TITLE 7 HEALTH
CHAPTER 27 EMERGENCY MEDICAL SERVICES
PART 5 CERTIFICATION OF AIR AMBULANCE
7.27.5.1 ISSUING
AGENCY: New Mexico Department of
Health, Epidemiology and Response Division, Emergency Medical Systems Bureau.
[7.27.5.1 NMAC - Rp, 7.27.5.1 NMAC,
01-01-06]
7.27.5.2 SCOPE: This regulation applies to any air service
within New Mexico that transports persons requiring medical care including, but
not limited to: basic life support (BLS), advanced
life support (ALS), critical care, or specialty care.
Out-of-state services that fly into New Mexico to pick up and/or deliver
medical patients shall also be certified in accordance with these rules, or
through reciprocity in accordance with these rules. The United States
department of defense and the New Mexico department of military affairs are
exempt from this rule when conducting official military operations. Public safety agencies that routinely provide
air ambulance services shall be certified.
[7.27.5.2 NMAC - Rp, 7.27.5.2
NMAC, 01-01-06]
7.27.5.3 STATUTORY
AUTHORITY: These rules are
promulgated pursuant to the following statutory authorities: 1) the Department
of Health Act, section 9-7-6.E. NMSA 1978, which
authorizes the secretary of the department to “... make and adopt such
reasonable and procedural rules and rules as may be necessary to carry out the
duties of the department and its divisions,” and; 2) the Emergency Medical
Services Act, Section 24-10B-4-H, NMSA 1978, which authorizes the department to adopt
regulations for the certification of air medical transport. Administration and enforcement of these
regulations is the responsibility of the emergency medical systems bureau of
the epidemiology and response division, department of health.
[7.27.5.3 NMAC - Rp, 7.27.5.3
NMAC, 01-01-06]
7.27.5.4 DURATION: Permanent.
[7.27.5.4 NMAC - Rp, 7.27.5.4
NMAC, 01-01-06]
7.27.5.5 EFFECTIVE DATE: January 1, 2006, unless a later date is cited
at the end of a section.
[7.27.5.5 NMAC - Rp, 7.27.5.5
NMAC, 01-01-06]
7.27.5.6 OBJECTIVE: The purpose of this document is to inform the
public and air ambulance services about the requirements and standards for the
certification of air ambulance services operating within New Mexico, and the
process and procedures to become certified as specified below.
A. These rules provide the minimum
criteria and process for the certification of both fixed and rotor wing air
ambulance services that operate within the state of New Mexico, based upon the
recommendations of the air medical transport advisory committee; to provide
minimum standards for certified services to abide by; and, to assist in the
provision of a comprehensive system of emergency medical services in the state
of New Mexico.
B. These rules are designed to assist
air ambulance services in preparing for, achieving, and maintaining
certification as a certified air ambulance service in the state of New
Mexico. Air ambulance services that have
and maintain the commission on accreditation of medical transport systems (CAMTS) accreditation meet the standards for air ambulance
certification in the state of New Mexico.
The bureau shall certify an air ambulance service with CAMTS accreditation following review and approval of the
application and inspection, if necessary, as determined by the bureau, and payment of necessary fees and approval by the
bureau.
[7.27.5.6 NMAC - Rp, 7.27.5.6
NMAC, 01-01-06]
7.27.5.7 DEFINITIONS:
A. “Act (EMS Act)” means the Emergency Medical Services Act,
[Sections 24‑10B‑1, et seq., NMSA 1978].
B. “Advanced life support air ambulance
service” means an organization, certified by the bureau, to transport in an air
ambulance, patient(s) who require basic life support (BLS)
or advanced life support (ALS) care.
C. “Advanced life support (ALS)" means advanced pre‑hospital and
inter-facility care and treatment, as authorized by regulation, which may be
performed only by a person licensed by the department as an emergency medical
technician - paramedic (EMT-P), or licensed by the
state at a higher level, or otherwise authorized to practice ALS.
D. “Air ambulance service” means any
governmental or private service that provides air transportation specifically
designed to accommodate the medical needs of a person who is ill, injured or
otherwise mentally or physically incapacitated and who requires in-flight
medical supervision.
E. “Air ambulance certificate” means a
document issued by the department as evidence that an air ambulance service
meets the requirements for certification at the advanced life support, critical
or specialty care level, as found in these rules.
F. “Aircraft type” means a particular
make and model of helicopter or fixed wing aircraft.
G. “Aircraft operator” means the vendor
and/or owner who operates and maintains the aircraft utilized by an air
ambulance service.
H. “Air medical transport advisory
committee (AMTAC)” means a subcommittee of the
statewide EMS advisory committee as authorized by the EMS Act, Section
24-10B-7.A., NMSA 1978. The term “air medical transport advisory
committee” as used throughout these rules is synonymous with “air transport
advisory committee”.
