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             relocating provisions related to emergency medical 
  1.5             services; appropriating money; providing penalties; 
  1.6             proposing coding for new law as Minnesota Statutes, 
  1.7             chapter 144E; repealing Minnesota Statutes 1996, 
  1.8             sections 144.801; 144.802; 144.803; 144.804; and 
  1.9             144.806. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11            EMERGENCY MEDICAL SERVICES REGULATORY BOARD 
  1.12     Section 1.  [144E.001] [DEFINITIONS.] 
  1.13     Subdivision 1.  [SCOPE.] For the purposes of sections 
  1.14  144E.001 to 144E.52, the terms defined in this section have the 
  1.15  meaning given them.  
  1.16     Subd. 2.  [AMBULANCE.] "Ambulance" means any vehicle 
  1.17  designed or intended for and actually used in providing 
  1.18  ambulance service to ill or injured persons, or expectant 
  1.19  mothers. 
  1.20     Subd. 3.  [AMBULANCE SERVICE.] "Ambulance service" means 
  1.21  transportation and treatment which is rendered or offered to be 
  1.22  rendered preliminary to or during transportation to, from, or 
  1.23  between health care facilities for ill or injured persons, or 
  1.24  expectant mothers.  The term includes all transportation 
  1.25  involving the use of a stretcher, unless the person to be 
  1.26  transported is not likely to require medical treatment during 
  1.27  the course of transport. 
  2.1      Subd. 4.  [BASE OF OPERATIONS.] "Base of operations"  means 
  2.2   the address at which the physical plant housing ambulances, 
  2.3   related equipment, and personnel is located.  
  2.4      Subd. 5.  [BOARD.] "Board" means the emergency medical 
  2.5   services regulatory board.  
  2.6      Subd. 6.  [FIRST RESPONDER.] "First responder" means an 
  2.7   individual who is registered by the board to perform, at a 
  2.8   minimum, basic emergency skills before the arrival of a licensed 
  2.9   ambulance service, and is a member of an organized service 
  2.10  recognized by a local political subdivision whose primary 
  2.11  responsibility is to respond to medical emergencies to provide 
  2.12  initial medical care before the arrival of a licensed ambulance 
  2.13  service. 
  2.14     Subd. 7.  [LICENSE.] "License" means authority granted by 
  2.15  the board for the operation of an ambulance service in the state 
  2.16  of Minnesota.  
  2.17     Subd. 8.  [LICENSEE.] "Licensee" means a natural person, 
  2.18  partnership, association, corporation, or unit of government 
  2.19  which possesses an ambulance service license.  
  2.20     Subd. 9.  [MUNICIPALITY.] "Municipality" means any city of 
  2.21  any class, however organized, and any town.  
  2.22     Subd. 10.  [PRIMARY SERVICE AREA.] "Primary service area" 
  2.23  means the geographic area that can reasonably be served by an 
  2.24  ambulance service.  
  2.25     Sec. 2.  [144E.05] [GENERAL AUTHORITY.] 
  2.26     Subdivision 1.  [RULEMAKING.] The board may adopt, amend, 
  2.27  and repeal rules necessary to carry out the purposes of this 
  2.28  chapter, in accordance with chapter 14, except the board is 
  2.29  exempt from the provisions of section 14.125. 
  2.30     Subd. 2.  [GRANTS OR GIFTS.] The board may accept grants or 
  2.31  gifts of money, property, or services from a person, a public or 
  2.32  private entity, or any other source for an emergency medical 
  2.33  health purpose within the scope of its statutory authority. 
  2.34     Subd. 3.  [CONTRACTS.] The board may enter into contractual 
  2.35  agreements with a person or public or private entity for the 
  2.36  provision of statutorily prescribed emergency medical 
  3.1   services-related activities by the board.  The contract shall 
  3.2   specify the services to be provided and the amount and method of 
  3.3   reimbursement for the contracted services.  Funds generated in a 
  3.4   contractual agreement made pursuant to this section are 
  3.5   appropriated to the board for purposes of providing the services 
  3.6   specified in the contracts. 
  3.7      Subd. 4.  [FEES; ESTABLISHMENT AND COLLECTION.] (a) The 
  3.8   board may, by rule, prescribe fees for the issuance of original 
  3.9   and renewal licenses and credentials issued under authority of 
  3.10  the board.  Fees may include application and examination fees 
  3.11  and a penalty fee for renewal applications submitted after the 
  3.12  expiration date of the previously issued license or 
  3.13  certification.  All fees prescribed shall be reasonable.  The 
  3.14  board is exempt from the provisions of section 16A.1285. 
  3.15     (b) Fees collected by the board shall be deposited in the 
  3.16  state treasury and credited to a special account.  Money in the 
  3.17  account is appropriated to the board to administer this chapter 
  3.18  and is available until expended. 
  3.19                LIFE SUPPORT TRANSPORTATION SERVICES 
  3.20     Sec. 3.  [144E.06] [PRIMARY SERVICE AREAS.] 
  3.21     The board shall adopt rules defining primary service areas 
  3.22  under which the board shall designate each licensed ambulance 
  3.23  service as serving a primary service area or areas. 
