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2009 Texas Code
HEALTH AND SAFETY CODE
TITLE 9. SAFETY
CHAPTER 773. EMERGENCY MEDICAL SERVICES

HEALTH AND SAFETY CODE

TITLE 9. SAFETY

SUBTITLE B. EMERGENCIES

CHAPTER 773. EMERGENCY MEDICAL SERVICES

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 773.001. SHORT TITLE. This chapter may be cited as the

Emergency Health Care Act.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by:

Acts 2005, 79th Leg., Ch.

299, Sec. 1, eff. September 1, 2005.

Sec. 773.002. PURPOSE. The purpose of this chapter is to

provide for the prompt and efficient transportation of sick and

injured patients, after necessary stabilization, and to encourage

public access to that transportation in each area of the state.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.003. DEFINITIONS. In this chapter:

(1) "Advanced life support" means emergency prehospital care

that uses invasive medical acts.

(2) "Basic life support" means emergency prehospital care that

uses noninvasive medical acts.

(3) "Board" means the Texas Board of Health.

(4) "Bureau" means the department's bureau of emergency

management.

(5) "Bureau chief" means the chief of the bureau of emergency

management.

(6) "Commissioner" means the commissioner of health.

(7) "Department" means the Department of State Health Services.

(8) "Emergency medical services" means services used to respond

to an individual's perceived need for immediate medical care and

to prevent death or aggravation of physiological or psychological

illness or injury.

(9) "Emergency medical services and trauma care system" means an

arrangement of available resources that are coordinated for the

effective delivery of emergency health care services in

geographical regions consistent with planning and management

standards.

(10) "Emergency medical services personnel" means:

(A) emergency care attendant;

(B) emergency medical technicians;

(D) emergency medical technicians--paramedic; or

(E) licensed paramedic.

(11) "Emergency medical services provider" means a person who

uses or maintains emergency medical services vehicles, medical

equipment, and emergency medical services personnel to provide

emergency medical services.

(12) "Emergency medical services vehicle" means:

(A) a basic life-support emergency medical services vehicle;

(B) an advanced life-support emergency medical services vehicle;

(D) a specialized emergency medical services vehicle.

(13) "Emergency medical services volunteer" means emergency

medical services personnel who provide emergency prehospital care

without remuneration, except reimbursement for expenses.

(14) "Emergency medical services volunteer provider" means an

emergency medical services provider that has at least 75 percent

of its total personnel as volunteers and is recognized as a

Section 501(c)(3) nonprofit corporation by the Internal Revenue

Service.

(15) "Emergency prehospital care" means care provided to the

sick or injured before or during transportation to a medical

facility, and includes any necessary stabilization of the sick or

injured in connection with that transportation.

(15-a) "Executive commissioner" means the executive commissioner

of the Health and Human Services Commission.

(16) "First responder organization" means a group or association

of certified emergency medical services personnel that, working

in cooperation with a licensed emergency medical services

provider, provides immediate on-scene care to ill or injured

persons but does not transport those persons.

(17) "Governmental entity" means a county, municipality, school

district, or special district or authority created in accordance

with the Texas Constitution.

(18) "Medical supervision" means direction given to emergency

medical services personnel by a licensed physician under Subtitle

B, Title 3, Occupations Code, and the rules adopted under that

subtitle by the Texas State Board of Medical Examiners.

Text of subsec. (19) as amended by Acts 1991, 72nd Leg., ch. 605,

Sec. 1

(19) "Trauma facility" means a health care facility that is

capable of comprehensive treatment of seriously injured persons

and is a part of an emergency medical services and trauma care

system.

Text of subsec. (19) as amended by Acts 1991, 72nd Leg., ch. 853,

Sec. 3

(19) "Emergency medical care" means bona fide emergency services

provided after the sudden onset of a medical or traumatic

condition manifesting itself by acute symptoms of sufficient

severity, including severe pain, such that the absence of

immediate medical attention could reasonably be expected to

result in:

(A) placing the patient's health in serious jeopardy;

(B) serious impairment to bodily functions; or

(20) "Trauma patient" means a critically injured person who has

been:

(A) evaluated by a physician, a registered nurse, or emergency

medical services personnel; and

(B) found to require medical care in a trauma facility.

(21) [Blank].

(22) "Trauma services" includes services provided to a severely

or seriously injured patient who has a principal diagnosis listed

in the Injuries and Poisonings Chapter of the International

Classification of Diseases, Clinical Modification.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 239, eff. Sept. 1,

1991; Acts 1991, 72nd Leg., ch. 605, Sec. 1, eff. Sept. 1, 1991;

Acts 1991, 72nd Leg., ch. 853, Sec. 3, eff. Sept. 1, 1991; Acts

1995, 74th Leg., ch. 915, Sec. 1, eff. Aug. 28, 1995; Acts 1997,

75th Leg., ch. 435, Sec. 1, eff. Sept. 1, 1997; Acts 1999, 76th

Leg., ch. 1377, Sec. 2.02, eff. Sept. 1, 1999; Acts 2001, 77th

Leg., ch. 1420, Sec. 14.808, eff. Sept. 1, 2001.

Amended by:

Acts 2005, 79th Leg., Ch.

299, Sec. 2, eff. September 1, 2005.

Sec. 773.004. VEHICLES AND PERSONNEL EXCLUDED FROM CHAPTER. (a)

This chapter does not apply to:

(1) air transfer that does not advertise as an ambulance

service and that is not licensed by the department;

(2) the use of ground or air transfer vehicles to transport sick

or injured persons in a casualty situation that exceeds the basic

vehicular capacity or capability of emergency medical services

providers in the area;

(3) an industrial ambulance; or

(4) a physician, registered nurse, or other health care

practitioner licensed by this state unless the health care

practitioner staffs an emergency medical services vehicle

regularly.

(b) In this section, "industrial ambulance" means a vehicle

owned and operated by an industrial facility that is not

available for hire or use by the public except to assist the

local community in a disaster or when existing ambulance service

is not available, and includes a ground vehicle at an industrial

site used:

(1) for the initial transportation or transfer of the unstable

urgently sick or injured; or

(2) to transport from the job site to an appropriate medical

facility a person who becomes sick, injured, wounded, or

otherwise incapacitated in the course of employment.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 240, eff. Sept. 1,

1991; Acts 1991, 72nd Leg., ch. 605, Sec. 2, eff. Sept. 1, 1991;

Acts 1993, 73rd Leg., ch. 376, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

305, Sec. 1, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch.

1034, Sec. 4, eff. September 1, 2005.

Acts 2007, 80th Leg., R.S., Ch.

268, Sec. 14(a), eff. September 1, 2007.

Sec. 773.0045. TEMPORARY EXEMPTIONS FOR EMERGENCY MEDICAL

SERVICES PERSONNEL PRACTICING IN RURAL AREA. (a) In this

section, "rural area" means:

(1) a county with a population of 50,000 or less; or

(2) a relatively large, isolated, and sparsely populated area in

a county with a population of more than 50,000.

(b) The department on a case-by-case basis may temporarily

exempt emergency medical services personnel who primarily

practice in a rural area from a requirement imposed either by

Section 773.050 or 773.055 or by a rule adopted by the department

under Section 773.050 or 773.055 if specific circumstances that

affect the rural area served by the emergency medical services

personnel justify the exemption. The department may temporarily

exempt the emergency medical services personnel from a

requirement imposed:

(1) by a department rule adopted under Section 773.050 or

773.055 only if the department finds that, under the

circumstances, imposing the requirement would not be in the best

interests of the people in the rural area who are served by the

emergency medical services personnel; and

(2) by Section 773.050 or 773.055 only if the department finds

that, under the circumstances, there is a substantial risk that

imposing the requirement will detrimentally affect the health or

safety of one or more persons in the affected rural area or

hinder the ability of emergency medical services personnel who

practice in the area to alleviate a threat to the health or

safety of one or more persons in the area.

required by Subsection (b), and expire at a stated time. The

written findings must be accompanied by a concise and explicit

statement that specifically describes the circumstances that

support the finding.

(d) In granting the exemption, the department in writing must

require the affected emergency medical services personnel or the

appropriate emergency medical services provider to adopt a

written plan under which the applicable requirement will be met

as soon as possible.

(e) A temporary exemption under this section may allow emergency

medical services personnel who are applicants for certification

at a higher level of training to temporarily practice at the

higher level.

Added by Acts 2003, 78th Leg., ch. 848, Sec. 1, eff. June 20,

2003.

Sec. 773.005. BUREAU OF EMERGENCY MANAGEMENT. (a) The bureau

of emergency management is in the department under the direction

of a bureau chief.

(b) The bureau chief must have:

(1) proven ability as an administrator and organizer; and

(2) direct experience in emergency medical services.

shall give preference to a physician who applies for the

position.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.006. FUND FOR EMERGENCY MEDICAL SERVICES, TRAUMA

FACILITIES, AND TRAUMA CARE SYSTEMS. (a) The fund for emergency

medical services, trauma facilities, and trauma care systems is

established as an account in the general revenue fund. Money in

the account may be appropriated only to the bureau for the

purposes specified by Section 773.122.

(b) The account is composed of money deposited to the account

under Article 102.0185, Code of Criminal Procedure, and the

earnings of the account.

to the account.

Added by Acts 2003, 78th Leg., ch. 1213, Sec. 1, eff. Sept. 1,

2003.

Sec. 773.007. SUPERVISION OF EMERGENCY PREHOSPITAL CARE. (a)

The provision of advanced life support must be under medical

supervision and a licensed physician's control.

(b) The provision of basic life support may be under medical

supervision and a licensed physician's control.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.008. CONSENT FOR EMERGENCY CARE. Consent for emergency

care of an individual is not required if:

(1) the individual is:

(A) unable to communicate because of an injury, accident, or

illness or is unconscious; and

(B) suffering from what reasonably appears to be a

life-threatening injury or illness;

(2) a court of record orders the treatment of an individual who

is in an imminent emergency to prevent the individual's serious

bodily injury or loss of life; or

(3) the individual is a minor who is suffering from what

reasonably appears to be a life-threatening injury or illness and

whose parents, managing or possessory conservator, or guardian is

not present.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.009. LIMITATION ON CIVIL LIABILITY. A person who

authorizes, sponsors, supports, finances, or supervises the

functions of emergency room personnel and emergency medical

services personnel is not liable for civil damages for an act or

omission connected with training emergency medical services

personnel or with services or treatment given to a patient or

potential patient by emergency medical services personnel if the

training, services, or treatment is performed in accordance with

the standard of ordinary care.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.011. SUBSCRIPTION PROGRAMS. (a) An emergency medical

services provider may create and operate a subscription program

to fund and provide emergency medical services.

(b) The board shall adopt rules establishing minimum standards

for the creation and operation of a subscription program.

medical services provider to secure a surety bond in the amount

of sums to be subscribed before soliciting subscriptions and

creating and operating a subscription program. The surety bond

must be issued by a company that is licensed by or eligible to do

business in this state.

(d) The board may adopt rules for waiver of the surety bond.

(e) The Insurance Code does not apply to a subscription program

established under this section.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 242, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 915, Sec. 2, eff. Aug. 28, 1995.

Sec. 773.012. ADVISORY COUNCIL. (a) The governor shall appoint

an advisory council to advise the board regarding matters related

to the responsibilities of the board, commissioner, and

department under this chapter. In making appointments to the

advisory council, the governor shall ensure that approximately

one-half of the members of the advisory council are residents of

rural areas of the state.