I. “Bureau” means the emergency
medical systems bureau of the epidemiology and response division, of the
department of health.
J. “Certification evaluation team”
means a team appointed by the bureau for the purpose of performing an initial
or subsequent inspection of air medical services seeking certification, or of
those already certified.
K. “Combination service” means any
service that has more than one type of aircraft, for example, fixed wing and
rotor wing.
L. “Commission on the accreditation of
medical transport systems (CAMTS)” means a national
accrediting organization that evaluates air ambulance services based on air
ambulance industry standards established by CAMTS.
M. “Critical care air ambulance service”
means an organization certified by the bureau to transport patients in an air
ambulance that requires critical care.
N. “Critical care” means pre-hospital
or inter-facility care and treatment, respectively, that exceeds the advanced
life support level of care, as authorized by rule. The critical care mission shall consist of at
least one critical care provider and at least one additional provider which
shall be licensed at or above the ALS level of care,
and/or specifically trained in the area of care required. Additional providers may be added as
necessary.
O. “Critical care provider” means the
critical care primary provider shall consist of at least one registered nurse,
physician assistant, nurse practitioner and/or medical physician trained in the
area of critical care.
P. “Department” means the department
of health.
Q. “Emergency medical services
(EMS)" means the services rendered by providers in response to an
individual’s need for immediate medical care to prevent loss of life or
aggravation of physical or psychological illness or injury.
R. “Federal aviation regulations (FAR)”
means regulations promulgated by the federal aviation administration of the
U.S. department of transportation, governing the operation of all aircraft
within the United States.
S. “Level of service” means the
highest level at which the air ambulance service is certified to function on a
24 hours a day, seven days a week basis.
T. “Medical control” means supervision,
provided by or under the direction of physicians to providers by written
protocol and/or direct communication.
U. “Medical direction” means guidance
or supervision provided by a physician to a provider or emergency medical
services system and which includes authority over and responsibility for
emergency medical dispatch, direct patient care and transport of patients,
arrangements for medical control and all other aspects of patient care
delivered by a provider.
V. “Medical direction committee” means
a committee of physicians and emergency medical technicians, appointed by the
secretary of health to advise the bureau on all matters relating to medical
control and medical direction.
W. ”Medical director” means a physician who
has the responsibility for oversight of patient care of an EMS system or EMS
provider service, including providing for or ensuring the medical control of
emergency medical technicians, the development, implementation, and evaluation
of medical protocols, and quality assurance activities.
X. “Physician” means a doctor of
medicine or doctor of osteopathy who is licensed or otherwise authorized to
practice medicine or osteopathic medicine in New Mexico.
Y. “Protocol” means a predetermined,
written medical care plan and includes standing orders.
Z. “Provider” means a person who has
been licensed by the appropriate agency to provide patient care at the ALS, critical or specialty care level.
AA. “Regional
office” means an emergency medical services planning and development agency
formally recognized and supported by the bureau.
BB. “Secretary”
means the secretary of health.
CC. “Service” means a certified air
ambulance service authorized to operate in the state of New Mexico under these
rules.
DD. “Specialty care” means care and
treatment that exceeds the advanced life support level of care, as authorized
by regulation. The specialty care
mission shall consist of at least one specialty care provider and at least one
additional provider which shall be licensed at or above the ALS
level of care, and/or specifically trained in the area of care required. Additional providers may be added as
necessary.
EE. “Specialty
care provider” means a caregiver appropriately trained and licensed to provide
patient care as defined by the mission.
[7.27.5.7 NMAC - Rp, 7.27.5.7
NMAC, 01-01-06]
7.27.5.8 USE OF TERMS AND ADVERTISING: It shall be prohibited for any air ambulance
service to advertise or perform air ambulance services, or use the title
“certified air ambulance service,” in New Mexico, unless it is certified under
these rules.
[7.27.5.8 NMAC - Rp, 7.27.5.8
NMAC, 01-01-06]
7.27.5.9 DISCLOSURE TO THE PUBLIC: At the initiation of contact with a potential
client, patient or the public, the certified air ambulance service shall
disclose the current level of state of New Mexico certification and what level
of service can be provided.
[7.27.5.9 NMAC - Rp, 7.27.5.9
NMAC, 01-01-06]
7.27.5.10 FULL CERTIFICATION PERIOD: The certification period for all air
ambulance services shall be for a 3-year period. Once a certified air ambulance service
becomes accredited by CAMTS, the certification period
shall be adjusted by the bureau to correspond with the CAMTS
accreditation period.
[7.27.5.10 NMAC - Rp, 7.27.5.10
NMAC, 01-01-06]
7.27.5.11 REPORTING: Certified air ambulance services shall
complete a patient run report for each patient that is transported by air. The minimum data elements identified by the
bureau shall be compiled and submitted to the bureau on a quarterly basis, or
as determined by the bureau. Certified
services shall provide as a minimum, an annual number of runs of patients
picked up in New Mexico including location and patient complaint. Review of
completed patient care reports may be required during initial and/or subsequent
inspections.
