AN ACT to amend and reenact sections 23-27-01 and 23-27-02 of the North Dakota Century Code, relating to the licensing of emergency medical services operations.
HB 1394 revises North Dakota’s emergency medical services licensing laws. The bill directs the Department of Health and Human Services to license EMS operations, allows the department to designate service areas, and clarifies that a license is generally nontransferable unless the department approves a transfer. It also states that EMS may only be advertised, offered, or provided by licensed operators using EMS personnel, and it updates the definition of an EMS operation to include basic life support, advanced life support, air ambulance, and quick response unit services.
The bill also changes how EMS operations may be structured and licensed. In general, each EMS operation must be separately licensed, but a single headquarters site may dispatch vehicles and personnel from more than one location if dispatch decisions are made at the headquarters within the designated service area. The bill creates a specific exception allowing certain preexisting substation ambulance services to operate under one license if they were designated before December 31, 2024, remain continuously designated, meet bordering and dispatch requirements, and pay a license fee for each substation. It also preserves an exception for out-of-state operators transporting patients across state lines and directs the department to adopt rules for special licenses and waivers for EMS operations serving industrial sites not open to the general public.
HB 1394 amends North Dakota Century Code sections 23-27-01 and 23-27-02, affecting the licensing, service-area designation, and operational structure of EMS providers. It gives the Department of Health and Human Services clearer authority over licensing decisions, including limiting new licenses based on service-area need, approving transfers, and adopting rules for special licenses and waivers. The bill also defines and regulates substation ambulance services more specifically, which may affect existing ambulance stations, multi-site EMS providers, and industrial-site EMS operations.
The bill appears to have broad legislative support. It passed the House 80-10 and the Senate unanimously 46-0, suggesting general agreement that the licensing framework needed clarification or modernization. The absence of committee transcript material limits insight into detailed debate, but the vote margins indicate the measure was not highly controversial overall.
The main points of potential contention are the restrictions on new EMS licenses, the requirement that most operations be separately licensed, and the narrow grandfathering provision for substation ambulance services designated before December 31, 2024. These provisions could affect competition, consolidation, and service-area access for EMS providers. Another possible issue is the department’s discretion to limit licenses based on service-area need and to adopt rules for special industrial-site licenses, which may be viewed as either necessary oversight or as regulatory burden depending on the stakeholder.