing requirements, added Subsec. (f) re issuance of emergency medical technician certification to certain members of the armed forces or the National Guard and veterans, and added Subsec. (g) defining “veteran” and “armed forces”; P.A. 14-141 deleted former Subsec. (f) re issuance of emergency medical technician certification to certain members of the armed forces or the National Guard and veterans, and redesignated existing Subsec. (g) as Subsec. (f); P.A. 14-231 amended Subsec. (a) by deleting former Subdiv. (1) re methods and conditions for issuance, renewal and reinstatement of licensure and certification or recertification and by making conforming changes, and deleted former Subsecs. (b) to (e); P.A. 21-79 amended Subsec. (b) by redefining “veteran” and making technical changes.

Sec. 19a-179a. Scope of practice of emergency medical responder, emergency medical technician, emergency medical services instructor or paramedic. Notwithstanding any provision of the general statutes or any regulation adopted pursuant to this chapter, the scope of practice of any person certified or licensed as an emergency medical responder, emergency medical technician, advanced emergency medical technician, emergency medical services instructor or a paramedic under regulations adopted pursuant to this section may include treatment modalities not specified in the regulations of Connecticut state agencies, provided such treatment modalities are (1) approved by the Connecticut Emergency Medical Services Medical Advisory Committee established pursuant to section 19a-178a and the Commissioner of Public Health, and (2) administered at the medical oversight and direction of a sponsor hospital.

(P.A. 05-259, S. 5; P.A. 09-232, S. 31; P.A. 14-231, S. 22; P.A. 15-223, S. 11.)

History: P.A. 05-259 effective July 13, 2005; P.A. 09-232 substituted “emergency medical technician” for “emergency medical technician-basic”, “advanced emergency medical technician” for “emergency medical technician-intermediate”, “paramedic” for “emergency medical technician-paramedic” and “medical oversight” for “medical control”, effective January 1, 2010; P.A. 14-231 designated existing provisions as Subsec. (a) and amended same by adding “emergency medical responder” and “emergency medical services instructor”, deleting references to Secs. 19a-179 and 28-8b and making a technical change, and added Subsec. (b) re regulations concerning methods and conditions for issuance, renewal and reinstatement of licensure and certification or recertification; P.A. 15-223 deleted Subsec. (a) designator and deleted former Subsec. (b) re regulations.

Sec. 19a-179b. Emergency medical technicians and paramedics engaged in civil preparedness duty or training. Chain of command. Any emergency medical technician or paramedic who is part of The Connecticut Disaster Medical Assistance Team or the Medical Reserve Corps, under the auspices of the Department of Public Health, or the Connecticut Urban Search and Rescue Team, under the auspices of the Department of Emergency Services and Public Protection, shall be under the active surveillance, medical oversight and direction of the chief medical officer of such team or corps while engaged in officially authorized civil preparedness duty or civil preparedness training conducted by such team or corps.

(P.A. 05-259, S. 1; P.A. 09-232, S. 32; P.A. 11-51, S. 134.)

History: P.A. 05-259 effective July 13, 2005; P.A. 09-232 substituted “medical oversight” for “medical control”, effective January 1, 2010; pursuant to P.A. 11-51, “Department of Public Safety” was changed editorially by the Revisors to “Department of Emergency Services and Public Protection”, effective July 1, 2011.

Sec. 19a-179c. Interfacility critical care transport. Emergency interfacility transport. (a) Any ambulance used for interfacility critical care transport shall meet the requirements for a basic level ambulance, as prescribed in regulations adopted pursuant to section 19a-179, including requirements concerning medically necessary supplies and services, and may be supplemented by a licensed registered nurse, advanced practice registered nurse, physician assistant or respiratory care practitioner, provided such licensed professionals shall have current training and certification in pediatric or adult advanced life support, or from the Neonatal Resuscitation Program of the American Academy of Pediatrics, as appropriate, based on the patient's condition.

(b) A general hospital or children's general hospital licensed in accordance with section 19a-490 may utilize a ground or air ambulance service other than the primary service area responder for emergency interfacility transports of patients when (1) the primary service area responder is not authorized to the level of care required for the patient, (2) the primary service area responder does not have the equipment necessary to transport the patient safely, or (3) the transport takes the primary service area responder out of its service area for more than two hours and there is another ambulance service with the appropriate level of medical authorization and proper equipment available. The patient's attending physician shall determine when it is necessary to utilize the primary service area responder or other ambulance service for an expeditious and medically appropriate transport.

(P.A. 09-16, S. 3; P.A. 14-231, S. 24.)

History: P.A. 09-16 effective April 30, 2009; P.A. 14-231 designated existing provisions as Subsec. (a) and added Subsec. (b) re general hospital or children's general hospital utilizing ground or air ambulance service for emergency interfacility transports.

Sec. 19a-179d. Implementation of policies and procedures re training, recertification and reinstatement of certification or licensure of emergency medical service personnel. Section 19a-179d is repealed, effective October 1, 2014.

(P.A. 10-117, S. 25; P.A. 14-231, S. 72.)

Sec. 19a-179e. Department of Public Health to compile list of training programs. Provision of lists. (a) Not later than June 30, 2020, and annually thereafter, the Department of Public Health shall, within available appropriations, compile a list of training programs that are available to members of commercial ambulance services, commercial rescue services, volunteer and municipal ambulance services, ambulance services and paramedic intercept services operated and maintained by a state agency and emergency medical services personnel, as defined in section 20-206jj. Such training programs shall be approved by the Commissioner of Public Health and include techniques for handling incidents, such as wandering, that involve juveniles and adults with autism spectrum disorder, cognitive impairment and nonverbal learning disorder. Such training programs may be offered by institutions of higher education, health care professionals and advocacy organizations that are concerned with juveniles and adults with autism spectrum disorder, cognitive impairment or nonverbal learning disorder, and collaborations of such institutions, professionals or organizations. The department may accept private donations for the purposes of this section.

(b) Not later than July 1, 2020, and annually thereafter, the Department of Public Health shall make the list compiled pursuant to subsection (a) of this section available to members of commercial ambulance services, commercial rescue services, volunteer and municipal ambulance services, ambulance services and paramedic intercept services operated and maintained by any state agency and emergency medical services personnel, as defined in section 20-206jj.

(P.A. 19-147, S. 3.)

History: P.A. 19-147 effective July 1, 2019.

Sec. 19a-179f. Transport of patient to an alternate destination. (a) A licensed or certified emergency medical services organization or provider may transport a patient by ambulance to an alternate destination, in consultation with the medical director of a sponsor hospital.

(b) On or before January 1, 2024, the Office of Emergency Medical Services shall develop protocols for a licensed or certified emergency medical services organization or provider to transport a pediatric patient with mental or behavioral health needs by ambulance to an urgent crisis center. As used in this subsection, “urgent crisis center” means a center licensed by the Department of Children and Families that is dedicated to treating children's urgent mental or behavioral health needs.

(c) Any ambulance used for transport to an alternate destination under subsection (a) or (b) of this section shall meet the requirements for a basic level ambulance, as prescribed in regulations adopted pursuant to section 19a-179, including requirements concerning medically necessary supplies and services.

(P.A. 19-118, S. 66; P.A. 22-47, S. 46.)

History: P.A. 19-118 effective July 1, 2019; P.A. 22-47 added new Subsec. (b) requiring development of protocols for transport of pediatric patient with mental or behavioral health needs to an urgent crisis center and redesignated existing Subsec. (b) as Subsec. (c).

Sec. 19a-180. (Formerly Sec. 19-73bb). Licensure and certification of ambulance service, paramedic intercept service or rescue service. Exception. Establishment of mobile integrated health care programs. Suspension or revocation of licensure or certification. Penalty. Duties of emergency medical service organization. Additional emergency vehicles. Change of address of principal or branch location or addition of branch location. Authorization as mobile integrated health care program for primary service area. (a) No person shall operate any ambulance service, paramedic intercept service or rescue service without either a license or a certificate issued by the commissioner. No person shall operate a commercial ambulance service or commercial rescue service without a license issued by the commissioner. A certificate shall be issued to any volunteer or municipal ambulance service or any ambulance service or paramedic intercept service that is operated and maintained by a state agency and that shows proof satisfactory to the commissioner that it meets the minimum standards of the commissioner in the areas of training, equipment and personnel. No license or certificate shall be issued to any volunteer, municipal or commercial ambulance service, paramedic intercept service or rescue service or any ambulance service or paramedic intercept service that is operated and maintained by a state agency, unless it meets the requirements of subsection (e) of section 14-100a. Applicants for a license shall use the forms prescribed by the commissioner and shall submit such application to the commissioner accompanied by an annual fee of two hundred dollars. In considering requests for approval of permits for new or expanded emergency medical services or the establishment of mobile integrated health care programs in any region, the commissioner shall consult with the Office of Emergency Medical Services and the emergency medical services council of such region and shall hold a public hearing to determine the necessity for such services. Written notice of such hearing shall be given to current emergency medical service organizations in the geographic region where such new or expanded services or mobile integrated health care programs would be implemented, provided, any volunteer ambulance service which elects not to levy charges for services rendered under this chapter shall be exempt from the provisions concerning requests for approval of permits for new or expanded emergency medical services set forth in this subsection. A primary service area responder that operates in the service area identified in the application shall, upon request, be granted intervenor status with opportunity for cross-examination. Each applicant for licensure shall furnish proof of financial responsibility which the commissioner deems sufficient to satisfy any claim. The commissioner may adopt regulations, in accordance with the provisions of chapter 54, to establish satisfactory kinds of coverage and limits of insurance for each applicant for either licensure or certification. Until such regulations are adopted, the following shall be the required limits for licensure: (1) For damages by reason of personal injury to, or the death of, one person on account of any accident, at least five hundred thousand dollars, and more than one person on account of any accident, at least one million dollars, (2) for damage to property at least fifty thousand dollars, and (3) for malpractice in the care of one passenger at least two hundred fifty thousand dollars, and for more than one passenger at least five hundred thousand dollars. In lieu of the limits set forth in subdivisions (1) to (3), inclusive, of this subsection, a single limit of liability shall be allowed as follows: (A) For damages by reason of personal injury to, or death of, one or more persons and damage to property, at least one million dollars; and (B) for malpractice in the care of one or more passengers, at least five hundred thousand dollars. A certificate of such proof shall be filed with the commissioner. Upon determination by the commissioner that an applicant is financially responsible, properly certified and otherwise qualified to operate a commercial ambulance service, paramedic intercept service, rescue service or mobile integrated health care program, the commissioner shall issue the appropriate license effective for one year to such applicant or authorize the establishment of a mobile integrated health care program. If the commissioner determines that an applicant for either a certificate or license is not so qualified, the commissioner shall notify such applicant of the denial of the application with a statement of the reasons for such denial. Such applicant shall have thirty days to request a hearing on the denial of the application.

