[43 Pa.B. 6093]
[Saturday, October 12, 2013]
[Continued from previous Web Page]
CHAPTER 1029. MEDICAL COMMAND FACILITIES AND RECEIVING FACILITIES Subchap.
A. MEDICAL COMMAND FACILITIES B. RECEIVING FACILITIES
Subchapter A. MEDICAL COMMAND FACILITIES Sec.
1029.1. General provisions. 1029.2. Operational requirements. 1029.3. Processing certification and registration applications. 1029.4. Inspections and investigations. 1029.5. Plan of correction. 1029.6. Discontinuation of service. § 1029.1. General provisions.
(a) Certification and registration required. To operate as a medical command facility, a medical unit shall be certified and currently registered as a medical command facility.
(b) Certification requirements.
(1) The Department will certify as a medical command facility a facility that was recognized by the Department as a medical command facility immediately prior to October 12, 2013.
(2) The Department will certify other applicants for certification as a medical command facility if the Department is satisfied that the applicant has met the following requirements:
(i) It is a distinct medical unit operated by a hospital or consortium of hospitals.
(ii) It has the equipment and personnel needed to provide medical command to and control over EMS providers.
(iii) It employs a medical command facility medical director.
(iv) It has adopted policies and procedures to ensure that a medical command physician is available to provide medical command at all times.
(v) It satisfies the communications, recordkeeping and other requirements imposed under this chapter.
(c) Certification application. An application for certification as a medical command facility shall be submitted on a form or through an electronic process, as prescribed by the Department, to the regional EMS council exercising responsibility for the EMS region in which the applicant is located. The application form shall solicit information to enable the Department to determine whether the applicant has satisfied the certification requirements under subsection (b).
(d) Triennial registration. A medical command facility's certification is deemed registered when the certification is issued. Except for a medical command facility certified under subsection (b)(1), a medical command facility's registration of its certification is valid for 3 years. The initial registration of the certification of a medical command facility certified under subsection (b)(1) based upon its prior recognition as a medical command facility will expire when its recognition as a medical command facility would have expired under the Emergency Medical Services Act (35 P. S. §§ 6921—6938) (repealed by the act of August 18, 2009 (P. L. 308, No. 37)).
(e) Registration application. A medical command facility shall submit an application for registration of its certification on a form or through an electronic process, as prescribed by the Department, between 60 and 90 days before its current registration expires to the regional EMS council exercising responsibility for the EMS region in which the applicant is located. The application form shall solicit information to enable the Department to determine whether the applicant continues to satisfy the certification requirements under subsection (b)(2).
§ 1029.2. Operational requirements.
The operational requirements of a medical command facility are as follows:
(1) It shall continue to satisfy all requirements under § 1029.1 (relating to general provisions).
(2) It shall satisfy the following communication and recordkeeping requirements:
(i) Compatibility with regional telecommunication systems plans, if in place.
(ii) Communication by way of telecommunications equipment/radios with EMS providers providing EMS for an EMS agency within the area in which medical command is exercised.
(iii) Audio recording of medical command communications or, when medical command is provided at the scene, otherwise documenting medical command sessions.
(iv) Maintenance of the recording of a medical command session, or documentation of a medical command session when medical command is provided at the scene, for 7 years.
(v) An appropriate program for training emergency department staff in the effective use of telecommunication equipment.
(vi) Protocols to provide for prompt response to requests from EMS providers for both radio and telephone medical guidance, assistance or advice.
(vii) Documentation that each medical command physician has been educated on all updates to Statewide EMS protocols.
(3) It shall accurately and promptly relay information regarding patients to the appropriate receiving facility.
(4) It shall adhere to EMS protocols approved by the Department except when a departure is required for good cause.
(5) It shall establish a process whereby the medical command facility medical director or the director's designee identifies problems to EMS providers and instructs how to correct those problems.
(6) It shall obtain a contingency agreement with at least one other medical command facility to ensure availability of medical command at all times, including during mass casualty situations, natural disasters and declared states of emergency.
(7) It shall establish internal procedures that comply with the Statewide EMS protocols.
(8) It shall notify PSAPs, through which it routinely receives requests for medical command, when it will not have a medical command physician available to provide medical command.
(9) It shall participate in the regional EMS council's quality improvement program.
(10) It shall employ sufficient administrative support staff to enable the institution to carry out its essential duties, including audits, equipment maintenance, and processing and responding to complaints.
(11) It shall establish a program of training for medical command physicians, EMS providers and emergency department staff and establish a method to ensure that each medical command physician receives education about all updates and changes to the Statewide EMS protocols.
(12) It shall provide medical command to EMS providers whenever they seek direction.
§ 1029.3. Processing certification and registration applications.
