OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 28 Bill Analysis
134th General Assembly
Click here for H.B. 28’s Fiscal Note
Version: As Reported by House Health
Primary Sponsor: Rep. Wiggam
Effective Date:
Elizabeth Molnar, Attorney
SUMMARY
 Requires a stretcher van organization to obtain a license from the State Board of
Emergency Medical, Fire, and Transportation Services before providing nonemergency
transportation services to individuals on a stretcher.
 Establishes requirements on the provision of stretcher van services, including by
requiring a stretcher van organization to offer to assist the individual onto and off a
stretcher and with entering or exiting the stretcher van, individual’s place of residence,
or location to which the individual is being transported and, if accepted, to provide such
assistance.
 Requires a stretcher van organization licensed to provide nonemergency transportation
services to possess a permit for each stretcher van owned or leased by the organization.
 Requires the Board to include data regarding stretcher van organization services and
stretcher vans in its annual report submitted to the Governor and General Assembly.
 Modifies certain licensing procedures used by the Board for other medical
transportation services, including provisions that require separate licenses and fees for
organizations that operate in multiple locations.
 This analysis was prepared before the report of the House Health Committee appeared in the House
Journal. Note that the legislative history may be incomplete.
May 31, 2022
Office of Research and Drafting LSC Legislative Budget Office
DETAILED ANALYSIS
License to provide stretcher van services
License requirement
The bill establishes a licensing mechanism for the regulation of nonemergency
transportation services that are provided by stretcher van organizations to individuals on a
stretcher. This mechanism is to be administered by the State Board of Emergency Medical, Fire,
and Transportation Services in the same manner that it regulates other medical transportation
services and vehicles, such as ambulances and ambulettes.1
Stretcher vans and stretcher van organizations
The bill defines “stretcher van” as a motor vehicle specifically designed and equipped to
provide nonemergency transportation to individuals on a stretcher.2
It also defines “stretcher van organization” as a person that does both of the following:
 Provides services to the public on a regular basis for the purpose of transporting
individuals who require the use of a stretcher to receive health care services in
nonemergency situations;
 Provides the services for a fee, regardless of whether the fee is paid by the person being
transported, a third-party payer, or another person or government entity.3
Stretcher van activities not subject to licensure
Under the bill, a health care facility and hospice care program that provides
transportation services with stretcher vans only to their patients are excluded from the bill’s
stretcher van organization definition and, accordingly, are exempt from its licensing
requirements, so long as the facility or program, before transporting a patient using a stretcher
van, notifies and obtains the consent of the patient or patient’s guardian or attorney in fact
under a durable power of attorney.
In addition to the exemptions available to certain health care facilities and hospice care
programs, the bill specifies that its licensing requirements do not apply to the following:
 Any person operating a stretcher van outside of Ohio;
 A stretcher van owned or leased and operated by the federal government.4
1 R.C. Chapter 4766.
2 R.C. 4766.01(Y).
3 R.C. 4766.01(Z).
4 R.C. 4766.09(B) and (D).
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Individuals served by stretcher van organizations
Under the bill, a stretcher van organization may use a stretcher van to provide
transportation to the following:
 An individual who needs transportation to or from a nonemergency medical
appointment or service, including transportation that originates or concludes at the
individual’s place of residence;
 An individual who is convalescent or otherwise nonambulatory;
 An individual who is medically stable and does not require ongoing medical monitoring,
medical aid, medical care, or medical treatment during transport or as a condition of
being transported.5
Provision of stretcher van services – requirements and limitations
The bill requires a stretcher van organization to do all of the following when providing
transportation to any of the foregoing individuals:
 Allow at least one other individual, which may include a family member or caregiver, to
remain in the stretcher van during the period of transport in order to provide support,
assistance, and comfort to the individual in need of transport;
 Offer to assist the individual onto and off a stretcher and with entering or exiting the
stretcher van, individual’s place of residence, or location to which the individual is being
transported and, if the offer is accepted, provide such assistance;
 As soon as practicable, request assistance from an emergency medical service
organization or transport the individual to the nearest hospital in the event the
individual’s medical condition changes during transport and requires medical care.6
The bill prohibits the stretcher van organization from administering oxygen when
transporting an individual. It specifies, however, that the individual or individual’s family
member or caregiver may administer oxygen that is supplied by the individual.