(b) On or after January 1, 2020, within available appropriations, the commissioner may authorize an emergency medical services organization that furnishes evidence satisfactory to the commissioner that such organization has met the requirements of this section to establish a mobile integrated health care program under the provisions of such organization's current license or certification. Emergency medical services organizations requesting approval to establish such mobile integrated health care program shall use the forms prescribed by the commissioner and shall submit such application to the commissioner. No emergency medical services organization shall provide a mobile integrated health care program unless authorized by the commissioner to provide such program. The commissioner may implement policies and procedures to administer the mobile integrated health care programs established in accordance with this section. The commissioner shall post such policies and procedures to the department's Internet web site and the eRegulations System not later than twenty days after the date of implementation.

(c) Any person or emergency medical service organization that does not maintain standards or violates regulations adopted under any section of this chapter applicable to such person or organization may have such person's or organization's license or certification suspended or revoked or may be subject to any other disciplinary action specified in section 19a-17 after notice by certified mail to such person or organization of the facts or conduct that warrant the intended action. Such person or emergency medical service organization shall have an opportunity to show compliance with all requirements for the retention of such certificate or license. In the conduct of any investigation by the commissioner of alleged violations of the standards or regulations adopted under the provisions of this chapter, the commissioner may issue subpoenas requiring the attendance of witnesses and the production by any medical service organization or person of reports, records, tapes or other documents that concern the allegations under investigation. All records obtained by the commissioner in connection with any such investigation shall not be subject to the provisions of section 1-210 for a period of six months from the date of the petition or other event initiating such investigation, or until such time as the investigation is terminated pursuant to a withdrawal or other informal disposition or until a hearing is convened pursuant to chapter 54, whichever is earlier. A complaint, as defined in subdivision (6) of section 19a-13, shall be subject to the provisions of section 1-210 from the time that it is served or mailed to the respondent. Records that are otherwise public records shall not be deemed confidential merely because they have been obtained in connection with an investigation under this chapter.

(d) Any person or emergency medical service organization aggrieved by an act or decision of the commissioner regarding certification or licensure may appeal in the manner provided by chapter 54.

(e) Any person who commits any of the following acts shall be guilty of a class C misdemeanor: (1) In any application to the commissioner or in any proceeding before or investigation made by the commissioner, knowingly making any false statement or representation, or, with knowledge of its falsity, filing or causing to be filed any false statement or representation in a required application or statement; (2) issuing, circulating or publishing or causing to be issued, circulated or published any form of advertisement or circular for the purpose of soliciting business which contains any statement that is false or misleading, or otherwise likely to deceive a reader thereof, with knowledge that it contains such false, misleading or deceptive statement; (3) giving or offering to give anything of value to any person for the purpose of promoting or securing ambulance, invalid coach, paramedic intercept vehicle or rescue service business or obtaining favors relating thereto; (4) administering or causing to be administered, while serving in the capacity of an employee of any licensed ambulance or rescue service, any alcoholic liquor to any patient in such employee's care, except under the supervision and direction of a licensed physician; (5) in any respect wilfully violating or failing to comply with any provision of this chapter or wilfully violating, failing, omitting or neglecting to obey or comply with any regulation, order, decision or license, or any part or provisions thereof; or (6) with one or more other persons, conspiring to violate any license or order issued by the commissioner or any provision of this chapter.

(f) No person shall place any advertisement or produce any printed matter that holds that person out to be an ambulance service or a mobile integrated health care program provider unless such person is licensed, certified or authorized pursuant to this section. Any such advertisement or printed matter shall include the license or certificate number issued by the commissioner.

(g) Each licensed or certified emergency medical service organization shall: (1) Ensure that its emergency medical personnel, whether such personnel are employees or contracted through an employment agency or personnel pool, are appropriately licensed or certified by the Department of Public Health to perform their job duties and that such licenses or certifications remain valid; (2) ensure that any employment agency or personnel pool, from which the emergency medical service organization obtains personnel meets the required general liability and professional liability insurance limits described in subsection (a) of this section and that all persons performing work or volunteering for the medical service organization are covered by such insurance; and (3) secure and maintain medical oversight, as defined in section 19a-175, by a sponsor hospital, as defined in section 19a-175.

(h) Each applicant whose request for new or expanded emergency medical services or the establishment of a mobile integrated health care program is approved shall, not later than six months after the date of such approval, acquire the necessary resources, equipment and other material necessary to comply with the terms of the approval and operate in the service area identified in the application. If the applicant fails to do so, the approval for new or expanded medical services or the establishment of a mobile integrated health care program shall be void and the commissioner shall rescind the approval.

(i) Notwithstanding the provisions of subsection (a) of this section, any emergency medical services organization that is licensed or certified and is a primary service area responder may apply to the commissioner to add one emergency vehicle to its existing fleet every three years, on a short form application prescribed by the commissioner. No such emergency medical services organization operated and maintained by a state agency may add more than one emergency vehicle to its existing fleet pursuant to this subsection regardless of the number of municipalities served by such volunteer, hospital-based or municipal ambulance service. Upon making such application, the applicant shall notify in writing all other primary service area responders in any municipality or abutting municipality in which the applicant proposes to add the additional emergency vehicle. Except in the case where a primary service area responder entitled to receive notification of such application objects, in writing, to the commissioner not later than fifteen calendar days after receiving such notice, the application shall be deemed approved thirty calendar days after filing. If any such primary service area responder files an objection with the commissioner within the fifteen-calendar-day time period and requests a hearing, the applicant shall be required to demonstrate need at a public hearing as required under subsection (a) of this section.

(j) The commissioner shall develop a short form application for primary service area responders seeking to add an emergency vehicle to their existing fleets pursuant to subsection (i) of this section. The application shall require an applicant to provide such information as the commissioner deems necessary, including, but not limited to, (1) the applicant's name and address, (2) the primary service area where the additional vehicle is proposed to be used, (3) an explanation as to why the additional vehicle is necessary and its proposed use, (4) proof of insurance, (5) a list of the emergency medical service organizations to whom notice was sent pursuant to subsection (i) of this section and proof of such notification, and (6) total call volume, response time and calls passed within the primary service area for the one-year period preceding the date of the application.

(k) Notwithstanding the provisions of subsection (a) of this section, any emergency medical services organization that is licensed or certified and a primary service area responder may apply to the commissioner, on a short form application prescribed by the commissioner, to change the address of a principal or branch location or to add a branch location within its primary service area. Upon making such application, the applicant shall notify in writing all other primary service area responders in any municipality or abutting municipality in which the applicant proposes to change principal or branch locations. Unless a primary service area responder entitled to receive notification of such application objects, in writing, to the commissioner and requests a hearing on such application not later than fifteen calendar days after receiving such notice, the application shall be deemed approved thirty calendar days after filing. If any such primary service area responder files an objection with the commissioner within the fifteen-calendar-day time period and requests a hearing, the applicant shall be required to demonstrate need to change the address of a principal or branch location within its primary service area at a public hearing as required under subsection (a) of this section.

(l) (1) The commissioner shall develop a short form application pursuant to subsection (k) of this section for primary service area responders seeking to (A) change the address of a principal location or the branch location, or (B) to add a branch location. (2) The application shall require an applicant to provide such information as the commissioner deems necessary, including, but not limited to, (A) the applicant's name and address, (B) the new address where the principal or branch is to be located, (C) an explanation as to why the principal or branch location is being moved, (D) an explanation as to the need for the addition of a branch location, and (E) a list of the emergency medical service organizations to whom notice was sent pursuant to subsection (k) of this section and proof of such notification.

(m) Notwithstanding the provisions of subsection (b) of this section, any ambulance service assigned as the primary service area responder for a primary service area on or before September 1, 2019, that notifies the Department of Public Health's Office of Emergency Medical Services, in writing, not later than October 1, 2019, of such assignment and attests to the ambulance service being in compliance with all statutes and regulations concerning the operation of such ambulance service shall be deemed authorized by the Commissioner of Public Health as the authorized mobile integrated health care program for the primary service area within which the ambulance service is the primary service area responder.

(P.A. 74-305, S. 9, 19; P.A. 75-112, S. 7, 18; 75-140; P.A. 77-614, S. 323, 610; P.A. 80-480, S. 2, 3; P.A. 81-259, S. 2, 3; 81-472, S. 47, 159; P.A. 85-585, S. 2; P.A. 86-59, S. 1, 2; P.A. 88-172, S. 1; P.A. 90-172, S. 2; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; 95-271, S. 37; P.A. 98-195, S. 8; P.A. 00-151, S. 5, 14; P.A. 06-195, S. 35; P.A. 07-134, S. 6; 07-252, S. 10; P.A. 08-184, S. 40; P.A. 09-16, S. 1; 09-232, S. 33, 71; June Sp. Sess. P.A. 09-3, S. 172; P.A. 10-117, S. 23; P.A. 12-80, S. 67; Dec. Sp. Sess. P.A. 12-1, S. 26; P.A. 14-231, S. 18; P.A. 15-242, S. 8; P.A. 19-118, S. 49, 50, 68; P.A. 21-121, S. 69; P.A. 22-58, S. 61.)