[7.27.5.11 NMAC - Rp, 7.27.5.11
NMAC, 01-01-06]
7.27.5.12 EMERGENCY INFORMATION REQUIRED: Certified air ambulance services shall
provide, during initial/renewal of certification, emergency information about
the service to the bureau. This
information shall be used by the bureau to provide effective communications and
resource management, in the event of a statewide or localized
disaster/emergency situation. The
information is included in the initial/renewal application for certification of
air ambulance services.
[7.27.5.12 NMAC - Rp, 7.27.5.12
NMAC, 01-01-06]
7.27.5.13 CERTIFICATION PROCESS AND
PROCEDURES:
A. General: Prior to beginning air ambulance operations
within the state of New Mexico, either a temporary or full air ambulance
certification is required for the levels of service, as outlined below.
(1) Levels of service: the
following levels of service are authorized in New Mexico:
(a) advanced air ambulance
service: the air medical crew shall at all times consist of at least 2 licensed
health care providers, one of which, shall be licensed at the advanced life
support (ALS) level or above (minimum licensed EMT-paramedic or above);
(b) critical care air ambulance service: the
critical care mission shall consist of at least one critical care provider and
at least one additional provider which shall be licensed at or above the ALS level of care, and/or specifically trained in the area
of care required; additional providers may be added as necessary;
(c) specialty care air
ambulance service: the specialty care mission shall consist of at least one
specialty care provider and at least one additional provider which shall be
licensed at or above the ALS level of care, and/or
specifically trained in the area of care required; additional providers may be
added as necessary;
(d) generally, services certified
to provide critical care are certified to perform advanced air ambulance
service care; in all such cases, the minimum level of certified/licensed health
care provider staffing, for each level of certification, shall be aboard the
aircraft;
(e) services that provide care at the
advanced, critical or specialty air ambulance level care are required to remain
with the patient until someone of equal or higher training assumes care of the
patient.
(2) Temporary certification: a temporary certification for a maximum
period of three years may be issued by the bureau for non-CAMTS
accredited services, upon successful completion of the application process, a
preliminary inspection and approval by the bureau, and payment of all required
fees.
(a) A preliminary inspection
includes an on site visit with the air ambulance service, aircraft, and
crew. The certification evaluation team
(CET) will normally consist of a bureau
representative, the state EMS medical director or a designated physician, state
aviation officer, EMS communications manager, and additional personnel as
determined by the bureau.
(b) Once a temporary
certification is issued, and within the three year certification, the service
shall obtain and maintain CAMTS accreditation in
order to become fully certified by the bureau.
All non-CAMTS accredited air ambulance
services shall submit a program information file (PIF)
to CAMTS and the bureau within 16 months of acquiring
a temporary certification from the bureau as outlined in Subsection B of
7.27.5.13 NMAC.
(3) Full certification: after successfully completing the CAMTS accreditation process, and upon approval by the
bureau, a three year air ambulance service certificate for the approved level
shall be issued to the service. To be
fully certified, an air ambulance service shall:
(a) comply
with applicable federal, state, and local laws and rules to operate a business
in New Mexico;
(b) submit
a copy of CAMTS accreditation certificate;
(c) complete
a service application and submit it along with the required application fee to
the bureau;
(d) may
be required to complete an air ambulance service inspection, as determined by
the bureau.
B. Application for certification of
non-CAMTS accredited services: Prior to transporting patients within the
state of New Mexico, an air ambulance service:
(1) shall
submit to the bureau a completed bureau approved New Mexico air ambulance
application with appropriate fees;
(2) shall insure compliance
with all federal and state requirements, such as proof of insurance, aircraft
inspection certificates, FAA Part 135 certificate, board of pharmacy permit(s),
and drug enforcement agency permits;
(3) shall
complete the initial bureau inspection process; and
(4) upon
successful completion, the bureau shall issue a temporary air ambulance
certificate for a period of up to three years for one of the approved levels of
service:
(a) by the end of the first (16) sixteen
months of the temporary certification period, the service shall provide to the
bureau with a copy of the initial CAMTS program
information form (PIF) and a letter from CAMTS acknowledging receipt of the PIF;
(b) failure
to complete the CAMTS accreditation process during
the temporary certification period shall be reviewed by the bureau and may
result in initiation of action to suspend the air ambulance service temporary
certification; this includes, but is not limited to:
(i) failure to submit a complete PIF
to the bureau or CAMTS within the first sixteen
months of the temporary certification period; or
(ii) submitting an
incomplete PIF; or
(iii) failure
to pay appropriate fees to the bureau; or
(iv) failure
of a bureau inspection or CAMTS accreditation inspection;
(5) upon
receipt of proof of CAMTS accreditation and approval
of the bureau, the bureau may issue a full air ambulance certification.