  3.24     Sec. 4.  [144E.07] [SUMMARY APPROVAL.] 
  3.25     Subdivision 1.  [ELIMINATING OVERLAP; EXPANSION.] An 
  3.26  ambulance service may request a change in its primary service 
  3.27  area, as established under section 144E.06, to eliminate any 
  3.28  overlap in primary service areas or to expand its primary 
  3.29  service area to provide service to a contiguous, but 
  3.30  undesignated, primary service area.  An ambulance service 
  3.31  requesting a change in its primary service area must submit a 
  3.32  written application to the board on a form provided by the board 
  3.33  and must comply with the requirements of this section. 
  3.34     Subd. 2.  [RETRACTION.] An applicant requesting to retract 
  3.35  service from a geographic area within its designated primary 
  3.36  service area must provide documentation showing that another 
  4.1   licensed ambulance service is providing or will provide 
  4.2   ambulance coverage within the proposed area of withdrawal. 
  4.3      Subd. 3.  [OVERLAPPING EXPANSION.] An applicant requesting 
  4.4   to provide service in a geographic area that is within the 
  4.5   primary service area of another licensed ambulance service or 
  4.6   services must submit documentation from the service or services 
  4.7   whose primary service areas overlap the proposed expansion area, 
  4.8   approving the expansion and agreeing to withdraw any service 
  4.9   coverage from the proposed expanded area.  The application may 
  4.10  include documentation from the public safety answering point 
  4.11  coordinator or coordinators endorsing the proposed change. 
  4.12     Subd. 4.  [NO PRIMARY SERVICE.] An applicant requesting to 
  4.13  provide service in a geographic area where no primary ambulance 
  4.14  service has been designated must submit documentation of 
  4.15  approval from the ambulance service or ambulance services which 
  4.16  are contiguous to the proposed expansion area.  The application 
  4.17  may include documentation from the public safety answering point 
  4.18  coordinator or coordinators endorsing the proposed change.  If a 
  4.19  licensed ambulance service provides evidence of historically 
  4.20  providing 911 ambulance coverage to the undesignated area, it is 
  4.21  not necessary to provide documentation from the contiguous 
  4.22  ambulance service or ambulance services approving the change.  
  4.23  At a minimum, a 12-month history of primary ambulance coverage 
  4.24  must be included with the application. 
  4.25     Subd. 5.  [REPORTING.] The board shall report any approved 
  4.26  change to the local public safety answering point coordinator. 
  4.27     Sec. 5.  [144E.10] [AMBULANCE SERVICE LICENSING.] 
  4.28     Subdivision 1.  [LICENSE REQUIRED.] No natural person, 
  4.29  partnership, association, corporation or unit of government may 
  4.30  operate an ambulance service within this state unless it 
  4.31  possesses a valid license to do so issued by the board.  The 
  4.32  license shall specify the base of operations, primary service 
  4.33  area, and the type or types of ambulance service for which the 
  4.34  licensee is licensed.  The licensee shall obtain a new license 
  4.35  if it wishes to expand its primary service area, or to provide a 
  4.36  new type or types of service.  The cost of licenses shall be in 
  5.1   an amount prescribed by the board pursuant to section 144E.05.  
  5.2   Licenses shall expire and be renewed in accordance with rules 
  5.3   adopted by the board. 
  5.4      Subd. 2.  [REQUIREMENTS FOR NEW LICENSES.] The board shall 
  5.5   not issue a license authorizing the operation of a new ambulance 
  5.6   service, provision of a new type or types of ambulance service 
  5.7   by an existing service, or an expanded primary service area for 
  5.8   an existing service unless the requirements of this section and 
  5.9   sections 144E.16 and 144E.18 are met.  
  5.10     Sec. 6.  [144E.11] [AMBULANCE SERVICE APPLICATION 
  5.11  PROCEDURE.] 
  5.12     Subdivision 1.  [WRITTEN APPLICATION.] Each prospective 
  5.13  licensee and each present licensee wishing to offer a new type 
  5.14  or types of ambulance service or to expand a primary service 
  5.15  area, shall make written application for a license to the board 
  5.16  on a form provided by the board.  
  5.17     Subd. 2.  [APPLICATION NOTICE.] The board shall promptly 
  5.18  send notice of the completed application to each county board, 
  5.19  community health board, governing body of a regional emergency 
  5.20  medical services system designated under section 144E.50, 
  5.21  ambulance service, and municipality in the area in which 
  5.22  ambulance service would be provided by the applicant.  The board 
  5.23  shall publish the notice, at the applicant's expense, in the 
  5.24  State Register and in a newspaper in the municipality in which 
  5.25  the base of operation is or will be located, or if no newspaper 
  5.26  is published in the municipality or if the service is or would 
  5.27  be provided in more than one municipality, in a newspaper 
  5.28  published at the county seat of the county or counties in which 
  5.29  the service would be provided.  
