N.J. Admin. Code § 8:40-2.1

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:40-2.1 - Application for licensure

(a) Any person, public or private institution, agency, entity, corporation, general hospital or business concern seeking to be licensed to operate an MAV or BLS ambulance service shall:

1. Fully complete an OEMS application for licensure, listing the name(s), home addresses and telephone numbers of all persons with an ownership interest in the proposed service. Applications may be obtained from OEMS at PO Box 360, Trenton, NJ 08625. However, applicants that are publicly held corporations need only list the person, corporation and/or entity with the controlling interest and those persons, corporations and/or entities holding five percent or more of the available shares of the corporation;

i. Incomplete applications shall not be processed and shall be returned to the applicant with no action taken. Incomplete applications may be completed and returned to the Department within six months from the date on which the application was returned to the applicant without the requirement of a second application fee. Once an applicant has been notified that the application is complete, the applicant shall have six months within which to request an initial provider audit and vehicle inspections. Failure to comply with these time frames shall require submission of a new application and fee;

ii. No application shall be processed if the proposed trade name of the service duplicates or is essentially similar to a licensed service's trade name or the proposed trade name of an applicant that has an application pending before the Department;

2. Provide the Department with the specific street address of the principal place of business of the proposed service. The principal place of business shall be located on an actual piece of real property and shall not be a post office box or mail drop. Applications listing a post office box or mail drop as the principal place of business shall be rejected;

3. Provide the Department with a copy of the standard operating procedures (SOP) manual, which addresses all of the areas identified at 8:40-3.5. No provider shall develop policies that are contrary to any applicable law, rule and/or regulation;

4. Demonstrate that it maintains crewmember personnel files that meet the standards set forth at 8:40-3.8;

5. Demonstrate that, except as provided in (a)5i below, it shall have at least one licensable vehicle in each class of service for which it is applying for licensure;

i. Consistent with 8:40-6.15(e)1, an applicant seeking licensure as a BLS ambulance service providing emergency response shall demonstrate that it shall have at least two licensable BLS ambulances, one of which shall be maintained as a back-up BLS ambulance;

6. Provide the Department with proof that insurance has been purchased and is in force, as outlined at 8:40-3.3;

7. Provide the Department with a signed "Request For Criminal History Record Information For A Noncriminal Justice Purpose" (SBI 212B Form), for submission by OEMS to the New Jersey State Police, State Bureau of Identification. The form shall be accompanied by payment in the form and amount specified at N.J.A.C. 13:59, as amended and supplemented;

i. A separate form must be submitted for each person with an ownership interest of five percent or more;

ii. General hospitals and governmental entities (such as municipalities and State agencies) shall be exempt from this requirement; and

8. Provide the Department with a copy of valid incorporation papers and a valid government issued photo I.D. (for example, a passport or a State-issued driver's license) that can be utilized to verify the applicant's identity.

(b) The ownership of any public or private institution, agency, entity, corporation or business concern applying for licensure shall be disclosed to the Department at the time of application. One hundred percent of the company's ownership shall be disclosed, indicating each entity's address and percentage of ownership. Proof of ownership shall be made available to Department staff upon demand.

1. Publicly held corporations (that is, corporations whose stock is publicly traded) shall list the person, corporation and/or entity with the controlling interest, as well as all persons, corporations and/or entities owning five percent or more of the shares of the corporation.

(c) An applicant shall not knowingly file any record or document that is falsified, fraudulent or untrue. The filing of such false records or documents shall be sufficient cause for refusal to issue or renew a license and/or revocation of any existing provider and/or vehicle licenses.

N.J. Admin. Code § 8:40-2.1