reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.307 - Memorandum of Agreement for ALS-level EFR Services

Current through Register 1525, July 5, 2024
(A) An ALS-level EFR service must maintain a
			 current memorandum of agreement with either:
(1) the primary ambulance service designated
			 in its service zone, provided that it is at the same level of ALS licensure or
			 higher; or
(2) another transporting
			 ALS ambulance service at the same or higher level of ALS licensure, provided
			 that the agreement is coordinated through the primary ambulance
			 service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.310 - Requirements for Additional Personnel on Ambulances

Current through Register 1525, July 5, 2024
Additional personnel, beyond the minimum staffing requirements
				for ambulances under
				105
				CMR 170.305, may function on an ambulance
				according to the provisions listed in
				105
				CMR 170.310(A) and
				(B).
(A) Such personnel must be currently
			 certified in Basic Life Support cardiopulmonary resuscitation through
			 completion of a course provided by a nationally recognized organization and
			 reflecting current cardiopulmonary resuscitation (CPR) and emergency cardiac
			 care resuscitation science and treatment recommendations issued by the
			 International Liaison Committee on Resuscitation (ILCOR)'s International
			 Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
			 Science With Treatment Recommendations (CoSTR), or successor body. Their
			 function may include the operation of a Class I, II or V ambulance if permitted
			 by the written policies and procedures of the ambulance service; provided,
			 however, that additional personnel may operate the vehicle only if the
			 supervising EMT on the ambulance makes a determination that the care of the
			 patient will be significantly improved by having both EMTs remain with the
			 patient during transport;
(B) A
			 registered nurse, physician or other health care professional may render care
			 to a patient during the transport of a patient(s) by an ambulance from a
			 hospital or other transferring facility when designated to do so by the
			 transferring facility.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.315 - Insurance

Current through Register 1525, July 5, 2024
(A) No original or renewal license shall be
			 issued, except in the case of services owned or operated by an agency or
			 political subdivision of the Commonwealth, to an applicant for an original or
			 renewal license, which operates its EMS vehicles in direct connection with a
			 place of business in Massachusetts, unless the applicant has satisfied the
			 insurance requirements necessary to register each of its Class I, II, and V
			 ambulances and its applicable EFR vehicles as a motor vehicle with the
			 Massachusetts Registrar of Motor Vehicles, pursuant to M.G.L. c. 90, § 3
			 and § 34A through 34O, and in addition, has satisfied the minimum limits
			 set out in
			 105
			 CMR 170.315(B).
(B) Each service shall carry the following
			 insurance coverage for each of its EMS vehicles:
(1) A minimum of $100,000 on account of
			 injury to or death of any one person;
(2) Subject to the limit as respects injury
			 to or death of one person, a minimum of $500,000 on account of any one accident
			 resulting in injury to or death of more than one person; and
(3) A minimum of $25,000 because of injury to
			 or destruction of property of others in any one accident.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.320 - Public Access

Current through Register 1525, July 5, 2024
(A) Every ambulance
			 service shall have a telephone with a publicly listed number to accept calls
			 from the public within its regular operating area.
(B) Every ambulance service licensed to
			 operate a Class I, IV, and Class II ambulances used as backup for a Class I
			 shall have a telephone number that is publicly listed. The service shall
			 provide that the telephone will be answered on a 24-hour-a-day basis either by
			 the service or its first backup as required in
			 105
			 CMR 170.385. The service must have telephone
			 capability for receiving two phone calls simultaneously.
(C)
Exception
: An
			 ambulance service that, according to its written policy, does not respond to
			 calls from the general public but responds only to calls from a unique
			 population is exempt from the requirements of
			 105
			 CMR 170.320(A) and (B).
			 However, the ambulance service shall have a telephone number made known to the
			 unique population it serves and the telephone must be answered either by the
			 service or its first backup as required in
			 105
			 CMR 170.385 during the period when that
			 population might require service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.323 - Code Black Status System Access

Current through Register 1525, July 5, 2024
All ambulance services shall have the ability to access the
				Department's code black status system through communication with a CMED or
				hospital connected to the code black status system.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.325 - Advertising

