The Oregon Administrative Rules contain OARs filed through November 15, 2015

 

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OREGON HEALTH AUTHORITY,

PUBLIC HEALTH DIVISION

 

DIVISION 250
AMBULANCE SERVICE LICENSING

333-250-0000
Effective Date and Preemption
(1) No person shall
operate an ambulance service unless issued an ambulance service license by the Oregon
Health Authority, Public Health Division.
(2) These
rules preempt any local ambulance ordinances and county ambulance service area plans
that are in conflict. This rule does not prevent a city or county from establishing
requirements more stringent than those set forth in these rules.
Stat. Auth.: ORS
682.015 & 682.215

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07
333-250-0010
Definitions
(1) "Advertise"
means to communicate information to the public, or to any person concerned, by any
oral, written, or graphic means including, but not limited to, handbills, newspapers,
television, billboards, radio, Internet and telephone directories.
(2) “Agent”
means a medical or osteopathic physician licensed under ORS chapter 677, actively
registered and in good standing with the Oregon Medical Board, a resident of or
actively participating in the area in which the emergency service is located, designated
by the supervising physician to provide direction of the medical services of EMS
providers as specified in OAR chapter 847.
(3) "Ambulance"
or "Ambulance Vehicle" means any privately or publicly owned motor vehicle, aircraft,
or watercraft that is regularly provided or offered to be provided for the emergency
transportation of persons who are ill or injured or who have disabilities.
(4) “Ambulance
Based Clinician” means a registered nurse, physician, or physician assistant
who:
(a) Has an
active license in Oregon and is in good standing with the Oregon Board of Nursing
or the Oregon Medical Board; and
(b) Staffs
an ambulance for a licensed ambulance service.
(5) "Ambulance
Service" means any person, governmental unit, corporation, partnership, sole proprietorship,
or other entity that operates ambulances and that holds itself out as providing
prehospital care or medical transportation to persons who are ill or injured or
who have disabilities.
(6) "Ambulance
Service Area (ASA)" means a geographic area served by one ground ambulance service
provider, and may include all or portion of a county, or all or portions of two
or more contiguous counties.
(7) “Authority”
means the Emergency Medical Services and Trauma Systems Program, within the Oregon
Health Authority.
(8) "Business
Day" means Monday through Friday when the Authority is open for business, excluding
holidays.
(9) "Emergency
Care" means the performance of acts or procedures under emergency conditions in
the observation, care and counsel of the ill, injured or disabled; in the administration
of care or medications as prescribed by a licensed physician, insofar as any of
these acts is based upon knowledge and application of the principles of biological,
physical and social science as required by a completed course utilizing an approved
curriculum in prehospital emergency care. However, "emergency care" does not include
acts of medical diagnosis or prescription of therapeutic or corrective measures.
(10) "EMS"
means Emergency Medical Services.
(11) "EMS
Medical Director" has the same meaning as "Supervising Physician" in ORS 682.025.
(12) "Emergency
Medical Services Provider (EMS Provider)" means a person who has received formal
training in prehospital and emergency care and is state-licensed to attend to any
ill, injured or disabled person. Police officers, fire fighters, funeral home employees
and other personnel serving in a dual capacity, one of which meets the definition
of "emergency medical services provider" are "emergency medical services providers"
within the meaning of ORS chapter 682.
(13) "EMT-Paramedic"
has the same meaning as Paramedic.
(14) "Employee"
means any full-time paid or part-time paid person acting within the scope of his
or her duties and for or on behalf of an ambulance service.
(15) "Fraud
or Deception" means the intentional misrepresentation or misstatement of a material
fact, concealment of or failure to make known any material fact or any other means
by which misinformation or false impression is knowingly given.
(16) "License"
means the documents issued by the Authority to the owner of an ambulance service
when the service and its ambulance are found to be in compliance with ORS chapter
682, OAR chapter 333, division 255 and OAR chapter 333, division 250.
(17) "Non-emergency
Care" means the performance of acts or procedures on a patient who is not expected
to die, become permanently disabled or suffer permanent harm within the next 24-hours,
including but not limited to observation, care and counsel of a patient and the
administration of medications prescribed by a physician licensed under ORS chapter
677, insofar as any of those acts are based upon knowledge and application of the
principles of biological, physical and social science and are performed in accordance
with scope of practice rules adopted by the Oregon Medical Board in the course of
providing prehospital care as defined by this rule.
(18) "Owner"
means the person having all the incidents of ownership in an ambulance service or
an ambulance or, where the incidents of ownership are in different persons, the
person, other than a security interest holder or lessor, entitled to the possession
of an ambulance vehicle or operation of an ambulance service under a security agreement
or a lease for a term of 10 or more successive days.
(19) “Paramedic”
means a person who is licensed by the Authority as a Paramedic.
(20) "Patient"
means a person who is ill or injured or who has a disability and who is transported
in an ambulance.
(21) "Person"
means any individual, corporation, association, firm, partnership, joint stock company,
group of individuals acting together for a common purpose, or organization of any
kind and includes any receiver, trustee, assignee, or other similar representative
thereof.
(22) "Physician"
means a person licensed under ORS chapter 677, actively registered and in good standing
with the Oregon Medical Board as a Medical Doctor (MD) or Doctor of Osteopathic
Medicine (DO).
(23) "Prehospital
Care" means that care rendered by EMS providers as an incident of the operation
of an ambulance as defined by ORS chapter 682 and that care rendered by EMS providers
as incidents of other public or private safety duties, and includes, but is not
limited to "emergency care" as defined by ORS chapter 682.
(24) "Prehospital
Care Report Form (PCRF)" means an Authority-approved form or electronic field data
format that is completed for all patients receiving prehospital assessment, care
or transportation to a medical facility.
(25) "Procedure"
means a written, dated and signed course of action to carry out a directive. A procedure
must be able to answer the questions; who, what, why, when and where.
(26) “Qualified
Driver” means someone who is not licensed by the Authority and who meets Authority
requirements to operate a ground ambulance.
(27) "Volunteer"
means a person who is working without wages and is acting within the scope of his
or her duties for an ambulance service, but who may receive reimbursement for personal
expenses incurred.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 11-2010, f. 6-30-10, cert. ef. 7-1-10; PH
1-2013, f. & cert. ef. 1-25-13
333-250-0020
Application
Process to Obtain an Ambulance Service License
(1) Every person
who furnishes, operates, conducts, maintains, advertises, engages in, proposes to
engage in, or professes to engage in the provision of ambulance service must apply
for and receive an ambulance service license from the Authority before offering
such service to the public.
