Ga. Comp. R. & Regs. R. 511-9-2-.06 - Licensure of Air Ambulance Services
(1)
Applicability
(a) No person shall operate,
advertise, or hold themselves out to be an Air Ambulance Service in the state
of Georgia without being in compliance with the provisions of O.C.G.A. Chapter
31-11 and these rules and regulations and without being duly licensed by the
Department. However, this Rule shall not apply to the following:
1. An air ambulance or air ambulance service
operated by an agency of the United States government;
2. A vehicle rendering assistance temporarily
in the case of a declared major catastrophe, disaster, or public health
emergency which is beyond the capabilities of available Georgia licensed Air
Ambulance Services;
3. An air
ambulance operated from a location outside of Georgia and transporting patients
picked up beyond the limits of Georgia to locations within Georgia;
4. An air ambulance service licensed to
operate in another state and transporting patients picked up at a medical
facility within the limits of Georgia to locations outside the limits of
Georgia, unless such air ambulance is pre-positioned within the limits of
Georgia prior to receiving the request for transport;
5. An air ambulance licensed in a state
adjacent to Georgia that is responding to a request from a Georgia licensed EMS
Agency;
6. An air ambulance or air
ambulance service owned and operated by a governmental entity whose primary
role is not to transport patients by air ambulance, and who is not receiving
payment for such services;
7. An
air ambulance or air ambulance service owned and operated by a bona fide
non-profit charitable institution and that is not for hire.
(2) Application for a
license or provisional license shall be made to the license officer in the
manner and on the forms approved by the Department, to include at a minimum the
name, address, email address, and employer identification number of the
owner(s).
(3) Renewal of License.
Renewal of any license issued under the provisions of O.C.G.A. Chapter 31-11
shall require conformance with all the requirements of these rules and
regulations as upon original licensing.
(a)
Any license not renewed prior to the license expiration date is considered
"Lapsed-Failure to Renew" and is not permitted to operate as an Air Ambulance
Service. Late renewal is permitted during the three (3) month period
immediately following the expiration date for the last license renewal cycle.
After that three-month period, and the agency must apply as a new applicant in
accordance with applicable rules and regulations.
(4) Air Ambulance Services must have
appropriate and current Federal Aviation Administration (FAA) approval to
operate an Air Ambulance Service or Helicopter Air Ambulance Operation, as
defined in 14 CFR § 135.
(5)
Standards for Air Ambulances
(a) General:
1. Air Ambulances must have appropriate and
current FAA approval (pursuant to 14 CFR § 135 and other applicable federal
regulations) to operate as an Air Ambulance;
2. Air Ambulances must be maintained on
suitable premises that meet the Department's specifications. The Department is
authorized to establish policy to define minimal standards for suitable
premises and base of operations.
3.
The Air Ambulance must be properly equipped, maintained, and operated in
accordance with other rules and regulations contained herein and be maintained
and operated so as to contribute to the general well-being of patients. The
aircraft must have an appropriate system for ensuring an adequate temperature
environment suitable for patient transport.
4. All Air Ambulances must be equipped with
approved safety belts and restraints for all seats.
5. Prior to use, Air Ambulances must be
inspected and approved by the Department and so registered by affixing a
Department decal at a location specified by the Department.
6. Prior to disposal by sale or otherwise, an
Air Ambulance removed from service must be reported to the
Department.
7. The Department shall
utilize the airframe's "N" number issued by the FAA to identify each registered
Air Ambulance.
(b)
Insurance:
1. The Air Ambulance Service must
have bodily injury, property damage, and professional liability insurance
coverage that meets or exceeds
14 C.F.R. §
205.5.
2. No Air Ambulance shall be registered nor
shall any registration be renewed unless the Air Ambulance has current
insurance coverage as required by this section. A certificate of insurance or
satisfactory evidence of self-insurance shall be submitted to the license
officer for approval prior to the issuance or renewal of each Air Ambulance
license or registration. Satisfactory evidence that such insurance is at all
times in force and effect shall be furnished to the license officer, in such
form as he may specify, by all licensees required to provide proof of such
insurance under this section. Any lapse in insurance coverage will be grounds
for immediate revocation of the Air Ambulance Service license.
3. Air Ambulance Services must maintain files
as required by the FAA.
4. The Air
Ambulance shall list the Georgia Office of EMS and Trauma as an additional
certificate holder for the vehicle insurance with the insurance
company.
(c) Fees:
1. Any fee submitted to the Department that
results in insufficient funds will be assessed a non-sufficient fund fee. The
return check fee and non-sufficient fee will be due within two business days by
cashier's check.
(d)
Communication:
1. Each registered Air
Ambulance shall be equipped with a two-way communication system that provides
air ambulance-to-hospital communications.
2. Each registered Air Ambulance shall have
two-way communication with the location receiving requests for emergency
service.
(e) Infectious
Disease Exposure Control:
1. Each Air
Ambulance Service shall have a written exposure control plan approved by their
Medical Director.
2. Air Ambulance
Services and Emergency Medical Services Personnel shall comply with all
applicable local, state, and federal laws and regulations in regard to
infectious disease control procedures.
(f) Equipment and Supplies:
1. All equipment and supplies must be
maintained in working order and shall be stored in an orderly manner so as to
protect the patient.
