louisiana revised statutes title 40. public health and ... regulations/louisiana ems... ·...

WEST’S LOUISIANA STATUTES ANNOTATEDLOUISIANA REVISED STATUTES

TITLE 40. PUBLIC HEALTH AND SAFETYCHAPTER 5. MISCELLANEOUS HEALTH PROVISIONS

PART VII. EMERGENCY MEDICAL SERVICESSUBPART C. EMERGENCY MEDICAL TRANSPORTATION

§1236.4. Required insurance coverage

A. Notwithstanding the provisions of R.S. 33:4791 and 4791.1, each ambulance provider,as defined in this Section, shall continuously have in effect the following minimumamounts of insurance:

(1) Medical malpractice liability insurance in the amount of five hundred thousanddollars.

(2) Automobile liability insurance in the amount of five hundred thousand dollars incombined single limits and five hundred thousand dollars in the aggregate.

(3) General liability insurance in the amount of five hundred thousand dollars peroccurrence and five hundred thousand dollars in the aggregate.

(4) Repealed by Acts 1999, No. 1113,§ 2.

B. Each ambulance provider shall submit a certificate of insurance issued by its insurancecarrier to the Department of Health and Hospitals as proof of the minimum insurancecoverage required by this Section. Each ambulance provider shall also be required tonotify the department in writing at least thirty days prior to any material change in orcancellation of such coverage.

C. For purposes of this Section, "ambulance provider" shall mean any entity owning,controlling, or operating any business or service which, as a substantial portion of itsbusiness, furnishes, operates, conducts, maintains, advertises, engages in, proposes toengage in, or professes to engage in the business or service of transporting persons whomay need medical attention during transport. However, "ambulance provider" shall notinclude:

(1) Agencies of the federal government;

(2) Volunteer nonprofit organizations or municipal nonprofit organizations operatinginvalid coaches, as defined in R.S. 40:1231(7);

(3) Entities rendering assistance to licensed ambulances in the case of a major disaster;

(4) Licensed hospitals providing nonemergency, noncritical interhospital transfer andpatient transportation for diagnostic and therapeutic purposes when such transportationoriginates at a licensed hospital;

(5) Entities operating ambulances from a location outside of the state to transport patientsfrom a location outside of the state to a location inside the state or to transport patientsfrom a medical facility inside to a point outside of the state; or

(6) Entities providing transportation to employees who become sick or injured during thecourse of their employment from a job site to the nearest appropriate medical facility.

Acts 1990, No. 442,§ 1; Acts 1992, No. 678,§ 1; Acts 1999, No. 1113,§ 2.




§1236.6. Air ambulance services; fees

Any person, partnership, corporation, unincorporated association, or other legal entity,currently operating or planning to operate an air ambulance service shall pay thefollowing fees to the department, as applicable:

(1) An initial licensing fee of one hundred fifty dollars, which shall be submitted with theinitial application for a license.

(2) An annual license renewal fee of one hundred dollars, which shall be submitted witheach annual application for renewal of a license.

(3) A delinquent fee of one hundred dollars for failure to timely pay an annual licenserenewal fee. Such delinquent fee shall be assessed and shall become due and payable at12:01 a.m. on the thirty-sixth day following the date of the invoice by which thedepartment bills the applicant or licensee for the annual license renewal fee.

(4) An aircraft inspection fee of seventy-five dollars for each aircraft, which shall besubmitted with the initial application for a license, with each annual application forrenewal of a license, and with each application for a permit for an aircraft added to theservice by the applicant.

(5) A delinquent fee of twenty-five dollars for each aircraft for failure to timely pay anaircraft inspection fee. Such delinquent fee shall be assessed and shall become due andpayable at 12:01 a.m. on the thirty-sixth day following the date of the invoice by whichthe department bills the applicant or licensee for the aircraft inspection fee.

(6) A change of address fee of ten dollars for each change of address.

(7) A duplicate license fee of ten dollars for each duplicate license.

Acts 1999, No. 1114,§ 1.




§1236.7. Air ambulance services; violations; penalties; fines; notice; hearings; appeal

A. The opening or operation of an air ambulance service without a current licensetherefor shall be a misdemeanor, punishable upon conviction by a fine of not less thanone thousand dollars and not more than five thousand dollars, and each day's violationshall constitute a separate offense.

B.(1) Any person or entity violating the provisions of this Part when such violation posesa threat to the health, safety, rights, or welfare of a patient or client may be liable to civilfines and other penalties, to be assessed by the department, in addition to any criminalaction which may be brought under other applicable laws. The department shall adoptrules in accordance with the Administrative Procedure Act which define specificclassifications of violations, articulate factors in assessing civil fines including mitigatingcircumstances, and explain the treatment of continuing and repeat deficiencies.

(2) The schedule of civil fines and other penalties by class of violation is as follows:

(a) Class A Violations: If an air ambulance is found to have been operated in violation ofany of the requirements of this Part concerning the number or qualifications of personnel,the air ambulance shall be immediately taken out of service until it meets thoserequirements, and the air ambulance service operating it shall be subject to a civil fine ofnot more than five hundred dollars for the first violation and not more than one thousanddollars per day for each repeat violation.

(b) Class B Violations: If an air ambulance service is found to have been operating inviolation of any of the requirements of this Part concerning insurance coverage, itslicense shall be immediately suspended until it meets those requirements, and it shall besubject to a civil fine of not more than five hundred dollars for the first violation and notmore than one thousand dollars per day for each repeat violation.

(c) Class C Violations: If an air ambulance is found to have been operated withoutundergoing any inspection required under the provisions of this Part, the air ambulanceshall be immediately taken out of service until it meets those requirements, and the airambulance service operating it shall be subject to a civil fine of not more than fivehundred dollars for the first violation and not more than one thousand dollars per day foreach repeat violation.

(d) Class D Violations: If an air ambulance is found to have been operated in violation ofany of the requirements of this Part concerning medical and safety equipment, the airambulance shall be immediately taken out of service until it meets those requirements,and the air ambulance service operating it shall be subject to a civil fine of not more thanone hundred dollars for the first violation and not more than five hundred dollars per dayfor each repeat violation.

C. The department shall adopt rules and regulations in accordance with theAdministrative Procedure Act to provide notice to the air ambulance service of anyviolation, of its right to an informal reconsideration process, and of the available appealprocedure, including judicial review. Such appeal shall be suspensive.

D. The air ambulance service shall furnish, with an appeal, bond in the minimum amountof one and one-half times the amount of the fine imposed by the department. The bondshall provide in substance that it is furnished as security that the air ambulance servicewill prosecute its appeal and that any judgment against it, including court costs, will bepaid or satisfied from the amount furnished. The appeal shall be heard as a summaryproceeding which shall be given precedence over other pending matters.

E. The department may institute all necessary civil court action to collect fines imposedand not timely appealed. No air ambulance service may claim imposed fines asreimbursable costs, nor increase charges to patients and clients as a result of such fines.Interest shall begin to accrue on any fine at the current judicial rate on the day followingthe date on which the fine becomes due and payable.

Acts 1999, No. 1114,§ 1.



PART VII. EMERGENCY MEDICAL SERVICESSUBPART D. AUTOMATED EXTERNAL DEFIBRILLATORS

§1236.11. Legislative findings

A. The Legislature of Louisiana finds that each year more than three hundred fiftythousand Americans die from out-of-hospital sudden cardiac arrest. More than ninety-five percent of these Americans die, in many cases because a lifesaving defibrillator didnot arrive at the scene of the emergency in time.

B. The American Heart Association estimates that more than twenty thousand deaths maybe prevented each year if defibrillators were more widely available to designatedresponders.

C. Many communities throughout the state and nation have invested in 911 emergencyresponse systems, emergency personnel, and ambulance vehicles. However, many ofthese communities do not have enough defibrillators in their community.

D. It is therefore the intent of the legislature to encourage greater acquisition, deployment,and use of automated external defibrillators in communities throughout the state.

Acts 1999, No. 825,§ 1.




§1236.12. Definitions

As used in this Subpart "automated external defibrillator" and "AED" mean a medicaldevice heart monitor and defibrillator that:

(1) Has received approval of its pre-market notification filed pursuant to 21 U.S.C. 360(k)from the United States Food and Drug Administration.

(2) Is capable of recognizing the presence or absence of ventricular fibrillation or rapidventricular tachycardia and is capable of determining whether defibrillation should beperformed.

(3) Upon determining that defibrillation should be performed, automatically charges andrequests delivery of an electrical impulse to an individual's heart.

(4) Is capable of delivering the electrical impulse to an individual's heart.

Acts 1999, No. 825,§ 1.




§1236.13. Persons in possession of AED's; training, testing, and notification requirements;manufacturer responsibility

A. In order to ensure public health and safety, any person or entity that possesses an AEDshall ensure that:

(1) The AED is maintained and tested according to the manufacturer's guidelines.

(2) A licensed physician or advanced practice registered nurse who is authorized toprescribe is involved in the possessor's program to ensure compliance with therequirements for training, emergency medical service (EMS) notification, andmaintenance.

(3)(a) Expected AED users regularly, on the premises of a particular entity, such as awork site, receive appropriate training in cardiopulmonary resuscitation (CPR) and in theuse of an AED by the American Heart Association or by any other nationally recognizedcourse in CPR and AED use.

(b) For purposes of this Paragraph, "expected AED users" shall be any person designatedby the possessor to render emergency care.

(4) The emergency medical services system is activated as soon as possible when anindividual renders emergency care to an individual in cardiac arrest by using an AED.

(5) Any clinical use of the AED is reported to the licensed physician or advanced practiceregistered nurse involved in the possessor's program.

B. Any person or entity that possesses an AED shall notify the bureau of emergencymedical services in the office of public health of the Department of Health and Hospitalsand a local provider of emergency medical services, such as 911 service, local ambulanceservice, or the fire department of the acquisition, location, and type of AED.

C. Any manufacturer, wholesale supplier, or retailer of an AED shall notify purchasers ofAED's intended for use in the state of the requirements of this Section.

Acts 1999, No. 825,§ 1.




§1236.14. Limitation of liability

In addition to the civil immunity provided to persons rendering emergency assistance asprovided by law, including R.S. 9:2793, R.S. 37:1731, 1732, and 1735, and R.S.40:1231.2, any prescribing advanced practice registered nurse or physician whoauthorizes the purchase of the AED, any physician or advanced practice registered nurseinvolved in the possessor's program, any individual or entity which provides training incardiopulmonary resuscitation and in the use of an AED, any purchaser of an AED, anyperson or entity responsible for the site where an AED is located, and any expected userregularly on the premises shall not be liable for any civil damages arising from any act oromission of acts related to the operation of an AED that do not amount to willful orwanton misconduct or gross negligence.

Acts 1999, No. 825,§ 1.




§1236.5. Emergency medical technician fundA. There is hereby established a special fund in the state treasury to be

known as the Emergency Medical Technician Fund, hereafter referred to as "fund",which shall consist of monies generated by the fees collected from the purchase ofprestige license plates for certified emergency medical technicians as provided inR.S. 47:463.47. In addition, the legislature may make annual appropriations to thefund for the purposes set forth in this Section.

B. All monies collected pursuant to R.S. 47:463.47 shall be deposited inthe Bond Security and Redemption Fund as required by Article VII, Section 9(B)of the Constitution of Louisiana and thereafter shall be credited to the fund.

C. The monies in the fund shall be appropriated to the Department ofHealth and Hospitals solely for purchasing equipment for the testing of applicantsfor certification as an emergency medical technician and to cover other testing-related costs. All unexpended and unencumbered monies remaining in the fund atthe close of each fiscal year shall remain in the fund. Monies in the fund shall beinvested by the state treasurer in the same manner as monies in the state generalfund. All interest earned from the investment of monies in the fund shall bedeposited and remain to the credit of the fund.

Acts 1997, No. 1131, §1, eff. July 14, 1997.

ENROLLED

Page 1 of 2

CODING: Words in struck through type are deletions from existing law; words underscoredare additions.

$&7�1R��Regular Session, 2004

HOUSE BILL NO. 1584

BY REPRESENTATIVES RICHMOND, FRITH, AND JACKSON

AN ACT1

To enact R.S. 40:1236.13(D), (E), and (F), relative to automated external defibrillators; to2

require physical fitness facilities and institutions of higher education that compete in3

intercollegiate sport contests to have an automated external defibrillator on its4

premises; and to provide for related matters.5

Be it enacted by the Legislature of Louisiana:6

Section 1. R.S. 40:1236.13(D), (E), and (F) are hereby enacted to read as follows:7

§1236.13. Persons in possession of AEDs; training, testing, and notification8

requirements; manufacturer responsibility; possession required9

* * *10

D.(1) The owner of or the entity responsible for a physical fitness facility11

shall keep an AED on its premises.12

(2) As used in this Subsection:13

(a) "Physical fitness facility" means a facility for profit or nonprofit with a14

membership of over fifty persons that offers physical fitness services. This term15

includes but is not limited to clubs, studios, health spas, weight control centers,16

clinics, figure salons, tanning centers, athletic or sport clubs, and YWCA and17

YMCA organizations.18

(b) "Physical fitness services" means services for the development of19

physical fitness through exercise or weight control. It shall not include a business20

limited solely to the practice of physical therapy, as defined in R.S. 37:2401, by a21

therapist licensed by the Louisiana State Board of Medical Examiners, nor shall it22

apply to medically related services performed by a physician licensed by the23

Louisiana State Board of Medical Examiners in a private office, clinic, or hospital.24

ENROLLEDH.B. NO. 1584

Page 2 of 2


E. Any institution of higher education that competes in intercollegiate1

athletics shall have an AED on its premises in its athletic department.2

F. The office of public health within the Department of Health and Hospitals,3

through its center for community health, emergency medical services shall4

promulgate all necessary rules and regulations to implement the provisions of5

Subsections D and E of this Section. Such rules and regulations shall, at a minimum,6

provide for compliance, enforcement, and penalties.7

Section 2. This Act shall become effective on January 1, 2005.8

SPEAKER OF THE HOUSE OF REPRESENTATIVES

PRESIDENT OF THE SENATE

GOVERNOR OF THE STATE OF LOUISIANA

APPROVED:

ENROLLED

Page 1 of 2



HOUSE BILL NO. 1543

BY REPRESENTATIVE BRUNEAU

AN ACT1

To amend and reenact R.S. 40:1236.13(A)(3)(a) and 1236.14, relative to automated external2

defibrillators; to authorize the use of automated external defibrillators by private3

security personnel; and to provide for related matters.4


Section 1. R.S. 40:1236.13(A)(3)(a) and 1236.14 are hereby amended and reenacted6

to read as follows:7

§1236.13. Persons in possession of AED's; training, testing, and notification8

requirements; manufacturer responsibility9

A. In order to ensure public health and safety, any person or entity that10

possesses an AED shall ensure that:11

* * *12

(3)(a) Expected AED users regularly, on the premises of a particular entity,13

such as a work site or users who carry an AED in a private security patrol vehicle,14

receive appropriate training in cardiopulmonary resuscitation (CPR) and in the use15

of an AED by the American Heart Association or by from any other nationally16

recognized course in CPR and AED use.17

* * *18

§1236.14. Limitation of liability19

In addition to the civil immunity provided to persons rendering emergency20

assistance as provided by law, including R.S. 9:2793, R.S. 37:1731, 1732, and 1735,21

and R.S. 40:1231.2, any prescribing advanced practice registered nurse or physician22

who authorizes the purchase of the AED, any physician or advanced practice23

registered nurse involved in the possessor's program, any individual or entity which24

provides training in cardiopulmonary resuscitation and in the use of an AED, any25


