The Vermont Statutes Online

Title 24: Municipal and County Government

Chapter 071: Ambulance Services

• Subchapter 001: EMERGENCY MEDICAL SERVICES DISTRICTS

• § 2651. Definitions

  As used in this chapter:

  (1) “Advanced emergency medical treatment” means those portions of emergency medical treatment as defined by the Department of Health, which may be performed by licensed emergency medical services personnel acting under the supervision of a physician within a system of medical control approved by the Department of Health.

  (2) “Ambulance” means any vehicle, whether air, ground, or water, that is designed, constructed, used, or intended for use in transporting ill or injured persons.

  (3) “Ambulance service” means a person licensed by the Department of Health to provide emergency medical treatment and transportation to ill or injured persons.

  (4) “Basic emergency medical treatment” means those portions of emergency medical treatment, as defined by the Department of Health, which may be exercised by licensed emergency medical services personnel acting under their own authority.

  (5) “District board” means the board of directors of a district appointed under section 2653 of this title.

  (6) “Emergency medical personnel” means persons, including volunteers, licensed by the Department of Health to provide emergency medical treatment on behalf of an affiliated agency whose primary function is the provision of emergency medical treatment. The term does not include duly licensed or registered physicians, dentists, nurses, or physician assistants when practicing in their customary work setting.

  (7) “Emergency medical services” means an integrated system of personnel, equipment, communication, and services to provide emergency medical treatment.

  (8) “Emergency medical services district” means a political subdivision established to facilitate the provision of pre-hospital emergency medical treatment within a given area.

  (9) “Emergency medical treatment” means pre-hospital, in-hospital, and interhospital medical treatment rendered by emergency medical personnel given to individuals who have experienced sudden illness or injury in order to prevent loss of life, the aggravation of the illness or injury, or to alleviate suffering. Emergency medical treatment includes basic emergency medical treatment and advanced emergency medical treatment.

  (10) “First responder service” means a person licensed by the Department of Health to provide emergency medical treatment.

  (11) “Medical control” means the entire system of quality assurance and medical accountability for basic and advanced emergency medical treatment as prescribed by this chapter. “Prehospital medical control” shall include direction and advice given to emergency medical personnel by a physician or a person acting under the direct supervision of a physician provided through:

  (A) off-line medical control functions or direction of emergency medical personnel through use of protocols, review of cases, and determination of outcomes, and through training programs; and

  (B) on-line medical control functions, via radio or telephone, of field personnel at the site of the emergency and en route to a hospital emergency department.

  (12) “Medical facilities” means a hospital providing emergency services to an emergency medical services district.

  (13) “Person” means any person, firm, partnership, association, corporation, municipality, or political subdivision, including emergency medical services districts as provided for in this subchapter.

  (14) [Repealed.]

  (15) “Volunteer personnel” means persons who are licensed by the Department of Health to provide emergency medical treatment on behalf of an affiliated agency without expectation of remuneration for the treatment rendered other than nominal payments and reimbursement for expenses, and who do not depend in any significant way on the provision of such treatment for their livelihood.

  (16) “Affiliated agency” means an ambulance service or first responder service licensed under this chapter, including a fire department, rescue squad, police department, ski patrol, hospital, or other entity licensed to provide emergency medical services under this chapter. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 1; 2011, No. 155 (Adj. Sess.), § 40; 2013, No. 96 (Adj. Sess.), § 151; 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• § 2652. Creation of districts

  The Department of Health may divide the State into emergency medical services districts, the number, size, and boundaries of which shall be determined by the Department in the interest of affording adequate and efficient emergency medical services throughout the State. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 2; 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• § 2653. Appointment of directors

  (a) Each emergency medical services district shall have a board of directors, composed of a representative of each of the medical facilities, ambulance services, and first responder services operating within the district, to serve for a term of two years each or until their successors are selected. The affected medical facility, ambulance service, or first responder service may appoint a director to fill any vacancy on the board of directors for the balance of an unexpired term.

  (b) The board of directors of an emergency medical services district may adopt bylaws which may contain provisions for the regulation and management of the affairs of the district. The bylaws may provide for creation of committees, including an executive committee, each consisting of two or more directors. An executive committee shall have and exercise all the authority of the board in the manner authorized by the resolution creating such committee.

  (c) Representatives shall be chosen by each medical facility, ambulance service, and first responder service before March 1 of each odd-numbered year. Each medical facility, ambulance service, and first responder service shall certify the name of its representative to the Commissioner of Health. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1969, No. 179 (Adj. Sess.), § 1; 1983, No. 226 (Adj. Sess.), § 3.)

