HOUSE OF REPRESENTATIVES	H.B. NO.	1410
TWENTY-NINTH LEGISLATURE, 2017
STATE OF HAWAII

A BILL FOR AN ACT

relating to emergency medical services.

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

     SECTION 1.  Chapter 46, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

     "§46-   Regulation of ambulance service. (a)  The authority to regulate ambulance service, including the certification of vehicles, equipment, supplies, and communication systems, shall rest with the respective county.

(b)  Any person who provides emergency medical service as an employee of any emergency ambulance service shall be subject to chapter 453.

(c)  Each county shall require that ambulance service providers licensed by the respective county establish and maintain an alcohol and substance abuse policy for employees that is equivalent to, or exceeds the provisions of, the safety and health standards established by the United States Department of Transportation for holders of commercial driver's licenses.

(d)  Ambulance service made available under the authority of this section shall not be denied to any person on the basis of the person's ability to pay therefor or because of the lack of prepaid health care coverage or proof of either ability to pay or of coverage.

(e)  The use of latex gloves by personnel providing ambulance services is prohibited."

     SECTION 2.  Section 237D-6.5, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

     "(b)  Revenues collected under this chapter shall be distributed in the following priority, with the excess revenues to be deposited into the general fund:

     (1)  $1,500,000 shall be allocated to the Turtle Bay conservation easement special fund beginning July 1, 2015, for the reimbursement to the state general fund of debt service on reimbursable general obligation bonds, including ongoing expenses related to the issuance of the bonds, the proceeds of which were used to acquire the conservation easement and other real property interests in Turtle Bay, Oahu, for the protection, preservation, and enhancement of natural resources important to the State, until the bonds are fully amortized;

     (2)  $26,500,000 shall be allocated to the convention center enterprise special fund established under section 201B-8;

     (3)  $82,000,000 shall be allocated to the tourism special fund established under section 201B-11; provided that:

         (A)  Beginning on July 1, 2012, and ending on June 30, 2015, $2,000,000 shall be expended from the tourism special fund for development and implementation of initiatives to take advantage of expanded visa programs and increased travel opportunities for international visitors to Hawaii;

         (B)  Of the $82,000,000 allocated:

              (i)  $1,000,000 shall be allocated for the operation of a Hawaiian center and the museum of Hawaiian music and dance at the Hawaii convention center; and

             (ii)  0.5 per cent of the $82,000,000 shall be transferred to a sub-account in the tourism special fund to provide funding for a safety and security budget, in accordance with the Hawaii tourism strategic plan 2005-2015; and

         (C)  Of the revenues remaining in the tourism special fund after revenues have been deposited as provided in this paragraph and except for any sum authorized by the legislature for expenditure from revenues subject to this paragraph, beginning July 1, 2007, funds shall be deposited into the tourism emergency special fund, established in section 201B-10, in a manner sufficient to maintain a fund balance of $5,000,000 in the tourism emergency special fund;

     (4)  $103,000,000 for fiscal year 2014-2015, $103,000,000 for fiscal year 2015-2016, $103,000,000 for fiscal year 2016-2017, and $93,000,000 for each fiscal year thereafter shall be allocated as follows:  Kauai county shall receive 14.5 per cent, Hawaii county shall receive 18.6 per cent, city and county of Honolulu shall receive 44.1 per cent, and Maui county shall receive 22.8 per cent; provided that [commencing]:

(A) Commencing with fiscal year 2017-2018, each county shall expend a portion of the tax revenues allocated to it pursuant to this paragraph to establish, operate, maintain, and regulate ambulance services in their respective county; and

(B) Commencing with fiscal year 2018-2019, a sum that represents the difference between a county public employer's annual required contribution for the separate trust fund established under section 87A-42 and the amount of the county public employer's contributions into that trust fund shall be retained by the state director of finance and deposited to the credit of the county public employer's annual required contribution into that trust fund in each fiscal year, as provided in section 87A-42, if the respective county fails to remit the total amount of the county's required annual contributions, as required under section 87A-43; and

     (5)  $3,000,000 shall be allocated to the special land and development fund established under section 171-19; provided that the allocation shall be expended in accordance with the Hawaii tourism authority strategic plan for:

         (A)  The protection, preservation, maintenance, and enhancement of natural resources, including beaches, important to the visitor industry;

         (B)  Planning, construction, and repair of facilities; and

         (C)  Operation and maintenance costs of public lands, including beaches, connected with enhancing the visitor experience.

     All transient accommodations taxes shall be paid into the state treasury each month within ten days after collection and shall be kept by the state director of finance in special accounts for distribution as provided in this subsection.

     As used in this subsection, "fiscal year" means the twelve-month period beginning on July 1 of a calendar year and ending on June 30 of the following calendar year."

