No. 39552 (Amendment): Rule R426-3. Licensure

(Amendment)

DAR File No.: 39552
Filed: 07/29/2015 09:50:37 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to update the licensing rules for ambulance and paramedic providers. It also reflects public comment and the Office of the Legislative Auditor General (OLAG) audit requests for adding comment and consolidation of license types.

Summary of the rule or change:

The changes clarify terms and licensing requirements for emergency medical services (EMS) providers.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 8a

Anticipated cost or savings to:

the state budget:

No effect on the state budget. Changing the licensing application process and consolidating the licensing types will not increase costs or impact the state budget.

local governments:

Fiscal impacts may be a reduction of license fees for service areas currently holding multiple license types.

small businesses:

Fiscal impacts may be a reduction of license fees for service areas currently holding multiple license types.

persons other than small businesses, businesses, or local governmental entities:

Fiscal impacts may be a reduction of license fees for service areas currently holding multiple license types.

Compliance costs for affected persons:

The simplification of license types may benefit in cost savings to the public.

Comments by the department head on the fiscal impact the rule may have on businesses:

The proposed amendments will fiscally impact business by reducing the need for a business to obtain multiple licenses and the costs associated with multiple licenses.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Guy Dansie at the above address, by phone at 801-273-6671, by FAX at 801-273-4165, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

09/14/2015

This rule may become effective on:

09/21/2015

Authorized by:

David Patton, Executive Director

RULE TEXT

R426. Health, Family Health and Preparedness, Emergency Medical Services.

R426-3. Licensure.

R426-3-100. Authority and Purpose.

(1) This Rule is established under Chapter 8, Title 26a, Chapter 8a. It establishes standards for the licensure of an air ambulance, ground ambulance, and paramedic services.

(2) The purpose of this rule is to set forth air and ground ambulance policies, rules, and standards adopted by the Utah Emergency Medical Services Committee, which promotes and protects the health and safety of the people of this state.

(3) The definitions in Title 26, Chapter 8a are adopted and incorporated by reference into this rule.

 

R426-3-200. Requirement for Licensure.

(1) A person [or entity that]who provides or represents that it provides air ambulance, ground ambulance, paramedic ground ambulance, or paramedic services [must]shall first be licensed by the Department.

 

R[246]426 -3-300. Licensure Types.

(1) The Department may issue exclusive ground ambulance transport licenses for the following types of service at the given levels:

(a) emergency medical technician (EMT);

(b) advanced emergency medical technician (AEMT); and

(c) paramedic .

([d]2) [c]Current emergency medical technician intermediate advanced (EMT-IA) licenses will remain in effect, no new EMT-IA ground ambulance licenses will be issued.

([2]3) The Department may issue exclusive ground ambulance inter-facility transport licenses for the following types of service at the given levels:

(a) emergency medical technician (EMT);

(b) advanced emergency medical technician (AEMT); and

(c) paramedic.

([3]4) The Department may issue exclusive paramedic, non-transport licenses.[for the following types of service at the given response configurations:

(a) paramedic; and

(b) paramedic tactical]

(5) The Department may issue a paramedic tactical license that is a designation of function not geographical location.

 

R426-3-310. Air Ambulance Licensure Types.

[(4)](1) The Department may issue an Air Ambulance [licenses ]provider a license in accordance with services accredited by a Department approved accreditation vendor.[for the following types of services at the given levels:

(a) advanced life support;

(b) specialized life support;

(5) The Department may issue Air Ambulance licenses for the following types of specialties for which the specialized Life support Air Ambulance Service is licensed.

(a) specialty obstetrics;

(b) specialty pediatrics;

(c) specialty neonatal;

(d) specialty burns; and

(e) specialty cardiac.]

 

R426-3-400. Scope of Operations.

(1) A [licensee]ground ambulance or paramedic licensed provider may only provide service to its specific licensed geographic service area and is responsible to provide all service s to its entire specific geographic service area except as provided by R426-3-[8]900 Aid Agreements. It will provide emergency medical services for its category of licensure that corresponds to the certification levels in R426-5 Emergency Medical Services Training and Certification Standards.

