190.109. Ground ambulance license.

MISSOURI STATUTES AND CODES

190.109. Ground ambulance license.

Ground ambulance license.

190.109. 1. The department shall, within a reasonable time afterreceipt of an application, cause such investigation as the department deemsnecessary to be made of the applicant for a ground ambulance license.

2. Any person that owned and operated a licensed ambulance onDecember 31, 1997, shall receive an ambulance service license from thedepartment, unless suspended, revoked or terminated, for that ambulanceservice area which was, on December 31, 1997, described and filed with thedepartment as the primary service area for its licensed ambulances onAugust 28, 1998, provided that the person makes application and adheres tothe rules and regulations promulgated by the department pursuant tosections 190.001 to 190.245.

3. The department shall issue a new ground ambulance service licenseto an ambulance service that is not currently licensed by the department,or is currently licensed by the department and is seeking to expand itsambulance service area, except as provided in subsection 4 of this section,to be valid for a period of five years, unless suspended, revoked orterminated, when the director finds that the applicant meets therequirements of ambulance service licensure established pursuant tosections 190.100 to 190.245 and the rules adopted by the departmentpursuant to sections 190.001 to 190.245. In order to be considered for anew ambulance service license, an ambulance service shall submit to thedepartment a letter of endorsement from each ambulance district or fireprotection district that is authorized to provide ambulance service, orfrom each municipality not within an ambulance district or fire protectiondistrict that is authorized to provide ambulance service, in which theambulance service proposes to operate. If an ambulance service proposes tooperate in unincorporated portions of a county not within an ambulancedistrict or fire protection district that is authorized to provideambulance service, in order to be considered for a new ambulance servicelicense, the ambulance service shall submit to the department a letter ofendorsement from the county. Any letter of endorsement required pursuantto this section shall verify that the political subdivision has conducted apublic hearing regarding the endorsement and that the governing body of thepolitical subdivision has adopted a resolution approving the endorsement.The letter of endorsement shall affirmatively state that the proposedambulance service:

(1) Will provide a benefit to public health that outweighs theassociated costs;

(2) Will maintain or enhance the public's access to ambulanceservices;

(3) Will maintain or improve the public health and promote thecontinued development of the regional emergency medical service system;

(4) Has demonstrated the appropriate expertise in the operation ofambulance services; and

(5) Has demonstrated the financial resources necessary for theoperation of the proposed ambulance service.

4. A contract between a political subdivision and a licensedambulance service for the provision of ambulance services for thatpolitical subdivision shall expand, without further action by thedepartment, the ambulance service area of the licensed ambulance service toinclude the jurisdictional boundaries of the political subdivision. Thetermination of the aforementioned contract shall result in a reduction ofthe licensed ambulance service's ambulance service area by removing thegeographic area of the political subdivision from its ambulance servicearea, except that licensed ambulance service providers may provideambulance services as are needed at and around the state fair grounds forprotection of attendees at the state fair.

5. The department shall renew a ground ambulance service license ifthe applicant meets the requirements established pursuant to sections190.001 to 190.245, and the rules adopted by the department pursuant tosections 190.001 to 190.245.

6. The department shall promulgate rules relating to the requirementsfor a ground ambulance service license including, but not limited to:

(1) Vehicle design, specification, operation and maintenancestandards;

(2) Equipment requirements;

(3) Staffing requirements;

(4) Five-year license renewal;

(5) Records and forms;

(6) Medical control plans;

(7) Medical director qualifications;

(8) Standards for medical communications;

(9) Memorandums of understanding with emergency medical responseagencies that provide advanced life support;

(10) Quality improvement committees; and

(11) Response time, patient care and transportation standards.

7. Application for a ground ambulance service license shall be madeupon such forms as prescribed by the department in rules adopted pursuantto sections 190.001 to 190.245. The application form shall contain suchinformation as the department deems necessary to make a determination as towhether the ground ambulance service meets all the requirements of sections190.001 to 190.245 and rules promulgated pursuant to sections 190.001 to190.245.