1.1                          A bill for an act 
  1.2             relating to health; establishing licensing 
  1.3             requirements for the provision of ambulance service; 
  1.4             establishing registration requirements for first 
  1.5             responders; proposing coding for new law in Minnesota 
  1.6             Statutes, chapter 144; repealing Minnesota Statutes 
  1.7             1996, section 144.802, subdivisions 1, 2, 3, 3b, 4, 5, 
  1.8             and 6. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  [144.8011] [GENERAL AUTHORITY.] 
  1.11     Subdivision 1.  [GRANTS OR GIFTS.] The board may accept 
  1.12  grants or gifts of money, property, or services from a person, a 
  1.13  public or private entity, or any other source for an emergency 
  1.14  medical health purpose within the scope of its statutory 
  1.15  authority. 
  1.16     Subd. 2.  [CONTRACTS.] The board may enter into contractual 
  1.17  agreements with a person or public or private entity for the 
  1.18  provision of statutorily prescribed emergency medical 
  1.19  services-related activities by the board.  The contract shall 
  1.20  specify the services to be provided and the amount and method of 
  1.21  reimbursement for the contracted services.  Funds generated in a 
  1.22  contractual agreement made pursuant to this section are 
  1.23  appropriated to the board for purposes of providing the services 
  1.24  specified in the contracts. 
  1.25     Sec. 2.  [144.8012] [AMBULANCE SERVICE LICENSING.] 
  1.26     The board shall not issue a license authorizing the 
  1.27  operation of a new ambulance service, provision of a new type or 
  2.1   types of ambulance service by an existing service, or an 
  2.2   expanded primary service area for an existing service unless the 
  2.3   requirements of sections 144.804 and 144.808 are met.  
  2.4      Sec. 3.  [144.8013] [AMBULANCE SERVICE APPLICATION 
  2.5   PROCEDURE.] 
  2.6      Subdivision 1.  [WRITTEN APPLICATION.] Each prospective 
  2.7   licensee and each present licensee wishing to offer a new type 
  2.8   or types of ambulance service or to expand a primary service 
  2.9   area, shall make written application for a license to the board 
  2.10  on a form provided by the board.  
  2.11     Subd. 2.  [APPLICATION NOTICE.] The board shall promptly 
  2.12  send notice of the completed application to each county board, 
  2.13  community health board, governing body of a regional emergency 
  2.14  medical services system designated under section 144.8093, 
  2.15  ambulance service, and municipality in the area in which 
  2.16  ambulance service would be provided by the applicant.  The board 
  2.17  shall publish the notice, at the applicant's expense, in the 
  2.18  State Register and in a newspaper in the municipality in which 
  2.19  the base of operation is or will be located, or if no newspaper 
  2.20  is published in the municipality or if the service is or would 
  2.21  be provided in more than one municipality, in a newspaper 
  2.22  published at the county seat of the county or counties in which 
  2.23  the service would be provided.  
  2.24     Subd. 3.  [COMMENTS.] Each municipality, county, community 
  2.25  health board, governing body of a regional emergency medical 
  2.26  services system, ambulance service, and other person wishing to 
  2.27  make recommendations concerning the disposition of the 
  2.28  application shall make written recommendations or comments 
  2.29  opposing the application to the board within 30 days of the 
  2.30  publication of notice of the application in the State Register. 
  2.31     Subd. 4.  [CONTESTED CASE EXEMPTION; PROCEDURE.] (a) If no 
  2.32  more than five written comments opposing the application have 
  2.33  been received by the board under subdivision 3, and the board 
  2.34  has determined, after considering the factors listed under 
  2.35  subdivision 6, that the proposed service or expansion of primary 
  2.36  service area is needed, the applicant shall be exempt from the 
  3.1   contested case hearing process under subdivision 5.  
  3.2      (b) An applicant exempted from a contested case hearing 
  3.3   under this subdivision shall furnish additional information, as 
  3.4   requested by the board, to support its application.  The board 
  3.5   shall grant a license to the applicant within 30 days after 
  3.6   final submission of requested information to the board, and upon 
  3.7   a determination by the board that the applicant is in compliance 
  3.8   with the rules adopted by the board.  
  3.9      (c) If an applicant does not comply with the inspection 
  3.10  requirements under section 144.808 within one year of the 
  3.11  board's approval of its application, the license shall be 
  3.12  denied.  The one-year time limit applies to any licensing 
  3.13  decision made by the board or to any prior licensing decision 
  3.14  made by the commissioner of health or an administrative law 
  3.15  judge.  