Page 2 of 2


purchaser of an AED, any person or entity responsible for the site or the private1

security patrol vehicle where an AED is located, and any expected user regularly on2

the premises or in the vehicle shall not be liable for any civil damages arising from3

any act or omission of acts related to the operation of or failure to operate an AED4

that do not amount to willful or wanton misconduct or gross negligence.5




APPROVED:

ENROLLED

Page 1 of 3



HOUSE BILL NO. 1228

BY REPRESENTATIVE DURAND

AN ACT1

To amend and reenact R.S. 40:1232.6(introductory paragraph) and 1300.51(3) and (5) and2

R.S. 44:9(F) and (G) and to enact R.S. 40:1300.51(2)(h), relative to emergency3

medical personnel; to provide grounds for disciplinary proceedings; to modify4

definitions; to provide for records of violations of municipal ordinances and of state5

statutes classified as a misdemeanor or felony; and to provide for related matters.6


Section 1. R.S. 40:1232.6(introductory paragraph) and 1300.51(3) and (5) are hereby8

amended and reenacted and R.S. 40:1300.51(2)(h) is hereby enacted to read as follows:9

§1232.6. Grounds for disciplinary proceedings10

The commission may discipline emergency medical personnel services11

professionals by directing the bureau to deny, withhold, revoke, restrict, probate, or12

suspend a certificate to practice as a certified emergency medical technician or13

certified first responder, impose fines and assess costs, or otherwise discipline an14

EMS professional, and the commission may direct the bureau to limit, restrict, or15

deny a student EMS professional from entering or continuing the clinical phase of16

EMS education for the following causes:17

* * *18

§1300.51. Definitions19

For the purposes of this Part:20

* * *21

(2) "Employer" means any of the following facilities, agencies, or programs:22

* * *23

(h) A nonemergency, nonambulance medical transportation facility or entity.24


Page 2 of 3


(3) "Nonlicensed person" means any person who provides for compensation1

nursing care or other health-related services to residents in a nursing facility,2

intermediate care facility for the mentally retarded, adult residential care facility, or3

adult day care center, and who is not a licensed health care provider. "Nonlicensed4

person" also means any person who provides such services to individuals in their5

own homes as an employee or contract provider of a home health agency or hospice.6

"Nonlicensed person" also means any person employed as a driver by or who7

contracts as a driver with a nonemergency, nonambulance transportation facility or8

entity.9

* * *10

(5) "Licensed ambulance personnel" means personnel who provide for11

compensation or volunteer, services of care as a licensed certified emergency medical12

service professional including certified emergency medical technician - basic,13

certified emergency medical technician - intermediate, or certified emergency14

medical technician - paramedic, or certified first responder. Nothing herein shall15

pertain to any licensed ambulance personnel working for a nursing home,16

intermediate care facility for the mentally retarded, adult residential care home, adult17

day care center, home health agency, or hospice.18

* * *19

Section 2. R.S. 44:9(F) and (G) are hereby amended and reenacted to read as follows:20

§44:9. Records of violations of municipal ordinances and of state statutes classified21

as a misdemeanor or felony22

* * *23

F. For investigative purposes only, the Department of Public Safety and24

Corrections may maintain a confidential, nonpublic record of the arrest and25

disposition. The information contained in this record may be released, upon specific26

request therefor and on a confidential basis, to any law enforcement agency, criminal27

justice agency, the Louisiana State Board of Medical Examiners, the Louisiana State28

Board of Nursing, the Louisiana State Board of Dentistry, or the Louisiana State29


Page 3 of 3


Board of Examiners of Psychologists, or the Emergency Medical Services1

Certification Commission. The receiving law enforcement agency, criminal justice2

agency, the Louisiana State Board of Medical Examiners, the Louisiana State Board3

of Nursing, the Louisiana State Board of Dentistry, or the Louisiana State Board of4

Examiners of Psychologists, or the Emergency Medical Services Certification5

Commission shall maintain the confidentiality of such record.6

G. "Expungement" means removal of a record from public access but does7

not mean destruction of the record. An expunged record is confidential, but remains8

available for use by law enforcement agencies, criminal justice agencies, the9

Louisiana State Board of Medical Examiners, the Louisiana State Board of Nursing,10

the Louisiana State Board of Dentistry, or the Louisiana State Board of Examiners11

of Psychologists, or the Emergency Medical Services Certification Commission.12

* * *13

Section 3. This Act shall become effective upon signature by the governor or, if not14

signed by the governor, upon expiration of the time for bills to become law without signature15

by the governor, as provided in Article III, Section 18 of the Constitution of Louisiana. If16

vetoed by the governor and subsequently approved by the legislature, this Act shall become17

effective on the day following such approval.18




APPROVED:



PART VII. EMERGENCY MEDICAL SERVICESSUBPART A. GENERAL PROVISIONS

§1231. Definitions

For purposes of this Part:

(1) "Ambulance" means any authorized emergency vehicle, equipped with warningdevices, designed and operated as a part of a regular course of conduct or business totransport a sick or injured individual or which is advertised or otherwise held out to thepublic as such. "Ambulance" shall not mean a hearse or other funeral home vehicleutilized for the transportation of the dead.

(2) "Ambulance service" or "ambulance provider" means any person, firm, association, orgovernment entity owning, controlling, or operating any business or service whichfurnishes, operates, conducts, maintains, advertises, engages in, proposes to engage in, orprofesses to engage in the business or service of transporting, in ambulances, individualswho may need medical attention during transport. However, "ambulance service" and"ambulance provider" shall not include any of the following:

(a) An agency of the federal government.

(b) A volunteer nonprofit organization or municipal nonprofit organization operating aninvalid coach or coaches.

(c) An entity rendering assistance to a licensed ambulance or ambulances in the case of amajor disaster.

(d) A licensed hospital providing nonemergency, noncritical interhospital transfer andpatient transportation for diagnostic and therapeutic purposes when such transportationoriginates at a licensed hospital.

(e) An entity operating an ambulance or ambulances from a location outside of the stateto transport patients from a location outside of the state to a location inside the state or totransport a patient or patients from a medical facility inside of the state to a locationoutside of the state.

(f) An entity providing transportation to employees who become sick or injured duringthe course of their employment from a job site to the nearest appropriate medical facility.

(3) "Air ambulance" means any aircraft, either fixed-wing or rotary- winged, designedand operated as a part of a regular course of conduct or business to transport a sick orinjured individual or which is advertised or otherwise held out to the public as such.

(3.1) "Air ambulance service" means any person, firm, association, or government entityowning, controlling, or operating any business or service which furnishes, operates,conducts, maintains, advertises, engages in, proposes to engage in, or professes to engagein the business or service of transporting, in air ambulances, individuals who may needmedical attention during transport.

(3.2) "Auto-injector" means a spring-loaded needle and syringe with a single dose ofepinephrine that will automatically release and inject the medicine.

(4) "Bureau" means the Department of Health and Hospitals, office of public health,bureau of emergency medical services.

(5) "Certified emergency medical technician" means an individual who is certified as anyone of the following:

(a) A certified emergency medical technician-basic.

(b) A certified emergency medical technician-intermediate.

(c) A certified emergency medical technician-paramedic.

(6) "Certified emergency medical technician-basic" means an individual who hassuccessfully completed an emergency medical technician- basic training programdeveloped and promulgated by the United States Department of Transportation andadopted by the bureau, who is nationally registered, and who is certified by the bureau.

(7) "Certified emergency medical technician-intermediate" means any individual who hassuccessfully completed an emergency medical technician- intermediate training programdeveloped and promulgated by the United States Department of Transportation andadopted by the bureau, who is nationally registered, and who is certified by the bureau.

(8) "Certified emergency medical technician-paramedic" means any individual who hassuccessfully completed an emergency medical technician- paramedic training programdeveloped and promulgated by the United States Department of Transportation andadopted by the bureau, who is nationally registered, and who is certified by the bureau.

(9) "Certified first responder" means any individual who has successfully completed atraining course developed and promulgated by the United States Department ofTransportation and adopted by the bureau and who is certified by the bureau.

(10) "Commission" means the Louisiana Emergency Medical Services CertificationCommission.

(11) "Department" means the Department of Health and Hospitals.

(12) "Emergency medical personnel" or "emergency service person(s)" means individualswho are certified first responders or certified emergency medical technicians.

(13) "Emergency medical response vehicle" means a marked emergency vehicle withfully visual and audible warning signals operated by a certified ambulance service, theprimary purpose of which is to respond to the scene of a medical emergency to provideemergency medical stabilization or support, or command, control, and communications,but which is not an ambulance designed or intended for the purpose of transporting avictim from the scene to a medical facility regardless of its designation. Included are suchvehicles referred to but not limited to the designation as "sprint car", "quick responsevehicle", "special response vehicle", "triage trucks", "staff cars", "supervisor units", andother similar designations. Emergency medical response vehicles shall not include fireapparatus and law enforcement patrol vehicles which carry first aid or emergencymedical supplies and which respond to medical emergencies as part of their routine duties.

(14) "Emergency medical services" or "EMS" means a system that represents thecombined efforts of several professionals and agencies to provide prehospital emergencycare to the sick and injured.

(15) "EMS task force" means the Emergency Medical Services Task Force, composed ofindividuals appointed by the assistant secretary of the office of public health, subject tothe approval of the secretary of the department, which advises and makesrecommendations to the office and the department on matters related to emergencymedical services.

(16) "First aid certificate" means a certificate in the Emergency Response Course issuedby the American Red Cross or other certificate in a first aid course approved by thebureau and issued to any individual who has successfully completed the required trainingand met the established standards of such organizations.

(17) "Industrial ambulance" means any vehicle owned and operated by an industrialfacility and used for transporting any employee who becomes sick, injured, or otherwiseincapacitated in the course and scope of his employment from a job site to an appropriatemedical facility.


(19) "Municipal nonprofit organization" means an organization owned by a parish,municipality, or entity of a parish or municipality which in its regular course of businessresponds to a call for help and renders medical treatment and whose attendants areemergency medical personnel, a registered nurse, or a physician.

(20) "Physician" means a physician licensed to practice medicine by the Louisiana StateBoard of Medical Examiners.

(21) "Volunteer nonprofit organization" means an organization which in its regularcourse of business responds to a call for help and renders medical treatment and whoseattendants are emergency medical personnel, a registered nurse, or a physician and whichis chartered as a nonprofit organization under Section 501c of the United States InternalRevenue Code, as a volunteer fire department by the Louisiana state fire marshal's office,or as a nonprofit organization by the Louisiana secretary of state.

Amended by Acts 1968, No. 278,§ 1; Acts 1976, No. 393,§ 1; Acts 1977, No. 626,§ 1;Acts 1978, No. 469,§ 1; Acts 1978, No. 786,§ 5, eff. July 17, 1978; Acts 1979, No. 554,§1; Acts 1985, No. 750,§ 1, eff. Jan. 1, 1987; Acts 1991, No. 974,§ 1, eff. July 24, 1991;Acts 1997, No. 297,§ 2; Acts 1997, No. 913,§ 2; Acts 1999, No. 1113,§ 1; Acts 1999, No.1114,§ 1; Acts 2001, No. 385,§ 1; Acts 2001, No. 625,§ 2.




§1231.2. Immunity from civil damages

No parish, specialty, component, or state medical society or organization, or its designee,which is statutorily mandated by this Part to participate without compensation orgratuitously participates in an emergency services system, nor any committee of suchparish, specialty, component, or state medical society or organization, including theindividual members of such committee, or its designee, shall be liable for any civildamages as a result of any act or omission in the performance of their administrativeduties or donated services with such emergency services system, including, withoutlimitation, advice, instructions, or other duties regarding policy, protocol, administration,and efficiency of the emergency medical services system. The immunity extended to aparish, specialty, component, or state medical society or organization, or any committeethereof, including the individual members of such committee, including their insurers, orits designee, shall not be applicable for willful or wanton acts or omissions. Theimmunity extended herein shall be applicable only to an action brought by the persondamaged as a result of the performance of any administrative duties or donated servicesrendered pursuant to the provisions of this Section.

Added by Acts 1979, No. 554,§ 2. Amended by Acts 1990, No. 428,§ 1; Acts 1997, No.913,§ 2.



PART VII. EMERGENCY MEDICAL SERVICESSUBPART B. EMERGENCY MEDICAL PERSONNEL

§1232. Emergency medical personnel training; certification

A. The bureau shall promulgate rules and regulations in accordance with theAdministrative Procedure Act for the following:

(1) To define and authorize appropriate functions and pre-certification and post-certification training programs for emergency medical personnel. All such trainingprograms shall meet or exceed the performance requirements developed by the UnitedStates Department of Transportation.

(2) To specify minimum operational requirements which will assure medical direction,supervision, and control over emergency medical services.

(3) To specify minimum testing and continuing education requirements for all emergencymedical personnel.

(4) To provide for the issuance of certificates and renewals of certificates for emergencymedical personnel.

(5) To specify initial certification and certification renewal requirements consistent withthe National Registry of Emergency Medical Technicians for each level of emergencymedical personnel.

(6) To establish fees for certification and certification renewal.

B. An individual petitioning for certification or certification renewal as a certifiedemergency medical technician or a certified first responder shall submit an application tothe bureau on forms provided by the bureau. The application shall be accompanied by theappropriate fee.

C. The bureau shall affirmatively provide that there is no discrimination toward anyindividual in the certification process on the basis of race, religion, creed, national origin,sex, or age.

Amended by Acts 1976, No. 393,§ §2, 3; Acts 1977, No. 626,§ 1; Acts 1985, No. 750,§ 1,eff. Jan. 1, 1987; Acts 1987, No. 665,§ 2, eff. July 9, 1987; Acts 1997, No. 913,§ 2.




§1232.1. Fee schedule; fees for certification prohibited

A.(1) The bureau shall not require or collect any fee or charges for certification orrecertification of emergency medical personnel who serve as such on a voluntary basisand who receive no compensation of any kind for such services.

(2) The bureau shall not set the fee for certification of an emergency medical technician-basic to exceed fifteen dollars for any individual who is an employee of a municipal lawenforcement agency, fire service, or fire protection district who does not performemergency medical services outside of the individual's official governmentalresponsibilities for any form of compensation.

(3) The bureau shall not set the fee for recertification of an emergency medicaltechnician-basic to exceed ten dollars for any individual who is an employee of amunicipal law enforcement agency, fire service, or fire protection district who does notperform emergency medical services outside of the individual's official governmentalresponsibilities for any form of compensation.

B. Except as provided in Subsection A of this Section, the bureau shall assess fees fortesting and certification based on the following schedule:

(1) Test fees: Fee

(a) First responder-written only $ 15.00

(b) First responder-written only

(out of state) 15.00

(c) Basic initial written & practical 60.00

(d) Basic entire practical exam 30.00

(e) Basic partial practical 15.00

(f) Basic testing/retesting-written only 15.00

(g) Basic testing/retesting-written only


(h) Intermediate initial written & practical 75.00

(i) Intermediate initial written & practical


(j) Intermediate retest entire practical 50.00

(k) Intermediate retest entire practical


(l) Intermediate retest partial practical 30.00

(m) Intermediate retest partial practical


(n) Intermediate testing/retesting-written only

(exam only) 15.00

(o) Intermediate testing/retesting-written only

(exam only) (out of state) 15.00

(p) Paramedic initial written & practical 90.00

(q) Paramedic initial written & practical


(r) Paramedic retesting-entire practical 60.00

(s) Paramedic retesting-entire practical


(t) Paramedic retesting-partial practical 35.00

(u) Paramedic retesting-partial practical


(v) Paramedic testing/retesting written 15.00

(w) Paramedic testing/retesting written


(2) Certification fees

(a) First responder 10.00

(b) Basic EMT 30.00

(c) Intermediate 40.00

(d) Paramedic 50.00

(3) Recertification


(b) Basic EMT 25.00


(d) Paramedic 45.00

(4) Reciprocity

(a) Basic EMT 60.00

(b) Intermediate 80.00

(c) Paramedic 100.00

C. The department may adopt rules and regulations in accordance with theAdministrative Procedure Act to provide for the collection of fees required by the feeschedule provided in this Section.

