W. Va. Code R. § 64-48-5 - [Effective 8/1/2025] Vehicles

5.1. General Requirements.

5.1.1. Unless specified differently herein, ground ambulances must meet applicable U.S. Government Services Agency or subsequent federally approved specifications at the time of the vehicle's manufacture.

5.1.2. Each EMS vehicle must be maintained in good repair and operating condition and shall have a current state inspection if required by the state issuing the vehicle license.

5.1.3. EMS vehicles may not be maintained or operated except by a licensed EMS agency. United States government EMS vehicles are exempt from this requirement.

5.1.4. The EMS agency may exercise emergency operating privileges, including the use of audible and visible emergency warning devices, only during response to the location of an emergency call, while at the location, and during transportation of a patient. Operation of these devices must be in compliance with W. Va. Code § 17C-2-5.

5.1.5. All operators of ground EMS vehicles shall meet the requirements of paragraphs 6.7.1.i, 6.7.1.j., and 6.7.1.k. of this rule, in addition to minimum standards established for the individual's level of licensure.

5.1.6. Sanitation. -- The following requirements for sanitary conditions apply to all EMS vehicles:

5.1.6.a. The interior of EMS vehicles, including all storage areas, linens, equipment, and supplies must be clean and sanitary;

5.1.6.b. Freshly laundered linen or disposable sheets and pillow cases must be used during the transporting of patients and shall be changed after each use;

5.1.6.c. Pillows and mattresses used in EMS vehicles must be clean and in good repair;

5.1.6.d. Plastic bags, covered containers, or compartments must be used for the storage of soiled supplies and used disposable items. Biohazard bags clearly marked with the biohazard symbol shall be used for infectious waste;

5.1.6.e. Exterior surfaces must be clean;

5.1.6.f. Blankets used in EMS vehicles must be clean and replaced after use;

5.1.6.g. Single use devices or supplies must be stored in a sterile manner and appropriately disposed of after use. Reusable items must be sterilized in accordance with current medical practices;

5.1.6.h. Waterless antibacterial hand cleaner must be available on each EMS vehicle;

5.1.6.i. A bleach or disinfectant solution, approved by the United States Centers for Disease Control, must be available on EMS vehicles for cleaning purposes;

5.1.6.j. A disposal container for used sharp items must be available on each EMS vehicle; and

5.1.6.k. The EMS agency shall ensure that, when EMS vehicles are used to transport a patient with an infectious disease, all interior contact surfaces must be cleaned and disinfected prior to being occupied by another patient.

5.1.7. Equipment and Supplies. -- The EMS agency shall ensure that each EMS vehicle has all required equipment and supplies necessary for the level of service being provided while en route to an incident, at the scene, and during transport of a patient.

5.1.7.a. The EMS agency shall ensure that vehicle equipment is maintained in good working operation at all times.

5.1.7.b. The EMS agency shall ensure that supplies are restocked as necessary to maintain the minimum requirements during each response.

5.1.8. The operator's compartment must accommodate safe operation of the EMS vehicle.

5.1.9. Safety belts must be available and operational for all seat positions in EMS vehicles; no shoulder harness-type restraints are allowed on side-facing seat positions.

5.1.10. All EMS vehicles must have a lockable storage compartment for medications in accordance with federal Drug Enforcement Administration regulations.

5.1.11. Exterior Vehicle Marking Requirements:

5.1.11.a. All ground ambulances purchased on or after July 1, 2018, shall be consistent with 2017 reflective marking standards published by the Commission on Accreditation of Ambulance Services (CAAS).

5.1.11.b. An EMS vehicle may only be lettered with the terms "Paramedic," "Advanced Life Support," "Critical Care Transport," or similar service-level designations when the vehicle is licensed by OEMS for that level of service.

5.1.11.c. The public access emergency telephone number 9-1-1 must be displayed on the ambulance. SMPMT and non-public access EMS vehicles may display a different number.

5.1.11.d. Emergency warning lights must be visible from all four sides of the vehicle.

5.1.11.e. One or more audible warning devices must be installed to provide adequate audible warning.

5.1.11.f. All EMS vehicles must have communications equipment which provides voice communication between the vehicle and its dispatch center, other EMS vehicles of the same EMS agency, and medical command. Communication equipment must be operational and compatible with the EMS communication system and comply with state and federal rules, regulations, policies, and protocols.

5.1.12. Inspection. -- All EMS vehicles are subject to inspection by the Secretary for compliance with this rule at any time and without prior notification. This inspection is in addition to other inspections required for EMS vehicles by federal, state, or local law, rules, and regulations.