  3.16     (d) If, after considering the factors under subdivision 6, 
  3.17  the board determines that the proposed service or expansion of 
  3.18  primary service area is not needed, the case shall be treated as 
  3.19  a contested case under subdivision 5, paragraphs (c) to (g). 
  3.20     Subd. 5.  [CONTESTED CASE; PROCEDURE.] (a) If more than 
  3.21  five written comments opposing the application are received by 
  3.22  the board as specified under subdivision 3, the board shall give 
  3.23  the applicant the option of immediately proceeding to a 
  3.24  contested case hearing or trying to resolve the objections 
  3.25  within 30 days.  
  3.26     (b) If, after considering the factors under subdivision 6, 
  3.27  the board determines that the proposed service or expansion of 
  3.28  primary service area is not needed, the board shall give the 
  3.29  applicant the option of immediately proceeding to a contested 
  3.30  case hearing or using up to 30 days to satisfy the board that 
  3.31  the proposed service or expansion of primary service area is 
  3.32  needed.  
  3.33     (c) The board shall request the chief administrative law 
  3.34  judge appoint an administrative law judge to hold a public 
  3.35  hearing in the municipality in which the applicant's base of 
  3.36  operation is or will be located: 
  4.1      (1) if more than five opposing comments remain after 30 
  4.2   days; 
  4.3      (2) if, after considering the factors under subdivision 6, 
  4.4   the board determines that the proposed service or expansion of 
  4.5   primary service area is not needed after 30 days; or 
  4.6      (3) at the applicant's initial request. 
  4.7      (d) If the applicant's base of operation is located outside 
  4.8   of Minnesota, the hearing shall be held at a location within the 
  4.9   area in which service would be provided in Minnesota.  The 
  4.10  public hearing shall be conducted as a contested case hearing 
  4.11  under chapter 14.  The board shall pay the expenses for the 
  4.12  hearing location and the administrative law judge. 
  4.13     (e) The board shall provide notice of the public hearing, 
  4.14  at the applicant's expense, in the State Register and in the 
  4.15  newspaper or newspapers in which the notice was published under 
  4.16  subdivision 2 for two successive weeks at least ten days before 
  4.17  the date of the hearing. 
  4.18     (f) The administrative law judge shall:  
  4.19     (1) hold a public hearing as specified in paragraphs (c) 
  4.20  and (d); 
  4.21     (2) allow any interested person the opportunity to be 
  4.22  heard, to be represented by counsel, and to present oral and 
  4.23  written evidence at the public hearing; and 
  4.24     (3) provide a transcript of the hearing at the expense of 
  4.25  any individual requesting it. 
  4.26     (g) The administrative law judge shall review and comment 
  4.27  upon the application and make written recommendations as to its 
  4.28  disposition to the board within 90 days of publication of notice 
  4.29  of the hearing in the State Register.  In making the 
  4.30  recommendations, the administrative law judge shall consider and 
  4.31  make written comments as to whether the proposed service or 
  4.32  expansion in primary service area is needed, based on 
  4.33  consideration of the factors specified in subdivision 6.  
  4.34     Subd. 6.  [REVIEW CRITERIA.] When reviewing an application 
  4.35  for licensure, the board and administrative law judge shall 
  4.36  consider the following factors: 
  5.1      (1) the relationship of the proposed service or expansion 
  5.2   in primary service area to the current community health plan as 
  5.3   approved by the commissioner of health under section 145A.12, 
  5.4   subdivision 4; 
  5.5      (2) the recommendations or comments of the governing bodies 
  5.6   of the counties, municipalities, and regional emergency medical 
  5.7   services system designated under section 144.8093 in which the 
  5.8   service would be provided; 
  5.9      (3) the deleterious effects on the public health from 
  5.10  duplication, if any, of ambulance services that would result 
  5.11  from granting the license; 
  5.12     (4) the estimated effect of the proposed service or 
  5.13  expansion in primary service area on the public health; and 
  5.14     (5) whether any benefit accruing to the public health would 
  5.15  outweigh the costs associated with the proposed service or 
  5.16  expansion in primary service area.  The administrative law judge 
  5.17  shall recommend that the board either grant or deny a license or 
  5.18  recommend that a modified license be granted.  The reasons for 
  5.19  the recommendation shall be set forth in detail.  The 
  5.20  administrative law judge shall make the recommendations and 
  5.21  reasons available to any individual requesting them.  