(b) The advisory council is composed of the following 15 members

appointed by the governor:

(1) a board-certified emergency physician, appointed from a list

of names recommended by a statewide professional association of

emergency physicians;

(2) a licensed physician who is an emergency medical services

medical director, appointed from a list of names recommended by a

statewide professional association of emergency medical services

medical directors;

(3) a fire chief for a municipality that provides emergency

medical services, appointed from a list of names recommended by a

statewide fire chiefs association;

(4) an officer or employee of a private provider of emergency

medical services who is involved with the development of a Texas

Trauma System, appointed from a list of names recommended by a

statewide association of private providers of emergency medical

services;

(5) a volunteer who provides emergency medical services,

appointed from a list of names recommended by a statewide

association of volunteers;

(6) an educator in the field of emergency medical services;

(7) a member of an emergency medical services air medical team

or unit, appointed from a list of names recommended by a

statewide emergency medical services air medical association;

(8) a representative of a fire department that provides

emergency medical services, appointed from a list of names

recommended by a statewide association of firefighters;

(9) a representative of hospitals who is affiliated with a

hospital that is a designated trauma facility in an urban

community, appointed from a list of names recommended by a

statewide association of hospitals;

(10) a representative of hospitals, who is affiliated with a

hospital that is a designated trauma facility in a rural

community, appointed from a list of names recommended by a

statewide association of hospitals;

(11) a representative of a county provider of emergency medical

services;

(12) one licensed physician who is a pediatrician with trauma or

emergency care expertise;

(13) one trauma surgeon or one registered nurse with trauma

expertise; and

(14) two representatives of the general public who are not

qualified to serve under another subdivision of this subsection.

if the person or the person's spouse:

(1) is registered, certified, or licensed by a regulatory agency

in the field of emergency medical services;

(2) is employed by or participates in the management of a

business entity or other organization regulated by or receiving

money from the department;

(3) owns or controls, directly or indirectly, more than a 10

percent interest in a business entity or other organization

regulated by or receiving money from the department; or

(4) uses or receives a substantial amount of tangible goods,

services, or money from the department other than reimbursement

authorized by law for advisory council membership, attendance, or

expenses.

(d) In this subsection, "Texas trade association" means a

cooperative and voluntarily joined association of business or

professional competitors in this state designed to assist its

members and its industry or profession in dealing with mutual

business or professional problems and in promoting their common

interest. A person may not be a member of the advisory council

if:

(1) the person is an officer, employee, or paid consultant of a

Texas trade association in the field of emergency medical

services; or

(2) the person's spouse is an officer, manager, or paid

consultant of a Texas trade association in the field of emergency

medical services.

(e) A person may not be a member of the advisory council if the

person is required to register as a lobbyist under Chapter 305,

Government Code, because of the person's activities for

compensation on behalf of a profession related to the operation

of the department.

(f) Members of the advisory council serve staggered six-year

terms with the terms of five members expiring January 1 of each

even-numbered year. A vacancy on the advisory council is filled

in the same manner as the original appointment for the unexpired

term.

(g) The governor shall appoint the presiding officer of the

advisory council.

(h) A member of the advisory council serves without

compensation. Chapter 2110, Government Code, does not apply to

the size, composition, or duration of the advisory council.

(i) The advisory council shall meet at least quarterly in the

city of Austin. The advisory council shall meet as provided by

procedural rules adopted by the advisory council or at the call

of the presiding officer. The advisory council may appoint

committees it considers necessary to perform its duties.

(j) The advisory council periodically shall review board rules

relating to this chapter and may recommend changes in those rules

to the board. The board and the commissioner shall ensure that

the advisory council is given adequate time and opportunity to

review and comment on each rule proposed for adoption by the

board under this chapter, including the amendment or repeal of an

existing rule, but not including an emergency rule.

(k) The advisory council shall assess the need for emergency

medical services in the rural areas of the state.

(l) The advisory council shall develop a strategic plan for:

(1) refining the educational requirements for certification and

maintaining certification as emergency medical services

personnel; and

(2) developing emergency medical services and trauma care

systems.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.01, eff. Sept.

1, 1999. Amended by Acts 2001, 77th Leg., ch. 874, Sec. 2, eff.

Sept. 1, 2001.

Sec. 773.013. PEER ASSISTANCE PROGRAM. The department may

establish, approve, and fund a peer assistance program in

accordance with Section 467.003 and board rules.

Added by Acts 2001, 77th Leg., ch. 874, Sec. 3, eff. Sept. 1,

2001.

Sec. 773.014. ADMINISTRATION OF EPINEPHRINE. (a) An emergency

medical services provider and a first responder organization may

acquire and possess epinephrine auto-injector devices in

accordance with this section. Emergency medical services

personnel may carry and administer epinephrine auto-injector

devices in accordance with this section.

(b) The department shall adopt rules designed to protect the

public health and safety to implement this section. The rules

must provide that emergency medical services personnel may

administer an epinephrine auto-injector device to another only if

the person has successfully completed a training course, approved

by the department, in the use of the device that is consistent

with the national standard training curriculum for emergency

medical technicians.

organization may acquire, possess, maintain, and dispose of

epinephrine auto-injector devices, and emergency medical services

personnel may carry, maintain, administer, and dispose of

epinephrine auto-injector devices, only in accordance with:

(1) rules adopted by the department under this section; and

(2) a delegated practice agreement that provides for medical

supervision by a licensed physician who either:

(A) acts as a medical director for an emergency medical services

system or a licensed hospital; or

(B) has knowledge and experience in the delivery of emergency

care.

(c-1) A licensed physician acting as a medical director for an

emergency medical services system may restrict the use and

administration of epinephrine auto-injector devices to certain

emergency medical services personnel of the system through:

(1) the delegated practice agreement; or

(2) the adoption of policies governing the use of the devices by

personnel within the system.

(d) Emergency medical services personnel who administer

epinephrine auto-injector devices to others shall immediately

report the use to the physician supervising the activities of the

emergency medical services personnel.

(e) The administration of an epinephrine auto-injector device to

another under this section is considered to be the administration

of emergency care for the purposes of any statute relating to

liability for the provision of emergency care. The administration

of an epinephrine auto-injector device to another in accordance

with the requirements of this section does not constitute the

unlawful practice of any health care profession.

(f) A person otherwise authorized to sell or provide an

epinephrine auto-injector device to another may sell or provide

the devices to an emergency medical services provider or a first

responder organization authorized to acquire and possess the

devices under this section.

(g) This section does not prevent emergency medical services

personnel who are also licensed health care professionals under

another health care licensing law and who are authorized to

acquire, possess, and administer an epinephrine auto-injector

device under the other health care licensing law from acting

under the other law.

(h) This section does not impose a standard of care not

otherwise required by law.

Added by Acts 2001, 77th Leg., ch. 874, Sec. 4, eff. Jan. 1,

2002; Acts 2001, 77th Leg., ch. 1131, Sec. 1, eff. Jan. 1, 2002.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

1079, Sec. 1, eff. June 15, 2007.

Sec. 773.015. IDENTIFICATION OF CERTAIN PATIENTS RECEIVING

EMERGENCY PREHOSPITAL CARE. Emergency medical services personnel

or emergency room medical or admissions personnel may take the

thumbprint of a person who receives emergency prehospital care if

the person:

(1) does not possess personal identification at the time the

care is administered;

(2) is unconscious;

(3) is transported across the Texas-Mexico border by ambulance

or helicopter while receiving emergency prehospital care; and

(4) is delivered to a hospital that has digital fingerprinting

capabilities.

Added by Acts 2005, 79th Leg., Ch.

517, Sec. 1, eff. September 1, 2005.

SUBCHAPTER B. STATE PLAN FOR EMERGENCY SERVICES

Sec. 773.021. STATE PLAN. (a) The bureau shall develop a state

plan for the prompt and efficient delivery of adequate emergency

medical services to acutely sick or injured persons.

(b) The state plan must include an emergency radio communication

plan to be used by local governments and districts that provide

emergency medical services to develop an emergency radio

communication network linking emergency medical services

providers with local hospitals or trauma centers.

under Subsection (a), and the board shall review the council's

recommendations.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1995, 74th Leg., ch. 488, Sec. 1, eff. June 12,

1995.

Sec. 773.022. SERVICE DELIVERY AREAS. The bureau shall divide

the state into emergency medical services delivery areas that

coincide, to the extent possible, with other regional planning

areas.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.023. AREA PLANS. (a) The bureau shall:

(1) identify all public or private agencies and institutions

that are used or may be used for emergency medical services in

each delivery area; and

(2) enlist the cooperation of all concerned agencies and

institutions in developing a well-coordinated plan for delivering

emergency medical services in each delivery area.

(b) A delivery area plan must include an interagency

communications network that facilitates prompt and coordinated

response to medical emergencies by the Department of Public

Safety, local police departments, ambulance personnel, medical

facilities, and other concerned agencies and institutions.

may be available from the Department of Public Safety, the

National Guard, or the United States Armed Forces.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.024. FEDERAL PROGRAMS. The bureau is the state agency

designated to develop state plans required for participation in

federal programs involving emergency medical services. The bureau

may receive and disburse available federal funds to implement the

service programs.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.025. ACCESSIBILITY OF TRAINING. (a) The bureau shall

identify all individuals and public or private agencies and

institutions that are or may be engaged in emergency medical

services training in each delivery area.

(b) A delivery area plan must include provisions for encouraging

emergency medical services training so as to reduce the cost of

training to emergency medical services providers and to make

training more accessible to low population or remote areas.

emergency medical services provider may request the bureau to

provide emergency medical services training for emergency care

attendants at times and places that are convenient for the

provider's personnel, if the training is not available locally.

(d) A governmental entity or nongovernmental organization that

sponsors or wishes to sponsor an emergency medical services

provider or first responder organization in a rural or

underserved area may request the bureau to provide or facilitate

the provision of initial training for emergency care attendants,

if the training is not available locally. The bureau shall ensure

that the training is provided. The bureau shall provide the

training without charge, or contract with qualified instructors

to provide the training without charge, to students who agree to

perform emergency care attendant services for at least one year

with the local emergency medical services provider or first

responder organization. The training must be provided at times

and places that are convenient to the students. The bureau shall

require that at least three students are scheduled to take any

class offered under this subsection.

(e) To facilitate all levels of emergency medical services

training, the bureau shall consult with and solicit comment from

emergency medical services providers, first responder

organizations, persons who provide emergency medical services

training, and other entities interested in emergency medical

services training programs.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 2001, 77th Leg., ch. 874, Sec. 5, eff. Sept. 1,

2001.

SUBCHAPTER C. LICENSES, CERTIFICATION, AND QUALIFICATIONS

Sec. 773.041. LICENSE OR CERTIFICATE REQUIRED. (a) A person

may not operate, conduct, or maintain an emergency medical

service, advertise that the person is an emergency medical

services provider, or otherwise engage in or profess to be

engaged in the provision of emergency medical services unless the

person holds a license as an emergency medical services provider

issued by the department in accordance with this chapter.

(a-1) A person may not transport a patient by stretcher in a

vehicle unless the person holds a license as an emergency medical

services provider issued by the department in accordance with

this chapter. For purposes of this subsection, "person" means an

individual, corporation, organization, government, governmental

subdivision or agency, business, trust, partnership, association,

or any other legal entity.

(b) A person may not practice as any type of emergency medical

services personnel unless the person is certified under this

chapter and rules adopted under this chapter.

transferable.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 244, eff. Sept. 1,

1991.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

268, Sec. 14(b), eff. September 1, 2007.

Sec. 773.0415. LIMITATION ON INFORMATION REQUIRED FOR

CERTIFICATE RENEWAL. The requirements and procedures adopted by

the department for the renewal of a certificate to practice as

emergency medical services personnel issued under this chapter:

(1) may not require an applicant to provide unchanged criminal

history information already included in one or more of the

applicant's previous applications for certification or for

certificate renewal filed with the department; and

(2) may require the applicant to provide only information

relevant to the period occurring since the date of the

applicant's last application for certification or for certificate

renewal, as applicable, including information relevant to any new

requirement applicable to the certificate held by the applicant.