History: P.A. 75-112 replaced commission on hospitals and health care with commissioner of health, transferred duty to establish regulations re insurance coverage and limits in Subsec. (a) and subpoena power in Subsec. (b) from office of emergency medical services to commissioner of health, exempted volunteer ambulance or rescue services from requirement of furnishing proof of financial responsibility in licensure application under Subsec. (a) and required issuance of temporary permits on or before December 1, 1975, in Subsec. (d); P.A. 75-140 inserted new Subsec. (e)(3) and (4) re gift or offer of gift of value to promote or secure ambulance or rescue service business and re administering alcoholic liquor to patient except as directed by physician and renumbered former Subdivs. (3) and (4) accordingly; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; P.A. 80-480 added provisions in Subsec. (a) re hearing procedure requests for approval of permits for new or expanded emergency medical services; P.A. 81-259 amended Subsec. (a) to conform with the definitions contained in Subsecs. (q), (r) and (s); P.A. 81-472 made technical changes; Sec. 19-73bb transferred to Sec. 19a-180 in 1983; P.A. 85-585 added provisions in Subsec. (b) re the confidentiality of investigations by the commission; P.A. 86-59 amended Subsec. (a) to increase the required insurance limits for licensure of any commercial ambulance or rescue service as follows: (1) Personal injury, from $100,000 to $500,000 for one person, and from $300,000 to $1,000,000 for more than one person; (2) property damage, from $25,000 to $50,000; and (3) malpractice, from $100,000 to $250,000 for one person, and from $300,000 to $500,000 for more than one person and to establish single liability limits of $1,000,000 for personal injury and $500,000 for malpractice; P.A. 88-172 amended Subsec. (b) by adding the reference to “any other disciplinary action specified in Sec. 19a-17” and made technical changes; P.A. 90-172 added the references to a management service and made technical changes; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 95-271 added Subsec. (f) re advertisements or printed matter; P.A. 98-195 transferred from the Office of Emergency Medical Services to the Commissioner of Public Health responsibility for authority over ambulance services, made adoption of regulations discretionary rather than mandatory, deleted obsolete former Subsec. (d) relettering remaining sections accordingly and made technical changes (Revisor's note: In codifying this section, two erroneous references in Subsec. (b) to “section 1-16” were deemed by the Revisors to be “section 1-19”, as they had been prior to a technical error in P.A. 98-195, and therefore codified as “section 1-210” since section 1-19 was transferred to that number in 1999); P.A. 00-151 made technical changes, effective July 1, 2000; P.A. 06-195 amended Subsec. (a) by granting primary service area responder intervenor status with opportunity for cross-examination in hearing re need for new or expanded emergency medical services, adding reference to “rescue service or management service” and replacing “issue a license” with “issue the appropriate license”, amended Subsecs. (b) and (c) by extending their applicability to management service organization, added Subsec. (f) to require licensed or certified ambulance service to secure and maintain medical control by a sponsor hospital for all emergency medical personnel, added Subsec. (g) to establish six-month deadline for acquiring resources, equipment and other material necessary to operate approved new or expanded medical services, added Subsec. (h) to permit certain primary service area responders to add one emergency vehicle every three years under an expedited review and approval process and added Subsec. (i) re development of short form application for primary service area responders seeking to add an emergency vehicle pursuant to Subsec. (h), effective June 7, 2006; P.A. 07-134 amended Subsec. (a) by adding provision re compliance with requirements of Sec. 14-100a(e); P.A. 07-252 made technical changes in Subsec. (i); P.A. 08-184 amended Subsec. (h) by adding hospital-based ambulance service; P.A. 09-16 amended Subsec. (a) by providing that no person shall “otherwise transport in a motor vehicle a patient on a stretcher” without a license or certificate issued by the commissioner; P.A. 09-232 amended Subsec. (a) by substituting “that operates in the service area identified in the application” for “in a municipality in which the applicant operates or proposes to operate”, effective July 8, 2009, and amended Subsec. (f) by substituting “medical oversight” for “medical control”, effective January 1, 2010; June Sp. Sess. P.A. 09-3 amended Subsec. (a) to increase annual fee from $100 to $200; P.A. 10-117 amended Subsec. (f) by substituting references to Sec. 19a-175 for references to Sec. 19a-179; P.A. 12-80 amended Subsec. (d) to replace “Any person guilty of any of the following acts shall be fined not more than two hundred fifty dollars, or imprisoned not more than three months, or be both fined and imprisoned” with “Any person who commits any of the following acts shall be guilty of a class C misdemeanor”; Dec. Sp. Sess. P.A. 12-1 amended Subsec. (a) to delete “or otherwise transport in a motor vehicle a patient on a stretcher”, effective December 21, 2012; P.A. 14-231 amended Subsec. (a) by adding “paramedic intercept service”, deleting references to management service and adding provision re certificate to be issued to ambulance service or paramedic intercept service operated and maintained by a state agency, amended Subsecs. (b) and (c) by deleting “management service organization”, amended Subsec. (d)(3) by adding “invalid coach, paramedic intercept vehicle”, substantially revised Subsec. (f) re licensed or certified emergency medical service organization, amended Subsec. (g) by adding “or any ambulance service or paramedic intercept service operated and maintained by a state agency”, added Subsec. (j) re ambulance service or paramedic intercept service operated and maintained by a state agency on or before October 1, 2014, and made technical changes; P.A. 15-242 added Subsec. (k) re application for change of address of principal or branch location and Subsec. (l) re development of short form application for change of address; P.A. 19-118 amended Subsec. (a) by adding provisions re establishment of mobile integrated health care programs and replacing “providers” with “emergency medical service organizations”, added new Subsec. (b) re commissioner permitted to authorize establishment of mobile integrated health care program and implementation of policies and procedures to administer mobile integrated health care programs, redesignated existing Subsecs. (b) to (i) as Subsecs. (c) to (j), amended redesignated Subsec. (f) by adding reference to mobile integrated health care program provider, amended redesignated Subsec. (h) by adding references to establishment of mobile integrated health care program, amended redesignated Subsec. (i) by replacing “providers” with “emergency medical service organizations” in Subdiv. (5), deleted Subsec. (j) re ambulance service or paramedic intercept service operated and maintained by state agency on or before October 1, 2014, amended Subsec. (k) by adding “or to add a branch location” re short form application, amended Subsec. (l) by designating existing provisions re development of short form application as new Subdiv. (1) and amended same by adding Subpara. designator (A) and adding Subpara. (B) re adding branch location, designating existing provisions re information to be provided on application as new Subdiv. (2), redesignating existing Subdivs. (1) to (3) as Subparas. (A) to (C), adding Subpara. (D) re explanation as to need for addition of branch location, redesignating existing Subdiv. (4) as Subpara. (E), and replacing “providers” with “emergency medical service organizations”, adding Subsec. (m) re ambulance service assigned as primary service area responder for a primary service area on or before September 1, 2019, and made technical and conforming changes, effective July 1, 2019; P.A. 21-121 amended Subsec. (k) by replacing “volunteer, hospital-based or municipal ambulance service” with “emergency medical services organization”, effective July 6, 2021; P.A. 22-58 amended Subsec. (i) by replacing “volunteer, hospital-based or municipal ambulance service or any ambulance service or paramedic intercept service operated and maintained by a state agency” with “emergency medical services organization”.

Cited. 242 C. 152.

Sec. 19a-180a. Emergency medical service organization filing of strike contingency plan. Penalty. Regulations. (a) Each emergency medical service organization licensed or certified by the Commissioner of Public Health shall, upon receipt of a notice of intention to strike by a labor organization representing the employees of such emergency medical service organization file a strike contingency plan, in accordance with the provisions of the National Labor Relations Act, 29 USC 158, as amended from time to time, with the commissioner not later than five days before the date indicated for commencement of the strike.

(b) The commissioner may issue a summary order to any emergency medical service organization, as defined in section 19a-175, that fails to file a strike contingency plan that complies with the provisions of this section and the regulations adopted by the commissioner pursuant to this section within the specified time period. Such order shall require the emergency medical service organization to immediately file a strike contingency plan that complies with the provisions of this section and the regulations adopted by the commissioner pursuant to this section.

(c) Any emergency medical service organization that fails to comply with this section shall be subject to a civil penalty of not more than ten thousand dollars for each day of noncompliance.

(d) (1) If the commissioner determines that an emergency medical service organization has failed to comply with the provisions of this section or the regulations adopted pursuant to this section, for which a civil penalty is authorized by subsection (c) of this section, the commissioner may send to an authorized officer or agent of the emergency medical service organization, by certified mail, return receipt requested, or personally serve upon such officer or agent, a notice that includes: (A) A reference to this section or the section or sections of the regulations with which the emergency medical service organization has failed to comply; (B) a short and plain statement of the matters asserted or charged; (C) a statement of the maximum civil penalty that may be imposed for such noncompliance; and (D) a statement of the party's right to request a hearing to contest the imposition of the civil penalty.

(2) An emergency medical service organization may make written application for a hearing to contest the imposition of a civil penalty pursuant to this section not later than twenty days after the date such notice is mailed or served. All hearings under this section shall be conducted in accordance with the provisions of chapter 54. If an emergency medical service organization fails to request a hearing or fails to appear at the hearing or if, after the hearing, the commissioner finds that the emergency medical service organization is in noncompliance, the commissioner may, in the commissioner's discretion, order a civil penalty to be imposed that is not greater than the penalty stated in the notice. The commissioner shall send a copy of any order issued pursuant to this subsection by certified mail, return receipt requested, to the emergency medical service organization named in such order.