(a) A regional EMS council that receives an application for medical command facility certification or an application to register that certification shall review the application for completeness. The regional EMS council shall apprise the applicant if the application is incomplete and obtain a completed application from the applicant.
(b) The regional EMS council shall conduct an onsite inspection of the applying facility to verify information contained within the application and to complete a physical inspection of the medical command area.
(c) After completing its review, the regional EMS council shall forward a copy of its recommendation to the Department and to the applying facility. If the applying facility disagrees with the recommendation of the regional EMS council, it may submit a written rebuttal to the Department within 10 days of its receipt of the recommendation.
(d) The Department will review the application, information and recommendation submitted by the regional EMS council and the rebuttal statement, if any, submitted by the applying facility and make a decision within 30 days from the time of its receipt of the regional EMS council's recommendation to grant or deny the application.
(e) The Department may inspect the facility and gather additional information to aid it in making a decision on the application.
§ 1029.4. Inspections and investigations.
(a) The Department will conduct inspections of a medical command facility from time to time, as deemed appropriate and necessary, but at least once every 3 years, including when necessary to investigate a complaint or a reasonable belief that a violation of this subchapter may exist. The Department may have a regional EMS council conduct or assist the Department in conducting an inspection or investigation.
(b) A medical command facility and an applicant for medical command facility certification shall fully respond to an inquiry of the Department or a regional EMS council regarding its compliance with this subchapter and provide them full and free access to examine the facility and its records relating to its operation as a medical command facility.
§ 1029.5. Plan of correction.
(a) Notification of violation. Upon determining that a medical command facility has violated the act or this subchapter, the Department may issue a written notice to the medical command facility specifying the violation or violations. The notice will require the medical command facility to take immediate action to discontinue the violation or violations or to submit a plan of correction, or both, to bring the medical command facility into compliance. If the medical command facility cannot remedy the problem immediately and a plan of correction is therefore required, the Department may direct that the violation be remedied within a specified period of time.
(b) Response by medical command facility. After receiving the notice of violation or violations, the medical command facility shall do one of the following:
(1) Comply with the requirements specified in the notice.
(2) Refuse to comply with one or more of the requirements specified in the notice and apprise the Department of its decision, with an explanation, within the time and manner specified in the notice.
(3) Comply with the requirements specified in the notice and apprise the Department of its decision, within the time and manner specified in the notice of any violation identified in the notice with which it disagrees, supported by an explanation for its disagreement.
(c) Medical command facility disagreement or refusal to comply. If the medical command facility fails to comply with any of the directives in the notice and responds as required under subsection (b)(2), or disagrees with any of the violations identified and responds as required under subsection (b)(3), the Department will evaluate the explanation provided by the medical command facility to determine whether the response was justified. If the Department determines that the response was justified in whole or part, it will inform the medical command facility and rescind any violation identified or directive given in the notice that the Department determines should not have applied.
(d) Consequence of failure to comply. A medical command facility's response to a notice under subsection (b)(2) does not act to stay any of the directives in the notice. A medical command facility's failure to comply with a directive in the notice constitutes a ground for discipline if the violation to which the directive relates is found to be true following a hearing.
§ 1029.6. Discontinuation of service.
A medical command facility may not discontinue medical command operations without providing 90 days advance written notice to the Department, regional EMS councils responsible for regions in which the medical command facility routinely provides medical command and EMS agencies for which it routinely provides medical command. A medical command facility shall advertise notice of its intent to discontinue service as a medical command facility in a newspaper of general circulation in its service area at least 90 days in advance of discontinuing service as a medical command facility.
Subchapter B. RECEIVING FACILITIES Sec.
1029.21. Receiving facilities. § 1029.21. Receiving facilities.
(a) General requirements. A receiving facility shall include a fixed location, with an organized emergency department, including a physician educated to manage cardiac, trauma, pediatric, obstetrics, medical behavioral and all-hazards emergencies. A physician who satisfies these requirements shall be present in the facility and available to the emergency department 24 hours-a-day, 7 days-a-week.
(b) Patients with special needs. Patients with special needs, particularly those with time-sensitive illnesses, who need to be transported to a receiving facility shall be transported to a specialty receiving facility consistent with the Statewide EMS protocols.
(c) Transports to receiving facilities. Unless directed otherwise by a medical command physician, if patient transport by ambulance is required for additional care that has not been prearranged, an ambulance must transport the patient to a receiving facility or other facility as the Department has designated in the Statewide EMS protocols.
(d) Confirmation of receiving patient. When a patient has been transported to a receiving facility, the receiving facility shall acknowledge in writing that it has received the patient if the transporting ambulance crew requests that acknowledgement.
CHAPTER 1031. COMPLAINTS, DISCIPLINARY ACTIONS, ADJUDICATIONS AND APPEALS Sec.
