Ground Ambulance Licensing - Local Authorization FAQ
Service Specific Questions
Q: I understand that the state is taking over the licensing of ground ambulance services. Our ambulance service has been operating in our community for years. What is local authorization to operate and why is it necessary?
A: The state will begin licensing ground ambulance services on July 1, 2024, but counties and city-and-counties will still be able to choose which licensed ground ambulance services operate in their communities. Local authorization to operate is permission granted by a county/city-and-county for licensed ground ambulance services to operate within their jurisdiction.
Starting July 1, 2024, licensed ground ambulance services must apply for local authorization to operate with any county/city-and-county where they operate or seek to operate on a regular basis if the county/city-and-county requires local authorization. If a county/city-and-county intends to issue local authorization to operate but has not done so by August 1, 2024, licensed ground ambulance services operating on a regular basis in the jurisdiction will be considered to have obtained authorization until the jurisdiction implements an authorization process or opts out of issuing authorizations.
Q: Our ambulance service occasionally picks up or transports individuals outside our county. Would this be considered operating on a regular basis in those other jurisdictions?
A: According to 6 CCR 1015-3, Chapter Four, an ambulance service is considered to operate on a regular basis within a county/city-and-county if any of the following are true:
- The service establishes a fixed operational base and provides patient transport in a prehospital setting.
- The service initiates patient transport twelve (12) or more times in any calendar year.
- The service enters into any contractual agreement, memorandum of understanding, or other legal instrument for the provision of ambulance services within the jurisdiction.
Q: Is there ever a time when local authorization is not required for a ground ambulance service to operate in a county/city-and-county?
A: Yes. There are several situations where local authorization is not required:
- Ground ambulance services that do not operate on a regular basis as defined above or that operate in counties/cities-and-counties that have opted out of issuing local authorizations are not required to have a local authorization issued by a county/city-and-county to operate in that jurisdiction.
- Ground ambulance services that are exempt from licensing and permitting requirements, such as services based outside Colorado that transport patients into Colorado, are not required to have local authorization to operate.
- Transports that are initiated under circumstances in which locally authorized ground ambulance services are unavailable do not require local authorization.
- Transports conducted pursuant to mutual aid agreements do not require local authorization.
- A county/city-and-county has opted out of issuing local authorization to operate.
Q: My ground ambulance service operates on a regular basis in more than one county, each of which requires local authorization to operate. How do we apply for local authorization to operate in these counties?
A: The department will issue a license letter to each licensed ground ambulance service. To apply for local authorization to operate, the ground ambulance service will submit the license letter to the county/city-and-county in which the service plans to operate. The license letter contains the name and license number of the service, the issue and expiration date, and the vehicles permitted under the license.
Counties/cities-and-counties may have additional requirements. You will need to contact your county/city-and-county directly to follow its local authorization process.
County/City-and-County Specific Questions
Q: Are counties/cities-and-counties required to issue local authorization to operate?
A: No. Starting July 1, 2024, counties/cities-and-counties may choose to opt-out of issuing local authorization to operate.
Q: Our county/city-and-county has chosen to opt out of issuing local authorization to operate. How do we notify the department of our decision?
A: Starting July 1, 2024, counties/cities-and-counties must notify the department of their decision related to issuing local authorization using the ground ambulance local authorization to operate form posted on the ground ambulance page of the department’s website, coems.info.
Q: What if our county/city-and-county changes its decision to issue local authorization to operate?
A: If a county/city-and-county changes its decision related to issuing local authorization to operate, the department must be notified within thirty (30) days using the ground ambulance local authorization to operate form posted on the ground ambulance page of the department’s website, coems.info.
Q: There are a large number of ambulance services in our area. Can local jurisdictions limit the number of ambulance services or set specific operational standards?
A: Yes, local ordinances or resolutions may limit the number of ambulance services, determine service areas, authorize contracts with services, and establish requirements consistent with state statutes and regulations. Counties/cities-and-counties may impose obligations that exceed the minimum standards set forth in 6 CCR 1015-3, Chapter Four, but they may not impose standards that are less stringent than the minimum state standards.
Q: Our county/city-and-county has issued local authorization to operate to a newly licensed ground ambulance service. Do we need to notify the department?
A: Yes. Counties/cities-and-counties that choose to issue local authorization to operate must notify the department within thirty (30) days of either issuing or terminating an ambulance service’s local authorization using the ground ambulance local authorization to operate form posted on the ground ambulance page of the department’s website, coems.info.
For questions regarding ground ambulance licensing, please email cdphe_groundambulance@state.co.us or call 303-691-4932.