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H.B. 121 Enrolled

             1     

EMERGENCY MEDICAL SERVICES ACT

             2     
TRANSPORT AMENDMENTS

             3     
2010 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Gregory H. Hughes

             6     
Senate Sponsor: Curtis S. Bramble

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill amends provisions related to licensing of non-911 transport services in the
             11      Utah Emergency Medical Services System Act.
             12      Highlighted Provisions:
             13          This bill:
             14          .    defines terms;
             15          .    provides that when the Department of Health finds that a complaint against a
             16      non-911 provider has merit, the Department of Health shall issue a notice of
             17      meritorious finding to the political subdivision in which the non-911 provider is
             18      operating;
             19          .    permits a political subdivision that receives the notice of meritorious finding to
             20      determine appropriate corrective actions, which may include issuing a request for
             21      proposal for non-911 services;
             22          .    requires the Department of Health to issue the request for proposal for non-911
             23      services if the political subdivision intends to respond to a request for proposal; and
             24          .    makes technical and conforming amendments.
             25      Monies Appropriated in this Bill:
             26          None
             27      Other Special Clauses:
             28          None
             29      Utah Code Sections Affected:


             30      AMENDS:
             31          26-8a-102, as last amended by Laws of Utah 2000, Chapter 305
             32          26-8a-405.1, as last amended by Laws of Utah 2008, Chapter 360
             33          26-8a-405.2, as last amended by Laws of Utah 2008, Chapter 360
             34          26-8a-405.3, as last amended by Laws of Utah 2009, Chapter 388
             35      ENACTS:
             36          26-8a-405.4, Utah Code Annotated 1953
             37          26-8a-405.5, Utah Code Annotated 1953
             38     
             39      Be it enacted by the Legislature of the state of Utah:
             40          Section 1. Section 26-8a-102 is amended to read:
             41           26-8a-102. Definitions.
             42          As used in this chapter:
             43          (1) (a) "911 ambulance or paramedic services" means:
             44          (i) either:
             45          (A) 911 ambulance service;
             46          (B) 911 paramedic service; or
             47          (C) both 911 ambulance and paramedic service; and
             48          (ii) a response to a 911 call received by a designated dispatch center that receives 911
             49      or E911 calls.
             50          (b) "911 ambulance or paramedic service" does not mean a seven or ten digit
             51      telephone call received directly by an ambulance provider licensed under this chapter.
             52          [(1)] (2) "Ambulance" means a ground, air, or water vehicle that:
             53          (a) transports patients and is used to provide emergency medical services; and
             54          (b) is required to obtain a permit under Section 26-8a-304 to operate in the state.
             55          [(2)] (3) "Ambulance provider" means an emergency medical service provider that:
             56          (a) transports and provides emergency medical care to patients; and
             57          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.


             58          [(3)] (4) "Committee" means the State Emergency Medical Services Committee
             59      created by Section 26-1-7 .
             60          [(4)] (5) "Direct medical observation" means in-person observation of a patient by a
             61      physician, registered nurse, physician's assistant, or individual certified under Section
             62      26-8a-302 .
             63          [(5)] (6) "Emergency medical condition" means:
             64          (a) a medical condition that manifests itself by symptoms of sufficient severity,
             65      including severe pain, that a prudent layperson, who possesses an average knowledge of health
             66      and medicine, could reasonably expect the absence of immediate medical attention to result in:
             67          (i) placing the individual's health in serious jeopardy;
             68          (ii) serious impairment to bodily functions; or
             69          (iii) serious dysfunction of any bodily organ or part; or
             70          (b) a medical condition that in the opinion of a physician or his designee requires
             71      direct medical observation during transport or may require the intervention of an individual
             72      certified under Section 26-8a-302 during transport.
             73          [(6)] (7) "Emergency medical service personnel":
             74          (a) means an individual who provides emergency medical services to a patient and is
             75      required to be certified under Section 26-8a-302 ; and
             76          (b) includes a paramedic, medical director of a licensed emergency medical service
             77      provider, emergency medical service instructor, and other categories established by the
             78      committee.
             79          [(7)] (8) "Emergency medical service providers" means:
             80          (a) licensed ambulance providers and paramedic providers;
             81          (b) a facility or provider that is required to be designated under Section 26-8a-303 ;
             82      and
             83          (c) emergency medical service personnel.
             84          [(8)] (9) "Emergency medical services" means medical services, transportation
             85      services, or both rendered to a patient.


