202 KAR 7:560 - [Effective until 9/28/2029] Ground vehicle staff
RELATES TO: KRS 189.910-189.950, 311A.030, 311A.190
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
311A.020 requires the Board of
Section 1. Staffing
Requirements.
(1) Each Class I agency BLS
ambulance shall at minimum, be staffed by:
(a)
A driver certified as an emergency medical responder (EMR); and
(b) An attendant certified as an emergency
medical technician (EMT).
(2) Each Class I agency ALS ambulance shall
at minimum be staffed by:
(a) A driver
certified as an emergency medical responder (EMR); and
(b) An attendant certified as an Advanced EMT
or licensed as a paramedic.
1. Each Class I
ALS agency shall ensure that it has at least one (1) paramedic on-duty at all
times.
2. To ensure compliance,
each agency shall maintain its work schedules from the previous twelve (12)
months until reviewed by board staff during its annual inspection.
(3) Each Class I agency
operating an ALS ambulance providing a BLS level of care shall at minimum be
staffed by:
(a) A driver certified as an
emergency medical responder (EMR); and
(b) An attendant certified as an emergency
medical technician (EMT).
(4) Each Class II agency shall at minimum be
staffed by:
(a) A driver certified as an
emergency medical responder (EMR); and
(b) An attendant certified as an emergency
medical technician (EMT).
(5) A Class III Adult Critical Care ambulance
agency shall at minimum be staffed by:
(a) A
driver certified as an emergency medical responder (EMR);
(b) An attendant licensed as a paramedic;
and
(c) One (1) licensed:
1. Registered nurse;
2. Advanced practice registered
nurse;
3. Respiratory
therapist;
4. Physician
assistant;
5. Physician ;
or
6. Additional
paramedic.
(6)
(a)
Each Class III Pediatric Specialty Care Ambulance Agency shall at minimum be
staffed by:
1. A driver certified as an
emergency medical responder (EMR);
2. A primary attendant licensed as a
registered nurse; and
3. One (1)
additional attendant licensed as a:
a.
Registered nurse;
b. Advanced
practice registered nurse;
c.
Respiratory therapist;
d. Physician
assistant;
e. Physician ;
or
f. Paramedic.
(b) Any attendant hired
after January 1, 2020 shall acquire and maintain within one (1) year of hire, a
specialty certification in Pediatric Critical Care or Neonatal Critical Care
acquired through successful completion of a validated examination administered
by an independent entity not associated with a specific course or program of
education.
(7)
(a) Each Class III Neonatal Specialty Care
Ambulance Agency shall at minimum be staffed by:
1. A driver certified as an emergency medical
responder (EMR);
2. A primary
attendant licensed as a registered nurse; and
3. One (1) additional attendant licensed as:
a. An advanced practice registered
nurse;
b. A respiratory
therapist;
c. A physician
assistant;
d. A
physician ;
e. A registered nurse;
or
f. Paramedic.
(b) Any attendant hired
after January 1, 2020 shall acquire and maintain within one (1) year of hire, a
specialty certification in Pediatric Critical Care or Neonatal Critical Care
acquired through successful completion of a validated examination administered
by an independent entity not associated with a specific course or program of
education.
(8) Each
Class IV agency operating a BLS ambulance shall at minimum be staffed by:
(a) A driver certified as an emergency
medical responder (EMR); and
(b) An
attendant certified as an emergency medical technician (EMT).
(9) Each Class IV service
operating an ALS ambulance shall at minimum be staffed by:
(a) A driver certified as an emergency
medical technician (EMT); and
(b)
An attendant certified as an Advanced EMT or licensed as a paramedic.
(c) Each Class IV ALS agency shall have at
least one (1) licensed paramedic on duty at all times. To ensure compliance,
each agency shall maintain its work schedules from the previous twelve (12)
months until reviewed by board staff during its annual inspection.
(10) Each Class VI BLS medical
first response agency shall at minimum be staffed by a certified:
(a) Emergency medical responder (EMR);
or
(b) Emergency medical technician
(EMT).
(11) Each Class
VI ALS medical first response agency shall at minimum be staffed by:
(a) A certified Advanced EMT; or
(b) A licensed paramedic.
(12) Each Class VIII BLS agency
shall be minimally staffed by a certified:
(a)
Emergency medical responder (EMR); or
(b) Emergency medical technician
(EMT).
(13) Each Class
VIII ALS agency shall be minimally staffed by:
(a) A certified Advanced EMT; or
(b) A licensed paramedic.
(14) At all times, the attendant
shall monitor the patient and remain with the patient in the patient
compartment.
