article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Helicopter Medical Services Patient Safety, Protection, and Coordination Act''. SEC. 2. FINDINGS. Congress finds the following: (1) The Federal Aviation Administration is responsible for regulating civil aviation in the United States. (2) Each State is responsible for the regulation of public health planning and protection, patient safety and protection, emergency medical services, the quality and coordination of medical care, and the practice of medicine within its jurisdiction. (3) Helicopter medical services are an essential component of the health care delivery and emergency medical services system in each State and are integral to each State's management of public health planning and protection, patient safety and protection, emergency medical services, the quality and coordination of medical care, and the practice of medicine within the State's jurisdiction. (4) Existing or future regulation of helicopter medical services by the several States is in the public interest. (5) Helicopter medical services represent a unique and discrete area of air transportation because those services present issues involving the adequacy and availability of medical services to patients. (6) Court rulings and statutory interpretations issued by the Secretary of Transportation have imposed limitations on, impeded, or prevented, the ability of States to effectively regulate helicopter medical services in a manner similar to the regulation of other health care services by the States. (7) Those rulings and interpretations have concluded that certain State actions related to public health planning and protection, patient safety and protection, emergency medical services, the quality and coordination of medical care, and the practice of medicine, and related aspects of helicopter medical services, are preempted by Federal law, either pursuant to the preemption provisions of the Airline Deregulation Act of 1978 (Public Law 95-504; 92 Stat. 1705) or through the application of the ``field occupation'' preemption doctrine. (8) The Airline Deregulation Act of 1978 did not contemplate helicopter medical services, and the use of the Act to strike down intrastate health-related regulations overseeing the provision of helicopter medical services that would otherwise be permissible with respect to any other segment of the health care industry is not in the public interest. (9) At the same time, it is also important to ensure that the Federal Aviation Administration's plenary and exclusive jurisdiction over matters of aviation safety is not infringed by any State. Accordingly, any State health-related regulation of helicopter medical services must be harmonized and shall not be inconsistent with Federal regulation of aviation safety because the safe operation of the helicopter medical services flight is of paramount importance. (10) Accordingly, there is a need for clarification of existing Federal law so that States may regulate helicopter medical services with respect to public health planning and protection, patient safety and protection, emergency medical services, the quality and coordination of medical care, and the practice of medicine without infringing on the Federal government's plenary power to regulate aviation safety. SEC. 3. CLARIFICATION OF STATE AUTHORITY OVER HELICOPTER MEDICAL SERVICES. (a) In General.--Chapter 401 of title 49, United States Code, is amended by adding at the end the following: ``Sec. 40130. Clarification of State authority over helicopter medical services ``(a) Clarification of State Authority.--Nothing in this subtitle shall prohibit a State from-- ``(1) requiring medical licenses for the provision of helicopter medical services between locations within the State; or ``(2) prescribing regulations relating to the provision of such services if such regulations are prescribed pursuant to subsection (c), (d), or (e). ``(b) Applicability of Federal Aviation Safety Authority.--No State health-related regulation established pursuant to this section shall supersede or be inconsistent with any Federal operating requirement with respect to aviation safety. ``(c) State Authority Over Medical Services.--A State may prescribe regulations relating to the provision of helicopter medical services with respect to the following: ``(1) The medical qualifications and medical training of helicopter medical personnel, except that a State may not impose any requirement with respect to a pilot. ``(2) The obligation of providers of helicopter medical services to comply with the health planning, patient safety, and medical service requirements of the State, including-- ``(A) coordination of the interrelationship, interaction, and agreements among providers of helicopter medical services, providers of other emergency medical services, providers of other medical transport services, referring entities, and medical institutions that receive patients transported by providers of helicopter medical services with respect to the transport of patients; ``(B) demonstration of adequate capacity to provide helicopter medical services; ``(C) demonstration of the need for new or expanded helicopter medical services; ``(D) determinations with respect to the number and base location of helicopters used in the provision of helicopter medical services within the State or region of the State or the regulation of competition for specific markets within the State; ``(E) affiliation with health care institutions; ``(F) sanitation and infection control protocols; ``(G) medical records requirements; ``(H) quality of medical care requirements, including participation in patient safety and medical quality control efforts, such as peer review processes, utilization review, and error reporting systems; and ``(I) the proffer of gifts of monetary value (other than training or educational programs) to referring entities (or personnel employed by such entities) within the State. ``(d) State Authority Over Medical Services Subject to Harmonization Requirement.--A State may prescribe regulations relating to the provision of helicopter medical services with respect to the following, if such regulations are harmonized with, and do not infringe upon, any applicable Federal operating requirements: ``(1) The establishment of appropriate medical criteria for determining the appropriate medical institution to receive a patient being transported from the scene at which the patient's injury or accident, or other event resulting in the need for medical services for the patient, occurred. ``(2) The specification of service requirements with respect to geographic areas within the State or during specified hours and days. ``(3) The coordination of flight requests for emergency helicopter medical services. ``(4) The compliance with accreditation requirements regarding medical services, except where such requirements infringe upon relevant Federal operating requirements. ``(5) The provision of emergency helicopter medical services to all persons for whom such services are medically necessary and appropriate. ``(e) State Authority Over Medical Services Subject to Consistency Requirement.