             86          [(9)] (10) "Emergency medical service vehicle" means a land, air, or water vehicle that
             87      is:
             88          (a) maintained and used for the transportation of emergency medical personnel,
             89      equipment, and supplies to the scene of a medical emergency; and
             90          (b) required to be permitted under Section 26-8a-304 .
             91          (11) "Governing body":
             92          (a) is as defined in Subsection 11-42-102 (19); and
             93          (b) for purposes of a "special service district" under Subsection 11-42-102 (19), means
             94      a special service district that has been delegated the authority to select a provider under this
             95      chapter by the special service district's legislative body or administrative control board.
             96          [(10)] (12) "Interested party" means:
             97          (a) a licensed or designated emergency medical services provider that provides
             98      emergency medical services within or in an area that abuts an exclusive geographic service
             99      area that is the subject of an application submitted pursuant to Part 4, Ambulance and
             100      Paramedic Providers;
             101          (b) any municipality, county, or fire district that lies within or abuts a geographic
             102      service area that is the subject of an application submitted pursuant to Part 4, Ambulance and
             103      Paramedic Providers; or
             104          (c) the department when acting in the interest of the public.
             105          [(11)] (13) "Medical control" means a person who provides medical supervision to an
             106      emergency medical service provider.
             107          (14) "Non-911 service" means transport of a patient that is not 911 transport under
             108      Subsection (1).
             109          [(12)] (15) "Paramedic provider" means an entity that:
             110          (a) employs emergency medical service personnel; and
             111          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
             112          [(13)] (16) "Patient" means an individual who, as the result of illness or injury, meets
             113      any of the criteria in Section 26-8a-305 .


             114          (17) "Political subdivision" means:
             115          (a) a city or town located in a county of the first or second class as defined in Section
             116      17-50-501 ;
             117          (b) a county of the first or second class;
             118          (c) the following districts located in a county of the first or second class:
             119          (i) a special service district created under Title 17D, Chapter 1, Special Service
             120      District Act; or
             121          (ii) a local district under Title 17B, Limited Purpose Local Government Entities -
             122      Local Districts, for the purpose of providing fire protection, paramedic, and emergency
             123      services;
             124          (d) areas coming together as described in Subsection 26-8a-405.2 (2)(b)(ii);
             125          (e) an interlocal entity under Title 11, Chapter 13, Interlocal Cooperation Act; or
             126          (f) a special service district for fire protection service under Subsection 17D-1-201 (9).
             127          [(14)] (18) "Trauma" means an injury requiring immediate medical or surgical
             128      intervention.
             129          [(15)] (19) "Trauma system" means a single, statewide system that:
             130          (a) organizes and coordinates the delivery of trauma care within defined geographic
             131      areas from the time of injury through transport and rehabilitative care; and
             132          (b) is inclusive of all prehospital providers, hospitals, and rehabilitative facilities in
             133      delivering care for trauma patients, regardless of severity.
             134          [(16)] (20) "Triage" means the sorting of patients in terms of disposition, destination,
             135      or priority. For prehospital trauma victims, triage requires a determination of injury severity to
             136      assess the appropriate level of care according to established patient care protocols.
             137          [(17)] (21) "Triage, treatment, transportation, and transfer guidelines" means written
             138      procedures that:
             139          (a) direct the care of patients; and
             140          (b) are adopted by the medical staff of an emergency patient receiving facility, trauma
             141      center, or an emergency medical service provider.


