[29 Pa.B. 903]
[Continued from previous Web Page]
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 [Department has the duty under the act] 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. [The Department will accomplish this purpose through this part.]
§ 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 [and transportation] 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 [set forth] 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 [to] 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 [certified] 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.
* * * * * Air ambulance--A rotorcraft [licensed by the Department for use as an EMS 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, and air transportation of, patients.
[Air ambulance medical crew member--A licens- ed physician, registered nurse or certified EMTparamedic, who meets the qualifications required by Chapter 1007 (relating to licensing of air ambulance services--rotor craft) and who is employed to provide prehospital medical care and services to patients transported by air ambulance.]
Air ambulance medical director--A medical command physician or a physician meeting the minimum qualifications [set forth] in [§ 1003.41 (relating to air ambulance medical director)] § 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 [ALS] air ambulance service, and [to] 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.
* * * * * 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 [holds a valid certificate evidencing the successful completion of a course in advanced first aid sponsored by the American Red Cross and a valid certificate evidencing the successful completion of a course in CPR sponsored by the American Heart Association or the American Red Cross, or an individual who can evidence the successful completion of an equivalent training program approved by the Department] possesses the qualifications in § 1003.21(b) (relating to ambulance attendant).
Ambulance call report--A summary of an emergency ambulance response, nonemergency ALS response, interfacility transport or nonemergency BLS transport that becomes an emergency. The report shall contain information specified in a format provided by the Department.
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 [mobile] ALS ambulance services that may or may not transport patients.
Ambulance service affiliate number--[The] A unique number assigned by the Department to an ambulance service, the first two digits of which designate the county in which the ambulances of the ambulance service are based.
[Ambulance trip report number--A unique number assigned to an ambulance response and recorded on the ambulance trip report form.]
BLS ambulance service--Basic life support ambulance service--An entity licensed by the Department to provide BLS services and transportation by ambulance to [seriously ill or injured] 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 [and], certified or licensed personnel.
[BLS training institute--Basic life support training institute--An entity accredited by the Department to conduct BLS training courses designed to prepare individuals to render prehospital and interhospital BLS within an organized EMS system.]
Basic rescue practices technician--An individual who [holds a valid certificate of successful completion of a rescue training program conducted in accordance with the training curriculum approved by the Department] 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 [holds a valid certificate of successful completion of a vehicle rescue training program conducted in accordance with the training curriculum approved by the Department] 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[, by those properly trained and certified to do so].
CPR [Certification] course--Cardiopulmonary resuscitation [certification] course--A [certificate evidencing successful completion of a] course of instruction in CPR, meeting the [most current American Heart Association] Emergency Cardiac Care Committee National Conference on CPR and Emergency Cardiac Care standards. The [certification] course shall [have a current valid date and] encompass one and two-rescuer adult, infant and child CPR, and obstructed airway methods.
[Closest available ambulance--An ambulance, which as a result of a combination of location and other factors, such as traffic conditions, weather, and the like, can reach a patient most promptly.]
* * * * * 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 [applies to the Department and satisfies the Department's requirements to become an] is accredited by the Department as a sponsor of continuing education courses.
Council--The [State Advisory Council, which shall be known as the] Board of Directors of the Pennsylvania Emergency Health Services Council.
Critical care specialty receiving facility--[Facilities] A facility identified by [their] its capability of providing specialized emergency and continuing care to patients [within], including, in one of the following medical areas: poisoning, neonatal, spinal cord injury, behavioral, burns, cardiac and trauma.
* * * * * Department [of Health certification] identification number--A number issued [through the Department's computer system] by the Department that identifies an individual who participates in the Statewide EMS system and, who has been certified [as an EMT, EMT-paramedic, EMT instructor, first responder, and the like. The certification includes the expiration date and the status level.], 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 council--A nonprofit incorporated entity or appropriate equivalent whose function is to plan, develop, maintain, expand and improve EMS systems within a specific geographical area of this Commonwealth and which is deemed by the Department as being representative of health professions and major public and voluntary agencies, organizations and institutions concerned with providing EMS. See the definition of ''regional EMS council.'']
* * * * * 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.
* * * * * 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 [NSC for basic EMTs] EMT-NSC, as set forth in this part.
EMT-NSC--Emergency medical technician-National standard curriculum--[The current National training program for emergency medical technicians] 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 [under] in accordance with the current [NSC for EMT-paramedics] EMT-NSC, as set forth in this part.
