Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 303 Sixth Substitute (2021GS)

Sponsor

Rep. Johnson, D.N.

Final action

Governor Signed 3/17/2021

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• requires municipalities and counties to ensure at least a minimum level of 911 ambulance services are provided within the municipality or county;
• extends certain requirements for the selection of ambulance and paramedic providers to all other municipalities, counties, local districts, and special service districts;
• requires the State Emergency Medical Services Committee to adopt rules establishing the minimum level of 911 ambulance services provided within municipalities and counties;
• allows the Department of Health to align the boundaries of an ambulance or paramedic provider's exclusive geographic service area with the boundaries of a political subdivision in certain circumstances;
• allows a political subdivision to terminate a contract with a 911 ambulance services provider in certain circumstances;
• modifies provisions related to the Department of Health's renewal of certain licenses; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

EMERGENCY MEDICAL SERVICES REVISIONS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Dan N. Johnson
Senate Sponsor: 
Curtis S. Bramble
LONG TITLE
General Description:
This bill amends provisions related to emergency medical services.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ requires municipalities and counties to ensure at least a minimum level of 911
ambulance services are provided within the municipality or county;
▸ extends certain requirements for the selection of ambulance and paramedic
providers to all other municipalities, counties, local districts, and special service
districts;
▸ requires the State Emergency Medical Services Committee to adopt rules
establishing the minimum level of 911 ambulance services provided within
municipalities and counties;
▸ allows the Department of Health to align the boundaries of an ambulance or
paramedic provider's exclusive geographic service area with the boundaries of a
political subdivision in certain circumstances;
▸ allows a political subdivision to terminate a contract with a 911 ambulance services
provider in certain circumstances;
▸ modifies provisions related to the Department of Health's renewal of certain
licenses; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
11-48-102
, as enacted by Laws of Utah 2011, Chapter 230
26-8a-102
, as last amended by Laws of Utah 2019, Chapter 265
26-8a-104
, as last amended by Laws of Utah 2017, Chapter 326
26-8a-401
, as enacted by Laws of Utah 1999, Chapter 141
26-8a-402
, as last amended by Laws of Utah 2000, Chapter 1
26-8a-405.1
, as last amended by Laws of Utah 2010, Chapter 187
26-8a-405.4
, as last amended by Laws of Utah 2019, Chapter 265
26-8a-405.5
, as last amended by Laws of Utah 2012, Chapter 347
26-8a-413
, as last amended by Laws of Utah 2011, Chapter 297
ENACTS:
11-48-101.5
, Utah Code Annotated 1953
11-48-103
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
11-48-101.5
 is enacted to read:
 11-48-101.5.
Definitions.
As used in this chapter:
(1) (a) "911 ambulance services" means ambulance services rendered in response to a
call received by a designated dispatch center that receives 911 or E911 calls.
(b) "911 ambulance services" does not mean a seven or ten digit telephone call
received directly by an ambulance provider licensed under Title 26, Chapter 8a, Utah
Emergency Medical Services System Act.
(2) "Municipality" means a city, town, or metro township.
(3) "Political subdivision" means a county, city, town, local district, or special district.
Section 2. Section 
11-48-102
 is amended to read:
11-48-102.
Prohibition of response fees.
[
(1) As used in this section, "political subdivision" means a county, city, town, local
district, or special district.
]
[
(2)
] 
(1)
 A political subdivision, or a person who contracts with a political subdivision
to provide emergency services:
(a) may not impose a flat fee, or collect a flat fee, from an individual involved in a
traffic incident; and
(b) may only charge the individual for the actual cost of services provided in
responding to the traffic incident, limited to:
(i) medical costs for:
(A) transporting an individual from the scene of a traffic accident; or
(B) treatment of [
a person
] 
an individual
 injured in a traffic accident;
(ii) repair to damaged public property, if the individual is legally liable for the damage;
(iii) the cost of materials used in cleaning up the traffic accident, if the individual is
legally liable for the traffic accident; and
(iv) towing costs.
