HB-5842, As Passed Senate, December 18, 2014

SENATE SUBSTITUTE FOR

HOUSE BILL NO. 5842

(As amended December 18, 2014)

<<A bill to amend 1978 PA 368, entitled

"Public health code,"

by amending sections 16135, 16216, 16245, 16247, 16248, 16249, 17711,

17748, 17768, 20920, and 20921 (MCL 333.16135, 333.16216, 333.16245,

333.16247, 333.16248, 333.16249, 333.17711, 333.17748, 333.17768,

333.20920, and 333.20921), section 16135 as amended by 1993 PA 80,

section 16216 as amended by 2014 PA 98, sections 16245 and 17768 as

amended by 2013 PA 268, sections 16247, 16248, and 16249 as amended

by 1993 PA 79, section 17711 as amended by 2014 PA 285, section 17748

as amended by 2014 PA 280, sections 20920 and 20921 as amended by 2004

PA 200, and by adding sections 16245a and 20921a.>>

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 16135. (1) Except as otherwise provided in subsection

(2), a member of a board, the committee, or a task force created by

this article shall must meet all of the following requirements:

     (a) Be 18 or more years of age.

     (b) Be of good moral character.

     (c) Be a resident of this state for not less than the 6 months

immediately preceding appointment and remain a resident of this

state throughout the term of the appointment.

     (d) Be currently licensed or registered in this state where if

licensure or registration in a health profession is a requirement

for membership. The member shall must have actively practiced that

profession or taught in an approved educational institution that

prepares applicants for licensure or registration in that

profession, or a combination of both, in any state for not less

than the 2 years immediately preceding appointment.

     (e) Not be a spouse, parent, child, or sibling of another

member of the board, committee, or task force and meet this

requirement throughout the term of the appointment.

     (f) Not provide supervision over or be under the supervision

of another member of the board, committee, or task force and meet

this requirement throughout the term of the appointment.

     (2) Subject to subsection (3), for a board created on or after

January 1, 1989, the governor may appoint as the members a member

of the a board who are is required to be licensed or registered

under subsection (1)(d) individuals an individual who meet meets

either or both of the following requirements:

     (a) Are Is certified or otherwise approved by a national

organization that certifies or otherwise approves individuals in

the profession to be licensed or registered by the board.

     (b) Have Has actively practiced the profession licensed or

registered by the board or taught in an educational institution

that prepares applicants for licensure or registration in that

profession, or a combination of both, for not less than the 2 years

immediately preceding their his or her appointment.

     (3) Each An individual appointed under subsection (2) shall

must be licensed or registered under this article in the profession

licensed or registered by that board within 3 years after the

effective date of the amendatory act that created the board.

     Sec. 16216. (1) The chair of each board or task force shall

appoint 1 or more disciplinary subcommittees for that board or task

force. A disciplinary subcommittee for a board or task force shall

consist of 2 public members and 3 professional members from the

board or task force. The chair of a board or task force shall not

serve as a member of a disciplinary subcommittee.

     (2) A final decision of the a disciplinary subcommittee

finding a violation of this article, article 7, or article 8 shall

be by requires a majority vote of the members appointed and serving

on the disciplinary subcommittee.

     (3) A final decision of the a disciplinary subcommittee

imposing a sanction under this article, article 7, or article 8 or

a final decision of the a disciplinary subcommittee other than a

final decision described in subsection (2) requires a majority vote

of the members appointed and serving on the disciplinary

subcommittee with an affirmative vote by at least 1 public member.

     (4) The chairperson of each disciplinary subcommittee shall be

a public member and shall be appointed by the chair of the a board

or task force shall appoint a public member of the disciplinary

subcommittee of that board or task force as the chairperson of that

disciplinary subcommittee. The chair of a board or task force shall

not serve as a member of the disciplinary subcommittee of that

board or task force.

     (5) The department may review a final decision of the a

disciplinary subcommittee within 30 days after the date of the

disciplinary subcommittee's decision. If the department determines

that the action taken by the a disciplinary subcommittee does not

protect the health, safety, and welfare of the public, the

department, with the approval of the board chair, may set aside the

decision of the disciplinary subcommittee and issue a different

final action. The final action of the department shall serve serves

as the final action on the matter and is subject to judicial review

in the same manner as the final decision of the disciplinary

subcommittee.