EMT-paramedic NSC--Emergency medical technician-paramedic National standard curriculum--[The National training program for EMT-paramedics] 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 department--An area of the hospital dedicated to offering emergency medical evaluation and initial treatment to individuals in need of emergency care. [An emergency department may be a section/division of the medicine or surgery department, or may be organized as a separate department.]
* * * * * Federal KKK standards--The minimum standards and specifications for ambulance vehicles [set up] adopted by the United States Department of Transportation [Federal KKK-A-1822-B 1985, and amendments or revisions thereto].
* * * * * [Field internship--A portion of a required EMT-paramedic training program during which the student obtains supervised experience on a licensed ALS unit.
Field preceptor--A person who evaluates a student's performance in a prehospital setting and is approved by the ALS training institute medical director.]
* * * * * Health professional--A [licensed] physician who has education and continuing education in ALS services and prehospital care or a prehospital registered nurse.
* * * * * [Incident location--The geographic site of an emergency usually indicated by a minor civil division code number.]
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 [an] another EMS vehicle.
[Licensing agency--The Department.]
Medical advisory committee--An advisory body, composed of a majority of physicians, to advise [the] a regional[/State] EMS council or the Council on issues that have potential impact on the delivery of emergency medical care.
* * * * * Medical command--An order given [to a provider of EMS by an authorized medical command physician who meets qualifications prescribed by the Department] 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.
Medical command authorization--Permission given by the ALS service medical director, including an air ambulance medical director, to an EMT- paramedic or a prehospital registered nurse under § 1003.28 (relating to medical command authorization) to perform, on behalf of an ALS ambulance service, ALS services pursuant to medical command or in accordance with Department approved regional EMS council transfer and medical treatment protocols when medical command cannot be secured, is disrupted or is not required pursuant to the approved regional EMS council transfer and medical treatment protocols.
Medical Command Base Station Course--The course adopted by the Department for medical command physicians and ALS service medical directors which provides an overview of the medical command system and base station direction.
Medical command facility--The distinct unit within a facility that contains the necessary equipment and personnel, as prescribed in § 1009.1 (relating to operational criteria) for providing medical command to and control [to an ambulance service] over prehospital personnel when providing medical command.
Medical command facility medical director--A medical command physician [responsible] who meets the criteria established by the Department to assume responsibility for the [medical] direction and control of the [medical command physicians at an accredited] equipment and personnel at a medical command facility.
Medical command physician--A physician [licensed in this Commonwealth who meets the criteria set forth by the Department for a medical command physician and] who is approved by [the] a regional EMS council [medical director] to provide medical command [to prehospital and interhospital providers].
Medical [control] coordination--A system which involves the medical community in all phases of the regional EMS system and consists of the following elements:
* * * * * (ii) Responsibility for [overall supervision] oversight to assure implementation of all medical requirements, with special emphasis on patient triage and medical treatment protocol.
(iii) Effective emergency medical planning and [designation] recommendation for Department recognition of [on-line] online command facilities with medical command physicians who give orders to prehospital patient care providers.
(iv) [Medical] Transfer and treatment protocols.
* * * * * [Medical protocols--Written prescribed medical procedures, adopted by the regional EMS councils after consultation with the regional EMS medical advisory committee and approval by the Department. Review of medical protocols by the regional councils shall be made on an annual basis with notification to the Department of changes.]
* * * * * [Medical service area--A specified geographic area within which responsibility for medical supervision and control is designated by a regional EMS council based upon factors such as patient flow patterns, area population and EMS call volumes.]
Medical treatment protocols--Written prescribed medical procedures.
Mutual aid response--Response by an ambulance unit to an emergency based on a written agreement between [EMS providers] ambulance services whereby the signing parties agree to lend aid to one another under conditions specified in the agreement.
* * * * * [On-line communication--Direct radio or telephonic communication.]
PALS course--Pediatric advanced life support course--A course in advanced pediatric life support sanctioned by the American Heart Association and the American Academy of Pediatrics.
PSAP--Public safety answering point--A communications center established to serve as the first point at which calls by or on behalf of patients are received requesting emergency medical assistance.
Patient--An individual who is believed to be sick, injured, wounded or otherwise incapacitated and helpless and who needs immediate medical attention.
