HS HCS HB 280, 69, 497 & 689 -- MEDICAL TRANSPORT SERVICES,
REGULATION OF STRETCHER VANS, AND FIRE PROTECTION (Hoppe)

This substitute makes changes to laws governing ambulance
services, stretcher van services, and fire protection.

AMBULANCE SERVICES

The substitute:

(1)  Allows ambulance boards to increase to 7 members or
decrease to 5 or 3 members upon voter approval;

(2)  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;

(3)  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;

(4)  Requires most counties to have at least 2 licensed
individuals when transporting a patient;

(5)  Requires ambulance owners to notify the Department of
Health of the sale or transfer of any ambulance ownership.  The
department must inspect the new service to verify compliance
with licensure standards;

(6)  Changes 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;

(7)  Allows a temporary ambulance service license to be granted
to the Firefighter's Association of Missouri for operation at
the Missouri State Fair;

(8)  Allows the Department of Health to grant temporary
emergency medical technician licenses;

(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;

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

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been revoked twice within a 10-year period;

(12)  Requires a patient care report to be completed for each
run on which are entered 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;

(13)  Requires ambulance services 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;

(14)  Requires the department to license certain non-profit
public benefit corporations that own and operate a licensed
ambulance service;

(15)  Allows for the transfer of ambulance district territory
under certain conditions; and

(16)  Allows ambulance districts and municipal ambulance
services to impose, upon voter approval, a retail sales tax of
up to one-fourth of 1% on all retail sales in the district for
the operation of the district.

STRETCHER VAN SERVICES

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 of Health 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 5 years;

(2)  Allows political subdivisions that are authorized to
provide ambulance service to adopt ordinances and regulations
governing the use of stretcher vans as long as those regulations
are as strict as the minimum state standards.  Ordinances and
regulations in effect prior to August 28, 2001, may continue to
be enforced by any political subdivision;

(3)  Allows the governing body in St. Louis County to set
standards for all stretcher van services.  Any service in the
county must be licensed by the state.  The county may not
prohibit a licensed service from operating in the county as long
as the service meets county standards;

(4)  Requires stretcher vans to operate with a 2-person crew;

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

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

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

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

(9)  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;

(10)  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
Administrative Hearing 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;

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

(12)  Allows the department to suspend a license if the
department 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 the
suspension; and

(13)  Gives the Attorney General concurrent jurisdiction with
all prosecuting attorneys to prosecute persons in violation of
these laws and regulations.  Injunctive proceedings may be
instituted against persons in violation.  Persons violating
these laws are guilty of a class B misdemeanor.  Each day that
any violation continues constitutes a separate offense, but the
court may stay the cumulative penalties.

FIRE PROTECTION

The substitute makes several changes regarding fire protection
laws.

(1)  Under current law, no cause of action exists against fire
protection entities for equipment they donate to other entities
if the State Fire Marshal approves the equipment.  Immunity only
applies to actions directly related to the donated equipment.
The substitute requires any motor vehicle that is donated to
pass a safety inspection by the State Highway Patrol.  Receiving
agencies must also demonstrate to the Fire Marshal that any
equipment received works properly.  Donor agencies must inform
the receiving agency in writing of any defect in the equipment
about which it knows;

(2)  Under current law, the Fire Education Fund annually
receives an amount equal to 3% of the difference between premium
taxes collected from insurance companies during the preceding
fiscal year and during Fiscal Year 1997.  The fund may not
receive more than $1.5 million from these taxes in any fiscal
year.  The substitute reduces the Fire Education Tax to 0.5% of
the amount of premium taxes collected in the preceding fiscal
year.  Fifty-five percent of these funds are required to be used
for fire education;

(3)  A subaccount of the Fire Education Fund to be known as the
Fire District Equipment Fund is established.  Twenty-five
percent of the money transferred to the Fire Education Fund must
be deposited in the Fire District Equipment Fund.  Money in the
equipment fund may only be used for purposes authorized by the
Missouri Fire Education Commission and the Missouri Division of
Fire Safety.  The commission and division may make grants to aid
in funding equipment of any fire department or district with
less than $10,000 in revenue per year or any volunteer fire
protection association with a population of less than 10,000.
The division will administer, regulate, and make rules for the
grant program.  The substitute outlines criteria for the program
rules;

(4)  A fire protection district that provides emergency service
to a redevelopment project in a redevelopment area is allowed to
impose a retail sales tax of up to 0.5% on all sales made in the
district, upon voter approval.  If a sales tax is approved, it
must coincide with a reduction in property taxes equal to 50% of
the amount of sales taxes collected.  No fire protection
district authorized to impose a sales tax by the substitute
which has not imposed a sales tax prior to August 28, 2000, may
impose any new sales tax for fire protection other than the
sales tax authorized by the substitute;

(5)  Residency and age requirements for fire and ambulance
boards are standardized; and

(6)  Cities annexing an area protected by an existing fire
protection district are required to reimburse the district for
any outstanding obligations and equipment used for providing
fire protection in the area annexed.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$477,467 in FY 2002, $413,501 in FY 2003, and $410,595 in FY
2004.  Costs do not include unknown revenue for collection fees
and unknown appropriations of grant funds.  Estimated Net Effect
on Fire Education Fund, Fire District Equipment Fund, and
Missouri Fire Education Trust Fund of $0 in FY 2002, FY 2003,
and FY 2004.

Missouri House of Representatives
Last Updated November 26, 2001 at 11:43 am