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2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2217 - Exemption from regulation

36-2217.
Exemption from regulation
A. This chapter does not apply to:
1. Vehicles used for the emergency transportation of persons injured at an industrial site.
2. Persons engaged in and vehicles used for air transportation of sick or injured people in a noncritical or nonemergency situation as determined by a physician.
3. Medical evacuation equipment used and owned by the department of public safety in air,  ground or water evacuation and including fixed wing aircraft,  helicopters,  ground ambulances and similar ground conveyances,  snowmobiles and water traversing equipment.
4. Vehicles provided or contracted for emergency medical services by a political subdivision if these vehicles are primarily used to provide on the scene stabilization of sick,  injured,  wounded,  incapacitated or helpless persons.
5. Ambulances from other states that are:
(a) Responding to a major catastrophe or emergency in this state because there are insufficient registered ambulances in this state to respond in that situation.
(b) Operating either from a location outside of this state to transport a patient to a location within this state or operating from a location outside of this state and crossing through this state to transport a patient to a location outside this state.
6. Stretcher vans that meet the requirements of section 36-2223.
B. Except as provided in subsection A,  paragraph 5,  subdivision (a) of this section,  an ambulance from another state shall not pick up a patient in this state and transport that patient to another location in this state unless that ambulance is registered under this chapter.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2218 - Emergency medical services operating fund

36-2218.
Emergency medical services operating fund
A. An emergency medical services operating fund is established. The director shall administer the fund. The emergency medical services operating fund shall consist of monies collected pursuant to sections 12-116.02 and 36-3251 and distributed pursuant to section 36-2219.01,  subsection B,  paragraph 2.
B. The director of the department of health services with advice from the council shall expend monies in the fund for funding local and state emergency medical services systems. Monies in the fund are subject to annual legislative appropriation.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2219 - Emergency medical care technicians; requirements; transportation

36-2219.
Emergency medical care technicians;  requirements;  transportation
A. An emergency medical care technician shall comply with either emergency medical standards and protocols established by the regional council or the medical direction for the local jurisdiction when considering emergency transport,  including the appropriate use of telecommunications.
B. An emergency medical care technician may not do either of the following:
1. Provide a patient with a presumptive medical diagnosis and use that medical diagnosis as the basis for counseling the patient to decline emergency medical services transportation.
2. Counsel a patient to decline emergency medical services transportation,  except as part of a specific alternate destination or treat-and-refer program that includes quality management and comprehensive medical direction oversight.
C. An emergency medical care technician shall explain to a patient the risks and consequences to the patient's health of not being transported.
D. It is not a violation of this section for an emergency medical care technician to inform a patient of the patient's right to accept or decline emergency medical services transportation,  unless the emergency medical care technician does so in an effort to coerce the patient to decline emergency medical services.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2219.01 - Medical services enhancement fund

36-2219.01.
Medical services enhancement fund
A. A medical services enhancement fund is established consisting of monies collected pursuant to section 12-116.02. The state treasurer shall administer the fund.
B. On the first day of each month,  the state treasurer shall distribute or deposit:
1. Fourteen and two-tenths per cent in the substance abuse services fund established pursuant to section 36-2005.
2. Forty-eight and nine-tenths per cent in the emergency medical services operating fund established pursuant to section 36-2218 of which at least eight per cent shall be used for personnel expenses,  education,  training and equipment purchases in cities or towns with a population of less than ninety thousand persons according to the most recent United States decennial census.
3. Twenty-two per cent in the spinal and head injuries trust fund established pursuant to section 41-3203.
4. Nine and four-tenths per cent in a separate account of the substance abuse services fund established by section 36-2005 for use in administering the provisions of section 36-141.
5. Five and five-tenths per cent in the state general fund.
C. Monies distributed pursuant to subsection B of this section constitute a continuing appropriation.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2220 - Records; confidentiality; definition

