Code of Maine Rules › 16 - DEPARTMENT OF PUBLIC SAFETY › 163 - BUREAU OF EMERGENCY MEDICAL SERVICES (MAINE EMS) › Chapter 4 - AIR AMBULANCE SERVICES LICENSES › Section 163-4-5 - Licensing Standards

Current through 2024-29, July 17, 2024
1. An application
				will not be accepted as complete unless it includes all materials required to
				be evaluated for licensure. To obtain a new license, an applicant must:
A. Apply on forms available from Maine
				EMS.
B. Submit a fee of
				$100.00.
C. Demonstrate to Maine
				EMS that:
1. The applicant has placed a
				notice, approved by Maine EMS, in the most widely circulated newspaper(s)
				serving the proposed service area(s). The notice must state:
(a) The name and legal status of the entity
				making application.
(b) The name of
				the proposed service;
(c) The type
				of service proposed;
(d) The level
				of care to be provided;
(e) The
				names of the municipalities within the primary response area of the proposed
				service;
(f) That the public is
				invited to make comment to Maine EMS regarding the proposed application, and
				that comments must be received by Maine EMS within 30 calendar days after the
				date of the notice's publication; and,
(g) The current mailing address of the Maine
				EMS office.
2. The
				applicant has made a detailed manual of policies and procedures available for
				reference in the flight coordination office and available for inspection by
				Maine EMS to assist with EMS system planning and resource coordination efforts.
				Personnel shall be familiar and comply with policies contained within the
				manual, which shall include, but not be limited to:
(a) A written policy and procedure specifying
				the:
(i) Service's mission statement;
(ii) Scope of care to be provided
				by the service in accordance with Medical Direction and Practices
				Board-approved protocols; and
(iii)
				Education, clinical experience and competency requirements of the medical crew
				commensurate with the scope of care to be provided.
(b) Notification phone numbers and access
				dispatch procedure, including identification of those who may request a mission
				and those who will approve missions;
(c) Capabilities of medical transport
				personnel;
(d) Type of aircraft
				vehicle(s) used and operational protocols specific to type;
(e) Coordination of medical protocols and
				operating practices with hospital and pre-hospital providers and other public
				safety agencies;
(f) Response and
				coverage area for the service;
(g)
				Preparation and stabilization of the patient;
(h) A safety program of policies and
				procedures specific to patient care.
(i) Coordination of medical protocols and
				operating practices with those of the hospital and pre-hospital providers and
				public safety agencies with whom the service will interact;
(j) Ongoing familiarization for those
				ambulance and non-transporting services, public safety agencies, and hospital
				personnel with whom the air ambulance service may interact routinely.
(k) Scene Response Services must
				have ongoing safety communications program consisting of integration with
				Public Safety Answering Points and other emergency dispatch facilities in the
				state.
(l) Procedures for
				acceptance of requests, referrals, and/or denial of service for medically
				related reasons.
(m) Geographical
				boundaries and features for the service area.
(n) Service area maps shall be readily
				available.
(o) Scheduled hours of
				operation.
(p) Criteria for the
				medical conditions and indications or medical contraindications for
				flight.
(q) Field triage criteria
				for all trauma patients that include anatomic, physiologic, and situational
				components identified in order to risk-stratify injury severity and guide
				decisions as to activation, destination, and transport modality.
(r) Procedures for call verification and
				advisories to the requesting party.
(s) Acceptable destinations and landing
				areas.
(t) Procedures for medical
				crew assignments and notification including rosters of medical
				personnel.
(u) Written policy that
				ensures that air medical personnel shall not be assigned or assume cockpit
				duties concurrent with patient care duties and responsibilities.
(v) Communications procedures.
(w) On-ground communications.
(x) Flight cancellation procedures.
(y) Mutual aid procedures.
(z) Written plan that addresses the actions
				to be taken in the event of an emergency or patient crisis during transport
				operations.
(aa) Procedures for
				informing requesting party of flight procedures, anticipated time of helicopter
				arrival, and termination of flight.
(bb) Patient tracking procedures that shall
				assure air/ground position reports at intervals not to exceed ten (10) minutes
				(in flight).
(cc) Scene Response
				Services must have provisions for contemporaneous flight following and during
				all operations and a readily accessible post-accident incident plan as they
				relate to patient care.
(dd)
				Services that respond to incident scenes and/or support disaster response shall
				provide Helicopter Safety and Landing Zone Procedures in a written format to
				all public safety/law enforcement agencies and hospital personnel who interface
				with the medical service that includes but is not limited to the following:
1. The identification, designation and
				preparation of appropriate landing zones
2. Ground personnel safety in and around the
				aircraft
3. Ground to air
				communications
4. Victim recovery
				procedures in the post-crash or unanticipated incident
3. The applicant possesses the
				equipment, required by these Rules for the type of service and level of care
				proposed.
