23-27 Licensing of Emergency Medical Services Operations
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<![CDATA[CHAPTER 23-27LICENSING OF EMERGENCY MEDICAL SERVICES OPERATIONS23-27-01. License required - Licensing of emergency medical services operations -Exception - Waiver.1.The state department of health shall license emergency medical services<br>operations. After June 30, 2001, the department shall limit the issuance of a license<br>for any new emergency medical services operation based on the needs of the<br>service area if the applicant for the new license was licensed before July 1, 2001,<br>and was subsequently relicensed under section 23-27-04.5.A license for anemergency medical services operation is nontransferable.2.Emergency medical services may not be advertised, offered, or provided to the<br>public except by an emergency medical services operator that provides the<br>emergency medical services through emergency medical services personnel.3.Except as otherwise provided under subsection 4, an emergency medical services<br>operator must be separately licensed for each of the operator's emergency medical<br>services operations and an operation that is headquartered from a separate location<br>must be considered a separate operation. Under this subsection, an operation with<br>a single headquarters site may dispatch vehicles and emergency medical services<br>personnel from more than one location if calls requesting services are received and<br>orders for vehicle dispatch are made at the single headquarters site.4.Notwithstanding subsection 3, an operator of an emergency medical services<br>operation may operate one or more substation ambulance services operations under<br>a single license if:a.The headquarters ambulance services operation is not a substation ambulance<br>services operation of another emergency medical services operation;b.The substation ambulance services operation area borders the headquarters<br>ambulance services operation area or borders another substation of the<br>headquarters ambulance services operation;c.The headquarters ambulance services operation and the substation ambulance<br>services operation are dispatched by the same entity; andd.The operator of the emergency medical services operation pays a license fee<br>for each of its substation ambulance services operations.5.The provisions of this chapter do not apply to an operator from another state which<br>is headquartered at a location outside of this state and transports patients across<br>state lines, but the operator may not treat patients within this state or pick up<br>patients within this state for transportation to locations within this state, except as<br>provided by rule.6.The state health council shall adopt rules for special licenses and waiver provisions<br>for an operator of an emergency medical services operation intended for industrial<br>sites not available to the general public.23-27-02. Definitions. For the purpose of this chapter, unless the context otherwiserequires:1."Department" means the state department of health.Page No. 12."Emergency medical services" means the prehospital medical stabilization or<br>transportation of an individual who is sick, injured, wounded, or otherwise<br>incapacitated or helpless, or in a real or perceived acute medical condition, by a<br>person that holds oneself out to the public as being in that service or that regularly<br>provides that service. The term includes:a.Assessing, stabilizing, and treating life-threatening and non-life-threatening<br>medical conditions; orb.Transporting a patient who is in a real or perceived acute medical condition to a<br>hospital emergency room.3."Emergency medical services operation" means an entity licensed to offer and<br>provide emergency medical services by emergency medical services personnel with<br>physician oversight.The term includes basic life support ambulance services,advanced life support ambulance services, air ambulance services, and quick<br>response unit services.4."Emergency medical services personnel" means individuals who provide emergency<br>medical services for emergency medical services operations. The term includes<br>emergency medical services professionals, drivers, and department-certified<br>emergency medical services providers, such as cardiopulmonary resuscitation<br>drivers and first responders.5."Emergency medical services professional" means an individual licensed by the<br>department as an emergency medical technician-basic, emergency medical<br>technician-intermediate, or emergency medical technician-paramedic.23-27-03. License fees. The fee for an emergency medical services operation licenseto operate an emergency medical services operation or a substation ambulance services<br>operation must be set by the state health council at a sum of not more than twenty-five dollars<br>annually, as may be required to defray the costs of administration of the licensing program. This<br>operation license fee does not apply to licensure or certification of emergency medical services<br>personnel. All license fees must be paid to the state department of health and deposited with the<br>state treasurer and credited to the state general fund.23-27-04. Standards for operators.1.An emergency medical services operation within this state may not operate unless<br>the operation is licensed in accordance with this chapter and rules adopted by the<br>state health council. The rules must include:a.Time when operator's services must be available.b.Type of motor vehicle operator's license needed for drivers of ground vehicles.c.Training standards for operation personnel.d.Equipment and ground vehicle standards.e.Annual license fees.f.Number of personnel required for each run.g.The scope of practice for uncertified drivers, certified personnel, and<br>emergency medical services professionals.h.Performance standards, which may include response time standards.Page No. 2i.Other requirements as may be found necessary to carry out the intent of this<br>chapter.2.An officer, employee, or agent of any prehospital emergency medical services<br>operation may refuse to transport an individual for which transport is not medically<br>necessary