Ariz. Admin. Code § 9-25-704

Current through Register Vol. 30, No. 25, June 21, 2024

Section R9-25-704 - Application and Licensing Process (Authorized by A.R.S. Sections 36-2202(A)(3) and (4), 36-2209(A)(2), 36-2213, 36-2214, and 36-2215)

A. An applicant for an initial license shall submit an application packet to the Department, including:

1. The following information in a Department-provided format:

a. The applicant's name; mailing address; e-mail address; fax number, if any; and telephone number;

b. The names of all other business organizations operated by the applicant related to the air ambulance service;

c. The physical and mailing addresses to be used for the air ambulance service, if different from the applicant's mailing address;

d. The name, title, address, e-mail address, and telephone number of the applicant's statutory agent or the individual designated by the applicant to accept service of process and subpoenas for the air ambulance service;

e. The name, title, address, e-mail address, and telephone number of the individual acting on behalf of the applicant according to R9-25-102;

f. If the applicant is a business organization:

i. The type of business organization; and

ii. The name; address; e-mail address; telephone number; and fax number, if any, of the individual who is to serve as the primary contact for information regarding the application;

g. The name and Arizona license number for the physician who is to serve as the administrative medical director for the air ambulance service;

h. The intended hours of operation for the air ambulance service;

i. The intended schedule of rates for the air ambulance service;

j. Which of the following mission types is to be provided:

i. Emergency medical services transports,

ii. Interfacility transports,

iii. Interfacility maternal transports, or

iv. Interfacility neonatal transports;

k. Which of the following mission levels is to be provided:

i. Critical care, or

ii. Advanced life support;

l. Whether the applicant plans to use fixed-wing or rotor-wing aircraft for the air ambulance service;

m. Whether the applicant agrees to allow the Department to submit supplemental requests for information under R9-25-1201(C)(3);

n. Attestation that the applicant will comply with all applicable requirements in this Article, Articles 2 and 8 of this Chapter, and A.R.S. Title 36, Chapter 21.1;

o. Attestation that the information provided in the application packet, including the information in the accompanying documents, is accurate and complete; and

p. The signature of the applicant and the date signed;

2. Documentation for the individual specified according to subsection (A)(1)(e) that complies with A.R.S. § 41-1080;

3. A copy of the business organization's articles of incorporation, articles of organization, or partnership documents, if applicable;

4. For each aircraft to be used as an air ambulance by the air ambulance service:

a. An application for registration that includes all of the information and documents required under R9-25-801(B); and

b. A copy of a current and valid registration, issued by the Arizona Department of Transportation under A.R.S. Title 28, Chapter 25, Article 4;

5. A certificate of insurance establishing that the applicant has current and valid liability insurance coverage for the air ambulance service as required under R9-25-703(B)(3);

6. A certificate of insurance establishing that the applicant has current and valid malpractice insurance coverage for the air ambulance service as required under R9-25-703(B)(4);

7. A list of each entity that or physician who is to provide on-line medical direction to EMCTs of the air ambulance service, including:

a. For each entity, such as an ALS base hospital, centralized medical direction communications center, or physician group practice, the name, mailing address, e-mail address, and telephone number of the entity; or

b. For each physician who is to provide on-line medical direction, the name, professional license number, mailing address, email address, and telephone number for the physician; and

8. If the applicant holds current CAMTS accreditation for the air ambulance service, a copy of the current CAMTS accreditation report

.

B. No more than 30 days before the expiration date of the current license, a licensee shall submit to the Department a renewal application packet including:

1. The information required in subsection (A)(1), in a Department-provided format;

2. The documents required in subsections (A)(5), (6), (7), and, if applicable, (8); and

3. For each aircraft used or to be used as an air ambulance by the air ambulance service:

a. Either:

i. A copy of a current and valid certificate of registration issued by the Department under Article 8 of this Chapter, or

ii. An application packet for registration that includes all of the information and documents required under R9-25-801(B); and

b. A copy of a current and valid registration, issued by the Arizona Department of Transportation under A.R.S. Title 28, Chapter 25, Article 4.

C. Unless an applicant or licensee documents current CAMTS accreditation, as provided in subsection (A)(8), or is applying for an initial license because of a change of ownership as described in R9-25-710(D), the Department shall conduct an inspection, as required under A.R.S. § 36-2214(B) and R9-25-711, during the substantive review period for the application for a license.

D. The Department shall review each application packet as described in Article 12 of this Chapter, and:

1. Approve the application;

2. Approve the application with a corrective action plan, as specified in R9-25-711(G)(2); or

3. Deny the application.

E. The Department may deny an application if an applicant or licensee:

1. Fails to meet the eligibility requirements of R9-25-703(B);

2. Fails or has failed to comply with any provision in A.R.S. Title 36, Chapter 21.1;

3. Fails or has failed to comply with any provision in this Article or Article 2 or 8 of this Chapter;

4. Knowingly or negligently provides false documentation or false or misleading information to the Department; or

5. Fails to submit to the Department documents or information requested under R9-25-1201(B)(1) or (C)(3) and requests a denial as permitted under R9-25-1201(E).

Ariz. Admin. Code § R9-25-704

New Section made by final rulemaking at 12 A.A.R. 656, effective April 8, 2006 (Supp. 06-1). Amended by exempt rulemaking at 19 A.A.R. 4032, effective December 1, 2013 (Supp. 13-4). Amended by final rulemaking at 28 A.A.R. 842, effective 6/5/2022. Amended by final expedited rulemaking at 29 A.A.R. 1461, effective 6/6/2023.