[
(3)
] 
(2)
 If a political subdivision, or a person who contracts with a political
subdivision to provide emergency services, imposes a charge on more than one individual for
the actual cost of responding to a traffic incident, the political subdivision or person contracting
with the political subdivision shall apportion the charges so that [
it
] 
the political subdivision or
person contracting with the political subdivision
 does not receive more for responding to the
traffic incident than the actual response cost.
Section 3. Section 
11-48-103
 is enacted to read:
 11-48-103.
Provision of 911 ambulance services in municipalities and counties.
(1) The governing body of each municipality and county shall, subject to Title 26,
Chapter 8a, Part 4, Ambulance and Paramedic Providers, ensure at least a minimum level of
ambulance services are provided:
(a) within the territorial limits of the municipality or county;
(b) by a ground ambulance provider, licensed by the Department of Health under Title
26, Chapter 8a, Part 4, Ambulance and Paramedic Providers; and
(c) in accordance with rules established by the State Emergency Medical Services
Committee under Subsection 
26-8a-104
(8).
(2) A municipality or county may:
(a) subject to Subsection (3), maintain and support 911 ambulance services for the
municipality's or county's own jurisdiction; or
(b) contract to:
(i) provide 911 ambulance services to any county, municipal corporation, local district,
special service district, interlocal entity, private corporation, nonprofit corporation, state
agency, or federal agency;
(ii) receive 911 ambulance services from any county, municipal corporation, local
district, special service district, interlocal entity, private corporation, nonprofit corporation,
state agency, or federal agency;
(iii) jointly provide 911 ambulance services with any county, municipal corporation,
local district, special service district, interlocal entity, private corporation, nonprofit
corporation, state agency, or federal agency; or
(iv) contribute toward the support of 911 ambulance services in any county, municipal
corporation, local district, special service district, interlocal entity, private corporation,
nonprofit corporation, state agency, or federal agency in return for 911 ambulance services.
(3) (a) A municipality or county that maintains and supports 911 ambulance services
for the municipality's or county's own jurisdiction under Subsection (2)(a) shall obtain a license
as a ground ambulance provider from the Department of Health under Title 26, Chapter 8a,
Part 4, Ambulance and Paramedic Providers.
(b) Subsections 
26-8a-405
 through 
26-8a-405.3
 do not apply to a license described in
Subsection (3)(a).
Section 4. Section 
26-8a-102
 is amended to read:
26-8a-102.
Definitions.
As used in this chapter:
(1) (a) "911 ambulance or paramedic services" means:
(i) either:
(A) 911 ambulance service;
(B) 911 paramedic service; or
(C) both 911 ambulance and paramedic service; and
(ii) a response to a 911 call received by a designated dispatch center that receives 911
or E911 calls.
(b) "911 ambulance or paramedic [
service
] 
services
" does not mean a seven or ten digit
telephone call received directly by an ambulance provider licensed under this chapter.
(2) "Ambulance" means a ground, air, or water vehicle that:
(a) transports patients and is used to provide emergency medical services; and
(b) is required to obtain a permit under Section 
26-8a-304
 to operate in the state.
(3) "Ambulance provider" means an emergency medical service provider that:
(a) transports and provides emergency medical care to patients; and
(b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
(4) "Committee" means the State Emergency Medical Services Committee created by
Section 
26-1-7
.
(5) "Direct medical observation" means in-person observation of a patient by a
physician, registered nurse, physician's assistant, or individual licensed under Section
26-8a-302
.
