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H.B. 494

This document includes House Committee Amendments incorporated into the bill on Mon, Feb 18, 2008 at 2:15 PM by ddonat. --> This document includes House Floor Amendments incorporated into the bill on Wed, Feb 27, 2008 at 3:00 PM by jeyring. -->              1     

AMENDMENTS TO THE UTAH MEDICAL

             2     
SERVICE SYSTEM ACT

             3     
2008 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: John Dougall

             6     
Senate Sponsor: Darin G. Peterson

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill amends the Utah Emergency Medical Services System Act.
             11      Highlighted Provisions:
             12          This bill:
             13          .    changes a license to provide inter-facility transport services from an exclusive
             14      license in a geographic service area to a non-exclusive license in a geographic
             15      service area when the political subdivision is not providing inter-facility transport;
             16          .    permits both a licensed ground ambulance provider and a licensed paramedic
             17      provider to obtain an inter-facility transport license;
             18          .    defines inter-facility transport;
             19          .    allows a political subdivision that currently provides inter-facility transport services
             20      to subcontract inter-facility transport services to another licensed provider, once
             21      notice is given to the department;
             22          .    establishes certain requirements for a non-exclusive inter-facility transport license;
             23          .    requires a political subdivision that is seeking a license to provide paramedic
             24      services to demonstrate to the department how the political subdivision will impact
             25      providers who are providing inter-facility transfers in the geographic service area;
             26          .    limits the marketing activities of an inter-facility transport provider; and
             27          .    defines certain activities as illegal activities.


             28      Monies Appropriated in this Bill:
             29          None
             30      Other Special Clauses:
             31          None
             32      Utah Code Sections Affected:
             33      AMENDS:
             34          26-8a-102, as last amended by Laws of Utah 2000, Chapter 305
             35          26-8a-401, as enacted by Laws of Utah 1999, Chapter 141
             36          26-8a-402, as last amended by Laws of Utah 2000, Chapter 1
             37          26-8a-404, as last amended by Laws of Utah 2003, Chapter 213
             38          26-8a-405.1, as last amended by Laws of Utah 2007, Chapter 329
             39          26-8a-405.2, as last amended by Laws of Utah 2005, Chapters 25 and 205
             40          26-8a-413, as last amended by Laws of Utah 2003, Chapter 213
             41          26-8a-502, as last amended by Laws of Utah 2000, Chapter 1
             42      ENACTS:
             43          26-8a-405.4, Utah Code Annotated 1953
             44     
             45      Be it enacted by the Legislature of the state of Utah:
             46          Section 1. Section 26-8a-102 is amended to read:
             47           26-8a-102. Definitions.
             48          As used in this chapter:
             49          (1) "Ambulance" means a ground, air, or water vehicle that:
             50          (a) transports patients and is used to provide emergency medical services; and
             51          (b) is required to obtain a permit under Section 26-8a-304 to operate in the state.
             52          (2) "Ambulance provider" means an emergency medical service provider that:
             53          (a) transports and provides emergency medical care to patients; and
             54          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
             55          (3) "Committee" means the State Emergency Medical Services Committee created by
             56      Section 26-1-7 .
             57          (4) "Direct medical observation" means in-person observation of a patient by a
             58      physician, registered nurse, physician's assistant, or individual certified under Section