1031.1. Administrative and appellate procedure. 1031.2. Complaints and investigations. 1031.3. Discipline of EMS providers. 1031.4. Petition for certification after revocation. 1031.5. Discipline of EMS vehicle operators. 1031.6. Temporary suspension of EMS provider and EMS vehicle operator certifications. 1031.7. Discipline of EMS instructors. 1031.8. Discipline of medical command physicians and medical command facility medical directors. 1031.9. Automatic suspension for incapacity. 1031.10. Discipline of EMS agencies. 1031.11. Discipline of medical command facilities. 1031.12. Discipline of EMS educational institutes. 1031.13. Discipline of providers of EMS continuing education. 1031.14. Civil money penalty for practicing without a license or certification. 1031.15. Discipline of vendors of EMS PCR software. 1031.16. Discipline of management companies. § 1031.1. Administrative and appellate procedure.
(a) Administrative proceedings. Except as otherwise provided in this chapter, the Department will hold hearings and issue adjudications for proceedings conducted under the act and this subpart in accordance with 2 Pa.C.S. (relating to administrative law and procedure) and will conduct those proceedings under 1 Pa. Code Part II (relating to General Rules of Administrative Practice and Procedure).
(b) Judicial appeals. Department adjudications issued under the act and this chapter may be appealed to the Commonwealth Court under 42 Pa.C.S. § 763 (relating to direct appeals from government agencies).
§ 1031.2. Complaints and investigations.
(a) Filing a complaint. A person may file with the Department a complaint about a violation of the act or this subpart by an individual or entity regulated by the Department under the act or an individual or entity believed to have provided EMS or have engaged in any other activity for which some type of authorization under the act or this subpart is required, without that individual or entity having secured a certification, license or other authorization from the Department to engage in that activity as required by the act and this subpart.
(b) Filing office. The complaint shall be filed with the regional EMS council that serves the EMS region where the conduct occurred. The regional EMS council shall provide the Bureau with a copy of the complaint. A complaint concerning the conduct of a regional EMS council shall be filed directly with the Bureau.
(c) Status of complaint. If a person files a complaint seeking to have the Department impose a disciplinary or corrective measure under this chapter, the Department's action in the handling of the complaint will be on behalf of the Commonwealth to determine whether there has been a violation of a statutory or regulatory requirement over which the Department has jurisdiction under the act.
(d) Processing a complaint. Upon receipt of a complaint filed under this section, the Bureau will assess whether the Department has jurisdiction over the matter about which the complaint is filed. If the matter is within the Department's jurisdiction and an investigation is needed, the Bureau will investigate the complaint or assign the complaint to a regional EMS council or other appropriate entity to investigate. Unless the Bureau determines that disclosure to the individual or entity about whom the complaint has been filed will compromise the investigation or would be inappropriate for some other reason, the investigation will be initiated by providing that individual or entity with a copy of the complaint and requesting a response. The Department will redact and withhold identifying information of the complainant throughout the investigation and will not provide this information if the Department determines that release of this information may compromise the investigation or that release of this information may endanger the life or physical safety of the complainant. In the event the Department does not release identifying information of the complainant, the Department may disclose this information to those persons authorized by the Department to conduct the investigation or as otherwise required by law. If the matter is not within the Department's jurisdiction to address, the Bureau will advise the person who filed the complaint and refer the complainant to another agency if the Bureau believes that the matter about which the complaint has been filed may be within the other agency's jurisdiction.
(e) Notification of results of investigation. When an investigation is completed, the Bureau will notify the complainant of the general results of the investigation of the matter about which the complaint was filed. This notification does not include providing the complainant with a copy of any document collected or prepared during the course of the investigation or communications with persons involved in the investigation, including the subject of the complaint. The Bureau will also provide the same information to the individual or entity about whom the complaint was filed if the individual or entity was officially apprised of the complaint or investigation. If the Department is considering taking disciplinary action against the individual or entity, notification may occur when a disciplinary decision is reached or when disciplinary charges are filed.
§ 1031.3. Discipline of EMS providers.
(a) Grounds for discipline. The Department may discipline or impose corrective measures on an EMS provider or an applicant for EMS provider certification for one or more of the following reasons:
(1) Having a lack of physical or mental ability to provide adequate EMS, with reasonable accommodations if the person has a disability.
(2) Deceptively or fraudulently procuring or representing certification or registration credentials, or making misleading, deceptive or untrue representations to secure or aid or abet another person to secure a certification, license, registration or other authorization issued under this subpart.
(3) Engaging in willful or negligent misconduct in providing EMS or engaging in practice beyond the scope of certification authorization without legal authority to do so.
(4) Abusing or abandoning a patient.
(5) Rendering EMS while under the influence of alcohol, illegal drugs or the knowing abuse of legal drugs.
(6) Operating an emergency vehicle in a reckless manner or while under the influence of alcohol, illegal drugs or the knowing abuse of legal drugs.