(6) "Emergency medical condition" means:
(a) a medical condition that manifests itself by symptoms of sufficient severity,
including severe pain, that a prudent layperson, who possesses an average knowledge of health
and medicine, could reasonably expect the absence of immediate medical attention to result in:
(i) placing the individual's health in serious jeopardy;
(ii) serious impairment to bodily functions; or
(iii) serious dysfunction of any bodily organ or part; or
(b) a medical condition that in the opinion of a physician or [
his
] 
the physician's
designee requires direct medical observation during transport or may require the intervention of
an individual licensed under Section 
26-8a-302
 during transport.
(7) "Emergency medical service personnel":
(a) means an individual who provides emergency medical services to a patient and is
required to be licensed under Section 
26-8a-302
; and
(b) includes a paramedic, medical director of a licensed emergency medical service
provider, emergency medical service instructor, and other categories established by the
committee.
(8) "Emergency medical service providers" means:
(a) licensed ambulance providers and paramedic providers;
(b) a facility or provider that is required to be designated under Subsection
26-8a-303
(1)(a); and
(c) emergency medical service personnel.
(9) "Emergency medical services" means medical services, transportation services, or
both rendered to a patient.
(10) "Emergency medical service vehicle" means a land, air, or water vehicle that is:
(a) maintained and used for the transportation of emergency medical personnel,
equipment, and supplies to the scene of a medical emergency; and
(b) required to be permitted under Section 
26-8a-304
.
(11) "Governing body":
(a) [
is as
] 
means the same as that term is
 defined in Section 
11-42-102
; and
(b) for purposes of a "special service district" under Section 
11-42-102
, means a
special service district that has been delegated the authority to select a provider under this
chapter by the special service district's legislative body or administrative control board.
(12) "Interested party" means:
(a) a licensed or designated emergency medical services provider that provides
emergency medical services within or in an area that abuts an exclusive geographic service area
that is the subject of an application submitted pursuant to Part 4, Ambulance and Paramedic
Providers;
(b) any municipality, county, or fire district that lies within or abuts a geographic
service area that is the subject of an application submitted pursuant to Part 4, Ambulance and
Paramedic Providers; or
(c) the department when acting in the interest of the public.
(13) "Medical control" means a person who provides medical supervision to an
emergency medical service provider.
(14) "Non-911 service" means transport of a patient that is not 911 transport under
Subsection (1).
(15) "Nonemergency secured behavioral health transport" means an entity that:
(a) provides nonemergency secure transportation services for an individual who:
(i) is not required to be transported by an ambulance under Section 
26-8a-305
; and
(ii) requires behavioral health observation during transport between any of the
following facilities:
(A) a licensed acute care hospital;
(B) an emergency patient receiving facility;
(C) a licensed mental health facility; and
(D) the office of a licensed health care provider; and
(b) is required to be designated under Section 
26-8a-303
.
(16) "Paramedic provider" means an entity that:
(a) employs emergency medical service personnel; and
(b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
(17) "Patient" means an individual who, as the result of illness or injury, meets any of
the criteria in Section 
26-8a-305
.
(18) "Political subdivision" means:
(a) a city [
or
]
,
 town [
located in a county of the first or second class as defined in
Section 
17-50-501
]
, or metro township
;
(b) a county [
of the first or second class
];
[
(c) the following districts located in a county of the first or second class:
]
[
(i)
] 
(c)
 a special service district created under Title 17D, Chapter 1, Special Service
District Act
, for the purpose of providing fire protection services under Subsection
17D-1-201
(9)
; [
or
]
[
(ii)
] 
(d)
 a local district 
created
 under Title 17B, Limited Purpose Local Government
Entities - Local Districts, for the purpose of providing fire protection, paramedic, and
emergency services;
[
(d)
] 
(e)
 areas coming together as described in Subsection 
26-8a-405.2
(2)(b)(ii); 
or
[
(e)
] 
(f)
 an interlocal entity under Title 11, Chapter 13, Interlocal Cooperation Act[
;
or
]
.
[
(f) a special service district for fire protection service under Subsection
17D-1-201
(9).
]
(19) "Trauma" means an injury requiring immediate medical or surgical intervention.
