Bill Text: MI HB4785 | 2013-2014 | 97th Legislature | Introduced

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Bill Title: Health facilities; emergency medical services; various fees for the emergency medical services program; modify. Amends secs. 20910, 20912, 20918, 20920, 20923, 20926, 20929, 20931, 20934, 20936, 20941, 20945, 20950, 20954 & 20958 of 1978 PA 368 (MCL 333.20910 et seq.).

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2013-05-30 - Printed Bill Filed 05/30/2013 [HB4785 Detail]

Download: Michigan-2013-HB4785-Introduced.html

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HOUSE BILL No. 4785

 

May 29, 2013, Introduced by Rep. Lori and referred to the Committee on Appropriations.

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 20910, 20912, 20918, 20920, 20923, 20926,

 

20929, 20931, 20934, 20936, 20941, 20945, 20950, 20954, and 20958

 

(MCL 333.20910, 333.20912, 333.20918, 333.20920, 333.20923,

 

333.20926, 333.20929, 333.20931, 333.20934, 333.20936, 333.20941,

 

333.20945, 333.20950, 333.20954, and 333.20958), section 20910 as

 

amended by 2006 PA 582, sections 20912, 20918, 20929, and 20954

 

as amended by 2000 PA 375, sections 20920 and 20923 as amended by

 

2004 PA 200, sections 20926, 20931, 20936, 20941, and 20945 as

 

added by 1990 PA 179, section 20934 as amended by 2012 PA 269,

 

section 20950 as amended by 2006 PA 568, and section 20958 as

 

amended by 2010 PA 304.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 20910. (1) The department shall do all of the

 

 1  following:

 

 2        (a) Be responsible for the development, coordination, and

 

 3  administration of Develop, coordinate, and administer a statewide

 

 4  emergency medical services system.

 

 5        (b) Facilitate and promote programs of public information

 

 6  and education concerning emergency medical services.

 

 7        (c) In case of During actual disasters and disaster training

 

 8  drills and exercises, provide emergency medical services

 

 9  resources pursuant to applicable provisions of as prescribed in

 

10  the Michigan emergency preparedness management plan, or as

 

11  prescribed by the state director of emergency services pursuant

 

12  to management under the emergency management act, 1976 PA 390,

 

13  MCL 30.401 to 30.421.

 

14        (d) Consistent with the rules of the federal communications

 

15  commission, plan, develop, coordinate, and administer a statewide

 

16  emergency medical services communications system.

 

17        (e) Develop and maintain standards of emergency medical

 

18  services and personnel as follows:

 

19        (i) License emergency medical services personnel in

 

20  accordance with under this part.

 

21        (ii) License ambulance operations, nontransport prehospital

 

22  life support operations, and medical first response services in

 

23  accordance with under this part.

 

24        (iii) At least annually, inspect or provide for the inspection

 

25  of each life support agency, except medical first response

 

26  services. As part of that inspection, the department shall

 

27  conduct random inspections of life support vehicles. If a life

 

 1  support vehicle is determined by the department to be out of

 

 2  compliance, the department shall give the life support agency 24

 

 3  hours to bring the life support vehicle into compliance. If the

 

 4  life support vehicle is not brought into compliance in that time

 

 5  period, the department shall order the life support vehicle taken

 

 6  out of service until the life support agency demonstrates to the

 

 7  department, in writing, that the life support vehicle has been

 

 8  brought into compliance. In addition to any other penalty,

 

 9  remedy, or sanction applicable to a life support agency that

 

10  violates this part or a rule promulgated under this part, a life

 

11  support agency that is determined to have a life support vehicle

 

12  out of compliance as provided in this subparagraph is subject to

 

13  an administrative fine of up to $1,000.00 for the violation.

 

14        (iv) Promulgate rules to establish the requirements for

 

15  licensure of life support agencies, vehicles, and individuals

 

16  licensed under this part to provide emergency medical services

 

17  and other rules necessary to implement this part. The department

 

18  shall submit all proposed rules and changes to the state

 

19  emergency medical services coordination committee and provide a

 

20  reasonable time for the committee's review and recommendations

 

21  before submitting the rules for public hearing under the

 

22  administrative procedures act of 1969.

 

23        (f) Promulgate rules to establish and maintain standards for

 

24  and regulate the use of descriptive words, phrases, symbols, or

 

25  emblems that represent or denote that an ambulance operation,

 

26  nontransport prehospital life support operation, or medical first

 

27  response service is or may be provided. The department's

 

 1  authority to regulate use of the descriptive devices includes use

 

 2  for the purposes of advertising, promoting, or selling the

 

 3  services rendered by an ambulance operation, nontransport

 

 4  prehospital life support operation, or medical first response

 

 5  service, or by emergency medical services personnel.

 

 6        (g) Designate a medical control authority as the medical

 

 7  control for emergency medical services for a particular

 

 8  geographic region as provided for under this part.

 

 9        (h) Develop and implement field studies involving the use of

 

10  skills, techniques, procedures, or equipment that are not

 

11  included as part of the standard education for medical first

 

12  responders, emergency medical technicians, emergency medical

 

13  technician specialists, or paramedics, if all of the following

 

14  conditions are met:

 

15        (i) The state emergency medical services coordination

 

16  committee reviews the field study prior to before implementation.

 

17        (ii) The field study is conducted in an area for which a

 

18  medical control authority has been approved pursuant to under

 

19  subdivision (g).

 

20        (iii) The medical first responders, emergency medical

 

21  technicians, emergency medical technician specialists, and

 

22  paramedics participating in the field study receive training for

 

23  the new skill, technique, procedure, or equipment.

 

24        (i) Collect data as necessary to assess the need for and

 

25  quality of emergency medical services throughout the this state

 

26  pursuant to 1967 PA 270, MCL 331.531 to 331.533.331.534.

 

27        (j) Develop, with the advice of the state emergency medical

 

 1  services coordination committee, an emergency medical services

 

 2  plan that includes rural issues.

