The Vermont Statutes Online

Title 18: Health

Chapter 017: Emergency Medical Services

• § 901. Purpose, findings, policy

  (a) Purpose. It is the purpose of this chapter to promote and provide for a comprehensive and effective emergency medical services system to ensure optimum patient care.

  (b) Findings. The General Assembly finds that:

  (1) Emergency medical services provided by an ambulance service are essential services.

  (2) The provision of medical assistance in an emergency is a matter of vital concern affecting the health, safety, and welfare of the public.

  (3) Key elements of an emergency medical services system include:

  (A) the provision of prompt, efficient, and effective emergency medical dispatch and emergency medical care;

  (B) a well-coordinated trauma care system;

  (C) effective communication between prehospital care providers and hospitals; and

  (D) the safe handling and transportation, and the treatment and transportation under appropriate medical guidance, of individuals who are sick or injured.

  (c) Policy. It is the policy of the State of Vermont that all persons who suffer sudden and unexpected illness or injury should have access to the emergency medical services system in order to prevent loss of life or the aggravation of the illness or injury, and to alleviate suffering.

  (1) The system should include competent emergency medical treatment provided by adequately trained, licensed, and equipped personnel acting under appropriate medical control.

  (2) Persons involved in the delivery of emergency medical care should be encouraged to maintain and advance their levels of training and licensure, and to upgrade the quality of their vehicles and equipment. (Added 1981, No. 61; amended 2011, No. 155 (Adj. Sess.), § 32; 2019, No. 100 (Adj. Sess.), § 3, eff. May 14, 2020; 2023, No. 157 (Adj. Sess.), § 1, eff. June 6, 2024.)

• § 902. Definitions

  As used in this chapter, unless the context requires otherwise, words and phrases shall have the meaning given in 24 V.S.A. § 2651. (Added 1981, No. 61; amended 1983, No. 226 (Adj. Sess.), § 15.)

• § 903. Authorization for provision of emergency medical services

  Notwithstanding any other provision of law, including provisions of 26 V.S.A. chapter 23, persons who are affiliated with an affiliated agency and licensed to provide emergency medical treatment pursuant to the requirements of this chapter and the rules adopted under it are hereby authorized to provide such care without further certification, registration, or licensing. (Added 1981, No. 61; amended 2011, No. 155 (Adj. Sess.), § 33; 2019, No. 100 (Adj. Sess.), § 3, eff. May 14, 2020; 2019, No. 166 (Adj. Sess.), § 29, eff. Oct. 1, 2020.)

• § 904. Administrative provisions

  (a) In order to carry out the purposes and responsibilities of this chapter, the Department of Health may contract for the provision of specific services.

  (b) The Secretary of Human Services, upon the recommendation of the Commissioner of Health, may adopt rules to carry out the purposes and responsibilities of this chapter. (Added 1981, No. 61; amended 2011, No. 155 (Adj. Sess.), § 34; 2017, No. 113 (Adj. Sess.), § 56; 2019, No. 166 (Adj. Sess.), § 29, eff. Oct. 1, 2020.)

• § 905. Repealed. 1983, No. 226 (Adj. Sess.), § 16.

• § 906. Emergency Medical Services Division; responsibilities

  To implement the policy of section 901 of this chapter, the Department of Health shall be responsible for:

  (1) Developing and implementing minimum standards for training emergency medical personnel in basic life support and advanced life support, and licensing emergency medical personnel according to their level of training and competence. The Department shall establish by rule at least three levels of emergency medical personnel instructors and the education required for each level.

  (2) Developing and implementing minimum standards for vehicles used in providing emergency medical care, designating the types and quantities of equipment that must be carried by these vehicles, and registering those vehicles according to appropriate classifications.

  (3) Developing a statewide system of emergency medical services, including planning, organizing, coordinating, improving, expanding, monitoring, and evaluating emergency medical services.

  (4) [Repealed.]

  (5) Developing volunteer and career response time standards for urban and rural requests for emergency services.

  (6) Training, or assisting in the training of, emergency medical personnel.

  (7) Assisting hospitals in the development of programs that will improve the quality of in-hospital services for persons requiring emergency medical treatment.

