EMSC in State Regulation and Policy

Advocates & Policymakers EMSC Stakeholders State Partnerships

This section provides documents showing how states/territories have influenced change by including EMSC priorities in regulation or policy. Listed below are EMSC Program Priorities (as listed in Performance Measure 09), Performance Measures, and System Establishment Regulations with links (when available) to either state statutes, rules, regulations, or policies that support pediatric emergency care.

If you have items you would like to add, please send your information to Rachael Alter (alter@nasemso.org).

Agency requirements to submit NEMSIS-compliant data to the state EMS Office.


References:

  • EMSC Program Priority 1
  • Performance Measure 01

Illinois

Administrative Code:

  • Section 515.350  Data Collection and Submission requires that a patient care run report shall be completed by each Illinois-licensed transport vehicle service provider for every inter-hospital transport and pre-hospital emergency call, regardless of the ultimate outcome or disposition of the call.
  • 515 Appendix E Minimum Prescribed Data Elements. Submit all data elements as listed in the Illinois Department of Public Health, Division of EMS and Highway Safety, National Emergency Medical Services Information System (NEMSIS)  Prehospital Dataset.

Massachusetts

AR 5-403 Statewide EMS Minimum Data Set. Under M.G.L. c. 111C, §3(b)(15), the Department, as lead agency for EMS in the Commonwealth, is charged with the collection and maintenance of standardized patient data and information by ambulance services, which services must ensure their EMTs are collecting on a trip record. The minimum EMS data set defined in this Administrative Requirement (AR) is being updated to align with the most current version available nationally and is based on the National EMS Information System Dataset (NEMSIS), as set out in the NEMSIS Data Dictionary Version 3.4.0. The MATRIS data dictionary is derived from the 585 elements in the NEMSIS V3.4.0 data dictionary.

  • Some pediatric measures incorporated into the data set
    • Estimated body weight in kilograms or
    • Length-based tape measure size
    • Temperature & method
    • APGAR (where applicable)

Oregon

SB 52 requires ambulance services report patient encounter data to an electronic emergency medical services data system managed by the authority. The requirements must specify the data that an ambulance service must report, the form and frequency of the re- porting and the procedures and standards for the administration of the data system.

Prehospital Patient Care Reporting FAQs indicate that ePCR data must be reported to the Oregon EMS Information System (OR-EMSIS).

OR-EMSIS is NEMSIS 3.4 compliant.


Vermont

All transporting agencies are required to report and first response agencies are encouraged. 

4.4.2.10. (Ambulance Service Licenses) The applicant agrees to provide complete and accurate documentation of all EMS response incidents to the SIREN system within one business day of the incident.

SIREN is NEMSIS v3.4 compliant.

EMS agencies in the state or territory have a designated individual who coordinates pediatric emergency care.


References:

  • EMSC Program Priority 2
  • Performance Measure 02

Alabama

Identifying a pediatric emergency care coordinator is a required field on the EMS Provider License Application.

"Provider" is an EMS agency in Alabama.


Georgia

EMS Agency Licensure. Agencies must designate ONE (1) Pediatric Emergency Care Coordinator (for 911 agencies) (Person responsible for coordinating pediatric-specific activities).
See "Minimum Personnel for EMS Agencies Not Using a Service Delivery Contract".


Indiana

Identifying a pediatric emergency care coordinator is a required field on the Initial and Renewal applications for agency licensure. EMS Rule re-write, which includes identification of a PECC at all Indiana EMS agencies is currently under review at the governor's office.


Rhode Island

216-RICR-20-10-2 (Regulation). Ambulance Services (2.7 B.4.g.) must identify the individual or individuals who fulfill the functions of Pediatric Emergency Care Coordinator (the individual who ensures that the ambulance service and its providers are prepared to care for ill and injured children).

EMS agencies in the state or territory have a process that requires EMS providers to physically demonstrate the correct use of pediatric-specific equipment.


References:

  • EMSC Program Priority 3
  • Performance Measure 03


Content Coming Soon.

A statewide, territorial, or regional standardized system that recognizes hospitals that are able to stabilize and/or manage pediatric medical emergencies.


References:

  • EMSC Program Priority 4
  • Performance Measure 04

Illinois

Administrative Code:


Oregon

ORS 431A.105 Emergency Medical Services for Children Program

(2)(e) Establish guidelines for:
(A) The approval of ... critical care medical service facilities for pediatric care, and for the designation of specialized regional pediatric critical care centers.
(D) Developing a coordinated system that will allow children to receive appropriate initial stabilization and treatment with timely provision of, or referral to, the appropriate level of care, including critical care, trauma care or pediatric subspecialty care.