 

 3        (k) Develop recommendations for territorial boundaries of

 

 4  medical control authorities that are designed to assure that

 

 5  there exists reasonable emergency medical services capacity

 

 6  within the boundaries for the estimated demand for emergency

 

 7  medical services.

 

 8        (l) Within 1 year after the statewide trauma care advisory

 

 9  subcommittee is established under section 20917a and in In

 

10  consultation with the statewide trauma care advisory subcommittee

 

11  established under section 20917a, develop, implement, and

 

12  promulgate rules for the implementation and operation of a

 

13  statewide trauma care system within the emergency medical

 

14  services system consistent with the document entitled "Michigan

 

15  Trauma Systems Plan" prepared by the Michigan trauma coalition,

 

16  dated November 2003. The implementation and operation of the

 

17  statewide trauma care system, including the rules promulgated in

 

18  accordance with under this subdivision, are subject to review by

 

19  the state emergency medical services coordination committee and

 

20  the statewide trauma care advisory subcommittee. The rules

 

21  promulgated under this subdivision shall not require a hospital

 

22  to be designated as providing a certain level of trauma care.

 

23  Upon implementation of a statewide trauma care system, the

 

24  department shall review and identify potential funding mechanisms

 

25  and sources for the statewide trauma care system.

 

26        (m) Promulgate other rules to implement this part.

 

27        (n) Perform other duties as set forth in this part.

 

 1        (2) The department may do all any of the following:

 

 2        (a) In consultation with the state emergency medical

 

 3  services coordination committee, promulgate rules to require an

 

 4  ambulance operation, nontransport prehospital life support

 

 5  operation, or medical first response service to periodically

 

 6  submit designated records and data for evaluation by the

 

 7  department. In addition to any other penalty, remedy, or sanction

 

 8  applicable to an ambulance operation, nontransport prehospital

 

 9  life support operation, or medical first response service that

 

10  violates this part or a rule promulgated under this part, an

 

11  ambulance operation, nontransport prehospital life support

 

12  operation, or medical first response service that violates a

 

13  requirement to submit designated records and data as provided in

 

14  this subdivision is subject to an administrative fine of up to

 

15  $500.00 for each month the records or data are not submitted. The

 

16  department may waive the administrative fine provided in this

 

17  subdivision for good cause as determined by the department.

 

18        (b) Establish a grant program or contract with a public or

 

19  private agency, emergency medical services professional

 

20  association, or emergency medical services coalition to provide

 

21  training, public information, and assistance to medical control

 

22  authorities and emergency medical services systems or to conduct

 

23  other activities as specified in this part.

 

24        Sec. 20912. (1) The department shall perform do all of the

 

25  following with regard to educational programs and services:

 

26        (a) Review and approve education program sponsors, ongoing

 

27  education program sponsors, and curricula for emergency medical

 

 1  services personnel. Approved education programs and refresher

 

 2  programs shall be coordinated by a licensed emergency medical

 

 3  services instructor-coordinator commensurate with level of

 

 4  licensure. Approved education programs conducted by ongoing

 

 5  education program sponsors shall be coordinated by a licensed

 

 6  emergency medical services instructor-coordinator.

 

 7        (b) Maintain a listing of approved education program

 

 8  sponsors and licensed emergency medical services instructor-

 

 9  coordinators.

 

10        (c) Develop and implement standards for all education

 

11  program sponsors and ongoing education program sponsors based

 

12  upon criteria recommended by the state emergency medical services

 

13  coordination committee and developed by the department.

 

14        (d) Collect application and corresponding fees as follows:

 

 

15       (i) Initial education program sponsor fee

16 (triennial)..........................................  $ 500.00

17       (ii) Satellite education location fee

18 (per location).......................................  $ 250.00

19       (iii) Ongoing education program sponsor fee

20 (triennial)..........................................  $ 250.00

21       (iv) Ongoing education program sponsor fee per topic

22          1-10 topics.................................  $  20.00

23          11-20 topics................................  $  30.00

24          21-30 topics................................  $  40.00

25          31-40 topics................................  $  50.00

26          41-50 topics................................  $  60.00

27          51-60 topics................................  $  70.00

1           61-70 topics................................  $  80.00

2           71-80 topics................................  $  90.00

3           81-90 topics................................  $ 100.00

4           91-100 topics...............................  $ 110.00

5           100+ topics.................................  $ 150.00

6        (v) Ongoing education applications from individual

7  instructor coordinators

8           1-10 topics.................................  $  20.00

9           11-20 topics................................  $  30.00

10          21-30 topics................................  $  40.00

11          31-40 topics................................  $  50.00

12          41-50 topics................................  $  60.00

13          51-60 topics................................  $  70.00

14          61-70 topics................................  $  80.00

15          71-80 topics................................  $  90.00

16          81-90 topics................................  $ 100.00

17          91-100 topics...............................  $ 110.00

18          100+ topics.................................  $ 150.00

 

 

19        (2) An education program sponsor that conducts education

 

20  programs for paramedics and that receives accreditation from the

 

21  joint review committee on educational programs for the EMT-

 

22  paramedic or other organization approved by the department as

 

23  having equivalent expertise and competency in the accreditation

 

24  of paramedic education programs is considered approved by the

 

25  department under subsection (1)(a) if the education program

 

26  sponsor meets both of the following requirements:

 

27        (a) Submits an application to the department that includes

 

28  verification of accreditation described in this subsection.

 

 1        (b) Maintains accreditation as described in this subsection.

 

 2        Sec. 20918. (1) Each hospital licensed under part 215 and

 

 3  each freestanding surgical outpatient facility licensed under

 

 4  part 208 that operates a service for treating emergency patients

 

 5  24 hours a day, 7 days a week and meets standards established by

 

 6  medical control authority protocols shall be given the

 

 7  opportunity to participate in the ongoing planning and

 

 8  development activities of the local medical control authority

 

 9  designated by the department and shall adhere to protocols for

 

10  providing services to a patient before care of the patient is

 

11  transferred to hospital personnel, to the extent that those

 

12  protocols apply to a hospital or freestanding surgical outpatient

 

13  facility. The department shall designate a medical control

 

14  authority for each Michigan county or part of a county in this

 

15  state, except that the department may designate a medical control

 

16  authority to cover 2 or more counties if the department and

 

17  affected medical control authorities determine that the available

 

18  resources would be better utilized with a multiple county medical

 

19  control authority. In designating a medical control authority,

 

20  the department shall assure that there is a reasonable

 

21  relationship between the existing emergency medical services

 

22  capacity in the geographical area geographic region to be served

 

23  by the medical control authority and the estimated demand for

 

24  emergency medical services in that area.the geographic region.

