First Substitute S.B. 54

Senator Leonard M. Blackham proposes to substitute the following bill:

1 EMERGENCY MEDICAL SERVICES SYSTEMS ACT
2 1999 GENERAL SESSION
3 STATE OF UTAH
4 Sponsor: Leonard M. Blackham
5 AN ACT RELATING TO HEALTH; REPEALING AND ENACTING THE EMERGENCY
6 MEDICAL SERVICES SYSTEM ACT; DEFINING TERMS; CREATING AN EMERGENCY
7 MEDICAL SERVICES COMMITTEE; EXTENDING RULEMAKING AUTHORITY TO THE
8 COMMITTEE AND THE DEPARTMENT; PERMITTING RULES TO BE WAIVED;
9 ESTABLISHING EMERGENCY MEDICAL SERVICE PROGRAMS, PLANS, AND DUTIES;
10 AMENDING THE EMERGENCY MEDICAL SERVICES GRANT PROGRAM;
11 ESTABLISHING CERTIFICATE REQUIREMENTS FOR PERSONNEL, DESIGNATION
12 REQUIREMENTS FOR FACILITIES AND PROVIDERS, PERMIT REQUIREMENTS FOR
13 EMERGENCY MEDICAL VEHICLES, LICENSING REQUIREMENTS FOR AMBULANCE
14 PROVIDERS AND PARAMEDIC PROVIDERS, AND CARVING OUT EXEMPTIONS;
15 ESTABLISHING STATE REGULATION OF THE EMERGENCY MEDICAL SERVICES
16 MARKET; REQUIRING THE DEPARTMENT TO SET JUST AND REASONABLE RATES
17 AND TO CREATE EXCLUSIVE GEOGRAPHIC SERVICE AREAS FOR LICENSED
18 PROVIDERS; CREATING AN ADMINISTRATIVE PROCESS FOR ISSUING LICENCES FOR
19 EXCLUSIVE GEOGRAPHIC SERVICE AREAS TO AMBULANCE AND PARAMEDIC
20 PROVIDERS; ESTABLISHING THE REQUIREMENT OF PUBLIC CONVENIENCE AND
21 NECESSITY; PERMITTING THE DEPARTMENT TO TAKE DISCIPLINARY ACTION;
22 AUTHORIZING THE DEPARTMENT TO CONDUCT INSPECTIONS; MAKING
23 TECHNICAL AND CONFORMING AMENDMENTS; AND PROVIDING AN EFFECTIVE
24 DATE.
25 This act affects sections of Utah Code Annotated 1953 as follows:

26 AMENDS:
27 26-6a-1, as last amended by Chapter 282, Laws of Utah 1998
28 58-57-7, as last amended by Chapter 297, Laws of Utah 1993
29 62A-12-232, as last amended by Chapter 142, Laws of Utah 1995
30 63-46b-1, as last amended by Chapter 375, Laws of Utah 1997
31 63-63a-3, as last amended by Chapter 156, Laws of Utah 1993
32 63C-7-202, as enacted by Chapter 136, Laws of Utah 1997
33 75-2-1105.5, as enacted by Chapter 45, Laws of Utah 1993
34 76-5-102.7, as enacted by Chapter 4, Laws of Utah 1997
35 76-10-915, as enacted by Chapter 79, Laws of Utah 1979
36 78-29-101, as last amended by Chapter 282, Laws of Utah 1998
37 ENACTS:
38 26-8a-101, Utah Code Annotated 1953
39 26-8a-102, Utah Code Annotated 1953
40 26-8a-104, Utah Code Annotated 1953
41 26-8a-105, Utah Code Annotated 1953
42 26-8a-106, Utah Code Annotated 1953
43 26-8a-201, Utah Code Annotated 1953
44 26-8a-202, Utah Code Annotated 1953
45 26-8a-203, Utah Code Annotated 1953
46 26-8a-204, Utah Code Annotated 1953
47 26-8a-205, Utah Code Annotated 1953
48 26-8a-206, Utah Code Annotated 1953
49 26-8a-208, Utah Code Annotated 1953
50 26-8a-301, Utah Code Annotated 1953
51 26-8a-302, Utah Code Annotated 1953
52 26-8a-303, Utah Code Annotated 1953
53 26-8a-304, Utah Code Annotated 1953
54 26-8a-305, Utah Code Annotated 1953
55 26-8a-306, Utah Code Annotated 1953
56 26-8a-307, Utah Code Annotated 1953

57 26-8a-308, Utah Code Annotated 1953
58 26-8a-309, Utah Code Annotated 1953
59 26-8a-310, Utah Code Annotated 1953
60 26-8a-401, Utah Code Annotated 1953
61 26-8a-402, Utah Code Annotated 1953
62 26-8a-403, Utah Code Annotated 1953
63 26-8a-404, Utah Code Annotated 1953
64 26-8a-405, Utah Code Annotated 1953
65 26-8a-406, Utah Code Annotated 1953
66 26-8a-407, Utah Code Annotated 1953
67 26-8a-408, Utah Code Annotated 1953
68 26-8a-409, Utah Code Annotated 1953
69 26-8a-410, Utah Code Annotated 1953
70 26-8a-411, Utah Code Annotated 1953
71 26-8a-412, Utah Code Annotated 1953
72 26-8a-413, Utah Code Annotated 1953
73 26-8a-414, Utah Code Annotated 1953
74 26-8a-415, Utah Code Annotated 1953
75 26-8a-416, Utah Code Annotated 1953
76 26-8a-501, Utah Code Annotated 1953
77 26-8a-502, Utah Code Annotated 1953
78 26-8a-503, Utah Code Annotated 1953
79 26-8a-504, Utah Code Annotated 1953
80 26-8a-505, Utah Code Annotated 1953
81 26-8a-506, Utah Code Annotated 1953
82 26-8a-507, Utah Code Annotated 1953
83 RENUMBERS AND AMENDS:
84 26-8a-601, (Renumbered from 26-8-11, as last amended by Chapter 320, Laws of Utah
85 1990)
86 26-8a-103, (Renumbered from 26-8-3, as last amended by Chapters 194 and 243, Laws of
87 Utah 1996)

88 26-8a-207, (Renumbered from 26-8-2.5, as last amended by Chapter 156, Laws of Utah
89 1993)
90 REPEALS:
91 26-8-1, as enacted by Chapter 126, Laws of Utah 1981
92 26-8-2, as last amended by Chapter 288, Laws of Utah 1994
93 26-8-4, as last amended by Chapter 288, Laws of Utah 1994
94 26-8-5, as last amended by Chapter 169, Laws of Utah 1988
95 26-8-5.5, as enacted by Chapter 195, Laws of Utah 1993
96 26-8-6, as enacted by Chapter 126, Laws of Utah 1981
97 26-8-7, as last amended by Chapter 170, Laws of Utah 1996
98 26-8-7.5, as enacted by Chapter 90, Laws of Utah 1998
99 26-8-8, as enacted by Chapter 126, Laws of Utah 1981
100 26-8-9, as enacted by Chapter 126, Laws of Utah 1981
101 26-8-10, as enacted by Chapter 126, Laws of Utah 1981
102 26-8-12, as last amended by Chapter 161, Laws of Utah 1987
103 26-8-13, as enacted by Chapter 126, Laws of Utah 1981
104 26-8-14, as enacted by Chapter 126, Laws of Utah 1981
105 Be it enacted by the Legislature of the state of Utah:
106 Section 1. Section 26-6a-1 is amended to read:
107 26-6a-1. Definitions.
108 For purposes of this chapter:
109 (1) "Designated agent" means a person or persons designated by an agency employing or
110 utilizing emergency medical services providers as employees or volunteers to receive and
111 distribute test results in accordance with this chapter.
112 (2) "Disability" means the event of becoming physically incapacitated from performing
113 any work for remuneration or profit.
114 (3) "Disease" means Acquired Immunodeficiency Syndrome, Human Immunodeficiency
115 Virus infection, Hepatitis B, Hepatitis B seropositivity, and any other infectious disease designated
116 by the department.
117 (4) "Emergency medical services agency" means an agency, entity, or organization that
118 employs or utilizes emergency medical services providers as employees or volunteers.

119 (5) "Emergency medical services provider" means [an emergency medical technician as
120 defined in Section 26-8-2 ] a person certified under Section 26-8a-302 , a peace officer as defined
121 in Title 53, Chapter 13, Peace Officer Classifications, local fire department personnel, or officials
122 or personnel employed by the Department of Corrections or by a county jail, who provides
123 prehospital emergency medical care for an emergency medical services agency either as an
124 employee or as a volunteer.
125 (6) "Patient" means any individual cared for by an emergency medical services provider,
126 including but not limited to victims of accidents or injury, deceased persons, and prisoners or
127 persons in the custody of the Department of Corrections.
128 (7) "Significant exposure" means:
129 (a) contact of an emergency medical services provider's broken skin or mucous membrane
130 with a patient's blood or bodily fluids other than tears or perspiration;
131 (b) that a needle stick, or scalpel or instrument wound has occurred in the process of caring
132 for a patient; or
133 (c) exposure that occurs by any other method of transmission defined by the department
134 as a significant exposure.
135 Section 2. Section 26-8a-101 is enacted to read:
136 CHAPTER 8a. UTAH EMERGENCY MEDICAL SERVICES SYSTEM ACT
137 Part 1. General Provisions
138 26-8a-101. Title.
139 This chapter is known as the "Utah Emergency Medical Services System Act."
140 Section 3. Section 26-8a-102 is enacted to read:
141 26-8a-102. Definitions.
142 As used in this chapter:
143 (1) "Ambulance" means a ground, air, or water vehicle that:
144 (a) transports patients and is used to provide emergency medical services; and
145 (b) is required to obtain a permit under Section 26-8a-304 to operate in the state.
146 (2) "Ambulance provider" means an emergency medical service provider that:
147 (a) transports and provides emergency medical care to patients; and
148 (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
149 (3) "Committee" means the State Emergency Medical Services Committee created by

150 Section 26-1-7 .
151 (4) (a) "Critical care categorization guidelines" means a stratified profile of hospital critical
152 care services related to emergency patient condition which aids a physician in selecting the most
153 appropriate facility for critical patient referral.
154 (b) Guideline categories include trauma, spinal cord, burns, high risk infant, pediatrics,
155 poisons, cardiac, respiratory, and psychiatric.
156 (5) "Direct medical observation" means in-person observation of a patient by a physician,
157 registered nurse, physician's assistant, or individual certified under Section 26-8a-302 .
158 (6) "Emergency medical condition" means:
159 (a) a medical condition that manifests itself by symptoms of sufficient severity, including
160 severe pain, that a prudent layperson, who possesses an average knowledge of health and medicine,
161 could reasonably expect the absence of immediate medical attention to result in:
162 (i) placing the individual's health in serious jeopardy;
163 (ii) serious impairment to bodily functions; or
164 (iii) serious dysfunction of any bodily organ or part; or
165 (b) a medical condition that in the opinion of a physician or his designee requires direct
166 medical observation during transport or may require the intervention of an individual certified
167 under Section 26-8a-302 during transport.
168 (7) "Emergency medical service personnel":
169 (a) means an individual who provides emergency medical services to a patient and is
170 required to be certified under Section 26-8a-302 ; and
171 (b) includes a paramedic, medical director of a licensed emergency medical service
172 provider, emergency medical service instructor, and other categories established by the committee.
173 (8) "Emergency medical service providers" means:
174 (a) licensed ambulance providers and paramedic providers;
175 (b) a facility or provider that is required to be designated under Section 26-8a-303 or
176 26-8a-304 ; and
177 (c) emergency medical service personnel.
178 (9) "Emergency medical services" means medical services, transportation services, or both
179 rendered to a patient.
180 (10) "Emergency medical service vehicle" means a land, air, or water vehicle that is:

181 (a) maintained and used for the transportation of emergency medical personnel, equipment,
182 and supplies to the scene of a medical emergency; and
183 (b) required to be permitted under Section 26-8a-304 .
184 (11) "Interested party" means:
185 (a) a licensed or designated emergency medical services provider that provides emergency
186 medical services within or in an area that abuts an exclusive geographic service area that is the
187 subject of an application submitted pursuant to Part 4, Ambulance and Paramedic Providers;
188 (b) any municipality, county, or fire district that lies within or abuts a geographic service
189 area that is the subject of an application submitted pursuant to Part 4, Ambulance and Paramedic
190 Providers; or
191 (c) the department when acting in the interest of the public.
192 (12) "Medical control" means a person who provides medical supervision to an emergency
193 medical service provider.
194 (13) "Paramedic provider" means an entity that:
195 (a) employs emergency medical service personnel; and
196 (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
197 (14) "Patient" means an individual who, as the result of illness or injury, meets any of the
198 criteria in Subsection 26-8a-305 (1).
199 Section 4. Section 26-8a-103 , which is renumbered from Section 26-8-3 is renumbered
200 and amended to read:
201 [26-8-3]. 26-8a-103. State Emergency Medical Services Committee --
202 Membership -- Expenses.
203 (1) The State Emergency Medical Services Committee created by Section 26-1-7 shall be
204 composed of [14] the following 16 members appointed by the governor[. The members are], at
205 least five of whom must reside in a county of the third, fourth, fifth, or sixth class:
206 (a) five physicians licensed [to practice in this state, who practice in the following areas]
207 under Title 58, Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic Medical
208 Practice Act, as follows:
209 (i) one [trauma] surgeon who actively provides trauma care at a hospital;
210 (ii) one rural physician [practicing in a rural area] involved in emergency medical care;
211 (iii) two physicians who practice in the emergency department of a general acute hospital;

212 and
213 (iv) one pediatrician who practices in the emergency department or critical care unit of a
214 general acute hospital or a children's specialty hospital;
215 (b) one representative from a private ambulance [services representative] provider;
216 (c) one representative from an ambulance provider that is neither privately owned nor
217 operated by a fire department;
218 [(c)] (d) two chief officers from fire [chiefs, one who is a paramedic services provider and
219 one who is an advanced life support provider] agencies operated by the following classes of
220 licensed or designated emergency medical services providers: municipality, county, and fire
221 district, provided that no class of medical services providers may have more than one
222 representative under this Subsection (1)(d);
223 [(d)] (e) one [local public safety agency] director of [an] a law enforcement agency that
224 provides emergency medical services;
225 [(e)] (f) one individual representing hospital [administrator] administration;
226 [(f)] (g) one emergency care nurse;
227 [(g)] (h) one [emergency medical technician-paramedic] paramedic in active field practice;
228 [(h)] (i) one emergency medical technician [with basic or advanced life support
229 certification; and] in active field practice;
230 (j) one certified emergency medical dispatcher affiliated with an emergency medical
231 dispatch center; and
232 [(i)] (k) one consumer.
233 (2) (a) Except as [required by] provided in Subsection (2)(b), members shall be appointed
234 [for a term of four years with terms] to a four-year term beginning July 1.
235 (b) Notwithstanding [the requirements of] Subsection (2)(a), the governor shall, at the time
236 of appointment or reappointment, adjust the length of terms to ensure that the terms of committee
237 members are staggered so that approximately half of the committee is appointed every two years.
238 (c) When a vacancy occurs in the membership for any reason, the replacement shall be
239 appointed by the governor for the unexpired term [by the governor].
240 (3) (a) [The] Each January, the committee shall organize [annually] and select one of its
241 members as chair and one member as vice chair. [The chair or vice chair shall be a physician.]
242 The committee may organize standing or ad hoc subcommittees[, but members may not serve on

243 standing committees], which shall operate in accordance with guidelines established by the
244 committee.
245 (b) The chair shall convene a minimum of four meetings per year. [Special] The chair may
246 call special meetings [may be called by the chair and]. The chair shall [be called by the chair] call
247 a meeting upon receipt of a written request signed by five or more members of the committee.
248 (c) [Eight] Nine members of the committee constitute a quorum for the transaction of
249 business and the action of a majority of the members present is the action of the committee.
250 (4) (a) Members shall receive no compensation or benefits for their services, but may
251 receive per diem and expenses incurred in the performance of the member's official duties at the
252 rates established by the Division of Finance under Sections 63A-3-106 and 63A-3-107 .
253 (b) Members may decline to receive per diem and expenses for their service.
254 (5) Administrative services for the committee shall be provided by the department.
255 Section 5. Section 26-8a-104 is enacted to read:
256 26-8a-104. Committee powers.
257 The committee shall adopt rules in accordance with Title 63, Chapter 46a, Utah
258 Administrative Rulemaking Act, that:
259 (1) establish certification and reciprocity requirements under Section 26-8a-302 ;
260 (2) establish designation requirements under Section 26-8a-303 ;
261 (3) promote the development of a statewide emergency medical services system under
262 Section 26-8a-203 ;
263 (4) establish insurance requirements for ambulance providers;
264 (5) provide guidelines for requiring patient data under Section 26-8a-203 ;
265 (6) establish criteria for awarding grants under Section 26-8a-207 ;
266 (7) establish requirements for the coordination of emergency medical services and the
267 medical supervision of emergency medical service providers under Section 26-8a-306 ; and
268 (8) are necessary to carry out the responsibilities of the committee as specified in other
269 sections of this chapter.
270 Section 6. Section 26-8a-105 is enacted to read:
271 26-8a-105. Department powers.
272 The department shall:
273 (1) coordinate the emergency medical services within the state;

274 (2) administer this chapter and the rules established pursuant to it;
275 (3) establish a voluntary task force representing a diversity of emergency medical service
276 providers to advise the department and the committee on rules; and
277 (4) adopt rules in accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking
278 Act, to:
279 (a) license ambulance providers and paramedic providers;
280 (b) permit ambulances and emergency response vehicles;
281 (c) establish application, submission, and procedural requirements for licenses,
282 designations, certificates, and permits; and
283 (d) establish and implement the programs, plans, and responsibilities as specified in other
284 sections of this chapter.
285 Section 7. Section 26-8a-106 is enacted to read:
286 26-8a-106. Waiver of rules.
287 (1) Upon application, the committee or department may waive the requirements of a rule
288 it has adopted if:
289 (a) the person applying for the waiver satisfactorily demonstrates that:
290 (i) the waiver is necessary for a pilot project to be undertaken by the applicant;
291 (ii) in the particular situation, the requirement serves no beneficial public purpose; or
292 (iii) circumstances warrant that waiver of the requirement outweighs the public benefit to
293 be gained by adherence to the rule; and
294 (b) for a waiver granted under Subsection (1)(a)(ii) or (iii), the committee or department:
295 (i) extends the wavier to similarly situated persons upon application; or
296 (ii) amends the rule to be consistent with the waiver.
297 (2) No waiver may be granted under this section that is inconsistent with the provisions
298 of this chapter.
299 Section 8. Section 26-8a-201 is enacted to read:
300 Part 2. Programs, Plans, and Duties
301 26-8a-201. Public awareness efforts.
302 The department may:
303 (1) develop programs to inform the public of the emergency medical service system; and
304 (2) develop and disseminate emergency medical training programs for the public, which

305 emphasize the prevention and treatment of injuries and illnesses.
306 Section 9. Section 26-8a-202 is enacted to read:
307 26-8a-202. Emergency medical communications.
308 Consistent with federal law, the department is the lead agency for coordinating the
309 statewide emergency medical service communication systems under which emergency medical
310 personnel, dispatch centers, and treatment facilities provide medical control and coordination
311 between emergency medical service providers.
312 Section 10. Section 26-8a-203 is enacted to read:
313 26-8a-203. Statewide trauma system and plan -- Data collection.
314 (1) The committee shall:
315 (a) approve or disapprove the state emergency medical service plan prepared by the
316 department pursuant to Subsection (2)(b) and make recommendations concerning the emergency
317 medical service plan prepared pursuant to P. L. 93-641, as amended;
318 (b) approve critical care categorization guidelines and treatment protocols developed by
319 the department pursuant to Subsections (2)(c) and (d);
320 (c) categorize all hospital critical care facilities and designate trauma, burn, spinal cord,
321 and poison care facilities in the state consistent with guidelines approved under Subsection (1)(b);
322 and
323 (d) specify the information that must be collected for the emergency medical services data
324 system established pursuant to Subsection 2(a).
325 (2) The department shall:
326 (a) establish an emergency medical services data system which shall provide for the
327 collection of information, as defined by the committee, relating to the treatment and care of
328 patients who use or have used the emergency medical services system;
329 (b) prepare a state plan for the coordinated delivery of emergency medical services which
330 shall be updated at least every three years and shall reflect recommendations of local government
331 emergency medical services councils;
332 (c) develop hospital critical care categorization guidelines, in consultation with the state
333 medical association and state hospital association, which may not require the transfer of any patient
334 contrary to the wishes of the patient, his next of kin, or his attending physician; and
335 (d) develop treatment protocols for the critical care guideline categories described in

336 Subsection 26-8a-102 (4)(b).
337 (3) Persons providing emergency medical services shall provide information to the
338 department for the emergency medical services data system established pursuant to Subsection
339 (2)(a).
340 Section 11. Section 26-8a-204 is enacted to read:
341 26-8a-204. Disaster coordination plan.
342 The department shall develop and implement, in cooperation with state, federal, and local
343 agencies empowered to oversee disaster response activities, plans to provide emergency medical
344 services during times of disaster or emergency.
345 Section 12. Section 26-8a-205 is enacted to read:
346 26-8a-205. Pediatric quality improvement program.
347 The department shall establish a pediatric quality improvement resource program.
348 Section 13. Section 26-8a-206 is enacted to read:
349 26-8a-206. Personnel stress management program.
350 (1) The department shall develop and implement a statewide program to provide support
351 and counseling for personnel who have been exposed to one or more stressful incidents in the
352 course of providing emergency services.
353 (2) This program shall include:
354 (a) ongoing training for agencies providing emergency services and counseling program
355 volunteers; and
356 (b) critical incident stress debriefing for personnel at no cost to the emergency provider.
357 Section 14. Section 26-8a-207 , which is renumbered from Section 26-8-2.5 is renumbered
358 and amended to read:
359 [26-8-2.5]. 26-8a-207. Emergency medical services grant program.
360 (1) (a) The department shall receive as [nonlapsing] dedicated credits the amount
361 established in Section 63-63a-3 . That amount shall be transferred to the department by the
362 Division of Finance from funds generated by the surcharge imposed under Title 63, Chapter 63a.
363 (b) Funds transferred to the department under this section shall be used for improvement
364 of statewide delivery of emergency medical services. Appropriations to the department for the
365 purposes enumerated in this section shall be made from those dedicated credits.
366 (c) All funding for the program created by this section shall be nonlapsing.