C. Application for certification of CAMTS accredited services: Prior to transporting patients
within the state of New Mexico, an air ambulance service shall:
(1) submit
to the bureau a completed bureau approved New Mexico air ambulance application
with appropriate fees; and
(2) ensure compliance with all
federal and state requirements such as proof of insurance, aircraft inspection
certificates, FAA Part 135 certificate, board of pharmacy permit(s), and drug
enforcement agency permits; and
(3) submit proof of current CAMTS accreditation; services that maintain CAMTS accreditation shall notify the bureau immediately of
any CAMTS accreditation status changes;
(4) upon
successful completion the bureau shall issue a full New Mexico air ambulance
certification at the appropriate level of care.
D. Certification evaluation team (CET): The CET shall typically
consist of the membership listed below.
The bureau shall convene the membership of the CET
as necessary to perform either the initial, temporary service inspections, or
whenever the bureau deems necessary.
(1) The CET
membership is composed of the following individuals, as determined by the
bureau:
(a) bureau
representative - team leader;
(b) state
EMS medical director or a designated physician;
(c) state
aviation representative;
(d) EMS communications
representative;
(e) other
members as deemed necessary by the bureau.
(2) Services shall be given
advanced notice, in writing, of those personnel selected for the CET. A service which
has a good faith belief that selected individual(s) on the CET
may be biased or have a possible conflict of interest, may request that the
bureau select a new member. In all such
cases, the bureau shall make the final determination of CET
membership.
(3) Other inspections:
Inspections of non-CAMTS accredited, out-of-state
services shall follow the certification process, as outlined. When out-of-state travel is required of the CET, the service applying for certification shall be
responsible for reimbursement of travel expenses.
E. Changing the level of service:
Changing a level of service shall require the service to submit an initial
application for that level of service, along with certification fees. Changing
from a rotor or fixed wing service to a combination service will also require a
new application and fee. Changing from a
combined rotor wing and fixed wing service to a single type of aircraft service
will require a new application and fee for the service(s) involved.
F. Renewal of certification and
inspection: Services shall retain state certification by renewing their
certification every three years, concurrent with CAMTS
accreditation. This is accomplished by submitting the required renewal
application, fee, and proof of current CAMTS
accreditation. Normally, the
certification for air ambulance services that maintain national accreditation
according to the standards of the CAMTS do not
require a renewal inspection by the bureau to maintain certification, but,
shall meet all other requirements, including the submission of a renewal
application and payment of fees. The
bureau may perform an inspection of a certified air ambulance service, as
determined by the bureau. The renewal
application contains general air ambulance service information and is used in
conjunction with the initial certification application standards when applying
for renewal to update the bureau on the air ambulance service.
[7.27.5.13 NMAC - Rp, 7.27.5.13
NMAC, 01-01-06]
7.27.5.14 FEES:
A. A fee shall be assessed by the bureau for certification
to operate an air ambulance in the state of New Mexico. The bureau, with the advice of the air
medical transport advisory committee and the statewide EMS advisory committee,
shall set the amount of the fee.
Exceptions: fees shall not apply
to:
(1) an
air ambulance service from another state assisting in the response to a major
disaster, mass casualty incident or other emergency;
(2) an
air ambulance service transferring patients to or from New Mexico less than two
times per month.
B. Fees for upgrading the level of
service will be the same fee that is required for initial application. Fees for
changing from fixed wing or rotor wing to a combination service will be the
same as for a new service. Fees for
changing from a combination rotor wing and fixed wing service to a single type
of service will be the same as a new service.
C. Fees Table:
(1) Initial certification fees
for CAMTS accredited services: The $625.00 base fee
for initial certification of single aircraft type includes one aircraft or
$925.00 initial certification fee for combination service includes two
aircraft. An additional $200.00 is
required for each additional assigned/operating aircraft and/or base, not to
exceed $1825.00 per service.. Additional fees may be assessed if additional
travel is required to accommodate out-of-state applicants:
Type of Service
In-State Fee
Out-of-State Fee
Additional Aircraft
Fee
Rotor Wing Service
$625.00
$1,125.00
$200.00 per aircraft
Fixed Wing Service
$625.00
$1,125.00
$200.00 per aircraft
Combination Service
$925.00
$1,425.00
$200.00 per aircraft
(2) Initial Certification Fees
for Non-CAMTS Accredited Services: The $1250.00 base
fee for initial certification of single aircraft type includes one aircraft or
$1850.00 initial certification fee for combination service includes two
aircraft. An additional $200.00 fee is required for each additional
assigned/operating aircraft and/or base, not to exceed $3,250.00 per service.
Additional fees may be assessed if additional travel is required to accommodate
out-of-state applicants.
