SENATE BILL NO. 133 January 27, 1999, Introduced by Senator BENNETT and referred to the Committee on Health Policy. A bill to amend 1978 PA 368, entitled "Public health code," by amending section 20920 (MCL 333.20920), as amended by 1997 PA 78. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 Sec. 20920. (1) A person shall not establish, operate, or 2 cause to be operated an ambulance operation unless the ambulance 3 operation is licensed under this section. 4 (2) Upon proper application and payment of a $100.00 fee, 5 the department shall issue a license as an ambulance operation to 6 a person who meets the requirements of this part and the rules 7 promulgated under this part. 8 (3) An applicant shall specify in the application each 9 ambulance to be operated. 00047'99 CPD 2 1 (4) An ambulance operation license shall specify the 2 ambulances licensed to be operated. 3 (5) An ambulance operation license shall state the level of 4 life support the ambulance operation is licensed to provide. An 5 ambulance operation shall operate in accordance with this part, 6 rules promulgated under this part, and approved local medical 7 control authority protocols and shall not provide life support at 8 a level that exceeds its license or violates approved local medi- 9 cal control authority protocols. 10 (6) An ambulance operation license may be renewed annually 11 upon application to the department and payment of a $100.00 12 renewal fee. Before issuing a renewal license, the department 13 shall determine that the ambulance operation is in compliance 14 with this part, the rules promulgated under this part, and local 15 medical control authority protocols. 16 (7) Beginning onthe effective date of the amendatory act17that added this subsectionJULY 22, 1997, an ambulance operation 18 that meets all of the following requirements may apply for an 19 ambulance operation upgrade license under subsection (8): 20 (a) On or beforethe effective date of the amendatory act21that added this subsectionJULY 22, 1997, holds an ambulance 22 operation license that designates the ambulance operation either 23 as a transporting basic life support service or as a transporting 24 limited advanced life support service. 25 (b) Is a transporting basic life support service,that is 26 able to staff and equip 1 or more ambulances for the transport of 27 emergency patients at a life support level higher than basic life 00047'99 3 1 support, or is a transporting limited advanced life support 2 service,that is able to staff and equip 1 or more ambulances 3 for the transport of emergency patients at the life support level 4 of advanced life support. 5 (c) Is owned or operated by or under contract to a local 6 unit of government and providing first-line emergency medical 7 response to that local unit of government on or beforethe8effective date of the amendatory act that added this subsection9 JULY 22, 1997. 10 (d) Will provide the services described in subdivision (b) 11 only to the local unit of government described in 12 subdivision (c), and only in response to a 911 call or other call 13 for emergency transport. 14 (8) An ambulance operation meeting the requirements of 15 subsection (7) that applies for an ambulance operation upgrade 16 license shall include all of the following information in the 17 application provided by the department: 18 (a) Verification of all of the requirements of subsection 19 (7) including, but not limited to, a description of the staffing 20 and equipment to be used in providing the higher level of life 21 support services. 22 (b) If the applicant is a transporting basic life support 23 service, a plan of action to upgrade from providing basic life 24 support to providing limited advanced life support or advanced 25 life support to take place over a period of not more than 2 26 years. If the applicant is a transporting limited advanced life 27 support service, a plan of action to upgrade from providing 00047'99 4 1 limited advanced life support to providing advanced life support 2 to take place over a period of not more than 2 years. 3 (c) The medical control authority protocols for the ambu- 4 lance operation upgrade license, along with a recommendation from 5 the medical control authority under which the ambulance operation 6 operates that the ambulance operation upgrade license be issued 7 by the department. 8 (d) Other information required by the department. 9 (9) The statewide emergency medical services coordinating 10 committee shall review the information described in 11 subsection (8)(c) and make a recommendation to the department as 12 to whether or not an ambulance operation upgrade license should 13 be granted to the applicant. 