             59      26-8a-302 .
             60          (5) "Emergency medical condition" means:
             61          (a) a medical condition that manifests itself by symptoms of sufficient severity,
             62      including severe pain, that a prudent layperson, who possesses an average knowledge of health
             63      and medicine, could reasonably expect the absence of immediate medical attention to result in:
             64          (i) placing the individual's health in serious jeopardy;
             65          (ii) serious impairment to bodily functions; or
             66          (iii) serious dysfunction of any bodily organ or part; or
             67          (b) a medical condition that in the opinion of a physician or his designee requires direct
             68      medical observation during transport or may require the intervention of an individual certified
             69      under Section 26-8a-302 during transport.
             70          (6) "Emergency medical service personnel":
             71          (a) means an individual who provides emergency medical services to a patient and is
             72      required to be certified under Section 26-8a-302 ; and
             73          (b) includes a paramedic, medical director of a licensed emergency medical service
             74      provider, emergency medical service instructor, and other categories established by the
             75      committee.
             76          (7) "Emergency medical service providers" means:
             77          (a) licensed ambulance providers and paramedic providers;
             78          (b) a facility or provider that is required to be designated under Section 26-8a-303 ; and
             79          (c) emergency medical service personnel.
             80          (8) "Emergency medical services" means medical services, transportation services, or
             81      both rendered to a patient.
             82          (9) "Emergency medical service vehicle" means a land, air, or water vehicle that is:
             83          (a) maintained and used for the transportation of emergency medical personnel,
             84      equipment, and supplies to the scene of a medical emergency; and
             85          (b) required to be permitted under Section 26-8a-304 .
             86          (10) "Interested party" means:
             87          (a) a licensed or designated emergency medical services provider that provides
             88      emergency medical services within or in an area that abuts an exclusive geographic service area
             89      that is the subject of an application submitted pursuant to Part 4, Ambulance and Paramedic


             90      Providers;
             91          (b) any municipality, county, or fire district that lies within or abuts a geographic
             92      service area that is the subject of an application submitted pursuant to Part 4, Ambulance and
             93      Paramedic Providers; or
             94          (c) the department when acting in the interest of the public.
             95          (11) "Inter-facility transport" H. and "non-911" .H means the transport of a patient
             95a      from one facility to
             96      another facility:
             97          (a) if the patient:
             98          (i) is in need of medical observation during transport as described in Subsection (5)(b);
             99      and
             100          (ii) does not need immediate medical attention as described in Subsection (5)(a);
             101          (b) if the transport is requested and scheduled by either the sending or receiving
             102      facility;
             103          (c) if the H. [ requesting ] sending .H facility or the receiving facility is:
             104          (i) one of the following facilities licensed by the department under Chapter 21, Health
             105      Care Facility Licensing and Inspection Act:
             106          (A) a general acute hospital;
             107          (B) a specialty hospital;
             108          (C) a small health care facility;
             109          (D) a nursing care facility; or
             110          (E) an ambulatory surgical facility; or
             111          (ii) a mental health facility as defined in Section 62A-15-602 ; and
             112          (d) if the sending facility is located within the geographic service area in which the
             113      inter-facility transporter has a license.
             114          [(11)] (12) "Medical control" means a person who provides medical supervision to an
             115      emergency medical service provider.
             116          [(12)] (13) "Paramedic provider" means an entity that:
             117          (a) employs emergency medical service personnel; and
             118          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
             119          [(13)] (14) "Patient" means an individual who, as the result of illness or injury, meets
             120      any of the criteria in Section 26-8a-305 .


             121          [(14)] (15) "Trauma" means an injury requiring immediate medical or surgical
             122      intervention.
             123          [(15)] (16) "Trauma system" means a single, statewide system that:
             124          (a) organizes and coordinates the delivery of trauma care within defined geographic
             125      areas from the time of injury through transport and rehabilitative care; and
             126          (b) is inclusive of all prehospital providers, hospitals, and rehabilitative facilities in
             127      delivering care for trauma patients, regardless of severity.
             128          [(16)] (17) "Triage" means the sorting of patients in terms of disposition, destination,
             129      or priority. For prehospital trauma victims, triage requires a determination of injury severity to
             130      assess the appropriate level of care according to established patient care protocols.
             131          [(17)] (18) "Triage, treatment, transportation, and transfer guidelines" means written
             132      procedures that:
             133          (a) direct the care of patients; and
             134          (b) are adopted by the medical staff of an emergency patient receiving facility, trauma
             135      center, or an emergency medical service provider.
             136          Section 2. Section 26-8a-401 is amended to read:
             137           26-8a-401. State regulation of emergency medical services market.
             138          (1) To ensure emergency medical service quality and minimize unnecessary
             139      duplication, the department shall regulate the emergency medical service market after October
             140      1, 1999, by creating and operating a statewide system that:
             141          (a) except as provided in Section 26-8a-405.4 , consists of exclusive geographic service
             142      areas as provided in Section 26-8a-402 ; and
             143          (b) establishes maximum rates as provided in Section 26-8a-403 .
             144          (2) (a) All licenses issued prior to July 1, 1996, shall expire as stated in the license.
             145          (b) If no expiration date is stated on a license issued before July 1, 1996, the license
             146      shall expire on October 1, 1999, unless:
             147          (i) the license holder requests agency action before August 1, 1999; and
             148          (ii) before October 1, 1999, the department:
             149          (A) finds the license has been used as the basis for responding to requests for
             150      ambulance or paramedic services during the past five years;
             151          (B) identifies one or more specific geographic areas covered by the license in which the


