2013 North Dakota Century Code Title 23 Health and Safety Chapter 23-27 Emergency Medical Services Operations Licenses
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CHAPTER 23-27
EMERGENCY MEDICAL SERVICES OPERATIONS LICENSES
23-27-01. License required - Licensing of emergency medical services operations Exception - Waiver.
1. The state department of health shall license emergency medical services operations
and may designate their service areas. The department shall limit the issuance of a
license for any new emergency medical services operation based on the needs of the
service area. A license for an emergency medical services operation is
nontransferable.
2. Emergency medical services may not be advertised, offered, or provided to the public
except by an emergency medical services operator that provides the emergency
medical services through emergency medical services personnel.
3. Except as otherwise provided under subsection 4, an emergency medical services
operator must be separately licensed for each of the operator's emergency medical
services operations and an operation that is headquartered from a separate location
must be considered a separate operation. Under this subsection, an operation with a
single headquarters site may dispatch vehicles and emergency medical services
personnel from more than one location if calls requesting services are received and
orders for vehicle dispatch are made at the single headquarters site.
4. Notwithstanding subsection 3, an operator of an emergency medical services
operation may operate one or more substation ambulance services operations under a
single license if:
a. The headquarters ambulance services operation is not a substation ambulance
services operation of another emergency medical services operation;
b. The substation ambulance services operation area borders the headquarters
ambulance services operation area or borders another substation of the
headquarters ambulance services operation;
c. The headquarters ambulance services operation and the substation ambulance
services operation are dispatched by the same entity; and
d. The operator of the emergency medical services operation pays a license fee for
each of its substation ambulance services operations.
5. The provisions of this chapter do not apply to an operator from another state which is
headquartered at a location outside of this state and transports patients across state
lines, but the operator may not treat patients within this state or pick up patients within
this state for transportation to locations within this state, except as provided by rule.
6. The state health council shall adopt rules for special licenses and waiver provisions for
an operator of an emergency medical services operation intended for industrial sites
not available to the general public.
23-27-02. Definitions.
For the purpose of this chapter, unless the context otherwise requires:
1. "Department" means the state department of health.
2. "Emergency medical services" means the prehospital medical stabilization or
transportation of an individual who is sick, injured, wounded, or otherwise
incapacitated or helpless, or in a real or perceived acute medical condition, by a
person that holds oneself out to the public as being in that service or that regularly
provides that service. The term includes:
a. Assessing, stabilizing, and treating life-threatening and non-life-threatening
medical conditions; or
b. Transporting a patient who is in a real or perceived acute medical condition to a
hospital emergency room.
3. "Emergency medical services operation" means an entity licensed to offer and provide
emergency medical services by emergency medical services personnel with physician
oversight. The term includes basic life support ambulance services, advanced life
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4.
5.
support ambulance services, air ambulance services, and quick response unit
services.
"Emergency medical services personnel" means individuals who provide emergency
medical services for emergency medical services operations. The term includes
emergency medical services professionals, drivers, and department-certified
emergency medical services providers, such as cardiopulmonary resuscitation drivers
and first responders.
"Emergency medical services professional" means an individual licensed by the
department as an emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical technician-paramedic.
23-27-03. License fees.
The fee for an emergency medical services operation license to operate an emergency
medical services operation or a substation ambulance services operation must be set by the
state health council at a sum of not more than twenty-five dollars annually, as may be required
to defray the costs of administration of the licensing program. This operation license fee does
not apply to licensure or certification of emergency medical services personnel. All license fees
must be paid to the state department of health and deposited with the state treasurer and
credited to the state general fund.
23-27-04. Standards for operators.
1. An emergency medical services operation within this state may not operate unless the
operation is licensed in accordance with this chapter and rules adopted by the state
health council. The rules must include:
a. Time when operator's services must be available.
b. Type of motor vehicle operator's license needed for drivers of ground vehicles.
c. Training standards for operation personnel.
d. Equipment and ground vehicle standards.
e. Annual license fees.
f. Number of personnel required for each run.
g. The scope of practice for uncertified drivers, certified personnel, and emergency
medical services professionals.
h. Performance standards, which may include response time standards.
i. Other requirements as may be found necessary to carry out the intent of this
chapter.
2. An officer, employee, or agent of any prehospital emergency medical services
operation may refuse to transport an individual for which transport is not medically
necessary and may recommend an alternative course of action to that individual if the
prehospital emergency medical service has developed protocols that include direct
medical control to refuse transport of an individual.
23-27-04.1. Emergency care or services rendered by officers, employees, or agents of
emergency medical services operations - Physician medical direction.
1. An officer, employee, or agent of an emergency medical services operation and a
physician licensed in this state who provides medical direction to an emergency
medical services operation, who is a volunteer, who in good faith renders emergency
care, services, or medical direction, is not liable to the recipient of the emergency care,
services, or medical direction for any civil damages resulting from any acts or
omissions by the person in rendering the emergency care, services, or medical
direction provided the person is properly trained according to law.