367 (2) (a) The department may use up to [3%] 6% of the funds transferred to it under
368 Subsection (1):
369 (i) to provide staff support; and
370 (ii) for other expenses incurred in administration of those funds.
371 [(3)] (b) After funding staff support [and], administrative expenses, and trauma system
372 development, the department and the committee shall make emergency medical services grants
373 [shall be made by the department to agencies, political subdivisions of local or state government,
374 or nonprofit entities] from the remaining funds received as dedicated credits under Subsection (1)
375 [as follows:]. A recipient of a grant under this Subsection (2)(b) must actively provide emergency
376 medical services within the state.
377 [(a)] (i) [Forty-two and one-half percent shall be available to prehospital emergency
378 medical services provider agencies in the form of] The department shall distribute 42-1/2% as per
379 capita block grants for [discretionary] use specifically related to the provision of emergency
380 medical services to nonprofit prehospital emergency medical services providers that are either
381 licensed or designated and to emergency medical services that are the primary emergency medical
382 services for a service area. [(i)] The department shall determine the grant amounts [of those
383 grants] by prorating available funds on a per capita basis by county as described in department rule.
384 [Population figures used as a basis for allocating grants shall be derived from the most recent
385 population estimates issued by the state planning coordinator.]
386 [(ii) Allocation of funds to prehospital emergency medical services provider agencies
387 within each county shall be in proportion to the weighted number of state certified prehospital
388 personnel in each prehospital emergency medical services provider agency that is actively involved
389 in the provision of emergency care within the county. Weighting factors are: basic life support
390 personnel = 1; advanced life support personnel (excluding EMT-paramedics) = 2; and
391 EMT-paramedics = 3. The number of certified personnel is based upon the personnel rosters of
392 each prehospital emergency medical services provider agency on March 1 immediately prior to the
393 grant year.]
394 [(iii) The department may only disburse grant funds under this section after receipt of a
395 claim for reimbursement from the agency, accompanied by a written description of the
396 expenditures made.]
397 [(b)] (ii) [Forty-two and one-half percent shall be distributed] The committee shall award

398 42-1/2% of the remaining funds as competitive grants [to applicants] for use specifically related
399 to the provision of emergency medical services based upon rules established by the [state
400 Emergency Medical Services Committee] committee.
401 [(c)] (iii) [Fifteen percent shall be used] The committee shall use 15% of the remaining
402 funds to fund high school emergency medical training programs [developed under Subsection
403 26-8-5 (13)].
404 [(4) Funds received under Subsection (1) may not be used to fund new local government
405 emergency medical services if the new services compete with existing licensed private emergency
406 medical services.]
407 [(5) (a) The department shall make an annual report to the Legislature which includes the
408 amount received during the previous fiscal year and the estimated amounts for the current fiscal
409 year. These amounts are the basis for legislative appropriations from the dedicated credits
410 described in Subsection (1).]
411 [(b) The Legislature finds that these funds are for a general and statewide public purpose.]
412 Section 15. Section 26-8a-208 is enacted to read:
413 26-8a-208. Fees for training equipment rental, testing, and quality assurance reviews.
414 (1) The department may charge fees, established pursuant to Section 26-1-6 :
415 (a) for the use of department-owned training equipment;
416 (b) to administer tests and conduct quality assurance reviews; and
417 (c) to process an application for a certificate, designation, permit, or license.
418 (2) (a) Fees collected under Subsections (1)(a) and (b) shall be separate dedicated credits.
419 (b) Fees under Subsection (1)(a) may be used to purchase training equipment.
420 (c) Fees under Subsection (1)(b) may be used to administer tests and conduct quality
421 assurance reviews.
422 (3) Fees and other funding available to purchase training equipment shall be nonlapsing.
423 Section 16. Section 26-8a-301 is enacted to read:
424 Part 3. Certificates, Designations, Permits, and Licenses.
425 26-8a-301. General requirement.
426 (1) Except as provided in Section 26-8a-308 :
427 (a) an individual may not provide emergency medical services without a certificate issued
428 under Section 26-8a-302 ;

429 (b) a facility or provider may not hold itself out as a designated emergency medical service
430 provider without a designation issued under Section 26-8a-303 ;
431 (c) a vehicle may not operate as an ambulance or emergency response vehicle without a
432 permit issued under Section 26-8a-304 ; and
433 (d) an entity may not respond as an ambulance or paramedic provider without the
434 appropriate license issued under Part 4, Ambulance and Paramedic Providers.
435 (2) Section 26-8a-502 applies to violations of this section.
436 Section 17. Section 26-8a-302 is enacted to read:
437 26-8a-302. Certification of emergency medical service personnel.
438 (1) To promote the availability of comprehensive emergency medical services throughout
439 the state, the committee shall establish:
440 (a) initial and ongoing certification and training requirements for emergency medical
441 service personnel in the following categories:
442 (i) paramedic;
443 (ii) medical director;
444 (iii) emergency medical service instructor; and
445 (iv) other types of emergency medical personnel as the committee considers necessary; and
446 (b) guidelines for giving credit for out-of-state training and experience.
447 (2) The department shall, based on the requirements established in Subsection (1):
448 (a) develop, conduct, and authorize training and testing for emergency medical service
449 personnel; and
450 (b) issue certifications and certification renewals to emergency medical service personnel.
451 (3) As provided in Section 26-8a-502 , an individual issued a certificate under this section
452 may only provide emergency medical services to the extent allowed by the certificate.
453 Section 18. Section 26-8a-303 is enacted to read:
454 26-8a-303. Designation of emergency medical service providers.
455 (1) To ensure quality emergency medical services, the committee shall establish
456 designation requirements for emergency medical service providers in the following categories:
457 (a) quick response provider;
458 (b) resource hospital for emergency medical providers;
459 (c) emergency medical service dispatch center;

460 (d) emergency patient receiving facilities; and
461 (e) other types of emergency medical service providers as the committee considers
462 necessary.
463 (2) The department shall, based on the requirements in Subsection (1), issue designations
464 to emergency medical service providers listed in Subsection (1).
465 (3) As provided in Section 26-8a-502 , an entity issued a designation under Subsection (1)
466 may only function and hold itself out in accordance with its designation.
467 Section 19. Section 26-8a-304 is enacted to read:
468 26-8a-304. Permits for emergency medical service vehicles.
469 (1) To ensure that emergency medical service vehicles are adequately staffed, safe,
470 maintained, and properly equipped, the committee shall establish permit requirements at levels it
471 considers appropriate in the following categories:
472 (a) ambulance; and
473 (b) emergency response vehicle.
474 (2) The department shall, based on the requirements established in Subsection (1), issue
475 permits to emergency medical service vehicles.
476 Section 20. Section 26-8a-305 is enacted to read:
477 26-8a-305. Ambulance license required for emergency medical transport.
478 Except as provided in Section 26-8a-308 , only an ambulance operating under permit issued
479 under Section 26-8a-304 , may transport an individual who:
480 (1) is in an emergency medical condition;
481 (2) is medically or mentally unstable, requiring direct medical observation during
482 transport;
483 (3) is physically incapacitated because of illness or injury and in need of immediate
484 transport by emergency medical service personnel;
485 (4) is likely to require medical attention during transport;
486 (5) is being maintained on any type of emergency medical electronic monitoring;
487 (6) is receiving or has recently received medications that could cause a sudden change in
488 medical condition that might require emergency medical services;
489 (7) requires IV administration or maintenance, oxygen that is not patient-operated, or other
490 emergency medical services during transport;

491 (8) needs to be immobilized during transport to a hospital, an emergency patient receiving
492 facility, or mental health facility due to a mental or physical condition, unless the individual is in
493 the custody of a peace officer and the primary purpose of the restraint is to prevent escape;
494 (9) needs to be immobilized due to a fracture, possible fracture, or other medical condition;
495 or
496 (10) otherwise requires or has the potential to require a level of medical care that the
497 committee establishes as requiring direct medical observation.
498 Section 21. Section 26-8a-306 is enacted to read:
499 26-8a-306. Medical control.
500 (1) The committee shall establish requirements for the coordination of emergency medical
501 services rendered by emergency medical service providers, including the coordination between
502 prehospital providers, hospitals, emergency patient receiving facilities, and other appropriate
503 destinations.
504 (2) The committee may establish requirements for the medical supervision of emergency
505 medical service providers to assure adequate physician oversight of emergency medical services
506 and quality improvement.
507 Section 22. Section 26-8a-307 is enacted to read:
508 26-8a-307. Patient destination.
509 (1) If an individual being transported by a ground or air ambulance is in critical or unstable
510 condition, the ground or air ambulance shall transport the patient to the trauma center or closest
511 emergency patient receiving facility appropriate to adequately treat the patient.
512 (2) If the patient's condition is not critical or unstable as determined by medical control,
513 the ground or air ambulance may transport the patient to the:
514 (a) hospital, emergency patient receiving facility, or other medical provider chosen by the
515 patient as appropriate for the patient's condition and needs; or
516 (b) nearest hospital, emergency patient receiving facility, or other medical provider
517 approved by medical control as appropriate for the patient's condition and needs if the patient
518 expresses no preference.
519 Section 23. Section 26-8a-308 is enacted to read:
520 26-8a-308. Exemptions.
521 (1) The following persons may provide emergency medical services to a patient without

522 being certified or licensed under this chapter:
523 (a) out-of-state emergency medical service personnel and providers in time of disaster;
524 (b) an individual who gratuitously acts as a Good Samaritan;
525 (c) a family member;
526 (d) a private business if emergency medical services are provided only to employees at the
527 place of business and during transport;
528 (e) an agency of the United States government if compliance with this chapter would be
529 inconsistent with federal law; and
530 (f) police, fire, and other public service personnel if:
531 (i) emergency medical services are rendered in the normal course of the person's duties;
532 and
533 (ii) medical control, after being apprised of the circumstances, directs immediate transport.
534 (2) An ambulance or emergency response vehicle may operate without a permit issued
535 under Section 26-8a-304 in time of disaster.
536 (3) Nothing in this chapter or Title 58, Occupations and Professions, may be construed as
537 requiring a license, or certificate for an individual to perform cardiopulmonary resuscitation and
538 use a fully automated external defibrillator if that individual has successfully completed a course
539 that includes instruction on cardiopulmonary resuscitation and the operation and use of a fully
540 automated external defibrillator that is conducted in accordance with guidelines of the American
541 Heart Association by a person qualified by training or experience.
542 (4) Nothing in this chapter may be construed as requiring a license, permit, designation,
543 or certificate for an acute care hospital, medical clinic, physician's office, or other fixed medical
544 facility that:
545 (a) is staffed by a physician, physician's assistant, nurse practitioner, or registered nurse;
546 and
547 (b) treats an individual who has presented himself or was transported to the hospital, clinic,
548 office, or facility.
549 Section 24. Section 26-8a-309 is enacted to read:
550 26-8a-309. Out-of-state vehicles.
551 (1) An ambulance or emergency response vehicle from another state may not pick up a
552 patient in Utah to transport that patient to another location in Utah or to another state without a