             152      license holder has actively and adequately responded as the primary provider to requests for
             153      ambulance or paramedic services during the past five years; and
             154          (C) determines that the continuation of a license in a specific geographic area identified
             155      in Subsection (2)(b)(ii)(B) satisfies:
             156          (I) the standards established pursuant to Subsection 26-8a-404 (2); and
             157          (II) the requirement of public convenience and necessity.
             158          (c) If the department finds that a license meets the requirements of Subsection (2)(b),
             159      the department shall amend the license to reflect:
             160          (i) the specific geographic area of the license; and
             161          (ii) a four-year term extension.
             162          (d) Before July 1, 1999, the department shall publish notice once a week for four
             163      consecutive weeks of the expiration of licenses pursuant to Subsection (2)(b) in a newspaper of
             164      general circulation in the state.
             165          (e) Nothing in this Subsection (2) may be construed as restricting the authority of the
             166      department to amend overlapping licenses pursuant to Section 26-8a-416 .
             167          (3) After October 1, 1999, new licenses and license renewals shall be for a four-year
             168      term.
             169          Section 3. Section 26-8a-402 is amended to read:
             170           26-8a-402. Exclusive geographic service areas.
             171          (1) (a) [Each] Except as provided in Section 26-8a-405.4 , each ground ambulance
             172      provider license issued under this part shall be for an exclusive geographic service area as
             173      described in the license[. Only].
             174          (b) Except as provided in Subsection (5), and Sections 26-8a-405.4 and 26-8a-416 , the
             175      licensed ground ambulance provider may respond to an ambulance request that originates
             176      within the provider's exclusive geographic service area[, except as provided in Subsection (5)
             177      and Section 26-8a-416 ].
             178          (2) Each paramedic provider license issued under this part shall be for an exclusive
             179      geographic service area as described in the license. Only the licensed paramedic provider may
             180      respond to a paramedic request that originates within the exclusive geographic service area,
             181      except as provided in Subsection (6) and Section 26-8a-416 .
             182          (3) Nothing in this section may be construed as either requiring or prohibiting that the