36-2220.
Records;  confidentiality;  definition
A. Information developed,  records kept and data collected by the department or a political subdivision of this state for the purpose of administering or evaluating the Arizona emergency medical services system or for the trauma system are available to the public except:
1. Any patient record,  including clinical records,  prehospital care records,  medical reports,  laboratory statements and reports,  any file,  film,  record or report or oral statement relating to diagnostic findings,  treatment or outcome of patients,  whether written or recorded,  and any information from which a patient,  the patient's family or the patient's health care provider or facility might be identified except records,  files and information are available to the patient,  the patient's guardian or the patient's agent.
2. Information obtained and data collected for purposes of chapter 25 or chapter 4,  article 5 of this title.
B. Unless otherwise provided by law,  all medical records developed and kept by a prehospital component of the statewide trauma system and information contained in these records are confidential and may not be released to the public without written authorization by the patient,  the patient's guardian or the patient's agent.
C. Notwithstanding subsection B of this section,  a prehospital incident history report completed and kept by a nonhospital political subdivision of this state is available to the public except for information in that report that is protected from disclosure by the laws of this state or federal law,  including confidential patient treatment information.
D. Patient records and medical records covered by this section may be obtained pursuant to section 12-2294.01.
E. Information,  documents and records received by the department or prepared by the department in connection with an investigation that is conducted pursuant to this article and that relates to emergency medical care technicians are confidential and are not subject to public inspection or civil discovery. The results of the investigation and the decision of the department are available to the public after the investigation is completed and the investigation file is closed.
F. For the purposes of this section,  " prehospital incident history report"  means a record of the prehospital response,  nature of the incident and transportation of an emergency medical services patient that is documented on a prehospital incident history report.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2221 - Trauma center data; requirements; confidentiality; violation; classification

36-2221.
Trauma center data;  requirements;  confidentiality;  violation;  classification
A. Trauma centers shall submit to the department a uniform data set for the trauma patient as prescribed by the department. Advanced life support base hospitals that are not trauma centers may also submit this data to the department. The director shall identify the categories of patients who are to be reported as trauma patients under this section.
B. The department shall provide quarterly trauma system data reports to each hospital and designated trauma center submitting data.
C. The department may authorize other persons and organizations to use state trauma registry data:
1. To study the sources and causes of trauma.
2. To evaluate the cost,  quality,  efficacy and appropriateness of diagnostic,  therapeutic,  rehabilitative and preventive services and programs that are related to trauma.
D. Information collected by the state trauma registry that can identify an individual is confidential and may be used only pursuant to this section. A person who discloses confidential information in violation of this section is guilty of a class 3 misdemeanor.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2223 - Stretcher vans; wheelchair vans; use; restrictions

36-2223.
Stretcher vans;  wheelchair vans;  use;  restrictions
A. A stretcher van may transport a person who:
1. Needs routine transportation to or from a medical appointment or service if that person is convalescent or otherwise nonambulatory and does not require medical monitoring en route to the destination facility,  or aid,  care or treatment during transport.
2. Is an inpatient at a facility and needs transportation to another hospital for diagnostic tests if that person's physician authorizes the use of a stretcher van.
B. A stretcher van or wheelchair van shall not transport a person who:
1. Is being administered intravenous fluids.
2. Was administered a medication that might prevent that person from caring for himself.
3. Needs or may need oxygen unless that person's physician has prescribed oxygen as a self-administered therapy.
4. Needs or may need suctioning.
5. Has sustained an injury and has not yet been evaluated by a physician.
6. Is experiencing an acute condition or the exacerbation of a chronic condition or a sudden injury or illness.
7. Needs to be transported from one hospital to another hospital if the destination hospital is the same level or a higher level as the hospital of origin.
8. Is being evaluated in an emergency room and for any reason must be transported to another hospital for diagnostic tests that are not available at the first hospital.
9. Is being medically monitored at the sending facility and will continue to be medically monitored at the destination facility.
C. A stretcher van or wheelchair van shall not contain medical equipment or supplies or display any marking,  symbols or warning devices that imply that it offers medical care or ambulance transportation.
D. A stretcher van shall not respond or transport a person if the request for service originated within a public dispatch system.
E. An ambulance service that provides both ambulances and stretcher vans or wheelchair vans shall not use a registered ambulance in place of a stretcher van or wheelchair van if a stretcher van or wheelchair van is specifically requested or if a stretcher van or wheelchair van may be used but is not immediately available.
F. A person transporting patients in stretcher vans or wheelchair vans in violation of the criteria in subsection B of this section or operating in violation of subsection C of this section may be determined by the department after notice and a hearing pursuant to section 36-2245 to have operated an unregistered ambulance in violation of section 36-2212.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2224 - Interfacility transportation of patients; requirements