Acts 1997, No. 913,§ 2; Acts 2001, No. 515,§ 1.




§1232.2. Louisiana Emergency Medical Services Certification Commission; creation;membership; qualifications; terms; vacancies; meetings; officers; compensation; domicile

A. The Louisiana Emergency Medical Services Certification Commission is herebycreated within the Department of Health and Hospitals.

B.(1) The commission shall be composed of nine voting members appointed by thegovernor as follows:

(a) Two emergency medical services administrators, including one representing theprivate sector and one representing the public sector.

(b) Two certified emergency medical technician-paramedics and one emergency medicaltechnician-basic, at least one of whom shall be a full-time employee of a fire department,who are certified as emergency medical services instructors by the bureau.

(c) Four physicians, one from each of the following organizations:

(i) The American College of Emergency Physicians.

(ii) The American College of Surgeons.

(iii) The Louisiana State Medical Society.

(iv) The American Academy of Pediatrics.

(2) The commission shall also have one nonvoting member appointed by the governorwho is a registered nurse and who is a state-certified paramedic to be nominated by theLouisiana State Nurses Association from a list of two names submitted by the LouisianaEmergency Nurses Association.

C. Each member of the commission shall be a resident of Louisiana for at least one year,have had three years experience in his respective field of practice, and be activelyengaged in the practice of emergency medical services at the time of his appointment.

D.(1) The initial voting members of the commission shall be appointed no later thanOctober 1, 1997, from a list of two nominees for each appointment submitted by the taskforce. If the task force fails to submit a list of nominees to the governor by September 1,

1997, the governor shall appoint the respective members of the commission without thenomination list required by this Section.

(2) The nonvoting member shall be appointed to serve terms of three years. The initialmember shall be appointed by the governor to an initial term of three years by October 1,1997 or within thirty days of receipt of the list from the Louisiana State NursesAssociation, whichever is later.

E. Each appointment by the governor shall be submitted to the Senate for confirmation.

F.(1) The voting members appointed to the commission shall serve as follows: threemembers shall be appointed to serve an initial term of one year; three members shall beappointed to serve an initial term of two years; and three members shall be appointed toserve an initial term of three years. Thereafter, each member shall be appointed to serve aterm of three years.

(2) No individual shall serve more than two consecutive terms.

G.(1) Subsequent to the appointment of the initial members, the voting members shall beappointed from a list of two nominees for each appointment submitted by the task force.No later than thirty days prior to the termination date of a member's term, the task forceor, for the nonvoting member, the Louisiana State Nurses Association, shall submit a listof nominees to the governor. If the Louisiana State Nurses Association or the task forcefails to submit the required list of nominees to the governor within thirty days, thegovernor shall appoint the respective member to fill the vacancy without the nominationlist required.

(2) A vacancy on the commission prior to the expiration of a term shall be filled for theremainder of the term. No later than thirty days after the occurrence of a vacancy prior tothe expiration of a term, the task force or, for the nonvoting member, the Louisiana StateNurses Association, shall submit a list of nominees to the governor. If the Louisiana StateNurses Association or the task force fails to submit the required list of nominees to thegovernor within thirty days, the governor shall appoint the respective member to fill thevacancy without the nomination list required.

H. The governor shall call the first meeting of the commission no later than November 30,1997. At a minimum, the commission shall meet on a quarterly basis and, in addition,shall meet when called by the chairman or upon the written request of at least four votingmembers of the commission.

I. The commission shall annually elect a chairman, vice chairman, and secretary fromamong its voting membership and shall maintain a record of the attendance of itsmembers at commission meetings.

J. For each day while performing his official duties, a member of the commission may bereimbursed for expenses and mileage at the same rate set by the division ofadministration for state employees under the provisions of R.S. 39:231.

K. The commission shall be domiciled in Baton Rouge.

L. The governor shall remove a member of the commission after a hearing by thecommission during which charges for removal have been established and provided that amajority of the members have recommended removal.

Acts 1997, No. 913,§ 2.




§1232.3. Powers and duties of the commission

The commission shall:

(1) Recommend to the bureau requirements and standards of practice for individualsseeking to be certified under this Subpart.

(2) Approve requirements and standards of practice submitted by the bureau foremergency medical personnel consistent with this Subpart.

(3) Recommend continuing education requirements and standards to the bureau inaccordance with criteria established by the National Registry of Emergency MedicalTechnicians for individuals seeking to renew a certificate.

(4) Conduct disciplinary hearings for emergency medical personnel.

(5) Request that the bureau conduct investigations as necessary.

(6) Cause the prosecution of any individual who violates any provision of this Subpart.

(7) Maintain a record of all commission proceedings.

Acts 1997, No. 913,§ 2.




§1232.4. Powers and duties of the bureau

The bureau shall:

(1) Issue a certificate and renew a certificate to any duly qualified applicant forcertification or for certification renewal as a certified first responder or certifiedemergency medical technician.

(2) Prescribe application forms for certification and certification renewal.

(3) Adopt requirements and standards of practice approved by the commission foremergency medical personnel.

(4) Conduct investigations as requested by the commission.

(5) Deny, withhold, revoke, restrict, probate, or suspend a certificate as directed by thecommission under the provisions of R.S. 40:1232.6.

(6) Prepare, publish, and update a roster of all emergency medical personnel, includingthe name and address of each individual.

(7) Adopt continuing education requirements and standards for individuals seeking torenew a certificate.

(8) Prepare an annual report detailing the activities of the commission during the pastfiscal year including the number and nature of the hearings conducted under theprovisions of R.S. 40:1232.7.

(9) Adopt rules and regulations to implement the provisions of this Subpart in accordancewith the Administrative Procedure Act.

Acts 1997, No. 913,§ 2.




§1232.5. Certification; requirements; renewal

A. Applicants for initial certification as emergency medical personnel shall submit thefollowing evidence to the bureau:

(1) Completion of the required approved educational program.

(2) Documentation that the applicant meets the qualifications and requirements asestablished by the bureau.

B. In lieu of the evidence required by Subsection A of this Section, an applicant maysubmit evidence that he has been duly licensed or certified in another state, territory, orcountry or has received military training and certification as emergency medicalpersonnel as defined in R.S. 40:1231, and meets the qualifications and requirementsestablished by the bureau.

C.(1) The certificate shall be renewed every two years provided the applicant seekingrenewal completes the application and meets the requirements for renewal established bythe bureau prior to the expiration date on his current certificate.

(2) An individual whose certificate expires by his failure to renew as provided may bereinstated provided the applicant submits a completed application and meets anyadditional requirements established by the bureau for an individual who has failed totimely renew his certificate.

Acts 1997, No. 913,§ 2.




§1232.6. Grounds for disciplinary proceedingsThe commission may discipline emergency medical personnel by directing

the bureau to deny, withhold, revoke, restrict, probate, or suspend a certificate topractice as a certified emergency medical technician or certified first responder,impose fines and assess costs, or otherwise discipline an EMS professional, andthe commission may direct the bureau to limit, restrict, or deny a student EMSprofessional from entering or continuing the clinical phase of EMS education forthe following causes:

(1) Conviction of selling or attempting to sell, falsely obtaining, orfurnishing to a person a certified emergency medical technician or certified firstresponder certification document.

(2) Conviction of a crime or offense which reflects the inability of acertified emergency medical technician or certified first responder to provideemergency medical services with due regard for the health and safety of clients orpatients or enters a plea of guilty or nolo contendere to a criminal chargeregardless of final disposition of the criminal proceeding, including but not limitedto expungement or nonadjudication.

(3) Is unfit or incompetent by reason of negligence, habit, or other cause.(4) Is habitually intemperate in the use of or abuses alcohol or habit-

forming drugs.(5) Is guilty of aiding or abetting another person in the violation of this

Subpart.(6) Is mentally incompetent.(7) Endeavors to deceive or defraud the public.(8) Professional or medical incompetency.(9) Unprofessional conduct.(10) Continuing or recurring practices which fail to meet the standards of

EMS care in this state.(11) Abandonment of a patient.(12) Has had a certification or license to practice as an EMS professional

or to practice as another health care provider denied, revoked, suspended, orotherwise restricted.

(13) Is guilty of moral turpitude.(14) Has violated any rules and regulations of the commission or the

bureau or any provision of this Subpart.

Acts 1997, No. 913, §2; Acts 2003, No. 208, §1.




§1232.7. Hearings of the commission; appeal of decision

A. If the commission determines there are grounds for a disciplinary proceeding againstan individual based upon an investigation by the bureau, the chairman of the commissionshall set a time and place for a hearing. No later than ten days prior to the date set for thehearing, the commission shall send notice of the time and place for the hearing and anexplanation of the grounds for the disciplinary proceedings to the individual by registeredmail, return receipt requested, at his last known address as it appears on the records of thebureau.

B. The commission may compel the attendance of witnesses, the production of books,papers, and documents, and administer oaths at the hearing. The commission shall not bebound by strict rules of procedure or other laws of evidence in the conduct of itsproceedings. The individual under investigation may appear personally, by counsel, orpersonally and by counsel, produce witnesses and evidence on his own behalf, and cross-examine witnesses. Such proceedings shall be closed to the general public and the recordsof the proceeding shall be confidential.

C. Notwithstanding any privilege of confidentiality recognized by law, a physician orhealth care agency with which the individual under investigation is associated shall notassert such privilege by failing or refusing to respond to a lawfully issued subpoena of thecommission for any medical information, testimony, records, data, reports, or otherdocuments, tangible items, or information relative to any patient cared for or assigned tothe individual under investigation. Any such items obtained pursuant to a subpoena shallbe confidential. Furthermore, the transcript of testimony from the hearing shall be alteredto prevent the disclosure of the identity of the patient to whom such records relate.

D. Notice of the commission's decision to revoke, restrict, suspend, or deny a certificateshall be sent to the individual under investigation by registered mail, return receiptrequested, at his last known address as it appears on the records of the bureau.

E. An individual whose certification has been revoked, restricted, suspended, placed inprobation, or denied may have the proceedings of the commission reviewed by a court ofcompetent jurisdiction, provided that an appeal is made no later than thirty days after thedate indicated on the registered mail receipt of the notice required by Subsection D of thisSection. The decision of the commission shall remain in force until an appeal is grantedunless the court orders a stay. If an appeal is granted, the decision of the commissionshall be suspended until a final disposition of the matter is ultimately rendered by thecourt affirming the decision of the commission.

F. The commission may maintain the confidentiality of an individual under investigationwhenever the commission determines the public interest will be best served byalternatives to the disciplinary hearing process.

Acts 1997, No. 913,§ 2.




§1232.8. Injunction

The commission, through the bureau, may obtain an injunction without bond forbiddingany person from violating or continuing to violate any of the provisions of this Subpart.This injunction shall not be subject to release upon bond.




§1232.9. Violations

No person or individual shall engage in any of the following activities:

(1) Sell, or attempt to sell, falsely obtain, or furnish to any person any emergency medicalpersonnel diploma, certification document, or record, or aid or abet therein.

(2) Practice as a certified emergency medical technician or certified first responder underany diploma or certificate illegally obtained or signed or issued unlawfully.

(3) Practice as a certified emergency medical technician or certified first responder unlesscertified to do so under the provisions of this Subpart.

(4) Use in connection with his name any designation tending to imply that he is acertified emergency medical technician or certified first responder unless duly authorizedto practice under the provisions of this Subpart.

(5) Practice as a certified emergency medical technician or certified first responder duringthe time the certification issued under the provisions of this Subpart is suspended orrevoked.

(6) Practice as a certified emergency medical technician or certified first responder duringthe time his certification has lapsed by reason of his intentional failure to renew thecertification.

(7) Conduct or serve as an assistant instructor in conducting any course claiming toprepare students for certification as emergency medical personnel under the provisions ofthis Subpart, unless both the course and the instructor have been approved by the bureau.

(8) Knowingly aid or abet another person in the violation of this Subpart.

Acts 1997, No. 913,§ 2.




§1232.10. Prosecution

A. Any person who violates the provisions of R.S. 40:1232.9 shall be subject toprosecution. This prosecution shall be brought in the name of the state, provided theprovisions of this Subpart shall not prevent or interfere with a prosecution brought by thedistrict attorney of a parish when a prosecution or a pre-prosecution proceeding has beeninitiated by the district attorney.

B. Whoever is found guilty of violating any provision of R.S. 40:1232.9 shall, upon afirst conviction, be fined not more than five hundred dollars or imprisoned for not morethan six months, or both. Upon a second or subsequent conviction, the offender shall beimprisoned with or without hard labor for not more than two years and fined not morethan five thousand dollars.

Acts 1997, No. 913,§ 2.




§1232.11. Exceptions

This Subpart shall not apply to the practice of emergency medical services by a legallyqualified emergency medical technician who is employed by the United Statesgovernment, or by any bureau, division, or agency thereof, while in the discharge of hisofficial duties.

Acts 1997, No. 913,§ 2.




§1233. Civil immunity

A.(1) Any emergency medical person certified pursuant to the provisions of this Subpartwho renders emergency medical care to an individual while in the performance of hismedical duties and following the instructions of a physician shall not be individuallyliable to such an individual for civil damages as a result of acts or omissions in renderingthe emergency medical care, except for acts or omissions intentionally designed to harm,or for grossly negligent acts or omissions which result in harm to such an individual.Nothing herein shall relieve the driver of the emergency vehicle from liability arisingfrom the operation or use of such vehicle.

(2) The immunity granted to emergency medical personnel by the provisions of thisSubpart shall extend to parish governing authorities, police departments, sheriffs' offices,fire department, or other public agencies engaged in rendering emergency medicalservices and its insurers with respect to such emergency medical services unless theemergency medical personnel employed by such agencies would be personally liableunder the provisions of Paragraph (1) of this Subsection.

B. Any physician who provides instructions to any emergency medical personnel by useof electronic or other means of transmission in connection with the rendering ofemergency medical services to an individual shall not be liable unto such personnel or toan individual or both for civil damages arising from his opinion, judgments, actions, orduties, except for acts or omissions intentionally designed to harm, or for grosslynegligent acts or omissions which result in harm to the individual, while exercising thatdegree of skill and care ordinarily employed by members of his profession in goodstanding.

C. No hospital facility which allows the use of telemetry or other equipment to maintaincontact between a certified emergency medical technician and a physician shall be liablefor any civil damages arising out of the use of such equipment except for acts oromissions by hospital personnel that are grossly negligent which result in harm to anindividual.

D. No registered nurse, certified emergency medical technician, or other healthprofessional licensed in Louisiana who supervises, instructs, or trains emergency medicalpersonnel in accordance with curricula developed or adopted by the bureau shall be liablefor any civil damages arising out of the actions or negligence of the emergency medicalpersonnel whom he supervised, instructed, or trained.

