MISSISSIPPI LEGISLATURE

1998 Regular Session

To: Public Health and Welfare; Appropriations

By: Representatives Fredericks, Barnett (92nd), Malone

House Bill 798

AN ACT RELATING TO A STATEWIDE TRAUMA CARE SYSTEM; TO AMEND SECTION 41-59-3, MISSISSIPPI CODE OF 1972, TO DEFINE THE TERMS "TRAUMA CARE SYSTEM," "TRAUMA CARE FACILITY" AND "TRAUMA REGISTRY"; TO AMEND SECTION 41-59-5, MISSISSIPPI CODE OF 1972, TO DELETE THE SPECIFIC AUTHORITY OF THE STATE BOARD OF HEALTH TO APPOINT AN EMERGENCY MEDICAL SERVICES DIRECTOR; TO AUTHORIZE AND DIRECT THE STATE DEPARTMENT OF HEALTH TO DEVELOP, ISSUE REGULATIONS FOR AND ADMINISTER A UNIFORM STATEWIDE TRAUMA CARE SYSTEM; TO SPECIFY THE COMPONENTS OF THE STATEWIDE TRAUMA CARE SYSTEM; TO PRESCRIBE THE ADDITIONAL RESPONSIBILITIES OF THE STATE DEPARTMENT OF HEALTH IN IMPLEMENTING THE TRAUMA CARE SYSTEM AND TRAUMA EDUCATION PROGRAMS; AND TO AUTHORIZE THE STATE BOARD OF HEALTH TO RECEIVE AND DISBURSE MISSISSIPPI TRAUMA CARE SYSTEM FUNDS; TO AMEND SECTION 41-59-7, MISSISSIPPI CODE OF 1972, TO CREATE AND PROVIDE FOR THE MEMBERSHIP OF THE MISSISSIPPI TRAUMA ADVISORY COMMITTEE AS A COMMITTEE OF THE EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL; TO AMEND SECTION 41-59-61, MISSISSIPPI CODE OF 1972, TO ADD IMPLEMENTATION AND OPERATION OF THE STATE TRAUMA CARE PLAN AS AN ADDITIONAL PURPOSE OF THE "EMERGENCY MEDICAL SERVICES OPERATING FUND"; TO CODIFY SECTION 41-59-75, MISSISSIPPI CODE OF 1972, TO PROVIDE FOR THE ESTABLISHMENT OF A MISSISSIPPI TRAUMA CARE SYSTEMS FUND; TO CODIFY SECTION 41-59-77, MISSISSIPPI CODE OF 1972, TO PROVIDE FOR THE CONFIDENTIALITY OF DATA IN THE TRAUMA REGISTRY; TO AMEND SECTION 41-63-1, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THOSE STATUTES AUTHORIZING ACCREDITATION AND QUALITY ASSURANCE REVIEW OF PROFESSIONAL HEALTH SERVICES PROVIDERS SHALL BE FULLY APPLICABLE TO ANY TRAUMA QUALITY IMPROVEMENT COMMITTEE ESTABLISHED AT A LICENSED TRAUMA CARE HOSPITAL OR ANY REGIONAL OR STATE TRAUMA CARE SYSTEM COMMITTEE DESIGNATED BY THE STATE DEPARTMENT OF HEALTH; AND FOR RELATED PURPOSES. 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

 

SECTION 1. Section 41-59-3, Mississippi Code of 1972, is amended as follows:

41-59-3. As used in this chapter, unless the context otherwise requires, the term:

(a) "Ambulance" shall mean any privately or publicly owned land or air vehicle that is especially designed, constructed, modified or equipped to be used, maintained and operated upon the streets, highways or airways of this state to assist persons who are sick, injured, wounded, or otherwise incapacitated or helpless;

(b) "Permit" shall mean an authorization issued for an ambulance vehicle and/or a special use EMS vehicle as meeting the standards adopted pursuant to this chapter;

(c) "License" shall mean an authorization to any person, firm, corporation, or governmental division or agency to provide ambulance services in the State of Mississippi;

(d) "Emergency medical technician" shall mean an individual who possesses a valid emergency medical technician's certificate issued pursuant to the provisions of this chapter;

