CHAPTER 401

401.013 Legislative intent. It is the intention and purpose of the Legislature that a statewide system of regional emergency medical telecommunications be developed whereby maximum use of existing radio channels is achieved in order to more effectively and rapidly provide emergency medical service to the general population. To this end, all emergency medical service entities within the state are directed to provide the Department of Management Services with any information the department requests for the purpose of implementing the provisions of s. 401.015, and such entities shall comply with the resultant provisions established pursuant to this part. History. — s. 1, ch. 73-254; s. 301, ch. 92-279; s. 55, ch. 92-326; s. 100, ch. 98-279. 401.015 Statewide regional emergency medical telecommunication system. The Department of Management Services is authorized and directed to develop a statewide system of regional emergency medical telecommunications. For the purpose of this part, the term “telecommunications” means those voice, data, and signaling transmissions and receptions between emergency medical service components, including, but not limited to: ambulances; rescue vehicles; hospitals or other related emergency receiving facilities; emergency communications centers; physicians and emergency medical personnel; paging facilities; law enforcement and fire protection agencies; and poison control, suicide, and emergency management agencies. In formulating such a system, the department shall divide the state into appropriate regions and shall develop a program which includes, but is not limited to, the following provisions: (1) A requirements provision, which shall state the telecommunications requirements for each emergency medical entity comprising the region. (2) An interfacility communications provision, which shall depict the telecommunications interfaces between the various medical service entities which operate within the region and state. (3) An organizational layout provision, which shall include each emergency medical entity and the number of radio operating units (base, mobile, handheld, etc.) per entity. (4) A frequency allocation and use provision, which shall include on an entity basis each assigned and planned radio channel and the type of operation (simplex, duplex, half duplex, etc.) on each channel. (5) An operational provision, which shall include dispatching, logging, and operating procedures pertaining to telecommunications on an entity basis and regional basis. (6) An emergency medical service telephone provision, which shall include the telephone and the numbering plan throughout the region for both the public and interface requirements. History. — s. 2, ch. 73-254; s. 41, ch. 83-334; s. 302, ch. 92-279; s. 55, ch. 92-326; s. 101, ch. 98-279. 401.018 System coordination. (1) The statewide system of regional emergency medical telecommunications shall be developed by the Department of Management Services, which department shall be responsible for the implementation and coordination of such system into the state telecommunications plan. The department shall adopt any necessary rules and regulations for implementing and coordinating such a system. (2) The Department of Management Services shall be designated as the state frequency coordinator for the special emergency radio service. History. — s. 3, ch. 73-254; s. 102, ch. 98-279. 401.021 System director. The Secretary of Management Services or his or her designee is designated as the director of the statewide telecommunications system of the regional emergency medical service and, for the purpose of carrying out the provisions of this part, is authorized to coordinate the activities of the telecommunications system with other interested state, county, local, and private agencies. History. — s. 4, ch. 73-254; s. 51, ch. 99-399. 401.024 System approval. No emergency medical telecommunications system shall be established or present systems expanded without prior approval of the Department of Management Services. History. — s. 5, ch. 73-254; s. 103, ch. 98-279; s. 67, ch. 2019-3. 401.027 Federal assistance. The Secretary of Management Services or his or her designee is authorized to apply for and accept federal funding assistance in the development and implementation of a statewide emergency medical telecommunications system. History. — s. 6, ch. 73-254; s. 52, ch. 99-399. PART II EMERGENCY MEDICAL SERVICES GRANTS 401.101 Short title. 401.104 Legislative intent. 401.107 Definitions. 401.111 Emergency medical services grant program; authority. 401.113 Department; powers and duties. 401.117 Grant agreements; conditions. 401.121 Rules and regulations. 401.101 Short title. This part shall be known and may be cited as the “Florida Emergency Medical Services Grant Act.” History. — s. 1, ch. 73-262; s. 8, ch. 89-275; s. 6, ch. 89-283. 401.104 Legislative intent. It is the legislative intent that emergency medical services are essential to the health and well-being of all citizens and that private and public expenditures for adequate emergency medical services represent a constructive and essential investment in the future of the state and our democratic society. A major impediment to the provision of adequate and economic emergency medical services to all citizens is the inability of governmental and private agencies within a service area to respond cooperatively in order to finance the systematic provision of such services. This grant program is established to encourage and assist such cooperative efforts. History. — s. 2, ch. 73-262. 401.107 Definitions. As used in this part, the term: (1) “Department” means the Department of Health. (2) “Local agency” means the board of county commissioners. (3) “Emergency medical services” means the activities or services to prevent or treat a sudden critical illness or injury and to provide emergency medical care and prehospital emergency medical transportation to sick, injured, or otherwise incapacitated persons in this state. (4) “Emergency medical services organizations” means public or private entities involved in emergency medical services systems. (5) “Rural emergency medical services” means emergency medical services in a county with a total population of 100,000 or fewer people and density of less than 100 people per square mile. (6) “Youth athletic organization” means a private not-for-profit organization that promotes and provides organized athletic activities to youth. (7) “Automated external defibrillator device” means a device as defined in s. 768.1325(2)(b). History. — s. 3, ch. 73-262; s. 245, ch. 77-147; s. 9, ch. 89-275; s. 7, ch. 89-283; s. 28, ch. 92-78; s. 39, ch. 97-237; s. 2, ch. 2006-125. 401.111 Emergency medical services grant program; authority. The department is hereby authorized to make grants to local agencies, emergency medical services organizations, and youth athletic organizations in accordance with any agreement entered into pursuant to this part. These grants shall be designed to assist local agencies and emergency medical services organizations in providing emergency medical services, including emergency medical dispatch, and to assist youth athletic organizations that work in conjunction with local emergency medical services organizations to expand the use of automated external defibrillator devices in the community. The cost of administering this program shall be paid by the department from funds appropriated to it. History. — s. 4, ch. 73-262; s. 246, ch. 77-147; s. 10, ch. 89-275; s. 8, ch. 89-283; s. 40, ch. 97-237; s. 2, ch. 2003-180; s. 3, ch. 2006-125. 