E. There shall be no cause of action or civil liability, and no certificate holder or applicantshall have any cause of action or any claim for damages against any individual, person, orinstitution providing information to the commission or its agents or employees when thatindividual, person, or institution acts without malice and when there is a reasonable beliefthat such information is accurate.

Acts 1977, No. 626,§ 2. Amended by Acts 1978, No. 469,§ 1; Acts 1997, No. 913,§ 2.




§1234. Duties of emergency medical personnel

A.(1) A certified emergency medical technician-basic may perform any of the followingfunctions:

(a) Rescue, first aid, resuscitation, and other services to the extent that he has been trainedto perform such services under the provisions of the National Standard EMT-Basictraining curriculum developed and promulgated by the United States Department ofTransportation that are adopted by the bureau.

(b) When authorized by medical direction, an emergency medical technician-basic or anemergency medical technician-intermediate may administer or aid the patient in theadministration of a dose of epinephrine from an auto-injector to treat allergic reaction andanaphylaxis.

(c) Services which may be performed by a certified emergency medical technician-intermediate as provided in Subsection B of this Section, but only while he is enrolled ingood standing in an approved emergency medical technician-intermediate clinical or fieldinternship program and while he is under the direct supervision of a physician, registerednurse, certified emergency technician-paramedic, or other preceptor approved by thebureau.

(d) Services which may be performed by a certified emergency medical technician-paramedic, as provided in Subsection C of this Section, but only while he is enrolled ingood standing in an approved emergency medical technician-paramedic clinical or fieldinternship program and while he is under the direct supervision of a physician, registerednurse, certified emergency technician-paramedic, or other preceptor approved by thebureau.

(2) The functions authorized by Paragraph (1) of this Subsection may be performed bythe certified emergency medical technician-basic under any of the following conditions:

(a) While he is at the scene of a medical or other emergency where voice contact isestablished with a physician and under the physician's order.

(b) While he is at the scene of a life threatening emergency and under a protocol that hasbeen approved by the local parish medical society, or its designee, until voicecommunication with the physician is established at the earliest possible time.

B.(1) A certified emergency medical technician-intermediate may perform any of thefollowing functions:

(a) Any services to the extent that he has been trained to perform such services under theprovisions of the National Standard EMT-Intermediate training curriculum developedand promulgated by the United States Department of Transportation that are adopted bythe bureau.

(b) Services which may be performed by a certified emergency medical technician-paramedic, as provided in Subsection C of this Section, but only while he is enrolled ingood standing in an approved emergency medical technician-paramedic clinical or fieldinternship program and while under the direct supervision of a physician, registered nurse,certified emergency technician-paramedic, or other preceptor approved by the bureau.

(2) The functions authorized by Paragraph (1) of this Subsection may be performed bythe certified emergency medical technician-intermediate under any of the followingconditions:

(a) While caring for a patient in a participating hospital under the direct supervision of aphysician.

(b) While he is at the scene of a medical or other emergency where voice contact isestablished with a physician and under the physician's orders.

(c) While he is at the scene of a life threatening emergency and under a protocol that hasbeen approved by the local parish medical society, or its designee, until voicecommunication with the physician is established at the earliest possible time.

C.(1) A certified emergency medical technician-paramedic may perform any of thefollowing functions:

(a) Any services to the extent that he has been trained to perform such service under theprovisions of the National Standard EMT-Paramedic training curriculum developed andpromulgated by the United States Department of Transportation that are adopted by thebureau.

(b) Administration of other drugs or procedures for which the certified emergencymedical technician-paramedic has received training, certification, and approval by thecommission and which may be considered necessary by the ordering physician.

(2) The functions authorized by Paragraph (1) of this Subsection may be performed by acertified emergency medical technician-paramedic under any of the following conditions:

(a) While his caring for a patient in a participating hospital under the direct supervision ofa physician.



D. A certified first responder may perform any of the following functions:

(1) Rescue, first aid, resuscitation, and other services to the extent that he has beentrained to perform such services under the provisions of the first responder trainingcurriculum developed and adopted by the bureau.

(2) Administration of automated cardiac defibrillation in accordance with rules andregulations promulgated by the bureau in accordance with the Administrative ProcedureAct and a protocol that shall be approved by the local parish medical society, or itsdesignee, and the local physician medical director.

E.(1) In a case of a life-threatening situation as determined by a certified emergencymedical technician-intermediate or an emergency medical technician-paramedic, whenvoice contact with a physician or when telemetered electrocardiogram communication isdelayed, not possible, or when the delay in treatment could endanger the life of thepatient, such a person may render services, in accordance with a protocol that shall beestablished by the emergency medical services committee or the executive committee ofthe parish or component medical society, or its designee, until voice or telemeteredelectrocardiogram communication can be established at the earliest possible time.

(2) Such services may be rendered for the following conditions:

(a) Cardiac arrest.

(b) Ventricular tachycardia.

(c) Supraventricular tachycardia.

(d) Premature ventricular ectopy when greater than six per minute, multifocal, bigeminal,occurring in bursts of two or more, falling on or close to the T wave.

(e) Severe, unrelieved, suspected cardiogenic chest pain, or suspected myocardialinfarction.

(f) Bradydysrhythmias.

(g) Hypoglycemia.

(h) Anaphylactic reactions.

(i) Hypovolemic shock.

(j) Unconsciousness, altered mental status, or respiratory depression from suspected drugoverdose.

(k) Treatment induced unconsciousness, altered mental status, hypotension, or respiratorydepression from physician ordered or protocol appropriate paramedic administerednarcotics.

(l) Respiratory failure or respiratory arrest.

(m) Active seizure.

(3) Nothing in this Subsection shall be construed to authorize a certified emergencymedical technician-paramedic to administer any Schedule II narcotic without a directorder by a physician licensed to practice medicine by the Louisiana State Board ofMedical Examiners or in accordance with an approved protocol adopted pursuant toSubsection E(1) and (2).

F.(1) The bureau shall adopt rules and regulations to allow emergency medical personnelto institute a program for the delivery of automated cardiac defibrillation in the pre-hospital setting.

(2) The bureau shall adopt rules and regulations for training to allow all levels of certifiedmedical technicians to carry and administer epinephrine by auto-injectors to patientsexperiencing allergic reactions or anaphylaxis.

G. Any individual, training organization, organization, or other entity violating theprovisions of this Section shall be guilty of a misdemeanor, conviction of which shallsubject the offender to a fine of not less than five hundred dollars nor more than onethousand dollars for each separate offense.

H. In the event that there is no organized or functional local parish medical society in aparish of the state, the provisions of this Section which require the approval of anemergency medical service protocol by the local parish medical society or its designeemay be performed by a parish or multiparish medical society which is adjacent orcontiguous to the parish without an organized or functional local parish medical society.In the absence of such adjacent or contiguous parish or multiparish medical society, thedistrict medical society shall approve an emergency medical service protocol for theparish without an organized or functional local parish medical society. In the event thedistrict medical society does not approve an emergency medical service protocol for theparish without an organized or functional local parish medical society, the disaster andemergency medical services committee of the Louisiana State Medical Society shallapprove an emergency medical service protocol for the parish without an organized orfunctional local parish medical society.

I. The department shall promulgate rules and regulations establishing basic guidelines forstatewide emergency medical service protocols. Such rules and regulations shall be basedon the recommendations of the Louisiana State Medical Society's disaster and emergencymedical services committee, which shall serve as an advisory committee to thedepartment for this purpose.

Acts 1977, No. 626,§ 2; Amended by Acts 1978, No. 469,§ 1; Acts 1979, No. 688,§ 1;Acts 1984, No. 242,§ 1; Acts 1984, No. 243,§ 1; Acts 1986, No. 630,§ 1, eff. July 6, 1986;Acts 1987, No. 665,§ 1, eff. July 9, 1987; Acts 1988, No. 776,§ 1; Acts 1989, No. 195,§ 1,eff. June 26, 1989; Acts 1990, No. 211,§ 1, eff. Jan. 1, 1991; Acts 1991, No. 974,§ 1, eff.July 24, 1991; Acts 1997, No. 913,§ §2, 3; Acts 1999, No. 427,§ 1; Acts 2001, No. 385,§1.




§1234.1. Hazardous substance transportation emergencies; payment for emergencymedical services

The person or entity who in the course of transporting hazardous substances or materialscauses or contributes to a discharge of a hazardous substance or material that causes anemergency condition shall be obligated to pay the reasonable costs of any emergencymedical services provider whose presence or service, including standby, is requested atsuch hazardous substance emergency by any person authorized by the Department ofPublic Safety and Corrections or the Department of Environmental Quality to respond toa hazardous substance transportation emergency. Nothing is this Section shall affect therights of any party to recover under any other provision of law.

Acts 1999, No. 209,§ 1.




§1235. Qualifications to operate ambulances; equipment; penalty

A.(1) No person or individual shall conduct, maintain, or operate an ambulance on anystreet, alley, or public way or place in the state unless the ambulance is staffed with aminimum of two persons, one of whom shall be a certified emergency medical technician.

(2)(a) No person or individual shall provide services in any capacity on any ambulanceunless he is a certified first responder, a certified emergency medical technician, alicensed registered or practical nurse, or a physician.

(b) No individual shall transport any ill or injured person on a stretcher in a vehicle that isnot staffed, equipped, insured, and licensed as an ambulance under this Subpart.

(c) No individual shall provide services in any capacity on any ambulance unless he holdsa cardiopulmonary resuscitation provider card issued by the American Heart Associationor the American Red Cross.

(d) No individual shall transport any ill or injured person by ambulance unless the sick orinjured person is attended by a certified emergency medical technician, a registered nurse,or a physician in the patient compartment.

(3)(a) The Department of Health and Hospitals shall promulgate rules and regulationsestablishing a list of required medical and safety equipment which shall be carried as partof the regular equipment of every ambulance. No person shall conduct, maintain, oroperate an ambulance which does not carry with it, in fully operational condition, all ofthe equipment included in the list, which shall be consistent with the scope of practice foremergency medical technicians established in R.S. 40:1234 and which shall be basedupon the recommendations of an advisory committee known as the Ambulance StandardsCommittee.

(b) After its initial establishment, the list shall be subject to review after four years and atany time thereafter. The list shall not be changed more often than once every four years.However, nothing in this Paragraph shall prohibit the department from supplementing thelist with state-of-the-art, newly developed devices, equipment, or medications approvedby the Ambulance Standards Committee that may be carried in lieu of other items on thelist.

(4) The Ambulance Standards Committee of the Emergency Medical Services Task Forceas established by the assistant secretary of the office of public health is hereby established.The committee shall be composed of the following members and such additionalmembers as the assistant secretary of the office of public health may appoint:

(a) The medical director of the Department of Health and Hospitals.

(b) The director of the bureau of emergency medical services of the Department of Healthand Hospitals.

(c) A representative of the health standards section of the Department of Health andHospitals.

(d) One representative, appointed by the assistant secretary of the office of public health,from each of the following:

(i) The Louisiana State Medical Society.

(ii) The American College of Emergency Physicians.

(iii) The American College of Surgeons.


(v) The Louisiana Ambulance Association.

(vi) The Louisiana Rural Ambulance Alliance.

(vii) The Louisiana Association of Nationally Registered Emergency MedicalTechnicians.

(viii) The Governor's Emergency Medical Services for Children Advisory Council.

(ix) Municipal third service ambulance providers.

(x) Rural ambulance providers.

(xi) Private sector ambulance providers.

(xii) Fire service-based ambulance providers.

(xiii) Hospital-based emergency medical services providers.

(xiv) Professional firefighters.

(xv) The Professional Firefighters Association of Louisiana.

(5) Nothing herein shall prohibit the transportation of an injured or ill person in anambulance or industrial ambulance staffed by persons with less than the requiredqualifications in an emergency situation where there is no reasonable expectation of theprompt response by an ambulance staffed by persons with the required qualifications.

(6) Nothing herein shall prohibit a firefighter, law enforcement officer, or good Samaritanfrom assisting an ambulance at the scene of an emergency or while transporting a patientto a medical facility at the request of the emergency medical technician.

(7) Nothing herein shall prohibit an individual without the required qualifications fromriding in an ambulance for the purpose of training, observation, or continuing education.

B.(1) Repealed by Acts 2001, No. 625,§ 2.

(2) Nothing in this Subpart shall be construed to prohibit the transportation of an injuredor ill individual in an invalid coach in an emergency situation where there is noreasonable expectation of the prompt response of an ambulance or industrial ambulance.

C. The department shall conduct or may authorize another public agency to conduct aninspection of any ambulance service provider or invalid coach provider and to report anyviolation to the appropriate district attorney's office.

D.(1) The provisions of this Section shall not apply:

(a) To ambulances operated by a federal agency of the United States government.

(b) Repealed by Acts 2001, No. 625,§ 2.

(c) To ambulances which are rendering assistance to licensed ambulances in the case of amajor disaster, be it natural or manmade, in which the licensed ambulances areinsufficient or otherwise not capable of coping.

(d) Repealed by Acts 2001, No. 625,§ 2.

(e) To ambulances which are operated from a location outside of the state to transportpatients from a location outside of the state to a location inside the state or to transportpatients from a medical facility inside to a point outside the state, but no such ambulanceshall transport any patient point to point within the state except in the case of disaster asoutlined in this Subpart.

(2) This provision shall not apply to individuals who are employed to function onlicensed air ambulances solely to act as pilots.

(3) The provisions of this Section shall not apply to industrial ambulances providingtransportation to employees who become sick or injured during the course of theiremployment from a job site to the nearest appropriate medical facility.

E. The provisions of this Section shall apply to all parishes or municipalities except thoseelecting not to comply as expressed to the department in a written resolution by thegoverning body of such parish or municipality. If any parish or municipality elects to beexcluded from this Section, it may later elect to be included by resolution. The election ofany parish to be included or excluded from this Section shall in no way affect the electionof any municipality to be included or excluded.

F. Whoever violates this Section shall be guilty of a misdemeanor and upon convictionshall be fined not more than five hundred dollars or imprisoned for not more than thirtydays or both. The penalty prescribed by this Section shall be doubled for any subsequentoffense.

Acts 1977, No. 626,§ 2. Amended by Acts 1978, No. 469,§ 1; Acts 1986, No. 632,§ 1;Acts 1987, No. 480,§ 1, eff. July 9, 1987; Acts 1997, No. 913,§ 2; Acts 1997, No. 982,§ 1,eff. July 10, 1997; Acts 2001, No. 625,§ §1 and 2.




§1235.1. Qualifications to operate emergency medical response vehicles; vehiclerequirements; equipment; penalties

A.(1) No person shall conduct, maintain, or operate an emergency medical responsevehicle as an emergency vehicle on any street, alley, or public way or place in the stateunless the vehicle is staffed with at least one individual who is a Louisiana state-certifiednationally registered emergency medical technician.

(2) No person shall provide services in any capacity on an emergency medical responsevehicle unless he is the holder of a certification by the Department of Health andHospitals or its agent as a first responder; or a certification of an emergency medicaltechnician issued by the National Registry of Emergency Medical Technicians; or acertificate of licensure as a registered nurse or licensed practical nurse; or is a physicianor surgeon licensed to practice medicine by the Louisiana State Board of MedicalExaminers. No person shall provide services in any capacity without holding a validcertification of cardiopulmonary resuscitation issued by the American National RedCross or the American Heart Association.

