|
REFERENCE TITLE: certificates of operation; interfacility transfers |
|
State of Arizona House of Representatives Fifty-sixth Legislature Second Regular Session 2024
|
|
HB 2290 |
|
|
|
Introduced by Representatives Kolodin: Jones, Martinez, McGarr, Parker B, Peņa, Smith, Wilmeth; Senator Burch
|
An Act
amending sections 36-2201 and 36-2240, Arizona Revised Statutes; amending title 36, chapter 21.1, Arizona Revised Statutes, by adding article 2.1; relating to emergency medical services.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 36-2201, Arizona Revised Statutes, is amended to read:
36-2201. Definitions
In this chapter, unless the context otherwise requires:
1. "Administrative medical direction" means supervision of emergency medical care technicians by a base hospital medical director, administrative medical director or basic life support medical director. For the purposes of this paragraph, "administrative medical director" means a physician who is licensed pursuant to title 32, chapter 13 or 17 and who provides direction within the emergency medical services and trauma system.
2. "Advanced emergency medical technician" means a person who has been trained in an advanced emergency medical technician program certified by the director or in an equivalent training program and who is certified by the director to render services pursuant to section 36-2205.
3. "Advanced life support" means the level of assessment and care identified in the scope of practice approved by the director for the advanced emergency medical technician, emergency medical technician I-99 and paramedic.
4. "Advanced life support base hospital" means a health care institution that offers general medical and surgical services, that is certified by the director as an advanced life support base hospital and that is affiliated by written agreement with a licensed ambulance service, municipal rescue service, fire department, fire district or health services district for medical direction, evaluation and control of emergency medical care technicians.
5. "Ambulance":
(a) Means any publicly or privately owned surface, water or air vehicle, including a helicopter, that contains a stretcher and necessary medical equipment and supplies pursuant to section 36-2202 and that is especially designed and constructed or modified and equipped to be used, maintained or operated primarily to transport individuals who are sick, injured or wounded or who require medical monitoring or aid.
(b) Does not include a surface vehicle that is owned and operated by a private sole proprietor, partnership, private corporation or municipal corporation for the emergency transportation and in-transit care of its employees or a vehicle that is operated to accommodate an incapacitated person or person with a disability who does not require medical monitoring, care or treatment during transport and that is not advertised as having medical equipment and supplies or ambulance attendants.
6. "Ambulance attendant" means any of the following:
(a) An emergency medical technician, an advanced emergency medical technician, an emergency medical technician I-99 or a paramedic whose primary responsibility is the care of patients in an ambulance and who meets the standards and criteria adopted pursuant to section 36-2204.
(b) An emergency medical responder who is employed by an ambulance service operating under section 36-2202 and whose primary responsibility is driving an ambulance.
(c) A physician who is licensed pursuant to title 32, chapter 13 or 17.
(d) A professional nurse who is licensed pursuant to title 32, chapter 15 and who meets the state board of nursing criteria to care for patients in the prehospital care system.
(e) A professional nurse who is licensed pursuant to title 32, chapter 15 and whose primary responsibility is the care of patients in an ambulance during an interfacility transport.
7. "Ambulance service" means a person who owns and operates one or more ambulances.
8. "Basic life support" means the level of assessment and care identified in the scope of practice approved by the director for the emergency medical responder and emergency medical technician.
9. "Bureau" means the bureau of emergency medical services and trauma system in the department.
10. "Centralized medical direction communications center" means a facility that is housed within a hospital, medical center or trauma center or a freestanding communication center that meets the following criteria:
(a) Has the ability to communicate with ambulance services and emergency medical services providers rendering patient care outside of the hospital setting via radio and telephone.
(b) Is staffed twenty-four hours a day seven days a week by at least a physician licensed pursuant to title 32, chapter 13 or 17.
11. "Certificate of necessity" means a certificate that is issued to an ambulance service by the department and that describes the following:
(a) The service area.
(b) The level of service.
(c) The type of service.
(d) The hours of operation.
(e) The effective date.
(f) The expiration date.
(g) The legal name and address of the ambulance service.
(h) The any limiting or special provisions the director prescribes.
12. "Certificate of operation" means a certificate that is issued pursuant to section 36-2255 to an eligible entity by the department for interfacility transports.
12. 13. "Council" means the emergency medical services council.