             183      formation of boundaries in a given location be the same for a licensed paramedic provider as it
             184      is for a licensed ambulance provider.
             185          (4) (a) A licensed ground ambulance or paramedic provider may, as necessary, enter
             186      into a mutual aid agreement to allow another licensed provider to give assistance in times of
             187      unusual demand, as that term is defined by the committee in rule.
             188          (b) A mutual aid agreement shall include a formal written plan detailing the type of
             189      assistance and the circumstances under which it would be given.
             190          (c) The parties to a mutual aid agreement shall submit a copy of the agreement to the
             191      department.
             192          (d) [Notwithstanding this Subsection (4)] Except for a political subdivision authorized
             193      under Subsection (4)(e), and notwithstanding Subsections (4)(a) through (c), a licensed
             194      provider may not subcontract with another entity to provide services in the licensed provider's
             195      exclusive geographic service area.
             196          (e) A political subdivision licensed to provide 911 ambulance services under Section
             197      26-8a-405.1 and holding an exclusive license to provide inter-facility transport services in the
             198      geographic service area, may subcontract with a licensed inter-facility transport provider if the
             199      subcontract:
             200          (i) is for inter-facility transport only;
             201          (ii) is in writing;
             202          (iii) specifies the circumstances under which the subcontractor will provide services
             203      and the scope of services; and
             204          (iv) is submitted to the department.
             205          (f) The department shall issue a license for inter-facility transport to a subcontractor
             206      selected by a political subdivision under Subsection (4)(e). The duration and scope of the
             207      license is subject to the license of the political subdivision for which the transport provider is
             208      the subcontractor.
             209          (5) Notwithstanding Subsection (1), a licensed ground ambulance provider may
             210      respond to an ambulance request that originates from the exclusive geographic service area of
             211      another provider:
             212          (a) pursuant to a mutual aid agreement;
             213          (b) to render assistance on a case-by-case basis to that provider; and


             214          (c) as necessary to meet needs in time of disaster or other major emergency.
             215          (6) Notwithstanding Subsection (2), a licensed paramedic provider may respond to a
             216      paramedic request that originates from the exclusive geographic service area of another
             217      provider:
             218          (a) pursuant to a mutual aid agreement;
             219          (b) to render assistance on a case-by-case basis to that provider; and
             220          (c) as necessary to meet needs in time of disaster or other major emergency.
             221          Section 4. Section 26-8a-404 is amended to read:
             222           26-8a-404. Ground ambulance and paramedic licenses -- Application and
             223      department review.
             224          (1) Except as provided in Section 26-8a-413 , an applicant for a ground ambulance or
             225      paramedic license shall apply to the department for a license only by:
             226          (a) submitting a completed application;
             227          (b) providing information in the format required by the department; and
             228          (c) paying the required fees, including the cost of the hearing officer.
             229          (2) The department shall make rules establishing minimum qualifications and
             230      requirements for:
             231          (a) personnel;
             232          (b) capital reserves;
             233          (c) equipment;
             234          (d) a business plan;
             235          (e) operational procedures;
             236          (f) medical direction agreements;
             237          (g) management and control; and
             238          (h) other matters that may be relevant to an applicant's ability to provide ground
             239      ambulance or paramedic service.
             240          (3) An application for a license to provide ground ambulance service or paramedic
             241      service shall be for all ground ambulance services or paramedic services arising within the
             242      geographic service area, except that:
             243          (a) an applicant may apply for a license for less than all ground ambulance services or
             244      less than all paramedic services arising within an exclusive geographic area if [it] the applicant


             245      can demonstrate how the remainder of [that] the geographic service area will be served; and
             246          (b) an applicant may apply for a license for inter-facility transfers only under Section
             247      26-8a-405.4 if the applicant can demonstrate how the remainder of the geographic service area
             248      will be served.
             249          (4) (a) A ground ambulance service licensee may apply to the department for a license
             250      to provide a higher level of service as defined by department rule if:
             251          (i) the application for the license is limited to non-911 ambulance or paramedic
             252      services; and
             253          (ii) the application includes:
             254          (A) a copy of the new treatment protocols for the higher level of service approved by
             255      the off-line medical director;
             256          (B) an assessment of field performance by the applicant's off-line director; and
             257          (C) an updated plan of operation demonstrating the ability of the applicant to provide
             258      the higher level of service.
             259          (b) If the department determines that the applicant has demonstrated the ability to
             260      provide the higher level of service in accordance with Subsection (4)(a), the department shall
             261      issue a revised license reflecting the higher level of service and the requirements of Section
             262      26-8a-408 do not apply.
             263          (5) Upon receiving a completed application and the required fees, the department shall
             264      review the application and determine whether the application meets the minimum
             265      qualifications and requirements for licensure.
             266          (6) The department may deny an application if it finds that it contains any materially
             267      false or misleading information, is incomplete, or if the application demonstrates that the
             268      applicant fails to meet the minimum qualifications and requirements for licensure under
             269      Subsection (2).
             270          (7) If the department denies an application, it shall notify the applicant in writing
             271      setting forth the grounds for the denial. A denial may be appealed under Title 63, Chapter 46b,
             272      Administrative Procedures Act.
             273          Section 5. Section 26-8a-405.1 is amended to read:
             274           26-8a-405.1. Selection of provider by political subdivision.
             275          (1) For purposes of this section and Sections 26-8a-405.2 [and 26-8a-405.3 ] through