Type of Service
In-State Fee
Out-of-State Fee
Additional Aircraft
Fee
Rotor Wing Service
$1,250.00
$2,250.00
$200.00 per aircraft
Fixed Wing Service
$1,250.00
$2,250.00
$200.00 per aircraft
Combination Service
$1,250.00
$2,250.00
$200.00 per aircraft
(3) Renewal Certification
Fees: The following fees are to be submitted along with the air ambulance
service renewal application whether based in-state or out-of-state:
Type of Service
Fee
Rotor Wing Service
$500.00
Fixed Wing Service
$500.00
Combination Service
$500.00
(4) Changes to Air Ambulance
Service After Certification:
Type of Service
In-State Fee
Out-of-State Fee
Rotor or Fixed Wing Service to Combination Service
$625.00
$625.00
Combination Services to Rotor or Fixed Wing Service
$625.00
$625.00
Adding Additional Aircraft After Certification
$200.00 per aircraft
$200.00 per aircraft
[7.27.5.14 NMAC - Rp, 7.27.5.14
NMAC, 01/01/06]
7.27.5.15 ENFORCEMENT:
A. Complaint/Incident Procedures: Any
person may communicate a complaint or knowledge of an incident to the
bureau. Complaints shall be submitted in
signed written form to the bureau as soon as practical. The bureau may begin an investigation if
there is sufficient cause.
(1) When a complaint is
received by the bureau, written acknowledgement shall be made within 10 working
days and the staff shall decide whether or not a preliminary or formal
investigation of the complaint shall be initiated.
(2) If no investigation is
warranted, the service or person filing the complaint will be notified, as
determined by the bureau.
(3)
Services being formally investigated shall receive written notification
within ten (10) working days after a decision is made to begin a formal
investigation, unless extenuating circumstances exist which would reasonably
preclude notification.
(4) At the conclusion of the bureau’s formal
investigation, the bureau may report its findings to the investigated service in written
form. If the bureau investigation
warrants disciplinary action against a service, the service will be given a
notice of contemplated action (see right to appeal and hearing in 7.27.15.D
NMAC).
(5) If the bureau makes a good
faith judgment that the health and/or safety of the public would be
jeopardized, it may take immediate action to suspend an air ambulance service’s
certification to prevent a service from operating within New Mexico. The suspended service shall be afforded an
expedited appeal and hearing process.
B. Investigations: Investigations shall
normally be conducted by the bureau.
(1) Preliminary
Investigations: When the bureau receives information that might form the basis
for disciplinary action against a service, it shall begin a preliminary
investigation. This is a fact
finding/information gathering investigation that will attempt to determine for
the bureau whether justification exists to initiate an action or to conduct a
formal investigation.
(2) Formal Investigations:
Formal investigations are for the purpose of obtaining additional information
to allow the bureau to determine if it will initiate an action. Notice will be given to the service that is
the subject of the formal investigation, unless extenuating circumstances exist
which would reasonably preclude notification.
(3) Confidentiality: The
bureau will take every precaution to insure that investigations are conducted
in a confidential manner.
(4) Records: An official record is maintained for every
New Mexico air ambulance service, certified under these rules. If the bureau begins an investigation, a
separate confidential record will be created containing all investigation
material. If the bureau initiates an
action, all records not exempt from disclosure under the inspection of public
records act, sections 14-2-1, et seq., NMSA 1978,
will be placed in the service’s official record. Any request for records maintained by the
bureau will be processed in accordance with the inspection of public records
act.
C. Grounds For
Denial, Suspension, and Revocation:
Air ambulance certification may be denied, suspended or revoked based on
the following grounds:
(1) fraud,
deceit, misrepresentation in obtaining certification, including misrepresentation
during the initial or renewal certification process;
(2) failure
to meet any certification/accreditation requirements including failing to
acquire and/or maintain accreditation with the commission on accreditation of
medical transport systems (CAMTS) as outlined in
these rules;
(3) negligence
in the delivery of air ambulance medical services, including, but not limited
to:
(a) malpractice
and/or substandard medical care or treatment; or
(b) using
non-licensed personnel or personnel performing outside the standard of
care/scope of practice; or
(c) failure
to have operational equipment and failure to carry the required equipment, or
inappropriate use of equipment during a flight; or
(d) unauthorized
disclosure of medical or other confidential information;
(4) loss
of federal aviation administration certification or failure to notify the
bureau of such loss of certification;
(5) loss
of CAMTS accreditation or failure to notify the
bureau of such loss of accreditation;
(6) failure to report
revocation, suspension, denial, or other adverse actions taken in any other
state or jurisdiction affecting the ability to provide air ambulance services;
(7) performing
air ambulance operations without being certified by the department to perform
the authorized level of service, including providing service after expiration
of a certification;
(8) the
use of any false, fraudulent, or deceptive statement in any document connected
with the operation of an air ambulance service;
(9) failure
to cooperate with an investigation or to furnish the bureau with requested
information;
(10) failure
to report required documentation, including patient run report data;
(11) failure
of a service to comply with the rotor wing response protocol or the fixed/rotor
wing inter-facility transportation protocol as outlined in these rules.
