Health and Safety Code
CHAPTER 773. EMERGENCY MEDICAL SERVICES
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 773.001. Short Title.
This chapter may be cited as the Emergency Medical Services
Act.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
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 Texas Department of Health.
(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;
(C) emergency medical technicians--intermediate;
(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;
(C) a mobile intensive-care unit; or
(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.
(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 the Medical Practice Act (Article 4495b, Vernon's Texas
Civil Statutes) and the rules adopted under that Act 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
(C) serious dysfunction of any bodily organ or part.
(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.
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.
Amended by Acts 1995, 74th Leg., ch. 915, Sec. 1, eff. Aug. 28,
1995; Acts 1997, 75th Leg., ch. 435, Sec. 1, eff. Sept. 1, 1997.
Sec. 773.004. Vehicles and Personnel Excluded from Chapter.
(a) This chapter does not apply to:
(1) a ground transfer vehicle and staff used to transport a
patient who is under a physician's care between medical
facilities or between a medical facility and a private
residence;
(2) ground or air transfer that does not advertise as an
ambulance service and that is not licensed by the department;
(3) 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;
(4) an industrial ambulance; or
(5) 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.
Amended by Acts 1993, 73rd Leg., ch. 376, Sec. 1, eff. Sept. 1,
1993.
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.
(c) In filling the position of bureau chief, the department
shall give preference to a physician who applies for the
position.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 773.007. 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.
(c) The board shall adopt a rule that requires an emergency
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.
Amended by Acts 1995, 74th Leg., ch. 915, Sec. 2, eff. Aug. 28,
1995.
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.
(c) The advisory council shall consider the bureau's actions
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.
(c) A delivery area plan may include the use of helicopters
that 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.
(c) A governmental entity that sponsors or wishes to sponsor an
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.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
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.
(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.
(c) A certificate or license issued under this chapter is not
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.
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 and has personnel and sufficient
equipment and supplies for providing basic life support.
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.
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.
(c) An air ambulance company based in another state that
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.
Amended by 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.
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.
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.
Amendment by Acts 1989, 71st Leg., ch. 372, Sec. 10
V.T.C.A. Government Code, Sec. 311.031(c) provides, in part, that
the repeal of a statute by a code does not affect an amendment of
the statute by the same legislature which enacted the code and
that the amendment is preserved and given effect as part of the
code provision.
Section 10 of Acts 1989, 71st Leg., ch. 372 amends Vernon's
Ann.Civ.St. art. 4447o, Sec. 3.16 [now, this section and Secs.
773.047 to 773.049] without reference to the repeal of said
article by Acts 1989, 71st Leg., ch. 678, Sec. 13(1). As so
amended Sec. 316 reads:
"A person who is certified by the department as a paramedic
emergency medical technician, specially skilled emergency medical
technician, basic emergency medical technician, or emergency care
attendant or an emergency medical services provider who has
permitted emergency medical services vehicles on the effective
date of this Act is considered to be certified or to have an
emergency medical services provider license under this Act until
the expiration of the respective certificate or vehicle permit.
However, certified emergency medical services personnel are not
subject to the certification fees provided in this Act until the
expiration date of certification."
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.
Amendment by Acts 1989, 71st Leg., ch. 372, Sec. 10
V.T.C.A. Government Code, Sec. 311.031(c) provides, in part, that
the repeal of a statute by a code does not affect an amendment of
the statute by the same legislature which enacted the code and
that the amendment is preserved and given effect as part of the
code provision.
Section 10 of Acts 1989, 71st Leg., ch. 372 amends Vernon's
Ann.Civ.St. art. 4447o, Sec. 3.16 [now, this section and Secs.
773.046, 773.048, 773.049] without reference to the repeal of
said article by Acts 1989, 71st Leg., ch. 678, Sec. 13(1).
For text of Sec. 3.16 as amended, see italicized note following
Sec. 773.046.
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.
Amendment by Acts 1989, 71st Leg., ch. 372, Sec. 10
V.T.C.A. Government Code, Sec. 311.031(c) provides, in part, that
the repeal of a statute by a code does not affect an amendment of
the statute by the same legislature which enacted the code and
that the amendment is preserved and given effect as part of the
code provision.
Section 10 of Acts 1989, 71st Leg., ch. 372 amends Vernon's
Ann.Civ.St. art. 4447o, Sec. 3.16 [now, this section and Secs.
773.046, 773.047, 773.049] without reference to the repeal of
said article by Acts 1989, 71st Leg., ch. 678, Sec. 13(1).
For text of Sec. 3.16 as amended, see italicized note following
Sec. 773.046.
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.
