Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 03 - Emergency Health Services › Rule 007.03.13-002 - Proposed Revisions to the Rules and Regulations for Emergency Medical Services

Current through Register Vol. 49, No. 6, June, 2024
AUTHORITY
The following Rules and Regulations Pertaining to Emergency
				Medical Services are duly adopted and promulgated by the Arkansas State Board
				of Health pursuant to the authority expressly conferred by the Laws of the
				State of Arkansas in Ark. Code Ann. § 20-13-200et.seq., and other laws of
				the State of Arkansas.
SECTION I.
			 DEFINITIONS
For the purpose of these regulations the following terms are
				defined:
A.
Advanced Emergency
			 Medical Technician:
A person who has successfully completed an Advanced
			 EMT education program approved by the Department and is licensed as an Advanced
			 EMT.
B.
Advanced Response
			 Service:
A licensed non-transporting service that is requested to
			 respond to the scene of an emergency and provides Advanced Life Support care to
			 ill or injured patients prior to the arrival of a licensed transporting
			 ambulance service, subject to compliance with the EMS Rules and Regulations
			 relating to the level of care available from the responding
			 personnel.
C.
Air Ambulance
			 Communication Specialist:
Personnel assigned to receive and coordinate
			 all requests for the air medical service.
D.
Air Ambulance Operation:
One
			 aircraft making one flight in response to a patient transport
			 request.
E.
Air Ambulance
			 Personnel:
Personnel responsible for patient care on an air
			 ambulance.
F.
Air Ambulance
			 Service
-
Emergency:
An air ambulance service that provides
			 emergency scene flights which can also provide inter-facility
			 transports.
G.
Air Ambulance
			 Service:
An entity operating an aircraft used for air transportation
			 that is specifically designed to accommodate the air medical needs of persons
			 who are ill, injured, wounded, or otherwise mentally or physically
			 incapacitated or helpless; who may require emergency medical care in-flight,
			 and who, in a physician's opinion, cannot be safely transported on a standard
			 commercial or charter flight. Air Ambulances shall be permitted by the
			 Department.
H.
Air Ambulance
			 Service Area:
The area of operation within the State of Arkansas for a
			 licensed air ambulance service as defined by the service and on file with the
			 Department.
I.
Air Ambulance
			 Service Medical Director:
An Arkansas licensed Medical Doctor (MD) or
			 Doctor of Osteopathy (DO) who provides medical oversight for any licensed air
			 ambulance service, and is either board certified or board eligible in emergency
			 medicine or general surgery, and is on file with the Department as the Medical
			 Director.
J.
Air Ambulance
			 Service Medical Director (Specialty):
An Arkansas licensed
Medical Doctor (MD) or Doctor of Osteopathy (DO) who provides
				medical oversight for any licensed air ambulance service, that solely provides
				specialty transport services (i.e. pediatrics, neonatal, high risk obstetrics),
				or fixed winged aircraft the individual requires licensure or board eligibility
				in emergency medicine, general surgery, pediatrics, neonatology, obstetrics or
				the specialty they have medical oversight for.
K.
Ambulance (Ground):
Those
			 vehicles used for transporting any person by stretcher or gurney upon the
			 streets or highways of Arkansas, excluding vehicles intended solely for
			 personal use by immediate family members. Ambulances shall be permitted by the
			 Department.
L.
Ambulance
			 Service:
Entities authorized and licensed by the Department to provide
			 care and transportation of patients upon the streets and highways of
			 Arkansas.
M.
Controlled
			 Drugs:
Those drugs identified as Schedule II-V as designated by federal
			 law
N.
Coordination
			 Point:
A fixed location(s) where information about the air ambulance
			 service may be obtained and where the activities of dispatch, resource
			 allocation, and flight operations are conducted.
O.
Department:
The Arkansas
			 Department of Health.
P.
Emergency Medical Services:
The transportation and medical care provided
			 to the ill or injured prior to arrival at a medical facility by licensed
			 emergency medical technician (EMT) or other healthcare providers and
			 continuation of the initial emergency care within a medical facility subject to
			 the approval of the medical staff and governing board of that
			 facility.
Q.
Emergency
			 Medical Services Advisory Council:
Those persons appointed by the
			 Governor to assist and advise the Department concerning matters dealing with
			 emergency medical services.
R.
Emergency Medical Services Education Program (EEP):
Those
			 organizations authorized and accredited by the Section or the Committee on
			 Accreditation of Educational Programs (CoAEMSP) to provide EMS
			 education.
S.
EMS Education
			 Program Training Site Authorization and Accreditation:
Authorization and accreditation issued by the Department or the
				Committee on Accreditation of Educational Programs (CoAEMSP) to an organization
				for the purpose of engaging in EMS education in the state of Arkansas.
T.
Emergency Medical
			 Technician:
A person who has been licensed as an EMT, in
			 Arkansas.
U.