A statewide, territorial, or regional standardized system that recognizes hospitals that are able to stabilize and/or manage pediatric trauma.


References:

  • EMSC Program Priority 4
  • Performance Measure 05

Illinois

Administrative Code:


Oregon

ORS 431A.105 Emergency Medical Services for Children Program

(2)(b) Provide technical assistance to the State Trauma Advisory Board on the integration of an emergency medical services for children program into the statewide emergency medical services and trauma system.

(2)(c) Provide advice and technical assistance to area trauma advisory boards on the integration of an emergency medical services for children program into area trauma system plans.

(2)(e) Establish guidelines for:
(A) The approval of emergency ... facilities for pediatric care, and for the designation of specialized regional ... pediatric trauma care centers.
(D) Developing a coordinated system that will allow children to receive appropriate initial stabilization and treatment with timely provision of, or referral to, the appropriate level of care, including critical care, trauma care or pediatric subspecialty care.


Tennessee

Hospitals in the state or territory have written interfacility transfer guidelines that cover pediatric patients and that include {required} components of transfer.

{expand this section to the the required components}


References

  • EMSC Program Priority 5
  • Performance Measure 06

Required Components

  • Defined process for initiation of transfer, including the roles and responsibilities of the referring facility and referral center (including responsibilities for requesting transfer and communication).
  • Process for selecting the appropriate care facility.
  • Process for selecting the appropriately staffed transport service to match the patient’s acuity level (level of care required by patient, equipment needed in transport, etc.).
  • Process for patient transfer (including obtaining informed consent).
  • Plan for transfer of patient medical record.
  • Plan for transfer of a signed copy of transport consent.
  • Plan for transfer of personal belongings of the patient.
  • Plan for provision of directions and referral-institution information to family.

State Resources

Illinois

Administrative Code:


New Jersey

26-2K-51 Purposes of the Program (see 4.b., d., e., f.)


Oregon

ORS 431A.105 Emergency Medical Services for Children Program

(2)(e) Establish guidelines for:
(B) Referring children to appropriate emergency or critical care medical facilities.
(G) An interfacility transfer system for critically ill or injured children.

Hospitals in the state or territory have written interfacility transfer agreements that cover pediatric patients.


References:

  • EMSC Program Priority 6
  • Performance Measure 07

Illinois

Administrative Code:

The degree to which the state or territory has established permanence of EMSC in the state or territory EMS system.

  • A state or territory EMSC Advisory Committee that meets regularly
  • A pediatric representative on the state or territory EMS Board
  • A full-time EMSC program manager

Reference:

  • Performance Measure 08

EMSC Advisory Committees

Arizona

Pediatric Advisory Council for Emergency Services (PACES) is a standing committee, and part of the Bureau of EMS' statutory committee structure. Bylaws and past meeting minutes can be found here.


South Carolina

Code of Laws 44-61, Article 3, Section 44-61-350. Advisory Committee.

(A) There is established the Emergency Medical Services for Children Advisory Committee to advise the department on matters concerning preventative, prehospital, hospital, rehabilitative, and other post-hospital medical care for children.

Pediatric Representation on the EMS Board

Alabama

1975 Section 22-18-40 State Emergency Medical Control Committee
One member shall be a physician appointed by the Alabama Chapter of the American Academy of Pediatrics


Georgia

511-9-2-.03 Statewide Emergency Medical Services Advisory Councils
Requirement for pediatric representation


Massachusetts

Part 1. Title XVI. Chapter 111C. Section 13: EMS system advisory board
Membership includes one person who shall be an expert in EMS for children.


New Jersey

26:2K-52 Emergency Medical Services for Children Advisory Council

Full-time EMSC Program Manager

Arizona

Article III of the Pediatric Advisory Council for Emergency Services (PACES) Bylaws identifies the EMSC grant manager as a member of the Council. The Bylaws can be found here.


Louisiana

§1075.4.B. Emergency Medical Services for Children Program; establishment. The secretary shall hire a full-time coordinator for the EMSC program.

The Louisiana EMS for Children program (EMSC) has a program manager whose full-time role is 100% dedicated to overseeing the success of the program across the state. Additionally, the program is supported by part-time and in-kind positions, including: project director, clinical liaison, and family advocate network representative. Separate from these roles, the Louisiana EMSC program is advised by a robust, active, engaged Advisory Board made up of pediatricians, nursing directors, emergency medicine physicians, policy makers, and family representation – each of these perspectives helps drive the mission of the EMSC program.