401.113 Department; powers and duties. (1) Funds deposited into the Emergency Medical Services Trust Fund as provided by ss. 316.061, 316.192, 318.21, and 938.07 must be used solely to improve and expand prehospital emergency medical services in the state. (2) The department shall annually dispense funds contained in the Emergency Medical Services Trust Fund as follows: (a) Forty-five percent of such moneys must be divided among the counties according to the proportion of the combined amount deposited in the trust fund from the county. These funds may not be used to match grant funds as identified in paragraph (b). An individual board of county commissioners may distribute these funds to emergency medical services organizations and youth athletic organizations within the county, as it deems appropriate. (b) Forty percent of such moneys must be used by the department for making matching grants to local agencies, municipalities, emergency medical services organizations, and youth athletic organizations for the purpose of conducting research, increasing existing levels of emergency medical services, evaluation, community education, injury-prevention programs, and training in cardiopulmonary resuscitation and other lifesaving and first aid techniques. 1. At least 90 percent of these moneys must be made available on a cash matching basis. A grant made under this subparagraph must be contingent upon the recipient providing a cash sum equal to 25 percent of the total department-approved grant amount. 2. No more than 10 percent of these moneys must be made available to rural emergency medical services, and notwithstanding the restrictions specified in subsection (1), these moneys may be used for improvement, expansion, or continuation of services provided. A grant made under this subparagraph must be contingent upon the recipient providing a cash sum equal to no more than 10 percent of the total department-approved grant amount. The department shall develop procedures and standards for grant disbursement under this paragraph based on the need for emergency medical services, the requirements of the population to be served, and the objectives of the state emergency medical services plan. (c) Fifteen percent of such moneys must be used by the department for capital equipment outlay, personnel, community education, evaluation, and other costs associated with the administration of this chapter. Any moneys not annually used for this purpose must be used for making additional rural grant funds available. History. — s. 5, ch. 73-262; s. 1, ch. 77-174; s. 47, ch. 85-81; s. 26, ch. 85-167; s. 5, ch. 85-337; s. 10, ch. 86-154; s. 52, ch. 86-220; s. 11, ch. 89-275; s. 9, ch. 89-283; s. 29, ch. 92-78; s. 35, ch. 97-271; s. 17, ch. 2001-53; s. 6, ch. 2001-380; s. 13, ch. 2002-402; s. 9, ch. 2004-6; s. 4, ch. 2006-125; s. 15, ch. 2015-4. 401.117 Grant agreements; conditions. The department shall use the following guidelines in developing the procedures for grant disbursement: (1) The need for emergency medical services and the requirements of the population to be served. (2) All emergency vehicles and attendants must conform to state standards established by law or rule of the department. (3) All vehicles shall contain minimum equipment and supplies as required by law or rule of the department. (4) All vehicles shall have at a minimum a direct communications linkup with the operating base and hospital designated as the primary receiving facility. (5) Emphasis shall be accorded to applications that contain one or more of the following provisions: (a) Services provided on a county, multicounty, or areawide basis. (b) A single provider, or a coordinated provider, method of delivering services. (c) Coordination of all communication links, including police, fire, emergency vehicles, and other related services. History. — s. 6, ch. 73-262; s. 247, ch. 77-147; s. 41, ch. 97-237. 401.121 Rules and regulations. The department is authorized to make rules and regulations necessary to carry out the purposes of this part, including funds and assistance to nonprofit volunteer ambulance organizations desiring to comply with the Florida Emergency Medical Services Grant Act. History. — s. 7, ch. 73-262; s. 75, ch. 95-143. PART III MEDICAL TRANSPORTATION SERVICES 401.2101 Short title. 401.211 Legislative intent. 401.23 Definitions. 401.24 Emergency medical services state plan. 401.243 Injury prevention. 401.245 Emergency Medical Services Advisory Council. 401.25 Licensure as a basic life support or an advanced life support service. 401.251 Air ambulance service; licensure. 401.252 Interfacility transfer. 401.253 Reporting of controlled substance overdoses. 401.254 Treatment of injured police canines. 401.26 Vehicle permits for basic life support and advanced life support services. 401.265 Medical directors. 401.268 Protocols with regional poison control centers. 401.27 Personnel; standards and certification. 401.2701 Emergency medical services training programs. 401.271 Certification of emergency medical technicians and paramedics who are on active duty with the Armed Forces of the United States. 401.2715 Recertification training of emergency medical technicians and paramedics. 401.272 Emergency medical services community health care. 401.273 Emergency medical technician and paramedic registry for disasters and emergencies. 401.281 Drivers. 401.2915 Automated external defibrillators. 401.2916 Educational campaign. 401.30 Records. 401.31 Inspection and examination. 401.321 Transferability of license; effect of sale, transfer, assignment, or lease of service. 401.33 Exemptions. 401.34 Fees. 401.345 Emergency Medical Services Trust Fund. 401.35 Rules. 401.38 Participation in federal programs. 401.41 Penalties. 401.411 Disciplinary action; penalties. 401.414 Complaint investigation procedures. 401.421 Injunctive relief; cease and desist notice; civil penalty; enforcement. 401.425 Emergency medical services quality assurance; immunity from liability. 401.435 Emergency medical responder agencies and training. 401.445 Emergency examination and treatment of incapacitated persons. 401.45 Denial of emergency treatment; civil liability. 401.465 911 public safety telecommunicator certification. 401.2101 Short title. This part may be cited as the “Raymond H. Alexander, M.D., Emergency Medical Transportation Services Act.” History. — s. 1, ch. 92-78. 