[30 Pa.B. 5363]
[Continued from previous Web Page] Comment
The proposal to have a regional EMS council conduct reviews of medical command facilities as requested by the Department, instead of biennially, as required previously, causes confusion, especially in light of proposed § 1009.2(h), which would make recognition of a medical command facility valid for 3 years.
Response
No changes are made based upon this comment. As explained in the preamble to the proposed rulemaking, the biennial review provision of this section has been deleted to permit the Department more flexibility in determining the frequency of reviews. Comprehensive reviews conducted biennially could impose an excessive work burden on some regional EMS councils, while other regional EMS councils could conduct the reviews more frequently. This is because there are many medical command facilities in some EMS regions, and very few in others. The Department anticipates requesting reviews more frequently than once every 2 years, but will modify the scope of some reviews so that they will not involve a comprehensive assessment of compliance with all recognition criteria.
Section 1009.6 (relating to discontinuance of service) is new. This section requires a medical command facility to provide 90 days notice to the Department, the appropriate regional EMS council and providers of EMS for which they routinely give medical command, prior to discontinuing medical command operations.
Comment
The proposed rulemaking are inconsistent with respect to the number of days various entities need to provide prior notice to the Department and other entities. The time periods should be consistent.
Response
Certain advance notice requirements need to be longer or shorter than others based upon the type of activity involved, and the potential harm to the public due to the commencement or termination of an activity. Nevertheless, the Department agrees that notices regarding the discontinuation of service should be consistent throughout the regulations. Therefore, the Department has revised the proposed 60 days advance notice for discontinuation of medical command facility operations to 90 days advance notice. This makes the advance notice requirement for discontinuation of a medical command facility the same as that imposed prior to the discontinuation of an ambulance service.
Chapter 1011. Accreditation of EMS Training Institutes
This chapter pertains to the Department's accreditation of teaching institutes that provide persons with the training required by the Department's regulations to become certified as a first responder, an EMT or an EMT- paramedic, or recognized as a prehospital registered nurse. Matters addressed are the criteria for accreditation, the process to secure accreditation, and the process for denying, withdrawing or conditioning accreditation.
Section 1011.1 (relating to EMS training institutes) identifies the criteria to operate as a BLS training institute to provide training leading to certification as a first responder or an EMT, and as an ALS training institute to provide training leading to certification as an EMT-paramedic or recognition as a prehospital registered nurse.
Comment
Section 1001.2 deletes the definition of ''BLS training institute'' and adds the definition of ''EMS training institute.'' Chapter 1011 repeatedly refers to ALS and BLS training institutes, not EMS training institutes. The term ''EMS training institute'' should be used consistently.
Response
The Department agrees with this observation and recommendation. It has changed the title of Chapter 1011 to ''Accreditation of EMS Training Institutes'' from ''Accreditation of Training Institutes,'' and the title of § 1011.1 to ''EMS training institutes'' instead of the proposed title of ''BLS and ALS training institutes.'' Additionally, the Department uses the term ''EMS training institute'' throughout the chapter to replace proposed references to ALS and BLS training institutes, except where the context requires that the Department make a distinction between an EMS institute that provides BLS training and one that provides ALS training.
Comment
The second subparagraph under subsection (b)(1) should be (ii) rather than (iii).
Response
The Department agrees. The Department has corrected the typographical error.
Comment
Subsection (f) should explain what a qualified instructor is.
Response
This subsection does state that an instructor shall be at least 18 years of age and possess a high school diploma or GED equivalent. It also states that the instructor shall either meet very specific requirements in paragraph (3) or be determined by the EMS training institute, after the EMS training institute has consulted specified resources, to be qualified to provide the instructional services that would be provided by the individual if that person is accepted as an instructor. The Department believes that no more definitive explanation is needed.
Comment
Proposed subsection (f)(4) references a ''Prehospital Practitioner Manual,'' while § 1001.2 defines ''Prehospital Personnel Training Manual.'' The Department should revise the reference in subsection (f)(4) or clarify the paragraph if a different manual is involved.