     SECTION 3.  Section 321-11, Hawaii Revised Statutes, is amended to read as follows:

     "§321-11  Subjects of health rules, generally.  The department of health pursuant to chapter 91 may adopt rules that it deems necessary for the public health and safety respecting:

     (1)  Nuisances, foul or noxious odors, gases, vapors, waters in which mosquitoes breed or may breed, sources of filth, and causes of sickness or disease, within the respective districts of the State, and on board any vessel;

     (2)  Adulteration and misbranding of food or drugs;

     (3)  Location, air space, ventilation, sanitation, drainage, sewage disposal, and other health conditions of buildings, courts, construction projects, excavations, pools, watercourses, areas, and alleys;

     (4)  Privy vaults and cesspools;

     (5)  Fish and fishing;

     (6)  Interments and dead bodies;

     (7)  Disinterments of dead human bodies, including the exposing, disturbing, or removing of these bodies from their place of burial, or the opening, removing, or disturbing after due interment of any receptacle, coffin, or container holding human remains or a dead human body or a part thereof and the issuance and terms of permits for the aforesaid disinterments of dead human bodies;

     (8)  Cemeteries and burying grounds;

     (9)  Laundries, and the laundering, sanitation, and sterilization of articles including linen and uniforms used by or in the following businesses and professions:  barber shops, manicure shops, beauty parlors, electrology shops, restaurants, soda fountains, hotels, rooming and boarding houses, bakeries, butcher shops, public bathhouses, midwives, masseurs, and others in similar calling, public or private hospitals, and canneries and bottling works where foods or beverages are canned or bottled for public consumption or sale; provided that nothing in this chapter shall be construed as authorizing the prohibiting of laundering, sanitation, and sterilization by those conducting any of these businesses or professions where the laundering or sterilization is done in an efficient and sanitary manner;

    (10)  Hospitals, freestanding surgical outpatient facilities, skilled nursing facilities, intermediate care facilities, adult residential care homes, adult foster homes, assisted living facilities, special treatment facilities and programs, home health agencies, home care agencies, hospices, freestanding birthing facilities, adult day health centers, independent group residences, and therapeutic living programs, but excluding youth shelter facilities unless clinical treatment of mental, emotional, or physical disease or handicap is a part of the routine program or constitutes the main purpose of the facility, as defined in section 346-16 under "child [caring] institution".  For the purpose of this paragraph, "adult foster home" has the same meaning as provided in section 321-11.2;

    (11)  Hotels, rooming houses, lodging houses, apartment houses, tenements, and residences for persons with developmental disabilities including those built under federal funding;

    (12)  Laboratories;

    (13)  Any place or building where noisome or noxious trades or manufacturing is carried on, or intended to be carried on;

    (14)  Milk;

    (15)  Poisons and hazardous substances, the latter term including any substance or mixture of substances that:

         (A)  Is corrosive;

         (B)  Is an irritant;

         (C)  Is a strong sensitizer;

         (D)  Is inflammable; or

         (E)  Generates pressure through decomposition, heat, or other means,

          if the substance or mixture of substances may cause substantial personal injury or substantial illness during or as a proximate result of any customary or reasonably foreseeable handling or use, including reasonably foreseeable ingestion by children;

    (16)  Pig and duck ranches;

    (17)  Places of business, industry, employment, and commerce, and the processes, materials, tools, machinery, and methods of work done therein; and places of public gathering, recreation, or entertainment;

    (18)  Any restaurant, theater, market, stand, shop, store, factory, building, wagon, vehicle, or place where any food, drug, or cosmetic is manufactured, compounded, processed, extracted, prepared, stored, distributed, sold, offered for sale, or offered for human consumption or use;

    (19)  Foods, drugs, and cosmetics, and the manufacture, compounding, processing, extracting, preparing, storing, selling, and offering for sale, consumption, or use of any food, drug, or cosmetic;

    (20)  [Device] as defined in section 328-1;

    (21)  Sources of ionizing radiation;

    (22)  Medical examination, vaccination, revaccination, and immunization of school children.  No child shall be subjected to medical examination, vaccination, revaccination, or immunization, whose parent or guardian objects in writing thereto on grounds that the requirements are not in accordance with the religious tenets of an established church of which the parent or guardian is a member or adherent, but no objection shall be recognized when, in the opinion of the department, there is danger of an epidemic from any communicable disease;

    (23)  Disinsectization of aircraft entering or within the State as may be necessary to prevent the introduction, transmission, or spread of disease or the introduction or spread of any insect or other vector of significance to health;

    (24)  Fumigation, including the process by which substances emit or liberate gases, fumes, or vapors that may be used for the destruction or control of insects, vermin, rodents, or other pests, which, in the opinion of the department, may be lethal, poisonous, noxious, or dangerous to human life;

   [(25) Ambulances and ambulance equipment;

(26)] (25)  Development, review, approval, or disapproval of management plans submitted pursuant to the Asbestos Hazard Emergency Response Act of 1986, Public Law 99-519; and

   [(27)] (26)  Development, review, approval, or disapproval of an accreditation program for specially trained persons pursuant to the Residential Lead-Based Paint Hazard Reduction Act of 1992, Public Law 102-550.