     (6) Beginning January 1, 2015, the department shall include on

its public licensing and registration website each final decision

where that imposes disciplinary action is taken against a licensee,

including the reason for and description of that disciplinary

action.

     Sec. 16245. (1) Except as otherwise provided in this section

or section 16245a, an individual whose license is limited,

suspended, or revoked under this part may apply to his or her board

or task force for a reinstatement of a revoked or suspended license

or reclassification of a limited license pursuant to section 16247

or 16249.

     (2) Except as otherwise provided in this section or section

16245a, an individual whose registration is suspended or revoked

under this part may apply to his or her board for a reinstatement

of a suspended or revoked registration pursuant to section 16248.

     (3) A board or task force shall reinstate a license or

registration suspended for grounds stated in section 16221(j) upon

payment of the installment.

     (4) Except as otherwise provided in this subsection, section

or section 16245a, in case of a revoked license or registration, an

applicant shall not apply for reinstatement before the expiration

of 3 years after the effective date of the revocation. In Except as

otherwise provided in this section or section 16245a, in the case

of a license or registration that was revoked for a violation of

section 16221(b)(vii) or (xiii), a violation of section 16221(c)(iv)

consisting of a felony conviction, any other felony conviction

involving a controlled substance, or a violation of section

16221(q), an applicant shall not apply for reinstatement before the

expiration of 5 years after the effective date of the revocation.

In the case of a license or registration that was permanently

revoked for a violation of section 16221(b)(xiii), the former

licensee or registrant is ineligible for reinstatement. The

department shall return an application for reinstatement received

before the expiration of the applicable time period under this

subsection. or if the applicant is ineligible for reinstatement

under this subsection.

     (5) The department shall provide an opportunity for a hearing

before final rejection of an application for reinstatement unless

the application is returned because the applicant is ineligible for

reinstatement under subsection (4) or (9).

     (6) Based upon the recommendation of the disciplinary

subcommittee for each health profession, the department shall adopt

guidelines to establish specific criteria to be met by an applicant

for reinstatement under this article, article 7, or article 8. The

criteria may include corrective measures or remedial education as a

condition of reinstatement. If a board or task force, in

reinstating a license or registration, deviates from the guidelines

adopted under this subsection, the board or task force shall state

the reason for the deviation on the record.

     (7) An individual who seeks reinstatement or reclassification

of a license or registration pursuant to under this section shall

pay the application processing fee as a reinstatement or

reclassification fee. If approved for reinstatement or

reclassification, the individual shall pay the per year license or

registration fee for the applicable license or registration period.

     (8) An individual who seeks reinstatement of a revoked or

suspended license or reclassification of a limited license under

this section shall have a criminal history check conducted in

accordance with section 16174 and submit a copy of the results of

the criminal history check to the board with his or her application

for reinstatement or reclassification.

     (9) An individual whose license is permanently revoked under

section 16221 is ineligible for reinstatement. The department shall

return an application for reinstatement received if the applicant

is ineligible for reinstatement under this subsection.

     Sec. 16245a. (1) In addition to any other penalty, remedy, or

sanction under this act, an individual whose license, registration,

or authorization to engage in the practice of a health profession

has been permanently revoked under this article is permanently

ineligible for a license, registration, or authorization to engage

in the practice of a health profession under this article by the

department or a board or task force.

     (2) The department or a board or task force shall not issue a

license or registration to an individual whose license,

registration, or authorization to engage in the practice of a

health profession has been permanently revoked under this article.

The department or a board or task force shall not otherwise

authorize an individual to engage in the practice of a health

profession under this article if that individual's license,

registration, or authorization to engage in the practice of a

health profession has been permanently revoked under this article.

     Sec. 16247. (1) A Except as otherwise provided in this

section, a board or task force may reinstate a license or issue a

limited license to an individual whose license has been suspended

or revoked under this part if after a hearing the board or task

force is satisfied by clear and convincing evidence that the

applicant is of good moral character, is able to practice the

profession with reasonable skill and safety to patients, has met

the criteria in the rules promulgated guidelines adopted under

section 16245(6), and should be permitted in the public interest to

practice. Pursuant to the rules promulgated guidelines adopted

under section 16245(6), as a condition of reinstatement, a

disciplinary subcommittee, upon the recommendation of a board or

task force, may impose a disciplinary or corrective measure

authorized under this part and require that the licensee attend a

school or program selected by the board or task force to take

designated courses or training to become competent or proficient in

those areas of practice in which the board or task force finds the

licensee to be deficient. The board or task force may require a

statement on a form approved by it from the chief administrator of

the school or program attended or the person responsible for the

training certifying that the licensee has achieved the required

competency or proficiency.