D. Right to Appeal: Any service may appeal a decision by the
department to deny, suspend or revoke air ambulance certification as provided
below:
(1) denial
of initial certification: any air ambulance service applying for certification
may appeal to the department a denial of an application for certification;
(2) suspension or
revocation of an existing certification: any certified air ambulance service
may appeal to the department the proposed suspension or revocation of
certification;
(3) denial
for renewal of certification: any certified air ambulance service may appeal to
the department the denial of a renewal application for certification.
E. Notice of Contemplated Action: When
the bureau contemplates taking any action specified in Subsection C of
7.27.5.15 NMAC, it shall serve upon the applicant or certified service a
written notice containing a statement of the grounds or subject upon which the
proposed action is based, and rule(s) violated.
F. Right to Hearing: The applicant or
certified service may request a hearing before a hearing officer appointed by
the Secretary to contest the proposed action, by mailing a certified return
receipt letter addressed to the bureau within twenty (20) days after service of
the notice.
G. Hearing: Upon receipt of a timely
request for a hearing, the department shall appoint a hearing officer and
schedule a hearing, to be held in Santa Fe, New Mexico, within forty five (45)
working days of receipt of the timely request for a hearing. Exception: in the event of an immediate
suspension by the bureau to protect the safety and health of the public, the
air ambulance service will be afforded an expedited hearing within twenty (20)
days of the date of the receipt of appeal.
H. Notice of Hearing: The department
shall notify the applicant or certified service of the date, time, and place of
the hearing, the identity of the hearing officer, and the subject matter of the
hearing, not less than thirty (30) days prior to the date of the hearing. Exception: in the event of an immediate
suspension to protect the safety and health of the public, notice will be
provided of an expedited hearing within ten (10) days of receipt of appeal.
I. Hearing Officer Duties: The
hearing officer shall preside over the hearing, administer oaths, take evidence
and decide evidentiary objections and rule on any motions or other matters that
arise prior to the hearing.
J. Discovery: Upon written request to
another party, any party is entitled to:
(1) obtain
the names and addresses of witnesses who will or may be called by the other
party to testify at the hearing; and
(2) inspect
and copy any documents or items which the other party will or may introduce in
evidence at the hearing.
K. Conduct of Hearing: Hearings are open
to the public unless a request for closed meeting is made by either party.
L. Hearing Officer Written Report and
Recommendation(s): The hearing officer shall make a written report and
recommendation(s) to the secretary containing a statement of the issues raised
at the hearing, proposed findings of fact, and conclusions of law, and a
recommended determination. The hearing
officer or designee shall record the hearing by means of a mechanical sound
recording device provided by the department for a record of the hearing. The hearing officer written report shall be
submitted to the secretary no later than 30 working days after the close of the
hearing.
M. Secretary’s Determination: The
secretary shall render a final determination within 10 working days of the
submission of the hearing officer’s written report. A copy of the final decision shall be mailed
to the appealing party by certified mail, return receipt requested. A copy shall be provided to legal counsel for
the bureau.
[7.27.5.15 NMAC - Rp, 7.27.5.15
NMAC, 01/01/06]
7.27.5.16 STANDARDS: The most recent standards for air ambulance
services published by the CAMTS are incorporated by
reference, with the written permission of CAMTS. Air ambulance services shall meet the standards
outlined in the CAMTS accreditation standards, with following exceptions:
A. Rotor Wing Scene Response Protocol
(Rotor Wing): All rotor wing air
ambulance services certified to operate in the state of New Mexico shall adhere
to the response and transportation policy outlined below. Failure to adhere to
the response protocol policy may be investigated by the department and may
result in disciplinary action against the service(s) involved in the
non-compliance. The department
recognizes that air ambulance services may need to occasionally deviate from
this policy in the best interest of patient care.
(1) Response: When a request from a
EMS provider, law enforcement officer, or the incident commander for a rotor
wing air ambulance is received by telephone or radio at a dispatch center to
respond to a scene, the dispatcher or air ambulance service shall ensure that
the closest available service shall respond.
If another rotor wing service is closer to the scene and their aircraft
is available to respond, the request shall be transferred and communicated to
that service, without delay.
(2) Transportation: All
patients shall be transported by the rotor wing air ambulance service to the
closest appropriate facility. For trauma
patients, the regional or local trauma transportation protocols/guidelines
should guide the destination decision.
Regional or EMS system transportation protocols/guidelines shall also
guide transportation decisions.
B. Inter-facility Transportation
Protocol (Rotor Wing and Fixed Wing): The department follows the federal
Emergency Medical Treatment and Labor Act (EMTALA)
for inter-facility transfers.