Current through Register 1525, July 5, 2024
(A) No person shall advertise by any means
			 including, but not limited to, signs or symbols on the vehicle, that he or she
			 operates or maintains a service, unless the service is licensed and its EMS
			 personnel and EMS vehicles are certified as required in
			 105 CMR
			 170.000.
(B) No person shall engage in any advertising
			 that is deceptive or misleading to the public or for services other than those
			 for which it is currently licensed, for which its EMS personel and EMS vehicles
			 are certified and for which it is placed in service.
(C) Prior to transfer of ownership of an EMS
			 vehicle, a licensed service, if it knows that the vehicle will be removed from
			 service and will no longer be certified, shall ensure that all vehicle markings
			 and emblems required by
			 105 CMR
			 170.000 are removed.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.333 - Duty to Operate in Accordance with Laws, Regulations, Protocols and Other Requirements

Current through Register 1525, July 5, 2024
Each service shall operate, and shall ensure that its agents
				operate, in accordance with M.G.L. c. 111C,
				105 CMR
				170.000, all other applicable laws and regulations,
				the Statewide Treatment Protocols, where relevant, administrative requirements
				and advisories of the Department, and the service's established policies and
				procedures that are consistent with
				105 CMR
				170.000.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.335 - Non-discrimination

Current through Register 1525, July 5, 2024
In accordance with requirements of federal and state
				anti-discrimination statutes, no person shall discriminate on the grounds of
				race, color, religion, sex, sexual orientation, age, national origin, ancestry
				or disability in any aspect of the provision of ambulance or EMS first response
				service or in employment practices.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.340 - Appointment of Designated Infection Control Officer

Current through Register 1525, July 5, 2024
Each service shall ensure that its EMS personnel are informed
				of the requirements relating to the reporting of exposures to the infectious
				diseases set forth in
				105 CMR
				172.000:
Implementation of Massachusetts
				General Laws C. 111, § 111C, Regulating the Reporting of Infectious
				Diseases Dangerous to the Public Health
, and shall appoint one
				official of the service to act as a designated infection control officer
				to:
(A) Receive notifications and
			 responses from health care facilities regarding exposures to infectious
			 diseases dangerous to the public health, as defined in
			 105
			 CMR 172.001:
Definitions;
(B)
			 Report said exposures to EMS personnel; and
(C) Make requests on behalf of EMS
			 personnel.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.341 - Requirement for Personnel to Be Vaccinated against Influenza Virus

Current through Register 1525, July 5, 2024
(A)
Definitions
.
1. For purposes of
			 105
			 CMR 170.341, personnel means an individual or
			 individuals who either work at or come to the licensed service or site or EMS
			 vehicle and who are employed by or affiliated with the service, whether
			 directly, by contract with another entity, or as an independent contractor,
			 paid or unpaid including, but not limited to, employees, members of the medical
			 staff, contract employees or staff, students, and volunteers, whether or not
			 such individual(s) provide direct care.
2. For purposes of
			 105
			 CMR 170.341, the requirement for influenza
			 vaccine or vaccination means immunization by either influenza vaccine,
			 inactivated or live; attenuated influenza vaccine including seasonal influenza
			 vaccine pursuant to
			 105
			 CMR 170.341(B); and/or other
			 influenza vaccine pursuant to
			 105
			 CMR 170.341(C).
3. For purposes of
			 105
			 CMR 170.341, mitigation measures mean
			 measures that personnel who are exempt from vaccination take to prevent viral
			 infection and transmission.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.342 - Requirement for Personnel to Be Vaccinated against Coronavirus Disease 2019 (COVID-19) Caused by the Virus SARS-CoV-2

Current through Register 1525, July 5, 2024
(A)
Definitions
.
1. For
			 purposes of
			 105
			 CMR 170.342, personnel means an individual or
			 individuals who either work at or come to the licensed service or site or EMS
			 vehicle and who are employed by or affiliated with the service, whether
			 directly, by contract with another entity, or as an independent contractor,
			 paid or unpaid including, but not limited to, employees, members of the medical
			 staff, contract employees or staff, students, and volunteers, whether or not
			 such individual(s) provide direct care.
2. For purposes of
			 105
			 CMR 170.342, COVID-19 vaccination means being
			 up to date with COVID-19 vaccines as recommended by the Centers for Disease
			 Control and Prevention (CDC).
3.
			 For purposes of
			 105
			 CMR 170.342, mitigation measures mean
			 measures that personnel who are exempt from vaccination take to prevent viral
			 infection and transmission.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.345 - Records

