My name is James D. Garcia. I am currently a Paramedic for MEDUCARE
at the Medical University of South Carolina
in Charleston, SC. On January 27, 1994, in Lexington County, SC, I was
run over while on duty by a vehicle driving at a high rate of speed through
an accident scene where I was working. Then driver of the vehicle was not
initially charged in the accident. I believed that as an on-duty Paramedic
working for a county 911 system, I had a legal right to be in the roadway
to treat and assist patients. You'd never believe just how wrong that was.......
After a year of digging, I found that EMS workers in SC (and EVERY other
state in the US) are legally considered PEDESTRIANS in the roadway, with
no rights or authority.There were no official guidelines for accidents
and emergencies, or driver's responsibilites at them. There were no legal
definitions for emergencies, and EMS had never actually been vested with
the authority to perform their required job function. Basically, we had
operated on the assumtion that we had badges, uniforms, lights, and worked
for Public Safety, so we must have some official legality.
We, as a field, had assumed very wrong. When EMS separated from Police
and Fire agencies in the 70's and 80's, no one bothered to officially take
our legal status with us. Unfortunately, it took nearly getting killed
for anyone to recognize that there was ever a question.
After many road blocks and dead ends, I finally realized the only way to
make my job legally recognizeable was to actually WRITE a law. See the
"The LAW" link below to view the law's legislative history.
It took several years, every penny I had ever saved, and every day I had
off to lobby to get this law passed. I had been permanantly disabled by
the accident, and had to relocate and go into interfacility transport due
to my injuries. After two years and the last of my resources and patience,
the law finally passed.
If you have seen any similar laws in session in your state,
let me know- At the bottom of the page I will list what other states, such
as Minnesota and Michigan, are moving forward on this issue.If you'd like
any advice or help in getting this going , please contact me.
I will frequently be adding more info about the law, it's intent and application,
and its effect on EMS. Please bookmark this page and check back to see
what's been added. Please e-mail me for personal updates or more in-depth
information.
Remember- If it's not legal, it's not real. And with such a risky profession,
that's not a chance we should have to take. Please don't assume that because
your state has a great EMS system that you are protected on the job. Ask
DOT, NHTSA, Civil Defense (NCCEM), and the National State EMS Director's
Association. This is real. And it's up to us to fix it, one state at a
time.
The SC EMS Scene Management Authority Act, signed into law April 1,
1996, allows S.C. EMS workers to manage, control, direct and perform their
duties at emergencies. It is frequently refered to in SC as "The
Garcia Bill". This page tells about the law, how it was written,
what it means for EMS in SC, and how to work towards similar legislation
in your area.
Last Updated 5/6/97
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SOUTH CAROLINA ACT #256
AN ACT TO AMMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION
56-5-1538 SO AS TO PROVIDE A DEFINITION OF AN EMERGENCY SCENE, TO DEFINE
WHO HAS AUTHORITY TO CONTROL AN EMERGENCY SCENE, AND TO DEFINE THE RESPONSIBILITIES
OF MOTOR VEHICLES PASSING THROUGH AND PEDESTRIANS OBSERVING AN EMERGENCY
SCENE.
Be it enacted by the General Assembly of the State of South Carolina:
Emergency Scene Management
SECTION 1. The 1976 Code is ammended by adding:
"Section 56-5-1538 (A) An emergency scene is a location designated
by the potential need to provide emergency medical care and is identified
by emergency vehicles with flashing red lights, rescue equipment, or emergency
personnel on the scene.
(B) An emergency scene is a special hazard.
(C) An emergency scene is under the authority of the first arriving emergency
personnel, which includes Emergency Medical Services personnel, until the
arrival of the fire or law enforcement officials having jurisdiction. All
motor vehicles passing through an emergency scene and pedestrians observing
an emergency scene must obey and not interfere with the duties of emergency
personnel. Motor vehicles and bystanders may not block access to or exit
from an emergency scene.
(D) The management authority of Emergency Medical Services is limited to
managing patient care and further injury to the patients and on scene personnel.
This authority may be delegated by emergency personnel to provide an adaquate
level of safety.
(E) A paid or volunteer worker at an emergency scene has proper authority
to be at and control the scene in a manner consistant with his training."