Response
As discussed under § 1001.2, the Department has removed ''prehospital personnel training manual'' from the terms defined in that section. The deletion of that term affords the Department greater flexibility in developing various guidance manuals, more properly titled, to address different prehospital personnel subjects. Consequently, the Department has substituted for the name of a manual in this paragraph, a reference to the manual the Department develops to provide guidance regarding course administration. The same substitution is made in subsection (i)(2).
Comment
Proposed subsections (g) and (h) require an ALS training institute to ensure the availability of clinical and field preceptors for each training course. The same requirements should be imposed for BLS training institutes.
Response
The same requirements are not needed for BLS training institutes, for each training course it offers, because the courses these institutes offer rarely include a field internship or clinical activities outside of the classroom. However, there may be occasion when a BLS training course does include these activities. Consequently, the Department has revised subsections (g) and (h) to require a BLS training institute to ensure the availability of clinical and field preceptors whenever it offers a BLS training course that has field and clinical components.
Other Changes
Nonsubstantive revisions have been made to subsections (a), (b)(1) and (2), (c)(1), (d)(3)(i) and (iii), (e)(3), (f)(1) and (3) and (i)(1) to improve clarity.
The Department has revised subsection (j)(4) to add the requirements that an EMS training institute shall provide its students with the Department's testing policies, and the EMS training institute's policy for the prevention of sexual harassment.
The Department has added subsection (j)(7)--(9) to require an EMS training institute to collect from each student an application for enrollment and a completed criminal history disclosure form and to then forward those forms to the appropriate regional EMS council; to complete a course completion form for each student who successfully completes an EMS training course and to then forward the form to the appropriate regional EMS council; and to participate in EMS training institute evaluation activities as requested by the Department.
As proposed, § 1011.2 is rescinded. The subject matter that had been addressed in that section is now incorporated in § 1011.1.
Section 1011.3 (relating to accreditation process) identifies the process for an entity to become accredited as an EMS training institute. No comments addressing this section were received.
Changes
The term ''EMS training institute'' is substituted for ''ALS or BLS institutes'' or similar terminology where appropriate.
Paragraphs (1), (5)(ii) and (8) are revised to improve clarity.
Paragraph (9) is added to address procedures for an EMS training institute to be able to offer an EMS training course for initial certification or recognition in an EMS region other than that through which it processed its application for accreditation.
Section 1011.4 (relating to denial, restriction or withdrawal of accreditation) identifies the procedures for investigating complaints against EMS training institutes, for denying, withdrawing or conditioning accreditation, and for appealing those decisions. No comments on this section were received. One person did ask to whom the term ''agency head'' refers. As stated in the proposed regulation, ''agency head'' is defined in 1 Pa. Code § 31.3 (relating to definitions). In the Department the ''agency head'' is the Secretary of Health or a deputy secretary designated by the Secretary.
Changes
The term ''EMS training institute'' is substituted for other terms where appropriate.
Chapter 1013. Special Event EMS
This chapter enables entities that are responsible for the management and administration of a special event to have a Department determination as to whether EMS arrangements are adequate. A special event is a planned activity that places attendees or participants in a defined geographic area where access by emergency vehicles and personnel might be delayed due to people or traffic congestion at or near the event, or perhaps due to the inadequacy of EMS resources at that location.
Section 1013.1 (relating to special event EMS planning requirements) explains the process for securing Department endorsement of an EMS plan for a special event and prescribes the contents that a plan needs to include to secure the Department's endorsement.
Comment
The regulation should not be revised, as proposed, to provide that the person who is responsible for the management and administration of a special event ''may,'' rather than ''shall,'' secure Department approval of an EMS plan for the event. What happens if a sponsor does not submit an EMS plan for a special event?
Response
This recommendation is rejected. As explained in the preamble to the proposed regulations, submitting a special event EMS plan to the Department for its approval is not mandated under the EMS act. Rather, as the Commonwealth's lead agency for EMS, the Department believes that approval of EMS plans for special events is a public service it should make available to entities desiring such a review. It encourages sponsors of special events to pursue EMS plan approval. There is nothing the Department can do if an entity sponsoring a special event does not submit a special event EMS plan. The Department believes that municipalities may choose to mandate such a review for special events held within their borders.
