HLS 10RS-1793 ORIGINAL
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Regular Session, 2010
HOUSE BILL NO. 1181
BY REPRESENTATIVE HARRISON
HEALTH CARE: Provides for the First Responder Financial Stabilization and
Enhancement Act
AN ACT1
To enact Subpart E of Part VII of Chapter 5 of Title 40 of the Louisiana Revised Statutes of2
1950, to be comprised of R.S. 40:1236.21 through 1236.31, relative to emergency3
medical services; to provide for the creation of the statewide ambulance service4
district; to provide for the purpose and object of the district; to provide for a board5
of commissioners; to provide for powers and duties of the board of commissioners;6
to provide for domicile of the district; to provide for rules and regulations; to provide7
for legislative findings; and to provide for related matters.8
Be it enacted by the Legislature of Louisiana:9
Section 1. Subpart E of Part VII of Chapter 5 of Title 40 of the Louisiana Revised10
Statutes of 1950, comprised of R.S. 40:1236.21 through 1236.31, is hereby enacted to read11
as follows:12
SUBPART E. STATEWIDE AMBULANCE SERVI CE DISTRICT13
§1236.21. Legislative findings14
The legislature hereby finds and declares the following:15
(1) Emergency medical services constitute an invaluable part of the16
healthcare delivery system of Louisiana and are an essential element of Louisiana's17
emergency preparedness system.18
(2) Emergency medical services will be a key element in any healthcare19
reform initiative.20 HLS 10RS-1793 ORIGINAL
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(3) Emergency medical services are a key component of any economic1
development program as they are essential to recruiting and retaining industry. 2
(4) The cost of funding the Medicaid program and healthcare for the poor3
and uninsured in the state must be carefully managed in a manner which recognizes4
the challenges associated with appropriate reimbursement for services under the5
program.6
(5) Emergency medical service providers want to assure that emergency7
medical services are available to all residents of Louisiana.8
(6) It is in the best interest of the state that there exist sufficient resources to9
assure the availability of emergency ambulance services to the citizens of Louisiana10
and the creation of a statewide ambulance service district will help to ensure this11
goal.12
§1236.22. Short title13
This Subpart shall be known and may be cited as the "First Responder14
Financial Stabilization and Enhancement Act."15
§1236.23. Statewide ambulance service district; creation16
In order to provide for sufficient resources to assure the availability of17
emergency ambulance services to the population of Louisiana, the legislature does18
hereby establish a statewide ambulance service district. The boundaries of the19
district shall be coterminous with the boundaries of the state. The ambulance service20
district thus created shall constitute a body corporate in law with all powers of a21
corporation, shall have perpetual existence, shall have the power and right to contract22
obligations, to sue and be sued, and to do and perform any and all acts in its23
corporate capacity and its corporate name necessary and proper for the carrying out24
of the objects and purposes for which the ambulance service district was created. It25
shall have the power and authority to acquire any and all necessary equipment and26
buildings for the purpose of performing the objects for which it is formed, and shall27
own all sites and physical facilities which are acquired either by donation, purchase,28
exchange, and otherwise in full ownership.29 HLS 10RS-1793 ORIGINAL
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§1236.24. Object and purpose of the district1
The object and purpose of the ambulance service district and the governing2
body created pursuant to the provisions of this Subpart shall be to enhance3
reimbursement and financial stability of ambulance providers. The Department of4
Health and Hospitals may submit waivers or state plan amendments to the Centers5
for Medicare and Medicaid Services in order to secure federal financial participation6
in relation to any such payments or reimbursement. Payments shall be made only in7
accordance with an approved waiver or state plan amendment. The department and8
the transferring statewide ambulance district may enter into an agreement, in9
accordance with state and federal law, concerning the use of transferred funds in a10
way that is consistent with the legislative intent set forth herein. The commission11
may establish a methodology utilizing a pool, or pools, to facilitate distribution of12
any transfers received in addition to any federal financial participation earned13
through the use of such transfers, as authorized herein. The methodology shall be14
created with the intent to maximize, to the fullest extent possible, the return to the15
providers located within the jurisdiction of the local governing body from which16
such transfer is derived. Any licensed provider of ambulance services shall be17