4. The applicant can
				provide personnel required by these Rules for the type of service and level of
				care proposed.
5. An applicant for
				a Scene Response Air Ambulance Service or Restricted Response Air Ambulance
				Service must demonstrate full time dispatch capabilities.
6. The applicant possesses two-way radio
				communications equipment and frequencies for the proposed type of service,
				including, but not limited to the hospital-ambulance frequencies utilized in
				the service area(s) pursuant to these Rules and the designated Maine EMS
				statewide frequency "155.385."
7.
				Applicants for licensure must demonstrate liability coverage for injuries to
				persons and for loss or property damages resulting from negligence by the
				service or medical crew. A license holder should immediately notify Maine EMS
				and cease operations if the coverage required by this section is cancelled or
				suspended. Maine EMS will not issue an air ambulance service license to an air
				ambulance service unless the applicant for a license or the licensee has:
a. Evidence of medical professional liability
				insurance that requires the insurer to compensate for injuries to persons or
				unintentional damage to property.
b. Worker's compensation coverage is required
				as defined by individual state regulating bodies.
8. The applicant meets the quality
				assurance/quality improvement requirements of Chapter 18 of these
				Rules.
9. The applicant has a
				physician medical director who is:
(a)
				Licensed and authorized to practice as a physician in Maine and is board
				certified in a specialty consistent to the mission of the service and actively
				practices in the care and management of critically ill or injured adult and
				pediatric patients;
(b) Experienced
				in both air and ground emergency medical services and is familiar with the
				national consensus criteria of appropriate utilization of air medical and
				ground inter-facility critical care services;
(c) Responsible for supervising and
				evaluating the quality of medical care provided by the medical personnel and
				the program;
(d) Actively involved
				in the selection, training and recurrent education and practice of the flight
				medical crew and has expertise with the flight environment, including flight
				physiology and the management of diseases affected by altitude;
(e) Actively involved in the Quality
				Assurance / Quality Improvement (QA/QI) program for the service, including the
				review of all missions by a qualified physician and in administrative decisions
				affecting medical care provided by the service;
(f) Familiar with Maine EMS Protocols, the
				Maine Trauma System and the capabilities of referring and receiving
				hospitals;
(g) Knowledgeable of the
				capabilities and limitations of the aircraft used in the service;
				and,
(h) Responsible to ensure that
				appropriate aircraft, medical crew and equipment are provided for each mission
				based on a system of preflight patient evaluation for inter-hospital transports
				and an established protocol consistent with types of scene responses
				anticipated if so licensed.
(i) Has
				established a plan for on-line medical direction if needed during
				transport.
10. If the
				application is for a new service or a change of service ownership: the
				applicant, if an individual is of good character, and if a partnership or
				corporation, its partners or principal officers are of good character. Four
				character references, written within the past year, must be submitted as a
				condition of meeting this requirement; none may be from a relative or employee
				of the applicant.
11. If the
				application is for a restricted air ambulance service, the service has either
				(1) guaranteed continuity of care for the patient by entering into written
				agreements with the ambulance services that will transport its patients or (2)
				otherwise addressed these concerns in a plan approved by Maine EMS that
				includes as a component a written agreement of this nature with at least one
				ambulance service.
12. The
				applicant has submitted a quality assurance plan that is subject to Maine EMS
				approval and that includes review of all flights by a qualified physician
				pursuant to these Rules.
13. The
				applicant has established a service level Quality Assurance/Quality Improvement
				Committee (for approval under
				32 M.R.S.
				§92-A ).
14. The applicant has designated a service
				director, who shall act as the point of contact for the service.
15. The applicant has designated a person who
				serves as the training and education point of contact for the service.
16. The applicant demonstrates
				that all medical crew members are appropriately trained and
				qualified.
17. The applicant has
				identified the designated infection control officer for the proposed service.
				Pursuant to
				42 U.S.C. §
												300ff-136, each employer of emergency
				response employees in the State of Maine must have a designated infection
				control officer (ICO) for the purposes of receiving notifications and responses
				and making requests under 42 U.S.C. Chapter 6A, Subchapter XXIV, Part G. The
				licensee shall provide the ICO name and contact information to Maine EMS, and
				promptly notify Maine EMS of any changes in ICO during the term of its license.
				Maine EMS will provide this information to the Department of Health and Human
				Services, Maine Center for Disease Control, Division of Infectious
				Disease.
18. The applicant complies
				with the drugs and medication requirements in Chapter 6 of these Rules.