36-2224.
Interfacility transportation of patients;  requirements
An ambulance service that transports a patient from a hospital within its certificated area to a hospital outside the certificated area is only required to transport that patient under medical direction to the nearest most appropriate facility as defined by federal medicare guidelines for ambulance services. This section shall not apply to any patient transport initiated or undertaken pursuant to the provisions of the federal emergency medical treatment and active labor act.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2225 - Statewide emergency medical services and trauma system; definitions

36-2225.
Statewide emergency medical services and trauma system;  definitions
A. The department shall develop and administer a statewide emergency medical services and trauma system to implement the Arizona emergency medical services and trauma system plan. The department shall adopt rules to establish standards for the following:
1. Injury prevention activities to decrease the incidence of trauma and decrease the societal cost of preventable mortality and morbidity.
2. Public access to prehospital emergency medical services.
3. A statewide network of trauma centers that provide trauma care and to which trauma patients can be transported.
4. A trauma center designation and dedesignation process for health care institutions that provide trauma care. The department may adopt rules that:
(a) Allow for designation based on:
(i) A health care institution s verification as a trauma facility by a national verification organization.
(ii) A determination by a national verification organization that a health care institution meets the state standards established by rule for designation as a trauma center.
(iii) A determination by the department that a health care institution meets the state standards established by rule for designation as a trauma center.
(b) Require that trauma centers submit data to the trauma registry.
5. Trauma system evaluation and quality review through the collection and analysis of data.
6. Protection of confidential patient care and trauma registry information.
B. For the purposes of this section:
1. " National verification organization"  means the American college of surgeons committee on trauma or other nationally recognized organization that verifies the ability of health care institutions to provide trauma services at various levels.
2. " Trauma center"  means a health care institution that is designated pursuant to rules adopted by the department to provide a specific level of trauma care.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2226 - Emergency administration of epinephrine by Good Samaritans; exemption from civil liability

36-2226.
Emergency administration of epinephrine by Good Samaritans;  exemption from civil liability
A. Notwithstanding any other law,  a person may administer epinephrine to another person who is suffering from a severe allergic reaction if the person acts in good faith and without compensation for the act of administering the epinephrine and a health professional who is qualified to administer epinephrine is not immediately available.
B. A person who administers epinephrine pursuant to subsection A is not subject to civil liability for any injury that results from that act unless the person acts with gross negligence,  wilful misconduct or intentional wrongdoing.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2226.02 - Administration of epinephrine; immunity; definitions

36-2226.02.
Administration of epinephrine;  immunity;  definitions
A. A first responder who is trained in administering epinephrine injections may administer an epinephrine injection to a person who the first responder believes in good faith is experiencing anaphylaxis pursuant to a standing order issued by any of the following:
1. A physician licensed pursuant to title 32,  chapter 13 or 17.
2. A naturopathic physician licensed pursuant to title 32,  chapter 14.
3. A physician assistant licensed pursuant to title 32,  chapter 25.
4. A nurse practitioner licensed pursuant to title 32,  chapter 15 who is authorized by law to prescribe drugs.
B. The following individuals are immune from professional liability and criminal prosecution for any decision made,  act or omission or injury that results from that act if the person acts with reasonable care and in good faith,  except in cases of wanton or wilful neglect:
1. Physicians who are licensed pursuant to title 32,  chapter 13 or 17 and who issue a standing order.
2. Naturopathic physicians who are licensed pursuant to title 32,  chapter 14 and who issue a standing order.
3. Physician assistants who are licensed pursuant to title 32,  chapter 25 and who issue a standing order.
4. Nurse practitioners who are licensed pursuant to title 32,  chapter 15 and authorized by law to prescribe drugs and who issue a standing order.
5. First responders who administer epinephrine injections pursuant to this section.
C. This section does not create a duty to act or standard of care for a first responder to administer an epinephrine injection.
D. For the purposes of this section:
1. " Ambulance attendant"  means either of the following:
(a) An emergency medical technician,  an advanced emergency medical technician,  an emergency medical technician I-99 or a paramedic whose primary responsibility is the care of patients in an ambulance and who meets the standards and criteria adopted pursuant to section 36-2204.
(b) An emergency medical responder who is employed by an ambulance service operating under section 36-2202 and whose primary responsibility is the driving of an ambulance.
2. " First responder"  means a law enforcement officer,  a firefighter or an ambulance attendant.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2227 - Informal interviews; request for information; nondissemination; violation; classification