(e) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54: (1) Establishing requirements for a strike contingency plan, that shall include, but need not be limited to, a requirement that the plan contain documentation that the emergency medical service organization has arranged, in the event of a strike, for adequate staffing and security, fuel, pharmaceuticals and other essential supplies and services necessary to meet the needs of the patient population served by the emergency medical service organization; and (2) for purposes of the imposition of a civil penalty upon an emergency medical service organization pursuant to subsections (c) and (d) of this section.

(f) Such plan shall be deemed a statement of strategy or negotiations with respect to collective bargaining for the purpose of subdivision (9) of subsection (b) of section 1-210.

(P.A. 14-231, S. 25.)

Sec. 19a-180b. Certificate of authorization for supplemental first responder. Suspension or revocation. (a) For the purposes of this section, “supplemental first responder” means an emergency medical service organization who holds a certificate of authorization by the Commissioner of Public Health and responds to a victim of sudden illness or injury when available and only when called upon, but does not offer transportation to patients or operate an ambulance service or paramedic intercept service, “emergency medical services personnel” means an individual certified pursuant to chapter 384d to practice as an emergency medical responder, emergency medical technician, advanced emergency medical technician or emergency medical services instructor or an individual licensed pursuant to chapter 384d as a paramedic, and “patient”, “ambulance service”, “emergency medical service organization”, “paramedic intercept service” and “emergency medical technician” have the same meanings as provided in section 19a-175.

(b) Notwithstanding the provisions of subsection (a) of section 19a-180, the Commissioner of Public Health may issue a certificate of authorization for a supplemental first responder to an emergency medical service organization who operates only in a municipality with a population of at least one hundred five thousand, but not more than one hundred fifteen thousand, as determined by the most recent population estimate by the Department of Public Health. A certificate of authorization shall be issued to an emergency medical service organization that shows proof satisfactory to the commissioner that such emergency medical service organization (1) meets the minimum standards of the commissioner in the areas of training, equipment and emergency medical services personnel, and (2) maintains liability insurance in an amount not less than one million dollars. Applications for such certificate of authorization shall be made in the form and manner prescribed by the commissioner. Upon determination by the commissioner that an applicant is qualified to be a supplemental first responder, the commissioner shall issue a certificate of authorization effective for two years to such applicant. Such certificate of authorization shall be renewable biennially. If the commissioner determines that an applicant for such license is not so qualified, the commissioner shall provide such applicant with written notice of the denial of the application with a statement of the reasons for such denial. Such applicant shall have thirty days to request a hearing concerning the denial of the application. Any hearing conducted pursuant to this subsection shall be conducted in accordance with the provisions of chapter 54. If the commissioner's denial of a certificate of authorization is sustained after such hearing, an applicant may make new application not less than one year after the date on which such denial was sustained.

(c) The commissioner may suspend or revoke a holder's certificate of authorization for a supplemental first responder if such holder does not maintain the minimum standards of the commissioner pursuant to subdivisions (1) and (2) of subsection (b) of this section or violates any provision of this chapter. Such holder shall have an opportunity to show compliance with all requirements for the retention of such certificate of authorization.

(S.A. 15-8, S. 1; P.A. 19-118, S. 51.)

History: S.A. 15-8 effective June 23, 2015; P.A. 19-118 amended Subsec. (a) by redefining “supplemental first responder” and replacing reference to provider with reference to emergency medical service organization and amended Subsec. (d) by replacing “services provider” with “service organization”, effective July 1, 2019.

Sec. 19a-180c. Authority of primary service area responder at certain scenes. (a) For the purposes of this section, “primary service area responder” has the same meaning as provided in section 19a-175 and “supplemental first responder” has the same meaning as provided in section 19a-180b.

(b) If a primary service area responder and a supplemental first responder are both on the scene of an emergency medical call, the primary service area responder shall control and direct emergency activities at such scene.

(S.A. 15-8, S. 2.)

History: S.A. 15-8 effective June 23, 2015.

Sec. 19a-180d. Responsibility for decision-making on scene of emergency medical call. Emergency medical services personnel, as defined in section 19a-175, who holds the highest classification of licensure or certification from the Department of Public Health under this chapter and chapter 384d shall be responsible for making decisions concerning patient care on the scene of an emergency medical call. If two or more emergency medical service organizations on such scene hold the same licensure or certification classification, the emergency medical service organization for the primary service area responder, as defined in said section, shall be responsible for making such decisions. If all emergency medical services personnel on such scene are emergency medical technicians or emergency medical responders, as defined in said section, the emergency medical service organization providing transportation services shall be responsible for making such decisions. An emergency medical service organization on the scene of an emergency medical call who has undertaken decision-making responsibility for patient care shall transfer patient care to a provider with a higher classification of licensure or certification upon such provider's arrival on the scene. All emergency medical services personnel with patient care responsibilities on the scene shall ensure such transfer takes place in a timely and orderly manner. For purposes of this section, the classification of licensure or certification from highest to lowest is: Paramedic, advanced emergency medical technician, emergency medical technician and emergency medical responder. Nothing in this section shall be construed to limit the authority of a fire chief or fire officer-in-charge under section 7-313e to control and direct emergency activities at the scene of an emergency.

(P.A. 15-223, S. 1; P.A. 19-118, S. 52; P.A. 22-92, S. 22.)

History: P.A. 19-118 replaced references to provider with references to emergency medical services personnel and emergency medical service organization, effective July 1, 2019; P.A. 22-92 made a technical change, effective May 24, 2022.

Sec. 19a-181. (Formerly Sec. 19-73cc). Inspection and registration of ambulance, invalid coach and authorized emergency medical services vehicle. Suspension or revocation of registration certificate. (a) In addition to the inspection required under subsection (b) of this section, each ambulance and invalid coach used by an emergency medical service organization shall be inspected to verify such ambulance or invalid coach has met the minimum standards prescribed by the Commissioner of Public Health. Such inspection shall be conducted (1) in accordance with 49 CFR 396.17, as amended from time to time, and (2) by a person (A) qualified to perform such inspection in accordance with 49 CFR 396.19 and 49 CFR 396.25, as amended from time to time, and (B) employed by the state or a municipality of the state or licensed in accordance with section 14-52. A record of each inspection shall be made in accordance with section 49 CFR 396.21, as amended from time to time. Each inspector, upon determining that such ambulance or invalid coach meets the standards of safety and equipment prescribed by the Commissioner of Public Health, shall provide notification to the emergency medical services organization in such manner and form as said commissioner designates. The Commissioner of Public Health shall affix a safety certificate sticker in the rear compartment of such ambulance or invalid coach in a location readily visible to any person.

(b) Each authorized emergency medical services vehicle used by an emergency medical service organization shall be inspected by the Department of Public Health to verify the authorized emergency medical services vehicle is in compliance with the minimum standards for vehicle design and equipment as prescribed by the Commissioner of Public Health. Each inspector, upon determining that such authorized emergency medical services vehicle meets the standards of safety and equipment prescribed by the Commissioner of Public Health, shall affix a compliance certificate in the rear compartment of such vehicle, in such manner and form as said commissioner designates, and such sticker shall be so placed as to be readily visible to any person. The Commissioner of Public Health or the commissioner's designee may inspect any rescue vehicle used by an emergency medical service organization for compliance with the minimum equipment standards prescribed by said commissioner.

(c) Each authorized emergency medical services vehicle shall be registered with the Department of Motor Vehicles pursuant to chapter 246. The Department of Motor Vehicles shall not issue a certificate of registration for any such authorized emergency medical services vehicle unless the applicant for such certificate of registration presents to said department a compliance certificate from the Commissioner of Public Health certifying that such authorized emergency medical services vehicle has been inspected and has met the minimum safety and vehicle design equipment standards prescribed by the Commissioner of Public Health. Each vehicle registered with the Department of Motor Vehicles in accordance with this subsection shall be inspected by the Commissioner of Public Health or the commissioner's designee not less than once every two years on or before the anniversary date of the issuance of the certificate of registration.

(d) The Department of Motor Vehicles shall suspend or revoke the certificate of registration of any vehicle inspected under the provisions of this section upon certification from the Commissioner of Public Health that such ambulance or rescue vehicle has failed to meet the minimum standards prescribed by said commissioner.

(P.A. 74-305, S. 10, 19; P.A. 75-112, S. 8, 18; P.A. 98-195, S. 9; P.A. 14-231, S. 11; P.A. 15-242, S. 12.)

History: P.A. 75-112 replaced references to standards of office of emergency services and commission on hospitals and health care with references to standards of commissioner; Sec. 19-73cc transferred to Sec. 19a-181 in 1983; (Revisor's note: In 1995 the word “Medical” was added editorially by the Revisors to correct reference to “Office of Emergency Services” and in 1997 references throughout the general statutes to “Motor Vehicle(s) Commissioner” and “Motor Vehicle(s) Department” were replaced editorially by the Revisors with “Commissioner of Motor Vehicles” or “Department of Motor Vehicles”, as the case may be, for consistency with customary statutory usage); P.A. 98-195 transferred authority over ambulance services from the Office of Emergency Medical Services to the Commissioner of Public Health; P.A. 14-231 amended Subsec. (a) by replacing “or rescue vehicle used by an ambulance or rescue service” with “invalid coach and intermediate or paramedic intercept vehicle used by an emergency medical service organization”, adding provisions re inspections and making technical and conforming changes; P.A. 15-242 amended Subsec. (a) by deleting references to intermediate or paramedic intercept vehicle and registration, replacing provision re safety certificate and sticker to be provided and affixed by inspector with provision re notification by inspector to commissioner and sticker to be affixed by commissioner and making technical changes, added new Subsec. (b) re inspection by Department of Public Health, added Subsec. (c) re registration with Department of Motor Vehicles and redesignated existing Subsec. (b) as Subsec. (d).

