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Regular Session, 2010
SENATE BILL NO. 523
BY SENATOR CHEEK
HEALTH CARE. Provides for the First Responder Financial Stabilization and Enhancement
Act. (gov sig) (2/3 - CA6s30.1(B))
AN ACT1
To enact Subpart E of Part VII of Chapter 5 of Title 40 of the Louisiana Revised Statutes,2
to be comprised of R.S. 40:1236.21 through 1236.31, relative to emergency medical3
services; to provide for the creation of the statewide ambulance service district; to4
provide for the purpose and object of the district; to provide for a board of5
commissioners; to provide for powers and duties of the board of commissioners; to6
provide for domicile of the district; to provide for rules and regulations; to provides7
for the authority to incur debt and issue general bonds; to provide for legislative8
findings; and to provide for related matters.9
Be it enacted by the Legislature of Louisiana:10
Section 1. Subpart E of Part VII of Chapter 5 of Title 40 of the Louisiana Revised11
Statutes, comprised of R.S. 40:1236.21 through 1236.31 is hereby enacted to read as follows:12
SUBPART E. FIRST RESPONDER FINANCIAL13
STABILIZATION AND ENHANCEMENT14
§1236.21. Legislative findings15
The legislature hereby finds and declares the following:16
(1) Emergency medical services constitute an invaluable part of the17 SB NO. 523
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healthcare delivery system of Louisiana and are an essential element of1
Louisiana's emergency preparedness system.2
(2) Emergency medical services will be a key element in any healthcare3
reform initiative.4
(3) Emergency medical services are a key component of any economic5
development program as they are essential to recruiting and retaining industry.6
(4) The cost of funding the Medicaid program and healthcare for the7
poor and uninsured in the state must be carefully managed in a manner which8
recognizes the challenges associated with appropriate reimbursement for9
services under the program.10
(5) Emergency medical service providers want to assure that emergency11
medical services are available to all residents of Louisiana.12
(6) It is in the best interest of the state that there exists sufficient13
resources to assure the availability of emergency ambulance services to the14
citizens of Louisiana and the creation of a statewide ambulance service district15
will help to ensure this goal.16
§1236.22. Short title17
This Subpart shall be known and may be cited as the "First Responder18
Financial Stabilization and Enhancement Act."19
§1236.23. Statewide ambulance service district; creation20
In order to provide for sufficient resources to assure the availability of21
emergency ambulance services to the population of Louisiana, the legislature22
does hereby establish a statewide ambulance service district. The boundaries23
of the district shall be coterminous with the boundaries of the state. The24
ambulance service district thus created shall constitute a body corporate in law25
with all powers of a corporation, shall have perpetual existence, shall have the26
power and right to contract obligations, to sue and be sued, and to do and27
perform any and all acts in its corporate capacity and its corporate name28
necessary and proper for the carrying out of the objects and purposes for which29 SB NO. 523
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the ambulance service district was created. It shall have the power and1
authority to acquire any and all necessary equipment and buildings for the2
purpose of performing the objects for which it is formed and shall own all sites3
and physical facilities which are acquired either by donation, purchase,4
exchange, and otherwise in full ownership.5
§1236.24. Object and purpose of the district6
The object and purpose of the ambulance service district and the7
governing body created under the provisions of this Subpart shall be to enhance8
reimbursement and financial stability of ambulance providers. The9
Department of Health and Hospitals may submit waivers or state plan10
amendments to the Centers for Medicare and Medicaid Services in order to11
secure federal financial participation in relation to any such payments or12
reimbursement. Payments shall be made only in accordance with an approved13
waiver or state plan amendment. The department and the transferring14
statewide ambulance district may enter into an agreement, in accordance with15
state and federal law, concerning the use of transferred funds in a way that is16
consistent with the legislative intent set forth herein. The commission may17
establish a methodology utilizing a pool, or pools, to facilitate distribution of any18
transfers received in addition to any federal financial participation earned19
through the use of such transfers, as authorized herein. The methodology shall20
be created with the intent to maximize, to the fullest extent possible, the return21
to the providers located within the jurisdiction of the local governing body from22
which such transfer is derived. Any licensed provider of ambulance services23
shall be eligible to participate in the district. Participation is on a strictly24
voluntary basis.25
§1236.25. Ambulance service district commission; qualifications, appointment,26
vacancies, removal and compensation of members27
A. The ambulance service district created under this Subpart shall be28
governed by the Ambulance Service District Commission, hereafter referred to29 SB NO. 523
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as the commission. The commission shall be composed of one member from1
each congressional district, appointed by the governor, subject to confirmation2
by the Senate, from a list of names submitted by the Louisiana Ambulance3
Alliance. The nomination list submitted to the governor shall include at least4
three nominees from each congressional district. Members of the commission5
shall be citizens and qualified electors of this state. Initially, three members of6
the commission shall be appointed for a two-year term, and the remaining7
members for four-year terms. Thereafter, all members shall be appointed for8
four years. Any vacancy on the board caused by death, resignation, removal or9
disability of a member shall be filled for the unexpired term by appointment by10
the governor from the congressional district where the vacancy occurred.11
B. Any member of the commission whose term expires shall continue to12
serve on the commission until such time that a successor is appointed.13
C. Any member of the commission may be removed from office for14
cause and his appointment rescinded by a two-thirds vote of the membership15
of the governing authority.16
D. The commission annually shall elect one of its member's chairman,17
and one vice-chairman. The meetings shall be held at the domicile of the18
district established by the commission. At least four regular meetings shall be19
held annually. Special meetings may be held at such times and places as shall20
be specified, by call of the chairman or by a simple majority of the commission.21
E. A majority of the members shall constitute a quorum of the board for22
all purposes and functions of the board.23
F. Each member of the board shall receive a certificate or commission24
from the governor and before beginning his term of office shall file with the25
secretary of state a written oath or affirmation of faithful discharge of his26
official duties.27
G. The members of the commission and all employees of the corporation28