36-2227.
Informal interviews;  request for information;  nondissemination;  violation;  classification
A. At least thirty days before the date of an informal interview held pursuant to this article or article 2 of this chapter,  the department shall notify a person who is under investigation,  or that person's designee,  that the person or designee may submit a written request with the department at least ten business days before that interview that the department provide the following before the interview:
1. Except as provided pursuant to section 41-1010,  the name of the person making the complaint.
2. Except as prohibited by state and federal privacy or confidentiality laws,  any documents received by the department,  in any format or medium,  that are relevant to the investigation,  including:
(a) Records obtained by the department from first responders,  emergency medical care technicians or other health care providers.
(b) Witness statements or summaries.
(c) Patient records.
B. The department shall redact any information provided pursuant to subsection A of this section necessary to protect the personal identifying information of a patient.
C. A person who receives information pursuant to subsection A of this section may not copy,  share or otherwise disseminate that information except as needed to participate in the informal interview or in an administrative proceeding or appeal arising from the investigation. A person who violates this subsection is guilty of a class 3 misdemeanor.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2228 - Administration of opioid antagonists; training; immunity; designation by director; definition

36-2228.
Administration of opioid antagonists;  training;  immunity;  designation by director;  definition
A. Pursuant to a standing order issued by a physician licensed pursuant to title 32,  chapter 13 or 17 or a nurse practitioner licensed pursuant to title 32,  chapter 15 and authorized by law to prescribe drugs,  an emergency medical care technician,  peace officer or ancillary law enforcement employee who is trained in the administration of naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration and designated by the director may administer naloxone hydrochloride or another opioid antagonist to a person who the emergency medical care technician,  peace officer or ancillary law enforcement employee believes is suffering from an opioid-related drug overdose.
B. The department,  in coordination with the Arizona peace officer standards and training board,  shall develop a training module for emergency medical care technicians,  peace officers and ancillary law enforcement employees that provides training regarding the identification of a person suffering from an opioid-related drug overdose and the use of naloxone hydrochloride or other opioid antagonists.
C. Physicians who are licensed pursuant to title 32,  chapter 13 or 17 and who issue a standing order,  nurse practitioners who are licensed pursuant to title 32,  chapter 15 and authorized by law to prescribe drugs and who issue a standing order and emergency medical care technicians,  peace officers and ancillary law enforcement employees who administer naloxone hydrochloride or any other opioid antagonist pursuant to this section are immune from professional liability and criminal prosecution for any decision made,  act or omission or injury that results from that act if those persons act with reasonable care and in good faith,  except in cases of wanton or wilful neglect. This section does not create a duty to act or standard of care for peace officers or ancillary law enforcement employees to administer an opioid antagonist.
D. The director shall designate opioid antagonists that may be used pursuant to this section based on an evaluation of the opioid antagonist's safety and efficacy.
E. For the purposes of this section,  " ancillary law enforcement employee"  means a detention officer,  a probation or surveillance officer,  a police aide or assistant,  a crime scene specialist,  a crime laboratory employee or any other type of law enforcement employee or employee of the state department of corrections who is authorized by the person's employing agency to administer naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration and designated by the director pursuant to this section.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2234.01 - Certificate of necessity; amendment; interfacility transport; definitions