(2) The applicant
for an ambulance service license must possess at least one ambulance, facilities,
equipment, and a communications system meeting the requirements of ORS chapter 682
and OAR chapter 333, division 250. In addition, an applicant must have a sufficient
number of EMS providers, a number approved by the Authority, to appropriately staff
each ambulance.
(3) An applicant
for an ambulance service license must submit an application to the Authority on
a form specified by the Authority. A completed application form must contain, at
a minimum:
(a) The name
and address of the person or public entity owning the ambulance service;
(b) If other
than the applicant's true name, the name under which the applicant is doing business;
(c) If for
a corporation, a limited partnership, or a limited liability company, attach to
the application:
(A) A written
statement from the Oregon Secretary of State's Corporation Division that the ambulance
service is registered in accordance with the requirements of the Secretary of State's
Corporation Division and that the ambulance service is in good standing and has
filed all its annual reports, together with filing fees;
(B) The name
of the registered agent of the ambulance service that is on file with the Secretary
of State's Corporation Division; and
(C) All trade
names recorded with the Secretary of State's Corporation Division for this business
entity, and if this business entity is a subsidiary, all trade names or names of
all other subsidiaries recorded with the Secretary of State's Corporation Division.
(d) If for
a public agency, documentation from local city or county authorizing operation as
an ambulance service;
(e) A copy
of a signed signature authorization form or a power of attorney;
(f) The name
of the principal contact person that the ambulance service wants contacted regarding
official communications with the Authority, if different than identified in subsection
(3)(a) of this rule;
(g) The mailing
and actual street address of the principal place of business of the ambulance service
and the actual street address of all fixed locations where an ambulance is parked
when not in operation;
(h) Proof
of financial responsibility as specified in ORS 682.105. Proof must be in the form
of a certificate of insurance;
(i) Copies
of all licenses issued by the Federal Communications Commission (FCC) for the operation
of the ambulance service's communications equipment and radio configuration data
as required by the Authority or written authorization from a FCC license holder
to use the license holder's frequencies;
(j) If laboratory
tests are conducted that require a license, a copy of that license;
(k) A copy
of the operator's Air Carrier Operating Certificate, if the service will be operating
an air ambulance;
(l) A copy
of the operator's US Coast Guard Certificate of Compliance, if the service will
be operating a marine ambulance;
(m) Copies
of all telephone book yellow pages and the website addresses, where ambulance service
advertising appears;
(n) A copy
of a Prehospital Care Report Form or electronic field data format, which must be
approved by the Authority, if not using the Authority's Prehospital Care Report
Form;
(o) Name
of the approved EMS medical director;
(p) A roster
of all EMS providers, ambulance based clinicians, and qualified drivers in alphabetical
order, who shall either operate an ambulance or attend to patients, or both, along
with the following information for each employee and volunteer:
(A) The full
legal name;
(B) The employment
status as either full-time paid, part-time paid or volunteer;
(C) The level
of professional license held; and
(D) License
numbers, including EMS provider license numbers, driver and pilot license numbers
for those persons operating the ambulance.
(q) A list
of all ambulances to be operated by the ambulance service under the ambulance service
license along with the information required for an ambulance license pursuant to
ORS chapter 682 and these rules;
(r) A statement
under the penalties of perjury that certifies the following:
(A) There
has been no attempt to knowingly and willfully falsify, conceal, or omit a material
fact, or make any false, fictitious, incomplete or fraudulent statements or representations,
or make or use any false writing or document knowing the same to contain any false,
fictitious, or fraudulent statement or entry for the purpose of obtaining or attempting
to obtain an ambulance service license to operate in the State of Oregon. Where
an applicant relies on documents submitted by employees, volunteers or agents, the
applicant has made a reasonable effort to verify the validity of those documents;
(B) The applicant
authorizes any persons or entities, including but not limited to hospitals, institutions,
organizations, or governmental entities to release to the Authority any information,
files, or records requested by the Authority in connection with the processing of
an application; and
(C) Upon
receiving an ambulance service license, the licensee authorizes disclosure of information
by insurance companies, physicians, health care facilities, including but not limited
to hospitals, nursing homes, or free standing medical centers, to the Authority
relating to service provided by the ambulance service to those facilities or to
patients being taken from or to those facilities.
(s) The completed
application must contain the signature(s) of the person(s) having the lawful responsibility
for the overall operation of an ambulance service or the person having the power
of attorney, or the authorized person empowered to sign on behalf of the ambulance
service; and
(t) Such
other information as the Authority may reasonably require.
(4) If the
applicant's primary ambulance service business office is located in another state,
the applicant must:
(a) Meet
requirements listed in sections (1) through (3)(t) of this rule; and
(b) Attach
copies of their current ambulance service and ambulance license(s) for that state
to the application.
(5) The completed
application to license an ambulance service must be accompanied by a nonrefundable
licensing fee of:
(a) $75,
when the service has a maximum of four full-time paid positions; or
(b) $250,
when the service has five or more full-time paid positions.
(6) Upon
review of the completed initial application and nonrefundable fee, the Authority
shall schedule an inspection of the applicant's facilities, records and ambulances.
The applicant must successfully complete the inspection to be issued an ambulance
service license. A license shall be issued within 10 business days of successful
inspection.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 11-2010, f. 6-30-10, cert. ef. 7-1-10; PH
1-2013, f. & cert. ef. 1-25-13
333-250-0030
Issuance
of License to Operate an Ambulance Service
(1) When the completed
ambulance service license application with the appropriate nonrefundable licensing
fee has been received by the Authority, and if it is found that the submitted data,
facilities and records comply with the requirements of ORS chapter 682 and these
rules, the Authority shall issue an ambulance service license for the specified
ambulance service.
(2) The ambulance
service license:
(a) Shall
be valid until June 30 of each year, unless sooner revoked or suspended. The initial
licensing period may not exceed 15 months;
(b) Shall
expire on June 30 of the following year, if a license is applied for and issued
between April 1 and June 30; and
(c) Must
be conspicuously displayed in the main business office of the ambulance service,
or otherwise as directed by the Authority.
