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Public Act 103-0521
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| HB1595 Enrolled | LRB103 06018 CPF 51045 b |
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Emergency Medical Services (EMS) Systems |
Act is amended by changing Sections 3.5, 3.25, 3.40, 3.45, and |
3.55 as follows:
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(210 ILCS 50/3.5)
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Sec. 3.5. Definitions. As used in this Act:
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"Clinical observation" means the ongoing observation of a |
patient's condition by a licensed health care professional |
utilizing a medical skill set while continuing assessment and |
care. |
"Department" means the Illinois Department of Public |
Health.
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"Director" means the Director of the Illinois Department |
of Public Health.
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"Emergency" means a medical condition of recent onset and |
severity that
would lead a prudent layperson, possessing an |
average knowledge of medicine and
health, to believe that |
urgent or unscheduled medical care is required.
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"Emergency Medical Services personnel" or "EMS personnel" |
means persons licensed as an Emergency Medical Responder (EMR) |
(First Responder), Emergency Medical Dispatcher (EMD), |
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Emergency Medical Technician (EMT), Emergency Medical |
Technician-Intermediate (EMT-I), Advanced Emergency Medical |
Technician (A-EMT), Paramedic (EMT-P), Emergency |
Communications Registered Nurse (ECRN), Pre-Hospital |
Registered Nurse (PHRN), Pre-Hospital Advanced Practice |
Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant |
(PHPA). |
"Exclusive representative" has the same meaning as defined |
in Section 3 of the Illinois Public Labor Relations Act. |
"Health care facility" means a hospital,
nursing home, |
physician's office or other fixed location at which
medical |
and health care services are performed. It does not
include |
"pre-hospital emergency care settings" which utilize EMS |
personnel to render
pre-hospital emergency care prior to the
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arrival of a transport vehicle, as defined in this Act.
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"Hospital" has the meaning ascribed to that
term in the |
Hospital Licensing Act.
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"Labor organization" has the same meaning as defined in |
Section 3 of the Illinois Public Labor Relations Act. |
"Medical monitoring" means the performance of medical |
tests and physical exams to evaluate an individual's ongoing |
exposure to a factor that could negatively impact that |
person's health. "Medical monitoring" includes close |
surveillance or supervision of patients liable to suffer |
deterioration in physical or mental health and checks of |
various parameters such as pulse rate, temperature, |
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respiration rate, the condition of the pupils, the level of |
consciousness and awareness, the degree of appreciation of |
pain, and blood gas concentrations such as oxygen and carbon |
dioxide. |
"Silver spanner program" means a
program in which a member |
under a fire department's or fire
protection district's |
collective bargaining agreement works on
or at the EMS System |
under another fire department's or fire
protection district's |
collective bargaining agreement and (i)
the other fire |
department or fire protection district is not
the member's |
full-time employer and (ii) any EMS services not
included |
under the original fire department's or fire protection |
district's collective bargaining agreement are
included in the |
other fire department's or fire protection district's |
collective bargaining agreement. |
"Trauma" means any significant injury which
involves |
single or multiple organ systems.
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(Source: P.A. 100-1082, eff. 8-24-19; 101-81, eff. 7-12-19.)
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(210 ILCS 50/3.25)
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Sec. 3.25. EMS Region Plan; Development.
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(a) Within 6 months after designation of an EMS
Region, an |
EMS Region Plan addressing at least the information
prescribed |
in Section 3.30 shall be submitted to the
Department for |
approval. The Plan shall be developed by the
Region's EMS |
Medical Directors Committee with advice from the
Regional EMS |
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Advisory Committee; portions of the plan
concerning trauma |
shall be developed jointly with the Region's
Trauma Center |
Medical Directors or Trauma Center Medical
Directors |
Committee, whichever is applicable, with advice from
the |
Regional Trauma Advisory Committee, if such Advisory
Committee |
has been established in the Region. Portions of the Plan |
concerning stroke shall be developed jointly with the Regional |
Stroke Advisory Subcommittee.
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(1) A Region's EMS Medical Directors
Committee shall |
be comprised of the Region's EMS Medical Directors,
along |
with the medical advisor to a fire department
vehicle |
service provider. For regions which include a municipal |
fire
department serving a population of over 2,000,000 |
people, that fire
department's medical advisor shall serve |
on the Committee. For other regions,
the fire department |
vehicle service providers shall select which medical
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advisor to serve on the Committee on an annual basis.