36-2234.01.
Certificate of necessity;  amendment;  interfacility transport;  definitions
A. A city or town that has a licensed health care institution within its jurisdictional boundaries and that operates an ambulance service may apply to amend its certificate of necessity pursuant to this article to provide interfacility transports in lieu of transports by a peace officer as authorized by section 36-503.02.
B. In addition to any other information required by the department,  a city or town must include the following information with the application to amend its certificate of necessity pursuant to subsection A of this section for the purposes of providing interfacility transports:
1. The number of interfacility transports made by peace officers in the applicant city or town from health care institutions to evaluation agencies or mental health treatment agencies in the preceding two years.
2. The projected call volume in the next year for the applicant city or town for interfacility transports to be made in lieu of peace officer transports from health care institutions to evaluation agencies or mental health treatment agencies.
C. For the purposes of this section:
1. " Evaluation agency"  has the same meaning prescribed in section 36-501.
2. " Interfacility transport"  means the transport of a patient from a licensed health care institution to an evaluation agency or mental health treatment agency as authorized by section 36-503.02.
3. " Mental health treatment agency"  has the same meaning prescribed in section 36-501.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2235 - Terms of certificates of necessity; initial term; renewal

36-2235.
Terms of certificates of necessity;  initial term;  renewal
A. The initial certificate of necessity issued pursuant to section 36-2233 to each ambulance service shall be for a term of one year.
B. On the expiration of a certificate of necessity,  if the holder of the certificate meets all requirements,  applies for a renewal and pays the fees prescribed in section 36-2240,  the director shall renew the certificate for a term of three years without public hearing or waiver unless cause is shown to set a hearing to consider denial or renewal for a shorter term.
C. If the director does not conclude a hearing to show cause within ninety days of the expiration date of the certificate,  the certificate shall be renewed for a period of not less than one year. The term of the certificate shall be extended to three years if the director determines that cause is not established for denial or renewal for a shorter term. For the purposes of this subsection,  " hearing to show cause"  means a hearing ordered by the director pursuant to section 36-2245 to determine if any grounds exist to prevent an ambulance service from carrying out the provisions of subsection B of this section during the current term of the certificate.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2236 - Nature of certificates of necessity; transfer; suspension; service area

36-2236.
Nature of certificates of necessity;  transfer;  suspension;  service area
A. A certificate of necessity issued pursuant to this article is not a franchise,  may be revoked by the director and does not confer a property right on its holder.
B. A certificate of necessity shall not be assigned or otherwise transferred without the written approval of the director. When any certificate is assigned or transferred,  the director shall issue to the assignee or transferee a new certificate that is valid only for the unexpired term of the transferred or assigned certificate.
C. In case of emergency,  the director may suspend a certificate of necessity as provided in section 36-2234.
D. If a certificate of necessity issued pursuant to this article is issued to a city,  town,  fire district,  fire authority or other political subdivision of this state,  the service area shall be all the geographic area lying within the jurisdictional boundaries of the city,  town,  fire district,  fire authority or political subdivision,  unless the certificate issued by the director specifically excludes a portion of the city,  town,  fire district,  fire authority or political subdivision or includes an additional service area outside the jurisdictional boundaries of the city,  town,  fire district,  fire authority or other political subdivision. If the jurisdictional boundaries of a city,  town,  fire district,  fire authority or other political subdivision expand,  the service area in the certificate of necessity expands to reflect those jurisdictional boundaries,  except as prescribed in section 36-2233,  subsection I,  paragraph 2. This subsection does not affect the validity of any previously granted certificate for an unincorporated area lying within the boundaries of a city.
E. If the population of a service area changes by ten percent or more based on the most recent decennial census or five-year census estimate,  the department must conduct a review to determine whether adjustments must be made to the response times in the service area,  taking into consideration the impact on rates and charges.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2237 - Required insurance, financial responsibility or bond; revocation for failure to comply

36-2237.
Required insurance,  financial responsibility or bond;  revocation for failure to comply
A. The director shall not issue a certificate of necessity to an ambulance service unless the service has filed with the department a certificate of insurance or other evidence of financial responsibility in an amount the director deems necessary to adequately protect the interests of the public. The liability insurance shall bind the insurer to pay compensation for injuries to persons and for loss or damage to property resulting from the negligent operation of the ambulance service.
B. If an application for a certificate of necessity includes any type of subscription service contract and,  in the director's discretion,  a surety bond is necessary pursuant to section 36-2232,  the director shall not issue a certificate of necessity until the applicant has filed a surety bond with the director in the form and amount determined by him on which bond the applicant is the principal obligor and this state is the obligee. The director shall approve the bond and the bond must be with a surety company authorized to transact business in this state as surety on the bond. The bond must be conditioned on the payment by the applicant to any subscribers that may be parties to any type of subscription service contract.
C. The director shall fix the total amount of the bond required and the director may increase or decrease the bond amount subject to criteria adopted by rule and regulation.
D. The director shall revoke the certificate of necessity of any ambulance service which fails to comply with this section.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2238 - Termination of service under certificate of necessity