Current through Register 1525, July 5, 2024
Each service shall prepare and maintain records, in electronic
				or print format, that are subject to, and shall be available for, inspection by
				the Department at any time upon request. Records shall be stored in such a
				manner as to ensure reasonable safety from water and fire damage and from
				unauthorized use, for a period of not less than seven years. Services shall
				also store and maintain the records of any service(s) they acquire, in the same
				manner.
(A) Records for services shall
			 include at a minimum, as applicable, the following:
(1) service policies and
			 procedures;
(2) EMS personnel
			 training records;
(3) EMS personnel
			 and employment files and records;
(4) documentation of EMS personnel's current
			 CPR and ACLS training credentials, as applicable for their certification level,
			 EMT or EFR certification and valid motor vehicle operator's license, including
			 when and by whom verification required by
			 105
			 CMR 170.285 was completed;
(5) all data from cardiac monitors and other
			 equipment used in patient care, downloaded and readily accessible, either in
			 electronic or paper format, for continuous quality improvement as well as
			 Department review upon request;
(6)
			 For services licensed at the critical care service level, documentation of
			 compliance with all CAMTS or Department-approved substantially equivalent
			 accreditation standards including, but not limited to, continuous quality
			 improvement (CQI); training and orientation of critical care transport
			 personnel; continuing clinical education, skills maintenance and requirements
			 for ongoing demonstration of clinical competency of its critical care medical
			 crews.
(7) preventive maintenance
			 and repair records for ambulances and biomedical equipment and
			 devices;
(8) current vehicle
			 registrations;
(9) current Federal
			 Aviation Administration (FAA) certifications and licenses for Class IV
			 ambulances and pilots; and
(10)
			 Federal Communications Commission (FCC) licenses.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.347 - Data Reports to the Department

Current through Register 1525, July 5, 2024
Each ambulance service shall comply with all requirements
				established by the Department for submission of data to the Department
				including, but not limited to, data pertaining to prehospital care and
				transport of trauma patients to appropriate health care facilities. Data
				submission requirements shall be specified in administrative requirements of
				the Department. Such administrative requirements and amendments thereto shall
				be circulated to all ambulance services for review and comment at least 60
				calendar days prior to adoption.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.350 - Accident Reports and Serious Incident Reporting Requirements

Current through Register 1525, July 5, 2024
(A) Each licensed service shall file a
			 written report with the Department within seven calendar days of the following
			 incidents. and immediately notify the Department by electronic mail or
			 telephone if the incident results in injury or death, involving its service,
			 personnel or property:
(1) fire affecting an
			 EMS vehicle or service place of business;
(2) theft of an EMS vehicle; and
(3) a motor vehicle crash involving an EMS
			 vehicle reportable under M.G.L. c. 90, § 26 relating to the mandatory
			 reporting of any crash involving a motor vehicle resulting in personal injury,
			 death, or property damage. For the purpose of
			 105
			 CMR 170.350(A)(3), the
			 written report shall be a copy of the approved Registry of Motor Vehicles'
			 "Operator's Report of Motor Vehicle Accident," or in the case of a Class IV
			 ambulance, a copy of the approved report form submitted to the FAA.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.355 - Responsibility to Dispatch, Treat and Transport

Current through Register 1525, July 5, 2024
(A) No service, or agent thereof including,
			 but not limited to, its EMS personnel, shall refuse in the case of an emergency
			 to dispatch an available EMS vehicle and to provide emergency response,
			 assessment and treatment, within the service's regular operating area, in
			 accordance with the Statewide Treatment Protocols, at the scene or during
			 transport, or to transport a patient to an appropriate health care facility in
			 accordance with the applicable service zone plan.
(B)
Primary Ambulance
			 Response
.
(1) Upon receipt of a
			 call to respond to an emergency, the service zone's primary ambulance service,
			 or a service operating pursuant to a service zone agreement, and the closest
			 appropriate designated EFR service(s), if any, shall be immediately notified
			 and dispatched in accordance with the applicable service zone plan and
			 105
			 CMR
			 170.510(I)(3)(f).
(2) When the primary ambulance service
			 receives a call, it shall ensure that the closest ambulance is immediately
			 dispatched, in accordance with the service zone plan. If the primary ambulance
			 service dispatcher believes at the time the call is received that an ambulance
			 is not available for immediate dispatch, or believes that another ambulance
			 service has the capacity to reach the scene in a significantly shorter period
			 of time, the dispatcher shall immediately contact the ambulance service with
			 the closest ambulance, in accordance with the service zone plan.
(3) When an ambulance service with a provider
			 contract providing primary ambulance response pursuant to a service zone
			 agreement receives a call for primary ambulance response, if it believes at the
			 time the call is received that it cannot meet the service zone standards for
			 primary ambulance response, the ambulance service must immediately refer the
			 call to the primary ambulance service, unless otherwise provided in the service
			 zone plan.
(4) When an ambulance
			 service other than the primary ambulance service receives a call to provide
			 primary ambulance response that is not pursuant to a provider contract and a
			 service zone agreement, it must immediately refer the call to the primary
			 ambulance service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.357 - Point-of-entry Plans