eligible to participate in the district. Participation is on a strictly voluntary basis.18
§1236.25. Ambulance service district commission; qualifications, appointment,19
vacancies, removal and compensation of members 20
A. The ambulance service district created pursuant to this Subpart shall be21
governed by the Ambulance Service District Commission, hereafter referred to as the22
commission. The commission shall be composed of one member from each23
congressional district appointed by the governor from a list of names submitted by24
the Louisiana Ambulance Alliance. The nomination list submitted to the governor25
shall include at least three nominees from each congressional district. Members of26
the commission shall be citizens and qualified electors of this state. Initially, three27
members of the commission shall be appointed for a two-year term, and the28
remaining members for four-year terms. Thereafter, all members shall be appointed29 HLS 10RS-1793 ORIGINAL
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for four years. Any vacancy on the board caused by death, resignation, removal, or1
disability of a member shall be filled for the unexpired term by appointment by the2
governor from the congressional district where the vacancy occurred.3
B. Any member of the commission whose term expires shall continue to4
serve on the commission until such time that a successor is appointed.5
C. Any member of the commission may be removed from office for cause6
and his appointment rescinded by a two-thirds vote of the membership of the7
governing authority.8
D. The commission shall annually elect one of its members chairman and one9
vicechairman. Meetings shall be held at the domicile of the district established by10
the commission. At least four regular meetings shall be held annually. Special11
meetings may be held at such times and places as shall be specified, by call of the12
chairman or by a simple majority of the commission.13
E. A majority of the members shall constitute a quorum of the board for all14
purposes and functions of the board.15
F. Each member of the board shall receive a certificate or commission from16
the governor and, before beginning his term of office, shall file with the secretary of17
state a written oath or affirmation of faithful discharge of his official duties.18
G. The members of the commission and all employees of the corporation19
shall be subject to the Code of Governmental Ethics. They shall be considered public20
employees as defined by R.S. 42:1102(18) and the corporation shall be considered21
an agency as defined by R.S. 42:1102(2) for purposes of the Code of Governmental22
Ethics only. All meetings of the board shall be open and subject to the provisions23
of R.S. 42:4.1 et seq. A record of all proceedings at regular and special meetings of24
the board shall be kept and shall be open to public inspection, except as otherwise25
provided by this Title or in R.S. 42:6.1.26
H. No member of the board shall receive a per diem or shall be reimbursed27
for expenses incurred when attending a meeting of the board or any of its committees28
or for the time spent on behalf of the board on official business.29 HLS 10RS-1793 ORIGINAL
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§1236.26. Powers and duties of the commission1
In addition to the duties defined elsewhere, the commission shall have the2
duty and authority:3
(1) To represent the public interest in facilitating ambulance care in the state.4
(2) To pursue grant funds to advance first responder services.5
(3) To enter into cooperative agreements with other public as well as private6
entities.7
(4) To assist ambulance providers in obtaining lowest possible cost for8
equipment and supplies through group purchasing.9
(5) To appoint a director of the ambulance service district and to perform10
such other duties as may now or hereafter be required by law.11
(6) To appoint the necessary standing and special committees which may be12
necessary to carry out the purposes of this Subpart.13
(7) To establish rates of pay for the use of facilities provided by the district.14
(8) To enter into contractual arrangements with recognized and duly15
constituted ambulance providers which are primarily engaged in the operation of16
ambulance related functions in order to enhance Medicaid funding and17
reimbursement and for related matters.18
(9) To designate a bank to act as agent for depositing funds.19
(10) To designate rules and regulations for safekeeping of the funds20
acquired, collected, or loaned by or to the district, and to provide for regular audits21
of the accounts of the district.22
§1236.27. Organization23
A. At the same time as the governor appoints the initial members of the24
commission, the governor shall designate a time and place for the first meeting of the25
commission. The first meeting shall take place within sixty days from the date of the26
initial appointments. At the first meeting of the commission, the commission shall27