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(2) A Region's Trauma Center Medical Directors
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Committee shall be comprised of the Region's Trauma Center
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Medical Directors.
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(b) A Region's Trauma Center Medical Directors may
choose |
to participate in the development of the EMS Region
Plan |
through membership on the Regional EMS Advisory
Committee, |
rather than through a separate Trauma Center Medical Directors
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Committee. If that option is selected,
the Region's Trauma |
Center Medical Director shall also
determine whether a |
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separate Regional Trauma Advisory
Committee is necessary for |
the Region.
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(c) In the event of disputes over content of the
Plan |
between the Region's EMS Medical Directors Committee and the
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Region's Trauma Center Medical Directors or Trauma Center
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Medical Directors Committee, whichever is applicable, the
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Director of the Illinois Department of Public Health shall
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intervene through a mechanism established by the Department
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through rules adopted pursuant to this Act. An individual |
interviewed or investigated by an EMS Medical Director or the |
Department shall have the right to a union representative and |
legal counsel of the individual's choosing present at any |
interview. The union representative must comply with any |
confidentiality requirements and requirements for the |
protection of any patient information presented during the |
proceeding.
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(d) "Regional EMS Advisory Committee" means a
committee |
formed within an Emergency Medical Services (EMS)
Region to |
advise the Region's EMS Medical Directors
Committee and to |
select the Region's representative to the
State Emergency |
Medical Services Advisory Council,
consisting of at least the |
members of the Region's EMS
Medical Directors Committee, the |
Chair of the Regional
Trauma Committee, the EMS System |
Coordinators from each
Resource Hospital within the Region, |
one administrative
representative from an Associate Hospital |
within the Region,
one administrative representative from a |
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Participating
Hospital within the Region, one administrative
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representative from the vehicle service provider which
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responds to the highest number of calls for emergency service |
within
the Region, one representative from the vehicle service |
provider that responds to the highest number of calls for |
non-emergency services within the Region, one representative |
from the labor organization recognized as the exclusive |
representative of employees of the vehicle service provider |
that responds to the highest number of calls for non-emergency |
services within the Region, if applicable, one administrative |
representative of a vehicle
service provider from each System |
within the Region, one representative from a labor |
organization recognized as the exclusive representative of a |
vehicle service provider's employees in each System and |
selected by a statewide organization of such labor |
organizations, one individual from each level of license |
provided in Section 3.50 of this Act, one Pre-Hospital |
Registered Nurse
practicing within the Region,
and one |
registered professional nurse currently practicing
in an |
emergency department within the Region.
Of the 2 |
administrative representatives of vehicle service providers, |
at
least one shall be an administrative representative of a |
private vehicle
service provider. The
Department's Regional |
EMS Coordinator for each Region shall
serve as a non-voting |
member of that Region's EMS Advisory
Committee.
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Every 2 years, the members of the Region's EMS Medical
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Directors Committee shall rotate serving as Committee Chair,
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and select the Associate Hospital, Participating Hospital
and |
vehicle service providers which shall send
representatives to |
the Advisory Committee, and the
EMS personnel and nurse who |
shall serve on the
Advisory Committee.
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(e) "Regional Trauma Advisory Committee" means a
committee |
formed within an Emergency Medical Services (EMS)
Region, to |
advise the Region's Trauma Center Medical
Directors Committee, |
consisting of at least the Trauma
Center Medical Directors and |
Trauma Coordinators from each
Trauma Center within the Region, |
one EMS Medical Director
from a resource hospital within the |
Region, one EMS System
Coordinator from another resource |
hospital within the
Region, one representative each from a |
public and private
vehicle service provider which transports |
trauma patients
within the Region, an administrative |
representative from
each trauma center within the Region, one |
EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, or PHRN |
representing
the highest level of EMS personnel practicing |
within the Region, one
emergency physician, and one Trauma |
Nurse Specialist (TNS)
currently practicing in a trauma |
center. The Department's
Regional EMS Coordinator for each |
Region shall serve as a
non-voting member of that Region's |
Trauma Advisory
Committee.