Added by Acts 2009, 81st Leg., R.S., Ch.

332, Sec. 1, eff. September 1, 2009.

Sec. 773.042. BASIC LIFE-SUPPORT EMERGENCY MEDICAL SERVICES

PROVIDER QUALIFICATIONS. A provider qualifies as a basic

life-support emergency medical services provider if it provides a

vehicle that is designed for transporting the sick or injured,

has personnel and sufficient equipment and supplies for providing

basic life support, and is capable of providing emergency and

nonemergency transportation.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1995, 74th Leg., ch. 915, Sec. 3, eff. Aug. 28,

1995.

Amended by:

Acts 2005, 79th Leg., Ch.

305, Sec. 2, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch.

1034, Sec. 5, eff. September 1, 2005.

Sec. 773.043. ADVANCED LIFE-SUPPORT EMERGENCY MEDICAL SERVICES

PROVIDER QUALIFICATIONS. A provider qualifies as an advanced

life-support emergency medical services provider if it:

(1) meets the requirements of a basic life-support emergency

medical services provider; and

(2) has personnel and sufficient equipment and supplies for

providing intravenous therapy and endotracheal or esophageal

intubation.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1995, 74th Leg., ch. 915, Sec. 4, eff. Aug. 28,

1995.

Sec. 773.044. MOBILE INTENSIVE-CARE PROVIDER QUALIFICATIONS. A

provider qualifies as a mobile intensive-care provider if it:

(1) meets the requirements of an advanced life-support emergency

medical services provider; and

(2) has personnel and sufficient equipment and supplies to

provide cardiac monitoring, defibrillation, cardioversion, drug

therapy, and two-way radio communication.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1995, 74th Leg., ch. 915, Sec. 5, eff. Aug. 28,

1995.

Sec. 773.045. SPECIALIZED EMERGENCY MEDICAL SERVICES PROVIDER

QUALIFICATIONS. (a) A provider using a vehicle, including a

helicopter, boat, fixed-wing aircraft, or ground vehicle,

qualifies as a specialized emergency medical services provider

if:

(1) the vehicle is designed for transporting the sick or injured

by air, water, or ground transportation; and

(2) the provider has personnel and sufficient equipment and

supplies to provide for the specialized needs of the patient

transported.

(b) A rotor or fixed-wing aircraft and staff based in this state

and used to transport a patient by stretcher and that holds

itself out as an air ambulance service is required to be licensed

by the department.

transports patients from a point in this state is required to be

licensed by the department as an emergency medical services

provider. The department shall issue a license to an air

ambulance company under this subsection if the company applies as

required by this chapter and has met the department's

qualifications for safely transporting patients. An air ambulance

company accredited by the Committee on Air Ambulance Medical

Services is rebuttably presumed to have met the department's

qualifications.

(d) An air ambulance company licensed under Subsection (c) must

include information regarding the physical location of the

company's base operations in any advertising by the company in

this state. This subsection does not prohibit an air ambulance

company with multiple locations from listing those locations in

advertising, provided that the air ambulance company meets all

the provisions of this chapter.

(e) An air ambulance company that is not located in this state

and that advertises within this state must have at least one

physical location in this state.

(f) This section does not require an air transportation provider

to be licensed if, in addition to the company's normal air

transportation service, the air transportation company provides

only voluntary, mercy-flight transportation at the company's own

expense.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 245, eff. Sept. 1,

1991; Acts 1993, 73rd Leg., ch. 376, Sec. 2, eff. Sept. 1, 1993;

Acts 1995, 74th Leg., ch. 915, Sec. 6, eff. Aug. 28, 1995; Acts

1997, 75th Leg., ch. 1182, Sec. 1, eff. Sept. 1, 1997.

Sec. 773.046. EMERGENCY CARE ATTENDANT QUALIFICATIONS. (a) An

individual qualifies as an emergency care attendant if the

individual is certified by the department as minimally proficient

to provide emergency prehospital care by providing initial aid

that promotes comfort and avoids aggravation of an injury or

illness.

(b) The department may not require an individual to have a high

school diploma or a high school equivalency certificate for

certification as an emergency care attendant under this chapter

if the individual certifies that the individual will serve only

as an emergency care attendant volunteer during the certification

period.

section.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 246, eff. Sept. 1,

1991; Acts 2003, 78th Leg., ch. 1035, Sec. 1, eff. Sept. 1, 2003.

Sec. 773.047. EMERGENCY MEDICAL TECHNICIAN QUALIFICATIONS. An

individual qualifies as an emergency medical technician if the

individual is certified by the department as minimally proficient

to perform emergency prehospital care that is necessary for basic

life support and that includes cardiopulmonary resuscitation and

the control of hemorrhaging.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 247, eff. Sept. 1,

1991.

Sec. 773.048. EMERGENCY MEDICAL TECHNICIAN--INTERMEDIATE

QUALIFICATIONS. An individual qualifies as an emergency medical

technician-intermediate if the individual is certified by the

department as minimally proficient to provide emergency

prehospital care by initiating under medical supervision certain

procedures, including intravenous therapy and endotracheal or

esophageal intubation.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 248, eff. Sept. 1,

1991.

Sec. 773.049. EMERGENCY MEDICAL TECHNICIAN--PARAMEDIC

QUALIFICATIONS. An individual qualifies as an emergency medical

technician-paramedic if the individual is certified by the

department as minimally proficient to provide advanced life

support that includes initiation under medical supervision of

certain procedures, including intravenous therapy, endotracheal

or esophageal intubation, electrical cardiac defibrillation or

cardioversion, and drug therapy.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 249, eff. Sept. 1,

1991.

Sec. 773.0495. LICENSED PARAMEDIC QUALIFICATIONS. An individual

qualifies as a licensed paramedic if the department determines

that the individual is minimally proficient to provide advanced

life support that includes initiation under medical supervision

of certain procedures, including intravenous therapy,

endotracheal or esophageal intubation, electrical cardiac

defibrillation or cardioversion, and drug therapy. In addition, a

licensed paramedic must complete a curriculum that includes

college-level course work in accordance with rules adopted by the

board.

Added by Acts 1997, 75th Leg., ch. 435, Sec. 2, eff. Sept. 1,

1997.

Sec. 773.050. MINIMUM STANDARDS. (a) Each basic life-support

emergency medical services vehicle when in service must be

staffed by at least two individuals certified as emergency care

attendants or certified at a higher level of training.

(b) The executive commissioner by rule shall establish minimum

standards for:

(1) staffing an advanced life-support emergency medical services

vehicle, a mobile intensive-care unit, or a specialized emergency

medical services vehicle;

(2) emergency medical services personnel certification and

performance, including provisional certification, certification,

decertification, recertification, suspension, emergency

suspension, and probation;

(3) the approval of courses and training programs, the

certification of program instructors, examiners, and course

coordinators for emergency medical services personnel training,

and the revocation and probation of an approval or certification;

(4) examinations of emergency medical services personnel;

(5) medical supervision of basic and advanced life-support

systems;

(6) granting, suspending, and revoking a license for emergency

medical services providers; and

(7) emergency medical services vehicles.

training, criminal background, and experience of allied health

professionals in adopting the minimum standards for emergency

medical services personnel certification and may establish

criteria for interstate reciprocity of emergency medical services

personnel. Each out-of-state application for certification must

be accompanied by a nonrefundable fee of not more than $120. The

executive commissioner may also establish criteria for

out-of-country emergency medical services personnel

certification. Each out-of-country application for certification

must be accompanied by a nonrefundable fee of not more than $180.

(d) The executive commissioner may not adopt a rule that

requires any system, service, or agency to provide advanced

life-support or staffing beyond basic life-support levels except

for providers of:

(1) advanced life-support emergency medical services;

(2) mobile intensive care; or

(3) specialized emergency medical services.

(e) The executive commissioner shall adopt minimum standards for

recognition of first responder organizations.

(f) The executive commissioner shall recognize, prepare, or

administer continuing education programs for certified personnel.

A certificate holder must participate in the programs to the

extent required by the executive commissioner to remain

certified.

(g) Rules adopting minimum standards under this section shall

require:

(1) an emergency medical services vehicle to be equipped with an

epinephrine auto-injector device or similar device to treat

anaphylaxis; and

(2) emergency medical services personnel to complete continuing

education training in the administration of anaphylaxis

treatment.

(h) The department may provide a prescreening criminal history

record check for an emergency medical services personnel

applicant to determine the applicant's eligibility to receive

certification before enrollment in the educational and training

requirements mandated by the executive commissioner. The

department may charge a reasonable fee for the costs associated

with prescreening to each applicant who requests prescreening.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 250, eff. Sept. 1,

1991; Acts 1991, 72nd Leg., ch. 605, Sec. 3, eff. Sept. 1, 1991;

Acts 1993, 73rd Leg., ch. 251, Sec. 1, eff. May 23, 1993; Acts

1995, 74th Leg., ch. 915, Sec. 7, eff. Aug. 28, 1995; Acts 1999,

76th Leg., ch. 1411, Sec. 19.02, eff. Sept. 1, 1999; Acts 2003,

78th Leg., ch. 198, Sec. 2.84(a), eff. Sept. 1, 2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

1079, Sec. 2, eff. June 15, 2007.

Acts 2009, 81st Leg., R.S., Ch.

1149, Sec. 2, eff. September 1, 2009.

Sec. 773.0505. RULES REGARDING ADVERTISING OR COMPETITIVE

BIDDING. (a) The board may not adopt rules restricting

advertising or competitive bidding by a license or certificate

holder except to prohibit false, misleading, or deceptive

practices.

(b) In its rules to prohibit false, misleading, or deceptive

practices, the board may not include a rule that:

(1) restricts the use of any medium for advertising;

(2) restricts the use of a license or certificate holder's

personal appearance or voice in an advertisement;

(3) relates to the size or duration of an advertisement by the

license or certificate holder; or

(4) restricts the license or certificate holder's advertisement

under a trade name.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.03, eff. Sept.

1, 1999.

Sec. 773.051. MUNICIPAL REGULATION. A municipality may

establish standards for an emergency medical services provider

that are stricter than the minimum standards of this chapter and

department rules adopted under this chapter.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1995, 74th Leg., ch. 915, Sec. 8, eff. Aug. 28,

1995.

Sec. 773.052. VARIANCES. (a) An emergency medical services

provider with a specific hardship may apply to the bureau chief

for a variance from a rule adopted under this chapter. The board

may adopt a fee of not more than $30 for filing an application

for a variance.

(b) On receipt of a request for a variance, the department shall

consider any relevant factors, including:

(1) the nearest available service;

(2) geography; and

(3) demography.

service area a variance from the minimum standards for staffing

and equipment for the provision of basic life-support emergency

medical services if the provider is an emergency medical services

provider exempt from the payment of fees under Section 773.0581.

(d) An applicant for a variance under Subsection (c) must submit

a letter to the department from the commissioners court of the

county or the governing body of the municipality in which the

provider intends to operate an emergency medical services

vehicle. The letter must state that there is no other emergency

medical services provider in the service area.

(e) The department shall grant a variance under Subsection (c)

if the department determines that the provider qualifies and may

deny the variance if the department determines that the provider

does not qualify. The department shall give a provider whose

application is denied the opportunity for a contested case

hearing under Chapter 2001, Government Code.

(f) The department shall issue an emergency medical services

license to a provider granted a variance under this section. The

license is subject to annual review by the department. A provider

is encouraged to upgrade staffing and equipment to meet the

minimum standards set by the rules adopted under this chapter.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 251, eff. Sept. 1,

1991; Acts 1991, 72nd Leg., ch. 605, Sec. 4, eff. Sept. 1, 1991;

Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995;

Acts 2003, 78th Leg., ch. 198, Sec. 2.84(b), eff. Sept. 1, 2003.