2. No supplies
may be used after their expiration date.
3. In order to substitute any item for the
required items, written approval must be obtained from the Department. The
Department shall have authority to grant exceptions and substitutions and shall
maintain and distribute an up-to-date policy listing of all approved exceptions
and substitutions.
4. The
Department shall establish through policy the minimum equipment and supplies
required on each Air Ambulance; however, other equipment and supplies may be
added as desired.
(6) General Provisions for Air Ambulance
Services
(a) Each Air Ambulance while in
service shall be staffed by two Georgia licensed healthcare providers:
1. When responding to an emergency scene at
least one of the personnel shall be a registered nurse, physician's assistant,
nurse practitioner, or physician and the second person must be a Paramedic,
both of whom must be licensed in Georgia;
2. When responding for an interfacility
transfer, at least one of the personnel shall be a registered nurse, nurse
practitioner, physician's assistant, or physician and the second person must be
at least a Paramedic or other non-EMS licensed healthcare provider as approved
by either the transferring or receiving physician, both of whom must be
licensed in Georgia;
3. Personnel
shall have successfully completed training specific to the air ambulance
environment;
4. Personnel shall
neither be assigned, nor assume the cockpit duties of the flight crew members
concurrent with patient care duties and responsibilities;
5. Personnel shall have documentation of
successful completion of training specific to patient care in the air ambulance
transport environment in general and licensee's operation, in specific, as
required by the Department; and
6.
If a Paramedic possesses an additional Georgia healthcare provider license,
then the Paramedic may perform to the higher level of training for which he or
she is qualified under that license when directed to do so by a physician,
either directly or by approved protocols.
(b) If an air ambulance transport is
requested for an inter-hospital transfer, then such transfer shall be conducted
by licensed Air Ambulance Services utilizing registered Air
Ambulances.
(c) Air Ambulance
Services shall be provided on a twenty-four hour a day, seven day a week basis
unless weather or mechanical conditions prevent safe operations.
(d) Personnel shall be available at all times
to receive emergency telephone calls and provide two-way
communications.
(e) Medical
Direction for Air Ambulance Services
1. The
Air Ambulance Service Medical Director shall be a physician licensed to
practice medicine in the state of Georgia, must complete Department required
training, and must be approved by the Department. The Air Ambulance Service
Medical Director must agree in writing to provide medical direction to that
particular Air Ambulance Service.
2. The Air Ambulance Service Medical Director
shall serve as medical authority for the Air Ambulance Service, serving as a
liaison between the Air Ambulance Service and the medical community, medical
facilities and governmental entities.
3. It will be the responsibility of the Air
Ambulance Service Medical Director, to provide for medical direction,
specifically to ensure there is a plan to provide medical oversight of patient
care delivered by air medical personnel during transport, to include on-line
medical control or off-line medical control (through written guidelines or
policies) and also to participate in training for the air ambulance personnel,
in conformance with acceptable air ambulance emergency medical practices and
procedures.
4. Duties of the Air
Ambulance Service Medical Director shall include, but not be limited to, the
following:
(i) The approval of policies and
procedures affecting patient care;
(ii) The development and approval of medical
guidelines or protocols;
(iii) The
formulation and evaluation of training objectives;
(iv) Continuous quality improvement of
patient care.
5. Each Air
Ambulance Service shall have a minimum set of clinical guidelines and/or
protocols for the assessment, treatment and transportation of both adult and
pediatric patients as specified by the Department.
6. All Air Ambulance personnel shall comply
with appropriate policies, protocols, requirements, and standards of the Air
Ambulance Service Medical Director, provided such policies and protocols are
not in conflict with these Rules and Regulations, the Department-specified
Scope of Practice, or other state statutes.
(f) Control of patient care at the scene of
an emergency shall be the responsibility of the individual in attendance most
appropriately trained and knowledgeable in providing prehospital emergency
stabilization care and transportation. When a Medic arrives at the scene of a
medical emergency, the Medic may act as an agent of a physician when a
physician-patient relationship has been established.
1. For purposes of this section, a
physician-patient relationship has been established when:
(i) A Medic utilizes medical control, either
through direct on-line medical control or off-line medical control, by the use
of medical protocols established by the local Medical Director; or
(ii) A physician is on the scene and
demonstrates a willingness to assume responsibility for patient management or
purports to be the patient's personal physician and the Medic takes reasonable
steps to immediately verify the medical credentials of the physician.
2. Once a physician-patient
relationship has been established, the Medic must follow the medical direction
of that physician. In the event of a conflict between the medical direction
given and the medical protocols established by the local Medical Director, the
Medic should immediately contact their local Medical Director.
(g) Air Ambulance Services and
applicants for Air Ambulance Services shall not misrepresent or falsify any
information, applications, forms or data filed with or submitted to the
Department.
(h) Air Ambulance
Services shall not employ, continue in employment, or use as Medics any
individuals who are not properly licensed under the applicable provisions of
O.C.G.A. Chapter 31-11 and these rules and regulations.
(7) CLIA Certification
(a) All Air Ambulance Services must maintain
current CLIA certification as a laboratory that is permitted to perform waived
tests, as defined in 42 CFR
§
493.2.
1.
Documentation regarding this certification must be submitted to the Department
in a manner and on forms specified by the
Department.
Notes
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