5.2. Non-Transporting EMS Vehicles.

5.2.1. The EMS agency may use non-transporting EMS vehicles intended for the immediate movement of personnel and equipment to the location of an incident. Personally owned vehicles (POVs) may be used for similar purposes and are exempt from this rule, provided that they are authorized by the official representative of the licensed EMS agency. POVs and their operators are subject to requirements of the Division of Motor Vehicles and OEMS Emergency Vehicle Permit program.

5.2.2. Non-transporting EMS vehicles may not be used for the transportation of patients, except in the case of a disaster.

5.3. Transporting EMS Vehicles, excluding SMPMT vehicles, must meet the following requirements:

5.3.1. Transporting EMS vehicles are used for the delivery of basic or advanced life support or critical care transport. The equipment, supplies, and staffing required are dependent upon the level of service being provided on a particular incident as specified in the Medical Direction System's policy, protocols, and scope of practice. Transporting EMS vehicles may be used to deliver services at the level at which they are certified or below. Transporting EMS vehicles may not deliver services at levels exceeding that at which they are certified.

5.3.2. Staffing is dependent upon the level of service being provided on a particular incident as specified in the Medical Direction system's policy, protocols, and scope of practice and appropriate staff shall be onboard at all times during patient treatment and transport:

5.3.2.a. BLS -- at a minimum a licensed EMVO and EMT;

5.3.2.b. ALS -- at a minimum a licensed EMVO and AEMT or Paramedic, provided that individual protocols may specify alternative staffing as specified by the OEMS Medical Direction System.

5.3.2.c. Critical care transport -- at a minimum a licensed EMVO and two MCCPs, or one MCCP and one MCCN as required by treatment guidelines and policies specific to the individual patient's care requirements as specified by the OEMS Medical Direction System. Hospital-based specialty medical personnel may replace one of the licensed personnel for the purpose of providing a higher level of care required by a particular patient.

5.3.2.d. The minimum equipment and supplies required are dependent upon the level of service being provided on a particular incident as specified in OEMS's policy, protocols, and scope of practice and shall be onboard at the time of response and during patient treatment and transport.

5.4. Air Ambulance. -- There shall be two categories, one for rotary wing aircraft and one for fixed wing aircraft. All EMS agencies engaging in air ambulance service under this rule shall operate in accordance with Federal Aviation Administration rules, 14 CFR Part 135.

5.4.1. Rotary Winged Aircraft.

5.4.1.a. A rotary winged aircraft is intended for response to the location of an EMS incident or for inter-facility transportation of patients.

5.4.1.b. The aircraft patient compartment must accommodate at least two medical personnel who must have access to the patient's head and upper body from a seat-belted position while in flight and at least one stretcher patient; and:

5.4.1.b.1. Provide necessary space to ensure that the patient's airway is maintained and to provide adequate ventilator support from a secured, seat-belted position of medical personnel; and

5.4.1.b.2. Be configured to allow medical personnel to have full-body patient view and access, and access to equipment and supplies to initiate basic, advanced, and critical care life support emergency procedures while in flight.

5.4.1.c. The cockpit must be configured so that flight controls and pilot communications equipment are protected from intended or accidental interference by the patient or medical equipment and supplies.

5.4.1.d. Door openings must accommodate the loading of a stretcher without compromising the stability of the patient or the functioning of monitoring systems, intravenous lines, and manual or mechanical ventilation;

5.4.1.e. A visible warning device may be installed on the underside of the aircraft to provide adequate day and night emergency warning. An audible warning device may be installed to provide adequate emergency warning and external voice communications;

5.4.1.f. Patient area lighting may not interfere with the safe operation of the aircraft; and

5.4.1.g. The aircraft must have communications equipment which provides voice communications between the aircraft and its base of operation, between the aircraft and other EMS aircraft of the same EMS agency for which this requirement applies and between the aircraft and a Medical Command Center. The communications equipment must be operational and compatible with the communications system and comply with state and federal rules, regulations, policies, and protocols.

5.5. An EMS Agency may use rotary winged aircraft for the delivery of critical care transport. The equipment, supplies, and staffing required are dependent upon the level of service being provided on a particular incident as specified in the Medical Direction System's policy, protocols, guidelines, and scope of practice.

5.5.1. Staffing requirements are determined by the level of service being provided on a particular incident as specified in the Medical Direction System's policy, protocols, and scope of practice. The following must be onboard at all times during patient treatment and transport:

5.5.1.a. Critical care transport -- a minimum of a pilot-in-command and one MCCP and one MCCN. Hospital-based specialty medical personnel may replace one of the licensed EMS personnel for the purposes of providing a higher level of care required by a particular patient;

5.5.1.b. The minimum equipment and supplies as defined by OEMS policy are determined by the level of service being provided on a particular incident and must be onboard at the time of response and during patient treatment and transport.