(3) Except
when specifically exempted by ORS 682.035, an out-of-state ambulance service that
operates or advertises in Oregon must be licensed by the Authority. An out-of-state
ambulance service is not required to obtain an ambulance service license and ambulance
license for the following situations:
(a) Transporting
a patient through the state;
(b) Delivering
a patient to a medical facility or other location within the state, if the beginning
of the transport originated outside of the state;
(c) Picking
up a patient at a medical facility or airport within the state for the purpose of
transporting the patient to a medical facility or other location outside of the
state, unless prohibited by the county's Ambulance Service Area plan; or
(d) In the
event of a man-made or natural disaster declared by federal, state or local officials
and resulting in the need to utilize all available resources to provide patient
care and transportation in the affected area.
(4) If an
ambulance service license becomes lost, damaged or destroyed, the licensee must
apply for a replacement license. The licensee must submit, to the Authority, the
completed application with a $10 nonrefundable fee for each replacement license.
(5) An ambulance
service license is not transferable to a new owner of a purchased ambulance service.
(6) When
an ambulance service is found to be in non-compliance with ORS chapter 682 or these
rules, the Authority may deny, suspend or revoke an ambulance service license or
place the ambulance service on probation.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0031
Ambulance
Service Requirements with Use of Qualified Drivers
(1) If a licensee
is using a driver of a ground ambulance who is not licensed as an EMS provider by
the Authority, a licensee must ensure the driver has:
(a) A valid
driver’s license;
(b) Emergency
ground ambulance operator's training that meets Authority standards;
(c) Current
healthcare provider cardiopulmonary resuscitation (CPR) card or proof of course
completion that meets or exceeds the 2010 American Heart Association Emergency Cardiovascular
Care (ECC) guidelines or equivalent standards approved by the Authority;
(d) Bloodborne
pathogen and infectious disease training that meets or exceeds standards found in
OAR chapter 437;
(e) Hazardous
materials awareness training that meets or exceeds the Oregon Occupational Safety
and Health Division standards found in OAR chapter 437; and
(f) A signed
statement by a driver not certified or licensed through the Authority that he or
she is:
(A) Not addicted
to alcohol or controlled substances and is free from any physical or mental condition
that might impair the ability to operate or staff an ambulance; and
(B) Physically
capable of assisting in the extrication, lifting and moving of a patient at the
direction of an EMS provider.
(2) A licensee
must have a certified copy of the qualified driver’s license check done through
the Oregon Department of Motor Vehicles Automated Reporting System Program or equivalent
reporting program as approved by the Authority. If the driver has an out-of-state
driver’s license, the licensee must obtain an equivalent certified copy from
that state, if available and if not available, conduct an annual driving record
check. The latest copy must be kept in the driver’s personnel file.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: PH
1-2013, f. & cert. ef. 1-25-13
333-250-0040
Ambulance
Service Operational Requirements
(1) The licensee
must ensure that the service, employees, volunteers and agents:
(a) Comply
with all of the requirements of ORS chapter 682, ORS 820.300 through 820.380 and
other applicable federal, state and local laws and regulations governing the operation
of a licensed ambulance service;
(b) Notify
the Authority, upon making initial application or within 14-days of the date of
registration, of any new "trading as", "division of", or "doing business as" names
utilized by the licensee; and
(c) Transport
only patients for which it has the resources to provide appropriate medical care
and transportation unless in transfers between medical facilities, the sending or
receiving facility has provided medically appropriate life support measures, personnel,
and equipment to sustain the patient during the transfer.
(2) The licensee
shall document that each employee or volunteer:
(a) Is provided
an initial orientation program that addresses, at a minimum, the ambulance service
standing orders, ambulance service policies and procedures, driving and operating
requirements for ambulance vehicles, and operations of equipment. The initial orientation
program must be completed prior to the employee or volunteer being allowed to staff
an ambulance; and
(b) Has access
to current copies of these rules, and the documents referred to within these rules
that are incorporated by reference.
(3) The licensee
must have written procedures to carry out daily ambulance service operations. Procedures
must include, but are not limited to:
(a) Bloodborne
pathogen procedures that are in compliance with OAR chapter 437;
(b) The storage
of medications including controlled substances if authorized by the EMS medical
director. This procedure must meet Oregon Board of Pharmacy requirements in OAR
chapter 855 and US Drug Enforcement Administration requirements found in 21 CFR
1301.75(b);
(c) The destruction
of outdated medications including controlled substances if authorized by the EMS
medical director. This procedure must meet Oregon Board of Pharmacy Requirements
found in OAR chapter 855 and US Drug Enforcement Administration requirements found
in 21 CFR 1307.21;
(d) A procedure
for notifying the licensee when an employee is impaired by excessive fatigue, illness,
injury or other factors that may reasonably be anticipated to constitute a threat
to the health and safety of patients or the public;
(e) The reporting
of suspected child abuse as required in ORS 419B.005 through 419.B.050; and
(f) The reporting
of suspected elderly abuse as required in ORS 124.050 through 124.095.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 11-2010, f. 6-30-10, cert. ef. 7-1-10; PH
1-2013, f. & cert. ef. 1-25-13
333-250-0041
Ambulance
Service Personnel Educational Requirements and Quality Improvement
(1) The licensee
shall provide, coordinate, and document the following:
(a) An orientation
program for all new EMS providers, ambulance based clinicians and qualified drivers.
The initial orientation program must include but is not limited to the subjects
listed in OAR 333-250-0040(2)(a); and
(b) The training
of all EMS providers and ambulance based clinicians on the proper use of any new
equipment, procedure or medication prior to being placed into operation on an ambulance.
(2) Before
the licensee permits a person to staff an ambulance, the licensee shall ensure that
the person has current training that includes but is not limited to:
(a) Bloodborne
pathogen and infectious disease training that meets or exceeds standards found in
OAR chapter 437;
(b) Hazardous
materials awareness training that meets or exceeds the Oregon Occupational Safety
and Health Division standards found in OAR chapter 437;
(c) Emergency
ground ambulance operator's training that meets Authority standards when operating
a ground ambulance;
(d) Air medical
crew training that meets Authority standards when operating an air ambulance; and
(e) Marine
crew training that meets Authority standards when operating a marine ambulance.
(3) The licensee
shall ensure that there is verifiable written documentation placed in the employee’s
or volunteer’s training file that the employee or volunteer has completed
the training and the documentation shall include when and where the training was
obtained.