Current through Register 1525, July 5, 2024
Each ambulance service shall ensure that its EMTs deliver
				patients in accordance with regional point-of-entry plans approved by the
				Department. No ambulance service shall develop a point-of-entry plan
				independent of a Department-approved regional point-of-entry
				plan.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.360 - Responsibility to Provide Appropriate Personnel during Transfer

Current through Register 1525, July 5, 2024
No ambulance service or agent thereof shall transport a patient
				between health care facilities who is receiving medical treatment that is
				beyond the training and certification capabilities of the EMTs staffing the
				ambulance unless an additional health care professional with that capability
				accompanies the patient. For this purpose, medical treatment received by a
				patient includes, but is not limited to, intravenous therapy, medications,
				respirators, cardiac monitoring, advanced airway support, or other treatment or
				instrumentation.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.365 - Transport of a Deceased Person

Current through Register 1525, July 5, 2024
An ambulance shall not be used to transport a dead body except
				in special circumstances where it is in the interest of public health and/or
				safety to do so.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.370 - Transport of a Person in a Wheelchair

Current through Register 1525, July 5, 2024
Disabled persons in wheelchairs shall not be transported in an
				ambulance unless required by medical necessity. In each such instance the
				disabled person must be transferred to an ambulance cot and the patient care
				report shall contain the nature of the person's illness or injury requiring
				transport by ambulance.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.373 - EMT Use of Patient Restraints

Current through Register 1525, July 5, 2024
(A) EMTs may
			 restrain a patient who presents an immediate or serious threat of bodily harm
			 to himself or others, in accordance with administrative requirements or
			 protocols of the Department.
(B)
Documentation
. EMTs shall thoroughly document all uses
			 of restraints on their patient care report, and at a minimum include the
			 following: reason for restraint use, time of application, types of restraints
			 used, patient position, number of EMS personnel and first responders used to
			 restrain the patient, and issues encountered during transport.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.380 - Medical Communications

Current through Register 1525, July 5, 2024
(A) Each ambulance
			 service licensed to operate Class I, IV, and/or V ambulances and Class II
			 ambulances, if they are used as backup for Class I ambulances, shall, at a
			 minimum, provide for the relay of medical information through a dispatcher to
			 appropriate health care facilities to which the ambulance service routinely
			 transports patients.
(B) Each BLS
			 ambulance service licensed to operate a Class I ambulance shall provide its
			 Class I ambulances with equipment for direct two-way mobile radio contact
			 between its Class I ambulances and those appropriate health care facilities
			 similarly equipped to which the ambulance routinely transports
			 patients.
(C) Each service licensed
			 at the ALS level must have adequate portable two-way radio communications
			 equipment to utilize the system of medical direction including a portable radio
			 that can be transported to the scene of the emergency.
(D) All BLS and ALS services' communications
			 and communications equipment must comply with the standards and requirements of
			 the Massachusetts Emergency Medical Services Communications Plan.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.385 - Service Availability and Backup

Current through Register 1525, July 5, 2024
(A)
(1) Each EFR service at the EMS first
			 response and BLS levels shall ensure that the level of service for which it is
			 licensed is available to the public within the service's regular operating area
			 24 hours per day, seven days per week, by providing the service's own personnel
			 and EMS vehicles, or supplementing its own EMS staff through written
			 agreement(s) with other service(s).
(2) Each ambulance service licensed to
			 operate and maintain Class I or IV ambulances shall ensure that BLS emergency
			 ambulance service is available to the public within the service's regular
			 operating area 24 hours per day, seven days per week, by providing the
			 service's own personnel and EMS vehicles, or by written agreement(s) with other
			 service(s).
(3) Adequate backup for
			 ambulance services shall consist of, at a minimum, both first and second backup
			 as defined in
			 105
			 CMR 170.385(A)(3)(a) and
			 (b), and shall meet any additional
			 requirements of the applicable service zone plan. First and second backup
			 vehicles shall be at least two separate ambulances.
(a)
First Backup
.
1. First backup for a Class I ambulance shall
			 be either a Class I or II ambulance;
2. First backup for a Class IV air ambulance
			 shall be another Class IV air ambulance, a Class I ambulance, or a Class II
			 ambulance.
(b)
Second Backup
.
1.
			 Second backup for a Class I ambulance shall be either a Class I, II, or V
			 ambulance.
2. Second backup for a
			 Class IV air ambulance shall be either a Class IV, a Class I ambulance, a Class
			 II ambulance, or a Class V ambulance.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.390 - EMS Vehicle Readiness