             276      26-8a-405.4 :
             277          (a) "911 ambulance or paramedic services" means either 911 ambulance service, or 911
             278      paramedic service, or both and:
             279          (i) means H. [ :
             280          (A)
] .H
a response to a 911 call received by a designated dispatch center that receives 911
             281      or E911 calls; H. [ [ ] and [ ] ] [ or
             282          (B) a response to a seven digit telephone call received directly by an ambulance
             283      provider licensed under this chapter if the person
] .H
is in an emergency medical condition as
             284      defined in Subsection 26-8a-102 (5)(a); and
             285          (ii) does not mean a seven digit telephone call received directly by an ambulance
             286      provider licensed under this chapter H. [ if the person's medical condition is as defined in
             287      Subsection 26-8a-102 (5)(b)
] .H
.
             288          (b) "Governing body" means:
             289          (i) in the case of a municipality or county, the elected council, commission, or other
             290      legislative body that is vested with the legislative power of the municipality;
             291          (ii) in the case of a special service district, local service district, or county service area,
             292      each elected council, commission, or other legislative body that is vested with the legislative
             293      power of the municipalities or counties that are members of the district or service area; and
             294          (iii) in the case of a local district or special service district for fire protection or
             295      interlocal entity, the board or other body vested with the power to adopt, amend, and repeal
             296      rules, bylaws, policies, and procedures for the regulation of its affairs and the conduct of its
             297      business.
             298          (c) "Political subdivision" means:
             299          (i) a city or town located in a county of the first or second class as defined in Section
             300      17-50-501 ;
             301          (ii) a county of the first or second class;
             302          (iii) the following districts located in a county of the first or second class:
             303          (A) a special service district created under Title 17A, Chapter 2, Part 13, Utah Special
             304      Service District Act; and
             305          (B) a local district under Title 17B, Limited Purpose Local Government Entities -
             306      Local Districts, for the purpose of providing fire protection, paramedic, and emergency


             307      services; [or]
             308          (iv) areas coming together as described in Subsection 26-8a-405.2 (2)(b)(ii);
             309          (v) municipalities and counties joining together pursuant to Title 11, Chapter 13,
             310      Interlocal Cooperation Act; or
             311          (vi) a special service district for fire protection as defined in Section 17A-2-1304 .
             312          (2) (a) Only an applicant approved under Section 26-8a-405 may respond to a request
             313      for a proposal for 911 ambulance or paramedic services issued in accordance with Section
             314      26-8a-405.2 by a political subdivision.
             315          (b) A response to a request for proposal is subject to the maximum rates established by
             316      the department under Section 26-8a-403 .
             317          (c) A political subdivision may award a contract to an applicant for the provision of
             318      911 ambulance or paramedic services:
             319          (i) in accordance with Section 26-8a-405.2 ; and
             320          (ii) subject to Subsection (3).
             321          (3) (a) The department shall issue a license to an applicant selected by a political
             322      subdivision under Subsection (2) unless the department finds that issuing a license to that
             323      applicant would jeopardize the health, safety, and welfare of the citizens of the geographic
             324      service area.
             325          (b) A license issued under this Subsection (3):
             326          (i) is for the exclusive geographic service area approved by the department in
             327      accordance with Subsection 26-8a-405.2 (2);
             328          (ii) is valid for four years;
             329          (iii) is not subject to a request for license from another applicant under the provisions
             330      of Sections 26-8a-406 through 26-8a-409 during the four-year term, unless the applicant's
             331      license is revoked under Section 26-8a-504 ; and
             332          (iv) is subject to supervision by the department under Sections 26-8a-503 and
             333      26-8a-504 .
             334          (4) Except as provided in Subsection 26-8a-405.3 (4)(a), the provisions of Sections
             335      26-8a-406 through 26-8a-409 do not apply to a license issued under this section.
             336          Section 6. Section 26-8a-405.2 is amended to read:
             337           26-8a-405.2. Selection of provider -- Request for competitive sealed proposal --