• § 2654. Repealed. 2021, No. 15, § 9(2).

• § 2655. Meetings of directors; election of officers

  (a) The board of directors shall hold an annual meeting on or before May 1 in each year, at which a chair, a clerk, and a treasurer shall be elected by the board to serve until the next annual meeting. A vice chair may be elected if the directors so vote. The chair and any vice chair shall be elected from members of the board, but the clerk and treasurer may be elected by the board from the general membership of the emergency medical services district, in which case they shall not be entitled to vote as directors. The directors shall also meet at such other times as they deem advisable.

  (b) Each district clerk shall cause to be recorded in the office of the Secretary of State the names of the elected district officers.

  (c) Meetings shall be called by the clerk on request of the chair or any two directors. However, in the event that no annual meeting is held on or before March 1 in any year, such a meeting may be called by any director. Five days’ written notice of all meetings shall be given to each director, unless waived in writing.

  (d) A majority of the directors shall constitute a quorum for the transaction of business at any meeting. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1969, No. 179 (Adj. Sess.), § 2; 1983, No. 226 (Adj. Sess.), § 5.)

• § 2656. Duties and powers of officers and directors

  (a) The board of directors shall have full power to manage, control, and supervise the conduct of the district and to exercise in the name of the district all powers and functions belonging to the district, subject to such laws or rules as may be applicable.

  (b) The chair of the board of directors shall preside at meetings of directors, and shall perform such other duties as the directors may delegate to him or her.

  (c) The treasurer shall have the custody of all monies belonging to the district and shall keep accurate and complete books of account. Prior to assuming his or her duties, the treasurer shall execute a bond in favor of the district, conditioned on the faithful performance of his or her duties, in such sum and with such sureties as the directors approve.

  (d) The clerk shall keep minutes of meetings of directors and of the district, and shall record all votes.

  (e) The vice chair, if one is elected, shall perform the duties of the chair in the chair’s absence. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• § 2657. Purposes and powers of emergency medical services districts

  (a) It shall be the function of each emergency medical services district to foster and coordinate emergency medical services within the district, in the interest of affording adequate ambulance services within the district. Each emergency medical services district shall have powers that include the power to:

  (1) buy, acquire, or lease fixtures and equipment related to district activities;

  (2) apply for, receive, and accept gifts, bequests, grants-in-aid; State, federal, and local aid; and other forms of financial assistance;

  (3) enter into agreements and contracts for furnishing technical, educational, and support services related to the provision of emergency medical treatment;

  (4) appoint and employ agents and employees;

  (5) impose and collect reasonable charges or fees for its services;

  (6) monitor the provision of emergency medical services within the district and make recommendations to the Department of Health regarding licensure, relicensure, and removal or suspension of licensure for ambulance vehicles, ambulance services, and first responder services;

  (7) develop, in conjunction with municipal officials, response plans for the provision of emergency medical treatment and transportation by ambulance services and first responder services within the district;

  (8) sponsor or approve programs of education approved by the Department of Health which lead to the licensure of emergency medical services personnel;

  (9) establish medical control within the district with physicians and representatives of medical facilities, including written protocols with the appropriate officials of receiving hospitals defining their operational procedures;

  (10) assist the Department of Health in a program of testing for licensure of emergency medical services personnel;

  (11) [Repealed.]

  (12) develop protocols for providing appropriate response times to requests for emergency medical services.

  (b) Two or more contiguous emergency medical services districts by a majority vote of the district board in each of the districts concerned may change the mutual boundaries of their emergency medical services districts. The district boards shall report all changes in district boundaries to the Department of Health.

  (c) Property delivered to an ambulance service or first responder service by an emergency medical services district shall remain the property of the district, unless otherwise agreed in writing. Any equipment purchased with federal funds will be managed in accordance with federal guidelines. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1969, No. 207 (Adj. Sess.), § 9, eff. March 24, 1970; 1983, No. 226 (Adj. Sess.), § 6; 2011, No. 155 (Adj. Sess.), § 41; 2019, No. 100 (Adj. Sess.), § 1, eff. May 14, 2020; 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• Subchapter 002: LICENSING OPERATION OF AFFILIATED AGENCIES

• § 2681. License required; ambulance license requirement

  (a) A person furnishing ambulance services or first responder services shall obtain a license to furnish services under this subchapter.

  (b)(1) In order to obtain and maintain a license, an ambulance service shall be required to provide its services in a manner that does not discriminate on the basis of income, funding source, or severity of health needs, in order to ensure access to ambulance services within the licensee’s service area.