[Pennsylvania Field Protocols for BLS--The most current BLS treatment guidelines recommended by the Council's Medical Advisory Committee and approved by the Department as defined in the act.]
* * * * * Physician--An individual who has a currently registered license to practice medicine or osteopathic medicine in this Commonwealth.
[Prehospital ambulance trip report--A summary of each ambulance call to which an ambulance responds. The report shall contain information specified on forms provided by the Department.]
Prehospital personnel--[Personnel certified or recognized by the Department to render EMS to patients outside of the hospital setting.] The term includes any of the following individuals:
(i) Ambulance attendants.
(ii) First responders.
(iii) EMTs.
(iv) EMT-paramedics.
(v) Prehospital registered nurses.
(vi) Health professional physicians.
Prehospital Personnel [Training] Manual--***
* * * * * [Prescribing physician--A physician licensed in this Commonwealth who is either the medical command physician who has ordered the controlled substance or the receiving emergency department physician who has received the patient from the ALS unit and will be replacing the controlled substance. A prescribing physician shall possess a valid DEA number.
Primary response area--The specified geographic area assigned to a licensed ambulance service that then has responsibility for the provision of prehospital emergency medical care and transportation in the area. Primary response areas are determined by regional EMS council plans, according to factors such as the location of ambulance resources, ambulance response times and area population. A primary response area designation is not intended to be an exclusive designation.]
Providers of EMS--A facility, BLS ambulance service or ALS ambulance service, or a QRS.
QRS--Quick [Response Service] response service--[A service which meets Department requirements and is strategically located to fill a response time gap if EMS cannot be provided within 10 minutes of the time a call for assistance is received.] An entity recognized by the Department to respond to an emergency and to provide EMS to patients pending the arrival of the prehospital personnel of an ambulance service.
[Quick responder--A person responding as part of a designated quick response service which is strategically located within a specified EMS service area and is coordinated through the local and regional EMS response system. The personnel shall be trained and certified to the first responder level or higher.]
Receiving facility--A fixed facility that provides an organized emergency department [of emergency medicine], with a [licensed and ACLS certified] physician who is trained to manage cardiac, trauma and pediatric emergencies, and is present in the facility [who is] and available to the emergency department 24 [hours a day] hours-a-day, 7 [hours a week] days-a-week, and a registered nurse who is present in the emergency department 24 [hours a day] hours-a-day, 7 [hours a week] days-a-week. The [facilities] facility shall also comply with Chapter 117 (relating to emergency services).
Regional EMS council--A nonprofit incorporated entity or appropriate equivalent whose function is to plan, develop, maintain, expand and improve EMS systems within a specific geographical area of this Commonwealth and which is deemed by the Department as being representative of health professions and major public and voluntary agencies, organizations and institutions concerned with providing EMS in the region. [See the definition of ''EMS council.'']
Registered nurse--An individual who has a current original or renewed license to practice nursing in this Commonwealth as a registered nurse.
* * * * * Service area--The area in which an ambulance service routinely provides services.
* * * * * Special event--A planned and organized activity or contest, which will place [a group of 10,000 or more known or estimated] participants or attendees, or both, in a defined geographic area where access by emergency vehicles might be delayed due to crowd or traffic congestion at or near the event.
[Specialized] Special vehicle rescue [training] technician--An individual who [holds a valid certificate of successful completion of a training program in specialized rescue training conducted in accordance with the curriculum approved by the Department] is certified by the Department to possess the training and skills to perform special rescue operations as taught in the special vehicle rescue training program approved by the Department.
* * * * * Statewide BLS medical treatment protocols--Written medical treatment protocols adopted by the Department that have Statewide application to the delivery of BLS services by prehospital personnel.
[Transfer agreements--A formal written agreement between facilities providing for transfer of patients to specialized facilities which offer follow-up care and rehabilitation as necessary to effect the maximum recovery of the patient.]
Trauma center--A facility accredited as a trauma center by the Pennsylvania Trauma Systems Foundation.
[Vehicle licensure identification number--A number issued by the Department to each ambulance of a ambulance service.]
§ 1001.3. Applicability.
[(a) This part implements the act.
(b)] This part affects regional EMS councils, the Council, other entities desiring to [contract with] receive funding from the Department or the regional EMS councils for the provision of EMS, ALS and BLS ambulance services, QRSs, instructors and institutes involved in the training of prehospital personnel including EMTs, EMT-paramedics, first responders, ambulance attendants and health professionals, and trauma centers and local governments involved in the administration and support of EMS.
