Enrolled Version - Final Version
House Bill 4143 History
OTHER VERSIONS -
HB4143 SUB ENR
H. B. 4143
(By Delegates Morgan, Stevens, Staggers,
Swartzmiller, Talbott, Martin, Givens,
C. Miller, Hartman, Butcher and Rowan)
[Passed March 13, 2010; in effect from passage.]
to repeal §16-4C-5a of the Code of West Virginia, 1931, as
amended; to amend and reenact §16-4C-3, §16-4C-6, §16-4C-6a,
§16-4C-8, §16-4C-9, §16-4C-10, §16-4C-12 and §16-4C-16 of said
code, all relating to emergency medical services; revising
definitions; revising powers and duties of the commissioner;
revising rulemaking authority; revising requirement to review
statewide emergency medical services implementation plan;
revising requirements to operate emergency medical vehicle;
revising standards for emergency medical service personnel;
requiring applicants to allow the State Police access to
personal background information; removing nonutilized code
sections; requiring certified persons to report violations;
providing immunity from civil liability for reporting
violations; clarifying procedures for complaint investigation,
hearings, rights of appeal and judicial review; removing automatic stay on appeal; increasing criminal penalties;
clarifying limitations on immunity in the absence of required
insurance policy; and removing antiquated language.
Be it enacted by the Legislature of West Virginia:
That §16-4C-5a of the Code of West Virginia, 1931, as amended,
be repealed; that §16-4C-3, §16-4C-6, §16-4C-6a, §16-4C-8,
§16-4C-9, §16-4C-10, §16-4C-12 and §16-4C-16 of said code be
amended and reenacted, all to read as follows:
ARTICLE 4C. EMERGENCY MEDICAL SERVICES ACT.
As used in this article, unless the context clearly requires
a different meaning:
(a) "Ambulance" means any privately or publicly-owned vehicle
or aircraft which is designed, constructed or modified; equipped or
maintained; and operated for the transportation of patients,
including, but not limited to, emergency medical services vehicles;
rotary and fixed wing air ambulances; gsa kkk-A-1822 federal
standard type I, type II and type III vehicles; and specialized
multipatient medical transport vehicles operated by an emergency
medical services agency;
(b) "Commissioner" means the Commissioner of the Bureau for
(c) "Council" means the Emergency Medical Service Advisory
Council created pursuant to this article;
(d) "Director" means the Director of the Office of Emergency
Medical Service in the Bureau for Public Health.
(e) "Emergency Medical Services" means all services which are
set forth in Public Law 93-154 "The Emergency Medical Services
Systems Act of 1973" and those included in and made a part of the
emergency medical services plan of the Department of Health and
Human Resources inclusive of, but not limited to, responding to the
medical needs of an individual to prevent the loss of life or
aggravation of illness or injury;
(f) "Emergency medical service agency" means any agency
licensed under section six-a of this article to provide emergency
(g) "Emergency medical service personnel" means any person
certified by the commissioner to provide emergency medical services
as set forth by legislative rule;
(h) "Emergency medical service provider" means any authority,
person, corporation, partnership or other entity, public or
private, which owns or operates a licensed emergency medical
services agency providing emergency medical service in this state;
(i) "Governing body" has the meanings ascribed to it as
applied to a municipality in subdivision (1), subsection (b),
section two, article one, chapter eight of this code;
(j) "Line officer" means the emergency medical service
personnel, present at the scene of an accident, injury or illness,
who has taken the responsibility for patient care;
(k) "Medical command" means the issuing of orders by a
physician from a medical facility to emergency medical service
personnel for the purpose of providing appropriate patient care;
(l) "Municipality" has the meaning ascribed to it in
subdivision (1), subsection (a), section two, article one, chapter
eight of this code;
(m) "Patient" means any person who is a recipient of the
services provided by emergency medical services;
(n) "Service reciprocity" means the provision of emergency
medical services to citizens of this state by emergency medical
service personnel certified to render those services by a
(o) "Small emergency medical service provider" means any
emergency medical service provider which is made up of less than
twenty emergency medical service personnel; and
(p) "Specialized multipatient medical transport" means a type
of ambulance transport provided for patients with medical needs
greater than those of the average population, which may require the
presence of a trained emergency medical technician during the
transport of the patient: Provided, That the requirement of
"greater medical need" may not prohibit the transportation of a
patient whose need is preventive in nature.
§16-4C-6. Powers and duties of commissioner.
The commissioner has the following powers and duties:
(a) To propose rules for legislative approval in accordance
with the provisions of article three, chapter twenty-nine-a of this
That the rules have been submitted at least thirty
days in advance for review by the Emergency Medical Services
Advisory Council, who may act only in the presence of a quorum.