14 (10) Upon receipt of a completed application as required 15 under subsection (8), a positive recommendation under 16 subsection (9), and payment of a $100.00 fee, the department 17 shall issue to the applicant an ambulance operation upgrade 18 license. Subject to subsection (12), the license is valid for 2 19 years from the date of issuance and is renewable for1addi- 20 tional 2-yearperiodPERIODS. An application for renewal of an 21 ambulance operation upgrade license shall contain documentation 22 of the progress made on the plan of action described in 23 subsection (8)(b). In addition, the medical control authority 24 under which the ambulance operation operates shall annually file 25 with the statewide emergency medical services coordinating com- 26 mittee a written report on the progress made by the ambulance 27 operation on the plan of action described in subsection (8)(b), 00047'99 5 1 including, but not limited to, information on training, 2 equipment, and personnel. 3 (11) If an ambulance operation is designated by its regular 4 license as providing basic life support services, then an ambu- 5 lance operation upgrade license issued under this section allows 6 the ambulance operation to provide limited advanced life support 7 services or advanced life support services when the ambulance 8 operation is able to staff and equip 1 or more ambulances to pro- 9 vide services at the higher levels. If an ambulance operation is 10 designated by its regular license as providing limited advanced 11 life support services, then an ambulance operation upgrade 12 license issued under this section allows the ambulance operation 13 to provide advanced life support services when the ambulance 14 operation is able to staff and equip 1 or more ambulances to pro- 15 vide services at the higher level. An ambulance operation shall 16 not provide services under an ambulance operation upgrade license 17 unless the medical control authority under which the ambulance 18 operation operates has adopted protocols for the ambulance opera- 19 tion upgrade license regarding quality monitoring procedures, use 20 and protection of equipment, and patient care. 21 (12) The department may revoke or fail to renew an ambulance 22 operation upgrade license for a violation of this part or a rule 23 promulgated under this part or for failure to comply with the 24 plan of action filed under subsection (8)(b). An ambulance oper- 25 ation that obtains an ambulance operation upgrade license must 26 annually renew its regular license under subsections (2) to (6). 00047'99 6 1 An ambulance operation's regular license is not affected by the 2 following: 3 (a) The fact that the ambulance operation has obtained or 4 renewed an ambulance operation upgrade license. 5 (b) The fact that an ambulance operation's ambulance opera- 6 tion upgrade license is revoked or is not renewed under this 7 subsection. 8(c) The fact that the ambulance operation's ambulance oper-9ation upgrade license expires at the end of the second 2-year10period prescribed by subsection (10).11 (13)Within 3 years after the effective date of the amenda-12tory act that added this subsectionBY JULY 22, 2000, the 13 department shall file a written reporttoWITH the 14 legislature. The department shall include all of the following 15 information in the report: 16 (a) The number of ambulance operations that were qualified 17 under subsection (7) to apply for an ambulance operation upgrade 18 license under subsection (8) during the 3-year period. 19 (b) The number of ambulance operations that in fact applied 20 for an ambulance operation upgrade license during the 3-year 21 period. 22 (c) The number of ambulance operations that successfully 23 upgraded from being a transporting basic life support service to 24 a transporting limited advanced service or a transporting 25 advanced life support service or that successfully upgraded from 26 being a transporting limited advanced life support service to a 00047'99 7 1 transporting advanced life support service under an ambulance 2 operation upgrade license. 3 (d) The number of ambulance operations that failed to suc- 4 cessfully upgrade, as described in subdivision (c), under an 5 ambulance operation upgrade license, but that improved their 6 services during the 3-year period. 7 (e) The number of ambulance operations that failed to suc- 8 cessfully upgrade, as described in subdivision (c), under an 9 ambulance operation upgrade license, and that showed no improve- 10 ment or a decline in their services. 11 (f) The effect of the amendatory act that added this subsec- 12 tion on the delivery of emergency medical services in this 13 state. 00047'99 Final page. 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