Conn. Gen. Stat. § 19a-177

Current with legislation from the 2024 Regular and Special Sessions.

Section 19a-177 - (Formerly Sec. 19-73w). Duties of commissioner

The commissioner shall:

(1) With the advice of the Office of Emergency Medical Services established pursuant to section 19a-178 and of an advisory committee on emergency medical services and with the benefit of meetings held pursuant to subsection (b) of section 19a-184, adopt every five years a state-wide plan for the coordinated delivery of emergency medical services;

(2) License or certify the following:

(A) Ambulance operations, emergency medical services personnel and communications personnel;

(B) emergency room facilities and communications facilities; and

(C) transportation equipment, including land, sea and air vehicles used for transportation of patients to emergency facilities and periodically inspect life saving equipment, emergency facilities and emergency transportation vehicles to ensure state standards are maintained;

(3) Annually inventory emergency medical services resources within the state, including facilities, equipment, and personnel, for the purposes of determining the need for additional services and the effectiveness of existing services;

(4) Review and evaluate all area-wide plans developed by the emergency medical services councils pursuant to section 19a-182 in order to insure conformity with standards issued by the commissioner;

(5) Not later than thirty days after their receipt, review all grant and contract applications for federal or state funds concerning emergency medical services or related activities for conformity to policy guidelines and forward such application to the appropriate agency, when required;

(6) Establish such minimum standards and adopt such regulations in accordance with the provisions of chapter 54, as may be necessary to develop the following components of an emergency medical service system:

(A) Communications, which shall include, but not be limited to, equipment, radio frequencies and operational procedures;

(B) transportation services, which shall include, but not be limited to, vehicle type, design, condition and maintenance, and operational procedures;

(C) training, which shall include, but not be limited to, emergency medical services personnel, communications personnel, paraprofessionals associated with emergency medical services, firefighters and state and local police;

(D) emergency medical service facilities, which shall include, but not be limited to, categorization of emergency departments as to their treatment capabilities and ancillary services; and

(E) mobile integrated health care programs, which shall include, but not be limited to, the standards to ensure the health, safety and welfare of the patients being served by such programs and data collection and reporting requirements to ensure and measure quality outcomes of such programs;

(7) Coordinate training of all emergency medical services personnel;

(8)

(A) Develop an emergency medical services data collection system. Each emergency medical service organization licensed or certified pursuant to this chapter shall submit data to the commissioner, on a quarterly basis, from each licensed ambulance service, certified ambulance service or paramedic intercept service that provides emergency medical services. Such submitted data shall include, but not be limited to:

(i) The total number of and reasons for calls for emergency medical services received by such licensed ambulance service, certified ambulance service or paramedic intercept service through the 9-1-1 system during the reporting period;

(ii) each level of emergency medical services, as defined in regulations adopted pursuant to section 19a-179, required for each such call;

(iii) the response time for each licensed ambulance service, certified ambulance service or paramedic intercept service during the reporting period;

(iv) the number of passed calls, cancelled calls and mutual aid calls, both made and received, during the reporting period; and

(v) for the reporting period, the prehospital data for the nonscheduled transport of patients required by regulations adopted pursuant to subdivision (6) of this section. The data required under this subdivision may be submitted in any electronic form selected by such licensed ambulance service, certified ambulance service or paramedic intercept service and approved by the commissioner, provided the commissioner shall take into consideration the needs of such licensed ambulance service, certified ambulance service or paramedic intercept service in approving such electronic form. The commissioner may conduct an audit of any such licensed ambulance service, certified ambulance service or paramedic intercept service as the commissioner deems necessary in order to verify the accuracy of such reported data.

(B) On or before June 1, 2023, and annually thereafter, the commissioner shall prepare a report to the Emergency Medical Services Advisory Board, established pursuant to section 19a-178a, that shall include, but not be limited to, the following data:

(i) The total number of calls for emergency medical services received during the reporting year by each licensed ambulance service, certified ambulance service or paramedic intercept service;

(ii) the level of emergency medical services required for each such call;

(iii) the name of the emergency medical service organization that provided each such level of emergency medical services furnished during the reporting year;

(iv) the response time, by time ranges or fractile response times, for each licensed ambulance service, certified ambulance service or paramedic intercept service, using a common definition of response time, as provided in regulations adopted pursuant to section 19a-179;

(v) the number of passed calls, cancelled calls and mutual aid calls during the reporting year; and

(vi) any shortage of emergency medical services personnel in the state. The commissioner shall prepare such report in a format that categorizes such data for each municipality in which the emergency medical services were provided, with each such municipality grouped according to urban, suburban and rural classifications.