  5.30     Subd. 3.  [COMMENTS.] Each municipality, county, community 
  5.31  health board, governing body of a regional emergency medical 
  5.32  services system, ambulance service, and other person wishing to 
  5.33  make recommendations concerning the disposition of the 
  5.34  application shall make written recommendations or comments 
  5.35  opposing the application to the board within 30 days of the 
  5.36  publication of notice of the application in the State Register. 
  6.1      Subd. 4.  [CONTESTED CASE EXEMPTION; PROCEDURE.] (a) If no 
  6.2   more than five written comments opposing the application have 
  6.3   been received by the board under subdivision 3, and the board 
  6.4   has determined, after considering the factors listed under 
  6.5   subdivision 6, that the proposed service or expansion of primary 
  6.6   service area is needed, the applicant shall be exempt from the 
  6.7   contested case hearing process under subdivision 5.  
  6.8      (b) An applicant exempted from a contested case hearing 
  6.9   under this subdivision shall furnish additional information, as 
  6.10  requested by the board, to support its application.  The board 
  6.11  shall approve the application and grant a license to the 
  6.12  applicant within 30 days after final submission of requested 
  6.13  information to the board, and upon a determination by the board 
  6.14  that the applicant is in compliance with the rules adopted by 
  6.15  the board and with the inspection requirements of section 
  6.16  144E.18. 
  6.17     (c) If an applicant does not comply with the inspection 
  6.18  requirements under section 144E.18 within one year of the 
  6.19  board's approval of its application, the license shall be 
  6.20  denied.  The one-year time limit applies to any licensing 
  6.21  decision made by the board or to any prior licensing decision 
  6.22  made by the commissioner of health or an administrative law 
  6.23  judge.  
  6.24     (d) If, after considering the factors under subdivision 6, 
  6.25  the board determines that the proposed service or expansion of 
  6.26  primary service area is not needed, the case shall be treated as 
  6.27  a contested case under subdivision 5, paragraphs (c) to (g). 
  6.28     Subd. 5.  [CONTESTED CASE; PROCEDURE.] (a) If more than 
  6.29  five written comments opposing the application are received by 
  6.30  the board as specified under subdivision 3, the board shall give 
  6.31  the applicant the option of immediately proceeding to a 
  6.32  contested case hearing or trying to resolve the objections 
  6.33  within 30 days.  
  6.34     (b) If, after considering the factors under subdivision 6, 
  6.35  the board determines that the proposed service or expansion of 
  6.36  primary service area is not needed, the board shall give the 
  7.1   applicant the option of immediately proceeding to a contested 
  7.2   case hearing or using up to 30 days to satisfy the board that 
  7.3   the proposed service or expansion of primary service area is 
  7.4   needed.  
  7.5      (c) The board shall request the chief administrative law 
  7.6   judge appoint an administrative law judge to hold a public 
  7.7   hearing in the municipality in which the applicant's base of 
  7.8   operation is or will be located: 
  7.9      (1) if more than five opposing comments remain after 30 
  7.10  days; 
  7.11     (2) if, after considering the factors under subdivision 6, 
  7.12  the board determines that the proposed service or expansion of 
  7.13  primary service area is not needed after 30 days; or 
  7.14     (3) at the applicant's initial request. 
  7.15     (d) If the applicant's base of operation is located outside 
  7.16  of Minnesota, the hearing shall be held at a location within the 
  7.17  area in which service would be provided in Minnesota.  The 
  7.18  public hearing shall be conducted as a contested case hearing 
  7.19  under chapter 14.  The board shall pay the expenses for the 
  7.20  hearing location and the administrative law judge. 
  7.21     (e) The board shall provide notice of the public hearing, 
  7.22  at the applicant's expense, in the State Register and in the 
  7.23  newspaper or newspapers in which the notice was published under 
  7.24  subdivision 2 for two successive weeks at least ten days before 
  7.25  the date of the hearing. 
  7.26     (f) The administrative law judge shall:  
  7.27     (1) hold a public hearing as specified in paragraphs (c) 
  7.28  and (d); 
  7.29     (2) allow any interested person the opportunity to be 
  7.30  heard, to be represented by counsel, and to present oral and 
  7.31  written evidence at the public hearing; and 
  7.32     (3) provide a transcript of the hearing at the expense of 
  7.33  any individual requesting it. 
  7.34     (g) The administrative law judge shall review and comment 
  7.35  upon the application and make written recommendations as to its 
  7.36  disposition to the board within 90 days of publication of notice 
  8.1   of the hearing in the State Register.  In making the 
  8.2   recommendations, the administrative law judge shall consider and 
  8.3   make written comments as to whether the proposed service or 
  8.4   expansion in primary service area is needed, based on 
  8.5   consideration of the factors specified in subdivision 6.  
