R426-2-900. Nonemergency Secured Behavioral Health Transport Designation Applications

  (1) A designated nonemergency secured behavioral health transport provider shall provide to the Department:

  (a) name of the organization and its principles;

  (b) name of the person or organization financially responsible for the service and documentation from that entity accepting responsibility; and

  (c) if the applicant is privately owned, they shall submit certified copies of the document creating the entity.

  (2) Provide a current plan of operations, which shall include:

  (a) a description of operational procedures;

  (b) description(s) of how the designated non-emergency secured behavioral health transport will interface with hospitals, emergency receiving facilities, licensed mental health facilities, and EMS providers;

  (c) a list of current insurance carriers and health facilities in which the designated provider has current contracts;

  (d) written policies that address under what circumstances a transport will be declined for medical or payment purposes;

  (e) a written protocol to activate 911 if an emergency medical situation arises; and

  (f) procedures for patient care.

  (3) Provide a written policy of how the designated nonemergency secured behavioral health transport will report patient care data to the Department.

  (4) Provide 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 in the and following minimum amounts:

  (a) liability insurance in the amount of $1,000,000 for each individual claim; and

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

  (5) A designated nonemergency secured behavioral health transport provider shall obtain the insurance from an insurance company authorized to write liability coverage in Utah or through a self-insurance program and shall:

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

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

  (c) provide the Department with a copy of its certificate of insurance indicating coverage at or above $1,000,000 for liability.

  (6) Prior to approval of the designation, all vehicles will be inspected and permitted by the Department and shall meet the requirements in R426-4-300(5).

  (7) Not be disqualified for any of the following reasons:

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

  (b) a history of disciplinary action relating to an EMS license, permit, designation or certification in this or any other state.