43

 


 

Third Session, 48th General Assembly

67 Elizabeth II, 2018

BILL 43

AN ACT RESPECTING THE PROVISION OF EMERGENCY HEALTH AND PARAMEDICINE SERVICES

Received and Read the First Time................................................................

Second Reading............................................................................................

Committee.....................................................................................................

Third Reading...............................................................................................

Royal Assent.................................................................................................

HONOURABLE JOHN HAGGIE

Minister of Health and Community Services

Ordered to be printed by the Honourable House of Assembly

 

EXPLANATORY NOTES

This Bill would enact the Emergency Health and Paramedicine Services Act.  The Bill would regulate emergency and paramedicine services in the province.


A BILL

AN ACT RESPECTING THE PROVISION OF EMERGENCY HEALTH AND PARAMEDICINE SERVICES

Analysis


        1.   Short title

        2.   Definitions

        3.   Non-application of Act

        4.   Labrador Inuit rights

        5.   Powers of minister

        6.   Provincial medical director

        7.   Operator licences

        8.   Agreement

        9.   Emergency and paramedicine services

      10.   Duties of operator

      11.   Renewal of operator licence

      12.   Variation, suspension or cancellation of operator licence

      13.   Transfer 

      14.   Suspension or discontinuance of service by operator

      15.   Paramedicine provider

      16.   Review of decisions

      17.   Inspectors

      18.   Inspections

      19.   Warrants

      20.   Telewarrant

      21.   Report by inspector

      22.   Disclosure of personal health information

      23.   Prohibiton

      24.   False or misleading information

      25.   Protection from liability

      26.   Liability of operator

      27.   Advance health care directive

      28.   Offences

      29.   Statutory review

      30.   Lieutenant-Governor in Council regulations

      31.   Ministerial regulations

      32.   Fees and forms

      33.   Transitional

      34.   SNL1995 cP-37.1 Amdt.

      35.   RSNL1990 cH-3
Amdt.

      36.   RSNL1990 cM-19 Amdt.

      37.   Commencement


Be it enacted by the Lieutenant-Governor and House of Assembly in Legislative Session convened, as follows:

Short title

        1. This Act may be cited as the Emergency Health and Paramedicine Services Act.

Definitions

        2. In this Act

             (a)  "adverse health event" means an occurrence that results in an unintended outcome which negatively affects a patient's health or quality of life;

             (b)  "agreement" means an agreement made under section 8;

             (c)  "ambulance" means a vehicle that is designed, constructed or equipped to transport patients and provide other emergency health services;

             (d)  "community paramedicine services" means health services provided by a paramedicine provider to a person who does not require emergency health services;

             (e)  "dispatch" means to direct a paramedicine provider or an emergency medical vehicle to respond to a request for emergency and paramedicine services;

             (f)  "emergency and paramedicine services" includes

                      (i)  emergency health services,

                     (ii)  the routine transportation of patients, and

                    (iii)  community paramedicine services;                    

             (g)  "emergency health services" means the assessment, stabilization, treatment or transportation of a patient that is required to preserve the patient's life or to prevent or alleviate serious harm to the patient but does not include the assessment, stabilization or treatment of a patient provided in a health care facility;

             (h)  "emergency medical vehicle" means

                      (i)  an ambulance, and

                     (ii)  another category of vehicle that is equipped to provide emergency health services and is prescribed in the regulations;

              (i)  "health care facility" means a facility operated by a regional health authority;

              (j)  "inspector" means a person appointed under section 17;

             (k)  "minister" means the minister appointed under the Executive Council Act to administer this Act;

              (l)  "occurrence" means an undesired or unplanned event that does not appear to be consistent with the safe provision of health services;

           (m)  "operator" means a person who holds a valid operator licence issued under section 7 and who

                      (i)  is a regional health authority or another crown agent, or

                     (ii)  has entered into an agreement;

             (n)  "paramedicine provider" means a person who holds a valid licence issued under section 15;

             (o)  "patient" means a person requiring medical attention or who is under medical care;          

             (p)  "personal health information" means personal health information as defined in the Personal Health Information Act;

             (q)  "provincial medical director" means a person appointed under section 6; and

              (r)  "regional health authority" means a regional health authority established under the Regional Health Authorities Act.

