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HB26-1238 • 2026

Designating Emergency Medical Services Essential Services

The act declares emergency medical services as an essential service in the state and an integral part of the state's health-care infrastructure. The act also declares that emergency medical service pr

Healthcare
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Rep. D. Johnson, Rep. M. Lukens, Sen. M. Baisley, Sen. W. Lindstedt, Rep. C. Barron, Rep. M. Bradfield, Rep. B. Bradley, Rep. C. Clifford, Rep. L. Feret, Rep. L. Garcia Sander, Rep. S. Lieder, Rep. M. Martinez, Rep. T. Mauro, Rep. J. McCluskie, Rep. K. Nguyen, Rep. C. Richardson, Rep. M. Soper, Rep. L. Suckla, Rep. R. Taggart, Rep. E. Velasco, Rep. T. Winter, Sen. L. Frizell, Sen. R. Pelton, Sen. J. Rich, Sen. D. Roberts, Rep. J. Bacon, Rep. A. Boesenecker, Rep. K. Brown, Rep. J. Caldwell, Rep. M. Duran, Rep. A. Flanell, Rep. M. Froelich, Rep. L. García, Rep. R. Gonzalez, Rep. E. Hamrick, Rep. J. Jackson, Rep. R. Keltie, Rep. M. Lindsay, Rep. J. Mabrey, Rep. B. Marshall, Rep. K. McCormick, Rep. A. Paschal, Rep. M. Rutinel, Rep. G. Rydin, Rep. L. Smith, Rep. K. Stewart, Rep. T. Story, Rep. B. Titone, Rep. R. Weinberg, Sen. J. Amabile, Sen. J. Carson, Sen. J. Coleman, Sen. L. Daugherty, Sen. T. Exum, Sen. I. Jodeh, Sen. C. Kipp, Sen. L. Liston, Sen. J. Marchman
Last action
2026-05-05
Official status
Governor Signed
Effective date
Not listed

Plain English Breakdown

The effective date listed in the bill text (August 12, 2026) depends on the specific adjournment date of the legislative session; if adjournment occurs later than May 13, 2026, the exact start date will shift accordingly.

Designating Emergency Medical Services as Essential in Colorado

This law declares that emergency medical services, including ambulance and air ambulance care, are an essential part of Colorado's health-care system.

What This Bill Does

  • Declares emergency medical services to be an essential service in the state.
  • States that these services are a vital component of the state's overall health-care infrastructure.
  • Recognizes providers acting on duty or as volunteers, including those providing ambulance and air ambulance services, as delivering essential services regardless of location.
  • Adds legal definitions for 'emergency ambulance service' and 'nonemergency ambulance service'.
  • Defines 'out-of-hospital services' as necessary health-care goods and services provided outside a hospital setting to treat illness or injury, excluding prehospital transports.
  • Clarifies that off-duty emergency medical service providers are not required to respond to the scene of a medical emergency.

Who It Names or Affects

  • Emergency medical service providers, including paramedics and technicians working on duty or as volunteers.
  • Entities operating ambulance services and air ambulances in Colorado.
  • Residents and visitors who rely on access to these essential health-care services.

Terms To Know

Essential service
A vital component of the state's health-care system that is necessary for public safety, particularly during declared disasters or emergencies.
Out-of-hospital services
Necessary goods and services provided outside a hospital setting to prevent, cure, or heal illness or injury, but does not include transporting patients between facilities.

Limits and Unknowns

  • The law takes effect on August 12, 2026, unless voters file a referendum petition within ninety days of the legislative session ending.
  • If a referendum is filed, the law will only take effect if approved by voters in November 2026.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

L.005

HOU Health & Human Services

Passed [*]

Plain English: This amendment removes several specific sections from the bill that would have changed existing state laws.