401.211 Legislative intent. The Legislature recognizes that the systematic provision of emergency medical services saves lives and reduces disability associated with illness and injury. In addition, that system of care must be equally capable of assessing, treating, and transporting children, adults, and frail elderly persons. Further, it is the intent of the Legislature to encourage the development and maintenance of emergency medical services because such services are essential to the health and well-being of all citizens of the state. The Legislature finds that it is in the public interest to foster the development of emergency medical services that address religious sensitivities. In accordance with the Florida Volunteer and Community Service Act of 2001, the Legislature further recognizes the value of augmenting existing county and municipal emergency medical services with those provided by volunteer service organizations. The Legislature also recognizes that the establishment of a comprehensive statewide injury-prevention program supports state and community health systems by further enhancing the total delivery system of emergency medical services and reduces injuries for all persons. The purpose of this part is to protect and enhance the public health, welfare, and safety through the establishment of an emergency medical services state plan, an advisory council, a comprehensive statewide injury-prevention program, minimum standards for emergency medical services personnel, vehicles, services and medical direction, and the establishment of a statewide inspection program created to monitor the quality of patient care delivered by each licensed service and appropriately certified personnel. History. — ss. 3, 25, ch. 82-402; ss. 1, 13, ch. 83-196; s. 3, ch. 84-317; s. 53, ch. 86-220; s. 12, ch. 89-275; s. 10, ch. 89-283; ss. 2, 36, ch. 92-78; s. 35, ch. 2004-350; s. 5, ch. 2021-90. 401.23 Definitions. As used in this part, the term: (1) “Acute and postacute hospital care at home” means acute and postacute health care services provided in a clinically qualified patient’s permanent residence, as defined in s. 196.012(17), through a program approved by the Centers for Medicare and Medicaid Services and the Agency for Health Care Administration. (2) “Advanced life support” means assessment or treatment by a person qualified under this part through the use of techniques such as endotracheal intubation, the administration of drugs or intravenous fluids, telemetry, cardiac monitoring, cardiac defibrillation, and other techniques described in the EMT-Paramedic National Standard Curriculum or the National EMS Education Standards, pursuant to rules of the department. (3) “Advanced life support service” means any emergency medical transport or nontransport service which uses advanced life support techniques. (4) “Air ambulance” means any fixed-wing or rotary-wing aircraft used for, or intended to be used for, air transportation of sick or injured persons requiring or likely to require medical attention during transport. (5) “Air ambulance service” means any publicly or privately owned service, licensed in accordance with the provisions of this part, which operates air ambulances to transport persons requiring or likely to require medical attention during transport. (6) “Ambulance” or “emergency medical services vehicle” means any privately or publicly owned land or water vehicle that is designed, constructed, reconstructed, maintained, equipped, or operated for, and is used for, or intended to be used for, land or water transportation of sick or injured persons requiring or likely to require medical attention during transport. (7) “Ambulance driver” means any person who meets the requirements of s. 401.281. (8) “Basic life support” means the assessment or treatment by a person qualified under this part through the use of techniques described in the EMT-Basic National Standard Curriculum or the National EMS Education Standards of the United States Department of Transportation and approved by the department. The term includes the administration of oxygen and other techniques that have been approved and are performed under conditions specified by rules of the department. (9) “Basic life support service” means any emergency medical service which uses only basic life support techniques. (10) “Certification” means any authorization issued pursuant to this part to a person to act as an emergency medical technician or a paramedic. (11) “Department” means the Department of Health. (12) “Emergency medical technician” means a person who is certified by the department to perform basic life support pursuant to this part. (13) “Interfacility transfer” means the transportation by ambulance of a patient between two facilities licensed under chapter 393, chapter 395, chapter 400, or chapter 429, pursuant to this part. (14) “Licensee” means any basic life support service, advanced life support service, or air ambulance service licensed pursuant to this part. (15) “Medical direction” means direct supervision by a physician through two-way voice communication or, when such voice communication is unavailable, through established standing orders, pursuant to rules of the department. (16) “Medical director” means a physician who is employed or contracted by a licensee and who provides medical supervision, including appropriate quality assurance but not including administrative and managerial functions, for daily operations and training pursuant to this part. (17) “Mutual aid agreement” means a written agreement between two or more entities whereby the signing parties agree to lend aid to one another under conditions specified in the agreement and as sanctioned by the governing body of each affected county. (18) “Paramedic” means a person who is certified by the department to perform basic and advanced life support pursuant to this part. (19) “Permit” means any authorization issued pursuant to this part for a vehicle to be operated as a basic life support or advanced life support transport vehicle or an advanced life support nontransport vehicle providing basic or advanced life support. (20) “Physician” means a practitioner who is licensed under the provisions of chapter 458 or chapter 459. For the purpose of providing medical direction for the treatment of patients immediately before or during transportation to a United States Department of Veterans Affairs medical facility, “physician” also means a practitioner employed by the United States Department of Veterans Affairs. (21) “Registered nurse” means a practitioner who is licensed to practice professional nursing pursuant to part I of chapter 464. (22) “Service location” means any permanent location in or from which a licensee solicits, accepts, or conducts business under this part. (23) “Volunteer ambulance service” means a faith-based, not-for-profit charitable corporation registered under chapter 617 which is licensed under this part as a basic life support service or an advanced life support service; which is not a parent, subsidiary, or affiliate of, or related to, any for-profit entity; and which uses only unpaid volunteers to provide basic life support services or advanced life support services free of charge, is not operating for pecuniary profit or financial gain, and does not distribute to or inure to the benefit of its directors, volunteers, members, or officers any part of its assets or income. History. — s. 3, ch. 73-126; s. 3, ch. 76-168; s. 248, ch. 77-147; s. 1, ch. 77-347; s. 1, ch. 77-457; ss. 1, 4, 10, ch. 79-280; s. 257, ch. 81-259; ss. 2, 3, ch. 81-318; ss. 4, 24, 25, ch. 82-402; ss. 2, 12, 13, ch. 83-196; s. 4, ch. 84-317; s. 54, ch. 86-220; s. 1, ch. 89-283; ss. 3, 36, ch. 92-78; s. 42, ch. 97-237; s. 107, ch. 2000-318; s. 72, ch. 2006-197; s. 50, ch. 2008-6; s. 2, ch. 2013-128; s. 6, ch. 2021-90; s. 1, ch. 2022-35; s. 86, ch. 2023-8. 