I 111th CONGRESS 1st Session H. R. 978 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.
1.
Short title
This Act may be cited as the Helicopter Medical Services Patient Safety, Protection, and Coordination Act.
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.
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:
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. .