North Dakota would help distressed ambulance services plan reliable emergency response

The Department of Health and Human Services would create and run a program to address ambulance services at risk of failing or stopping service. The program covers licensed emergency medical services operations that meet one or more listed risk criteria, including likely legal noncompliance or difficulty responding to service requests. The department must identify and evaluate services that meet the listed risk criteria.

The department may notify a service and require it to propose corrective steps; it may later declare the service distressed. Notice may go to the service, its service leader and medical director, and the local government with jurisdiction, if applicable. A service that receives notice must respond within 45 days with proposed corrective steps and a timeline; it may request a waiver if needed. The department may declare a service distressed for listed failures or stated risks, including failure to respond or make sufficient progress. The service has 45 days from the notice date to respond. The department must approve the response or ask for changes within 15 days after receiving it.

The department would assign a coordinator to develop and monitor a service plan, and the service must follow the plan if it approves it. The process applies after the department declares a licensed ambulance service distressed. The plan must consider effects on nearby service areas and input from the service, local governments, medical facilities, other emergency providers, and the public. At a second public meeting, the service must approve or reject the final plan; if it rejects the plan, its service leader must submit an amended plan. If the department and service cannot agree on a plan, or the service fails to follow an approved plan, the department may act to protect public health and safety. The department must assign a coordinator within seven days after notice of the declaration. The coordinator must present the proposed plan within 30 days after assignment.

The program fund's money would be available to the department on a continuing basis, and the department must report on the program each interim. Program money may pay the department's costs, including contractor fees and expenses. The fund consists of money transferred to it and its interest and earnings. The department may ask a distressed service to repay direct administrative costs and reasonable costs of ensuring reliable ambulance response. Each interim, the department must report on the program's status, distressed services, activities, costs, and effectiveness.