  • It deletes a part of the bill on page 7 that was meant to change section (1)(a) of an existing law.
  • It removes three separate blocks of text found at the bottom of page 7 and across pages 8 and 9.
  • The official amendment text only lists which lines are deleted but does not include the actual words being removed, so it is unclear exactly what rules or definitions were taken out.
  • Because the specific content of the deleted sections is missing from this document, we cannot explain the full impact on emergency medical services.
L.006

HOU Health & Human Services

Passed [*]

Plain English: This amendment changes the bill to require emergency medical services to join a specific mutual aid system managed by the state's fire prevention division.

  • Removes references to telecommunications subsystems and interoperable communications systems from the text.
  • Deletes numbered list formatting that was previously used in this section of the law.
  • Adds a requirement for emergency medical services to participate in regional and statewide mutual aid.
  • The amendment does not explain how the new mutual aid system works or what specific actions providers must take beyond participating.
  • The text refers to an existing law (Section 24-33.5-1235) for details, but this document does not include that information.
L.008

Second Reading

Passed [**]

Plain English: This amendment updates a state law to officially declare that all emergency medical services, including ambulance providers and volunteers acting on duty, are essential regardless of where they work.

  • It adds a new rule stating that the General Assembly recognizes emergency medical services as essential for both paid staff and volunteers responding to calls or working in ambulances.
  • It clarifies that this 'essential' status applies no matter what location the provider is serving patients at.
  • It changes definitions of where care happens by adding a category specifically called 'out-of-hospital services'.
  • It removes old text from later pages of the bill to match these new rules.
  • The amendment refers to specific page and line numbers in an official report dated March 3, 2026, which is a future date relative to current time.
  • Some technical details about how 'out-of-hospital services' are defined versus other transport types may be too complex for this summary.
L.009

Second Reading

Passed [**]

Plain English: This amendment removes a specific section of text from the bill that was located on page 6.

  • Deletes lines 9 through 19 found on page 6 of the original printed bill.
  • The official text provided only shows where words were removed, but it does not include the actual content that was deleted.
  • Because the missing text is unknown, we cannot explain exactly what rules or definitions are being taken out of the law.
L.010

Second Reading

Passed [**]

Plain English: This amendment removes a specific section of the bill that was originally written on page 7.

  • It deletes lines 3 through 20 found on page 7 of the printed version of HB26-1238.
  • The official text only says which words to remove but does not include the actual content that is being deleted.
  • Because the removed text is missing, it is impossible to explain exactly what rule or definition was in those lines before they were struck.
L.011

Second Reading

Passed [**]

Plain English: This amendment changes the bill's wording to refer more broadly to 'out-of-hospital services' instead of just an 'out-of-hospital setting'.

  • The text on page 3, lines 14 and 15 is updated.
  • The phrase "AN OUT-OF-HOSPITAL SETTING" is removed from the bill.
  • It is replaced with the new phrase "OUT-OF-HOSPITAL SERVICES".
  • The provided text does not explain why this specific wording change was made or how it affects patients and providers in practice.

Bill History

  1. 2026-05-05 Governor

    Governor Signed

  2. 2026-04-28 Governor

    Sent to the Governor

  3. 2026-04-28 Senate

    Signed by the President of the Senate

  4. 2026-04-28 House

    Signed by the Speaker of the House

  5. 2026-04-07 Senate

    Senate Third Reading Passed - No Amendments

  6. 2026-04-06 Senate

    Senate Second Reading Laid Over to 04/02/2026 - No Amendments

  7. 2026-04-06 Senate

    Senate Second Reading Passed - No Amendments

  8. 2026-04-01 Senate

    Senate Committee on Health & Human Services Refer Unamended - Consent Calendar to Senate Committee of the Whole

  9. 2026-03-17 Senate

    Introduced In Senate - Assigned to Health & Human Services

  10. 2026-03-12 House

    House Third Reading Passed - No Amendments

  11. 2026-03-11 House

    House Third Reading Passed with Amendments - Floor

  12. 2026-03-11 House

    House Second Reading Special Order - Passed with Amendments - Committee, Floor

  13. 2026-03-06 House

    House Second Reading Laid Over Daily - No Amendments

  14. 2026-03-03 House

    House Committee on Health & Human Services Refer Amended to House Committee of the Whole

  15. 2026-02-18 House

    Introduced In House - Assigned to Health & Human Services

Official Summary Text

The act declares emergency medical services as an essential service in the state and an integral part of the state's health-care infrastructure.