Comment
The Department should explain how it intends to coordinate the requirements of this chapter with other Commonwealth emergency operations plans, such as the Commonwealth Emergency Operations Plan, the Special Event Emergency Action Plan Guide and the Planning Guidance for Mass Fatalities Incidents.
Response
The Department has discussed its implementation of this chapter with representatives of the Pennsylvania Emergency Management Agency (PEMA). Population numbers PEMA has used in its policies dealing with the same subject matter have been based on the numbers specified in this chapter. PEMA has advised that it will revise population numbers in the above-referenced plans to be consistent with the changes made in this chapter.
No other comment addressing this section was received. This section is adopted as proposed, except minor revisions are made to subsection (a) to improve clarity, and references to the definition section, which is unnecessary surplusage, are removed.
Section 1013.2 (relating to administration, management and medical direction requirements) prescribes the qualifications and responsibilities for a special event EMS director and emergency supervisory physician. A special event EMS plan needs to show that these standards are met if the plan is to secure Department approval. No comments addressing this section were received. This section is adopted as proposed.
Sections 1013.3--1013.7 are not amended, except that population figures triggering the application of certain standards in §§ 1013.3 and 1013.5 (relating to special event EMS personnel and capability requirements; and onsite facility requirements) are adjusted downward by 5,000, equipment requirements in § 1013.5 are not confined to BLS equipment; and the term ''PSAPs'' is substituted for ''emergency communications centers'' in § 1013.6 (relating to communications system requirements).
Comment
Section 1013.5 should be amended to require a special event physician to be onsite at treatment facilities.
Response
The Department rejects this recommendation. The onsite presence of a physician should not normally be required, since prehospital personnel, when operating within the Statewide EMS system, are required to have the capability to immediately access a medical command physician as needed. If the Department believes that the peculiarities of a particular special event warrant the physical presence of a physician onsite, it will impose that requirement as a condition for its approval of the EMS plan for that special event.
Section 1013.8 (relating to special event report) is new. It requires an entity that secures Department approval of a special event EMS plan to file with the appropriate regional EMS council, after concluding a special event, a special event report containing information solicited by the Department in the report form.
Comment
The Department should explain the need for this report and should consider requiring a report only if EMS is provided at the special event.
Response
No change is made to the regulation based on this comment. Capturing information on the EMS outcomes of all events for which the Department approves a special event EMS plan will be helpful for continued quality improvement. Also, if no report is filed, the Department or a regional EMS council would need to follow-up with a special event sponsor to ensure that the failure to report was not merely an oversight. Another concern is that if the after-event reporting is not universally required, sponsors may be tempted not to file a report if the EMS incidents are few and minor. However, even that information is important to EMS planning. The Department will develop a reporting form to facilitate the quick and easy completion of the report when the special event does not give rise to the delivery of EMS.
Chapter 1015. Quick Response Service Recognition Program
This chapter addresses the mobilization of prehospital personnel to arrive at the scene of an emergency and provide EMS in advance of the arrival of an ambulance and its crew. While most areas of this Commonwealth can be reached by an ambulance within a few minutes, there are a few areas, generally rural or remote wilderness areas, where this is not the case. In those areas, the Department approves units of prehospital personnel to respond to emergencies prior to the arrival of an ambulance. The label the Department has given to an early EMS response team is ''quick response service (QRS).''
Section 1015.1 (relating to quick response service) is new. It establishes criteria for recognition as a QRS. It also establishes a process for securing that recognition and for renewal of that recognition.
Comment
Many small ambulance services in rural Pennsylvania encounter serious problems in meeting statutory staffing requirements. Greater staffing flexibility should be afforded to those services.
Response
The Department is not authorized to waive statutory staffing requirements for ambulance services other than through procedures associated with issuing provisional and temporary licenses. However, such licenses provide only short-term solutions. The EMS act does not provide for the perpetual renewal of those licenses. The Department has encouraged some small rural ambulance services to terminate their operations as an ambulance service and convert their operations to those of a QRS with AED capability. The regulatory requirements for QRS operation are less stringent than the statutory requirements for ambulance service operation. Several former small rural ambulance services have successfully made the transition. Under the EMS act and this part, QRSs are eligible for EMSOF funding.
Changes
Minor language changes have been made to this section to improve clarity.
