HB 5249: Health: emergency services; ambulance operation adaptive care license; create. Amends sec. 20920 of 1978 PA 368 (MCL 333.20920). - Michigan

Substitute (H-1) - 3 → House Concurred Bill · 4 edits

MODERATE

The House Concurred Bill adds six entirely new subsections (13-18) creating a new 'ambulance operation adaptive care license' that allows basic life support ambulance operations to provide limited advanced life support services under specific conditions. This new mechanism is distinct from the existing upgrade license and appears designed to help rural or small local government ambulance services maintain higher-level emergency response capability. All other changes are formatting (removal of line numbers, page headers, and reflowed text).

Scope change

The bill's scope expands significantly by adding a new licensing category (adaptive care license) alongside the existing upgrade license, creating an additional pathway for basic life support ambulance operations to provide limited advanced life support services, particularly those tied to local governmental units.

SCOPE

A new 'ambulance operation adaptive care license' is created (subsections 13-18), providing a separate licensing pathway for basic life support ambulance operations to deliver limited advanced life support services.

ELIGIBILITY

To qualify for the adaptive care license, an operation must hold a basic life support license, have been a transporting basic life support service on or before October 1, 2022, be able to staff and equip at least one ambulance for higher-level care, be owned/operated by or under contract to a local governmental unit as its designated provider, and limit services to that unit in response to 9-1-1 or emergency transport calls.

REQUIREMENT

The adaptive care license is valid for 4 years from issuance (longer than the existing upgrade license's 2-year term renewable once). It only permits limited advanced life support, not full advanced life support. The operation must still annually renew its regular basic life support license.

ENFORCEMENT

The department may revoke or fail to renew the adaptive care license for violations of the public health code or its rules. The regular license is explicitly protected from being affected by revocation, non-renewal, or expiration of the adaptive care license.

Substitute (H-1) → Substitute (H-1) - 2 · 2 edits

MINOR

The diff primarily reflects a transition from a committee records listing page to the actual text of HB 5249's Substitute (H-1), which creates an ambulance operation adaptive care license under the Public Health Code. Within the bill text itself, two minor technical edits are visible: '911' was changed to '9-1-1' and 'shall' was changed to 'must' in a renewal application requirement. These are clarifying changes with no substantive policy impact.

TECHNICAL

In subsection (7)(d), the emergency call reference was changed from '911' to '9-1-1', likely for clarity and consistency with how the number is formally written in Michigan statutes.

REQUIREMENT

In subsection (10), the word 'shall' was changed to 'must' when describing what a renewal application for an ambulance operation upgrade license must contain (documentation of progress on the plan of action). This is a minor stylistic change with no practical legal effect.

As Passed by the Senate → Substitute (H-1) · 2 edits

MINOR

The 'As Passed by the Senate' version contained the full legislative text of HB 5249, which added subsections (13) through (18) to MCL 333.20920 creating an 'ambulance operation adaptive care license.' The 'Substitute (H-1)' version contains no bill text at all - it is a captured webpage from the Michigan Legislature's Committee Bill Records page for the Rules Committee, showing navigation menus and a list of bills referred to that committee. This appears to be a data capture error rather than a genuine legislative amendment.

Scope change

The entire substantive scope of the bill was lost in this version. The original bill created a new licensing pathway for rural/basic life support ambulance operations to upgrade their capabilities; the substitute version contains no legislative content whatsoever.

SCOPE

All substantive legislative content was removed, including the new 'ambulance operation adaptive care license' provisions (subsections 13-18) that would have allowed basic life support ambulance operations that were in service before October 1, 2022 to upgrade to limited advanced life support for a 4-year period.

TECHNICAL

The replacement content is not legislative text but a webpage capture of the Michigan Legislature's Rules Committee bill listing page, including navigation menus, committee chair information (Bill Schuette), and a table of bills referred to the Rules Committee. This appears to be a data capture or scraping error rather than an actual substitute bill.

As Passed by the House → As Passed by the Senate · 1 edit · Mar 17, 2026

MINOR

The changes between the House-passed and Senate-passed versions of HB 5249 are limited to formatting adjustments at the top of the document, specifically adding the bill number header and blank lines. No substantive policy changes are visible in this diff.

TECHNICAL

Added the bill number 'House BILL NO. 5249' and several blank lines at the top of the document as a formatting/header adjustment when the bill moved to the Senate.

House Introduced Bill → As Passed by the House · 3 edits · Mar 12, 2026

MINOR

The bill was replaced with a substitute that restructures the eligibility criteria for ambulance operations seeking a transporting basic life support service designation. The key change splits what was previously a single criterion into two separate requirements: the operation must have been a BLS service on or before October 1, 2022 (a grandfathering provision), and it must currently be able to staff and equip ambulances for a higher level of care. The January 1, 2025 deadline for upgrade capability was removed.

Scope change

Eligibility for the BLS service designation is narrowed by adding a historical lookback requirement (must have been BLS before October 1, 2022), while the upgrade capability requirement loses its specific deadline.

ELIGIBILITY

The eligibility test for the BLS service designation was restructured. Previously, a single criterion required the operation to be able to staff and equip for higher life support by January 1, 2025. Now there are two separate criteria: (1) the operation must have been a BLS service on or before October 1, 2022, and (2) it must currently be able to staff and equip for a higher level of care with no specific deadline.

A new grandfathering requirement was added: the operation must have been a transporting basic life support service on or before October 1, 2022. This limits eligibility to operations that were already in BLS status before that date.

TIMELINE

The January 1, 2025 deadline for being able to staff and equip ambulances at a higher life support level was removed. The capability requirement now has no specific date attached.

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

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