Emergency
			 Medical Services Personnel - Instructor:
A person who has been licensed
			 to teach Emergency Medical Services Personnel courses after completing a
			 Department approved EMSP-Instructor course and completion of all of the
			 instructor requirements.
V.
Emergency Medical Services Personnel (EMSP):
An individual
			 licensed by the department at any level established by the rules adopted by the
			 board and authorized to perform those services set forth in the rules. These
			 shall include without limitation EMT, Advanced EMT, Paramedic, Emergency
			 Medical Services Instructor.
W.
Emergency Request:
A request for assistance to an incident for a
			 condition which is perceived by the individual to have created an actual threat
			 to human life or wellbeing where immediate medical intervention by any
			 Emergency Medical Service Personnel or other health professional is
			 needed.
X.
Encounter
			 Form:
A patient care record, which has been approved by the Department
			 that describes the EMS encounter and is left with the care facility at time of
			 service or (24) twenty-four hours after transfer of care. This form must
			 include a patient narrative.
Y.
Enrolled student:
A student who is attending an EMSP educational
			 program approved by the Department.
Z.
Extrication Services:
The
			 services provided by the use of equipment for the purpose of gaining access and
			 entry to entrapped patients.
AA.
FAA FAR Part 135:
Federal Aviation Administration Regulations
			 governing air taxi operations and commercial operation of fixed-wing and
			 rotor-wing aircraft.
BB.
Fixed Wing Aircraft:
A fixed wing air ambulance licensed by the
			 Department that is specially constructed and equipped and is intended to be
			 used for transportation of emergency medical patients.
CC.
Flight Nurse:
A registered
			 nurse (RN) licensed to practice in Arkansas who holds a current Arkansas EMT
			 License. For a Flight Nurse that solely provides air ambulance service-
			 specialty services (i.e. pediatrics, neonatal, high risk obstetrics, or fixed
			 wing) the Flight Nurse shall not be required to be an Arkansas licensed EMT and
			 shall not participate in air ambulance service - prehospital
			 transports..
DD.
Flight
			 Physician:
A physician assigned to flight duty, Post Graduate Year (PGY)
			 3 or above, with a current valid license to practice medicine as a Medical
			 Doctor (MD) or Doctor of Osteopathy (DO) in Arkansas or in the state of primary
			 operation of the air ambulance service, and who is board certified or board
			 eligible in emergency medicine or general surgery or is certified or in the
			 specialty (Neonatal, Pediatrics, high risk obstetrics, etc.) served by the
			 transport service and is certified in at least one of the following: Advanced
			 Cardiac Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation
			 Program or their equivalent for the patient population served.
EE.
Ground Ambulance Service
			 Area:
The contiguous land area within a county defined by city or
			 identifiable geographical landmarks or county boundaries for which area the
			 ground ambulance service has an operational base and commits to provide all
			 emergency medical services requested. Service Area Maps shall be kept on file
			 and renewed annually with the Services license renewal.
FF.
Intercept:
Instances where a
			 transporting service requests assistance fi-om an ambulance service which
			 provides a higher level of medical care and/or transport.
GG.
Lay Evaluator:
An individual
			 approved by the Department to evaluate the psychomotor portion of the Arkansas
			 EMSP licensure exam.
HH.
Legend Drug:
Any drug which requires a prescription by a licensed
			 physician as required by federal law.
II.
Mass Casualty Incident:
An
			 incident in which many people are suddenly injured or become ill which results
			 in the services available resources to become overwhelmed; which requires two
			 or more additional ambulance services to respond to the same event; and/or
			 assistance from the Department is needed to help coordinate medical resources
			 for the sick or injured.
JJ.
Medical Director (Advanced Life Support Services):
An Arkansas
			 licensed Medical Doctor (MD) or Doctor of Osteopathy (DO) who shall be
			 registered with the Department that is familiar with the design and operation
			 of EMS systems and experienced in pre-hospital emergency care and emergency
			 management of ill and injured patients. The Medical Director shall be board
			 certified or board eligible in Emergency Medicine or have current experience in
			 emergency medicine. For ALS services that currently have a Medical Director
			 that is not Board Certified in Emergency Medicine and holds a current ACLS
			 card, they shall be authorized to utilize that Medical Director until such time
			 they change or replace Medical Directors.
KK.
Medical Director (Basic Life
			 Support Services):
An Arkansas licensed Medical Doctor (MD) or Doctor of
			 Osteopathy (DO) who is either an Emergency Department Physician, or a Physician
			 who is either board certified or board eligible in their particular
			 specialty.
LL.
Medical
			 Facility:
Any hospital, medical clinic, physician's office, nursing home
			 or other health care facility.
MM.
Medical Facility Transport Service:
A medical facility regulated
			 by the Department of Health that owns and operates a stretcher ambulance
			 vehicle.
NN.
Mutual
			 Aid:
An agreement between emergency responders to lend assistance across
			 jurisdictional boundaries. This may occur due to an emergency response that
			 exceeds local resources, such as a disaster.
