190.105. Ambulance license required, exceptions--operation of ambulance services--sale or transfer of ownership, notice required. - Missouri Statutes

Ambulance license required, exceptions--operation of ambulanceservices--sale or transfer of ownership, notice required.

190.105. 1. No person, either as owner, agent or otherwise, shallfurnish, operate, conduct, maintain, advertise, or otherwise be engaged inor profess to be engaged in the business or service of the transportationof patients by ambulance in the air, upon the streets, alleys, or anypublic way or place of the state of Missouri unless such person holds acurrently valid license from the department for an ambulance service issuedpursuant to the provisions of sections 190.001 to 190.245.

2. No ground ambulance shall be operated for ambulance purposes, andno individual shall drive, attend or permit it to be operated for suchpurposes in the state of Missouri unless the ground ambulance is under theimmediate supervision and direction of a person who is holding a currentlyvalid Missouri license as an emergency medical technician. Nothing in thissection shall be construed to mean that a duly registered nurse or a dulylicensed physician be required to hold an emergency medical technician'slicense. Each ambulance service is responsible for assuring that anyperson driving its ambulance is competent in emergency vehicle operationsand has a safe driving record. Each ground ambulance shall be staffed withat least two licensed individuals when transporting a patient, except asprovided in section 190.094.

3. No license shall be required for an ambulance service, or for theattendant of an ambulance, which:

(1) Is rendering assistance in the case of an emergency, majorcatastrophe or any other unforeseen event or series of events whichjeopardizes the ability of the local ambulance service to promptly respondto emergencies; or

(2) Is operated from a location or headquarters outside of Missouriin order to transport patients who are picked up beyond the limits ofMissouri to locations within or outside of Missouri, but no such outsideambulance shall be used to pick up patients within Missouri fortransportation to locations within Missouri, except as provided insubdivision (1) of this subsection.

4. The issuance of a license pursuant to the provisions of sections190.001 to 190.245 shall not be construed so as to authorize any person toprovide ambulance services or to operate any ambulances without a franchisein any city not within a county or in a political subdivision in any countywith a population of over nine hundred thousand inhabitants, or afranchise, contract or mutual-aid agreement in any other politicalsubdivision which has enacted an ordinance making it unlawful to do so.

5. Sections 190.001 to 190.245 shall not preclude the adoption of anylaw, ordinance or regulation not in conflict with such sections by any citynot within a county, or at least as strict as such sections by any county,municipality or political subdivision except that no such regulations orordinances shall be adopted by a political subdivision in a county with apopulation of over nine hundred thousand inhabitants except by the county'sgoverning body.

6. In a county with a population of over nine hundred thousandinhabitants, the governing body of the county shall set the standards forall ambulance services which shall comply with subsection 5 of thissection. All such ambulance services must be licensed by the department.The governing body of such county shall not prohibit a licensed ambulanceservice from operating in the county, as long as the ambulance servicemeets county standards.

7. An ambulance service or vehicle when operated for the purpose oftransporting persons who are sick, injured, or otherwise incapacitatedshall not be treated as a common or contract carrier under the jurisdictionof the Missouri division of motor carrier and railroad safety.

8. Sections 190.001 to 190.245 shall not apply to, nor be construedto include, any motor vehicle used by an employer for the transportation ofsuch employer's employees whose illness or injury occurs on privateproperty, and not on a public highway or property, nor to any personoperating such a motor vehicle.

9. A political subdivision that is authorized to operate a licensedambulance service may establish, operate, maintain and manage its ambulanceservice, and select and contract with a licensed ambulance service. Anypolitical subdivision may contract with a licensed ambulance service.

10. Except as provided in subsections 5 and 6, nothing in section67.300, RSMo, or subsection 2 of section 190.109, shall be construed toauthorize any municipality or county which is located within an ambulancedistrict or a fire protection district that is authorized to provideambulance service to promulgate laws, ordinances or regulations related tothe provision of ambulance services. This provision shall not apply to anymunicipality or county which operates an ambulance service establishedprior to August 28, 1998.

11. Nothing in section 67.300, RSMo, or subsection 2 of section190.109 shall be construed to authorize any municipality or county which islocated within an ambulance district or a fire protection district that isauthorized to provide ambulance service to operate an ambulance servicewithout a franchise in an ambulance district or a fire protection districtthat is authorized to provide ambulance service which has enacted anordinance making it unlawful to do so. This provision shall not apply toany municipality or county which operates an ambulance service establishedprior to August 28, 1998.

12. No provider of ambulance service within the state of Missouriwhich is licensed by the department to provide such service shalldiscriminate regarding treatment or transportation of emergency patients onthe basis of race, sex, age, color, religion, sexual preference, nationalorigin, ancestry, handicap, medical condition or ability to pay.

13. No provision of this section, other than subsections 5, 6, 10 and11 of this section, is intended to limit or supersede the powers given toambulance districts pursuant to this chapter or to fire protectiondistricts pursuant to chapter 321, RSMo, or to counties, cities, towns andvillages pursuant to chapter 67, RSMo.

14. Upon the sale or transfer of any ground ambulance serviceownership, the owner of such service shall notify the department of thechange in ownership within thirty days of such sale or transfer. Afterreceipt of such notice, the department shall conduct an inspection of theambulance service to verify compliance with the licensure standards ofsections 190.001 to 190.245.

(L. 1973 S.B. 57 § 2, A.L. 1998 S.B. 743, A.L. 2002 S.B. 1107)

CROSS REFERENCE:

Commercial driver's licensing law not applicable to emergency vehicles, RSMo 302.775

(1987) This section requires one license per ambulance, not per business. Fenton Ambulance Service, Inc. v. Ritchie, 729 S.W.2d 493 (Mo.App.).