The rules may include:
(1) Standards and requirements for certification and
recertification of emergency medical service personnel, including,
but not limited to:
(A) Age, training, testing and continuing education;
(B) Procedures for certification and recertification, and for
denying, suspending, revoking, reinstating and limiting a
certification or recertification;
(C) Levels of certification and the scopes of practice for each
(D) Standards of conduct; and,
(E) Causes for disciplinary action and sanctions which may be
(2) Standards and requirements for licensure and licensure
renewals of emergency medical service agencies, including:
(A) Operational standards, levels of service, personnel
qualifications and training, communications, public access, records
management, reporting requirements, medical direction, quality
assurance and review, and other requirements necessary for safe and
(B) Inspection standards and establishment of improvement periods to ensure maintenance of the standards;
(C) Fee schedules for licensure, renewal of licensure and other
(D) Procedures for denying, suspending, revoking, reinstating
or limiting an agency licensure;
(E) Causes for disciplinary action against agencies; and
(F) Administrative penalties, fines and other disciplinary
sanctions which may be imposed on agencies;
(3) Standards and requirements for emergency medical service
vehicles, including classifications and specifications;
(4) Standards and requirements for training institutions,
including approval or accreditation of sponsors of continuing
education, course curricula and personnel;
(5) Standards and requirements for a State Medical Direction
System, including qualifications for a State Emergency Medical
Services Medical Director and Regional Medical Directors, the
establishment of a State Medical Policy and Care Committee and the
designation of Regional Medical Command Centers;
(6) Provision of services by emergency medical services
personnel in hospital emergency rooms; and
(7) Any other rules necessary to carry out the provisions of
(b) To apply for, receive and expend advances, grants,
contributions and other forms of assistance from the state or
federal government or from any private or public agencies or foundations to carry out the provisions of this article.
(c) To design, develop and review a Statewide Emergency Medical
Services Implementation Plan. The plan shall recommend aid and
assistance and all other acts necessary to carry out the purposes
of this article:
(1) To encourage local participation by area, county and
community officials and regional emergency medical services boards
of directors; and
(2) To develop a system for monitoring and evaluating emergency
medical services programs throughout the state.
(d) To provide professional and technical assistance and to
make information available to Regional Emergency Medical Services
Boards of Directors and other potential applicants or program
sponsors of emergency medical services for purposes of developing
and maintaining a statewide system of services.
(e) To assist local government agencies, Regional Emergency
Medical Services Boards of Directors and other public or private
entities in obtaining federal, state or other available funds and
(f) To cooperate and work with federal, state and local
governmental agencies, private organizations and other entities as
may be necessary to carry out the purposes of this article.
(g) To acquire in the name of the state by grant, purchase,
gift, devise or any other methods appropriate real and personal
property as may be reasonable and necessary to carry out the purposes of this article.
(h) To make grants and allocations of funds and property so
acquired or which may have been appropriated to the agency to other
agencies of state and local government as may be appropriate to
carry out the purposes of this article.
(i) To expend and distribute by grant or bailment funds and
property to all state and local agencies for the purpose of
performing the duties and responsibilities of the agency all funds
which it may have so acquired or which may have been appropriated
by the Legislature of this state.
(j) To develop a program to inform the public concerning
emergency medical services.
(k) To review and disseminate information regarding federal
grant assistance relating to emergency medical services.
(l) To prepare and submit to the Governor and Legislature
recommendations for legislation in the area of emergency medical
(m) To review, make recommendations for and assist in all
projects and programs that provide for emergency medical services
whether or not the projects or programs are funded through the
Office of Emergency Medical Services. A review and approval shall
be required for all emergency medical services projects, programs
or services for which application is made to receive state or
federal funds for their operation after the effective date of this
(n) To take all necessary and appropriate action to encourage
and foster the cooperation of all emergency medical service
providers and facilities within this state.
§16-4C-6a. Emergency medical services agency licensure.
(a) Any person who proposes to establish or maintain an
emergency medical services agency shall file an application with the
commissioner which includes the identity of the applicant, any
parent or affiliated entity, the proposed level of service and the
number of emergency medical service response vehicles of the agency
or proposed agency. The commissioner may require that additional
information be included on each application.
(b) Upon receipt and review of the application the commissioner
shall issue a license if he or she finds that the applicant meets
the requirements and quality standards, to be established by the
commissioner, for an emergency medical services agency license, and
if the applicant has certified under penalty of perjury that he or
she is current with all lawful obligations owed the State of West
Virginia, excluding obligations owed in the current quarter,
including, but not limited to, payment of taxes and workers'
compensation premiums: Provided,
That the certification set forth
in this paragraph
is required for the original application and
§16-4C-8. Standards for emergency medical service personnel.