(20) "Trauma system" means a single, statewide system that:
(a) organizes and coordinates the delivery of trauma care within defined geographic
areas from the time of injury through transport and rehabilitative care; and
(b) is inclusive of all prehospital providers, hospitals, and rehabilitative facilities in
delivering care for trauma patients, regardless of severity.
(21) "Triage" means the sorting of patients in terms of disposition, destination, or
priority. For prehospital trauma victims, triage requires a determination of injury severity to
assess the appropriate level of care according to established patient care protocols.
(22) "Triage, treatment, transportation, and transfer guidelines" means written
procedures that:
(a) direct the care of patients; and
(b) are adopted by the medical staff of an emergency patient receiving facility, trauma
center, or an emergency medical service provider.
Section 5. Section 
26-8a-104
 is amended to read:
26-8a-104.
Committee advisory duties.
The committee shall adopt rules , with the concurrence of the department, in accordance
with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, that:
(1) establish licensure and reciprocity requirements under Section 
26-8a-302
;
(2) establish designation requirements under Section 
26-8a-303
;
(3) promote the development of a statewide emergency medical services system under
Section 
26-8a-203
;
(4) establish insurance requirements for ambulance providers;
(5) provide guidelines for requiring patient data under Section 
26-8a-203
;
(6) establish criteria for awarding grants under Section 
26-8a-207
;
(7) establish requirements for the coordination of emergency medical services and the
medical supervision of emergency medical service providers under Section 
26-8a-306
; [
and
]
(8) establish the minimum level of service for 911 ambulance services provided under
Section 
11-48-103
; and
[
(8)
] 
(9)
 are necessary to carry out the responsibilities of the committee as specified in
other sections of this chapter.
Section 6. Section 
26-8a-401
 is amended to read:
26-8a-401.
State regulation of emergency medical services market -- License
term.
(1) To ensure emergency medical service quality and minimize unnecessary
duplication, the department shall regulate the emergency medical [
service
] 
services
 market
[
after October 1, 1999,
] by creating and operating a statewide system that:
(a) consists of exclusive geographic service areas as provided in Section 
26-8a-402
;
and
(b) establishes maximum rates as provided in Section 
26-8a-403
.
[
(2) (a) All licenses issued prior to July 1, 1996, shall expire as stated in the license.
]
[
(b) If no expiration date is stated on a license issued before July 1, 1996, the license
shall expire on October 1, 1999, unless:
]
[
(i) the license holder requests agency action before August 1, 1999; and
]
[
(ii) before October 1, 1999, the department:
]
[
(A) finds the license has been used as the basis for responding to requests for
ambulance or paramedic services during the past five years;
]
[
(B) identifies one or more specific geographic areas covered by the license in which
the license holder has actively and adequately responded as the primary provider to requests for
ambulance or paramedic services during the past five years; and
]
[
(C) determines that the continuation of a license in a specific geographic area
identified in Subsection (2)(b)(ii)(B) satisfies:
]
[
(I) the standards established pursuant to Subsection 
26-8a-404
(2); and
]
[
(II) the requirement of public convenience and necessity.
]
[
(c) If the department finds that a license meets the requirements of Subsection (2)(b),
the department shall amend the license to reflect:
]
[
(i) the specific geographic area of the license; and
]
[
(ii) a four-year term extension.
]
[
(d) Before July 1, 1999, the department shall publish notice once a week for four
consecutive weeks of the expiration of licenses pursuant to Subsection (2)(b) in a newspaper of
general circulation in the state.
]
[
(e) Nothing in this Subsection (2) may be construed as restricting the authority of the
department to amend overlapping licenses pursuant to Section 
26-8a-416
.
]
[
(3) After October 1, 1999, new licenses and license renewals shall be for a four-year
term.
]
(2) A license issued or renewed under this part is valid for four years.
Section 7. Section 
26-8a-402
 is amended to read:
26-8a-402.