Non-application of Act

        3. This Act does not apply to

             (a)  a person providing emergency medical services or first aid assistance in circumstances to which the Emergency Medical Aid Act applies;

             (b)  a person based outside the province providing a service for the interprovincial transportation of patients;

             (c)  police, firefighters, lifeguards and other persons prescribed in the regulations who are not paramedicine providers;

             (d)  a person providing an emergency service during

                      (i)  an emergency declared under the Emergency Services Act, or

                     (ii)  a public health emergency declared under the Public Health Protection and Promotion Act;

             (e)  a person practising or studying a health profession acting under the authority of an Act of the province; and

             (f)  a student enrolled in a paramedicine provider education program at a post-secondary educational institution who is participating in practical training under the direct supervision of a paramedicine provider.

Labrador Inuit rights

        4. This Act and regulations made under this Act shall be read and applied in conjunction with the Labrador Inuit Land Claims Agreement Act and, where a provision of this Act or regulations made under this Act is inconsistent or conflicts with a provision, term or condition of the Labrador Inuit Land Claims Agreement Act, the provision, term or condition of the Labrador Inuit Land Claims Agreement Act shall have precedence over the provision of this Act or a regulation made under this Act.

Powers of minister

        5. (1) The minister may

             (a)  establish standards for the management, operation and use of emergency medical vehicles in the provision of emergency and paramedicine services, including standards relating to

                      (i)  the services to be provided and the procedures to be followed by paramedicine providers, and

                     (ii)  the number and category of paramedicine providers required to be present in an emergency medical vehicle;

             (b)  establish standards for the management and provision of emergency and paramedicine services;       

             (c)  establish one or more communication centres for the dispatch of paramedicine providers and emergency medical vehicles throughout the province;

             (d)  prescribe the technical specifications of emergency medical vehicles; and

             (e)  set the rates that operators are required to charge for the provision of emergency and paramedicine services.

             (2)  The minister shall monitor compliance with this Act, the regulations, an agreement and the standards, protocols and guidelines established under the authority of this Act.

             (3)  The minister may delegate, in writing, the following powers and duties conferred on him or her under this Act:

             (a)  licensing operators and paramedicine providers; and

             (b)  monitoring compliance with this Act, the regulations, an agreement and the standards, protocols and guidelines established under the authority of this Act.

Provincial medical director

        6. (1) The minister shall appoint a medical practitioner to be the provincial medical director who shall have the qualifications prescribed in the regulations.                     

             (2)  The provincial medical director shall

             (a)  act as a medical advisor to the minister on matters respecting emergency and paramedicine services;

             (b)  establish or adopt, in whole or in part, protocols and guidelines for the provision of emergency and paramedicine services by paramedicine providers;

             (c)  provide a copy of the protocols and guidelines to each regional health authority;

             (d)  develop a quality assurance program relating to emergency and paramedicine services;

             (e)  direct and authorize paramedicine providers to provide emergency and paramedicine services in accordance with

                      (i)  his or her verbal direction, or

                     (ii)  the standards, protocols and guidelines established under the authority of this Act; and  

             (f)  perform other duties and functions as prescribed in the regulations.

             (3)  The provincial medical director may delegate, in writing, his or her power under paragraph (2)(e).

             (4)  Protocols and guidelines established or adopted by the provincial medical director under paragraph (2)(b) shall not conflict with

             (a)  any standards established by the minister; and

             (b)  generally accepted professional standards.

Operator licences

        7. (1) An applicant shall apply in writing to the minister for an operator licence in the form prescribed by the minister.

             (2)  The minister may issue an operator licence to an applicant where the minister is satisfied that

             (a)  the emergency and paramedicine services proposed by the applicant will be provided in accordance with this Act, the regulations and any standards, protocols and guidelines established under the authority of this Act;

             (b)  the vehicles proposed by the applicant to be used in the provision of emergency and paramedicine services are in compliance with the requirements of this Act, the regulations and any other Act or regulations of the province or of Canada;

             (c)  the emergency and paramedicine services proposed by the applicant will, based on the safety record of the applicant where the applicant was previously licensed as an operator under this Act or the Motor Carrier Act, be provided in a safe manner; and

             (d)  the applicant satisfies the other requirements prescribed in the regulations.