553 permit issued under Section 26-8a-304 and, in the case of an ambulance, a license issued under
554 Part 4, Ambulance and Paramedic Providers.
555 (2) Notwithstanding Subsection (1), an ambulance or emergency response vehicle from
556 another state may, without a permit or license:
557 (a) transport a patient into Utah; and
558 (b) provide assistance in time of disaster.
559 (3) The department may enter into agreements with ambulance and paramedic providers
560 and their respective licensing agencies from other states to assure the expeditious delivery of
561 emergency medical services beyond what may be reasonably provided by licensed ambulance and
562 paramedic providers, including the transportation of patients between states.
563 Section 25. Section 26-8a-310 is enacted to read:
564 26-8a-310. Criminal background check.
565 (1) At the time of application for, or renewal of, a certificate, the department shall obtain,
566 at the applicant's expense, information from a criminal history record or warrant of arrest
567 information maintained by the Department of Public Safety pursuant to Title 53, Chapter 10, Part
568 2, Bureau of Criminal Identification, to determine whether the individual has been convicted of
569 a crime that bears upon his fitness to be certified or to have responsibility for the safety and
570 well-being of children, the elderly, or persons with disabilities.
571 (2) (a) An applicant who has not had residency in the state for the last five years shall
572 submit fingerprints and other identifying information.
573 (b) The department shall submit fingerprints obtained under Subsection (2)(a) to the
574 Department of Public Safety to be forwarded to the Federal Bureau of Investigation for a
575 nationwide criminal history record check to determine whether the individual has been convicted
576 of a crime that bears upon his fitness to be certified or to have responsibility for the safety and
577 well-being of children, the elderly, or persons with disabilities.
578 (3) Information obtained pursuant to Subsections (1) and (2) may be used to:
579 (a) withhold certification or renewal;
580 (b) commence or substantiate disciplinary action under Section 26-8a-503 ;
581 (c) enforce the provisions of this chapter; and
582 (d) notify the individual's employer as necessary to protect the public.
583 Section 26. Section 26-8a-401 is enacted to read:

584 Part 4. Ambulance and Paramedic Providers
585 26-8a-401. State regulation of emergency medical services market.
586 (1) To ensure emergency medical service quality and minimize unnecessary duplication,
587 the department shall regulate the emergency medical service market after October 1, 1999, by
588 creating and operating a statewide system that:
589 (a) consists of exclusive geographic service areas as provided in Section 26-8a-402 ; and
590 (b) establishes maximum rates as provided in Section 26-8a-403 .
591 (2) (a) All licenses issued prior to July 1, 1996, shall expire as stated in the license.
592 (b) If no expiration date is stated on a license issued before July 1, 1996, the license shall
593 expire on October 1, 1999, unless:
594 (i) the license holder requests agency action before August 1, 1999; and
595 (ii) before October 1, 1999, the department:
596 (A) finds the license has been used as the basis for responding to requests for ambulance
597 or paramedic services during the past five years;
598 (B) identifies one or more specific geographic areas covered by the license in which the
599 license holder has actively and adequately responded as the primary provider to requests for
600 ambulance or paramedic services during the past five years; and
601 (C) determines that the continuation of a license in a specific geographic area identified
602 in Subsection (2)(b)(ii)(B) satisfies:
603 (I) the standards established pursuant to Subsection 26-8a-404 (2); and
604 (II) the requirement of public convenience and necessity.
605 (c) If the department finds that a license meets the requirements of Subsection (2)(b), the
606 department shall amend the license to reflect:
607 (i) the specific geographic area of the license; and
608 (ii) a four-year term extension.
609 (d) Before July 1, 1999, the department shall publish notice once a week for four
610 consecutive weeks of the expiration of licenses pursuant to Subsection (2)(b) in a newspaper of
611 general circulation in the state.
612 (e) Nothing in this Subsection (2) may be construed as restricting the authority of the
613 department to amend overlapping licenses pursuant to Section 26-8a-416 .
614 (3) After October 1, 1999, new licenses and license renewals shall be for a four-year term.

615 Section 27. Section 26-8a-402 is enacted to read:
616 26-8a-402. Exclusive geographic service areas.
617 (1) Each ground ambulance provider license issued under this part shall be for an exclusive
618 geographic service area as described in the license. Only the licensed ground ambulance provider
619 may respond to an ambulance request that originates within the provider's exclusive geographic
620 service area, except as provided in Subsection (5) and Section 26-8a-416 .
621 (2) Each paramedic provider license issued under this part shall be for an exclusive
622 geographic service area as described in the license. Only the licensed paramedic provider may
623 respond to a paramedic request that originates within the exclusive geographic service area, except
624 as provided in Subsection (6).
625 (3) Nothing in this section may be construed as either requiring or prohibiting that the
626 formation of boundaries in a given location be the same for a licensed paramedic provider as it is
627 for a licensed ambulance provider.
628 (4) (a) A licensed ground ambulance or paramedic provider may, as necessary, enter into
629 a mutual aid agreement to allow another licensed provider to give assistance in times of unusual
630 demand, as that term is defined by the committee in rule.
631 (b) A mutual aid agreement shall include a formal written plan detailing the type of
632 assistance and the circumstances under which it would be given.
633 (c) The parties to a mutual aid agreement shall submit a copy of the agreement to the
634 department.
635 (d) Notwithstanding this Subsection (4), a licensed provider may not subcontract with
636 another entity to provide services in the licensed provider's exclusive geographic service area.
637 (5) Notwithstanding Subsection (1), a licensed ground ambulance provider may respond
638 to an ambulance request that originates from the exclusive geographic area of another provider:
639 (a) pursuant to a mutual aid agreement;
640 (b) to render assistance on a case-by-case basis to that provider; and
641 (c) as necessary to meet needs in time of disaster or other major emergency.
642 (6) Notwithstanding Subsection (2), a licensed paramedic provider may respond to a
643 paramedic request that originates from the exclusive geographic area of another provider:
644 (a) pursuant to a mutual aid agreement;
645 (b) to render assistance on a case-by-case basis to that provider; and

646 (c) as necessary to meet needs in time of disaster or other major emergency.
647 Section 28. Section 26-8a-403 is enacted to read:
648 26-8a-403. Establishment of maximum rates.
649 (1) The department shall, after receiving recommendations under Subsection (2), establish
650 maximum rates for ambulance providers and paramedic providers that are just and reasonable.
651 (2) The committee may make recommendations to the department on the maximum rates
652 that should be set under Subsection (1).
653 Section 29. Section 26-8a-404 is enacted to read:
654 26-8a-404. Ground ambulance and paramedic licenses -- Application and department
655 review.
656 (1) Except as provided in Section 26-8a-413 , an applicant for a ground ambulance or
657 paramedic license shall apply to the department for a license only by:
658 (a) submitting a completed application;
659 (b) providing information in the format required by the department; and
660 (c) paying the required fees, including the cost of the hearing officer.
661 (2) The department may make rules establishing minimum qualifications and requirements
662 for:
663 (a) personnel;
664 (b) capital reserves;
665 (c) equipment;
666 (d) a business plan;
667 (e) operational procedures;
668 (f) resource hospital and medical direction agreements;
669 (g) management and control; and
670 (h) other matters that may be relevant to an applicant's ability to provide ground ambulance
671 or paramedic service.
672 (3) An application for a license to provide ground ambulance service or paramedic service
673 shall be for all ground ambulance services or paramedic services arising within the geographic
674 service area, except that an applicant may apply for a license for less than all ground ambulance
675 services or all paramedic services arising within an exclusive geographic area if it can demonstrate
676 how the remainder of that area will be served.

677 (4) Upon receiving a completed application and the required fees, the department shall
678 review the application and determine whether the application meets the minimum requirements
679 for licensure.
680 (5) The department may deny an application if it finds that it contains any materially false
681 or misleading information, is incomplete, or if the application demonstrates that the applicant fails
682 to meet the minimum requirements for licensure.
683 (6) If the department denies an application, it shall notify the applicant in writing setting
684 forth the grounds for the denial.
685 Section 30. Section 26-8a-405 is enacted to read:
686 26-8a-405. Ground ambulance and paramedic licenses -- Agency notice of
687 administrative proceeding.
688 If the department determines that the application meets the minimum requirements for
689 licensure under Section 26-8a-404 , the department shall:
690 (1) issue a notice of agency action to the applicant to commence an informal administrative
691 proceeding;
692 (2) provide notice of the application to all interested parties; and
693 (3) publish notice of the application, at the applicant's expense, once a week for four
694 consecutive weeks, in a newspaper of general circulation in the geographic service area that is the
695 subject of the application.
696 Section 31. Section 26-8a-406 is enacted to read:
697 26-8a-406. Ground ambulance and paramedic licenses -- Parties.
698 (1) An interested party has 30 days to object to an application.
699 (2) If an interested party objects, the presiding officer must join the interested party as an
700 indispensable party to the proceeding.
701 (3) The department may join the proceeding as a party to represent the public interest.
702 (4) Others who may be affected by the grant of a license to the applicant may join the
703 proceeding, if the presiding officer determines that they meet the requirement of legal standing.
704 Section 32. Section 26-8a-407 is enacted to read:
705 26-8a-407. Ground ambulance and paramedic licenses -- Proceedings.
706 (1) The presiding officer shall:
707 (a) commence an informal adjudicative proceeding within 120 days of receiving a

708 completed application;
709 (b) meet with the applicant and objecting interested parties and provide no less than 120
710 days for a negotiated resolution, consistent with the criteria in Section 26-8a-408 ;
711 (c) set aside a separate time during the proceedings to accept public comment on the
712 application; and
713 (d) present a written decision to the executive director if a resolution has been reached that
714 satisfies the criteria in Section 26-8a-408 .
715 (2) At any time during an informal adjudicative proceeding under Subsection (1), any party
716 may request conversion of the informal adjudicative proceeding to a formal adjudicative
717 proceeding in accordance with Section 63-46b-4 .
718 (3) Upon conversion to a formal adjudicative proceeding, a hearing officer shall be
719 assigned to the application as provided in Section 26-8a-409 . The hearing office shall:
720 (a) set aside a separate time during the proceedings to accept public comment on the
721 application;
722 (b) apply the criteria established in Section 26-8a-408 ; and
723 (c) present a recommended decision to the executive director in writing.
724 (4) The executive director may, as set forth in a final written order, accept, modify, reject,
725 or remand the decision of a presiding or hearing officer after:
726 (a) reviewing the record;
727 (b) giving due deference to the officer's decision; and
728 (c) determining whether the criteria in Section 26-8a-408 have been satisfied.
729 Section 33. Section 26-8a-408 is enacted to read:
730 26-8a-408. Criteria for determining public convenience and necessity.
731 (1) The criteria for determining public convenience and necessity is set forth in
732 Subsections (2) through (6).
733 (2) Access to emergency medical services must be maintained or improved. The officer
734 shall consider the impact on existing services, including the impact on response times, call
735 volumes, populations and exclusive geographic service areas served, and the ability of surrounding
736 licensed providers to service their exclusive geographic service areas. The issuance or amendment
737 of a license may not create an orphaned area.
738 (3) The quality of service in the area must be maintained or improved. The officer shall

