EMS Letters of Approval

a. The State of Texas has mandated that an emergency medical service provider must obtain a letter of approval from Commissioners Court during their application process to provide emergency medical services (emergency and non-emergency). Reference Health & Safety Code 773.0573(b).

b. Sec. 773.0573. LETTER OF APPROVAL FROM LOCAL GOVERNMENTAL ENTITY. (a) An emergency medical services provider applicant must obtain a letter of approval from:

(1) the governing body of the municipality in which the applicant is located and is applying to provide emergency medical services; or

(2) if the applicant is not located in a municipality, the commissioners court of the county in which the applicant is located and is applying to provide emergency medical services.

i. (b) A governing body of a municipality or a commissioners court of a county may issue a letter of approval to an emergency medical services provider applicant who is applying to provide emergency medical services in the municipality or county only if the governing body or commissioners court determines that:

(1) the addition of another licensed emergency medical services provider will not interfere with or adversely affect the provision of emergency medical services by the licensed emergency medical services providers operating in the municipality or county;

(2) the addition of another licensed emergency medical services provider will remedy an existing provider shortage that cannot be resolved through the use of the licensed emergency medical services providers operating in the municipality or county; and

(3) the addition of another licensed emergency medical services provider will not cause an oversupply of licensed emergency medical services providers in the municipality or county.

a. At the direction of Harris County Commissioners Court, the HCFMO shall receive EMS LOA requests and validate all information before providing a recommendation to Harris County Commissioners Court for possible action through the County Request for Court Action (“RCA”) process.

i. Court Order authorizing language:

1. The Harris County Fire Marshal’s Office is authorized to receive and process applications for Letters of Approval from Emergency Medical Service applicants pursuant to Tex. Health & Safety Code 773.0573(b). The Harris County Fire Marshal’s Office is authorized to request additional information from applicants in order to process applications and to ensure statutory requirements are satisfied. The Harris County Fire Marshal’s Office will provide to Harris County Commissioners Court a recommendation of approval, rejection, or revocation for a Letter of Approval application made under Section 773.0573(b).

2. All Harris County officials and employees are authorized to do any and all things necessary or convenient to accomplish the purposes of this order.

a. HCFMO shall make available on our website an electronic request document for those wishing to seek a Harris County Commissioners Court Letter of Authorization.

b. The information to be collected shall include, at a minimum, the following:

i. Submitter name, email, and phone number

ii. Business owner name, email, and phone number

iii. Business name and DBA (if utilizing)

iv. Business mailing and physical address

v. State of Texas Taxpayer Identification Number

vi. Medical Director name, email, phone number, and license number

vii. Verification of type of services

1. Emergency 911 Services (if selected, must attach letter of support from ESD Board President)

2. Non-Emergency 911 Services (if selected, must attach letter of support from an accredited non-emergency patient facility identifying need)

viii. Identification of areas to conduct business in Harris County (LOA only authorizes services in unincorporated Harris County)

ix. Other political subdivisions that have authorized an LOA for the applicant

x. Attach letter of request to Harris County Commissioners Court

xi. Attach appropriate letters based on type of services

xii. Sign the document validating the information provided is true and accurate.

xiii. Current link to online application: https://form.jotform.com/242534165913052

c. Upon receipt of the LOA request, the HCFMO representative shall:

i. Conduct a review of the material to validate completeness of the information provided.

ii. Request any additional information to validate the information provided and meet the statutory requirements of Tex. Health & Safety Code 773.0573(b).

d. Upon completion of review, the HCFMO representative shall complete an RCA request for the next available Commissioners Court along with a recommendation and explanation of why Court should consider approving or disapproving the request.

e. Upon final decision by Commissioners Court, communicate and share any associated documents on the Court’s decision to the Submitter and Business Owner via email provided.