[(2) A licensee may not subcontract. A subcontract is present if a licensee engages a person that is not licensed to provide emergency medical services to all or part of its specific geographic service area. A subcontract is not present if multiple licensees allocate responsibility to provide ambulance services between them within a specific geographic service area for which they are licensed to provide ambulance service.

(3) A ground ambulance inter-facility transfer licensee may only transport patients from a hospital, nursing facility, emergency patient receiving facility, mental health facility, or other licensed medical facility when arranged by the transferring physician for the particular patient.

(4) A person or entity may not furnish, operate, conduct, maintain, advertise, or provide ground or air ambulance transport services to patients within the state or from within the state to out of state unless licensed by the Department.]

[(5)](2) A ground ambulance provider or paramedic service provider[All licensed Emergency Medical Services conforming to R426-3-200] [must]shall provide services 24 hours a day, every day of the year.

(3) Air [Medical]ambulance services [must]shall provide [air medical ]services 24 hours a day, every day of the year as allowed by weather conditions.

[(6)](4) A ground ambulance provider or paramedic service [licensee]provider [must]shall provide all [ambulance or paramedic services, including ]standby services[,] for any special event that requires ground ambulance or paramedic services within its geographic service area . The licensed provider may arrange for those services through R426-3-900 aid agreements. Designated quick response units may also support licensed ground ambulance or paramedic services at special events. If a licensed provider refuses to provide service, or is non-responsive in a timely manner to a request for a special event, the event organizer may use a licensed or designated provider of their choice.

 

R426-3-500. Minimum Licensure Requirements Air Ambulance, Ground Ambulance, and Paramedic Services.

A [licensee]licensed provider conforming to R426-3-200 [must]shall meet the following minimum requirements:

(1) [have ]sufficient air or ground ambulances, emergency response vehicle(s), equipment, and supplies that meet the requirements of this rule and as may be necessary to carry out its responsibilities under its license or proposed license without relying upon aid agreements with other [licensees.]licensed provider;

(2) [have ]locations or staging areas for stationing its vehicles[.];

(3) [have ]a current written dispatch agreement with a designated emergency medical dispatch center[.];

(4) [have ]ground ambulances shall have current written aid agreements with other [licensees]ground ambulance licensed providers to give assistance in times of unusual demand[.];

(5) [have ]a Department certified EMS training officer that is responsible for continuing education[.];

(6) [have ]a current plan of operations .

(7) a description of how the licensed provider or applicant proposes to interface with other EMS agencies.

(8) demonstrate fiscal viability;[, which shall include;

(a) a business plan demonstrating:

(i) ability to provide the service; and

(ii) fiscal plan.]

[(b)](9) [a roster of ]medical personnel roster which includes level of certification [or licensure ]to ensure there is sufficient trained and certified staff [that]who meet[s] the requirements of R426-4-200 Staffing, and

[(c) ] operational procedures.

[(7) a description of how the licensee or applicant proposes to interface with other EMS agencies.

] ([8]10) all permitted vehicles shall be equipped to allow field EMS personnel to be able to:

(a) communicate with hospital emergency departments, dispatch centers, EMS providers, and law enforcement services; and

(b) communicate on radio frequencies assigned to the Department for EMS use by the Federal Communications Commission.

([9]11) [have ]a current written agreement with a Department-certified off-line medical director or a medical director certified in the state where the service is based pursuant to R426-3-700.

([10]12) provide the Department with a copy of its certificate of insurance or if seeking application, provide proof of the ability to obtain insurance to respond to damages due to operation of a vehicle or air ambulance in the manner and following minimum amounts:

(a) [have ]liability insurance in the amount of $1,000,000[$300,000] for each individual claim ;[and $500,000 for total claims for personal injury from any one occurrence; ]and

(b) liability insurance in the amount of $1,000,000[$100,000] for property damage from any one occurrence[.];

(c) the [licensee]licensed provider shall obtain the insurance from an insurance company authorized to write liability coverage in Utah or through a self-insurance program and shall:

(i) provide the Department with a copy of its certificate of insurance demonstrating compliance with this section; and

(ii) direct the insurance carrier or self-insurance program to notify the Department of all changes in insurance coverage within 60 days.

([11]13) not be disqualified for any of the following reasons:

(a) violation of Subsection 26-8a-504; or

(b) disciplinary action relating to an EMS license, permit, designation, or certification in this or any other state that adversely affect its service under its license[.]; and

([12]14) A paramedic tactical service [must]shall be a public safety agency or have a letter of recommendation from a county or city law enforcement agency within the paramedic tactical service's geographic service area.