             (3)  The minister may impose terms and conditions on an operator licence, including terms and conditions respecting

             (a)  the geographic location in which an operator may provide emergency and paramedicine services; and

             (b)  the number of emergency medical vehicles an operator may operate.            

             (4)  An operator licence shall expire in accordance with the regulations.

             (5)  The minister may prescribe by regulation different categories of operator licences.

Agreement

        8. The minister may enter into an agreement for the provision of emergency and paramedicine services with a person who holds a valid operator licence.

Emergency and paramedicine services

        9. (1) A person, other than a regional health authority or another crown agent, shall not provide emergency and paramedicine services unless the person

             (a)  holds a valid operator licence issued under this Act; and

             (b)  has entered into an agreement.

             (2)  A regional health authority or another crown agent shall not provide emergency and paramedicine services unless the regional health authority or crown agent holds a valid operator licence issued under this Act.

Duties of operator

      10. An operator shall                   

             (a)  provide emergency and paramedicine services in compliance with this Act, the regulations, any other Act or regulations of the province or of Canada, an agreement and the standards, protocols and guidelines established under the authority of this Act;

             (b)  comply with the terms and conditions of the operator licence issued under this Act;

             (c)  manage human and material resources in conformity with an agreement;

             (d)  carry out any quality improvement measures required by the provincial medical director;  

             (e)  maintain insurance coverage in accordance with the regulations;

             (f)  report and disclose an adverse health event in accordance with the regulations;

             (g)  provide emergency and paramedicine services in emergency medical vehicles that meet the specifications prescribed in the regulations;   

             (h)  only employ paramedicine providers to provide emergency and paramedicine services; and

              (i)  only use or permit an emergency medical vehicle to be used for the purposes stated in the operator licence.

Renewal of operator licence

      11. The minister may renew an operator licence in accordance with the regulations.

Variation, suspension or cancellation of operator licence

      12. (1) The minister may vary, suspend or cancel an operator licence where

             (a)  the operator contravenes this Act, the regulations, any other Act or regulations of the province or of Canada, an agreement or the standards, protocols or guidelines established under the authority of this Act;

             (b)  the minister is satisfied that the operator is unable to provide emergency and paramedicine services in accordance with this Act, the regulations, an agreement or the standards, protocols or guidelines established under the authority of this Act;

             (c)  the minister is satisfied that the operator is unable to comply with the terms and conditions of the operator licence;

             (d)  the operator obtained the operator licence based on false representations;

             (e)  the operator modified the emergency and paramedicine services required under the licence or an agreement without the approval of the minister;

             (f)  the operator provided emergency and paramedicine services negligently or in a manner prejudicial to the health or safety of individuals requiring emergency and paramedicine services; or

             (g)  the minister is satisfied that it is in the public interest to vary, suspend or cancel the operator licence.

             (2)  The minister shall give an operator at least 60 days notice before varying, suspending or cancelling an operator licence.

             (3)  A notice under subsection (2) shall state

             (a)  the reasons for varying, suspending or cancelling the operator licence; and

             (b)  the corrective action required to prevent the minister from varying, suspending or cancelling the operator licence.  

             (4)  Where the operator takes the corrective action required under the notice referred to in subsection (2) to the satisfaction of the minister within 60 days of receiving the notice, the minister shall not vary, suspend or cancel the operator licence.

             (5)  Where the operator does not take the corrective action required under the notice referred to in subsection (2), the minister may, in addition to varying, suspending or cancelling the licence, provide the emergency and paramedicine services that the operator was providing or authorize a crown agent to provide those services.

             (6)  Notwithstanding subsections (2) and (4), where the minister is of the opinion that a shorter time period is necessary to protect the public, the minister may give an operator less notice than prescribed in subsections (2) and (4).         