  8.6      Subd. 6.  [REVIEW CRITERIA.] When reviewing an application 
  8.7   for licensure, the board and administrative law judge shall 
  8.8   consider the following factors: 
  8.9      (1) the relationship of the proposed service or expansion 
  8.10  in primary service area to the current community health plan as 
  8.11  approved by the commissioner of health under section 145A.12, 
  8.12  subdivision 4; 
  8.13     (2) the recommendations or comments of the governing bodies 
  8.14  of the counties, municipalities, and regional emergency medical 
  8.15  services system designated under section 144E.50 in which the 
  8.16  service would be provided; 
  8.17     (3) the deleterious effects on the public health from 
  8.18  duplication, if any, of ambulance services that would result 
  8.19  from granting the license; 
  8.20     (4) the estimated effect of the proposed service or 
  8.21  expansion in primary service area on the public health; and 
  8.22     (5) whether any benefit accruing to the public health would 
  8.23  outweigh the costs associated with the proposed service or 
  8.24  expansion in primary service area.  The administrative law judge 
  8.25  shall recommend that the board either grant or deny a license or 
  8.26  recommend that a modified license be granted.  The reasons for 
  8.27  the recommendation shall be set forth in detail.  The 
  8.28  administrative law judge shall make the recommendations and 
  8.29  reasons available to any individual requesting them.  
  8.30     Subd. 7.  [LICENSING DECISION.] After receiving the 
  8.31  administrative law judge's report, the board shall approve or 
  8.32  deny the application and grant the license within 60 days if the 
  8.33  application is approved, and upon determination by the board, 
  8.34  that the applicant is in compliance with the rules adopted by 
  8.35  the board and with the inspection requirements of section 
  8.36  144E.18.  In approving or denying an application, the board 
  9.1   shall consider the administrative law judge's report, the 
  9.2   evidence contained in the application, and any hearing record 
  9.3   and other applicable evidence.  The board's decision shall be 
  9.4   based on a consideration of the factors contained in subdivision 
  9.5   6.  If the board determines to grant the applicant a license, 
  9.6   the applicant must comply with the inspection requirements under 
  9.7   144E.18 within one year of the board's approval of the 
  9.8   application or the license will be denied.  This one-year time 
  9.9   limit applies to any licensing decision by the board or to any 
  9.10  prior licensing decision made by the commissioner of health or 
  9.11  an administrative law judge.  
  9.12     Subd. 8.  [FINAL DECISION.] The board's decision made under 
  9.13  subdivision 7 shall be the final administrative decision.  Any 
  9.14  person aggrieved by the board's decision or action shall be 
  9.15  entitled to judicial review in the manner provided in sections 
  9.16  14.63 to 14.69. 
  9.17     Sec. 7.  [144E.12] [LICENSURE OF AIR AMBULANCE SERVICES.] 
  9.18     Except for submission of a written application to the board 
  9.19  on a form provided by the board, an application to provide air 
  9.20  ambulance service shall be exempt from the provisions of section 
  9.21  144E.11.  A license issued pursuant to this section need not 
  9.22  designate a primary service area.  No license shall be issued 
  9.23  under this section unless the board determines that the 
  9.24  applicant complies with sections 144E.10, 144E.11, subdivision 
  9.25  1, 144E.16, and 144E.18 and the requirements of applicable 
  9.26  federal and state statutes and rules governing aviation 
  9.27  operations within the state. 
  9.28     Sec. 8.  [144E.13] [TEMPORARY LICENSE.] 
  9.29     The board may issue a temporary license when a primary 
  9.30  service area would be deprived of ambulance service.  The 
  9.31  temporary license shall expire when an applicant has been issued 
  9.32  a regular license under this section.  The temporary license 
  9.33  shall be valid no more than six months from date of issuance.  A 
  9.34  temporary licensee must provide evidence that the licensee will 
  9.35  meet the requirements of section 144E.16 and the rules adopted 
  9.36  under this chapter.  
 10.1      Sec. 9.  [144E.14] [TRANSFER OF LICENSE OR OWNERSHIP.] 
 10.2      A license, or the ownership of a licensed ambulance 
 10.3   service, may be transferred only upon approval of the board, 
 10.4   based upon a finding that the proposed licensee or proposed new 
 10.5   owner of a licensed ambulance service meets or will meet the 
 10.6   requirements of section 144E.16.  If the proposed transfer would 
 10.7   result in an addition of a new base of operations, expansion of 
 10.8   the service's primary service area, or provision of a new type 
 10.9   or types of ambulance service, the board shall require the 
 10.10  prospective licensee or owner to comply with section 144E.11.  
 10.11  The board may approve the license or ownership transfer prior to 
 10.12  completion of the application process described in section 
 10.13  144E.11 upon obtaining written assurances from the proposed 
 10.14  licensee or proposed new owner that no expansion of the 
 10.15  service's primary service area or provision of a new type or 
 10.16  types of ambulance service will occur during the processing of 
 10.17  the application.  If requesting a transfer of its base of 
 10.18  operations, an applicant must comply with the requirements of 
 10.19  section 144E.15.  