 

R426-3-600. Cost, Quality, and Access Goals for Ground Ambulance Providers.

(1) A local government shall establish emergency medical service goals pursuant to Title 26-8a-408(7).

(2) Cost, quality and access goals should be reviewed by the local government and the licensed ground ambulance provider every two years, and shall be submitted to the Department as part of the re-licensing application every four years.

(3) Goals may be amended, if necessary, due to:

(a) unforeseen changes in service delivery,

(b) community impacts, or

(c) significant unforeseen impact in the geographical service area.

(4) Goals shall be written, approved by local governments, and submitted to the Department with licensure and re-licensure application by the EMS licensed provider for the geographical service area.

(5) Cost and revenues for goals may include the following:

(a) all forecasted costs involved in the provision of ambulance services in the geographical service area, which may include:

(i) expenses for equipment,

(ii) personnel,

(iii) maintenance,

(iv) facilities,

(v) insurance,

(vi) taxes, and

(vii) dispatching fees;

(b) all forecasted revenues involved in the provision of ambulance services in the geographical service area, which may include:

(i) Department approved rates charged to patients,

(ii) reimbursements,

(iii) local funds,

(iv) Department grants,

(v) outside grants,

(vi) gifts, and

(vii) related subsidies.

(6) Quality goals may include the following:

(a) appropriate licensure service levels rationale,

(b) local medical direction,

(c) coordination improvement with designated emergency medical dispatch,

(d) appropriate patient destinations,

(e) quality assurance process,

(f) recruitment plans,

(g) retention plans,

(h) training of response personnel, and

(i) accreditation.

(7) Access goals may include the following:

(a) quantity of permitted vehicles available,

(b) response times,

(c) numbers and availability of response personnel,

(d) mutual aid agreements, and

(e) planning for stand-by events requiring an ambulance on scene such as:

(i) mass gatherings,

(ii) sporting events,

(iii) commercial,

(iv) any special event, or

(v) disaster response planning and participation in disaster response exercises.

 

R426-3-[ 6 ] 7 00. Ground Ambulance or Paramedic Service Application.

(1) An applicant desiring to [be licensed]obtain a new license [or to renew its license ]for [an air ambulance, ]ground ambulance, or [and ]paramedic services shall submit the applicable fees and application on Department-approved forms to the Department. As part of the application, the applicant shall submit documentation that it meets the requirements listed in R426-3-500 [and]along with the following:

[(a) for an application for new service:

] ([i]a) a detailed description and detailed map of the exclusive geographical areas that will be served;

([ii]b) if the requested geographical service area is for less than all ground ambulance or paramedic services, the applicant shall include a written description and detailed map showing how the areas not included will receive ground ambulance or paramedic services;

([iii]c) if an applicant is responding to a public bid as described in 26-8a-405.2 the applicant shall include detailed maps and descriptions for all geographical areas served in accordance with 26-8a-405.2(2)[.];

([iv]d) documentation showing that the applicant meets all local zoning and business licensing standards within the exclusive geographical service area that it will serve;

([v]e) a written description of how the applicant will communicate with dispatch centers, law enforcement agencies, on-line medical control, and patient transport destinations;

(f) patient care protocols, medications, and equipment approved by the provider's medical director based on licensure level according to Department policies; and

(g) applicant's plans for operations during times of unusual demand.

[(b)](2) An applicant desiring to renew an existing license shall submit documentation that it meets the requirements listed in R426-3-500, along with the following:[for renewal applications:]

([i]a) a written assessment of field performance from the applicant's off-line medical director; and

([ii]b) other information that the Department determines necessary for the processing of the application and the oversight of the licensed entity.

(3) An applicant desiring to obtain a new license or renew an existing license shall submit written cost, quality, and access goals as described in R426-3-600.

