S To recognize and clarify the authority of the States to regulate intrastate helicopter medical services, and for other purposes.
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- Mervin Shanon Benson
- 8 years ago
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1 II 1TH CONGRESS 1ST SESSION S. 4 To recognize and clarify the authority of the States to regulate intrastate helicopter medical services, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL, 09 Mrs. MCCASKILL (for herself and Ms. SNOWE) introduced the following bill; which was read twice and referred to the Committee on Commerce, Science, and Transportation A BILL To recognize and clarify the authority of the States to regulate intrastate helicopter medical services, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the Helicopter Medical Services Patient Safety, Protection, and Coordination Act. SEC. 2. FINDINGS. SMARTINEZ on PROD1PC64 with BILLS Congress finds the following: VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
2 2 1 (1) The Federal Aviation Administration is re- 2 sponsible for regulating civil aviation in the United 3 States. 4 (2) Each State is responsible for the regulation 5 of public health planning and protection, patient 6 safety and protection, emergency medical services, the quality and coordination of medical care, and the practice of medicine within its jurisdiction. 9 (3) Helicopter medical services are an essential component of the health care delivery and emergency medical services system in each State and are inte- gral to each State s management of public health 13 planning and protection, patient safety and protec- 14 tion, emergency medical services, the quality and co- 15 ordination of medical care, and the practice of medi- cine within the State s jurisdiction. 1 (4) Existing or future regulation of helicopter medical services by the several States is in the public interest. (5) Helicopter medical services represent a unique and discrete area of air transportation be- cause those services present issues involving the ade- quacy and availability of medical services to patients. (6) Court rulings and statutory interpretations 25 issued by the Secretary of Transportation have im- VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
3 3 1 posed limitations on, impeded, or prevented, the abil- 2 ity of States to effectively regulate helicopter medical 3 services in a manner similar to the regulation of 4 other health care services by the States. 5 () Those rulings and interpretations have con- 6 cluded that certain State actions related to public health planning and protection, patient safety and protection, emergency medical services, the quality 9 and coordination of medical care, and the practice of medicine, and related aspects of helicopter medical services, are preempted by Federal law, either pur- suant to the preemption provisions of the Airline De- 13 regulation Act of (Public Law ; Stat. 5) or through the application of the field 15 occupation preemption doctrine. () The Airline Deregulation Act of did 1 not contemplate helicopter medical services, and the use of the Act to strike down intrastate health-re- lated regulations overseeing the provision of heli- copter medical services that would otherwise be per- missible with respect to any other segment of the health care industry is not in the public interest. (9) At the same time, it is also important to en- sure that the Federal Aviation Administration s ple- 25 nary and exclusive jurisdiction over matters of avia- VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
4 4 1 tion safety is not infringed by any State. Accord- 2 ingly, any State health-related regulation of heli- 3 copter medical services must be harmonized and 4 shall not be inconsistent with Federal regulation of 5 aviation safety because the safe operation of the hel- 6 icopter medical services flight is of paramount im- portance. () Accordingly, there is a need for clarifica- 9 tion of existing Federal law so that States may regu- late helicopter medical services with respect to public health planning and protection, patient safety and protection, emergency medical services, the quality 13 and coordination of medical care, and the practice of 14 medicine without infringing on the Federal govern- 15 ment s plenary power to regulate aviation safety. 1 SEC. 3. CLARIFICATION OF STATE AUTHORITY OVER HELI- COPTER MEDICAL SERVICES. (a) IN GENERAL. Chapter 401 of title 49, United States Code, is amended by adding at the end the following: Clarification of State authority over helicopter medical services (a) CLARIFICATION OF STATE AUTHORITY. Noth- ing in this subtitle shall prohibit a State from VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
5 5 1 (1) requiring medical licenses for the provision 2 of helicopter medical services between locations with- 3 in the State; or 4 (2) prescribing regulations relating to the pro- 5 vision of such services if such regulations are pre- 6 scribed pursuant to subsection (c), (d), or (e) (b) APPLICABILITY OF FEDERAL AVIATION SAFETY AUTHORITY. No State health-related regulation established pursuant to this section shall supersede or be inconsistent with any Federal operating requirement with respect to aviation safety. (c) STATE AUTHORITY OVER MEDICAL SERV- ICES. A State may prescribe regulations relating to the provision of helicopter medical services with respect to the following: (1) The medical qualifications and medical training of helicopter medical personnel, except that a State may not impose any requirement with respect to a pilot. (2) The obligation of providers of helicopter medical services to comply with the health planning, patient safety, and medical service requirements of the State, including (A) coordination of the interrelationship, interaction, and agreements among providers of VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
6 6 1 helicopter medical services, providers of other 2 emergency medical services, providers of other 3 medical transport services, referring entities, 4 and medical institutions that receive patients 5 transported by providers of helicopter medical 6 services with respect to the transport of pa- tients; (B) demonstration of adequate capacity 9 to provide helicopter medical services; (C) demonstration of the need for new or expanded helicopter medical services; (D) determinations with respect to the 13 number and base location of helicopters used in 14 the provision of helicopter medical services 15 within the State or region of the State or the regulation of competition for specific markets 1 within the State; (E) affiliation with health care institu- tions; (F) sanitation and infection control proto- cols; (G) medical records requirements; (H) quality of medical care requirements, including participation in patient safety and 25 medical quality control efforts, such as peer re- VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