(4) Any EMS
related or required continuing education offered by the licensee or designee must
be documented as follows:
(a) A class
roster that contains:
(A) Name
of the ambulance service;
(B) Full
name of the instructor;
(C) Full
name of the person attending the class;
(D) Class
date;
(E) Class
subject; and
(F) Class
length; or
(b) A computer-generated
printout history of an individual’s continuing education record that contains:
(A) The full
name of the person attending the class;
(B) Name
of the ambulance service;
(C) Class
dates;
(D) Class
subjects; and
(E) Class
lengths.
(5) Documentation
required in section (4) of this rule must be maintained in a secure manner with
limited access for a minimum of four years.
(6) The licensee
must establish a procedure to release copies of all records of continuing education
completed by an EMS provider or employee through the service in a verifiable format
to the requesting party within five business days of being requested.
(7) The licensee
must have a written quality improvement program that is approved by the EMS medical
director.
(8) To assist
the licensee and the EMS medical director in determining if appropriate and timely
emergency medical care was rendered, the ambulance service designated official may
request the following information from the hospital receiving the patient as authorized
by ORS 682.056:
(a) Patient
admit status and unit admitted to;
(b) Any procedure
listed in section D04_04 of the National Highway Transportation Safety Administration
dataset dictionary, version 2.2.1, and performed on the patient within the first
hour of being admitted;
(c) Any medication
administered to the patient within the first hour of being admitted; and
(d) Trauma
system entry by emergency department staff.
(9) Information
provided under section (8) of this rule is considered confidential pursuant to ORS
682.056. Any employee or volunteer participating in a quality improvement session
must have a signed confidentiality statement in their personnel file.
(10) If the
licensee accepts students for Paramedic internships from an accredited teaching
institution, the licensee must:
(a) Have
a signed and dated contract with each teaching institution providing internship
students; and
(b) Use qualified
preceptors, as defined by OAR 333-265-0000, who will be assigned to supervise, document
and evaluate the Paramedic interns.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0042
Ambulance
Operational Requirements
(1) The licensee
must ensure that the service, employees, volunteers and agents providing ground
ambulance service:
(a) Comply
with all applicable statutes in the 2007-2008 Oregon Motor Vehicle Codes relating
to motor vehicle and emergency vehicle operations, ORS 820.300 through 820.380 and
ORS chapter 445.
(b) Successfully
complete an emergency vehicle operator's course of instruction prior to independently
operating an ambulance. The course must meet or be equivalent to the National Safety
Council for Emergency Vehicle Operators Course (CEVO 2 or 3) or National Fire Protection
Agency (NFPA) Driver.
(c) Comply
with the licensee’s procedures.
(2) A licensee
shall have a procedure:
(a) Detailing
the operation of an ambulance for both emergency and non-emergency situations;
(b) To remove
an ambulance from service when the mechanical condition of an ambulance is sufficiently
unreliable so as to endanger or potentially endanger the health, safety, or welfare
of a patient or crew member;
(c) To handle
a mechanical breakdown and to repair or replace a damaged tire or wheel when the
ambulance is in operation; and
(d) Detailing
what steps are to be followed when an ambulance is involved in an accident. The
procedure must include the submission of a legible copy of the Department of Motor
Vehicles Accident Report to the Authority within 10 business days of the accident.
(3) The licensee
must ensure that the service, employees, volunteers and agents providing air ambulance
service:
(a) Comply
with the Federal Acquisition Regulation (FAR), 14 CFR Part 135 of the Operating
requirements; Commuter and on demand operations and rules governing persons on board
such aircraft; and
(b) Successfully
complete the 2004 Association of Air Medical Services (AAMS) Guidelines or equivalent.
There must also be an annual review of the Air Medical Crew course material, the
length of which must be established by the EMS medical director.
(4) A licensee
may only utilize an ambulance for the provision of providing ambulance service that
has been issued a license by the Authority and that complies with all requirements
of ORS chapter 682, OAR chapter 333, division 255, and these rules.
(5) A licensee
must not allow or schedule an employee or volunteer to serve on an ambulance who
is impaired by excessive fatigue, illness, injury or other factors that may reasonably
be anticipated to constitute a threat to the health and safety of patients or the
public.
[Publications: Publications
referenced are available from the agency.]
Stat. Auth.:
ORS 682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0043
Ambulance
Service Personnel Record Keeping and Reporting Requirements
(1) The licensee
must:
(a) Maintain
a complete and current personnel file, training file, and medical file for each
employee and volunteer, including but not limited to:
(A) Full
name;
(B) Current
home mailing address;
(C) Affiliation
status, listed as either an employee full-time paid, employee part-time paid, volunteer,
or agent;
(D) Copies
of:
(i) Reportable
actions forms as required under OAR 333-250-0043(5);
(ii) Applicable
professional certificates or licenses;
(iii) A current
driver's license;
(iv) A current
pilot’s license if the employee or volunteer operates an air ambulance;
(v) A certified
court printout of initial driver's license check done through the Oregon Department
of Motor Vehicles Automated Reporting System Program or equivalent reporting program
as approved by the Authority, and any subsequent reported convictions, accidents
or license suspensions. If the driver has an out-of-state driver’s license,
the licensee must participate in a similar program for that state, if available
and if not available, conduct an annual driving record check; and
(vi) Current
healthcare provider CPR card or proof of course completion that meets or exceeds
the 2010 American Heart Association ECC guidelines or equivalent standards approved
by the Authority.
(b) If the
licensee contracts with or employs ambulance based clinicians for the purpose of
providing advanced level care, the licensee shall ensure that the clinicians:
(A) Meet
all of the applicable requirements in OAR chapter 333, division 250;
(B) Have
documentation of a current Advanced Cardiac Life Support course or other Authority-approved
equivalent course completion;
(C) Have
documentation of current Pediatric Advanced Life Support or other Authority-approved
equivalent course completion; and
(D) Have
documentation of completing a current Prehospital Trauma Life Support, Basic Trauma
Life Support, Trauma Emergency Assessment Management or Trauma Nurse Core Course.
The Trauma Emergency Assessment Management and Trauma Nurse Core Course must include
a supplemental prehospital rapid extrication training session.