[(2) In addition to the above, an applicant for air ambulance services must submit the following:

(a) certified articles of incorporation, if incorporated;

(b) a statement summarizing the training and experience of the applicant in the air transportation and care of patients;

(c) a copy of current Federal Aviation Administration (FAA) Air Carrier Operating Certificate authorizing FAR, Part 135, operations;

(d) a copy of the current certificates of insurance demonstrating coverage for medical malpractice;

(e) a statement detailing the level of care for which the air ambulance service wishes to be licensed, either advanced or specialized;

(f) air ambulance services must have an agreement to allow hospital emergency department physicians, nurses, and other personnel who participate in emergency medical services to fly on air ambulances;

(g) air ambulance service shall submit a description and location of each dedicated and back-up air ambulance(s) procured for use in the Air ambulance service, including the make, model, and year of manufacture, FAA-N number, insignia, name or monogram, or other distinguishing characteristics; and

(h) successful completion of a Department approved accreditation process; and

(i) for new air ambulance services licensed under R426-3-200 they must submit an application for accreditation by a Department approved accreditation process within one year of receiving a license under this rule; and

(j) air ambulance services licensed under R426-3-200 must achieve accreditation and maintain accreditation.

] ([3]4) A ground ambulance or paramedic service holding a license under 26-8a-404, including any political subdivision that is part of a special district may respond to a request for proposal if it complies with 26-8a-405(2).

(5) Upon receipt of an appropriately completed application, ground ambulance or paramedic service license and submission of license fees, the Department shall collect supporting documentation and review each application.

(6) If, upon Department review, the application for a new license is complete and meets all the requirements, the Department shall issue a notice of approved application as required by 26-8a-405 and 406.

(7) Award of a new license or a renewal license is contingent upon the applicant's demonstration of compliance with all applicable statute and rules and a successful Department quality assurance review.

(8) After review and before issuing a license to a new service, the Department shall directly inspect the ground vehicle(s), equipment, and required documentation.

(9) A license may be issued for up to a four-year period unless revoked or suspended by the Department. The Department may alter the length of the license to standardize renewal cycles.

 

R426-3-710. Air Ambulance Application.

An applicant desiring to obtain a new license or to renew its license for air ambulance services shall submit the applicable fees and application on Department-approved forms to the Department. As part of the application, the applicant shall submit documentation that it meets the requirements listed in R426-3-500 and the following:

(1) certified articles of incorporation, if incorporated;

(2) a statement summarizing the training and experience of the applicant in the air transportation and care of patients;

(3) a copy of current Federal Aviation Administration (FAA) Air Carrier Operating Certificate authorizing FAR, Part 135, operations;

(4) a copy of the current certificates of insurance demonstrating coverage for medical malpractice;

(5) a description and location of each dedicated and back-up air ambulance(s) procured for use in the air ambulance service, including the make, model, and year of manufacture, FAA-N number, insignia, name or monogram, or other distinguishing characteristics;

(6) successful completion of a Department approved accreditation process and such accreditation decision shall exclude Federal Aviation Agency or Aviation Deregulation Act regulated activities;

(7) for new air ambulance services licensed under R426-3-200, the applicant shall submit an application for accreditation by a Department approved accreditation process within one year of receiving a license under this rule; and

(8) licensed air ambulance services shall achieve accreditation and maintain accreditation.

(9) Any new air ambulance providers applying for a license who have been licensed and operating in any other state for at least one year shall provide the Department with a copy of a successful accreditation decision, or an application sent to a Department approved accreditation vendors prior to receiving an air ambulance license.

(10) Upon receipt of an appropriately completed application for air ambulance provider license and submission of license fees, the Department shall collect supporting documentation and review each application.

(11) After review and before issuing a license to a new service, the Department shall directly inspect the air vehicle(s), equipment, and required documentation.

(12) Department approved accreditation vendors shall allow a Department representative to accompany accreditation surveyors on site surveys or during any accreditation inspections at the request of the Department.

(13) If, upon Department review, the application for a new license is complete and meets all the requirements, the Department shall issue a notice of approved application as required by 26-8a-405 and 406.

(14) Award of a new license or a renewal license is contingent upon the applicant's demonstration of compliance with all applicable statute and rules and a successful Department quality assurance review.

(15) Any events impacting patient safety including death, permanent harm, or severe temporary harm, or requiring intervention to sustain life shall be reported to the Department and the associated Department approved accreditation vendor(s) by the licensed air ambulance provider within 30 days or the event.

