Subchapter 6 Ambulance Services
A. No person, either as owner, agent, or otherwise shall furnish, operate, conduct, maintain, advertise, or otherwise be engaged
in or profess to be engaged in ambulance service in the state without holding a valid ambulance service license issued pursuant
to these regulations.
B. No ambulance shall be operated for ambulance services and no individual shall drive, ride in, or permit it to be operated for such
purposes in the state unless it is operated under a valid ambulance service license and staffed at least by 2 primary crew
C. This section does not apply to:
1. The operation of a fire department rescue vehicle with minimum staffing required when it is used during a period of
non-availability of an ambulance.
2. The operation of any vehicle, when, during a period of non-availability of an ambulance or when, under conditions
making a patient inaccessible to an ambulance, the vehicle is used for the extrication or transportation of a patient.
3. Assistance rendered to a licensed ambulance service or certified BLS or ALS personnel in the case of
a. A major catastrophe or disaster beyond the capabilities of the available licensed ambulance services; or
b. An emergency declared by the director to ensure that patient transportation services are not interrupted or
seriously deficient. (4) Ambulance service insufficiency in areas in regard to sufficient emergency ambulance calls
to support full staffing of conforming ambulances and equipment as determined by the director. Exceptions under
this paragraph may be granted by the director after full consideration of written and oral submissions respecting
the proposed exception.
[Eff. AUG 12 1985] (Auth: HRS §§321-223, 321-224, 321-227, 321-228, 321-233) (Imp: HRS §§321-224 321-233)
A. Applications for an ambulance service license shall be made upon forms, prepared and prescribed by the director.
B. Each application for an ambulance service license shall be accompanied by a nonrefundable fee of $10.
[Eff. AUG 12 1985] (Auth: HRS §§321-223, 321-224, 321-227, 321-228, 321-233)
(Imp: HRS §§321-223, 321-224, 321-227, 321-233)
A. Each licensed ambulance service ambulance shall, at all times when in, use as such:
- Be suitable for the transportation of patients with respect to health, sanitation, and safety;
- In the case of ground motor ambulance, conform to the document entitled Motor Vehicle Ambulance Design and Performance Standards, dated July 15, 1985 and available from the department. In the case of aircraft, conform to the document entitled Essential Equipment and Requirements for Air Ambulance Services, dated July 15, 1985 and available from the department;
- Have a state-licensed physician medical director and be staffed by primary crew members;
- Contain equipment conforming with the standards, requirements, and regulations prescribed in Section 11-71-55;
- Conform with all applicable laws relating to health, sanitation, and safety;
- Be maintained in suitable premises with facilities for washing and disinfecting equipment; handling linen and supplies; storing supplies in a clean, dry location; storing personal effects and maintaining cleanliness and orderliness of premises, and disposing of wastes in an acceptable manner.
B. An ambulance service shall notify the director of any change of ownership of an ambulance within ten working days after the
sale or other transfer of ownership.
C. Any additional or replacement ambulance acquired by an ambulance service shall conform with all the requirements applicable
upon original licensing.
D. Each ambulance service, ambulance, equipment, and the premises designated in the application, and the following records
relating to maintenance and operation shall be open to inspection by the director or his designee during usual hours of
- Personnel records of each ambulance service employee, including evidence of certification required in Hawaii Revised Statutes Sections 453- 31 to 453-32, and Administrative Rules 16-85-53 to 16-85-56;
- Vehicle records for each .ambulance, including preventative and corrective maintenance records, vehicle registration records, and records of department of transportation vehicle safety inspections;
- Records of ambulance service activity; trip records, patient care reports as specified in Section 11-72-22;
- Written policies and procedures, including a copy of these regulations, which provide to its employees guidelines for operating and maintaining the service and ambulances.
E. No official entry made upon a license may be defaced, removed, or obliterated.
F. No person, either as owner, agent or otherwise, shall advertise or profess to be engaged in ambulance service in the state
unless that person possesses a valid ambulance license, and all information contained in such advertisements, signs or
other publicity is accurate and does not mislead or result in misrepresentation to the public.