36-2238.
Termination of service under certificate of necessity
An ambulance service which is authorized to operate under any certificate of necessity issued pursuant to this article shall not abandon or discontinue any service to any portion of the service area established under the certificate without an order from the department,  unless the certificate has expired,  becomes invalid or is suspended or revoked.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2240 - Fees

36-2240.
Fees
Fees not to exceed the following amounts shall be paid by the owner of an ambulance service to the department for deposit in the state general fund to be available for legislative appropriation in order to carry out the provisions of this chapter:
1. One hundred dollars upon filing an application for a certificate of necessity.
2. Fifty dollars upon filing an application to amend,  transfer or renew a certificate of necessity.
3. For the issuance of an initial certificate of necessity,  two hundred dollars for each ambulance proposed to be operated by the ambulance service to which the certificate is granted.
4. An annual regulatory fee of two hundred dollars for each ambulance issued a certificate of registration pursuant to section 36-2212,  to be collected at the same time as the certificate of registration fee imposed by section 36-2212.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2241 - Required records; inspection by the department

36-2241.
Required records;  inspection by the department
A. Pursuant to rules adopted by the director,  an owner of an ambulance service shall maintain and keep within this state reasonable records,  books and other data the director requires to enforce the provisions of this article. These records,  books and other data shall not be destroyed for a period of three years after they are recorded. The records,  books and other data shall be open to inspection by the department during reasonable office hours if the department is conducting an investigation into the operation of an ambulance service pursuant to section 36-2245.
B. If the director is holding a public rate increase hearing pursuant to section 36-2234,  the department may inspect the records,  books and other data to verify the truth and accuracy of these documents. The department shall conduct the inspection of these documents for a rate increase hearing only during reasonable office hours and only after giving the service at least one working day's notice.
C. If an audit is required,  the department shall accept a certified audit that is performed by an independent auditor at the provider's expense in place of a department audit if the audit:
1. Is conducted in accordance with generally accepted auditing standards.
2. Includes findings regarding the ambulance service's compliance with the schedule of rates and charges approved by the director.
3. Is completed and forwarded to the department in a timely manner.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2242 - Temporary authority to operate in urgent circumstances; application; application to provide permanent service

36-2242.
Temporary authority to operate in urgent circumstances;  application;  application to provide permanent service
A. If the director determines that there is an immediate and urgent need for service to one or more points or within an area lacking adequate ambulance service,  the director may,  at the director's discretion and without a hearing or other proceeding,  grant an ambulance service,  fire department,  fire district or fire authority temporary authority to provide the needed service. The temporary authority is valid for the period specified by the director,  not to exceed ninety days,  and may be extended for one additional ninety-day period.
B. An applicant for temporary authority pursuant to this section shall submit to the director a verified written statement setting forth the circumstances of the immediate and urgent need for service. The applicant must demonstrate that the service provided under the temporary authority will be in appropriately equipped vehicles designed for patient transport and staffed with appropriately certified personnel for patient care. The director shall prescribe a temporary schedule of rates and charges that do not exceed rates and charges established by the director for similar services.
C. The department may make an independent investigation to determine whether there is an immediate and urgent need for the authority requested.
D. During the period of temporary authority,  a person granted temporary authority shall file an application for a certificate of necessity to conduct the service if the person intends to continue the service after the temporary authority expires. A grant of temporary authority pursuant to this section does not create a presumption that permanent authority for the service should be granted.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2246 - Fire districts; rural ambulance services; request for information; format

36-2246.
Fire districts;  rural ambulance services;  request for information;  format
A. The department shall implement a format to govern its requests for information from each fire district that holds a certificate of necessity to operate an ambulance service under this chapter that substantially conforms to the annual report prescribed by section 48-251.
B. The department's request for financial information from each fire district that holds a certificate of necessity to operate an ambulance service under this chapter shall substantially conform to the accounting method prescribed by section 48-251.
C. The department's request for information from each rural ambulance service that holds a certificate of necessity under this chapter shall include the minimum information the department requires under section 36-2232,  subsection A,  paragraphs 7 and 8.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2247 - Certificates of necessity; ambulance services; name change