             142          Section 2. Section 26-8a-405.1 is amended to read:
             143           26-8a-405.1. Selection of provider by political subdivision.
             144          [(1) For purposes of this section and Sections 26-8a-405.2 and 26-8a-405.3 :]
             145          [(a) "911 ambulance or paramedic services" means either 911 ambulance service, or
             146      911 paramedic service, or both and:]
             147          [(i) means a 911 call received by a designated dispatch center that receives 911 or
             148      E911 calls; and]
             149          [(ii) does not mean a seven digit telephone call received directly by an ambulance
             150      provider licensed under this chapter.]
             151          [(b) "Governing body" means:]
             152          [(i) in the case of a municipality or county, the elected council, commission, or other
             153      legislative body that is vested with the legislative power of the municipality;]
             154          [(ii) in the case of a special service district, local service district, or county service
             155      area, each elected council, commission, or other legislative body that is vested with the
             156      legislative power of the municipalities or counties that are members of the district or service
             157      area; and]
             158          [(iii) in the case of a local district or special service district for fire protection or
             159      interlocal entity, the board or other body vested with the power to adopt, amend, and repeal
             160      rules, bylaws, policies, and procedures for the regulation of its affairs and the conduct of its
             161      business.]
             162          [(c) "Political subdivision" means:]
             163          [(i) a city or town located in a county of the first or second class as defined in Section
             164      17-50-501 ;]
             165          [(ii) a county of the first or second class;]
             166          [(iii) the following districts located in a county of the first or second class:]
             167          [(A) a special service district created under Title 17D, Chapter 1, Special Service
             168      District Act; and]
             169          [(B) a local district under Title 17B, Limited Purpose Local Government Entities -


             170      Local Districts, for the purpose of providing fire protection, paramedic, and emergency
             171      services; or]
             172          [(iv) areas coming together as described in Subsection 26-8a-405.2 (2)(b)(ii);]
             173          [(v) municipalities and counties joining together pursuant to Title 11, Chapter 13,
             174      Interlocal Cooperation Act; or]
             175          [(vi) a special service district for fire protection service under Subsection
             176      17D-1-201 (9).]
             177          [(2)] (1) (a) Only an applicant approved under Section 26-8a-405 may respond to a
             178      request for a proposal [for 911 ambulance or paramedic services] issued in accordance with
             179      Section 26-8a-405.2 or Section 26-8a-405.4 by a political subdivision.
             180          (b) A response to a request for proposal is subject to the maximum rates established by
             181      the department under Section 26-8a-403 .
             182          (c) A political subdivision may award a contract to an applicant [for the provision of
             183      911 ambulance or paramedic services] in response to a request for proposal:
             184          (i) in accordance with Section 26-8a-405.2 ; and
             185          (ii) subject to Subsection [(3)] (2).
             186          [(3)] (2) (a) The department shall issue a license to an applicant selected by a political
             187      subdivision under Subsection [(2)] (1) unless the department finds that issuing a license to that
             188      applicant would jeopardize the health, safety, and welfare of the citizens of the geographic
             189      service area.
             190          (b) A license issued under this Subsection [(3)] (2):
             191          (i) is for the exclusive geographic service area approved by the department in
             192      accordance with Subsection 26-8a-405.2 (2);
             193          (ii) is valid for four years;
             194          (iii) is not subject to a request for license from another applicant under the provisions
             195      of Sections 26-8a-406 through 26-8a-409 during the four-year term, unless the applicant's
             196      license is revoked under Section 26-8a-504 ; and
             197          (iv) is subject to supervision by the department under Sections 26-8a-503 and


             198      26-8a-504 .
             199          [(4)] (3) Except as provided in Subsection 26-8a-405.3 (4)(a), the provisions of
             200      Sections 26-8a-406 through 26-8a-409 do not apply to a license issued under this section.
             201          Section 3. Section 26-8a-405.2 is amended to read:
             202           26-8a-405.2. Selection of provider -- Request for competitive sealed proposal --
             203      Public convenience and necessity.
             204          (1) (a) A political subdivision may contract with an applicant approved under Section
             205      26-8a-404 to provide [911 ambulance or paramedic] services for the geographic service area
             206      that is approved by the department in accordance with Subsection (2), if:
             207          (i) the political subdivision complies with the provisions of this section and Section
             208      26-8a-405.3 if the contract is for 9ll ambulance or paramedic services; or
             209          (ii) the political subdivision complies with Sections 26-8a-405.3 and 26-8a-405.4 , if
             210      the contract is for non-911 services.
             211          (b) (i) The provisions of this section and Sections 26-8a-405.1 [and], 26-8a-405.3 , and
             212      26-8a-405.4 do not require a political subdivision to issue a request for proposal for
             213      ambulance or paramedic services or non-911 services.
             214          (ii) If a political subdivision does not contract with an applicant in accordance with
             215      this section and Section 26-8a-405.3 , the provisions of Sections 26-8a-406 through 26-8a-409
             216      apply to the issuance of a license for ambulance or paramedic services in the geographic
             217      service area that is within the boundaries of the political subdivision.
             218          (iii) If a political subdivision does not contract with an applicant in accordance with
             219      this section, Section 26-8a-405.3 and Section 26-8a-405.4 , a license for the non-911 services
             220      in the geographic service area that is within the boundaries of the political subdivision may be
             221      issued:
             222          (A) under the public convenience and necessity provisions of Sections 26-8a-406
             223      through 26-8a-409 ; or
             224          (B) by a request for proposal issued by the department under Section 26-8a-405.5 .
             225          (c) (i) For purposes of this Subsection (1)(c):


