Ga. Comp. R. & Regs. R. 511-9-2-.08 - Licensure of Neonatal Transport Services

(1) Applicability.

(a) Any Ground Ambulance Service may utilize a registered and approved Ground Ambulance for the transport of Neonates.

(b) Any Air Ambulance Service may utilize a registered and approved Air Ambulance for the transport of Neonates.

(c) No person shall operate, advertise, or hold themselves out to be a licensed Neonatal Transport Service, or advertise as such without meeting the following requirements and without being duly licensed by the Department. However, the provisions of this chapter shall not apply to any neonatal transport vehicle operated by an agency of the United States government.

(2) Application for a license or provisional license shall be made to the license officer in the manner and on the forms prescribed by the Department, to include at a minimum the name, address, email address, and employer identification number of the owner(s).

(3) Fees.

(a) 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.

(4) Renewal of License. Renewal of any license issued under the provisions of these rules shall require conformance with all the requirements of these rules 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 a Neonatal 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.

(5) Standards for Neonatal Transport Vehicles.

(a) General.

1. A registered Neonatal Transport Vehicle is a special type of vehicle and must be maintained on suitable premises that meet the Department's specifications. The Department is authorized to establish policy to define minimum standards for suitable premises and Base of Operations.

2. The registered Neonatal Transport Vehicle must be properly equipped, maintained, and operated in accordance with these rules and regulations so as to contribute to the general well-being of patients. Heat and air conditioning must be available and operational in both the patient compartment and driver compartment.

3. The Neonatal Transport Vehicle must have sufficient floor space to accommodate two neonatal transport isolettes and a crew of three in the patient compartment.

4. Each Neonatal Transport Vehicle must be equipped with an electrical generator of at least 3.0 kilowatt output and an electrical inverter or motor generator of at least 1000 watts capacity.

5. There must be at least one compressed air outlet and one oxygen outlet available to each isolette.

6. There must be at least one duplex electrical outlet available to each isolette.

7. There must be at least one electrical wall-mounted suction outlet in the vehicle.

8. All registered Neonatal Transport Vehicles must be equipped with approved safety belts for all seats.

9. Registered Neonatal Transport Vehicles must be inspected and approved by the Department and so designated by affixing a Department decal at a location specified by the Department.

10. Prior to disposal by sale or otherwise, a registered Neonatal Transport Vehicle removed from service must be reported to the Department.

11. All registered Neonatal Transport Vehicles shall have on both sides of the vehicle an identification number designated by the Department. The name of the service and the number shall be visible on each side of the vehicle in at least 3-inch lettering for proper identification. In addition, each vehicle shall have the words "neonatal" or "neonatal transport" prominently displayed on each side of the vehicle.

(b) Insurance.

1. Every registered Neonatal Transport Vehicle shall have at least $1,000,000 combined single limit (CSL) insurance coverage.

2. No Neonatal Transport Vehicle shall be registered nor shall any registration be renewed unless the vehicle has insurance coverage in force 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 Neonatal Transport Service license. Satisfactory evidence that such insurance is at all times in force and effect shall be furnished to the license office, in such form as the license officer 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 neonatal transport service license.

3. Neonatal Transport Services must maintain a file, as defined in departmental policy, of all maintenance records on each vehicle registered by the Department.

4. The Neonatal Transport Service must list the Georgia Office of EMS and Trauma as an additional certificate holder for the vehicle insurance with the insurance company.

(c) Communication.

1. Each registered Neonatal Transport Vehicle shall be equipped with a two-way communication system that provides ambulance-to-hospital communications.

(d) Infectious Disease Exposure Control.

1. Each Neonatal Transport Service shall have a written infectious disease exposure control plan approved by the local medical director.

2. Neonatal Transport 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.

(e) 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 and shall be readily accessible when needed.

2. Supplies may not be used after their expiration date.

3. In order to substitute any item from 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. Vehicles approved to operate as both a Neonatal Transport Vehicle and a Ground Ambulance must be inspected as both.

5. The Department shall establish through policy the minimum equipment and supplies required for each neonatal transport unit while being used to transport Neonates; however, other equipment may be added as desired.

(f) Supplies and Medications.

1. The types and quantities of supplies and medications to be carried in the vehicle while being used to transport neonates shall be determined by the Medical Director of the Neonatal Transport Service in conformance with current medical standards of care in the treatment and transportation of neonates.

2. A listing of the supplies and medications shall be updated at least annually and signed by the Medical Director and a copy thereof is to be in the vehicle at all times. This list shall be used for any inspection purposes by the Department.

(g) Personnel.

1. Neonatal Transport Personnel shall function under protocols developed by the Medical Director.

2. Neonatal Transport Personnel with appropriate skills to treat and transport a neonate must be in the patient compartment during transport. Documentation attesting to their qualifications shall be signed by the local Medical Director and on file at the base location.

3. The driver of the vehicle shall be a Georgia licensed Medic.

4. A minimum of two patient care personnel shall be in the patient compartment and shall consist of any combination of the following during initial transport to the tertiary care center as determined by the local Medical Director:

(i) Paramedic;

(ii) Registered Nurse;

(iii) Respiratory Care Technician;

(iv) Physician's Assistant; or

(v) Physician.

Only one of the above shall be required in the patient compartment during transport back to the initial referring facility.

(6) General Provisions.

(a) The local Medical Director shall be a physician licensed to practice medicine in the state of Georgia, be a member of the staff of the neonatal intensive care facility from which the service originates or with which the service is contracted, and provide medical direction for the Neonatal Transport Service.

(b) Neonatal Transport Services shall be provided on a twenty-four hour, seven day a week basis.

(c) Neonatal Transport Services and applicants for Neonatal Transport Services shall not misrepresent or falsify any information, applications, forms or data filed with or submitted to the Department or completed as a result of any ambulance response.

(7) CLIA Certification

(a) All Neonatal Transport 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

Ga. Comp. R. & Regs. R. 511-9-2-.08

O.C.G.A. §§ 31-2A-3, 31-2A-6, 31-11-5 to 31-11-7, 31-11-9, 31-11-30 to 31-11-36, 31-11-50, 31-11-53.1, 31-11-60.1, 31-12-8, 40-6-6.

Original Rule entitled "Licensure of Neonatal Transport Services" adopted. F. December 14, 2011; eff. January 3, 2012. Amended: F. Apr. 27, 2016; eff. May 17, 2016. Amended: F. Sept. 29, 2021; eff. Oct. 27, 2021, as specified by the Agency. Amended: F. Feb. 17, 2025; eff. Mar. 16, 2025, as specified by the Agency.