  (2) The Department of Health shall adopt rules in accordance with the provisions of subdivision (1) of this subsection. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 7; 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• § 2682. Powers of the Department of Health

  (a) The Department of Health shall administer this subchapter and shall have power to:

  (1) Issue licenses for ambulance services and first responder services under this subchapter.

  (2) Revoke or suspend upon due notice and opportunity for hearing the license of any person who violates or fails to comply with any provision of this subchapter, or any rule or requirement adopted under its authority.

  (3) Make, adopt, amend, and revise, as it deems necessary or expedient, reasonable rules in order to promote and protect the health, safety, and welfare of members of the public using, served by, or in need of emergency medical treatment. Any rule may be repealed within 90 days of the date of its adoption by a majority vote of all the district boards. Such rules may cover or relate to:

  (A) age, training, and physical requirements for emergency medical services personnel;

  (B) design and equipping of ambulances;

  (C) cooperation with hospitals and organizations in other related fields, and participation in central communications procedures; and

  (D) any other matters properly within the purposes of this chapter.

  (b) No fee or other payment shall be required of an applicant for a license. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 8; 2011, No. 155 (Adj. Sess.), § 42; 2019, No. 100 (Adj. Sess.), § 1, eff. May 14, 2020; 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• § 2683. Term of license

  Full licenses shall be issued on forms to be prescribed by the Department of Health for a period of three years beginning on January 1 or for the balance of any such three-year period. Temporary, conditional, or provisional licenses may also be issued by the Department. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 9; 2019, No. 100 (Adj. Sess.), § 1, eff. May 14, 2020; 2019, No. 166 (Adj. Sess.), § 27, eff. Oct. 1, 2020.)

• § 2684. Penalty

  A person who violates this subchapter shall be subject to a civil fine of not more than $200.00. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 10.)

• § 2685. Liability for cost of services

  A person who receives emergency medical treatment from an ambulance or first responder service or transportation by an ambulance service shall be liable in contract to the person providing such services for the reasonable and necessary cost of the services, whether or not he or she has agreed or consented to such liability. (Added 1969, No. 112, § 1, eff. April 22, 1969; amended 1983, No. 226 (Adj. Sess.), § 11.)

• § 2686. False requests for ambulance service or first responder service

  A person shall be guilty of a misdemeanor if he or she requests ambulance or first responder service from a person or organization engaged in providing such service without actual need for such service, knowing that the request is false or baseless. A person who violates this section shall be fined not more than $200.00 or imprisoned not more than 30 days, or both. (Added 1969, No. 179 (Adj. Sess.), § 3, eff. July 1, 1970; amended 1983, No. 226 (Adj. Sess.), § 12.)

• § 2687. Civil liability limited

  Volunteer personnel, whether or not they receive or expect to receive nominal payments and reimbursement for expenses, who render emergency medical treatment shall:

  (1) be afforded the protection of 12 V.S.A. § 519;

  (2) not be considered practitioners of the healing arts for purposes of 12 V.S.A. § 519(b); and

  (3) not be liable for civil damages for rendering emergency medical treatment unless their actions constitute gross negligence or willful misconduct. (Added 1983, No. 226 (Adj. Sess.), § 13.)

• § 2688. Armed forces

  The provisions of this chapter shall not apply to the U.S. Armed Forces or the Vermont National Guard or their respective personnel while serving in such capacity. (Added 1983, No. 226 (Adj. Sess.), § 14.)

• § 2689. Reimbursement for ambulance service providers

  (a)(1) When an ambulance service provides emergency medical treatment to a person who is insured by a health insurance policy, plan, or contract that provides benefits for emergency medical treatment, the health insurer shall reimburse the ambulance service directly, subject to the terms and conditions of the health insurance policy, plan, or contract.

  (2) The Department of Financial Regulation shall enforce the provisions of this subsection.

  (b) Nothing in this section shall be construed to interfere with coordination of benefits or to require a health insurer to provide coverage for services not otherwise covered under the insured’s policy, plan, or contract.

  (c) Nothing in this section shall preclude an insurer from negotiating with and subsequently entering into a contract with a nonparticipating ambulance service to establish rates of reimbursement for emergency medical treatment.

  (d) Reimbursement for ambulance services provided to Medicaid beneficiaries shall be in accordance with 33 V.S.A. § 1901m. (Added 2011, No. 150 (Adj. Sess.), § 5; amended 2019, No. 100 (Adj. Sess.), § 1, eff. May 14, 2020; 2023, No. 157 (Adj. Sess.), § 4, eff. June 6, 2024.)