(c) Documentation
that an employee or volunteer has completed:
(A) An ambulance
service initial orientation program that includes requirements set forth in OAR
333-250-0040(2)(a) and (b);
(B) A bloodborne
pathogen and infectious disease training course that meets standards found in OAR
437-002-0360 and 437-002-1030 and an annual refresher training course;
(C) A Hazardous
Materials Awareness training course that meets or exceeds the Oregon Occupational
Safety and Health Division standards found in OAR chapter 437 and an annual refresher
training course;
(D) An Authority-approved
emergency vehicle operator's course for ground ambulance drivers only. The course
must meet or be equivalent to the standards of the National Safety Council for Emergency
Vehicle Operators Course, (CEVO II-IIIAMB) or NFPA Driver;
(E) The US
Department of Transportation's Air Medical Crew National Standard Curriculum course
or equivalent and annual refresher training for persons staffing air ambulances
only;
(F) Initial
Tuberculosis (TB) screening and any subsequent TB screenings;
(G) Hepatitis-B
immunizations or a signed statement of declination;
(H) A signed
statement by a driver not certified or licensed through the Authority that they
are:
(i) Not addicted
to alcohol or controlled substances and are free from any physical or mental condition
that might impair the ability to operate or staff an ambulance; and
(ii) Physically
capable of assisting in the extrication, lifting and moving of a patient.
(2) A licensee
shall have documentation of items listed in section (1) of this rule prior to the
employee or volunteer being allowed to independently staff an ambulance. Note: an
employee or volunteer must begin the Hepatitis-B immunization series or have a signed
statement of declination prior to independently staffing an ambulance.
(3) All records
relating to an ambulance service's operations must be retained by the licensee or
the licensee's successors or assigns for not less than seven years from the date
of implementation, purchase, dispatch, creation or longer if so required by law
or regulation. The record keeping mechanism may be in any permanent form including
paper or on magnetic media provided that the information can be made readily available
for inspection by the Authority.
(4) The licensee
must promptly submit to the Authority such information, including survey information
that the Authority may reasonably require.
(5) The licensee
must submit a completed reportable action form to the Authority, within the times
specified, for any of the following actions:
(a) Hiring
a new employee or volunteer, within 14 business days;
(b) Terminating
or suspending an employee or volunteer for cause, within 14 business days; and
(c) Disciplinary
action taken by the licensee or the EMS medical director for unprofessional conduct
as listed in OAR 333-265-0000, within 14 business days.
[Publications: Publications
referenced are available from the agency.]
Stat. Auth.:
ORS 682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0044
Prehospital
Care Report Form or Electronic Field Data Format Completion Requirements
(1) The licensee
must complete a PCRF in each instance where an ambulance arrives on the scene and
patient contact is initiated.
(2) A complete
PCRF or electronic field data format as specified by the Authority must be prepared
by ambulance personnel and delivered to appropriate hospital staff at the time patient
care is transferred, unless the PCRF is provided electronically under section (3)
of this rule.
(3) If a
PCRF is provided via electronic format, a licensee shall ensure that personnel verbally
relay pertinent patient care information to hospital staff prior to leaving the
hospital. A completed electronic report must be submitted to the hospital at a location
designated by the hospital within 12 hours of the patient being transported to the
hospital.
(4) If the
ambulance crew is unable to complete the PCRF at the time patient care is transferred,
the ambulance crew may depart after receiving verbal verification from an emergency
department employee involved with providing patient care that sufficient patient
information has been transferred to support safe and timely continuation of patient
care.
(5) The licensee
must return the ambulance crew to the hospital when requested by the attending physician
for the purpose of obtaining the completed PCRF or additional patient care information.
If acceptable to the attending physician, a completed PCRF can be faxed or electronically
sent to the hospital;
(6) A licensee
must ensure that a PCRF or electronic field data form contains data points as defined
by version 2.2.1 of the National Highway Transportation Safety Administration Uniform
Pre-Hospital Emergency Medical Services Dataset; and
(a) For any
patient meeting the criteria for trauma patient as defined in OAR 333-200-0010(26):
(A) Trauma
band number; and
(B) Triage
criteria as defined in OAR 333-200-0010, Exhibit 2.
(7) Notwithstanding
the requirements in this rule, a completed PCRF or electronic field data form is
not required when there is a disaster or a multiple patient incident consisting
of more than five patients or the number of patients prescribed in the county's
ASA plan, and which results in a single ambulance transporting two stretcher patients
at the same time or when an ambulance is required to make more than one trip to
and from the incident site. In those situations, a completed triage tag that includes
listing of the trauma systems identification bracelet number, recording of the times
and results of all vital signs taken and the times, name and dosage of any medication
given is acceptable patient care documentation. However, every reasonable attempt
must be made by the ambulance personnel or ambulance based clinicians to complete
an approved PCRF or electronic field data form for each patient at the conclusion
of the incident.
[ED. NOTE: Exhibits referenced are not included in rule text. Click here for PDF copy of exhibit(s).]
Stat. Auth.:
ORS 682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0045
Storage,
Release and Destruction of Prehospital Care Report Form Requirements
(1) The licensee
is responsible for:
(a) Providing
secure storage of PCRFs, with limited access to the PCRFs by office and ambulance
personnel;
(b) Providing
that the PCRFs are organized in a manner that will allow an authorized ambulance
service representative to locate a PCRF within a reasonable amount of time, given
a patient's name and the date and time of the ambulance call;
(c) Establishing
a procedure for when a copy of the PCRF may be released to a medical facility receiving
the patient, the patient, the patient's family, the patient's legal guardian, an
insurance company, an attorney, a law enforcement officer, or a law enforcement
agency;
(d) Protecting
the confidentiality of patient information during quality improvement sessions by
limiting access to the PCRF and having all persons having access to PCRFs sign a
confidentiality statement; and
(e) Establishing
a procedure for the method and verification of the destruction of a PCRF:
(A) An ambulance
service may not destroy a medical record or report about a patient for 10 years
after the record or report is made, or longer if so required by law or regulation
unless the patient is notified.
(B) In the
case of a minor patient, a medical record or report may not be destroyed until the
patient attains the age of majority plus three years or for 10 years after the record
or report is made, whichever is later, unless the parent or guardian of the minor
patient is notified.
(i) Notification
of a minor patient or the parent or guardian of the minor patient of the potential
destruction of a prehospital care report must:
(I) Be made
by first class mail to the last known address of the patient;
(II) Include
the date on which the record of the patient shall be destroyed; and
(III) Include
a statement that the record or synopsis of the record, if wanted, must be retrieved
at a designated location within 30 days of the proposed date of destruction.
(2) Under
no circumstances shall an employee, volunteer or agent make a copy of a PCRF for
their own personal record or remove the original or a copy of a completed PCRF from
the licensee's files or facilities without having written approval of the licensee.
