HB2437 - EMS reciprocity; compact

House Engrossed EMS reciprocity; compact State of Arizona House of Representatives Fifty-seventh Legislature Second Regular Session 2026 HOUSE BILL 2437 AN ACT amending sections 36-2202, 36-2220 and 36-2245, Arizona Revised Statutes; amending title 36, chapter 21.1, Arizona Revised Statutes, by adding article 2.1; amending sections 41-619.51, 41-1758 and 41-1758.01, Arizona Revised Statutes; relating to emergency medical services. (TEXT OF BILL BEGINS ON NEXT PAGE) Be it enacted by the Legislature of the State of Arizona: Section 1. Section 36-2202, Arizona Revised Statutes, is amended to read: START_STATUTE 36-2202. Duties of the director; qualifications of medical director A. The director shall: 1. Appoint a medical director of the emergency medical services and trauma system. 2. Adopt standards and criteria for the denial or granting of certification and recertification of emergency medical care technicians. These standards shall allow the department to certify qualified emergency medical care technicians who have completed statewide standardized training required under section 36-2204, paragraph 1 and a standardized certification test required under section 36-2204, paragraph 2, who hold valid certification with a national certification organization or who have completed training and testing by the United States armed forces at a level comparable to the national standards for emergency medical care technicians. Before the director may consider approving a statewide standardized training or a standardized certification test, or both, each of these must first be recommended by the medical direction commission and the emergency medical services council to ensure that the standardized training content is consistent with national education standards and that the standardized certification test examines comparable material to that examined in the tests of a national certification organization. Beginning the effective date of this amendment to this section or upon approval from the federal bureau of investigation, a person applying for initial certification as an emergency medical care technician pursuant to the emergency medical services personnel licensure interstate compact and in compliance with the requirements of section 36-2259 shall possess a valid fingerprint clearance card pursuant to title 41, chapter 12, article 3.1. 3. Adopt standards and criteria that pertain to the quality of emergency care pursuant to section 36-2204. 4. Adopt rules necessary to carry out this chapter. Each rule shall identify all sections and subsections of this chapter under which the rule was formulated. 5. Adopt reasonable medical equipment, supply, staffing and safety standards, criteria and procedures to issue a certificate of registration to operate an ambulance. 6. Maintain a state system for recertifying emergency medical care technicians, except as otherwise provided by section 36-2202.01, that is independent from any national certification organization recertification process. This system shall allow emergency medical care technicians to choose to be recertified under the state or the national certification organization recertification system subject to subsection H of this section. B. Emergency medical technicians who choose the state recertification process shall recertify in one of the following ways: 1. Successfully completing an emergency medical technician refresher course approved by the department. 2. Successfully completing an emergency medical technician challenge course approved by the department. 3. For emergency medical care technicians who are currently certified at the emergency medical technician level by the department, attesting on a form provided by the department that the applicant holds a valid and current cardiopulmonary resuscitation certification, has and will maintain documented proof of a minimum of twenty-four hours of continuing medical education within the last two years consistent with department rules and has functioned in the capacity of an emergency medical technician for at least two hundred forty hours during the last two years. C. After consultation with the emergency medical services council, the director may authorize pilot programs designed to improve the safety and efficiency of ambulance inspections for governmental or quasi-governmental entities that provide emergency medical services in this state. D. The rules, standards and criteria adopted by the director pursuant to subsection A, paragraphs 2, 3, 4 and 5 of this section shall be adopted in accordance with title 41, chapter 6, except that the director may adopt on an emergency basis pursuant to section 41-1026 rules relating to the regulation of ambulance services in this state necessary to protect the public peace, health and safety in advance of adopting rules, standards and criteria as otherwise provided by this subsection. E. The director may waive the requirement for compliance with a protocol adopted pursuant to section 36-2205 if the director determines that the techniques, drug formularies or training makes the protocol inconsistent with contemporary medical practices. F. The director may suspend a protocol adopted pursuant to section 36-2205 if the director does all of the following: 1. Determines that the rule is not in the public's best interest. 2. Initiates procedures pursuant to title 41, chapter 6 to repeal the rule. 3. Notifies all interested parties in writing of the director's action and the reasons for that action. Parties interested in receiving notification shall submit a written request to the director. G. To be eligible for appointment as the medical director of the emergency medical services and trauma system, the person shall be qualified in emergency medicine and shall be licensed as a physician in one of the states of the United States. H. Applicants for certification shall apply to the director for certification. Emergency medical care technicians shall apply for recertification to the director every two years. The director may extend the expiration date of an emergency medical care technician's certificate for thirty days. The department shall establish a fee for this extension by rule. Emergency medical care technicians shall pass an examination administered by the department as a condition for recertification only if required to do so by the advanced life support base hospital's medical director or the emergency medical care technician's medical director. I. The medical director of the emergency medical services and trauma system is exempt from title 41, chapter 4, articles 5 and 6 and is entitled to receive compensation pursuant to section 38-611, subsection A. J. The standards, criteria and procedures adopted by the director pursuant to subsection A, paragraph 5 of this section shall require that ambulance services: 1. Providing interfacility transportation in any certificate of necessity area of this state have one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a), (c), (d) or (e) and one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a), (b), (c), (d), or (e) staffing an ambulance while transporting a patient. If an ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (b) is staffing the ambulance pursuant to this paragraph, that ambulance attendant may exclusively drive the ambulance. 