401.24 Emergency medical services state plan. The department is responsible, at a minimum, for the improvement and regulation of basic and advanced life support programs. The department shall develop, and revise every 5 years, a comprehensive state plan for basic and advanced life support services, the emergency medical services grants program, trauma centers, the injury control program, and medical disaster preparedness. The state plan shall include, but need not be limited to: (1) Emergency medical systems planning, including the prehospital and hospital phases of patient care, and injury control effort and unification of such services into a total delivery system to include air, water, and land services. (2) Requirements for the operation, coordination, and ongoing development of emergency medical services, which includes: basic life support or advanced life support vehicles, equipment, and supplies; communications; personnel; training; public education; state trauma system; injury control; and other medical care components. (3) The definition of areas of responsibility for regulating and planning the ongoing and developing delivery service requirements. History. — s. 4, ch. 73-126; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 5, 10, ch. 79-280; ss. 2, 3, ch. 81-318; ss. 5, 24, 25, ch. 82-402; ss. 3, 13, ch. 83-196; s. 5, ch. 84-317; s. 55, ch. 86-220; ss. 4, 36, ch. 92-78; s. 9, ch. 2004-259; s. 3, ch. 2013-128. 401.243 Injury prevention. The department shall establish an injury-prevention program with responsibility for the statewide coordination and expansion of injury-prevention activities. The duties of the department under the program may include, but are not limited to, data collection, surveillance, education, and the promotion of interventions. In addition, the department may: (1) Provide communities, county health departments, and other state agencies with expertise and guidance in injury prevention. (2) Seek, receive, and expend funds received from grants, donations, or contributions from public or private sources for program purposes. (3) Develop, and revise as necessary, a comprehensive state plan for injury prevention. History. — s. 36, ch. 2004-350; s. 86, ch. 2012-184. 401.245 Emergency Medical Services Advisory Council. (1) There is hereby created an advisory council for the purpose of acting as the advisory body to the emergency medical services program. The duties of the council include, but are not limited to: (a) Identifying and making recommendations to the department concerning the appropriateness of suggested changes to statutes and administrative rules. (b) Acting as a clearinghouse for information specific to changes in the provision of emergency medical services and trauma care. (c) Providing technical support to the department in the areas of emergency medical services and trauma systems design, required medical and rescue equipment, required drugs and dosages, medical treatment protocols and emergency medical services personnel education and training requirements. (d) Assisting in developing the emergency medical services portion of the department’s annual legislative package. (e) Providing a forum for discussing significant issues facing the emergency medical services and trauma care communities. (f) Providing a forum for planning the continued development of the state’s emergency medical services system through the joint production of the emergency medical services state plan. (g) Assisting the department in developing the emergency medical services quality management program. (h) Assisting the department in setting program priorities. (i) Providing feedback to the department on the administration and performance of the emergency medical services program. (j) Providing technical support to the emergency medical services grants program. (k) Assisting the department in emergency medical services public education. (l) Assisting in the development of the department’s injury prevention and control program. (2)(a) No more than 15 members may be appointed to this council. Members shall be appointed for 4-year terms in such a manner that each year the terms of approximately one-fourth of the members expire. The chair of the council shall be designated by the State Surgeon General. Vacancies shall be filled for the remainder of unexpired terms in the same manner as the original appointment. Members shall receive no compensation but may be reimbursed for per diem and travel expenses. (b) Representation on the Emergency Medical Services Advisory Council shall include: two licensed physicians who are medical directors as defined in s. 401.23 or whose medical practice is closely related to emergency medical services; two emergency medical service administrators, one of whom is employed by a fire service; two certified paramedics, one of whom is employed by a fire service; two certified emergency medical technicians, one of whom is employed by a fire service; one emergency medical services educator; one emergency nurse; one hospital administrator; one representative of air ambulance services; one representative of a commercial ambulance operator; and two laypersons who are in no way connected with emergency medical services, one of whom is a representative of the elderly. Ex officio members of the advisory council from state agencies shall include, but are not limited to, representatives from the Department of Education, the Department of Management Services, the State Fire Marshal, the Department of Highway Safety and Motor Vehicles, the Department of Transportation, and the Division of Emergency Management. (c) Appointments to the council shall be made by the State Surgeon General, except that state agency representatives shall be appointed by the respective agency head. (3) Any Emergency Medical Services Advisory Council member shall be removed from office for malfeasance; misfeasance; neglect of duty; incompetence; permanent inability to perform official duties; or pleading guilty or nolo contendere to, or being found guilty of, a felony. (4) The council shall hold meetings at the call of the chair, upon the written request of five members of the council, or at the call of the staff director of the emergency medical services program office. A majority of the members of the council shall constitute a quorum. Minutes shall be recorded for all meetings of the council and shall be maintained on file in the emergency medical services program office. (5) There is established a committee to advise the Department of Health on matters concerning preventative, prehospital, hospital, rehabilitative, and other posthospital medical care for children. (a) Committee members shall be appointed by the State Surgeon General, and shall include, but not be limited to, physicians and other medical professionals that have experience in emergency medicine or expertise in emergency and critical care for children. (b) Appointments to the committee shall be for a term of 2 years. Vacancies may be filled for the unexpired term at the discretion of the State Surgeon General. The members shall serve without compensation, and shall not be reimbursed for necessary expenses incurred in the performance of their duties, unless there is funding available from the Federal Government or contributions or grants from private sources. History. — ss. 4, 13, ch. 83-196; ss. 14, 56, ch. 86-220; s. 5, ch. 88-186; s. 13, ch. 89-275; s. 11, ch. 89-283; ss. 1, 2, 3, ch. 92-46; s. 36, ch. 92-78; s. 7, ch. 92-174; s. 76, ch. 95-143; s. 791, ch. 95-148; s. 45, ch. 95-196; s. 43, ch. 97-237; s. 422, ch. 2003-261; s. 51, ch. 2008-6; s. 281, ch. 2011-142; s. 87, ch. 2012-184; s. 11, ch. 2022-35. 