(a) Every ambulance operated by an emergency medical service agency shall carry at least two personnel. At least one person
shall be certified in cardiopulmonary resuscitation or first aid and
the person in the patient compartment shall be certified as an
emergency medical technician-basic at a minimum except that in the
case of a specialized multipatient medical transport, only one staff
person is required and that person shall be certified, at a minimum,
at the level of an emergency medical technician-basic. The
requirements of this subsection will remain in effect until revised
by the legislative rule to be promulgated pursuant to subsection (b)
of this section.
(b) On or before May 28, 2010, the commissioner shall submit
a proposed legislative rule to the Emergency Medical Services
Advisory Council for review, and on or before June 30, 2010, shall
file the proposed legislative rule with the office of the Secretary
of State, in accordance with the provisions of chapter
twenty-nine-a, article three of this code, to establish
certification standards for emergency medical vehicle operators and
to revise the requirements for emergency medical service personnel.
(c) As of the effective date of the legislative rule to be
promulgated pursuant to subsection (b) of this section, emergency
medical service personnel who operate ambulances shall meet the
requirements set forth in the legislative rule.
(d) Any person desiring emergency medical service personnel
certification shall apply to the commissioner using forms and
procedures prescribed by the commissioner. Upon receipt of the application, the commissioner shall determine whether the applicant
meets the certification requirements and may examine the applicant,
if necessary to make that determination.
(e) The applicant shall submit to a national criminal
background check, the requirement of which is declared to be not
against public policy.
(1) The applicant shall meet all requirements necessary to
accomplish the national criminal background check, including
submitting fingerprints, and authorizing the West Virginia Office
of Emergency Medical Services, the West Virginia State Police and
the Federal Bureau of Investigation to use all records submitted and
produced for the purpose of screening the applicant for
(2) The results of the national criminal background check may
not be released to or by a private entity.
(3) The applicant shall submit a fee of $75 for initial
certification and a fee of $50 for recertification. The fees set
forth in this subsection remain in effect until modified by
(f) An application for an original, renewal or temporary
emergency medical service personnel certificate or emergency medical
services agency license, shall be acted upon by the commissioner and
the certificate or license delivered or mailed, or a copy of any
order of the commissioner denying any such application delivered or
mailed to the applicant, within fifteen days after the date upon which the complete application including test scores and background
checks, if applicable, was received by the commissioner.
(g) Any person may report to the commissioner or the Director
of the Office of Emergency Medical Services information he or she
may have that appears to show that a person certified by the
commissioner may have violated the provisions of this article or
legislative rules promulgated pursuant to this article. A person who
is certified by the commissioner, who knows of or observes another
person certified by the commissioner violating the provisions of
this article or legislative rules promulgated pursuant to this
article, has a duty to report the violation to the commissioner or
director. Any person who reports or provides information in good
faith is immune from civil liability.
(h) The commissioner may issue a temporary emergency medical
service personnel certificate to an applicant, with or without
examination of the applicant, when he or she finds that issuance to
be in the public interest. Unless suspended or revoked, a temporary
certificate shall be valid initially for a period not exceeding one
hundred twenty days and may not be renewed unless the commissioner
finds the renewal to be in the public interest.
§16-4C-9. Complaints; investigations; due process procedure;
grounds for disciplinary action.
(a) The commissioner may at any time upon his or her own
motion, and shall, upon the written complaint of any person, cause an investigation to be conducted to determine whether grounds exist
for disciplinary action under this article or legislative rules
promulgated pursuant to this article.
(b) An investigator or other person who, under the direction
of the commissioner or the director, gathers or reports information
in good faith to the commissioner or the director, is immune from
(c) After reviewing any information obtained through an
investigation, the commissioner or director shall determine if
probable cause exists that the licensee or certificate holder has
violated any provision of this article or rules promulgated pursuant
to this article.
(d) Upon a finding that probable cause exists that the licensee
or certificate holder has violated any provision of this article or
rules promulgated pursuant to this article, the commissioner or
director shall provide a copy of the complaint to the licensee or
(e) The commissioner or the director may enter into a consent
decree or hold a hearing for the suspension or revocation of the
license or certification or the imposition of sanctions against the
licensee or certificate holder.
(f) The commissioner or the director issue subpoenas and
subpoenas duces tecum to obtain testimony and documents to aid in
the investigation of allegations against any person or agency
regulated by the article.
(g) The commissioner or the director may sign a consent decree
or other legal document related to the complaint.
(h) The commissioner shall suspend or revoke any certificate,
temporary certificate or license when he or she finds the holder
(1) Obtained a certificate, temporary certificate or license
by means of fraud or deceit; or
(2) Been grossly incompetent, and/or grossly negligent as
defined by the commissioner in accordance with rules or by
prevailing standards of emergency medical services care; or
(3) Failed or refused to comply with the provisions of this
article or any legislative rule promulgated by the commissioner or
any order or final decision of the commissioner; or
(4) Engaged in any act during the course of duty which has
endangered or is likely to endanger the health, welfare or safety
of the public.
