,,ib  ,union ,cal5d> ,no4 #fbh  #aad?   
,,congress  #b;d ,session  ,h4 ,r4 #dcfe
  ,report ,no4 #aad-hjd1 ,"p ,i  ,,9 ,,!
 ,,h\se ,,( ,,repres5tatives  ,janu>y   
#ab1 #bjaf ,mr4 ,hudson 7= himself1 ,mr4
 ,butt]field1 ,mr4 ,coh51 ,mr4 ,f>5?old1
 ,mr4 ,heck ( ,nevada1 ,mr4 ,ruiz1 &    
,mr4 ,we/]man7 introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ! ,judici>y1 = a p]iod to be         
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,novemb] #ad1 #bjaf ,additional
 sponsors3 ,mr4 ,blum5au]1 ,ms4 ,j5k9s (
 ,kansas1 ,mr4 ,pet]son1 ,mr4           
,fitzpatrick1 ,mr4 ,h>ris1 ,mr4 ,s*rad]1
 ,mr4 ,david ,scott ( ,georgia1 ,ms4    
,mi*elle ,lujan ,gri%am ( ,new ,mexico1 
,mr4 ,a%=d1 ,mr4 ,burgess1 ,mr4 ,long1  
,mrs4 ,brooks ( ,indiana1 ,mr4 ,k9d1    
,mr4 ,c>twright1 ,mr4 ,bilirakis1 ,mr4  
,smi? ( ,texas1 ,mr4 ,pocan1 ,mr4       
,s5s5br5n]1 ,mr4 ,tipton1 ,mr4 ,"y (    

,alaska1 ,mr4 ,z9ke1 ,ms4 ,gabb>d1 ,mr4 
,br5dan ,f4 ,boyle ( ,p5nsylvania1 ,mr4 
,wald51 ,mr4 ,we/morel&1 ,mr4           
,diaz-,bal>t1 ,ms4 ,e%oo1 ,mr4 ,langev91
 ,mr4 ,coll9s ( ,new ,york1 ,mr4        
,abraham1 ,mr4 ,walz1 ,mr4 ,cram]1 ,mr4 
,clawson ( ,florida1 ,ms4 ,frankel (    
,florida1 ,mr4 ,nug5t1 ,mr4 ,duncan (   
,t5nessee1 ,mr4 ,graves ( ,miss\ri1 ,mr4
 ,yod]1 ,mr4 ,luetkemey]1 ,mr4          
,des,jarlais1 ,mr4 ,mull91 ,mr4 ,g>rett1
 ,mr4 ,roe ( ,t5nessee1 ,mr4 ,blum1 ,mr4
 ,culb]son1 ,mr4 ,de,fazio1 ,mr4        
,b\/any1 ,ms4 ,p+ree1 ,mrs4 ,blackburn1 
,mr4 ,flem+1 ,ms4 ,moore1 ,mr4          
,williams1 ,mrs4 ,kirkpatrick1 ,mr4     
,huelskamp1 ,mr4 ,all51 ,mr4 ,lucas1    
,mr4 ,"y ( ,i[a1 ,mr4 ,pompeo1 ,mr4     
,smi? ( ,wa%+ton1 ,mr4 ,emm] (          
,m9nesota1 ,ms4 ,bonamici1 ,mr4 ,co/ello
 ( ,p5nsylvania1 ,mr4 ,r\z]1 ,mr4       
,joyce1 ,mr4 ,graves ( ,l\isiana1 ,mr4  
,w5/rup1 ,mr4 ,buc%on1 ,mr4 ,graves (   
,georgia1 ,ms4 ,s*ak[sky1 ,mr4 ,jolly1  
,mr4 ,van ,holl51 ,mr4 ,bey]1 ,mr4      