Enacted by SC Governor David Beasley on 1 April, 1996
--------------------------------XXX--------------------------------------
Following is from the "Line Item References and Justification",
which was used during the law's journey through the SC General Assembly
to explain where the law came from, how it would apply, and certian clarifications
and exclusions.
(A) AN EMERGENCY SCENE IS A LOCATION DESIGNATED BY.....
SC 6-11-1410, the "Emergency Powers Act", is a law written to
protect firefighters at a fire scene. This law is restricted to fires,
and gives no definition for an emergency. Prior to #256, there had been
no actual definition of an emergency scene in SC law. SC 56-5-760, "Operations
of Authorized Emergency Vehicles," which requires that vehicles pull
to the right when approached by an emergency vehicle with lights and sirens,
ONLY applies when the emergency vehicle is in motion enroute to a call.
Once the energency vehicle arrived at the scene, it had no legal protection
or authorization except in regard to parking irrespective of traffic regulations.
....THE POTENTIAL NEED TO PROVIDE EMERGENCY MEDICAL CARE.....
This potential need is determined by the senior EMS crew member or dispatcher.
The phrase "potential need" is crucial to the intent of the law:
if they determine that there is no actual or potential need for medical
care, the EMS unit may be clear to leave the scene to respond to other
calls. This helps limit EMS authority to medical and safety situations
at emergency scenes, leaving traffic control or fire supression to appropriate
agencies once they arrive.
...... AND IS IDENTIFIED BY EMERGENCY VEHICLES WITH FLASHING RED LIGHTS,
RESCUE EQUIPMENT, OR EMERGENCY PERSONNEL ON THE SCENE.
SC 56-5-2260 and 56-5-760 identify audible and visual signals to designate
an approaching emergency vehicle. This provides a similar standard for
those vehicles and personnel once they arrive at their destination. Any
emergency vehicle is now given the same recognition while at a scene that
it has while in motion. This also indicates that the presence of an emergency
vehicle, equipment OR personnel (such as first responders) are indication
enough that approaching vehicles need to use additional caution.
(B) AN EMERGENCY SCENE IS A SPECIAL HAZARD.
This is a legal and technical term necessary to indicate the need for increased
awareness and responsibility.Drawn from SC 56-5-1520 "General Rules
as to Maximum Speed Limits," which states "(a) No person shall
drive a vehicle on a highway at a speed greater than is reasonable and
prudent under the conditions and having regard to the actual and potential
hazards then existing....(b) Maximum Speed Limits. Except when a special
hazard exists that requires lower speed for compliance with paragraph (a)...,
(c) When lower speeds required... the driver of every vehicle shall...drive
at an appropriate reduced speed when approaching and crossing an intersection
or railway grade crossing, when approaching and going around a curve, approaching
a hillcrest, when traveling upon ant narrow bridge or winding roadway,
and when SPECIAL HAZARD exists with respect to pedestrians or other traffic
or by reason of weather or highway condition."
The first draft of this law had a section stating that a driver "must
use caution and drive at a reasonable speed to properly control his vehicle"
at an emergency scene. It included a fine of $200-$500 and up to 30 days
in jail. That appeared very threating to some agencies, and could have
been misread to imply that EMS would be handing out tickets and fines.
That concern would have prevented it from passing, and was removed during
an ammendment rewrite. So how can we MAKE these drivers slow down, and
shift the responsibility of safe driving to them, and not burden EMS with
additional duties such as waving flags and flares and putting up big signs
at every wreck saying "HEY! LOOK OUT! DON'T RUN OVER THE EMT!"?
Several months of digging uncovered the phrase "Special Hazard"
in relation to "Too Fast For Conditions", which would make it
the driver's job to slow down, be aware and use addional caution at an
emergecy scene. Therefore, a police officer now has a specific reference
and clear guidelines allowing him to ticket a violator. On its passing,
this law was attached to the "Too Fast For Conditions" section
of the code, and includes points and a fine.
(C) AN EMERGENCY SCENE IS UNDER THE CONTROL OF THE FIRST ARRIVING EMERGENCY
PERSONNEL, WHICH INCLUDES EMERGENCY MEDICAL SERVICES PERSONNEL...