(7) Disclosing medical or other information about a patient when prohibited by Federal or State law.
(8) Willfully preparing or filing a false medical report or record or inducing another person to do so.
(9) Destroying a medical report or record required to be maintained.
(10) Refusing to render EMS because of a patient's race, sex, creed, national origin, sexual preference, age, handicap or medical problem or refusing to render emergency medical care because of a patient's financial inability to pay.
(11) Failing to comply with Department-approved EMS protocols.
(12) Failing to comply with reporting requirements imposed by the act or this subpart.
(13) Practicing without the current registration of a certification.
(14) Being convicted of a felony, a crime related to the practice of the EMS provider or a crime involving moral turpitude.
(15) Willfully falsifying or failing to prepare an EMS PCR or complete details on an EMS PCR.
(16) Misappropriating drugs or EMS agency property.
(17) Having a certification or other authorization to practice a profession or occupation revoked, suspended or subjected to other disciplinary sanction.
(18) Violating, aiding or abetting another person to violate a duty imposed by the act, this subpart or an order of the Department previously entered in a disciplinary proceeding.
(19) Based upon a finding of misconduct by the relevant Federal or State agency, having been excluded from a Federal or State health care program or having had equity or capital stock or profits of an entity equal to 5% or more of the value of the property or assets of the entity when it was excluded from a Federal or State health care program.
(20) Any other reason as determined by the Department that poses a threat to the health and safety of the public.
(b) Types of discipline authorized. If disciplinary action or corrective action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny an application for certification or registration of the certification.
(2) Issue a public reprimand.
(3) Revoke, suspend, limit or otherwise restrict the certification.
(4) Require the person to take refresher or other educational courses.
(5) Impose a civil money penalty not exceeding $1,000 for each incident in which the EMS provider engages in conduct that constitutes a basis for discipline.
(6) Stay enforcement of a suspension, revocation or other discipline and place the individual on probation with the right to vacate the probationary order for noncompliance.
(c) Denial of registration. The Bureau will not deny a registration of an EMS provider certification without giving the EMS provider prior notice of the reason for the denial and providing an opportunity for a hearing. If the reason for the denial is the failure of the EMS provider to present prima facie evidence that the continuing education or examination requirement for registration has been satisfied, the opportunity for a hearing may occur after the prior registration has expired.
§ 1031.4. Petition for certification after revocation.
(a) Petition for certification after revocation. A person whose certification has been revoked may not apply for reinstatement of that certification. A person whose EMS provider certification has been revoked may petition the Department for allowance to apply for a new certification no earlier than 5 years after the effective date of the revocation. The petition must aver facts to establish that the petitioner has been rehabilitated to the extent that issuing that person a certification would not be detrimental to the public interest. In assessing the public interest, the Department will weigh the facts that tend to show that the petitioner has been rehabilitated against the Department's duty to maintain public confidence in its ability to regulate EMS providers, deter other EMS providers from engaging in conduct similar to that which resulted in the revocation and protect persons who may require EMS.
(b) Department action on the petition.
(1) The Department will deny a petition for allowance to apply for a new certification, without conducting a hearing, if it accepts as true all facts averred and it concludes that those facts fail to establish that the petitioner has been rehabilitated to the extent that certification would not be detrimental to the public interest.
(2) The Department may grant or hold a hearing on a petition for a new certification if it concludes that the facts averred in the petition, if true, establish a prima facie case that the petitioner has been rehabilitated to the extent that certification would not be detrimental to the public interest.
(c) Grant of petition for a new certification. If the Department grants the petition, the petitioner shall repeat the educational program and the certification examinations that are required for the EMS provider certification the petitioner is seeking and shall satisfy all other requirements for that certification that exist at the time the petitioner files an application for certification after having successfully completed that education and the examinations.
(d) Denial of petition for a new certification. If the Department denies the petition, the petitioner may not again petition the Department for allowance to apply for certification until 1 year has expired from the date of the denial.
§ 1031.5. Discipline of EMS vehicle operators.
(a) Grounds for discipline. The Department may discipline or impose corrective measures on an EMSVO or an applicant for EMSVO certification for one or more of the following reasons:
(1) Having a lack of physical or mental ability to operate an EMS vehicle, with reasonable accommodations if the person has a disability.
(2) Deceptively or fraudulently procuring or representing certification or registration credentials, or making misleading, deceptive or untrue representations to secure a certification or registration.
(3) Operating an emergency vehicle in a reckless manner or while under the influence of alcohol, illegal drugs or the knowing abuse of legal drugs.
(4) Having a driver's license suspended in any jurisdiction due to the use of alcohol or drugs or a moving traffic violation.
(5) Operating a ground EMS vehicle without a driver's license or while a driver's license is suspended.
