Section R911-10-4 - Air Ambulance Provider Licensure Application(1) An applicant for an air ambulance license desiring to get or to renew a license shall submit the following to the department: (a) the applicable fees and application on the department-approved forms;(b) a copy of the air ambulance service licenses concurrently issued and on file with other states;(c) information about individual aircraft that will be used while providing medical care for physical inspection of medical compliance, as referenced in Section R911-10-10;(d) results from the prior ten years of any investigations, disciplinary actions, or exclusions with the potential to impact the quality of medical care provided to patients. Such investigations, disciplinary actions, or exclusions apply to: (i) current and prior legal names of the entity;(ii) other names used by the entity to provide health care services; and(iii) any person or entity who had direct or indirect ownership of at least 50% interest in the air ambulance service within the prior 10-year period;(e) the name of the air ambulance service medical director pursuant to requirements found in Sections R911-5-2500 and R911-5-2600;(f) proof of deemed status or state certification by state-approved auditors;(g) emergency contact information, which the department may use to provide effective communications and resource management in the event of a statewide or localized disaster or emergency situation;(h) a roster of medical personnel including level of certification or licensure to ensure there is sufficient trained and certified staff that meets the requirements in Section R911-10-22;(i) the air ambulance provider's policies and procedures based on state or nationally accepted emergency medical dispatch standards and state or nationally accepted EMS clinical guidelines to aid in directing the daily operation of the air ambulance communications center as referenced in Section R911-10-12;(j) a copy of the air ambulance provider's plan to send significant clinical data to hospital or emergency patient receiving facility medical personnel before arrival;(k) a copy of the air ambulance provider's quality improvement program that assesses and improves patient care provided by the air ambulance services, as referenced in Section R911-10-21;(l) an integrated medical transport plan, as established in Section R911-10-17; and(m) the air ambulance provider's insurance requirements as referenced in Section R911-10-8.Utah Admin. Code R911-10-4
Adopted by Utah State Bulletin Number 2024-14, effective 7/1/2024