2. Serving a rural or wilderness certificate of necessity area with a population of less than ten thousand persons have at least one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a), (c), (d) or (e) and one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a) or (b) staffing an ambulance while transporting a patient. 3. Serving a population of ten thousand persons or more have at least one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a) and one ambulance attendant as defined in section 36-2201, paragraph 6, subdivision (a), (c), (d) or (e) staffing an ambulance while transporting a patient. K. If the department determines there is not a qualified administrative medical director, the department shall ensure the provision of administrative medical direction for an emergency medical technician if the emergency medical technician meets all of the following criteria: 1. Is employed by a nonprofit or governmental provider employing less than twelve full-time emergency medical technicians. 2. Stipulates to the inability to secure a physician who is willing to provide administrative medical direction. 3. Stipulates that the provider agency does not provide administrative medical direction for its employees. END_STATUTE Sec. 2. Section 36-2220, Arizona Revised Statutes, is amended to read: START_STATUTE 36-2220. Records; confidentiality; definition A. Information developed, records kept and data collected by the department or a political subdivision of this state for the purpose of administering or evaluating the Arizona emergency medical services system or for the trauma system are available to the public except: 1. Any patient record, including clinical records, prehospital care records, medical reports, laboratory statements and reports, any file, film, record or report or oral statement relating to diagnostic findings, treatment or outcome of patients, whether written or recorded, and any information from which a patient, the patient's family or the patient's health care provider or facility might be identified except records, files and information are available to the patient, the patient's guardian or the patient's agent. 2. Information obtained and data collected for purposes of chapter 25 or chapter 4, article 5 of this title. B. Unless otherwise provided by law, all medical records developed and kept by a prehospital component of the statewide trauma system and information contained in these records are confidential and may not be released to the public without written authorization by the patient, the patient's guardian or the patient's agent. C. Notwithstanding subsection B of this section, a prehospital incident history report completed and kept by a nonhospital political subdivision of this state is available to the public except for information in that report that is protected from disclosure by the laws of this state or federal law, including confidential patient treatment information. D. Patient records and medical records covered by this section may be obtained pursuant to section 12-2294.01. E. Information, documents and records received by the department or prepared by the department in connection with an investigation that is conducted pursuant to this article and that relates to emergency medical care technicians are confidential and are not subject to public inspection or civil discovery. The results of the investigation and the decision of the department are available to the public after the investigation is completed and the investigation file is closed. This subsection does not prevent the department from submitting information in compliance with the emergency medical services personnel licensure interstate compact as required by section 36-2259. F. For the purposes of this section, "prehospital incident history report" means a record of the prehospital response, nature of the incident and transportation of an emergency medical services patient that is documented on a prehospital incident history report. END_STATUTE Sec. 3. Section 36-2245, Arizona Revised Statutes, is amended to read: START_STATUTE 36-2245. Investigations; complaints; informal interviews; hearings; stipulations; judicial review; civil penalty; confidentiality A. The department may conduct an investigation into the operation of ambulances and ambulance services. B. Proceedings under this section may be initiated by the department. C. If the department receives a written and signed statement of dissatisfaction or dispute of charges or any matter relating to the regulation of ambulance services, the customer is deemed to have filed an informal complaint against the ambulance service. Within fifteen days of receipt of after receiving the complaint, a designated representative of the department shall inform the ambulance service that an informal complaint has been filed, state the nature of the allegations made, specify the purported rule violation and identify specific records relating to the purported rule violation that the ambulance service shall provide to the department. The ambulance service shall comply with the request for records in a timely manner. D. Within forty-five days of receipt of after receiving the records, the department shall determine if whether the complaint is nonsubstantive or substantive. E. If the department determines that a complaint filed pursuant to this section is nonsubstantive, it the department shall render a written decision to all parties within five days of after that determination. The complainant may make a formal complaint to the department if the complainant disagrees with the department's decision. If the nonsubstantive complaint involves rates and charges, a designated representative of the department shall attempt to resolve the dispute by correspondence or telephone with the ambulance service and the customer. F. If the department determines that a complaint filed pursuant to this section is substantive, the complaint becomes a formal complaint. The department shall inform the ambulance service that the initial investigation was substantive in nature and may warrant action pursuant to this article. The department shall inform the ambulance service of the specific rule violation and shall allow the ambulance service thirty days to answer the complaint in writing. G. The department may issue a written request for an informal interview with the ambulance service if the department believes that the evidence indicates that grounds for action exist. The request shall state the reasons for the interview and shall schedule an informal interview at least ten days from after the date that the department sends the request for an interview. H. If the department determines that evidence warrants action or if the ambulance service refuses to attend the informal interview, the director shall institute formal proceedings and hold a hearing pursuant to title 41, chapter 6, article 10. I. If the department believes that a lesser disciplinary action is appropriate, the department may enter into a stipulated agreement with the ambulance service. This stipulation may include a civil penalty as provided under subsection J of this section. J. In addition to other disciplinary action provided under this section, the director may impose a civil penalty of not more than three hundred fifty dollars $350 for each violation of this chapter that constitutes grounds to suspend or revoke a certificate of necessity. This penalty shall not [Text truncated for display. Full text available on LegiScan.]