Amendment by Acts 1989, 71st Leg., ch. 372, Sec. 10
V.T.C.A. Government Code, Sec. 311.031(c) provides, in part, that
the repeal of a statute by a code does not affect an amendment of
the statute by the same legislature which enacted the code and
that the amendment is preserved and given effect as part of the
code provision.
Section 10 of Acts 1989, 71st Leg., ch. 372 amends Vernon's
Ann.Civ.St. art. 4447o, Sec. 3.16 [now, this section and Secs.
773.046, 773.047, 773.048] without reference to the repeal of
said article by Acts 1989, 71st Leg., ch. 678, Sec. 13(1).
For text of Sec. 3.16 as amended, see italicized note following
Sec. 773.046.
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 board 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) continuing education programs and 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.
(c) The board shall consider the education, training, 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 $100. The board 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 $150.
(d) The board 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 board shall adopt minimum standards for recognition of
first responder organizations.
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.
Amended by Acts 1993, 73rd Leg., ch. 251, Sec. 1, eff. May 23,
1993; Acts 1995, 74th Leg., ch. 915, Sec. 7, eff. Aug. 28, 1995.
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 $25 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.
(c) The bureau chief shall grant to a sole provider for a
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.
Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff.
Sept. 1, 1995.
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.
(c) Each application under Subsection (a)(3) must be
accompanied by a nonrefundable fee of $25 for a program
instructor or examiner or $50 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 $25 for a basic course or
training program or $50 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.
Amended by Acts 1995, 74th Leg., ch. 915, Sec. 9, eff. Aug. 28,
1995.
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) $75 for an emergency medical technician-paramedic or
emergency medical technician-intermediate;
(2) $50 for an emergency medical technician or emergency
care attendant;
(3) $75 for recertification of an emergency medical
technician-paramedic or emergency medical
technician-intermediate;
(4) $50 for recertification of an emergency medical
technician or emergency care attendant; or
(5) $100 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.
(c) The department shall notify an examinee of the results of
an 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 $25 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 $5 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.
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.
Amended by 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.
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 $5 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.
Amended by Acts 1995, 74th Leg., ch. 915, Sec. 11, eff. Aug. 28,
1995.
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 fee determined by the board must accompany
each application. The fee may not exceed $150 for each emergency
medical services vehicle operated by the provider.
(c) The department may delegate vehicle inspections to the
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.
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.
Amended by Acts 1995, 74th Leg., ch. 915, Sec. 12, eff. Aug. 28,
1995.
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 $25
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.
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) Except as provided by Subsection (b), a person applying for
recertification whose application is received after the
expiration date of the person's certificate must pay a late fee
of $25.
(b) 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.
Amended by Acts 1993, 73rd Leg., ch. 251, Sec. 3, eff. May 23,
1993.
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 may:
(1) decertify, suspend, place on emergency suspension, or
place on probation emergency medical services personnel;
(2) revoke or place on probation course or training program
approval;
(3) revoke, suspend, or place on probation the certificate
of a program instructor, examiner, or course coordinator; and
(4) revoke, suspend, or place on probation an emergency
medical services provider license.
(b) 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.
Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff.
Sept. 1, 1995.
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.
(c) The board shall adopt rules for unannounced inspections
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 $25
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.
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. 773.062. 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.
(c) The holder may request in writing a hearing on the
emergency 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.
Amended by 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.
(c) Civil penalties recovered in a suit brought by the state at
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.
(c) A person commits an offense if the person knowingly uses or
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; or
(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.
Amended by 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.
(c) The penalty may not exceed $1,000 for each violation. The
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.
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.
(c) If the emergency medical services provider or course
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; or
(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.
(c) If the commissioner receives a copy of an affidavit under
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.
SUBCHAPTER D. EMERGENCY MEDICAL SERVICES AND TRAUMA CARE SYSTEMS
[REDESIGNATED]
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.
(c) Any person who receives information from confidential
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 Criminal Evidence,
and Rule 501, Texas Rules of Civil 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.
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.
(c) Subdivision (5) does not authorize the release of
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.
(c) A person who receives information made confidential by this
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 trauma systems, or first
responder organizations relating to the review, evaluation, or
improvement of an emergency medical services provider, a first
responder organization, 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.
(c) This section does not apply to records made or maintained
in 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.
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. POISON CONTROL CENTERS [REDESIGNATED]
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.
(c) In order to improve the health of the people of the state, 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 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.
(c) The rules must include:
(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 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
(C) monitor trauma patient care in each health care
facility, 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 Sec. 773.083 by Acts 1991, 72nd Leg.,
ch. 605, Sec. 9, eff. Sept. 1, 1991.