Sec. 19a-181a. Indemnification of emergency medical services instructors. The state shall save harmless and indemnify any person certified as an emergency medical services instructor by the Department of Public Health under this chapter from financial loss and expense, including legal fees and costs, if any, arising out of any claim, demand, suit or judgment by reason of alleged negligence or other act resulting in personal injury or property damage, which acts are not wanton, reckless or malicious, provided such person at the time of the acts resulting in such injury or damage was acting in the discharge of his duties in providing emergency medical services training and instruction.

(P.A. 89-278, S. 2; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 10-18, S. 8; 10-117, S. 29.)

History: P.A. 93-381 replaced department of health services with department of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 10-18 replaced “emergency medical technician instructor” with “emergency medical services instructor”; P.A. 10-117 replaced “emergency medical technician instructor” with “emergency medical services instructor” and replaced “emergency medical technician training” with “emergency medical services training”.

Sec. 19a-181b. Local emergency medical services plan. (a) Each municipality shall establish a local emergency medical services plan. Such plan shall include the written agreements or contracts developed between the municipality, its emergency medical service organizations and the public safety answering point, as defined in section 28-25, that covers the municipality. The plan shall also include, but not be limited to, the following:

(1) The identification of levels of emergency medical services, including, but not limited to: (A) The public safety answering point responsible for receiving emergency calls and notifying and assigning the appropriate emergency medical service organization to a call for emergency medical services; (B) the emergency medical service organization that is notified for initial response; (C) basic ambulance service; (D) advanced life support level; and (E) mutual aid call arrangements;

(2) The name of the person or entity responsible for carrying out each level of emergency medical services that the plan identifies;

(3) The establishment of performance standards, including, but not limited to, standards for responding to a certain percentage of initial response notifications, response times, quality assurance and service area coverage patterns, for each segment of the municipality's emergency medical services system; and

(4) Any subcontracts, written agreements or mutual aid call agreements that emergency medical service organizations may have with other entities to provide services identified in the plan.

(b) In developing the plan required by subsection (a) of this section, each municipality: (1) May consult with and obtain the assistance of its regional emergency medical services council established pursuant to section 19a-183, its regional emergency medical services coordinator appointed pursuant to section 19a-186a, its regional emergency medical services medical advisory committees and any sponsor hospital, as defined in regulations adopted pursuant to section 19a-179, located in the area identified in the plan; and (2) shall submit the plan to its regional emergency medical services council for the council's review and comment.

(c) Each municipality shall update the plan required by subsection (a) of this section not less than once every five years. The municipality shall consult with the municipality's primary service area responder concerning any updates to the plan. The Department of Public Health shall, upon request, assist each municipality in the process of updating the plan by providing technical assistance and helping to resolve any disagreements concerning the provisions of the plan.

(d) Not less than once every five years, each municipality shall review its plan and the primary service area responder's provision of services under the plan and submit a revised plan to the Commissioner of Public Health. The commissioner shall evaluate each municipality's plan on an ongoing basis. The commissioner shall provide not less than one hundred twenty days of notice to a municipality as to when the commissioner's evaluation of the revised plan will be conducted. Upon the conclusion of such evaluation, the department shall assign a rating of “meets performance standards”, “exceeds performance standards” or “fails to comply with performance standards” for the primary service area responder and notify the municipality and primary service area responder of such rating. The commissioner may require any primary service area responder that is assigned a rating of “fails to comply with performance standards” to submit a performance improvement plan, not later than ninety days after being notified of such rating, and meet the department's requirements for compliance with performance standards. Such primary service area responder may be subject to subsequent performance reviews or removal as the municipality's primary service area responder for a failure to improve performance in accordance with section 19a-181c.

(P.A. 00-151, S. 9, 14; P.A. 10-117, S. 55; P.A. 14-217, S. 19; P.A. 17-84, S. 1; P.A. 19-118, S. 53.)

History: P.A. 00-151 effective July 1, 2000; P.A. 10-117 amended Subsec. (b)(1) by substituting reference to Sec. 19a-186a for reference to Sec. 19a-185, effective July 1, 2010; P.A. 14-217 added Subsec. (c) re municipality to update plan and added Subsec. (d) re department review of municipality's plan; P.A. 17-84 amended Subsec. (a) by deleting reference to July 1, 2002, and adding provision re standards for responding to certain percentage of initial response notifications, response times, quality assurance and service area coverage patterns in Subdiv. (3), amended Subsec. (c) by replacing “as the municipality determines is necessary” with “not less than once every five years”, amended Subsec. (d) by replacing provisions re department to review municipality's plan with provision re municipality to review its plan, deleted provision re review to include evaluation of responder's compliance with applicable laws and regulations, adding provisions re municipality to submit revised plan to commissioner and commissioner to evaluate municipality's revised plan, department to notify municipality and primary service area responder of rating, commissioner may require primary service area responder to submit performance improvement plan, and made technical and conforming changes; P.A. 19-118 amended Subsec. (a) by replacing “services providers” with “service organizations”, amended Subsec. (a)(1) by replacing “provider” with “emergency service organization” in Subpara. (A) and replacing “services provider” with “service organization” in Subpara. (B), and amended Subsec. (a)(4) by replacing “services providers” with “service organizations”, effective July 1, 2019.

Sec. 19a-181c. Removal of responder. Revocation of responder's primary service area assignment. (a) As used in this section and section 19a-181f:

(1) “Responder” means any primary service area responder that (A) is notified for initial response, (B) is responsible for the provision of basic life support service, or (C) is responsible for the provision of service above basic life support that is intensive and complex prehospital care consistent with acceptable emergency medical practices under the control of physician and hospital protocols.

(2) “Performance crisis” means (A) the responder has failed to respond to at least fifty per cent or more first call responses in any rolling three-month period and has failed to comply with the requirements of any corrective action plan agreement between the municipality and the responder, or (B) the sponsor hospital refuses to endorse or provide a recommendation for the responder due to unresolved issues relating to the quality of patient care provided by the responder.

(3) “Unsatisfactory performance” means the responder has failed to (A) respond to at least eighty per cent or more first call responses, excluding those responses excused by the municipality in any rolling twelve-month review period, or (B) meet defined response time standards agreed to between the municipality and responder, excluding those responses excused by the municipality, and comply with the requirements of a mutually agreed-upon corrective action plan, or (C) investigate and adequately respond to complaints related to the quality of emergency care or response times, on a repeated basis, or (D) report adverse events as required by the Commissioner of Public Health or as required under the local emergency medical services plan, on a repeated basis, or (E) communicate changes to the level of service or coverage patterns that materially affect the delivery of service as required under the local emergency medical services plan or communicate an intent to change such service that is inconsistent with such plan, or (F) communicate changes in its organizational structure that are likely to negatively affect the responder's delivery of service, and (G) deliver services in accordance with the local emergency medical services plan.

(b) Any municipality may petition the commissioner for the removal of a responder. A petition may be made (1) at any time if based on an allegation that a performance crisis exists and that the safety, health and welfare of the citizens of the affected primary service area are jeopardized by the responder's performance, or (2) not more often than once every three years, if based on the unsatisfactory performance of the responder. A responder for whom a municipality seeks removal pursuant to a petition under this section shall not transfer its responsibilities to another responder while the petition is pending. A hearing on a petition under this section shall be deemed to be a contested case and held in accordance with the provisions of chapter 54.

(c) If, after a hearing authorized by this section, the commissioner determines that (1) a performance crisis exists and the safety, health and welfare of the citizens of the affected primary service area are jeopardized by the responder's performance, (2) the responder has demonstrated unsatisfactory performance, or (3) it is in the best interests of patient care, the commissioner may revoke the primary service area responder's primary service area assignment and require the chief administrative official of the municipality in which the primary service area is located to submit a plan acceptable to the commissioner for the alternative provision of primary service area responder responsibilities, or may issue an order for the alternative provision of emergency medical services, or both.

(d) The commissioner, or the commissioner's designee, shall open any petition for the removal of a responder (1) not later than five business days after receipt of a petition where a performance crisis is alleged and shall conclude the investigation on such petition not later than thirty days after receipt of such petition, or (2) not later than fifteen business days after receipt of a petition where unsatisfactory performance is alleged and shall conclude the investigation on such petition not later than ninety days after receipt of such petition. The commissioner may redesignate any petition received pursuant to this section as due to a performance crisis or unsatisfactory performance based on the facts alleged in the petition and shall comply with the time requirements in this subsection that correspond to the redesignated classification.

(e) The commissioner may develop and implement procedures to designate a temporary responder for a municipality when such municipality has alleged a performance crisis in the petition during the time such petition is under the commissioner's consideration.

(f) The commissioner may hold a hearing and revoke a responder's primary service area assignment in accordance with the provisions of this section, although a petition has not been filed, where the commissioner has assigned a responder a rating of “fails to comply with performance standards” in accordance with section 19a-181b and the responder subsequently failed to improve its performance.

(P.A. 00-151, S. 10, 14; P.A. 14-217, S. 20.)

History: P.A. 00-151 effective July 1, 2000; P.A. 14-217 amended Subsec. (a) by adding reference to Sec. 19a-181f, designating existing provision defining “responder” as Subdiv. (1), redesignating existing Subdivs. (1) to (3) as Subparas. (A) to (C) therein, and adding new Subdiv. (2) defining “performance crisis” and new Subdiv. (3) defining “unsatisfactory performance”, substantially revised Subsec. (b) re removal of responder, amended Subsec. (c) by replacing “an emergency” with “a performance crisis” in Subdiv. (1) and, in Subdiv. (2), replacing former provisions with “responder has demonstrated unsatisfactory performance”, added Subsec. (d) re petition for removal of responder, added Subsec. (e) re procedures to designate temporary responder and added Subsec. (f) re hearing to revoke responder's assignment.