     The department of health may require any certificates, permits, or licenses that it may deem necessary to adequately regulate the conditions or businesses referred to in this section."

     SECTION 4.  Section 321-224, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  In addition to other functions and duties assigned under this part, the department shall:

[(1) Regulate ambulances and ambulance services;

(2)] (1)  Establish emergency medical services throughout the State, including emergency aeromedical services, which shall meet the requirements of this part, subject to section 321-228;

[(3)] (2) Review and approve the curricula and syllabi of training courses offered to emergency medical services personnel who provide basic, intermediate, and advanced life support, consult and coordinate with the University of Hawaii, or any other accredited community college, college, or university, or any professional organization that provides emergency medical services training, regarding the training for basic, intermediate, and advanced life support personnel, as provided in section 321-229;

[(4)] (3) Collect and evaluate data for the continued evaluation of the state system, subject to section 321-230;

[(5)] (4) Coordinate emergency medical resources and the allocation of the state system's services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;

[(6)] (5) Establish, administer, and maintain a communication system for the state system;

[(7)] (6) Assist each county in the development of a "911" emergency telephone system;

[(8)] (7) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;

[(9)] (8) Implement public information and education programs to inform the public of the state system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs in the State;

   [(10)] (9)  Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations;

[(11)] (10) Establish a program that will enable emergency service personnel to provide early defibrillation;

[(12)] (11) Establish within the department the emergency medical service system for children;

[(13)] (12)  Consult with the advisory committee on matters relating to the implementation of this part; and

[(14)] (13) Establish and maintain standards for emergency medical services course instructor qualifications and requirements for emergency medical services training facilities."

     SECTION 5.  Section 321-226, Hawaii Revised Statutes, is amended to read as follows:

     "§321-226  Emergency medical services and systems, standards.  The department of health shall establish standards for emergency medical services and for emergency medical service systems consistent with the state system and applicable federal guidelines for such services[, including a requirement that ambulance service providers licensed by the State establish and maintain an alcohol and substance abuse policy for employees that the department of health deems is equivalent to, or exceeds the provisions of, the safety and health standards established by the federal Department of Transportation for holders of commercial driver's licenses].  In the event the standards are determined or regulated by any other law, or by applicable federal guidelines, standards required to be set by this section shall be at least equivalent to or exceed the other state and federal standards."

     SECTION 6.  Section 321-228, Hawaii Revised Statutes, is amended to read as follows:

     "§321-228  Emergency medical services; counties.  The department shall determine, in consultation with the advisory committee under section 321-225, the levels of emergency medical services that shall be implemented in each county.  The department may contract to provide emergency medical services, including emergency aeromedical services, or any necessary component of a county emergency services system in conformance with the state system.  [In the event any county shall apply to the department to operate emergency medical ambulance services within the respective county, the department may contract with the county for the provision of those services.  The department shall operate emergency medical ambulance services or contract with a private agency in those counties which do not apply to it under this section.  Any county or private agency contracting to provide emergency medical ambulance services under this section shall be required by the department to implement those services in a manner and at a level consistent with the levels determined under this section.]"

     SECTION 7.  Section 321-232, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

     "(b)  No [ambulance services, or any other] emergency medical services available from or under the authority of this chapter shall be denied to any person on the basis of the ability of the person to pay therefor or because of the lack of prepaid health care coverage or proof of such ability or coverage."

     SECTION 8.  Section 321-236, Hawaii Revised Statutes, is amended to read as follows:

     "[[]§321-236[]]  Emergency medical services; use of latex gloves prohibited.  The use of latex gloves by personnel providing [ambulance services or] emergency medical services pursuant to this part shall be prohibited."

     SECTION 9.  Section 321-227, Hawaii Revised Statutes, is repealed.

     ["§321-227  Regulation of ambulances.  The department of health shall adopt, amend, and repeal rules under chapter 91 for the regulation of ambulances within the State, including but not limited to the certification of vehicles, equipment, supplies, and communications systems.  Any person who provides emergency medical service as an employee of any emergency ambulance service shall be subject to chapter 453."]

     SECTION 10.  The legislature declares that the amendments made to section 237D-6.5(b), Hawaii Revised Statutes, by section 2 of this Act satisfy the requirements of article VIII, section 5 of the Hawaii State Constitution.

     SECTION 11.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 12.  This Act shall take effect on July 1, 2017; provided that the department of health shall continue to provide for the regulation of ambulances until December 31, 2017, and on January 1, 2018, the respective counties shall assume the duty to regulate ambulance service.

INTRODUCED BY:

_____________________________

Report Title:

Ambulances; Counties

Description:

Transfers the regulation of ambulance services from the DOH to the counties.  Allocates a portion of the transient accommodations tax to the counties for ambulance regulation and operation.  Effective 7/1/2017.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.