  (8) Developing and implementing procedures to ensure that emergency medical services are rendered only with appropriate medical control. For the provision of advanced life support, appropriate medical control shall include at a minimum:

  (A) written protocols between the appropriate officials of receiving hospitals and emergency medical services districts defining their operational procedures;

  (B) where necessary and practicable, direct communication between emergency medical personnel and a physician or person acting under the direct supervision of a physician;

  (C) when such communication has been established, a specific order from the physician or person acting under the direct supervision of the physician to employ a certain medical procedure;

  (D) use of advanced life support, when appropriate, only by emergency medical personnel who are certified by the Department of Health to employ advanced life support procedures.

  (9) Establishing requirements for the collection of data by emergency medical personnel and hospitals as may be necessary to evaluate emergency medical treatment.

  (10) Establishing, by rule, license levels for emergency medical personnel. The Commissioner shall use the guidelines established by the National Highway Traffic Safety Administration (NHTSA) in the U.S. Department of Transportation as a standard or other comparable standards, except that a felony conviction shall not necessarily disqualify an applicant. The rules shall also provide that:

  (A) An individual may apply for and obtain one or more additional licenses, including licensure as an advanced emergency medical technician or as a paramedic.

  (B) An individual licensed by the Commissioner as an emergency medical technician, advanced emergency medical technician, or paramedic, who is affiliated with an affiliated agency, shall be able to practice fully within the scope of practice for such level of licensure as defined by NHTSA’s National EMS Scope of Practice Model consistent with the license level of the affiliated agency, and subject to the medical direction of the emergency medical services district medical advisor.

  (C)(i) Unless otherwise provided under this section, an individual seeking any level of licensure shall be required to pass an examination approved by the Commissioner for that level of licensure, except that any psychomotor skills testing for emergency medical responder, or emergency medical technician licensure shall be accomplished either by the demonstration of those skills competencies as part of the education required for that license level as approved by the Department or by the National Registry of Emergency Medical Technicians’ psychomotor examination.

  (ii) Written and practical examinations shall not be required for relicensure; however, to maintain licensure, all individuals shall complete a specified number of hours of continuing education as established by rule by the Commissioner. The Commissioner shall ensure that continuing education classes are available online and provided on a regional basis to accommodate the needs of volunteers and part-time individuals, including those in rural areas of the State.

  (D) If there is a hardship imposed on any applicant for a license under this section because of unusual circumstances, the applicant may apply to the Commissioner for a temporary or permanent waiver of one or more of the licensure requirements, which the Commissioner may grant for good cause.

  (E) An applicant who has served as a hospital corpsman or a medic in the U.S. Armed Forces, or who is licensed as a registered nurse or a physician assistant shall be granted a permanent waiver of the training requirements to become a licensed emergency medical technician, an advanced emergency medical technician, or a paramedic, provided the applicant passes the applicable examination approved by the Commissioner for that level of licensure and is affiliated with an affiliated agency.

  (F) An applicant who is registered on the National Registry of Emergency Medical Technicians as an emergency medical technician, an advanced emergency medical technician, or a paramedic shall be granted licensure as a Vermont emergency medical technician, an advanced emergency medical technician, or a paramedic without the need for further testing, provided he or she is affiliated with an affiliated agency or is serving as a medic with the Vermont National Guard.

  (G) [Repealed.]

  (11) In addition to the licenses established under subdivision (10) of this section, the Department shall establish by rule an entry-level certification for Vermont EMS first responders. (Added 1981, No. 61; amended 2009, No. 78 (Adj. Sess.), § 10e, eff. April 15, 2010; 2009, No. 142 (Adj. Sess.), § 18, eff. June 1, 2010; 2011, No. 155 (Adj. Sess.), § 35; 2015, No. 97 (Adj. Sess.), § 46a; 2019, No. 100 (Adj. Sess.), § 3, eff. May 14, 2020; 2019, No. 166 (Adj. Sess.), § 29, eff. Oct. 1, 2020.)

• § 906a. Relicensure; grace period

  A person certified or licensed as an emergency medical provider shall have six months after his or her certification or license has expired to resubmit the necessary information for renewal of the certificate or license. (Added 2011, No. 155 (Adj. Sess.), § 36.)

• § 906b. Repealed. 2019, No. 166 (Adj. Sess.), § 29.