(6) Being convicted of a felony or a crime involving moral turpitude.
(7) Failing to report a criminal conviction that the applicant or EMSVO is required to report or failing to report the suspension of a driver's license due to the use of alcohol or drugs or a moving traffic violation.
(8) Any other reason as determined by the Department that poses a threat to the health and safety of the public.
(b) Types of discipline authorized. If disciplinary or corrective action is appropriate under subsection (a), the Department may:
(1) Deny an application for certification or registration of the certification.
(2) Issue a public reprimand.
(3) Revoke or suspend the certification.
(4) Impose conditions for lifting a suspension.
(c) Automatic suspension. An EMSVO certification shall be automatically suspended for 4 years if an EMSVO is convicted of a criminal offense that involves driving under the influence of alcohol or drugs, and for 2 years if the EMSVO is convicted of a criminal offense that involves reckless driving or had a driver's license suspended due to the use of drugs or alcohol or a moving traffic violation.
§ 1031.6. Temporary suspension of EMS provider and EMS vehicle operator certifications.
(a) Issuance of temporary suspension. The Department will issue an order temporarily suspending an EMS provider or EMS vehicle operator certification, without a hearing, if based upon evidence received that appears to be credible the Department determines that the person is a clear and immediate danger to the public health and safety.
(b) Notice and preliminary hearing. Notice of the temporary suspension will include a written statement of the factual allegations upon which the determination is based. Unless an extension of time is requested by the EMS provider or EMS vehicle operator, within 30 days after an order under subsection (a) is issued, the Department shall conduct a preliminary hearing to determine whether there is a prima facie case supporting the temporary suspension. The EMS provider or EMS vehicle operator may be present at the preliminary hearing and may be represented by counsel, cross-examine witnesses, inspect physical evidence, call witnesses and offer testimony and other evidence to rebut the prima facie case. If and when the Department determines that the evidence does not establish a prima facie case that the EMS provider or EMS vehicle operator is a clear and immediate danger to the public health and safety, the Department will immediately issue an order lifting the suspension.
(c) Beginning of formal disciplinary proceedings. After issuing an order under subsection (a), the Department shall begin formal disciplinary action under § 1031.3 or § 1031.5 (relating to discipline of EMS providers; and discipline of EMS vehicle operators).
(d) Duration of temporary suspension if prima facie case is established. If the Department determines that a prima facie case supporting the temporary suspension is established at the preliminary hearing, the temporary suspension shall remain in effect, but no longer than 180 days unless agreed upon by the parties.
§ 1031.7. Discipline of EMS instructors.
(a) Grounds for discipline. The Department may discipline or impose corrective measures on a certified EMS instructor, or an applicant for certification as an EMS instructor, for one or more of the following reasons:
(1) Any reason an EMS provider may be disciplined under § 1031.3 (relating to discipline of EMS providers).
(2) Providing instruction while under the influence of alcohol or illegal drugs or the knowing abuse of legal drugs.
(3) Failing to perform a duty imposed upon an EMS instructor under this subpart.
(4) Any other reason as determined by the Department that poses a threat to the health and safety of students.
(b) Types of discipline authorized. If disciplinary action or corrective action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny an application for certification.
(2) Issue a public reprimand.
(3) Revoke, suspend, limit or otherwise restrict the certification.
(4) Impose a civil money penalty not exceeding $1,000 for each incident in which the EMS instructor engages in conduct that constitutes a basis for discipline.
(5) Stay enforcement of a suspension, revocation or other discipline and place the individual on probation with the right to vacate the probationary order for noncompliance.
§ 1031.8. Discipline of medical command physicians and medical command facility medical directors.
(a) Grounds for discipline. The Department may discipline or impose corrective measures on a medical command physician or medical command facility medical director for the following reasons:
(1) Violating a responsibility imposed on the physician by § 1023.2 or § 1023.3 (relating to medical command physician; and medical command facility medical director).
(2) Without good cause, failing to comply with an EMS protocol established or approved by the Department.
(b) Types of discipline authorized. If disciplinary action or corrective action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny the application for certification.
(2) Issue a public reprimand.
(3) Revoke, suspend, limit or otherwise restrict or condition the certification.
(4) Impose a civil money penalty not exceeding $1,000 for each incident in which the physician engages in conduct that constitutes a basis for discipline.
(5) Stay enforcement of any suspension, revocation or other discipline and place the individual on probation with the right to vacate the probationary order for noncompliance.
§ 1031.9. Automatic suspension for incapacity.
The Department will automatically suspend a certification issued under this subpart upon receiving a certified copy of court records establishing that the person has been adjudicated as incapacitated under 20 Pa.C.S. § 5511 (relating to petition and hearing; independent evaluation) or an equivalent statutory provision, and will lift the suspension upon receiving a certified copy of court records establishing that the person has regained capacity under 20 Pa.C.S. § 5517 (relating to adjudication of capacity and modification of existing orders) or an equivalent statutory provision.