Exclusive geographic service areas.
(1) Each ground ambulance provider license issued under this part shall be for an
exclusive geographic service area as described in the license. Only the licensed ground
ambulance provider may respond to an ambulance request that originates within the provider's
exclusive geographic service area, except as provided in Subsection (5) and Section 
26-8a-416
.
(2) Each paramedic provider license issued under this part shall be for an exclusive
geographic service area as described in the license. Only the licensed paramedic provider may
respond to a paramedic request that originates within the exclusive geographic service area,
except as provided in Subsection (6) and Section 
26-8a-416
.
(3) Nothing in this section may be construed as either requiring or prohibiting that the
formation of boundaries in a given location be the same for a licensed paramedic provider [
as it
is for
] 
and
 a licensed ambulance provider.
(4) (a) A licensed ground ambulance or paramedic provider may, as necessary, enter
into a mutual aid agreement to allow another licensed provider to give assistance in times of
unusual demand, as that term is defined by the committee in rule.
(b) A mutual aid agreement shall include a formal written plan detailing the type of
assistance and the circumstances under which it would be given.
(c) The parties to a mutual aid agreement shall submit a copy of the agreement to the
department.
(d) Notwithstanding this Subsection (4), a licensed provider may not subcontract with
another entity to provide services in the licensed provider's exclusive geographic service area.
(5) Notwithstanding Subsection (1), a licensed ground ambulance provider may
respond to an ambulance request that originates from the exclusive geographic area of another
provider:
(a) pursuant to a mutual aid agreement;
(b) to render assistance on a case-by-case basis to that provider; and
(c) as necessary to meet needs in time of disaster or other major emergency.
(6) Notwithstanding Subsection (2), a licensed paramedic provider may respond to a
paramedic request that originates from the exclusive geographic area of another provider:
(a) pursuant to a mutual aid agreement;
(b) to render assistance on a case-by-case basis to that provider; and
(c) as necessary to meet needs in time of disaster or other major emergency.
(7) The department may, upon the renewal of a license, align the boundaries of an
exclusive geographic area with the boundaries of a political subdivision:
(a) if the alignment is practical and in the public interest;
(b) if each licensed provider that would be affected by the alignment agrees to the
alignment; and
(c) taking into consideration the requirements of:
(i) Section 
11-48-103
; and
(ii) Section 
26-8a-408
.
Section 8. Section 
26-8a-405.1
 is amended to read:
26-8a-405.1.
Selection of provider by political subdivision.
(1) (a) Only an applicant approved under Section 
26-8a-405
 may respond to a request
for a proposal issued in accordance with Section 
26-8a-405.2
 or Section 
26-8a-405.4
 by a
political subdivision.
(b) A response to a request for proposal is subject to the maximum rates established by
the department under Section 
26-8a-403
.
(c) A political subdivision may award a contract to an applicant in response to a
request for proposal:
(i) in accordance with Section 
26-8a-405.2
; and
(ii) subject to [
Subsection (2)
] 
Subsections (2) and (3)
.
(2) (a) The department shall issue a license to an applicant selected by a political
subdivision under Subsection (1) unless the department finds that issuing a license to that
applicant would jeopardize the health, safety, and welfare of the citizens of the geographic
service area.
(b) A license issued under this Subsection (2):
(i) is for the exclusive geographic service area approved by the department in
accordance with Subsection 
26-8a-405.2
(2);
(ii) is valid for four years;
(iii) is not subject to a request for license from another applicant under the provisions
of Sections 
26-8a-406
 through 
26-8a-409
 during the four-year term, unless the applicant's
license is revoked under Section 
26-8a-504
; [
and
]
(iv) is subject to revocation or revision under Subsection (3)(d); and
[
(iv)
] 
(v)
 is subject to supervision by the department under Sections 
26-8a-503
 and
26-8a-504
.