(3) All PCRFs
must be made available for inspection and duplication when requested by the Authority
as authorized by ORS 41.675 and 41.685.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0046
Ambulance
Service Communications and Dispatching Operational Requirements
(1) The licensee
is responsible for:
(a) Having
a valid license from the Federal Communications Commission (FCC) to operate an EMS
radio on assigned frequencies, or proper authorization from another agency holding
a valid FCC license to operate on designated radio frequencies;
(b) Having
24-hour-a-day phone answering and dispatching capabilities or having a signed agreement
or contract with a recognized primary or secondary Public Safety Answering Point
(PSAP), who will provide telephone answering and emergency dispatching services;
(c) Providing
a reliable means of alerting and communicating with an ambulance crew before, during
and after an ambulance call;
(d) Immediately
routing all emergency calls received from the public on any of the licensee's 10-digit
telephone number to the primary PSAP. When a licensee receives a request for an
emergency ambulance and the licensee is a recognized secondary PSAP, the licensee
shall dispatch the ambulance and notify the primary PSAP for coordination of other
emergency responder agencies;
(e) Ensuring
that any request for an ambulance received on the licensee's 10-digit telephone
number is answered by a live person or that there is an answering machine referring
the caller to the appropriate emergency telephone number; and
(f) Maintaining
ambulance dispatch records as prescribed in ORS 820.330 and 820.340. The records
must be kept by the licensee or the licensee must have a signed agreement with the
PSAP, service or agency that provides telephone answering and dispatching services
that they will maintain and make available copies of the official dispatch records
for a minimum of seven years.
(2) When
the licensee employs dispatchers for the purpose of answering the telephone, taking
information regarding the need for an ambulance and dispatching the ambulance, the
dispatcher must have written documentation of completing:
(a) The Department
of Public Safety Standards and Training's Emergency Medical Dispatcher's Course
or equivalent; and
(b) Four
hours of annual refresher training for dispatchers that meets the standards set
forth by the Department of Public Safety Standards and Training.
(3) Air ambulance
must meet Federal Acquisition Regulation (FAR), 14 CFR Part 135 of the Operating
requirements; Commuter and on demand operations and rules governing persons on board
such aircraft.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10
333-250-0047
Ambulance
Service EMS Medical Director Operational Requirements
(1) The licensee
must have a single EMS medical director except:
(a) When
the licensee operates in non-contiguous counties, then the licensee may have one
EMS medical director in each non-contiguous county of operation; or
(b) Where
a county or regional EMS system prescribes that multiple agencies within a county
or region must have a governmentally appointed EMS medical director, that agency
may have a different EMS medical director in contiguous counties. In this event,
the signed agreement or contract may be between the EMS medical director and the
county or regional EMS system.
(2) The licensee
must ensure that the EMS medical director:
(a) Meets
the requirements and duties as prescribed in OAR 847-035-0020 through 847-035-0030;
(b) Has a
written set of treatment protocols for each level of service offered by the licensee;
and
(c) Has a
signed and dated agreement or contract with the licensee.
(3) When
an EMS medical director authorizes the administration of controlled substances,
the EMS medical director must have on file with the licensee:
(a) A US
Drug Enforcement Administration License listing the name of the ambulance service
and address where the controlled substances are stored when not on an ambulance;
and
(b) A signed
and dated procedure as to the amount stored on the ambulance and how controlled
substances will be stored, accessed, recorded, administered, destroyed and secured.
It is the responsibility of the EMS medical director to ensure that the procedure
meets the minimum US Drug Enforcement Administration requirements found in 21 CFR
1301.75(b).
(4) The licensee
must notify the Authority in writing of:
(a) The denial,
suspension, or voluntary surrender of an EMS medical director's medical license
or US Drug Enforcement Administration license within 72 hours; and
(b) A change
in the EMS medical director, 21 days prior to the change.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0048
Ambulance
Service Ambulance Personnel Operational Requirements
(1) The licensee
must ensure that the service, employees, volunteers and agents meet the personnel
requirements as prescribed in these rules.
(2) The licensee
must not schedule or allow an employee or volunteer to serve on an ambulance who
is impaired by excessive fatigue, illness, injury or other factors that may reasonably
be anticipated to constitute a threat to the health and safety of patients or the
public.
(3) The licensee
shall require each person staffing an ambulance or providing prehospital emergency
or non-emergency care to display his or her level of licensure on the outermost
garment of his or her usual work uniform at all times while staffing an ambulance
or rendering patient care, and shall make reasonable efforts to display this information
under other circumstances.
(4) The licensee
shall ensure that any EMS providers, ambulance based clinicians or qualified drivers:
(a) Are trained
to properly operate all ambulances and equipment that he or she is authorized to
use; and
(b) Are physically
capable and have the ability to lift and move patients and assist in extrication
of patients when necessary.
(5) The licensee
shall not permit employees or volunteers to operate an ambulance, equipment, or
have patient contact if:
(a) They
are taking any medications that could impair safe operation and handling of the
ambulance, equipment, or patient; or
(b) The employee
or volunteer has consumed any alcoholic beverages within the last eight hours.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0049
Ambulance
Service Housing of Personnel, Ambulance and Equipment Operational Requirements
(1) The licensee
must provide:
(a) An area
where an employee or volunteer working a 24-hour shift may sleep or rest;
(b) An area
equipped with adequate toilet, hand-washing and shower facilities with hot and cold
running water, antiseptic soap and clean towels for hand and body drying. If the
ambulance service facility does not have shower facilities, the licensee must have
a signed agreement or contract with a medical facility or other entity to make available
shower facilities to ambulance personnel for the purpose of showering after coming
in contact with medical or other biohazardous waste;
(c) Separate
areas for clean and soiled linen receptacles in accordance with the applicable Oregon
Occupational Safety and Health Division and other rules governing the handling of
special medical wastes;
(d) A designated
secure area for storing, or an alternate method and a procedure for identification
and storage of, all medications which are deteriorated, outdated, misbranded, adulterated
or otherwise unfit for use. This area or procedure must provide for the physical
separation of defective supplies so that products are not confused with usable products.
Security procedures for unusable medications, fluids and controlled substances must
be the same as for usable supplies;
(e) A separate
area to place clearly marked “out of service” malfunctioning patient
care equipment until the equipment has been repaired or replaced or enforces a procedure
for an alternate method of identification and storage to assure that defective equipment
will not be used; and
(f) A reasonable
inventory of patient care equipment, supplies and medications, properly secured,
or in the alternative, a signed agreement with a medical facility that the medical
facility will provide the patient care equipment, supplies, and medications.