             338      Public convenience and necessity.
             339          (1) (a) A political subdivision may contract with an applicant approved under Section
             340      26-8a-404 to provide 911 ambulance or paramedic services for the geographic service area that
             341      is approved by the department in accordance with Subsection (2), if the political subdivision
             342      complies with the provisions of this section and Section 26-8a-405.3 .
             343          (b) The provisions of this section and Sections 26-8a-405.1 and 26-8a-405.3 do not
             344      require a political subdivision to issue a request for proposal for ambulance or paramedic
             345      services. If a political subdivision does not contract with an applicant in accordance with this
             346      section and Section 26-8a-405.3 , the provisions of Sections 26-8a-406 through 26-8a-409 apply
             347      to the issuance of a license for ambulance or paramedic services in the geographic service area
             348      that is within the boundaries of the political subdivision.
             349          (c) (i) For purposes of this Subsection (1)(c):
             350          (A) "local district" and "county service area" are defined in Subsection
             351      26-8a-405.1 (1)(b)(iii);
             352          (B) "participating municipality" means a city or town whose area is partly or entirely
             353      included within a county service area or local district; and
             354          (C) "participating county" means a county whose unincorporated area is partly or
             355      entirely included within a county service area or local district.
             356          (ii) A participating municipality or participating county may contract with a provider
             357      for 911 ambulance or paramedic service as provided in this section and Section 26-8a-405.3 .
             358          (iii) If the participating municipality or participating county contracts with a provider
             359      for 911 ambulance or paramedic services under this section and Section 26-8a-405.3 :
             360          (A) the county service area or local district is not obligated to provide the ambulance or
             361      paramedic services that are included in the contract between the participating municipality or
             362      the participating county and the 911 ambulance or paramedic provider;
             363          (B) the county service area and local district may impose taxes and obligations within
             364      the county service area or local district in the same manner as if the participating municipality
             365      or participating county were receiving all services offered by the local district or county service
             366      area; and
             367          (C) the participating municipality's and participating county's obligations to the local
             368      district or county service area are not diminished.


             369          (2) (a) The political subdivision shall submit the request for proposal and the exclusive
             370      geographic service area to be included in the request for proposal to the department for
             371      approval prior to issuing the request for proposal. The department shall approve the request for
             372      proposal and the exclusive geographic service area:
             373          (i) unless the geographic service area creates an orphaned area; and
             374          (ii) in accordance with Subsections (2)(b) and (c).
             375          (b) The exclusive geographic service area may:
             376          (i) include the entire geographic service area that is within the political subdivision's
             377      boundaries;
             378          (ii) include islands within or adjacent to other peripheral areas not included in the
             379      political subdivision that governs the geographic service area; or
             380          (iii) exclude portions of the geographic service area within the political subdivision's
             381      boundaries if another political subdivision or licensed provider agrees to include the excluded
             382      area within their license.
             383          (c) (i) [The proposed geographic service area for 911 ambulance or paramedic service
             384      must demonstrate that non-911 ambulance or paramedic service] The political subdivision
             385      must demonstrate to the department that inter-facility H. [ ambulance or inter-facility paramedic ]
             385a      transport services and 911 ambulance or paramedic .H
             386      services will be provided in the geographic service area, either by the current provider, the
             387      applicant, or some other method acceptable to the department.
             388          (ii) The department may consider:
             389          (A) the effect of the proposed geographic service area on the costs to the [non-911
             390      provider and that provider's ability to provide only non-911 services in the proposed area.]
             391      current inter-facility service provider or providers; and
             392          (B) the current provider's ability to provide only inter-facility transport services in the
             393      proposed geographic service area.
             394          Section 7. Section 26-8a-405.4 is enacted to read:
             395          26-8a-405.4. Competition for inter-facility transport services.
             396          (1) This section H. :
             396a          (a) .H does not apply to a political subdivision that H. :
             396b          (i) .H is the exclusive licensed
             397      provider for inter-facility transport services H. ; or
             397a1          (ii) prior to May 6, 2008, has applied to the Bureau of Emergency Medical Services for
             397a2      an exclusive license to provide inter-facility transport services; [ and ]
             397a          (b) only applies to a county of the first class ;and
             397b          (c) does not invalidate a settlement agreement entered into between a political
             397c      subdivision and a 911 or non-911 provider prior to June 30, 2008 .H .
             398          (2) In any geographic service area where a political subdivision is not providing
             399      inter-facility transport services, the department may issue more than one non-exclusive license


