6 Colo. Code Regs. § 1015-3-4-16

Current through Register Vol. 47, No. 11, June 10, 2024

Section 6 CCR 1015-3-4-16 - County and City-and-County Authorization to Operate

16.1 Local Authorization to Operate

16.1.1 On and after July 1, 2024, a licensed ambulance service shall not operate on a regular basis without a local authorization to operate from the governing body of a city-and-county or the board of county commissioners for the county or city-and-county ("local authorizing authority") in which the ambulance service operates or seeks to operate, except as provided below:

A) Licensed ambulance services that do not operate on a regular basis as defined in Section 16.2.2 do not have to obtain an authorization to operate.

B) Licensed ambulance services do not have to obtain local authorization to operate on a regular basis in counties or city-and-counties that have opted out of issuing authorizations to operate in accordance with Section 16.7 of this Chapter Four.

C) Local authorization to operate is not required for any of the exemptions set forth in Section 3.3 of this Chapter Four.

16.2 Operate on a Regular Basis

16.2.1 A licensed ambulance service that initiates a patient transport from points originating in a county or city-and-county is deemed to operate on a regular basis within that jurisdiction if any of the following conditions are satisfied:

A) The ambulance service establishes a fixed operational base in the jurisdiction governed by the local authorizing authority and provides, within that jurisdiction, patient transport in a prehospital setting;

B) The ambulance service initiates or is expected to initiate patient transport in the jurisdiction governed by the local authorizing authority twelve (12) or more times in any calendar year; or

C) The ambulance service enters into any contractual agreement, memorandum of understanding, or other legal instrument for the provision of ambulance services:

1) With the local authorizing authority;

2) With an entity that has entered into any contractual agreement, memorandum of understanding, or other legal instrument with the local authorizing authority; or

3) Within the jurisdiction of the local authorizing authority.

16.2.2 An ambulance service is not considered to be operating on a regular basis and is not required to obtain an authorization to operate in any of the following instances:

A) Ambulance services that initiate, or are expected to initiate, a patient transport in the jurisdiction governed by the local authorizing authority eleven (11) or fewer times in any calendar year;

B) Transports that are initiated under circumstances in which locally-authorized ground ambulance services are unavailable;

C) Transports by an emergency responder, as defined in Section 24-33.5-1235(2)(d)(I), C.R.S., that provides ambulance services as part of/in conjunction with the Colorado coordinated regional mutual aid system or the regional and statewide mutual aid system, pursuant to Section 24-33.5-1235(4)(f), C.R.S.; or

D) Transports conducted pursuant to mutual aid agreements.

16.3 Issuance of Local Authorization to Operate

16.3.1 If, on or before August 1, 2024, a county or city-and-county has not implemented the issuance of authorization to operate and has not opted out of issuing authorization to operate, licensed ambulance services operating on a regular basis in those jurisdictions shall be considered to have obtained authorization to operate from those jurisdictions until:

A) The county or city-and-county implements an authorization to operate process; or

B) The county or city-and-county opts out of issuing authorization to operate in accordance with Section 16.7 below.

16.3.2 Any county or city-and-county that requires ambulance services to receive local authorization to operate in its jurisdiction shall:

A) Require every applicant to submit an application, in a form and manner as determined by the Department, to the county or city-and-county; and

B) Notify the Department at least on an annual basis, or within thirty (30) days of when the county or city-and-county either issues or terminates an ambulance service's local authorization.

16.4 If a county or city-and-county enacts an ordinance or resolution governing the local authorization to operate, the ordinance or resolution may:

16.4.1 Limit the number of ambulance services that will be authorized to operate within the county's or city-and-county's jurisdiction;

16.4.2 Determine and prescribe ambulance service areas within the county's or city-and-county's jurisdiction;

16.4.3 Authorize the local authority to contract with ambulance services; and

16.4.4 Establish other necessary requirements that are consistent with statute and these rules.

16.5 A county or city-and-county shall not impose standards that are less stringent than the minimum standards set forth in these rules.

16.5.1 However, a county or city-and-county may impose obligations that exceed the minimum standards set forth in these rules through the use of memoranda of understanding, contracts, or other such agreements.

16.6 Pursuant to Section 25-3.5-314(5)(e), C.R.S., a local authority that suspends or revokes an ambulance service's local authorization to operate in its jurisdiction shall, within thirty (30) days of issuing the suspension or revocation:

16.6.1 Notify the Department of the suspension or revocation; and

16.6.2 Provide supporting documentation for the Department's review of the possible effect that the suspension or revocation has on the ambulance service's state license.

16.7 Opting Out of Local Authorization to Operate

16.7.1 A county or city-and-county is required either to issue local authorization to operate or opt-out of issuing local authorization to operate.

A) After July 1, 2024, and before July 1 of any year thereafter, any county or city-and-county that opts out of issuing local authorization to operate within its jurisdiction to ambulance services shall notify the Department within thirty (30) days of its decision to opt out in a form and manner as determined by the Department.

B) However, a county or city-and-county that has opted out of issuing local authorization to operate is not prohibited from determining at a later date to reverse its decision and to require licensed ground ambulance services that operate on a regular basis in its jurisdiction to obtain local authorization to operate. Under these circumstances, the county or city-and-county shall notify the Department of its decision within thirty (30) days.

6 CCR 1015-3-4-16

47 CR 02, January 25, 2024, effective 2/14/2024