(C) If any licensed ambulance service, certified ambulance service or paramedic intercept service does not submit the data required under subparagraph (A) of this subdivision for a period of six consecutive months, or if the commissioner believes that such licensed ambulance service, certified ambulance service or paramedic intercept service knowingly or intentionally submitted incomplete or false data, the commissioner shall issue a written order directing such licensed ambulance service, certified ambulance service or paramedic intercept service to comply with the provisions of subparagraph (A) of this subdivision and submit all missing data or such corrected data as the commissioner may require. If such licensed ambulance service, certified ambulance service or paramedic intercept service fails to fully comply with such order not later than three months from the date such order is issued, the commissioner (i) shall conduct a hearing, in accordance with chapter 54, at which such licensed ambulance service, certified ambulance service or paramedic intercept service shall be required to show cause why the primary service area assignment of such licensed ambulance service, certified ambulance service or paramedic intercept service should not be revoked, and (ii) may take such disciplinary action under section 19a-17 as the commissioner deems appropriate.

(D) The commissioner shall collect the data required by subparagraph (A) of this subdivision, in the manner provided in said subparagraph, from each emergency medical service organization licensed or certified pursuant to this chapter. Any such emergency medical service organization that fails to comply with the provisions of this section shall be liable for a civil penalty not to exceed one hundred dollars per day for each failure to report the required data regarding emergency medical services provided to a patient, as determined by the commissioner. The civil penalties set forth in this subparagraph shall be assessed only after the department provides a written notice of deficiency and the organization is afforded the opportunity to respond to such notice. An organization shall have not more than fifteen business days after the date of receiving such notice to provide a written response to the department. The commissioner may adopt regulations, in accordance with chapter 54, concerning the development, implementation, monitoring and collection of emergency medical service system data. All state agencies licensed or certified as emergency medical service organizations shall be exempt from the civil penalties set forth in this subparagraph.

(E) The commissioner shall, with the recommendation of the Connecticut Emergency Medical Services Advisory Board established pursuant to section 19a-178a, adopt for use in trauma data collection the most recent version of the National Trauma Data Bank's National Trauma Data Standards and Data Dictionary and nationally recognized guidelines for field triage of injured patients.

(F) On or before June 1, 2024, and annually thereafter, the commissioner shall submit the report described in subparagraph (B) of this subdivision, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to public health;

(9)

(A) Establish rates for the conveyance and treatment of patients by licensed ambulance services and invalid coaches and establish emergency service rates for certified ambulance services and paramedic intercept services, provided (i) the present rates established for such services and vehicles shall remain in effect until such time as the commissioner establishes a new rate schedule as provided in this subdivision, and (ii) any rate increase not in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, filed in accordance with subparagraph (B)(iii) of this subdivision shall be deemed approved by the commissioner. For purposes of this subdivision, licensed ambulance services and paramedic intercept services shall not include emergency air transport services or mobile integrated health care programs.

(B) Adopt regulations, in accordance with the provisions of chapter 54, establishing methods for setting rates and conditions for charging such rates. Such regulations shall include, but not be limited to, provisions requiring that on and after July 1, 2000:

(i) Requests for rate increases may be filed no more frequently than once a year, except that, in any case where an agency's schedule of maximum allowable rates falls below that of the Medicare allowable rates for that agency, the commissioner shall immediately amend such schedule so that the rates are at or above the Medicare allowable rates;

(ii) only licensed ambulance services, certified ambulance services and paramedic intercept services that apply for a rate increase in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, and do not accept the maximum allowable rates contained in any voluntary state-wide rate schedule established by the commissioner for the rate application year shall be required to file detailed financial information with the commissioner, provided any hearing that the commissioner may hold concerning such application shall be conducted as a contested case in accordance with chapter 54;

(iii) licensed ambulance services, certified ambulance services and paramedic intercept services that do not apply for a rate increase in any year in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, or that accept the maximum allowable rates contained in any voluntary state-wide rate schedule established by the commissioner for the rate application year shall, not later than the last business day in August of such year, file with the commissioner a statement of emergency and nonemergency call volume, and, in the case of a licensed ambulance service, certified ambulance service or paramedic intercept service that is not applying for a rate increase, a written declaration by such licensed ambulance service, certified ambulance service or paramedic intercept service that no change in its currently approved maximum allowable rates will occur for the rate application year; and

(iv) detailed financial and operational information filed by licensed ambulance services, certified ambulance services and paramedic intercept services to support a request for a rate increase in excess of the Medical Care Services Consumer Price Index, as published by the Bureau of Labor Statistics of the United States Department of Labor, for the prior year, shall cover the time period pertaining to the most recently completed fiscal year and the rate application year of the licensed ambulance service, certified ambulance service or paramedic intercept service.

