1.1 	A bill for an act
1.2 	relating to health; eliminating the requirement of a variance for a staff 
1.3 	requirement for ambulance services; allowing alternative ambulance staffing in 
1.4 	certain areas; allowing a licensed ambulance service in limited areas to accept 
1.5 	full mutual aid on a part-time basis;amending Minnesota Statutes 2014, section 
1.6 	144E.101, subdivisions 6, 12.
1.7 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.8 	Section 1. Minnesota Statutes 2014, section 144E.101, subdivision 6, is amended to 
1.9 	read:
1.10 		Subd. 6.Basic life support. (a) Except as provided in paragraphs paragraph (e) and 
1.11 	(f), a basic life-support ambulance shall be staffed by at least two EMTs, one of whom 
1.12 	must accompany the patient and provide a level of care so as to ensure that:
1.13 	(1) life-threatening situations and potentially serious injuries are recognized;
1.14 	(2) patients are protected from additional hazards;
1.15 	(3) basic treatment to reduce the seriousness of emergency situations is administered; 
1.16 	and
1.17 	(4) patients are transported to an appropriate medical facility for treatment.
1.18 	(b) A basic life-support service shall provide basic airway management.
1.19 	(c) A basic life-support service shall provide automatic defibrillation.
1.20 	(d) A basic life-support service licensee's medical director may authorize ambulance 
1.21 	service personnel to perform intravenous infusion and use equipment that is within the 
1.22 	licensure level of the ambulance service, including administration of an opiate antagonist. 
1.23 	Ambulance service personnel must be properly trained. Documentation of authorization 
1.24 	for use, guidelines for use, continuing education, and skill verification must be maintained 
1.25 	in the licensee's files.
2.1 	(e) Upon application from an ambulance service that includes evidence 
2.2 	demonstrating hardship, the board may grant a variance from the staff requirements in 
2.3 	paragraph (a) and may authorize a basic life-support ambulance to be staffed by one EMT 
2.4 	and one registered emergency medical responder driver for all emergency ambulance calls 
2.5 	and interfacility transfers. The variance shall apply to basic life-support ambulances 
2.6 	operated by the ambulance service until the ambulance service renews its license. When a 
2.7 	variance expires, an ambulance service may apply for a new variance under this paragraph.
2.8 	For emergency ambulance calls and interfacility transfers, an ambulance service may 
2.9 	staff its basic life-support ambulances with one EMT, who must accompany the patient, 
2.10 	and one registered emergency medical responder driver. For purposes of this paragraph, 
2.11 	"ambulance service" means either an ambulance service whose primary service area is 
2.12 	mainly located outside the metropolitan counties listed in section 473.121, subdivision 4, 
2.13 	and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an 
2.14 	ambulance service based in a community with a population of less than 1,000 2,500.
2.15 	(f) After an initial emergency ambulance call, each subsequent emergency ambulance 
2.16 	response, until the initial ambulance is again available, and interfacility transfers, may 
2.17 	be staffed by one registered emergency medical responder driver and an EMT. The 
2.18 	EMT must accompany the patient and provide the level of care required in paragraph 
2.19 	(a). This paragraph applies only to an ambulance service whose primary service area is 
2.20 	mainly located outside the metropolitan counties listed in section 473.121, subdivision 
2.21 	4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an 
2.22 	ambulance based in a community with a population of less than 1,000 persons.

2.23 	Sec. 2. Minnesota Statutes 2014, section 144E.101, subdivision 12, is amended to read:
2.24 		Subd. 12.Mutual aid agreement. (a) A licensee shall have a written agreement 
2.25 	with at least one neighboring licensed ambulance service for the preplanned and organized 
2.26 	response of emergency medical services, and other emergency personnel and equipment, 
2.27 	to a request for assistance in an emergency when local ambulance transport resources have 
2.28 	been expended. The response is predicated upon formal agreements among participating 
2.29 	ambulance services. A copy of each mutual aid agreement shall be maintained in the 
2.30 	files of the licensee.
2.31 	(b) A licensee may have a written agreement with a neighboring licensed ambulance 
2.32 	service, including a licensed ambulance service from a neighboring state if that service is 
2.33 	currently and remains in compliance with its home state licensing requirements, to provide 
2.34 	part-time support to the primary service area of the licensee upon the licensee's request. 
2.35 	The agreement may allow the licensee to suspend ambulance services in its primary 
3.1 	service area during the times the neighboring licensed ambulance service has agreed to 
3.2 	provide all emergency services to the licensee's primary service area. The agreement may 
3.3 	not permit the neighboring licensed ambulance service to serve the licensee's primary 
3.4 	service area for more than 12 hours per day. This paragraph applies only to an ambulance 
3.5 	service whose primary service area is mainly located outside the metropolitan counties 
3.6 	listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, 
3.7 	Moorhead, Rochester, and St. Cloud, or an ambulance based in a community with a 
3.8 	population of less than 2,500 persons.

3.9 	Sec. 3. EFFECTIVE DATE.
 3.10 	Sections 1 and 2 are effective the day following final enactment.