Current through Register 1525, July 5, 2024
Each service shall ensure that each of its EMS vehicles that
				are in current operation and needed to comply with the applicable service zone
				plan, are ready to respond to a call at any time. Each service shall implement
				a system to verify that EMS vehicles are in ready working order, and that each
				EMS vehicle has all the required equipment, drugs and supplies to respond in
				accordance with the Statewide Treatment Protocols, to a call at any time. Each
				service shall ensure the following:
(A)
			 Each EMS vehicle in current operation and needed to comply with the applicable
			 service zone plan is housed in a secured, temperature-controlled fully enclosed
			 garage owned or operated by the service, whenever the vehicle's expected time
			 between calls would compromise vehicle, drugs and equipment performance and
			 readiness or when its EMS personnel need facilities only available at a
			 garage;
(B) EMS vehicles, their
			 interior and all equipment, are kept clean and sanitary, in accordance with
			 standards established in administrative requirements of the
			 Department;
(C) EMS vehicles'
			 temperature controls are functioning correctly, so that all drugs and equipment
			 are maintained in conformance with manufacturers' recommendations and in proper
			 condition for immediate use, and that the patient compartment is heated or
			 cooled, depending on the season; and
(D) EMS vehicles are kept in a secured area,
			 free of debris and hazards.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.395 - Storage Space

Current through Register 1525, July 5, 2024
Adequate and clean enclosed storage space for linens, equipment
				and supplies shall be provided and accessible to EMTs at each place of
				business. These storage spaces shall be so constructed to ensure cleanliness of
				equipment supplies to permit thorough cleaning and ensure equipment, drugs and
				supplies are maintained within manufacturers' recommended temperature
				ranges.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.400 - Supplies

Current through Register 1525, July 5, 2024
An adequate amount of medical supplies, as described in the
				Department's administrative requirements, and linen for stocking EMS vehicles
				shall be stored wherever EMS vehicles are garaged, unless a service has
				established centralized supply hubs containing the required supplies, a system
				for timely field replacement of supplies from support units, or unless a
				service obtains all medical supplies and linen from a hospital pursuant to a
				written agreement with the hospital.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.405 - Waivers for Special Projects

Current through Register 1525, July 5, 2024
At the discretion of the Department, regulations established in
				this chapter may be waived for special projects which demonstrate innovative
				delivery of emergency medical care services. Proposals for special projects
				must be submitted to the Department in writing and no regulatory standards will
				be waived without explicit Department approval. Special projects will be
				considered experimental in nature and will be reviewed and renewed at such time
				periods as the Department shall establish.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.410 - General Requirements Regarding EMS Vehicles

Current through Register 1525, July 5, 2024
Each service shall ensure that each EMS vehicle for which the
				service is licensed to operate is certified and conforms to the applicable
				standards set forth in
				105 CMR
				170.000. No EMS vehicle shall be operated or
				maintained except by a licensed service that meets the applicable requirements
				of 105 CMR
				170.000.
(A)
Ambulances
. The Department may, prior to
			 certification, inspect the ambulance, equipment and supplies for conformance
			 with the standards set forth in
			 105 CMR
			 170.000 and the Department's administrative
			 requirements. Authorized personnel of the Department may inspect, at any time
			 and without prior notice, any ambulance, equipment and supplies. For the
			 purposes of
			 105
			 CMR 170.410(A), such
			 inspection includes, but is not limited to, ambulances, equipment, supplies,
			 the garage, records and files.
(B)
EFR Vehicles
. Each EFR service shall submit to the
			 Department a written affirmation that its EFR vehicles, owned or operated by
			 the EFR service, have passed safety inspection(s) as required by federal, state
			 or local law. Prior to certification, the Department may inspect each vehicle's
			 EMS equipment and supplies for conformance with the standards set forth in
			 105 CMR
			 170.000 and the Department's administrative
			 requirements. Authorized personnel of the Department may inspect at any time
			 and without prior notice, the EMS equipment and supplies in the vehicles, and
			 audit EFR vehicle records and files, as well as other records and files as set
			 forth in
			 105
			 CMR 170.225.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.415 - Certificate of Inspection Required