The act also declares that emergency medical service providers, whether responding on duty or as a volunteer and regardless of location, provide essential services when providing emergency ambulance services and nonemergency ambulance services.
The act also updates certain definitions related to emergency medical services, including the addition of a definition of 'out-of-hospital services', which term is defined to mean the furnishing of necessary health-care goods and services outside of a hospital setting but does not include prehospital setting transports.
The act clarifies that an off-duty emergency medical service provider is not obligated to respond to the scene of a medical emergency or provide emergency medical services.
(Note: This summary applies to this bill as enacted.)

Current Bill Text

Read the full stored bill text
HOUSE BILL 26-1238
BY REPRESENTATIVE(S) Johnson and Lukens, Barron, Bradfield,
Bradley, Clifford, Feret, Garcia Sander, Lieder, Martinez, Mauro,
McCluskie, Nguyen, Richardson, Soper, Suckla, Taggart, Velasco,
WinterT., Bacon, Boesenecker, Brown, Caldwell, Duran, Flanell, Froelich,
Garcia, GonzalezR., Hamrick, Jackson, Keltie, Lindsay, Mabrey, Marshall,
McCormick, Paschal, Rutinel, Rydin, Smith, Stewart K., Story, Titone,
Weinberg;
also SENATOR(S) Baisley and Lindstedt, Frizell, Pelton R., Rich, Roberts,
Amabile, Carson, Daugherty, Exum, Jodeh, Kipp, Liston, Marchman,
Coleman.
CONCERNING EMERGENCY MEDICAL SERVICES PROVIDED IN THE ST A TE, AND,
IN CONNECTION THEREWITH, DESIGNATING EMERGENCY MEDICAL
SERVICES, INCLUDING AMBULANCE SERVICES AND AIR AMBULANCE
SERVICES, TO BE ESSENTIAL SERVICES.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. Legislative declaration. (1) The general assembly
finds that:
(a) The state of Colorado recognizes the critical and essential role
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act.
that emergency medical service providers play in safeguarding the health
and safety of our communities;
(b) These dedicated professionals serve as first responders during
medical crises, delivering immediate and often lifesaving care to people in
dire need; and
( c) Emergency medical service providers encompass a diverse range
of highly trained and skilled medical personnel, including paramedics,
emergency medical technicians, and other specialized medical responders.
(2) The general assembly therefore declares that:
(a) The provision of emergency medical services constitutes a vital
component of the health-care system in the state; and
(b) Our health-care system is multifaceted, and emergency medical
services play a crucial role in the system and provide an essential service in
the state.
SECTION 2. In Colorado Revised Statutes, 25-3.5-102, add (5)
and (6) as follows:
25-3.5-102. Legislative declaration.
(5) (a) THE GENERAL ASSEMBLY FURTHER FINDS THAT:
(I) THE PROVISION OF EMERGENCY MEDICAL SERVICES, INCLUDING
AMBULANCE SERVICES AND AIR AMBULANCE SERVICES, IS ESSENTIAL TO THE
