SECTION 310:641-3-10. License required

(a)   No person, company, governmental entity or trust authority shall operate, advertise, or hold themselves out as providing any type of ambulance service without first obtaining a license to operate an ambulance service from the Department. The Department shall have sole discretion to approve or deny an application for ambulance service license based on the ability of the applicant to meet the requirements of this rule.

(b)   Governmental entities that respond to requests for service off governmental property are required to become licensed by the Department.

(1)   Governmental entities not licensed by the Department may be part of mutual aid and disaster plans.

(2)   Governmental entities may transport patients of governmental entities off governmental property to appropriate facilities.

(3)   Contractors for governmental entities that provide transport services shall be licensed by the Department.

(c)   Persons, companies, and governmental entities which operate on their own premises, are exempt from this licensing requirement, unless an ambulance patient is transported on the public streets and highways of Oklahoma, or outside of their own premises.

(d)   An application for a license to operate an ambulance service shall be submitted on forms prescribed and provided by the Department. Ground, air, stretcher aid van and specialty care services shall each be considered a separate license.

(e)   The application shall be signed under oath by the party or parties seeking to secure the license.

(f)   The party or parties who sign the application shall be considered the owner or agent (licensee), and responsible for compliance to the Act and rules.

(g)   The application shall contain, but not be limited to the following:

(1)   a statement of ownership which shall include the name, address, telephone number, occupation and/or other business activities of all owners or agents who shall be responsible for the service;

(A)   If the owner is a partnership or corporation, a copy of incorporation documents and the name of all partner(s) or stockholder(s) with an ownership interest of five (5%) percent or more (principal), and the name and addresses of any other ambulance service in which any partner or stockholder holds an interest shall also be included.

(B)   If the owner is an entity of government, governmental trust, trust authority, or non-profit corporation, the name of each board member, or the chief administrative officer and/or chief operation officer shall be included.

(C)   A business plan which includes a financial disclosure statement showing evidence of the ability to sustain the operation for at least one (1) year.

(2)   proof of vehicle and liability insurance, at least in the amount of one million dollars ($1,000,000.00) or to the amount provided for in "The Governmental Tort Claims Act", Title 51 O.S. Section 151 et seq. This insurance requirement shall remain in effect at all times while the service is licensed;

(3)   proof of professional liability insurance, at least in the amount of one million dollars ($1,000,000) or to the amount provided for in "The Governmental Tort Claims Act," Title 51 O.S. Section 151 et seq. This insurance requirement shall remain in effect at all times while the service is licensed;

(4)   Proof of participation in a workers' compensation insurance program for employees who are subject to pertinent labor laws. This insurance requirement shall remain in effect at all times while the service is licensed;

(5)   each licensee shall have medical control as prescribed by the Act and these rules;

(6)   a copy of any contract(s) for vehicles, medical equipment, and/or personnel, if such exist;

(7)   a copy of patient care protocols and quality assurance plan or policy as required by the medical director and as prescribed by the Act and this chapter;

(A)   The Department may require quality assurance documentation for review and shall protect the confidentiality of that information.

(B)   The quality assurance documentation shall be maintained by the agency for three (3) years.

(C)   The quality assurance policy shall include, but not be limited to:

(i)   policy to review refusals,

(ii)   policy to review air ambulance utilization,

(iii)   policy to review airway management,

(iv)   policy to review cardiac arrest interventions,

(v)   policy to review time sensitive medical and trauma cases,

(vi)   policy to review other selected patient care reports not specifically included, and

(vii)   policy to provide internal and external feedback of findings determined through reviews. Documentation of the feedback will be maintained as part of the quality assurance documentation;

(8)   Documents that support agency licensure from the governmental authority(ies) having jurisdiction over the proposed emergency response area. If the emergency response area encompasses multiple jurisdictions, a written endorsement shall be presented from each and will be consistent with the County EMS plan as required in 19 O.S. Section 1-1203. Each endorsement shall contain the following;

(A)   a map and written description of the endorsed or approved response area,

(B)   name(s) and title(s) of the person(s) providing approval,

(C)   any expiration date,

(D)   name of the service receiving the endorsement.

(9)   a description of the proposed level of service in the proposed licensed service area, including:

(A)   a map defining the licensed service area including location(s) of base station, substations, and posts;

(B)   a description of the level of care to be provided, describing variations in care within the proposed service area, and;

(C)   en route response time standards consistent with the requirements in this Chapter.

(10)   written policy addressing:

(A)   receiving and dispatching emergency and non-emergency calls;

(B)   ensuring compliance with State and local EMS communication plans.

(11)   a response plan that includes:

(A)   providing and receiving mutual aid with all surrounding, contiguous, or overlapping, licensed service areas,

(B)   providing for and receiving disaster assistance in accordance with local and regional plans and command structures such as an incident command structure using national incident management support models.

(12)   confidentiality policy ensuring confidentiality of all documents and communications regarding protected patient health information.

(13)   An application for an initial, or new license, shall be accompanied by a non-refundable fee of six hundred ($600.00) dollars plus twenty ($20.00) dollars for each vehicle, in excess of two (2) vehicles utilized for patient transport. An additional fee of one hundred fifty ($150.00) dollars shall be included for each ambulance substation in addition to the base station.

(14)   If an area of Oklahoma is being served by a licensed ambulance service, or services, and the area has adopted "sole source" resolutions or ordinances or an Emergency Services District as established pursuant to Article 10, Section 9 (c) of the Oklahoma Constitution, the Department shall require the approval of the community(ies) and/or the emergency medical services authority of that service area, before an additional ambulance service shall be licensed for that same service area.

[Source: Added at 8 Ok Reg 3143, eff 7-18-91 (emergency); Added at 9 Ok Reg 1495, eff 5-1-92; Amended at 17 Ok Reg 392, eff 11-1-99 (emergency); Amended at 17 Ok Reg 2948, eff 7-13-00; Amended at 18 Ok Reg 2501, eff 6-25-01; Amended at 21 Ok Reg 2755, eff 7-12-04; Amended at 23 Ok Reg 2386, eff 6-25-06; Amended at 24 Ok Reg 1183, eff 4-2-07 (emergency); Amended at 25 Ok Reg 2443, eff 7-11-08; Amended at 33 Ok Reg 1529, eff 9-11-16]