(16) A license may be issued for up to a four-year period unless revoked or suspended by the Department. The Department may alter the length of the license to standardize renewal cycles.

 

R426-3-[7]8 00. Medical Control.

(1) All [licensees]licensed providers [must]shall enter into a written agreement with a physician to serve as its off-line medical director to supervise the medical care or instructions provided by the field EMS personnel and dispatchers. The physician [must]shall be familiar with:

(a) the design and operation of the local pre -hospital EMS system; and

(b) local dispatch and communication systems and procedures.

(2) The off-line medical director shall:

(a) develop and implement patient care standards which include written standing orders and triage, treatment, and transport protocols;

(b) ensure the qualification of field EMS personnel involved in patient care through the provision of ongoing continuing medical education programs and appropriate review and evaluation;

(c) develop and implement an effective quality improvement program, including medical audit, review, and critique of patient care;

(d) annually review triage, treatment, and transport protocols and update them as necessary;

(e) suspend from patient care, pending Department review, a field EMS personnel who does not comply with local medical triage, treatment and transport protocols, or who violates any of the EMS rules, or who the medical director determines is providing emergency medical service in a careless or unsafe manner. The medical director [must]shall notify the Department within one business day of the suspension[.];

(f) attend meetings of the local EMS Council, if one exists, to participate in the coordination and operations of local EMS providers[.]; and

(g) licensed [agencies]providers shall notify the Department if an off-line medical director is replaced, within thirty days[after the action].

[(h) have current treatment protocols approved by the agency's off-line medical director for the existing service level for renewal or new treatment protocols if seeking an application.

] (3) It is the responsibility of the air ambulance medical director to:

(a) authorize written protocols for the use by air medical attendants and review policies and procedures of the Air ambulance service[.]; and

(b) develop and review treatment protocols, assess field performance, and critique at least 10% of the Air ambulance service runs.

 

R426-3-[ 8 ] 9 00. Ground Ambulance or Paramedic Service Provider Aid Agreements.

(1) All licensed ground ambulance providers shall [have/]maintain aid agreement(s) with other ground ambulance provider(s) to call upon them for assistance during times of unusual demand, inter-facility transports, or stand -by events.

(2) Aid agreements shall be in writing, signed by both parties, and detail the:

(a) purpose of the agreement;

(b) type of assistance required;

(c) circumstances under which the assistance would be given; and

(d) duration of the agreement.

(3) The parties shall provide a copy of the aid agreement to the Department and to the emergency medical dispatch centers that dispatch the [licensees]licensed providers.

[(4) If the ground ambulance licensee is unable or unwilling to provide ambulance standby service or special event coverage, the licensee shall allow a ground ambulance licensee through the use of aid agreements to provide all ground ambulance service for the standby or special event.

]

R426-3-[ 9 ] 10 00. Selection of a Ground Ambulance Provider by Public Bid.

(1) A political subdivision that desires to select a provider through a public bid process as provided in 26-8a-405.1, shall submit its draft request for proposal to the Department in accordance with 26-8a-405.2(2), together with a cover letter listing all contact information. The proposal shall include all the criteria listed in 26-8a-405.1 and 405.2.

(2) The Department shall, within 14 business days of receipt of a request for proposal from a political subdivision, review the request according to 26-8a-405.2(2); and

(a) approve the proposal by sending a letter of approval to the political subdivision;

(b) require the political subdivision to alter the request for proposal to meet statutory and rule requirements; or

(c) deny the proposal by sending a letter detailing the reasons for the denial and process for appeal.

 

R426-3-[10]11 00. Application Review and Award for Ground Ambulance Providers Selected by Public Bid.

(1) Upon receipt of an appropriately completed application, for [Air ambulance service, ]ground ambulance or paramedic service license and submission of license fees, the Department shall collect supporting documentation and review each application.

[(2) After review and before issuing a license to a new service the Department shall directly inspect the air or ground vehicle(s), equipment, and required documentation.

] ([3]2) If, upon Department review, the application is complete and meets all the requirements, the Department shall:

(a) for a new license application, issue a notice of approved application as required by 26-8a-405 and 406;

(b) issue a renewal license to an applicant in accordance with 26-8a-413(1) and (2) or 26-8a-405.1(3), whichever is applicable.