B. No person shall conduct, maintain, or operate an emergency medical response vehicleas an emergency vehicle which:

(1) Does not carry with it as part of its regular equipment the list of equipment foremergency medical response vehicles as prescribed in rules and regulations promulgatedby the Department of Health and Hospitals based on the recommendations of theAmbulance Standards Committee of the Emergency Medical Services Task Force asestablished by the assistant secretary of the office of public health. This list shall be basedupon the recommendations of the American College of Surgeons as provided in R.S.40:1235(A)(3). The list shall be consistent with the scope of practice for emergencymedical technicians established in R.S. 40:1234. After initial promulgation, such list shallbe subject to review after four years and anytime thereafter. The list shall not be changedmore often than once every four years. However, nothing shall preclude the Departmentof Health and Hospitals from supplementing the list with state of the art, newlydeveloped devices, equipment, or medications approved by the Ambulance StandardsCommittee of the Emergency Medical Services Task Force that may be carried in lieu ofother items on the list of equipment.

(2) Is not marked with the company name or logo on both sides and the rear and does nothave fully visible and audible warning signals in accordance with rules and regulationspromulgated by the Department of Health and Hospitals.

(3) Does not meet the minimum motor vehicle safety standards as prescribed in the rulesand regulations promulgated pursuant to the Motor Vehicle Inspection Act, R.S. 32:1302et seq.

(4) Is not insured in accordance with the provisions of R.S. 40:1236.4.

(5) Is not owned or leased by the certified ambulance service operating the vehicle.

C.(1) The Department of Health and Hospitals or its designee shall be empowered toconduct inspections of emergency medical response vehicles. The department shallcertify such vehicles and shall have the authority to deny, probate, suspend, or revokecertifications. The department shall also have the authority to report any violations to theappropriate district attorney's office.

(2) Certification issued by the Department of Health and Hospitals shall serve asauthorization of the ambulance service to operate the emergency medical responsevehicle pursuant to the provisions of this Section.

D. Whoever violates the provisions of this Section shall be guilty of a misdemeanor andupon conviction shall be fined not more than five hundred dollars or imprisoned for notmore than thirty days, or both. The penalty prescribed by this Subsection shall be doubledfor any subsequent offense.

Acts 1997, No. 297,§ 2.




§1235.2. Ambulance providers; licensure

A. No person, firm, corporation, association, or government entity shall conduct, manage,operate, or maintain an ambulance service in Louisiana without a valid current licensefrom the department.

B. The application for such license shall be submitted to the department on formsprovided for that purpose. The application shall provide documentation that the applicantmeets the appropriate requirements for an ambulance provider as specified by regulationspromulgated by the department under the Administrative Procedure Act.

C. An applicant seeking licensure as an ambulance provider shall:

(1) Submit a completed application to the department on such forms and including suchinformation and supporting documentation as required by the department. Suchinformation shall include:

(a) A notarized certificate of insurance verifying that the provider has the legallymandated insurance coverage.

(b) Proof that the provider has a medical director and that such director is a physicianlicensed to practice medicine by the Louisiana State Board of Medical Examiners.

(c) All medical protocols signed by the physician-medical director with their prescribedapprovals by the parish or component medical society.

(d) Copies of personnel certifications. However, the department may provide forinspection and review of these certifications at an applicant's offices by prior agreementbetween the applicant and the department.

(e) For those providers providing advanced life support, verification that the providerpossesses a Louisiana Controlled Substance License and a United States DrugEnforcement Administration Controlled Substance Registration.

(2) Submit to a background investigation which includes but is not limited tofingerprinting and a criminal history check by the Department of Public Safety andCorrections, office of state police.

(3) Successfully complete an inspection by the department which includes the following:

(a) An inspection of all vehicles to determine that they are in safe and working order andthat they are equipped with all of the prescribed medical equipment as required by thisSection and R.S. 40:1235 and 1235.1. What is safe and working order shall bedetermined pursuant to provisions of Title 32 of the Louisiana Revised Statutes of 1950and the Louisiana Motor Vehicle Inspection Manual in addition to the provisions of thisSection and R.S. 40:1235 and 1235.1. Each vehicle successfully completing theinspection shall receive a permit authorizing it to be operated as part of the applicant'sservice.

(b) An inspection of all personnel certifications to verify that they meet the requirementsof law.

(c) Inspection and, when deemed necessary by the department, verification of theinformation provided as required by Paragraph (1) of this Subsection and that suchinformation remains current.

(d) Verification that the provider has complied with all applicable federal, state, and localstatutes, rules, and regulations, and that the provider has obtained all necessary andapplicable licenses, permits, and certifications, including certificates of need orcertificates of public convenience and necessity.


D. If an applicant's background investigation indicates that the applicant has a felonyconviction or has had any license pertaining to the provision of emergency medicalservices revoked in another jurisdiction, then the license may be denied.

E. In order to renew an ambulance provider license, the applicant shall:

(1) Submit a renewal application to the department not more than thirty days prior toexpiration of the license.

(2) Provide any required documentation.

(3) Successfully complete a review of any required documentation and any inspection orverification of any documentation of any vehicle as deemed appropriate by thedepartment.

F. Intentional falsification of material information provided pursuant to this Section shallbe grounds for immediate revocation of any license granted pursuant to this Section.

G. Failure to comply with any of the provisions of this Section shall constitute groundsfor probation or license suspension or revocation in accordance with rules and regulationsestablished pursuant to the Administrative Procedure Act.

H. Any person whose license has been revoked, suspended, or denied by the departmentshall have the right to have the proceedings of the department reviewed by a court ofcompetent jurisdiction, provided that such appeal is made within thirty days after thenotice of the decision of the department. If an appeal is granted, the decision of thedepartment shall not be implemented until a decision affirming the department decision isrendered on judicial review. The department's decision shall remain in force until anappeal is granted unless the court orders a stay. Judicial review shall be by trial de novo.

I. Any entity currently certified to provide ambulance services in Louisiana shall not berequired to be licensed by the state in order to maintain certification for a period of oneyear after July 15, 1999, in order to continue providing such services.





§1235.3. Ambulance services; fees

Any person, partnership, corporation, unincorporated association, or other legal entitycurrently operating or planning to operate an ambulance service shall pay the followingfees to the department, as applicable:

(1) An initial licensing fee of one hundred fifty dollars, to be submitted with the initialapplication for a license.

(2) An annual license renewal fee of one hundred dollars, to be submitted with eachannual application for renewal of a license.


(4) A vehicle inspection fee of seventy-five dollars for each ambulance or emergencymedical response vehicle, which shall be submitted with the initial application for alicense, with each annual application for renewal of a license, and with each applicationfor a permit for a vehicle added to service by the applicant.

(5) A delinquent fee of one hundred dollars for each ambulance and emergency medicalresponse vehicle, for failure to timely pay a vehicle inspection fee. Such delinquent feeshall be assessed and shall become due and payable at 12:01 a.m. on the thirty-sixth dayfollowing the date of the invoice by which the department bills the applicant or licenseefor the vehicle inspection fee.



Acts 1999, No. 1113,§ 1.




§1235.4. Ambulance services; violations; penalties; fines; notices; hearings; appeals

A. The opening or operation of an ambulance service without a current license thereforshall be a misdemeanor, punishable upon conviction by a fine of not less than onethousand dollars and not more than five thousand dollars. Each day's violation shallconstitute a separate offense.

B.(1) Any person or entity violating the provisions of this Part when such violation posesa threat to the health, safety, rights, or welfare of a patient or client may be liable to civilfines and other penalties, to be assessed by the department, in addition to any criminalaction which may be brought under other applicable laws. The department shall adoptrules, in accordance with the Administrative Procedure Act, which define specificclassifications of violations, articulate factors in assessing civil fines including mitigatingcircumstances, and explain the treatment of continuing and repeat deficiencies.


(a) Class A violations: If an ambulance or emergency medical response vehicle is foundto have been operated in violation of any of the requirements of this Part concerning thenumber or qualifications of personnel, the ambulance or emergency medical responsevehicle shall be immediately taken out of service until it meets those requirements, andthe ambulance service operating it shall be subject to a civil fine of not more than fivehundred dollars for the first violation and not more than one thousand dollars per day foreach repeat violation.

(b) Class B violations: If an ambulance service is found to have been operating inviolation of any of the requirements of this Part concerning insurance coverage, itslicense shall be immediately suspended until it meets those requirements, and it shall besubject to a civil fine of not more than five hundred dollars for the first violation and notmore than one thousand dollars per day for each repeat violation.

(c) Class C violations: If an ambulance or emergency medical response vehicle is foundto have been operated without undergoing any inspection required under the provisions ofthis Part, the ambulance or emergency medical response vehicle shall be immediatelytaken out of service until it meets those requirements, and the ambulance serviceoperating it shall be subject to a civil fine of not more than five hundred dollars for thefirst violation and not more than one thousand dollars per day for each repeat violation.

(d) Class D violations: If an ambulance or emergency medical response vehicle is foundto have been operated in violation of any of the requirements of this Part concerningmedical and safety equipment, the ambulance or emergency medical response vehicleshall be immediately taken out of service until it meets those requirements, and theambulance service operating it shall be subject to a civil fine of not more than onehundred dollars for the first violation and not more than five hundred dollars per day foreach repeat violation.

(e) Class E violations: If an ambulance or emergency medical response vehicle is foundto have been operated in violation of any of the requirements of Chapter 7 of Title 32 ofthe Louisiana Revised Statutes of 1950, the ambulance or emergency response vehicleshall be immediately taken out of service until it meets those requirements, and theambulance service operating it shall be subject to a civil fine of not more than onehundred dollars for the first violation and not more than five hundred dollars per day foreach repeat violation.

C. The department shall adopt rules and regulations, in accordance with theAdministrative Procedure Act, to provide notice to the ambulance service of anyviolation, of its right to an informal reconsideration process, and of the available appealprocedure, including judicial review. Such appeal shall be suspensive.

D. The ambulance service shall furnish, with an appeal, bond in the minimum amount ofone and one-half times the amount of the fine imposed by the department. The bond shallprovide in substance that it is furnished as security that the ambulance service willprosecute its appeal and that any judgment against it, including court costs, will be paidor satisfied from the amount furnished. The appeal shall be heard as a summaryproceeding which shall be given precedence over other pending matters.

E. The department may institute all necessary civil court action to collect fines imposedand not timely appealed. No ambulance service may claim imposed fines as reimbursablecosts, nor increase charges to patients or clients as a result of such fines. Interest shallbegin to accrue on any fine at the current judicial rate on the day following the date onwhich the fine becomes due and payable.

Acts 1999, No. 1113,§ 1.




§1236. Advanced emergency medical technicians

In addition to the requirements of R.S. 40:1235, any hospital, ancillary medical facility,or ambulance service, whether public or private, may conduct a program utilizing anycertified emergency medical technician-intermediate or certified emergency medicaltechnician-paramedic to supervise and direct the delivery of emergency medical care tothe sick and injured at the scene of an emergency during transport to a hospital, while inthe hospital emergency department, and until care responsibility is assumed by theregular hospital staff.





§1236.1. Unauthorized response by commercial ambulances; penalties

A. No commercial ambulance shall make any emergency run based solely on informationintercepted by use of a radio communication scanner or similar device except in caseswhere human life is threatened, unless that commercial ambulance has been specificallyrequested to respond to such emergency. Nothing in this Section shall be construed toprohibit service to a subscriber of a commercial ambulance service. No person certifiedunder this Part or certified or licensed pursuant to any provision of Louisiana law shalloperate a commercial ambulance in violation of this Section.

B. The certificate or license of any person certified under this Part or certified or licensedpursuant to Louisiana law who violates the provisions of this Section shall be suspendedby the appropriate certification or licensing authority for not less than thirty days, normore than six months.

C. Proceedings to enforce the provisions of this Section shall be conducted in accordancewith the Administrative Procedure Act.

Acts 1987, No. 187,§ 1.




§1236.2. Air ambulance services; licensure

A. No person, firm, corporation, association, or governmental entity shall conduct,manage, operate, or maintain an air ambulance service in the state without a valid currentlicense from the department.

B. The application for such license shall be submitted to the department on formsprovided for this purpose. The application shall provide documentation that the applicantmeets the appropriate requirements for an air ambulance service as specified byregulations promulgated by the department in accordance with the AdministrativeProcedure Act.

C. An applicant seeking licensure as an air ambulance service shall:

(1) Submit a completed application to the department on such forms and including suchinformation as specified by the department.

(2) Submit the appropriate initial license fee as provided in this Part.


(4) Submit to and successfully complete an inspection by the department to include thefollowing:

(a) An inspection of all aircraft utilized as air ambulances to ensure that all requiredmedical and safety equipment is present and operational. The medical and safetyequipment shall conform to local protocol as established by the medical director of the airambulance service. The list of required medical and safety equipment shall be establishedunder rules promulgated by the department and shall be based upon the recommendationsof an advisory committee to be composed of the following persons:

(i) The medical director of the department.

(ii) The director of the bureau.

(iii) One representative of the health standards section of the department's office of thesecretary, bureau of health services financing.

(iv) One representative of the Governor's Emergency Medical Services for ChildrenAdvisory Council.

(v) One representative of the Department of Transportation and Development, office ofpublic works and intermodal transportation, aviation section.

(vi) One representative of each air ambulance service certified or licensed in accordancewith this Part.

(b) Verification that all aircraft meet the appropriate Federal Aviation Administrationrequirements.

(c) Review of certifications of all personnel to ensure that they meet all Federal AviationAdministration requirements and local pilot and medical personnel staffing protocols.

(d) Verification that the applicant is in receipt of an original notarized certificate ofinsurance for the following coverage:

(i) Five hundred thousand dollars of aircraft liability insurance.

(ii) Five hundred thousand dollars of medical malpractice insurance or proof ofparticipation in the Patient's Compensation Fund.

(iii) Five hundred thousand dollars of commercial general liability insurance.

(e) Verification that the service has a medical director and that such director is aphysician licensed to practice medicine by the Louisiana State Board of MedicalExaminers.

(f) A review of medical protocols signed by the physician medical director of the airambulance service, accompanied by the necessary approvals of the parish or componentmedical society in the service's parish of domicile.

(g) Verification that the service has complied with all applicable federal, state, and localstatutes, rules, and regulations, and that the service has obtained all necessary andapplicable licenses, permits, and certifications, including certificates of need orcertificates of public convenience and necessity.

(5) Certify that all aircraft and crew members meet applicable Federal AviationAdministration regulations.

(6) Specify if the service uses either fixed-wing or rotary-winged aircraft, or both.

D. If a service provides interhospital air transport, air transport from hospital to anotherfacility, air transport from hospital to home, or similar air transport, the service mustcertify that a medical director is employed to advise the service on the appropriate

staffing, equipment, and supplies to be used for the transport of patients aboard an airambulance.

E. In order to renew a license for an air ambulance service, the applicant shall:

(1) Submit a renewal application to the department not more than ninety days before theexpiration of the license.

(2) Submit the appropriate fee as provided herein in Subsection B.

(3) Provide documentation that current standards for issuance of a license are met.

(4) Successfully complete a review of any required documentation and any inspection orverification of any documentation of any airplane deemed appropriate by the department.

F. Intentional falsification of information provided pursuant to this Section or failure tocomply with any provisions hereof shall be grounds for immediate revocation of anylicense granted pursuant to this Section.

G.(1) Nothing in this Section shall be construed to prohibit, limit, or regulate randommercy flights made by a person or corporation in privately or publicly owned aircraft whomay on occasion transport individuals who may need medical attention during transport,or human organs, intended for transplantation, including but not limited to the heart,lungs, kidneys, liver, and other soft tissue and bones, on either a not-for-profit basis orgratuitously.