     (2) As a condition of reinstatement, a board or task force

shall place the licensee on probation for 1 year under conditions

set by the board or task force. If a licensee whose license has

been revoked cannot apply for reinstatement for 5 years after the

date of revocation, then, as a condition of reinstatement, the

board or task force shall require the licensee to take and pass the

current licensure examination.

     (3) A board or task force shall not reinstate a license

suspended or revoked for grounds stated in section 16221(b)(i),

(iii), or (iv) until it finds that the licensee is mentally or

physically able to practice with reasonable skill and safety to

patients. The board or task force may require further examination

of the licensee, at the licensee's expense, necessary to verify

that the licensee is mentally or physically able. A The board or

task force shall give a licensee affected by described in this

section shall be afforded the opportunity at reasonable intervals

to demonstrate that he or she can resume competent practice in

accordance with standards of acceptable and prevailing practice.

     (4) A board or task force shall not reinstate a license or

issue a limited license to an individual whose license has been

permanently revoked under section 16221.

     Sec. 16248. (1) A Except as otherwise provided in this

section, a registration board may reinstate a registration revoked

or suspended under this part if, after a hearing, the board is

satisfied by clear and convincing evidence that the individual is

of good moral character, has the education and experience as

required in this article, has met the criteria in the rules

promulgated guidelines adopted under section 16245(6), and will use

the title lawfully and act in accordance with this article.

     (2) A board or task force shall not reinstate a registration

or issue a limited registration to an individual whose license has

been permanently revoked under section 16221.

     Sec. 16249. A Except as otherwise provided in section 16245a,

a disciplinary subcommittee may reclassify a license limited under

this part to alter or remove the limitations if, after a hearing,

it is satisfied that the applicant will practice the profession

safely and competently within the area of practice and under

conditions stipulated by the disciplinary subcommittee, and should

be permitted in the public interest to so practice. The

disciplinary subcommittee may require the submission of information

necessary to make the determination required for reclassification.

As a condition of reclassification, the disciplinary subcommittee

may require that the licensee take an examination or attend a

school or program selected by the disciplinary subcommittee to take

designated courses or training to become competent in those areas

of practice the disciplinary subcommittee determines necessary for

House Bill No. 5842 as amended December 15 and 18, 2014      (1 of 8)

reclassification. The disciplinary subcommittee may require a

statement on a form approved by it from the chief administrator of

the school or program attended or the person responsible for the

training certifying that the licensee has achieved the required

competency.

<<Sec. 17711. (1) A person An individual shall not engage in the

practice of pharmacy or serve as a pharmacy technician unless licensed

or otherwise authorized by this article. Beginning June 30, 2015, an

individual shall not serve as a pharmacy technician unless licensed or

otherwise authorized by this article.

(2) The following words, titles, or letters or a combination of

words, titles, or letters, with or without qualifying words or phrases,

are restricted in use only to those persons authorized under this part

to use the terms and in a way prescribed in this part: "pharmacy",

"pharmacist", "Pharm.D", "doctor of pharmacy", "pharmacy intern",

"pharmacy technician", "licensed pharmacy technician", "certified pharmacy technician", "CPhT", "apothecary", "dispensary", "drugstore", "druggist", "medicine store", "prescriptions", and "r.ph.".

<<Sec. 17748. (1) To do business in this state, a pharmacy,

manufacturer, or wholesale distributor, whether or not located in

this state, must be licensed under this part. To do business in this state, a person that provides compounding services must be licensed as

a pharmacy or manufacturer under this part and, if a pharmacy,

authorized to provide compounding services under this section and

sections 17748a and 17748b. To do business in this state, an

outsourcing facility must be licensed as a pharmacy under this part.

Licenses are renewable biennially.