Section 1015.2 (relating to discontinuation of service) is also new. It requires a QRS to provide advance notice to the Department, the appropriate regional EMS council, and each political subdivision within its service area before discontinuing services. No comments addressing this section were received, and the Department has made no revisions to the proposal
Fiscal Impact
The cost to the Department to administer and monitor the continuing education program will increase. The Department will incur costs in developing review processes to incorporate alternative methods of course presentation that are permitted by the amendments. All currently approved continuing education courses (approximately 1,400) will need to be reevaluated and assigned new course numbers to reflect trauma and medical continuing education credit hours for which the course qualifies. The Department will need to revise the reporting and recordkeeping procedures for it to process continuing education information. Revision of forms and printing will also result in associated costs.
The Department will also incur additional costs for the continuing education program to update computer software to maintain a registry of continuing education courses. Also, costs will be incurred in updating continuing education data processing capabilities. The total estimated costs for these expenditures are $33,500 for FY 2001-02.
Costs to patients and insurers associated with the routine transport of BLS patients requiring intravenous maintenance medications should decrease. BLS ambulance services, as well as ALS ambulance services, will now be able to transport these patients. Although it is difficult to quantify the savings at this time, it should be sizeable, both in dollars and time saved. ALS ambulance services, freed from the sole responsibility for these transports, should be able to have ambulances increasingly available to respond to emergencies requiring an ALS response. However, services that provide these transports will incur some additional costs in ensuring EMTs are trained to appropriately address patient needs when transporting patients with intravenous medications running.
Individuals who choose to participate in the EMS instructors program will need to attend an update program every 2 years. The update course will probably last 2 days. Persons who attend may incur travel and subsistence costs.
Specified record retention requirements for ambulance services and medical command facilities may create some additional costs for those entities based upon the dedication of additional storage space for that purpose. Those costs may be less for entities that store the records electronically.
Currently, an entity must secure a separate license from the Department for each EMS region in which it stations and operates ambulances. As amended, the regulations provide for a single license, augmented by a process for amending the license if an entity chooses to conduct operations out of a region not identified in the license application. The Department and regional EMS councils may experience some cost-savings from reduced inspection and paperwork processing requirements.
Paper Requirements
The Department intends to employ all reasonable opportunity afforded by technology to reduce paperwork and costs. Websites and e-commerce initiatives will be used, where possible, to reduce paperwork and to support data transmission required by the regulations.
Forms associated with the approval of medical command physicians and the recognition of medical command facilities will need to be revised to accommodate revised qualifying criteria. The Department's records pertaining to continuing education courses will need to be modified. For example, they will need to be revised to reflect trauma and medical continuing education credit assigned to each course. Course forms will need to be revised by continuing education sponsors. Sponsors of continuing education courses will also incur revised reporting and recordkeeping responsibilities.
The Department will also need to revise existing guidance manuals to assist regional EMS councils and regulated entities to meet new requirements imposed upon them.
Ambulance services will be required to maintain additional documentation regarding staff, policies and responsiveness to calls for emergency assistance. They will also be required to develop and maintain additional written policy records and duty rosters or staff availability schedules. They will be required to secure criminal and disciplinary histories from their personnel and to maintain a written record of that information. Additionally, they will also be required to report ambulance accidents resulting in injuries to personnel and patients that result in hospital care. Ambulance services will also need to complete modification of fleet or temporary change of vehicle forms when they add, replace or temporarily use an ambulance not previously inspected and approved by the Department.
QRSs will need to complete part of the EMS patient care report.
Special event sponsors that submit EMS plans for special events will also need to submit a special event report following conclusion of the event.
EMS training institutes that intend to conduct courses leading to the certification of prehospital personnel, in an EMS region other than that through which their applications for accreditation were processed, will need to file an application for amendment to the accreditation. EMS training institutes will also be required to develop and maintain additional written policy records.
Effective Date/Sunset Date
The regulations are effective upon publication in the Pennsylvania Bulletin as final-form regulations. No sunset date is imposed. The Department will monitor the regulations to ensure that they meet EMS needs within the scope of the Department's authority to address through regulations.
