216 R.I. Code R. 216-RICR-20-10-2.8

Current through December 26, 2024

Section 216-RICR-20-10-2.8 - Ambulance Vehicles

A. Ambulance vehicles shall be licensed at the following classifications:

1. Class A-1C: Advanced Life Support transporting ambulance

2. Class A-1P: Advanced Life Support transporting ambulance, paramedic level

3. Class A-2C: Advanced Life Support non-transporting ambulance

4. Class A-2P: Advanced Life Support non-transporting ambulance, paramedic level

5. Class A-2A: Advanced Life Support non-transporting ambulance, advanced EMT level

6. Class B-1: Basic Life Support transporting ambulance

7. Class B-2: Basic Life Support non-transporting ambulance

8. Class C: Advanced Life Support: Air Medical Services

B. Requirements for initial and renewal licensure for all classifications of ambulance vehicles:

1. The applicant for an ambulance vehicle license must be the entity responsible for its governance, and the license is not transferable among entities or vehicles.

2. A license will immediately become null and void and must be returned to RIDOH when service is discontinued or when any changes in ownership occur pursuant to R.I. Gen. Laws § 23-4.1-6(f).

3. A license must be posted in a conspicuous place in the ambulance.

4. The ambulance must comply with the equipment and supply requirements in § 2.12 of this Part.

5. Any deficiencies cited in the initial or any other inspection must be corrected before a license will be issued or renewed.

6. Pay the application fee stated in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title), if applicable.

7. Any other information required by RIDOH

C. Requirements for initial and renewal licensure for all classifications of transporting ambulance vehicles in class A-1C, A-1P, and B-1:

1. A newly manufactured ambulance vehicle must conform to the Federal Specification for Star of Life Ambulances (KKK-A-1822(F)), incorporated at § 2.2(G) of this Part, and/or the National Fire Protection Agency (NFPA) 1917 Standard for Automotive Ambulances, 2019 edition, incorporated at § 2.2(C) of this Part, as of the date of the original purchase order. Remounted ambulances shall be considered a newly manufactured ambulance vehicle.

2. An ambulance vehicle must be identified with the name of the service prominently lettered on both sides and the rear of the vehicle.

3. The material for the emblems and markings must be applied using reflective material that has a coefficient of retro-reflection measured in accordance with ASTM International E810 Test Method for Coefficient of Retroreflection of Retroreflective Sheeting Utilizing the Coplanar Geometry.

4. The reflective color used shall be blue, color a, and white, color i, in accordance with the American National Standard Z535.1, Safety Color Code. They must comply with the tolerances expressed in terms of Munsell hue, value, and chroma.

5. For a newly manufactured ambulance vehicle, the emblems and markings shall be of the type, size, color, and location as follows:

a. Only ambulance vehicles licensed as Advanced Life Support Class A-1C, A-1P, A-2C, A-2P, A-2A or C may be identified by lettering or any other means as "Advanced Life Support" or any similar designation.

b. Front markings: the word "AMBULANCE" or "RESCUE" in mirror image, in block, blue, die cut style letters, not less than four inches (4") high, centered above the grille. The placement of the word "AMBULANCE" or "RESCUE" on the curved surface of the hood or on a flat plastic type bug screen is permitted. A Star of Life in three inch (3") blue, die cut style, with a white border must be located both to the right and left of the word "AMBULANCE" or "RESCUE."

c. Side markings: each side of the ambulance must be marked with one (1) Star of Life emblem not less than sixteen inches (16") in blue, die cut style with a white border.

d. Rear markings: the rear of the ambulance must be marked with two (2) Star of Life emblems not less than ten inches (10"), in blue, die cut style with a white border.

e. Roof marking: a Star of Life of not less than thirty-two inches (32") in blue, die cut style, which may be without the white Staff of Asclepius, must be provided on the ambulance rooftop.

D. Requirements for initial and renewal licensure for all classifications of non-transporting ambulance vehicles in Class A-2C, A-2P, A-2A, or B-2:

1. Be equipped with a warning device, such as a mechanical siren or electric penetrating unit, which is audible five hundred feet (500') to the front

2. Be equipped with red, flashing, warning lights

3. Be designed to safely and adequately house required medical equipment and supplies

4. Be marked with one (1) Star of Life emblem not less than eight inches (8"), in blue, die cut style with a white border located on one (1) side of the vehicle

5. Be equipped with an audible backup warning device, activated when the vehicle is shifted into reverse gear. The device must be rated SAE International J 1849 for 97 dB-a at four feet (4').

E. Requirements for all Categories of Ambulance Vehicles:

1. An ambulance vehicle can be designated as a reserve vehicle. Reserve ambulance vehicles must have a current Rhode Island Department of Transportation (RIDOT) inspection sticker. A listing of all required equipment not stocked at the time of inspection must be maintained in the vehicle, and the equipment must be placed in the vehicle when the ambulance is placed into service.

2. An ambulance vehicle must have current Rhode Island Division of Motor Vehicles (RIDMV) and RIDOT inspection stickers.

3. An ambulance vehicle must be maintained in good repair and in safe operating condition at all times.

4. The interior of an ambulance vehicle, including equipment and supplies, must be maintained in accordance with environmental infection control practices to prevent transmission of disease from patient to EMS practitioner, as well as from patient to patient between runs.

5. A licensed EMS practitioner who utilizes latex gloves must do so in accordance with the provisions of the Rules and Regulations pertaining to the Use of Latex Gloves by Health Care Workers, in Licensed Health Care Facilities, and by Other Persons, Firms, or Corporations Licensed or Registered by the Department (Subchapter 15, Part 3 of this Chapter).

F. Staffing Requirements for Ambulance Vehicles:

1. Each class of ambulance must be staffed by Emergency Medical Services practitioners in accordance with the level of Emergency Medical Services provided.

a. Class A-1C or A-1P ambulances must be staffed at all times when providing patient care, by at least two (2) practitioners:

(1) One (1) ALS practitioner, such as an AEMT-C or a paramedic, who must remain with the patient while providing advanced life support measures during transportation, and an EMT, AEMT-C, or paramedic

(2) In accordance with R.I. Gen. Laws § 23-1-1, volunteer ambulance services must make every attempt to meet the above standards to provide ALS care; however, if these standards cannot be met, the ambulance must be staffed by at least one (1) AEMT-C or one (1) paramedic, who must remain with the patient during transport, and one (1) Emergency Medical Responder (EMR). All initially responding personnel must be functioning in a volunteer capacity.

b. Class B-1 ambulances must be staffed by at least two (2) EMTs, one (1) of whom may be the driver, the other to remain with the patient during transport.

(1) In accordance with R.I. Gen. Laws § 23-1-1, a volunteer ambulance service must make every attempt to meet the above standards to provide BLS care; however, if these standards cannot be met, the ambulance must be staffed by at least one (1) EMT, who must remain with the patient during transport. All initially responding personnel must be functioning in a volunteer capacity.

c. Class A-2 ambulances must be staffed by at least one (1) AEMT, one (1) AEMT-C, or one (1) paramedic to provide ALS, or one (1) EMT to provide BLS.

d. Class B-2 ambulances must be staffed by at least one (1) EMT, AEMT, AEMT-C or paramedic.

216 R.I. Code R. 216-RICR-20-10-2.8

Adopted effective 12/27/2018
Amended effective 12/27/2020