Transfer  

      13. (1) An operator licence shall not be transferred.

             (2)  Where an operator transfers the ownership of shares carrying 50% or more of the voting rights to one or more persons, the operator licence shall be cancelled unless the minister is satisfied that the person to whom the shares are being transferred will provide emergency and paramedicine services in accordance with this Act, the regulations, any other Act or regulations of the province or of Canada, an agreement and any standards, protocols and guidelines established under the authority of this Act.

Suspension or discontinuance of service by operator

      14. An operator shall not suspend or discontinue an emergency and paramedicine service unless the operator obtains the prior approval of the minister in accordance with the regulations.

Paramedicine provider

      15. (1) An applicant shall apply in writing to the minister for a paramedicine provider licence in the form prescribed by the minister.

             (2)  The minister may issue a paramedicine provider licence to an applicant where the applicant satisfies the requirements prescribed in the regulations.

             (3)  The minister may impose terms and conditions on a paramedicine provider licence.

             (4)  A paramedicine provider shall comply with

             (a)  this Act and the regulations;

             (b)  standards established by the minister; and

             (c)  protocols and guidelines established by the provincial medical director.

             (5)  A paramedicine provider licence shall expire in accordance with the regulations.

             (6)  The minister may vary, suspend, cancel or renew a paramedicine provider licence in accordance with the regulations.

             (7)  The minister may prescribe by regulation different categories of paramedicine provider licences.

             (8)  A paramedicine provider shall act in accordance with his or her scope of practice unless otherwise authorized by the provincial medical director. 

             (9)  Where a paramedicine provider is dispatched to a premises in response to a request for emergency health services, the paramedicine provider may enter the premises, including a dwelling-house, without a warrant where he or she reasonably believes that a person in the premises requires emergency health services immediately. 

          (10)  A paramedicine provider referred to in subsection (9) may use reasonable force to enter the premises where necessary.

Review of decisions

      16. (1) A person may request a review of a decision of the minister under this Act or the regulations.

             (2)  A request for review under subsection (1) shall be in writing and made to the minister within 30 days of the date the person received notice of the decision.

             (3)  A request for review under this section does not stay the decision being reviewed.

             (4)  The minister shall allow the person requesting the review to make submissions in accordance with the regulations.

             (5)  The minister may confirm, reverse or vary a decision reviewed under this section.

             (6)  The minister's decision under subsection (5) is final and binding.

Inspectors

      17. The minister may appoint a person or a category of persons to act as inspectors for the purposes of this Act and the regulations.

Inspections

      18. (1) An inspector, may, without a warrant, at all reasonable times, inspect or examine the premises, emergency medical vehicles, processes, books and records of a person that the inspector considers relevant for 

             (a)  the purpose of determining compliance with this Act, the regulations, an agreement or the standards, protocols or guidelines established under the authority of this Act, including all records related to staff schedules, payroll, inventory, maintenance and cleaning of emergency medical vehicles, patient fee collections, dispatch and insurance;

             (b)  the purpose of evaluating the emergency and paramedicine services being provided by an operator;

             (c)  the purpose of assessing the registration, inspection and maintenance of an emergency medical vehicle; and

             (d)  other purposes related to the administration, compliance or enforcement of this Act, the regulations, an agreement or the standards, protocols or guidelines established under the authority of this Act.

             (2)  An inspector may, without a warrant,

             (a)  enter any premises

                      (i)  where an emergency medical vehicle is located,

                     (ii)  where any property, books or records relating to the provision of emergency and paramedicine services are or may be kept, or

                    (iii)  where anything is done or is suspected by the inspector of being done in connection with a requirement of this Act, the regulations, an agreement or any standards, protocols or guidelines established under the authority of this Act;

             (b)  make copies, extracts, photographs or videos the inspector considers necessary;

             (c)  require the operator or the owner or person in charge of a premises to give the inspector all reasonable assistance, including the production of books and records as requested by the inspector, and to answer all questions relating to the administration, compliance or enforcement of this Act, the regulations, an agreement or the standards, protocols or guidelines established under the authority of this Act and, for that purpose, require the operator or owner or person in charge to attend at the premises with the inspector; and

             (d)  require the operator or the owner or person in charge to make available the means to generate and manipulate books and records that are in machine readable or electronic form and any other means or information necessary for the inspector to assess the books and records.