Sec. 773.054. APPLICATIONS FOR PERSONNEL CERTIFICATION AND

TRAINING PROGRAM APPROVAL. (a) This section applies to an

application for:

(1) examination for certification of emergency medical services

personnel;

(2) approval of a course or training program; or

(3) certification of a program instructor, examiner, or course

coordinator.

(b) Each application must be made to the department on a form

prescribed by the board and under rules adopted by the board.

by a nonrefundable fee of not more than $30 for a program

instructor or examiner or $60 for a course coordinator. The

department may not require a fee for a certification from an

instructor, examiner, or coordinator who does not receive

compensation for providing services.

(d) Each application under Subsection (a)(2) must be accompanied

by a nonrefundable fee of not more than $30 for a basic course or

training program or $60 for an advanced course or training

program. The department may not require a fee for approval of a

course or training program if the course coordinator or

sponsoring agency does not receive compensation for providing the

course or training program.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 253, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 915, Sec. 9, eff. Aug. 28, 1995;

Acts 2003, 78th Leg., ch. 198, Sec. 2.84(c), eff. Sept. 1, 2003.

Sec. 773.055. CERTIFICATION OF EMERGENCY MEDICAL SERVICES

PERSONNEL. (a) A nonrefundable fee must accompany each

application for emergency medical services personnel

certification. The fee may not exceed:

(1) $90 for an emergency medical technician-paramedic or

emergency medical technician-intermediate;

(2) $60 for an emergency medical technician or emergency care

attendant;

(3) $90 for recertification of an emergency medical

technician-paramedic or emergency medical

technician-intermediate;

(4) $60 for recertification of an emergency medical technician

or emergency care attendant; or

(5) $120 for certification or recertification of a licensed

paramedic.

(b) Except as provided by Subsection (c), the department shall

notify each examinee of the results of an examination for

certification not later than the 30th day after the date on which

the examination is administered.

examination not later than the 14th day after the date on which

the department receives the results if the examination is graded

or reviewed by a national testing service. If the notice of the

examination results will be delayed longer than 90 days after the

examination date, the department shall notify each examinee of

the reason for the delay before the 90th day.

(d) The department shall furnish a person who fails an

examination for certification with an analysis of the person's

performance on the examination if requested in writing by that

person. The board may adopt rules to allow a person who fails the

examination to retake all or part of the examination. A fee of

not more than $30 must accompany each application for

reexamination.

(e) The department shall issue certificates to emergency medical

services personnel who meet the minimum standards for personnel

certification adopted under Section 773.050. A certificate is

valid for four years from the date of issuance. The department

shall charge a fee of not more than $10 to replace a lost

certificate.

(f) A fee required by this section is the obligation of the

applicant but may be paid by the emergency medical services

provider. If an applicant is required to be certified as a

condition of employment, the emergency medical services provider

shall pay for all fees required by this section, except for a fee

to replace a lost certificate, in addition to any other

compensation paid to that applicant if the provider is a

municipality. A municipality that requires a fire fighter to be

certified as emergency medical services personnel shall pay the

fees required by this section.

(g) The board by rule may adopt a system under which

certificates expire on various dates during the year. For the

year in which the certificate expiration date is changed, the

department shall prorate certificate fees on a monthly basis so

that each certificate holder pays only that portion of the

certificate fee that is allocable to the number of months during

which the certificate is valid. On renewal of the certificate on

the new expiration date, the total certificate renewal fee is

payable.

(h) The department shall ensure that the written examinations

and any other tests that the department requires a person to take

and pass to obtain or retain certification as emergency medical

services personnel shall be administered during the course of a

year at various locations around the state so that a person who

resides in any part of the state will be able to take the

examinations or tests without having to travel a distance that as

a practical matter requires either travel by air or an overnight

stay.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 254, eff. Sept. 1,

1991; Acts 1993, 73rd Leg., ch. 251, Sec. 2, eff. May 23, 1993;

Acts 1995, 74th Leg., ch. 915, Sec. 10, eff. Aug. 28, 1995; Acts

1997, 75th Leg., ch. 435, Sec. 3, eff. Sept. 1, 1997; Acts 1999,

76th Leg., ch. 1411, Sec. 19.04, eff. Sept. 1, 1999; Acts 2003,

78th Leg., ch. 198, Sec. 2.84(d), eff. Sept. 1, 2003.

Sec. 773.056. APPROVAL OF TRAINING PROGRAMS; CERTIFICATION OF

INSTRUCTORS, EXAMINERS, AND COORDINATORS. (a) The department

shall approve each course or training program that meets the

minimum standards adopted under Section 773.050.

(b) The department shall issue a certificate to each program

instructor, examiner, or course coordinator who meets the minimum

standards adopted under Section 773.050. The certificate is valid

for two years. The department shall charge a fee of not more than

$10 to replace a lost or stolen certificate.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 255, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 915, Sec. 11, eff. Aug. 28, 1995;

Acts 2003, 78th Leg., ch. 198, Sec. 2.84(e), eff. Sept. 1, 2003.

Sec. 773.057. EMERGENCY MEDICAL SERVICES PROVIDERS LICENSE. (a)

An emergency medical services provider must submit an

application for a license in accordance with procedures

prescribed by the board.

(b) A nonrefundable application and vehicle fee determined by

the board must accompany each application. The application fee

may not exceed $500 for each application and the vehicle fee may

not exceed $180 for each emergency medical services vehicle

operated by the provider.

commissioners court of a county or the governing body of a

municipality. The delegation must be made:

(1) at the request of the commissioners court or governing body;

and

(2) in accordance with criteria and procedures adopted by the

board.

(d) The commissioners court of a county or governing body of a

municipality that conducts inspections under Subsection (c) shall

collect and retain the fee for vehicles it inspects.

(e) In addition to any other qualifications that an emergency

medical services provider must possess to obtain the type of

license sought, all emergency medical services providers must

possess the qualifications required for a basic emergency medical

services provider under Section 773.042.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 256, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 915, Sec. 12, eff. Aug. 28, 1995;

Acts 2003, 78th Leg., ch. 198, Sec. 2.84(f), eff. Sept. 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

305, Sec. 3, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch.

1034, Sec. 6, eff. September 1, 2005.

Sec. 773.0571. REQUIREMENTS FOR PROVIDER LICENSE. The

department shall issue to an emergency medical services provider

a license that is valid for two years if the department is

satisfied that:

(1) the emergency medical services provider has adequate staff

to meet the staffing standards prescribed by this chapter and the

rules adopted under this chapter;

(2) each emergency medical services vehicle is adequately

constructed, equipped, maintained, and operated to render basic

or advanced life support services safely and efficiently;

(3) the emergency medical services provider offers safe and

efficient services for emergency prehospital care and

transportation of patients; and

(4) the emergency medical services provider complies with the

rules adopted by the board under this chapter.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 257, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 915, Sec. 13, eff.

Aug. 28, 1995.

Sec. 773.0572. PROVISIONAL LICENSES. The board by rule shall

establish conditions under which an emergency medical services

provider who fails to meet the minimum standards prescribed by

this chapter may be issued a provisional license. The department

may issue a provisional license to an emergency medical services

provider under this chapter if the department finds that issuing

the license would serve the public interest and that the provider

meets the requirements of the rules adopted under this section. A

nonrefundable fee of not more than $30 must accompany each

application for a provisional license.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 258, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 915, Sec. 14, eff.

Aug. 28, 1995; Acts 2003, 78th Leg., ch. 198, Sec. 2.84(g), eff.

Sept. 1, 2003.

Sec. 773.058. VOLUNTEERS EXEMPT FROM FEES. An individual who is

an emergency medical services volunteer is exempt from the

payment of fees under Section 773.055 if the individual does not

receive compensation for providing emergency medical services. If

an individual accepts compensation during the certification

period, the individual shall pay to the department a prorated

application fee for the duration of the certification period. In

this section, "compensation" does not include reimbursement for

actual expenses for medical supplies, gasoline, clothing, meals,

and insurance incurred in providing emergency medical services.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 259, eff. Sept. 1,

1991; Acts 1991, 72nd Leg., ch. 605, Sec. 5, eff. Sept. 1, 1991.

Sec. 773.0581. PROVIDERS EXEMPT FROM FEES. (a) An emergency

medical services provider is exempt from the payment of fees

under this subchapter if the provider uses emergency medical

services volunteers exclusively to provide emergency prehospital

care. However, an emergency medical services provider is not

disqualified from the exemption if the provider compensates

physicians who provide medical supervision and not more than five

full-time staff or their equivalent.

(b) This chapter does not prohibit an emergency medical services

provider who uses volunteer emergency medical services personnel

but has more than five paid staff from using the word "volunteer"

in advertising if the organization is composed of at least 75

percent volunteer personnel.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 260, eff. Sept. 1,

1991.

Sec. 773.059. LATE RECERTIFICATION. (a) A person who is

otherwise eligible to renew a certificate may renew an unexpired

certificate by paying the required renewal fee to the department

before the expiration date of the certificate. A person whose

certificate has expired may not engage in activities that require

certification until the certificate has been renewed.

(b) A person whose certificate has been expired for 90 days or

less may renew the certificate by paying to the department a

renewal fee that is equal to 1-1/2 times the normally required

renewal fee.

days but less than one year may renew the certificate by paying

to the department a renewal fee that is equal to two times the

normally required renewal fee.

(d) A person whose certificate has been expired for one year or

more may not renew the certificate. The person may become

certified by complying with the requirements and procedures,

including the examination requirements, for an original

certification.

(e) A person who was certified in this state, moved to another

state, and is currently certified or licensed and has been in

practice in the other state for the two years preceding the date

of application may become certified without reexamination. The

person must pay to the department a fee that is equal to two

times the normally required renewal fee for certification.

(f) Not later than the 30th day before the date a person's

certificate is scheduled to expire, the department shall send

written notice of the impending expiration to the person at the

person's last known address according to the records of the

department.

(g) A person certified by the department who is deployed in

support of military, security, or other action by the United

Nations Security Council, a national emergency declared by the

president of the United States, or a declaration of war by the

United States Congress is eligible for recertification under

Section 773.050 on the person's demobilization for one calendar

year after the date of demobilization.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 261, eff. Sept. 1,

1991; Acts 1991, 72nd Leg., ch. 605, Sec. 6, eff. Sept. 1, 1991;

Acts 1993, 73rd Leg., ch. 251, Sec. 3, eff. May 23, 1993; Acts

1999, 76th Leg., ch. 1411, Sec. 19.05, eff. Sept. 1, 1999.

Sec. 773.060. DISPOSITION OF FUNDS. (a) The department shall

account for all fees and other funds it receives under this

chapter.

(b) The department shall deposit the fees and other funds in the

state treasury to the credit of the bureau of emergency

management fund. The fund may be used only to administer this

chapter.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.061. DISCIPLINARY ACTIONS. (a) For a violation of

this chapter or a rule adopted under this chapter, the department

shall revoke, suspend, or refuse to renew a license or

certificate of or shall reprimand:

(1) emergency medical services personnel;

(2) a program instructor, examiner, or course coordinator; and

(3) an emergency medical services provider license holder.

(b) For a violation of this chapter or a rule adopted under this

chapter, the department shall revoke, suspend, or refuse to renew

approval of a course or training program.

chapter, the department may place on emergency suspension

emergency medical services personnel.

(d) The department may place on probation a course or training

program or a person, including emergency medical services

personnel, an emergency medical services provider license holder,

or a program instructor, examiner, or course coordinator, whose

certificate, license, or approval is suspended. If a suspension

is probated, the department may require the person or the sponsor

of a course or training program, as applicable:

(1) to report regularly to the department on matters that are

the basis of the probation;

(2) to limit practice to the areas prescribed by the board; or

(3) to continue or review professional education until the

person attains a degree of skill satisfactory to the department

in those areas that are the basis of the probation.