13. 14. "Department" means the department of health services.
14. 15. "Director" means the director of the department of health services.
16. "Direct owner" has the same meaning prescribed in section 36-401.
17. "Eligible entity" means a direct owner or an indirect owner of a hospital.
15. 18. "Emergency medical care technician" means an individual who has been certified by the department as an emergency medical technician, an advanced emergency medical technician, an emergency medical technician I-99 or a paramedic.
16. 19. "Emergency medical responder" as an ambulance attendant, whose primary responsibility is driving an ambulance, means a person who has successfully completed training in an emergency medical responder program that is certified by the director or is approved by the emergency medical services provider's administrative medical director on file with the department or in an equivalent training program.
17. 20. "Emergency medical responder program" means a program that includes at least the following:
(a) Emergency vehicle driver training.
(b) Cardiopulmonary resuscitation certification.
(c) Automated external defibrillator training.
(d) Training in the use of noninvasive diagnostic devices, including blood glucose monitors and pulse oximeters.
(e) Training on obtaining a patient's vital signs, including blood pressure, pulse and respiratory rate.
18. 21. "Emergency medical services" means those services required following an accident or an emergency medical situation:
(a) For on-site emergency medical care.
(b) To transport the sick or injured by a licensed ground or air ambulance.
(c) In using emergency communications media.
(d) In using emergency receiving facilities.
(e) In administering initial care and preliminary treatment procedures by emergency medical care technicians.
19. 22. "Emergency medical services provider" means any governmental entity, quasi-governmental entity or corporation whether public or private that renders emergency medical services in this state.
20. 23. "Emergency medical technician" means a person who has been trained in an emergency medical technician program certified by the director or in an equivalent training program and who is certified by the director as qualified to render services pursuant to section 36-2205.
21. 24. "Emergency receiving facility" means a licensed health care institution that offers emergency medical services, is staffed twenty-four hours a day and has a physician on call.
22. 25. "Fit and proper" means that the director determines that an applicant for a certificate of necessity or a certificate holder has the expertise, integrity, fiscal competence and resources to provide ambulance service in the service area.
26. "Hospital" means a class of health care institutions that provide, through an organized medical staff, inpatient beds, medical services, continuous nursing services and diagnosis and treatment to patients.
27. "Indirect owner" has the same meaning prescribed in section 36-401.
28. "Interfacility transport" means an ambulance transport of a patient from a health care institution to another health care institution.
23. 29. "Medical record" means any patient record, including clinical records, prehospital care records, medical reports, laboratory reports and statements, any file, film, record or report or oral statements relating to diagnostic findings, treatment or outcome of patients, whether written, electronic or recorded, and any information from which a patient or the patient's family might be identified.
24. 30. "National certification organization" means a national organization that tests and certifies the ability of an emergency medical care technician and whose tests are based on national education standards.
25. 31. "National education standards" means the emergency medical services education standards of the United States department of transportation or other similar emergency medical services education standards developed by that department or its successor agency.
26. 32. "Paramedic" means a person who has been trained in a paramedic program certified by the director or in an equivalent training program and who is certified by the director to render services pursuant to section 36-2205.
27. 33. "Physician" means any person licensed pursuant to title 32, chapter 13 or 17.
28. 34. "Police dog":
(a) Means a specially trained dog that is owned or used by a law enforcement department or agency of this state or any political subdivision of this state and that is used in the course of the department's or agency's official work.
(b) Includes a search and rescue dog, service dog, accelerant detection canine or other dog that is in use by the law enforcement department or agency for official duties.
29. 35. "Stretcher van" means a vehicle that contains a stretcher and that is operated to accommodate an incapacitated person or person with a disability who does not require medical monitoring, aid, care or treatment during transport.
30. 36. "Suboperation station" means a physical facility or location at which an ambulance service conducts operations for the dispatch of ambulances and personnel and that may be staffed twenty-four hours a day or less as determined by system use.
31. 37. "Trauma center" means any acute care hospital that provides in-house twenty-four-hour daily dedicated trauma surgical services that is designated pursuant to section 36-2225.
32. 38. "Trauma registry" means data collected by the department on trauma patients and on the incidence, causes, severity, outcomes and operation of a trauma system and its components.