739 consider the:
740 (a) staffing and equipment standards of the current licensed provider and the applicant;
741 (b) training and certification levels of the current licensed provider's staff and the
742 applicant's staff;
743 (c) continuing medical education provided by the current licensed provider and the
744 applicant;
745 (d) levels of care as defined by department rule;
746 (e) plan of medical control; and
747 (f) the negative or beneficial impact on the regional emergency medical service system to
748 provide service to the public.
749 (4) The cost to the public must be justified. The officer must consider:
750 (a) the financial solvency of the applicant;
751 (b) the applicant's ability to provide services within the rates established under Section
752 26-8a-403 ;
753 (c) the applicant's ability to comply with cost reporting requirements;
754 (d) the cost efficiency of the applicant; and
755 (e) the cost effect of the application on the public, interested parties, and the emergency
756 medical services system.
757 (5) Local desires concerning cost, quality, and access must be considered. The officer
758 shall assess and consider:
759 (a) the existing provider's record of providing services and the applicant's record and
760 ability to provide similar or improved services;
761 (b) locally established emergency medical services goals, including those established in
762 Subsection (7);
763 (c) comment by local governments on the applicant's business and operations plans;
764 (d) comment by interested parties that are providers on the impact of the application on
765 the parties' ability to provide emergency medical services;
766 (e) comment by interested parties that are local governments on the impact of the
767 application on the citizens it represents; and
768 (f) public comment on any aspect of the application or proposed license.
769 (6) Other related criteria:

770 (a) the officer considers necessary; or
771 (b) established by department rule.
772 (7) The role of local governments in the licensing of ground ambulance and paramedic
773 providers that serve areas also served by the local governments is important. The Legislature
774 strongly encourages local governments to establish cost, quality, and access goals for the ground
775 ambulance and paramedic services that serve their areas.
776 (8) In a formal adjudicative proceeding, the applicant bears the burden of establishing that
777 public convenience and necessity require the approval of the application for all or part of the
778 exclusive geographic service area requested.
779 Section 34. Section 26-8a-409 is enacted to read:
780 26-8a-409. Ground ambulance and paramedic licenses -- Hearing and presiding
781 officers.
782 (1) The department shall set certification and training standards for hearing officers and
783 presiding officers.
784 (2) At a minimum, a presiding officer shall:
785 (a) be familiar with the theory and application of public convenience and necessity; and
786 (b) have a working knowledge of the emergency medical service system in the state.
787 (3) In addition to the requirements in Subsection (2), a hearing officer shall also be
788 licensed to practice law in the state.
789 (4) The department shall provide training for hearing officer and presiding officer
790 candidates in the theory and application of public convenience and necessity and on the emergency
791 medical system in the state.
792 (5) The department shall maintain a roster of no less than five individuals who meet the
793 minimum qualifications for both presiding and hearing officers and the standards set by the
794 department.
795 (6) The parties may mutually select an officer from the roster if the officer is available.
796 (7) If the parties cannot agree upon an officer under Subsection (4), the department shall
797 randomly select an officer from the roster or from a smaller group of the roster agreed upon by the
798 applicant and the objecting interested parties.
799 Section 35. Section 26-8a-410 is enacted to read:
800 26-8a-410. Local approvals.

801 (1) Licensed ambulance providers and paramedic providers must meet all local zoning and
802 business licensing standards generally applicable to businesses operating within the jurisdiction.
803 (2) Publicly subsidized providers must demonstrate approval of the taxing authority that
804 will provide the subsidy.
805 (3) A publicly operated service must demonstrate that the governing body has approved
806 the provision of services to the entire exclusive geographic service area that is the subject of the
807 license, including those areas that may lie outside the territorial or jurisdictional boundaries of the
808 governing body.
809 Section 36. Section 26-8a-411 is enacted to read:
810 26-8a-411. Limitation on repetitive applications.
811 A person who has previously applied for a license under this part may not apply for a
812 license for the same service that covers any exclusive geographic service area that was the subject
813 of the prior application unless:
814 (1) one year has passed from the date of the issuance of a final decision under Section
815 26-8a-407 ; or
816 (2) all interested parties and the department agree that a new application is in the public
817 interest.
818 Section 37. Section 26-8a-412 is enacted to read:
819 26-8a-412. License for air ambulance providers.
820 (1) An applicant for an air ambulance provider shall apply to the department for a license
821 only by:
822 (a) submitting a complete application;
823 (b) providing information in the format required by the department; and
824 (c) paying the required fees.
825 (2) The department may make rules establishing minimum qualifications and requirements
826 for:
827 (a) personnel;
828 (b) capital reserves;
829 (c) equipment;
830 (d) business plan;
831 (e) operational procedures;

832 (f) resource hospital and medical direction agreements;
833 (g) management and control qualifications and requirements; and
834 (h) other matters that may be relevant to an applicant's ability to provide air ambulance
835 services.
836 (3) Upon receiving a completed application and the required fees, the department shall
837 review the application and determine whether the application meets the minimum requirements
838 for licensure.
839 (4) The department may deny an application for an air ambulance if:
840 (a) the department finds that the application contains any materially false or misleading
841 information or is incomplete;
842 (b) the application demonstrates that the applicant fails to meet the minimum requirements
843 for licensure; or
844 (c) the department finds after inspection that the applicant does not meet the minimum
845 requirements for licensure.
846 (5) If the department denies an application under this section, it shall notify the applicant
847 in writing setting forth the grounds for the denial.
848 Section 38. Section 26-8a-413 is enacted to read:
849 26-8a-413. License renewals.
850 (1) A licensed provider desiring to renew its license must meet the renewal requirements
851 established by department rule.
852 (2) The department shall issue a renewal license for a ground ambulance provider or a
853 paramedic provider upon the licensee's application for a renewal and without a public hearing if
854 there has been no:
855 (a) change in controlling interest in the ownership of the licensee as defined in Section
856 26-8a-415 ;
857 (b) serious, substantiated public complaints filed with the department against the licensee
858 during the term of the previous license;
859 (c) material or substantial change in the basis upon which the license was originally
860 granted;
861 (d) reasoned objection from the committee or the department; and
862 (e) conflicting license application.

863 (3) The department shall issue a renewal license for an air ambulance provider upon the
864 licensee's application for renewal and completion of the renewal requirements established by
865 department rule.
866 Section 39. Section 26-8a-414 is enacted to read:
867 26-8a-414. Annexations.
868 (1) If a licensee is a municipality that desires to provide service to an area that it has
869 annexed, the municipality may apply to the department to amend its license to include the annexed
870 area. Upon receipt of a completed application to amend the license, the department shall issue
871 written notice of the municipality's application to all other licensed providers who serve any
872 portion of the annexed area.
873 (2) If the department does not receive an objection from a licensed provider that serves
874 some portion of the annexed area within 30 days of issuing the notice that identifies an adverse
875 impact to the provider or the public, the department shall:
876 (a) review the application to amend the license to determine whether the applicant can
877 adequately provide services to the proposed area and whether the public interest in the areas of
878 cost, quality, and access would be harmed; and
879 (b) if the application meets the requirements of Subsection (2)(a), amend the municipality's
880 license and all other affected licenses to reflect the municipality's new boundaries.
881 (3) If an objection is received under Subsection (2), the municipality shall file a standard
882 application for a license with the department under the provisions of Sections 26-8a-404 through
883 26-8a-409 .
884 Section 40. Section 26-8a-415 is enacted to read:
885 26-8a-415. Changes in ownership.
886 (1) A licensed provider whose ownership or controlling ownership interest has changed
887 shall submit information to the department, as required by department rule:
888 (a) to establish whether the new owner or new controlling party meets minimum
889 requirements for licensure; and
890 (b) except as provided in Subsection (2), to commence an administrative proceeding to
891 determine whether the new owner meets the requirement of public convenience and necessity
892 under Section 26-8a-408 .
893 (2) An administrative proceeding is not required under Subsection (1)(b) if:

894 (a) the change in ownership interest is among existing owners of a closely held corporation
895 and the change does not result in a change in the management of the licensee or in the name of the
896 licensee;
897 (b) the change in ownership in a closely held corporation results in the introduction of new
898 owners, provided that:
899 (i) the new owners are limited to individuals who would be entitled to the equity in the
900 closely held corporation by the laws of intestate succession had the transferor died intestate at the
901 time of the transfer;
902 (ii) the majority owners on January 1, 1999, have been disclosed to the department by
903 October 1, 1999, and the majority owners on January 1, 1999, retain a majority interest in the
904 closely held corporation; and
905 (iii) the name of the licensed provider remains the same;
906 (c) the change in ownership is the result of one or more owners transferring their interests
907 to a trust, limited liability company, partnership, or closely held corporation so long as the
908 transferors retain control over the receiving entity;
909 (d) the change in ownership is the result of a distribution of an estate or a trust upon the
910 death of the testator or the trustor and the recipients are limited to individuals who would be
911 entitled to the interest by the laws of intestate succession had the transferor died intestate at the
912 time of the transfer; or
913 (e) other similar changes that the department establishes, by rule, as having no significant
914 impact on the cost, quality, or access to emergency medical services.
915 Section 41. Section 26-8a-416 is enacted to read:
916 26-8a-416. Transition to eliminate inconsistent licenses.
917 (1) By May 30, 2000, the department shall review all licenses in effect on October 2, 1999,
918 to identify overlap, as defined in department rule, in the service areas of two or more licensed
919 providers.
920 (2) By June 30, 2000, the department shall notify all licensed providers affected by an
921 overlap. By September 30, 2000, the department shall schedule, by order, a deadline to resolve
922 each overlap, considering the effects on the licensed providers and the areas to be addressed.
923 (3) For each overlap, the department shall meet with the affected licensed providers and
924 provide 120 days for a negotiated resolution, consistent with the criteria in Section 26-8a-408 .