401.25 Licensure as a basic life support or an advanced life support service. (1) Every person, firm, corporation, association, or governmental entity owning or acting as agent for the owner of any business or service which furnishes, operates, conducts, maintains, advertises, engages in, proposes to engage in, or professes to engage in the business or service of providing prehospital or interfacility advanced life support services or basic life support transportation services must be licensed as a basic life support service or an advanced life support service, whichever is applicable, before offering such service to the public. The application for such license must be submitted to the department on forms provided for this purpose. The application must include documentation that the applicant meets the appropriate requirements for a basic life support service or an advanced life support service, whichever is applicable, as specified by rule of the department. (2) The department shall issue a license for operation to any applicant who complies with the following requirements: (a) The applicant has paid the fees required by s. 401.34. (b) The ambulances, equipment, vehicles, personnel, communications systems, staffing patterns, and services of the applicant meet the requirements of this part, including the appropriate rules for either a basic life support service or an advanced life support service, whichever is applicable. (c) The applicant has furnished evidence of adequate insurance coverage for claims arising out of injury to or death of persons and damage to the property of others resulting from any cause for which the owner of such business or service would be liable. The applicant must provide insurance in such sums and under such terms as required by the department. In lieu of such insurance, the applicant may furnish a certificate of self-insurance evidencing that the applicant has established an adequate self-insurance plan to cover such risks and that the plan has been approved by the Office of Insurance Regulation of the Financial Services Commission. (d) The applicant has obtained a certificate of public convenience and necessity from each county in which the applicant will operate. In issuing the certificate of public convenience and necessity, the governing body of each county shall consider the recommendations of municipalities within its jurisdiction. 1. An applicant that is an active first responder agency is exempt from this requirement if it: a. Is a faith-based, not-for-profit charitable corporation registered under chapter 617 which has been responding to medical emergencies in this state for at least 15 consecutive years. b. Is not a parent, subsidiary, or affiliate of, or related to, any for-profit entity. c. Provides basic life support services or advanced life support services solely through at least 150 unpaid licensed emergency medical technician or paramedic volunteers in at least three counties at the time of application. d. Is not operating for pecuniary profit or financial gain. e. Does not distribute to or inure to the benefit of its directors, members, or officers or other related parties any part of its assets or income. f. Has never had a license denied, revoked, or suspended. g. Provides services at no cost to the patient. h. As part of its application for licensure, provides to the department a management plan that includes a training program, dispatch protocols, a complaint management system, an accident or injury handling system, a quality assurance program, and proof of adequate insurance coverage to meet state or county insurance requirements, whichever requirements are greater. i. Provides a disclaimer on all written materials that the volunteer ambulance service is not associated with the state’s 911 system. 2. An applicant seeking an exemption from this requirement must submit to the department a sworn affidavit that complies with s. 92.50(1) attesting that the applicant meets the requirements for an exemption provided in sub-subparagraphs 1.a.-i. A person who submits an affidavit fraudulently attesting to meeting such requirements violates s. 837.012 and commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083. 3. The exemption under subparagraph 1. may be granted to no more than 15 counties. This exemption notwithstanding, an applicant is not exempted from and must comply with all other requirements for licensure. An applicant must also take all reasonable efforts to enter into a memorandum of understanding with the emergency medical services licensee within whose jurisdiction the applicant will provide services in order to facilitate communications and coordinate emergency services for situations beyond the scope of the applicant’s capacity and for situations of advanced life support that are deemed priority 1 or priority 2 emergencies. (3) The department may suspend or revoke a license at any time if it determines that the licensee has failed to maintain compliance with the requirements prescribed for operating a basic or advanced life support service. (4) Each license issued in accordance with this part will expire automatically 2 years after the date of issuance. (5) The requirements for renewal of any license issued under this part are the same as the requirements for original licensure that are in effect at the time of renewal. (6) A volunteer ambulance service licensed under this section may not apply for, receive funds under, or participate in any grant program designed exclusively for publicly operated fire departments or emergency medical service agencies. (7)(a) The governing body of each county may adopt ordinances that provide reasonable standards for certificates of public convenience and necessity for basic or advanced life support services and air ambulance services. In developing standards for certificates of public convenience and necessity, the governing body of each county must consider state guidelines, recommendations of the local or regional trauma agency created under chapter 395, and the recommendations of municipalities within its jurisdiction. (b) A county or municipal government may not limit, prohibit, or prevent a volunteer ambulance service from responding to an emergency or from providing emergency medical services or transport within its jurisdiction. However, an emergency medical services provider or fire rescue services provider operated by a county, municipality, or special district is responsible for the care and transport of an unresponsive patient if a volunteer ambulance service arrives at the scene of an emergency simultaneously with such a provider and a person authorized to consent to the medical treatment of the unresponsive patient is not present. (c) A county or municipal government may not require a volunteer ambulance service to obtain a license or certificate or pay a fee to provide ambulance services or nonemergency air ambulance services within its jurisdiction, provided that the ambulance or air ambulance is approved by the Department of Health. However, a county or municipal government may impose, collect, or enforce payment of any occupational license tax authorized by law. (8)(a) Each permitted basic life support ambulance not specifically exempted from this part, when transporting a person who is sick, injured, wounded, incapacitated, or helpless, must be occupied by at least two persons: one patient attendant who is a certified emergency medical technician, certified paramedic, or licensed physician; and one ambulance driver who meets the requirements of s. 401.281. This paragraph does not apply to interfacility transfers governed by s. 401.252. (b) Each permitted advanced life support ambulance not specifically exempted from this part, when transporting a person who is sick, injured, wounded, incapacitated, or helpless, must be occupied by at least two persons: one who is a certified paramedic or licensed physician; and one who is a certified emergency medical technician, certified paramedic, or licensed physician who also meets the requirements of s. 401.281 for drivers. The person with the highest medical certifications shall be in charge of patient care. This paragraph does not apply to interfacility transfers governed by s. 401.252. History. — ss. 5, 16, ch. 73-126; s. 3, ch. 76-168; s. 249, ch. 77-147; s. 1, ch. 77-457; s. 19, ch. 78-95; ss. 6, 10, ch. 79-280; ss. 2, 3, ch. 81-318; ss. 6, 24, 25, ch. 82-402; ss. 5, 13, ch. 83-196; s. 54, ch. 83-218; s. 6, ch. 84-317; s. 57, ch. 86-220; s. 14, ch. 89-275; s. 12, ch. 89-283; ss. 5, 36, ch. 92-78; s. 29, ch. 99-397; s. 423, ch. 2003-261; s. 7, ch. 2021-90; s. 5, ch. 2022-48; s. 2, ch. 2025-94. 