,rigell1 ,mr4 ,brooks ( ,alabama1 ,mr4  
,m>*ant1 ,mr4 ,cony]s1 ,mr4 ,b>r1 ,mr4  
,lance1 ,mr4 ,roskam1 ,mrs4 ,mc,morris  
,rodg]s1 ,mr4 ,c>t] ( ,texas1 ,mr4      
,=bes1 ,mrs4 ,wagn]1 ,mr4 ,t$ ,lieu (   
,cali=nia1 ,mr4 ,cumm+s1 ,mrs4          
,walorski1 ,ms4 ,del,bene1 ,mr4 ,walb]g1
 ,mr4 ,mc,caul1 ,mr4 ,kilm]1 ,ms4       
,br[nley ( ,cali=nia1 ,mr4 ,dold1 ,mr4  
,donovan1 ,mr4 ,wel*1 ,mr4 ,gu9ta1 ,mr4 
,ri*mond1 ,ms4 ,grang]1 ,mr4 ,pitt5g]1  
,mr4 ,ellison1 ,ms4 ,h]r]a ,beutl]1 ,mr4
 ,r5acci1 ,mr4 ,labrador1 ,mr4 ,rog]s ( 
,k5tucky1 ,mr4 ,pauls51 ,mr4 ,bab91 ,mr4
 ,/iv]s1 ,mr4 ,smi? ( ,miss\ri1 ,ms4    
,ca/or ( ,florida1 ,mr4 ,bi%op (        
,mi*igan1 ,ms4 ,graham1 ,mr4 ,gos>1 ,mr4
 ,mc,henry1 ,mr4 ,ro?fus1 ,mr4 ,duncan (
 ,s\? ,c>ol9a1 ,mrs4 ,beatty1 ,mr4      
,gu?rie1 ,mrs4 ,noem1 ,mr4 ,brady (     
,p5nsylvania1 ,ms4 ,hahn1 ,mrs4 ,ellm]s 
( ,nor? ,c>ol9a1 ,mr4 ,/ew>t1 ,mr4 ,d5t1
 ,mrs4 ,bu/os1 ,mr4 ,c\rtney1 ,mr4      
,lip9ski1 ,miss ,rice ( ,new ,york1 ,mr4
 ,s*weik]t1 & ,ms4 ,mc,sally  ,novemb]  

#ad1 #bjaf ,report$ f ! ,committee on   
,en]gy & ,comm]ce ) an am5dm5t ,/rike   
out all aft] ! enact+ clause & ins]t !  
"p pr9t$ 9 italic  ,novemb] #ad1 #bjaf  
,! ,committee on ! ,judici>y dis*>g$2   
committ$ to ! ,committee ( ! ,:ole ,h\se
 on ! ,/ate ( ! ,union & ord]$ to be    
pr9t$ ,= text ( introduc$ bill1 see copy
 ( bill z introduc$ on ,janu>y #ab1     
#bjaf  ,a ,,bill  ,to am5d ! ,controll$ 
,sub/ances ,act ) reg>d to ! provision (
 em]g5cy m$ical s]vices4  #a4 ,%ort     
title ,?is ,act may be cit$ z !         
,protect+ ,pati5t ,access to ,em]g5cy   
,m$ications ,act ( #bjaf4  #b4 ,em]g5cy 
m$ical s]vices ,section #cjc ( !        
,controll$ ,sub/ances ,act 7#ba         
,u4,s4,c4 #hba et seq47 is am5d$--  7#a7
 by r$esignat+ subsection 7j7 z         
subsection 7k72 &  7#b7 by ins]t+ aft]  
subsection 7i7 ! foll[+3  7j7 ,em]g5cy  
m$ical s]vices t adm9i/] controll$      
sub/ances  7#a7 ,regi/ration ,= !       
purpose ( enabl+ em]g5cy m$ical s]vices 
pr(essionals to adm9i/] controll$       

sub/ances 9 s*$ule ,,ii1 ,,iii1 ,,iv1 or
 ,v to ultimate us]s receiv+ em]g5cy    
m$ical s]vices 9 accordance ) !         
requirem5ts ( ?is subsection1 !         
,attorney ,g5]al-- 7,a7 %all regi/] an  
em]g5cy m$ical s]vices ag5cy if ! ag5cy 
submits an application demon/rat+ x is  
au?oriz$ to conduct su* activity "u !   
laws ( ea* ,/ate 9 :i* ! ag5cy          
practices2 &  7,b7 may d5y an           
application = su* regi/ration if !      
,attorney ,g5]al det]m9es t ! issuance (
 su* regi/ration w\ld be inconsi/5t ) ! 
requirem5ts ( ?is subsection or ! public
 int]e/ bas$ on ! factors li/$ 9        
subsection 7f74  7#b7 ,option = s+le    
regi/ration ,9 regi/]+ an em]g5cy m$ical
 s]vices ag5cy pursuant to p>agraph     
7#a71 ! ,attorney ,g5]al %all all[ su*  
ag5cy ! option ( a s+le regi/ration 9   
ea* ,/ate :]e ! ag5cy adm9i/]s controll$
 sub/ances 9 lieu ( requir+ a sep>ate   
regi/ration = ea* location ( ! em]g5cy  
m$ical s]vices ag5cy4  7#c7             
,hospital-bas$ ag5cy ,if a hospital-bas$