(e) "Certificate" shall mean official acknowledgment that an individual has successfully completed the recommended basic emergency medical technician training course referred to in this chapter which entitles that individual to perform the functions and duties of an emergency medical technician;

(f) "Board" shall mean the State Board of Health;

(g) "Department" means the Mississippi State Department of Health, Emergency Medical Services program;

(h) "Executive officer" shall mean the Executive Officer of the State Board of Health or his designated representative;

(i) "Invalid vehicle" shall mean any privately or publicly owned land or air vehicle which is maintained, operated and used only to transport persons routinely who are convalescent or otherwise nonambulatory and do not require the service of an emergency medical technician while in transit;

(j) "Special use EMS vehicle" means any privately or public owned land, water or air emergency vehicle used to support the provision of emergency medical services. These vehicles shall not be used routinely to transport patients;

(k) "Trauma care system" or "trauma system" means a formally organized arrangement of health care resources that has been designated by the * * * department * * * by which major trauma victims are triaged, transported to and treated at trauma care facilities;

(l) "Trauma care facility" or "trauma center" means a hospital that has been designated by the department to perform specified trauma care services within a trauma care system pursuant to standards adopted by the department. Participation in this designation by each hospital is voluntary;

(m) "Trauma registry" means a collection of data on patients who receive hospital care for certain types of injuries. Such data are primarily designed to ensure quality trauma care and outcomes in individual institutions and trauma systems, but have the secondary purpose of providing useful data for the surveillance of injury morbidity and mortality.

SECTION 2. Section 41-59-5, Mississippi Code of 1972, is amended as follows:

41-59-5. (1) The State Board of Health shall establish and maintain a program for the improvement and regulation of emergency medical services (hereinafter EMS) in the State of Mississippi. The responsibility for implementation and conduct of this program shall be vested in the State Health Officer * * * along with such other officers and boards as may be specified by law or regulation.

(2) The board shall provide for the regulation and licensing of public and private ambulance service, inspection and issuance of permits for ambulance vehicles, training and certification of EMS personnel, including drivers and attendants, the development and maintenance of a statewide EMS records program, development and adoption of EMS regulations, the coordination of an EMS communications system, and other related EMS activities.

(3) The board is authorized to promulgate and enforce such rules, regulations and minimum standards as needed to carry out the provisions of this chapter.

 

 * * *

(4) The board is authorized to receive any funds appropriated to the board from the Emergency Medical Services Operating Fund created in Section 41-59-61 and is further authorized, with the Emergency Medical Services Advisory Council acting in an advisory capacity, to administer the disbursement of such funds to the counties, municipalities and organized emergency medical service districts and the utilization of such funds by the same, as provided in Section 41-59-61.

 * * *

(5) The department * * * acting as the lead agency, in consultation with and having solicited advice from the EMS Advisory Council, shall develop a uniform nonfragmented inclusive statewide trauma care system that provides excellent patient care. It is the intent of the Legislature that the purpose of this system is to reduce death and disability resulting from traumatic injury, and in order to accomplish this goal it is necessary to assign additional responsibilities to the department. The department is assigned the responsibility for creating, implementing and managing the statewide trauma care system. The department shall be designated as the lead agency for trauma care systems development. The department shall develop and administer trauma regulations that include, but are not limited to, the Mississippi Trauma Care System Plan, trauma system standards, trauma center designations, field triage, interfacility trauma transfer, EMS aero medical transportation, trauma data collection, trauma care system evaluation and management of state trauma systems funding. The department shall take the necessary steps to develop, adopt and implement the Mississippi Trauma Care System Plan and all associated trauma care system regulations necessary to implement the Mississippi trauma care system. The State Health Officer shall cause the implementation of both professional and lay trauma education programs. These trauma educational programs shall include both clinical trauma education and injury prevention. As it is recognized that rehabilitation services are essential for traumatized individuals to be returned to active, productive lives, the State Health Officer shall coordinate the development of the inclusive trauma system with the Mississippi Department of Rehabilitation Services and all other appropriate rehabilitation systems.

(6) The State Board of Health is authorized to receive any funds appropriated to the board from the Mississippi Trauma Care System Fund created in Section 41-59-73. It is further authorized, with the Emergency Medical Services Advisory Council and the Mississippi Trauma Advisory Committee acting in advisory capacities, to administer the disbursements of such funds according to adopted trauma care system regulations.