(e) Except as provided by Section 773.062, the procedures by

which the department takes action under this section and the

procedures by which that action is appealed are governed by the

procedures for a contested case hearing under Chapter 2001,

Government Code.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 262, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1,

1995; Acts 1999, 76th Leg., ch. 1411, Sec. 19.06, eff. Sept. 1,

1999.

Sec. 773.0611. INSPECTIONS. (a) The department or its

representative may enter an emergency medical services vehicle or

the premises of an emergency medical services provider's place of

business at reasonable times to ensure compliance with this

chapter and the rules adopted under this chapter.

(b) The department or its representative may conduct an

unannounced inspection of a vehicle or a place of business if the

department has reasonable cause to believe that a person is in

violation of this chapter or a rule adopted under this chapter.

authorized under this section. The department or its

representative shall perform unannounced inspections in

accordance with those rules. An emergency medical services

provider shall pay to the department a nonrefundable fee of not

more than $30 if reinspection is necessary to determine

compliance with this chapter and the rules adopted under this

chapter.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 263, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 915, Sec. 15, eff.

Aug. 28, 1995; Acts 2003, 78th Leg., ch. 198, Sec. 2.84(h), eff.

Sept. 1, 2003.

Sec. 773.0612. ACCESS TO RECORDS. (a) The department or its

representative is entitled to access to records and other

documents maintained by a person that are directly related to

patient care or to emergency medical services personnel to the

extent necessary to enforce this chapter and the rules adopted

under this chapter. A person who holds a license or certification

or an applicant for a certification or license is considered to

have given consent to a representative of the department entering

and inspecting a vehicle or place of business in accordance with

this chapter.

(b) A report, record, or working paper used or developed in an

investigation under this section is confidential and may be used

only for purposes consistent with the rules adopted by the board.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 264, eff. Sept. 1,

1991.

Sec. 773.0613. INFORMATION REPORT TO DEPARTMENT. (a) An

emergency medical services provider licensed under this chapter

shall annually submit a report to the department containing

information relating to the number and types of runs the

emergency medical services provider makes.

(b) The department shall adopt rules relating to the type of

information an emergency medical services provider must provide

under this section and the manner in which the information must

be provided.

receives under Subsection (a) in summary form on the department's

Internet website. The department may not post any health

information that is made confidential by another statute.

Added by Acts 2003, 78th Leg., ch. 871, Sec. 1, eff. Sept. 1,

2003.

Sec. 773.0614. AUTHORITY TO REVOKE, SUSPEND, DISQUALIFY FOR, OR

DENY CERTIFICATION OF EMERGENCY MEDICAL SERVICES PERSONNEL FOR

CERTAIN CRIMINAL OFFENSES. (a) In addition to the grounds under

Section 773.061, the commissioner may suspend or revoke a

certificate, disqualify a person from receiving a certificate, or

deny a person the opportunity to take a certification examination

on the grounds that the person has been convicted of, or placed

on deferred adjudication community supervision or deferred

disposition for, an offense that directly relates to the duties

and responsibilities of emergency medical services personnel.

(b) For purposes of Subsection (a), the department may not

consider offenses for which points are assessed under Section

708.052, Transportation Code.

certificate holder is convicted of or placed on deferred

adjudication community supervision or deferred disposition for:

(1) an offense listed in Sections 3g(a)(1)(A) through (H),

Article 42.12, Code of Criminal Procedure; or

(2) an offense, other than an offense described by Subdivision

(1), committed on or after September 1, 2009, for which the

person is subject to registration under Chapter 62, Code of

Criminal Procedure.

Added by Acts 2009, 81st Leg., R.S., Ch.

1149, Sec. 3, eff. September 1, 2009.

Sec. 773.0615. FACTORS CONSIDERED IN SUSPENSION, REVOCATION, OR

DENIAL OF CERTIFICATE. (a) In determining whether an offense

directly relates to the duties and responsibilities of emergency

medical services personnel under Section 773.0614(a), the

commissioner shall consider:

(1) the nature and seriousness of the crime;

(2) the relationship of the crime to the purposes for requiring

certification to engage in emergency medical services;

(3) the extent to which certification might offer an opportunity

to engage in further criminal activity of the same type as that

in which the person previously had been involved; and

(4) the relationship of the crime to the ability, capacity, or

fitness required to perform the duties and discharge the

responsibilities of emergency medical services personnel.

(b) In determining the fitness to perform the duties and

discharge the responsibilities of emergency medical services

personnel for a person who has been convicted of, or placed on

deferred adjudication community supervision or deferred

disposition for, a crime the commissioner shall consider, in

addition to the factors listed in Subsection (a):

(1) the extent and nature of the person's past criminal

activity;

(2) the age of the person when the crime was committed;

(3) the amount of time that has elapsed since the person's last

criminal activity;

(4) the conduct and work activity of the person before and after

the criminal activity;

(5) evidence of the person's rehabilitation or rehabilitative

effort while incarcerated, after release, or since imposition of

community supervision or deferred adjudication; and

(6) other evidence of the person's fitness, including letters of

recommendation from:

(A) prosecutors, law enforcement officers, correctional

officers, or community supervision officers who prosecuted,

arrested, or had custodial or other responsibility for the

person;

(B) the sheriff or chief of police in the community where the

person resides; and

to the extent possible, to obtain and provide to the commissioner

the recommendations of the persons required by Subsection (b)(6).

(d) In addition to providing evidence related to the factors

under Subsection (b), the applicant or certificate holder shall

furnish proof in the form required by the department that the

applicant or certificate holder has:

(1) maintained a record of steady employment;

(2) supported the applicant's or certificate holder's

dependents;

(3) maintained a record of good conduct; and

(4) paid all outstanding court costs, supervision fees, fines,

and restitution ordered in any criminal case in which the

applicant or certificate holder has been convicted, been placed

on community supervision, or received deferred adjudication.

Added by Acts 2009, 81st Leg., R.S., Ch.

1149, Sec. 3, eff. September 1, 2009.

Sec. 773.0616. PROCEEDINGS GOVERNED BY ADMINISTRATIVE PROCEDURE

ACT; GUIDELINES. (a) A proceeding before the commissioner to

consider the issues under Section 773.0615 is governed by Chapter

2001, Government Code.

(b) The executive commissioner shall issue guidelines relating

to the commissioner's decision-making under Sections 773.0614 and

773.0615. The guidelines must state the reasons a particular

crime is considered to relate to emergency medical services

personnel and include any other criterion that may affect the

decisions of the commissioner.

the secretary of state for publication in the Texas Register.

(d) The department annually shall issue any amendments to the

guidelines.

Added by Acts 2009, 81st Leg., R.S., Ch.

1149, Sec. 3, eff. September 1, 2009.

Sec. 773.0617. NOTICE AND REVIEW OF SUSPENSION, REVOCATION,

DISQUALIFICATION FOR, OR DENIAL OF CERTIFICATION. (a) If the

commissioner suspends or revokes a certification, denies a person

a certificate, or denies the opportunity to be examined for a

certificate under Section 773.0614, the commissioner shall notify

the person in writing of:

(1) the reason for the suspension, revocation, denial, or

disqualification;

(2) the review procedure provided by Subsection (b); and

(3) the earliest date the person may appeal the action of the

commissioner.

(b) A person whose certificate has been suspended or revoked or

who has been denied a certificate or the opportunity to take an

examination and who has exhausted the person's administrative

appeals may file an action in the district court in Travis County

for review of the evidence presented to the commissioner and the

decision of the commissioner.

filed not later than the 30th day after the date the

commissioner's decision is final.

Added by Acts 2009, 81st Leg., R.S., Ch.

1149, Sec. 3, eff. September 1, 2009.

Sec. 773.062. EMERGENCY SUSPENSION. (a) The bureau chief shall

issue an emergency order to suspend a certificate or license

issued under this chapter if the bureau chief has reasonable

cause to believe that the conduct of any certificate or license

holder creates an imminent danger to the public health or safety.

(b) An emergency suspension is effective immediately without a

hearing on notice to the certificate or license holder. Notice

must also be given to the sponsoring governmental entity if the

holder is a provider exempt from payment of fees under Section

773.0581.

suspension. The department shall conduct the hearing not earlier

than the 10th day or later than the 30th day after the date on

which the request is received and may continue, modify, or

rescind the suspension. The department hearing rules and Chapter

2001, Government Code govern the hearing and any appeal from a

disciplinary action related to the hearing.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 265, eff. Sept. 1,

1991; Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1,

1995.

Sec. 773.063. CIVIL PENALTY. (a) The attorney general, a

district attorney, or a county attorney may bring a civil action

to compel compliance with this chapter or to enforce a rule

adopted under this chapter.

(b) A person who violates this chapter or a rule adopted under

this chapter is liable for a civil penalty in addition to any

injunctive relief or other remedy provided by law. The civil

penalty may not exceed $250 a day for each violation.

the department's request shall be deposited in the state treasury

to the credit of the general revenue fund.

(d) Civil penalties recovered in a suit brought by a local

government shall be paid to the local government that brought the

suit. A municipality or county is encouraged to use the amount of

recovered penalties that exceed the cost of bringing suit to

improve the delivery of emergency medical services in the

municipality or county.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 773.064. CRIMINAL PENALTIES. (a) A person commits an

offense if the person knowingly practices as, attempts to

practice as, or represents himself to be an emergency medical

technician-paramedic, emergency medical technician-intermediate,

emergency medical technician, emergency care attendant, or

licensed paramedic and the person does not hold an appropriate

certificate issued by the department under this chapter. An

offense under this subsection is a Class A misdemeanor.

(b) An emergency medical services provider commits an offense if

the provider knowingly advertises or causes the advertisement of

a false, misleading, or deceptive statement or representation

concerning emergency medical services staffing, equipment, and

vehicles. An offense under this subsection is a Class A

misdemeanor.

permits to be used a vehicle that the person owns, operates, or

controls to transport a sick or injured person unless the person

is licensed as an emergency medical services provider by the

department. An offense under this subsection is a Class A

misdemeanor.

(d) It is an exception to the application of Subsection (c) that

the person transports a sick or injured person:

(1) to medical care as an individual citizen not ordinarily

engaged in that activity;

(2) in a casualty situation that exceeds the basic vehicular

capacity or capability of an emergency medical services provider;

(3) as an emergency medical services provider in a vehicle for

which a variance has been granted under Section 773.052.

(e) Venue for prosecution of an offense under this section is in

the county in which the offense is alleged to have occurred.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 266, eff. Sept. 1,

1991; Acts 1997, 75th Leg., ch. 435, Sec. 4, eff. Sept. 1, 1997.

Sec. 773.065. ADMINISTRATIVE PENALTY. (a) The commissioner may

assess an administrative penalty against an emergency medical

services provider or a course coordinator who violates this

chapter or a rule adopted or an order issued under this chapter.

(b) In determining the amount of the penalty, the commissioner

shall consider:

(1) the emergency medical services provider's or course

coordinator's previous violations;

(2) the seriousness of the violation;

(3) any hazard to the health and safety of the public;

(4) the emergency medical services provider's or course

coordinator's demonstrated good faith; and

(5) any other matter as justice may require.

board by rule shall establish gradations of penalties in

accordance with the relative seriousness of the violation.

(d) Each day a violation continues may be considered a separate

violation.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 7, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 915, Sec. 16, eff.

Aug. 28, 1995; Acts 1997, 75th Leg., ch. 435, Sec. 5, eff. Sept.

1, 1997; Acts 2003, 78th Leg., ch. 198, Sec. 2.84(i), eff. Sept.

1, 2003.

Sec. 773.066. ASSESSMENT OF ADMINISTRATIVE PENALTY. (a) An

administrative penalty may be assessed only after an emergency

medical services provider or course coordinator charged with a

violation is provided notice and given an opportunity to request

a hearing.

