Section 163-4-5 - Licensing Standards1. An application will not be accepted as complete unless it includes all materials required to be evaluated for licensure. To obtain a new license, an applicant must: A. Apply on forms available from Maine EMS.B. Submit a fee of $100.00.C. Demonstrate to Maine EMS that:1. The applicant has placed a notice, approved by Maine EMS, in the most widely circulated newspaper(s) serving the proposed service area(s). The notice must state: (a) The name and legal status of the entity making application.(b) The name of the proposed service;(c) The type of service proposed; (d) The level of care to be provided;(e) The names of the municipalities within the primary response area of the proposed service; (f) That the public is invited to make comment to Maine EMS regarding the proposed application, and that comments must be received by Maine EMS within 30 calendar days after the date of the notice's publication; and,(g) The current mailing address of the Maine EMS office.2. The applicant has made a detailed manual of policies and procedures available for reference in the flight coordination office and available for inspection by Maine EMS to assist with EMS system planning and resource coordination efforts. Personnel shall be familiar and comply with policies contained within the manual, which shall include, but not be limited to: (a) A written policy and procedure specifying the:(i) Service's mission statement; (ii) Scope of care to be provided by the service in accordance with Medical Direction and Practices Board-approved protocols; and(iii) Education, clinical experience and competency requirements of the medical crew commensurate with the scope of care to be provided.(b) Notification phone numbers and access dispatch procedure, including identification of those who may request a mission and those who will approve missions; (c) Capabilities of medical transport personnel;(d) Type of aircraft vehicle(s) used and operational protocols specific to type;(e) Coordination of medical protocols and operating practices with hospital and pre-hospital providers and other public safety agencies;(f) Response and coverage area for the service;(g) Preparation and stabilization of the patient;(h) A safety program of policies and procedures specific to patient care.(i) Coordination of medical protocols and operating practices with those of the hospital and pre-hospital providers and public safety agencies with whom the service will interact; (j) Ongoing familiarization for those ambulance and non-transporting services, public safety agencies, and hospital personnel with whom the air ambulance service may interact routinely. (k) Scene Response Services must have ongoing safety communications program consisting of integration with Public Safety Answering Points and other emergency dispatch facilities in the state.(l) Procedures for acceptance of requests, referrals, and/or denial of service for medically related reasons.(m) Geographical boundaries and features for the service area.(n) Service area maps shall be readily available.(o) Scheduled hours of operation.(p) Criteria for the medical conditions and indications or medical contraindications for flight.(q) Field triage criteria for all trauma patients that include anatomic, physiologic, and situational components identified in order to risk-stratify injury severity and guide decisions as to activation, destination, and transport modality.(r) Procedures for call verification and advisories to the requesting party.(s) Acceptable destinations and landing areas.(t) Procedures for medical crew assignments and notification including rosters of medical personnel.(u) Written policy that ensures that air medical personnel shall not be assigned or assume cockpit duties concurrent with patient care duties and responsibilities.(v) Communications procedures.(w) On-ground communications.(x) Flight cancellation procedures.(y) Mutual aid procedures.(z) Written plan that addresses the actions to be taken in the event of an emergency or patient crisis during transport operations.(aa) Procedures for informing requesting party of flight procedures, anticipated time of helicopter arrival, and termination of flight.(bb) Patient tracking procedures that shall assure air/ground position reports at intervals not to exceed ten (10) minutes (in flight).(cc) Scene Response Services must have provisions for contemporaneous flight following and during all operations and a readily accessible post-accident incident plan as they relate to patient care. (dd) Services that respond to incident scenes and/or support disaster response shall provide Helicopter Safety and Landing Zone Procedures in a written format to all public safety/law enforcement agencies and hospital personnel who interface with the medical service that includes but is not limited to the following: 1. The identification, designation and preparation of appropriate landing zones2. Ground personnel safety in and around the aircraft3. Ground to air communications4. Victim recovery procedures in the post-crash or unanticipated incident 3. The applicant possesses the equipment, required by these Rules for the type of service and level of care proposed.4. The applicant can provide personnel required by these Rules for the type of service and level of care proposed.5. An applicant for a Scene Response Air Ambulance Service or Restricted Response Air Ambulance Service must demonstrate full time dispatch capabilities.6. The applicant possesses two-way radio communications equipment and frequencies for the proposed type of service, including, but not limited to the hospital-ambulance frequencies utilized in the service area(s) pursuant to these Rules and the designated Maine EMS statewide frequency "155.385." 