Sec. 19a-181d. Hearing re performance standards. (a) Any municipality may petition the commissioner to hold a hearing if the municipality cannot reach a written agreement with its primary service area responder concerning performance standards. The commissioner shall conduct such hearing not later than ninety days from the date the commissioner receives the municipality's petition. A hearing on a petition under this section shall not be deemed to be a contested case for purposes of chapter 54.

(b) In conducting a hearing authorized by this section, the commissioner shall determine if the performance standards adopted in the municipality's local emergency medical services plan are reasonable based on the state-wide plan for the coordinated delivery of emergency medical services adopted pursuant to subdivision (1) of section 19a-177, model local emergency medical services plans and the standards, contracts and written agreements in use by municipalities of similar population and characteristics.

(c) If, after a hearing authorized by this section, the commissioner determines that the performance standards adopted in the municipality's local emergency medical services plan are reasonable, the primary service area responder shall have thirty calendar days in which to agree to such performance standards. If the primary service area responder fails or refuses to agree to such performance standards, the commissioner may revoke the primary service area responder's primary service area assignment and require the chief administrative official of the municipality in which the primary service area is located to submit a plan acceptable to the commissioner for the alternative provision of primary service area responder responsibilities, or may issue an order for the alternative provision of emergency medical services, or both.

(d) If, after a hearing authorized by this section, the commissioner determines that the performance standards adopted in the municipality's local emergency medical services plan are unreasonable, the commissioner shall provide performance standards considered reasonable based on the state-wide plan for the coordinated delivery of emergency medical services adopted pursuant to subdivision (1) of section 19a-177, model emergency medical services plans and the standards, contracts and written agreements in use by municipalities of similar population and characteristics. If the municipality refuses to agree to such performance standards, the primary service area responder shall meet the minimum performance standards provided in regulations adopted pursuant to section 19a-179.

(P.A. 00-151, S. 11, 14.)

History: P.A. 00-151 effective July 1, 2000.

Sec. 19a-181e. Pilot program for municipal selection of emergency medical services provider based on issuance of requests for proposals. Section 19a-181e is repealed, effective October 1, 2008.

(P.A. 00-135, S. 17, 21; 00-151, S. 12, 14; P.A. 08-184, S. 63.)

Sec. 19a-181f. Change in primary service area responder. Submission of alternative local emergency medical services plan. (a) For purposes of this section, “primary service area responder” has the same meaning as in section 19a-175. A municipality that seeks a change in a primary service area responder shall submit an alternative local emergency medical services plan prepared pursuant to section 19a-181b to the Department of Public Health when: (1) The municipality's current primary service area responder has failed to meet the standards outlined in the local emergency medical services plan, established pursuant to section 19a-181b; (2) the municipality has established a performance crisis or unsatisfactory performance, as defined in section 19a-181c; (3) the primary service area responder does not meet a performance measure provided in regulations adopted pursuant to section 19a-179; (4) the municipality has developed a plan for regionalizing service; or (5) the municipality has developed a plan that will improve or maintain patient care and the municipality has the opportunity to align a new primary service area responder that is better suited than the current primary service area responder to meet the community's current needs. Such plan shall include the name of a recommended primary service area responder for each category of emergency medical response services.

(b) Not later than forty-five days after a municipality submits an alternative local emergency medical services plan pursuant to the provisions of this section, each new recommended primary service area responder who agrees to be considered for the primary service area designation shall submit an application to the commissioner, on a form prescribed by the commissioner.

(c) (1) The Commissioner of Public Health shall conduct a hearing on any alternative local emergency medical services plan submitted pursuant to subsection (a) of this section, including the proposed removal of a primary service area responder and the proposed designation of a new primary service area responder. Not later than thirty days prior to the hearing, the commissioner shall notify the municipality's current primary service area responder, in writing, of the hearing. Such primary service area responder shall be given the opportunity to be heard and may submit information for the commissioner's consideration.

(2) In order to determine whether to approve or disapprove such plan, the commissioner shall consider any relevant factors, including, but not limited to: (A) The impact of the plan on patient care; (B) the impact of the plan on emergency medical services system design, including system sustainability; (C) the impact of the plan on the local, regional and state-wide emergency medical services system; (D) the recommendation from the sponsor hospital's medical oversight staff; and (E) the financial impact to the municipality without compromising the quality of patient care. If the commissioner approves the alternative plan and the application of the recommended primary service area responder, the commissioner shall issue a written decision to reassign the primary service area in accordance with the alternative plan and indicate the effective date for the reassignment. A primary service area responder shall deliver services in accordance with the local emergency medical services plan prepared pursuant to section 19a-181b until the effective date of the reassignment stated in the commissioner's written decision approving the alternative plan.

(P.A. 14-217, S. 22.)

Sec. 19a-181g. Primary service area responder sale or transfer of ownership. A primary service area responder, as defined in section 19a-175, shall notify the Department of Public Health and the chief elected official or the chief executive officer of the municipality to which it is assigned not later than sixty days prior to the sale or transfer of more than fifty per cent of its ownership interest or assets. Any person who intends to obtain ownership or control of a primary service area responder in a sale or transfer for which notification is required under this section shall submit an application for approval of such purchase or change in control on a form prescribed by the Commissioner of Public Health. The commissioner shall, in determining whether to grant approval of the sale or transfer, consider: (1) The applicant's performance history in the state or another state; and (2) the applicant's financial ability to perform the responsibilities of the primary service area responder in accordance with the local emergency medical services plan, established in accordance with section 19a-181b. The commissioner shall approve or reject the application not later than forty-five calendar days after receipt of the application. The commissioner shall consult with any municipality or sponsor hospital in the primary service area, as such terms are defined in section 19a-175, in making a determination on the application and may hold a hearing on the application.

(P.A. 14-217, S. 21.)

History: P.A. 14-217 effective June 13, 2014.

Sec. 19a-182. (Formerly Sec. 19-73dd). Emergency medical services councils. Plans for delivery of services. (a) The emergency medical services councils shall advise the commissioner on area-wide planning and coordination of agencies for emergency medical services for each region and shall provide continuous evaluation of emergency medical services for their respective geographic areas. A regional emergency medical services coordinator, in consultation with the commissioner, shall assist the emergency medical services council for the respective region in carrying out the duties prescribed in subsection (b) of this section. As directed by the commissioner, the regional emergency medical services coordinator for each region shall facilitate the work of each respective emergency medical services council including, but not limited to, representing the Department of Public Health at any Council of Regional Presidents meetings.

(b) Each emergency medical services council shall develop and revise every five years a plan for the delivery of emergency medical services in its area, using a format established by the Office of Emergency Medical Services. Each council shall submit an annual update for each regional plan to the Office of Emergency Medical Services detailing accomplishments made toward plan implementation. Such plan shall include an evaluation of the current effectiveness of emergency medical services and detail the needs for the future, and shall contain specific goals for the delivery of emergency medical services within their respective geographic areas, a time frame for achievement of such goals, cost data for the development of such goals, and performance standards for the evaluation of such goals. Special emphasis in such plan shall be placed upon coordinating the existing services into a comprehensive system. Such plan shall contain provisions for, but shall not be limited to, the following: (1) Clearly defined geographic regions to be serviced by each emergency medical service organization including cooperative arrangements with other organizations, personnel and backup services; (2) an adequate number of trained personnel for staffing of ambulances, communications facilities and hospital emergency rooms, with emphasis on former military personnel trained in allied health fields; (3) a communications system that includes a central dispatch center, two-way radio communication between the ambulance and the receiving hospital and a universal emergency telephone number; and (4) a public education program that stresses the need for adequate training in basic lifesaving techniques and cardiopulmonary resuscitation. Such plan shall be submitted to the Commissioner of Public Health no later than June thirtieth each year the plan is due.

(P.A. 74-305, S. 11, 19; P.A. 75-112, S. 9, 18; P.A. 77-268, S. 4; 77-614, S. 323, 610; P.A. 87-420, S. 5, 14; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 98-195, S. 10; P.A. 10-117, S. 56; P.A. 16-185, S. 11; P.A. 19-118, S. 54.)

History: P.A. 75-112 required submission of plan to commissioner of health rather than to commission on hospitals and health care in Subsec. (b); P.A. 77-268 replaced “comprehensive health planning “b” agency” with “health systems agency” and required annual revision of plan and submission of revision annually, replacing previous provisions which had set deadlines for initial development of plan and initial report; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73dd transferred to Sec. 19a-182 in 1983; P.A. 87-420 substituted “emergency medical services councils” for “health systems agencies”, deleted provision re performance of health systems agency's functions, and substituted June thirtieth for December thirty-first re submission of plan; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 98-195 amended Subsec. (b) to require revision of plan every five years rather than annually, to require format established by the Office of Emergency Medical Services and to require the council to submit annual updates on progress toward plan implementation; P.A. 10-117 amended Subsec. (a) by providing that emergency medical services councils shall advise commissioner on area-wide coordination of agencies for each region and by adding provisions re duties of regional emergency medical services coordinator, effective July 1, 2010; P.A. 16-185 amended Subsec. (a) by replacing “Council of Regional Chairpersons meetings” with “Council of Regional Presidents meetings”, effective June 7, 2016; P.A. 19-118 amended Subsec. (b) by replacing “provider” with “emergency medical service organization” and replacing “providers” with “organizations, personnel” in Subdiv. (1), effective July 1, 2019.

Annotation to former section 19-73dd:

Cited. 35 CS 136.

Sec. 19a-183. (Formerly Sec. 19-73ee). Regional emergency medical services councils. There shall be established an emergency medical services council in each region. A region shall be composed of the towns so designated by the commissioner. Opportunity for membership shall be available to all appropriate representatives of emergency medical services including, but not limited to, one representative from each of the following: (1) Local governments; (2) fire and law enforcement officials; (3) medical and nursing professions, including mental health, paraprofessional and other allied health professionals; (4) emergency medical service organizations that provide ambulance services, at least one of which shall be a member of a volunteer ambulance association; (5) institutions of higher education; (6) federal agencies involved in the delivery of health care; and (7) consumers. All emergency medical services councils shall submit to the commissioner information concerning the organizational structure and council bylaws for the commissioner's approval. Such bylaws shall include the process by which each council shall elect a president. The commissioner shall foster the development of emergency medical services councils in each region.