Statutory Authority
Section 17.1 of the EMS act (35 P. S. § 6937.1) provides that the Department, in consultation with PEHSC, may promulgate regulations as may be necessary to carry out the provisions of the EMS act. Other sections of the EMS act contain more narrow grants of authority to the Department to promulgate regulations.
In section 3 of the EMS act, the definitions of ''advanced life support service medical director'' and ''Commonwealth Emergency Medical Director'' provide that to qualify as either, one must be a medical command physician or meet equivalent qualifications as established by the Department through regulation. In the same section, the definitions of ''emergency medical technician'' and ''emergency medical technician-paramedic'' provide that both are to be certified in accordance with the current National standard curriculum as set forth in the regulations of the Department. See, also, section 11(b)(1)(i) and (d)(1)(i) of the EMS act. The definition of ''medical command'' in section 3 of the EMS act provides that medical command physicians are to meet qualifications prescribed by the Department.
Section 5(2) of the EMS act authorizes the Department to employ regulations to establish standards and criteria governing the award and administration of contracts under the EMS act. Section 5(11) of the EMS act authorizes the Department to adopt regulations to establish standards and criteria for EMS systems.
Section 11(a)(1) of the EMS act provides that the Department shall employ regulations to develop standards for the accreditation of educational institutes for EMS personnel. Section 11(a)(4), (d)(3) and (e) of the EMS act provide that EMTs and EMT-paramedics may, in the case of an emergency, perform duties deemed appropriate by the Department in accordance with the Department's regulations. Section 11(d)(2)(ii)(A) and (B), and (e.1)(3)(i) and (ii)) of the EMS act provide that ALS service medical directors shall base a decision on whether to grant medical command authorization to an EMT-paramedic or prehospital registered nurse upon the individual's demonstrated competency in knowledge and skills as defined by Department regulation and the individual's completion of continuing education requirements adopted by regulation. Section 11(d)(2)(vi) and (e.1)(5) of the EMS act provide that when an EMT-paramedic or prehospital registered nurse chooses to not seek or maintain medical command authorization, and to function exclusively as an EMT, that person is to apply to the Department for recognition as an EMT under Department regulations. Section 11(f) of the EMS act provides that physicians approved by regional EMS councils as medical command physicians may give medical commands subject to Department regulatory requirements. Section 11(h) and (i) of the EMS act provide that regional EMS council transfer and medical treatment protocols are to be established under Department regulation. Section 11(j)(2) of the EMS act grants immunity, for specified conduct, to EMS students enrolled in approved courses and supervised under Department regulations.
Section 12(b) of the EMS act provides that applications for renewal of ambulance service licenses shall be made on forms prescribed by the Department in accordance with its regulations. Section 12(d) of the EMS act provides that the Department shall promulgate regulations setting forth minimum essential equipment for BLS and ALS ambulances, as well as design criteria for ambulances.
Section 14(d) of the EMS act provides that the standards the Department employs to disburse monies from EMSOF to providers of EMS shall be under the regulations.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (act) (71 P. S. § 745.5(a)), on January 29, 1999, the Department submitted a copy of proposed rulemaking, published at 29 Pa.B. 903, to the Independent Regulatory Review Commission (IRRC) and the Chairpersons of the House Health and Human Services Committee and the Senate Public Health and Welfare Committee for review and comment. In compliance with section 5(c) of the act, the Department also provided IRRC and the Committees with copies of all comments received, as well as other documentation.
In compliance with section 5.1(a) of the Regulatory Review Act (71 P. S. § 745.5a(a)) the Department submitted a copy of the final-form regulations to IRRC and the Committees on August 7, 2000. In addition, the Department provided IRRC and the Committees with information pertaining to commentators and a copy of a detailed Regulatory Analysis Form prepared by the Department in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
In preparing these final-form regulations the Department considered all comments received from IRRC, the Committees and the public.
These final-form regulations were deemed approved by the House Health and Human Services Committee and the Senate Public Health and Welfare Committee on August 28, 2000. IRRC met on September 7, 2000, and approved the regulations in accordance with section 5.1(e) of the Regulatory Review Act. The Office of Attorney General approved the regulations on September 27, 2000.