(b) If a hearing is held, the commissioner shall make findings

of fact and shall issue a written decision regarding whether the

emergency medical services provider or course coordinator

committed a violation and the amount of any penalty to be

assessed.

coordinator charged with the violation does not request a

hearing, the commissioner shall determine whether the provider or

course coordinator committed a violation and the amount of any

penalty to be assessed.

(d) After making a determination under Subsection (b) or (c)

that a penalty is to be assessed against an emergency medical

services provider or a course coordinator, the commissioner shall

issue an order requiring that the emergency medical services

provider or course coordinator pay the penalty.

(e) Not later than the 30th day after the date an order is

issued under Subsection (d), the commissioner shall give written

notice of the order to the emergency medical services provider or

course coordinator.

(f) The commissioner may consolidate a hearing held under this

section with another proceeding.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 7, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 915, Sec. 17, eff.

Aug. 28, 1995.

Sec. 773.067. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not later

than the 30th day after the date on which an order charging the

emergency medical services provider or course coordinator with a

penalty is final as provided by Chapter 2001, Government Code,

the person charged shall:

(1) pay the penalty in full;

(2) pay the penalty and file a petition for judicial review

contesting the occurrence of the violation, the amount of the

penalty, or both the occurrence of the violation and the amount

of the penalty; or

(3) without paying the penalty, file a petition for judicial

review contesting the occurrence of the violation, the amount of

the penalty, or both the occurrence of the violation and the

amount of the penalty.

(b) Within the 30-day period, a person who acts under Subsection

(a)(3) may:

(1) stay enforcement of the penalty by:

(A) paying the amount of the penalty to the court for placement

in an escrow account; or

(B) giving to the court a supersedeas bond that is approved by

the court for the amount of the penalty and that is effective

until all judicial review of the commissioner's order is final;

(2) request the court to stay enforcement of the penalty by:

(A) filing with the court a sworn affidavit of the person

stating that the person is financially unable to pay the amount

of the penalty and is financially unable to give the supersedeas

bond; and

(B) giving a copy of the affidavit to the commissioner by

certified mail.

Subsection (b)(2), the commissioner may file with the court,

within five days after the date the copy is received, a contest

to the affidavit. The court shall hold a hearing on the facts

alleged in the affidavit as soon as practicable and shall stay

the enforcement of the penalty on finding that the alleged facts

are true. The person who files an affidavit has the burden of

proving that the person is financially unable to pay the amount

of the penalty and to give a supersedeas bond.

(d) If the person does not pay the amount of the penalty and the

enforcement of the penalty is not stayed, the commissioner may

refer the matter to the attorney general for collection of the

amount of the penalty.

(e) Judicial review of the order of the commissioner:

(1) is instituted by filing a petition as provided by Subchapter

G, Chapter 2001, Government Code; and

(2) is under the substantial evidence rule.

(f) If the court sustains the occurrence of the violation, the

court may uphold or reduce the amount of the penalty and order

the person to pay the full or reduced amount of the penalty. If

the court does not sustain the occurrence of the violation, the

court shall order that no penalty is owed.

(g) When the judgment of the court becomes final, the court

shall proceed under this subsection. If the person paid the

penalty and if the amount of the penalty is reduced or the

penalty is not upheld by the court, the court shall order that

the appropriate amount plus accrued interest be remitted to the

person. The rate of the interest is the rate charged on loans to

depository institutions by the New York Federal Reserve Bank, and

the interest shall be paid for the period beginning on the date

the penalty was paid and ending on the date the penalty is

remitted. If the person gave a supersedeas bond and if the

penalty is not upheld by the court, the court shall order the

release of the bond. If the person gave a supersedeas bond and if

the amount of the penalty is reduced, the court shall order the

release of the bond after the person pays the amount.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 7, eff. Sept. 1,

1991. Amended by Acts 1995, 74th Leg., ch. 915, Sec. 18, eff.

Aug. 28, 1995.

Sec. 773.069. RECOVERY OF ADMINISTRATIVE PENALTY BY ATTORNEY

GENERAL. The attorney general at the request of the commissioner

may bring a civil action to recover an administrative penalty

assessed under this subchapter.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 7, eff. Sept. 1,

1991.

Sec. 773.070. ACCESS TO CERTAIN CRIMINAL HISTORY RECORD

INFORMATION. (a) to (d) Repealed by Acts 1993, 73rd Leg., ch.

790, Sec. 46(22), eff. Sept. 1, 1993.

(e) The board may deny licensure or certification to an

applicant who does not provide a complete set of the required

fingerprints.

(f) to (i) Repealed by Acts 1993, 73rd Leg., ch. 790, Sec.

46(22), eff. Sept. 1, 1993.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 7, eff. Sept. 1,

1991. Amended by Acts 1993, 73rd Leg., ch. 790, Sec. 46(17), eff.

Sept. 1, 1993.

Sec. 773.071. FEES. (a) To the extent feasible, the board by

rule shall set the fees under this subchapter in amounts

necessary for the department to recover the cost of administering

this subchapter.

(b) Subsection (a) does not apply to fees for which Section

773.059 prescribes the method for determining the amount of the

fees.

Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.84(j), eff. Sept.

1, 2003.

SUBCHAPTER D. CONFIDENTIAL COMMUNICATIONS

Sec. 773.091. CONFIDENTIAL COMMUNICATIONS. (a) A communication

between certified emergency medical services personnel or a

physician providing medical supervision and a patient that is

made in the course of providing emergency medical services to the

patient is confidential and privileged and may not be disclosed

except as provided by this chapter.

(b) Records of the identity, evaluation, or treatment of a

patient by emergency medical services personnel or by a physician

providing medical supervision that are created by the emergency

medical services personnel or physician or maintained by an

emergency medical services provider are confidential and

privileged and may not be disclosed except as provided by this

chapter.

communications or records as described by this chapter, other

than a person listed in Section 773.092 who is acting on the

survivor's behalf, may not disclose the information except to the

extent that disclosure is consistent with the authorized purposes

for which the information was obtained.

(d) This subchapter governs confidential communications or

records concerning a patient regardless of when the patient

received the services of emergency medical services personnel or

a physician providing medical supervision.

(e) Notwithstanding Rule 501, Texas Rules of Evidence, the

privilege of confidentiality may be claimed in any criminal,

civil, or administrative proceeding and may be claimed by the

patient or the emergency medical services personnel or physician

acting on the patient's behalf.

(f) If the emergency medical services personnel or physician

claims the privilege of confidentiality on behalf of the patient,

the authority to do so is presumed in the absence of evidence to

the contrary.

(g) The privilege of confidentiality under this section does not

extend to information regarding the presence, nature of injury or

illness, age, sex, occupation, and city of residence of a patient

who is receiving emergency medical services. Nothing in this

subsection shall be construed as requiring or permitting

emergency services personnel to make a diagnosis.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 8, eff. Sept. 1,

1991. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 10.008,

eff. Sept. 1, 2001.

Sec. 773.092. EXCEPTIONS. (a) Exceptions to the

confidentiality or privilege in court or administrative

proceedings exist:

(1) when proceedings are brought by the patient against

emergency medical services personnel, a physician providing

medical supervision, or an emergency medical services provider,

and in any criminal proceeding or certification revocation or

license revocation proceeding in which the patient is a

complaining witness and in which disclosure is relevant to the

claim or defense of emergency medical services personnel, a

physician providing medical supervision, or an emergency medical

services provider;

(2) when the patient or someone authorized to act on behalf of

the patient submits a written consent to release any of the

confidential information as provided by Section 773.093;

(3) when the purpose of the proceedings is to substantiate and

collect on a claim for emergency medical services rendered to the

patient;

(4) in any civil litigation or administrative proceeding, if

relevant, brought by the patient or someone on the patient's

behalf, if the patient is attempting to recover monetary damages

for any physical or mental condition, including death of the

patient;

(5) when the proceeding is a disciplinary investigation or

proceeding against emergency medical services personnel conducted

under this chapter, provided that the department shall protect

the identity of any patient whose medical records are examined,

unless the patient is covered under Subdivision (1) or has

submitted written consent to the release of the patient's

emergency medical services records under Section 773.093; or

(6) when the proceeding is a criminal prosecution in which the

patient is a victim, witness, or defendant.

(b) Information under Subdivision (4) is discoverable in any

court or administrative proceeding in this state if the court or

administrative body has jurisdiction of the subject matter,

pursuant to rules of procedure specified for the matter.

confidential information to instigate or substantiate criminal

charges against a patient.

(d) Confidential records or communications are not discoverable

in a criminal proceeding until the court in which the prosecution

is pending makes an in camera determination as to the relevancy

of the records or communications or any portion of the records or

communications. A determination that confidential records or

communications are discoverable is not a determination as to the

admissibility of the records or communications.

(e) Communications and records that are confidential under this

section may be disclosed to:

(1) medical or law enforcement personnel if the emergency

medical services personnel, the physician providing medical

supervision, or the emergency medical services provider

determines that there is a probability of imminent physical

danger to any person or if there is a probability of immediate

mental or emotional injury to the patient;

(2) governmental agencies if the disclosure is required or

authorized by law;

(3) qualified persons to the extent necessary for management

audits, financial audits, program evaluation, system improvement,

or research, except that any report of the research, audit, or

evaluation may not directly or indirectly identify a patient;

(4) any person who bears a written consent of the patient or

other persons authorized to act on the patient's behalf for the

release of confidential information as provided by Section

773.093;

(5) the department for data collection or complaint

investigation;

(6) other emergency medical services personnel, other

physicians, and other personnel under the direction of a

physician who are participating in the diagnosis, evaluation, or

treatment of a patient;

(7) individuals, corporations, or governmental agencies involved

in the payment or collection of fees for emergency medical

services rendered by emergency medical services personnel.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 8, eff. Sept. 1,

1991. Amended by Acts 1997, 75th Leg., ch. 435, Sec. 6, eff.

Sept. 1, 1997.

Sec. 773.093. CONSENT. (a) Consent for the release of

confidential information must be in writing and signed by the

patient, a parent or legal guardian if the patient is a minor, a

legal guardian if the patient has been adjudicated incompetent to

manage the patient's personal affairs, an attorney ad litem

appointed for the patient, or a personal representative if the

patient is deceased. The written consent must specify:

(1) the information or records to be covered by the release;

(2) the reasons or purpose for the release; and

(3) the person to whom the information is to be released.

(b) The patient or other person authorized to consent may

withdraw consent to the release of any information by submitting

a written notice of withdrawal to the person or program to which

consent was provided. Withdrawal of consent does not affect any

information disclosed before the date on which written notice of

the withdrawal was received.

chapter may disclose the information to others only to the extent

consistent with the authorized purposes for which consent to

release the information was obtained.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 8, eff. Sept. 1,

1991.

Sec. 773.094. INJUNCTION; DAMAGES. A person aggrieved by an

unauthorized disclosure of communications or records that are

confidential under this subchapter may petition the district

court of the county in which the person resides or, in the case

of a nonresident of the state, a district court of Travis County

for appropriate injunctive relief. The petition takes precedence

over all civil matters on the docketed court except those matters

to which equal precedence on the docket is granted by law. A

person injured by an unauthorized disclosure of communications or

records that are confidential under this subchapter may bring an

action for damages.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 8, eff. Sept. 1,

1991.

Sec. 773.095. RECORDS AND PROCEEDINGS CONFIDENTIAL. (a) The

proceedings and records of organized committees of hospitals,

medical societies, emergency medical services providers,

emergency medical services and trauma care systems, or first

responder organizations relating to the review, evaluation, or

improvement of an emergency medical services provider, a first

responder organization, an emergency medical services and trauma

care system, or emergency medical services personnel are

confidential and not subject to disclosure by court subpoena or

otherwise.