§ 1031.10. Discipline of EMS agencies.
(a) Grounds for discipline. The Department may discipline an EMS agency or an applicant for an EMS agency license for one or more of the following reasons:
(1) Violating a requirement of the act or a regulation adopted under the act.
(2) Failing to submit a plan of correction acceptable to the Department to correct a violation cited by the Department or failing to comply with a plan of correction accepted by the Department.
(3) Refusing to accept a conditional temporary license properly sought by the Department or to abide by its terms.
(4) Engaging in fraud or deceit in obtaining or attempting to obtain a license.
(5) Lending its license or, except as authorized by the Department in acting upon the license application or an application to amend the license, enabling another person to manage or operate the EMS agency or any service the EMS agency is licensed to provide.
(6) Engaging in incompetence, negligence or misconduct in operating the EMS agency or in providing EMS to patients.
(7) Using the license of another or in any way knowingly aiding or abetting the improper granting of a license, certification, accreditation or other authorization issued under the act.
(8) Failing to meet or continue to meet applicable licensure standards.
(9) The EMS agency is not a responsible person or is not staffed by responsible persons and refuses to remove from its staff the irresponsible person or persons when directed to do so by the Department.
(10) Being convicted of a felony or a crime involving moral turpitude or related to the practice of the EMS agency.
(11) Making misrepresentations in seeking funds made available through the Department.
(12) Refusing to render EMS because of a patient's race, sex, creed, national origin, sexual preference, age, handicap, medical problem or refusing to respond to an emergency and render EMS because of a patient's financial inability to pay.
(13) Violating an order previously issued by the Department in a disciplinary matter.
(b) Types of discipline authorized. If disciplinary action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny an application for a license.
(2) Issue a public reprimand.
(3) Revoke, suspend, limit or otherwise restrict the license.
(4) Impose a civil money penalty not exceeding $5,000 for each incident in which the EMS agency engages in conduct that constitutes a basis for discipline.
(5) Stay enforcement of a suspension, revocation or other discipline and place the EMS agency on probation with the right to vacate the probationary order for noncompliance.
§ 1031.11. Discipline of medical command facilities.
(a) Grounds for discipline. The Department may discipline a medical command facility or an applicant for a medical command facility certification for one or more of the following reasons:
(1) Submitting a fraudulent or deceptive application for certification or registration of the certification.
(2) Violating a requirement in § 1029.1 or § 1029.2 (relating to general provisions; and operational requirements).
(3) Refusing to permit an inspection or to respond to an inquiry as required under § 1029.4 (relating to inspections and investigations).
(4) Failing to comply, without just cause, with an EMS protocol approved by the Department.
(5) Failing to submit a plan of correction acceptable to the Department to correct a violation cited by the Department or failing to comply with a plan of correction accepted by the Department.
(b) Types of discipline authorized. If disciplinary action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny an application for certification.
(2) Issue a public reprimand.
(3) Revoke, suspend, limit or otherwise restrict or condition the certification.
(4) Impose a civil money penalty not exceeding $5,000 for each act that constitutes a basis for discipline.
(5) Stay enforcement of a suspension, revocation or other discipline and place the medical command facility on probation with the right to vacate the probationary order for noncompliance.
§ 1031.12. Discipline of EMS educational institutes.
(a) Grounds for discipline. The Department may discipline an EMS educational institute or an applicant for an EMS educational institute certification for one or more of the following reasons:
(1) Failure to satisfy the responsibilities imposed upon it under §§ 1025.1—1025.3 (relating to accreditation and operational requirements of EMS educational institutes; accreditation process; and advertising).
(2) An absence of students in the program for 2 consecutive years.
(3) Submission of a fraudulent or deceptive application for accreditation.
(b) Types of discipline authorized. If disciplinary action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny the application for accreditation or reaccreditation.
(2) Impose terms of probation.
(3) Revoke, suspend, limit or otherwise restrict the accreditation.
(4) Impose a civil money penalty not exceeding $1,000 for each infraction.
§ 1031.13. Discipline of providers of EMS continuing education.
(a) Grounds for discipline. The Department may discipline a continuing education sponsor or an applicant for accreditation or reaccreditation as a continuing education sponsor for one or both of the following reasons:
(1) Failure to satisfy the requirements in Chapter 1025, Subchapter B (relating to EMS continuing education courses).
(2) Submission of a fraudulent or deceptive application for accreditation or reaccreditation.
(b) Types of discipline authorized. If disciplinary action is appropriate under subsection (a), the Department may do one or more of the following:
(1) Deny or withdraw its accreditation or reaccreditation.
