SS SCS SB 1107 -- Emergency Services

Sponsor:  Childers

This substitute makes changes to laws governing ambulance
services, stretcher van services, and air ambulances.

AMBULANCE SERVICES

The substitute:

(1)  Changes the residency requirements for candidates for
directors of ambulance districts (Section 190.050, RSMo);

(2)  Allows ambulance boards to increase to seven members or
decrease to five or three members upon voter approval (Section
190.051);

(3)  Allows for the recall by petition of an ambulance board
member.  If a board member is recalled, the election authority
must order an election for a new member at the next scheduled
public election (Sections 190.053 - 190.054);

(4)  Changes requirements for the use of an automated external
defibrillator (Section 190.092);

(5)  Removes the requirement that Cass, Bates, Henry, Johnson,
and St. Clair counties have a mobile emergency medical technician
in the ambulance when transporting a patient (Section 190.094);

(6)  Requires most ground ambulances to have at least two
licensed individuals when transporting a patient (Section
190.105);

(7)  Requires the owner, upon the sale or transfer of an
ambulance service, to notify the Department of Health and Senior
Services of the change within 30 days.  The department is
required to inspect the service to verify compliance with
licensure standards (Sections 190.105 - 190.108);

(8)  Changes the requirements for the county letter of
endorsement to the department for new ambulance service within
unincorporated portions of a county.  The letter must state the
public health benefits of the service and show that the service
has the expertise and resources to operate the service (Section
190.109);

(9)  Requires all ambulance services, including services in St.
Louis City, to maintain adequate insurance coverage or proof of
financial responsibility with adequate reserves maintained.
Provisions for the self-insurance of St. Louis City ambulance
services are removed (Sections 190.100 and 190.120);

(10)  Expands the type of patient care that may be performed by
emergency medical technicians to include care given in an
emergency situation (Section 190.142);

(11)  Expands causes for which a complaint may be filed with the
Administrative Hearing Commission against an ambulance service
(Section 190.165);

(12)  Forbids relicensure of any individual whose license has
been revoked twice within a 10-year period (Section 190.165);

(13)  Requires the department to submit a copy of certain
licensee settlement agreements to the Administrative Hearing
Commission (Section 190.172);

(14)  Requires a patient care report to be completed for each run
which includes pertinent remarks by a registered nurse or
physician.  A patient care report is also required to be given by
a health care facility when a patient is transferred to another
facility (Section 190.175);

(15)  Requires an ambulance service to report to the department
within 72 hours of their having knowledge of certain felony
charges filed against an employee of the licensee.  The employee
of a service is also required to notify the service of these
charges within 72 hours (Section 190.196);

(16)  Requires any investigation into violation of ambulance laws
to be completed within six months.  The department is given
access to all records related to the investigation (Section
190.248);

(17)  Requires the director of the department to appoint at least
one member to each regional Emergency Medical Services Committee
who is associated with an air ambulance service that is
accredited by a nationally recognized air ambulance accrediting
organization (Section 190.102);

(18)  Requires air ambulances to be accredited after January
2003, and every five years thereafter by a nationally recognized
aeromedical transport accreditation organization selected by the
department (Section 190.108); and

(19)  Repeals state law prohibiting the taxation by both an
ambulance district and a fire district in counties of the third
classification.

STRETCHER VAN SERVICE

The substitute also contains provisions related to the regulation
of stretcher van services.  A stretcher van service provides
transportation to passengers who are confined to stretchers and
whose conditions are not likely to need medical attention during
transportation.  The substitute:

(1)  Requires any person, owner, or agent to be licensed by the
department if the person or entity advertises, operates,
maintains, engages, or proposes to engage in the transport of
persons confined to stretchers.  The department can issue these
licenses for a period of five years (Section 190.528);

(2)  Allows political subdivisions that are authorized to provide
ambulance service, prior to August 28, 2001, to continue to
enforce laws, ordinances, and regulations regarding ambulances
(Section 190.528);

(3)  Requires stretcher vans to operate with a two-person crew
(Section 190.528);

(4)  Requires stretcher van operators to immediately contact the
appropriate ground ambulance service if a passenger's medical
condition deteriorates (Section 190.528);

(5)  Prohibits services from transporting persons currently
admitted to a hospital or persons being transported to a hospital
for admission or emergency treatment (Section 190.528);

(6)  Requires the department to establish regulations requiring
adequate insurance, vehicle maintenance and specifications,
passenger safety, and service records and reports (Section
190.528);

(7)  Requires the department to establish the application forms
for stretcher van service licenses in order to ensure compliance
with rules (Section 190.528);

(8)  Requires services to notify the department upon the sale or
transfer of any service ownership.  The department must inspect
the new service to verify compliance with licensure standards
(Section 190.528);

(9)  Allows the department to refuse to issue or deny renewal of
a stretcher van license for failure to comply with the law or any
regulation promulgated by the department.  Guidelines for
disciplinary action and relicensure are established.  The
department may cause a complaint to be filed with the
Administrative Hearing Commission against a licensee for
noncompliance with regulations.  Procedures are established for
the notification of the applicant that a license has been refused
and for the applicant to file a complaint with the commission.
An individual whose license has been revoked must wait one year
to apply for relicensure.  The department may notify any other
state in which a person is licensed of a suspended or revoked
license in this state (Section 190.531);

(10)  Protects any person or organization from civil damage when
in good faith the person provides information to the department
regarding stretcher van regulations (Section 190.531);

(11)  Allows the department to suspend a license if it finds that
there is an imminent threat to public health.  The department
must file a complaint with the Administrative Hearing Commission
upon the suspension.  Procedures are established for the
suspension and appeal of suspension (Section 190.531); and

(12)  Makes persons violating these laws guilty of a class B
misdemeanor.  Each day that any violation continues constitutes a
separate offense, but the court may stay the cumulative penalties
(Section 190.534).

OTHER

The substitute changes the qualifications of candidates for fire
protection district directors in third and fourth classification
counties.  A candidate must reside in the district for two years
before the election or appointment.  Currently, the candidate
must reside in the county in which the district is located for
two years.  A candidate for director in a newly formed district
must reside in the district for one year before the election or
appointment.

The substitute allows, upon voter approval, any ambulance or fire
protection district in a county of the first classification with
over 200,000 inhabitants, except Greene County, to impose a
retail sales tax of up to one-half of 1% on all retail sales made
within the district.  The tax must be used for the operation of
the district and for the reduction of property taxes.  The
ambulance or fire protection district must reduce property tax
revenues by and amount equal to 50% of the amount of sales tax
collected in the preceding year.  The Department of Revenue will
collect the retail sales taxes.  When the fire protection
district or ambulance district receives a petition signed by at
least 20% of the qualified voters in the last gubernatorial
election calling for an election to repeal the sales tax, the
district must submit the question to the voters.

Missouri House of Representatives
Last Updated October 11, 2002 at 9:04 am