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Some EMS providers have been confused about changes to the federal "Ryan White law" protections for EMTs and other first responders sustaining an unprotected exposure on the job, and what that means in Massachusetts.
As background, the portion of the federal "Ryan White law" requiring notification by receiving hospitals to emergency responders of possible exposure to infectious diseases was eliminated in 2006 (public law 109-415).
Changes to the federal law have no effect on EMTs and& first responders in MA because the Commonwealth has its own statute governing this -- MA General Laws Chapter 111, section 111C, and the Department's regulations for unprotected exposure to infectious disease promulgated pursuant to this statute, 105 CMR 172.000. These remain in place and unchanged, so EMTs and first responders retain all its protections, regardless of what has changed in federal law.
You can find the state's statute, MGL Chap.111 Sec 111C.
The Department's regulations pursuant to this statute are 105 CMR 172.000, Unprotected Exposure Reporting Form
The purpose of this guide is to aid the State EMS offices and experienced medical directors with their preparation of a one-day course for potential medical directors.
This guide outlines the major responsibilities of a medical director and instructors may need to prepare audiovisuals, handouts and other support materials to make the class more successful.
The Executive Office of Elder Affairs is required by law to administer a statewide system for receiving and investigating reports of elder abuse, and for providing needed protective services to abused elders when warranted. To fulfill this responsibility, Elder Affairs has established 22 designated Protective Services (PS) agencies throughout the Commonwealth to respond to reports of elder abuse. Elder abuse includes physical, emotional and sexual abuse, neglect by a caregiver, self-neglect and financial exploitation. The goal of protective services is to remedy or alleviate the abusive situation and to prevent the reoccurrence of abuse.
The Executive Office of Elder Affairs Protective Services Program
Emergency Medical Technicians are mandated reporters subject to fine.
Call and report elder (age ≥60 years) abuse immediately to the Massachusetts Executive Office of Elder Affairs Hotline: 1-800-922-2275
The office will fax you a written report that must be completed within 48 hours.
(1) Physical Abuse: The non-accidental infliction of serious physical injury to an Elder or the threat of serious physical injury in which the Protective Services Agency has Reasonable Cause to Believe that an individual may have the intent and capacity to carry out the threatened serious physical injury.
(2) Sexual Abuse: Sexual assault, rape, sexual misuse, or sexual exploitation of an Elder or threats of Sexual Abuse where the individual has the intent and capacity to carry out the threatened Sexual Abuse.
(3) Emotional Abuse: The non-accidental infliction of serious emotional injury to an Elder. Emotional Abuse must establish a relationship between abusive actions, behaviors, or language and a resulting effect on the emotional state or functioning of the Elder.
(4) Neglect: The failure or refusal by a Caretaker to provide one or more of the necessities essential for physical well-being, such as food, clothing, shelter, personal care, and medical care, which has resulted in or where there is substantial reason to believe that such failure or refusal will immediately result in serious physical harm to an Elder.
(5) Financial Exploitation:The non-accidental act or omission by another person without the consent of the Elder causing substantial monetary or property loss to the Elder or substantial monetary or property gain to the other person which gain would otherwise benefit the Elder, but for the act or omission of the other person. Financial exploitation may result from consent obtained as a result of misrepresentation, undue influence, coercion or threat of force by the other person. Financial exploitation may not result from a bona fide gift or from any act or practice by another person in the conduct of a trade or commerce prohibited by M.G.L. c. 93A, § 2.
Source: 651 CMR 5.00
The position of an emergency medical services (EMS) agency medical director allows the opportunity for a physician to become engaged in the unique and ever-evolving realm of out-of-hospital care, a clinical practice offering a distinct set of challenges, and rewarding impacts in improving a community’s emergency medical care abilities.
For most, the driving force behind the desire to become an EMS agency medical director stems from a deep passion for helping patients in times of marked acute medical need whenever and wherever the need appears. Yet, understanding the nuances involved in the oversight and direction of an EMS agency requires specialized knowledge, skills, and abilities beyond the typical curriculum of emergency medicine or alternative acute care medical practices. It is for this precise reason that EMS has been recently recognized by the American Board of Medical Specialties as a formal physician sub-specialty.
Massachusetts law requires professionals whose work brings them in contact with children to notify the Department of Children and Families (DCF) if they suspect that a child is being abused, neglected, or both. EMS should complete the 51A paperwork and reporting even if another agency is doing so.
Mandated reporters who are licensed by the Commonwealth are required to complete training on recognizing and reporting suspected child abuse or neglect (51A Reports).
Abuse is any non-accidental act to a child that causes or creates a risk of physical or emotional injury. Abuse includes any sexual contact between a caretaker and a child.
Neglect is the failure by a caretaker, either deliberately or through negligence or inability, to provide a child with minimal care.
For more information on reporting alleged child abuse or neglect, please see the Department of Children and Families' guide for mandated reporters.
For the Massachusetts General Law on reporting of suspected abuse or neglect, please see MGL c.119, § 51A.
