Ala. Admin. Code r. 420-2-1-.11 - Licensure For Emergency Medical Provider Services
(1) No person shall operate an emergency
medical provider service until obtaining a license. All emergency medical
provider service licenses are issued by the OEMS under the authority of the
Board. Each emergency medical provider service license will be issued with the
appropriate level of authorization.
(2) Categories of emergency medical provider
service licenses.
(a) ALS Transport (ground or
air)
(b) ALS
Non-transport
(c) BLS
Transport
(3)
Classification of emergency medical provider services licenses.
(a) Unrestricted - An unrestricted license
may be granted by the Board after it has determined that the EMS provider is
willing and capable of maintaining compliance with these rules.
(b) Probationary - At its discretion, the
Board may grant a probationary license or downgrade an unrestricted license,
for a specific period which shall not exceed 1 year, when it determines that
the provider has engaged in one or more deficient practices which are serious
in nature, chronic in nature, or which the provider has failed to correct. This
failure could lead to additional licensure actions including suspension or
revocation.
(4)
Categories of ALS emergency medical provider service license authorizations.
(a) ALS Level 1: Paramedic
authorization
(b) ALS Level
1-Critical Care: Paramedic authorization
(c) ALS Level 2: Advanced EMT
authorization
(d) ALS Level 3:
Intermediate authorization
(5) Licensure applications shall be submitted
to and approved by the OEMS prior to an emergency medical provider service
conducting operations. All licenses are valid for a period that shall not
exceed 12 months. Applications are available upon request or may be obtained at
http://www.alabamapublichealth.gov/ems.
In order to apply for licensure, the emergency medical provider service shall
submit the following:
(a) Completed license
application
(b) Plans to describe:
(initial and when changes occur)
1. Infection
control
2. Fluid and medication
security
3. Controlled substance
(if applicable)
4. Employee drug
screening
5. Emergency Vehicle
Operator training (ground providers only)
6. Quality Assurance/Quality
Improvement
(c)
Declaration of Citizenship Form, if applicable
(d) The following agreements:
1. Emergency Medical Dispatch
2. Alabama Incident Management System
(AIMS)
3. ALS
4. Pharmacy or Pharmaceutical
5. Service Medical Director
6. e-PCR conforming to National EMS
Information System (NEMSIS) and Alabama validation requirements available at
http://www.alabamapublichealth.gov/ems.
(e) Proof of a minimum of
$1,000,000 liability insurance from a carrier licensed by the Alabama
Department of Insurance. This includes all transport, non-transport vehicles,
and professional liability on all EMSP employed or volunteering for duty.
Alternatively, a licensed provider service may be self-insured in the same
amount through a plan approved by the OEMS. This liability insurance coverage
shall be binding and in force prior to the service being issued a license or
authorization.
(f) An application
fee as provided in Rule
420-1-5-.08(3).
(g) A roster of active licensed EMSP
appropriate for the category of service desired.
(h) Demonstration of an ability to comply
with the OEMS patient care reporting requirements.
(i) Prior to approval for a license, the OEMS
will inspect the proposed emergency medical provider service to determine
compliance with §
22-18-1, et seq., Code
of Ala. 1975, and the requirements of these
rules.
(6) Emergency
medical provider service licenses shall be renewed before the expiration date
provided on the current license. Any service with an expired license shall
immediately cease all operations. On the date of expiration, the OEMS will
notify all third-party payors and pharmaceutical suppliers regarding the
affected service's license status.
(7) Each licensed emergency medical provider
service shall obtain a separate license for each county in which a ground
ambulance, or service area in which an air ambulance, is based. The license
shall be displayed in a conspicuous place in the emergency medical provider's
main office in the county or service area.
(8) The emergency medical provider service
license and ALS authorization are nontransferable and shall be granted only to
the service operator named on the application.
(9) Within 60 calendar days of receipt from
the State Board of Health of its initial (first) license to operate as a
provider service from a base within a ground provider's licensed county or an
air provider's licensed service area, each licensed provider service shall be
in continuous operation in the county in which it is licensed, providing
emergency response 24 hours a day, 7 days a week, 365 days a year for any
emergency medical service request issued within the licensed county. Mutual aid
response to other counties is not required but is recommended if resources are
available. ALS Non-Transport services and all fully volunteer services are
exempt from this requirement, but a fully volunteer transport service must
ensure coverage when service is not available.
(10) Licensed emergency medical provider
services shall ensure:
(a) The highest level
EMSP provides patient care when treating and transporting any unstable
patient.
(b) The highest level EMSP
has the responsibility to provide care for patients until care is transferred
to appropriate medical personnel.
(c) Acknowledgement of the ability to respond
within minutes of initial dispatch of an emergency call (ground and air
providers).
(d) An EMS response
unit is en route within 7 minutes of the initial dispatch (excluding air
medical).
(e) The execution of
mutual aid and dispatch agreements so that no emergency calls are purposefully
delayed.
(f) Continuous telephone
service with the capability to record or forward calls so that the service is
accessible by phone to the public at all times (non-emergency calls).
(g) A written roster for an ALS transport
service of at least six properly licensed EMSP with a minimum of three at the
ALS level of license. ALS non-transport shall have at least one properly
licensed EMSP at the level of provider license. A written roster for a BLS
transport service of at least three properly licensed EMSP.
(h) The provision of immediate verbal
notification to the OEMS of any civil or criminal action brought against the
service, or any criminal action brought against an employee, and the submission
of a written report within 5 working days of the provider becoming
aware.
(i) The provision of
immediate verbal notification to the OEMS and a written report within 5 working
days of any accident involving an ambulance that was responding to an
emergency, that injured any crew members, or that had a patient on board. A
copy of the accident police report must be provided to the OEMS as soon as it
becomes available.
(j) The
provision of an Ambulance Add/Remove via EMS Web Management to the OEMS
immediately for any permitted vehicle added or removed from service for any
reason other than scheduled maintenance. Information shall include the
disposition of the removed vehicle.
(11) Compliance with all statewide system
components i.e., Trauma, Stroke, and Cardiac) as written in the Alabama OEMS
Patient Care Protocols.
(12)
Licensed emergency medical provider services shall not:
(a) Transfer a provider service license
certificate or ALS authorization.
(b) Self-dispatch or cause a vehicle to be
dispatched on a call in which another provider service has been
dispatched.
(c) Allow EMSP to
exceed their scope of practice as outlined within these rules.
(d) Intentionally bill or collect from
patients or third- party payors for services not rendered.
(e) Refuse to provide appropriate treatment
or transport for an emergency patient for any reason including the patient's
inability to pay.
(f) Allow any ALS
equipment, fluids, or medications to remain unsecured on a permitted vehicle
without the appropriate licensed EMSP on board.
(g) Allow EMSP to respond to a medical
emergency with the intent to treat or transport a patient unless the EMSP is
clean and appropriately dressed.
Notes
Rule 420-2-1-.17 was repealed as per certification Filed March 20, 2001; effective April 24, 2001. As a result of this Rule 420-2-1-.21 was renumbered to 420-2-1-.20. Rule 420-2-1-.20 was renumbered 420-2-1-.11 as per certification Filed February 20, 2019; effective April 7, 2019.
Authors: William Crawford, M.D.; Jamie Gray
Statutory Authority: Code of Ala. 1975, § 22-18-1, et seq.
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