 

25        (2) A medical control authority shall be administered by the

 

26  participating hospitals. A medical control authority shall accept

 

27  participation in its administration by a freestanding surgical

 

 1  outpatient facility licensed under part 208 if the freestanding

 

 2  surgical outpatient facility operates a service for treating

 

 3  emergency patients 24 hours a day, 7 days a week determined by

 

 4  the medical control authority to meet the applicable standards

 

 5  established by medical control authority protocols. Subject to

 

 6  subsection (4), the participating hospitals shall appoint an

 

 7  advisory body for the medical control authority that shall

 

 8  include, includes, at a minimum, a representative of each type of

 

 9  life support agency and each type of emergency medical services

 

10  personnel functioning within the medical control authority's

 

11  boundaries.geographic region.

 

12        (3) With the advice of the advisory body of the medical

 

13  control authority appointed under subsection (2), a medical

 

14  control authority shall appoint a medical director of the medical

 

15  control authority. The medical director shall must be a physician

 

16  who is board certified in emergency medicine by a national

 

17  organization approved by the department, or who practices

 

18  emergency medicine and is certified in both advanced cardiac life

 

19  support and advanced trauma life support by a national

 

20  organization approved by the department, and who meets other

 

21  standards set forth in department rules. The medical director is

 

22  responsible for medical control for the emergency medical

 

23  services system served by the medical control authority.

 

24        (4) No The participating hospitals shall appoint individuals

 

25  as members of the advisory body of a medical control authority so

 

26  that no more than 10% of the membership of the advisory body of a

 

27  medical control authority shall be consists of employees of the

 

 1  medical director or of an entity substantially owned or

 

 2  controlled by the medical director.

 

 3        (5) A designated medical control authority shall operate in

 

 4  accordance with under the terms of its designation. In addition

 

 5  to any other penalty, remedy, or sanction applicable to a

 

 6  designated medical control authority that violates this part or a

 

 7  rule promulgated under this part, a designated medical control

 

 8  authority that violates this subsection by not operating under

 

 9  the terms of its designation is subject to an administrative fine

 

10  up to $1,000.00 for the violation.

 

11        (6) Each life support agency and individual licensed under

 

12  this part is accountable to the medical control authority in the

 

13  provision of emergency medical services, as defined in protocols

 

14  developed by the medical control authority and approved by the

 

15  department under this part.

 

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

 

17  cause to be operated an ambulance operation unless the ambulance

 

18  operation is licensed under this section.

 

19        (2) Upon receipt of a proper application and payment of a

 

20  $100.00 $150.00 application fee, the department shall issue a

 

21  license as an ambulance operation to a person who that meets the

 

22  requirements of this part and the rules promulgated under this

 

23  part.

 

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

 

25  ambulance to be operated.

 

26        (4) An The department shall specify in an ambulance

 

27  operation license shall specify the ambulances licensed to be

 

 1  operated.

 

 2        (5) An The department shall state in an ambulance operation

 

 3  license shall state the highest level of life support the

 

 4  ambulance operation is licensed to provide. An ambulance

 

 5  operation shall operate in accordance compliance with this part,

 

 6  rules promulgated under this part, and approved medical control

 

 7  authority protocols and shall not provide life support at a level

 

 8  that exceeds its license and available licensed personnel or

 

 9  violates approved medical control authority protocols.

 

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

 

11  upon application to the department and payment of a $100.00

 

12  $150.00 renewal fee. Before issuing a renewal license, the

 

13  department shall determine that the ambulance operation is in

 

14  compliance with this part, the rules promulgated under this part,

 

15  and medical control authority protocols.

 

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

 

17  meets all of the following requirements may apply for an

 

18  ambulance operation upgrade license under subsection (8):

 

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

 

20  license that designates the ambulance operation either as a

 

21  transporting basic life support service or as a transporting

 

22  limited advanced life support service.

 

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

 

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

 

25  emergency patients at a life support level higher than basic life

 

26  support, or is a transporting limited advanced life support

 

27  service, that is able to staff and equip 1 or more ambulances for

 

 1  the transport of emergency patients at the life support level of

 

 2  advanced life support.

 

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

 

 4  unit of government and providing first-line emergency medical

 

 5  response to that local unit of government on or before July 22,

 

 6  1997.

 

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

 

 8  only to the local unit of government described in subdivision

 

 9  (c), and only in response to a 911 call or other call for

 

10  emergency transport.

 

11        (8) An ambulance operation meeting that meets the

 

12  requirements of subsection (7) that and applies for an ambulance

 

13  operation upgrade license shall include all of the following

 

14  information in the application provided by the department:

 

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

 

16  (7) including, but not limited to, a description of the staffing

 

17  and equipment to be used in providing the higher level of life

 

18  support services.

 

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

 

20  service, a plan of action to upgrade from providing basic life

 

21  support to providing limited advanced life support or advanced

 

22  life support to take place over a period of not more than 2

 

23  years. If the applicant is a transporting limited advanced life

 

24  support service, a plan of action to upgrade from providing

 

25  limited advanced life support to providing advanced life support

 

26  to take place over a period of not more than 2 years.

 

27        (c) The medical control authority protocols for the

 

 1  ambulance operation upgrade license, along with and a

 

 2  recommendation from the medical control authority under which the

 

 3  ambulance operation operates that the ambulance operation upgrade

 

 4  license be issued by the department.

 

 5        (d) Other information required by the department.