             400      to an inter-facility transport provider for that geographic service area.
             401          (3) The following shall apply to an application for an inter-facility transport license
             402      under this section:
             403          (a) Section 26-8a-404 ;
             404          (b) Section 26-8a-406 ;
             405          (c) Section 26-8a-407 ;
             406          (d) Subsections 26-8a-408 (1) through (7); and
             407          (e) Section 26-8a-409 .
             408          (4) If the requirements of Subsection (3) are met, the department shall issue a license
             409      for inter-facility transport to a qualified ambulance provider or paramedic service provider.
             410      The license issued by the department under this section:
             411          (a) is a non-exclusive license;
             412          (b) is valid for a period of four years;
             413          (c) is subject to department supervision under Section 26-8a-504 ; and
             414          (d) may be renewed pursuant to Subsection 26-8a-413 (2).
             415          (5) A license holder under this section:
             416          (a) must provide inter-facility transport services in response to a request for services
             417      originating from within that geographic service area unless:
             418          (i) the licensed provider receives notice from the person requesting the transport that
             419      another licensed ambulance or paramedic service provider, or another licensed inter-facility
             420      transport provider, is responding to the request for inter-facility transport; or
             421          (ii) the licensed inter-facility transport provider lacks sufficient resources to respond to
             422      the request for inter-facility transport services and the provider secures another licensed
             423      ambulance or paramedic service provider, or another licensed inter-facility transport provider,
             424      to respond to the request for inter-facility transport;
             425          (b) may only transport patients from a facility described in Subsection
             426      26-8a-102 (11)(c) when scheduled by the sending or receiving facility; and
             427          (c) shall, when receiving a call in response to an emergency medical condition as
             428      defined in Subsection 26-8a-102 (5)(a):
             429          (i) use a priority dispatch system, if available, to gather and transmit information H. :
             429a          (A) prior to the dispatch of the inter-facility transporter, if required by the political
             429b      subdivision; and
             429c          (B) .H to the
             430      local 911 dispatch that is sufficient for the appropriate dispatch of H. 911 .H resources; or