             226          (A) ["Local] "Fire district" means a local district under Title 17B, Limited Purpose
             227      Local Government Entities - Local Districts, that:
             228          (I) is located in a county of the first or second class; and
             229          (II) provides fire protection, paramedic, and emergency services.
             230          (B) "Participating municipality" means a city or town whose area is partly or entirely
             231      included within a county service area or [local] fire district.
             232          (C) "Participating county" means a county whose unincorporated area is partly or
             233      entirely included within a [local] fire district.
             234          (ii) A participating municipality or participating county may [contract with a provider
             235      for 911 ambulance or paramedic service] as provided in this section and Section
             236      26-8a-405.3 [.], contract with a provider for 911 ambulance or paramedic service.
             237          (iii) If the participating municipality or participating county contracts with a provider
             238      for [911 ambulance or paramedic] services under this section and Section 26-8a-405.3 :
             239          (A) the [local] fire district is not obligated to provide the [ambulance or paramedic]
             240      services that are included in the contract between the participating municipality or the
             241      participating county and the [911 ambulance or paramedic] provider;
             242          (B) the [local] fire district may impose taxes and obligations within the [local] fire
             243      district in the same manner as if the participating municipality or participating county were
             244      receiving all services offered by the [local] fire district; and
             245          (C) the participating municipality's and participating county's obligations to the [local]
             246      fire district are not diminished.
             247          (2) (a) The political subdivision shall submit the request for proposal and the exclusive
             248      geographic service area to be included in [the] a request for proposal issued under Subsections
             249      (1)(a)(i) or (ii) to the department for approval prior to issuing the request for proposal. The
             250      department shall approve the request for proposal and the exclusive geographic service area:
             251          (i) unless the geographic service area creates an orphaned area; and
             252          (ii) in accordance with Subsections (2)(b) and (c).
             253          (b) The exclusive geographic service area may:


             254          (i) include the entire geographic service area that is within the political subdivision's
             255      boundaries;
             256          (ii) include islands within or adjacent to other peripheral areas not included in the
             257      political subdivision that governs the geographic service area; or
             258          (iii) exclude portions of the geographic service area within the political subdivision's
             259      boundaries if another political subdivision or licensed provider agrees to include the excluded
             260      area within their license.
             261          (c) The proposed geographic service area for 911 ambulance or paramedic service
             262      must demonstrate that non-911 ambulance or paramedic service will be provided in the
             263      geographic service area, either by the current provider, the applicant, or some other method
             264      acceptable to the department. The department may consider the effect of the proposed
             265      geographic service area on the costs to the non-911 provider and that provider's ability to
             266      provide only non-911 services in the proposed area.
             267          Section 4. Section 26-8a-405.3 is amended to read:
             268           26-8a-405.3. Use of competitive sealed proposals -- Procedure -- Appeal rights.
             269          (1) (a) Competitive sealed proposals for paramedic or 911 ambulance services under
             270      Section 26-8a-405.2 , or for non-911 services under Section 26-8a-405.4 , shall be solicited
             271      through a request for proposal and the provisions of this section.
             272          (b) The governing body of the political subdivision shall approve the request for
             273      proposal prior to the notice of the request for proposals under Subsection (1)(c).
             274          (c) (i) Notice of the request for proposals shall be published:
             275          (A) at least once a week for three consecutive weeks in a newspaper of general
             276      circulation published in the county; or
             277          (B) if there is no such newspaper, then notice must be posted for at least 20 days in at
             278      least five public places in the county; and
             279          (ii) in accordance with Section 45-1-101 for at least 20 days.
             280          (2) (a) Proposals shall be opened so as to avoid disclosure of contents to competing
             281      offerors during the process of negotiations.