(2) Downgrade its accreditation status to provisional accreditation, subject to withdrawal if deficiencies are not resolved within a time period prescribed by the Department.
(3) Withdraw approval of a continuing education course applicable to any future presentation of the course.
(4) Impose terms of probation.
(5) Revoke, suspend, limit or otherwise restrict the accreditation or reaccreditation.
(6) Impose a civil money penalty not exceeding $1,000 for each infraction.
§ 1031.14. Civil money penalty for practicing without a license or certification.
(a) Operating an EMS agency without a license. The Department may impose a civil money penalty of up to $5,000 per day upon a person who owns or operates an EMS agency in this Commonwealth without having a license to operate that EMS agency.
(b) Practicing as an EMS provider without a certification. The Department may impose a civil money penalty of up to $1,000 per day upon a person who provides EMS without an EMS provider's certification or other legal authority to provide EMS.
§ 1031.15. Discipline of vendors of EMS PCR software.
The Department may assess a vendor of EMS PCR software a civil money penalty of up to $5,000 for each day a vendor violates a duty imposed by § 1021.43(b) or (d) (relating to vendors of EMS patient care reports).
§ 1031.16. Discipline of management companies.
(a) The Department may deny, withdraw or condition the approval of an entity to offer management services for one or more of the following reasons:
(1) The entity is not a responsible person.
(2) Persons having a substantial ownership interest in the entity are not responsible persons.
(3) The entity will not be staffed by or conduct its activities through responsible persons.
(4) The entity refuses to provide the Department with records or information reasonably requested by the Department to make a determination regarding paragraphs (1)—(3).
(5) The entity conducts the operation or managerial control of an EMS agency, or conducts the day-to-day operations of the EMS agency, in a manner that subjects the EMS agency to possible disciplinary action under § 1031.10 (relating to discipline of EMS agencies).
(6) The entity violates a requirement of the act or a regulation adopted under the act that is applicable to the entity.
(7) Engaging in fraud or deceit in obtaining or attempting to obtain or maintain Department approval.
(b) For purposes of subsection (a):
(1) A responsible person is a person who has not engaged in an act contrary to justice, honesty or good morals which indicates that the person is likely to betray the public trust in managing the operation of the EMS agency, or is a person who has engaged in this conduct but has been rehabilitated and is not likely to again betray the public trust.
(2) A person has a substantial ownership in the entity if the person has equity in the capital, stock or the profits of the applicant equal to 5% or more of the property or assets of the applicant.
(3) A person staffs an entity that manages an EMS agency if the person manages activity integral to the operation of the EMS agency.
CHAPTER 1033. SPECIAL EVENT EMS Sec.
1033.1. Special event EMS planning requirements. 1033.2. Administration, management and medical direction requirements. 1033.3. Special event EMS personnel and capability requirements. 1033.4. Onsite facility requirements. 1033.5. Communications system requirements. 1033.6. Requirements for educating event attendees regarding access to EMS. 1033.7. Special event report. § 1033.1. Special event EMS planning requirements.
(a) Procedure for obtaining required plan approval. The entity responsible for the management and administration of a special event may submit a special event EMS plan to the Department, through the regional EMS council assigned responsibility for the region in which the special event is to occur, to secure a determination from the Department as to whether the plan is adequate to address the EMS needs presented by a special event or a series of special events conducted at the same location.
(1) The applicant shall submit its plan at least 90 days prior to the date of the first day of the event.
(2) The Department will approve or disapprove a special event EMS plan within 60 days after a complete plan is filed with the regional EMS council.
(3) The Department's approval of a special event EMS plan will be for the special event or series of special events in a calendar year, as identified in the plan. The entity shall submit a new special event EMS plan to secure Department approval of a plan for a special event or series of special events in a subsequent calendar year.
(b) Plan content. The special event EMS plan must contain the following information:
(1) The type and nature of event, location, length and anticipated attendance.
(2) Identification of sponsoring organization.
(3) The name and qualifications of the special event EMS medical director and the special event EMS director.
(4) A listing of all EMS agencies that will be involved, the type of EMS service each EMS agency will provide and the number and level of certification of EMS providers each EMS agency will provide, as well as the number and type of health care practitioners who are not participating on behalf of an EMS agency, including EMS providers who are not participating on behalf of an EMS agency, who will be involved.
(5) The type and quantity of EMS vehicles and other vehicles, equipment and supplies to be utilized by each EMS agency that will be involved.
(6) A written agreement with each EMS agency that has agreed to participate, in which the EMS agency identifies the type of EMS service, the number of EMS providers by certification level, the vehicles, the equipment and supplies it will provide.
(7) A description of the onsite treatment facilities including maps of the special event site.
(8) A description of the special event emergency medical communications capabilities.
(9) A risk assessment for the event, and a plan for responding to a possible disaster or mass casualty incident at the event site, including a plan for emergency evacuation of the event site.
