There is a newer version of the North Dakota Century Code
2009 North Dakota Code
23 Health and Safety
23-27 Licensing of Emergency Medical Services Operations
Download pdfoperations. After June 30, 2001, the department shall limit the issuance of a license
for any new emergency medical services operation based on the needs of the
service area if the applicant for the new license was licensed before July 1, 2001,
and was subsequently relicensed under section 23-27-04.5. 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. Page No. 1 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 support ambulance services, air ambulance services, and quick
response unit services. 4. "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. 5. "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. Page No. 2 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. 3. 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. 4. 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 Page No. 3 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. 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, § 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 ensure that every
ambulance service that has portions of its service area in that taxing district receives a portion of
the revenue from this tax. The taxing district shall allocate the special tax levy revenue to each
ambulance service based upon the taxable value of the property within each township of the
taxing district, allocating the taxable value of each 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 Page No. 4 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. Page No. 5 Document Outline chapter 23-27 licensing of emergency medical services operations
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