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.