Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 293 (2022GS)

Sponsor

Rep. Wilcox, R.

Final action

Governor Signed 3/24/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• requires an applicant for ground ambulance or paramedic services to meet certain requirements with respect to a geographic service area; and
• repeals obsolete language regarding a transition to eliminate inconsistent licenses.

Every vote on this bill

Bill text

GROUND AMBULANCE INTERFACILITY TRANSPORT
LICENSING
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Ryan D. Wilcox
Senate Sponsor: 
Curtis S. Bramble
LONG TITLE
General Description:
This bill amends the Utah Emergency Medical Services System Act.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ requires an applicant for ground ambulance or paramedic services to meet certain
requirements with respect to a geographic service area; and
▸ repeals obsolete language regarding a transition to eliminate inconsistent licenses.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-8a-102
, as last amended by Laws of Utah 2021, Chapters 208, 237, and 265
26-8a-404
, as last amended by Laws of Utah 2019, Chapter 390
26-8a-416
, as enacted by Laws of Utah 1999, Chapter 141
Be it enacted by the Legislature of the state of Utah:
Section 1. 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 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) (a) "Behavioral emergency services" means delivering a behavioral health
intervention to a patient in an emergency context within a scope and in accordance with
guidelines established by the department.
(b) "Behavioral emergency services" does not include engaging in the:
(i) practice of mental health therapy as defined in Section 
58-60-102
;
(ii) practice of psychology as defined in Section 
58-61-102
;
(iii) practice of clinical social work as defined in Section 
58-60-202
;
(iv) practice of certified social work as defined in Section 
58-60-202
;
(v) practice of marriage and family therapy as defined in Section 
58-60-302
; or
(vi) practice of clinical mental health counseling as defined in Section 
58-60-402
; and
(vii) practice as a substance use disorder counselor as defined in Section 
58-60-502
.
(5) "Committee" means the State Emergency Medical Services Committee created by
Section 
26-1-7
.
(6) "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
.
(7) "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 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.
(8) (a) "Emergency medical service personnel" means an individual who provides
emergency medical services or behavioral emergency services to a patient and is required to be
licensed or certified under Section 
26-8a-302
.
(b) "Emergency medical service personnel" includes a paramedic, medical director of a
licensed emergency medical service provider, emergency medical service instructor, behavioral
emergency services technician, other categories established by the committee, and a certified
emergency medical dispatcher.
(9) "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.
(10) "Emergency medical services" means:
(a) medical services;
(b) transportation services;
(c) behavioral emergency services; or
(d) any combination of the services described in Subsections (10)(a) through (c).
(11) "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
.
(12) "Governing body":
(a) 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.
(13) "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.
(14) "Level of service" means the level at which an ambulance provider type of service
is licensed as:
(a) emergency medical technician;
(b) advanced emergency medical technician; or
(c) paramedic.
[
(14)
] 
(15)
 "Medical control" means a person who provides medical supervision to an
emergency medical service provider.
[
(15)
] 
(16)
 "Non-911 service" means transport of a patient that is not 911 transport
under Subsection (1).
[
(16)
] 
(17)
 "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
.
[
(17)
] 
(18)
 "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.
[
(18)
] 
(19)
 "Patient" means an individual who, as the result of illness, injury, or a
behavioral emergency condition, meets any of the criteria in Section 
26-8a-305
.
[
(19)
] 
(20)
 "Political subdivision" means:
(a) a city, town, or metro township;
(b) a county;
(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);
(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;
(e) areas coming together as described in Subsection 
26-8a-405.2
(2)(b)(ii); or
(f) an interlocal entity under Title 11, Chapter 13, Interlocal Cooperation Act.
[
(20)
] 
(21)
 "Trauma" means an injury requiring immediate medical or surgical
intervention.
[
(21)
] 
(22)
 "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.
[
(22)
] 
(23)
 "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.
[
(23)
] 
(24)
 "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.
(25) "Type of service" means the category at which an ambulance provider is licensed
as:
(a) ground ambulance transport;
(b) ground ambulance interfacility transport; or
(c) both ground ambulance transport and ground ambulance interfacility transport.
Section 2. Section 
26-8a-404
 is amended to read:
26-8a-404.
Ground ambulance and paramedic licenses -- Application and
department review.
(1) Except as provided in Section 
26-8a-413
, an applicant for a ground ambulance or
paramedic license shall apply to the department for a license only by:
(a) submitting a completed application;
(b) providing information in the format required by the department; and
(c) paying the required fees, including the cost of the hearing officer.
(2) The department shall make rules establishing minimum qualifications and
requirements for:
(a) personnel;
(b) capital reserves;
(c) equipment;
(d) a business plan;
(e) operational procedures;
(f) medical direction agreements;
(g) management and control; and
(h) other matters that may be relevant to an applicant's ability to provide ground
ambulance or paramedic service.
(3) An application for a license to provide ground ambulance service or paramedic
service shall be for all ground ambulance services or paramedic services arising within the
geographic service area, except that an applicant may apply for a license for less than all
ground ambulance services or all paramedic services arising within an exclusive geographic
area if it can demonstrate how the remainder of that area will be served.
(4) (a) A ground ambulance service licensee may apply to the department for a license
to provide a higher level of service as defined by department rule if the application includes:
(i) a copy of the new treatment protocols for the higher level of service approved by the
off-line medical director;
(ii) an assessment of field performance by the applicant's off-line director; and
(iii) an updated plan of operation demonstrating the ability of the applicant to provide
the higher level of service.
(b) If the department determines that the applicant has demonstrated the ability to
provide the higher level of service in accordance with Subsection (4)(a), the department shall
issue a revised license reflecting the higher level of service and the requirements of Section
26-8a-408
 do not apply.
(c) A revised license issued under Subsection (4)(b):
(i) may only affect the level of service that the licensee may provide; 
and
(ii) may not affect any other terms, conditions, or limitations of the original license[
;
and
]
.
[
(iii) may not impact the rights of other licensees.
]
(5) Upon receiving a completed application and the required fees, the department shall
review the application and determine whether the application meets the minimum 
qualifications and requirements for licensure.
(6) The department may deny an application if it finds that it contains any materially
false or misleading information, is incomplete, or if the application demonstrates that the
applicant fails to meet the minimum qualifications and requirements for licensure under
Subsection (2).
(7) If the department denies an application, it shall notify the applicant in writing
setting forth the grounds for the denial. A denial may be appealed under Title 63G, Chapter 4,
Administrative Procedures Act.
Section 3. Section 
26-8a-416
 is amended to read:
26-8a-416.
Overlapping licenses.
[
(1) By May 30, 2000, the department shall review all licenses in effect on October 2,
1999, to identify overlap, as defined in department rule, in the service areas of two or more
licensed providers.
]
[
(2) By June 30, 2000, the department shall notify all licensed providers affected by an
overlap. By September 30, 2000, the department shall schedule, by order, a deadline to resolve
each overlap, considering the effects on the licensed providers and the areas to be addressed.
]
[
(3) For each overlap, the department shall meet with the affected licensed providers
and provide 120 days for a negotiated resolution, consistent with the criteria in Section
26-8a-408
.
]
[
(4) (a) If a resolution is reached under Subsection (2) that the department finds
satisfies the criteria in Section 
26-8a-408
, the department shall amend the licenses to reflect the
resolution consistent with Subsection (6).
]
[
(b) If a resolution is not reached under Subsection (2), the department or any of the
licensed providers involved in the matter may request the commencement of a formal
adjudicative proceeding to resolve the overlap.
]
[
(5) The department shall commence adjudicative proceedings for any overlap that is
not resolved by July 1, 2003.
]
(1) As used in this section:
(a) "Overlap" means two ground ambulance interfacility transport providers that are
licensed at the same level of service in all or part of a single geographic service area.
(b) "Overlay" means two ground ambulance interfacility transport providers that are
licensed at a different level of service in all or part of a single geographic service area.
[
(6)
] 
(2)
 Notwithstanding the exclusive geographic service requirement of Section
26-8a-402
, the department [
may amend one or more licenses after a resolution is reached or an
adjudicative proceeding has been held to allow:
] 
shall recognize overlap and overlay ground
ambulance interfacility transport licenses that existed on or before May 4, 2022.
[
(a) a single licensed provider to serve all or part of the overlap area;
]
[
(b) more than one licensed provider to serve the overlap area;
]
[
(c) licensed providers to provide different types of service in the overlap area; or
]
[
(d) licenses that recognize service arrangements that existed on September 30, 1999.
]
(3) The department may, without an adjudicative proceeding but with at least 30 days
notice to providers in the same geographic service area, amend an existing overlay ground
ambulance interfacility transport license solely to convert an overlay into an overlap if the
existing ground ambulance interfacility transport licensed provider meets the requirements
described in Subsection 
26-8a-404
(4).
(4) An amendment of a license under this section may not alter:
(a) other terms of the original license, including the applicable geographic service area;
or
(b) the license of other providers that provide interfacility transport services in the
geographic service area.
[
(7)
] 
(5)
 Notwithstanding Subsection [
(6)
] 
(2)
, any license for an overlap area
terminates upon:
(a) relinquishment by the provider; or
(b) revocation by the department.