 

 6        (9) The statewide state emergency medical services

 

 7  coordination committee shall review the information described in

 

 8  subsection (8)(c) and make a recommendation recommend to the

 

 9  department as to whether or not an ambulance operation upgrade

 

10  license should be granted to the applicant.

 

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

 

12  under subsection (8), a positive recommendation under subsection

 

13  (9), and payment of a $100.00 $150.00 application fee, the

 

14  department shall issue to the applicant an ambulance operation

 

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

 

16  operation upgrade license is valid for 2 years from the date of

 

17  issuance and is renewable for 1 additional 2-year period. An

 

18  application applicant that applies for renewal of an ambulance

 

19  operation upgrade license shall contain include with the

 

20  application documentation of the progress made on the plan of

 

21  action described in subsection (8)(b). In addition, the medical

 

22  control authority under which the ambulance operation operates

 

23  shall annually file with the statewide state emergency medical

 

24  services coordination committee a written report on the progress

 

25  made by the ambulance operation on the plan of action described

 

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

 

27  on training, equipment, and personnel.

 

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

 

 2  license as providing basic life support services, then an

 

 3  ambulance operation upgrade license issued under this section

 

 4  allows the ambulance operation to provide limited advanced life

 

 5  support services or advanced life support services when the

 

 6  ambulance operation is able to staff and equip 1 or more

 

 7  ambulances to provide services at the higher levels. If an

 

 8  ambulance operation is designated by its regular license as

 

 9  providing limited advanced life support services, then an

 

10  ambulance operation upgrade license issued under this section

 

11  allows the ambulance operation to provide advanced life support

 

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

 

13  1 or more ambulances to provide services at the higher level. An

 

14  ambulance operation shall not provide services under an ambulance

 

15  operation upgrade license unless the medical control authority

 

16  under which the ambulance operation operates has adopted

 

17  protocols for the ambulance operation upgrade license regarding

 

18  quality monitoring procedures, use and protection of equipment,

 

19  and patient care.

 

20        (12) The department may revoke or fail to not renew an

 

21  ambulance operation upgrade license for a violation of this part

 

22  or a rule promulgated under this part or for failure to comply

 

23  with the plan of action filed under subsection (8)(b). An

 

24  ambulance operation that obtains an ambulance operation upgrade

 

25  license must shall annually renew its regular license under

 

26  subsections (2) to (6). An ambulance operation's regular license

 

27  is not affected by any of the following:

 

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

 

 2  renewed an ambulance operation upgrade license.

 

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

 

 4  operation upgrade license is revoked or is not renewed under this

 

 5  subsection.

 

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

 

 7  operation upgrade license expires at the end of the second 2-year

 

 8  period prescribed by subsection (10).

 

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

 

10  report to the legislature. The department shall include all of

 

11  the following information in the report:

 

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

 

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

 

14  license under subsection (8) during the 3-year period.

 

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

 

16  for an ambulance operation upgrade license during the 3-year

 

17  period.

 

18        (c) The number of ambulance operations that successfully

 

19  upgraded from being a transporting basic life support service to

 

20  a transporting limited advanced service or a transporting

 

21  advanced life support service or that successfully upgraded from

 

22  being a transporting limited advanced life support service to a

 

23  transporting advanced life support service under an ambulance

 

24  operation upgrade license.

 

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

 

26  successfully upgrade, as described in subdivision (c), under an

 

27  ambulance operation upgrade license, but that improved their

 

 1  services during the 3-year period.

 

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

 

 3  successfully upgrade, as described in subdivision (c), under an

 

 4  ambulance operation upgrade license, and that showed no

 

 5  improvement or a decline in their services.

 

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

 

 7  subsection on the delivery of emergency medical services in this

 

 8  state.

 

 9        Sec. 20923. (1) Except as otherwise provided in section

 

10  20924(2), a person shall not operate an ambulance unless the

 

11  ambulance is licensed under this section and is operated as part

 

12  of a licensed ambulance operation.

 

13        (2) Upon receipt of a proper application and payment of a

 

14  $25.00 $50.00 application fee, the department shall issue an

 

15  ambulance license , or annual renewal of an ambulance license ,

 

16  to the applicant ambulance operation. Receipt of the By

 

17  submitting an application by to the department, serves as

 

18  attestation to the department by the ambulance operation attests

 

19  that the ambulance being licensed or renewed is in compliance

 

20  with the minimum standards required by the department. The

 

21  inspection of an ambulance by the department is not required as a

 

22  basis for licensure renewal, unless otherwise determined by the

 

23  department.

 

24        (3) An ambulance operation shall submit an application and

 

25  fee to the department for each ambulance in service. Each An

 

26  ambulance operation shall include with the application shall

 

27  include a certificate of insurance for the ambulance in the

 

 1  amount and coverage required by the department.

 

 2        (4) Upon purchase by an An ambulance operation , shall not

 

 3  purchase an ambulance shall for service under this part that does

 

 4  not meet all vehicle standards established by the department

 

 5  under section 20910(e)(iv).20910(1)(e)(iv).

 

 6        (5) Once licensed for service, an ambulance is not required

 

 7  to meet subsequently modified state vehicle standards during its

 

 8  use by the ambulance operation that obtained the license.

 

 9        (6) Patient An ambulance operation shall only carry patient

 

10  care equipment and safety equipment carried on an ambulance shall

 

11  that meet the minimum requirements prescribed by the department

 

12  and the approved local medical control authority protocols.

 

13        (7) An ambulance operation that maintains patient care

 

14  equipment and medications necessary to upgrade from providing

 

15  basic or limited advanced life support to providing a higher

 

16  level of life support in accordance with under section 20921(4)

 

17  shall secure the necessary patient care equipment and medications

 

18  in a way such so that the equipment or medications can only be

 

19  used by the appropriately licensed personnel.

 

20        (8) An ambulance operation shall be equipped equip an

 

21  ambulance with a communications system utilizing frequencies and

 

22  procedures consistent with the statewide emergency medical

 

23  services communications system developed by the department.

 

24        (9) An ambulance license is not transferable to another

 

25  ambulance operation.