(P.A. 74-305, S. 12, 19; P.A. 75-112, S. 10, 18; P.A. 77-268, S. 5; 77-614, S. 323, 610; P.A. 87-420, S. 6, 14; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 00-27, S. 17, 24; P.A. 16-185, S. 12; P.A. 19-118, S. 55.)

History: P.A. 75-112 replaced commission on hospitals and health care with commissioner of health; P.A. 77-268 replaced “comprehensive health planning agency” with “health system agency”; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73ee transferred to Sec. 19a-183 in 1983; P.A. 87-420 redefined the composition of a region and made technical changes; P.A. 93-381 replaced department of health services with department of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 00-27 made technical changes, effective May 1, 2000; P.A. 16-185 added provision re bylaws to include process for electing president, effective June 7, 2016; P.A. 19-118 amended Subdiv. (4) by replacing “providers of” with “emergency medical service organizations that provide” and amended Subdiv. (7) by deleting, “, including those in existence on July 1, 1974,”, effective July 1, 2019.

Annotations to former section 19-73ee:

Cited. 35 CS 136; 37 CS 124.

Sec. 19a-184. (Formerly Sec. 19-73ff). Functions of regional emergency medical services councils. (a) Each emergency medical services council shall (1) forward to the Commissioner of Public Health the emergency medical services plan for its region, and (2) review and within sixty days forward to the commissioner, together with its recommendations, all grant and contract applications for federal and state funds pertaining to emergency medical services from the following entities within its region: (A) A unit of local government, (B) a public entity administering a compact or other regional arrangement or consortium, or (C) any other public entity or any nonprofit private agency.

(b) The presidents, or their designees, of said councils shall meet as a group, at least bimonthly, with the Office of Emergency Medical Services to discuss the planning, coordination and implementation of the state-wide emergency medical care service system.

(P.A. 74-305, S. 13, 19; P.A. 75-112, S. 11, 18; P.A. 77-268, S. 6; 77-614, S. 323, 610; P.A. 87-420, S. 7, 14; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 98-195, S. 11; P.A. 16-185, S. 13.)

History: P.A. 75-112 replaced commission on hospitals and health care with commissioner of health; P.A. 77-268 replaced “b” agencies with “health systems” agencies and added Subsec. (c) re monthly meetings of council chairpersons and director of office of emergency medical services; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73ff transferred to Sec. 19a-184 in 1983; P.A. 87-420 deleted all references to health systems agencies, the thirty-day limit for review and the provision requiring comments from the emergency medical services council; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 98-195 amended Subsec. (b) by deleting “the director of” before “Office of Emergency Medical Services”; P.A. 16-185 amended Subsec. (b) by replacing “chairpersons” with “presidents”, effective June 7, 2016.

Sec. 19a-185. (Formerly Sec. 19-73gg). Regional emergency medical services coordinators; appointment. Section 19a-185 is repealed, effective October 1, 2010.

(P.A. 74-305, S. 14, 19; P.A. 75-112, S. 12, 18; P.A. 77-268, S. 7; P.A. 87-420, S. 8, 14; P.A. 10-117, S. 95.)

Sec. 19a-186. (Formerly Sec. 19-73hh). Functions of regional emergency medical services coordinators. The regional emergency medical services coordinator shall be responsible for: (1) Facilitating the work of the emergency medical services council in developing the plan for the coordination of emergency medical services within the region, (2) implementation of the regional plan formulated by the emergency medical services council pursuant to subsection (b) of section 19a-182, (3) continuous monitoring and evaluation of all emergency medical services in that region and (4) making a complete inventory of all personnel, facilities and equipment within the region related to the delivery of emergency medical services pursuant to guidelines established by the Commissioner of Public Health.

(P.A. 74-305, S. 15, 19; P.A. 75-112, S. 13, 18; P.A. 77-268, S. 8; 77-614, S. 323, 610; P.A. 87-420, S. 9, 14; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58.)

History: P.A. 75-112 replaced commission on hospitals and health care with commissioner of health; P.A. 77-268 replaced “b” agencies with “health systems” agencies; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73hh transferred to Sec. 19a-186 in 1983; P.A. 87-420 substituted “emergency medical services council” for “health systems agencies”; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995.

Sec. 19a-186a. Regional emergency medical services coordinators. Employment with Department of Public Health. Any individual employed on June 30, 2010, as a regional emergency medical services coordinator or as an assistant regional emergency medical services coordinator shall be offered an unclassified durational position within the Department of Public Health for the period from July 1, 2010, to June 30, 2011, inclusive, provided no more than five unclassified durational positions shall be created. Within available appropriations, such unclassified durational positions may be extended beyond June 30, 2011. The Commissioner of Administrative Services shall establish job classifications and salaries for such positions in accordance with the provisions of section 4-40. Any such created positions shall be exempt from collective bargaining requirements and no individual appointed to such position shall have reemployment or any other rights that may have been extended to unclassified employees under a State Employees' Bargaining Agent Coalition agreement. Individuals employed in such unclassified durational positions shall be located at the offices of the Department of Public Health. In no event shall an individual employed in an unclassified durational position pursuant to this section receive credit for any purpose for services performed prior to July 1, 2010.

(P.A. 10-117, S. 57.)

History: P.A. 10-117 effective July 1, 2010.

Sec. 19a-187. (Formerly Sec. 19-73ii). Cooperation of state agencies. Advice and consultation by The University of Connecticut Health Center. (a) All state agencies which are concerned with the emergency medical service delivery system shall, to the fullest extent consistent with their authorities under state law administered by them, carry out programs under their control in such a manner as to further the policy of establishing a coordinated state-wide emergency medical service system.

(b) All such state agencies shall cooperate with the Office of Emergency Medical Services, and the regional emergency medical service coordinators and emergency medical services councils in developing the state emergency medical services program under this chapter.

(c) All state agencies concerned with the state-wide emergency medical services system shall cooperate with the appropriate agencies of the United States or of other states or interstate agencies with respect to the planning and coordination of emergency medical services.

(d) The Commissioner of Public Health and the trustees of The University of Connecticut may contract for the provision of medical advice and consultation by The University of Connecticut Health Center to the Office of Emergency Medical Services. This subsection shall not affect the responsibilities of said University and health center under subsections (a), (b) and (c) of this section.

(P.A. 74-305, S. 16, 19; P.A. 75-112, S. 14, 18; P.A. 77-268, S. 9; 77-614, S. 323, 587, 610; P.A. 78-303, S. 85, 136; P.A. 87-420, S. 10, 14; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58.)

History: P.A. 75-112 deleted requirement that agencies cooperate with commission on hospitals and health care in Subsec. (b); P.A. 77-268 replaced “b” agencies with “health systems” agencies in Subsec. (b) and added Subsec. (d) re contracts between commissioner of health and University of Connecticut trustees; P.A. 77-614 and P.A. 78-303 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-73ii transferred to Sec. 19a-187 in 1983; P.A. 87-420 deleted reference to health systems agencies in Subsec. (b); P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; (Revisor's note: In 1995 in Subsec. (d) of words “the health center of said University” were changed editorially by the Revisors to “The University of Connecticut Health Center” for consistency with other statutory references); P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995.

Sec. 19a-188. (Formerly Sec. 19-73jj). Transfer of staff and funds. All existing staff, equipment and office supplies and all budgeted funds for the Emergency Medical Services Division of the Commission on Hospitals and Health Care are hereby transferred to and made part of the Office of Emergency Medical Services.

(P.A. 75-112, S. 15, 18; P.A. 95-257, S. 39, 58.)

History: Sec. 19-73jj transferred to Sec. 19a-188 in 1983; P.A. 95-257 replaced Commission on Hospitals and Health Care with Office of Health Care Access, effective July 1, 1995 (Revisor's note: This section took effect on May 16, 1975, and since its provisions are obsolete the Revisors did not change the reference to the former Commission on Hospitals and Health Care).

Secs. 19a-189 to 19a-192. (Formerly Secs. 19-73kk to 19-73nn). Definitions. Municipal contracts with volunteer ambulance companies; residence requirements. Volunteer ambulance personnel compensated under chapter 568; hypertension or heart disease presumptions. Benefits for volunteers serving another ambulance company. Sections 19a-189 to 19a-192, inclusive, are repealed, effective July 1, 1997.

(P.A. 75-102, S. 1–4; P.A. 77-502, S. 2; P.A. 79-376, S. 22, 23; P.A. 81-279; June 18 Sp. Sess. P.A. 97-8, S. 87, 88.)

Sec. 19a-192a. Transferred to Chapter 447, Sec. 23-14a.

Sec. 19a-193. Transferred to Chapter 384d, Sec. 20-206jj.

Sec. 19a-193a. Liability for emergency medical treatment services or transportation services provided by an ambulance service or paramedic intercept service. Liability for medical services or transport services under nonemergency conditions from mobile integrated health care program. (a) Except as provided in subsection (c) of this section and subject to the provisions of sections 19a-177, 38a-498 and 38a-525, any person who receives emergency medical treatment services or transportation services from a licensed ambulance service, certified ambulance service or paramedic intercept service shall be liable to such ambulance service for the reasonable and necessary costs of providing such services, irrespective of whether such person agreed or consented to such liability.

(b) Except as provided in subsection (c) of this section, any person who receives medical services or transport services under nonemergency conditions from a mobile integrated health care program shall be liable to such mobile health care integrated program for the reasonable and necessary costs of providing such services.

(c) The provisions of this section shall not apply to any person who receives emergency medical treatment services or transportation services from a licensed ambulance service, certified ambulance service, paramedic intercept service or mobile integrated health care program for an injury arising out of and in the course of such person's employment as defined in section 31-275.