and may recommend an alternative course of action to that individual if<br>the prehospital emergency medical service has developed protocols that include<br>direct medical control to refuse transport of an individual.23-27-04.1. Emergency care or services rendered by officers, employees, or agentsof emergency medical services operations - Physician medical direction.1.An officer, employee, or agent of an emergency medical services operation and a<br>physician licensed in this state who provides medical direction to an emergency<br>medical services operation, who is a volunteer, who in good faith renders emergency<br>care, services, or medical direction, is not liable to the recipient of the emergency<br>care, services, or medical direction for any civil damages resulting from any acts or<br>omissions by the person in rendering the emergency care, services, or medical<br>direction provided the person is properly trained according to law.2.For the purpose of this section, "volunteer" means an individual who receives no<br>compensation or who is paid expenses, reasonable benefits, nominal fees, or a<br>combination of expenses, reasonable benefits, and nominal fees to perform the<br>services for which the individual volunteered, provided that the fees do not exceed<br>ten thousand dollars in any calendar year.3.For a volunteer physician providing medical overview to an emergency medical<br>services operation and the operation's personnel, the ten thousand dollar maximum<br>fees amount is calculated separately for each emergency medical services operation<br>for which the physician volunteered medical overview. This section does not relieve<br>a person from liability for damages resulting from the intoxication, willful misconduct,<br>or gross negligence of the person rendering the emergency care or services.4.An officer, employee, or agent of any emergency medical services operation and a<br>physician licensed in this state who provides medical direction to any emergency<br>medical services operation who in good faith does not render emergency care,<br>service, or medical direction to an individual based on a determination that transport<br>of that individual to a hospital is not medically necessary is not liable to that<br>individual for damages unless the damages resulted from intoxication, willful<br>misconduct, or gross negligence.23-27-04.2. Emergency medical services - State assistance. The state department ofhealth shall assist in the training of emergency medical services personnel of certain emergency<br>medical services operations as determined by the department and financially shall assist certain<br>emergency medical services operations as determined by the department in obtaining<br>equipment.Assistance provided under this section must be within the limits of legislativeappropriation. The department shall adopt criteria for eligibility for assistance in the training of<br>emergency medical services personnel of various types of emergency medical services<br>operations. To qualify for financial assistance for equipment an emergency medical services<br>operation shall certify, in the manner required by the department, that the operation has fifty<br>percent of the amount of funds necessary for identified equipment acquisitions. The department<br>shall adopt a schedule of eligibility for financial assistance for equipment. The schedule must<br>provide for a direct relationship between the amount of funds certified and the number of<br>responses during the preceding calendar year for the purpose of rendering medical care,<br>transportation, or both, to individuals who were sick or incapacitated. The schedule must require<br>that as the number of responses increases, a greater amount of funds certified is required. The<br>schedule must classify responses and the financial assistance available for various<br>classifications.The department may establish minimum and maximum amounts of financialassistance to be provided to an emergency medical services operation under this section. IfPage No. 3applications for financial assistance exceed the amount of allocated and available funds, the<br>department may prorate the funds among the applicants in accordance with criteria adopted by<br>the department. No more than one-half of the funds appropriated by the legislative assembly<br>each biennium and allocated for training assistance may be distributed in the first year of the<br>biennium.23-27-04.3. Emergency medical services personnel training, testing, certification,licensure, and quality review - Penalty. The state health council shall adopt rules prescribing<br>minimum training, testing, certification, licensure, and quality review standards for emergency<br>medical services personnel, instructors, and training institutions. Rules adopted must include a<br>definition of minimum applicable standards, a definition of emergency medical services<br>personnel, provide for a mechanism for certifying or licensing persons who have met the required<br>standards, provide a mechanism to review and improve the quality of care rendered by<br>emergency medical services personnel, and define minimum standards for emergency medical<br>services training institutions. Licensing as an emergency medical services training institution is<br>optional. It is a class B misdemeanor for an individual to willfully misrepresent that individual's<br>certification or licensing status as emergency medical services personnel. Quality review and<br>improvement information, data, records, and proceedings are not subject to subpoena or<br>discovery or introduction into evidence in any civil action.23-27-04.4.Supervision of certified or licensed emergency medical technicianhospital personnel.Certified or licensed emergency medical technicians-intermediate andparamedics, who are employed by a hospital may provide patient care within a scope of practice<br>established by the department.Under this section, these emergency medical servicesprofessionals are under the supervision of the hospital's nurse executive.23-27-04.5. Quick response unit service pilot program. Expired under S.L. 2001,ch. 246, </p>
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