§ 1001.4. Exceptions.
(a) The Department may, for justifiable reason, grant exceptions to, and departures from, this part when the policy objectives and intentions of this part are otherwise met or when compliance would create an unreasonable hardship, but would not impair the health, safety or welfare of the public. No exceptions or departures from this part will be granted if compliance with the [requirement is provided for] standard is required by statute.
* * * * * (f) The Department may, on its own initiative, grant an exception to this part if the substantive requirements of subsection (a) are satisfied.
§ 1001.5. Investigation.
[(a) The Department may investigate accidents involving an ambulance or other EMS vehicle.
(b) The Department may investigate complaints involving EMS providers or personnel.] The Department may investigate any person, entity or activity for compliance with the provisions of the act and this part.
§ 1001.6. Comprehensive EMS development plan.
(a) The Department, with the advice of the Council, will develop and annually update a Statewide EMS development plan for the coordinated delivery of EMS in this Commonwealth.
* * * * * (c) The Department will incorporate regional EMS development plans into the Statewide EMS development plan.
(d) The Department will adopt a Statewide EMS development plan, and updates to the plan, after public notice, an opportunity for comment and its consideration of comments received, and will make the plan available to the General Assembly and all concerned agencies, entities and individuals who request a copy.
§ 1001.7. Comprehensive regional EMS development plan.
(a) A regional EMS council shall develop and annually update a regional EMS development plan for coordinating and improving the delivery of EMS in the region for which it has been assigned responsibility.
(b) The plan shall contain:
(1) An inventory of emergency services resources available in the region.
(2) An assessment of the effectiveness of the existing services and a determination of the need for additional services.
(3) A statement of goals and specific measurable objectives for delivery of EMS to persons in need of EMS in the region.
(4) Identification of interregional problems and recommended measures to resolve those problems.
(5) Methods to be used in achieving stated objectives.
(6) A schedule for achievement of the stated objectives.
(7) A method for evaluating whether the stated objectives have been achieved.
(8) Estimated costs for achieving the stated objectives.
(9) Other information as requested by the Department.
(c) A regional EMS council shall, in the course of preparing a regional EMS development plan, and updates to the plan, provide public notice and an opportunity for comment. It shall consider all comments before submitting a proposed plan to the Department.
(d) A regional EMS development plan shall become final after it is approved by the Department. The regional EMS council shall make the plan available to all concerned agencies, entities and individuals who request a copy.
Subchapter B. AWARD AND ADMINISTRATION OF [CONTRACTS] FUNDING § 1001.21. Purpose.
This subchapter implements section 5(b)(2) of the act (35 P. S. § 6925(b)(2)), which authorizes the Department to establish, by regulation, standards and criteria governing the award and administration of contracts under the act, and section 10 of the act (35 P. S. § 6930), which authorizes the Secretary to enter into contracts with regional EMS councils and other appropriate entities for the initiation, expansion, maintenance and improvement of EMS systems which are in accordance with the Statewide EMS development plan, and which further authorizes the Secretary to enter into contracts with organizations other than regional EMS councils to assist the Department in complying with the provisions of the act.
§ 1001.22. Criteria for funding.
(a) A potential contractor or other recipient of funds from the Department, either directly or through the Department's agent, may receive funding for the following:
(1) Public education, information and prevention regarding EMS, including:
* * * * * (2) Purchasing ambulances, medical equipment and rescue equipment which enables or enhances the delivery of EMS. Equipment will be funded only if approved by the Department.
(i) Ambulances will be considered for funding if the funds will be used for [expansion for the service] the addition or replacement of existing vehicles or parts, by a licensed ambulance service or an [ambulance service] entity submitting an application for licensure as an ambulance service. [Ambulances which are funded shall meet or exceed standards defined, published and distributed by the Department.]
(ii) Medical equipment will be considered for funding if the funds will be used to purchase medical equipment for ambulances, [QRS] QRSs, [first responder agencies], rescue services and other emergency services approved by the Department, including police and fire departments and recognized medical command facilities.
(iii) Rescue equipment will be considered for funding if the funds will be used to purchase rescue equipment for ambulance services, rescue services, fire departments, [QRS] QRSs, police agencies and other emergency services approved by the Department.