(b) The records and proceedings may be used by the committee and

the committee members only in the exercise of proper committee

functions.

the regular course of business by an emergency medical services

provider, a first responder organization, or emergency medical

services personnel.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 8, eff. Sept. 1,

1991. Amended by Acts 1997, 75th Leg., ch. 435, Sec. 7, eff.

Sept. 1, 1997; Acts 2001, 77th Leg., ch. 874, Sec. 6, eff. Sept.

1, 2001.

Sec. 773.096. IMMUNITY FOR COMMITTEE MEMBERS. A member of an

organized committee under Section 773.095 is not liable for

damages to a person for an action taken or recommendation made

within the scope of the functions of the committee if the

committee member acts without malice and in the reasonable belief

that the action or recommendation is warranted by the facts known

to the committee member.

Added by Acts 1991, 72nd Leg., ch. 605, Sec. 8, eff. Sept. 1,

1991.

SUBCHAPTER E. EMERGENCY MEDICAL SERVICES AND TRAUMA CARE SYSTEMS

Sec. 773.111. LEGISLATIVE FINDINGS. (a) The legislature finds

that death caused by injury is the leading cause of death for

persons one through 44 years of age, and the third overall cause

of death for all ages. Effective emergency medical services

response and resuscitation systems, medical care systems, and

medical facilities reduce the occurrence of unnecessary

mortality.

(b) It is estimated that trauma costs more than $63 million a

day nationally, which includes lost wages, medical expenses, and

indirect costs. Proportionately, this cost to Texas would be more

than $4 million a day. Many hospitals provide emergency medical

care to patients who are unable to pay for catastrophic injuries

directly or through an insurance or entitlement program.

it is necessary to improve the quality of emergency and medical

care to the people of Texas who are victims of unintentional,

life-threatening injuries by encouraging hospitals to provide

trauma care and increasing the availability of emergency medical

services.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.081 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Sec. 773.112. DUTIES OF BOARD; RULES. (a) The board by rule

shall adopt minimum standards and objectives to implement

emergency medical services and trauma care systems. The board by

rule shall provide for the designation of trauma facilities and

for triage, transfer, and transportation policies. The board

shall consider guidelines adopted by the American College of

Surgeons and the American College of Emergency Physicians in

adopting rules under this section.

(b) The rules must provide specific requirements for the care of

trauma patients, must ensure that the trauma care is fully

coordinated with all hospitals and emergency medical services in

the delivery area, and must reflect the geographic areas of the

state, considering time and distance.

(1) prehospital care management guidelines for triage and

transportation of trauma patients;

(2) flow patterns of trauma patients and geographic boundaries

regarding trauma patients;

(3) assurances that trauma facilities will provide quality care

to trauma patients referred to the facilities;

(4) minimum requirements for resources and equipment needed by a

trauma facility to treat trauma patients;

(5) standards for the availability and qualifications of the

health care personnel, including physicians and surgeons,

treating trauma patients within a facility;

(6) requirements for data collection, including trauma incidence

reporting, system operation, and patient outcome;

(7) requirements for periodic performance evaluation of the

system and its components; and

(8) assurances that designated trauma facilities will not refuse

to accept the transfer of a trauma patient from another facility

solely because of the person's inability to pay for services or

because of the person's age, sex, race, religion, or national

origin.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.082 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Amended by Acts 1997, 75th Leg., ch. 623, Sec. 1, eff. Sept. 1,

1997.

Sec. 773.113. DUTIES OF BUREAU. (a) The bureau shall:

(1) develop and monitor a statewide emergency medical services

and trauma care system;

(2) designate trauma facilities;

(3) develop and maintain a trauma reporting and analysis system

to:

(A) identify severely injured trauma patients at each health

care facility in this state;

(B) identify the total amount of uncompensated trauma care

expenditures made each fiscal year by each health care facility

in this state; and

including each designated trauma center, in emergency medical

services and trauma care systems in this state; and

(4) provide for coordination and cooperation between this state

and any other state with which this state shares a standard

metropolitan statistical area.

(b) The bureau may grant an exception to a rule adopted under

Section 773.112 if it finds that compliance with the rule would

not be in the best interests of the persons served in the

affected local emergency medical services and trauma care

delivery area.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.083 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Sec. 773.1135. DUTIES OF DEPARTMENT. The department shall

develop performance measures for regional advisory councils in

trauma service areas to:

(1) promote the provision of a minimum level of emergency

medical services in a trauma service area in accordance with the

rules adopted under Section 773.112;

(2) promote the provision of quality care and service by the

emergency medical services and trauma care system in accordance

with the rules adopted under Section 773.112; and

(3) maximize the accuracy of information provided by a regional

advisory council to the department or bureau for increased

council effectiveness.

Added by Acts 2003, 78th Leg., ch. 849, Sec. 1, eff. Sept. 1,

2003.

Sec. 773.114. SYSTEM REQUIREMENTS. (a) Each emergency medical

services and trauma care system must have:

(1) local or regional medical control for all field care and

transportation, consistent with geographic and current

communications capability;

(2) triage, transport, and transfer protocols; and

(3) one or more hospitals categorized according to trauma care

capabilities using standards adopted by board rule.

(b) This subchapter does not prohibit a health care facility

from providing services that it is authorized to provide under a

license issued to the facility by the department.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.084 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Sec. 773.115. TRAUMA FACILITIES. (a) The bureau may designate

trauma facilities that are a part of an emergency medical

services and trauma care system. A trauma facility shall be

designated by the level of trauma care and services provided in

accordance with the American College of Surgeons guidelines for

level I and II trauma facilities and rules adopted by the board

for level III and IV trauma facilities. In adopting rules under

this section, the board may consider trauma caseloads, geographic

boundaries, or minimum population requirements, but the bureau

may not deny designation solely on these criteria. The board may

not set an arbitrary limit on the number of facilities designated

as trauma facilities.

(b) A health care facility may apply to the bureau for

designation as a trauma facility, and the bureau shall grant the

designation if the facility meets the requirements for

designation prescribed by board rules.

the terms "trauma facility," "trauma hospital," "trauma center,"

or similar terminology in its signs or advertisements or in the

printed materials and information it provides to the public

unless the facility has been designated as a trauma facility

under this subchapter.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.085 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Amended by Acts 1997, 75th Leg., ch. 435, Sec. 8, eff. Sept. 1,

1997; Acts 2001, 77th Leg., ch. 874, Sec. 7, eff. Sept. 1, 2001.

Sec. 773.116. FEES. (a) The bureau shall charge a fee to a

health care facility that applies for initial or continuing

designation as a trauma facility.

(b) The board by rule shall set the amount of the fee schedule

for initial or continuing designation as a trauma facility

according to the number of beds in the health care facility. The

amount of the fee may not exceed:

(1) $5,000 for a Level I or II facility;

(2) $2,500 for a Level III facility; or

(3) $1,000 for a Level IV facility.

(d) To the extent feasible, the board by rule shall set the fee

in an amount necessary for the department to recover the cost

directly related to designating trauma facilities under this

subchapter.

(e) This section does not restrict the authority of a health

care facility to provide a service for which it has received a

license under other state law.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.086 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.84(k), (l), eff.

Sept. 1, 2003.

Sec. 773.117. DENIAL, SUSPENSION, OR REVOCATION OF DESIGNATION.

(a) The department may deny, suspend, or revoke a health care

facility's designation as a trauma facility if the facility fails

to comply with the rules adopted under this subchapter.

(b) The denial, suspension, or revocation of a designation by

the department and the appeal from that action are governed by

the department's rules for a contested case hearing and by

Chapter 2001, Government Code.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.087 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff.

Sept. 1, 1995.

Sec. 773.119. GRANT PROGRAM. (a) The department shall

establish a program to award grants to initiate, expand,

maintain, and improve emergency medical services and to support

medical systems and facilities that provide trauma care.

(b) The board by rule shall establish eligibility criteria for

awarding the grants. The rules must require the department to

consider:

(1) the need of an area for the provision of emergency medical

services or trauma care and the extent to which the grant would

meet the identified need;

(2) the availability of personnel and training programs;

(3) the availability of other funding sources;

(4) the assurance of providing quality services;

(5) the use or acquisition of helicopters for emergency medical

evacuation; and

(6) the development or existence of an emergency medical

services system.

adopted by the board. A grant awarded under this section is

governed by the Uniform Grant and Contract Management Act of 1981

(Article 4413(32g), Vernon's Texas Civil Statutes) and by the

rules adopted under that Act.

(d) The department may require a grantee to provide matching

funds equal to not more than 75 percent of the amount of the

grant.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.089 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Sec. 773.120. ACCEPTANCE OF GIFTS. A trauma facility or an

emergency medical services and trauma care system may accept

gifts or other contributions for the purposes of this subchapter.

Added by Acts 1991, 72nd Leg., ch. 14, Sec. 267, eff. Sept. 1,

1991. Redesignated from Health & Safety Code Sec. 773.090 by

Acts 1991, 72nd Leg., ch. 605, Sec. 9, eff. Sept. 1, 1991.

Sec. 773.122. PAYMENTS FROM THE ACCOUNTS. (a) The

commissioner, with advice and counsel from the chairpersons of

the trauma service area regional advisory councils, shall use

money in the accounts established under Sections 771.072(f) and

773.006 to fund county and regional emergency medical services,

designated trauma facilities, and trauma care systems in

accordance with this section.

(b) The commissioner shall maintain a reserve of $500,000 of

money appropriated from the accounts for extraordinary

emergencies.

the appropriated money remaining from the accounts, after any

amount necessary to maintain the reserve established by

Subsection (b) is deducted, to fund, in connection with an effort

to provide coordination with the appropriate trauma service area,

the cost of supplies, operational expenses, education and

training, equipment, vehicles, and communications systems for

local emergency medical services. The money shall be distributed

on behalf of eligible recipients in each county to the trauma

service area regional advisory council for that county. To

receive a distribution under this subsection, the regional

advisory council must be incorporated as an entity that is exempt

from federal income tax under Section 501(a), Internal Revenue

Code of 1986, and its subsequent amendments, by being listed as

an exempt organization under Section 501(c)(3) of the code. The

share of the money allocated to the eligible recipients in a

county's geographic area shall be based on the relative

geographic size and population of the county and on the relative

number of emergency or trauma care runs performed by eligible

recipients in the county. Money that is not disbursed by a

regional advisory council to eligible recipients for approved

functions by the end of the fiscal year in which the funds were

disbursed may be retained by the regional advisory council to be

used during the following fiscal year in accordance with this

subsection. Money that is not disbursed by the regional advisory

council during the following fiscal year shall be returned to the

account.

(d) In any fiscal year, the commissioner may use not more than

20 percent of the appropriated money remaining from the accounts,

after any amount necessary to maintain the reserve established by

Subsection (b) is deducted, for operation of the 22 trauma

service areas and for equipment, communications, and education

and training for the areas. Money distributed under this

subsection shall be distributed on behalf of eligible recipients

in each county to the trauma service area regional advisory

council for that county. To receive a distribution under this

subsection, the regional advisory council must be incorporated as

an entity that is exempt from federal income tax under Section

501(a), Internal Revenue Code of 1986, and its subsequent

amendments, by being listed as an exempt organization under

Section 501(c)(3) of the code. A regional advisory council's

share of money distributed under this section shall be based on

the relative geographic size and population of each trauma

service area and on the relative amount of trauma care provided.

Money that is not disbursed by a regional advisory council to

eligible recipients for approved functions by the end of the

fiscal year in which the funds were disbursed may be retained by

the regional advisory council to be used during the following

fiscal year in accordance with this subsection. Money that is not

disbursed by the regional advisory council during the following

fiscal year shall be returned to the account.