(P.A. 12-142, S. 1; P.A. 14-231, S. 50; P.A. 19-118, S. 69.)

History: P.A. 14-231 added “or paramedic intercept service” and made technical changes; P.A. 19-118 added new Subsec. (b) re liability for services from mobile health care integrated program, redesignated existing Subsec. (b) as Subsec. (c) and amended same by adding reference to mobile integrated health care program, and made technical and conforming changes, effective July 1, 2019.

Sec. 19a-193b. Collection of payment by an ambulance service. An ambulance service, as defined in section 19a-175, shall make a good faith effort to determine whether a person has health insurance coverage prior to attempting to collect payment from such person for services provided to such person. If the ambulance service determines that such person has health insurance coverage, such ambulance service shall not attempt to collect payment, other than a coinsurance, copayment or deductible, for any covered medical services provided to such person prior to receiving oral or written notice from such person's health insurer that it declines to pay for such services. If the health insurer does not pay for such services or provide notice that it declines to pay for such services on or before the sixtieth calendar day after receiving a bill for such services, the ambulance service may attempt to collect payment from such person for such services.

(P.A. 15-110, S. 1.)

Sec. 19a-194. (Formerly Sec. 19-73pp). Motorcycle rescue vehicles. (a) A motorcycle equipped to handle medical emergencies shall be deemed a rescue vehicle. The commissioner shall issue a safety certificate to such motorcycle upon examination of such vehicle and a determination that such motorcycle (1) is in satisfactory mechanical condition, (2) is as safe to operate as the average motorcycle, and (3) is equipped with such emergency medical equipment as may be required by subsection (b) of this section.

(b) The commissioner shall annually issue a list specifying the minimum equipment that a motorcycle must carry to operate as a rescue vehicle pursuant to this section. Such equipment shall include those items that would enable an emergency medical technician, paramedic or other individual similarly trained to render to a person requiring emergency medical assistance the maximum benefit possible from the operation of such motorcycle rescue vehicle.

(P.A. 78-156, S. 1; P.A. 98-195, S. 12; P.A. 09-232, S. 35; P.A. 14-231, S. 47.)

History: Sec. 19-73pp transferred to Sec. 19a-194 in 1983; P.A. 98-195 transferred authority over motorcycle rescue vehicles from the director of the Office of Emergency Medical Services to the Commissioner of Public Health, and made regulations discretionary rather than mandatory; P.A. 09-232 amended Subsec. (b) by replacing provision re regulations concerning equipment motorcycles must carry to operate as rescue vehicles with provision requiring commissioner to issue annual list concerning minimum equipment requirements for such motorcycles, effective January 1, 2010; P.A. 14-231 amended Subsec. (a) by deleting reference to Sec. 19a-181.

Sec. 19a-195. Regulations re staffing of ambulances. The commissioner shall adopt regulations in accordance with the provisions of chapter 54 to require all ambulances to be staffed by at least one certified emergency medical technician, who shall be in the patient compartment attending the patient during all periods in which a patient is being transported, and one certified emergency medical responder.

(P.A. 81-260; P.A. 21-121, S. 58.)

History: P.A. 21-121 replaced “emergency medical response services” with “ambulances” and “medical response technician” with “emergency medical responder”.

Secs. 19a-195a and 19a-195b. Regulations re recertification and state-wide standardization of certification. Reinstatement of expired certification; validity of expired certificate. Sections 19a-195a and 19a-195b are repealed, effective October 1, 2015.

(P.A. 83-240; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 97-170; P.A. 00-135, S. 6, 21; P.A. 01-1, S. 2, 3; P.A. 09-232, S. 36, 37; P.A. 10-18, S. 9; P.A. 13-306, S. 2; P.A. 14-194, S. 12; 14-231, S. 23; P.A. 15-223, S. 13.)

Sec. 19a-196. Complaints against emergency medical services councils, hearings and appeals. (a) For purposes of this section and sections 19a-196a and 19a-196b, “municipality” means any town, city or borough, whether consolidated or unconsolidated.

(b) For purposes of this section, the Commissioner of Public Health may appoint hearing officers to investigate complaints filed pursuant to this section.

(c) Any municipality aggrieved by any action of an emergency medical service council may file a written complaint with the commissioner describing such action and shall mail a copy of such complaint to the party that is the subject of the complaint. Any complaint filed pursuant to this section shall be filed not later than one hundred eighty days after the alleged act. Upon receipt of a properly filed complaint, the commissioner shall refer such complaint to a hearing officer appointed to investigate such complaints. The hearing officer shall, after investigation and not later than ninety days after the date of such referral, either (1) make a report to the commissioner recommending dismissal of the complaint or (2) issue an official written complaint charging the emergency medical service council with the appropriate violation. Upon receiving a report from the officer recommending dismissal of the complaint, the commissioner may issue an order dismissing the complaint or may order a further investigation or a hearing thereon. Upon receiving a complaint issued by the officer, the commissioner shall set a time and place for the hearing. The hearing shall be held in accordance with the provisions of chapter 54. If no such report or complaint is issued, the commissioner may, in his discretion, proceed to a hearing upon the party's original complaint in accordance with the provisions of chapter 54.

(d) A final decision shall be in writing and shall include any findings of fact and conclusions of law necessary to the commissioner's decision. Findings of fact shall be based exclusively on the evidence in the record. The final decision shall be delivered promptly to each party or his authorized representative, personally or by United States mail, certified or registered, postage prepaid, return receipt requested. The final decision shall be effective when personally delivered or mailed.

(e) A municipality aggrieved by a decision of the commissioner pursuant to this section may appeal therefrom to the Superior Court in accordance with the provisions of section 4-183.

(P.A. 95-198, S. 1; 95-257, S. 12, 21, 58; P.A. 98-195, S. 13.)

History: P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 98-195 transferred authority over complaints against council from the director of the Office of Emergency Medical Services to the Commissioner of Public Health, and made technical changes.

Sec. 19a-196a. Termination of services to municipalities restricted. No emergency medical service council or emergency communication system shall terminate service to any municipality which participates in such council or system or which is a member of an agency or regional emergency medical service council which participates in such council or system for nonpayment of a disputed bill during the pendency of any complaint, investigation, hearing or appeal involving such dispute, provided the subscriber shall pay the amount of any current and undisputed bills during such pendency.

(P.A. 95-198, S. 2.)

Sec. 19a-196b. Response to calls from other municipalities. Transporting patients to the state's mobile field hospital. (a) Each emergency medical service council and emergency medical service system shall respond to and honor calls from any municipality that participates in another emergency medical service council or emergency communication system or which is a member of an agency that participates in such council or system.

(b) Any licensed or certified ambulance may transport patients to the state's mobile field hospital when the hospital has been deployed by the Governor or the Governor's designee for the purposes specified in subsection (a) of section 19a-487.

(P.A. 95-198, S. 3; P.A. 07-252, S. 72; P.A. 10-117, S. 60.)

History: P.A. 07-252 designated existing provisions as Subsec. (a), made technical changes therein and added Subsec. (b) authorizing ambulances to transport patients to state's mobile field hospital upon deployment by the Governor or the Governor's designee, effective July 12, 2007; P.A. 10-177 amended Subsec. (b) by replacing reference to Sec. 19a-490(m) with reference to Sec. 19a-487(a).

Sec. 19a-197. Automatic external defibrillators. Registry established. Regulations. Simultaneous communication with physician not required. Section 19a-197 is repealed, effective October 1, 2008.

(P.A. 98-62, S. 3; P.A. 00-47, S. 1; P.A. 08-184, S. 63.)

Sec. 19a-197a. Administration of epinephrine. (a) As used in this section, “emergency medical technician” means (1) any class of emergency medical technician certified under regulations adopted pursuant to section 20-206oo, including, but not limited to, any advanced emergency medical technician, and (2) any paramedic licensed pursuant to section 20-206ll.

(b) Any emergency medical technician who has been trained, in accordance with national standards recognized by the Commissioner of Public Health, in the administration of epinephrine using automatic prefilled cartridge injectors or similar automatic injectable equipment and who functions in accordance with written protocols and the standing orders of a licensed physician serving as an emergency department director may administer epinephrine using such injectors or equipment. All emergency medical technicians shall receive such training. All licensed or certified ambulances shall be equipped with epinephrine in such injectors or equipment which may be administered in accordance with written protocols and standing orders of a licensed physician serving as an emergency department director.

(P.A. 00-135, S. 16, 21; P.A. 09-232, S. 38; P.A. 15-223, S. 4.)

History: P.A. 00-135 effective January 1, 2001; P.A. 09-232 redefined “emergency medical technician” in Subsec. (a), effective January 1, 2010; P.A. 15-223 amended Subsec. (a) by replacing “19a-179” with “20-206oo”.

Sec. 19a-197b. Training standards for the use of automatic external defibrillators. A paid or volunteer firefighter or police officer, a member of a ski patrol, a lifeguard, a conservation officer, patrol officer or special police officer of the Department of Energy and Environmental Protection or emergency medical service personnel who has been trained in the use of an automatic external defibrillator in accordance with the standards set forth by the American Red Cross or American Heart Association shall not be subject to additional requirements, except recertification requirements, in order to use an automatic external defibrillator.

(June Sp. Sess. P.A. 01-4, S. 38; P.A. 11-80, S. 1.)

History: Pursuant to P.A. 11-80, “Department of Environmental Protection” was changed editorially by the Revisors to “Department of Energy and Environmental Protection”, effective July 1, 2011.

Sec. 19a-197c. Automatic external defibrillators required on public golf courses. Each public golf course, as defined in section 30-33, shall provide and maintain in a central location on the premises of the public golf course, at least one automatic external defibrillator, as defined in section 19a-175.

(P.A. 06-195, S. 54.)

Secs. 19a-198 and 19a-199. Reserved for future use.