             (3)  Notwithstanding subsections (1) and (2), an inspector shall not enter a dwelling-house without the consent of the occupant except under the authority of a warrant.

Warrants

      19. (1) Where an inspector under this Act

             (a)  is denied entry to a premises, emergency medical vehicle or dwelling-house to carry out an inspection; or

             (b)  believes on reasonable and probable grounds that there has been a contravention of this Act or the regulations,

the inspector may file an application with the Provincial Court for a warrant.

             (2)  Where a Provincial Court judge is satisfied on the basis of an inspector's sworn information that there are reasonable grounds to believe that the inspector has been denied entry to a premises, emergency medical vehicle or dwelling-house to carry out an inspection or there has been a contravention of this Act or the regulations, the judge may issue a warrant authorizing the inspector to do one or both of the following:

             (a)  enter the premises, emergency medical vehicle or dwelling-house and carry out an inspection under this Act; or

             (b)  seize or remove any of the books or records that may be required as evidence of contravention and may retain those documents until the time they are required in a court proceeding.

             (3)  A Provincial Court judge may receive and consider an application for a warrant or extension of a warrant without notice to the  operator or the owner or person in charge of the premises, emergency medical vehicle or dwelling-house.

             (4)  An operator or an owner or a person in charge of a premises or an emergency medical vehicle and their employees, or an occupant of a dwelling-house shall not obstruct an inspector while the inspector is exercising the powers and performing the duties and functions as authorized by the warrant.

             (5)  At the request of an inspector, a peace officer shall assist in enforcing a warrant.

Telewarrant

      20. (1) Where, in the opinion of an inspector it would not be practical to appear before a Provincial Court judge to apply for a warrant, the inspector may make the application by telephone or other means of telecommunication.

             (2)  Where the information on which an application for a warrant is submitted by telephone or other means of telecommunication, the information shall be given under oath or affirmation, and the oath or affirmation may be administered by telephone or other means of telecommunication.

             (3)  The information submitted by telephone or other means of telecommunication shall include

             (a)  a statement of the circumstances that make it impracticable for the inspector to appear personally before a Provincial Court judge; and

             (b)  a statement of the inspector’s grounds for believing that a person has contravened this Act or the regulations or that entry onto public or private premises where a contravention of this Act or the regulations is believed to occur has been denied.

             (4)  The sworn or affirmed information submitted by telephone or other means of telecommunication by an inspector shall specify the name of the person giving evidence, the facts ascertained and the manner and location in which evidence was received, and a record of that information shall be filed by the Provincial Court judge with the clerk of the court over which the judge presides.

             (5)  Where an inspector acts under the authority of a warrant obtained under this section, he or she shall provide a facsimile of the warrant to the operator or the owner or employee of the premises at the time the warrant is carried out.

             (6)  In subsection (5), "facsimile" includes a record produced by electronic means or a written record of a telephone conversation made by both parties to the conversation while it is in progress and which the parties have confirmed as to its accuracy by reading their record of the conversation to one another at the end of the conversation.

Report by inspector

      21. (1) An inspector shall prepare a report which sets out the findings and results of the inspection.

             (2)  An inspector shall provide a copy of the report to the minister, operator and those other persons prescribed in the regulations.

Disclosure of personal health information

      22. An operator shall, at the request of the minister and without the consent of the person who is the subject of the information, disclose to the minister personal health information for the purposes of

             (a)  determining or providing payment to the operator for the provision of emergency and paramedicine services or for processing, monitoring, verifying or reimbursing claims for payment for the provision of emergency health and paramedicine services;

             (b)  delivering, evaluating or monitoring a program of the minister that relates to the provision of emergency health and paramedicine services; and

             (c)  review and planning that relates to the provision of emergency health and paramedicine services.