 10.20     Sec. 10.  [144E.15] [RELOCATION OF BASE OF OPERATIONS.] 
 10.21     To relocate the base of operations to another municipality 
 10.22  or township within its primary service area, a licensee must 
 10.23  provide written notification to the board prior to relocating.  
 10.24  The board shall review the proposal to determine if relocation 
 10.25  would adversely affect service coverage within the primary 
 10.26  service area.  The applicant must furnish any additional 
 10.27  information requested by the board to support its proposed 
 10.28  transfer.  If the board does not approve the relocation 
 10.29  proposal, the licensee must comply with the application 
 10.30  requirements for a new license under section 144E.11. 
 10.31     Sec. 11.  [144E.16] [AMBULANCE SERVICE REQUIREMENTS.] 
 10.32     Subdivision 1.  [DRIVERS AND ATTENDANTS.] No publicly or 
 10.33  privately owned basic ambulance service shall be operated in the 
 10.34  state unless its drivers and attendants possess a current 
 10.35  emergency care course certificate authorized by rules adopted by 
 10.36  the board according to chapter 14.  Until August 1, 1997, a 
 11.1   licensee may substitute a person currently certified by the 
 11.2   American Red Cross in advanced first aid and emergency care or a 
 11.3   person who has successfully completed the United States 
 11.4   Department of Transportation first responder curriculum, and who 
 11.5   has also been trained to use basic life support equipment as 
 11.6   required by rules adopted by the board under subdivision 4 for 
 11.7   one of the persons on a basic ambulance, provided that person 
 11.8   will function as the driver while transporting a patient.  The 
 11.9   board may grant a variance to allow a licensed ambulance service 
 11.10  to use attendants certified by the American Red Cross in 
 11.11  advanced first aid and emergency care and, until August 1, 1997, 
 11.12  to use attendants who have successfully completed the United 
 11.13  States Department of Transportation first responder curriculum, 
 11.14  and who have been trained to use basic life support equipment as 
 11.15  required by rules adopted by the board under subdivision 4, in 
 11.16  order to ensure 24-hour emergency ambulance coverage. 
 11.17     Subd. 2.  [EQUIPMENT AND STAFF.] (a) Every ambulance 
 11.18  offering ambulance service shall be equipped as required by the 
 11.19  board and carry at least the minimal equipment necessary for the 
 11.20  type of service to be provided as determined by standards 
 11.21  adopted by the board pursuant to subdivision 3. 
 11.22     (b) Each ambulance service shall offer service 24 hours per 
 11.23  day every day of the year, unless otherwise authorized by the 
 11.24  board.  
 11.25     (c) Each ambulance while transporting a patient shall be 
 11.26  staffed by at least a driver and an attendant, according to 
 11.27  subdivision 1.  An ambulance service may substitute for the 
 11.28  attendant a physician, osteopath, registered nurse, or 
 11.29  physician's assistant who is qualified by training to use 
 11.30  appropriate equipment in the ambulance.  Advanced life support 
 11.31  procedures including, but not limited to, intravenous fluid 
 11.32  administration, drug administration, endotracheal intubation, 
 11.33  cardioversion, defibrillation, and intravenous access may be 
 11.34  performed by the physician, osteopath, registered nurse, or 
 11.35  physician's assistant who has appropriate training and 
 11.36  authorization, and who provides all of the equipment and 
 12.1   supplies not normally carried on basic ambulances. 
 12.2      Subd. 3.  [DENIAL OF SERVICE PROHIBITED.] An ambulance 
 12.3   service shall not deny emergency ambulance service to any person 
 12.4   needing emergency ambulance service because of inability to pay 
 12.5   or due to source of payment for services if the need develops 
 12.6   within the licensee's primary service area.  Transport for the 
 12.7   patient may be limited to the closest appropriate emergency 
 12.8   medical facility.  
 12.9      Subd. 4.  [TYPES OF SERVICES TO BE REGULATED.] The board 
 12.10  may adopt rules needed to carry out this chapter, including the 
 12.11  following types of ambulance service: 
 12.12     (1) basic ambulance service that has appropriate personnel, 
 12.13  vehicles, and equipment, and is maintained according to rules 
 12.14  adopted by the board according to chapter 14, and that provides 
 12.15  a level of care so as to ensure that life-threatening situations 
 12.16  and potentially serious injuries can be recognized, patients 
 12.17  will be protected from additional hazards, basic treatment to 
 12.18  reduce the seriousness of emergency situations will be 
 12.19  administered and patients transported to an appropriate medical 
 12.20  facility for treatment; 
 12.21     (2) intermediate ambulance service that has appropriate 
 12.22  personnel, vehicles, and equipment, and is maintained according 
 12.23  to standards the board adopts according to chapter 14, and that 
 12.24  provides basic ambulance service and intravenous infusions or 
 12.25  defibrillation or both.  Standards adopted by the board shall 
 12.26  include, but not be limited to, equipment, training, procedures, 
 12.27  and medical control; 
 12.28     (3) advanced ambulance service that has appropriate 
 12.29  personnel, vehicles, and equipment, and is maintained according 
 12.30  to standards the board adopts according to chapter 14, and that 
 12.31  provides basic ambulance service, and in addition, advanced 
 12.32  airway management, defibrillation, and administration of 
 12.33  intravenous fluids and pharmaceuticals.  Vehicles of advanced 
 12.34  ambulance service licensees not equipped or staffed at the 
 12.35  advanced ambulance service level shall not be identified to the 
 12.36  public as capable of providing advanced ambulance service; 
 13.1      (4) specialized ambulance service that provides basic, 
 13.2   intermediate, or advanced service as designated by the board, 
 13.3   and is restricted by the board to (i) less than 24 hours of 
 13.4   every day, (ii) designated segments of the population, or (iii) 
 13.5   certain types of medical conditions; and 
 13.6      (5) air ambulance service, that includes fixed-wing and 
 13.7   helicopter, and is specialized ambulance service. 
