Section R. 325.22141 - Nontransport prehospital life support operation; initial application for licensureRule 141. A nontransport prehospital life support operation and its vehicles shall be licensed by the department in accordance with section 20926 of the code. Application for initial licensure shall include all of the following:
(a) Be on forms provided by the department and include the required fees and identification of level of life support of the operation.(b) Specify each vehicle to be operated, the level of life support being provided by that vehicle, and include a certificate of insurance covering each vehicle as identified in subrule (5) of this rule.(c) Provide as part of the application, the name and address of each medical control authority under which the life support agency is operating. The agency shall complete an application for licensure, as prescribed by the department, for each medical control authority in which it operates. Signature on the application of the emergency medical services medical director, from each medical control authority, shall be proof that the medical control authority agrees to provide medical control to the life support agency.(d) Attest, as evidenced by signing the application, to all of the following: (i) Radio communications for each vehicle are in compliance with the medcom requirements.(ii) Each vehicle meets minimum equipment requirements.(iii) Minimum staff requirements will be met in order to operate at least 1 vehicle on a 24 hour-a-day, 7 day-a-week basis, consistent with section 20927(3) of the code.(iv) Verification of compliance with subrules (3) and (4) of this rule, shall be available to the department upon request.(e) Include evidence that the operation possesses not less than $1,000,000.00 insurance coverage or is under a self-insurance program authorized under 1951 PA 35, MCL 124.1 et seq. for property damage and personal injury.(f) Include full disclosure of the operation ownership, including all of the following:(i) Copies of documents relating to the official type of legal organization of the operation, stating whether it is an individual proprietorship, partnership, corporation, or subsidiary of any other corporation or unit of government. These documents shall be maintained by the operation and shall be available to the department upon request.(ii) Copies of official registration of the entity with the secretary of state or other designated official in each state in which the agency is chartered, incorporated, or authorized to do business. These documents shall be maintained by the operation and shall be available to the department upon request.(iii) Disclose all legally responsible individuals, owners, or officers of the operation at the time of license application, including any trade names under which the organization operates. These shall include, but not limited to the name or names under which the operation is known to the public.(iv) Disclose all parent organizations and any person as defined in the code, that have at least a 10% interest in the applicant operation.(g) Identify 1 individual who will serve as the primary contact person for the operation.Mich. Admin. Code R. 325.22141