Prohibiton

      23. A person shall not discipline, suspend, demote, dismiss, discharge, harass, interfere with or otherwise disadvantage another person or threaten to do any of those things to another person where that person, in good faith, complies with this Act, the regulations or the standards, protocols or guidelines established under the authority of this Act.

False or misleading information

      24. A person shall not knowingly provide false or misleading information, either orally or in writing, to the minister or his or her delegate, the provincial medical director or his or her delegate or an inspector while he or she is exercising powers or carrying out duties or functions under this Act, the regulations or the standards, protocols or guidelines established under the authority of this Act.

Protection from liability

      25. (1) An action does not lie against a person who, in good faith, complies with this Act, the regulations or the standards, protocols or guidelines established under the authority of this Act.

      (2) An action does not lie against the minister or his or her delegate, a regional health authority, a crown agent, the provincial medical director or his or her delegate, an inspector, an operator, a paramedicine provider or any other person acting under the authority of this Act, the regulations or the standards, protocols or guidelines established under the authority of this Act for anything done or omitted to be done in good faith

             (a)  in the performance or intended performance of a duty imposed under this Act or the regulations; or

             (b)  in the exercise or intended exercise of a power conferred under this Act or the regulations.

Liability of operator

      26. Where a person employed or engaged by an operator acts within the scope of his or her practice, an act, omission or failure to act of that person shall be considered to be the act, omission or failure of the operator.

Advance health care directive

      27. Where a paramedicine provider is aware that the patient has an advance health care directive under the Advance Health Care Directives Act, the paramedicine provider shall comply with the advance health care directive.

Offences

      28. (1) A person who contravenes this Act or the regulations is guilty of an offence and is liable on summary conviction

             (a)  in the case of an individual, to a fine of not more than $10,000 or to imprisonment for a term of not more than 12 months, or to both; and

             (b)  in the case of a corporation, to a fine of not more than $50,000.

             (2)  A prosecution for an offence under this Act shall be commenced within 2 years of the date of discovery of the offence.

Statutory review

      29. The minister shall, every 5 years, conduct a review of this Act and the regulations and consider the areas which may be improved.

Lieutenant-Governor in Council regulations

      30. The Lieutenant-Governor in Council may make regulations

             (a)  prescribing other categories of vehicles for the purposes of subparagraph 2(h)(ii) and establishing different requirements and conditions for each category;

             (b)  respecting the variation, suspension and cancellation of paramedicine provider licences;

             (c)  respecting submissions under subsection 16(4);

             (d)  exempting certain categories of emergency medical vehicles, emergency and paramedicine services, operators and paramedicine providers from this Act or sections of this Act;

             (e)  respecting the provision of emergency and paramedicine services by emergency medical vehicles where transportation by the emergency medical vehicle is not for compensation;

             (f)  incorporating by reference, in whole or in part, a written standard, rule or guideline, as it reads on a prescribed day or as it is amended from time to time;

             (g)  defining a word or phrase used but not defined in this Act; and

             (h)  generally, to give effect to this Act.

Ministerial regulations

      31. The minister may make regulations

             (a)  respecting the reporting and disclosure of an adverse health event;

             (b)  prescribing the qualifications of the provincial medical director;

             (c)  respecting other duties and functions of the provincial medical director;

             (d)  prescribing the qualifications of paramedicine providers;

             (e)  respecting applications for licences;     

             (f)  establishing different categories of licences and establishing different requirements, standards and conditions for each category;

             (g)  respecting the expiration and renewal of licences;

             (h)  prescribing persons for the purpose of paragraph 3(c);

              (i)  respecting the specifications of emergency medical vehicles;

              (j)  respecting the purpose for which an emergency medical vehicle may be used;

             (k)  respecting the insurance coverage that shall be carried by an  operator;         

              (l)  prescribing persons to whom a copy of an inspector's report shall be provided;

           (m)  prescribing the emergency and paramedicine services that a paramedicine provider may provide;       

             (n)  respecting the process for obtaining approval under section 14;

             (o)  prescribing time periods for notices and decisions under this Act;

             (p)  incorporating by reference, in whole or in part, a written standard, rule or guideline, as it reads on a prescribed day or as it is amended from time to time;

             (q)  defining a word or phrase used but not defined in this Act; and

              (r)  generally, to give effect to this Act.