401.251 Air ambulance service; licensure. (1) Each person, firm, corporation, association, or governmental entity that owns or acts as an agent for the owner of any business or service that furnishes, operates, conducts, maintains, advertises, engages in, proposes to engage in, or professes to engage in the business or service of transporting by air ambulance persons who require or are likely to require medical attention during transport must be licensed as an air ambulance service, before offering such service. (2) The application for this license must be submitted to the department on forms provided for this purpose. The application must include documentation that the applicant meets the appropriate requirements for an air ambulance service as specified by rule of the department. (3) An applicant who seeks licensure as an air ambulance service must: (a) Submit a completed application to the department on such forms and including such information as specified by rule of the department. (b) Submit the appropriate fee as provided in s. 401.34. (c) Specify the location of all required medical equipment and provide documentation that all such equipment is available and in good working order. (d) Provide documentation that all aircraft and crew members meet applicable Federal Aviation Administration (FAA) regulations. (e) Provide proof of adequate insurance coverage of not less than $100,000 per person and $300,000 per incident, or a greater amount if specified by rule of the department, for claims arising out of injury or death of persons and damage to property of others resulting from any cause for which the owner of such business or service would be liable. Self-insurance is an acceptable alternative as specified in s. 401.25(2)(c). (f) Specify whether the service uses either fixed-winged or rotary-winged aircraft, or both. (4)(a) If a service provides interhospital air transport, air transport from hospital to another facility, air transport from hospital to home, or similar air transport, the service must provide evidence that it has employed or contracted with a medical director to advise the service on the appropriate staffing, equipment, and supplies to be used for the transport of any patient aboard an air ambulance and must provide information to referring physicians regarding special medical requirements and restrictions when transporting by air ambulance. (b) If the air ambulance service uses rotary-winged aircraft in conjunction with another emergency medical service, the air ambulance service must meet the provisions of this section and must meet separate basic life support and advanced life support requirements unique to air ambulance operations as is required by rules of the department. Such service is subject to the provisions of s. 401.25 relating to a certificate of public convenience and necessity; however, a service may operate in any county under the terms of mutual aid agreements. (c) Unless, in the opinion of the attending physician, the patient has an emergency medical condition as defined by s. 395.002, the service must provide each person using the service, before rendering the service, a written description of the services to be rendered and the cost of those services. (5) In order to renew a license for air ambulance service, the applicant must: (a) Submit a renewal application to the department not more than 90 days nor less than 60 days before the license expires. (b) Submit the appropriate renewal fee as provided in s. 401.34. (c) Provide documentation that current standards for issuance of a license are met. (6) Any advanced life support service licensee may engage in air ambulance operations by complying with the appropriate provisions of this section and requirements specified by rule of the department. History. — ss. 11, 13, ch. 83-196; s. 1, ch. 91-169; ss. 27, 36, ch. 92-78; s. 73, ch. 92-289. Note. — Former s. 401.48. 401.252 Interfacility transfer. (1) When conducting an interfacility transfer, a permitted advanced life support ambulance must be occupied by at least two persons: one patient attendant who is a certified paramedic, a registered nurse authorized under subsection (2), or a licensed physician; and one who is a certified emergency medical technician, a certified paramedic, a licensed physician, or an ambulance driver who meets the driver requirements of s. 401.281. The person occupying the ambulance who has the highest medical certification in this state is in charge of patient care during the interfacility transfer. (2) A licensed basic or advanced life support ambulance service may conduct interfacility transfers in a permitted ambulance using a registered nurse in place of an emergency medical technician or paramedic if: (a) The registered nurse holds a current certificate of successful course completion in advanced cardiac life support; (b) The physician in charge has granted permission for such a transfer, has designated the level of service required for such transfer, and has deemed the patient to be in such a condition appropriate to this type of ambulance staffing; and (c) The registered nurse operates within the scope of part I of chapter 464. (3) A licensed basic or advanced life support service may conduct interfacility transfers in a permitted ambulance if the patient’s treating physician certifies that the transfer is medically appropriate and the physician provides reasonable transfer orders. An interfacility transfer must be conducted in a permitted ambulance if it is determined that the patient needs, or is likely to need, medical attention during transport. If the emergency medical technician or paramedic believes the level of patient care required during the transfer is beyond his or her capability, the medical director, or his or her designee, must be contacted for clearance prior to conducting the transfer. If necessary, the medical director, or his or her designee, shall attempt to contact the treating physician for consultation to determine the appropriateness of the transfer. (4) Infants younger than 28 days old or weighing less than 5 kilograms who require critical care interfacility transport to a neonatal intensive care unit must be transported in a permitted advanced life support or basic life support transport ambulance, or in a permitted advanced life support or basic life support ambulance that is recognized by the department as meeting designated criteria for neonatal interfacility critical care transport. History. — ss. 7, 25, ch. 82-402; s. 13, ch. 83-196; ss. 6, 36, ch. 92-78; s. 792, ch. 95-148; s. 44, ch. 97-237; s. 108, ch. 2000-318; s. 16, ch. 2015-4; s. 2, ch. 2022-48. 