HB3233ham001 104TH GENERAL ASSEMBLY

Rep. Bradley Fritts

Filed: 3/14/2025

10400HB3233ham001 LRB104 10785 BAB 23955 a

AMENDMENT TO HOUSE BILL 3233

AMENDMENT NO. ______. Amend House Bill 3233 by replacing everything after the enacting clause with the following:

"Section 5. The Emergency Medical Services (EMS) Systems Act is amended by changing Section 3.20 and by adding Section 3.23 as follows:

(210 ILCS 50/3.20)

Sec. 3.20. Emergency Medical Services (EMS) Systems.

(a) "Emergency Medical Services (EMS) System" means an organization of hospitals, vehicle service providers and personnel approved by the Department in a specific geographic area, which coordinates and provides pre-hospital and inter-hospital emergency care and non-emergency medical transports at a BLS, ILS and/or ALS level pursuant to a System program plan submitted to and approved by the Department, and pursuant to the EMS Region Plan adopted for the EMS Region in which the System is located.

(b) One hospital in each System program plan must be designated as the Resource Hospital. All other hospitals which are located within the geographic boundaries of a System and which have standby, basic or comprehensive level emergency departments must function in that EMS System as either an Associate Hospital or Participating Hospital and follow all System policies specified in the System Program Plan, including but not limited to the replacement of drugs and equipment used by providers who have delivered patients to their emergency departments. All hospitals and vehicle service providers participating in an EMS System must specify their level of participation in the System Program Plan.

(c) The Department shall have the authority and responsibility to:

(1) Approve BLS, ILS and ALS level EMS Systems which meet minimum standards and criteria established in rules adopted by the Department pursuant to this Act, including the submission of a Program Plan for Department approval. Beginning September 1, 1997, the Department shall approve the development of a new EMS System only when a local or regional need for establishing such System has been verified by the Department. This shall not be construed as a needs assessment for health planning or other purposes outside of this Act. Following Department approval, EMS Systems must be fully operational within one year from the date of approval.

(2) Monitor EMS Systems, based on minimum standards for continuing operation as prescribed in rules adopted by the Department pursuant to this Act, which shall include requirements for submitting Program Plan amendments to the Department for approval.

(3) Renew EMS System approvals every 4 years, after an inspection, based on compliance with the standards for continuing operation prescribed in rules adopted by the Department pursuant to this Act.

(4) Suspend, revoke, or refuse to renew approval of any EMS System, after providing an opportunity for a hearing, when findings show that it does not meet the minimum standards for continuing operation as prescribed by the Department, or is found to be in violation of its previously approved Program Plan.

(5) Require each EMS System to adopt written protocols for the bypassing of or diversion to any hospital, trauma center or regional trauma center, which provide that a person shall not be transported to a facility other than the nearest hospital, regional trauma center or trauma center unless the medical benefits to the patient reasonably expected from the provision of appropriate medical treatment at a more distant facility outweigh the increased risks to the patient from transport to the more distant facility, or the transport is in accordance with the System's protocols for patient choice or refusal.

(6) Require that the EMS Medical Director of an ILS or ALS level EMS System be a physician licensed to practice medicine in all of its branches in Illinois, and certified by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine, and that the EMS Medical Director of a BLS level EMS System be a physician licensed to practice medicine in all of its branches in Illinois, with regular and frequent involvement in pre-hospital emergency medical services. In addition, all EMS Medical Directors shall:

(A) Have experience on an EMS vehicle at the highest level available within the System, or make provision to gain such experience within 12 months prior to the date responsibility for the System is assumed or within 90 days after assuming the position;

(B) Be thoroughly knowledgeable of all skills included in the scope of practices of all levels of EMS personnel within the System;

(C) Have or make provision to gain experience instructing students at a level similar to that of the levels of EMS personnel within the System; and

(D) For ILS and ALS EMS Medical Directors, successfully complete a Department-approved EMS Medical Director's Course.

(7) Prescribe statewide EMS data elements to be collected and documented by providers in all EMS Systems for all emergency and non-emergency medical services, with a one-year phase-in for commencing collection of such data elements.