     (2) A pharmacy shall designate a pharmacist licensed in this

state as the pharmacist in charge for the pharmacy. A Except as

otherwise provided in this subsection, a manufacturer or wholesale

distributor shall designate a pharmacist licensed in or outside of

this state as the pharmacist in charge for the manufacturer. or

Except as otherwise provided in this subsection, a wholesale

distributor shall designate a pharmacist licensed in or outside of

this state as the pharmacist in charge for the wholesale

distributor or shall designate an employee with the appropriate

education or experience, or both, to assume responsibility for

compliance with licensing requirements as facility manager for the

wholesale distributor. The pharmacy, manufacturer, or wholesale

distributor and the individual designated as the PIC or facility

manager under this subsection are jointly responsible for the

pharmacy's, manufacturer's, or wholesale distributor's compliance

with this part and rules promulgated under this part. A person that

is a manufacturer or wholesale distributor with respect to a device

salable on prescription only but not with respect to any drug

salable on prescription only is exempt from this subsection.

(3) Subject to this subsection, a pharmacist may be designated

as the PIC for more than 1 pharmacy. A PIC described in this

subsection shall work an average of at least 8 hours per week at

each pharmacy for which he or she is the PIC. The pharmacy and the

PIC shall maintain appropriate records and demonstrate compliance

with this subsection upon the request of the board or its designee.

(4) A pharmacy, manufacturer, or wholesale distributor shall

report to the department a change in ownership, management,

location, or its PIC or facility manager designated PIC under

subsection (2) not later than 30 days after the change occurs.

(5) A pharmacist in charge designated as the PIC for a

pharmacy shall supervise the practice of pharmacy for the pharmacy.

in which he or she has been designated the PIC. The duties of the

PIC include, but are not limited to, the following:

(a) Supervision of all activities of pharmacy employees as

they relate to the practice of pharmacy including the purchasing,

storage, compounding, repackaging, dispensing, and distribution of

drugs and devices to ensure that those activities are performed in

compliance with this part and the rules promulgated under this

part.

(b) Enforcement and oversight of policies and procedures

applicable to the employees of the pharmacy for the procurement,

storage, compounding, and dispensing of drugs and the communication

of information to the patient in relation to drug therapy.

(c) Establishment and supervision of the method and manner for

storage and safekeeping of pharmaceuticals, including maintenance

of security provisions to be used when the pharmacy is closed.

(d) Establishment and supervision of the record-keeping system

for the purchase, sale, delivery, possession, storage, and

safekeeping of drugs and devices.

(e) Establishment of policies and procedures for individuals

who are delegated responsibilities for any of the tasks described

in this subsection by the PIC.

(6) Except as otherwise provided in this subsection, an

applicant for a new pharmacy, manufacturer, or wholesale

distributor license under this part who is not a health

professional licensed or otherwise authorized to engage in a health

profession under this article or who is a health professional but

was licensed or otherwise authorized to engage in his or her health

profession under this article before October 1, 2008 shall submit

fingerprints in the same manner as required in section 16174 for

the purpose of a criminal history check. The board, department, and

department of state police shall comply with section 16174 for the

purpose of a criminal history check on an applicant described in

this subsection. This subsection does not apply if a criminal

history check that meets the requirements of section 16174 has been

was obtained for the applicant within the 2 years preceding the

date of the application. To qualify for the exception under this

subsection, the applicant shall submit proof of the previous

criminal history check with his or her application for a new

pharmacy, manufacturer, or wholesale distributor license under this

part. If the department or board determines that the criminal

history check does not meet the requirements of section 16174 or

was not obtained within the time period prescribed, the applicant

shall comply with this subsection.submit fingerprints in the same

manner as required in section 16174.

(7) If, as authorized or required under this article, the

department inspects or investigates an applicant for a new pharmacy

license for a pharmacy that will provide compounding services or a

compounding pharmacy, which and the applicant or compounding

pharmacy is located outside of this state, the applicant or

compounding pharmacy shall reimburse the department for its

expenses incurred in carrying out its authority or duty to inspect

or investigate the applicant or licensee under this article.

Sec. 17768. (1) In a manner consistent with part 161, the

disciplinary subcommittee may fine, reprimand, or place on

probation , a person licensed under this part, or may deny, limit,

suspend, or revoke a person's license, or may order restitution or

community service for a violation of this part or rules promulgated

under this part.

(2) In addition to the grounds set forth in subsection (1),

and in a manner consistent with part 161, the board may fine,

reprimand, or place on probation a person licensed under this part,

or may deny, limit, suspend, or revoke a license issued under this

part, or may order restitution or community service if the board

finds that any of the following categories apply to an applicant;

or a partner, officer, or member of the board of directors of a

pharmacy, manufacturer, or wholesale distributor licensed under

this part; or a stockholder of a pharmacy, manufacturer, or

wholesale distributor which that is a privately held corporation

licensed under this part; or a facility manager for a wholesale

distributor designated under section 17748(2):

(a) The applicant or other person described in this subsection

lacks good moral character.