Current through Register 1525, July 5, 2024
(A) No person
			 shall operate, maintain, or otherwise use any aircraft, boat, motor vehicle, or
			 any other means of transportation as an EMS vehicle without a valid certificate
			 of inspection. This applies to temporary replacement or additional ambulances
			 or EFR vehicles an EMS service plans to deploy.
(B)
Exception
.
			 Uncertified vehicles may be used to render emergency medical transportation in
			 the case of a major catastrophe when the number of certified ambulances capable
			 of emergency dispatch in the locality of the catastrophe is insufficient to
			 render the required emergency medical transportation services, pursuant to a
			 statewide mass casualty incident plan.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.420 - Certification Procedure

Current through Register 1525, July 5, 2024
(A) To request a
			 certificate of inspection, the applicant must complete and submit forms
			 supplied by the Department, provided that a service license application has
			 been filed.
(B) The applicable
			 inspection fee established in
			 105
			 CMR 170.215(B)  shall be
			 submitted with a completed application form for certification.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.425 - Renewal of Certification

Current through Register 1525, July 5, 2024
(A) Pursuant to
			 M.G.L. c. 111C, § 7, certification for each EMS vehicle shall terminate on
			 the same date that the license for the service expires. Renewal applications
			 shall be submitted to the Department no later than 90 calendar days prior to
			 the date of the expiration of the certificate. An applicant for renewal of a
			 certificate of inspection shall follow the procedures set forth in
			 105
			 CMR 170.420. A renewal certificate shall not
			 be issued if there are any outstanding assessments.
(B) If the applicant has applied for a
			 renewal of a certificate of inspection and the Department is unable to inspect
			 the vehicle, the current certificate of inspection shall remain in full force
			 and effect until such time as the Department takes action on the renewal
			 application, which shall ordinarily be within 30 days after the date the
			 certificate expires.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.430 - Temporary Certification for EMS Vehicles

Current through Register 1525, July 5, 2024
(A)
Replacement Vehicle for Those
			 Already Certified
. To certify a replacement vehicle for one of its
			 certified EMS vehicles, the licensee shall notify the Department and apply for
			 a temporary certificate.
(1) The Department
			 must receive notice within three business days of the date that the replacement
			 EMS vehicle is put into operation.
(2) The licensee shall include a statement:
(a) describing the EMS vehicle (and for
			 ambulances, indicating the class) for which the replacement is to be
			 certified;
(b) attesting that the
			 replacement EMS vehicle conforms to the applicable standards for that vehicle
			 under
			 105 CMR 170.000;
			 and
(c) describing the reasons for
			 replacement.
(3) The
			 Department may issue a temporary certificate of inspection for the EMS vehicle
			 that the licensee describes in the statement. This temporary certificate shall
			 expire on the date that the licensee receives the regular certificate of
			 inspection or the denial of the certificate of inspection.
(a) The licensee shall return the temporary
			 certificate of inspection to the Department immediately upon receipt of the
			 regular certificate.
(b) If the
			 regular certificate of inspection is for a class other than that of the
			 replaced EMS vehicle, the service's license shall be modified to reflect the
			 change, as provided in
			 105 CMR
			 170.240.
(4) If upon inspection, it is found that the
			 temporary certificate of inspection was issued for a type or class whose
			 requirements the EMS vehicle did not meet, the applicant may be liable for a
			 fine of up to $1,000.00 under
			 105 CMR
			 170.790.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.435 - Grounds for Denial, Suspension and Revocation of a Certificate of Inspection

Current through Register 1525, July 5, 2024
(A) The Department
			 may deny, suspend, revoke, or refuse to renew a certificate of inspection for
			 the following grounds, including:
(1) Failure
			 of an ambulance to comply with vehicle specifications for the appropriate class
			 established in
			 105 CMR
			 170.000 and the Department's administrative
			 requirements;
(2) Failure of an EFR
			 vehicle to comply with the applicable requirements of
			 105 CMR
			 170.000 and the EFR service's written statement that
			 it has met all safety and other vehicle inspection standards required by
			 law;
(3) Failure to comply with the
			 equipment requirements of
			 105 CMR
			 170.000 and the Department's administrative
			 requirements;
(4) Failure to comply
			 with a Department-approved plan of correction;
(5) Failure of a service to allow the
			 Department to inspect, as provided for in
			 105
			 CMR 170.410; or
(6) Lack of sufficient certified and
			 qualified EMS personnel to staff the EMS vehicle as required by
			 105 CMR
			 170.000 and the applicable service zone
			 plan.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.440 - Safety Inspections