  5.22     Subd. 7.  [LICENSING DECISION.] Within 60 days after 
  5.23  receiving the administrative law judge's report, the board shall 
  5.24  grant or deny a license to the applicant.  In granting or 
  5.25  denying a license, the board shall consider the administrative 
  5.26  law judge's report, the evidence contained in the application, 
  5.27  and any hearing record and other applicable evidence.  The 
  5.28  board's decision shall be based on a consideration of the 
  5.29  factors contained in subdivision 6.  If the board determines to 
  5.30  grant the applicant a license, the applicant must comply with 
  5.31  the inspection requirements under section 144.808 within one 
  5.32  year of the board's approval of the application or the license 
  5.33  will be denied.  This one-year time limit applies to any 
  5.34  licensing decision by the board or to any prior licensing 
  5.35  decision made by the commissioner of health or an administrative 
  5.36  law judge.  
  6.1      Subd. 8.  [FINAL DECISION.] The board's decision made under 
  6.2   subdivision 7 shall be the final administrative decision.  Any 
  6.3   person aggrieved by the board's decision or action shall be 
  6.4   entitled to judicial review in the manner provided in sections 
  6.5   14.63 to 14.69. 
  6.6      Sec. 4.  [144.8014] [SUMMARY APPROVAL.] 
  6.7      Subdivision 1.  [ELIMINATING OVERLAP; EXPANSION.] An 
  6.8   ambulance service may request a change in its primary service 
  6.9   area, as established under section 144E.06, to eliminate any 
  6.10  overlap in primary service areas or to expand its primary 
  6.11  service area to provide service to a contiguous, but 
  6.12  undesignated, primary service area.  An ambulance service 
  6.13  requesting a change in its primary service area must submit a 
  6.14  written application to the board on a form provided by the board 
  6.15  and must comply with the requirements of this section. 
  6.16     Subd. 2.  [RETRACTION.] An applicant requesting to retract 
  6.17  service from a geographic area within its designated primary 
  6.18  service area must provide documentation showing that another 
  6.19  licensed ambulance service is providing or will provide 
  6.20  ambulance coverage within the proposed area of withdrawal. 
  6.21     Subd. 3.  [OVERLAPPING EXPANSION.] An applicant requesting 
  6.22  to provide service in a geographic area that is within the 
  6.23  primary service area of another licensed ambulance service or 
  6.24  services must submit documentation from the service or services 
  6.25  whose primary service areas overlap the proposed expansion area, 
  6.26  approving the expansion and agreeing to withdraw any service 
  6.27  coverage from the proposed expanded area.  The application may 
  6.28  include documentation from the public safety answering point 
  6.29  coordinator or coordinators endorsing the proposed change.  
  6.30     Subd. 4.  [NO PRIMARY SERVICE.] An applicant requesting to 
  6.31  provide service in a geographic area where no primary ambulance 
  6.32  service has been designated must submit documentation of 
  6.33  approval from the ambulance service or ambulance services which 
  6.34  are contiguous to the proposed expansion area.  The application 
  6.35  may include documentation from the public safety answering point 
  6.36  coordinator or coordinators endorsing the proposed change.  If a 
  7.1   licensed ambulance service provides evidence of historically 
  7.2   providing 911 ambulance coverage to the undesignated area, it is 
  7.3   not necessary to provide documentation from the contiguous 
  7.4   ambulance service or ambulance services approving the change.  
  7.5   At a minimum, a 12-month history of primary ambulance coverage 
  7.6   must be included with the application. 
  7.7      Subd. 5.  [REPORTING.] The board shall report any approved 
  7.8   change to the local public safety answering point coordinator. 
  7.9      Sec. 5.  [144.8015] [TRANSFER OF LICENSE OR OWNERSHIP.] 
  7.10     A license, or the ownership of a licensed ambulance 
  7.11  service, may be transferred only upon approval of the board, 
  7.12  based upon a finding that the proposed licensee or proposed new 
  7.13  owner of a licensed ambulance service meets or will meet the 
  7.14  requirements of section 144.804.  If the proposed transfer would 
  7.15  result in an addition of a new base of operations, expansion of 
  7.16  the service's primary service area, or provision of a new type 
  7.17  or types of ambulance service, the board shall require the 
  7.18  prospective licensee or owner to comply with section 144.8013.  
  7.19  The board may approve the license or ownership transfer prior to 
  7.20  completion of the application process described in section 
  7.21  144.8013 upon obtaining written assurances from the proposed 
  7.22  licensee or proposed new owner that no expansion of the 
  7.23  service's primary service area or provision of a new type or 
  7.24  types of ambulance service will occur during the processing of 
  7.25  the application.  If requesting a transfer of its base of 
  7.26  operations, an applicant must comply with the requirements of 
  7.27  section 144.8016.  