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Every 2 years, the members of the Trauma Center Medical
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Directors Committee shall rotate serving as Committee Chair,
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and select the vehicle service providers, EMS personnel, |
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emergency
physician, EMS System Coordinator and TNS who shall |
serve on
the Advisory Committee.
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(Source: P.A. 98-973, eff. 8-15-14.)
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(210 ILCS 50/3.40)
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Sec. 3.40. EMS System Participation Suspensions and
Due |
Process. |
(a) An EMS Medical Director may suspend from
participation |
within the System any EMS personnel, EMS Lead Instructor (LI), |
individual, individual
provider or other participant |
considered not to be meeting
the requirements of the Program |
Plan of that approved EMS
System. An EMS Medical Director must |
submit a suspension order to the Department describing which |
requirements of the Program Plan were not met and the |
suspension's duration. The Department shall review and confirm |
receipt of the suspension order, request additional |
information, or initiate an investigation. The Department |
shall incorporate the duration of that suspension into any |
further action taken by the Department to suspend, revoke, or |
refuse to issue or renew the license of the individual or |
entity for any violation of this Act or the Program Plan |
arising from the same conduct for which the suspension order |
was issued if the suspended party has neither requested a |
Department hearing on the suspension nor worked as a provider |
in any other System during the term of the suspension.
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(b) Prior to suspending any individual or entity, an EMS |
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Medical Director
shall provide an opportunity for a hearing |
before the
local System review board in accordance with |
subsection (f) and the rules
promulgated by the Department.
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(1) If the local System review board affirms or |
modifies the EMS Medical
Director's suspension order, the |
individual or entity shall have the opportunity for
a |
review of the local board's decision by the State EMS |
Disciplinary Review
Board, pursuant to Section 3.45 of |
this Act.
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(2) If the local System review board reverses or |
modifies the EMS Medical
Director's order, the EMS Medical |
Director shall have the
opportunity for a review of the |
local board's decision by the State EMS
Disciplinary |
Review Board, pursuant to Section 3.45 of this Act.
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(3) The suspension shall commence only upon the |
occurrence of one of the
following:
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(A) the individual or entity has waived the |
opportunity for a hearing before
the local System |
review board; or
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(B) the order has been affirmed or modified by the |
local system review
board
and the individual or entity |
has waived the opportunity for review by the State
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Board; or
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(C) the order has been affirmed or modified by the |
local system review
board,
and the local board's |
decision has been affirmed or modified by the State
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Board. |
(c) An individual interviewed or investigated by the local |
system review board or the Department shall have the right to a |
union representative and legal counsel of the individual's |
choosing present at any interview. The union representative |
must comply with any confidentiality requirements and |
requirements for the protection of any patient information |
presented during the proceeding.
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(d) (c) An EMS Medical Director may immediately suspend an |
EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHRN, LI, PHPA, |
PHAPRN, or other individual or entity if he or she finds that |
the
continuation in practice by the individual or entity would |
constitute an
imminent danger to the public. The suspended |
individual or entity shall be
issued an immediate verbal |
notification followed by a written suspension order
by the EMS |
Medical Director which states the
length, terms and basis for |
the suspension.
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(1) Within 24 hours following the commencement of the |
suspension, the EMS
Medical Director shall deliver to the |
Department, by messenger, telefax, or other |
Department-approved electronic communication, a
copy of |
the suspension order and copies of any written materials |
which relate
to the EMS Medical Director's decision to |
suspend the individual or entity. All medical and |
patient-specific information, including Department |
findings with respect to the quality of care rendered, |
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shall be strictly confidential pursuant to the Medical |
Studies Act (Part 21 of Article VIII of the Code of Civil |
Procedure).
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(2) Within 24 hours following the commencement of the |
suspension, the
suspended individual or entity may deliver |
to the Department, by messenger,
telefax, or other |
Department-approved electronic communication, a written |
response to the suspension order and copies of any written
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materials which the individual or entity feels are |
appropriate. All medical and patient-specific information, |
including Department findings with respect to the quality |
of care rendered, shall be strictly confidential pursuant |
to the Medical Studies Act.
