Technical Update vol. 28 no. 35 - Emergency Medical Services Updates

The Colorado Code of Regulations (CCR) 1015-3 pertains to the new legislation regarding ambulance services in Colorado. For detailed information, refer to the full text of CCR 1015-3 on the Colorado Secretary of State’s website or contact the Colorado Department of Public Health and Environment (CDPHE). Below are some key points:

• State Licensing Authority: The new bill transitions the licensing authority for ambulance services from the county level to the state level. This centralization aims to streamline the process and ensure uniform standards across the state.
• Regulation Standards: The state will implement consistent standards for ambulance services, including vehicle specifications, equipment requirements, staffing qualifications, and operational protocols. This ensures a uniform level of service and safety across Colorado.
• Inspection and Compliance: The state will conduct regular inspections and compliance checks to ensure ambulance services adhere to the new regulations. Non-compliance can result in penalties, including fines or license suspension.
• Training and Certification: The bill outlines new training and certification requirements for emergency medical personnel. This includes ongoing education to ensure staff are up-to-date with the latest medical practices and technologies.
• Driver Requirements: Starting July 1, 2026, anyone driving for the service—whether hired, contracted, or volunteering—must meet the following requirements: be at least 18 years old, have a valid driver’s license with the right endorsements for the vehicle, and show proof that they’ve completed an emergency vehicle operation program approved by the agency. 
• Public Reporting: Ambulance services must publicly report certain performance metrics, such as response times and patient outcomes. This transparency is intended to improve accountability and allow residents to make informed choices about their healthcare providers.
• Funding and Resources: The state will allocate funds to support the transition and ensure ambulance services have the necessary resources to comply with the new regulations. This includes funding for new equipment, training programs, and administrative support.
• Stakeholder Engagement: The bill mandates ongoing consultation with ambulance service providers, healthcare professionals, and the public. This collaborative approach aims to address concerns and ensure that the regulations meet the needs of all parties involved.

STATE LICENSING PROCESS

Every ambulance service must comply with all applicable laws and regulations, including those required to operate and maintain an ambulance service in Colorado to become licensed and maintain licensure by the CDPHE. 

The following highlights requirements that must be completed by the owner or operator of an ambulance service to obtain an initial or renewal license:

• A completed application form and fee;
• The contact information for the medical director[s] of the services;
• A complete list of equipment carried on each permitted ambulance;
• Copies of the ambulance service’s written policy and procedure manual, operational or medical protocols or guidelines, or other documentation the CDPHE may deem necessary;
• Proof of workers’ compensation consistent with the Colorado Workers' Compensation Act; and
• Proof of general liability insurance coverage or a surety bond in an amount not less than the amount calculated per Sections 24-10-114(1)(a) and (1)(b), C.R.S.

WHAT THIS MEANS FOR COUNTIES

With the state now serving as the licensing entity for ambulance services, it is essential to note that counties have coverage under the Colorado Counties Casualty and Property Pool (CAPP). Counties must understand that the state will handle all inspections, compliance checks, and licensing processes. They must ensure local ambulance services know and adhere to these new state standards. For more information, contact CAPP at (303) 861-0507.