36-2247.
Certificates of necessity;  ambulance services;  name change
At least thirty days before the date an ambulance service changes its legal name,  the ambulance service shall send the department written notice of the name change. Within thirty days after the date of receiving the notice,  the department shall issue an amended certificate of necessity that incorporates the name change but retains the expiration date of the current certificate of necessity.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2261 - Definitions

36-2261.
Definitions
In this article,  unless the context otherwise requires:
1. " Automated external defibrillator"  means a medical device heart monitor and defibrillator that:
(a) Is approved for premarket modification by the United States food and drug administration pursuant to 21 United States Code section 360(k).
(b) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia and is capable of determining,  without intervention by an operator,  if defibrillation should be performed.
(c) Automatically charges and delivers an electrical impulse to a person's heart when it determines that defibrillation should be performed.
2. " Defibrillation"  means the administration of a controlled electrical charge to the heart to restore a viable cardiac rhythm.
3. " Physician"  means a physician who is licensed pursuant to title 32,  chapter 13 or 17,  and who provides medical oversight services pursuant to section 36-2262.
4. " Trained user"  means a person who is the expected user of an automated external defibrillator and who has completed training in its use.
5. " Training"  means a state approved course in cardiopulmonary resuscitation and the use of an automated external defibrillator for the lay rescuer and first responder,  including the course adopted by the American heart association and in effect as of December 31,  1998.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2262 - Automated external defibrillators; use; requirements

36-2262.
Automated external defibrillators;  use;  requirements
Except as provided in section 36-2264,  a person or entity that acquires an automated external defibrillator shall:
1. Enter into an agreement with a physician who shall oversee the aspects of public access to defibrillation.
2. Require each trained user who uses an automated external defibrillator on a person in cardiac arrest to
call telephone number 911 as soon as possible.
3. Submit a written report to the bureau of emergency medical services and trauma systems in the department of health services within five working days after its use.
4. Ensure that the automated external defibrillator is maintained in good working order and tested according to the manufacturer's guidelines.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2263 - Civil liability; limited immunity; Good Samaritan

36-2263.
Civil liability;  limited immunity;  Good Samaritan
A. The following persons and entities are not subject to civil liability for any personal injury that results from any act or omission that does not amount to wilful misconduct or gross negligence:
1. A physician who provides oversight.
2. A person or entity that provides training in cardiopulmonary resuscitation and use of an automated external defibrillator.
3. A person or entity that acquires an automated external defibrillator pursuant to this article.
4. The owner of the property or facility where the automated external defibrillator is located.
5. A person or entity that provides the automated external defibrillator pursuant to this article.
6. A nonprofit entity that,  in the placement of an automated external defibrillator pursuant to this article,  acts as an intermediary between the provider of an automated external defibrillator and the person or entity that acquired the automated external defibrillator or the owner of the property or facility where the automated external defibrillator is located.
7. A Good Samaritan. For the purposes of this paragraph,  " Good Samaritan"  means a person who uses an automated external defibrillator to render emergency care or assistance in good faith and without compensation at the scene of any accident,  fire or other life-threatening emergency.
8. A trained user.
B. The exception from civil liability provided in subsection A does not affect a manufacturer's product liability regarding the design,  manufacturing or instructions for use and maintenance of an automated external defibrillator.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2264 - Exemption from regulation

36-2264.
Exemption from regulation
A. A person who obtains an automated external defibrillator for home use pursuant to a physician's prescription is exempt from the requirements of this article.
B. A person who is employed as a firefighter,  emergency medical care technician or ambulance attendant by a fire district established pursuant to title 48,  chapter 5 is exempt from the requirements of this article.
C. A person who is employed as a firefighter,  emergency medical care technician or ambulance attendant by a public or private fire department or an ambulance service regulated by this chapter is exempt from the requirements of this article.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2266 - Prescribing and dispensing; immunity; definition