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(3) Within 24 hours following receipt of the EMS |
Medical Director's
suspension order or the individual or |
entity's written response, whichever is later,
the |
Director or the Director's designee shall determine |
whether the suspension
should be stayed pending an |
opportunity for a hearing or
review in accordance with |
this Act, or whether the suspension should continue
during |
the course of that hearing or review. The Director or the |
Director's
designee shall issue this determination to the |
EMS Medical Director, who shall
immediately notify the |
suspended individual or entity. The suspension shall |
remain
in effect during this period of review by the |
Director or the Director's
designee.
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(e) (d) Upon issuance of a suspension order for reasons |
directly related to
medical care, the EMS Medical Director |
shall also provide the individual or entity
with the |
opportunity for a hearing before the local System review |
board, in
accordance with subsection (f) and the rules |
promulgated by the Department.
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(1) If the local System review board affirms or |
modifies the EMS Medical
Director's suspension order, the |
individual or entity shall have the opportunity for
a |
review of the local board's decision by the State EMS |
Disciplinary Review
Board, pursuant to Section 3.45 of |
this Act.
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(2) If the local System review board reverses or |
modifies the EMS Medical
Director's suspension order, the |
EMS Medical Director shall have the
opportunity for a |
review of the local board's decision by the State EMS
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Disciplinary Review Board, pursuant to Section 3.45 of |
this Act.
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(3) The suspended individual or entity may elect to |
bypass the local System review board
and seek direct |
review of the EMS Medical Director's suspension order by |
the
State EMS Disciplinary Review Board.
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(f) (e) The Resource Hospital shall designate a local |
System review board in
accordance with the rules of the |
Department, for the purpose of providing a
hearing to any |
individual or entity participating within the
System who is |
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suspended from participation by the EMS Medical Director. The
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EMS Medical Director shall arrange for a certified shorthand |
reporter to make a
stenographic record of that hearing and |
thereafter prepare a transcript of the
proceedings. The EMS |
Medical Director shall inform the individual of the |
individual's right to have a union representative and legal |
counsel of the individual's choosing present at any interview. |
The union representative must comply with any confidentiality |
requirements and requirements for the protection of any |
patient information presented during the proceeding. The |
transcript, all documents or materials received as evidence
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during the hearing and the local System review board's written |
decision shall
be retained in the custody of the EMS system. |
The System shall implement a
decision of the local System |
review board unless that decision has been
appealed to the |
State Emergency Medical Services Disciplinary Review Board in
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accordance with this Act and the rules of the Department.
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(g) (f) The Resource Hospital shall implement a decision |
of the State Emergency
Medical Services Disciplinary Review |
Board which has been rendered in
accordance with this Act and |
the rules of the Department.
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(Source: P.A. 100-201, eff. 8-18-17; 100-1082, eff. 8-24-19.)
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(210 ILCS 50/3.45)
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Sec. 3.45. State Emergency Medical Services Disciplinary
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Review Board. |
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(a) The Governor shall appoint a State Emergency
Medical |
Services Disciplinary Review Board, composed of an
EMS Medical |
Director, an EMS System Coordinator, a Paramedic, an Emergency
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Medical Technician (EMT), and the following members,
who shall |
only review cases in which a party is from the
same |
professional category: a Pre-Hospital Registered Nurse, a |
Pre-Hospital Advanced Practice Registered Nurse, a |
Pre-Hospital Physician Assistant, an ECRN, a
Trauma Nurse |
Specialist, an Emergency Medical
Technician-Intermediate |
(EMT-I), an Advanced Emergency Medical Technician (A-EMT), a |
representative from a
private vehicle service provider, a |
representative from a
public vehicle service provider, and an |
emergency physician
who monitors telecommunications from and |
gives voice orders
to EMS personnel. The Governor shall also |
appoint one
alternate for each member of the Board, from the |
same
professional category as the member of the Board.
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(b) The members
shall be appointed for a term of 3 years. |
All appointees
shall serve until their successors are |
appointed. The
alternate members shall be appointed and serve |
in the same
fashion as the members of the Board. If a member |
resigns
his or her appointment, the corresponding alternate |
shall serve the
remainder of that member's term until a |
subsequent member is
appointed by the Governor.
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(c) The function of the Board is to review and affirm,
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reverse or modify disciplinary orders.
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(d) Any individual or entity, who received an immediate |
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suspension from an EMS
Medical Director may request the Board |
to reverse or modify
the suspension order. If the suspension |
had been affirmed
or modified by a local System review board, |
the suspended individual or entity
may request the Board to |
reverse or modify the
local board's decision.