PROTECTION OF THE PUBLIC HEALTH, SAFETY, AND WELFARE OF THE PEOPLE
OF THE STATE OF COLORADO;
(II) ACCESS TO TIMELY AND APPROPRIATE MEDICAL CARE IN
OUT-OF-HOSPITAL SERVICES IS A CRITICAL COMPONENT OF THE STATE'S
HEALTH-CARE INFRASTRUCTURE, PARTICULARLY IN RURAL AND FRONTIER
AREAS OF THE ST A TE IN WHICH HOSPITALS AND OTHER HEAL TH-CARE
RESOURCES MAY BE LIMITED; AND
(III) EMERGENCY MEDICAL SERVICES FUNCTION AS AN INTEGRAL
PART OF THE CONTINUUM OF CARE BY BRIDGING PREHOSPITAL,
PAGE 2-HOUSE BILL 26-1238
INTERFACILITY, AND COMMUNITY-BASED HEALTH-CARE DELIVERY.
(b) THEREFORE, THE GENERAL ASSEMBLY DECLARES THAT:
(I) IT IS NECESSARY TO RECOGNIZE AND SUPPORT EMERGENCY
MEDICAL SERVICES AS AN ESSENTIAL SERVICE IN THE STATE OF COLORADO
AND TO ENSURE THAT EACH RESIDENT OF AND VISITOR TO THE STATE HAS
ACCESS TO EMERGENCY MEDICAL SERVICES;
(11) AS ESSENTIAL HEAL TH-CARE PROVIDERS AND FIRST RESPONDERS,
EMERGENCY MEDICAL SERVICE PROVIDERS A RE EXPECTED TO RESPOND
DURING A DECLARED DISASTER, PRESCRIBED CLOSURE, CRISIS, OR
EMERGENCY;AND
(III) IT IS THE POLICY OF THE STATE OF COLORADO THAT:
(A) WHEN IN ACTIVE SERVICE, EMERGENCY MEDICAL SERVICE
PROVIDERS ARE AUTHORIZED TO TRAVEL UNENCUMBERED UPON THE ROADS
AND HIGHWAYS WITHIN THE STATE; AND
(B) AT ANY TIME OR PLACE IN WHICH EMERGENCY MEDICAL SERVICE
PROVIDERS ARE CALLED TO RESPOND, THEIR PERFORMANCE OF EMERGENCY
MEDICAL SERVICES FALLS WITHIN THE DUTIES AND CLASSIFIED DEMANDS OF
THEIR JOBS AND THE REGULAR USAGE AND WEAR OF THEIR VEHICLES AND
EQUIPMENT .
(6) THE GENERAL ASSEMBLY RECOGNIZES AND DECLAR ES THAT
EMERGENCY MEDICAL SERVICES ARE ESSENTIAL. WHEN ACTING ON DUTY OR
RESPONDING AS A VOLUNTEER, EMERGENCY MEDICAL SERVICE PROVIDERS,
INCLUDING PROVIDERS OF EMERGENCY AMBULANCE SERVICE AND
NONEMERGENCY AMBULANCE SERVICE, ARE RECOGNIZED AS PROVIDING
ESSENTIAL SERVICES REGARDLESS OF LOCATION.
SECTION 3. In Colorado Revised Statutes, 25-3.5-103, amend
(1.3), (3), (9), and (10.3); and add (7.2), (8.9), and (9.2) as follows:
25-3.5-103. Definitions.
As used in this article 3.5, unless the context otherwise requires:
PAGE 3-HOUSE BILL 26-1238
(1.3) "Air ambulance service" means any A public or private entity
that uses an air ambulance to transport patients to a medical facility AND
INCLUDES THE PROVISION OF EMERGENCY AMBULANCE SERVICE AND
NONEMERGENCY AMBULANCE SERVICE.
(3) (a) "Ambulance service" means the furnishing, operating,
conducting, maintaining, advertising, or otherwise engaging in or professing
to be engaged in the transportation of patients by ambulance AND INCLUDES
THE PROVISION OF EMERGENCY AMBULANCE SERVICE AND NONEMERGENCY
AMBULANCE SERVICE.
(b) Taken in context, it "AMBULANCE SERVICE" also means the
person so engaged PROVIDING or professing to be so engaged PROVIDING
AMBULANCE SERVICE.
( c) The person so engaged PROVIDING and the vehicles used for the
emergency transportation of persons INDIVIDUALS injured at a mine are
excluded from this definition when the personnel utilized in the operation