proceed to organize by electing a chairman and a vice chairman.28
B. It shall be the duty of the chairman to preside over the meetings of the29 HLS 10RS-1793 ORIGINAL
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commission and to perform such other duties as are usually required of presidents1
or chairmen of the other corporate bodies. It shall be the duty of the vice chairman2
to act in the absence of the chairman and in case of the disability of the chairman to3
act.4
§1236.28. Domicile; service of process5
A. The domicile of the district shall be fixed by the commission and may be6
changed at the pleasure of the commission. All the books and records of the district7
shall be kept at the domicile.8
B. Service of process shall be made upon the director, and in his absence,9
upon the chairman of the commission, and in his absence or their absence, then upon10
the vice chairman of the commission.11
§1236.29. District as a political subdivision; power to incur debt and issue general12
bonds13
The ambulance service district is hereby declared to be a political subdivision14
of the state. For carrying out the purposes of the ambulance service district as15
provided in this Subpart, the district, pursuant to the provisions of the Louisiana16
Constitution of 1974, shall have the power to incur debt and issue general obligation17
bonds or revenue.18
§1236.30. Federal and state aid19
The ambulance service district shall have full power to do such things and20
enter into any contracts and agreements with any state or federal agency or21
instrumentality as may be necessary to procure aids and grants to assist such districts22
in carrying out the purpose for which they are created.23
§1236.31. Rules and regulations24
The commission shall have the power, and it shall be its duty, to adopt rules25
and regulations, in accordance with the Administrative Procedures Act, for the26
proper disbursement of funds to participating providers. Such rules and regulations27
shall be submitted to the Senate and House Committees on Health and Welfare and28
such committees shall have jurisdiction for purposes of the Administrative29 HLS 10RS-1793 ORIGINAL
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Procedures Act.1
Section 2. This Act shall become effective upon signature by the governor or, if not2
signed by the governor, upon expiration of the time for bills to become law without signature3
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If4
vetoed by the governor and subsequently approved by the legislature, this Act shall become5
effective on the day following such approval.6
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Harrison HB No. 1181
Abstract: Relative to emergency medical services, creates a statewide ambulance service
district.
Proposed law provides for legislative findings.
Proposed law creates a statewide ambulance service district, hereinafter referred to as "the
district." The boundaries of the district shall be coterminous with the boundaries of the state.
Proposed law provides that the district shall constitute a body corporate in law with all
powers of a corporation, shall have perpetual existence, shall have the power and right to
contract obligations, to sue and be sued, and to do and perform any and all acts in its
corporate capacity and its corporate name necessary and proper for the carrying out of the
objects and purposes for which the district was created.
Proposed law provides that the district shall have the power and authority to acquire
necessary equipment and buildings for the purpose of performing the objects for which it is
formed, and shall own all sites and physical facilities which are acquired either by donation,
purchase, exchange, and otherwise in full ownership.
Proposed law provides that the purpose of the district shall be to enhance reimbursement and
financial stability of ambulance providers.
Proposed law provides that DHH may submit waivers or state plan amendments to the
Centers for Medicare and Medicaid Services in order to secure federal financial participation
in relation to any such payments or reimbursement.
Proposed law provides that payments shall be made only in accordance with an approved
waiver or state plan amendment and that DHH and the transferring statewide ambulance
district may enter into an agreement, in accordance with state and federal law, concerning
the use of transferred funds in a way that is consistent with the legislative intent set forth
herein.
Proposed law provides that the commission may establish a methodology utilizing a pool,
or pools, to facilitate distribution of any transfers received in addition to any federal financial
participation earned through the use of such transfers and that the methodology shall be
created with the intent to maximize the return to the providers within the jurisdiction of the
local governing body from which such transfer is derived. HLS 10RS-1793 ORIGINAL
HB NO. 1181
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are additions.
