Ariz. Admin. Code § R9-25-1005 - Minimum Standards for Ground Ambulance Vehicles (Authorized by A.R.S. Sections 36-2202(A)(5), 36-2232(C)(5))

A. An applicant for a certificate of registration or a certificate holder shall ensure that a ground ambulance vehicle is marked on the sides of the ground ambulance vehicle with the legal business or corporate name of the applicant or certificate holder, with letters not less than six inches in height.

B. An applicant for a certificate of registration or a certificate holder shall ensure a ground ambulance vehicle is equipped with the following:

1. An engine intake air cleaner that meets the ground ambulance vehicle manufacturer's engine specifications;

2. A brake system that meets the requirements in A.R.S. § 28-952;

3. A cooling system in the engine compartment that maintains the engine temperature operating range required to prevent damage to the ground ambulance vehicle engine;

4. A battery:

a. With no leaks, corrosion, or other visible defects; and

b. As measured by a voltage meter, capable of generating:

i. 12.6 volts at rest, and

ii. 13.2 to 14.2 volts on high idle with all electrical equipment turned on;

5. A wiring system in the engine compartment designed to prevent the wire from being cut by or tangled in the engine or hood;

6. Hoses, belts, and wiring with no visible defects;

7. An electrical system capable of maintaining a positive amperage charge while the ground ambulance vehicle is stationary and operating at high idle with headlights, running lights, patient compartment lights, environmental systems, and all warning devices turned on;

8. An exhaust pipe, muffler, and tailpipe that meet the requirements in A.R.S. § 28-955 under the ground ambulance vehicle and securely attached to the chassis;

9. A frame capable of supporting the:

a. Gross vehicle weight of the ground ambulance vehicle; and

b. The anticipated weight of ambulance attendants, supplies and equipment, and patients;

10. A horn that meets the requirements in A.R.S. § 28-954(A);

11. A siren that meets the requirements in A.R.S. § 28-954(E);

12. A front bumper that is positioned at the forward-most part of the ground ambulance vehicle extending to the ground ambulance vehicle's outer edges;

13. A fuel cap of a type specified by the manufacturer for each fuel tank;

14. A steering system to include:

a. For a hydraulic power steering system:

i. Power-steering belts free from frays, cracks, or slippage;

b.ii. Power-steering system that is free from leaks; and

c.iii. Fluid in the power-steering system that fills the reservoir between the full level and the add level indicator on the dipstick;

b. For an electrical or other type of steering system that does not contain the components of a hydraulic power steering system, components that:

i. Provide the same functions as a hydraulic power steering system, and

ii. Meet manufacturer's specifications; and

d.c. Bracing extending from the center of the steering wheel to the steering wheel ring that is not cracked;

15. Front and rear shock absorbers that are free from leaks;

16. Tires on each axle that:

a. Are properly inflated;

b. Are of equal size, equal ply ratings, and equal type;

c. Are free of bumps, knots, or bulges;

d. Have no exposed ply or belting; and

e. Have tread groove depth equal to or more than 4/32 inch;

17. An air cooling system capable of achieving and maintaining a 20° F difference between the air intake and the cool air outlet;

18. Air cooling and heater hoses secured in all areas of the ground ambulance vehicle and chassis to prevent wear due to vibration;

19. Body free of damage or rust that interferes with the physical operation of the ground ambulance vehicle or creates a hole in the driver's compartment or the patient compartment;

20. Windshield defrosting and defogging equipment;

21. Emergency warning lights that provide 360° conspicuity;

22. At least one 5-lb. ABC dry, chemical, multi-purpose fire extinguisher in a quick release bracket, either disposable with an indicator of a full charge or with a current inspection tag;

23. A heating system capable of achieving and maintaining a temperature of not less than 68° F in the patient compartment within 30 minutes;

24. Sides of the ground ambulance vehicle insulated and sealed to prevent dust, dirt, water, carbon monoxide, and gas fumes from entering the interior of the patient compartment and to reduce noise;

25. Interior patient compartment wall and floor coverings that are:

a. In good repair and capable of being disinfected, and

b. Maintained in a sanitary manner;

26. Padding over exit areas from the patient compartment and over sharp edges in the patient compartment;

27. Secured interior equipment and other objects;

28. When present, hangers or supports for equipment mounted not to protrude more than 2 inches when not being used;

29. Functional lamps and signals, including:

a. Bright and dim headlamps,

b. Brake lamps,

c. Parking lamps,

d. Backup lamps,

e. Tail lamps,

f. Turn signal lamps,

g. Side marker lamps,

h. Hazard lamps,

i. Patient loading door lamps and side spot lamps,

j. Spot lamp in the driver's compartment and within reach of the ambulance attendant, and

k. Patient compartment interior lamps;