401.253 Reporting of controlled substance overdoses. (1)(a) A basic life support service or advanced life support service which treats and releases, or transports to a medical facility, in response to an emergency call for a suspected or actual overdose of a controlled substance may report such incidents to the department. Such reports must be made using the Emergency Medical Service Tracking and Reporting System or other appropriate method with secure access, including, but not limited to, the Washington/Baltimore High Intensity Drug Trafficking Overdose Detection Mapping Application Program or other program identified by the department in rule. If a basic life support service or advanced life support service reports such incidents, it shall make its best efforts to make the report to the department within 120 hours after it responds to the incident. (b) The data collected by the department shall be made available within 120 hours to law enforcement, public health, fire rescue, and emergency medical service agencies in each county. (c) For purposes of this section, the term “overdose” means a condition, including, but not limited to, extreme physical illness, decreased level of consciousness, respiratory depression, coma, or death resulting from the consumption or use of any controlled substance that requires medical attention, assistance or treatment, and clinical suspicion for drug overdose, such as respiratory depression, unconsciousness, or altered mental status, without other conditions to explain the clinical condition. (2)(a) A report of an overdose of a controlled substance under this section shall include: 1. The date and time of overdose. 2. The approximate address of where the person was picked up or where the overdose took place. 3. Whether an emergency opioid antagonist, as defined in s. 381.887, was administered. 4. Whether the overdose was fatal or nonfatal. (b) A report of an overdose of a controlled substance under this section shall also include, if the reporting mechanism permits: 1. The gender and approximate age of the person receiving attention or treatment. 2. The suspected controlled substance involved in the overdose. (3) A basic life support service or advanced life support service that reports information to or from the department pursuant to this section in good faith is not subject to civil or criminal liability for making the report. (4) Failure to report an overdose under this section is not grounds for disciplinary action or penalties pursuant to s. 401.411(1)(a). (5) The department shall produce a quarterly report to the Statewide Drug Policy Advisory Council, the Department of Children and Families, and the Florida FUSION Center summarizing the raw data received pursuant to this section. Such reports shall also be made immediately available to the county-level agencies described in paragraph (1)(b). The Statewide Drug Policy Advisory Council, the Department of Children and Families, and the department may use these reports to maximize the utilization of funding programs for licensed basic life support service providers or advanced life support service providers, and for the dissemination of available federal, state, and private funds for local substance abuse services in accordance with s. 397.321(4). History. — s. 2, ch. 2017-54. 401.254 Treatment of injured police canines. (1) As used in this section, the term “police canine” means any canine that is owned, or the service of which is employed, by a state or local law enforcement agency, a correctional agency, a fire department, a special fire district, or the State Fire Marshal for the principal purpose of aiding in the detection of criminal activity, flammable materials, or missing persons; the enforcement of laws; the investigation of fires; or the apprehension of offenders. (2) A licensee with a valid permit for the transport vehicle may transport a police canine injured in the line of duty to a veterinary clinic or similar facility if there is no individual requiring medical attention or transport at that time. (3) Notwithstanding s. 474.213, a paramedic or an emergency medical technician may provide emergency medical care to a police canine injured in the line of duty while at the scene of the emergency or while the police canine is being transported to a veterinary clinic or similar facility. A paramedic or an emergency medical technician who acts in good faith to provide emergency medical care to an injured police canine is immune from criminal or civil liability. History. — s. 1, ch. 2021-119. 401.26 Vehicle permits for basic life support and advanced life support services. (1) Every licensee shall possess a valid permit for each transport vehicle, advanced life support nontransport vehicle, and aircraft in use. Applications for such permits shall be made upon forms prescribed by the department. The licensee shall provide documentation that each vehicle for which a permit is sought meets the appropriate requirements for a basic life support or advanced life support service vehicle, whichever is applicable, as specified by rule of the department. A permit is not required for an advanced life support nontransport vehicle that is intended to be used for scene supervision, incident command, or the augmentation of supplies. (2) To receive a valid permit, the applicant must submit a completed application form for each vehicle or aircraft for which a permit is desired, pay the appropriate fees established as provided in s. 401.34, and provide documentation that each vehicle or aircraft meets the following requirements as established by rule of the department; the vehicle or aircraft must: (a) Be furnished with essential medical supplies and equipment which is in good working order. (b) Meet appropriate standards for design and construction. (c) Be equipped with an appropriate communication system. (d) Meet appropriate safety standards. (e) Meet sanitation and maintenance standards. (f) Be insured for an appropriate sum against injuries to or the death of any person arising out of an accident. (3) The department may deny, suspend, or revoke a permit if it determines that the vehicle, aircraft, or equipment fails to meet the requirements specified in this part or in the rules of the department. (4) A permit issued in accordance with this section will expire automatically concurrent with the service license. (5) In order to renew a vehicle or aircraft permit issued pursuant to this part, the applicant must: (a) Submit a renewal application. Such application must be received by the department not more than 90 days or less than 30 days prior to the expiration of the permit. (b) Submit the appropriate fee or fees, established as provided in s. 401.34. (c) Provide documentation that current standards for issuance of a permit are met. (6) The department shall establish criteria and time limits for substitution of permitted vehicles that are out of service for maintenance purposes. (7) The department shall adopt and enforce rules necessary to administer this section. History. — s. 6, ch. 73-126; s. 3, ch. 76-168; s. 250, ch. 77-147; s. 1, ch. 77-457; s. 19, ch. 78-95; ss. 7, 10, ch. 79-280; ss. 2, 3, ch. 81-318; ss. 9, 24, 25, ch. 82-402; s. 13, ch. 83-196; s. 56, ch. 83-218; s. 8, ch. 84-317; s. 58, ch. 86-220; ss. 7, 36, ch. 92-78; s. 19, ch. 98-151. 