(3) Notwithstanding Subsection (2)(b), a political subdivision may terminate a contract
described in Subsection (1)(c), with or without cause, if:
(a) the contract:
(i) is entered into on or after May 5, 2021; and
(ii) allows an applicant to provide 911 ambulance services;
(b) the political subdivision provides written notice to the applicant described in
Subsection (3)(a)(ii) and the department:
(i) at least 18 months before the day on which the contract is terminated; or
(ii) within a period of time shorter than 18 months before the day on which the contract
is terminated, if otherwise agreed to by the applicant and the department;
(c) the political subdivision selects another applicant to provide 911 ambulance
services for the political subdivision in accordance with Section 
26-8a-405.2
;
(d) the department:
(i) revokes the license of the applicant described in Subsection (3)(a)(ii), or issues a
new or revised license for the applicant described in Subsection (3)(a)(ii):
(A) in order to remove the area that is subject to the contract from the applicant's
exclusive geographic service area; and
(B) to take effect the day on which the contract is terminated; and
(ii) issues a new or revised license for the applicant described in Subsection (3)(c):
(A) in order to allow the applicant to provide 911 ambulance services for the area
described in Subsection (3)(d)(i)(A); and
(B) to take effect the day on which the contract is terminated; and
(e) the termination does not create an orphaned area.
[
(3)
] 
(4)
 Except as provided in Subsection 
26-8a-405.3
(4)(a), the provisions of
Sections 
26-8a-406
 through 
26-8a-409
 do not apply to a license issued under this section.
Section 9. Section 
26-8a-405.4
 is amended to read:
26-8a-405.4.
Non-911 provider -- Finding of meritorious complaint -- Request for
proposals.
[
(1) Notwithstanding Subsection 
26-8a-102
(18), for purposes of this section, political
subdivision includes:
]
[
(a) a county of any class; and
]
[
(b) a city or town located in a county of any class.
]
[
(2)
] 
(1)
 (a) This section applies to a non-911 provider license under this chapter.
(b) The department shall, in accordance with Subsections 
(3) and
 (4) [
and (5)
]:
(i) receive a complaint about a non-911 provider;
(ii) determine whether the complaint has merit;
(iii) issue a finding of:
(A) a meritorious complaint; or
(B) a non-meritorious complaint; and
(iv) forward a finding of a meritorious complaint to the governing body of the political
subdivision:
(A) in which the non-911 provider is licensed; or
(B) that provides the non-911 services, if different from Subsection [
(2)
] 
(1)
(b)(iv)(A).
[
(3)
] 
(2)
 (a) A political subdivision that receives a finding of a meritorious complaint
from the department:
(i) shall take corrective action that the political subdivision determines is appropriate;
and
(ii) shall, if the political subdivision determines corrective action will not resolve the
complaint or is not appropriate:
(A) issue a request for proposal for non-911 service in the geographic service area if
the political subdivision will not respond to the request for proposal; or
(B) (I) make a finding that a request for proposal for non-911 services is appropriate
and the political subdivision intends to respond to a request for proposal; and
(II) submit the political subdivision's findings to the department with a request that the
department issue a request for proposal in accordance with Section 
26-8a-405.5
.
(b) (i) If Subsection [
(3)
] 
(2)
(a)(ii)(A) applies, the political subdivision shall issue the
request for proposal in accordance with Sections 
26-8a-405.1
 through 
26-8a-405.3
.
(ii) If Subsection [
(3)
] 
(2)
(a)(ii)(B) applies, the department shall issue a request for
proposal for non-911 services in accordance with Section 
26-8a-405.5
.
[
(4)
] 
(3)
 The department shall make a determination under Subsection [
(2)
] 
(1)
(b) if:
(a) the department receives a written complaint from any of the following in the
geographic service area:
(i) a hospital;
(ii) a health care facility;
(iii) a political subdivision; or
(iv) an individual; and
(b) the department determines, in accordance with Subsection [
(2)
] 
(1)
(b), that the
complaint has merit.