[Eff. AUG 12 1985 ] (Auth: HRS §§321-223, 321-224, 321-226, 321-227, 321-228, 321-233)
(Imp: HRS §§ 321-223, 321-224, 321-226, 321-227, 321-228, 321-233)
A. No ambulance shall be operated in the State of Hawaii unless there is at all times in force and in effect insurance coverage,
issued by an insurance company licensed to do business in the State of Hawaii, for each and every ambulance owned or
operated by or for the applicant licensee providing for the payment of benefits and including, but not limited to, the following:
1. No-fault insurance policy (motor vehicle):
a. No-fault benefits, as defined in Chapter 294-2, Hawaii Revised Statutes with respect to any accidental harm
arising out of a motor vehicle accident.
b. Liability coverage for all damages arising out of bodily injury to or death of any one person as a result of any one
motor vehicle accident.
c. Liability coverage for all damages arising out of injury to or destruction of property, including motor vehicles and
including the loss of use thereof, as a result of any one motor vehicle accident.
2. Professional or Occupational Liability or Bodily Injury Insurance ( other than motor vehicle) in an amount of not less
than that specified by the director.
B. The insurance policies required by this section shall be submitted to the director for approval prior to the issuance of the
ambulance service license.
[Eff. AUG 12 1985] (Auth: HRS §§321-223, 321-224, 321-226, 321- 227, 321-228, 321-233)
(Imp: HRS §§321-223, 321-224, 321-226,321-227)
A. Within thirty days after receipt of an application for an ambulance service license, an investigation will be made of the applicant
and the proposed operations;
B. Prior to issuance or denial of an ambulance service license, an inspection will be made of the ambulances, equipment and
supplies, and premises designated in the application;
C. A non-transferable license or denial of the application will be issued not later than sixty days of receipt of an application; each
license issued to an ambulance service shall specify the ambulances authorized to be operated under the license and shall be
valid for a period of one year unless earlier amended, suspended, revoked, or terminated;
D. The ambulance service license not shall be transferable nor assignable;
E. A license will be issued upon receipt of an initial licensing fee of $ 25 after finding that:
1. When required under Chapter 323D, Hawaii Revised Statutes, finding that a certificate of need has been issued.
2. Each such ambulance and its required equipment and the premises designated in the application meet the standards of
3. Only state certified drivers, basic life support personnel, advanced life support personnel, and prehospital registered nurses
are employed in such capacities; and
4. All the requirements of these regulations and all other applicable laws and ordinances have been met.
F. Subsequent to issuance of an ambulance service license, an inspection shall be made of each ambulance authorized under the
license and of equipment and premises at least annually and immediately following any disabling vehicular collision and
subsequent repair in which an ambulance is involved.
G. Within sixty days a copy of each initial, periodic, or other investigation and inspection report will be transmitted to the applicant
or ambulance service to whom it refers.
[Eff. AUG 12 1985] (Auth: HRS §§ 321-223, 321-224, 321-226, 321-227, 321-228, 321-233)
(Imp: HRS §§321-223, 211-224, 321-226, 321-227)
A. Annual renewal of an ambulance service license shall be obtained prior to expiration.
B. The annual renewal fee for a license that has not expired or been suspended or revoked shall be $20.
C. The annual renewal fee for a license that has expired for one to fifty- nine days shall be $25.
[Eff. AUG 12 1985] (Auth: HRS §§321-223, 321-224, 321-226, 321-227, 321-228, 321-233)
(Imp: HRS §§321-223, 321-224, 321-226, 321-227, 321-233)
A. The director may suspend or revoke an ambulance service license for failure of a licensee to comply and to maintain
compliance with, or for violation of, an applicable provision, standard, or requirement of these regulations or of any other
applicable law or ordinance or regulation promulgated thereunder, but only in compliance with the procedures and
requirements of Chapter 91, Hawaii Revised Statutes.
B. Upon suspension, revocation, or termination of an ambulance service license the ambulance service shall cease operations as
such and no person shall permit the ambulance service to continue operations.
[Eff. AUG 12 1985] (Auth: HRS §§321-223, 321-224, 321-226, 321-227, 321-233)
(Imp: HRS §§ 321-223, 321-224, 321-226, 321-227, 321-233)