Training in the use of stretchers
The bill requires each stretcher van organization to train its personnel in the use of
stretchers.7
Penalty for unlicensed activity
Under the bill, generally, a person or government entity is prohibited from engaging in
or professing to engage in the business or service of providing nonemergency medical
5 R.C. 4766.18.
6 R.C. 4766.18.
7 R.C. 4766.18.
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transportation services to an individual who requires the use of a stretcher and is not
experiencing a medical emergency without a license.8 Violators are guilty of a minor
misdemeanor on a first offense, while subsequent offenses result in a fourth degree
misdemeanor.9
Eligibility for a license
In order to qualify for a license to provide stretcher van services, a stretcher van
organization must do all of the following:
 Apply for a permit for each stretcher van owned or leased by the stretcher van
organization (see “Van permit requirement”);
 Maintain the appropriate amount and type of insurance (see “Insurance”);
 Meet all requirements established in rules adopted by the Board, including
requirements that pertain to equipment, communication systems, staffing, and types of
permitted services (see “Rulemaking”).10
Applying for a license
A stretcher van organization seeking to provide services with a stretcher van must
submit an application to the Board. The application process is the same used under current law
for the licensure of other medical transportation service providers. As a result, the application
must include the following information:11
 The name and business address of the stretcher van organization for which licensure is
sought;
 The name under which the applicant will operate the stretcher van organization;
 A list of the names and addresses of all officers and directors of the stretcher van
organization;
 A description of each vehicle to be used to provide stretcher van transport services,
including the make, model, year of manufacture, mileage, vehicle identification number,
and the color scheme, insignia, name, monogram, or other distinguishing characteristics
to be used to designate the applicant’s vehicle;
 The location and description of each place from which the stretcher van organization
will operate;
 A description of the geographic area to be served by the applicant; and
8 R.C. 4766.04(A)(3).
9 R.C. 4766.04(A)(3); R.C. 4766.99, not in the bill.
10 R.C. 4766.04(E).
11 R.C. 4766.04(F).
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 Any other information the Board determines by rule is necessary.
Van permit requirement
The bill requires every stretcher van organization licensed to provide stretcher van
transport services to possess a permit from the Board for each of the stretcher vans the
organization owns or leases.12
Applying for a permit
To receive a permit for a stretcher van, a stretcher van organization must submit an
application to the Board. As with the application process used for licensure, the application
process used for stretcher van permits is the same as the process used for other medical
transportation vehicle permits. Accordingly, the application must include the following:13
 Documentation that the stretcher van has been inspected (see “Inspection of
vehicles and aircraft”);
 Documentation that the permit applicant maintains insurance for the stretcher van (see
“Insurance”);
 Documentation that the stretcher van meets appropriate standards set by the Board
and any other requirements established by Board rules (see “Rulemaking”).
Fees
The bill requires fees to be paid for issuance and renewal of licenses and permits for
stretcher van organizations and stretcher vans. The Board must adopt rules establishing the
amount of the fees, taking into account the Board’s actual costs. The bill limits the amount of
the fees in a manner that corresponds to the limits that apply under current law to the Board’s
regulation of other medical transportation services and vehicles. As such, the maximum fees
are as follows:14
 For each license and renewal, not more than $100.
 For each permit and renewal, not more than $100.