This line, similar to the Emergency Powers Act, gives EMS workers the ability
to manage an emergency scene when they are the only agency at the scene.
This is a routine occurence, and there is often a significant delay in
police or fire back up. This law does not take away any of the authority
from police or fire agencies. It merely allows EMS to also act as an official
agency on the scene. This implied authority had always been assumed, but
has now been legalized to protect us in our routine duties.
...UNTIL THE ARRIVAL OF THE FIRE OR LAW ENFORCEMENT OFFICIALS HAVING JURISDICTION.
All Public Safety agencies seem to be concerned with who is in control
of a scene. EMS does not want to assume any other agency's duties or authority.
This line clearly answers any doubts as to who is in charge: immediately
upon their arrival, police and fire units are solely and completely in
charge. Once a scene is secured, EMS is concerned exclusively with patient
care and transport. This line was written specifically at the request of
the SC Fire Fighters Association and SC Law Enforcement Officers Association.
ALL VEHICLES PASSING THROUGH AN EMERGENCY SCENE AND PEDESTRIANS OBSERVING
AN EMERGENCY SCENE MUST OBEY AND NOT INTERFERE WITH THE DUTIES OF EMERGENCY
PERSONNEL. MOTOR VEHICLES AND BYSTANDERS MAY NOT BLOCK ACCESS TO OR EXIT
FROM AN EMERGENCY SCENE.
SC 6-11-1420, "Operations at a Fire," states "The fire authority
having jurisdiction may prohibit any person, vehicle, vessel or object
from approaching the scene and may remove or cause to be removed or kept
away from the scene any person, vehicle, vessel or object which may impede
or interfere with the operations of the fire authority having jurisdiction."
We needed something similar for EMS.
This line provides the same protection and scene access to all emergency
workers in a more limited and specific scope, in accordance with the differing
needs of EMS. EMS vehicles require rapid access to and exit from scenes,
and need to perform their duties without interference. If EMS workers have
determined the potential need for care, we need unimpeded access to the
injured person until we can determine if they need definitive medical treatment.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Many states have recently passed laws regarding interfering with EMS workers
(some have even made assaulting an EMS worker a major felony. Great idea,
but too late to ammend to this law this year). This law is generally directed
to accidents, but it is no way limited exclusively to them. At the discretion
of local law enforcement, this section DOES address interference and may
be used as a basis for further legal action. SC is currently considering
a bill regarding assaults on health care workers, but until then, this
law may be effective for EMS in the field.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(D) THE MANAGEMENT AUTHORITY OF EMERGENCY MEDICAL SERVICES IS LIMITED TO
MANAGING PATIENT CARE AND PREVENTING FURTHER INJURY TO THE PATIENTS AND
ON SCENE PERSONNEL. THIS AUTHORITY MAY BE DELEGATED BY EMERGENCY PERSONNEL
TO PROVIDE AN ADEQUATE LEVEL OF SAFETY.
This law was not designed to add additional authority or increased liability
to EMS workers. When we arrive at an emergency scene, our first standard
of practice is scene safety and security, even before we initiate patient
care. We need to recognize the potential for "authority overlap"
and prevent misunderstanding as to what our exact role may include. But
we also need to be able to take necessary steps to protect ourselves and
our patients, which MAY include traffic flow control.
Most EMS units have two crew members. This is often not enough manpower
to control multi-patient or large scenes. In a mass casualty situation,
the first arriving crew must initiate an Incident Command Station, and
direct the efforts of arriving units. EMS also frequently relies on the
skills of First Responders, Rescue Squads, First Aid caregivers and other
volunteers at difficult scenes. These personnel also need, and are now
provided, protection and legitimacy at the scene. Their scene authority
will also revert to police or fire units immediately upon their arrival.
(E) A PAID OR VOLUNTEER WORKER AT AN EMERGENCY SCENE HAS PROPER AUTHORITY
TO BE AT AND CONTROL A SCENE IN A MANNER CONSISTANT WITH HIS TRAINING.