(2) Failure to comply with any of the provisions of this Section shall constitute groundsfor probation, suspension, revocation of license, or other administrative sanction inaccordance with rules and regulations established by the department.

(3) Any person whose license has been revoked, suspended, or denied by the departmentshall have the right to have the proceedings of the department reviewed by a court ofcompetent jurisdiction, provided that such appeal is made within thirty days after thenotice of the decision of the department. If an appeal is granted, the decision of thedepartment shall not be implemented until a decision affirming the department decision isrendered on judicial review. The department's decision shall remain in force until anappeal is granted unless the court orders a stay. Judicial review shall be by trial de novo.

H. Any entity currently certified to provide ambulance service in Louisiana shall not berequired to be licensed by the state in order to maintain certification for a period of oneyear after July 15, 1999, in order to continue providing such services.





§1236.3. Emergency transportation in ambulances; payment

A. Payment under Title XIX of the Social Security Act medical assistance program foremergency transportation services of a person by ambulance shall be the same rate, butnot to exceed the rate established under Medicare.

B. Emergency medical transportation services shall include but not be limited to thefollowing:

(1) Basic life support.

(2) Advanced life support.

(3) Mileage.

(4) Oxygen.

(5) Intravenous fluids.

(6) Disposable supplies.

Acts 1990, No. 448,§ 1.




§1236.7. Air ambulance services; violations; penalties; fines; notice; hearings; appeal

A. The opening or operation of an air ambulance service without a current licensetherefor shall be a misdemeanor, punishable upon conviction by a fine of not less thanone thousand dollars and not more than five thousand dollars, and each day's violationshall constitute a separate offense.

B.(1) Any person or entity violating the provisions of this Part when such violation posesa threat to the health, safety, rights, or welfare of a patient or client may be liable to civilfines and other penalties, to be assessed by the department, in addition to any criminalaction which may be brought under other applicable laws. The department shall adoptrules in accordance with the Administrative Procedure Act which define specificclassifications of violations, articulate factors in assessing civil fines including mitigatingcircumstances, and explain the treatment of continuing and repeat deficiencies.


(a) Class A Violations: If an air ambulance is found to have been operated in violation ofany of the requirements of this Part concerning the number or qualifications of personnel,the air ambulance shall be immediately taken out of service until it meets thoserequirements, and the air ambulance service operating it shall be subject to a civil fine ofnot more than five hundred dollars for the first violation and not more than one thousanddollars per day for each repeat violation.

(b) Class B Violations: If an air ambulance service is found to have been operating inviolation of any of the requirements of this Part concerning insurance coverage, itslicense shall be immediately suspended until it meets those requirements, and it shall besubject to a civil fine of not more than five hundred dollars for the first violation and notmore than one thousand dollars per day for each repeat violation.

(c) Class C Violations: If an air ambulance is found to have been operated withoutundergoing any inspection required under the provisions of this Part, the air ambulanceshall be immediately taken out of service until it meets those requirements, and the airambulance service operating it shall be subject to a civil fine of not more than fivehundred dollars for the first violation and not more than one thousand dollars per day foreach repeat violation.

(d) Class D Violations: If an air ambulance is found to have been operated in violation ofany of the requirements of this Part concerning medical and safety equipment, the airambulance shall be immediately taken out of service until it meets those requirements,and the air ambulance service operating it shall be subject to a civil fine of not more thanone hundred dollars for the first violation and not more than five hundred dollars per dayfor each repeat violation.

C. The department shall adopt rules and regulations in accordance with theAdministrative Procedure Act to provide notice to the air ambulance service of anyviolation, of its right to an informal reconsideration process, and of the available appealprocedure, including judicial review. Such appeal shall be suspensive.

D. The air ambulance service shall furnish, with an appeal, bond in the minimum amountof one and one-half times the amount of the fine imposed by the department. The bondshall provide in substance that it is furnished as security that the air ambulance servicewill prosecute its appeal and that any judgment against it, including court costs, will bepaid or satisfied from the amount furnished. The appeal shall be heard as a summaryproceeding which shall be given precedence over other pending matters.

E. The department may institute all necessary civil court action to collect fines imposedand not timely appealed. No air ambulance service may claim imposed fines asreimbursable costs, nor increase charges to patients and clients as a result of such fines.Interest shall begin to accrue on any fine at the current judicial rate on the day followingthe date on which the fine becomes due and payable.

Acts 1999, No. 1114,§ 1.




§1236.11. Legislative findings

A. The Legislature of Louisiana finds that each year more than three hundred fiftythousand Americans die from out-of-hospital sudden cardiac arrest. More than ninety-five percent of these Americans die, in many cases because a lifesaving defibrillator didnot arrive at the scene of the emergency in time.

B. The American Heart Association estimates that more than twenty thousand deaths maybe prevented each year if defibrillators were more widely available to designatedresponders.

C. Many communities throughout the state and nation have invested in 911 emergencyresponse systems, emergency personnel, and ambulance vehicles. However, many ofthese communities do not have enough defibrillators in their community.

D. It is therefore the intent of the legislature to encourage greater acquisition, deployment,and use of automated external defibrillators in communities throughout the state.

Acts 1999, No. 825,§ 1.




§1236.12. Definitions

As used in this Subpart "automated external defibrillator" and "AED" mean a medicaldevice heart monitor and defibrillator that:

(1) Has received approval of its pre-market notification filed pursuant to 21 U.S.C. 360(k)from the United States Food and Drug Administration.

(2) Is capable of recognizing the presence or absence of ventricular fibrillation or rapidventricular tachycardia and is capable of determining whether defibrillation should beperformed.

(3) Upon determining that defibrillation should be performed, automatically charges andrequests delivery of an electrical impulse to an individual's heart.

(4) Is capable of delivering the electrical impulse to an individual's heart.

Acts 1999, No. 825,§ 1.




§1236.13. Persons in possession of AED's; training, testing, and notification requirements;manufacturer responsibility

A. In order to ensure public health and safety, any person or entity that possesses an AEDshall ensure that:

(1) The AED is maintained and tested according to the manufacturer's guidelines.

(2) A licensed physician or advanced practice registered nurse who is authorized toprescribe is involved in the possessor's program to ensure compliance with therequirements for training, emergency medical service (EMS) notification, andmaintenance.

(3)(a) Expected AED users regularly, on the premises of a particular entity, such as awork site, receive appropriate training in cardiopulmonary resuscitation (CPR) and in theuse of an AED by the American Heart Association or by any other nationally recognizedcourse in CPR and AED use.

(b) For purposes of this Paragraph, "expected AED users" shall be any person designatedby the possessor to render emergency care.

(4) The emergency medical services system is activated as soon as possible when anindividual renders emergency care to an individual in cardiac arrest by using an AED.

(5) Any clinical use of the AED is reported to the licensed physician or advanced practiceregistered nurse involved in the possessor's program.

B. Any person or entity that possesses an AED shall notify the bureau of emergencymedical services in the office of public health of the Department of Health and Hospitalsand a local provider of emergency medical services, such as 911 service, local ambulanceservice, or the fire department of the acquisition, location, and type of AED.

C. Any manufacturer, wholesale supplier, or retailer of an AED shall notify purchasers ofAED's intended for use in the state of the requirements of this Section.

Acts 1999, No. 825,§ 1.




§1236.14. Limitation of liability

In addition to the civil immunity provided to persons rendering emergency assistance asprovided by law, including R.S. 9:2793, R.S. 37:1731, 1732, and 1735, and R.S.40:1231.2, any prescribing advanced practice registered nurse or physician whoauthorizes the purchase of the AED, any physician or advanced practice registered nurseinvolved in the possessor's program, any individual or entity which provides training incardiopulmonary resuscitation and in the use of an AED, any purchaser of an AED, anyperson or entity responsible for the site where an AED is located, and any expected userregularly on the premises shall not be liable for any civil damages arising from any act oromission of acts related to the operation of an AED that do not amount to willful orwanton misconduct or gross negligence.

Acts 1999, No. 825,§ 1.




§1236.5. Emergency medical technician fundA. There is hereby established a special fund in the state treasury to be

known as the Emergency Medical Technician Fund, hereafter referred to as "fund",which shall consist of monies generated by the fees collected from the purchase ofprestige license plates for certified emergency medical technicians as provided inR.S. 47:463.47. In addition, the legislature may make annual appropriations to thefund for the purposes set forth in this Section.

B. All monies collected pursuant to R.S. 47:463.47 shall be deposited inthe Bond Security and Redemption Fund as required by Article VII, Section 9(B)of the Constitution of Louisiana and thereafter shall be credited to the fund.

C. The monies in the fund shall be appropriated to the Department ofHealth and Hospitals solely for purchasing equipment for the testing of applicantsfor certification as an emergency medical technician and to cover other testing-related costs. All unexpended and unencumbered monies remaining in the fund atthe close of each fiscal year shall remain in the fund. Monies in the fund shall beinvested by the state treasurer in the same manner as monies in the state generalfund. All interest earned from the investment of monies in the fund shall bedeposited and remain to the credit of the fund.

Acts 1997, No. 1131, §1, eff. July 14, 1997.

ENROLLED

Page 1 of 2



HOUSE BILL NO. 1584

BY REPRESENTATIVES RICHMOND, FRITH, AND JACKSON

AN ACT1

To enact R.S. 40:1236.13(D), (E), and (F), relative to automated external defibrillators; to2

require physical fitness facilities and institutions of higher education that compete in3

intercollegiate sport contests to have an automated external defibrillator on its4

premises; and to provide for related matters.5


Section 1. R.S. 40:1236.13(D), (E), and (F) are hereby enacted to read as follows:7

§1236.13. Persons in possession of AEDs; training, testing, and notification8

requirements; manufacturer responsibility; possession required9

* * *10

D.(1) The owner of or the entity responsible for a physical fitness facility11

shall keep an AED on its premises.12

(2) As used in this Subsection:13

(a) "Physical fitness facility" means a facility for profit or nonprofit with a14

membership of over fifty persons that offers physical fitness services. This term15

includes but is not limited to clubs, studios, health spas, weight control centers,16

clinics, figure salons, tanning centers, athletic or sport clubs, and YWCA and17

YMCA organizations.18

(b) "Physical fitness services" means services for the development of19

physical fitness through exercise or weight control. It shall not include a business20

limited solely to the practice of physical therapy, as defined in R.S. 37:2401, by a21

therapist licensed by the Louisiana State Board of Medical Examiners, nor shall it22

apply to medically related services performed by a physician licensed by the23

Louisiana State Board of Medical Examiners in a private office, clinic, or hospital.24


Page 2 of 2


E. Any institution of higher education that competes in intercollegiate1

athletics shall have an AED on its premises in its athletic department.2

F. The office of public health within the Department of Health and Hospitals,3

through its center for community health, emergency medical services shall4

promulgate all necessary rules and regulations to implement the provisions of5

Subsections D and E of this Section. Such rules and regulations shall, at a minimum,6

provide for compliance, enforcement, and penalties.7

Section 2. This Act shall become effective on January 1, 2005.8




APPROVED:

ENROLLED

Page 1 of 2



HOUSE BILL NO. 1543

BY REPRESENTATIVE BRUNEAU

AN ACT1

To amend and reenact R.S. 40:1236.13(A)(3)(a) and 1236.14, relative to automated external2

defibrillators; to authorize the use of automated external defibrillators by private3

security personnel; and to provide for related matters.4


Section 1. R.S. 40:1236.13(A)(3)(a) and 1236.14 are hereby amended and reenacted6

to read as follows:7

§1236.13. Persons in possession of AED's; training, testing, and notification8

requirements; manufacturer responsibility9

A. In order to ensure public health and safety, any person or entity that10

possesses an AED shall ensure that:11

* * *12

(3)(a) Expected AED users regularly, on the premises of a particular entity,13

such as a work site or users who carry an AED in a private security patrol vehicle,14

receive appropriate training in cardiopulmonary resuscitation (CPR) and in the use15

of an AED by the American Heart Association or by from any other nationally16

recognized course in CPR and AED use.17

* * *18

§1236.14. Limitation of liability19

In addition to the civil immunity provided to persons rendering emergency20

assistance as provided by law, including R.S. 9:2793, R.S. 37:1731, 1732, and 1735,21

and R.S. 40:1231.2, any prescribing advanced practice registered nurse or physician22

who authorizes the purchase of the AED, any physician or advanced practice23

registered nurse involved in the possessor's program, any individual or entity which24

provides training in cardiopulmonary resuscitation and in the use of an AED, any25


Page 2 of 2


purchaser of an AED, any person or entity responsible for the site or the private1

security patrol vehicle where an AED is located, and any expected user regularly on2

the premises or in the vehicle shall not be liable for any civil damages arising from3

any act or omission of acts related to the operation of or failure to operate an AED4

that do not amount to willful or wanton misconduct or gross negligence.5




APPROVED:

ENROLLED

Page 1 of 3



HOUSE BILL NO. 1228

BY REPRESENTATIVE DURAND

AN ACT1

To amend and reenact R.S. 40:1232.6(introductory paragraph) and 1300.51(3) and (5) and2

R.S. 44:9(F) and (G) and to enact R.S. 40:1300.51(2)(h), relative to emergency3

medical personnel; to provide grounds for disciplinary proceedings; to modify4

definitions; to provide for records of violations of municipal ordinances and of state5

statutes classified as a misdemeanor or felony; and to provide for related matters.6


Section 1. R.S. 40:1232.6(introductory paragraph) and 1300.51(3) and (5) are hereby8

amended and reenacted and R.S. 40:1300.51(2)(h) is hereby enacted to read as follows:9

§1232.6. Grounds for disciplinary proceedings10

The commission may discipline emergency medical personnel services11

professionals by directing the bureau to deny, withhold, revoke, restrict, probate, or12

suspend a certificate to practice as a certified emergency medical technician or13

certified first responder, impose fines and assess costs, or otherwise discipline an14

EMS professional, and the commission may direct the bureau to limit, restrict, or15

deny a student EMS professional from entering or continuing the clinical phase of16

EMS education for the following causes:17

* * *18

§1300.51. Definitions19

For the purposes of this Part:20

* * *21

(2) "Employer" means any of the following facilities, agencies, or programs:22

* * *23

(h) A nonemergency, nonambulance medical transportation facility or entity.24


Page 2 of 3


(3) "Nonlicensed person" means any person who provides for compensation1

nursing care or other health-related services to residents in a nursing facility,2

intermediate care facility for the mentally retarded, adult residential care facility, or3

adult day care center, and who is not a licensed health care provider. "Nonlicensed4

person" also means any person who provides such services to individuals in their5

own homes as an employee or contract provider of a home health agency or hospice.6

"Nonlicensed person" also means any person employed as a driver by or who7

contracts as a driver with a nonemergency, nonambulance transportation facility or8

entity.9

* * *10

(5) "Licensed ambulance personnel" means personnel who provide for11

compensation or volunteer, services of care as a licensed certified emergency medical12

service professional including certified emergency medical technician - basic,13

certified emergency medical technician - intermediate, or certified emergency14

medical technician - paramedic, or certified first responder. Nothing herein shall15

pertain to any licensed ambulance personnel working for a nursing home,16

intermediate care facility for the mentally retarded, adult residential care home, adult17

day care center, home health agency, or hospice.18

* * *19

Section 2. R.S. 44:9(F) and (G) are hereby amended and reenacted to read as follows:20

§44:9. Records of violations of municipal ordinances and of state statutes classified21

as a misdemeanor or felony22

* * *23

F. For investigative purposes only, the Department of Public Safety and24

Corrections may maintain a confidential, nonpublic record of the arrest and25

disposition. The information contained in this record may be released, upon specific26

request therefor and on a confidential basis, to any law enforcement agency, criminal27

justice agency, the Louisiana State Board of Medical Examiners, the Louisiana State28

Board of Nursing, the Louisiana State Board of Dentistry, or the Louisiana State29


Page 3 of 3


Board of Examiners of Psychologists, or the Emergency Medical Services1

Certification Commission. The receiving law enforcement agency, criminal justice2

agency, the Louisiana State Board of Medical Examiners, the Louisiana State Board3

of Nursing, the Louisiana State Board of Dentistry, or the Louisiana State Board of4

Examiners of Psychologists, or the Emergency Medical Services Certification5

Commission shall maintain the confidentiality of such record.6

G. "Expungement" means removal of a record from public access but does7

not mean destruction of the record. An expunged record is confidential, but remains8

available for use by law enforcement agencies, criminal justice agencies, the9

Louisiana State Board of Medical Examiners, the Louisiana State Board of Nursing,10

the Louisiana State Board of Dentistry, or the Louisiana State Board of Examiners11

of Psychologists, or the Emergency Medical Services Certification Commission.12

* * *13

Section 3. This Act shall become effective upon signature by the governor or, if not14

signed by the governor, upon expiration of the time for bills to become law without signature15

by the governor, as provided in Article III, Section 18 of the Constitution of Louisiana. If16

vetoed by the governor and subsequently approved by the legislature, this Act shall become17

effective on the day following such approval.18




APPROVED:




§1231. Definitions

For purposes of this Part:

(1) "Ambulance" means any authorized emergency vehicle, equipped with warningdevices, designed and operated as a part of a regular course of conduct or business totransport a sick or injured individual or which is advertised or otherwise held out to thepublic as such. "Ambulance" shall not mean a hearse or other funeral home vehicleutilized for the transportation of the dead.