30. Side-mounted rear vision mirrors and wide vision mirror mounted on, or attached to, the side-mounted rear vision mirrors or other optical devices allowing monitoring of the area surrounding the ground ambulance vehicle;

31. A patient loading door that permits the safe loading and unloading of a patient occupying a stretcher in a supine position;

32. At least two means of egress from the patient compartment to the outside through a door;

33. Functional open door securing devices on a patient loading door;

34. Patient compartment upholstery free of cuts or tears and capable of being disinfected;

35. A three-point occupant restraint system installed for each seat in the driver's compartment;

36. Belts or devices installed on a stretcher to be used to secure a patient;

37.36. A restraint system installed for each seat in the patient compartment:

a. For a ground ambulance vehicle manufactured before January 1, 2025, that consists of at least a seat belt; and

b. For a ground ambulance vehicle manufactured on or after January 1, 2025, with at least three-points of contact with the occupant of a seat;

37. A wheeled, multi-level stretcher that is:

a. Suitable for supporting a patient at each level;

b. At least 69 inches long and 20 inches wide;

c. Rated for use with a patient weighing either:

i. Up to 350 pounds, or

ii. For a ground ambulance vehicle capable of transporting a patient weighing over 350 pounds, up to the rated capability of the ground ambulance vehicle;

d. Adjustable to allow a patient to recline and to elevate the patient's head and upper torso to an angle at least 70° from the horizontal plane;

e. Equipped with a mattress that has a protective cover that is free of cracks, cuts, or tears and capable of being disinfected;

f. Equipped with a five-point restraint system to secure a patient during transport; and

g. Equipped to secure the stretcher to the interior of the vehicle during transport using the fastener required under subsection (B)(38);

38. A crash stable side or center mounting fastener of the quick release type to secure a stretcher to a ground ambulance vehicle;

39. Windshield and windows free of obstruction;

40. A windshield free from unrepaired starred cracks and line cracks that extend more than 1 inch from the bottom or sides of the windshield or that extend more than 2 inches from the top of the windshield;

41. A windshield-washer system that applies enough cleaning solution to clear the windshield;

42. Operable windshield wipers with a minimum of two speeds;

43. Functional hood latch for the engine compartment;

44. Fuel system with fuel tanks and lines that meets manufacturer's specifications;

45. Suspension system that meets the ground ambulance vehicle manufacturer's specifications;

46. Instrument panel that meets the ground ambulance vehicle manufacturer's specifications; and

47. Wheels that meet and are mounted according to manufacturer's specifications.

C. An applicant for a certificate of registration or a certificate holder shall ensure that a ground ambulance vehicle is equipped:

1. To provide, and capable of providing, voice communication between:

a. An ambulance attendant and the dispatch center; and

b. An ambulance attendant and a source from which the ambulance attendant may request and receive on-line medical direction, according to R9-25-201(E)(2)(a)(i); and

2. Except as provided in subsection (E), with a global positioning monitoring device to enable the recording of times of arrival onscene for determining response times.

D. An applicant for a certificate of registration or a certificate holder shall ensure that a ground ambulance vehicle is equipped, as specified in Table 10.2, to provide the level of service for which the ground ambulance vehicle is to be used.

E. An applicant for a certificate of registration or a certificate holder may request a waiver of the requirement in subsection (C)(2) by submitting to the Department, on an annual basis and in a Department-provided format, the following information:

1. The applicant's or certificate holder's name;

2. If applicable, the identification number of the certificate of necessity under which the ground ambulance vehicle is registered;

3. The identifying information specified in R9-25-1001(B)(1)(c) for the ground ambulance vehicle to which the waiver would pertain;

4. A reason and justification for the waiver;

5. The name, title, address, e-mail address, and telephone number of the individual acting on behalf of the applicant or certificate holder according to R9-25-102;

6. Whether the applicant agrees to allow the Department to submit supplemental requests for information under R9-25-1201(C)(3);

7. Attestation that the information provided is accurate and complete; and

8. The signature of the specified according to subsection (E)(5) and date signed.

Notes

Ariz. Admin. Code § R9-25-1005

New Section adopted by final rulemaking at 7 A.A.R. 1098, effective February 13, 2001 (Supp. 01-1). Renumbered and amended from R9-25-1002 by final rulemaking at 30 A.A.R. 581, effective 3/7/2024.