 

26        Sec. 20926. (1) A person shall not establish, operate, or

 

27  cause to be operated a nontransport prehospital life support

 

 1  operation unless it is licensed under this section.

 

 2        (2) The department, upon Upon receipt of a proper

 

 3  application and payment of a $100.00 $150.00 application fee, the

 

 4  department shall issue a license for a nontransport prehospital

 

 5  life support operation to a person meeting that meets the

 

 6  requirements of this part and rules promulgated under this part.

 

 7        (3) A The department shall specify in a nontransport

 

 8  prehospital life support operation license shall specify the

 

 9  level of life support the operation is licensed to provide. A

 

10  nontransport prehospital life support operation shall operate in

 

11  accordance compliance with this part, rules promulgated under

 

12  this part, and approved local medical control authority protocols

 

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

 

14  license or violates approved local medical control authority

 

15  protocols.

 

16        (4) An applicant for a nontransport prehospital life support

 

17  operation license shall specify in the application for licensure

 

18  each nontransport prehospital life support vehicle to be

 

19  operated.

 

20        (5) A The department shall specify in a nontransport

 

21  prehospital life support operation license shall specify the

 

22  nontransport prehospital life support vehicles licensed to be

 

23  operated.

 

24        (6) A nontransport prehospital life support operation

 

25  license may be renewed annually upon application to the

 

26  department and payment of a $100.00 $150.00 renewal fee. Before

 

27  issuing a renewal license, the department shall determine that

 

 1  the nontransport prehospital life support operation is in

 

 2  compliance with this part, rules promulgated under this part, and

 

 3  local medical control authority protocols.

 

 4        Sec. 20929. (1) A person shall not operate a nontransport

 

 5  prehospital life support vehicle unless the vehicle is licensed

 

 6  by the department under this section and is operated as part of a

 

 7  licensed nontransport prehospital life support operation.

 

 8        (2) Upon receipt of a proper application and payment of a

 

 9  $25.00 $50.00 application fee, the department shall issue a

 

10  nontransport prehospital life support vehicle license or annual

 

11  renewal of a nontransport prehospital life support vehicle

 

12  license to the applicant nontransport prehospital life support

 

13  operation. Receipt of the By submitting an application by to the

 

14  department, serves as attestation to the department by the

 

15  nontransport prehospital life support operation attests that the

 

16  vehicle being licensed or renewed is in compliance with the

 

17  minimum standards required by the department. The inspection of a

 

18  nontransport prehospital life support vehicle by the department

 

19  is not required as a basis for issuing to issue a licensure

 

20  renewal, unless otherwise determined by the department.

 

21        (3) A nontransport prehospital life support operation shall

 

22  submit an application and required fee to the department for each

 

23  vehicle in service. Each A nontransport prehospital life support

 

24  operation shall include with the application shall include a

 

25  certificate of insurance for the vehicle in the amount and

 

26  coverage required by the department.

 

27        (4) A nontransport prehospital life support operation shall

 

 1  equip a nontransport prehospital life support vehicle shall be

 

 2  equipped with a communications system utilizing frequencies and

 

 3  procedures consistent with the statewide emergency medical

 

 4  services communications system developed by the department.

 

 5        (5) A nontransport prehospital life support operation shall

 

 6  equip a nontransport prehospital life support vehicle shall be

 

 7  equipped according to in compliance with the department's minimum

 

 8  equipment list and approved medical control authority protocols

 

 9  based upon the level of life support the vehicle and personnel

 

10  are licensed to provide.

 

11        Sec. 20931. (1) A person shall not establish, operate, or

 

12  cause to be operated an aircraft transport operation unless it is

 

13  licensed under this section.

 

14        (2) The department, upon Upon receipt of a proper

 

15  application and payment of a $100.00 $150.00 application fee, the

 

16  department shall issue a license for an aircraft transport

 

17  operation to a person meeting that meets the requirements of this

 

18  part and rules promulgated under this part.

 

19        (3) An The department shall specify in an aircraft transport

 

20  operation license shall specify the level of life support the

 

21  operation is licensed to provide. An aircraft transport operation

 

22  shall operate in accordance compliance with this part, rules

 

23  promulgated under this part, and orders established by the

 

24  patient's physician and shall not provide life support at a level

 

25  that exceeds its license or violates those orders.

 

26        (4) An applicant for an aircraft transport operation license

 

27  shall specify in the application for licensure each aircraft

 

 1  transport vehicle to be operated and licensed.

 

 2        (5) An aircraft transport operation license may be renewed

 

 3  annually upon application to the department and payment of a

 

 4  $100.00 $150.00 renewal fee. Before issuing a renewal license,

 

 5  the department shall determine that the aircraft transport

 

 6  operation is in compliance with this part and rules promulgated

 

 7  under this part.

 

 8        Sec. 20934. (1) A person shall not operate an aircraft

 

 9  transport vehicle unless the vehicle is licensed by the

 

10  department under this section and is operated as part of a

 

11  licensed aircraft transport operation.

 

12        (2) Upon receipt of a proper application and payment of a

 

13  $100.00 $150.00 application fee, the department shall issue an

 

14  aircraft transport vehicle license or annual renewal of an

 

15  aircraft transport vehicle license to the applicant aircraft

 

16  transport operation. Receipt of the By submitting an application

 

17  by to the department, serves as attestation to the department by

 

18  the aircraft transport operation attests that the vehicle is in

 

19  compliance with the minimum standards required by the department.

 

20  The inspection of an aircraft transport vehicle by the department

 

21  is not required as a basis for licensure renewal, unless

 

22  otherwise determined by the department.

 

23        (3) An aircraft transport operation shall submit an

 

24  application and required fee to the department for each vehicle

 

25  in service. Except as provided in subsection (6), each The

 

26  applicant shall include with the application shall include a

 

27  certificate of insurance for the vehicle in the amount and

 

 1  coverage required by the department or, if applicable, the amount

 

 2  and coverage required under subsection (6).

 

 3        (4) An aircraft transport operation shall equip an aircraft

 

 4  transport vehicle shall be equipped with a communications system

 

 5  utilizing frequencies and procedures consistent with the

 

 6  statewide emergency medical services communications system

 

 7  developed by the department.

