Senate Bill No. 21
(By Senators Oliverio and Kessler)
[Introduced January 14, 1998;
referred to the Committee on Health and Human Resources; and
then to the Committee on Finance.]
A BILL to amend chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article four-d, relating
to public health; creating the children's emergency medical
and injury prevention systems act; legislative findings and
declaration; definitions; coordinator of emergency medical
service systems for children; program; advisory council; and
Be it enacted by the Legislature of West Virginia:
That chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article four-d, to read
ARTICLE 4D. CHILDREN'S EMERGENCY MEDICAL AND INJURY PREVENTION SYSTEMS ACT.
§16-4D-1. Legislative findings and declarations.
The Legislature finds and declares that:
(a) Traumatic injuries, such as automobile accidents,
bicycle accidents, drownings and poisonings are the most common
cause of death in children over the age of one; and children have
a high death rate in these emergency situations. Lifetime cost
associated with injury has been estimated at thirteen billion
eight hundred million dollars for children under the age of
fifteen years and thirty-nine billion one hundred million dollars
for ages fifteen to twenty-four years. Available estimates
indicate that the implementation of comprehensive and effectively
linked services for emergency medical care does insure better
outcomes and that the economic benefits of an emergency medical
service system enhanced to address the needs of children would be
(b) Children react differently than adults to stress,
metabolize drugs differently, and suffer different illnesses and
injuries. Because of these differences, children's emergency
medical needs should be recognized.
(c) Emergency medical systems training programs focus almost
exclusively on adults and therefore currently offer inadequate
hours of pediatric training. In addition, many emergency medical
service systems personnel have insufficient clinical experience with children, indicating a public health need to improve
training of these personnel in pediatric emergencies.
(d) It is the public policy of this state that children are
entitled to comprehensive emergency medical services and injury
prevention systems, including prehospital, hospital and
rehabilitative care, and that the public is entitled to accurate
information regarding the availability of such systems.
(e) A 1993 report from the Institute of Medicine of the
National Academy of Sciences found that emergency medical
services for children in the United States are inadequate. The
report recommends that states develop emergency medical systems
capability to care for children to ensure that children receive
adequate and appropriate emergency medical care necessary to
prevent loss of life and human potential.
As used in this article:
"Advanced life support" means an advanced level of
prehospital, interhospital and emergency service care that
includes basic life support functions, cardiac monitoring,
cardiac defibrillation, telemetered electrocardiography,
administration of antiarrhythmic agents, intravenous therapy,
administration of specific medications, drugs and solutions, use
of adjunctive ventilation devices, trauma care and other
techniques and procedures authorized in writing by the commissioner pursuant to department rule and the provisions of
section three, article four-c, chapter sixteen of this code.
"Advisory council" means the emergency medical service and
injury prevention systems for the children advisory council
(EMSC) established pursuant to section five of this article.
"Basic life support" means a basic level of prehospital care
which includes patient stabilization, airway clearance,
cardiopulmonary resuscitation, hemorrhage control, initial wound
and fracture stabilization and other techniques and procedures
authorized by the commissioner.
"Commissioner" means the commissioner of the department of
"Coordinator" means the person coordinating the EMSC program
within the office of emergency medical service systems in the
department of health.
"Department" means the department of health.
"EMIPSC program" means the emergency medical service and
injury prevention systems for children program, pursuant to
section three of this article, and other relevant activities
conducted by the office of emergency medical service systems in
the department of health in support of prevention programs and
the appropriate treatment, transport and triage of ill or injured
"Emergency medical services systems personnel" means persons trained to provide emergency medical care and certified or
licensed to do so whether on a paid volunteer basis, as part of
a basic life support or advanced life support prehospital
emergency care service or in an emergency department or pediatric
critical care or specialty unit in a licensed hospital.
"Prehospital care" means emergency medical care or
transportation by persons trained to provide emergency medical
care, and certified or licensed to do so at the scene of an
emergency and while transporting sick or injured persons to a
medical care facility or provider.
§16-4D-3. Office of emergency medical systems for children
(a) There is established within the office of emergency
medical services systems, in the department of health, the
emergency medical service and injury prevention systems for
children (EMIPSC) program.
(b) The commissioner shall hire a full-time coordinator for
the EMIPSC program in consultation with and by the recommendation
of the advisory council. The state may choose to place the
coordinator and the charge to develop the EMIPSC program with the
West Virginia emergency medical services technical support
network, the nonprofit corporation maintained to administer the
West Virginia state emergency medical service (EMS) system.
(c) The coordinator shall implement the statewide EMIPSC following consultation with, and at the recommendation of, the
advisory council. The coordinator shall serve as a liaison to
the advisory council.
(d) The coordinator may employ professional, technical,
research and clerical staff as necessary within the limits of
The coordinator may solicit and accept grants of funds
from the federal government and from other public and private
(f) The coordinator shall annually file a public report with
the Legislature on the state of emergency medical service for
children in the state of West Virginia.