 em]g5cy m$ical s]vices ag5cy is regi/]$
 "u subsection 7f71 ! ag5cy may use !   
regi/ration ( ! hospital to adm9i/]     
controll$ sub/ances 9 accordance ) ?is  
subsection )\t be+ regi/]$ "u ?is       
subsection4  7#d7 ,adm9i/ration outside 
physical pres5ce ( m$ical director or   
au?oriz+ m$ical pr(essional ,em]g5cy    
m$ical s]vices pr(essionals ( a         
regi/rant em]g5cy m$ical s]vices ag5cy  
may adm9i/] controll$ sub/ances 9 s*$ule
 ,,ii1 ,,iii1 ,,iv1 or ,v outside !     
physical pres5ce ( a m$ical director or 
au?oriz+ m$ical pr(essional 9 ! c\rse ( 
provid+ em]g5cy m$ical s]vices if !     
adm9i/ration is--  7,a7 au?oriz$ by !   
law ( ! ,/ate 9 :i* x occurs2 &  7,b7   
pursuant to--  7i7 a /&+ ord] t is--    
7,i7 issu$ & adopt$ by #a or m m$ical   
directors ( ! ag5cy2 or  7,,ii7 develop$
 by a specific ,/ate au?ority2 or  7ii7 
a v]bal ord] t is--  7,i7 issu$ 9       
accordance ) a policy ( ! ag5cy2  7,,ii7
 provid$ by an au?oriz+ m$ical          
pr(essional 9 response to a reque/ by ! 

em]g5cy m$ical s]vices pr(essional )    
respect to a specific pati5t2  7,,iii7 9
 ! case ( a mass casualty incid5t2 or   
7,,iv7 to ensure ! prop] c>e & treatm5t 
( a specific pati5t4  7#e7 ,deliv]y ,a  
regi/rant em]g5cy m$ical s]vices ag5cy  
may deliv] controll$ sub/ances f a      
regi/]$ location ( ! ag5cy to an        
unregi/]$ location ( ! ag5cy only if--  
7,a7 ! ag5cy designates ! unregi/]$     
location = su* deliv]y2 &  7,b7 notifies
 ! ,attorney ,g5]al at lea/ #cj days    
prior to fir/ deliv]+ controll$         
sub/ances to ! unregi/]$ location4  7#f7
 ,/orage ,a regi/rant em]g5cy m$ical    
s]vices ag5cy may /ore controll$        
sub/ances--  7,a7 at a regi/]$ location 
( ! ag5cy2  7,b7 at any designat$       
location ( ! ag5cy or 9 an em]g5cy      
s]vices vehicle situat$ at a regi/]$ or 
designat$ location ( ! ag5cy2 or  7,c7 9
 an em]g5cy m$ical s]vices vehicle us$  
by ! ag5cy t is-- 7i7 travel+ f1 or     
return+ to1 a regi/]$ or designat$      
location ( ! ag5cy 9 ! c\rse ( respond+ 

to an em]g5cy2 or  7ii7 o!rwise actively
 9 use by ! ag5cy4  7#g7 ,no treatm5t z 
di/ribution ,! deliv]y ( controll$      
sub/ances by a regi/rant em]g5cy m$ical 
s]vices ag5cy pursuant to ?is subsection
 %all n be treat$ z di/ribution =       
purposes ( section #cjh4  7#h7 ,re/ock+ 
( em]g5cy m$ical s]vices vehicles at a  
hospital ,not)/&+ p>agraph 7#ac77;,j71 a
 regi/rant em]g5cy m$ical s]vices ag5cy 
may receive controll$ sub/ances f a     
hospital = purposes ( re/ock+ an em]g5cy
 m$ical s]vices vehicle foll[+ an       
em]g5cy response1 & )\t be+ subject to !
 requirem5ts ( section #cjh1 provid$ all
 ( ! foll[+ conditions are satisfi$3    
7,a7 ,! regi/]$ or designat$ location ( 
! ag5cy :]e ! vehicle is prim>ily       
situat$ ma9ta9s a record ( su* receipt 9
 accordance ) p>agraph 7#i74  7,b7 ,!   
hospital ma9ta9s a record ( su* deliv]y 
to ! ag5cy 9 accordance ) section #cjg4 
7,c7 ,if ! vehicle is prim>ily situat$  
at a designat$ location1 su* location   
notifies ! regi/]$ location ( ! ag5cy )9