of said THE vehicles are subject to the mandatory safety standards of the
federal mine safety and health administration, or its successor agency.
(7.2) "EMERGENCY AMBULANCE SERVICE" MEANS AN IMMEDIATE
AMBULANCE OR AIR AMBULANCE RESPONSE AT THE TIME AMBULANCE
SERVICE OR AIR AMBULANCE SERVICE IS REQUESTED THAT RESULTS IN THE
ASSESSMENT, TREATMENT, OR TRANSPORT OF A PATIENT BY AN AMBULANCE
OR AIR AMBULANCE.
(8.9) "NONEMERGENCY AMBULANCE SERVICE" MEANS THE
TRANSPORT OF A PATIENT BY AN AMBULANCEORAIRAMBULANCEANDTHAT
INCLUDES THE PROVISION OF MEDICALLY NECESSARY SUPPLIES AND
SERVICES AND MEETS THE MEDICAL NECESSITY REQUIREMENTS UNDER 42
CFR410.40 (e), AS THAT SECTION EXISTED ON JULY 1, 2025.
(9) "Patient" means an, individual who is sick, injmed, or other wise
ineapaeitated OI helpless "OUT-OF-HOSPITAL SERVICES" MEANS FURNISHING
ANYNECESSARYGOODSANDSERVICESOUTSIDEOFAHOSPITALSETTINGFOR
THE PURPOSE OF PREVENTING, ALLEVIATING, CURING, OR HEALING HUMAN
ILLNESS, A PHYSICAL DISABILITY, A PHYSICAL INJURY, OR A SUBSTANCE USE
DISORDER WHILE RESPONDING TO AN EMERGENCY OR OTHER HEAL TH-CARE
CONDITION. "OUT-OF-HOSPITAL SERVICES" DOES NOTINCLUDEPREHOSPITAL
PAGE 4-HOUSE BILL 26-1238
SETTING TRANSPORTS.
(9.2) "PATIENT" MEANS AN INDIVIDUAL WHO IS SICK, INJURED, OR
OTHERWISE INCAPACITATED OR HELPLESS.
(10.3) "Prehospital setting" means one of the following settings in
which an emergency medical service provider performs patient care, which
care is subject to medical direction by a medical director:
(a) At the site of an emergency;
(b) During emergency transport; or
( c) During interfacility transport; OR
(d) WHILE PROVIDING OUT-OF-HOSPITAL SERVICES.
SECTION 4. In Colorado Revised Statutes, 25-3.5-203, add (6) as
follows:
25-3.5-203. Emergency medical service providers -licensure -
renewal of license - duties of department - rules - record checks -
definitions.
(6) NOTWITHSTANDING ANY OTHER PROVJSION OF LAW, NOTHING IN
THIS ARTICLE 3.5 IMPOSES ON AN EMERGENCY MEDICAL SERVICE PROVIDER
AN OBLIGATION TO RESPOND TO THE SCENE OF A MEDICAL EMERGENCY OR
TO PROVIDE EMERGENCY MEDICAL SERVICES WHEN THE EMERGENCY
MEDICAL SERVICE PROVIDER IS OFF DUTY.
SECTION 5. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly (August
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a
referendum petition is filed pursuant to section 1 (3) of article V of the state
constitution against this act or an item, section, or part of this act within
such period, then the act, item, section, or part will not take effect unless
PAGE 5-HOUSE BILL 26-1238
approved by the people at the general election to be held in November 2026
and, in such case, will take effect on the date of the official declaration of
the vote thereon by the governor .
.Ju~
SPEAKER OF THE HOUSE
OF REPRESENTATIVES
v~ ~
Vanessa Reilly ~
CHIEF CLERK OF THE HOUSE
OF REPRESENTATIVES
Jared
GOVE
PAGE 6-HOUSE BILL 26-1238
James Rashad Coleman, Sr.
PRESIDENT OF
THE SENATE
w~
..,-;
Esther van Mourik
SECRETARY OF
THE SENATE
TA TE OF COLORADO