This, along with (D), are considered "limiting definitions",
to provide protection to on-duty EMS workers and off-duty volunteers. As
EMS workers, we have a legal obligation to provide medical care at emergency
scenes even while off-duty. If we happen upon a wreck or any person requiring
medical care, we are legally responsible for them once we identify ourselves
and initiate care. This paragraph is meant to protect us in these situations
where we are called upon by our "Duty To Act". Many people are
not aware that the "Good Samaritan" laws only protect us against
liability from the injured party, and do not address your rights or capacity
on a scene.
The "Emergency Powers Act" for fires scenes states "The
fire authority ....have the power and authority to to direct such operations
as may be necessary to extinguish the fire... and of taking any other action
necessary in the reasonable performance of their duties". This wording
may be too liberal for EMS situations. EMS authority is limited as stated
to medical care and scene safety to avoid any concerns about EMS overstepping
their abilities. We respond and perform according to our training and our
current standards to provide for patient and crew safety.
=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=++=
ADDITIONAL CONCERNS Q&A
WHEN AND HOW DOES AUTHORITY CHANGE HANDS AT AN EMERGENCY SCENE?
Immediately upon their arrival, any fire service or law enforcement
agency having jurisdiction will retain sole authority. There is no need
for a briefing or direct change of command. Police and fire units may coordinate
with EMS to manage a scene, but once they arrive EMS will limit their authority
to patient care.
WILL EMS BE A TRAFFIC ENFORCEMENT AGENCY?
NO! Scene authority is limited to reaching the patient, scene security,
and patient care. If patient accessibility or scene security needs require
EMS to regulate traffic flow or crowd control, they may do so only to the
extent needed to provide for crew and patient safety. The National Highway
Transportation Safety Administration provides state EMS agencies with a
Emergency Vehicle Operations Course(EVOC). This includes regulatory standards
for initiating scene security. All EMS crews need to be aware of their
local protocals and standards for securing a scene.
WILL EMS BE REQUIRED TO REMAIN AT A SCENE UNTIL POLICE OR FIRE UNITS
ARRIVE?
NO. The crew or dispatcher will determine the potential need for medical
care. By definition,if it is determined that there is no actual or potential
need for emergency medical care, EMS may conclude the location is not an
emergency scene and clear their unit for incoming calls. This will allow
the senior crew member limited flexability needed to adapt for the diverse
nature of EMS calls.
DOES THIS LAW GIVE EMS ANY POLICING AUTHORITY?
No. EMS cannot determine violations or actually charge any persons or vehicles
with violating this section. However, this law gives arriving law enforcement
agencies a clear and definitive standard for reference on emergency scenes.
Prior to the passage of this law, EMS workers were legally considered pedestrians
with no official capacity to be at an emergency scene. This law has clarified
EMS's need for scene access and protection to any arriving law enforcement
agency. It clearly puts the responsibility of reasonable speed on the driver,
but this too will still be determined and enforced by the arriving officer.
This law has been attached to current "Too Fast For Conditions"
laws, and provides the recognition that an emergency scene is a special
hazard requiring additional caution and reduced speed on the part of the
driver. Any accidents or injuries occurring at an emergency scene should
now be especially considered under the guidelines of this new legislation.
DOES THIS LAW APPLY ONLY TO WRECKS AND ACCIDENTS?
No. An emergency scene is ANY location with the potential need- to include
residences, businesses, industries, mass casualties and natural disasters.
This is usally determined by the 911 dispatch system, but also includes
situations considered under "Duty to Act", i.e., any situation
where similarly trained person would identify themself as a medical personnel
and initiate aid. Since you are legally liable at that point for your care,
you are now acting as a volunteer/first responder or "official"
medical personnel and are protected from interference.
This law was intended to apply generally to accident scenes, but its protection
is not limited exclusively to them. It defines an "EMERGENCY SCENE",
not just an "ACCIDENT SCENE".
THIS ALL SEEMS SO COMMON SENSE- WHY DID IT NEED TO BE A LAW?
Because unfortunately in this litigous society, "if it ain't legal,
it don't fly". My case apparently was this first to ever question
EMS's actual rights on the job. This situation had never been addresssed
by DOT/NHTSA, OSHA(workplace safety), or EMS organizations, and they are
all still cautious about approaching it. We had all made a dangerous assumtion
that has since been proven dead wrong. Challenging that assumtion has been
most of the battle.