(2) A licensee
shall ensure that:
(a) Controlled
substances, when authorized by the EMS Medical Director, are stored, accessed, inventoried,
administered, destroyed and secured in a manner consistent with the signed and dated
procedure established by the EMS Medical Director. The procedure must be in accordance
with the regulations promulgated by the US Drug Enforcement Administration (DEA)
found in 21 CFR 1301.75(b).
(b) A copy
of the EMS Medical Director's DEA license is maintained in a secure manner, inaccessible
to the public, at each fixed ambulance location where controlled substances are
stored other than in the ambulance.
(c) Pharmacological
and medical supplies with expiration dates affixed thereon by the manufacturer or
packager are removed from service no later than the expiration date. Expired pharmacological
and medical supplies must be disposed of in accordance with applicable laws and
regulations.
(d) Medications
and equipment are stored in a manner that protects viability and proper operation;
and
(e) Ambulances
available for or subject to a call are maintained to allow immediate starting of
the engine and to prevent medications and medical supplies from becoming environmentally
degraded.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
7-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010,
f. 6-30-10, cert. ef. 7-1-10
333-250-0050
Request for
Variance from Standards
(1) The licensee
may request a variance from the standards established in ORS 820.330 to 820.380,
ORS chapter 682 and these rules when:
(a) The licensee
believes that compliance with a rule is inappropriate because of special circumstances
which would render compliance unreasonable, burdensome, or impractical due to special
conditions or causes, or because compliance would result in substantial curtailment
of necessary ambulance service; and
(b) A city
ordinance or county ASA plan exists, and the licensee has presented his or her request
for a variance to the local city or county governing body and that body has given
their approval for the proposed variance.
(2) A written
request for a variance must be made to the Authority. The Authority may not grant
a variance that may cause danger or harm to the public or to persons operating or
staffing the ambulance. A written variance request must include:
(a) Justification
for the variance request; and
(b) A detailed
and realistic plan to resolve the need for a future variance.
(3) The request
for variance may be presented to the State Emergency Medical Service Committee at
a regularly scheduled meeting. The Public Health Director or designee, after considering
the Committee's recommendation, when requested, may grant a variance:
(a) A variance
shall be granted for a period of time as prescribed by the Authority; and
(b) A subsequent
variance may only be granted when the licensee has demonstrated to the Authority,
insofar as possible, adequate progress in resolving the need for the initial variance
as described in the plan.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0060
Right of
Entry and Inspection of an Ambulance Service and Ambulance
(1) The Authority
may conduct an inspection for the purpose of evaluating the eligibility of an ambulance
service or an ambulance to receive or retain a license and to ensure the health,
safety, and welfare of the persons who utilize ambulances. Ambulance services that
acquire and maintain current status with a nationally recognized EMS service program
accreditation entity that meets or exceeds Oregon requirements may be exempted from
the inspection process. A copy of the inspection report from the nationally recognized
EMS service program accreditation entity must be filed with the Authority for approval.
(2) Routine
inspections of an ambulance service or an ambulance must be scheduled with the management
of the ambulance service at least 72 hours in advance of the inspection unless otherwise
mutually agreed upon by the Authority and the ambulance service representative.
(3) Investigative
inspections for the purpose of ensuring continued compliance with ORS chapter 682
and these rules do not require giving advanced notice to the licensee.
(4) In conducting
an inspection or interview, the Authority representative must:
(a) Identify
him or herself by presenting the Authority identification to the owner, manager,
or ranking employee or volunteer present at the site of an inspection or interview;
(b) Inform
the ambulance service representative of the purpose for the inspection or interview;
and
(c) Inform
the ambulance service representative when the inspection or interview has been completed
and the results of the inspection only.
(5) The Authority
may make photographic or video-graphic documentation as part of an inspection for
or an investigation of non-compliance with ORS chapter 682 and these rules.
(6) Failure
of the licensee to produce records for inspection or to permit examination of equipment
and facilities by the Authority shall be grounds for the denial, suspension or revocation
of an ambulance service or ambulance license.
(7) The Authority
may accept local city or county governing body inspections that meet or exceed requirements
outlined in ORS chapter 682 and OAR chapter 333, divisions 250 and 255 in lieu of
an inspection by the Authority.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01l:
PH 2-2007, f. & cert. ef. 2-1-07; PH 11-2010, f. 6-30-10, cert. ef. 7-1-10;
PH 1-2013, f. & cert. ef. 1-25-13
333-250-0070
Denial, Suspension,
or Revocation of an Ambulance Service License or Placing an Ambulance Service on
Probation
(1) Conduct subjecting
an ambulance service to discipline means conduct unbecoming a person who is either
applying for or holds an ambulance service license and is detrimental to the best
interest of the public and includes, but is not limited to the conduct listed in
this rule.
(2) The Authority
may, in accordance with the provisions of ORS chapter 183, deny, suspend, or revoke
an ambulance service license or ambulance license. The Authority may also place
an ambulance service on probation, the terms of which shall be established by the
Authority. In addition to or in lieu of probation, suspension or revocation, the
Authority may cite an ambulance service for a violation and request corrective action.