  7.28     Sec. 6.  [144.8016] [RELOCATION OF BASE OF OPERATIONS.] 
  7.29     To relocate the base of operations to another municipality 
  7.30  or township within its primary service area, a licensee must 
  7.31  provide written notification to the board prior to relocating.  
  7.32  The board shall review the proposal to determine if relocation 
  7.33  would adversely affect service coverage within the primary 
  7.34  service area.  The applicant must furnish any additional 
  7.35  information requested by the board to support its proposed 
  7.36  transfer.  If the board does not approve the relocation 
  8.1   proposal, the licensee must comply with the application 
  8.2   requirements for a new license under section 144.8013. 
  8.3      Sec. 7.  [144.8017] [FIRST RESPONDER REGISTRATION.] 
  8.4      Subdivision 1.  [TRAINING PROGRAMS.] Curriculum for initial 
  8.5   and refresher training programs must meet the current standards 
  8.6   of the United States Department of Transportation first 
  8.7   responder curriculum or its equivalent as determined by the 
  8.8   board.  
  8.9      Subd. 2.  [REGISTRATION.] The board shall register the 
  8.10  following persons as first responders: 
  8.11     (1) a person who successfully completes a board-approved 
  8.12  initial or refresher first responder training program.  
  8.13  Registration under this clause is valid for two years and 
  8.14  expires at the end of the month in which the registration was 
  8.15  issued; or 
  8.16     (2) a person who is credentialed as a first responder by 
  8.17  the National Registry of Emergency Medical Technicians.  
  8.18  Registration under this clause expires the same day as the 
  8.19  National Registry credential.  
  8.20     Subd. 3.  [RENEWAL.] (a) The board may renew the 
  8.21  registration of a first responder who: 
  8.22     (1) successfully completes a board-approved refresher 
  8.23  course; and 
  8.24     (2) submits a completed renewal application to the board 
  8.25  before the registration expiration date.  
  8.26     (b) The board may renew the lapsed registration of a first 
  8.27  responder who: 
  8.28     (1) successfully completes a board-approved refresher 
  8.29  course; and 
  8.30     (2) submits a completed renewal application to the board 
  8.31  within 12 months after the registration expiration date.  
  8.32     Subd. 4.  [EXPIRATION.] A first responder registration 
  8.33  issued by the board or the commissioner of health before August 
  8.34  1, 1997, expires in 1999 at the end of the month in which it was 
  8.35  issued. 
  8.36     Sec. 8.  [144.8018] [DISCIPLINARY ACTION.] 
  9.1      Subdivision 1.  [SUSPENSION; REVOCATION; NONRENEWAL.] The 
  9.2   board may initiate a contested case hearing upon reasonable 
  9.3   notice to suspend, revoke, refuse to renew, or place conditions 
  9.4   on the license of a licensee upon finding that the licensee has 
  9.5   violated a provision of sections 144.8012 to 144.808 or has 
  9.6   ceased to provide the service for which the licensee is 
  9.7   licensed.  The board may initiate a contested case hearing upon 
  9.8   reasonable notice to suspend, revoke, refuse to renew, or place 
  9.9   conditions on the credential of a person credentialed by the 
  9.10  board upon finding that the person credentialed by the board has 
  9.11  violated sections 144.8012 to 144.808.  The board may also 
  9.12  initiate a contested case hearing upon reasonable notice to 
  9.13  suspend, revoke, refuse to renew, or place conditions on a 
  9.14  training program approved by the board upon finding that the 
  9.15  training program has violated sections 144.8012 to 144.808.  
  9.16     Subd. 2.  [TEMPORARY SUSPENSION.] (a) In addition to any 
  9.17  other remedy provided by law, the board may temporarily suspend 
  9.18  the license of a licensee, credential of a person, or approval 
  9.19  of a training program after conducting a preliminary inquiry to 
  9.20  determine if the board believes that the licensee, person, or 
  9.21  training program has violated a statute that the board is 
  9.22  empowered to enforce and that the continued provision of service 
  9.23  by the licensee, person, or training program would create an 
  9.24  imminent risk to public health or harm to others. 
  9.25     (b) The order prohibiting the licensee, person credentialed 
  9.26  by the board, or training program approved by the board from 
  9.27  providing ambulance service, medical care, or training shall 
  9.28  give notice of the right to a hearing pursuant to this 
  9.29  subdivision and shall state the reasons for the entry of the 
  9.30  order. 