             282          (b) (i) Subsequent to the published notice, and prior to selecting an applicant, the
             283      political subdivision must hold a presubmission conference with interested applicants for the
             284      purpose of assuring full understanding of, and responsiveness to, solicitation requirements.
             285          (ii) A political subdivision shall allow at least 90 days from the presubmission
             286      conference for the proposers to submit proposals.
             287          (c) Subsequent to the presubmission conference, the political subdivision may issue
             288      addenda to the request for proposals. An addenda to a request for proposal must be finalized
             289      and posted by the political subdivision at least 45 days prior to the date on which the proposal
             290      must be submitted.
             291          (d) Offerors to the request for proposals shall be accorded fair and equal treatment
             292      with respect to any opportunity for discussion and revisions of proposals, and revisions may be
             293      permitted after submission and before a contract is awarded for the purpose of obtaining best
             294      and final offers.
             295          (e) In conducting discussions, there shall be no disclosures of any information derived
             296      from proposals submitted by competing offerors.
             297          (3) (a) (i) A political subdivision may select an applicant approved by the department
             298      under Section 26-8a-404 to provide 911 ambulance or paramedic services by contract to the
             299      most responsible offeror as defined in Subsection 63G-6-103 (24).
             300          (ii) An award under Subsection (3)(a)(i) shall be made to the responsible offeror
             301      whose proposal is determined in writing to be the most advantageous to the political
             302      subdivision, taking into consideration price and the evaluation factors set forth in the request
             303      for proposal.
             304          (b) The applicants who are approved under Section 26-8a-405 and who are selected
             305      under this section may be the political subdivision issuing the request for competitive sealed
             306      proposals, or any other public entity or entities, any private person or entity, or any
             307      combination thereof.
             308          (c) A political subdivision may reject all of the competitive proposals.
             309          (4) In seeking competitive sealed proposals and awarding contracts under this section,


             310      a political subdivision:
             311          (a) shall apply the public convenience and necessity factors listed in Subsections
             312      26-8a-408 (2) through (6);
             313          (b) shall require the applicant responding to the proposal to disclose how the applicant
             314      will meet performance standards in the request for proposal;
             315          (c) may not require or restrict an applicant to a certain method of meeting the
             316      performance standards, including:
             317          (i) requiring ambulance medical personnel to also be a firefighter; or
             318          (ii) mandating that offerors use fire stations or dispatch services of the political
             319      subdivision;
             320          (d) [(i)] shall require an applicant to submit the proposal:
             321          (i) based on full cost accounting in accordance with generally accepted accounting
             322      principals; and
             323          (ii) if the applicant is a governmental entity, in addition to the requirements of
             324      Subsection (4)(e)(i), in accordance with generally accepted government auditing standards and
             325      in compliance with the State of Utah Legal Compliance Audit Guide; and
             326          (e) shall set forth in the request for proposal:
             327          (i) the method for determining full cost accounting in accordance with generally
             328      accepted accounting principles, and require an applicant to submit the proposal based on such
             329      full cost accounting principles;
             330          (ii) guidelines established to further competition and provider accountability; and
             331          (iii) a list of the factors that will be considered by the political subdivision in the
             332      award of the contract, including by percentage, the relative weight of the factors established
             333      under this Subsection (4)(e), which may include such things as:
             334          (A) response times;
             335          (B) staging locations;
             336          (C) experience;
             337          (D) quality of care; and