(1) For inter-facility
transfers, it is the responsibility of the physician at the sending facility to
arrange an “appropriate transfer” under the EMTALA
requirements. The EMTALA
requirements include as part of arranging an “appropriate transfer” that the
sending physician secure an appropriate method of transportation that is
consistent with the patient’s needs. (It is recommended that the sending
physician and the receiving physician consult when making the decision about
the appropriate method of transportation.)
(2) Physicians arranging
inter-facility transfers must remain current on available EMS transportation
options within their area. In New
Mexico, the following options are available in many geographical areas; Regular
ground ambulance (BLS and ALS),
critical care ground ambulance, fixed wing air ambulances (BLS,
ALS, and critical care), and rotor wing air
ambulances (critical care).
C. Specific Exceptions to the CAMTS Accreditation Standards.
(1) Throughout the standards,
the words "should be" means "shall" for the purpose of
certification in New Mexico.
(2) In the far right hand
column, "RW" applies to "rotor
wing" and "FW" applies to "fixed wing". Both "RW"
and "FW" apply for certification of air ambulance services in New
Mexico.
(3) In the far right hand column,
"G" refers to "ground transport" and "ME" refers
to "medical escort". These do
not apply for air ambulance certification in New Mexico.
(4) In section 01.10.02, the
minimum "general liability insurance" required for rotor wing
services is 50 million dollars in New Mexico.
(5) In section 01.10.01, if an
accredited program refers a flight to another service, it shall follow the
rotor wing scene response protocol and the inter-facility transportation
protocol as found in section 7.27.5.16 NMAC.
(6) In section 01.12.00, all
air ambulance services shall report aviation incidents and accidents to the
CONCERN network and the bureau, as well as all appropriate other government
agencies. See the CAMTS standards glossary for a
definition of incident and accident. The CONCERN network provides information
regarding accidents and incidents in the air medical and critical care
transport community. This information is provided by the transport service
involved and then distributed via email by the CONCERN network. The purpose of the CONCERN network is to
increase awareness of safety hazards in the medical transport community. It is accessible via the world
wide web at http://www.concern-network.org.
(7) In section 01.12.00, air
ambulance services shall report all aviation incidents and accidents to the
CONCERN network and the bureau, in addition to all other appropriate government
agencies required by law.
(8) In section 02.03.00, a
clinical care supervisor shall be an EMT-P or higher
level of licensure.
(9) In section 02.04.01, on
site shifts scheduled for greater than twenty-four hours are discouraged.
[7.27.5.16 NMAC - Rp, 7.27.5.16
NMAC, 01/01/06]
7.27.5.17 RADIO COMMUNICATION FREQUENCIES:
A. The following UHF medical
frequencies are required in all air ambulance vehicles to communicate with the
New Mexico EMS system and to conduct medical communication in the state of New
Mexico.
(1) Transmit 463.000, receive
468.000.
(2) Transmit 463.235, receive
468.025.
(3) Transmit 463.050, receive 468.050.
(4) Transmit 463.075, receive
468.075.
(5) Transmit 463.100, receive
468.100.
(6) Transmit 463.125, receive
468.125.
(7) Transmit 463.150, receive 468.150.
(8) Transmit 463.175, receive
468.175.
(9) Transmit 462.950, receive
467.950.
(10) Transmit 462.975, receive
467.975.
[7.27.5.17 NMAC - Rp, 7.27.5.17
NMAC, 01/01/06]
7.27.5.18 STANDARDS
AND REQUIREMENTS CHECKLISTS: Standards and requirements are
outlined in the CAMTS accreditation standards
incorporated by reference, with the written permission of CAMTS,
with the noted exceptions in section 7.27.5.16 NMAC.
