32.1-111.3 - Statewide emergency medical care system.
§ 32.1-111.3. Statewide emergency medical care system.
A. The Board of Health shall develop a comprehensive, coordinated, emergencymedical care system in the Commonwealth and prepare a Statewide EmergencyMedical Services Plan which shall incorporate, but not be limited to, theplans prepared by the regional emergency medical services councils. The Boardshall review, update, and publish the Plan triennially, making such revisionsas may be necessary to improve the effectiveness and efficiency of theCommonwealth's emergency medical care system. Publishing through electronicmeans and posting on the Department website shall satisfy the publicationrequirement. The objectives of such Plan and the system shall include, butnot be limited to, the following:
1. Establishing a comprehensive statewide emergency medical care system,incorporating facilities, transportation, manpower, communications, and othercomponents as integral parts of a unified system that will serve to improvethe delivery of emergency medical services and thereby decrease morbidity,hospitalization, disability, and mortality;
2. Reducing the time period between the identification of an acutely ill orinjured patient and the definitive treatment;
3. Increasing the accessibility of high quality emergency medical services toall citizens of Virginia;
4. Promoting continuing improvement in system components including ground,water and air transportation, communications, hospital emergency departmentsand other emergency medical care facilities, consumer health information andeducation, and health manpower and manpower training;
5. Ensuring performance improvement of the Emergency Medical Services systemand emergency medical care delivered on scene, in transit, in hospitalemergency departments and within the hospital environment;
6. Working with professional medical organizations, hospitals, and otherpublic and private agencies in developing approaches whereby the many personswho are presently using the existing emergency department for routine,nonurgent, primary medical care will be served more appropriately andeconomically;
7. Conducting, promoting, and encouraging programs of education and trainingdesigned to upgrade the knowledge and skills of health manpower involved inemergency medical services, including expanding the availability of paramedicand advanced life support training throughout the Commonwealth withparticular emphasis on regions underserved by personnel having such skillsand training;
8. Consulting with and reviewing, with agencies and organizations, thedevelopment of applications to governmental or other sources for grants orother funding to support emergency medical services programs;
9. Establishing a statewide air medical evacuation system which shall bedeveloped by the Department of Health in coordination with the Department ofState Police and other appropriate state agencies;
10. Establishing and maintaining a process for designation of appropriatehospitals as trauma centers and specialty care centers based on an applicablenational evaluation system;
11. Maintaining a comprehensive emergency medical services patient care datacollection and performance improvement system pursuant to Article 3.1 (§32.1-116.1 et seq.) of this chapter;
12. Collecting data and information and preparing reports for the solepurpose of the designation and verification of trauma centers and otherspecialty care centers pursuant to this section. All data and informationcollected shall remain confidential and shall be exempt from the provisionsof the Virginia Freedom of Information Act (§ 2.2-3700 et seq.);
13. Establishing and maintaining a process for crisis intervention and peersupport services for emergency medical services and public safety personnel,including statewide availability and accreditation of critical incidentstress management teams;
14. Establishing a statewide emergency medical services for children programto provide coordination and support for emergency pediatric care,availability of pediatric emergency medical care equipment, and pediatrictraining of medical care providers;
15. Establishing and supporting a statewide system of health and medicalemergency response teams, including emergency medical services disaster taskforces, coordination teams, disaster medical assistance teams, and othersupport teams that shall assist local emergency medical services at theirrequest during mass casualty, disaster, or whenever local resources areoverwhelmed;
16. Establishing and maintaining a program to improve dispatching ofemergency medical services including establishment of and support foremergency medical dispatch training, accreditation of 911 dispatch centers,and public safety answering points;
17. Identifying and establishing best practices for managing and operatingagencies, improving and managing emergency medical response times, anddisseminating such information to the appropriate persons and entities; and
18. Ensuring that the Department of Criminal Justice Services and theVirginia Criminal Injuries Compensation Fund shall be contacted immediatelyto deploy assistance in the event there are victims as defined in §19.2-11.01.
B. The Board of Health shall also develop and maintain as a component of theEmergency Medical Services Plan a statewide prehospital and interhospitalTrauma Triage Plan designed to promote rapid access for pediatric and adulttrauma patients to appropriate, organized trauma care through the publicationand regular updating of information on resources for trauma care andgenerally accepted criteria for trauma triage and appropriate transfer. TheTrauma Triage Plan shall include:
1. A strategy for maintaining the statewide Trauma Triage Plan through formalregional trauma triage plans that incorporate each region's geographicvariations and trauma care capabilities and resources, including hospitalsdesignated as trauma centers pursuant to subsection A of this section. Theregional trauma triage plans shall be reviewed triennially.
