02-19 10:04 1st Sub. (Green) S.B. 215 Derrin R. Owens proposes the following substitute bill: 1 Emergency Medical Services Modifications 2025 GENERAL SESSION STATE OF UTAH Chief Sponsor: Derrin R. Owens House Sponsor: 2 3 LONG TITLE 4 General Description: 5 This bill addresses ground ambulance interfacility transport services. 6 Highlighted Provisions: 7 This bill: 8 ▸ grants authority to and requires municipalities and counties to ensure that a minimum 9 level of ground ambulance interfacility transport services are provided within the 10 respective municipality or county; 11 ▸ removes the Bureau of Emergency Medical Services Management (bureau) from 12 involvement in the process by which a municipality or county selects emergency 13 medical service providers, except verifying and providing notice that an applicant 14 emergency medical service provider meets minimum requirements; 15 ▸ recognizes the bureau's jurisdiction to discipline non-911 ambulance service providers; 16 ▸ requires a county or municipality to: 17 ● offer a first right to provide interfacility transports to the current 911 ambulance 18 service provider; 19 ● conduct formal reviews of 911 service providers and interfacility transport service 20 providers; 21 ▸ grants investigative authority to the bureau; 22 ▸ makes it a class B misdemeanor to willfully disobey a valid subpoena or cease and desist 23 letter from the bureau; and 24 ▸ makes technical changes. 25 Money Appropriated in this Bill: 26 None 27 Other Special Clauses: 28 None 1st Sub. S.B. 215 1st Sub. (Green) S.B. 215 02-19 10:04 29 Utah Code Sections Affected: 30 AMENDS: 31 11-48-103, as last amended by Laws of Utah 2024, Chapter 506 32 53-2d-103, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 and 33 last amended by Coordination Clause, Laws of Utah 2023, Chapter 307 34 53-2d-505, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 35 53-2d-604, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 36 53-2d-607, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 and 37 last amended by Coordination Clause, Laws of Utah 2023, Chapter 307 38 ENACTS: 39 53-2d-606.5, Utah Code Annotated 1953 40 REPEALS: 41 53-2d-505.1, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 42 53-2d-505.2, as last amended by Laws of Utah 2023, Chapter 16 and renumbered and 43 amended by Laws of Utah 2023, Chapters 307, 310 44 53-2d-505.3, as last amended by Laws of Utah 2023, Chapter 435 and renumbered and 45 amended by Laws of Utah 2023, Chapters 307, 310 46 53-2d-505.4, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 and 47 last amended by Coordination Clause, Laws of Utah 2023, Chapter 307 48 53-2d-505.5, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 49 53-2d-506, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 50 53-2d-507, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 51 53-2d-508, as renumbered and amended by Laws of Utah 2023, Chapters 307, 310 52 53-2d-509, as last amended by Laws of Utah 2024, Chapter 147 53 54 Be it enacted by the Legislature of the state of Utah: 55 Section 1. Section 11-48-103 is amended to read: 56 11-48-103 . Provision of ambulance services in municipalities and counties. 57 (1) The governing body of each municipality and county has exclusive authority to and 58 shall, subject to Title 53, Chapter 2d, Part 5, Ambulance and Paramedic Providers, 59 ensure at least a minimum level of 911 ambulance services and ground ambulance 60 interfacility transport services are provided: 61 (a) within the territorial limits of the municipality or county; 62 (b) by a ground ambulance provider, licensed by the Bureau of Emergency Medical - 2 - 02-19 10:04 1st Sub. (Green) S.B. 215 63 Services under Title 53, Chapter 2d, Part 5, Ambulance and Paramedic Providers; and 64 (c) in accordance with rules established by the Trauma System and Emergency Medical 65 Services Committee under Section 53-2d-105. 66 (2) A municipality or county may: 67 (a) [subject to Subsection (3), ] provide, maintain, and support 911 ambulance services 68 for the municipality's or county's own jurisdiction; or 69 (b) [contract to:] enter into an interlocal agreement or procurement contract with a public 70 or private entity to provide, receive, support, or maintain, 911 ambulance services or 71 ground ambulance interfacility transport services, under any arrangement and to any 72 extent that the municipality or county determines. 