[7.27.5.18 - Rp, 7.27.5.18 NMAC,
01/01/06]
7.27.5.19 APPLICATION
FOR AIR AMBULANCE CERTIFICATION: All applications for certification as
an air ambulance shall contain the following:
A. service name;
B. ownership structure: sole
proprietor, partnership, corporation, etc.;
C. service mailing address;
D. physical location of facilities: use
additional sheets as necessary;
E. communications;
(1) business
telephone;
(2) facsimile
number;
(3) dispatch center telephone;
(4) emergency
point of contact;
(5) operations
telephone;
(6) cellular
telephone;
(7) pager
number;
F. communications center: physical
location of the communications center;
G. medical service management
personnel:
(1) program
administrator: name, telephone, facsimile, and other contact information as
applicable;
(2)
medical director: name, license number,
telephone, facsimile, and other contact information as applicable;
(3) clinical
care supervisor: name, telephone, facsimile, and other contact information as
applicable;
H. hours of operations: 24 hour, 7 days
a week, other (please explain);
I. type of air ambulance certificate
requested:
(1) fixed wing only;
(2) rotor
wing only;
(3) combination
service;
J. level of service requested:
(1) advanced
life support;
(2) critical
care;
(3) specialty
care;
K. service affiliation:
(1) private
or government service;
(2) hospital, police,
independent, or municipal;
L. aircraft certificate holder:
(1) service
name;
(2) contact person;
(3) address;
(4) business
telephone;
(5) facsimile;
(6) certificate
number;
M. type of aircraft: for fixed and rotor
wing, the following information is required:
(1) make
of aircraft(s);
(2)
model of aircraft(s);
(3) tail
number(s);
N. level of staffing: For both fixed
and rotor wing, please attach a copy of your staffing plan to include the
following:
(1) EMS personnel: EMT-P and the
number of each;
(2) nursing
personnel: number and type;
(3) physician(s): number and type;
(4) other
personnel: number and type;
O. emergency information: emergency
contact information shall be provided for the service director, clinical care
supervisor, medical director, and dispatch agency;
P. all applicants shall meet the CAMTS accreditation standards for the level of service of
the air ambulance service; some CAMTS accreditation
standards may be waived by the bureau for initial certification since new
start-up air ambulance services cannot achieve CAMTS
accreditation without being in service for a period of time; some CAMTS accreditation standards have exceptions that are
listed in 7.27.5.16 NMAC; in general the initial application for air ambulance
certification shall include the following:
Standards
Reference Number
Medical Section
Capabilities and Resources of the Medical Transport Service
and receiving hospitals
01.00.00
Medical Personnel
02.00.00
Medical Director
02.01.00
Medical Control Physician
02.02.00
Clinical Care Supervisor
02.03.00
Staffing
02.04.00
Mission Types
02.05.00
Training and Continuing Education
02.06.00
Aircraft/Ambulance Section
Medical Configuration
03.00.00
Operational Issues
04.00.00
Aircraft/Ambulance Equipment
05.00.00
Communications
06.00.00
Management and Administrative Responsibilities
Management Policies
07.00.00
Utilization Review
07.01.08
Quality Management
08.00.00
Infection Control
09.00.00
Rotor Wing Standards
Certificate of the Aircraft Operator
10.00.00
Weather and Weather Minimums
11.00.00
Pilot Personnel
12.00.00
Maintenance
13.00.00
Helipad
14.00.00
Refueling
15.00.00
Community Outreach
16.00.00
Fixed Wing Standards
Certificate of the Aircraft Operator
17.00.00
Aircraft
18.00.00
Weather
19.00.00
Pilot Personnel
20.00.00
Policies
21.00.00
Maintenance
22.00.00
Refueling
26.00.00
Community Outreach
27.00.00
Ground Inter-facility Standards: Not Applicable.
N/A
Addendums
Addendum A - Rationale for Change - Critical Care
Alternative
Addendum B - Education Matrix
ALS-BLS Ground
Standards: Not Applicable
N/A
Medical Escort Standards: Not Applicable
N/A
[7.27.5.19 NMAC - Rp, 7.27.5.19
NMAC, 01/01/06]
7.27.5.20 AIRCRAFT
EQUIPMENT STANDARDS: Standards and requirements
are outlined in the CAMTS accreditation standards
incorporated by reference, with the noted exceptions in section 7.27.5.16 NMAC.
[7.27.5.20 NMAC - Rp, 7.27.5.20
NMAC, 01/01/06]
7.27.5.21 TRAINING
STANDARDS: Standards and
requirements are outlined in the CAMTS accreditation
standards incorporated by reference, with the noted exceptions in section
7.27.5.16 NMAC.
7.27.5.21 NMAC - Rp, 7.27.5.21
NMAC, 01/01/06]
HISTORY of 7.27.5
NMAC:
Pre NMAC History: The material in this part was derived from
that previously filed with the commission of public records - state records
center and archives:
DOH Regulation 94-09 (CHSD),
Regulations Governing The Certification Of Air
Ambulance Services For The state Of New Mexico, filed 12-30-94.
History of repealed
material:
7 NMAC 27.5, Certification of Air Ambulance Services,
repealed 9/13/2001.
7.27.5 NMAC, Certification of Air Ambulance, repealed
01/01/06.
Other History:
DOH Regulation 94-09 (CHSD),
Regulations Governing The Certification Of Air Ambulance Services For The State
of New Mexico (filed 12-30-94), renumbered and reformatted to and replaced by 7
NMAC 27.5 NMAC, Certification of Air Ambulance Services, effective 9/13/2001.
7 NMAC 27.5 NMAC, Certification of Air Ambulance Services
(filed 11-26-96) replaced by 7.27.5 NMAC, Certification of Air Ambulance, effective 9/13/2001.
7.27.5 NMAC, Certification of Air Ambulance (filed 8/30/01)
replaced by 7.27.5 NMAC, Certification of Air Ambulance, effective
01/01/06.