925 (4) (a) If a resolution is reached under Subsection (2) that the department finds satisfies
926 the criteria in Section 26-8a-408 , the department shall amend the licenses to reflect the resolution
927 consistent with Subsection (6).
928 (b) If a resolution is not reached under Subsection (2), the department or any of the
929 licensed providers involved in the matter may request the commencement of a formal adjudicative
930 proceeding to resolve the overlap.
931 (5) The department shall commence adjudicative proceedings for any overlap that is not
932 resolved by July 1, 2003.
933 (6) Notwithstanding the exclusive geographic service requirement of Section 26-8a-402 ,
934 the department may amend one or more licenses after a resolution is reached or an adjudicative
935 proceeding has been held to allow:
936 (a) a single licensed provider to serve all or part of the overlap area;
937 (b) more than one licensed provider to serve the overlap area;
938 (c) licensed providers to provide different types of service in the overlap area; or
939 (d) licenses that recognize service arrangements that existed on September 30, 1999.
940 (7) Notwithstanding Subsection (6), any license for an overlap area terminates upon:
941 (a) relinquishment by the provider; or
942 (b) revocation by the department.
943 Section 42. Section 26-8a-501 is enacted to read:
944 Part 5. Enforcement Provisions
945 26-8a-501. Discrimination.
946 (1) No person licensed, certified, or designated pursuant to this chapter may discriminate
947 in the provision of emergency medical services on the basis of race, sex, color, creed, or prior
948 inquiry as to ability to pay.
949 (2) This chapter does not authorize or require medical assistance or transportation over the
950 objection of an individual on religious grounds.
951 Section 43. Section 26-8a-502 is enacted to read:
952 26-8a-502. Illegal activity.
953 (1) Except as provided in Section 26-8a-308 , a person may not:
954 (a) practice or engage in the practice, represent himself to be practicing or engaging in the
955 practice, or attempting to practice or engage in the practice of any activity that requires a license,

956 certification, or designation under this chapter unless that person is so licensed, certified, or
957 designated; or
958 (b) offer an emergency medical service that requires a license, certificate, or designation
959 unless the person is so licensed, certified, or designated.
960 (2) A person may not advertise or hold himself out as one holding a license, certification,
961 or designation required under this chapter, unless that person holds the license, certification, or
962 designation.
963 (3) A person may not employ or permit any employee to perform any service for which
964 a license or certificate is required by this chapter, unless the person performing the service
965 possesses the required license or certificate.
966 (4) A person may not wear, display, sell, reproduce, or otherwise use any Utah Emergency
967 Medical Services insignia without authorization from the department.
968 (5) A person may not reproduce or otherwise use materials developed by the department
969 for certification or recertification testing or examination without authorization from the
970 department.
971 (6) A person may not willfully summon an ambulance or emergency response vehicle or
972 report that one is needed when such person knows that the ambulance or emergency response
973 vehicle is not needed.
974 (7) A person who violates this section is subject to Section 26-23-6 .
975 Section 44. Section 26-8a-503 is enacted to read:
976 26-8a-503. Discipline of emergency medical services personnel.
977 (1) The department may refuse to issue a certificate or renewal, or revoke, suspend,
978 restrict, or place on probation an individual's certificate if:
979 (a) the individual does not meet the qualifications for certification under Section
980 26-8a-302 ;
981 (b) the individual has engaged in conduct, as defined by committee rule, that:
982 (i) is unprofessional;
983 (ii) is adverse to the public health, safety, morals, or welfare; or
984 (iii) would adversely affect public trust in the emergency medical service system;
985 (c) the individual has violated Section 26-8a-502 or other provision of this chapter;
986 (d) a court of competent jurisdiction has determined the individual to be mentally

987 incompetent for any reason; or
988 (e) the individual is unable to provide emergency medical services with reasonable skill
989 and safety because of illness, drunkenness, use of drugs, narcotics, chemicals, or any other type
990 of material, or as a result of any other mental or physical condition, when the individual's condition
991 demonstrates a clear and unjustifiable threat or potential threat to oneself, coworkers, or the public
992 health, safety, or welfare that cannot be reasonably mitigated.
993 (2) (a) An action to revoke, suspend, restrict, or place a certificate on probation shall be
994 done in accordance with Title 63, Chapter 46b, Administrative Procedures Act.
995 (b) Notwithstanding Subsection (2)(a), the department may issue a cease and desist order
996 under Section 26-8a-507 to immediately suspend an individual's certificate pending an
997 administrative proceeding to be held within 30 days if there is evidence to show that the individual
998 poses a clear, immediate, and unjustifiable threat or potential threat to the public health, safety, or
999 welfare.
1000 (3) An individual whose certificate has been suspended, revoked, or restricted may apply
1001 for reinstatement of the certificate at reasonable intervals and upon compliance with any conditions
1002 imposed upon the certificate by statute, committee rule, or the terms of the suspension, revocation,
1003 or restriction.
1004 (4) In addition to taking disciplinary action under Subsection (1), the department may
1005 impose sanctions in accordance with Section 26-23-6 .
1006 Section 45. Section 26-8a-504 is enacted to read:
1007 26-8a-504. Discipline of designated and licensed providers.
1008 (1) The department may refuse to issue a license or designation or a renewal, or revoke,
1009 suspend, restrict, or place on probation, an emergency medical service provider's license or
1010 designation if the provider has:
1011 (a) failed to abide by terms of the license or designation;
1012 (b) violated statute or rule;
1013 (c) failed to provide services at the level or in the exclusive geographic service area
1014 required by the license or designation;
1015 (d) failed to submit a renewal application in a timely fashion as required by department
1016 rule;
1017 (e) failed to follow operational standards established by the committee; or

1018 (f) committed an act in the performance of a professional duty that endangered the public
1019 or constituted gross negligence.
1020 (2) (a) An action to revoke, suspend, restrict, or place a license or designation on probation
1021 shall be done in accordance with Title 63, Chapter 46b, Administrative Procedures Act.
1022 (b) Notwithstanding Subsection (2)(a), the department may issue a cease and desist order
1023 under Section 26-8a-507 to immediately suspend a license or designation pending an
1024 administrative proceeding to be held within 30 days if there is evidence to show that the provider
1025 or facility poses a clear, immediate, and unjustifiable threat or potential threat to the public health,
1026 safety, or welfare.
1027 (3) In addition to taking disciplinary action under Subsection (1), the department may
1028 impose sanctions in accordance with Section 26-23-6 .
1029 Section 46. Section 26-8a-505 is enacted to read:
1030 26-8a-505. Service interruption or cessation -- Receivership -- Default coverage --
1031 Notice.
1032 (1) Acting in the public interest, the department may petition the district court where an
1033 ambulance or paramedic provider operates or the district court with jurisdiction in Salt Lake
1034 County to appoint the department or an independent receiver to continue the operations of a
1035 provider upon any one of the following conditions:
1036 (a) the provider ceases or intends to cease operations;
1037 (b) the provider becomes insolvent;
1038 (c) the department has initiated proceedings to revoke the provider's license and has
1039 determined that the lives, health, safety, or welfare of the population served within the provider's
1040 exclusive geographic service area are endangered because of the provider's action or inaction
1041 pending a full hearing on the license revocation; or
1042 (d) the department has revoked the provider's license and has been unable to adequately
1043 arrange for another provider to take over the provider's exclusive geographic service area.
1044 (2) If a licensed or designated provider ceases operations or is otherwise unable to provide
1045 services, the department may arrange for another licensed provider to provide services on a
1046 temporary basis until a license is issued.
1047 (3) A licensed provider shall give the department 30 days notice of its intent to cease
1048 operations.

1049 Section 47. Section 26-8a-506 is enacted to read:
1050 26-8a-506. Investigations for enforcement of chapter.
1051 (1) The department may, for the purpose of ascertaining compliance with the provisions
1052 of this chapter, enter and inspect on a routine basis the business premises and equipment of a
1053 person:
1054 (a) with a certificate, designation, permit, or license; or
1055 (b) who holds himself out to the general public as providing a service for which a
1056 certificate, designation, permit, or license is required under Section 26-8a-301 .
1057 (2) Before conducting an inspection under Subsection (1), the department shall, after
1058 identifying the person in charge:
1059 (a) give proper identification;
1060 (b) describe the nature and purpose of the inspection; and
1061 (c) if necessary, explain the authority of the department to conduct the inspection.
1062 (3) In conducting an inspection under Subsection (1), the department may, after meeting
1063 the requirements of Subsection (2):
1064 (a) inspect records, equipment, and vehicles; and
1065 (b) interview personnel.
1066 (4) An inspection conducted under Subsection (1) shall be during regular operational
1067 hours.
1068 Section 48. Section 26-8a-507 is enacted to read:
1069 26-8a-507. Cease and desist orders.
1070 The department may issue a cease and desist order to any person who:
1071 (1) may be disciplined under Section 26-8a-503 or 26-8a-504 ; or
1072 (2) otherwise violates this chapter or any rules adopted under this chapter.
1073 Section 49. Section 26-8a-601 , which is renumbered from Section 26-8-11 is renumbered
1074 and amended to read:
1075 Part 6. Miscellaneous
1076 [26-8-11]. 26-8a-601. Persons and activities exempt from civil liability.
1077 (1) A licensed physician [or], physician's assistant, licensed registered nurse who, in good
1078 faith, gives oral or written instructions to an individual certified [basic or advanced life support
1079 personnel to provide emergency care authorized by this chapter] under Section 26-8a-302 is not

1080 liable for any civil damages as a result of issuing the instructions, unless the instructions given
1081 were the result of gross negligence or willful misconduct.
1082 (2) [A basic or advanced life support person] An individual certified under Section
1083 26-8a-302 , during either training or after certification, a licensed physician, physician's assistant,
1084 or a registered nurse who, in good faith, provides emergency medical instructions or renders
1085 emergency medical care authorized by this chapter is not liable for any civil damages as a result
1086 of any act or omission in providing the emergency medical instructions or medical care, unless
1087 the act or omission is the result of gross negligence or willful misconduct.
1088 (3) [A] An individual certified [basic or advanced life support person] under Section
1089 26-8a-302 is not subject to civil liability for failure to obtain consent in rendering emergency
1090 medical [care] services authorized by this chapter to any individual who is unable to give his
1091 consent, regardless of the individual's age, where there is no other person present legally authorized
1092 to consent to emergency [treatment] medical care, provided that [such personnel act] the certified
1093 individual acted in good faith.
1094 (4) A principal, agent, contractor, employee, or representative of an agency, organization,
1095 institution, corporation, or entity of state or local government that sponsors, authorizes, supports,
1096 finances, or supervises any functions of an [emergency medical services person] individual
1097 certified [and authorized pursuant to this chapter, including an advanced life support person,]
1098 under Section 26-8a-302 is not liable for any civil damages for any act or omission in connection
1099 with such sponsorship, authorization, support, finance, or supervision of [such emergency medical
1100 services person] the certified individual where the act or omission occurs in connection with [that
1101 person's] the certified individual's training or occurs outside a hospital where the life of a patient
1102 is in immediate danger, unless the act or omission is inconsistent with the training of the
1103 [emergency medical services personnel] certified individual, and unless the act or omission is the
1104 result of gross negligence or willful misconduct.
1105 (5) A physician who in good faith arranges for, requests, recommends, or initiates the
1106 transfer of a patient from a hospital to a critical [medical] care [facility] unit in another hospital
1107 is not liable for any civil damages as a result of such transfer where:
1108 (a) sound medical judgment indicates that the patient's medical condition is beyond the
1109 care capability of the transferring hospital or the medical community in which that hospital is
1110 located; and

1111 (b) the physician has secured an agreement from the [transferee] receiving facility to accept
1112 and render necessary treatment to the patient.
1113 (6) A person who is a registered member of the National Ski Patrol System (NSPS) or a
1114 member of a ski patrol who has completed a course in winter emergency care offered by the NSPS
1115 combined with CPR for medical technicians offered by the American Red Cross or American
1116 Heart Association, or an equivalent course of instruction, and who in good faith renders emergency
1117 [medical] care in the course of ski patrol duties is not liable for civil damages as a result of any act
1118 or omission in rendering the emergency care, unless the act or omission is the result of gross
1119 negligence or willful misconduct.
1120 (7) An emergency medical service provider who, in good faith, transports an individual
1121 against his will but at the direction of a law enforcement officer pursuant to Section 62A-12-232
1122 is not liable for civil damages for transporting the individual.
1123 Section 50. Section 58-57-7 is amended to read:
1124 58-57-7. Exemptions from licensure.
1125 (1) In addition to the exemptions from licensure in Section 58-1-307 , the following
1126 persons may engage in the practice of respiratory therapy subject to the stated circumstances and
1127 limitations without being licensed under this chapter:
1128 (a) any person who provides gratuitous care for a member of his immediate family without
1129 representing himself as a licensed respiratory care practitioner;
1130 (b) any person who is a licensed or qualified member of another health care profession,
1131 if this practice is consistent with the accepted standards of the profession and if the person does
1132 not represent himself as a respiratory care practitioner;
1133 (c) any person who serves in the Armed Forces of the United States or any other agency
1134 of the federal government and is engaged in the performance of his official duties; and
1135 (d) any person who acts under a certification issued pursuant to Title 26, Chapter [8] 8a,
1136 Utah Emergency Medical Services System Act, while providing emergency medical services.
1137 (2) Nothing in this chapter permits a respiratory care practitioner to engage in the
1138 unauthorized practice of other health disciplines.
1139 Section 51. Section 62A-12-232 is amended to read:
1140 62A-12-232. Temporary commitment -- Requirements and procedures.
1141 (1) (a) An adult may be temporarily, involuntarily committed to a local mental health