(2) "Ambulance service" or "ambulance provider" means any person, firm, association, orgovernment entity owning, controlling, or operating any business or service whichfurnishes, operates, conducts, maintains, advertises, engages in, proposes to engage in, orprofesses to engage in the business or service of transporting, in ambulances, individualswho may need medical attention during transport. However, "ambulance service" and"ambulance provider" shall not include any of the following:

(a) An agency of the federal government.

(b) A volunteer nonprofit organization or municipal nonprofit organization operating aninvalid coach or coaches.

(c) An entity rendering assistance to a licensed ambulance or ambulances in the case of amajor disaster.

(d) A licensed hospital providing nonemergency, noncritical interhospital transfer andpatient transportation for diagnostic and therapeutic purposes when such transportationoriginates at a licensed hospital.

(e) An entity operating an ambulance or ambulances from a location outside of the stateto transport patients from a location outside of the state to a location inside the state or totransport a patient or patients from a medical facility inside of the state to a locationoutside of the state.

(f) An entity providing transportation to employees who become sick or injured duringthe course of their employment from a job site to the nearest appropriate medical facility.

(3) "Air ambulance" means any aircraft, either fixed-wing or rotary- winged, designedand operated as a part of a regular course of conduct or business to transport a sick orinjured individual or which is advertised or otherwise held out to the public as such.

(3.1) "Air ambulance service" means any person, firm, association, or government entityowning, controlling, or operating any business or service which furnishes, operates,conducts, maintains, advertises, engages in, proposes to engage in, or professes to engagein the business or service of transporting, in air ambulances, individuals who may needmedical attention during transport.

(3.2) "Auto-injector" means a spring-loaded needle and syringe with a single dose ofepinephrine that will automatically release and inject the medicine.

(4) "Bureau" means the Department of Health and Hospitals, office of public health,bureau of emergency medical services.

(5) "Certified emergency medical technician" means an individual who is certified as anyone of the following:

(a) A certified emergency medical technician-basic.

(b) A certified emergency medical technician-intermediate.

(c) A certified emergency medical technician-paramedic.

(6) "Certified emergency medical technician-basic" means an individual who hassuccessfully completed an emergency medical technician- basic training programdeveloped and promulgated by the United States Department of Transportation andadopted by the bureau, who is nationally registered, and who is certified by the bureau.

(7) "Certified emergency medical technician-intermediate" means any individual who hassuccessfully completed an emergency medical technician- intermediate training programdeveloped and promulgated by the United States Department of Transportation andadopted by the bureau, who is nationally registered, and who is certified by the bureau.

(8) "Certified emergency medical technician-paramedic" means any individual who hassuccessfully completed an emergency medical technician- paramedic training programdeveloped and promulgated by the United States Department of Transportation andadopted by the bureau, who is nationally registered, and who is certified by the bureau.

(9) "Certified first responder" means any individual who has successfully completed atraining course developed and promulgated by the United States Department ofTransportation and adopted by the bureau and who is certified by the bureau.

(10) "Commission" means the Louisiana Emergency Medical Services CertificationCommission.

(11) "Department" means the Department of Health and Hospitals.

(12) "Emergency medical personnel" or "emergency service person(s)" means individualswho are certified first responders or certified emergency medical technicians.

(13) "Emergency medical response vehicle" means a marked emergency vehicle withfully visual and audible warning signals operated by a certified ambulance service, theprimary purpose of which is to respond to the scene of a medical emergency to provideemergency medical stabilization or support, or command, control, and communications,but which is not an ambulance designed or intended for the purpose of transporting avictim from the scene to a medical facility regardless of its designation. Included are suchvehicles referred to but not limited to the designation as "sprint car", "quick responsevehicle", "special response vehicle", "triage trucks", "staff cars", "supervisor units", andother similar designations. Emergency medical response vehicles shall not include fireapparatus and law enforcement patrol vehicles which carry first aid or emergencymedical supplies and which respond to medical emergencies as part of their routine duties.

(14) "Emergency medical services" or "EMS" means a system that represents thecombined efforts of several professionals and agencies to provide prehospital emergencycare to the sick and injured.

(15) "EMS task force" means the Emergency Medical Services Task Force, composed ofindividuals appointed by the assistant secretary of the office of public health, subject tothe approval of the secretary of the department, which advises and makesrecommendations to the office and the department on matters related to emergencymedical services.

(16) "First aid certificate" means a certificate in the Emergency Response Course issuedby the American Red Cross or other certificate in a first aid course approved by thebureau and issued to any individual who has successfully completed the required trainingand met the established standards of such organizations.

(17) "Industrial ambulance" means any vehicle owned and operated by an industrialfacility and used for transporting any employee who becomes sick, injured, or otherwiseincapacitated in the course and scope of his employment from a job site to an appropriatemedical facility.


(19) "Municipal nonprofit organization" means an organization owned by a parish,municipality, or entity of a parish or municipality which in its regular course of businessresponds to a call for help and renders medical treatment and whose attendants areemergency medical personnel, a registered nurse, or a physician.

(20) "Physician" means a physician licensed to practice medicine by the Louisiana StateBoard of Medical Examiners.

(21) "Volunteer nonprofit organization" means an organization which in its regularcourse of business responds to a call for help and renders medical treatment and whoseattendants are emergency medical personnel, a registered nurse, or a physician and whichis chartered as a nonprofit organization under Section 501c of the United States InternalRevenue Code, as a volunteer fire department by the Louisiana state fire marshal's office,or as a nonprofit organization by the Louisiana secretary of state.

Amended by Acts 1968, No. 278,§ 1; Acts 1976, No. 393,§ 1; Acts 1977, No. 626,§ 1;Acts 1978, No. 469,§ 1; Acts 1978, No. 786,§ 5, eff. July 17, 1978; Acts 1979, No. 554,§1; Acts 1985, No. 750,§ 1, eff. Jan. 1, 1987; Acts 1991, No. 974,§ 1, eff. July 24, 1991;Acts 1997, No. 297,§ 2; Acts 1997, No. 913,§ 2; Acts 1999, No. 1113,§ 1; Acts 1999, No.1114,§ 1; Acts 2001, No. 385,§ 1; Acts 2001, No. 625,§ 2.




§1231.2. Immunity from civil damages

No parish, specialty, component, or state medical society or organization, or its designee,which is statutorily mandated by this Part to participate without compensation orgratuitously participates in an emergency services system, nor any committee of suchparish, specialty, component, or state medical society or organization, including theindividual members of such committee, or its designee, shall be liable for any civildamages as a result of any act or omission in the performance of their administrativeduties or donated services with such emergency services system, including, withoutlimitation, advice, instructions, or other duties regarding policy, protocol, administration,and efficiency of the emergency medical services system. The immunity extended to aparish, specialty, component, or state medical society or organization, or any committeethereof, including the individual members of such committee, including their insurers, orits designee, shall not be applicable for willful or wanton acts or omissions. Theimmunity extended herein shall be applicable only to an action brought by the persondamaged as a result of the performance of any administrative duties or donated servicesrendered pursuant to the provisions of this Section.

Added by Acts 1979, No. 554,§ 2. Amended by Acts 1990, No. 428,§ 1; Acts 1997, No.913,§ 2.




§1232. Emergency medical personnel training; certification

A. The bureau shall promulgate rules and regulations in accordance with theAdministrative Procedure Act for the following:

(1) To define and authorize appropriate functions and pre-certification and post-certification training programs for emergency medical personnel. All such trainingprograms shall meet or exceed the performance requirements developed by the UnitedStates Department of Transportation.

(2) To specify minimum operational requirements which will assure medical direction,supervision, and control over emergency medical services.

(3) To specify minimum testing and continuing education requirements for all emergencymedical personnel.

(4) To provide for the issuance of certificates and renewals of certificates for emergencymedical personnel.

(5) To specify initial certification and certification renewal requirements consistent withthe National Registry of Emergency Medical Technicians for each level of emergencymedical personnel.

(6) To establish fees for certification and certification renewal.

B. An individual petitioning for certification or certification renewal as a certifiedemergency medical technician or a certified first responder shall submit an application tothe bureau on forms provided by the bureau. The application shall be accompanied by theappropriate fee.

C. The bureau shall affirmatively provide that there is no discrimination toward anyindividual in the certification process on the basis of race, religion, creed, national origin,sex, or age.

Amended by Acts 1976, No. 393,§ §2, 3; Acts 1977, No. 626,§ 1; Acts 1985, No. 750,§ 1,eff. Jan. 1, 1987; Acts 1987, No. 665,§ 2, eff. July 9, 1987; Acts 1997, No. 913,§ 2.




§1232.1. Fee schedule; fees for certification prohibited

A.(1) The bureau shall not require or collect any fee or charges for certification orrecertification of emergency medical personnel who serve as such on a voluntary basisand who receive no compensation of any kind for such services.

(2) The bureau shall not set the fee for certification of an emergency medical technician-basic to exceed fifteen dollars for any individual who is an employee of a municipal lawenforcement agency, fire service, or fire protection district who does not performemergency medical services outside of the individual's official governmentalresponsibilities for any form of compensation.

(3) The bureau shall not set the fee for recertification of an emergency medicaltechnician-basic to exceed ten dollars for any individual who is an employee of amunicipal law enforcement agency, fire service, or fire protection district who does notperform emergency medical services outside of the individual's official governmentalresponsibilities for any form of compensation.

B. Except as provided in Subsection A of this Section, the bureau shall assess fees fortesting and certification based on the following schedule:

(1) Test fees: Fee

(a) First responder-written only $ 15.00

(b) First responder-written only


(c) Basic initial written & practical 60.00

(d) Basic entire practical exam 30.00

(e) Basic partial practical 15.00

(f) Basic testing/retesting-written only 15.00

(g) Basic testing/retesting-written only


(h) Intermediate initial written & practical 75.00

(i) Intermediate initial written & practical


(j) Intermediate retest entire practical 50.00

(k) Intermediate retest entire practical


(l) Intermediate retest partial practical 30.00

(m) Intermediate retest partial practical


(n) Intermediate testing/retesting-written only

(exam only) 15.00

(o) Intermediate testing/retesting-written only

(exam only) (out of state) 15.00

(p) Paramedic initial written & practical 90.00

(q) Paramedic initial written & practical


(r) Paramedic retesting-entire practical 60.00

(s) Paramedic retesting-entire practical


(t) Paramedic retesting-partial practical 35.00

(u) Paramedic retesting-partial practical


(v) Paramedic testing/retesting written 15.00

(w) Paramedic testing/retesting written


(2) Certification fees


(b) Basic EMT 30.00


(d) Paramedic 50.00

(3) Recertification


(b) Basic EMT 25.00


(d) Paramedic 45.00

(4) Reciprocity

(a) Basic EMT 60.00

(b) Intermediate 80.00

(c) Paramedic 100.00

C. The department may adopt rules and regulations in accordance with theAdministrative Procedure Act to provide for the collection of fees required by the feeschedule provided in this Section.

Acts 1997, No. 913,§ 2; Acts 2001, No. 515,§ 1.




§1232.2. Louisiana Emergency Medical Services Certification Commission; creation;membership; qualifications; terms; vacancies; meetings; officers; compensation; domicile

A. The Louisiana Emergency Medical Services Certification Commission is herebycreated within the Department of Health and Hospitals.

B.(1) The commission shall be composed of nine voting members appointed by thegovernor as follows:

(a) Two emergency medical services administrators, including one representing theprivate sector and one representing the public sector.

(b) Two certified emergency medical technician-paramedics and one emergency medicaltechnician-basic, at least one of whom shall be a full-time employee of a fire department,who are certified as emergency medical services instructors by the bureau.

(c) Four physicians, one from each of the following organizations:

(i) The American College of Emergency Physicians.

(ii) The American College of Surgeons.

(iii) The Louisiana State Medical Society.


(2) The commission shall also have one nonvoting member appointed by the governorwho is a registered nurse and who is a state-certified paramedic to be nominated by theLouisiana State Nurses Association from a list of two names submitted by the LouisianaEmergency Nurses Association.

C. Each member of the commission shall be a resident of Louisiana for at least one year,have had three years experience in his respective field of practice, and be activelyengaged in the practice of emergency medical services at the time of his appointment.

D.(1) The initial voting members of the commission shall be appointed no later thanOctober 1, 1997, from a list of two nominees for each appointment submitted by the taskforce. If the task force fails to submit a list of nominees to the governor by September 1,

1997, the governor shall appoint the respective members of the commission without thenomination list required by this Section.

(2) The nonvoting member shall be appointed to serve terms of three years. The initialmember shall be appointed by the governor to an initial term of three years by October 1,1997 or within thirty days of receipt of the list from the Louisiana State NursesAssociation, whichever is later.

E. Each appointment by the governor shall be submitted to the Senate for confirmation.

F.(1) The voting members appointed to the commission shall serve as follows: threemembers shall be appointed to serve an initial term of one year; three members shall beappointed to serve an initial term of two years; and three members shall be appointed toserve an initial term of three years. Thereafter, each member shall be appointed to serve aterm of three years.

(2) No individual shall serve more than two consecutive terms.

G.(1) Subsequent to the appointment of the initial members, the voting members shall beappointed from a list of two nominees for each appointment submitted by the task force.No later than thirty days prior to the termination date of a member's term, the task forceor, for the nonvoting member, the Louisiana State Nurses Association, shall submit a listof nominees to the governor. If the Louisiana State Nurses Association or the task forcefails to submit the required list of nominees to the governor within thirty days, thegovernor shall appoint the respective member to fill the vacancy without the nominationlist required.

