Life Support Agency & Vehicle Licensure

Effective January 1st 2020 the EMS Section will No Longer Accept Paper Applications for Agencies and Vehicles

The Division of EMS and Trauma is preparing to roll-out the agency module of the eLicensing system.

The module will enable Life Support Agencies (LSAs) to maintain and renew the agency license and
vehicles online. The individual(s) that will be given system permission to maintain and renew the
agency license and vehicles, must be assigned prior to the roll-out of the agency module on January
1, 2020.

This role in the eLicensing system will be known as an Agency Licensure Administrator. Each agency
must designate the person(s) to be assigned to this role.

The following form has been sent to all agencies, and must be returned before January 1, 2020.

Instructions on how to claim your ImageTrend account can be found here.

Instructions on how to create a ImageTrend account can be found here.

We will be updating the Life Support Agency Licensure and Inspection Manual with application instructions prior to January 1, 2020.

 

 

Verify EMS Agency

 

Forms & Publications

 

All forms and publications are in PDF format unless otherwise noted.  To preview and download the PDF forms, you will need Adobe Acrobat Reader.  If you do not have this program, it can be downloaded from the Adobe website.

 

Medical Waste Registration Memo 8-7-19

 

Ambulance Operation Licensing

Life Support Agency Licensure and Inspection Manual V 1.3

 

PDF Version 1.3 (8/19)

 

Certificate of Insurance for Life Support Agencies

BHS/EMS-0092 (Revision: 2016) 

Ambulance Safety Inspection (Transport ONLY)

BHS/EMS-316 (Revision: 2016) 

Ambulance Safety Inspection - Notarized Statement (Transport ONLY)

BHS/EMS-318 (Revision: 2016) 

Vehicle Operation Course Criteria

BHS/EMS-2007 

Manufacturers Certificate of Compliance (Transport ONLY)

BHS/EMS-314 (Revision: 2016) 

Data Collection Requirements 

 

MI-EMSIS / Data Page

 

Loaner Vehicle Application (New or Extended Loan)

Data Collection Requirement - MI-EMSIS

MI-EMSIS / Data Page

 

BHS/EMS-182 (Revision: 4-30-17)

Medical Waste Information (EGLE, Formerly the DEQ)) Website
   
Michigan Occupational Safety & Health Administration (MIOSHA) Website

CLIA Information

Instructions for obtaining CLIA Waiver     PDF
Michigan Department of Licensing and Regulatory Affairs CLIA  Website

Updated Equipment and Agency Requirements Effective 7-1-19

Items listed under MCA Approved Equipment is only required if included in MCA protocols.

Equipment Changes Memo 4-18-19

Equipment Clarifications Memo 5-2-19

Equipment Changes Spreadsheet 5-1-19

Important Safety Information Regarding Newborn Warming Mattresses 9-16-19

MFR Vehicle Minimum Equipmenmt Requirements    (Updated 9-17-19)

BLS Transport Minimum Equipment Requirements     (Updated 9-17-19)

BLS Non-Transport Minimum Equipment Requirements   (Updated 9-17-19)

LALS Transport Minimum Equipment Requirements    (Updated 9-17-19)

LALS Non-Transport Minimum Equipment Requirements    (Updated 9-17-19)

ALS Transport Minimum Equipment Requirements    (Updated 9-17-19)

ALS Non-Transport Minimum Equipment Requirements    (Updated 9-17-19)

Required Life Support Agency Criteria (Updated 9-4-19)

 

 

 

Miscellaneous Publications

MEDCOM Requirements

MEDCOM (Revision 5/20/19)

Certificate Of Need (CON) Review Standards For Air Ambulance Services

CON Review Standards

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Policy

Life Support Agency Operating at an Increased or Decreased Level of Service    EMS 202

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What are the fees? 

Licensing Fee's for Basic Life Support, Limited Advanced Life Support, and Advanced Life Support Agencies: 

Initial and renewal fee: $100.00 for the Agency License and a $25.00 fee per vehicle 

Late fees are enforced if license is not renewed by the expiration renewal date: $300 for the Agency License and a $100.00 fee per vehicle 

Licensing Fee's for a Medical First Responder Agency: 

No Initial or renewal fees apply. 

Late fees are enforced if license is not renewed by the expiration renewal date: $300 for the Agency and $100.00 fee per vehicle 

Remove or Downgrade a vehicle: 

No fee.

Add, Upgrade, or Replace a vehicle:

$25.00 fee per vehicle 

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What do I need to do to add or remove a vehicle from the Agency license? 

You need to complete form # BHS/EMS-181, Life Support Vehicle Application and submit it to the department.  If the vehicles are for transporting patients, you will also need to complete form # BHS/EMS-314.  If the transporting vehicle is two years from the date of manufacture, then you will also need to complete form # BHS/EMS-316 and BHS/EMS-318. 

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Does my agency have to be available to provide services at all times? 

Yes, all levels of licensed life support agencies need to be available to respond to emergencies 24/7. 

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How often do I have to renew my license? 

Life support agencies renew annually. 

Contact Information

Derek Flory, BAS, EMT-P / IC

Life Support Agency and Vehicle Licensing Coordinator

Phone 517-335-8382 

Fax: 517-335-9434

Email: FloryD@michigan.gov

 

 

MDHHS-EMS Section
Agency/Vehicle Licensing Application
P.O. Box 30437
Lansing, Michigan 48909
Phone: 517-335-8382
Fax: 517-335-9434