(3) An individual,
firm, partnership, limited liability company, corporation, association, or organization
shall be considered in violation of ORS chapter 682 and these rules if the Authority
determines that the individual, firm, partnership, limited liability company, corporation,
association, or organization has done any of the following:
(a) Been
convicted of a crime, including conviction of Medicare or Medicaid fraud, relating
adversely to the person's capability of owning or operating an ambulance service;
(b) Violated
ORS chapter 682 or any of these rules, which poses a significant threat to the health
and safety of the public;
(c) Made
a material omission or misrepresentation of facts on an application for a license
or waiver, or in response to an inquiry or investigation. This includes fraud or
deceit in obtaining or attempting to obtain a license or waiver or in any other
transaction with the Authority;
(d) Failed
to employ or contract for an approved EMS medical director, or to operate under
the direction of an EMS medical director appointed by an appropriate governmental
authority;
(e) Failed
to have medical equipment and supplies required for operation at the highest level
of service provided;
(f) Lent
a license, borrowed, or used the license of another, or knowingly aided or abetted
the improper granting of a license;
(g) Defaced,
altered, removed or obliterated any portion of any official entry upon a license,
licensing decal, or waiver issued by the Authority;
(h) Refused
to respond to or render prehospital emergency care as required by protocol because
of a patient's race, sex, creed, national origin, sexual preference, age, handicap,
medical problem, or financial inability to pay;
(i) Failed
to promptly notify the Authority of a change of ownership, or to report any matter
the reporting of which is required by ORS 682.220(4);
(j) Disclosed
medical or other confidential information;
(k) Altered
or inappropriately destroyed medical records;
(l) Willfully
prepared or filed false reports or records, or induced another to do so;
(m) Engaged
in a pattern of any of the following:
(A) Incompetence,
negligence or misconduct in operating the ambulance service or in providing emergency
medical care and transportation to patients;
(B) Abuse
or abandonment of patients;
(C) Failure
to comply with the county ASA plan, area trauma plan, or other lawfully promulgated
policies, plans, or procedures;
(D) Failure
to meet response time standards as prescribed by the county ASA plan or if no ASA
plan is in effect, the area trauma plan;
(E) Misuse
or misappropriation of medications or medical materials; and
(F) Other
conduct determined by the Authority to pose a significant threat to the public health
and safety and the well being of ambulance patients.
(n) Failed
to comply with the minimum personnel requirements or failed to have the required
equipment in working order on an ambulance as prescribed in these rules;
(o) Had a
continuing pattern of violations over a period of two or more years;
(p) Failed
to submit a reasonable timetable to correct the violations cited by the Authority;
(q) Interfered
with the performance of the Authority's duties; and
(r) Failed
to pay all applicable licensing fees or civil penalties set by the Authority.
(4) Upon
receipt of a sufficient written or verbal complaint describing specific violations
of ORS chapter 682 or any other relevant statute or rule, the Authority shall initiate
an investigation of the allegations. The Authority does not have jurisdiction over
and shall not take action on complaints that relate solely to rates charged a patient
by an ambulance service.
(5) When
an ambulance, upon inspection by the Authority, manifests evidence of a mechanical
or equipment deficiency, which poses a significant threat to the health or safety
of patients or crew, the Authority shall immediately suspend that ambulance from
operation. No ambulance that has been suspended from operation may be operated until
the licensee has certified and the Authority has confirmed that all of the violations
have been corrected.
(6) The Authority
shall confirm by inspection or other appropriate means that all violations have
been corrected within 48 hours of notification by the licensee. The licensee must
notify the Authority of corrections by personal telephone contact (voice mail messages
will suffice), or facsimile, or in person during normal business hours. Notifications
received by facsimile outside of business hours will be considered received the
next business day. Telephonic notifications shall be deemed received at the time
actual voice contact between the licensee and the Authority's ambulance service
licensing program representative or designee is established.
(7) In the
event that a license is suspended or revoked, the licensee must cease ambulance
service operations and no person except the Authority may permit or cause the service
to continue.
(8) The licensee
must return all indications of licensing, including certificates and the remains
of ambulance license decals to the Authority by registered mail, posted within 48
hours of either receipt of notification of suspension or revocation or the effective
date of revocation, whichever is later.
(9) The Authority
shall notify applicable local government, county ASA administrator, and supervising
physician of the suspension or revocation of an ambulance service license, or the
placing of a service on probation.
(10) The
Authority may assess civil penalties up to $5000 per violation against any entity
or person licensed under these rules or subject to licensure under these rules for
a violation of ORS chapter 682 or these rules.
(11) If a
principal owner of an ambulance service has had its ambulance service license revoked,
following the opportunity for a hearing as provided by ORS chapter 183, that person
may not be eligible to apply for or hold an ambulance service license for a period
of two years from the date of revocation as specified in ORS chapter 682.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 11-2010, f. 6-30-10, cert. ef. 7-1-10; PH
1-2013, f. & cert. ef. 1-25-13
333-250-0080
Surrender
of License to Operate an Ambulance Service
(1) An ambulance
service license is non-transferable.
(2) When
the owner sells or closes an ambulance service, the owner must:
(a) Provide
a minimum 30-days written notice of the intent to cease operation to the Authority;
(b) Provide
the required notice as prescribed in the county ASA plan to the county health department
and the ASA authority in which the ambulance service operates; and
(c) Take
such other actions as may be determined to be necessary by the Authority or the
county health, or the ASA authority to assure the smooth transition to a new ambulance
service provider, including but not limited to permitting the continued operation
of the existing provider for more than the required period of legal notice or making
equipment and supplies available to an interim ambulance service provider.
(3) Within
10 days of final closing of the ambulance service sale, the owner must return the
ambulance service license to the Authority.
(4) An owner
may not terminate the ambulance service business or otherwise cease operations in
contravention of any provisions, rules or ordinances established under the provision
of ORS chapter 682.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-250-0100
Advertising
of an Ambulance Service
(1) The licensee
may advertise only when the ambulance service and ambulance meets the requirements
of ORS chapter 682 and these rules.
(2) If the
licensee does not provide the level of service advertised, the license may be denied,
suspended or revoked in accordance with the provisions of ORS chapter 183 for failure
to comply.
(3) No licensee
shall advertise or promote the use of any telephone number other than "9-1-1" for
emergency ambulance service.
(4) A licensee
which offers non-emergency service may advertise its non-emergency or business telephone
number for other than emergency use, provided that in any print, audio or video
advertising the phrase "FOR EMERGENCIES -- CALL 9-1-1" is provided. When using the
phrase "FOR EMERGENCIES -- CALL 9-1-1" in print, it must be in bold-faced type at
least one and one-half times the point size in which the non-emergency or business
telephone number is displayed.
(5) Contents
of ambulance service advertising must include:
(a) The legal
name of the ambulance service indicated on the license issued by the Authority;
(b) If the
licensee advertises 24-hours-a-day operation, the ambulance service must provide
uninterrupted service 24-hours-a-day, 7 days-a-week, 365 days-a-year; and
(c) If the
licensee provides service for only a portion of a 24-hour day or week, any advertising
must specify the hours and days of operation.
(6) Advertising
materials disclosure upon request. The licensee must maintain copies of all print,
audio, video, and all other types of advertisements for one year after use and distribution
have ceased, and must make those copies available to the Authority upon request.
(7) Novelty
or promotional items which are not distributed to the general public do not meet
the definition of advertisement.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
18-1994, f. 6-30-94, cert. ef. 7-1-9; OHD 7-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13

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