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HB 5249

Health: emergency services; ambulance operation adaptive care license; create. Amends sec. 20920 of 1978 PA 368 (MCL 333.20920).

2025-2026 Regular Session Introduced by Greg Alexander and 32 co-sponsors

HB 5249 allows eligible Michigan local-government ambulance services to upgrade to higher life-support levels via a 2-year upgrade license (renewable), with oversight and $100 fees

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Bill Summary · HB 5249

Summary — HB 5249 (House Bill No. 5249)

Status: Introduced (first reading Nov 12, 2025); referred to Committee on Health Policy. Primary sponsor: Rep. David Prestin.

Purpose / Intent

HB 5249 amends section 20920 of Michigan’s Public Health Code to (re)state and clarify licensing requirements for ambulance operations and to formalize a process by which certain pre‑existing local government ambulance services may obtain an “ambulance operation upgrade license” to provide higher levels of life support (limited advanced life support or advanced life support).

Key provisions

  • Ambulance operation licensure

    • A person may not establish or operate an ambulance operation unless it is licensed under §20920.
    • Initial license application and annual renewal each require a $100 fee.
    • Applications must list each ambulance to be operated; licenses must specify the ambulances and must state the highest level of life support the operation is allowed to provide.
    • Ambulance operations must operate only at or below the licensed life‑support level and in accordance with department rules and approved medical control authority protocols (except as noted in §20921a(2)).

  • Ambulance operation upgrade license (special pathway for qualifying local government providers)

    • Eligibility (limited to ambulance operations that met all criteria on or before July 22, 1997):
    • Held a transporting BLS or transporting limited ALS license on or before July 22, 1997.
    • Is able to staff and equip one or more ambulances to transport emergency patients at a higher level (BLS → limited ALS or ALS; limited ALS → ALS).
    • Is owned, operated by, or under contract to a local governmental unit and provided first‑line emergency response to that unit on or before July 22, 1997.
    • Will provide upgraded services only to that local governmental unit and only in response to 9‑1‑1 calls or other emergency transport calls.
    • Application requirements:
    • Verification of the eligibility criteria and description of staffing/equipment for the higher level.
    • A plan of action to upgrade services (to be completed within up to 2 years).
    • Medical control authority protocols plus a recommendation from that medical control authority.
    • Other information as required by the department.
    • Review and issuance:
    • The statewide emergency medical services coordination committee reviews the medical control authority materials and recommends to the department.
    • Upon a completed application, a positive committee recommendation, and payment of a $100 fee, the department issues an upgrade license valid for 2 years, renewable once for an additional 2‑year period.
    • Renewal applications must document progress on the upgrade plan. The medical control authority must file an annual progress report with the statewide committee.
    • Operational limits and oversight:
    • Upgrade license permits provision of higher‑level services only when the operation can staff and equip ambulances at that level and only when the medical control authority has adopted appropriate protocols (including quality monitoring and equipment protection).
    • The department may revoke or refuse to renew the upgrade license for violations of the Public Health Code, rules, or failure to comply with the upgrade plan.
    • The status (issue, renewal, revocation, or expiration) of an upgrade license does not affect the operation’s regular ambulance license.

Who is affected

  • Ambulance service operators across Michigan (both private and public), especially local government–owned or contracted ambulance services that meet the historical eligibility criteria.
  • Medical control authorities and the statewide emergency medical services coordination committee (involved in protocol approval, recommendations, and oversight reporting).
  • Department of Health (department) for licensure processing, enforcement, and rule compliance.

Timeline and procedural notes

  • Upgrade plan: intended to be implemented within a maximum 2‑year period; upgrade licenses issued initially for 2 years and renewable once for an additional 2‑year period.
  • Annual renewals and reporting requirements for both regular and upgrade licenses.
  • Department enforcement authority includes revocation or nonrenewal of upgrade licenses for noncompliance.
  • The bill text included an additional subsection beginning “6 months after the effective date…” but that provision is truncated in the provided text; review of the full enrolled/introduced text is recommended to capture any delayed‑effective provisions.

Potential impact

  • Creates a clear statutory pathway for certain longstanding local government ambulance providers to expand to higher levels of life support, subject to staffing, equipment, medical control protocols, and oversight.
  • Administrative impact is limited by modest application/renewal fees ($100), but operational impacts (training, staffing, equipment, medical oversight) could require significant local investment.
  • Strengthens role of medical control authorities and statewide EMS coordination committee in assessing and overseeing upgrades in scope of care.

For full legal effect and any additional provisions (including the truncated subsection), consult the complete introduced bill text and any committee analyses or subsequent amendments.

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

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