2. For the purpose of this section, "volunteer" means an individual who receives no
compensation or who is paid expenses, reasonable benefits, nominal fees, or a
combination of expenses, reasonable benefits, and nominal fees to perform the
services for which the individual volunteered, provided that the fees do not exceed ten
thousand dollars in any calendar year.
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3.
4.
For a volunteer physician providing medical overview to an emergency medical
services operation and the operation's personnel, the ten thousand dollar maximum
fees amount is calculated separately for each emergency medical services operation
for which the physician volunteered medical overview. This section does not relieve a
person from liability for damages resulting from the intoxication, willful misconduct, or
gross negligence of the person rendering the emergency care or services.
An officer, employee, or agent of any emergency medical services operation and a
physician licensed in this state who provides medical direction to any emergency
medical services operation who in good faith does not render emergency care,
service, or medical direction to an individual based on a determination that transport of
that individual to a hospital is not medically necessary is not liable to that individual for
damages unless the damages resulted from intoxication, willful misconduct, or gross
negligence.
23-27-04.2. Emergency medical services - State assistance.
The state department of health shall assist in the training of emergency medical services
personnel of certain emergency medical services operations as determined by the department
and financially shall assist certain emergency medical services operations as determined by the
department in obtaining equipment. Assistance provided under this section must be within the
limits of legislative appropriation. The department shall adopt criteria for eligibility for assistance
in the training of emergency medical services personnel of various types of emergency medical
services operations. To qualify for financial assistance for equipment an emergency medical
services operation shall certify, in the manner required by the department, that the operation has
fifty percent of the amount of funds necessary for identified equipment acquisitions. The
department shall adopt a schedule of eligibility for financial assistance for equipment. The
schedule must provide for a direct relationship between the amount of funds certified and the
number of responses during the preceding calendar year for the purpose of rendering medical
care, transportation, or both, to individuals who were sick or incapacitated. The schedule must
require that as the number of responses increases, a greater amount of funds certified is
required. The schedule must classify responses and the financial assistance available for
various classifications. The department may establish minimum and maximum amounts of
financial assistance to be provided to an emergency medical services operation under this
section. If applications for financial assistance exceed the amount of allocated and available
funds, the department may prorate the funds among the applicants in accordance with criteria
adopted by the department. No more than one-half of the funds appropriated by the legislative
assembly each biennium and allocated for training assistance may be distributed in the first year
of the biennium.
23-27-04.3. Emergency medical services personnel training, testing, certification,
licensure, and quality review - Penalty.
The state health council shall adopt rules prescribing minimum training, testing, certification,
licensure, and quality review standards for emergency medical services personnel, instructors,
and training institutions. Rules adopted must include a definition of minimum applicable
standards, a definition of emergency medical services personnel, provide for a mechanism for
certifying or licensing persons who have met the required standards, provide a mechanism to
review and improve the quality of care rendered by emergency medical services personnel, and
define minimum standards for emergency medical services training institutions. Licensing as an
emergency medical services training institution is optional. It is a class B misdemeanor for an
individual to willfully misrepresent that individual's certification or licensing status as emergency
medical services personnel. Quality review and improvement information, data, records, and
proceedings are not subject to subpoena or discovery or introduction into evidence in any civil
action.
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23-27-04.4. Supervision of certified or licensed emergency medical technician
hospital personnel.
Certified or licensed emergency medical technicians-intermediate and paramedics, who are
employed by a hospital may provide patient care within a scope of practice established by the
department. Under this section, these emergency medical services professionals are under the
supervision of the hospital's nurse executive.
23-27-04.5. Quick response unit service pilot program.
Expired under S.L. 2001, ch. 246, ยง 14.
23-27-04.6. Quick response units.
Department licensure as a quick response unit is not optional. The department's standards
under section 23-27-04 for the time when a quick response unit's services must be available
may not require twenty-four hour availability.
23-27-04.7. County reporting - Use of property tax levies.
The board of county commissioners of every county in this state shall conduct an annual
review of the emergency medical services coverage within that county and shall submit an
annual report to the state health officer in a format approved by the state department of health.
A taxing district that levies a special emergency medical services or ambulance service levy
shall allocate all of the special tax levy revenue collected in a particular township to the
ambulance service that serves the largest area within that township.
23-27-04.8. Emergency medical services operation communications.
The department may regulate the communications methods and protocols for emergency
medical services operations in a manner consistent with the protocols established by the
department of emergency services.
23-27-04.9. Administration of influenza vaccination.
1. A licensed emergency medical technician-paramedic working for a hospital or an
emergency medical services operation may administer the influenza vaccine to an
individual who is at least eighteen years of age if:
a. The physician providing oversight for the emergency medical services operation
or the hospital medical director has established protocols that meet department
standards that may be based on the advisory committee on immunization
practices of the federal centers for disease control and prevention; and
b. The emergency medical technician-paramedic has satisfactorily completed a
department-approved course on administering vaccines.
2. If a hospital or emergency medical services operation allows the administration of
vaccines under this section, the hospital or emergency medical services operation
shall maintain records documenting the emergency medical technician-paramedic's
completion of the training required under subsection 1. These records are subject to
review by the department.
23-27-05. Penalty.
Any person violating the provisions of this chapter is guilty of an infraction.
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