Proposed law provides that any licensed provider of ambulance services shall be eligible to
participate in the district and that participation is strictly voluntary.
Proposed law provides that the district shall be governed by Ambulance Service District
Commission, hereafter referred to as "the commission," and that the commission shall be
composed of one member from each congressional district appointed by the governor from
a list of names submitted by the Louisiana Ambulance Alliance.
Proposed law provides that, initially, 3 members of the commission shall be appointed for
a two-year term, and the remaining members for 4-year terms and thereafter, all members
shall be appointed for 4 years.
Proposed law provides that any member of the commission whose term expires shall
continue to serve on the commission until such time that a successor is appointed.
Proposed law provides that any member of the commission may be removed from office for
cause and his appointment rescinded by a two-thirds vote of the membership of the
governing authority.
Proposed law provides that the commission annually shall elect one of its members
chairman, and one vice chairman and meetings shall be held at the domicile of the district
established by the commission.
Proposed law provides that a majority of the members shall constitute a quorum of the board
for all purposes and functions of the board.
Proposed law provides that each member of the board shall receive a certificate or
commission from the governor and before beginning his term of office shall file with the
secretary of state a written oath or affirmation of faithful discharge of his official duties.
Proposed law provides that the members of the commission and all employees of the
corporation shall be subject to the Code of Governmental Ethics and shall be considered
public employees and the corporation shall be considered an agency.
Proposed law provides that no member of the board shall receive a per diem or be
reimbursed for expenses incurred when attending a meeting of the board or any of its
committees or for the time spent on behalf of the board on official business.
Proposed law provides for the following powers and duties of the commission:
(1) To represent the public interest in facilitating ambulance care in the state.
(2) To pursue grant funds to advance first responder services.
(3) To enter into cooperative agreements with other public and as well as private entities.
(4)To assist ambulance providers in obtaining lowest possible cost for equipment and
supplies through group purchasing.
(5) To appoint a director of the ambulance service district and to perform such other
duties as may now or hereafter be required by law.
(6) To appoint the necessary standing and special committees.
(7) To establish rates of pay for the use of facilities provided by the district.
(8) To enter into contractual arrangements with recognized and duly constituted
ambulance providers which are primarily engaged in the operation of ambulance HLS 10RS-1793 ORIGINAL
HB NO. 1181
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are additions.
related functions in order to enhance Medicaid funding and reimbursement and for
related matters.
(9) To designate a bank to act as agent for depositing funds.
(10) To designate rules and regulations for safekeeping of the funds acquired, collected,
or loaned by or to the district, and to provide for regular audits of the accounts of the
district.
Proposed law provides that the governor shall designate a time and place for the first
meeting of the commission and such meeting shall take place within 60 days from the date
of the initial appointments.
Proposed law provides for the duties of the chairman and the vice chairman.
Proposed law provides that the domicile of the district shall be fixed by the commission and
may be changed at the pleasure of the commission. All the books and records of the district
shall be kept at the domicile.
Proposed law provides that service of process shall be made upon the director, and in his
absence, upon the chairman of the commission, and in his absence or their absence, then
upon the vice chairman of the commission.
Proposed law provides that the ambulance service district is hereby declared to be a political
subdivision of the state and for carrying out the purposes of the ambulance service district,
the district, under the provisions of the Louisiana Constitution of 1974, shall have the power
to incur debt and issue general obligation bonds or revenue.
Proposed law provides that the ambulance service districts created hereunder shall have full
power to do such things and enter into any contracts and agreements with any state or federal
agency or instrumentality as may be necessary to procure aids and grants to assist such
districts in carrying out the purpose for which they are created.
Proposed law provides that the commission shall have the power, and it shall be its duty, to
adopt rules and regulations, in accordance with the APA, for the proper disbursement of
funds to participating providers. Such rules and regulations shall be submitted to the Senate
and House committees on health and welfare and such committees shall have jurisdiction
for purposes of the APA.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 40:1236.21-1236.31)