SECTION 3. Section 41-59-7, Mississippi Code of 1972, is amended as follows:

41-59-7. (1) There is hereby created an emergency medical services advisory council to consist of the following eleven (11) members who shall be appointed by the Governor:

(a) One (1) licensed physician to be appointed from a list of nominees presented by the Mississippi Trauma Committee, American College of Surgeons;

(b) One (1) licensed physician to be appointed from a list of nominees who are actively engaged in rendering emergency medical services presented by the Mississippi State Medical Association;

(c) One (1) registered nurse whose employer renders emergency medical services, to be appointed from a list of nominees presented by the Mississippi Nurses Association;

(d) Two (2) hospital administrators who are employees of hospitals which provide emergency medical services, to be appointed from a list of nominees presented by the Mississippi Hospital Association;

(e) Two (2) operators of ambulance services; and

(f) Three (3) officials of county or municipal government.

(g) One (1) licensed physician to be appointed from a list of nominees presented by the Mississippi Chapter of the American College of Emergency Physicians.

The terms of the advisory council members shall begin on July 1, 1974. Four (4) members shall be appointed for a term of two (2) years, three (3) members shall be appointed for a term of three (3) years, and three (3) members shall be appointed for a term of four (4) years. Thereafter, members shall be appointed for a term of four (4) years. The executive officer or his designated representative shall serve as ex officio chairman of the advisory council.

The advisory council shall meet at the call of the chairman at least annually. For attendance at such meetings, the members of the advisory council shall be reimbursed for their actual and necessary expenses including food, lodging and mileage as authorized by law, and they shall be paid per diem compensation authorized under Section 25-3-69.

The advisory council shall advise and make recommendations to the board regarding rules and regulations promulgated pursuant to this chapter.

(2) There is created a committee of the Emergency Medical Services Advisory Council to be named the Mississippi Trauma Advisory Committee (hereinafter "MTAC"). This committee shall act as the advisory body for trauma care system development and provide technical support to the department in all areas of trauma care system design, trauma standards, data collection and evaluation, continuous quality improvement, trauma care system funding, and evaluation of the trauma care system and trauma care programs. The membership of the Mississippi Trauma Advisory Committee shall be appointed as follows:

(a) One (1) representative from each trauma care region as designated by the department, to be named by the department.

(b) One (1) licensed physician appointed by the Governor from a list of nominees presented by the Mississippi Committee on Trauma, American College of Surgeons.

(c) One (1) licensed physician appointed by the Governor from a list of nominees presented by the Mississippi Chapter of the American College of Emergency Physicians.

(d) One (1) licensed neurosurgeon appointed by the Governor from a list of nominees presented by the Mississippi State Medical Association.

(e) Two (2) hospital administrators or former hospital administrators of hospitals designated as trauma care hospitals by the department, to be appointed by the Governor.

(f) One (1) hospital administrator appointed by the Governor from a list of nominees submitted by the Mississippi Hospital Association.

(g) One (1) registered nurse appointed by the Governor from a list of nominees submitted by the Mississippi Emergency Nurses Association.

(h) One (1) registered nurse appointed by the Governor from a list of nominees submitted by the Mississippi Nurses Association.

(i) One (1) EMT-Paramedic whose employer renders emergency medical services in a trauma care region as designated by the department, to be named by the department.

(j) One (1) representative appointed by the Governor from the Mississippi Department of Rehabilitative Services.

(k) One (1) member appointed by the Governor, who shall be a person who has been a recipient of trauma care in Mississippi or who has an immediate family member who has been a recipient of trauma care in Mississippi.

The terms of the MTAC members shall begin on July 1, 1998. Four (4) members shall be appointed for a term of two (2) years, four (4) members shall be appointed for a term of three (3) years, and four (4) members shall be appointed for a term of four (4) years, to be designated by the appointing authority at the time of appointment. Thereafter, members shall be appointed for a term of four (4) years from the expiration date of the previous term.

At the first meeting of the Mississippi Trauma Advisory Committee, a chairman and vice chairman shall be elected and rules for transacting business and keeping records shall be adopted. The advisory council shall meet at the call of the chairman at least annually. Members of the Mississippi Trauma Advisory Committee shall receive reimbursement for travel expenses incurred while engaged in official business in accordance with Section 25-3-41, and they shall be paid the per diem compensation authorized under Section 25-3-69.