  (Repealed. 2019, No. 166 (Adj. Sess.), § 29.)

• § 906c. Veterans and service members returning from deployment; prior positions

  (a) As used in this section:

  (1) “Service member” means an individual who is an active duty member of:

  (A) the U.S. Armed Forces;

  (B) a reserve component of the U.S. Armed Forces;

  (C) the U.S. Coast Guard; or

  (D) the National Guard of any state.

  (2) “Veteran” means a former service member who received an honorable discharge or a general discharge under honorable conditions from active duty.

  (b)(1) A veteran or service member who held a position as an emergency medical provider prior to his or her most recent military deployment but whose license or certification lapsed as a direct result of that deployment shall be permitted to return to that same position at the same rate of compensation upon his or her return from deployment once licensure is renewed, so long as all other requirements for employment are met.

  (2) The provisions of subdivision (1) of this subsection shall apply to such a veteran or service member until the expiration of six months after his or her return from deployment or the renewal cycle during which he or she returns from deployment, whichever is later. (Added 2013, No. 177 (Adj. Sess.), § 2.)

• § 906d. Renewal requirements; sunset review

  (a) Not less than once every five years, the Department shall review emergency medical personnel continuing education and other continuing competency requirements. The review results shall be in writing and address the following:

  (1) the renewal requirements of the profession;

  (2) the renewal requirements in other jurisdictions, particularly in the Northeast region;

  (3) the cost of the renewal requirements for emergency medical personnel; and

  (4) an analysis of the utility and effectiveness of the renewal requirements with respect to public protection.

  (b) The Department shall amend its rules or propose any necessary statutory amendments to revise any emergency medical personnel continuing education and other continuing competency requirements that are not necessary for the protection of the public health, safety, or welfare. (Added 2019, No. 166 (Adj. Sess.), § 29, eff. Oct. 1, 2020.)

• § 907. Automated external defibrillators

  (a) As used in this section:

  (1) “Automated external defibrillator (AED)” means a medical device approved by the U.S. Food and Drug Administration, that:

  (A) is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

  (B) is capable of determining whether defibrillation should be performed on an individual;

  (C) upon determination that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart; and

  (D) then, upon action by an operator, delivers an appropriate electrical impulse to the patient’s heart to perform defibrillation.

  (b) [Repealed.]

  (c) Any person who owns or leases an AED, or to whom an AED is donated, shall:

  (1) notify the Department and the person’s regional ambulance service or first responder service of the existence, location, and type of device the person possesses; and

  (2) maintain and test the device in accordance with the applicable standards of the manufacturer.

  (d)(1) Any person, other than a person defined as a health care provider by subdivision 9432(9) of this title or as emergency medical personnel by 24 V.S.A. § 2651(6) acting in the normal course of his or her duties as a health care provider or as emergency medical personnel, who acts in good faith and who renders emergency care by the use of an AED, acquires an AED, owns a premises on which an AED is located, or provides a training course in the operation of an AED shall not be liable for civil damages for that person’s acts or omissions with respect to such use, ownership, or training in the operation of an AED unless those acts or omissions were grossly negligent or willful and wanton. As used in this subdivision (d)(1), “ownership” shall not include the maintenance and testing of the device in accordance with the applicable standards of the manufacturer as required by subdivision (c)(2) of this section.

  (2) This subsection shall not relieve an AED manufacturer, designer, developer, distributor, installer, or seller of any liability under any applicable statute or rule of law.

  (e) This section shall not be construed to create a duty to act under 12 V.S.A. § 519 for any person. (Added 1999, No. 136 (Adj. Sess.), § 2; amended 2009, No. 7, § 1, eff. May 1, 2009; 2017, No. 8, § 1, eff. April 25, 2017.)

• § 908. Emergency Medical Services Special Fund

  (a)(1) The Emergency Medical Services Special Fund is established pursuant to 32 V.S.A. chapter 7, subchapter 5 comprising revenues received by the Department from the Fire Safety Special Fund, pursuant to 32 V.S.A. § 8557(a), that are designated for this Special Fund and public and private sources as gifts, grants, and donations together with additions and interest accruing to the Fund.