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(e) Any individual or entity who received a non-immediate |
suspension order
from an EMS Medical Director which was |
affirmed or modified
by a local System review board may |
request the Board to
reverse or modify the local board's |
decision. The individual shall be informed of the individual's |
right to have one representative from the labor organization |
recognized as the exclusive representative of that |
individual's bargaining unit present and a legal |
representative present during the State Emergency Medical |
Services Disciplinary Review Board proceedings during open |
session. The labor organization's representative must also |
comply with all confidentiality requirements and requirements |
for the protection of any patient information presented during |
the proceeding.
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(f) An EMS Medical Director whose suspension order
was |
reversed or modified by a local System review board may
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request the Board to reverse or modify the local board's
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decision.
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(g) The Board shall meet on the first
Tuesday of every |
month, unless no requests for review have
been submitted. |
Additional meetings of the Board shall be
scheduled to ensure |
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that a request for direct
review of an immediate suspension |
order is scheduled within
14 days after the Department |
receives the request for review
or as soon thereafter as a |
quorum is available. The Board
shall meet in Springfield or |
Chicago, whichever location is
closer to the majority of the |
members or alternates
attending the meeting. The Department |
shall reimburse the
members and alternates of the Board for |
reasonable travel
expenses incurred in attending meetings of |
the Board.
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(h) A request for review shall be submitted in
writing to |
the Chief of the Department's Division of Emergency
Medical |
Services and Highway Safety, within 10 days after
receiving |
the local board's decision or the EMS Medical
Director's |
suspension order, whichever is applicable, a copy
of which |
shall be enclosed.
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(i) At its regularly scheduled meetings, the Board
shall |
review requests which have been received by the
Department at |
least 10 working days prior to the Board's
meeting date. |
Requests for review which are received less
than 10 working |
days prior to a scheduled meeting shall be
considered at the |
Board's next scheduled meeting, except
that requests for |
direct review of an immediate suspension
order may be |
scheduled up to 3 working days prior to the
Board's meeting |
date.
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(j) A quorum shall be required for the Board to
meet, which |
shall consist of 3 members or alternates, including
the EMS |
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Medical Director or alternate and the member or
alternate from |
the same professional category as the subject
of the |
suspension order. At each meeting of the Board, the
members or |
alternates present shall select a Chairperson to
conduct the |
meeting.
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(k) Deliberations for decisions of the State EMS
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Disciplinary Review
Board shall be conducted in closed |
session. Department
staff may attend for the purpose of |
providing clerical
assistance, but no other persons may be in |
attendance except
for the parties to the dispute being |
reviewed by the Board
and their attorneys, unless by request |
of the Board.
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(l) The Board shall review the transcript,
evidence, and |
written decision of the local review board, or the
written |
decision and supporting documentation of the EMS
Medical |
Director, whichever is applicable, along with any
additional |
written or verbal testimony or argument offered
by the parties |
to the dispute.
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(m) At the conclusion of its review, the Board
shall issue |
its decision and the basis for its decision on a form
provided |
by the Department, and shall submit to the
Department its |
written decision together with the record of
the local System |
review board. The Department shall
promptly issue a copy of |
the Board's decision to all
affected parties. The Board's |
decision shall be binding on
all parties.
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(Source: P.A. 100-1082, eff. 8-24-19.)
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(210 ILCS 50/3.55)
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Sec. 3.55. Scope of practice.
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(a) Any person currently licensed as an EMR, EMT, EMT-I,
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A-EMT, PHRN, PHAPRN, PHPA, or Paramedic may perform emergency |
and non-emergency medical
services as defined in this Act, in |
accordance with his or her level of
education, training and |
licensure, the standards of
performance and conduct prescribed |
by the Department in
rules adopted pursuant to this Act, and |
the requirements of
the EMS System in which he or she |
practices, as contained in the
approved Program Plan for that |
System. The Director may, by written order, temporarily modify |
individual scopes of practice in response to public health |
emergencies for periods not exceeding 180 days.
|
(a-5) EMS personnel who have successfully completed a |
Department approved
course in automated defibrillator |
operation and who are functioning within a
Department approved |
EMS System may utilize such automated defibrillator
according |
to the standards of performance and conduct prescribed by the
|
Department
in rules adopted pursuant to this Act and the |
requirements of the EMS System in
which they practice, as |
contained in the approved Program Plan for that
System.