 13.8      Until standards have been developed under clauses (2), (4), 
 13.9   and (5), the current provisions of Minnesota Rules shall govern 
 13.10  these services. 
 13.11     Subd. 5.  [LOCAL GOVERNMENT'S POWERS.] (a) Local units of 
 13.12  government may, with the approval of the board, establish 
 13.13  standards for ambulance services which impose additional 
 13.14  requirements upon such services.  Local units of government 
 13.15  intending to impose additional requirements shall consider 
 13.16  whether any benefit accruing to the public health would outweigh 
 13.17  the costs associated with the additional requirements. 
 13.18     (b) Local units of government that desire to impose 
 13.19  additional requirements shall, prior to adoption of relevant 
 13.20  ordinances, rules or regulations, furnish the board with a copy 
 13.21  of the proposed ordinances, rules or regulations, along with 
 13.22  information that affirmatively substantiates that the proposed 
 13.23  ordinances, rules or regulations:  (1) will in no way conflict 
 13.24  with the relevant rules of the board; (2) will establish 
 13.25  additional requirements tending to protect the public health; 
 13.26  (3) will not diminish public access to ambulance services of 
 13.27  acceptable quality; and (4) will not interfere with the orderly 
 13.28  development of regional systems of emergency medical care. 
 13.29     (c) The board shall base any decision to approve or 
 13.30  disapprove local standards upon whether or not the local unit of 
 13.31  government in question has affirmatively substantiated that the 
 13.32  proposed ordinances, rules or regulations meet the criteria 
 13.33  specified in paragraph (b). 
 13.34     Subd. 6.  [DRIVERS.] An ambulance service vehicle shall be 
 13.35  staffed by a driver possessing a current Minnesota driver's 
 13.36  license or equivalent and whose driving privileges are not under 
 14.1   suspension or revocation by any state.  If red lights and siren 
 14.2   are used, the driver must also have completed training approved 
 14.3   by the board in emergency driving techniques.  An ambulance 
 14.4   transporting patients must be staffed by at least two persons 
 14.5   who are trained according to subdivision 1, or section 144E.25, 
 14.6   one of whom may be the driver.  A third person serving as driver 
 14.7   shall be trained according to this subdivision. 
 14.8      Subd. 7.  [FIRST RESPONDER REGISTRATION.] The board shall 
 14.9   adopt rules to establish a registration program for first 
 14.10  responders and first responder squads. 
 14.11     Sec. 12.  [144E.30] [PENALTIES; DISCIPLINARY ACTION.] 
 14.12     Subdivision 1.  [SUSPENSION; REVOCATION; NONRENEWAL.] The 
 14.13  board may initiate a contested case hearing upon reasonable 
 14.14  notice to suspend, revoke, refuse to renew, or place conditions 
 14.15  on the license of a licensee upon finding that the licensee has 
 14.16  violated a provision of this chapter or rules adopted under this 
 14.17  chapter, or has ceased to provide the service for which the 
 14.18  licensee is licensed.  The board may initiate a contested case 
 14.19  hearing upon reasonable notice to suspend, revoke, refuse to 
 14.20  renew, or place conditions on the credential of a person 
 14.21  credentialed by the board upon finding that the person 
 14.22  credentialed by the board has violated sections 144E.06 to 
 14.23  144E.30 or rules adopted thereunder.  The board may also 
 14.24  initiate a contested case hearing upon reasonable notice to 
 14.25  suspend, revoke, refuse to renew, or place conditions on a 
 14.26  training program approved by the board upon finding that the 
 14.27  training program has violated sections 144E.06 to 144E.30, or 
 14.28  rules adopted thereunder.  
 14.29     Subd. 2.  [TEMPORARY SUSPENSION.] (a) In addition to any 
 14.30  other remedy provided by law, the board may temporarily suspend 
 14.31  the license of a licensee, credential of a person, or approval 
 14.32  of a training program after conducting a preliminary inquiry to 
 14.33  determine if the board believes that the licensee, person, or 
 14.34  training program has violated a statute or rule that the board 
 14.35  is empowered to enforce and that the continued provision of 
 14.36  service by the licensee, person, or training program would 
 15.1   create an imminent risk to public health or harm to others. 