  9.31     (c) Service of the order is effective when the order is 
  9.32  served on the licensee, person credentialed by the board, or 
  9.33  representative of the training program personally or by 
  9.34  certified mail, which is complete upon receipt, refusal, or 
  9.35  return for nondelivery to the most recent address provided to 
  9.36  the board for the licensee, person, or training program. 
 10.1      (d) At the time the board issues a temporary suspension 
 10.2   order, the board shall schedule a hearing to be held before a 
 10.3   group of its members designated by the board which shall begin 
 10.4   no later than 60 days after issuance of the temporary suspension 
 10.5   order or within 15 working days of the date of the board's 
 10.6   receipt of a request for hearing by a licensee, person 
 10.7   credentialed by the board, or training program approved by the 
 10.8   board on the sole issue of whether there is a reasonable basis 
 10.9   to continue, modify, or lift the temporary suspension.  This 
 10.10  hearing is not subject to chapter 14.  Evidence presented by the 
 10.11  board, licensee, person credentialed by the board, or training 
 10.12  program approved by the board must be in the form of an 
 10.13  affidavit.  The licensee, the person credentialed by the board, 
 10.14  a representative of the training program, or a counsel of record 
 10.15  may appear for oral argument. 
 10.16     (e) Within five working days of the hearing, the board 
 10.17  shall issue its order and, if the suspension is continued, 
 10.18  schedule a contested case hearing within 30 days of the issuance 
 10.19  of the order.  The administrative law judge shall issue a report 
 10.20  and recommendation within 30 days after the closing of the 
 10.21  contested case hearing record.  The board shall issue a final 
 10.22  order within 30 days after receipt of the administrative law 
 10.23  judge's report. 
 10.24     Subd. 3.  [COOPERATION DURING INVESTIGATION.] A licensee, 
 10.25  person credentialed by the board, training program approved by 
 10.26  the board, or agent of one who is the subject of an 
 10.27  investigation or who is questioned in connection with an 
 10.28  investigation by or on behalf of the board shall cooperate fully 
 10.29  with the investigation.  Cooperation includes responding fully 
 10.30  and promptly to any question raised by or on behalf of the board 
 10.31  relating to the subject of the investigation, executing all 
 10.32  releases requested by the board, providing copies of ambulance 
 10.33  service records, as reasonably requested by the board to assist 
 10.34  it in its investigation, and appearing at conferences or 
 10.35  hearings scheduled by the board.  The board shall pay reasonable 
 10.36  costs for copies requested. 
 11.1      Subd. 4.  [INJUNCTIVE RELIEF.] In addition to any other 
 11.2   remedy provided by law, the board may bring an action for 
 11.3   injunctive relief in the district court in Hennepin county or, 
 11.4   at the board's discretion, in the district court in the county 
 11.5   in which a violation of any statute or order that the board is 
 11.6   empowered to enforce or issue, has occurred, to enjoin the 
 11.7   violation. 
 11.8      Subd. 5.  [SUBPOENA POWER.] The board may, as part of an 
 11.9   investigation to determine whether a serious public health 
 11.10  threat exists, issue subpoenas to require the attendance and 
 11.11  testimony of witnesses and production of books, records, 
 11.12  correspondence, and other information relevant to any matter 
 11.13  involved in the investigation.  The board or the board's 
 11.14  designee may administer oaths to witnesses or take their 
 11.15  affirmation.  The subpoenas may be served upon any person named 
 11.16  therein anywhere in the state by any person authorized to serve 
 11.17  subpoenas or other processes in civil actions of the district 
 11.18  courts.  If a person to whom a subpoena is issued does not 
 11.19  comply with the subpoena, the board may apply to the district 
 11.20  court in any district and the court shall order the person to 
 11.21  comply with the subpoena.  Failure to obey the order of the 
 11.22  court may be punished by the court as contempt of the court.  No 
 11.23  person may be compelled to disclose privileged information as 
 11.24  described in section 595.02, subdivision 1.  All information 
 11.25  pertaining to individual medical records obtained under this 
 11.26  section shall be considered health data under section 13.38.  
 11.27  All other information is considered public data unless otherwise 
 11.28  protected under the Minnesota data practices act or other 
 11.29  specific law.  The fees for the service of a subpoena must be 
 11.30  paid in the same manner as prescribed by law for service of 
 11.31  process used out of a district court.  Subpoenaed witnesses must 
 11.32  receive the same fees and mileage as in civil actions. 
 11.33     Sec. 9.  [REPEALER.] 
 11.34     Minnesota Statutes 1996, section 144.802, subdivisions 1, 
 11.35  2, 3, 3b, 4, 5, and 6, are repealed.