[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 978 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 978

   To recognize and clarify the authority of the States to regulate 
intrastate helicopter medical services pursuant to their authority over 
 public health planning and protection, patient safety and protection, 
  emergency medical services, the quality and coordination of medical 
     care, and the practice of medicine within their jurisdictions.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 11, 2009

  Mr. Altmire (for himself, Mrs. Miller of Michigan, Mr. Cleaver, Mr. 
 Holden, Mr. Massa, Mr. Platts, Ms. Pingree of Maine, Mr. Shuler, Mr. 
  Peterson, Mr. Space, Mr. Ehlers, Mr. McIntyre, Mr. Capuano, and Mr. 
   Michaud) introduced the following bill; which was referred to the 
Committee on Transportation and Infrastructure, and in addition to the 
   Committee on Energy and Commerce, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To recognize and clarify the authority of the States to regulate 
intrastate helicopter medical services pursuant to their authority over 
 public health planning and protection, patient safety and protection, 
  emergency medical services, the quality and coordination of medical 
     care, and the practice of medicine within their jurisdictions.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Helicopter Medical Services Patient 
Safety, Protection, and Coordination Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The Federal Aviation Administration is responsible for 
        regulating civil aviation in the United States.
            (2) Each State is responsible for the regulation of public 
        health planning and protection, patient safety and protection, 
        emergency medical services, the quality and coordination of 
        medical care, and the practice of medicine within its 
        jurisdiction.
            (3) Helicopter medical services are an essential component 
        of the health care delivery and emergency medical services 
        system in each State and integral to each State's management of 
        public health planning and protection, patient safety and 
        protection, emergency medical services, the quality and 
        coordination of medical care, and the practice of medicine 
        within its jurisdiction.
            (4) Existing or future regulation of helicopter medical 
        services by the several States is in the public interest.
            (5) Court rulings and statutory interpretations issued by 
        the Department of Transportation have imposed limitations on 
        the authority of States to regulate helicopter medical services 
        in a manner similar to the regulation of other health care 
        services by the States.
            (6) These rulings and interpretations have concluded that 
        certain State actions related to public health planning and 
        protection, patient safety and protection, emergency medical 
        services, the quality and coordination of medical care, and the 
        practice of medicine and related aspects of helicopter medical 
        services are preempted by Federal law, either pursuant to the 
        preemption provisions of the Airline Deregulation Act of 1978 
        or through the application of the ``field occupation'' 
        preemption doctrine.
            (7) The Airline Deregulation Act of 1978 did not 
        contemplate helicopter medical services, and the use of the Act 
        to strike down intrastate health-related regulations overseeing 
        helicopter medical services that would otherwise be permissible 
        with respect to any other segment of the health care industry 
        is not in the public interest.
            (8) At the same time, it is also important to ensure that 
        the Federal Aviation Administration's plenary and exclusive 
        jurisdiction over matters of aviation safety is not infringed 
        by any State and that State health-related regulation of 
        helicopter medical services is harmonized with Federal 
        regulation of aviation safety.
            (9) Accordingly, there is a need for clarification of 
        existing Federal law so that States may regulate helicopter 
        medical services with respect to public health planning and 
        protection, patient safety and protection, emergency medical 
        services, the quality and coordination of medical care, and the 
        practice of medicine without infringing on the Federal 
        government's plenary power to regulate aviation safety.

SEC. 3. CLARIFICATION OF STATE AUTHORITY OVER INTRASTATE HELICOPTER 
              MEDICAL SERVICES.