Contact Person
Questions regarding these final-form regulations may be submitted to Margaret E. Trimble, Director, Emergency Medical Services Office, Department of Health, 912 Health and Welfare Building, P. O. Box 90, Harrisburg, PA 17108-0090, (717) 787-8740. Persons with disabilities may submit questions in alternative formats, such as by audio tape or Braille. Speech or hearing impaired persons may use V/TT (717) 783-6514, or the Pennsylvania AT&T Relay Services at (800) 654-5984 [TT].
Persons with disabilities who would like to obtain this document in an alternative format (that is, large print, audiotape or Braille) should contact Margaret Trimble so that necessary arrangements may be made.
Findings
The Department finds:
(1) Public notice of intention to adopt the regulations adopted by this order has been given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202), and the regulations thereunder, 1 Pa. Code §§ 7.1 and 7.2.
(2) A public comment period was provided as required by law and all comments were considered and forwarded to IRRC, the House Committee on Health and Human Services and the Senate Committee on Public Health and Welfare.
(3) The adoption of the final-form regulations is necessary and appropriate for the administration of the authorizing statutes.
Order
The Department, acting under the authorizing statutes, orders that:
(a) The regulations of the Department, 28 Pa. Code Part VII, are amended by adding §§ 1001.7, 1001.28, 1001.65, 1003.23a, 1003.31--1003.34, 1005.2a, 1005.7a, 1005.15, 1009.6, 1013.8 and 1015.1--1015.2; by amending §§ 1001.1--1001.6, 1001.21--1001.27, 1001.41, 1001.42, 1001.61, 1001.62, 1001.81, 1001.82, 1001.101, 1001.121, 1001.123--1001.125, 1001.141, 1001.161, 1003.1--1003.5, 1003.21--1003.24, 1003.25a--1003.30, 1005.1, 1005.2, 1005.3--1005.7, 1005.8--1005.14, 1007.1, 1007.2, 1007.7, 1007.8, 1009.1, 1009.2, 1009.4, 1009.5, 1011.1, 1011.3, 1011.4, 1013.1--1013.3, 1013.5 and 1013.6; and by repealing 1001.63, 1001.64, 1001.102, 1001.103, 1003.41--1003.44, 1007.3--1007.6, 1007.9, 1009.3 and 1011.2 as set forth in Annex A.
(b) The Secretary of Health shall submit this order and Annex A to the Office of General Counsel and the Office of Attorney General for approval as required by law.
(c) The Secretary of Health shall submit this order, Annex A and a Regulatory Analysis Form to IRRC, the House Committee on Health and Human Services and the Senate Committee on Public Health and Welfare for their review and action as required by law.
(d) The Secretary of Health shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(e) This order shall take effect upon publication in the Pennsylvania Bulletin.
ROBERT S. ZIMMERMAN, Jr.,
Secretary(Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this document, see 30 Pa.B. 4989 (September 23, 2000).)
Fiscal Note: Fiscal Note 10-143 remains valid for the final adoption of the subject regulations.
Annex A
TITLE 28. HEALTH AND SAFETY
PART VII. EMERGENCY MEDICAL SERVICES
CHAPTER 1001. ADMINISTRATION OF
THE EMS SYSTEM
Subchapter A. GENERAL PROVISIONS
GENERAL INFORMATION § 1001.1. Purpose.
The purpose of this part is to plan, guide, assist and coordinate the development of regional EMS systems into a unified Statewide system and to coordinate the system with similar systems in neighboring states, and to otherwise implement the Department's responsibilities under the act consistent with the Department's rulemaking authority.
§ 1001.2. Definitions.
The following words and terms, when used in this part, have the following meanings, unless the context clearly indicates otherwise:
ACLS course--Advanced cardiac life support course--A course in advanced cardiac life support sanctioned by the American Heart Association.
ALS ambulance service--Advanced life support ambulance service--An entity licensed by the Department to provide ALS services by ambulance to seriously ill or injured patients. The term includes mobile ALS ambulance services that may or may not transport patients.
ALS service medical director--Advanced life support service medical director--A medical command physician or a physician meeting the equivalent qualifications in § 1003.5 (relating to ALS service medical director) who is employed by, contracts with or volunteers with, either directly, or through an intermediary, an ALS ambulance service to make medical command authorization decisions, provide medical guidance and advice to the ALS ambulance service, and evaluate the quality of patient care provided by the prehospital personnel utilized by the ALS ambulance service.