7 1 view processes, utilization review, and error re- 2 porting systems; and 3 (I) the proffer of gifts of monetary value 4 (other than training or educational programs) 5 to referring entities (or personnel employed by 6 such entities) within the State (d) STATE AUTHORITY OVER MEDICAL SERVICES SUBJECT TO HARMONIZATION REQUIREMENT. A State may prescribe regulations relating to the provision of helicopter medical services with respect to the following, if such regulations are harmonized with, and do not infringe upon, any applicable Federal operating requirements: (1) The establishment of appropriate medical criteria for determining the appropriate medical institution to receive a patient being transported from the scene at which the patient s injury or accident, or other event resulting in the need for medical services for the patient, occurred. (2) The specification of service requirements with respect to geographic areas within the State or during specified hours and days. (3) The coordination of flight requests for emergency helicopter medical services. (4) The compliance with accreditation requirements regarding medical services, except where such VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm 0000 Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
8 1 requirements infringe upon relevant Federal oper- 2 ating requirements. 3 (5) The provision of emergency helicopter 4 medical services to all persons for whom such serv- 5 ices are medically necessary and appropriate (e) STATE AUTHORITY OVER MEDICAL SERVICES SUBJECT TO CONSISTENCY REQUIREMENT. (1) IN GENERAL. Subject to paragraph (2), a State may prescribe regulations relating to the provision of helicopter medical services with respect to the following, if such regulations are consistent with, and do not infringe upon, any applicable Federal operating requirements: (A) The necessary medical equipment and supplies to be carried on board or affixed to the helicopter. (B) The physical attributes of the helicopter (i) necessary for the provision of quality medical care, including (I) permanently installed climate control systems capable of meeting specified temperature settings; (II) a configuration that allows adequate access to the patient, med- VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm 0000 Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
9 9 1 ical equipment, and medical supplies 2 by the helicopter medical personnel; 3 (III) use of materials in the hel- 4 icopter that are appropriate for proper 5 patient care; 6 (IV) sufficient electrical supply to support medical equipment without compromising helicopter power; and 9 (V) the ability of the helicopter to transport a patient a certain dis- tance without refueling within the State; and 13 (ii) necessary 14 (I) for the protection of heli- 15 copter personnel, ground medical per- sonnel, and emergency response per- 1 sonnel; and (II) to ensure that the heli- copter has no structural or functional defects that may adversely affect such personnel, such as by requiring tailroter illumination for loading pa- tients at night or external search lights. VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
10 1 (C) Communication capabilities ena- 2 bling 3 (i) the helicopter medical personnel 4 to communicate with emergency medical 5 services and public safety personnel and 6 personnel at medical institutions that re- ceive patients transported by providers of helicopter medical services; and 9 (ii) the flightcrew to communicate with the helicopter medical personnel, to the extent that the communications do not interfere with the safe operation of the 13 flight (2) LIMITATIONS. (A) PROVIDERS LICENSED IN MULTIPLE STATES. If a provider of helicopter medical services is licensed to provide such services in more than one State and the regulations established pursuant to this subsection by the States in which the provider is licensed are inconsistent, the provider shall comply with the most stringent of such regulations. (B) NONDELEGATION REQUIREMENT. A State may not delegate authority provided VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm 000 Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
11 1 under this subsection to a political subdivision 2 of the State. 3 (f) INTERSTATE AGREEMENTS. In regulating the 4 provision of helicopter medical services pursuant to this 5 section, a State shall, if necessary, establish regulations 6 or negotiate mutual aid agreements with adjacent States or providers of helicopter medical services in adjacent States to ensure access to helicopter medical services 9 across State borders. (g) DEFINITIONS. In this section: (1) HELICOPTER MEDICAL SERVICES. The term helicopter medical services means the helicopter transport of a patient, in both emergency and nonemergency situations, as well as the medical services provided to such patient in the course of transport by such helicopter. (2) FEDERAL OPERATING REQUIREMENTS. The term Federal operating requirements means requirements under part A of subtitle VII of title 49, United States Code, and Federal aviation regulations set forth in title 14, Code of Federal Regulations. (3) REFERRING ENTITIES. The term referring entity means any entity that dispatches or provides a referral for a provider of helicopter medical VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm 000 Fmt 6652 Sfmt 61 E:\BILLS\S4.IS S4
12 services, such as a medical institution, an agency providing emergency medical services, or a first responder.. (b) CONFORMING AMENDMENT. The table of sections at the beginning of chapter 401 of title 49, United States Code, is amended by adding at the end the following: Clarification of State authority over intrastate helicopter medical services.. Æ SMARTINEZ on PROD1PC64 with BILLS VerDate Nov 0 04:53 Apr, 09 Jkt 090 PO Frm 000 Fmt 6652 Sfmt 6301 E:\BILLS\S4.IS S4
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