SECTION 4. Section 41-59-61, Mississippi Code of 1972, is amended as follows:

41-59-61. (1) Such assessments as are collected under subsections (1) and (2) of Section 99-19-73 shall be deposited in a special fund hereby created in the State Treasury to be designated the "Emergency Medical Services Operating Fund." The Legislature may make appropriations from the Emergency Medical Services Operating Fund to the State Board of Health for the purpose of defraying costs of administration of the Emergency Medical Services program, for the planning, development and implementation of the comprehensive state trauma care plan and for redistribution of such funds to the counties, municipalities and organized medical service districts (hereinafter referred to as "governmental units") for the support of the emergency medical services programs. The State Board of Health, with the Emergency Medical Services Advisory Council acting in an advisory capacity, shall administer the disbursement to such governmental units of any funds appropriated to the board from the Emergency Medical Services Operating Fund and the utilization of such funds by the governmental units.

(2) Funds appropriated from the Emergency Medical Services Operating Fund to the State Board of Health shall be made available to all such governmental units to support the emergency medical services programs therein, and such funds shall be distributed to each governmental unit based upon its general population relative to the total population of the state. Disbursement of such funds shall be made on an annual basis at the end of the fiscal year upon the request of each governmental unit. Funds distributed to such governmental units shall be used in addition to existing annual emergency medical services budgets of the governmental units, and no such funds shall be used for the payment of any attorney's fees. The Director of the Emergency Medical Services program or his appointed designee is hereby authorized to require financial reports from the governmental units utilizing these funds in order to provide satisfactory proof of the maintenance of the funding effort by the governmental units.

SECTION 5. The following provision shall be codified as Section 41-59-75, Mississippi Code of 1972:

41-59-75. The Mississippi Trauma Care Systems Fund is established. The purpose of this fund is to provide hospital and physician indigent trauma care block grant funding to trauma centers designated by the department. All designated trauma care hospitals are eligible to contract with the department for these funds.

SECTION 6. The following provision shall be codified as Section 41-59-77, Mississippi Code of 1972:

41-59-77. Data obtained under this act for use in the trauma registry is for the confidential use of the Mississippi State Department of Health and the persons, public entities or private entities that participate in the collection of the trauma registry data.

Any data which identifies an individual or a family unit that is collected for use in the trauma registry shall be confidential and shall not be subject to discovery or introduction into evidence in any civil action.

SECTION 7. Section 41-63-1, Mississippi Code of 1972, is amended as follows:

41-63-1. (1) The terms "medical or dental review committee" or "committee," when used in this chapter, shall mean a committee of a state or local professional medical, nursing, pharmacy or dental society or a licensed hospital, nursing home or other health care facility, or of a medical, nursing, pharmacy or dental staff or a licensed hospital, nursing home or other health care facility or of a medical care foundation or health maintenance organization, preferred provider organization, individual practice association, or any trauma improvement committee established at a licensed hospital designated as a trauma care facility by the Mississippi State Department of Health, Emergency Medical Services program, or any regional or state committee designated by the Mississippi State Department of Health, Emergency Medical Services program, and which participates in the trauma care system, or similar entity, the function of which, or one (1) of the functions of which, is to evaluate and improve the quality of health care rendered by providers of health care service, to evaluate the competence or practice of physicians or other health care practitioners, or to determine that health care services rendered were professionally indicated or were performed in compliance with the applicable standard of care or that the cost of health care rendered was considered reasonable by the providers of professional health care services in the area and includes a committee functioning as a utilization review committee, a utilization or quality control peer review organization, or a similar committee or a committee of similar purpose, and the governing body of any licensed hospital while considering a recommendation or decision concerning a physician's competence, conduct, staff membership or clinical privileges.

(2) The term "proceedings" mean all reviews, meetings, conversations, and communications of any medical or dental review committee.

(3) The term "records" shall mean any and all committee minutes, transcripts, applications, correspondence, incident reports, and other documents created, received or reviewed by or for any medical or dental review committee.

SECTION 8. This act shall take effect and be in force from and after July 1, 1998.