Although the fee amounts are limited, the bill also permits the Board, with approval of
the Controlling Board, to establish fees that exceed the specified maximum amounts. In doing
so, the fees cannot exceed the maximum amounts by more than 50%.15
12 R.C. 4766.07.
13 R.C. 4766.07(A).
14 R.C. 4766.05(A).
15 R.C. 4766.05(C).
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Insurance
As a condition of receiving a license to provide stretcher van services and a permit for a
stretcher van, a stretcher van organization must provide the Board with adequate evidence of
(1) liability insurance and (2) bodily injury and property damage insurance. The coverage
requirements are the same as those that apply under current law to organizations that are
licensed to use ambulances and ambulettes.
Specifically, a stretcher van organization’s liability insurance must cover at least
$500,000 per occurrence and at least $500,000 in the aggregate. It must cover any cause for
which the stretcher van organization may be liable.16 A stretcher van organization’s bodily
injury and property damage insurance must cover each stretcher van used by the organization
and must cover at least the following amounts: $100,000 for bodily injury or death to one
person; $300,000 for bodily injury or death to more than one person; and $50,000 for damage
to property arising from any one accident.17
Rulemaking
The bill requires the Board to adopt rules governing stretcher van organizations licensed
to provide stretcher van services and rules governing stretcher vans. The rules, which are to be
adopted in accordance with the Administrative Procedure Act, must include the following: 18
 Requirements for a stretcher van organization to receive a license;
 Requirements for a stretcher van organization to receive a permit for a stretcher van;
 Fee amounts for the inspection of stretcher vans;
 Requirements for the types of equipment that must be carried, the communication
systems that must be maintained, and the personnel who must staff a stretcher van;
 The types of services that may be provided by a stretcher van organization;
 Any other rules the Board determines necessary.
Annual reporting
As part of the annual report that current law requires to be submitted to the Governor
and the General Assembly regarding the Board’s regulation of medical transportation services,
the bill requires the Board to include information on stretcher van organizations. The
information reported must include the number of stretcher van organization licenses and
16 R.C. 4766.06(A)(1).
17 R.C. 4766.06(B).
18 R.C. 4766.03(A).
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stretcher van permits issued during a fiscal year, the fees that are collected, the number of
inspections conducted, and the disciplinary and other enforcement actions taken.19
Extension of other licensure and enforcement provisions
In addition to the procedures described above, the bill extends to stretcher van
organizations and stretcher vans all of the following provisions that apply under existing law to
the Board’s regulation of other medical transportation services and vehicles:
 An annual renewal period, application process, and fee for each stretcher van
organization license and stretcher van permit;20
 A requirement that the license holder maintain accurate records of all service responses
conducted;21
 A decal issued for display in the rear window of each stretcher van that receives a
permit;22
 The Board’s authority to investigate alleged violations and complaints of alleged
violations, including the authority to issue subpoenas and apply for injunctions; 23
 The Board’s authority to suspend or revoke a license or permit for violating statutory or
administrative requirements or for other specified causes;24
 The Board’s authority to suspend a license without a prior hearing when the license
holder presents a danger of immediate and serious harm to the public, and the Board’s
duty to immediately suspend a license if the license holder is convicted or otherwise
found guilty of human trafficking;25
 The Board’s authority to impose an additional penalty of up to $1,500 for any violation
that may be a cause for suspension or revocation of a license or permit.26
Extension of driver eligibility requirements
The bill extends to each stretcher van driver the current law eligibility requirements for
employment as an ambulette driver, including criminal records checks, motor vehicle law
19 R.C. 4766.22.
20 R.C. 4766.04(J).
21 R.C. 4766.04(K).
22 R.C. 4766.07(B)(2).
23 R.C. 4766.11(A), not in the bill.
24 R.C. 4766.08(A), (B), and (C).
25 R.C. 4766.11(B) and 4766.23, neither in the bill.
26 R.C. 4766.08(D).
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violation checks, training in first aid and cardiopulmonary resuscitation, and alcohol and drug
testing.27
Licensure by endorsement
The bill extends to the Board authority to issue a license or stretcher van permit to a
stretcher van organization regulated by another state, just as the Board is authorized to do
under current law for an emergency m