33. 39. "Trauma system" means an integrated and organized arrangement of health care resources having the specific capability to perform triage, transport and provide care.
34. 40. "Validated testing procedure" means a testing procedure that includes practical skills, or attests practical skills proficiency on a form developed by the department by the educational training program, identified pursuant to section 36-2204, paragraph 2, that is certified as valid by an organization capable of determining testing procedure and testing content validity and that is recommended by the medical direction commission and the emergency medical services council before the director's approval.
35. 41. "Wheelchair van" means a vehicle that contains or that is designed and constructed or modified to contain a wheelchair and that is operated to accommodate an incapacitated person or person with a disability who does not require medical monitoring, aid, care or treatment during transport.
Sec. 2. Section 36-2240, Arizona Revised Statutes, is amended to read:
36-2240. Fees
Fees not to exceed the following amounts shall be paid by the owner of an ambulance service to the department for deposit in the state general fund to be available for legislative appropriation in order to carry out the provisions of this chapter:
1. One hundred dollars upon $100 on filing an application for a certificate of necessity or certificate of operation.
2. Fifty dollars upon $50 on filing an application to amend, transfer or renew a certificate of necessity or certificate of operation.
3. For the issuance of an initial certificate of necessity or certificate of operation, two hundred dollars $200 for each ambulance proposed to be operated by the ambulance service to which the certificate is granted.
4. An annual regulatory fee of two hundred dollars $200 for each ambulance issued a certificate of registration pursuant to section 36-2212, to be collected at the same time as the certificate of registration fee imposed by section 36-2212.
Sec. 3. Title 36, chapter 21.1, Arizona Revised Statutes, is amended by adding article 2.1, to read:
ARTICLE 2.1. CERTIFICATES OF OPERATION
36-2255. Application for certificate of operation; interfacility transports; exemption
A. Any eligible entity that wishes to operate an ambulance service in this state to provide interfacility transports shall apply to the department on a form prescribed by the director for a certificate of operation.
B. An eligible entity may operate an ambulance service directly or through a service contract with a service provider registered in this state in accordance with section 36-2212.
C. Certificate of operation holders may, but need not, bill for services provided, at not more than the applicable rate or charge approved by the director.
D. Certificate of operation holders shall comply with the certificate of registration requirements prescribed in section 36-2212.
E. Certificate of operation holders are exempt from the certificate of necessity requirements prescribed in section 36-2233.
36-2256. Initial certificate of operation; term; renewal
A. Within forty-five days after receiving an application from an eligible entity for a certificate of operation, the director shall issue a certificate of operation if all the following requirements are met:
1. The director finds that the applicant has the expertise, integrity, fiscal competence and resources to provide interfacility transport services.
2. The applicant pays the appropriate fees pursuant to section 36-2240.
3. The applicant files a surety bond pursuant to section 36-2257.
c. The initial certificate of operation issued to each eligible entity is for a term of one year.
d. Within ninety days before the expiration of a certificate of operation, the director shall renew the certificate of operation for a term of three years if the certificate of operation holder meets all requirements, applies for a renewal and pays the fees prescribed in section 36-2240.
36-2257. Eligible entities; required insurance; financial responsibility or bond; revocation
A. The director may not issue a certificate of operation to an eligible entity unless the eligible entity has filed with the department a certificate of insurance or other evidence of financial responsibility equivalent to that which is required for a certificate of necessity pursuant to section 36-2237. The liability insurance shall bind the insurer to pay compensation for injuries to persons and for loss or damage to property resulting from the negligent operation of the ambulance service.
B. The director shall revoke the certificate of operation of any eligible entity that fails to comply with this section.
36-2258. Eligible entities; name change; amended certificate of operation
AT LEAST THIRTY DAYS BEFORE THE DATE AN eligible entity that holds a certificate of operation CHANGES ITS LEGAL NAME, THE eligible entity SHALL SEND THE DEPARTMENT WRITTEN NOTICE OF THE NAME CHANGE. WITHIN THIRTY DAYS AFTER THE DATE OF RECEIVING THE NOTICE, THE DEPARTMENT SHALL ISSUE AN AMENDED CERTIFICATE OF OPERATION THAT INCORPORATES THE NAME CHANGE BUT RETAINS THE EXPIRATION DATE OF THE CURRENT CERTIFICATE OF OPERATION.