Members of the conference committee on Senate Bill 2,033 voted to adopt Department of Health and Human Services (DHHS) amendments that add tools for identifying and assisting “distressed” ambulance services, including temporary waivers, a coordinator role and a clarified reimbursement provision.

The action, moved by Senator Roars and seconded by Senator Clemens, added the word “direct” before “costs” in the subsection that allows the department to request that a distressed ambulance service reimburse the department for costs incurred administering the section; the motion passed on a roll call with committee members recorded as voting aye.

The committee’s DHHS witnesses described the amendment set as starting from the Senate version and incorporating DHHS changes. Allison Hicks, general counsel for the public health division of the Department of Health and Human Services, said the amendment rewords enforcement language and shifts the early trigger from an actual violation to a “substantial likelihood to fail.” She told the committee that “one of the kind of key indicators of a substantial likelihood to fail or substantial likelihood to be unable to comply with the current, rules or laws would be the inability to fill your staffing requirements.”

Tim Weider, section director for health response and licensure in DHHS’s licensing/EMS unit, expanded on how DHHS would recognize the precursor conditions that justify use of the new tool. “One of the primary ones is our inability to rely on a ability to, on an ongoing basis, fill out the the roster,” Weider said, describing chronic staffing shortages rather than one-time missed responses as the kind of problem the language is intended to catch. Weider and other DHHS staff noted required ambulance run reports and potential PSAP (9-1-1) reporting as data sources, but said run reports arrive after the fact and PSAP reporting is not yet consistently used statewide.

Committee members raised operational concerns about daytime coverage in commuter or “bedroom” communities and the difficulty of distinguishing active roster members from people merely listed on agency rosters. Chris Price, director of the Emergency Medical Services Unit at DHHS, described existing practice: agencies and DHHS typically work with services to remediate problems rather than immediately pursuing disciplinary action. “I’ve been the director for almost 7 years and we’ve yet to take any disciplinary or regulatory action against an ambulance service in that, in that time,” Price said.

The amendment package also directs the department to assign a coordinator to help assemble and steer stabilization efforts for distressed services; committee members discussed whether that coordinator would be a DHHS employee, a contractor or a local squad leader and concluded the bill language should allow flexibility, including contracting with neighboring services or hiring outside consultants who “know the territory.” DHHS witnesses said the expectation is to use the tool for a small number of services and to seek local collaboration before state intervention.

On the narrower reimbursement language that the committee adopted, DHHS staff and legislators agreed to tighten the text so the department may request reimbursement only for direct costs incurred in administering the section (for example, hiring temporary staff), not for general agency salary allocations or indirect administrative overhead. As moved during the meeting, the revision reads in substance that the department “may request the distressed ambulance service reimburse the department for direct costs incurred in administering this section.” Committee members noted that the provision uses permissive language (“may request”) and that, where local funds exist, the local entity should be expected to pay for direct interventions.

Votes at a glance: the committee adopted the DHHS amendment package (the 2,000 version plus DHHS amendments) with the added word “direct” in the reimbursement subsection. The motion was moved by Senator Roars, seconded by Senator Clemens, and recorded as passing with the committee members on the roll call recorded as voting yes.

The committee discussion ranged from technical drafting (replacing language that assumed an existing violation with one describing a substantial likelihood of failure) to practical indicators (staffing rosters, run reports, PSAP alerts), possible coordinator models (DHHS staff, contractor, neighboring squad leader) and funding mechanics for short-term interventions. The committee closed the conference committee after adopting the revised language.