(15) This
administrative regulation shall not prevent an agency from utilizing staff
other than those required by this administrative regulation in:
(a) Disasters;
(b) Mass casualty incidents; or
(c) Extraordinary scene conditions that would
impair the safety of the patient or personnel operating at the scene.
(16) Alternative staff shall not
operate a licensed vehicle unless the:
(a)
Agency administrator so directs; and
(b) Vehicle is out of service and not subject
to an emergency response.
Section 2. Temporary Waiver of Paramedic
Staffing Requirement.
(1) Notwithstanding
Section 1(2)(b)1. of this administrative regulation or
202 KAR 7:550, Section 10(5), if
the board grants a temporary waiver to a Class I ALS agency pursuant to this
section, the agency shall ensure that it has at least one (1) AEMT or one (1)
paramedic on duty at all times.
(2)
A Class I ALS agency may request a temporary waiver by submitting to the office
of the board a sworn and notarized affidavit from the agency's chief operations
or service director. In the affidavit, the chief operations or service director
shall:
(a) Explain why the agency is unable
to have at least one (1) paramedic on duty at all times;
(b) Explain the steps the agency has taken to
have at least one (1) paramedic on duty at all times;
(c) Identify the number of paramedics the
agency has on staff;
(d) Identify
the compensation the agency pays paramedics;
(e) Identify the additional steps the agency
will take to hire paramedics;
(f)
Identify the number of ambulances the agency has staffed each day;
and
(g) Certify that the chief
local elected official of the agency's geographic service area has been
notified, in writing, that the agency is requesting a temporary waiver pursuant
to this section.
(3) The
chief operations or service director shall attach to the affidavit any
documentation supporting the statements made in the affidavit.
(4) In addition to the affidavit and any
supporting documentation submitted pursuant to subsections (2) and (3) of this
section, the board may consider any other relevant information in determining
whether to grant a temporary waiver.
(5) The board shall grant a request for a
temporary waiver if it determines that the agency has made a good faith effort
to have at least one (1) paramedic on duty at all times but has been unable to
do so.
(6) If the board has
probable cause to believe that the agency has not made a good faith effort to
have at least one (1) paramedic on duty at all times, the board shall refer the
matter for a hearing in accordance with KRS Chapter 13B to determine whether a
temporary waiver should be granted to the agency.
(7) An agency granted a temporary waiver
pursuant to this section shall submit a report to the office of the board on
January 1, April 1, July 1, and October 1 of each year. Each report shall
include:
(a) The additional steps the agency
has taken to hire paramedics since the last report deadline or, if no report
deadline has passed, since the temporary waiver was granted;
(b) The number of paramedics on
staff;
(c) The number of days that
the agency was without at least one (1) paramedic on duty at all times since
the last report deadline or, if no report deadline has passed, since the
temporary waiver was granted;
(d)
The number of paramedic employment applications received by the agency since
the last report deadline or, if no report deadline has passed, since the
temporary waiver was granted; and
(e) For each paramedic who applied for
employment with the agency since the last report deadline or, if no report
deadline has passed, since the temporary waiver was granted, but was not hired
by the agency, the reasons why the paramedic was not hired.
(8) An agency granted a temporary
waiver in the month preceding a report deadline is not required to submit the
next month's report. (For example, if the temporary waiver is granted in March
2025, the agency is not required to submit the April 1, 2025 report.)
(9) All temporary waivers granted pursuant to
this section shall expire on December 31, 2026.
(10) Notwithstanding subsection (9) of this
section, if an agency fails to submit a report required by subsection (7) of
this section, the agency's temporary waiver shall expire seven (7) days after
the report deadline if the report still has not been received by the office of
the board by that date.
(11) The
board shall publish on its Web site all agencies that have been granted a
temporary waiver pursuant to this section.
Section 3. Motor Vehicle Operator
Requirements.
(1) Each person operating a
vehicle shall:
(a) Be at least eighteen (18)
years of age;
(b) Hold a valid
driver's license in any state or territory of the United States; and
(c) Complete at least four (4) hours of
driver training and education every two (2) years.
(2) The driver training and education shall
consist of a:
(a) Review of driving a vehicle
under emergency conditions;
(b)
Review of KRS
189.910 through
189.950 regarding operation of
emergency vehicles;
(c)
Demonstration by the student of forward and back-up driving maneuvers in a
controlled situation, such as in an obstacle course designed specifically for
this purpose; and
(d) Review of
defensive driving techniques and procedures with hands-on experience or
exposure by visual aids or planned demonstrations.
Section 4. Public Notice of
Negative Action. The board office shall cause to be published, on the KBEMS Web
site or similar publication of the board, or otherwise disseminate, the name of
any licensed agency that is fined, placed on probationary status, placed on
restricted status, suspended, or had a license revoked.
Notes
STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.190
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