(3) Costs associated with training programs for prehospital personnel.
(i) [These funds will be provided only to EMS training facilities accredited by the Department for classes that include first responders, EMTs, EMT-paramedics, emergency services dispatchers, health professionals and rescue technicians.
(ii) Costs associated with the training programs in subparagraph (i) that will be eligible for funding include expenses associated with providing:
(A) Instructors.
(B) Course coordinators.
(C) Program medical directors.
(D) Clinical and field preceptors.
(E) Medical and nonmedical equipment and supplies.
(F) Field internships.
(G) Related travel expenses.
(H) Program directors.]
Educational costs associated with the conduct of training programs for prehospital personnel, and for other personnel who are involved in managing interfacility patient transports.
[(iii)] (ii) ***
* * * * * (5) Purchasing communications equipment, including medical command communications equipment, and alerting equipment for EMS purposes, if the purchases are in accordance with regional EMS council and Statewide telecommunications plans.
(6) Purchasing equipment for [hospital] emergency departments, if the equipment is used or intended to be used in equipment exchange programs with ambulance services. The equipment purchased shall be of a type used by prehospital and interhospital EMS personnel in the care, treatment, stabilization and transportation of patients in a prehospital or interhospital setting. It shall be the type of equipment that can be easily or safely removed from the patient upon arrival or during treatment at the receiving [medical] facility.
* * * * * (9) Emergency allocations.
(i) Costs associated with a State or Federally declared emergency which the [Secretary] Department finds necessary to carry out the purpose of the act. Eligible applicants are those recognized by the regional EMS council as participants in the delivery of emergency medical or rescue services to or in the affected area.
(ii) Other emergency allocations found necessary by the [Secretary] Department to provide immediate resources or equipment to an area where the health and safety of the residents of this Commonwealth are in jeopardy.
(10) Costs associated with the implementation of voluntary certification or recognition programs, [including] such as a voluntary rescue service certification program.
* * * * * (b) [To be considered for funding, a potential contractor may not propose to provide] Funds will not be made available for any of the following:
* * * * * (c) The Department will set forth additional priorities for funding on a yearly basis in notices published in the Pennsylvania Bulletin.
(d) The Department, by contract or notice published in the Pennsylvania Bulletin, may require a contractor or other applicant for funding to provide matching funds in specified percentages as a condition for receiving funds distributed by the Department or a regional EMS council.
§ 1001.23. Allocation of funds.
[(a)] The Department and regional EMS councils will consider the following factors in determining who shall receive funding and in what amount:
* * * * * (2) Conformity of the proposed application to the [State] Statewide EMS development plan.
* * * * * (4) [Source of other funds] Funds available to the applicant for the purpose set forth in the application, including non-State contributions, Federal grants[,] or Federal contracts pertaining to EMS. Non-State contributions include cash and in-kind services provided to the contractor or toward the operation of an EMS system by private, public or government entities, including the Federal government.
* * * * * [(b) The Department will set forth priorities for funding on a yearly basis in policies published by notice in the Pennsylvania Bulletin.]
§ 1001.24. Application for contract.
To be considered for funding by the Department to plan, initiate, maintain, expand or improve an EMS system, a regional EMS council or other appropriate entity shall submit an application on a form [presented] prepared by the Department[, including, but not limited to,] and shall provide the following information:
* * * * * § 1001.26. Restrictions on contracting.
(a) The Department will not contract, during the same term of contract, [for the organization of] with more than one regional EMS council [which covers the same geographic area or a substantial] to exercise responsibility for all or a portion of the same geographic area.
* * * * * § 1001.27. Subcontracting.
(a) A regional EMS council, which has received a contract from the Department, may receive the Department's written approval to subcontract certain of its contractual duties to other [EMS] entities as deemed necessary and appropriate for the proper execution of the contract with the Department.
* * * * * § 1001.28. Contracts with the Council
Sections 1001.22--1001.27 do not apply to contracts between the Department and the Council. The Department will contract with the Council to provide it funds to perform the services the Council is required to perform under the act, and may contract with the Council for it to assist the Department in complying with other provisions of the act.
Subchapter C. COLLECTION OF DATA AND INFORMATION § 1001.41. Data and information requirements for ambulance services.
(a) Ambulance services licensed to operate in this Commonwealth shall collect, maintain and report accurate and reliable patient data and information for calls for assistance [in the format prescribed and on forms provided by the Department within a specified time period]. The report shall be made by completing an ambulance call report.