             431          (ii) if a priority dispatch system is not available, transmit to the local 911 dispatch
             432      center H. :
             432a          (A) prior to the dispatch of the inter-facility transporter if required by the political
             432b      subdivision; and
             432c          (B) .H the location of the incident, call back information, and any other information
             432d      available
             433      for the appropriate dispatch of H. 911 .H resources.
             434          Section 8. Section 26-8a-413 is amended to read:
             435           26-8a-413. License renewals.
             436          (1) A licensed provider desiring to renew its license must meet the renewal
             437      requirements established by department rule.
             438          (2) The department shall issue a renewal license for a ground ambulance provider or a
             439      paramedic provider upon the licensee's application for a renewal and without a public hearing
             440      if there has been:
             441          (a) no change in controlling interest in the ownership of the licensee as defined in
             442      Section 26-8a-415 ;
             443          (b) no serious, substantiated public complaints filed with the department against the
             444      licensee during the term of the previous license;
             445          (c) no material or substantial change in the basis upon which the license was originally
             446      granted;
             447          (d) no reasoned objection from the committee or the department; and
             448          (e) if the applicant was licensed under the provisions of Sections 26-8a-406 through
             449      26-8a-409 , no conflicting license application.
             450          (3) (a) (i) The provisions of this Subsection (3) apply to a provider licensed under the
             451      provisions of Sections 26-8a-405.1 [and 26-8a-405.2 ] through 26-8a-405.4 .
             452          (ii) A provider may renew its license if the provisions of Subsections (1), (2)(a)
             453      through (d), and this Subsection (3) are met.
             454          (b) (i) The department shall issue a renewal license to a provider upon the provider's
             455      application for renewal for one additional four-year term if the political subdivision certifies to
             456      the department that the provider has met all of the specifications of the original bid.
             457          (ii) If the political subdivision does not certify to the department that the provider has
             458      met all of the specifications of the original bid, the department may not issue a renewal license
             459      and the political subdivision must enter into a public bid process under Sections 26-8a-405.1
             460      and 26-8a-405.2 .


             461          (c) (i) The department shall issue an additional renewal license to a provider who has


             462      already been issued a one-time renewal license under the provisions of Subsection (3)(b)(i) if
             463      the department and the political subdivision do not receive, prior to the expiration of the
             464      provider's license, written notice from an approved applicant informing the political
             465      subdivision of the approved applicant's desire to submit a bid for ambulance or paramedic
             466      service.
             467          (ii) If the department and the political subdivision receive the notice in accordance with
             468      Subsection (3)(c)(i), the department may not issue a renewal license and the political
             469      subdivision must enter into a public bid process under Sections 26-8a-405.1 and 26-8a-405.2 .
             470          (4) The department shall issue a renewal license for an air ambulance provider upon
             471      the licensee's application for renewal and completion of the renewal requirements established
             472      by department rule.
             473          Section 9. Section 26-8a-502 is amended to read:
             474           26-8a-502. Illegal activity.
             475          (1) Except as provided in Section 26-8a-308 , a person may not:
             476          (a) practice or engage in the practice, represent himself to be practicing or engaging in
             477      the practice, or attempt to practice or engage in the practice of any activity that requires a
             478      license, certification, or designation under this chapter unless that person is so licensed,
             479      certified, or designated; or
             480          (b) offer an emergency medical service that requires a license, certificate, or
             481      designation unless the person is so licensed, certified, or designated.
             482          (2) A person may not advertise or hold himself out as one holding a license,
             483      certification, or designation required under this chapter, unless that person holds the license,
             484      certification, or designation.
             485          (3) A person may not employ or permit any employee to perform any service for which
             486      a license or certificate is required by this chapter, unless the person performing the service
             487      possesses the required license or certificate.
             488          (4) A person may not wear, display, sell, reproduce, or otherwise use any Utah
             489      Emergency Medical Services insignia without authorization from the department.
             490          (5) A person may not reproduce or otherwise use materials developed by the
             491      department for certification or recertification testing or examination without authorization from
             492      the department.


             493          (6) A person may not willfully summon an ambulance or emergency response vehicle
             494      or report that one is needed when such person knows that the ambulance or emergency
             495      response vehicle is not needed.
             496          (7) A licensed inter-facility transport provider shall not advertise, market, or solicit any
             497      person to use a number other than 911 to obtain emergency 911 ambulance or paramedic
             498      services.
             499          (8) A person may not violate the provisions of Subsection 26-8a-405.4 (5).
             500          [(7)] (9) A person who violates this section is subject to Section 26-23-6 .




Legislative Review Note
    as of 2-11-08 3:58 PM


Office of Legislative Research and General Counsel


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