73 [(i) provide 911 ambulance services to any county, municipal corporation, special 74 district, special service district, interlocal entity, private corporation, nonprofit 75 corporation, state agency, or federal agency;] 76 [(ii) receive 911 ambulance services from any county, municipal corporation, special 77 district, special service district, interlocal entity, private corporation, nonprofit 78 corporation, state agency, or federal agency;] 79 [(iii) jointly provide 911 ambulance services with any county, municipal corporation, 80 special district, special service district, interlocal entity, private corporation, 81 nonprofit corporation, state agency, or federal agency; or] 82 [(iv) contribute toward the support of 911 ambulance services in any county, 83 municipal corporation, special district, special service district, interlocal entity, 84 private corporation, nonprofit corporation, state agency, or federal agency in 85 return for 911 ambulance services.] 86 (3)(a) Subject to Subsections (3)(b) and (c), at the expiration of a license term under 87 Subsection 53-2d-501, a county or municipality shall offer a first right to provide 88 interfacility transports for an area to the current 911 ambulance service provider for 89 that area. 90 (b) If the first right under Subsection (3)(a) is not exercised, the county or municipality 91 shall ensure that 911 ambulance services are provided in accordance with this section. 92 (c) If the current 911 ambulance service provider under Subsection (3)(a) is not the 93 current interfacility transport provider, the current interfacility provider's license shall 94 remain intact through the next formal review conducted in accordance with 95 Subsection (4). 96 (4) A county or municipality shall conduct a formal review of 911 service providers and - 3 - 1st Sub. (Green) S.B. 215 02-19 10:04 97 interfacility transport service providers: 98 (a) not less than every eight years; 99 (b) in an open and public meeting in accordance with Title 52, Chapter 4, Open and 100 Public Meetings Act; and 101 (c) not more than three months prior to the day on which the current license will expire 102 under Subsection 53-2d-501(2). 103 [(3)] (5)[(a)] A municipality or county that provides, maintains, and supports 911 104 ambulance services for the municipality's or county's own jurisdiction under 105 Subsection (2)(a) shall obtain a license as a ground ambulance provider from the 106 Bureau of Emergency Medical Services under Title 53, Chapter 2d, Part 5, 107 Ambulance and Paramedic Providers. 108 [(b) Sections 53-2d-505 through 53-2d-505.3 do not apply to a license described in 109 Subsection (3)(a).] 110 Section 2. Section 53-2d-103 is amended to read: 111 53-2d-103 . Bureau duties -- Data sharing. 112 (1) The bureau shall: 113 (a) coordinate the emergency medical services within the state; 114 (b) administer and enforce any programs and applicable rules created under this chapter; 115 (c) establish a voluntary task force representing a diversity of emergency medical 116 service providers to advise the bureau and the committee on rules; 117 (d) establish an emergency medical service personnel peer review board to advise the 118 bureau concerning discipline of emergency medical service personnel under this 119 chapter; and 120 (e) adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative 121 Rulemaking Act, to: 122 (i) license ambulance providers and paramedic providers; 123 (ii) permit ambulances, emergency medical response vehicles, and nonemergency 124 secured behavioral health transport vehicles, including approving an emergency 125 vehicle operator's course in accordance with Section 53-2d-404; 126 (iii) establish: 127 (A) the qualifications for membership of the peer review board created by this 128 section; 129 (B) a process for placing restrictions on a license while an investigation is pending; 130 (C) the process for the investigation and recommendation by the peer review - 4 - 02-19 10:04 1st Sub. (Green) S.B. 215 131 board; and 132 (D) the process for determining the status of a license while a peer review board 133 investigation is pending; 134 (iv) establish application, submission, and procedural requirements for licenses, 135 designations, and permits; and 136 (v) establish and implement the programs, plans, and responsibilities as specified in 137 other sections of this chapter. 138 (2)(a) The bureau shall share data related to the bureau's duties with the Department of 139 Health and Human Services. 140 (b) The Department of Health and Human Services shall share data related to the 141 bureau's duties with the bureau. 142 (c) All data collected by the bureau under this chapter is subject to Title 26B, Chapter 8, 143 Part 4, Health Statistics, including data privacy protections. 144 Section 3. Section 53-2d-505 is amended to read: 145 53-2d-505 . Ground ambulance and paramedic licenses. 