             338          (E) cost, consistent with the cost accounting method in Subsection (4)(e)(i).
             339          (5) (a) Notwithstanding the provisions of Subsection 63G-6-104 (3), the provisions of
             340      Title 63G, Chapter 6, Part 8, Legal and Contractual Remedies, apply to the procurement
             341      process required by this section, except as provided in Subsection (5)(c).
             342          (b) The Procurement Appeals Board created in Section 63G-6-807 shall have
             343      jurisdiction to review and determine an appeal of an offeror under this section in the same
             344      manner as provided in Section 63G-6-810 .
             345          (c) (i) An offeror may appeal the solicitation or award as provided by the political
             346      subdivision's procedures. After all political subdivision appeal rights are exhausted, the
             347      offeror may appeal under the provisions of Subsections (5)(a) and (b).
             348          (ii) The factual determination required by Subsection 63G-6-813 (1) shall be based on
             349      whether the solicitation or award was made in accordance with the procedures set forth in this
             350      section and Section 26-8a-405.2 .
             351          (d) The determination of an issue of fact by the appeals board shall be final and
             352      conclusive unless arbitrary and capricious or clearly erroneous as provided in Section
             353      63G-6-813 .
             354          Section 5. Section 26-8a-405.4 is enacted to read:
             355          26-8a-405.4. Non-911 provider -- Finding of meritorious complaint -- Request for
             356      proposals.
             357          (1) Notwithstanding Subsection 26-8a-102 (17), for purposes of this section, political
             358      subdivision includes:
             359          (a) a county of any class; and
             360          (b) a city or town located in a county of any class.
             361          (2) (a) This section applies to a non-911 provider license under this chapter.
             362          (b) The department shall, in accordance with Subsections (4) and (5):
             363          (i) receive a complaint about a non-911 provider;
             364          (ii) determine whether the complaint has merit;
             365          (iii) issue a finding of:


             366          (A) a meritorious complaint; or
             367          (B) a non-meritorious complaint; and
             368          (iv) forward a finding of a meritorious complaint to the governing body of the political
             369      subdivision:
             370          (A) in which the non-911 provider is licensed; or
             371          (B) that provides the non-911 services, if different from Subsection (2)(b)(iv)(A).
             372          (3) (a) A political subdivision that receives a finding of a meritorious complaint from
             373      the department:
             374          (i) shall take corrective action that the political subdivision determines is appropriate;
             375      and
             376          (ii) shall, if the political subdivision determines corrective action will not resolve the
             377      complaint or is not appropriate:
             378          (A) issue a request for proposal for non-911 service in the geographic service area if
             379      the political subdivision will not respond to the request for proposal; or
             380          (B) (I) make a finding that a request for proposal for non-911 services is appropriate
             381      and the political subdivision intends to respond to a request for proposal; and
             382          (II) submit the political subdivision's findings to the department with a request that the
             383      department issue a request for proposal in accordance with Section 26-8a-405.5 .
             384          (b) (i) If Subsection (3)(a)(ii)(A) applies, the political subdivision shall issue the
             385      request for proposal in accordance with Sections 26-8a-405.1 through 26-8a-405.3 .
             386          (ii) If Subsection (3)(a)(ii)(B) applies, the department shall issue a request for proposal
             387      for non-911 services in accordance with Section 26-8a-405.5 .
             388          (4) The department shall make a determination under Subsection (2)(b) if:
             389          (a) the department receives a written complaint from any of the following in the
             390      geographic service area:
             391          (i) a hospital;
             392          (ii) a health care facility;
             393          (iii) a political subdivision; or


             394          (iv) an individual; and
             395          (b) the department determines, in accordance with Subsection (2)(b), that the
             396      complaint has merit.
             397          (5) (a) If the department receives a complaint under Subsection (2)(b), the department
             398      shall request a written response from the non-911 provider concerning the complaint.
             399          (b) The department shall make a determination under Subsection (2)(b) based on:
             400          (i) the written response from the non-911 provider; and
             401          (ii) other information that the department may have concerning the quality of service
             402      of the non-911 provider.
             403          (c) (i) The department's determination under Subsection (2)(b) is not subject to an
             404      adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act.
             405          (ii) The department shall adopt administrative rules in accordance with Title 63G,
             406      Chapter 3, Utah Administrative Rulemaking Act, to implement the provisions of Subsection
             407      (2)(b).
             408          Section 6. Section 26-8a-405.5 is enacted to read:
             409          26-8a-405.5. Use of competitive sealed proposals -- Procedure -- Appeal rights.
             410          (1) (a) The department shall issue a request for proposal for non-911 services in a
             411      geographic service area if the department receives a request from a political subdivision under
             412      Subsection 26-8a-405.4 (3)(a)(ii)(B) to issue a request for proposal for non-911 services.
             413          (b) Competitive sealed proposals for non-911 services under Subsection (1)(a) shall be
             414      solicited through a request for proposal and the provisions of this section.
             415          (c) (i) Notice of the request for proposals shall be published:
             416          (A) at least once a week for three consecutive weeks in a newspaper of general
             417      circulation published in the county; or
             418          (B) if there is no such newspaper, then notice must be posted for at least 20 days in at
             419      least five public places in the county; and
             420          (ii) in accordance with Section 45-1-101 for at least 20 days.
             421          (2) (a) Proposals shall be opened so as to avoid disclosure of contents to competing