(2) A vacancy on the commission prior to the expiration of a term shall be filled for theremainder of the term. No later than thirty days after the occurrence of a vacancy prior tothe expiration of a term, the task force or, for the nonvoting member, the Louisiana StateNurses Association, shall submit a list of nominees to the governor. If the Louisiana StateNurses Association or the task force fails to submit the required list of nominees to thegovernor within thirty days, the governor shall appoint the respective member to fill thevacancy without the nomination list required.

H. The governor shall call the first meeting of the commission no later than November 30,1997. At a minimum, the commission shall meet on a quarterly basis and, in addition,shall meet when called by the chairman or upon the written request of at least four votingmembers of the commission.

I. The commission shall annually elect a chairman, vice chairman, and secretary fromamong its voting membership and shall maintain a record of the attendance of itsmembers at commission meetings.

J. For each day while performing his official duties, a member of the commission may bereimbursed for expenses and mileage at the same rate set by the division ofadministration for state employees under the provisions of R.S. 39:231.

K. The commission shall be domiciled in Baton Rouge.

L. The governor shall remove a member of the commission after a hearing by thecommission during which charges for removal have been established and provided that amajority of the members have recommended removal.

Acts 1997, No. 913,§ 2.




§1232.3. Powers and duties of the commission

The commission shall:

(1) Recommend to the bureau requirements and standards of practice for individualsseeking to be certified under this Subpart.

(2) Approve requirements and standards of practice submitted by the bureau foremergency medical personnel consistent with this Subpart.

(3) Recommend continuing education requirements and standards to the bureau inaccordance with criteria established by the National Registry of Emergency MedicalTechnicians for individuals seeking to renew a certificate.

(4) Conduct disciplinary hearings for emergency medical personnel.

(5) Request that the bureau conduct investigations as necessary.

(6) Cause the prosecution of any individual who violates any provision of this Subpart.

(7) Maintain a record of all commission proceedings.

Acts 1997, No. 913,§ 2.




§1232.4. Powers and duties of the bureau

The bureau shall:

(1) Issue a certificate and renew a certificate to any duly qualified applicant forcertification or for certification renewal as a certified first responder or certifiedemergency medical technician.

(2) Prescribe application forms for certification and certification renewal.

(3) Adopt requirements and standards of practice approved by the commission foremergency medical personnel.

(4) Conduct investigations as requested by the commission.

(5) Deny, withhold, revoke, restrict, probate, or suspend a certificate as directed by thecommission under the provisions of R.S. 40:1232.6.

(6) Prepare, publish, and update a roster of all emergency medical personnel, includingthe name and address of each individual.

(7) Adopt continuing education requirements and standards for individuals seeking torenew a certificate.

(8) Prepare an annual report detailing the activities of the commission during the pastfiscal year including the number and nature of the hearings conducted under theprovisions of R.S. 40:1232.7.

(9) Adopt rules and regulations to implement the provisions of this Subpart in accordancewith the Administrative Procedure Act.

Acts 1997, No. 913,§ 2.




§1232.5. Certification; requirements; renewal

A. Applicants for initial certification as emergency medical personnel shall submit thefollowing evidence to the bureau:

(1) Completion of the required approved educational program.

(2) Documentation that the applicant meets the qualifications and requirements asestablished by the bureau.

B. In lieu of the evidence required by Subsection A of this Section, an applicant maysubmit evidence that he has been duly licensed or certified in another state, territory, orcountry or has received military training and certification as emergency medicalpersonnel as defined in R.S. 40:1231, and meets the qualifications and requirementsestablished by the bureau.

C.(1) The certificate shall be renewed every two years provided the applicant seekingrenewal completes the application and meets the requirements for renewal established bythe bureau prior to the expiration date on his current certificate.

(2) An individual whose certificate expires by his failure to renew as provided may bereinstated provided the applicant submits a completed application and meets anyadditional requirements established by the bureau for an individual who has failed totimely renew his certificate.

Acts 1997, No. 913,§ 2.




§1232.6. Grounds for disciplinary proceedingsThe commission may discipline emergency medical personnel by directing

the bureau to deny, withhold, revoke, restrict, probate, or suspend a certificate topractice as a certified emergency medical technician or certified first responder,impose fines and assess costs, or otherwise discipline an EMS professional, andthe commission may direct the bureau to limit, restrict, or deny a student EMSprofessional from entering or continuing the clinical phase of EMS education forthe following causes:

(1) Conviction of selling or attempting to sell, falsely obtaining, orfurnishing to a person a certified emergency medical technician or certified firstresponder certification document.

(2) Conviction of a crime or offense which reflects the inability of acertified emergency medical technician or certified first responder to provideemergency medical services with due regard for the health and safety of clients orpatients or enters a plea of guilty or nolo contendere to a criminal chargeregardless of final disposition of the criminal proceeding, including but not limitedto expungement or nonadjudication.

(3) Is unfit or incompetent by reason of negligence, habit, or other cause.(4) Is habitually intemperate in the use of or abuses alcohol or habit-

forming drugs.(5) Is guilty of aiding or abetting another person in the violation of this

Subpart.(6) Is mentally incompetent.(7) Endeavors to deceive or defraud the public.(8) Professional or medical incompetency.(9) Unprofessional conduct.(10) Continuing or recurring practices which fail to meet the standards of

EMS care in this state.(11) Abandonment of a patient.(12) Has had a certification or license to practice as an EMS professional

or to practice as another health care provider denied, revoked, suspended, orotherwise restricted.

(13) Is guilty of moral turpitude.(14) Has violated any rules and regulations of the commission or the

bureau or any provision of this Subpart.

Acts 1997, No. 913, §2; Acts 2003, No. 208, §1.




§1232.7. Hearings of the commission; appeal of decision

A. If the commission determines there are grounds for a disciplinary proceeding againstan individual based upon an investigation by the bureau, the chairman of the commissionshall set a time and place for a hearing. No later than ten days prior to the date set for thehearing, the commission shall send notice of the time and place for the hearing and anexplanation of the grounds for the disciplinary proceedings to the individual by registeredmail, return receipt requested, at his last known address as it appears on the records of thebureau.

B. The commission may compel the attendance of witnesses, the production of books,papers, and documents, and administer oaths at the hearing. The commission shall not bebound by strict rules of procedure or other laws of evidence in the conduct of itsproceedings. The individual under investigation may appear personally, by counsel, orpersonally and by counsel, produce witnesses and evidence on his own behalf, and cross-examine witnesses. Such proceedings shall be closed to the general public and the recordsof the proceeding shall be confidential.

C. Notwithstanding any privilege of confidentiality recognized by law, a physician orhealth care agency with which the individual under investigation is associated shall notassert such privilege by failing or refusing to respond to a lawfully issued subpoena of thecommission for any medical information, testimony, records, data, reports, or otherdocuments, tangible items, or information relative to any patient cared for or assigned tothe individual under investigation. Any such items obtained pursuant to a subpoena shallbe confidential. Furthermore, the transcript of testimony from the hearing shall be alteredto prevent the disclosure of the identity of the patient to whom such records relate.

D. Notice of the commission's decision to revoke, restrict, suspend, or deny a certificateshall be sent to the individual under investigation by registered mail, return receiptrequested, at his last known address as it appears on the records of the bureau.

E. An individual whose certification has been revoked, restricted, suspended, placed inprobation, or denied may have the proceedings of the commission reviewed by a court ofcompetent jurisdiction, provided that an appeal is made no later than thirty days after thedate indicated on the registered mail receipt of the notice required by Subsection D of thisSection. The decision of the commission shall remain in force until an appeal is grantedunless the court orders a stay. If an appeal is granted, the decision of the commissionshall be suspended until a final disposition of the matter is ultimately rendered by thecourt affirming the decision of the commission.

F. The commission may maintain the confidentiality of an individual under investigationwhenever the commission determines the public interest will be best served byalternatives to the disciplinary hearing process.

Acts 1997, No. 913,§ 2.




§1232.8. Injunction

The commission, through the bureau, may obtain an injunction without bond forbiddingany person from violating or continuing to violate any of the provisions of this Subpart.This injunction shall not be subject to release upon bond.




§1232.9. Violations

No person or individual shall engage in any of the following activities:

(1) Sell, or attempt to sell, falsely obtain, or furnish to any person any emergency medicalpersonnel diploma, certification document, or record, or aid or abet therein.

(2) Practice as a certified emergency medical technician or certified first responder underany diploma or certificate illegally obtained or signed or issued unlawfully.

(3) Practice as a certified emergency medical technician or certified first responder unlesscertified to do so under the provisions of this Subpart.

(4) Use in connection with his name any designation tending to imply that he is acertified emergency medical technician or certified first responder unless duly authorizedto practice under the provisions of this Subpart.

(5) Practice as a certified emergency medical technician or certified first responder duringthe time the certification issued under the provisions of this Subpart is suspended orrevoked.

(6) Practice as a certified emergency medical technician or certified first responder duringthe time his certification has lapsed by reason of his intentional failure to renew thecertification.

(7) Conduct or serve as an assistant instructor in conducting any course claiming toprepare students for certification as emergency medical personnel under the provisions ofthis Subpart, unless both the course and the instructor have been approved by the bureau.

(8) Knowingly aid or abet another person in the violation of this Subpart.

Acts 1997, No. 913,§ 2.




§1232.10. Prosecution

A. Any person who violates the provisions of R.S. 40:1232.9 shall be subject toprosecution. This prosecution shall be brought in the name of the state, provided theprovisions of this Subpart shall not prevent or interfere with a prosecution brought by thedistrict attorney of a parish when a prosecution or a pre-prosecution proceeding has beeninitiated by the district attorney.

B. Whoever is found guilty of violating any provision of R.S. 40:1232.9 shall, upon afirst conviction, be fined not more than five hundred dollars or imprisoned for not morethan six months, or both. Upon a second or subsequent conviction, the offender shall beimprisoned with or without hard labor for not more than two years and fined not morethan five thousand dollars.

Acts 1997, No. 913,§ 2.




§1232.11. Exceptions

This Subpart shall not apply to the practice of emergency medical services by a legallyqualified emergency medical technician who is employed by the United Statesgovernment, or by any bureau, division, or agency thereof, while in the discharge of hisofficial duties.

Acts 1997, No. 913,§ 2.




§1233. Civil immunity

A.(1) Any emergency medical person certified pursuant to the provisions of this Subpartwho renders emergency medical care to an individual while in the performance of hismedical duties and following the instructions of a physician shall not be individuallyliable to such an individual for civil damages as a result of acts or omissions in renderingthe emergency medical care, except for acts or omissions intentionally designed to harm,or for grossly negligent acts or omissions which result in harm to such an individual.Nothing herein shall relieve the driver of the emergency vehicle from liability arisingfrom the operation or use of such vehicle.

(2) The immunity granted to emergency medical personnel by the provisions of thisSubpart shall extend to parish governing authorities, police departments, sheriffs' offices,fire department, or other public agencies engaged in rendering emergency medicalservices and its insurers with respect to such emergency medical services unless theemergency medical personnel employed by such agencies would be personally liableunder the provisions of Paragraph (1) of this Subsection.

B. Any physician who provides instructions to any emergency medical personnel by useof electronic or other means of transmission in connection with the rendering ofemergency medical services to an individual shall not be liable unto such personnel or toan individual or both for civil damages arising from his opinion, judgments, actions, orduties, except for acts or omissions intentionally designed to harm, or for grosslynegligent acts or omissions which result in harm to the individual, while exercising thatdegree of skill and care ordinarily employed by members of his profession in goodstanding.

C. No hospital facility which allows the use of telemetry or other equipment to maintaincontact between a certified emergency medical technician and a physician shall be liablefor any civil damages arising out of the use of such equipment except for acts oromissions by hospital personnel that are grossly negligent which result in harm to anindividual.

D. No registered nurse, certified emergency medical technician, or other healthprofessional licensed in Louisiana who supervises, instructs, or trains emergency medicalpersonnel in accordance with curricula developed or adopted by the bureau shall be liablefor any civil damages arising out of the actions or negligence of the emergency medicalpersonnel whom he supervised, instructed, or trained.

E. There shall be no cause of action or civil liability, and no certificate holder or applicantshall have any cause of action or any claim for damages against any individual, person, orinstitution providing information to the commission or its agents or employees when thatindividual, person, or institution acts without malice and when there is a reasonable beliefthat such information is accurate.





§1234. Duties of emergency medical personnel

A.(1) A certified emergency medical technician-basic may perform any of the followingfunctions:

(a) Rescue, first aid, resuscitation, and other services to the extent that he has been trainedto perform such services under the provisions of the National Standard EMT-Basictraining curriculum developed and promulgated by the United States Department ofTransportation that are adopted by the bureau.

(b) When authorized by medical direction, an emergency medical technician-basic or anemergency medical technician-intermediate may administer or aid the patient in theadministration of a dose of epinephrine from an auto-injector to treat allergic reaction andanaphylaxis.

(c) Services which may be performed by a certified emergency medical technician-intermediate as provided in Subsection B of this Section, but only while he is enrolled ingood standing in an approved emergency medical technician-intermediate clinical or fieldinternship program and while he is under the direct supervision of a physician, registerednurse, certified emergency technician-paramedic, or other preceptor approved by thebureau.

(d) Services which may be performed by a certified emergency medical technician-paramedic, as provided in Subsection C of this Section, but only while he is enrolled ingood standing in an approved emergency medical technician-paramedic clinical or fieldinternship program and while he is under the direct supervision of a physician, registerednurse, certified emergency technician-paramedic, or other preceptor approved by thebureau.

(2) The functions authorized by Paragraph (1) of this Subsection may be performed bythe certified emergency medical technician-basic under any of the following conditions:

(a) While he is at the scene of a medical or other emergency where voice contact isestablished with a physician and under the physician's order.

(b) While he is at the scene of a life threatening emergency and under a protocol that hasbeen approved by the local parish medical society, or its designee, until voicecommunication with the physician is established at the earliest possible time.

B.(1) A certified emergency medical technician-intermediate may perform any of thefollowing functions:

(a) Any services to the extent that he has been trained to perform such services under theprovisions of the National Standard EMT-Intermediate training curriculum developedand promulgated by the United States Department of Transportation that are adopted bythe bureau.

(b) Services which may be performed by a certified emergency medical technician-paramedic, as provided in Subsection C of this Section, but only while he is enrolled ingood standing in an approved emergency medical technician-paramedic clinical or fieldinternship program and while under the direct supervision of a physician, registered nurse,certified emergency technician-paramedic, or other preceptor approved by the bureau.

(2) The functions authorized by Paragraph (1) of this Subsection may be performed bythe certified emergency medical technician-intermediate under any of the followingconditions:

(a) While caring for a patient in a participating hospital under the direct supervision of aphysician.



C.(1) A certified emergency medical technician-paramedic may perform any of thefollowing functions:

(a) Any services to the extent that he has been trained to perform such service under theprovisions of the National Standard EMT-Paramedic training curriculum developed andpromulgated by the United States Department of Transportation that are adopted by thebureau.

(b) Administration of other drugs or procedures for which the certified emergencymedical technician-paramedic has received training, certification, and approval by thecommission and which may be considered necessary by the ordering physician.

(2) The functions authorized by Paragraph (1) of this Subsection may be performed by acertified emergency medical technician-paramedic under any of the following conditions:

(a) While his caring for a patient in a participating hospital under the direct supervision ofa physician.