1142 authority upon:
1143 (i) written application by a responsible person who has reason to know, stating a belief that
1144 the individual is likely to cause serious injury to himself or others if not immediately restrained,
1145 and stating the personal knowledge of the individual's condition or circumstances which lead to
1146 that belief; and
1147 (ii) a certification by a licensed physician or designated examiner stating that the physician
1148 or designated examiner has examined the individual within a three-day period immediately
1149 preceding that certification, and that he is of the opinion that the individual is mentally ill and,
1150 because of his mental illness, is likely to injure himself or others if not immediately restrained.
1151 (b) Application and certification as described in Subsection (1)(a) authorizes any peace
1152 officer to take the individual into the custody of a local mental health authority and transport the
1153 individual to that authority's designated facility.
1154 (2) If a duly authorized peace officer observes a person involved in conduct that gives the
1155 officer probable cause to believe that the person is mentally ill, as defined in Section 62A-12-202 ,
1156 and because of that apparent mental illness and conduct, there is a substantial likelihood of serious
1157 harm to that person or others, pending proceedings for examination and certification under this
1158 part, the officer may take that person into protective custody. The peace officer shall transport the
1159 person to be transported to the designated facility of the appropriate local mental health authority
1160 pursuant to this section, either on the basis of his own observation or on the basis of a mental
1161 health officer's observation that has been reported to him by that mental health officer.
1162 Immediately thereafter, the officer shall place the person in the custody of the local mental health
1163 authority and make application for commitment of that person to the local mental health authority.
1164 The application shall be on a prescribed form and shall include the following:
1165 (a) a statement by the officer that he believes, on the basis of personal observation or on
1166 the basis of a mental health officer's observation reported to him by the mental health officer, that
1167 the person is, as a result of a mental illness, a substantial and immediate danger to himself or
1168 others;
1169 (b) the specific nature of the danger;
1170 (c) a summary of the observations upon which the statement of danger is based; and
1171 (d) a statement of facts which called the person to the attention of the officer.
1172 (3) A person committed under this section may be held for a maximum of 24 hours,

1173 excluding Saturdays, Sundays, and legal holidays. At the expiration of that time period, the person
1174 shall be released unless application for involuntary commitment has been commenced pursuant
1175 to Section 62A-12-234 . If that application has been made, an order of detention may be entered
1176 under Subsection 62A-12-234 (3). If no order of detention is issued, the patient shall be released
1177 unless he has made voluntary application for admission.
1178 (4) Transportation of mentally ill persons pursuant to Subsections (1) and (2) shall be
1179 conducted by the appropriate municipal, or city or town, law enforcement authority or, under the
1180 appropriate law enforcement's authority, by ambulance. However, if the designated facility is
1181 outside of that authority's jurisdiction, the appropriate county sheriff shall transport the person or
1182 cause the person to be transported by ambulance.
1183 (5) Notwithstanding Subsections (2) and (4), a peace officer shall cause a person to be
1184 transported by ambulance if the person meets any of the criteria in Subsection 26-8a-305 (1). In
1185 addition, if the person requires physical medical attention, the peace officer shall direct that
1186 transportation be to an appropriate medical facility for treatment.
1187 Section 52. Section 63-46b-1 is amended to read:
1188 63-46b-1. Scope and applicability of chapter.
1189 (1) Except as set forth in Subsection (2), and except as otherwise provided by a statute
1190 superseding provisions of this chapter by explicit reference to this chapter, the provisions of this
1191 chapter apply to every agency of the state and govern:
1192 (a) all state agency actions that determine the legal rights, duties, privileges, immunities,
1193 or other legal interests of one or more identifiable persons, including all agency actions to grant,
1194 deny, revoke, suspend, modify, annul, withdraw, or amend an authority, right, or license; and
1195 (b) judicial review of these actions.
1196 (2) This chapter does not govern:
1197 (a) the procedures for making agency rules, or the judicial review of those procedures or
1198 rules;
1199 (b) the issuance of any notice of a deficiency in the payment of a tax, the decision to waive
1200 penalties or interest on taxes, the imposition of and penalties or interest on taxes, or the issuance
1201 of any tax assessment, except that this chapter governs any agency action commenced by a
1202 taxpayer or by another person authorized by law to contest the validity or correctness of those
1203 actions;

1204 (c) state agency actions relating to extradition, to the granting of pardons or parole,
1205 commutations or terminations of sentences, or to the rescission, termination, or revocation of
1206 parole or probation, to actions and decisions of the Psychiatric Security Review Board relating to
1207 discharge, conditional release, or retention of persons under its jurisdiction, to the discipline of,
1208 resolution of grievances of, supervision of, confinement of, or the treatment of inmates or residents
1209 of any correctional facility, the Utah State Hospital, the Utah State Developmental Center, or
1210 persons in the custody or jurisdiction of the Division of Mental Health, or persons on probation
1211 or parole, or judicial review of those actions;
1212 (d) state agency actions to evaluate, discipline, employ, transfer, reassign, or promote
1213 students or teachers in any school or educational institution, or judicial review of those actions;
1214 (e) applications for employment and internal personnel actions within an agency
1215 concerning its own employees, or judicial review of those actions;
1216 (f) the issuance of any citation or assessment under Title 34A, Chapter 6, Utah
1217 Occupational Safety and Health Act, and Title 58, Chapter 55, Utah Construction Trades Licensing
1218 Act, except that this chapter governs any agency action commenced by the employer, licensee, or
1219 other person authorized by law to contest the validity or correctness of the citation or assessment;
1220 (g) state agency actions relating to management of state funds, the management and
1221 disposal of school and institutional trust land assets, and contracts for the purchase or sale of
1222 products, real property, supplies, goods, or services by or for the state, or by or for an agency of
1223 the state, except as provided in those contracts, or judicial review of those actions;
1224 (h) state agency actions under Title 7, Chapter 1, Article 3, Powers and Duties of
1225 Commissioner of Financial Institutions; and Title 7, Chapter 2, Possession of Depository
1226 Institution by Commissioner; Title 7, Chapter 19, Acquisition of Failing Depository Institutions
1227 or Holding Companies; and Title 63, Chapter 30, [Utah] Governmental Immunity Act, or judicial
1228 review of those actions;
1229 (i) the initial determination of any person's eligibility for unemployment benefits, the
1230 initial determination of any person's eligibility for benefits under Title 34A, Chapter 2, Workers'
1231 Compensation, and Title 34A, Chapter 3, Utah Occupational Disease Act, or the initial
1232 determination of a person's unemployment tax liability;
1233 (j) state agency actions relating to the distribution or award of monetary grants to or
1234 between governmental units, or for research, development, or the arts, or judicial review of those

1235 actions;
1236 (k) the issuance of any notice of violation or order under Title 26, Chapter [8] 8a, Utah
1237 Emergency Medical Services System Act; Title 19, Chapter 2, Air Conservation Act; Title 19,
1238 Chapter 3, Radiation Control Act, Title 19, Chapter 4, Safe Drinking Water Act; Title 19, Chapter
1239 5, Water Quality Act; Title 19, Chapter 6, Part 1, Solid and Hazardous Waste Act; Title 19,
1240 Chapter 6, Part 4, Underground Storage Tank Act; or Title 19, Chapter 6, Part 7, Used Oil
1241 Management Act, except that this chapter governs any agency action commenced by any person
1242 authorized by law to contest the validity or correctness of the notice or order;
1243 (l) state agency actions, to the extent required by federal statute or regulation to be
1244 conducted according to federal procedures;
1245 (m) the initial determination of any person's eligibility for government or public assistance
1246 benefits;
1247 (n) state agency actions relating to wildlife licenses, permits, tags, and certificates of
1248 registration;
1249 (o) licenses for use of state recreational facilities; and
1250 (p) state agency actions under Title 63, Chapter 2, Government Records Access and
1251 Management Act, except as provided in Section 63-2-603 .
1252 (3) This chapter does not affect any legal remedies otherwise available to:
1253 (a) compel an agency to take action; or
1254 (b) challenge an agency's rule.
1255 (4) This chapter does not preclude an agency, prior to the beginning of an adjudicative
1256 proceeding, or the presiding officer during an adjudicative proceeding from:
1257 (a) requesting or ordering conferences with parties and interested persons to:
1258 (i) encourage settlement;
1259 (ii) clarify the issues;
1260 (iii) simplify the evidence;
1261 (iv) facilitate discovery; or
1262 (v) expedite the proceedings; or
1263 (b) granting a timely motion to dismiss or for summary judgment if the requirements of
1264 Rule 12(b) or Rule 56, respectively, of the Utah Rules of Civil Procedure are met by the moving
1265 party, except to the extent that the requirements of those rules are modified by this chapter.