 #gb h\rs ( ! vehicle receiv+ !         
controll$ sub/ances4  7#i7 ,ma9t5ance ( 
records  7,a7 ,9 g5]al ,a regi/rant     
em]g5cy m$ical s]vices ag5cy %all ma9ta9
 records 9 accordance ) subsections 7a7 
& 7b7 ( section #cjg ( all controll$    
sub/ances t are receiv$1 adm9i/]$1 or   
o!rwise dispos$ ( pursuant to ! ag5cy's 
regi/ration1 )\t reg>d to subsection    
#cjg7;c77#a77;,b74  7,b7 ,requirem5ts   
,su* records--  7i7 %all include records
 ( deliv]ies ( controll$ sub/ances      
betwe5 all locations ( ! ag5cy2 &  7ii7 
%all be ma9ta9$1 :e!r electronically or 
o!rwise1 at ea* regi/]$ & designat$     
location ( ! ag5cy :]e ! controll$      
sub/ances involv$ are receiv$1 adm9i/]$1
 or o!rwise dispos$ (4  7#aj7 ,o!r      
requirem5ts ,a regi/rant em]g5cy m$ical 
s]vices ag5cy1 "u ! sup]vision ( a      
m$ical director1 %all be responsible =  
ensur+ t-- 7,a7 all em]g5cy m$ical      
s]vices pr(essionals :o adm9i/]         
controll$ sub/ances us+ ! ag5cy's       
regi/ration act 9 accordance ) !        

requirem5ts ( ?is subsection2  7,b7 !   
recordkeep+ requirem5ts ( p>agraph 7#i7 
are met ) respect to a regi/]$ location 
& ea* designat$ location ( ! ag5cy2     
7,c7 ! applicable physical security     
requirem5ts e/abli%$ by regulation ( !  
,attorney ,g5]al are compli$ ) :]ev]    
controll$ sub/ances are /or$ by ! ag5cy 
9 accordance ) p>agraph 7#f72 &  7,d7 ! 
ag5cy ma9ta9s1 at a regi/]$ location ( !
 ag5cy1 a record ( ! /&+ ord]s issu$ or 
adopt$ 9 accordance ) p>agraph 7#i74    
7#aa7 ,regulations ,! ,attorney ,g5]al  
may issue regulations--  7,a7 specify+1 
) reg>d to deliv]y ( controll$ sub/ances
 "u p>agraph 7#e7-- 7i7 ! types (       
locations t may designat$ "u su*        
p>agraph2 &  7ii7 ! mann] 9 :i* a       
notification "u p>agraph 7#e77;,b7 mu/  
be made2  7,b7 specify+1 ) reg>d to !   
/orage ( controll$ sub/ances "u p>agraph
 7#f71 ! mann] 9 :i* su* sub/ances mu/  
be /or$ at regi/]$ & designat$          
locations1 includ+ 9 em]g5cy m$ical     
s]vice vehicles2 &  7,c7 address+ !     

ability ( hospitals1 regi/]$ locations1 
& designat$ locations to deliv]         
controll$ sub/ances to ea* o!r 9 ! ev5t 
(-- 7i7 %ortages ( su* sub/ances2  7ii7 
a public heal? em]g5cy2 or  7iii7 a mass
 casualty ev5t4  7#ab7 ,rule (          
con/ruction ,no?+ 9 ?is subsection %all 
be con/ru$-- 7,a7 to limit ! au?ority   
ve/$ 9 ! ,attorney ,g5]al by o!r        
provisions ( ?is title to take measures 
to prev5t div]sion ( controll$          
sub/ances2 or  7,b7 to ov]ride !        
au?ority ( any ,/ate to regulate !      
provision ( em]g5cy m$ical s]vices4     
7#ac7 ,def9itions ,9 ?is section3  7,a7 
,! t]m designat$ location means a       
location designat$ by an em]g5cy m$ical 
s]vices ag5cy "u p>agraph 7#e74  7,b7 ,!
 t]m em]g5cy m$ical s]vices means       
em]g5cy m$ical response & em]g5cy mobile
 m$ical s]vices provid$ outside ( a fix$
 m$ical facility4  7,c7 ,! t]m em]g5cy  
m$ical s]vices ag5cy means an           
organization provid+ em]g5cy m$ical     
s]vices1 includ+ su* an organization t--