(e) In any fiscal year, the commissioner may use not more than

three percent of the appropriated money from the accounts after

any amount necessary to maintain the reserve established by

Subsection (b) is deducted to fund the administrative costs of

the bureau of emergency management of the department associated

with administering the state emergency medical services program,

the trauma program, and the accounts and to fund the costs of

monitoring and providing technical assistance for those programs

and the accounts.

(f) In any fiscal year, the commissioner shall use at least 27

percent of the appropriated money remaining from the accounts

after any amount necessary to maintain the reserve established by

Subsection (b) is deducted and the money from the accounts not

otherwise distributed under this section to fund a portion of the

uncompensated trauma care provided at facilities designated as

state trauma facilities by the department. The administrator of a

designated facility may request a regional advisory council

chairperson to petition the department for disbursement of funds

to a designated trauma facility in the chairperson's trauma

service area that has provided uncompensated trauma care. Funds

may be disbursed under this subsection based on a proportionate

share of uncompensated trauma care provided in the state and may

be used to fund innovative projects to enhance the delivery of

patient care in the overall emergency medical services and trauma

care system.

(g) The department shall review the percentages for disbursement

of funds in the accounts on an annual basis and shall make

recommendations for proposed changes to ensure that appropriate

and fair funding is provided under this section.

Added by Acts 1997, 75th Leg., ch. 1157, Sec. 1, eff. Sept. 1,

1997. Amended by Acts 1999, 76th Leg., ch. 1045, Sec. 16, eff.

June 18, 1999; Acts 1999, 76th Leg., ch. 1411, Sec. 19.07, eff.

Sept. 1, 1999; Acts 2003, 78th Leg., ch. 1213, Sec. 2, eff. Sept.

1, 2003.

Sec. 773.123. CONTROL OF EXPENDITURES FROM ACCOUNTS. Money

distributed from the accounts established under Sections

771.072(f) and 773.006 shall be used in accordance with Section

773.122 on the authorization of the executive committee of the

trauma service area regional advisory council.

Added by Acts 1997, 75th Leg., ch. 1157, Sec. 1, eff. Sept. 1,

1997. Amended by Acts 1999, 76th Leg., ch. 1045, Sec. 17, eff.

June 18, 1999; Acts 1999, 76th Leg., ch. 1411, Sec. 19.08, eff.

Sept. 1, 1999; Acts 2003, 78th Leg., ch. 1213, Sec. 3, eff. Sept.

1, 2003.

Sec. 773.124. LOSS OF FUNDING ELIGIBILITY. For a period of not

less than one year or more than three years, as determined by the

department, the department may not disburse money under Section

773.122 to a trauma service area regional advisory council,

county, municipality, or local recipient that the department

finds used money in violation of that section.

Added by Acts 1997, 75th Leg., ch. 1157, Sec. 1, eff. Sept. 1,

1997. Amended by Acts 1999, 76th Leg., ch. 1411, Sec. 19.09, eff.

Sept. 1, 1999.

SUBCHAPTER F. MEDICAL INFORMATION PROVIDED BY CERTAIN EMERGENCY

MEDICAL SERVICES OPERATORS

Sec. 773.141. DEFINITIONS. In this subchapter:

(1) "Emergency call" means a telephone call or other similar

communication from a member of the public, as part of a 9-1-1

system or otherwise, made to obtain emergency medical services.

(2) "Emergency medical services operator" means a person who, as

a volunteer or employee of a public agency, as that term is

defined by Section 771.001, receives emergency calls.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

Sec. 773.142. APPLICATION OF SUBCHAPTER. This subchapter does

not apply to a physician or other licensed person who may provide

medical information under law.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

Sec. 773.143. PROVISION OF MEDICAL INFORMATION. An emergency

medical services operator may provide medical information to a

member of the public during an emergency call if:

(1) the operator has successfully completed an emergency medical

services operator training program and holds a certificate issued

under Section 773.144; and

(2) the information provided substantially conforms to the

protocol for delivery of the information adopted by the board

under Section 773.145.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

Sec. 773.144. TRAINING PROGRAMS. (a) The department may offer

emergency medical services operator training programs and may

approve training programs offered by other persons. The board by

rule shall establish minimum standards for approval of training

programs and certification and decertification of program

instructors.

(b) The provider of an emergency medical services operator

training program shall issue an emergency medical services

operator a certificate evidencing completion of the training

program. The board by rule may require that, before issuance of

the certificate, the operator successfully complete an

examination administered by the board, by the provider of the

training program, or by another person.

under Subsection (b) expires at the end of a specified period not

less than one year after the date on which the certificate is

issued and may adopt requirements, including additional training

or examination, for renewal of the certificate.

(d) The board by rule may adopt other requirements relating to

emergency medical services operator training programs. The

establishment of minimum standards under this section does not

prohibit the entity that is employing or accepting the volunteer

services of the emergency medical services operator from imposing

additional training standards or procedures.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

Sec. 773.145. MEDICAL INFORMATION. The board by rule shall

adopt a protocol that must be used to provide medical information

under Section 773.143. The protocol may include the use of a

flash-card system or other similar system designed to make the

information readily accessible to the emergency medical services

operator in an understandable form.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

Sec. 773.146. LIMITATION ON CIVIL LIABILITY. (a) An emergency

medical services operator who holds a certificate under Section

773.144 is not liable for damages that arise from the provision

of medical information according to the protocol adopted under

Section 773.145 if the information is provided in good faith.

This subsection does not apply to an act or omission of the

operator that constitutes gross negligence, recklessness, or

intentional misconduct. This subsection does not affect any

liability imposed on a public agency for the conduct of the

emergency medical services operator under Section 101.062, Civil

Practice and Remedies Code.

(b) Section 101.062, Civil Practice and Remedies Code, governs

the liability of a public agency the employees or volunteers of

which provide medical information under this subchapter.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

Sec. 773.147. FEES. (a) The board by rule may adopt fees for:

(1) training programs provided by the board under Section

773.144; and

(2) the approval of program instructors and of training programs

offered by other persons.

(b) The fees adopted under this section may not exceed the

amount necessary for the department to recover the cost of

administering this subchapter.

Added by Acts 1999, 76th Leg., ch. 1411, Sec. 19.10, eff. Sept.

1, 1999.

SUBCHAPTER G. PEDIATRIC EMERGENCY MEDICAL SERVICES

Sec. 773.171. EMERGENCY MEDICAL SERVICES FOR CHILDREN PROGRAM.

(a) The emergency medical services for children program is in

the bureau of emergency management.

(b) The department shall provide coordination and support for a

statewide pediatric emergency services system.

receives from the federal government and public or private

sources to carry out the purposes of this subchapter.

Added by Acts 1993, 73rd Leg., ch. 513, Sec. 1, eff. Aug. 30,

1993.

Sec. 773.173. DUTIES OF BOARD; RULES. (a) On the

recommendation of the advisory committee, the board shall adopt

minimum standards and objectives to implement a pediatric

emergency services system, including rules that:

(1) provide guidelines for categorization of a facility's

pediatric capability;

(2) provide for triage, transfer, and transportation policies

for pediatric care;

(3) establish guidelines for:

(A) prehospital care management for triage and transportation of

a pediatric patient;

(B) prehospital and hospital equipment that is necessary and

appropriate for the care of a pediatric patient;

long-term care facilities; and

(D) an interhospital transfer system for a critically ill or

injured pediatric patient; and

(4) provide for data collection and analysis.

(b) The board and the advisory committee shall consider

guidelines endorsed by the American Academy of Pediatrics and the

American College of Surgeons in recommending and adopting rules

under this section.

this section if it finds that compliance with the rule would not

be in the best interests of persons served in the affected local

pediatric emergency medical services system.

(d) This subchapter does not prohibit a health care facility

from providing services that it is authorized to provide under a

license issued to the facility by the department.

Added by Acts 1993, 73rd Leg., ch. 513, Sec. 1, eff. Aug. 30,

1993.

SUBCHAPTER H. EMERGENCY STROKE SERVICES

Sec. 773.201. LEGISLATIVE INTENT. The legislature finds that a

strong system for stroke survival is needed in the state's

communities in order to treat stroke victims in a timely manner

and to improve the overall treatment of stroke victims.

Therefore, the legislature intends to construct an emergency

treatment system in this state so that stroke victims may be

quickly identified and transported to and treated in appropriate

stroke treatment facilities.

Added by Acts 2005, 79th Leg., Ch.

299, Sec. 3, eff. September 1, 2005.

Sec. 773.202. DEFINITIONS. In this subchapter:

(1) "Advisory council" means the advisory council established

under Section 773.012.

(2) "Stroke committee" means the committee appointed under

Section 773.203.

(3) "Stroke facility" means a health care facility that:

(A) is capable of primary or comprehensive treatment of stroke

victims;

(B) is part of an emergency medical services and trauma care

system as defined by Section 773.003;

seven days a week who is knowledgeable about stroke care and

capable of carrying out acute stroke therapy; and

(D) records patient treatment and outcomes.

Added by Acts 2005, 79th Leg., Ch.

299, Sec. 3, eff. September 1, 2005.

Sec. 773.203. STROKE COMMITTEE. (a) The advisory council shall

appoint a stroke committee to assist the advisory council in the

development of a statewide stroke emergency transport plan and

stroke facility criteria.

(b) The stroke committee must include the following members:

(1) a licensed physician appointed from a list of physicians

eligible for accreditation in vascular neurology from the

Accreditation Council for Graduate Medical Education, recommended

by a statewide organization of neurologists;

(2) a licensed interventional neuroradiologist appointed from a

list of neuroradiologists recommended by a statewide organization

of radiologists;

(3) a neurosurgeon with stroke expertise;

(4) a member of the Texas Council on Cardiovascular Disease and

Stroke who has expertise in stroke care;

(5) a licensed physician appointed from a list of physicians

recommended by a statewide organization of emergency physicians;

(6) a neuroscience registered nurse with stroke expertise; and

(7) a volunteer member of a nonprofit organization specializing

in stroke treatment, prevention, and education.

committee.

Added by Acts 2005, 79th Leg., Ch.

299, Sec. 3, eff. September 1, 2005.

Sec. 773.204. DUTIES OF STROKE COMMITTEE; DEVELOPMENT OF STROKE

EMERGENCY TRANSPORT PLAN AND STROKE FACILITY CRITERIA. (a) The

advisory council, with the assistance of the stroke committee and

in collaboration with the Texas Council on Cardiovascular Disease

and Stroke, shall develop a statewide stroke emergency transport

plan and stroke facility criteria.

(b) The stroke emergency transport plan must include:

(1) training requirements on stroke recognition and treatment,

including emergency screening procedures;

(2) a list of appropriate early treatments to stabilize

patients;

(3) protocols for rapid transport to a stroke facility when

rapid transport is appropriate and it is safe to bypass another

health care facility; and

(4) plans for coordination with statewide agencies or committees

on programs for stroke prevention and community education

regarding stroke and stroke emergency transport.

facility criteria, the stroke committee shall consult the

criteria for stroke facilities established by national medical

organizations such as the Joint Commission on Accreditation of

Healthcare Organizations.

Added by Acts 2005, 79th Leg., Ch.

299, Sec. 3, eff. September 1, 2005.

Sec. 773.205. RULES. The executive commissioner may adopt rules

regarding a statewide stroke emergency transport plan and stroke

facility criteria based on recommendations from the advisory

council.

Added by Acts 2005, 79th Leg., Ch.

299, Sec. 3, eff. September 1, 2005.

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2009 Texas Code HEALTH AND SAFETY CODE TITLE 9. SAFETY CHAPTER 773. EMERGENCY MEDICAL SERVICES

2009 Texas Code
HEALTH AND SAFETY CODE
TITLE 9. SAFETY
CHAPTER 773. EMERGENCY MEDICAL SERVICES