2. A uniform set of proposed criteria for prehospital and interhospitaltriage and transport of trauma patients developed by the Emergency MedicalServices Advisory Board, in consultation with the Virginia Chapter of theAmerican College of Surgeons, the Virginia College of Emergency Physicians,the Virginia Hospital and Healthcare Association, and prehospital careproviders. The Emergency Medical Services Advisory Board may revise suchcriteria from time to time to incorporate accepted changes in medicalpractice or to respond to needs indicated by analyses of data on patientoutcomes. Such criteria shall be used as a guide and resource for health careproviders and are not intended to establish, in and of themselves, standardsof care or to abrogate the requirements of § 8.01-581.20. A decision by ahealth care provider to deviate from the criteria shall not constitutenegligence per se.
3. A performance improvement program for monitoring the quality of care,consistent with other components of the Emergency Medical Services Plan. Theprogram shall provide for collection and analysis of data on emergencymedical and trauma services from existing validated sources, including butnot limited to the emergency medical services patient care informationsystem, pursuant to Article 3.1 (§ 32.1-116.1 et seq.) of this chapter, thePatient Level Data System, and mortality data. The Emergency Medical ServicesAdvisory Board shall review and analyze such data on a quarterly basis andreport its findings to the Commissioner. The Emergency Medical ServicesAdvisory Board may execute these duties through a committee composed ofpersons having expertise in critical care issues and representatives ofemergency medical services providers. The program for monitoring andreporting the results of emergency medical and trauma services data analysisshall be the sole means of encouraging and promoting compliance with thetrauma triage criteria.
The Commissioner shall report aggregate findings of the analysis annually toeach regional emergency medical services council. The report shall beavailable to the public and shall identify, minimally, as defined in thestatewide plan, the frequency of (i) incorrect triage in comparison to thetotal number of trauma patients delivered to a hospital prior topronouncement of death and (ii) incorrect interfacility transfer for eachregion.
The Emergency Medical Services Advisory Board or its designee shall ensurethat each hospital or emergency medical services director is informed of anyincorrect interfacility transfer or triage, as defined in the statewide plan,specific to the provider and shall give the provider an opportunity tocorrect any facts on which such determination is based, if the providerasserts that such facts are inaccurate. The findings of the report shall beused to improve the Trauma Triage Plan, including triage, and transport andtrauma center designation criteria.
The Commissioner shall ensure the confidentiality of patient information, inaccordance with § 32.1-116.2. Such data or information in the possession ofor transmitted to the Commissioner, the Emergency Medical Services AdvisoryBoard, any committee acting on behalf of the Emergency Medical ServicesAdvisory Board, any hospital or prehospital care provider, any regionalemergency medical services council, licensed emergency medical servicesagency, or group or committee established to monitor the quality of carepursuant to this subdivision, or any other person shall be privileged andshall not be disclosed or obtained by legal discovery proceedings, unless acircuit court, after a hearing and for good cause shown arising fromextraordinary circumstances, orders disclosure of such data.
C. The Board of Health shall also develop and maintain as a component of theEmergency Medical Services Plan a statewide prehospital and interhospitalStroke Triage Plan designed to promote rapid access for stroke patients toappropriate, organized stroke care through the publication and regularupdating of information on resources for stroke care and generally acceptedcriteria for stroke triage and appropriate transfer. The Stroke Triage Planshall include:
1. A strategy for maintaining the statewide Stroke Triage Plan through formalregional stroke triage plans that incorporate each region's geographicvariations and stroke care capabilities and resources, including hospitalsdesignated as "primary stroke centers" through certification by the JointCommission or a comparable process consistent with the recommendations of theBrain Attack Coalition. The regional stroke triage plans shall be reviewedtriennially.
2. A uniform set of proposed criteria for prehospital and interhospitaltriage and transport of stroke patients developed by the Emergency MedicalServices Advisory Board, in consultation with the American StrokeAssociation, the Virginia College of Emergency Physicians, the VirginiaHospital and Healthcare Association, and prehospital care providers. TheBoard of Health may revise such criteria from time to time to incorporateaccepted changes in medical practice or to respond to needs indicated byanalyses of data on patient outcomes. Such criteria shall be used as a guideand resource for health care providers and are not intended to establish, inand of themselves, standards of care or to abrogate the requirements of §8.01-581.20. A decision by a health care provider to deviate from thecriteria shall not constitute negligence per se.
D. Whenever any state-owned aircraft, vehicle, or other form of conveyance isutilized under the provisions of this section, an appropriate amount not toexceed the actual costs of operation may be charged by the agency havingadministrative control of such aircraft, vehicle or other form of conveyance.
(1996, c. 899; 1997, c. 321; 1998, c. 317; 1999, c. 1000; 2005, cc. 632, 686;2006, c. 412; 2007, c. 15; 2008, cc. 66, 567; 2009, cc. 222, 269.)