 7i7 is gov]nm5tal 7includ+ fire-bas$ & 
hospital-bas$ ag5cies71 nongov]nm5tal   
7includ+ hospital-bas$ ag5cies71        
private1 or volunte]-bas$2  7ii7        
provides em]g5cy m$ical s]vices by      
gr\nd1 air1 or o!rwise2 &  7iii7 is     
au?oriz$ by ! ,/ate 9 :i* ! organization
 is provid+ su* s]vices to provide      
em]g5cy m$ical c>e1 includ+ ! adm9i/]+ (
 controll$ sub/ances1 to memb]s ( !     
g5]al public on an em]g5cy basis4  7,d7 
,! t]m em]g5cy m$ical s]vices           
pr(essional means a heal? c>e           
pr(essional 7includ+ a nurse1 p>am$ic1  
or em]g5cy m$ical te*nician7 lic5s$ or  
c]tifi$ by ! ,/ate 9 :i* ! pr(essional  
practices & cr$5tial$ by a m$ical       
director ( ! respective em]g5cy m$ical  
s]vices ag5cy to provide em]g5cy m$ical 
s]vices )9 ! scope ( ! pr(essional's    
,/ate lic5se or c]tification4  7,e7 ,!  
t]m em]g5cy m$ical s]vices vehicle means
 an ambulance1 fire app>atus1 sup]visor 
truck1 or o!r vehicle own$ or op]at$ by 
an em]g5cy m$ical s]vices ag5cy = !     

purpose ( provid+ or facilitat+ em]g5cy 
m$ical c>e & transport or transport+    
controll$ sub/ances to & f ! regi/]$ &  
designat$ locations4  7,f7 ,! t]m       
hospital-bas$ means1 ) respect to an    
ag5cy1 own$ or op]at$ by a hospital4    
7,g7 ,! t]m m$ical director means a     
physician :o is regi/]$ "u subsection   
7f7 & provides m$ical ov]sight = an     
em]g5cy m$ical s]vices ag5cy4  7,h7 ,!  
t]m m$ical ov]sight means sup]vision ( !
 provision ( m$ical c>e by an em]g5cy   
m$ical s]vices ag5cy4  7,i7 ,! t]m      
m$ical pr(essional means an em]g5cy or  
o!r physician1 or ano!r m$ical          
pr(essional 7includ+ an advanc$ practice
 regi/]$ nurse or physician assi/ant7 ^:
 scope ( practice "u a ,/ate lic5se or  
c]tification includes ! ability to      
provide v]bal ord]s4  7,j7 ,! t]m       
regi/]$ location means a location t     
appe>s on ! c]tificate ( regi/ration    
issu$ to an em]g5cy m$ical s]vices ag5cy
 "u ?is subsection or subsection 7f71   
:i* %all be :]e ! ag5cy receives        

controll$ sub/ances f di/ributors4  7,k7
 ,! t]m regi/rant em]g5cy m$ical s]vices
 ag5cy means--  7i7 an em]g5cy m$ical   
s]vices ag5cy t is regi/]$ pursuant to  
?is subsection2 or  7ii7 a hospital-bas$
 em]g5cy m$ical s]vices ag5cy t is cov]$
 by ! regi/ration ( ! hospital "u       
subsection 7f74  7,l7 ,! t]m specific   
,/ate au?ority means a gov]nm5tal ag5cy 
or o!r su* au?ority1 includ+ a regional 
ov]sight & coord9at+ body1 t1 pursuant  
to ,/ate law or regulation1 develops    
cl9ical protocols reg>d+ ! deliv]y (    
em]g5cy m$ical s]vices 9 ! geographic   
jurisdiction ( su* ag5cy or au?ority )9 
! ,/ate t may be adopt$ by m$ical       
directors4  7,m7 ,! t]m /&+ ord] means a
 writt5 m$ical protocol 9 :i* a m$ical  
director det]m9es 9 advance ! m$ical    
crit]ia t mu/ be met be=e adm9i/]+      
controll$ sub/ances to individuals 9 ne$
 ( em]g5cy m$ical s]vices4  7,n7 ,! t]m 
v]bal ord] means an oral directive t is 
giv5 ?r\gh any me?od ( communication    
includ+ by radio or telephone1 directly 

to an em]g5cy m$ical s]vices            
pr(essional1 to contemporane\sly adm9i/]
 a controll$ sub/ance to individuals 9  
ne$ ( em]g5cy m$ical s]vices outside !  
physical pres5ce ( ! au?oriz+ m$ical    
director4  4  ,novemb] #ad1 #bjaf       
,report$ f ! ,committee on ,en]gy &     
,comm]ce ) an am5dm5t ,novemb] #ad1     
#bjaf ,! ,committee on ! ,judici>y      
dis*>g$2 committ$ to ! ,committee ( !   
,:ole ,h\se on ! ,/ate ( ! ,union &     
ord]$ to be pr9t$