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 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 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, II, and III trauma centers and
rules adopted by the board for level IV and V trauma centers. 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.
(c) After September 1, 1993, a health care facility may not use
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 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.
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.
(c) The board shall set the fee for the highest level
designation at not more than $3 a bed, but the total fee for the
facility may not be less than $100 or more than $3,000. The fee
for an intermediate level designation shall be set at not more
than $2 a bed, but the total fee for the facility may not be less
than $100 or more than $2,000. The fee for the lowest level
designation shall be set at not more than $1 a bed, but the total
fee for the facility may not be less than $100 or more than
$1,000.
(d) A fee under Subsection (c) may not exceed 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 Sec. 773.086 by Acts 1991, 72nd Leg.,
ch. 605, Sec. 9, eff. Sept. 1, 1991.
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 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.
(c) The department may approve grants according to the rules
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 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 Sec. 773.090 by Acts 1991, 72nd Leg.,
ch. 605, Sec. 9, eff. Sept. 1, 1991.
Sec. 773.121. Fund.
(a) The emergency medical services and trauma care system fund
is created as a special account in the state treasury. Money in
the fund may be appropriated only to the department for the
purposes described by Section 773.122.
(b) The emergency medical services and trauma care system fund
is composed of money appropriated to the credit of the fund.
Added by Acts 1997, 75th Leg., ch. 1157, Sec. 1, eff. Sept. 1,
1997.
Sec. 773.122. Payments From the Fund.
(a) The commissioner, with advice and counsel from the
chairpersons of the regional advisory councils, shall use money
in the emergency medical services and trauma care system fund
established under Section 773.121 to fund county and regional
emergency medical services and trauma care systems in accordance
with this section.
(b) The commissioner shall maintain a reserve of $250,000 of
money appropriated from the emergency medical services and trauma
care system fund for extraordinary emergencies.
(c) In any fiscal year the commissioner shall use at least 70
percent of the appropriated money remaining in the emergency
medical services and trauma care system fund, 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 support 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 to
counties on behalf of eligible recipients. A county's share of
the money 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 county to eligible
recipients for approved functions by the end of the fiscal year
in which the funds were disbursed to the county shall be returned
to the fund to be used in accordance with Subsection (f).
(d) In any fiscal year, the commissioner may use not more than
25 percent of the appropriated money remaining in the emergency
medical services and trauma care system fund, after any amount
necessary to maintain the reserve established by Subsection (b)
is deducted, for operation of the 22 trauma support areas and for
equipment, communications, and education and training for the
areas. Money distributed under this subsection shall be
distributed to the county in which the chairperson of an area's
regional advisory council sits on behalf of eligible recipients.
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 support area and the relative amount of
trauma care provided. Money that is not disbursed by a county to
eligible recipients for approved functions by the end of the
fiscal year in which the funds were disbursed to the county shall
be returned to the fund to be used in accordance with Subsection
(f).
(e) In any fiscal year, the commissioner may use not more than
three percent of the appropriated money remaining in the
emergency medical services and trauma care system fund 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 fund and to fund the costs of
monitoring and providing technical assistance for those programs
and that fund.
(f) In any fiscal year, the commissioner shall use at least two
percent of the appropriated money remaining in the emergency
medical services and trauma care system fund after any amount
necessary to maintain the reserve established by Subsection (b)
is deducted and the money in the fund 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. A regional advisory council chairperson may
petition the department for disbursement of funds to a trauma
center in the chairperson's trauma support area that has suffered
deleterious effects due to 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 emergency medical services and
trauma care system fund 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.
Sec. 773.123. Control of Expenditures From the Fund.
(a) Except as provided by Subsection (b), money distributed
from the emergency medical services and trauma care system fund
shall be used in accordance with Section 773.122 on the
authorization of the chief executive of the county to which the
money is disbursed on vouchers issued by the county's treasurer.
(b) In a county with a population of 291,000 or more, money
distributed from the emergency medical services and trauma care
system fund shall be used in accordance with Section 773.122 on
the joint authorization of the chief executive of the county to
which the money is disbursed and the mayor of the principal
municipality in that county on vouchers issued by the county's
treasurer.
(c) For the purposes of this section, "principal municipality"
means the municipality with the largest population in a county to
which this section applies.
Added by Acts 1997, 75th Leg., ch. 1157, Sec. 1, eff. Sept. 1,
1997.
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 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.
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.
(c) The department may solicit, receive, and spend funds it
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;
(C) necessary pediatric emergency equipment and training
in 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.
(c) The bureau may grant an exception to a rule adopted under
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