(10) A plan for educating event attendees regarding EMS system access and specific hazards, such as severe weather.
(11) Measures that have and will be taken to coordinate EMS for the special event or events with local emergency care services and public safety agencies—such as EMS, police, fire, rescue, and hospital agencies or organizations.
(c) Plan approval. To secure Department approval of a special event EMS plan, the applicant shall satisfy the requirements in this chapter.
§ 1033.2. Administration, management and medical direction requirements.
(a) Special event EMS director. EMS provided at a special event shall be supervised by a special event EMS director.
(1) Responsibilities. The responsibilities of the special event EMS director include:
(i) Preparing a plan under § 1033.1 (relating to special event EMS planning requirements).
(ii) Managing the delivery of special event EMS.
(iii) Ensuring implementation of the EMS coordination measures contained in the special event EMS plan.
(iv) Ensuring that a record is kept that lists the individuals that requested or received EMS and the disposition of each case, including identification of the transporting EMS agency and ambulance, and the receiving facility, if the individual was transported to a receiving facility.
(2) Qualifications. A special event EMS director shall be experienced in the administration and management of EMS at the level of EMS provided for in the special event EMS plan.
(b) Special event EMS medical director.
(1) Responsibilities. The responsibilities of a special event EMS medical director include:
(i) Ensuring that each EMS provider provided by an EMS agency that is used under the special event EMS plan has been appropriately credentialed by the provider's EMS agency medical director to provide EMS at the level required in the plan.
(ii) Ensuring that if onsite medical command is provided, that it be provided through a medical command facility and that medical command communications are documented.
(iii) Ensuring that equipment and medications are appropriately stored and secured.
(iv) Reviewing with the EMS agency medical directors for the EMS agencies involved, quality improvement issues related to the special event.
(v) Ensuring that adequate EMS PCRs and records are maintained for patients who receive EMS during the special event.
(2) Qualifications. A special event EMS medical director shall be an EMS agency medical director or satisfy the standards for being an EMS agency medical director in § 1023.1(b) (relating to EMS agency medical director) without serving as an EMS agency medical director.
§ 1033.3. Special event EMS personnel and capability requirements.
(a) Special event EMS providers shall be certified at appropriate levels based on the level of EMS approved by the Department in the special event EMS plan.
(b) One ambulance shall be stationed onsite at a special event if the event is expected to involve the presence of between 5,000 and 25,000 persons at any one time.
(c) Two ambulances shall be stationed onsite at a special event if the event is expected to involve the presence of more than 25,000 but less than 55,000 persons at any one time.
(d) Three ambulances shall be stationed onsite at a special event if the event is expected to involve the presence of more than 55,000 persons at any one time.
(e) Sufficient EMS providers shall be available to enssure the availability of EMS to persons present at the special event.
§ 1033.4. Onsite facility requirements.
A special event expected to involve the presence of more than 25,000 persons at any one time shall require the use of onsite treatment facilities. The onsite treatment facilities shall provide:
(1) Environmental control, providing protection from weather elements to ensure patient safety and comfort.
(2) Sufficient beds, cots and equipment to provide for evaluation and treatment of at least four simultaneous patients.
(3) Adequate lighting and ventilation to allow for patient evaluation and treatment.
§ 1033.5. Communications system requirements.
A special event EMS system shall have onsite communications capabilities to ensure:
(1) Uniform access to care for patients in need of EMS.
(2) Onsite coordination of the activities of EMS providers, including capability for interoperable communication with all EMS agencies involved in the plan and with EMS agencies local to the event site that are not involved in the special event EMS plan.
(3) Communication with existing community PSAPs.
(4) Communication interface with other involved public safety agencies.
(5) Communication with receiving facilities.
(6) Communication with ambulances providing emergency transportation.
(7) Communication with medical command physicians.
§ 1033.6. Requirements for educating event attendees regarding access to EMS.
(a) The entity responsible for the management and administration of a special event shall develop and implement a plan to educate special event participants and spectators about the following:
(1) The presence and location of EMS at the special event.
(2) The methods of obtaining EMS at the special event.
(b) The entity responsible for the management and administration of a special event shall establish a procedure and means for alerting the participants and spectators of specific hazards or serious changing conditions, such as severe weather, and for providing event evacuation instructions.
§ 1033.7. Special event report.
An entity for which the Department has approved a special event EMS plan shall complete a special event report form prepared by the Department and provided to it by the relevant regional EMS council and file the completed report with that regional EMS council within 30 days following the last day of a special event. Among other matters, the report shall provide a summary of the patient information required to be kept under § 1033.2(a)(1)(iv) (relating to administration, management and medical direction requirements).
[Pa.B. Doc. No. 13-1953. Filed for public inspection September 27, 2013, 9:00 a.m.]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