(i) The commissioner or the director may, after notice and
opportunity for hearing, deny or refuse to renew, suspend or revoke
the license or certification of, impose probationary conditions upon
or take disciplinary action against, any licensee or certificate
holder for any violation of this article or any rule promulgated
pursuant to this article, once a violation has been proven by a
preponderance of the evidence.
(j) Disciplinary action may include:
(3) Administrative penalties and fines;
(4) Mandatory attendance at continuing education seminars or
(5) Practicing under supervision or other restriction;
(6) Requiring the licensee or holder of a certificate to report
to the commissioner or director for periodic interviews for a
specified period of time;
(7) Other disciplinary action considered by the commissioner
or director to be necessary to protect the public, including
advising other parties whose legitimate interests may be at risk;
(8) Other sanctions as set forth by legislative rule
promulgated pursuant to this article.
(k) The commissioner shall suspend or revoke any certificate
, temporary certificate or license if he or she finds the existence
of any grounds which would justify the denial of an application for
the certificate, temporary certificate or license if application
were then being made for it.
§16-4C-10. Procedures for hearing; right of appeal; judicial
(a) Hearings are governed by the provisions of article five,
chapter twenty-nine a of this code.
(b) The commissioner or director may conduct the hearing or elect to have an Administrative Law Judge conduct the hearing.
(c) If the hearing is conducted by an Administrative Law Judge,
the Administrative Law Judge shall prepare a proposed written order
at the conclusion of a hearing containing findings of fact and
conclusions of law. The proposed order may contain proposed
disciplinary actions if the commissioner or director so directs.
The commissioner may accept, reject or modify the decision of the
Administrative Law Judge.
(d) The commissioner or director has the authority to
administer oaths, examine any person under oath and issue subpoenas
and subpoenas duces tecum.
(e) If, after a hearing, the commissioner or director
determines the licensee or holder of a certificate has violated any
provision of this article or the legislative rules promulgated
pursuant to this article, a formal written decision shall be
prepared which contains findings of fact, conclusions of law and a
specific description of the disciplinary actions imposed.
(f) The order of the Commissioner or director is final unless
vacated or modified upon judicial review.
(g) Any licensee or certificate holder adversely affected by
a final order made and entered by the commissioner or director is
entitled to judicial review. All of the pertinent provisions of
section four, article five, chapter twenty-nine-a of this code apply
to and govern the review with like effect as if the provisions of
the section were set forth herein.
(h) The judgment of the circuit court is final unless reversed,
vacated or modified on appeal to the Supreme Court of Appeals in
accordance with the provisions of section one, article six, chapter
twenty-nine-a of this code.
§16-4C-12. Violations; criminal penalties.
(a) When, as a result of an investigation under this article
or otherwise, the commissioner or director has reason to believe
that a licensee or certificate holder has committed a criminal
offense, the commissioner or director may bring the information to
the attention of an appropriate law-enforcement official.
(b) Any person who violates any law or rule or operates an
ambulance with an insufficient number of emergency medical service
personnel aboard when not lawfully permitted to do so, or who
represents himself or herself as a certified emergency medical
service personnel knowing the representation to be untrue, is guilty
of a misdemeanor and, upon conviction thereof, shall be fined not
less than $100 nor more than $1,000: Provided, That after July 1,
2010, the fine shall not be more than $5,000
§16-4C-16. Limitation of liability; mandatory errors and omissions
(a) Every person, corporation, ambulance service, emergency
medical service provider, emergency ambulance authority, emergency
ambulance service or other person which employs emergency medical
service personnel with or without wages for ambulance service or provides ambulance service in any manner, shall obtain a policy of
insurance insuring the person or entity and every employee, agent
or servant, against loss from the liability imposed by law for
damages arising from any error or omission in the provision of
emergency medical services as enumerated by this article, in an
amount no less than $1,000,000 per incident.
(b) No emergency medical service personnel or emergency medical
service provider is liable for civil damages or injuries in excess
of the amounts for which the person or entity is actually insured,
unless the damages or injuries are intentionally or maliciously
(c) Every person or entity required by this section to obtain
a policy of insurance shall furnish proof of the existence of the
policy to the commissioner on or before January 1 of each calendar
(d) Any person or entity who fails to secure a policy of
insurance before providing emergency medical services is not
entitled to the limited liability created by subsection (b) of this
section: Provided, That any physician, who gives instructions to
emergency medical service personnel without being compensated, or
who treats any patient transported in an ambulance or treats any
patient prior to the transport, without being compensated, is
entitled to the limited liability provided in subsection (b) of this