[
(5)
] 
(4)
 (a) If the department receives a complaint under Subsection [
(2)
] 
(1)
(b), the
department shall request a written response from the non-911 provider concerning the
complaint.
(b) The department shall make a determination under Subsection [
(2)
] 
(1)
(b) based on:
(i) the written response from the non-911 provider; and
(ii) other information that the department may have concerning the quality of service of
the non-911 provider.
(c) (i) The department's determination under Subsection [
(2)
] 
(1)
(b) is not subject to an
adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act.
(ii) The department shall adopt administrative rules in accordance with Title 63G,
Chapter 3, Utah Administrative Rulemaking Act, to implement the provisions of Subsection
[
(2)
] 
(1)
(b).
Section 10. Section 
26-8a-405.5
 is amended to read:
26-8a-405.5.
Use of competitive sealed proposals -- Procedure -- Appeal rights.
(1) (a) The department shall issue a request for proposal for non-911 services in a
geographic service area if the department receives a request from a political subdivision under
Subsection 
26-8a-405.4
[
(3)
]
(2)
(a)(ii)(B) to issue a request for proposal for non-911 services.
(b) Competitive sealed proposals for non-911 services under Subsection (1)(a) shall be
solicited through a request for proposal and the provisions of this section.
(c) (i) Notice of the request for proposals shall be published:
(A) at least once a week for three consecutive weeks in a newspaper of general
circulation published in the county; or
(B) if there is no such newspaper, then notice shall be posted for at least 20 days in at
least five public places in the county; and
(ii) in accordance with Section 
45-1-101
 for at least 20 days.
(2) (a) Proposals shall be opened so as to avoid disclosure of contents to competing
offerors during the process of negotiations.
(b) (i) Subsequent to the published notice, and prior to selecting an applicant, the
department shall hold a presubmission conference with interested applicants for the purpose of
assuring full understanding of, and responsiveness to, solicitation requirements.
(ii) The department shall allow at least 90 days from the presubmission conference for
the proposers to submit proposals.
(c) Subsequent to the presubmission conference, the department may issue addenda to
the request for proposals. An addenda to a request for proposal shall be finalized and posted by
the department at least 45 days before the day on which the proposal must be submitted.
(d) Offerors to the request for proposals shall be accorded fair and equal treatment with
respect to any opportunity for discussion and revisions of proposals, and revisions may be
permitted after submission and before a contract is awarded for the purpose of obtaining best
and final offers.
(e) In conducting discussions, there shall be no disclosures of any information derived
from proposals submitted by competing offerors.
(3) (a) (i) The department may select an applicant approved by the department under
Section 
26-8a-404
 to provide non-911 services by contract to the most responsible offeror as
defined in Section 
63G-6a-103
.
(ii) An award under Subsection (3)(a)(i) shall be made to the responsible offeror whose
proposal is determined in writing to be the most advantageous to the public, taking into
consideration price and the evaluation factors set forth in the request for proposal.
(b) The applicants who are approved under Section 
26-8a-405
 and who are selected
under this section may be the political subdivision responding to the request for competitive
sealed proposals, or any other public entity or entities, any private person or entity, or any
combination thereof.
(c) The department may reject all of the competitive proposals.