WERE YOU REALLY CHARGED FOR THE ACCIDENT?
No, that's a misconception. No ticket was issued, and that's what started
my digging around regarding the legal issues of EMS workers at scenes.
A civil case is still pending.
SPECIAL CONSIDERATIONS
*It should be stressed that in no way does this law protect the care
provider from neglegence or carelessness, and is only intended to provide
the rights EMS had assumed were there all along.
*This is a law, not a shield. It will not slow down every rubbernecker
on the road, or make a drunk husband back away at a domstic dispute.
Unfortunately, in most cases it will only come in after the fact or injury.
I only wish that the law could do more before something does go wrong.
Be careful out there.
* Where to next? Increasing public awareness here in SC and across the
nation, and trying every method possible to inform the US/World community
about this oversight and soloution.
WHERE IT'S GONE SO FAR:
Minnesota has submitted pending legislation stating "THE DRIVER OF
ANY VEHICLE SHALL ENSURE THAT THE VEHICLE IS KEPT UNDER CONTROL WHENEVER
APPROACHING OR PASSING AN AUTHORIZED EMERGENCY VEHICLE STOPPED WITH EMERGENCY
LIGHTS FLASHING ON THE RIGHT-OF-WAY OF ANY STREET OR HIGHWAY. THE EXERCISE
OF CONTROL REQUIRED FOR A DRIVER TO COMPLY WITH THIS PARAGRAPH IS THAT
CONTROL POSSIBLE AND NECESSARY BY THE DRIVER TO PREVENT INJURY TO PERSON
OR PROPERTY AND TO AVOID INTERFERENCE WITH THE PERFORMANCE OF EMERGENCY
DUTIES BY EMERGENCY PERSONNEL."
OJ Doyle swears that they still speak English way up there, but lawyers
everywhere have a language all their own. But this is the first attempt
by another state to work on the problem.
Michigan was working on a similar law last year after 2 EMS workers were
killed on the scene. It has passed a law where any citations issued at
an emergency scene will have double the points and double the fine (a good
way to put a few extra dollars into the state EMS funds! How's that for
incentive.) Unfortunately, my old e-mail box ate most of this info. Anyone
up there (ems@shianet?) care to update me please?
The National Coordinating Council on Emergency Management (NCCEM, formerly
known as Civil Defense) has agreed to investigate and gather info on this
problem, and assist states interested in persuing it. I will send that
info to you upon request.
If you belong to an EMS organization, please ask them to look into this
law and see if they can support it for your area.
SPECIAL PERSONAL THANKS:
*To my wife Cara and daughter Samantha for understanding my desire
to "make this right" and giving me the time and support to continue.
*To Sharon Tarlton, Paramedic, Master
Diver, RN Student and aspiring guitarist, for all the friendship, support,
and sacrifice through these years. She is everything you could want for
a friend, and I could have never done this without her. You're the best!
*To Tom Gross, Mike Drennon and all at Lexington County EMS who stood with
me through the many suprises uncovered here.
*To the SC EMS Association, Al Futrel and Joe Fanning at DHEC, Glenn Adams
at Training Matters, and anyone who actually stood with me shaking hands
at the SC Statehouse to show the presence of EMS voters in this state.
*To SC Rep. Larry Koon, Rep. Jake Knotts, Sen. Doug Jennings, Sen Joe Wilson,
and Sen. John Land for understanding how intimidating passing a law can
be, and their amazing willingness to be available to me throughout this
ordeal. And I'll never forget all the assistance from Carolyn Richardson,
and the SC House Transportaion Committee offices for the year of digging
through the law books for me. I truly learned the government is REALLY
just individuals, and most of them do care.
*To Dan Manz at National EMS Directors Assoc, Gary Criddle at DOT, OJ Doyle
in the progressive,remarkable state of MINNESOTA (where albino alligators
hide beneath the snow), Dr.Spencer Hall (and Winnie!) in N.M., Mannie Angel
at JEMS, and Shari Coffin at NCCEM for the support, information and national
recognition on this effort.
And most of all, to every Paramedic, EMT, First Responder and Volunteer
who puts their life on the line every single time they crank up the truck:
I'm doing this for you.
More to come - check back soon!
JD
Drop
me an Email!