ALS services--Advanced life support services--The advanced prehospital and interhospital emergency medical care of serious illness or injury by appropriately trained health professionals and EMT-paramedics.
APLS course--Advanced pediatric life support course--A course in advanced pediatric life support sanctioned by the American Academy of Pediatrics and the American College of Emergency Physicians.
ATLS course--Advanced trauma life support course--A course in advanced trauma life support sanctioned by the American College of Surgeons Committee on Trauma.
Act--The Emergency Medical Services Act (35 P. S. §§ 6921--6938).
Air ambulance--A rotorcraft specifically designed, constructed or modified and equipped, used or intended to be used, and maintained or operated for the purpose of providing emergency medical care to, and air transportation of, patients.
Air ambulance medical director--A medical command physician or a physician meeting the minimum qualifications in § 1003.5 who is employed by, or contracts with, or volunteers with, either directly, or through an intermediary, an air ambulance service to make medical command authorization decisions, provide medical guidance and advice to the air ambulance service, and evaluate the quality of patient care provided by the prehospital personnel utilized by the air ambulance service.
Air ambulance service--An agency or entity licensed by the Department to provide transportation and ALS care of patients by air ambulance.
Aircraft operator--The person, company or agency, certified by the FAA, under 14 CFR Part 135 (relating to air taxi operators and commercial operators), to conduct air taxi operations.
Ambulance--A vehicle specifically designed, constructed or modified and equipped, used or intended to be used, and maintained or operated for the purpose of providing emergency medical care to patients, and the transportation of patients if used for that purpose. The term includes ALS or BLS vehicles that may or may not transport patients.
Ambulance attendant--An individual who possesses the qualifications in § 1003.21(b) (relating to ambulance attendant).
Ambulance identification number--A number issued by the Department to each ambulance operated by an ambulance service.
Ambulance service--An entity which regularly engages in the business or service of providing emergency medical care and transportation of patients in this Commonwealth. The term includes ALS ambulance services that may or may not transport patients.
Ambulance service affiliate number--A unique number assigned by the Department to an ambulance service, the first two digits of which designate the county in which the ambulance service maintains its primary headquarters.
BLS ambulance service--Basic life support ambulance service--An entity licensed by the Department to provide BLS services and transportation by ambulance to patients.
BLS services--Basic life support services--The basic prehospital or interhospital emergency medical care and management of illness or injury performed by specially trained, certified or licensed personnel.
Basic rescue practices technician--An individual who is certified by the Department to possess the training and skills to perform a rescue operation as taught in a basic rescue practices technician program approved by the Department.
Basic vehicle rescue technician--An individual who is certified by the Department to possess the training and skills to perform a rescue from a vehicle as taught in a basic vehicle rescue technician program approved by the Department.
Board certification--Current certification in a medical specialty or subspecialty recognized by either the American Board of Medical Specialties or the American Osteopathic Association.
CPR--Cardiopulmonary resuscitation--The combination of artificial respiration and circulation which is started immediately as an emergency procedure when cardiac arrest or respiratory arrest occurs.
CPR course--Cardiopulmonary resuscitation course--A course of instruction in CPR, meeting the Emergency Cardiac Care Committee National Conference on CPR and Emergency Cardiac Care standards. The course shall encompass one and two-rescuer adult, infant and child CPR, and obstructed airway methods.
Commonwealth Emergency Medical Director--A medical command physician or a physician meeting the equivalent qualifications in § 1003.1 (relating to Commonwealth Emergency Medical Director) and approved by the Department to advise, formulate and direct policy on matters pertaining to EMS.
Continuing education--Learning activities intended to build upon the education and experiential basis of prehospital personnel for the enhancement of practice, education, administration, research or theory development, to strengthen the quality of care provided.
Continuing education sponsor--An entity or institution that is accredited by the Department as a sponsor of continuing education courses.
Council--The Board of Directors of the Pennsylvania Emergency Health Services Council.
Critical care specialty receiving facility--A facility identified by its capability of providing specialized emergency and continuing care to patients, including, in one of the following medical areas: poisoning, neonatal, spinal cord injury, behavioral, burns, cardiac and trauma.