(b) Subject to subsection (3), the applicant or other person

described in this subsection has been convicted of a misdemeanor or

a felony under a state or federal law relating to a controlled

substance or the practice of pharmacy.

(c) The applicant or other person described in this subsection

has furnished false or fraudulent material information or has

knowingly omitted material information in an application filed

under this part.

(d) The applicant or other person described in this subsection

has previously maintained a financial interest in a pharmacy,

manufacturer, or wholesale distributor which that has been denied a license or federal registration, has had its license or federal registration limited, suspended, or revoked, or has been subject to any other criminal, civil, or administrative penalty.

(e) The applicant or other person described in this subsection

is not in compliance with article 7 or article 8 or the rules

promulgated under article 7 or article 8.

(f) The applicant or other person described in this subsection

has violated section 17748.

(3) Except for a conviction for a misdemeanor under section

7404(2)(d) or a local ordinance that is substantially similar to

section 7404(2)(d), the reference to a misdemeanor in subsection

(2)(b) applies only to a conviction for a misdemeanor that is

directly related to the manufacture, delivery, possession,

possession with intent to manufacture or deliver, use,

distribution, prescription, or dispensing of a controlled

substance. Subsection (2)(b) does not apply to a conviction for a

misdemeanor based upon an unintentional error or omission involving

a clerical or record-keeping function.

Sec. 20920. (1) A person shall not establish, operate, or cause

to be operated an ambulance operation unless the ambulance operation is

licensed under this section.

     (2) Upon proper application and payment of a $100.00 fee, the

department shall issue a license as an ambulance operation to a person

who meets the requirements of this part and the rules promulgated

under this part.

     (3) An applicant shall specify in the application each ambulance

to be operated.

     (4) An ambulance operation license shall specify the ambulances

licensed to be operated.

     (5) An ambulance operation license shall state the highest

level of life support the ambulance operation is licensed to provide.

An ambulance operation shall operate in accordance with this part,

rules promulgated under this part, and approved medical control

authority protocols and, except as provided in section 20921a(2),

shall not provide life support at a level that exceeds its license and

available licensed personnel or violates approved medical control

authority protocols.

     (6) An ambulance operation license may be renewed annually upon

application to the department and payment of a $100.00 renewal fee.

Before issuing a renewal license, the department shall determine that

the ambulance operation is in compliance with this part, the rules

promulgated under this part, and medical control authority protocols.

     (7) Beginning on July 22, 1997, an ambulance operation that meets

all of the following requirements may apply for an ambulance operation

upgrade license under subsection (8):

(a) On or before July 22, 1997, holds an ambulance operation

license that designates the ambulance operation either as a transporting

basic life support service or as a transporting limited advanced life

support service.

(b) Is a transporting basic life support service, that is able to

staff and equip 1 or more ambulances for the transport of emergency

patients at a life support level higher than basic life support, or

is a transporting limited advanced life support service, that is able

to staff and equip 1 or more ambulances for the transport of emergency

patients at the life support level of advanced life support.

(c) Is owned or operated by or under contract to a local unit of

government and providing first-line emergency medical response to that

local unit of government on or before July 22, 1997.

(d) Will provide the services described in subdivision (b) only

to the local unit of government described in subdivision (c), and only

in response to a 911 call or other call for emergency transport.

     (8) An ambulance operation meeting the requirements of subsection

(7) that applies for an ambulance operation upgrade license shall

include all of the following information in the application provided by

the department:

(a) Verification of all of the requirements of subsection (7)

including, but not limited to, a description of the staffing and

equipment to be used in providing the higher level of life support

services.

(b) If the applicant is a transporting basic life support service,

a plan of action to upgrade from providing basic life support to

providing limited advanced life support or advanced life support

to take place over a period of not more than 2 years. If the applicant

is a transporting limited advanced life support service, a plan of

action to upgrade from providing limited advanced life support to

providing advanced life support to take place over a period of not

more than 2 years.

(c) The medical control authority protocols for the ambulance

operation upgrade license, along with a recommendation from the medical

control authority under which the ambulance operation operates that the

ambulance operation upgrade license be issued by the department.

     (d) Other information required by the department.

     (9) The statewide emergency medical services coordination committee

shall review the information described in subsection (8)(c) and make a

recommendation to the department as to whether or not an ambulance

operation upgrade license should be granted to the applicant.