 15.2      (b) The order prohibiting the licensee, person credentialed 
 15.3   by the board, or training program approved by the board from 
 15.4   providing ambulance service, medical care, or training shall 
 15.5   give notice of the right to a hearing pursuant to this 
 15.6   subdivision and shall state the reasons for the entry of the 
 15.7   order. 
 15.8      (c) Service of the order is effective when the order is 
 15.9   served on the licensee, person credentialed by the board, or 
 15.10  representative of the training program personally or by 
 15.11  certified mail, which is complete upon receipt, refusal, or 
 15.12  return for nondelivery to the most recent address provided to 
 15.13  the board for the licensee, person, or training program. 
 15.14     (d) At the time the board issues a temporary suspension 
 15.15  order, the board shall schedule a hearing to be held before a 
 15.16  group of its members designated by the board which shall begin 
 15.17  no later than 60 days after issuance of the temporary suspension 
 15.18  order or within 15 working days of the date of the board's 
 15.19  receipt of a request for hearing by a licensee, person 
 15.20  credentialed by the board, or training program approved by the 
 15.21  board on the sole issue of whether there is a reasonable basis 
 15.22  to continue, modify, or lift the temporary suspension.  This 
 15.23  hearing is not subject to chapter 14.  Evidence presented by the 
 15.24  board, licensee, person credentialed by the board, or training 
 15.25  program approved by the board must be in the form of an 
 15.26  affidavit.  The licensee, the person credentialed by the board, 
 15.27  a representative of the training program, or a counsel of record 
 15.28  may appear for oral argument. 
 15.29     (e) Within five working days of the hearing, the board 
 15.30  shall issue its order and, if the suspension is continued, 
 15.31  schedule a contested case hearing within 30 days of the issuance 
 15.32  of the order.  The administrative law judge shall issue a report 
 15.33  and recommendation within 30 days after the closing of the 
 15.34  contested case hearing record.  The board shall issue a final 
 15.35  order within 30 days after receipt of the administrative law 
 15.36  judge's report. 
 16.1      Subd. 3.  [COOPERATION DURING INVESTIGATION.] A licensee, 
 16.2   person credentialed by the board, training program approved by 
 16.3   the board, or agent of one who is the subject of an 
 16.4   investigation or who is questioned in connection with an 
 16.5   investigation by or on behalf of the board shall cooperate fully 
 16.6   with the investigation.  Cooperation includes responding fully 
 16.7   and promptly to any question raised by or on behalf of the board 
 16.8   relating to the subject of the investigation, executing all 
 16.9   releases requested by the board, providing copies of ambulance 
 16.10  service records, as reasonably requested by the board to assist 
 16.11  it in its investigation, and appearing at conferences or 
 16.12  hearings scheduled by the board.  The board shall pay reasonable 
 16.13  costs for copies requested. 
 16.14     Subd. 4.  [INJUNCTIVE RELIEF.] In addition to any other 
 16.15  remedy provided by law, the board may bring an action for 
 16.16  injunctive relief in the district court in Hennepin county or, 
 16.17  at the board's discretion, in the district court in the county 
 16.18  in which a violation of any statute, rule, or order that the 
 16.19  board is empowered to enforce or issue, has occurred, to enjoin 
 16.20  the violation. 
 16.21     Subd. 5.  [SUBPOENA POWER.] The board may, as part of an 
 16.22  investigation to determine whether a serious public health 
 16.23  threat exists, issue subpoenas to require the attendance and 
 16.24  testimony of witnesses and production of books, records, 
 16.25  correspondence, and other information relevant to any matter 
 16.26  involved in the investigation.  The board or the board's 
 16.27  designee may administer oaths to witnesses or take their 
 16.28  affirmation.  The subpoenas may be served upon any person named 
 16.29  therein anywhere in the state by any person authorized to serve 
 16.30  subpoenas or other processes in civil actions of the district 
 16.31  courts.  If a person to whom a subpoena is issued does not 
 16.32  comply with the subpoena, the board may apply to the district 
 16.33  court in any district and the court shall order the person to 
 16.34  comply with the subpoena.  Failure to obey the order of the 
 16.35  court may be punished by the court as contempt of the court.  No 
 16.36  person may be compelled to disclose privileged information as 
 17.1   described in section 595.02, subdivision 1.  All information 
 17.2   pertaining to individual medical records obtained under this 
 17.3   section shall be considered health data under section 13.38.  
 17.4   All other information is considered public data unless otherwise 
 17.5   protected under the Minnesota data practices act or other 
 17.6   specific law.  The fees for the service of a subpoena must be 
 17.7   paid in the same manner as prescribed by law for service of 
 17.8   process used out of a district court.  Subpoenaed witnesses must 
 17.9   receive the same fees and mileage as in civil actions. 