(b) [The information collected shall include, but not be limited to:
(1) Ambulance service affiliate number and vehicle identification number.
(2) Ambulance trip report number.
(3) Patient sex and age.
(4) Patient vital signs.
(5) Incident location.
(6) Type of incident.
(7) Classification of the call at time of dispatch as either emergency or nonemergency.
(8) Date of call.
(9) Times as follows:
(i) Time call received for dispatch of ambulance service.
(ii) Time of dispatch of responding ambulance.
(iii) Time of ambulance responding to incident scene.
(iv) Time of ambulance arrival at the scene.
(v) Time extrication was completed.
(vi) Time of ambulance departure from the scene.
(vii) Time of ambulance arrival at facility.
(viii) Time ambulance available for further service.
(10) Patient condition at the time emergency personnel arrived at the scene and arrived at the receiving facility.
(11) History of present illness or injury.
(12) Type of injury or illness.
(13) Anatomic site of injury or illness.
(14) Seriousness of patient illness or injury.
(15) Highest level of care rendered to the patient.
(16) Treatments, aids and medications given.
(17) Indication of mutual aid response.
(18) If mutual aid response, time of initial dispatch for the incident.
(19) Times medications or treatment, or both were rendered.
(20) Medical command: time, type and quality of transmission.
(21) Type of telecommunication utilized to notify receiving facility.
(22) Department identification number of medical command physician, when medical command is obtained.
(23) Each ambulance crew member's name, level of EMS training and Department ID number if assigned.
(24) Indication that CPR was in progress before arrival; for example, citizen, QRS, first responder, if applicable.
(25) Support services utilized; for example, rescue, fire, helicopter or coroner.
(26) Indication that QRS was utilized, if applicable.
(27) If utilized, the QRS's arrival time at the scene of the incident.
(28) Receiving facility and location.
(29) Documentation regarding refusal of care by patient.
(30) Documentation regarding a decision that emergency care and transportation were not needed.
(31) Information regarding patient seat belt usage, if pertinent and available.] The Department will identify data items for the ambulance call report as either confidential or not confidential.
(c) [No person or ambulance service may disseminate the information collected under this section except as provided in § 1001.42 (relating to dissemination of information). Licensed] An ambulance [services] service shall [provide to the Department evidence that] store the information designated as confidential in secured areas to assure that access to unauthorized persons is prevented, and shall take other necessary measures to ensure that the information is maintained in a confidential manner and is not available for public inspection or dissemination, except as authorized by § 1001.42 (relating to dissemination of information). [Ambulance services that fail to maintain confidentiality of information are subject to suspension, revocation or denial for license as provided for in Chapter 1005 (relating to licensing of BLS and ALS ambulance services).]
(d) When an ambulance service transports a patient to a hospital, before its ambulance departs from the hospital, it shall provide to the individual at the hospital assuming responsibility for the patient, either verbally, or in writing or other means by which information is recorded, the patient information designated in the ambulance call report as essential for immediate transmission for patient care. Within 24 hours following the conclusion of its provision of services to the patient, the ambulance service shall complete the full ambulance call report and provide a copy or otherwise transmit the data to the receiving facility.
(e) The ambulance service shall have a policy for designating which member of the ambulance crew is responsible for completing the ambulance call report.
§ 1001.42. Dissemination of information.
(a) [No] A person who collects, has access to, or knowledge of, confidential information collected under § 1001.41 (relating to data and information requirements for ambulance services), by virtue of that person's participation in the Statewide EMS system, may not provide the ambulance call report, or disclose the [knowledge] confidential information contained in the report or a report or record thereof, except:
* * * * * (2) To another person or agency under contract with or licensed by the Department and subject to strict supervision by the Department to insure that the use of the data is limited to specific research, planning [and], quality [assurance] improvement and complaint investigation purposes and that appropriate measures are taken to protect patient confidentiality.
* * * * * (5) For the purpose of quality [assurance] improvement activities, with strict attention to patient confidentiality.
* * * * * (b) [A person or organization in the possession of patient identifying data or records, shall store the information in secured areas to assure that access to unauthorized persons is prohibited.] The Department will regularly disseminate nonconfidential, statistical data collected from ambulance call reports to providers of EMS for improvement of services.
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