    (a) In General.--Chapter 401 of title 49, United States Code, is 
amended by adding at the end the following:
``Sec. 40130. Clarification of State authority over intrastate 
              helicopter medical services
    ``(a) Clarification of State Authority.--Nothing in this subtitle 
shall prohibit a State from regulating helicopter medical services 
provided between locations within such State (or helicopter medical 
services provided between locations in more than one State if 
undertaken pursuant to an agreement between or among such States) in 
the manner described in subsection (b), (c), or (d).
    ``(b) State Authority Over Medical Services.--A State may regulate 
helicopter medical services with respect to the following:
            ``(1) The medical qualifications and medical training of 
        helicopter medical personnel, except that a State shall not 
        impose new or additional requirements on a pilot.
            ``(2) The obligation of providers of helicopter medical 
        services to comply with the health planning, patient safety, 
        and medical service requirements of a State, including--
                    ``(A) coordination between emergency medical 
                services providers, receiving institutions, and other 
                medical transport service providers regarding the 
                transport of a patient;
                    ``(B) demonstration of adequate capacity to provide 
                helicopter medical services;
                    ``(C) demonstration of the need for new or expanded 
                helicopter medical services;
                    ``(D) limitations on the number of helicopters 
                providing helicopter medical services within the State 
                or region of the State;
                    ``(E) affiliation with health care institutions;
                    ``(F) sanitation and infection control protocols;
                    ``(G) medical records requirements;
                    ``(H) quality requirements, including participation 
                in patient safety and medical quality control efforts, 
                such as peer review processes, utilization review, and 
                error reporting systems; and
                    ``(I) the provision of emergency helicopter medical 
                services to all persons for whom such services are 
                medically necessary and appropriate.
    ``(c) State Authority Over Medical Services Subject to 
Harmonization Requirement.--To the extent that any State regulations 
are harmonized with any relevant Federal operating requirements, a 
State may regulate helicopter medical services with respect to the 
following:
            ``(1) The designation of destinations for emergency patient 
        transport.
            ``(2) The specification of service requirements with 
        respect to geographic areas within a State or during specified 
        hours and days.
            ``(3) The coordination of flight requests for emergency 
        helicopter medical services.
            ``(4) Compliance with accreditation requirements.
    ``(d) State Authority Over Medical Services Subject to Consistency 
Requirement.--To the extent that any State regulations are consistent 
with any relevant Federal operating requirements (such as airworthiness 
and the proper storage and installation of medical equipment) 
applicable to a helicopter that is otherwise capable of meeting such 
State regulations, a State may regulate helicopter medical services 
with respect to the following:
            ``(1) The necessary medical equipment to be carried on 
        board or affixed to the helicopter.
            ``(2) The physical attributes of the helicopter--
                    ``(A) necessary for the provision of quality 
                medical care, including--
                            ``(i) climate control;
                            ``(ii) a configuration that allows adequate 
                        access to the patient, medical equipment, and 
                        medical supplies by the helicopter medical 
                        personnel;
                            ``(iii) use of materials in the helicopter 
                        that are appropriate for proper patient care; 
                        and
                            ``(iv) sufficient electrical supply to 
                        support medical equipment without compromising 
                        helicopter power; and
                    ``(B) necessary for the protection of helicopter 
                and ground medical personnel.
            ``(3) Communication capabilities enabling--
                    ``(A) the helicopter personnel to communicate with 
                emergency medical services and public safety personnel 
                and personnel at receiving institutions; and
                    ``(B) the flightcrew to communicate with the 
                helicopter medical personnel.
    ``(e) Definitions.--In this section, the following definitions 
apply:
            ``(1) Helicopter medical services.--The term `helicopter 
        medical services' means the helicopter transport of a patient, 
        in both emergency and nonemergency situations, as well as the 
        medical services provided to such patient in the course of 
        transport by such helicopter.
            ``(2) Federal operating requirements.--The term `Federal 
        operating requirements' means requirements under part A of 
        subtitle VII of title 49, United States Code, and Federal 
        aviation regulations set forth in title 14, Code of Federal 
        Regulations.''.
    (b) Conforming Amendment.--The analysis for such chapter is amended 
by adding at the end the following:

``Sec. 40130. Clarification of State authority over intrastate 
                            helicopter medical services.''.
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