Department--The Department of Health of the Commonwealth or a designee.
Department identification number--A number issued by the Department that identifies an individual who participates in the Statewide EMS system and who has been certified, recognized or otherwise assigned an identification number by the Department.
Direct support of EMS systems--Activities, equipment and supplies that are involved in the planning, initiation, maintenance, expansion or improvement of EMS systems.
EMSOF--Emergency Medical Services Operating Fund--Moneys appropriated to the Department under section 14(c) of the act (35 P. S. § 6934(c)) and which are not assigned to the Catastrophic Medical and Rehabilitation Fund.
EMS--Emergency medical services--The services utilized in responding to the needs of an individual for immediate medical care to prevent loss of life or aggravation of physiological or psychological illness or injury.
EMS patient care report--A report that provides standardized data and information relating to patient assessment and care.
EMS system--The arrangement of personnel, facilities and equipment for the effective and coordinated delivery of EMS required in the prevention and management of incidents which occur either as a result of a medical emergency or of an accident, natural disaster or similar situation.
EMS training institute--Emergency medical services training institute--An institute accredited by the Department to provide a course required for the certification or recognition of a prehospital practitioner.
EMS training manual--Emergency medical services training manual--A manual adopted by the Department and reviewed biennially by the Council to aid ALS service medical directors in determining whether EMT-paramedics and prehospital registered nurses have demonstrated competency in the knowledge and skills necessary to be granted or maintain medical command authorization.
EMT--Emergency medical technician--An individual trained to provide prehospital emergency medical treatment and certified as such by the Department in accordance with the current EMT-NSC, as set forth in this part.
EMT-NSC--Emergency medical technician-National standard curriculum--An outline of knowledge and skills recommended for the education and training of EMTs, as adopted by the United States Department of Transportation.
EMT-paramedic--Emergency medical technician-paramedic--An individual who is trained to provide prehospital emergency medical treatment at an advanced level and certified as such by the Department in accordance with the current EMT-paramedic NSC, as set forth in this part.
EMT-paramedic NSC--Emergency medical technician-paramedic National standard curriculum--An outline of knowledge and skills recommended for the education and training of EMT-paramedics, as adopted by the United States Department of Transportation.
Emergency--A combination of circumstances resulting in a need for immediate medical intervention.
Emergency department--An area of the hospital dedicated to offering emergency medical evaluation and initial treatment to individuals in need of emergency care.
FAA--The Federal Aviation Administration.
FAA certification number--An air taxi/commercial operator operating certificate number assigned by the FAA, authorizing the certificate holder to operate aircraft as required by 14 CFR Part 135.
Facility--A hospital.
Federal KKK standards--The minimum standards and specifications for ambulance vehicles adopted by the United States Department of Transportation.
Federally declared emergency--A state of emergency declared by the President of the United States, upon the request of a governor. Once the President declares the situation a ''major disaster,'' the Federal government supplements State and local efforts to meet the crisis.
First responder--An individual who is certified by the Department as a first responder.
Health professional--A physician who has education and continuing education in ALS services and prehospital care or a prehospital registered nurse.
Hospital--An institution having an organized medical staff which is primarily engaged in providing to inpatients by or under the supervision of physicians, diagnostic and therapeutic services or rehabilitation services for the care or rehabilitation of injured, disabled, pregnant, diseased, sick or mentally ill persons. The term includes a facility for the diagnosis and treatment of disorders within the scope of specific medical specialties, but not a facility caring exclusively for the mentally ill.
Invalid coach--A vehicle primarily maintained, operated and intended to be used for routine transport of persons who are convalescent or otherwise nonambulatory and do not ordinarily require emergency medical treatment while in transit. The term does not include an ambulance or another EMS vehicle.
Medical advisory committee--An advisory body, composed of a majority of physicians, to advise a regional EMS council or the Council on issues that have potential impact on the delivery of emergency medical care.
Medical audit--A mechanism to evaluate patient care.
Medical command--An order given by a medical command physician to a prehospital practitioner in a prehospital, interfacility, or emergency care setting in a hospital, to provide immediate medical care to prevent loss of life or aggravation of physiological or psychological illness or injury, or to withdraw or withhold treatment.
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