shall be subject to the Code of Governmental Ethics. They shall be considered29 SB NO. 523
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public employees as defined by R.S. 42:1102(18) and the corporation shall be1
considered an agency as defined by R.S. 42:1102(2) for purposes of the Code of2
Governmental Ethics only. All meetings of the board shall be open and subject3
to the provisions of R.S. 42:4.1 et seq. A record of all proceedings at regular and4
special meetings of the board shall be kept and shall be open to public5
inspection, except as otherwise provided by this Title or in R.S. 42:6.1.6
H. No member of the board shall receive a per diem or shall be7
reimbursed for expenses incurred when attending a meeting of the board or any8
of its committees or for the time spent on behalf of the board on official9
business.10
§1236.26. Powers and duties of the commission11
In addition to the duties defined elsewhere, the commission shall have the12
duty and authority:13
(1) To represent the public interest in facilitating ambulance care in the14
state.15
(2) To pursue grant funds to advance first responder services.16
(3) To enter into cooperative agreements with other public and private17
entities.18
(4) To assist ambulance providers in obtaining lowest possible cost for19
equipment and supplies through group purchasing.20
(5) To appoint a director of the ambulance service district and to21
perform such other duties as may now or hereafter be required by law.22
(6) To appoint the necessary standing and special committees which may23
be necessary to carry out the purposes of this Subpart.24
(7) To establish rates of pay for the use of facilities provided by the25
district.26
(8) To enter into contractual arrangements with recognized and duly27
constituted ambulance providers which are primarily engaged in the operation28 SB NO. 523
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of ambulance related functions in order to enhance Medicaid funding and1
reimbursement, and for related matters.2
(9) To designate a bank to act as agent for depositing funds.3
(10) To designate rules and regulations for safekeeping of the funds4
acquired, collected, or loaned by or to the district, and to provide for regular5
audits of the accounts of the district.6
§1236.27. Procedure for organizing the ambulance service district7
A. At the same time as the governor appoints the initial members of the8
commission, the governor shall designate a time and place for the first meeting9
of the commission. The first meeting shall take place within sixty days from the10
date of the initial appointments. At the first meeting of the commission, the11
commission shall proceed to organize by electing a chairman and a vice12
chairman.13
B. It shall be the duty of the chairman to preside over the meetings of the14
commission and to perform such other duties as are usually required of the15
chairman of a corporate board. It shall be the duty of the vice chairman to act16
in the absence of the chairman and in case of the disability of the chairman.17
§1236.28. Domicile; service of process18
A. The domicile of the district shall be fixed by the commission and may19
be changed at the pleasure of the commission. All books and records of the20
district shall be kept at the domicile.21
B. Service of process shall be made upon the director, and in his22
absence, upon the chairman of the commission, and in his absence or their23
absence, then upon the vice-chairman of the commission.24
§1236.29. District as a political subdivision; power to incur debt and issue25
general bonds26
The ambulance service district is hereby declared to be a political27
subdivision of the state. For carrying out the purposes of the ambulance service28
district as provided in this Subpart, the district, under the provisions of the29 SB NO. 523
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Louisiana Constitution of 1974, shall have the power to incur debt and issue1
general obligation bonds or revenue.2
§1236.30. Federal and state aid3
The ambulance service district created hereunder shall have full power4
to do such things and enter into any contracts and agreements with any state or5
federal agency or instrumentality as may be necessary to procure aids and6
grants to assist such districts in carrying out the purpose for which they are7
created.8
§1236.31. Rules and regulations9
The commission shall have the power, and it shall be its duty, to adopt10
rules and regulations, in accordance with the Administrative Procedure Act, for11
the proper disbursement of funds to participating providers. Such rules and12
regulations shall be submitted to the Senate and House committees on health13
and welfare and such committees shall have jurisdiction for purposes of the14
Administrative Procedure Act.15
Section 2. This Act shall become effective upon signature by the governor or, if not16
signed by the governor, upon expiration of the time for bills to become law without signature17
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If18
vetoed by the governor and subsequently approved by the legislature, this Act shall become19
effective on the day following such approval.20
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Greg Waddell.
DIGEST
Proposed law provides for legislative findings.
Proposed law creates a statewide ambulance service district, hereinafter referred to as the
"district," whose boundaries are be coterminous with the boundaries of the state.
Proposed law provides that the ambulance service district thus created 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 ambulance service district was
created. SB NO. 523
SLS 10RS-548 ORIGINAL
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words in boldface type and underscored are additions.
Proposed law provides that the district shall have the power and authority to acquire any and
all 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 object and purpose of the ambulance service district and the
governing body 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, to the fullest extent possible, the return to the providers
located within the jurisdiction of the local governing body from which such transfer is
derived.
Proposed law provides that any licensed provider of ambulance services shall be eligible to
participate in the district and that participation is on a strictly voluntary basis.
Proposed law provides that the ambulance service 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, three members of the commission shall be appointed
for a two-year term, and the remaining members for four-year terms and thereafter, all
members shall be appointed for four 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 member's
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 SB NO. 523
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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 shall 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 which may be necessary
to carry out the purposes of this Subpart.
(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
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 and that the domicile shall be within the
district, and books and records 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 SB NO. 523
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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 the governor or lapse of time for gubernatorial action.
(Adds R.S. 40:1236.21 - 1236.31)