1266 (5) (a) Declaratory proceedings authorized by Section 63-46b-21 are not governed by this
1267 chapter, except as explicitly provided in that section.
1268 (b) Judicial review of declaratory proceedings authorized by Section 63-46b-21 are
1269 governed by this chapter.
1270 (6) This chapter does not preclude an agency from enacting rules affecting or governing
1271 adjudicative proceedings or from following any of those rules, if the rules are enacted according
1272 to the procedures outlined in Title 63, Chapter 46a, Utah Administrative Rulemaking Act, and if
1273 the rules conform to the requirements of this chapter.
1274 (7) (a) If the attorney general issues a written determination that any provision of this
1275 chapter would result in the denial of funds or services to an agency of the state from the federal
1276 government, the applicability of those provisions to that agency shall be suspended to the extent
1277 necessary to prevent the denial.
1278 (b) The attorney general shall report the suspension to the Legislature at its next session.
1279 (8) Nothing in this chapter may be interpreted to provide an independent basis for
1280 jurisdiction to review final agency action.
1281 (9) Nothing in this chapter may be interpreted to restrict a presiding officer, for good cause
1282 shown, from lengthening or shortening any time period prescribed in this chapter, except those
1283 time periods established for judicial review.
1284 Section 53. Section 63-63a-3 is amended to read:
1285 63-63a-3. EMS share of surcharge -- Accounting.
1286 (1) The Division of Finance shall allocate 14% of the collected surcharge established in
1287 Section 63-63a-1 , but not to exceed the amount appropriated by the Legislature, to the Emergency
1288 Medical Services (EMS) Grants Program Account under Section [ 26-8-2.5 ] 26-8a-207 .
1289 (2) The amount shall be recorded by the Department of Health as a dedicated credit.
1290 Section 54. Section 63C-7-202 is amended to read:
1291 63C-7-202. Powers of the Utah Communications Agency Network.
1292 The Utah Communications Agency Network shall have the power to:
1293 (1) sue and be sued in its own name;
1294 (2) have an official seal and power to alter that seal at will;
1295 (3) make and execute contracts and all other instruments necessary or convenient for the
1296 performance of its duties and the exercise of its powers and functions under this chapter, including

1297 contracts with private companies licensed under Title 26, Chapter [8] 8a, Utah Emergency Medical
1298 Services System Act;
1299 (4) own, acquire, construct, operate, maintain, and repair a communications network, and
1300 dispose of any portion of it;
1301 (5) borrow money and incur indebtedness;
1302 (6) issue bonds as provided in this chapter;
1303 (7) enter into agreements with public agencies, the state, and federal government to
1304 provide communications network services on terms and conditions it considers to be in the best
1305 interest of its members;
1306 (8) acquire, by gift, grant, purchase, or by exercise of eminent domain, any real property
1307 or personal property in connection with the acquisition and construction of a communications
1308 network and all related facilities and rights-of-way which it owns, operates, and maintains;
1309 (9) contract with other public agencies, the state, or federal government to provide public
1310 safety communications services in excess of those required to meet the needs or requirements of
1311 its members and the state and federal government if:
1312 (a) it is determined by the executive committee to be necessary to accomplish the purposes
1313 and realize the benefits of this chapter; and
1314 (b) any excess is sold to other public agencies, the state, or federal government and is sold
1315 on terms that assure that the cost of providing the excess service will be received by the Utah
1316 Communications Agency Network; and
1317 (10) perform all other duties authorized by this chapter.
1318 Section 55. Section 75-2-1105.5 is amended to read:
1319 75-2-1105.5. Emergency medical services -- Directive not to resuscitate.
1320 (1) (a) A person 18 years of age or older who is in a terminal condition may, by a directive
1321 made under this section, direct that emergency medical [services] service providers licensed or
1322 certified under Title 26, Chapter [8] 8a, who respond to a call to provide to that person emergency
1323 medical services as defined in Section [ 26-8-2 ] 26-8a-102 , withhold all life sustaining procedures.
1324 (b) The directive is binding upon emergency medical services providers only if the person
1325 issuing the directive is in compliance with the system developed under Subsection (2).
1326 (2) (a) The Department of Health shall by rule establish a uniform system to allow
1327 emergency medical service providers to readily identify persons who have made a directive under

1328 this section.
1329 (b) The system may provide for personal, tamper-proof identifying bracelets or other
1330 means necessary to assure identification of persons who have made a directive under this section.
1331 (3) An emergency medical services provider is not bound to act in accordance with a
1332 directive issued under this section unless the person executing the directive complies with
1333 Department of Health rules made under this section, such as the wearing of an identifying bracelet,
1334 to clearly express to emergency medical service providers the continued intent to be readily
1335 identified as a person who has made a directive under this section.
1336 (4) A directive made under this section shall be:
1337 (a) in writing and on a form approved by the Department of Health;
1338 (b) signed by the declarant or by another person in the declarant's presence and by the
1339 declarant's expressed direction, or if the declarant does not have the ability to give current
1340 directions concerning his care and treatment, by the following persons, as proxy, in the following
1341 order of priority if no person in a prior class is available, willing, and competent to act:
1342 (i) an attorney-in-fact appointed as provided in Section 75-2-1106 , but authorized to act
1343 under this section;
1344 (ii) any previously appointed legal guardian of the declarant;
1345 (iii) the person's spouse if not legally separated;
1346 (iv) the parents or surviving parent;
1347 (v) the person's child 18 years of age or older, or if the person has more than one child, by
1348 a majority of the children 18 years of age or older who are reasonably available for consultation
1349 upon good faith efforts to secure participation of all those children;
1350 (vi) by the declarant's nearest reasonably available living relative 18 years of age or older
1351 if the declarant has no parent or child living; or
1352 (vii) by a legal guardian appointed for the purposes of this section; [and]
1353 (c) dated;
1354 (d) signed, completed, and certified by the declarant's attending physician; and
1355 (e) signed pursuant to Subsection (4)(b) above in the presence of two or more witnesses
1356 who are 18 years of age or older.
1357 (5) Neither of the witnesses may be:
1358 (a) the person who signed the directive on behalf of the declarant;

1359 (b) related to the declarant by blood or marriage;
1360 (c) entitled to any portion of the declarant's estate according to the laws of intestate
1361 succession of this state or under any will or codicil of the declarant;
1362 (d) directly financially responsible for the declarant's medical care; or
1363 (e) an agent of any health care facility in which the declarant is a patient or resident at the
1364 time of executing the directive.
1365 (6) A directive made under this section takes precedence over a directive made pursuant
1366 to Section 75-2-1104 .
1367 Section 56. Section 76-5-102.7 is amended to read:
1368 76-5-102.7. Assault against health care provider and emergency medical service
1369 worker -- Penalty.
1370 (1) A person who assaults a health care provider or [basic life support] emergency medical
1371 service worker is guilty of a class A misdemeanor if:
1372 (a) the person knew that the victim was a health care provider or [basic life support]
1373 emergency medical service worker; and
1374 (b) the health care provider or [basic life support] emergency medical service worker was
1375 performing emergency or life saving duties within the scope of his authority at the time of the
1376 assault.
1377 (2) As used in this section:
1378 (a) "[Basic life support] Emergency medical service worker" [has the same meaning as
1379 "basic life support personnel" provided in Section 26-8-2 ] means a person certified under Section
1380 26-8a-302 .
1381 (b) "Health care provider" has the meaning as provided in Section 78-14-3 .
1382 Section 57. Section 76-10-915 is amended to read:
1383 76-10-915. Exempt activities.
1384 (1) No provision of this act shall be construed to prohibit:
1385 (a) the activities of any public utility to the extent that those activities are subject to
1386 regulation by the public service commission, the state or federal department of transportation, the
1387 federal energy regulatory commission, the federal communications commission, the interstate
1388 commerce commission, or successor agencies;
1389 (b) the activities of any insurer, insurance agent, insurance broker, independent insurance

1390 adjuster or rating organization including, but not limited to, making or participating in joint
1391 underwriting or reinsurance arrangements, to the extent that those activities are subject to
1392 regulation by the commissioner of insurance;
1393 (c) the activities of securities dealers, issuers or agents, to the extent that those activities
1394 are subject to regulation under the laws of either this state or the United States;
1395 (d) the activities of any state or national banking institution, to the extent that such
1396 activities are regulated or supervised by state government officers or agencies under the banking
1397 laws of this state or by federal government officers or agencies under the banking laws of the
1398 United States;
1399 (e) the activities of any state or federal savings and loan association to the extent that those
1400 activities are regulated or supervised by state government officers or agencies under the banking
1401 laws of this state or federal government officers or agencies under the banking laws of the United
1402 States; [or]
1403 (f) the activities of a municipality to the extent authorized or directed by state law; or
1404 (g) the activities of an emergency medical service provider licensed under Title 26,
1405 Chapter 8a, Utah Emergency Medical Service System Act, to the extent that those activities are
1406 regulated by state government officers or agencies under that act.
1407 (2) The labor of a human being is not a commodity or article of commerce. Nothing
1408 contained in the antitrust laws shall be construed to forbid the existence and operation of labor,
1409 agricultural or horticultural organizations, instituted for the purpose of mutual help and not having
1410 capital stock or conducted for profit, or to forbid or restrain individual members of such
1411 organizations from lawfully carrying out the legitimate object thereof; nor shall such organizations
1412 or membership in them be held to be illegal combinations or conspiracies in restraint of trade under
1413 the antitrust laws.
1414 Section 58. Section 78-29-101 is amended to read:
1415 78-29-101. Definitions.
1416 For purposes of this part:
1417 (1) "Blood or blood-contaminated body fluids" include blood, amniotic fluid, pericardial
1418 fluid, peritoneal fluid, pleural fluid, synovial fluid, cerebrospinal fluid, semen, and vaginal
1419 secretions, and any body fluid visibly contaminated with blood.
1420 (2) "Emergency medical services provider" means an [emergency medical technician as

1421 defined in] individual certified under Section [ 26-8-2 ] 26-8a-302 , local fire department personnel,
1422 or county jail personnel, who provide prehospital emergency medical care for an emergency
1423 medical services [agency] provider either as an employee or as a volunteer.
1424 (3) "First aid volunteer" means a person who provides voluntary emergency assistance or
1425 first aid medical care to an injured person prior to the arrival of an emergency medical services
1426 provider or public safety officer.
1427 (4) "HIV" means the Human Immunodeficiency Virus infection as determined by current
1428 medical standards and detected by any of the following:
1429 (a) presence of antibodies to HIV, verified by a positive confirmatory test, such as Western
1430 blot or other methods approved by the Utah State Health Laboratory. Western blot interpretation
1431 will be based on criteria currently recommended by the Association of State and Territorial Public
1432 Health Laboratory Directors;
1433 (b) presence of HIV antigen;
1434 (c) isolation of HIV; or
1435 (d) demonstration of HIV proviral DNA.
1436 (5) "Public safety officer" means a peace officer as defined in Title 53, Chapter 13, Peace
1437 Officer Classifications.
1438 (6) "Significantly exposed" means exposure of the body of one person to HIV or other
1439 blood-borne pathogens from the blood of another person by:
1440 (a) percutaneous inoculation; or
1441 (b) contact with an open wound, nonintact skin which includes chapped, abraded, weeping,
1442 or dermatitic skin, or mucous membranes to blood and blood-contaminated body fluids.
1443 Section 59. Repealer.
1444 This act repeals:
1445 Section 26-8-1, Short title.
1446 Section 26-8-2, Definitions.
1447 Section 26-8-4, Powers and responsibilities of committee.
1448 Section 26-8-5, Powers and responsibilities of department.
1449 Section 26-8-5.5, Emergency personnel stress debriefing program -- General Fund
1450 appropriation for training and reimbursement.
1451 Section 26-8-6, Delegation of responsibilities to local departments -- Collection of fees

1452 -- Entry into reciprocity agreements -- Authority of department.
1453 Section 26-8-7, License or permit required for operation of emergency medical
1454 services -- Hearing and ruling on new licenses -- Information required of licensees --
1455 Employees to be licensed.
1456 Section 26-8-7.5, Fully automatic external defibrillator.
1457 Section 26-8-8, Discrimination in provision of services prohibited -- Religious
1458 objections to services.
1459 Section 26-8-9, Out-of-state services -- Reciprocity agreements.
1460 Section 26-8-10, Exemptions from application of chapter.
1461 Section 26-8-12, Notice of violations.
1462 Section 26-8-13, Denial, suspension or revocation of license -- Issuance of new license
1463 -- Period of suspension.
1464 Section 26-8-14, Injunction or other process to restrain or prevent operations in
1465 violation of chapter.
1466 Section 60. Effective date.
1467 This act takes effect on October 1, 1999, except Section 26-8a-401 which takes effect on
1468 June 1, 1999.