5.5.2. Fixed Wing Aircraft.

5.5.2.a. A fixed wing aircraft is primarily intended for extended air transport between medical facilities within the state or across state boundaries.

5.5.2.b. The aircraft patient compartment must accommodate at least two medical personnel who must have access to the patient's head and upper body from a seat-belted position while in flight and at least one stretcher patient and:

5.5.2.b.1. Provide necessary space to ensure that the patient's airway is maintained and to provide adequate ventilator support from a secured, seat-belted position of medical personnel.

5.5.2.b.2. Be configured to allow medical personnel to have full-body patient view and access, and access to equipment and supplies to initiate basic, advanced, and critical care life support emergency procedures.

5.5.2.c. The cockpit must be configured so that flight controls and pilot communications equipment are protected from intended or accidental interference by the patient or medical equipment and supplies.

5.5.2.d. Door openings must accommodate the loading of a stretcher without compromising the stability of the patient or the functioning of monitoring systems, intravenous lines, and manual or mechanical ventilation.

5.5.2.e. Patient area lighting may not interfere with the safe operation of the aircraft.

5.5.2.f. All aircraft must have communications equipment which provides voice communications between the aircraft and its base of operation and voice communications between the aircraft and other aircraft of the same EMS agency for which this requirement applies and between the aircraft and its Medical Command Center. The communications equipment must be operational and compatible with the communications system and comply with state and federal rules, regulations, policies, and protocols.

5.5.2.g. Staffing is determined by the level of service being provided on a particular incident as specified by Medical Direction System's policy, protocols, and scope of practice and appropriate staff shall be onboard at all times during patient treatment and transport:

5.5.2.g.1. BLS. -- a minimum of a pilot-in-command and an EMT;

5.5.2.g.2. ALS. -- a minimum of a pilot-in-command and Paramedic, provided that individual protocols may specify alternative staffing as specified by the OEMS Medical Direction System;

5.5.2.g.3. Critical care transport. -- a minimum of a pilot-in-command and two MCCPs, or one MCCP and one MCCN based on treatment guidelines and policies as specified by the OEMS Medical Direction System. Hospital-based specialty medical personnel may replace one of the licensed EMS personnel for the purpose of providing a higher level of care required by a particular patient.

5.5.2.g.4. The minimum equipment and supplies as defined by OEMS policy are determined by the level of service being provided on a particular incident and must be onboard at the time of response and during patient treatment and transport.

5.6. SMPMT vehicles:

5.6.1. A SMPMT vehicle is used to transport patients, with a medical history and no apparent immediate need for any level of medical supervision, to and from scheduled medical appointments.

5.6.2. SMPMT vehicles must be maintained in good repair and operating condition and have a current state inspection, if required by the state issuing the vehicle license.

5.6.3. The interior of SMPMT vehicles, including all storage areas, equipment, and supplies must be clean and sanitary;

5.6.4. Safety belts must be available and operational for all seat positions in SMPMT vehicles.

5.6.5. SMPMT vehicles shall not be equipped with any form of stretcher.

5.6.6. An EMS agency may not use a SMPMT vehicle for delivery of basic or advanced life support, except in the case of a disaster.

5.6.7. SMPMT vehicle specifications include the following:

5.6.7.a. The vehicle may be a commercial passenger van or specially modified passenger van. Passenger sedans, limousines, recreational vehicles, and sport utility vehicles with fewer than three passenger doors and a wheelbase of less than 100 inches are not permitted.

5.6.7.b. The name of the agency must appear on both sides and the back of the vehicle in four inch minimum-height letters. Clearly readable logos or emblems are acceptable.

5.6.7.c. A contact phone number, other than 9-1-1, may appear on the vehicle.

5.6.7.d. Neither the word ambulance nor other emergency designation must appear on the vehicle; Provided: That such appearing as part of the name of the agency shall be exempt.

5.6.7.e. A Star of Life is not permitted on the vehicle.

5.6.8. Equipment and supplies for SMPMT vehicles include:

5.6.8.a. Communications equipment which provides voice communications between the vehicle and its dispatch center; and

5.6.8.b. The minimum equipment and supplies required are as specified in OEMS's policy.

5.6.9. All SMPMT vehicles must be inspected by OEMS.

5.6.10. SMPMT vehicles must be staffed with one person who shall be licensed, at a minimum, as an EMVO pursuant to subsection 6.7. of this rule.

Notes

W. Va. Code R. § 64-48-5