     (10) Upon receipt of a completed application as required under

subsection (8), a positive recommendation under subsection (9), and

payment of a $100.00 fee, the department shall issue to the applicant

an ambulance operation upgrade license. Subject to subsection (12),

the license is valid for 2 years from the date of issuance and is

renewable for 1 additional 2-year period. An application for renewal

of an ambulance operation upgrade license shall contain documentation

of the progress made on the plan of action described in subsection

(8)(b). In addition, the medical control authority under which the

ambulance operation operates shall annually file with the statewide

emergency medical services coordination committee a written report on

the progress made by the ambulance operation on the plan of action

described in subsection (8)(b), including, but not limited to,

information on training, equipment, and personnel.

     (11) If an ambulance operation is designated by its regular

license as providing basic life support services, then an ambulance

operation upgrade license issued under this section allows the

ambulance operation to provide limited advanced life support services

or advanced life support services when the ambulance operation is able

to staff and equip 1 or more ambulances to provide services at the

higher levels. If an ambulance operation is designated by its regular

license as providing limited advanced life support services, then

an ambulance operation upgrade license issued under this section

allows the ambulance operation to provide advanced life support

services when the ambulance operation is able to staff and equip 1

or more ambulances to provide services at the higher level. An

ambulance operation shall not provide services under an ambulance

operation upgrade license unless the medical control authority under

which the ambulance operation operates has adopted protocols for the

ambulance operation upgrade license regarding quality monitoring

procedures, use and protection of equipment, and patient care.

     (12) The department may revoke or fail to renew an ambulance

operation upgrade license for a violation of this part or a rule

promulgated under this part or for failure to comply with the plan

of action filed under subsection (8)(b). An ambulance operation that

obtains an ambulance operation upgrade license must annually renew

its regular license under subsections (2) to (6). An ambulance

operation's regular license is not affected by the following:

(a) The fact that the ambulance operation has obtained or

renewed an ambulance operation upgrade license.

(b) The fact that an ambulance operation's ambulance operation

upgrade license is revoked or is not renewed under this subsection.

(c) The fact that the ambulance operation's ambulance operation

upgrade license expires at the end of the second 2-year period

prescribed by subsection (10).

     (13) By July 22, 2000, the department shall file a written report

to the legislature. The department shall include all of the following

information in the report:

     (a) The number of ambulance operations that were qualified under

subsection (7) to apply for an ambulance operation upgrade license under

subsection (8) during the 3-year period.

     (b) The number of ambulance operations that in fact applied for an

ambulance operation upgrade license during the 3-year period.

     (c) The number of ambulance operations that successfully upgraded

from being a transporting basic life support service to a transporting

limited advanced service or a transporting advanced life support service

or that successfully upgraded from being a transporting limited advanced

life support service to a transporting advanced life support service

under an ambulance operation upgrade license.

(d) The number of ambulance operations that failed to successfully

upgrade, as described in subdivision (c), under an ambulance operation

upgrade license, but that improved their services during the 3-year

period.

(e) The number of ambulance operations that failed to successfully

upgrade, as described in subdivision (c), under an ambulance operation

upgrade license, and that showed no improvement or a decline in their

services.

(f) The effect of the amendatory act that added this subsection on

the delivery of emergency medical services in this state.

     Sec. 20921. (1) An ambulance operation shall do all of the

following:

(a) Provide Except as provided in section 20921a, provide at

least 1 ambulance available for response to requests for emergency

assistance on a 24-hour-a-day, 7-day-a-week basis in accordance with

local medical

control authority protocols.

(b) Respond or ensure that a response is provided to each

request for emergency assistance originating from within the bounds

of its service area.

(c) Operate under the direction of a medical control authority

or the medical control authorities with jurisdiction over the ambulance

operation.

(d) Notify the department immediately of a change that would

alter the information contained on its application for an ambulance

operation

license or renewal.

(e) Subject to section 20920(7) to (12) and section 20921a,

provide life support consistent with its license and approved local

medical control authority protocols to each emergency patient without

prior inquiry into ability to pay or source of payment.

     (2) An ambulance operation shall not do 1 or more any of the

following:

(a) Knowingly provide a person with false or misleading

information concerning the time at which an emergency response will be

initiated or the location from which the response is being initiated.