New Jersey

26:2k-50.3.b. Emergency Medical Services for Children Program.

The commissioner shall hire a full-time coordinator for the EMSC program in consultation with, and by the recommendation of the advisory council.


South Carolina

Code of Laws 44-61, Article 3, Section 44-61-350(C). Advisory Committee. Identifies the EMSC Program manager will be a member of the committee.

Basic life support (BLS) and advanced life support (ALS) prehopital provider agencies in the state or territory have on-line and off-line pediatric medical direction available.


Reference:

  • EMSC Program Priority 7

On-line Medical Direction

Arizona

Administrative Code R9-25-201. Article 2 Medical Direction; ALS Base Hospital Certification. (A.1.d.iii) An emergency medical services provider or ambulance service is an emergency medicine physician in an emergency department located in Arizona and has current certification in Pediatric advanced life support that includes didactic instruction and a practical skills test, consistent with training recognized by the American Heart Association.


Illinois

Administrative Code

  • 515.330 EMS System Program Plan. Indicates that EMS System Program Plans must include: (Section l.5.B) Protocols ensuring that physician direction and voice orders to EMS vehicle personnel and other hospitals participating in the System are provided from the operational control point of the Resource or Associate Hospital; and (Section 1.5.C) Protocols ensuring that the voice orders via radio and using telemetry shall be given by or under the direction of the EMS MD or the EMS MD's designee, who shall be either an ECRN or physician.
  • 515.400 General Communications.

Vermont

EMS Rule defines on-line medical direction as "via radio or telephone, of field personnel at the site of the emergency and en route to a hospital emergency department." Ambulance services must demonstrate that they "will receive medical direction to be supplied by the hospital(s) within the service area" (4.4.2.6). Additionally, the Statewide EMS Protocols identify situations when on-line medical control should be contacted.

Off-line Medical Direction

Illinois

Administrative Code:


Michigan

Protocols adopted by the MCA and approved by the department have the force and effect of law. These protocols include considerations for pediatric patients in every relevant/applicable scenario, as well as designated sections for Pediatric Cardiac Protocols, Obstetric and Pediatric Protocols.


Vermont

Pediatrics are integrated throughout the Statewide EMS Protocols.

BLS and ALS patient-care units in the state or territory have the essential pediatric equipment and supplies, as outlined in the nationally recognized and endorsed guidelines.


Reference:

  • EMSC Program Priority 8

Arizona

Article 10-R9-25-1003. Minimum Equipment and Supplies for Ground Ambulance Vehicles.
Requirements include pediatric-specific equipment and supplies.


Illinois

Administrative Code:

  • 515.830 Ambulance Licensing Requirements (Section b) Equipment Requirements – Basic Life Support Vehicles Each ambulance used as a Basic Life Support vehicle shall meet the following equipment requirements, as determined by the Department by an inspection:
    • (b.4.) Medical equipment (list identifies multiple pediatric-specific items)
    • (b.5.) Medical supplies (list identifies multiple pediatric-specific items)
      515.830 Ambulance Licensing Requirements
  • 515.830 Ambulance Licensing Requirements (Section c) Equipment Requirements – Intermediate and Advanced Life Support Vehicles.
    • Each ambulance used as an Intermediate Life Support vehicle or as an Advanced Life Support vehicle shall meet the requirements in subsections (b) and (d) and shall also comply with the equipment and supply requirements as determined by the EMS MD in the System in which the ambulance and its crew participate.  Drugs shall include both adult and pediatric dosages. These vehicles shall have a current pediatric equipment/drug dosage sizing tape or pediatric equipment/drug dosage age/weight chart.

Massachusetts

Administrative Requirements include Ambulance Equipment Lists for both BLS (AR 5-401) and ALS (AR 5-402) ambulances. These lists include pediatric-specific equipment requirements.


Michigan

Pediatric restraints are on the minimum equipment list for transporting vehicles and voted on by the EMSCC Ambulance Operations Subcommittee. Our “minimum standard” is defined in administrative rule. Every vehicle is inspected and if they don’t have that piece of equipment, they have 24 hours to bring it to standard. If they can’t, the vehicle is removed from service until they can prove that they have brought it to standard. Equipment lists are linked at the bottom this webpage.


New Jersey

26-2K-51 Purposes of the Program (see 4.c.)


