Request By:
Daniel R. Braun, Esq.
Assistant City Solicitor
City of Newport
4th and York Streets
Newport, Kentucky 41071
Opinion
Opinion By: David L. Armstrong, Attorney General; Thomas R. Emerson, Assistant Attorney General
This is in reply to your letter asking whether a city which owns and operates an ambulance, provided as a service by the city fire department and staffed by its professional personnel, must comply with the provisions of KRS Chapter 216B and 902 KAR 20:115(3).
You are aware that KRS Chapter 216B does not require a certificate of need in this situation. However, you are concerned with whether a city owned ambulance, staffed by municipal firefighters, may operate without obtaining a license pursuant to KRS Chapter 216B. You refer to KRS 216B.105 dealing with licensing procedures and ask whether this statute and other provisions of KRS Chapter 216B apply to your fact situation. Of particular concern to you is whether 902 KAR 20:115 Section 3(2) requiring ambulance personnel to be certified as EMTs is applicable.
As you have stated in your letter and as we said in OAG 82-561, copy enclosed, at page two, no ambulance service needs a certificate of need. KRS 216B.020(1) states in part that the provisions of KRS Chapter 216B relating to the issuance of a certificate of need shall not apply to ambulance services. However, all ambulance services must now be licensed.
KRS 216B.105(1) provides in part that unless otherwise provided in KRS Chapter 216B, no person shall operate any health facility in this Commonwealth without first obtaining a license issued by the Kentucky Health Facilities and Health Services Certificate of Need and Licensure Board, which license shall specify the kind or kinds of health services the facility is authorized to provide. KRS 216B.015(20) in defining "person" states that the word includes state or political subdivision or instrumentality (including a municipal corporation) of a state. KRS 216B.015(11) in defining "health facility" states in part that the term includes ambulance services.
An exception to the licensing requirements is set forth in KRS 216B.020(2)(f) which provides that licensing is not required where on-duty police and fire department personnel assist in emergency situations by providing first-aid or transportation when regular emergency units licensed to provide first-aid or transportation are unable to arrive at the scene of an emergency situation within a reasonable time. This exception would not appear to be available in the fact situation you have set forth as you are apparently proposing the existence of a regular ongoing entity rather than a back up unit to the regular and licensed emergency units already in existence in the area.
In connection with licensing procedures, KRS 216B.105(2) states in part that the Board may deny a license request in any case where there has been a substantial failure to comply with the requirements of KRS Chapter 216B or the rules and regulations promulgated under that Chapter. KRS 216B.040(2)(a) states that the Board has the authority to issue administrative regulations.
Administrative regulations have been enacted concerning ambulance services (902 KAR 20:115) and Section 3(2) deals with personnel. The regulations as amended, effective August 3, 1983, provide in part that each emergency ambulance service shall be staffed to provide at least one driver and one attendant for each run. One attendant on each emergency care ambulance run shall be certified as an Emergency Medical Technician - Ambulance (EMT A), or shall be a physician or registered nurse. Either the driver or the second attendant on each emergency care ambulance run shall be certified within six months after employment as an EMT-A or have received Medical Corpsman Training within the last five years or have received Red Cross Advanced, Red Cross Standard First Aid and Personal Safety or Red Cross Advanced First Aid and Emergency Care Certification each with supplemental CPR instruction certified by the American Red Cross or the American Heart Association.
Thus, the ambulance service operated by the city, through its fire department, does not need to obtain a certificate of need but the ambulance service does need to obtain a license (KRS 216B.105), from the Kentucky Health Fascilities and Health Services Certificate of Need and Licensure Board, unless it will function merely as a back up unit to the regular and licensed emergency units already in existence, and can bring itself within the exception set forth in KRS 216B.020(2)(f). Where an ambulance service is required to be licensed it must observe the statutory requirements relative thereto as well as the applicable administrative regulations, including those concerning the qualifications required of ambulance service personnel, 902 KAR 20:115 Section 3(2).