(b) Induce or seek to induce any person engaging an ambulance to

patronize a long-term care facility, mortuary, or hospital.

(c) Advertise, or permit advertising of, within or on the

premises of the ambulance operation or within or on an ambulance, the

name or the services of an attorney, accident investigator, nurse,

physician, long-term care facility, mortuary, or hospital. If 1 of

those persons or facilities owns or operates an ambulance operation,

the person or facility may use its business name in the name of the

ambulance operation and may display the name of the ambulance operation

within or on the premises of the ambulance operation or within or on an

ambulance.

(d) Advertise or disseminate information for the purpose of

obtaining contracts under a name other than the name of the person

holding an ambulance operation license or the trade or assumed name of

the ambulance operation.

(e) If the ambulance operation is operating under an ambulance

operation upgrade license issued under section 20920(7) to (12),

advertise or otherwise hold itself out as a full-time transporting

limited advanced life support service or a full-time transporting

advanced life support service unless the ambulance operation

actually provides those services on a 24-hour-per-day, 7-day-a-week

basis.

     (3) Except as provided in subsection (4) and section 20921a,

an ambulance operation shall not operate, attend, or permit an

ambulance to be operated while transporting a patient unless the

ambulance is, at a minimum, staffed as follows:

(a) If designated as providing basic life support, with at

least 1 emergency medical technician and 1 medical first responder.

(b) If designated as providing limited advanced life support,

with at least 1 emergency medical technician specialist and 1

emergency medical technician.

(c) If designated as providing advanced life support, with at

least 1 paramedic and 1 emergency medical technician.

     (4) An ambulance operation that is licensed to provide advanced

life support and has more than 1 ambulance licensed under its

operation may operate an ambulance licensed to provide basic life

support or limited advanced life support at a higher level of life

support if all of the following are met:

(a) The ambulance operation has at least 1 ambulance under its

operation that is properly staffed and available to provide advanced

life support on a 24-hour-a-day, 7-day-a-week basis.

(b) The licensed personnel required to operate at that higher

level of life support are available at the scene and in the ambulance

during the patient transport to provide life support to that patient

at that higher level.

(c) The ambulance meets all equipment and communication

requirements to operate at that higher level of life support.

(d) The ambulance operation that is unable to respond to a

request for emergency assistance immediately requests assistance

pursuant to protocols established by the local medical control

authority and approved by the department under this part.

     (5) Except as provided in subsection (6), an ambulance

operation shall ensure that an emergency medical technician, an

emergency medical technician specialist, or a paramedic is in the

patient compartment of an ambulance while transporting an emergency

patient.

     (6) Subsection (5) does not apply to the transportation of a

patient by an ambulance if the patient is accompanied in the patient

compartment of the ambulance by an appropriate licensed health

professional designated by a physician and after a physician-patient

relationship has been established as prescribed in this part or the

rules promulgated by the department under this part.

Sec. 20921a. (1) A limited or advanced ambulance operation whose

primary service area is in a county or micropolitan area with a

population of 10,000 or less and whose primary service area has a

population density of less than 7 people per square mile may have an

ambulance available at less than the limited or advanced level of

licensure if both of the following conditions are met:

(A) The medical control authority under which the ambulance

operation operates authorizes the lesser availability.

(B) The advanced ambulance operation has department–approved

local medical control authority protocols in place.

     (2) A basic ambulance operation whose primary service area is

in a county or micropolitan area with a population of 10,000 or less

and whose primary service area has a population density of less than 7

people per square mile may operate at an increased level of licensure

when staffed with an EMT-specialist or EMT-paramedic, if all of the

following conditions are met:

     (a) The basic ambulance is equipped at the greater licensure level.

     (b) The medical control authority under which the ambulance

operation operates authorizes the conditional increased level of

licensure.

(C) The basic ambulance operation has department–approved local

medical control authority protocols in place.

     (3) As used in this section, "micropolitan area" means a

micropolitan statistical area as most recently delineated by the

United States office of management and budget.

Enacting section 1. Section 20921a of the public health code,

1978 PA 368, MCL 333.20921a, is repealed effective January 1, 2018.>>

     Enacting section <<2>>. This amendatory act takes effect 90 days

after the date it is enacted into law.

     Enacting section <<3>>. This amendatory act does not take effect

unless all of the following bills of the 97th Legislature are

enacted into law:

     (a) House Bill No. 5839.

     (b) House Bill No. 5840.

     (c) House Bill No. 5841.