(8) Define, through rules adopted pursuant to this Act, the terms "Resource Hospital", "Associate Hospital", "Participating Hospital", "Basic Emergency Department", "Standby Emergency Department", "Comprehensive Emergency Department", "EMS Medical Director", "EMS Administrative Director", and "EMS System Coordinator".

(A) (Blank).

(B) (Blank).

(9) Investigate the circumstances that caused a hospital in an EMS system to go on bypass status to determine whether that hospital's decision to go on bypass status was reasonable. The Department may impose sanctions, as set forth in Section 3.140 of the Act, upon a Department determination that the hospital unreasonably went on bypass status in violation of the Act.

(10) Evaluate the capacity and performance of any freestanding emergency center established under Section 32.5 of this Act in meeting emergency medical service needs of the public, including compliance with applicable emergency medical standards and assurance of the availability of and immediate access to the highest quality of medical care possible.

(11) Permit limited EMS System participation by facilities operated by the United States Department of Veterans Affairs, Veterans Health Administration. Subject to patient preference, Illinois EMS providers may transport patients to Veterans Health Administration facilities that voluntarily participate in an EMS System. Any Veterans Health Administration facility seeking limited participation in an EMS System shall agree to comply with all Department administrative rules implementing this Section. The Department may promulgate rules, including, but not limited to, the types of Veterans Health Administration facilities that may participate in an EMS System and the limitations of participation.

(12) Ensure that EMS systems are transporting pregnant women to the appropriate facilities based on the classification of the levels of maternal care described under subsection (a) of Section 2310-223 of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois.

(13) Provide administrative support to the EMT Training, Recruitment, and Retention Task Force.

(14) Provide administrative support to the Emergency Medical Service Response Task Force.

(Source: P.A. 103-547, eff. 8-11-23.)

(210 ILCS 50/3.23 new)

Sec. 3.23. Emergency Medical Service Response Task Force.

(a) The Emergency Medical Service Response Task Force is created to investigate and provide legislative and policy recommendations regarding slow and dangerous response times for ambulance and EMS services in parts of the State, in particular services in rural communities.

(b) The Emergency Medical Service Response Task Force shall address, study, and provide recommendations on any aspect of this response time crisis deemed appropriate by the Task Force, including the following:

(1) the sustainability of Emergency Medical Services (EMS) Systems in rural communities throughout the State;

(2) any regulatory or administrative burdens or staffing restrictions placed on providers that contribute to staffing issues or slow response times;

(3) revenue shortfalls that challenge the sustainability and survival of ambulance or emergency medical services; and

(4) the report, findings, and any recommendations of the EMT Training, Recruitment, and Retention Task Force.

(c) The Task Force shall be comprised of the following members:

(1) one member of the Illinois General Assembly, appointed by the President of the Senate, who shall serve as co-chair;

(2) one member of the Illinois General Assembly, appointed by the Speaker of the House of Representatives;

(3) one member of the Illinois General Assembly, appointed by the Minority Leader of the Senate;

(4) one member of the Illinois General Assembly, appointed by the Minority Leader of the House of Representatives, who shall serve as co-chair;

(5) 9 members representing private ground ambulance providers throughout this State representing for-profit and non-profit rural and urban ground ambulance providers, appointed by the President of the Senate;

(6) 3 members representing hospitals, appointed by the Speaker of the House of Representatives, with one member representing safety-net hospitals and one member representing rural hospitals;

(7) 3 members representing a statewide association of nursing homes, appointed by the President of the Senate;

(8) one member representing the State Board of Education, appointed by the Minority Leader of the House of Representatives;

(9) 2 EMS Medical Directors from a Regional EMS Medical Directors Committee, appointed by the Governor;

(10) one member representing the Illinois Community College Systems, appointed by the Minority Leader of the Senate;

(11) 3 members representing the Associated Fire Fighters of Illinois, appointed by the President of the Senate; and

(12) 3 members representing volunteer rural fire service, appointed by the Speaker of the House.

(d) Members of the Task Force shall serve without compensation.

(e) The Task Force shall convene at the call of the co-chairs and shall hold at least 6 meetings.

(f) The Task Force shall submit its final report containing legislative and policy decisions to the General Assembly and the Governor no later than September 1, 2026, and upon the submission of its final report, the Task Force shall be dissolved.

(g) This Section is repealed on January 1, 2027.".