1.This Act may be cited as the
Helicopter Medical Services Patient
Safety, Protection, and Coordination Act
.
2.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 are 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 the State's jurisdiction.
(4)Existing or future regulation of helicopter
medical services by the several States is in the public interest.
(5)Helicopter
medical services represent a unique and discrete area of air transportation
because those services present issues involving the adequacy and availability
of medical services to patients.
(6)Court rulings and statutory interpretations
issued by the Secretary of Transportation have imposed limitations on, impeded,
or prevented, the ability of States to effectively regulate helicopter medical
services in a manner similar to the regulation of other health care services by
the States.
(7)Those 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 (Public Law 95–504; 92 Stat. 1705) or through the application of the
field occupation
preemption doctrine.
(8)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 the provision of
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.
(9)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. Accordingly, any State health-related regulation of
helicopter medical services must be harmonized and shall not be inconsistent
with Federal regulation of aviation safety because the safe operation of the
helicopter medical services flight is of paramount importance.
(10)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 helicopter medical services
(a)Chapter 401 of title
49, United States Code, is amended by adding at the end the following:
40130.Clarification
of State authority over helicopter medical services
(a)Clarification of
State authorityNothing in
this subtitle shall prohibit a State from—
(1)requiring medical licenses for the
provision of helicopter medical services between locations within the State;
or
(2)prescribing regulations relating to the
provision of such services if such regulations are prescribed pursuant to
subsection (c), (d), or (e).
(b)Applicability
of Federal aviation safety authorityNo State health-related
regulation established pursuant to this section shall supersede or be
inconsistent with any Federal operating requirement with respect to aviation
safety.
(c)State authority
over medical servicesA State may prescribe regulations relating
to the provision of helicopter medical services with respect to the
following:
(1)The medical qualifications and medical
training of helicopter medical personnel, except that a State may not impose
any requirement with respect to a pilot.
(2)The obligation of providers of helicopter
medical services to comply with the health planning, patient safety, and
medical service requirements of the State, including—
(A)coordination of the interrelationship,
interaction, and agreements among providers of helicopter medical services,
providers of other emergency medical services, providers of other medical
transport services, referring entities, and medical institutions that receive
patients transported by providers of helicopter medical services with respect
to the transport of patients;
(B)demonstration of
adequate capacity to provide helicopter medical services;
(C)demonstration of the need for new or
expanded helicopter medical services;
(D)determinations
with respect to the number and base location of helicopters used in the
provision of helicopter medical services within the State or region of the
State or the regulation of competition for specific markets within the
State;
(E)affiliation with
health care institutions;
(F)sanitation and
infection control protocols;
(G)medical records
requirements;
(H)quality of medical
care 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 proffer of
gifts of monetary value (other than training or educational programs) to
referring entities (or personnel employed by such entities) within the
State.
(d)State authority
over medical services subject to harmonization requirementA
State may prescribe regulations relating to the provision of helicopter medical
services with respect to the following, if such regulations are harmonized
with, and do not infringe upon, any applicable Federal operating
requirements:
(1)The establishment of appropriate medical
criteria for determining the appropriate medical institution to receive a
patient being transported from the scene at which the patient's injury or
accident, or other event resulting in the need for medical services for the
patient, occurred.
(2)The specification
of service requirements with respect to geographic areas within the State or
during specified hours and days.
(3)The coordination of flight requests for
emergency helicopter medical services.
(4)The compliance
with accreditation requirements regarding medical services, except where such
requirements infringe upon relevant Federal operating requirements.
(5)The provision of emergency helicopter
medical services to all persons for whom such services are medically necessary
and appropriate.
(e)State authority
over medical services subject to consistency requirement
(1)Subject to paragraph
(2), a State may prescribe regulations relating to the provision of helicopter
medical services with respect to the following, if such regulations are
consistent with, and do not infringe upon, any applicable Federal operating
requirements:
(A)The necessary
medical equipment and supplies to be carried on board or affixed to the
helicopter.
(B)The physical
attributes of the helicopter—
(i)necessary for the
provision of quality medical care, including—
(I)permanently
installed climate control systems capable of meeting specified temperature
settings;
(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;
(IV)sufficient
electrical supply to support medical equipment without compromising helicopter
power; and
(V)the ability of
the helicopter to transport a patient a certain distance without refueling
within the State; and
(ii)necessary—
(I)for the
protection of helicopter personnel, ground medical personnel, and emergency
response personnel; and
(II)to ensure that
the helicopter has no structural or functional defects that may adversely
affect such personnel, such as by requiring tailroter illumination for loading
patients at night or external search lights.
(C)Communication
capabilities enabling—
(i)the helicopter
medical personnel to communicate with emergency medical services and public
safety personnel and personnel at medical institutions that receive patients
transported by providers of helicopter medical services; and
(ii)the flightcrew to
communicate with the helicopter medical personnel, to the extent that the
communications do not interfere with the safe operation of the flight.
(2)
(A)Providers
licensed in multiple StatesIf a provider of helicopter medical
services is licensed to provide such services in more than one State and the
regulations established pursuant to this subsection by the States in which the
provider is licensed are inconsistent, the provider shall comply with the most
stringent of such regulations.
(B)Nondelegation
requirementA State may not delegate authority provided under
this subsection to a political subdivision of the State.
(f)In regulating the provision of helicopter medical
services pursuant to this section, a State shall, if necessary, establish
regulations or negotiate mutual aid agreements with adjacent States or
providers of helicopter medical services in adjacent States to ensure access to
helicopter medical services across State borders.
(g)In
this section:
(1)Helicopter
medical servicesThe 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 requirementsThe
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.
(3)The term referring entity means any entity
that dispatches or provides a referral for a provider of helicopter medical
services, such as a medical institution, an agency providing emergency medical
services, or a first
responder.
.
(b)The table of
sections at the beginning of 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.
.