Current through Register 1525, July 5, 2024
Each EMS vehicle shall be kept in good repair and operating
				condition, as demonstrated by, at a minimum, a valid inspection sticker from
				the appropriate registering agency for the type of vehicle. Periodic inspection
				of ambulances by the Department shall be in addition to other federal, state or
				local safety inspections required for the vehicle under law or ordinance. A
				violation of required safety inspections shall be a violation of
				105 CMR
				170.000.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.450 - All Ambulances Subject to Classification

Current through Register 1525, July 5, 2024
All ambulances shall conform to the minimum standards of one of
				the classes set out in
				105
				CMR 170.455,
				170.460,
				170.465 and
				170.470, and shall be
				certified accordingly as provided in
				105
				CMR 170.415 and
				170.420. There are three
				classes of ground ambulances (Class I, II and V), and one class of air
				ambulance (Class IV).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.455 - Class I

Current through Register 1525, July 5, 2024
A Class I ambulance shall be used primarily for emergency
				dispatch to and transport of sick and injured persons from the scene of an
				emergency. A Class I ambulance may also be used for scheduled transportation by
				prior appointment of persons having known and non-emergent medical condition.
				It shall meet the following minimum requirements:
(A)
Vehicle Design and
			 Construction
.
(1) An ambulance
			 service may put into operation a Class I vehicle which conforms with the
			 specifications set out in administrative requirements of the Department which
			 are in effect at the date of vehicle production. In the case of municipal
			 services, standards are those in effect at the date of acceptance of a
			 manufacturer's bid.
(2) The
			 Commissioner or his or her designee may waive specific requirements included in
			 the specifications referenced in
			 105
			 CMR 170.455(A)(1)  where
			 alternatives provide comparable protection of the public health and safety.
			 Requests for waivers or variations must be filed and approved by the Department
			 before the bid or order process is undertaken. Such requests for waiver or
			 variations are not subject to the general waiver requirement set forth in
			 105
			 CMR 170.275.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.460 - Class II

Current through Register 1525, July 5, 2024
A Class II ambulance shall be used for scheduled transportation
				by prior appointment of persons having known and non-emergent medical
				conditions. In addition it may be used as a backup ambulance in emergency
				situations when a Class I ambulance is not available. It shall meet the
				following minimum requirements:
(A)
Vehicle Design and Construction
.
(1) A Class II vehicle shall meet or exceed
			 the specifications set out in administrative requirements of the Department. In
			 the case of municipal services, standards are those in effect at the date of
			 acceptance of a manufacturer's bid.
(2) The Commissioner or his or her designee
			 may waive specific requirements included in the specifications referenced in
			 105
			 CMR 170.460(A)(1)  where
			 alternatives provide comparable protection of the public health and safety.
			 Requests for waivers of variations must be filed and approved by the Department
			 before the bid or order process is undertaken. Such requests for waiver or
			 variation are not subject to the general waiver requirement set forth in
			 105
			 CMR 170.275.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.465 - Class IV

Current through Register 1525, July 5, 2024
A Class IV air ambulance is an aircraft used to provide safe
				air transportation of sick or injured persons. A Class IV air ambulance shall
				meet the following minimum requirements:
(A)
Aircraft Design and
			 Construction
.
(1) The aircraft
			 shall conform to all applicable Federal Aviation Administration
			 standards.
(2) The aircraft shall
			 be capable of carrying a patient(s), on a stretcher, in a horizontal position.
			 The stretcher shall be firmly secured with quick-release fasteners.
(3) The patient(s) cabin area shall provide a
			 minimum of 30 inches of clear space over the torso half of the stretcher,
			 measured along the centerline of stretcher.
(4) The patient(s) cabin area shall provide
			 sufficient room for an EMT to care for a patient(s). At a minimum, the EMT
			 shall have free access to the torso half of the stretcher.
(5) The aircraft door(s) must be of
			 sufficient size as to allow for easy loading of a stretcher(s) in a horizontal
			 or any elevated position.
(6) The
			 aircraft cabin must be of sufficient size to allow for effective use of medical
			 equipment. All life support equipment and supplies must be easily available to
			 the EMT from within the cabin.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.470 - Class V