 

 8        (5) An aircraft transport operation shall equip an aircraft

 

 9  transport vehicle shall be equipped according to in compliance

 

10  with the department's minimum equipment list based upon the level

 

11  of life support the vehicle and personnel are licensed to

 

12  provide.

 

13        (6) When determining the amount of liability coverage

 

14  required by the department under subsection (3), The department

 

15  shall not require an aircraft transport operation that transports

 

16  patients less than an average of 45 times a year over the 5-year

 

17  period preceding the date coverage begins, is not required meets

 

18  all of the following to have more than $2,000,000.00 in liability

 

19  coverage on each aircraft transport vehicle in that aircraft

 

20  transport operation: . An

 

21        (a) The aircraft transport operation transports patients

 

22  less than an average of 45 times a year over the 5-year period

 

23  preceding the date coverage begins.

 

24        (b) The aircraft transport operation has an aircraft

 

25  transport operator described under this subsection that has with

 

26  a valid federal aviation regulation part 135 air carrier

 

27  certificate issued by the federal aviation administration shall

 

 1  have its and with a base of operation and primary business

 

 2  address on an island in the Great Lakes more than 20 miles from

 

 3  the nearest mainland airport. The For the purposes of this

 

 4  subdivision, an aircraft transport operator's primary business

 

 5  address is the address shown in the operations specifications and

 

 6  on the air carrier certificate.

 

 7        Sec. 20936. (1) If an application for renewal of an

 

 8  ambulance operation, nontransport prehospital life support

 

 9  operation, or aircraft transport operation license is received by

 

10  the department after the expiration date of the license, the

 

11  applicant shall pay a late fee in the amount of $300.00 in

 

12  addition to the renewal fee. If an application for renewal is not

 

13  received by the department within 60 days after the license

 

14  expires, the department shall not issue a renewal license unless

 

15  the licensee completes the requirements for initial licensure and

 

16  pays the late fee.

 

17        (2) If an application for renewal of an ambulance, or

 

18  nontransport prehospital life support vehicle, or aircraft

 

19  transport vehicle license is received by the department after the

 

20  expiration date of the license, the applicant shall pay a late

 

21  fee in the amount of $100.00 $150.00 in addition to the renewal

 

22  fee. If an application for renewal is not received by the

 

23  department within 60 days after the license expires, the

 

24  department shall not issue a renewal license unless the licensee

 

25  completes the requirements for initial licensure and pays the

 

26  late fee.

 

27        Sec. 20941. (1) A person shall not establish, operate, or

 

 1  cause to be operated a medical first response service unless the

 

 2  service is licensed by the department. A person shall not operate

 

 3  a medical first response vehicle unless the vehicle is licensed

 

 4  by the department under this section and is operated as part of a

 

 5  medical first response service.

 

 6        (2) Upon receipt of a proper application and a $150.00

 

 7  application fee, the department shall issue a license as a

 

 8  medical first response service license or annual renewal of a

 

 9  medical first response license to a person who the applicant

 

10  medical first response service that meets the requirements of

 

11  this part and rules promulgated under this part. The department

 

12  shall not charge a fee for licensing a medical first response

 

13  service.

 

14        (3) Upon receipt of a proper application and a $50.00

 

15  application fee, the department shall issue a medical first

 

16  response vehicle license or annual renewal of a medical first

 

17  response vehicle license to the applicant medical first response

 

18  service. By submitting an application to the department, the

 

19  medical first response service attests that the vehicle is in

 

20  compliance with the minimum standards required by the department.

 

21  The inspection of a medical first response vehicle by the

 

22  department is not required to issue a licensure renewal, unless

 

23  otherwise determined by the department.

 

24        (4) (3) A medical first response service shall provide life

 

25  support in accordance compliance with approved local medical

 

26  control authority protocols and shall not provide life support at

 

27  a level that exceeds its license or violates approved local

 

 1  medical control authority protocols.

 

 2        (4) A medical first response service license may be renewed

 

 3  annually upon the application to the department.

 

 4        (5) A person shall not advertise or disseminate information

 

 5  leading the public to believe that the person provides a medical

 

 6  first response service unless that person does in fact provide

 

 7  that service and has been licensed by the department.

 

 8        (6) A medical first response service shall have at least 1

 

 9  licensed medical first response vehicle available on a 24-hour-a-

 

10  day, 7-day-a-week basis, to provide a medical first response

 

11  capability. Each A medical first response service shall equip and

 

12  staff a medical first response vehicle shall be equipped and

 

13  staffed as required by this part or rules promulgated under this

 

14  part.

 

15        (7) A medical first response service shall provide life

 

16  support consistent with its license and approved local medical

 

17  control authority protocols to all patients without prior inquiry

 

18  into ability to pay or source of payment.

 

19        (8) To the extent that a police or fire suppression agency

 

20  is dispatched to provide medical first response life support,

 

21  that agency is subject to this section and the other provisions

 

22  of this part relating to medical first response services.

 

23        Sec. 20945. If the department determines that grounds exist

 

24  under section 20165 for denial, suspension, or revocation of a

 

25  life support agency license but that the denial, suspension, or

 

26  revocation of the license may be detrimental to the health,

 

27  safety, and welfare of the residents served by the life support

 

 1  agency or applicant, the department may issue a nonrenewable

 

 2  conditional license under this section. The department shall not

 

 3  issue a nonrenewable conditional license under this section until

 

 4  the life support agency or applicant pays to the department a

 

 5  $150.00 license fee. A nonrenewable conditional license issued

 

 6  under this section is effective for not more than 1 year. and The

 

 7  department may prescribe such conditions on a nonrenewable

 

 8  conditional license under this section as the department

 

 9  determines to be necessary to protect the public health, safety,

 

10  and welfare.

 

11        Sec. 20950. (1) An individual shall not practice or

 

12  advertise to practice as a medical first responder, emergency

 

13  medical technician, emergency medical technician specialist,

 

14  paramedic, or emergency medical services instructor-coordinator

 

15  unless licensed to do so by the department under this section.

