Ala. Admin. Code r. 420-2-1-.11
Current through Register Vol. 43, No. 1, October 31, 2024
Section 420-2-1-.11 - Licensure For Emergency Medical Provider Services(1) No person shall operate an emergency medical provider service until obtaining a license. All emergency medical provider service licenses are issued by the OEMS under the authority of the Board. Each emergency medical provider service license will be issued with the appropriate level of authorization.(2) Categories of emergency medical provider service licenses.(a) ALS Transport (ground or air)(3) Classification of emergency medical provider services licenses. (a) Unrestricted - An unrestricted license may be granted by the Board after it has determined that the EMS provider is willing and capable of maintaining compliance with these rules.(b) Probationary - At its discretion, the Board may grant a probationary license or downgrade an unrestricted license, for a specific period which shall not exceed 1 year, when it determines that the provider has engaged in one or more deficient practices which are serious in nature, chronic in nature, or which the provider has failed to correct. This failure could lead to additional licensure actions including suspension or revocation.(4) Categories of ALS emergency medical provider service license authorizations. (a) ALS Level 1: Paramedic authorization(b) ALS Level 1-Critical Care: Paramedic authorization(c) ALS Level 2: Advanced EMT authorization(d) ALS Level 3: Intermediate authorization(5) Licensure applications shall be submitted to and approved by the OEMS prior to an emergency medical provider service conducting operations. All licenses are valid for a period that shall not exceed 12 months. Applications are available upon request or may be obtained at http://www.alabamapublichealth.gov/ems. In order to apply for licensure, the emergency medical provider service shall submit the following: (a) Completed license application(b) Plans to describe: (initial and when changes occur)2. Fluid and medication security3. Controlled substance (if applicable)4. Employee drug screening5. Emergency Vehicle Operator training (ground providers only)6. Quality Assurance/Quality Improvement(c) Declaration of Citizenship Form, if applicable(d) The following agreements: 1. Emergency Medical Dispatch2. Alabama Incident Management System (AIMS)4. Pharmacy or Pharmaceutical5. Service Medical Director(e) Proof of a minimum of $1,000,000 liability insurance from a carrier licensed by the Alabama Department of Insurance. This includes all transport, non-transport vehicles, and professional liability on all EMSP employed or volunteering for duty. Alternatively, a licensed provider service may be self-insured in the same amount through a plan approved by the OEMS. This liability insurance coverage shall be binding and in force prior to the service being issued a license or authorization.(f) An application fee as provided in Rule 420-1-5-.08(3).(g) A roster of active licensed EMSP appropriate for the category of service desired.(h) Demonstration of an ability to comply with the OEMS patient care reporting requirements.(i) Prior to approval for a license, the OEMS will inspect the proposed emergency medical provider service to determine compliance with § 22-18-1, et seq., Code of Ala. 1975, and the requirements of these rules.(6) Emergency medical provider service licenses shall be renewed before the expiration date provided on the current license. Any service with an expired license shall immediately cease all operations. On the date of expiration, the OEMS will notify all third-party payors and pharmaceutical suppliers regarding the affected service's license status.(7) Each licensed emergency medical provider service shall obtain a separate license for each county in which a ground ambulance, or service area in which an air ambulance, is based. The license shall be displayed in a conspicuous place in the emergency medical provider's main office in the county or service area.(8) The emergency medical provider service license and ALS authorization are nontransferable and shall be granted only to the service operator named on the application.(9) Within 60 calendar days of receipt from the State Board of Health of its initial (first) license to operate as a provider service from a base within a ground provider's licensed county or an air provider's licensed service area, each licensed provider service shall be in continuous operation in the county in which it is licensed, providing emergency response 24 hours a day, 7 days a week, 365 days a year for any emergency medical service request issued within the licensed county. Mutual aid response to other counties is not required but is recommended if resources are available. ALS Non-Transport services and all fully volunteer services are exempt from this requirement, but a fully volunteer transport service must ensure coverage when service is not available.(10) Licensed emergency medical provider services shall ensure:(a) The highest level EMSP provides patient care when treating and transporting any unstable patient.(b) The highest level EMSP has the responsibility to provide care for patients until care is transferred to appropriate medical personnel.(c) Acknowledgement of the ability to respond within minutes of initial dispatch of an emergency call (ground and air providers).(d) An EMS response unit is en route within 7 minutes of the initial dispatch (excluding air medical).(e) The execution of mutual aid and dispatch agreements so that no emergency calls are purposefully delayed.(f) Continuous telephone service with the capability to record or forward calls so that the service is accessible by phone to the public at all times (non-emergency calls).(g) A written roster for an ALS transport service of at least six properly licensed EMSP with a minimum of three at the ALS level of license. ALS non-transport shall have at least one properly licensed EMSP at the level of provider license. A written roster for a BLS transport service of at least three properly licensed EMSP.(h) The provision of immediate verbal notification to the OEMS of any civil or criminal action brought against the service, or any criminal action brought against an employee, and the submission of a written report within 5 working days of the provider becoming aware.(i) The provision of immediate verbal notification to the OEMS and a written report within 5 working days of any accident involving an ambulance that was responding to an emergency, that injured any crew members, or that had a patient on board. A copy of the accident police report must be provided to the OEMS as soon as it becomes available.(j) The provision of an Ambulance Add/Remove via EMS Web Management to the OEMS immediately for any permitted vehicle added or removed from service for any reason other than scheduled maintenance. Information shall include the disposition of the removed vehicle.(11) Compliance with all statewide system components i.e., Trauma, Stroke, and Cardiac) as written in the Alabama OEMS Patient Care Protocols.(12) Licensed emergency medical provider services shall not: (a) Transfer a provider service license certificate or ALS authorization.(b) Self-dispatch or cause a vehicle to be dispatched on a call in which another provider service has been dispatched.(c) Allow EMSP to exceed their scope of practice as outlined within these rules.(d) Intentionally bill or collect from patients or third- party payors for services not rendered.(e) Refuse to provide appropriate treatment or transport for an emergency patient for any reason including the patient's inability to pay.(f) Allow any ALS equipment, fluids, or medications to remain unsecured on a permitted vehicle without the appropriate licensed EMSP on board.(g) Allow EMSP to respond to a medical emergency with the intent to treat or transport a patient unless the EMSP is clean and appropriately dressed.Ala. Admin. Code r. 420-2-1-.11
New Rule: Filed September 20, 1996; effective October 24, 1996. Amended: Filed March 20, 2001; effective April 24, 2001. Repealed and New Rule: Filed December 17, 2007; effective January 21, 2008. Repealed and New Rule: Filed April 20, 2011; effective May 25, 2011.Amended by Alabama Administrative Monthly Volume XXXV, Issue No. 06, March 31, 2017, eff. 4/30/2017.Adopted by Alabama Administrative Monthly Volume XXXVII, Issue No. 05, February 28, 2019, eff. 4/7/2019.Adopted by Alabama Administrative Monthly Volume XXXVIII, Issue No. 07, April 30, 2020, eff. 6/14/2020.Adopted by Alabama Administrative Monthly Volume XL, Issue No. 05, February 28, 2022, eff. 4/14/2022.Rule 420-2-1-.17 was repealed as per certification Filed March 20, 2001; effective April 24, 2001. As a result of this Rule 420-2-1-.21 was renumbered to 420-2-1-.20. Rule 420-2-1-.20 was renumbered 420-2-1-.11 as per certification Filed February 20, 2019; effective April 7, 2019.
Authors: William Crawford, M.D.; Jamie Gray
Statutory Authority:Code of Ala. 1975, § 22-18-1, et seq.