(c) issue a four-year renewal license to a license selected by a political subdivision if the political subdivision certified to the Department that the [licensee]licensed provider has met all of the specifications of the original bid and requirements of 26-8a-413(1) through 26-8a-313(3); or

(d) issue a second four-year renewal license to a [licensee]licensed provider selected by a political subdivision if:

(i) the political subdivision certified to the Department that the [licensee]licensed provider has met all of the specifications of the original bid and requirements of 26-8a(1) through (3); and

(ii) if the Department or the political subdivision has not received, prior to the expiration date, written notice from an approved applicant desiring to submit a bid for ambulance or paramedic services.

[(4) Award of a new license or a renewal license is contingent upon the applicant's demonstration of compliance with all applicable statute and rules and a successful Department quality assurance review.

(5) A license may be issued for up to a four-year period unless revoked or suspended by the Department. The Department may alter the length of the license to standardize renewal cycles.

] ([6]3) Upon the request of the political subdivision and the agreement of all interested parties and the Department that the public interest would be served, the renewal license may be issued for a period of less than four years or a new request for the proposal process may be commenced at any time.

 

R426-3-[11]12 00. Criteria for Denial or Revocation of Licensure.

(1) The Department may deny an application for a license, a renewal of a license, or revoke, suspend or restrict a license without reviewing whether a license [must]shall be granted or renewed to meet public convenience and necessity for any of the following reasons:

(a) failure to meet substantial requirements as specified in the rules governing the service;

(b) failure to meet vehicle, equipment, staffing, or insurance requirements;

(c) failure to meet agreements covering training standards or testing standards;

(d) substantial violation of Subsection 26-8a-504(1);

(e) a history of disciplinary action relating to a license, permit, designation, or certification in this or any other state;

(f) a history of serious or substantial public complaints;

(g) a history of criminal activity by the licensee or its principals while licensed or designated as an EMS provider or while operating as an EMS service with permitted vehicles;

(h) falsification or misrepresentation of any information in the application or related documents;

(i) failure to pay the required licensing or permitting fees or other fees or failure to pay outstanding balances owed to the Department;

[(j) financial insolvency;

] ([k]j) failure to submit records and other data to the Department as required by R426-7;

([l]k) a history of inappropriate billing practices, such as:

(i) charging a rate that exceeds the maximum rate allowed by rule;

(ii) charging for items or services for which a charge is not allowed by statute or rule; or

(iii) Medicare or Medicaid fraud.

([m]l) misuse of grant funds received under Section 26-8a-207; or

([n]m) violation of OSHA or other federal standards that it is required to meet in the provision of the EMS service.

(2) An applicant or [licensee]licensed provider that has been denied, revoked, suspended or issued a restricted license may appeal by filing a written appeal within thirty calendar days of the receipt of the issuance of the Department's denial.

 

[R426-3-1200. Change in Non-911 Service Level.

(1) A ground ambulance service licensee may apply to provide a higher level of non-911 ambulance service as referred to under 26-8a-102(14). The applicant shall submit:

(a) the applicable fees;

(b) an application on Department-approved forms to the Department.

(c) a copy of the new treatment protocols for the higher level of service approved by the off-line medical director;

(d) an updated plan of operations demonstrating the applicant's ability to provide the higher level of service; and

(e) a written assessment of the performance of the applicant's field performance by the applicant's off-line medical director.

(2) If the Department determines that the applicant has demonstrated the ability to provide the higher level of service, it shall issue a revised license reflecting the higher level of service without making a separate finding of public convenience and necessity.

 

]R426-3-1300. Change of Owner.

(1) A license and the vehicle permits cannot be transferred[terminate if the holder of a licensed service transfers ownership of the service] to another party.

(2) As outlined in 26-8a-415, [the]a new owner [must]shall submit[,] within 10 (ten ) [business]calendar days prior to[of] acquisition of property, applications and fees for a new license and vehicle permits.

 

[R426-3-1400. Penalties.

As required by Subsection 63G-3-201(5): Any person that violates any provision of this rule may be assessed a civil money penalty as provided in Section 26-23-6 and/or suspension or revocation of license(s).

 

]KEY: emergency medical services

Date of Enactment or Last Substantive Amendment: [October 18, 2013]2015

Authorizing, and Implemented or Interpreted Law: 26-8a

 

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