 

16        (2) The department shall issue a license under this section

 

17  only to an individual who meets all of the following

 

18  requirements:

 

19        (a) Is 18 years of age or older.

 

20        (b) Has successfully completed the appropriate education

 

21  program approved under section 20912.

 

22        (c) Subject to subsection (3), has attained a passing score

 

23  on the appropriate department prescribed examination, as follows:

 

24        (i) A medical first responder shall pass the written

 

25  examination proctored by the department or the department's

 

26  designee and a practical examination approved by the department.

 

27  The practical examination shall be administered by the

 

 1  instructors of the medical first responder course. The department

 

 2  or the department's designee may also proctor the practical

 

 3  examination. The individual shall pay the fee for the written

 

 4  examination required under this subparagraph directly to the

 

 5  national registry of emergency medical technicians or other

 

 6  organization approved by the department.

 

 7        (ii) An emergency medical technician, emergency medical

 

 8  technician specialist, and a paramedic shall pass the written

 

 9  examination proctored by the department or the department's

 

10  designee and a practical examination proctored by the department

 

11  or the department's designee. The individual shall pay the fee

 

12  for the written examination required under this subparagraph

 

13  directly to the national registry of emergency medical

 

14  technicians or other organization approved by the department.

 

15        (iii) The fee for the written examinations required under

 

16  subparagraphs (i) and (ii) shall be paid directly to the national

 

17  registry of emergency medical technicians or other organization

 

18  approved by the department.

 

19        (d) Meets other requirements of this part.

 

20        (3) The department shall require for purposes of compliance

 

21  with subsection (2)(c) successful passage by each first-time

 

22  applicant of an examination. as that term is defined in section

 

23  20904(10).

 

24        (4) The department shall issue a license as an emergency

 

25  medical services instructor-coordinator only to an individual who

 

26  meets the requirements of subsection (2) for an emergency medical

 

27  services instructor-coordinator and at the time of application is

 

 1  currently licensed as a medical first responder, emergency

 

 2  medical technician, emergency medical technician specialist, or

 

 3  paramedic and has at least 3 years' field experience with a

 

 4  licensed life support agency as a medical first responder,

 

 5  emergency medical technician, emergency medical technician

 

 6  specialist, or paramedic. The department shall provide for the

 

 7  development and administration of an examination for emergency

 

 8  medical services instructor-coordinators. The license shall

 

 9  specify the level of instruction-coordination the individual is

 

10  licensed to provide. An emergency medical services instructor-

 

11  coordinator shall not instruct or coordinate emergency medical

 

12  training courses at a level that exceeds his or her designated

 

13  level of licensure and for which he or she does not have at least

 

14  3 years' field experience at that level of licensure.

 

15        (5) Except as otherwise provided by in section 20952, a

 

16  license under this section is effective for 3 years from the date

 

17  of issuance unless revoked or suspended by the department.

 

18        (6) Except as otherwise provided in subsection (7), (9), an

 

19  applicant for licensure under this section shall pay the

 

20  following triennial licensure fees:

 

21        (a) Medical first responder - no fee.$100.00.

 

22        (b) Emergency medical technician - $40.00.$100.00.

 

23        (c) Emergency medical technician specialist -

 

24  $60.00.$100.00.

 

25        (d) Paramedic - $80.00.$100.00.

 

26        (e) Emergency medical services instructor-coordinator -

 

27  $100.00.$150.00.

 

 1        (7) An individual who is applying for licensure as a medical

 

 2  first responder, emergency medical technician, emergency medical

 

 3  technician specialist, paramedic, or emergency medical services

 

 4  instructor-coordinator by reciprocity as provided in section

 

 5  20961 or under national registry status shall pay an initial

 

 6  application fee of $225.00.

 

 7        (8) An individual who is applying for licensure under this

 

 8  section for which a criminal history check is required shall pay

 

 9  a $100.00 processing fee.

 

10        (9) (7) If a life support agency certifies to the department

 

11  that an applicant for licensure under this section will act as a

 

12  volunteer and if the life support agency does not charge for its

 

13  services, the department shall not require the applicant to pay

 

14  the fee required under subsection (6). If the applicant ceases to

 

15  meet the definition of a volunteer under this part at any time

 

16  during the effective period of his or her license and is employed

 

17  as a licensee under this part, the applicant shall at that time

 

18  pay the fee required under subsection (6).

 

19        Sec. 20954. (1) Upon receipt of a proper application to the

 

20  department and payment of the renewal fee under subsection (2),

 

21  the department may renew an emergency medical services personnel

 

22  license if the applicant meets the requirements of this part and

 

23  provides, upon request of the department, verification of having

 

24  met ongoing education requirements established by the department.

 

25  If an applicant for renewal fails to provide the department with

 

26  a change of address, the applicant shall pay a $20.00 $25.00 fee

 

27  in addition to the renewal and late fees required under

 

 1  subsections (2) and (3).

 

 2        (2) Except as otherwise provided in subsection (5), an

 

 3  applicant for renewal of a license under section 20950 shall pay

 

 4  a triennial renewal fee as follows:

 

 5        (a) Medical first responder - no fee.$75.00.

 

 6        (b) Emergency medical technician - $25.00.$75.00.

 

 7        (c) Emergency medical technician specialist - $25.00.$75.00.

 

 8        (d) Paramedic - $25.00.$75.00.

 

 9        (e) Emergency medical services instructor-coordinator -

 

10  $25.00.$75.00.

 

11        (3) Except as otherwise provided in subsection (5), if an

 

12  application for renewal under subsection (1) is postmarked or

 

13  delivered after the date the license expires, the applicant shall

 

14  pay a late fee in addition to the renewal fee under subsection

 

15  (2) as follows:

 

16        (a) Medical first responder - $50.00.$100.00.

 

17        (b) Emergency medical technician - $50.00.$100.00.

 

18        (c) Emergency medical technician specialist -

 

19  $50.00.$100.00.