Oregon

ORS 431A.105 Emergency Medical Services for Children Program. (2)(e) Establish guidelines for:
(C) Necessary prehospital and other pediatric emergency and critical care medical service equipment.


Pennsylvania

49 Pa.B. 3404 Vehicle, Equipment and Supply Requirements for Emergency Medical Services Agencies.
Requirements include pediatric-specific equipment and supplies.


Vermont

Ambulance Vehicle Inspection & License includes pediatric transport devices and other pediatric sized equipment.

Requirements adopted by the state or territory for pediatric continuing education prior to the renewal of BLS and ALS licensing and/or certification.


Reference:

  • EMSC Program Priority 9

Arizona

R9-25-404 (C.3.c.iii) Application Requirements for EMCT Recertification.
For recertification (which is required every two years), EMCTs are required to have five hours of pediatric-specific continuing education.


Georgia

511-9-2-.13 Licensure Renewal for Emergency Medical Services Personnel


Illinois

  • Administrative Code 515.590 EMS Personnel License Renewals
    • (Section a.2.A-B) To be relicensed the EMS MD or designee shall provide an electronic authorization to the Department regarding completion of the following minimum requirements: Paramedics and PHRNs shall have a minimum of 100 approved CE hours. A-EMTs and EMT-Is shall have a minimum of 80 approved CE hours.  EMTs shall have a minimum of 60 approved CE hours. CE hours shall consist of EMS System-approved in-services, Department-recognized college health care courses, online CE courses, seminars and workshops, addressing both adult and pediatric care.  The System shall define in the Program Plan the number of CE hours to be accrued for relicensure.  No more than 20 percent of those hours may be in the same subject.
  • Illinois Department of Public Health EMS Continuing Education Relicensure Recommendations (Pediatric sections on page 1 and 3).

Louisiana

Louisiana is a NREMT Recertification State, so the Louisiana Bureau of EMS Education policy (BEMS) requires that EMS professionals recertify based on NREMT Requirements at each Certification Level (each include pediatric requirements).


New Jersey

26-2K-51 Purposes of the Program (see 4.a.)


Oregon

ORS 431A.105 Emergency Medical Services for Children Program. (2)(e) Establish guidelines for:
(H) Initial and continuing professional education programs for emergency medical services personnel, including training in the emergency care of infants and children.


Tennessee

Continuing Education includes pediatric hours.


Vermont

EMT, AEMT, and Paramedic renewal requirements include various pediatric hours, and include one additional pediatric hour for each state level beyond the national registry requirements.

While the establishment of an EMSC system is not a Program requirement, some state programs have been able to institute legislation addressing EMSC system establishment.


Louisiana

Revised Statute Code 40.1075 Part III. Emergency Medical Services for Children Program.

The Louisiana EMS for Children program (EMSC) is located in the Louisiana Department of Health (LDH) | Office of Public Health (OPH) | Bureau of Family Health (BFH).  The mission of EMSC is to reduce pediatric morbidity and mortality rates caused by acute injury and illness.  It is integrated into the Bureau of Family Health’s mission to provide leadership, expertise and partnership to advance the health and well-being of women, children, adolescents, and families. 


Nebraska

Revised Statute 71-51,103. Nebraska Emergency Medical System Operations Fund; created; use; investment.
The fund shall be used to carry out the purposes of the Statewide Trauma System Act and the Emergency Medical Services Practice Act, including... support for the emergency medical services programs for children.

LB 191 (6) The county treasurer or his or her agent shall collect, in addition to other registration fees,fifty cents for each certificate issued and shall remit the fee to the State Treasurer for credit to the Nebraska Emergency Medical System Operations Fund.


New Jersey

An Act concerning emergency medical services for children and supplementing chapter 2K of Title 26 of the Revised Statues.

“EMSC program” means the Emergency Medical Services for Children program established pursuant to section 3 of this act, and other relevant programmatic activities conducted by the Office of Emergency Medical Services in the Department of Health in support of appropriate treatment, transport, and triage of ill or injured children in New Jersey.


Oregon

ORS 431A.105: Emergency Medical Services for Children Program.
The Emergency Medical Services for Children Program shall operate in cooperation with the Emergency Medical Services and Trauma Systems Program to promote the delivery of emergency medical and trauma services to the children of Oregon.


South Carolina

Code of Laws 44-61, Article 3: Children's Emergency Medical Services Act.
There is established within the Department of Health and Environmental Control, Division of Emergency Medical Services, the Emergency Medical Services and Trauma for Children Program.


Tennessee

Enabling Legislation for the Children's Emergency Care Alliance.