7. Applicants for licensure must demonstrate liability coverage for injuries to persons and for loss or property damages resulting from negligence by the service or medical crew. A license holder should immediately notify Maine EMS and cease operations if the coverage required by this section is cancelled or suspended. Maine EMS will not issue an air ambulance service license to an air ambulance service unless the applicant for a license or the licensee has: a. Evidence of medical professional liability insurance that requires the insurer to compensate for injuries to persons or unintentional damage to property.b. Worker's compensation coverage is required as defined by individual state regulating bodies.8. The applicant meets the quality assurance/quality improvement requirements of Chapter 18 of these Rules.9. The applicant has a physician medical director who is: (a) Licensed and authorized to practice as a physician in Maine and is board certified in a specialty consistent to the mission of the service and actively practices in the care and management of critically ill or injured adult and pediatric patients;(b) Experienced in both air and ground emergency medical services and is familiar with the national consensus criteria of appropriate utilization of air medical and ground inter-facility critical care services;(c) Responsible for supervising and evaluating the quality of medical care provided by the medical personnel and the program;(d) Actively involved in the selection, training and recurrent education and practice of the flight medical crew and has expertise with the flight environment, including flight physiology and the management of diseases affected by altitude;(e) Actively involved in the Quality Assurance / Quality Improvement (QA/QI) program for the service, including the review of all missions by a qualified physician and in administrative decisions affecting medical care provided by the service;(f) Familiar with Maine EMS Protocols, the Maine Trauma System and the capabilities of referring and receiving hospitals;(g) Knowledgeable of the capabilities and limitations of the aircraft used in the service; and,(h) Responsible to ensure that appropriate aircraft, medical crew and equipment are provided for each mission based on a system of preflight patient evaluation for inter-hospital transports and an established protocol consistent with types of scene responses anticipated if so licensed.(i) Has established a plan for on-line medical direction if needed during transport.10. If the application is for a new service or a change of service ownership: the applicant, if an individual is of good character, and if a partnership or corporation, its partners or principal officers are of good character. Four character references, written within the past year, must be submitted as a condition of meeting this requirement; none may be from a relative or employee of the applicant.11. If the application is for a restricted air ambulance service, the service has either (1) guaranteed continuity of care for the patient by entering into written agreements with the ambulance services that will transport its patients or (2) otherwise addressed these concerns in a plan approved by Maine EMS that includes as a component a written agreement of this nature with at least one ambulance service. 12. The applicant has submitted a quality assurance plan that is subject to Maine EMS approval and that includes review of all flights by a qualified physician pursuant to these Rules. 13. The applicant has established a service level Quality Assurance/Quality Improvement Committee (for approval under 32 M.R.S. §92-A) . 14. The applicant has designated a service director, who shall act as the point of contact for the service. 15. The applicant has designated a person who serves as the training and education point of contact for the service. 16. The applicant demonstrates that all medical crew members are appropriately trained and qualified.17. The applicant has identified the designated infection control officer for the proposed service. Pursuant to 42 U.S.C. § 300ff-136, each employer of emergency response employees in the State of Maine must have a designated infection control officer (ICO) for the purposes of receiving notifications and responses and making requests under 42 U.S.C. Chapter 6A, Subchapter XXIV, Part G. The licensee shall provide the ICO name and contact information to Maine EMS, and promptly notify Maine EMS of any changes in ICO during the term of its license. Maine EMS will provide this information to the Department of Health and Human Services, Maine Center for Disease Control, Division of Infectious Disease.18. The applicant complies with the drugs and medication requirements in Chapter 6 of these Rules. 2. Except as provided in paragraph 3, below, a service license is issued for a period of 12 months. Maine EMS may issue a license that expires prior to the twelfth month and may prorate the licensing fee; if it is determined that such a change is in the best interest of the service and the system.3. Effective January 1, 2020, initial and renewal service applications will be issued/renewed with a November 30, 2020 expiration date in order to establish a common month of expiration for all services. Maine EMS will prorate service and vehicle fees during the transition period.4. Notwithstanding the notice requirements of §5(C) (1), Maine EMS may issue a temporary service license for up to 60 days to an applicant if Maine EMS determines that issuance of the temporary license will avert the disruption of emergency medical services in the primary service area(s) listed in the applicant's application.