 

20        (d) Paramedic - $50.00.$100.00.

 

21        (e) Emergency medical services instructor-coordinator -

 

22  $50.00.$100.00.

 

23        (4) A licensee shall renew a license or registration shall

 

24  be renewed by the licensee on or before the expiration date as

 

25  prescribed by rule. The department shall mail a notice to the

 

26  licensee at the last known address on file with the department

 

27  advising of the time, procedure, and fee for renewal. Failure of

 

 1  the a licensee to receive notice under this subsection does not

 

 2  relieve the licensee of the responsibility for renewing his or

 

 3  her license. A license not renewed by the expiration date may be

 

 4  renewed within 60 days of the expiration date upon application,

 

 5  payment of renewal and late renewal fees, and fulfillment of any

 

 6  continued continuing education requirements set forth as

 

 7  prescribed in rules promulgated under this article. The licensee

 

 8  may continue to practice and use the title during the 60-day

 

 9  period. If a license is not so renewed as required in this

 

10  section within 60 days of the expiration date, the license is

 

11  void. The A licensee whose license is void under this section

 

12  shall not practice or use the a title protected under this part.

 

13  An individual may be relicensed within 3 years of the expiration

 

14  date upon application, payment of the application processing,

 

15  renewal, and late renewal fees, and fulfillment of any continuing

 

16  education requirements in effect at the time of the expiration

 

17  date, or that would have been required had the individual renewed

 

18  his or her license pursuant to subsection (1). An individual may

 

19  be relicensed more than 3 years after the expiration date upon

 

20  application as a new applicant, meeting all licensure

 

21  requirements in effect at the time of application, taking or

 

22  retaking and passing any examinations required for initial

 

23  licensure, and payment of fees required of new applicants.

 

24        (5) If a life support agency certifies to the department

 

25  that an applicant for renewal under this section is a volunteer

 

26  and if the life support agency does not charge for its services,

 

27  the department shall not require the applicant to pay the fee

 

 1  required under subsection (2) or a late fee under subsection (3).

 

 2  If the applicant for renewal ceases to meet the definition of a

 

 3  volunteer under this part at any time during the effective period

 

 4  of his or her license renewal and is employed as a licensee under

 

 5  this part, the applicant for renewal shall at that time pay the

 

 6  fee required under subsection (2).

 

 7        (6) An individual seeking renewal under this section is not

 

 8  required to maintain national registry status as a condition of

 

 9  license renewal.

 

10        Sec. 20958. (1) The department may deny, revoke, or suspend

 

11  an emergency medical services personnel license upon finding that

 

12  an applicant or licensee meets 1 or more of the following:

 

13        (a) Is guilty of fraud or deceit in procuring or attempting

 

14  to procure licensure.

 

15        (b) Has illegally obtained, possessed, used, or distributed

 

16  drugs.

 

17        (c) Has Except as otherwise specifically provided in this

 

18  part, has practiced after his or her license has expired or has

 

19  been suspended.

 

20        (d) Has knowingly violated, or aided or abetted others in

 

21  the violation of, this part or rules promulgated under this part.

 

22        (e) Is not performing in a manner consistent with his or her

 

23  education, licensure, or approved medical control authority

 

24  protocols.

 

25        (f) Is physically or mentally incapable of performing his or

 

26  her prescribed duties.

 

27        (g) Has been convicted of a criminal offense under sections

 

 1  520a to 520l of the Michigan penal code, 1931 PA 328, MCL 750.520a

 

 2  to 750.520l. A certified copy of the court record is conclusive

 

 3  evidence of the conviction.

 

 4        (h) Has been convicted of a misdemeanor or felony reasonably

 

 5  related to and adversely affecting the ability to practice in a

 

 6  safe and competent manner. A certified copy of the court record

 

 7  is conclusive evidence of the conviction.

 

 8        (2) In addition to any other penalty, remedy, or sanction

 

 9  applicable to a licensee that violates this part or a rule

 

10  promulgated under this part, a licensee who is found to meet any

 

11  of the items in subsection (1) is subject to an administrative

 

12  fine of up to $500.00 for the violation.

 

13        (3) (2) The department shall provide notice of intent to

 

14  deny, revoke, or suspend an emergency services personnel license

 

15  or impose an administrative fine by certified mail or personal

 

16  service. The notice of intent shall set forth the particular

 

17  reasons for the proposed action and shall advise the applicant or

 

18  licensee that he or she is entitled to the opportunity for a

 

19  hearing before the director or the director's authorized

 

20  representative. If the person individual to whom the notice is

 

21  sent does not make a written request to the department for a

 

22  hearing within 30 days of receiving the notice, the license is

 

23  considered denied, revoked, or suspended or administrative fine

 

24  imposed as stated in the notice. If requested, the department

 

25  shall conduct the hearing shall be conducted pursuant to under

 

26  the administrative procedures act of 1969 and rules promulgated

 

27  by the department. A The department shall keep a full and

 

 1  complete record shall be kept of the proceeding and shall be

 

 2  transcribed when transcribe the record if requested by an

 

 3  interested party. , who The interested party requesting the

 

 4  transcription shall pay the cost of preparing the transcript. On

 

 5  the basis of a hearing or on the default of the applicant or

 

 6  licensee, the department may issue, deny, suspend, or revoke a

 

 7  license or impose an administrative fine.

 

 8        (4) (3) The department may establish procedures, hold

 

 9  hearings, administer oaths, issue subpoenas, or order testimony

 

10  to be taken at a hearing or by deposition in a proceeding pending

 

11  at any stage of the proceeding. A person may be compelled to

 

12  appear and testify and to produce books, papers, or documents in

 

13  a proceeding.

 

14        (5) (4) In case of disobedience of If a person disobeys a

 

15  subpoena, a party to a hearing may invoke the aid of the circuit

 

16  court of the jurisdiction in which the hearing is held to require

 

17  the attendance and testimony of witnesses. The circuit court may

 

18  issue an order requiring an individual to appear and give

 

19  testimony. Failure to obey the order of the circuit court may be

 

20  punished by the court as a contempt.