-- ``(1) In general.--Subject to paragraph (2), a State may prescribe regulations relating to the provision of helicopter medical services with respect to the following, if such regulations are consistent with, and do not infringe upon, any applicable Federal operating requirements: ``(A) The necessary medical equipment and supplies to be carried on board or affixed to the helicopter. ``(B) The physical attributes of the helicopter-- ``(i) necessary for the provision of quality medical care, including-- ``(I) permanently installed climate control systems capable of meeting specified temperature settings; ``(II) a configuration that allows adequate access to the patient, medical equipment, and medical supplies by the helicopter medical personnel; ``(III) use of materials in the helicopter that are appropriate for proper patient care; ``(IV) sufficient electrical supply to support medical equipment without compromising helicopter power; and ``(V) the ability of the helicopter to transport a patient a certain distance without refueling within the State; and ``(ii) necessary-- ``(I) for the protection of helicopter personnel, ground medical personnel, and emergency response personnel; and ``(II) to ensure that the helicopter has no structural or functional defects that may adversely affect such personnel, such as by requiring tailroter illumination for loading patients at night or external search lights. ``(C) Communication capabilities enabling-- ``(i) the helicopter medical personnel to communicate with emergency medical services and public safety personnel and personnel at medical institutions that receive patients transported by providers of helicopter medical services; and ``(ii) the flightcrew to communicate with the helicopter medical personnel, to the extent that the communications do not interfere with the safe operation of the flight. ``(2) Limitations.-- ``(A) Providers licensed in multiple states.--If a provider of helicopter medical services is licensed to provide such services in more than one State and the regulations established pursuant to this subsection by the States in which the provider is licensed are inconsistent, the provider shall comply with the most stringent of such regulations. ``(B) Nondelegation requirement.--A State may not delegate authority provided under this subsection to a political subdivision of the State. ``(f) Interstate Agreements.--In regulating the provision of helicopter medical services pursuant to this section, a State shall, if necessary, establish regulations or negotiate mutual aid agreements with adjacent States or providers of helicopter medical services in adjacent States to ensure access to helicopter medical services across State borders. ``(g) Definitions.--In this section: ``(1) Helicopter medical services.--The term `helicopter medical services' means the helicopter transport of a patient, in both emergency and nonemergency situations, as well as the medical services provided to such patient in the course of transport by such helicopter. ``(2) Federal operating requirements.--The term `Federal operating requirements' means requirements under part A of subtitle VII of title 49, United States Code, and Federal aviation regulations set forth in title 14, Code of Federal Regulations. ``(3) Referring entities.--The term `referring entity' means any entity that dispatches or provides a referral for a provider of helicopter medical services, such as a medical institution, an agency providing emergency medical services, or a first responder.''. (b) Conforming Amendment.--The table of sections at the beginning of chapter 401 of title 49, United States Code, is amended by adding at the end the following: ``40130. Clarification of State authority over intrastate helicopter medical services.''.
summary: Helicopter Medical Services Patient Safety, Protection, and Coordination Act - Authorizes states to regulate helicopter medical services with respect to: (1) the medical qualifications and training of helicopter medical personnel; and (2) the obligation of providers of helicopter medical services to comply with a state's health planning, patient safety, and medical service requirements. Prohibits states from imposing requirements on pilots. Authorizes states to regulate the following aspects of helicopter medical services to the extent such regulations are harmonized with applicable federal operating requirements: (1) establishment of criteria for determination of the appropriate medical institution to receive a transported patient; (2) specification of service requirements with respect to geographic areas within a state or during specified hours and days; (3) coordination of flight requests for emergency helicopter medical services; (4) compliance with medical services accreditation requirements, except where they infringe upon relevant federal operating requirements; and (5) provision of emergency helicopter medical services to all persons where needed. Authorizes a state to regulate certain aspects of helicopter medical services to the extent that such regulations are consistent with, and do not infringe upon, applicable federal operating requirements. Specifies among the aspects of helicopter medical services which states may regulate: (1) the necessary medical equipment and supplies to be carried on board or affixed to the helicopter; (2) the physical attributes of the helicopter necessary for the provision of quality medical care and for the protection of helicopter, ground medical, and emergency response personnel; and (3) specified communication capabilities among helicopter medical personnel and emergency medical services and public safety personnel, and between the flight crew and helicopter medical personnel. Requires a provider of helicopter medical services that is licensed in more than one state where state helicopter medical services regulations are inconsistent to comply with the most stringent regulation. Requires a state, if necessary, to establish regulations or negotiate mutual aid agreements with adjacent states, or providers of helicopter medical services in such states, to ensure access to such services across state borders.