146 [(1)] If the bureau determines that the application meets the minimum requirements for 147 licensure under Section 53-2d-504, the bureau shall issue a notice of the approved 148 application to the applicant. 149 [(2) A current license holder responding to a request for proposal under Section 53-2d-505.2 150 is considered an approved applicant for purposes of Section 53-2d-505.2 if the current 151 license holder, prior to responding to the request for proposal, submits the following to 152 the department:] 153 [(a) the information described in Subsections 53-2d-504(4)(a)(i) through (iii); and] 154 [(b)(i) if the license holder is a private entity, a financial statement, a pro forma 155 budget and necessary letters of credit demonstrating a financial ability to expand 156 service to a new service area; or] 157 [(ii) if the license holder is a governmental entity, a letter from the governmental 158 entity's governing body demonstrating the governing body's willingness to 159 financially support the application.] 160 Section 4. Section 53-2d-604 is amended to read: 161 53-2d-604 . Discipline of designated and licensed providers. 162 (1) The bureau may refuse to issue a license or designation or a renewal, or revoke, 163 suspend, restrict, or place on probation, [an] any emergency medical service provider's 164 license or designation, including the license or designation of a non-911 service provider, - 5 - 1st Sub. (Green) S.B. 215 02-19 10:04 165 if the provider has: 166 (a) failed to abide by terms of the license or designation; 167 (b) violated statute or rule; 168 (c) failed to provide services at the level or in the exclusive geographic service area 169 required by the license or designation; 170 (d) failed to submit a renewal application in a timely fashion as required by department 171 rule; 172 (e) failed to follow operational standards established by the committee; or 173 (f) committed an act in the performance of a professional duty that endangered the 174 public or constituted gross negligence. 175 (2)(a) An action to revoke, suspend, restrict, or place a license or designation on 176 probation shall be done in accordance with Title 63G, Chapter 4, Administrative 177 Procedures Act. 178 (b) Notwithstanding Subsection (2)(a), the department may issue a cease and desist 179 order under Section 53-2d-607 to immediately suspend a license or designation 180 pending an administrative proceeding to be held within 30 days if there is evidence to 181 show that the provider or facility poses a clear, immediate, and unjustifiable threat or 182 potential threat to the public health, safety, or welfare. 183 Section 5. Section 53-2d-606.5 is enacted to read: 184 53-2d-606.5 . Investigative authority of the bureau -- Subpoenas -- Criminal 185 penalty. 186 (1) In connection with conducting a formal investigation or any matters pending before the 187 peer review board, the bureau may administer oaths and affirmations, subpoena 188 witnesses, take evidence, and require by subpoena duces tecum the production of 189 relevant papers, records, or other documents or information. 190 (2) A person who willfully disobeys a valid subpoena issued by the bureau is guilty of a 191 class B misdemeanor. 192 Section 6. Section 53-2d-607 is amended to read: 193 53-2d-607 . Cease and desist letters -- Criminal penalty. 194 (1) The bureau may issue a cease and desist order to any person who: 195 [(1)] (a) may be disciplined under Section 53-2d-603 or 53-2d-604; or 196 [(2)] (b) otherwise violates this chapter or any rules adopted under this chapter. 197 (2) An individual who willfully disobeys a valid cease and desist letter issued by the bureau 198 is guilty of a class B misdemeanor. - 6 - 02-19 10:04 1st Sub. (Green) S.B. 215 199 Section 7. Repealer. 200 This bill repeals: 201 Section 53-2d-505.1, Selection of provider by political subdivision. 202 Section 53-2d-505.2, Selection of provider -- Request for competitive sealed proposal -- 203 Public convenience and necessity. 204 Section 53-2d-505.3, Use of competitive sealed proposals -- Procedure -- Appeal rights. 205 Section 53-2d-505.4, Non-911 provider -- Finding of meritorious complaint -- Request 206 for proposals. 207 Section 53-2d-505.5, Use of competitive sealed proposals -- Procedure -- Appeal rights. 208 Section 53-2d-506, Ground ambulance and paramedic licenses -- Parties. 209 Section 53-2d-507, Ground ambulance and paramedic licenses -- Proceedings. 210 Section 53-2d-508, Criteria for determining public convenience and necessity. 211 Section 53-2d-509, Ground ambulance and paramedic licenses -- Hearing and presiding 212 officers. 213 Section 8. Effective Date. 214 This bill takes effect on May 7, 2025. - 7 -