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HB 1394

AN ACT to amend and reenact sections 23-27-01 and 23-27-02 of the North Dakota Century Code, relating to the licensing of emergency medical services operations.

69th Legislative Assembly (2025-26) Introduced by Michelle Axtman and 8 co-sponsors

HB 1394 rewrites ND EMS licensing: licenses tied to service areas, allows transfer with DHHS approval, adds substation licensing rules (fees) and updated EMS definitions.

Filed with Secretary Of State 03/27
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Bill Summary · HB 1394

Summary — HB 1394 (North Dakota)

Amends and reenacts NDCC §§ 23‑27‑01 and 23‑27‑02 (licensing and definitions for emergency medical services operations)

Main purpose

HB 1394 revises how emergency medical services (EMS) operations are licensed and defined in North Dakota. The bill clarifies licensing units (service areas), updates the treatment of substations, makes licenses transferable with department approval, and modernizes several statutory definitions used in the EMS licensing chapter.

Key provisions / changes

  • Licensing authority and limits (23‑27‑01)
    • Reaffirms Department of Health and Human Services (DHHS) authority to license EMS operations and to designate service areas and to limit issuance of new licenses based on service‑area needs.
    • Changes the statute to allow an EMS operation license to be transferable upon DHHS approval (statute previously described a license as nontransferable).
  • License unit and dispatching
    • Clarifies that licensing is organized around the operation’s designated service area. An operation with a single headquarters may dispatch vehicles and personnel from more than one location only if calls and dispatch orders are made at the single headquarters within the operation’s designated service area.
  • Substation ambulance services (new/clarified treatment)
    • Allows an operator to continue to operate one or more substation ambulance services under a single license only if the substation was designated before December 31, 2024 and remains continuously designated.
    • Additional conditions: the headquarters is not itself a substation of another operation; the substation area borders the headquarters area (or another substation of the same headquarters); dispatching is done by the same entity.
    • The operator must pay a license fee for each substation.
    • Defines “substation ambulance services” as an ambulance station that has its own DHHS‑designated service area and is not individually licensed.
  • Exceptions and special rules
    • Confirms chapter provisions do not apply to out‑of‑state operators headquartered outside North Dakota who merely transport patients across state lines, but such operators may not treat or pick up patients inside North Dakota for in‑state transport except as permitted by rule.
    • Directs DHHS to adopt rules for special licenses and waivers for industrial/closed‑site EMS operations not open to the general public.
  • Definitions (23‑27‑02)
    • Updates and clarifies definitions for “emergency medical services,” “emergency medical services operation,” “emergency medical services personnel,” and “emergency medical services professional” (the latter defined as an individual licensed by the department).
    • Clarifies that EMS includes prehospital assessment, stabilization, treatment, and transport (including interfacility transport).

Who is affected

  • EMS operators and ambulance services (especially those operating multiple substations)
  • Operators seeking to transfer licenses (may do so with DHHS approval)
  • DHHS (rulemaking, licensing oversight, fee collection)
  • Out‑of‑state transport operators (limited exceptions preserved)
  • Local communities and EMS consumers indirectly (through licensing and service‑area designations)

Procedural / timeline notes

  • Bill amends ND Century Code §§ 23‑27‑01 and 23‑27‑02.
  • Committee action: Human Services Committee adopted amendments (Jan 27, 2025).
  • Legislative action recorded: passed both chambers (House and Senate vote tallies reported), enrolled, emergency clause adopted, signed by Governor (documented March 26, 2025), and filed with the Secretary of State (March 27, 2025). The emergency clause suggests immediate or expedited effective date upon signature; check the enrolled act for the precise effective date.

Potential impacts / considerations

  • Operators with substations established before Dec 31, 2024 retain ability to operate multiple substations under one license; new substations after that date will generally require separate licensing, potentially increasing licensing complexity and fees for expansions.
  • Transferability (with DHHS approval) introduces flexibility for ownership/operational changes but requires department oversight.
  • DHHS rulemaking will be required to implement special licensing/waiver processes and to interpret dispatch and service‑area provisions.

If you want, I can produce a side‑by‑side comparison of current law vs. bill text for the most significant sections (licenses, substations, definitions).

Compiled from official sources — confirm details with the bill’s official record.

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