Ariz. Admin. Code § R9-25-904 - Transfer of a Certificate of Necessity (Authorized by A.R.S. Sections 36-2232, 36-2233, 36-2236(A) and (B), 36-2238)

A. A certificate holder shall request that a certificate of necessity be transferred if:

1. There is an anticipated change of ownership, which is considered to occur when:

a. In the case of ownership by a sole proprietor, 20% or more interest or a beneficial interest is sold or transferred;

b. In the case of ownership by a partnership or a private corporation, 20% or more of the stock, interest, or beneficial interest is sold or transferred; or

c. The controlling influence changes to the extent that the management and control of the ground ambulance service is significantly altered, as determined according to subsection (B);

2. The certificate holder and another certificate holder plan to execute a ground ambulance service contract for the provision of ambulance response or transport by one of the certificate holder's ground ambulance service in a portion of the other certificate holder's service area, except as part of a backup agreement; or

3. There is a change in the type of business organization.

B. The Department shall consider the following when determining whether a controlling influence in the ground ambulance service is changing to the extent that the management and control of the ground ambulance service has altered significantly:

1. Whether there has been or will be a change in who manages or controls the day-to-day operations of one or more ground ambulance vehicles operated by the ground ambulance service, including whether the certificate holder has entered into or intends to enter into a contract or an agreement with another person or entity to supervise or manage all or a part of the ground ambulance service;

2. Whether there has been or will be a change in who manages or controls staffing and personnel decisions for one or more ground ambulance vehicles operated by the ground ambulance service;

3. Whether there has been or will be a change in the operating policies and procedures for one or more ground ambulance vehicles operated by the ground ambulance service;

4. Whether there has been or will be a change in who pays the operating expenses or who receives the operating revenue;

5. Whether there has been or will be a change in the policy holder on the insurance coverage of one or more ground ambulance vehicles operated by the ground ambulance service;

6. Whether there has been or will be a change in ownership, management, or control of the supplies, equipment, and materials for one or more ground ambulance vehicles operated by the ground ambulance service;

7. Whether there has been or will be a change in the risk or liability attendant to the operation of one or more ground ambulance vehicles operated by the ground ambulance service;

8. Whether there has been or will be a change in who manages or controls the strategic or long-term planning of the ground ambulance service;

9. Whether the certificate holder has changed or intends to change affiliations, such as a parent company or a subsidiary owned or operated by the certificate holder, from that specified according to R9-25-902(A)(1)(d); and

10. Other information related to the management and control of the ground ambulance service that the Department deems relevant.

C. When requesting a transfer of a certificate of necessity:

1. A certificate holder wanting to transfer the certificate of necessity shall submit the following information to the Department in a written format:

a. The name and certificate of necessity number of the certificate holder;

b. A request that the certificate of necessity be transferred, including the rationale for the transfer;

c. Whether the transfer is due to a change of ownership or to a change in the type of business organization; and

d. If the transfer is due to a change of ownership, the name of the person to whom the certificate of necessity is to be transferred; and

2. The person identified in subsection (C)(1)(d) or the individual acting according to R9-25-102 for the new type of business organization shall submit to the Department:

a. The information and documents specified in R9-25-902(A)(1), (3) through (7), (9) through (12), (15) through (18), and (22) through (29);

b. The $50 application filing fee for a transfer of a certificate of necessity, as required under A.R.S. § 36-2240(3); and

c. A description of any planned amendments to the certificate of necessity during the next 12 months.

D. In deciding whether to transfer a certificate of necessity is in the public's best interest, the Director shall consider the following:

1. The information required in subsections (C)(2)(a) and (c);

2. Whether the person specified according to subsection (C)(1)(d) is fit and proper;

3. Whether there is a public need for the transfer to take place:

a. Based on a possible gap in service or unmet needs in the service area; and

b. To ensure consistent service provision, efficiency, cost-effectiveness, and the health and safety of individuals in the service area;

4. Whether the person specified according to subsection (C)(1)(d) demonstrates the ability to provide quality patient care; and

5. Other matters determined by the Director or the applicant to be relevant to the determination of public necessity.

E. The Department shall approve or deny an application under this Section according to A.R.S. § 36-2233 and Article 12 of this Chapter.

F. If the Department approves an application for a transfer and sends the person in subsection (C)(1)(d) the written notice of approval, specified in R9-25-1201(C)(5), the Department shall issue the certificate of necessity to the person in subsection (C)(1)(d):

1. After the person in subsection (C)(1)(d) has submitted to the Department for each ground ambulance vehicle to be operated by the ground ambulance service:

a. An application for registration of the ground ambulance vehicle that includes all of the information required according to R9-25-1001(B)(1);

b. A copy of a current and valid motor vehicle registration for the ground ambulance vehicle, issued according to A.R.S. Title 28, Chapter 7, Article 2, or similar statutes in another state; and

c. Unless the person in subsection (C)(1)(d) intends to operate the ground ambulance vehicle only as a volunteer not-for-profit service, the following fees for each ground ambulance vehicle to be registered:

i. A $50 registration fee, as required under A.R.S. § 36-2212(D); and

ii. A $200 ambulance operation fee, as required under A.R.S. § 36-2240(3); and

2. When the certificate of registration for the first ground ambulance vehicle to be operated by the ground ambulance service is issued.

G. The Department may deny an application under this Section if an applicant:

1. Fails to comply with any provision in A.R.S. Title 36, Chapter 21.1;

2. Fails to comply with any provision in this Article or Article 2, 10, or 11 of this Chapter;

3. Knowingly or negligently provides false documentation or false or misleading information to the Department; or

4. Fails to submit to the Department documents or information requested under R9-25-1201(B)(1) or (C)(3) and requests a denial as permitted under R9-25-1201(E).

H. If the Department denies the transfer of a certificate of necessity, the certificate holder shall not discontinue service, except as provided in A.R.S. § 36-2238.

Notes

Ariz. Admin. Code § R9-25-904

New Section adopted by final rulemaking at 7 A.A.R. 1098, effective February 13, 2001 (Supp. 01-1). New Section made by final rulemaking at 30 A.A.R. 581, effective 3/7/2024.