401.265 Medical directors. (1) Each basic life support transportation service or advanced life support service must employ or contract with a medical director. The medical director must be a licensed physician; a corporation, association, or partnership composed of physicians; or physicians employed by any hospital that delivers in-hospital emergency medical services and employs or contracts with physicians specifically for that purpose. Such a hospital, physician, corporation, association, or partnership must designate one physician from that organization to be medical director at any given time. The medical director must supervise and assume direct responsibility for the medical performance of the emergency medical technicians and paramedics operating for that emergency medical services system. The medical director must perform duties including advising, consulting, training, counseling, and overseeing of services, including appropriate quality assurance but not including administrative and managerial functions. (2) Each medical director shall establish a quality assurance committee to provide for quality assurance review of all emergency medical technicians and paramedics operating under his or her supervision. If the medical director has reasonable belief that conduct by an emergency medical technician or paramedic may constitute one or more grounds for discipline as provided by this part, he or she shall document facts and other information related to the alleged violation. The medical director shall report to the department any emergency medical technician or paramedic whom the medical director reasonably believes to have acted in a manner which might constitute grounds for disciplinary action. Such a report of disciplinary concern must include a statement and documentation of the specific acts of the disciplinary concern. Within 7 days after receipt of such a report, the department shall provide the emergency medical technician or paramedic a copy of the report of the disciplinary concern and documentation of the specific acts related to the disciplinary concern. If the department determines that the report is insufficient for disciplinary action against the emergency medical technician or paramedic pursuant to s. 401.411, the report shall be expunged from the record of the emergency medical technician or paramedic. (3) Any medical director who in good faith gives oral or written instructions to certified emergency medical services personnel for the provision of emergency care shall be deemed to be providing emergency medical care or treatment for the purposes of s. 768.13(2). (4) Each medical director who uses a paramedic or emergency medical technician to perform blood pressure screening, health promotion, and wellness activities, or to administer immunization on any patient under a protocol as specified in s. 401.272, which is not in the provision of emergency care, is liable for any act or omission of any paramedic or emergency medical technician acting under his or her supervision and control when performing such services. (5) The department shall adopt and enforce all rules necessary to administer this section. History. — ss. 6, 25, ch. 82-402; ss. 12, 13, ch. 83-196; s. 8, ch. 88-186; s. 15, ch. 89-275; s. 13, ch. 89-283; s. 70, ch. 89-374; ss. 8, 36, ch. 92-78; s. 34, ch. 93-211; s. 793, ch. 95-148; s. 45, ch. 97-237; s. 3, ch. 98-87; s. 20, ch. 98-151. 401.268 Protocols with regional poison control centers. By October 1, 1999, each licensee shall implement a prehospital emergency dispatch protocol with the regional poison control center established pursuant to s. 395.1027. The prehospital emergency dispatch protocol shall be developed by the licensee’s medical director in conjunction with the designated regional poison control center responsible for the geographic area in which the licensee operates. The protocol shall define toxic substances and describe the procedure by which the designated regional poison control center may be consulted by the licensee. If a call is transferred to the regional poison control center in accordance with the protocol established under this section and s. 395.1027, the regional poison control center shall assume responsibility and liability for the call. History. — s. 2, ch. 98-7. 401.27 Personnel; standards and certification. (1) Each permitted ambulance not specifically exempted from this part, when transporting a person who is sick, injured, wounded, incapacitated, or helpless, must be occupied by at least two persons, one of whom must be a certified emergency medical technician, certified paramedic, or licensed physician and one of whom must be a driver who meets the requirements for ambulance drivers. This subsection does not apply to interfacility transfers governed by s. 401.252. (2) The department shall establish by rule educational and training criteria and examinations for the certification and recertification of emergency medical technicians and paramedics. Such rules must require, but need not be limited to: (a) For emergency medical technicians, proficiency in basic life support as defined in s. 401.23 and in rules of the department. (b) For paramedics, proficiency in advanced life support as defined in s. 401.23 and in rules of the department. (3) Any person who desires to be certified or recertified as an emergency medical technician or paramedic must apply to the department on forms provided by the department which shall contain such information as the department reasonably requires, which may include affirmative evidence of ability to comply with applicable laws and rules. The department shall determine whether the applicant meets the requirements specified in this section and in rules of the department and shall issue a certificate to any person who meets such requirements. (4) An applicant for certification or recertification as an emergency medical technician or paramedic must: (a) Have completed an appropriate training program as follows: 1. For an emergency medical technician, an emergency medical technician training program approved by the department as equivalent to the most recent EMT-Basic National Standard Curriculum or the National EMS Education Standards of the United States Department of Transportation; 2. For a paramedic, a paramedic training program approved by the department as equivalent to the most recent EMT-Paramedic National Standard Curriculum or the National EMS Education Standards of the United States Department of Transportation; (b) Attest that he or she is not addicted to alcohol or any controlled substance; (c) Attest that he or she is free from any physical or mental defect or disease that might impair the applicant’s ability to perform his or her duties; (d) Within 2 years after program completion have passed an examination developed or required by the department; (e)1. For an emergency medical technician, hold a current American Heart Association cardiopulmonary resuscitation course card or an American Red Cross cardiopulmonary resuscitation course card or its equivalent as defined by department rule; 2. For a paramedic, hold a certificate of successful course completion in advanced cardiac life support from the American Heart Association or its equivalent as defined by department rule; (f) Submit the certification fee and the nonrefundable examination fee prescribed in s. 401.34, which examination fee will be required for each exam