36-2266.
Prescribing and dispensing;  immunity;  definition
A. A physician who is licensed pursuant to title 32,  chapter 13 or 17,  a nurse practitioner licensed pursuant to title 32,  chapter 15 and authorized by law to prescribe drugs or any other health professional who has prescribing authority and who is acting within the health professional's scope of practice may prescribe or dispense,  directly or by a standing order,  naloxone hydrochloride or any other opioid antagonist that is approved by the United States food and drug administration for use according to the protocol specified by the physician,  nurse practitioner or other health professional to a person who is at risk of experiencing an opioid-related overdose,  to a family member of that person,  to a community organization that provides services to persons who are at risk of an opioid-related overdose or to any other person who is in a position to assist a person who is at risk of experiencing an opioid-related overdose.
B. A physician,  nurse practitioner or other health professional who prescribes or dispenses naloxone hydrochloride or any other opioid antagonist pursuant to subsection A of this section shall instruct the individual to whom the opioid antagonist is dispensed to summon emergency services as soon as practicable,  either before or after administering the opioid antagonist.
C. Except in cases of gross negligence,  wilful misconduct or intentional wrongdoing,  a physician,  nurse practitioner or other health professional who in good faith prescribes or dispenses an opioid antagonist pursuant to subsection A of this section is immune from professional liability and criminal prosecution for any decision made,  act or omission or injury that results from that act if the physician,  nurse practitioner or other health professional acts with reasonable care and in good faith.
D. For the purposes of this section,  " person"  includes an employee of a school district or charter school who is acting in the person's official capacity.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2267 - Administration of opioid antagonist; exemption from civil liability; definition

36-2267.
Administration of opioid antagonist;  exemption from civil liability;  definition
A. A person may administer an opioid antagonist that is prescribed or dispensed pursuant to section 32-1979 or 36-2266 in accordance with the protocol specified by the physician,  nurse practitioner,  pharmacist or other health professional or that is received from a county health department pursuant to section 36-192 to a person who is experiencing an opioid-related overdose.
B. A person who in good faith and without compensation administers an opioid antagonist to a person who is experiencing an opioid-related overdose is not liable for any civil or other damages as the result of any act or omission by the person rendering the care or as the result of any act or failure to act to arrange for further medical treatment or care for the person experiencing the overdose,  unless the person while rendering the care acts with gross negligence,  wilful misconduct or intentional wrongdoing.
C. For the purposes of this section,  " person"  includes an employee of a school district or charter school who is acting in the person's official capacity.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2271 - Consent of parents required for surgical procedures upon minor; exception; classification

36-2271.
Consent of parents required for surgical procedures upon minor;  exception;  classification
A. Except as otherwise provided by law,  no person,  corporation,  association,  organization,  state-supported institution,  or individual employed by any of same may procure,  solicit to perform,  arrange for the performance of,  or perform surgical procedures upon a minor without first obtaining a written consent of a parent or legal guardian of the minor.
B. No health care institution as defined in section 36-401 may permit surgical procedures to be performed upon a minor in its facilities without first having received a written consent from a parent or legal guardian of the minor.
C. The provisions of this section shall not apply when it has been determined by a physician that an emergency exists and that it is necessary to perform such surgical procedures for the treatment of a serious disease,  injury or drug abuse,  or to save the life of the patient,  or when such parent or legal guardian cannot be located or contacted after reasonably diligent effort.
D. A person who violates a provision of this section is guilty of a class 1 misdemeanor.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2272 - Consent of parent required for mental health screening or treatment of minors; exception; violation; classification; definition

36-2272.
Consent of parent required for mental health screening or treatment of minors;  exception;  violation;  classification;  definition
A. Except as otherwise provided by law or a court order,  no person,  corporation,  association,  organization or state-supported institution,  or any individual employed by any of these entities,  may procure,  solicit to perform,  arrange for the performance of or perform mental health screening in a nonclinical setting or mental health treatment on a minor without first obtaining the written or oral consent of a parent or a legal custodian of the minor child. If the parental consent is given through telehealth,  the health professional must verify the parent's identity at the site where the consent is given.
B. This section does not apply when an emergency exists that requires a person to perform mental health screening or provide mental health treatment to prevent serious injury to or save the life of a minor child.
C. A person who violates this section is guilty of a class 1 misdemeanor.
D. For the purposes of this section,  " parent"  means the parent or legal guardian of a minor child.