(C) Establish rates for licensed ambulance services, certified ambulance services or paramedic intercept services for the following services and conditions:

(i) "Advanced life support assessment" and "specialty care transports", which terms have the meanings provided in 42 CFR 414.605; and

(ii) mileage, which may include mileage for an ambulance transport when the point of origin and final destination for a transport is within the boundaries of the same municipality. The rates established by the commissioner for each such service or condition shall be equal to (I) the ambulance service's base rate plus its established advanced life support/paramedic surcharge when advanced life support assessment services are performed; (II) two hundred twenty-five per cent of the ambulance service's established base rate for specialty care transports; and (III) "loaded mileage", as the term is defined in 42 CFR 414.605, multiplied by the ambulance service's established rate for mileage. Such rates shall remain in effect until such time as the commissioner establishes a new rate schedule as provided in this subdivision.

(D) Establish rates for the treatment and release of patients by a licensed or certified emergency medical services organization or a provider who does not transport such patients to an emergency department and who is operating within the scope of such organization's or provider's practice and following protocols approved by the sponsor hospital. The rates established pursuant to this subparagraph shall not apply to the treatment provided to patients through mobile integrated health care programs;

(10) Establish primary service areas and assign in writing a primary service area responder for each primary service area. Each state-owned campus having an acute care hospital on the premises shall be designated as the primary service area responder for that campus;

(11) Revoke primary service area assignments upon determination by the commissioner that it is in the best interests of patient care to do so; and

(12) Annually issue a list of minimum equipment requirements for authorized emergency medical services vehicles based upon current national standards. The commissioner shall distribute such list to all emergency medical service organizations and sponsor hospital medical directors and make such list available to other interested stakeholders. Emergency medical service organizations shall have one year from the date of issuance of such list to comply with the minimum equipment requirements.

Conn. Gen. Stat. § 19a-177

(P.A. 74-305, S. 3, 19; P.A. 75-112, S. 3, 18; P.A. 77-268, S. 3; P.A. 78-331, S. 12, 58; P.A. 80-480, S. 1, 3; P.A. 87-420, S. 4, 14; P.A. 98-195 , S. 5 ; P.A. 00-151 , S. 2 , 14 ; June Sp. Sess. P.A. 01-4 , S. 51 , 58 ; May 9 Sp. Sess. P.A. 02-7 , S. 47 ; P.A. 03-46 , S. 1 ; P.A. 04-221 , S. 39 ; P.A. 05-272 , S. 17 ; P.A. 09-232 , S. 26 , 27 ; P.A. 10-18 , S. 7 ; P.A. 11-242 , S. 30 ; P.A. 14-122 , S. 118 ; 14-217 , S. 162 ; 14-231 , S. 17 ; P.A. 15-223 , S. 2 ; 15-242 , S. 10 , 37 ; P.A. 16-66 , S. 1 ; P.A. 18-168 , S. 17 .)

Amended by P.A. 23-0097,S. 36 of the Connecticut Acts of the 2023 Regular Session, eff. 10/1/2023.

Amended by P.A. 22-0058, S. 21 of the Connecticut Acts of the 2022 Regular Session, eff. 5/23/2022.

Amended by P.A. 21-0121, S. 10 of the Connecticut Acts of the 2021 Regular Session, eff. 10/1/2021.

Amended by P.A. 19-0118, SS.  19 of the Connecticut Acts of the 2019 Regular Session, 47 of the Connecticut Acts of the 2019 Regular Session, 65 of the Connecticut Acts of the 2019 Regular Sessioneff. 7/1/2019.

Amended by P.A. 19-0056, S. 6 of the Connecticut Acts of the 2019 Regular Session, eff. 6/28/2019.

Amended by P.A. 18-0168, S. 17 of the Connecticut Acts of the 2018 Regular Session, eff. 10/1/2018.

Amended by P.A. 16-0066, S. 1 of the Connecticut Acts of the 2016 Regular Session, eff. 5/27/2016.

Amended by P.A. 15-0223, S. 2 of the Connecticut Acts of the 2015 Regular Session, eff. 10/1/2015.

Amended by P.A. 15-0242, S. 37 of the Connecticut Acts of the 2015 Regular Session, eff. 10/1/2015.

Amended by P.A. 15-0242, S. 10 of the Connecticut Acts of the 2015 Regular Session, eff. 10/1/2015.

Amended by P.A. 14-0231, S. 17 of the Connecticut Acts of the 2014 Regular Session, eff. 10/1/2014.

Amended by P.A. 14-0217, S. 162 of the Connecticut Acts of the 2014 Regular Session, eff. 10/1/2014.

Amended by P.A. 14-0122, S. 118 of the Connecticut Acts of the 2014 Regular Session, eff. 10/1/2014.

Amended by P.A. 11-0242, S. 30 of the the 2011 Regular Session, eff. 7/13/2011.

Amended by P.A. 10-0018, S. 7 of the February 2010 Regular Session, eff. 10/1/2010.

Amended by P.A. 09-0232, S. 27 of the the 2009 Regular Session, eff. 1/1/2010.

Amended by P.A. 09-0232, S. 26 of the the 2009 Regular Session, eff. 1/1/2010.

Annotation to former section 19-73w: Cited. 35 Conn.Supp. 136 .