Sponsor says new 'adaptive care' ambulance license would let rural crews use advanced skills when staffed

Representative Preston told the House Rules Committee that House Bill 52‑49 would create an "adaptive care" ambulance operation license to address staffing mismatches in rural Michigan. The sponsor said current law requires ambulance rigs to be licensed at the highest level of care continuously, which forces many volunteer services to operate at BLS levels even when higher‑trained personnel are available on a given shift.

"When a paramedic is on the rig in a small rural service such as where I live and where I serve, I should not have to sit on my hands and watch a patient circle the drain when I could be doing more," Preston said, explaining the bill would permit limited ALS interventions when an eligible crew is present.

The bill would empower the statewide Emergency Medical Services Coordination Committee (EMSCC) within the Department of Health and Human Services to review applications and recommend approval; it requires services to have held a BLS license as of October 2022, be owned or contracted by a local unit of government, and operate under local medical control oversight. Preston said the measure draws on a 1997 Bennett Bill model but is tailored for rural services that cannot sustain full‑time higher licensure.

Committee members asked whether the proposal would require additional full‑time staff to administer the new license; the sponsor said it would be application based and that the EMSCC and EMS division would handle the workload without added FTEs. No committee vote was taken.