             422      offerors during the process of negotiations.
             423          (b) (i) Subsequent to the published notice, and prior to selecting an applicant, the
             424      department must hold a presubmission conference with interested applicants for the purpose of
             425      assuring full understanding of, and responsiveness to, solicitation requirements.
             426          (ii) The department shall allow at least 90 days from the presubmission conference for
             427      the proposers to submit proposals.
             428          (c) Subsequent to the presubmission conference, the department may issue addenda to
             429      the request for proposals. An addenda to a request for proposal must be finalized and posted
             430      by the department at least 45 days prior to the date on which the proposal must be submitted.
             431          (d) Offerors to the request for proposals shall be accorded fair and equal treatment
             432      with respect to any opportunity for discussion and revisions of proposals, and revisions may be
             433      permitted after submission and before a contract is awarded for the purpose of obtaining best
             434      and final offers.
             435          (e) In conducting discussions, there shall be no disclosures of any information derived
             436      from proposals submitted by competing offerors.
             437          (3) (a) (i) The department may select an applicant approved by the department under
             438      Section 26-8a-404 to provide non-911 services by contract to the most responsible offeror as
             439      defined in Subsection 63G-6-103 (24).
             440          (ii) An award under Subsection (3)(a)(i) shall be made to the responsible offeror
             441      whose proposal is determined in writing to be the most advantageous to the public, taking into
             442      consideration price and the evaluation factors set forth in the request for proposal.
             443          (b) The applicants who are approved under Section 26-8a-405 and who are selected
             444      under this section may be the political subdivision responding to the request for competitive
             445      sealed proposals, or any other public entity or entities, any private person or entity, or any
             446      combination thereof.
             447          (c) The department may reject all of the competitive proposals.
             448          (4) In seeking competitive sealed proposals and awarding contracts under this section,
             449      the department:


             450          (a) shall consider the public convenience and necessity factors listed in Subsections
             451      26-8a-408 (2) through (6);
             452          (b) shall require the applicant responding to the proposal to disclose how the applicant
             453      will meet performance standards in the request for proposal;
             454          (c) may not require or restrict an applicant to a certain method of meeting the
             455      performance standards, including:
             456          (i) requiring ambulance medical personnel to also be a firefighter; or
             457          (ii) mandating that offerors use fire stations or dispatch services of the political
             458      subdivision;
             459          (d) shall require an applicant to submit the proposal:
             460          (i) based on full cost accounting in accordance with generally accepted accounting
             461      principals; and
             462          (ii) if the applicant is a governmental entity, in addition to the requirements of
             463      Subsection (4)(e)(i), in accordance with generally accepted government auditing standards and
             464      in compliance with the State of Utah Legal Compliance Audit Guide; and
             465          (e) shall set forth in the request for proposal:
             466          (i) the method for determining full cost accounting in accordance with generally
             467      accepted accounting principles, and require an applicant to submit the proposal based on such
             468      full cost accounting principles;
             469          (ii) guidelines established to further competition and provider accountability; and
             470          (iii) a list of the factors that will be considered by the department in the award of the
             471      contract, including by percentage, the relative weight of the factors established under this
             472      Subsection (4)(e), which may include such things as:
             473          (A) response times;
             474          (B) staging locations;
             475          (C) experience;
             476          (D) quality of care; and
             477          (E) cost, consistent with the cost accounting method in Subsection (4)(e)(i).


             478          (5) A license issued under this section:
             479          (a) is for the exclusive geographic service area approved by the department;
             480          (b) is valid for four years;
             481          (c) is not subject to a request for license from another applicant under the provisions
             482      of Sections 26-8a-406 through 26-8a-409 during the four-year term, unless the applicant's
             483      license is revoked under Section 26-8a-504 ;
             484          (d) is subject to supervision by the department under Sections 26-8a-503 and
             485      26-8a-504 ; and
             486          (e) except as provided in Subsection (4)(a), is not subject to the provisions of Sections
             487      26-8a-406 through 26-8a-409 .


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