 17.10     Subd. 6.  [PENALTIES.] Any person who violates a provision 
 17.11  of sections 144E.06 to 144E.30 is guilty of a misdemeanor.  The 
 17.12  board may issue fines to ensure compliance with sections 144E.06 
 17.13  to 144E.30 and rules adopted thereunder.  The board shall adopt 
 17.14  rules to implement a schedule of fines. 
 17.15     Sec. 13.  [FIRST RESPONDER REGISTRATION.] 
 17.16     Subdivision 1.  [TRAINING PROGRAMS.] Until rules are 
 17.17  adopted by the board, curriculum for initial and refresher 
 17.18  training programs must meet the current standards of the United 
 17.19  States Department of Transportation First Responder curriculum 
 17.20  or its equivalent as determined by the board.  
 17.21     Subd. 2.  [REGISTRATION.] Until rules are adopted by the 
 17.22  board, the board shall register the following persons as first 
 17.23  responders: 
 17.24     (1) a person who successfully completes a board-approved 
 17.25  initial or refresher first responder training program.  
 17.26  Registration under this clause is valid for two years and 
 17.27  expires at the end of the month in which the registration was 
 17.28  issued; or 
 17.29     (2) a person who is credentialed as a first responder by 
 17.30  the National Registry of Emergency Medical Technicians.  
 17.31  Registration under this clause expires the same day as the 
 17.32  National Registry credential.  
 17.33     Subd. 3.  [RENEWAL.] (a) Until rules are adopted by the 
 17.34  board, the board may renew the registration of a first responder 
 17.35  who: 
 17.36     (1) successfully completes a board-approved refresher 
 18.1   course; and 
 18.2      (2) submits a completed renewal application to the board 
 18.3   before the registration expiration date.  
 18.4      (b) Until rules are adopted by the board, the board may 
 18.5   renew the lapsed registration of a first responder who: 
 18.6      (1) successfully completes a board-approved refresher 
 18.7   course; and 
 18.8      (2) submits a completed renewal application to the board 
 18.9   within 12 months after the registration expiration date.  
 18.10     Subd. 4.  [EXPIRATION.] A first responder registration 
 18.11  issued by the board or the commissioner of health before August 
 18.12  1, 1997, expires in 1999 at the end of the month in which it was 
 18.13  issued. 
 18.14     Sec. 14.  [INSTRUCTION TO REVISOR.] 
 18.15     (a) The revisor of statutes shall renumber each section of 
 18.16  Minnesota Statutes specified in column A with the number set 
 18.17  forth in column B.  The revisor shall also make necessary 
 18.18  cross-reference changes consistent with the renumbering. 
 18.19            Column A            Column B
 18.20            144.807             144E.17
 18.21            144.808             144E.18
 18.22            144.809             144E.25
 18.23            144.8091            144E.35
 18.24            144.8093            144E.50
 18.25            144.8095            144E.52
 18.26            144C.01             144E.40
 18.27            144C.02             144E.41
 18.28            144C.03             144E.42
 18.29            144C.05             144E.43
 18.30            144C.06             144E.44
 18.31            144C.07             144E.45
 18.32            144C.08             144E.46
 18.33            144C.09             144E.47
 18.34            144C.10             144E.48
 18.35     (b) In each section of Minnesota Statutes referred to in 
 18.36  column A, the revisor of statutes shall delete the reference in 
 19.1   column B and insert the reference in column C. 
 19.2         Column A           Column B              Column C
 19.3      62J.25              144.801, subd. 4     144E.001, subd. 3 
 19.4      62J.48              144.802              144E.10
 19.5      116.76, subd. 9     144.802              144E.10 
 19.6      144.761, subd. 4    144.801 to 144.8091  144E.001 to 144E.35
 19.7      144.761, subd. 5    144.801 to 144.8091  144E.001 to 144E.35
 19.8      144.807, subd. 1    144.801 to 144.806   144E.001 to 144E.16
 19.9      144.808             144.801 to 144.804   144E.001 to 144E.16
 19.10     144.809             144.804, subd. 7     144E.16, subd. 6
 19.11     144.8091            144.804              144E.16
 19.12     144C.02             144.804              144E.16
 19.13     145A.02             144.804              144E.16
 19.14     147A.09             144.804              144E.16
 19.15     168.012, subd. 1    144.802              144E.10
 19.16     174.29, subd. 1     144.801, subd. 4     144E.001, subd. 3
 19.17     174.315, subd. 1    144.801, subd. 4     144E.001, subd. 3
 19.18     297A.25, subd. 44   144.802              144E.10
 19.19     297B.03             144.802              144E.10
 19.20     353.64              144.804, subd. 3     144E.16, subd. 4
 19.21     383B.221, subd. 2   144.801 to 144.8091  144E.001 to 144E.35
 19.22     609.7495, subd. 1   144.801              144E.001
 19.23     Sec. 15.  [REPEALER.] 
 19.24     Minnesota Statutes 1996, sections 144.801; 144.802; 
 19.25  144.803; 144.804; and 144.806, are repealed. 
 19.26     Sec. 16.  [EFFECTIVE DATE.] 
 19.27     Section 2 is effective the day following final enactment.