Licensure as a basic life support or an advanced life support service.

(1) Every person, firm, corporation, association, or governmental entity owning or acting as agent for the owner of any business or service which furnishes, operates, conducts, maintains, advertises, engages in, proposes to engage in, or professes to engage in the business or service of providing prehospital or interfacility advanced life support services or basic life support transportation services must be licensed as a basic life support service or an advanced life support service, whichever is applicable, before offering such service to the public. The application for such license must be submitted to the department on forms provided for this purpose. The application must include documentation that the applicant meets the appropriate requirements for a basic life support service or an advanced life support service, whichever is applicable, as specified by rule of the department.

(2) The department shall issue a license for operation to any applicant who complies with the following requirements:

(a) The applicant has paid the fees required by s. 401.34.

(b) The ambulances, equipment, vehicles, personnel, communications systems, staffing patterns, and services of the applicant meet the requirements of this part, including the appropriate rules for either a basic life support service or an advanced life support service, whichever is applicable.

(c) The applicant has furnished evidence of adequate insurance coverage for claims arising out of injury to or death of persons and damage to the property of others resulting from any cause for which the owner of such business or service would be liable. The applicant must provide insurance in such sums and under such terms as required by the department. In lieu of such insurance, the applicant may furnish a certificate of self-insurance evidencing that the applicant has established an adequate self-insurance plan to cover such risks and that the plan has been approved by the Office of Insurance Regulation of the Financial Services Commission.

(d) The applicant has obtained a certificate of public convenience and necessity from each county in which the applicant will operate. In issuing the certificate of public convenience and necessity, the governing body of each county shall consider the recommendations of municipalities within its jurisdiction.

1. An applicant that is an active first responder agency is exempt from this requirement if it:

a. Is a faith-based, not-for-profit charitable corporation registered under chapter 617 which has been responding to medical emergencies in this state for at least 15 consecutive years.

b. Is not a parent, subsidiary, or affiliate of, or related to, any for-profit entity.

c. Provides basic life support services or advanced life support services solely through at least 150 unpaid licensed emergency medical technician or paramedic volunteers in at least three counties at the time of application.

d. Is not operating for pecuniary profit or financial gain.

e. Does not distribute to or inure to the benefit of its directors, members, or officers or other related parties any part of its assets or income.

f. Has never had a license denied, revoked, or suspended.

g. Provides services at no cost to the patient.

h. As part of its application for licensure, provides to the department a management plan that includes a training program, dispatch protocols, a complaint management system, an accident or injury handling system, a quality assurance program, and proof of adequate insurance coverage to meet state or county insurance requirements, whichever requirements are greater.

i. Provides a disclaimer on all written materials that the volunteer ambulance service is not associated with the state’s 911 system.

2. An applicant seeking an exemption from this requirement must submit to the department a sworn affidavit that complies with s. 92.50(1) attesting that the applicant meets the requirements for an exemption provided in sub-subparagraphs 1.a.-i. A person who submits an affidavit fraudulently attesting to meeting such requirements violates s. 837.012 and commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.

3. The exemption under subparagraph 1. may be granted to no more than 15 counties. This exemption notwithstanding, an applicant is not exempted from and must comply with all other requirements for licensure. An applicant must also take all reasonable efforts to enter into a memorandum of understanding with the emergency medical services licensee within whose jurisdiction the applicant will provide services in order to facilitate communications and coordinate emergency services for situations beyond the scope of the applicant’s capacity and for situations of advanced life support that are deemed priority 1 or priority 2 emergencies.

(3) The department may suspend or revoke a license at any time if it determines that the licensee has failed to maintain compliance with the requirements prescribed for operating a basic or advanced life support service.

(4) Each license issued in accordance with this part will expire automatically 2 years after the date of issuance.

(5) The requirements for renewal of any license issued under this part are the same as the requirements for original licensure that are in effect at the time of renewal.

(6) A volunteer ambulance service licensed under this section may not apply for, receive funds under, or participate in any grant program designed exclusively for publicly operated fire departments or emergency medical service agencies.

(7)(a) The governing body of each county may adopt ordinances that provide reasonable standards for certificates of public convenience and necessity for basic or advanced life support services and air ambulance services. In developing standards for certificates of public convenience and necessity, the governing body of each county must consider state guidelines, recommendations of the local or regional trauma agency created under chapter 395, and the recommendations of municipalities within its jurisdiction.

(b) A county or municipal government may not limit, prohibit, or prevent a volunteer ambulance service from responding to an emergency or from providing emergency medical services or transport within its jurisdiction. However, an emergency medical services provider or fire rescue services provider operated by a county, municipality, or special district is responsible for the care and transport of an unresponsive patient if a volunteer ambulance service arrives at the scene of an emergency simultaneously with such a provider and a person authorized to consent to the medical treatment of the unresponsive patient is not present.

(c) A county or municipal government may not require a volunteer ambulance service to obtain a license or certificate or pay a fee to provide ambulance services or nonemergency air ambulance services within its jurisdiction, provided that the ambulance or air ambulance is approved by the Department of Health. However, a county or municipal government may impose, collect, or enforce payment of any occupational license tax authorized by law.

(8)(a) Each permitted basic life support ambulance not specifically exempted from this part, when transporting a person who is sick, injured, wounded, incapacitated, or helpless, must be occupied by at least two persons: one patient attendant who is a certified emergency medical technician, certified paramedic, or licensed physician; and one ambulance driver who meets the requirements of s. 401.281. This paragraph does not apply to interfacility transfers governed by s. 401.252.

(b) Each permitted advanced life support ambulance not specifically exempted from this part, when transporting a person who is sick, injured, wounded, incapacitated, or helpless, must be occupied by at least two persons: one who is a certified paramedic or licensed physician; and one who is a certified emergency medical technician, certified paramedic, or licensed physician who also meets the requirements of s. 401.281 for drivers. The person with the highest medical certifications shall be in charge of patient care. This paragraph does not apply to interfacility transfers governed by s. 401.252.