  (2)(A) The Commissioner of Health shall administer the Fund to the extent funds are available to support online and regional training programs, data collection and analysis, and other activities relating to the training of emergency medical personnel and delivery of emergency medical services and ambulance services in Vermont, as determined by the Commissioner, after consulting with the EMS Advisory Committee established under section 909 of this title. The Commissioner shall prioritize the use of funds to provide grants to programs that offer basic emergency medical services training at low cost or no cost to participants.

  (B) The Commissioner shall make reasonable efforts to award grants in a manner that supports geographic equity among the emergency medical services districts. The Commissioner shall also provide technical assistance to emergency medical services districts to ensure that grants are available to support emergency medical services training in districts that have historically experienced challenges in receiving grants from the Fund.

  (3) Any balance at the end of the fiscal year shall be carried forward in the Fund.

  (b) From the funds in the Emergency Medical Services Special Fund, the Commissioner of Health shall develop and implement by September 1, 2012 online training opportunities and offer regional classes to enable individuals to comply with the requirements of subdivision 906(10)(C) of this title. (Added 2011, No. 155 (Adj. Sess.), § 38; amended 2013, No. 73, § 3, eff. June 5, 2013; 2023, No. 157 (Adj. Sess.), § 2, eff. June 6, 2024.)

• § 909. EMS Advisory Committee; EMS Education Council

  (a) The Emergency Medical Services Advisory Committee shall advise the Department of Health on matters relating to the delivery of emergency medical services (EMS) in Vermont.

  (b) The Committee shall comprise the following members:

  (1) one representative from each EMS district in the State, with each representative being appointed by the EMS Board in that individual’s district;

  (2) a representative from the Vermont Ambulance Association or designee;

  (3) a representative from the Initiative for Rural Emergency Medical Services program at the University of Vermont or designee;

  (4) a representative from the Professional Firefighters of Vermont or designee;

  (5) a representative from the Vermont Career Fire Chiefs Association or designee;

  (6) a representative from the Vermont State Firefighters’ Association or designee;

  (7) an emergency department nurse manager or emergency department director of a Vermont hospital appointed by the Vermont Association of Hospitals and Health Systems;

  (8) the Commissioner of Health or designee; and

  (9) a local government member not affiliated with emergency medical services, firefighter services, or hospital services, appointed by the Vermont League of Cities and Towns.

  (c)(1) The Committee shall select from among its members a chair who is not an employee of the State.

  (2) The Committee shall have the administrative, technical, and legal assistance of the Agency of Human Services.

  (d) The Committee shall meet not less than quarterly and may be convened at any time by the Chair or at the request of 11 Committee members. Not more than two meetings each year shall be held in the same EMS district. One meeting each year shall be held at a Vermont EMS conference.

  (e)(1) The Committee shall develop and maintain a five-year statewide plan for the coordinated delivery of emergency medical services in Vermont. The plan, which shall be updated at least annually, shall include:

  (A) specific goals for the delivery of emergency medical services in this State;

  (B) a time frame for achieving the stated goals;

  (C) cost data and alternative funding sources for achieving the stated goals; and

  (D) performance standards for evaluating the stated goals.

  (2) Annually, on or before December 15, the Committee shall deliver to the Commissioner of Health and the General Assembly a report reviewing progress toward achieving the goals in the five-year plan and the goals set by the Committee for the coming year.

  (f) In addition to its plan and report set forth in subsection (e) of this section, the Committee shall identify EMS resources and needs in each EMS district and provide that information to the Green Mountain Care Board to inform the Board’s periodic revisions to the Health Resource Allocation Plan developed pursuant to subsection 9405(b) of this title.

  (g) The Committee shall establish from among its members the EMS Education Council, which may:

  (1) sponsor training and education programs required for emergency medical personnel licensure in accordance with the Department of Health’s required standards for that training and education; and

  (2) provide advice to the Department of Health regarding the standards for emergency medical personnel licensure and any recommendations for changes to those standards. (Added 2011, No. 155 (Adj. Sess.), § 39; amended 2017, No. 202 (Adj. Sess.), § 1, eff. May 30, 2018; 2019, No. 100 (Adj. Sess.), § 3, eff. May 14, 2020; 2019, No. 166 (Adj. Sess.), § 29, eff. Oct. 1, 2020; 2023, No. 157 (Adj. Sess.), § 5, eff. June 6, 2024.)