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(a-7) An EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or |
Paramedic
who has successfully completed a Department approved |
course in the
administration of epinephrine shall be required |
to carry epinephrine
with him or her as part of the EMS |
|
personnel medical supplies whenever
he or she is performing |
official duties as determined by the EMS System. The |
epinephrine may be administered from a glass vial, |
auto-injector, ampule, or pre-filled syringe.
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(b) An EMR, EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or |
Paramedic may practice as an EMR, EMT, EMT-I, A-EMT, or |
Paramedic or utilize his or her EMR, EMT, EMT-I, A-EMT, PHRN, |
PHAPRN, PHPA, or Paramedic license
in pre-hospital or |
inter-hospital emergency care settings or
non-emergency |
medical transport situations, under the
written or verbal |
direction of the EMS Medical Director.
For purposes of this |
Section, a "pre-hospital emergency care
setting" may include a |
location, that is not a health care
facility, which utilizes |
EMS personnel to render pre-hospital
emergency care prior to |
the arrival of a transport vehicle.
The location shall include |
communication equipment and all
of the portable equipment and |
drugs appropriate for the EMR, EMT, EMT-I, A-EMT, or |
Paramedic's
level of care, as required by this Act, rules |
adopted
by the Department pursuant to this Act, and the |
protocols of
the EMS Systems, and shall operate only with the |
approval
and under the direction of the EMS Medical Director.
|
This Section shall not prohibit an EMR, EMT, EMT-I, A-EMT, |
PHRN, PHAPRN, PHPA, or Paramedic
from practicing within an |
emergency department or
other health care setting for the |
purpose of receiving
continuing education or training approved |
by the EMS Medical
Director. This Section shall also not |
|
prohibit an EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or |
Paramedic from seeking credentials other than his or her EMT, |
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic
license and |
utilizing such credentials to work in emergency
departments or |
other health care settings under the
jurisdiction of that |
employer.
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(c) An EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic |
may honor Do Not Resuscitate (DNR) orders and powers
of |
attorney for health care only in accordance with rules
adopted |
by the Department pursuant to this Act and protocols
of the EMS |
System in which he or she practices.
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(d) A student enrolled in a Department approved EMS |
personnel
program, while fulfilling the
clinical training and |
in-field supervised experience
requirements mandated for |
licensure or approval by the
System and the Department, may |
perform prescribed procedures
under the direct supervision of |
a physician licensed to
practice medicine in all of its |
branches, a qualified
registered professional nurse, or |
qualified EMS personnel, only when
authorized by the EMS |
Medical Director.
|
(e) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or |
Paramedic may transport a police dog injured in the line of |
duty to a veterinary clinic or similar facility if there are no |
persons requiring medical attention or transport at that time. |
For the purposes of this subsection, "police dog" means a dog |
owned or used by a law enforcement department or agency in the |
|
course of the department or agency's work, including a search |
and rescue dog, service dog, accelerant detection canine, or |
other dog that is in use by a county, municipal, or State law |
enforcement agency. |
(f) Nothing in this Act shall be construed to prohibit an |
EMT, EMT-I, A-EMT, Paramedic, or PHRN from completing an |
initial Occupational Safety and Health Administration |
Respirator Medical Evaluation Questionnaire on behalf of fire |
service personnel, as permitted by his or her EMS System |
Medical Director. |
(g) A member of a fire department's or fire protection |
district's collective bargaining unit shall be eligible to |
work under a silver spanner program for another EMS System's |
fire department or fire protection district that is not the |
full-time employer of that member, for a period not to exceed 2 |
weeks, if the member: (1) is under the direct supervision of |
another licensed individual operating at the same or higher |
licensure level as the member; (2) made a written request to |
the EMS System's Medical Director for approval to work under |
the silver spanner program, which shall be approved or denied |
within 24 hours after the EMS System's Medical Director |
received the request; and (3) tests into the EMS System based |
upon appropriate standards as outlined in the EMS System |
Program Plan. The EMS System within which the member is |
seeking to join must make all required testing available to |
the member within 2 weeks of the written request. Failure to do |