Current through Register 1525, July 5, 2024
A Class V ambulance is a vehicle that does not meet the minimum
				vehicle design and construction standards of any other class of ambulance. A
				Class V ambulance may be dispatched to the scene of an emergency to bring
				trained personnel and appropriate equipment and supplies. It shall meet the
				following minimum requirements:
(A)
Vehicle Equipment
. A Class V ambulance shall be
			 equipped at a minimum with the vehicle equipment specified in the
			 administrative requirements entitled
Vehicle Equipment Guidelines -
			 Class V
. Amendments to such administrative requirements shall be
			 circulated to licensees for review and comment at least 60 calendar days prior
			 to adoption.
(B)
Medical Equipment and Supplies
. A Class V ambulance
			 shall be equipped at a minimum with medical equipment and supplies as specified
			 in the administrative requirements entitled
Medical Equipment and
			 Supplies - Class V
. Amendments to such administrative requirements
			 shall be circulated to licensees for review and comment at least 60 calendar
			 days prior to adoption.
(C) A Class
			 V ambulance shall not be used to transport a patient to a hospital or other
			 appropriate health care facility except as a backup ambulance when the Class I
			 ambulance and its first back-up, as set forth in
			 105
			 CMR 170.385, are demonstrably
			 unavailable.
(D) A service licensed
			 to operate and maintain a Class V ambulance, must also be licensed to operate
			 and maintain a Class I ambulance, or provide evidence of a written cooperative
			 arrangement by which a Class I ambulance, and its first and second backup as
			 required in
			 105
			 CMR 170.385, are readily available to provide
			 emergency medical transportation in the regular operating area of the
			 service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.475 - ALS Ambulances

Current through Register 1525, July 5, 2024
Only certified Class I and Class IV ambulances shall be used
				for transport of patients receiving ALS care, except that a certified Class II
				or Class V ambulance may be used as a backup ambulance according to
				pre-arranged agreement, if the vehicle meets all other ALS requirements
				contained herein and is in accordance with
				105
				CMR
				170.470(C).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.480 - Equipment, Medication and Supplies

Current through Register 1525, July 5, 2024
(A) All EMS
			 vehicles shall be equipped and staffed to provide care at the level of service
			 for which the EMS vehicle is put into service, in accordance with the Statewide
			 Treatment Protocols and the applicable service zone plan. When responding to a
			 call, each EMS vehicle shall carry the equipment, supplies and medications
			 required by the Department's administrative requirements for its type or
			 classification.
(B) All equipment
			 on EMS vehicles shall be maintained in good working order at all times, in
			 accordance with the manufacturer's recommendations and/or specifications. All
			 equipment on EMS vehicles shall be used by the service's EMS personnel only in
			 accordance with the manufacturer's recommendations and/or
			 specifications.
(C) All medications
			 shall be stored and maintained in conformance with the manufacturer's
			 recommendations and shall be used by the service's EMS personnel in accordance
			 with the Statewide Treatment Protocols.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.485 - Display of Certificate of Inspection

Current through Register 1525, July 5, 2024
Each ambulance service shall display the Department-issued
				certificate of inspection in the ambulance for which it was issued, in a manner
				so that the certificate is readily visible to any person in the patient
				compartment of the ambulance.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.490 - Ambulance Identification

Current through Register 1525, July 5, 2024
(A) All ambulance
			 services shall comply with the requirements for vehicle markings, emblems, and
			 warning devices in the specifications set out in administrative requirements of
			 the Department with regard to their Class I and Class II ambulances.
(B) Each certified ambulance shall be
			 equipped with emergency warning lights and audible warning devices as provided
			 for in the class for which the vehicle is certified.
(C) The use of emergency warning lights
			 and/or audible warning devices is permitted only as needed when an ambulance is
			 on a call for the purpose of an emergency transport of a sick or injured person
			 or at the scene or en route to the scene of an emergency.
(D) Each certified Class I or Class II
			 ambulance shall have the name under which the ambulance service is licensed
			 prominently lettered on the back and sides of the vehicle.
(E) No ambulance may display any words,
			 markings or lettering which indicate or represent a special care ambulance,
			 unless the use of each such identifier has been approved by the
			 Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.500 - Service Zone Plans

Current through Register 1525, July 5, 2024
(A) Pursuant to
			 M.G.L. c. 111C, § 10, each local jurisdiction shall be covered by a
			 service zone plan approved by the Department that:
(1) identifies and makes optimal use of all
			 available EMS resources;
(2) sets
			 out how emergency response is coordinated and carried out; and
(3) ensures the dispatch and response of the
			 closest, appropriate, available EMS resources.