OO.
National Registry of Emergency
			 Medical Technicians (NREMT):
A not-for-profit, independent,
			 non-governmental agency that functions as a registration agency which issues
			 certificates of competency verified by achievement of minimal competencies of
			 EMTs, Advanced EMTs and Paramedics. NREMT provides a valid, uniform process to
			 assess the knowledge and skills required for competent practice required by
			 (EMS) personnel.
PP.
Of
			 Unsound Mind:
Means and includes the inability to perceive all relevant
			 facts related to one's condition and proposed treatment of whether the
			 inability is only temporary or has existed for an extended period of time or
			 occurs or has occurred only intermittently and whether or not it is due to
			 natural state, age, shock or anxiety, illness, injury, drugs or sedation,
			 intoxication, or other cause of whatever nature. (See Ark. Code §
									20-9-601
			 ).
QQ.
Operational
			 Base:
Facility within the service area of the ground or air ambulance
			 service designated to house the ground or air ambulance(s), crew members,
			 supplies, and communication.
RR.
Paramedic:
A person who has successfully completed a Paramedic
			 education program approved by the Department and is licensed in Arkansas as a
			 Paramedic.
SS.
Patient Care
			 Performance Improvement Plan:
A written plan that provides objective,
			 systematic and comprehensive monitoring of the quality, safety and
			 appropriateness of patient care; identifying and prioritizing opportunities for
			 improvement. The Ambulance Service Medical Director will be responsible for
			 approving and supervising the service's patient care performance improvement
			 plan.
TT.
Program Director:
Individual responsible for oversight of a Department approved EMS
			 education program. Program directors are authorized to verify the successful
			 completion of EMS education.
UU.
Probation:
An administrative action imposed on an EMS service,
			 EMSP license, EMSP-Instructor license or authorized and accredited training
			 site for violations of EMS Rules and Regulations.
VV.
Protocols:
Offline written
			 standing orders authorized by ambulance services, approved and signed by the
			 ambulance service Medical Director of that licensed ambulance
			 service.
WW.
Provisional
			 Instructor:
An EMT who has completed initial instructor training but is
			 in the process of finishing their teaching requirements, with appropriate
			 recommendation from the Instructor-Trainer, before becoming a licensed EMS
			 Instructor.
XX.
Reaction
			 Time:
The time from when the emergency call is received by the ambulance
			 services' dispatch and adequate information and adequate information is made
			 available which identifies the location and nature of the call, and until the
			 ambulance is enroute. This time shall be 2 minutes or less.
YY.
Receiving Facility:
A
			 hospital emergency department or a hospital capable of receiving and treating
			 emergency patients.
ZZ.
Revocation:
An administrative action imposed by the Department
			 that terminates an EMS service license, EMT license, EMT-Instructor license or
			 authorized training site for violating EMS Rules and Regulations.
AAA.
Rotor-Wing Aircraft:
A
			 rotor-winged air ambulance licensed by the Department that is specially
			 constructed and equipped and is intended to be used for transportation of
			 emergency medical patients.
BBB.
Service License:
Authorization issued by the Department to a
			 person, firm, corporation, association, county, municipality or other legal
			 entity for the purpose of engaging in care and/or transport of patients in the
			 State of Arkansas.
CCC.
Short
			 Form:
Abbreviated Patient Care Report that is left at the Receiving
			 Facility at time of transfer of care when an completed encounter form is not
			 available.
DDD.
Specialty
			 Crew Members:
Any person substituted by the Medical Director of an air
			 ambulance service for a Specialty Mission.
EEE.
Specialty Mission:
An
			 assignment for air ambulance service for which the specified needs of a
			 particular patient which may require the substitution of particular medical
			 care providers, Medical Direction and/or equipment.
FFF.
Specialty Purpose Service:
A licensed service that provides a specific medical service to a limited
			 population group and emergency evacuation services only, and does not
			 participate in the business of providing continuous general population response
			 for emergency medical services.
GGG.
Stretcher:
Any apparatus
			 that is used to transport individuals in the supine or Fowler's position. This
			 includes all devices that can be transformed from wheelchair to
			 stretcher.
HHH.
Suspension:
An administrative action imposed by the Department
			 that temporarily removes an EMS service license, EMT License, EMT-Instructor
			 License or training site authorization and accreditation for violating EMS
			 Rules and Regulations.
III.
Training Site Representative:
Individual responsible for the
			 organization, coordination, and day-to-day operations of the EMS training
			 programs.
JJJ.
Volunteer
			 Ambulance Service:
An ambulance service operating an EMT-Volunteer
			 permitted ambulance that is staffed by personnel who perform and give services
			 without expectation of compensation.
KKK.
Written Warning:
An
			 administrative action imposed on an EMS service, EMT certification,
			 EMT-Instructor certification or authorized training-site for first-time or
			 minor offenses unless otherwise stated.