§16-4D-4. EMIPSC program.
The EMIPSC program shall include, but not be limited to, the
establishment of the following:
(a) Initial and continuing education programs for emergency
medical service systems personnel that include training in the
emergency care of infants and children;
(b) Guidelines for referring children to appropriate
emergency treatment facilities;
(c) Pediatric equipment guidelines for prehospital care;
(d) Guidelines for hospital-based emergency departments
appropriate for pediatric care to assess, stabilize and treat
critically ill infants and children, either to resolve the problem, or to prepare the child for transfer to a pediatric
intensive care unit or a pediatric trauma center;
(e) Guidelines for pediatric intensive care units, pediatric
trauma center and intermediate care units fully equipped and
staffed by appropriately trained critical care pediatric
physicians, surgeons, nurses and therapists;
(f) An interhospital transfer system for critically ill or
(g) Pediatric rehabilitation units staffed by rehabilitation
specialists and capable of providing any service required to
assure maximum recovery from the physical, emotional and
cognitive effects of critical illness and severe trauma;
(h) Guidelines for the implementation of injury prevention
programs throughout the state in conjunction with local fire,
public safety and school personnel;
(i) Guidelines for the collection, analysis and public
dissemination of quality assurance information regarding ongoing
improvements in the EMIPSC program. The identities of patients,
emergency and critical care medical services personnel and
emergency and critical care medical services facilities
mentioned, referenced or otherwise appearing in any information
or data collected or prepared pursuant to the EMSIPC program
shall be treated as strictly confidential. The identities of
such persons or entities are not available to the public under the state freedom of information act or discoverable or
admissible in any civil, administrative or criminal proceeding.
An individual in attendance at any such proceeding may not be
required to testify as to the identity of any such person or
(j) A West Virginia EMS pediatric advisory committee
consisting of a pediatric advisor to each of the seven EMS
regional critical care committees in the state. The pediatric
consultant will be chosen by the respective region.
§16-4D-5. Emergency medical service and injury prevention
systems for children's advisory council.
(a) There is created an emergency medical service and injury
prevention systems for children's advisory council to advise the
office of emergency medical service systems and the coordinator
of the EMIPSC program on all matters concerning emergency medical
service systems for children. The advisory council shall assist
in the formulation of policy and rules to effectuate the purposes
of this article. This council shall provide a voting physician
representative to the West Virginia state EMS advisory council
which will necessarily approve guidelines for incorporation into
the state EMS system.
(b) The advisory council shall consist of a minimum of
fifteen public members to be appointed by the governor, based on
recommendation of the state medical director of EMS and other groups listed below, for a term of three years. Membership of
the advisory council shall include: One practicing pediatrician;
one pediatric critical care physician; one pediatric emergency
medical physician and one pediatric psychiatrist or licensed
psychologist to be appointed upon the recommendation of the West
Virginia chapter of the American academy of pediatrics; one
pediatric surgeon to be appointed upon the recommendation of the
West Virginia chapter of the American college of surgeons; one
emergency physician, to be appointed upon the recommendation of
the West Virginia chapter of the American college of emergency
physicians; one emergency medical technician and one paramedic,
to be appointed upon the recommendation of the mountain state EMS
association; one paramedic to be appointed upon the
recommendation of the West Virginia ambulance association; one
family practice physician, to be appointed upon the
recommendation of the West Virginia chapter of the American
family practice association; one registered emergency nurse to be
appointed upon recommendation of the West Virginia state
emergency nurses association and three members, each with a non- medical background, two of whom are parents with one or more
children under the age of eighteen who are not state employees,
to be appointed upon the recommendation of the governor's council
on children, family and youth. Other members of the council
shall include the seven physicians who are also appointed to serve as pediatric consultants to the seven West Virginia EMS
regional critical care committees. This group shall meet at
least once yearly.
(c) Vacancies on the advisory council shall be filled for
the unexpired term by appointment of the governor in the same
manner as originally filled. The members of the advisory council
shall serve without compensation, but shall be reimbursed for
necessary expenses incurred in the performance of their duties as
funds are available. The advisory council shall elect a
chairperson, who may select from among the members a vice- chairperson and other officers or subcommittees that are deemed
necessary or appropriate. The council may further organize
itself in any manner it deems appropriate and enact bylaws as
deemed necessary to carry out the responsibilities of the
§16-4D-6. Additional administrative procedures.
The commissioner shall, pursuant to the administrative
procedures act, adopt rules necessary to implement the purposes
of this article.
NOTE: This bill creates the Children's Emergency Medical
and Injury Prevention Systems Act. It establishes a coordinator
and advisory group within the state emergency medical service
system to address the needs of children in emergency situations.
This article is new; therefore, strike-throughs and
underscoring have been omitted.