Fees and forms

      32. The minister may set fees and establish forms for the purpose and administration of this Act and the regulations.

Transitional

      33. (1) On the coming into force of this Act, a valid motor carrier certificate relating to the operation of a vehicle designed or used for the transportation of ill or injured persons on a highway issued under the Motor Carrier Act shall continue to be valid as if it were an operator licence issued under this Act until whichever of the following occurs first:

             (a)  the certificate expires; or

             (b)  3 months after the coming into force of this Act.

             (2)  On the coming into force of this Act, the registration of a paramedicine provider in accordance with the Provincial Medical Oversight Policies and Procedures Manual shall continue to be valid as if it were a paramedicine provider licence issued under this Act until it expires.

SNL1995 cP-37.1 Amdt.

      34. (1) Paragraphs 11(1)(jj) and (kk) of the Health and Community Services Act are repealed.

             (2)  Subsection 11(6) of the Act is repealed.

RSNL1990 cH-3
Amdt.

      35. (1) Paragraph 2(a.2) of the Highway Traffic Act is repealed.

             (2)  Subparagraph 2(v)(iii) of the Act is repealed and the following substituted:

                    (iii)  an emergency medical vehicle responding to a call or transporting a patient where there is an emergency justifying a rate of speed in excess of a maximum rate of speed provided for in this Act;

             (3)  Section 2 of the Act is amended by adding immediately after paragraph (u) the following:

         (u.1)  "emergency medical vehicle" means emergency medical vehicle as defined in the Emergency Health and Paramedicine Services Act;

             (4)  Section 77 of the Act is repealed and the following substituted:

Insuring emergency medical vehicles, etc.

      77. The minister may make regulations respecting

             (a)  the coverage of emergency medical vehicles, buses, school buses, taxis and commercial motor vehicles by insurance;

         (a.1)  the coverage by insurance of motor vehicles which are contracted to school boards in the province for the transportation of students to and from school and school related activities;

             (b)  the form and kind of an insurance policy respecting a vehicle referred to in paragraphs (a) and (a.1);

             (c)  the amount of insurance;

             (d)  other matters or things in connection with that insurance; and

             (e)  the imposition of penalties for a violation of those regulations.

             (5)  Subsection 123(4) of the Act is repealed and the following substituted:

             (4)  A driver of an emergency medical vehicle is considered to be responding to an emergency call from the time the driver receives the call until he or she arrives at the destination of the passenger.

             (6)  Paragraph 176.1(3)(a) of the Act is repealed and the following substituted:

             (a)  the driver of an emergency medical vehicle, fire department vehicle or police vehicle;

             (7)  Paragraph 176.1(4)(a) of the Act is repealed and the following substituted:

             (a)  a device to contact emergency medical vehicle, police or fire department emergency services; or

RSNL1990 cM-19 Amdt.

      36. (1) Paragraph 2(a) of the Motor Carrier Act is repealed.

             (2)  Paragraph 3(1)(f) of the Act is repealed and the following substituted:

             (f)  a vehicle while being operated under the management and control or in accordance with a franchise or licence granted by or on behalf of

                      (i)  the City of St. John's, other than a vehicle operating outside the limits of that city under subsection 216(3) of the City of St. John's Act,

                     (ii)  the City of Corner Brook,

                    (iii)  the City of Mount Pearl, or

                    (iv)  a town, community or region established or continued under the Municipalities Act,

for the purpose of a municipal undertaking;

             (3)  Paragraph 4(1)(a) of the Act is repealed.

             (4)  Paragraph 6(1)(a) of the Act is repealed.

             (5)  Paragraph 28(1)(hh) of the Act is repealed.

             (6)  Subsection 28(2) of the Act is repealed.

Commencement

      37. This Act, or a section, subsection, paragraph or subparagraph of this Act, comes into force on a day or days to be proclaimed by the Lieutenant-Governor in Council.