(4) In seeking competitive sealed proposals and awarding contracts under this section,
the department:
(a) shall consider the public convenience and necessity factors listed in Subsections
26-8a-408
(2) through (6);
(b) shall require the applicant responding to the proposal to disclose how the applicant
will meet performance standards in the request for proposal;
(c) may not require or restrict an applicant to a certain method of meeting the
performance standards, including:
(i) requiring ambulance medical personnel to also be a firefighter; or
(ii) mandating that offerors use fire stations or dispatch services of the political
subdivision;
(d) shall require an applicant to submit the proposal:
(i) based on full cost accounting in accordance with generally accepted accounting
principals; and
(ii) if the applicant is a governmental entity, in addition to the requirements of
Subsection (4)(e)(i), in accordance with generally accepted government auditing standards and
in compliance with the State of Utah Legal Compliance Audit Guide; and
(e) shall set forth in the request for proposal:
(i) the method for determining full cost accounting in accordance with generally
accepted accounting principles, and require an applicant to submit the proposal based on such
full cost accounting principles;
(ii) guidelines established to further competition and provider accountability; and
(iii) a list of the factors that will be considered by the department in the award of the
contract, including by percentage, the relative weight of the factors established under this
Subsection (4)(e), which may include [
such things as
]:
(A) response times;
(B) staging locations;
(C) experience;
(D) quality of care; and
(E) cost, consistent with the cost accounting method in Subsection (4)(e)(i).
(5) A license issued under this section:
(a) is for the exclusive geographic service area approved by the department;
(b) is valid for four years;
(c) is not subject to a request for license from another applicant under the provisions of
Sections 
26-8a-406
 through 
26-8a-409
 during the four-year term, unless the applicant's license
is revoked under Section 
26-8a-504
;
(d) is subject to supervision by the department under Sections 
26-8a-503
 and
26-8a-504
; and
(e) except as provided in Subsection (4)(a), is not subject to the provisions of Sections
26-8a-406
 through 
26-8a-409
.
Section 11. Section 
26-8a-413
 is amended to read:
26-8a-413.
License renewals.
(1) A licensed provider desiring to renew its license shall meet the renewal
requirements established by department rule.
(2) The department shall issue a renewal license for a ground ambulance provider or a
paramedic provider upon the licensee's application for a renewal and without a public hearing
if [
there has been
]:
(a) the applicant was licensed under the provisions of Sections 
26-8a-406
 through
26-8a-409
; and
(b) there has been:
[
(a)
] 
(i)
 no change in controlling interest in the ownership of the licensee as defined in
Section 
26-8a-415
;
[
(b)
] 
(ii)
 no serious, substantiated public complaints filed with the department against
the licensee during the term of the previous license;
[
(c)
] 
(iii)
 no material or substantial change in the basis upon which the license was
originally granted;
[
(d)
] 
(iv)
 no reasoned objection from the committee or the department; and
[
(e) if the applicant was licensed under the provisions of Sections 
26-8a-406
 through
26-8a-409
, no conflicting license application.
]
(v) no change to the license type.
(3) (a) (i) The provisions of this Subsection (3) apply to a provider licensed under the
provisions of Sections 
26-8a-405.1
 and 
26-8a-405.2
.
(ii) A provider may renew its license if the provisions of Subsections (1), (2)(a)
through (d), and this Subsection (3) are met.
(b) (i) The department shall issue a renewal license to a provider upon the provider's
application for renewal for one additional four-year term if the political subdivision certifies to
the department that the provider has met all of the specifications of the original bid.
(ii) If the political subdivision does not certify to the department that the provider has
met all of the specifications of the original bid, the department may not issue a renewal license
and the political subdivision shall enter into a public bid process under Sections 
26-8a-405.1
and 
26-8a-405.2
.
(c) (i) The department shall issue an additional renewal license to a provider who has
already been issued a one-time renewal license under the provisions of Subsection (3)(b)(i) if
the department and the political subdivision do not receive, prior to the expiration of the
provider's license, written notice from an approved applicant informing the political
subdivision of the approved applicant's desire to submit a bid for ambulance or paramedic
service.
(ii) If the department and the political subdivision receive the notice in accordance with
Subsection (3)(c)(i), the department may not issue a renewal license and the political
subdivision shall enter into a public bid process under Sections 
26-8a-405.1
 and 
26-8a-405.2
.
(4) The department shall issue a renewal license for an air ambulance provider upon
the licensee's application for renewal and completion of the renewal requirements established
by department rule.