Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 170.000 - Emergency Medical Services System › Section 170.020 - Definitions

Current through Register 1525, July 5, 2024
The definitions set forth in
				105
				CMR 170.020 shall apply for the purpose of
				105 CMR
				170.000, unless the context or subject matter clearly
				requires a different interpretation.
Accreditation
means the process by
				which a certificate is issued by the Department pursuant to
				105
				CMR 170.946 through
				170.950 indicating that the
				holder has met the requirements for providing Department-approved training for
				EMTs and EMT-candidates.
Administrative Requirements (A/R)
means requirements issued by the Department's Office of Emergency Medical
				Services to interpret, clarify and further define the application of certain
				provisions of
				105 CMR
				170.000.
Advanced EMT
means the level of EMS
				personnel that has replaced "EMT-Intermediate" as set forth, at a minimum, in
				the U.S. Department of Transportation's National Highway Traffic Safety
				Administration's
National EMS Scope of Practice Model
and as
				used in its
National EMS Education Standards
. The Advanced
				EMT's clinical practice is defined by the Statewide Treatment Protocols.
Advanced Life Support (ALS)
means the
				pre-hospital use of medical techniques and skills defined by the Statewide
				Treatment Protocols by Paramedics and Advanced EMTs certified pursuant to
				105 CMR
				170.000.
Ambulance
means any aircraft, boat,
				motor vehicle, or any other means of transportation, however named, whether
				privately or publicly owned, which is intended to be used for, and is
				maintained and operated for, the response to and the transportation of sick or
				injured individuals.
Ambulance Service
means the business
				or regular activity, whether for profit or not, of providing emergency medical
				services, emergency response, primary ambulance response, pre-hospital
				emergency care, with or without transportation, to sick or injured individuals
				by ambulance.
Appropriate Health Care Facility
means
				an emergency department, either physically located within an acute care
				hospital licensed by the Department pursuant to
				105 CMR
				130.000:
Hospital Licensure
to
				provide emergency services, or in a satellite emergency facility approved by
				the Department pursuant to
				105
				CMR 130.821:
Approval for Satellite
				Emergency Facility
, that is closest by transport time or conforms to a
				Department-approved point-of-entry plan. EMS personnel may, upon the direction
				of an emergency department physician, take incoming ambulance patients to one
				of the following other hospital departments, based on the patient's medical
				needs: labor and delivery, cardiac catheterization, operating room,
				interventional neurology, intensive care unit, pediatric emergency department
				area, burn resuscitation and treatment area or acute resuscitation area. An
				appropriate health care facility also means a facility that meets the
				definition of a community behavioral health center (CBHC) established by the
				Executive Office of Health and Human Services that is closest by transport
				time, but only as set out in a Department-approved point-of-entry plan and only
				for those patients who fit triage criteria set out in a Department-approved
				point-of-entry plan.
Authorization to Practice
means
				approval granted to an EMT by his or her employing EMS service's affiliate
				hospital medical director, which enables that EMT to work as an EMT and receive
				medical control pursuant to the employing service's affiliation agreement and
				in conformance with the Statewide Treatment Protocols.
Basic Life Support (BLS)
means the
				pre-hospital use of techniques and skills defined by the Statewide Treatment
				Protocols by EMT-Basics certified pursuant to
				105 CMR
				170.000.
Certificate of Inspection
means the
				formal certification, issued pursuant to
				105
				CMR 170.415, that the EMS vehicle meets the
				standards applicable to its type or class of vehicle.
Certification of EMTs
means a process
				by which a certificate is issued by the Department indicating that the holder
				has met the requirements for an EMT at a specified level of training
				established by the Department.
Chief Examiner
means a person
				appointed by the Department who is responsible for the organization and
				operation of a Department-approved EMT examination at a specific site.
CMED
means the medical communications
				subsystem within the statewide EMS communications system.
Code Black Status System
means a
				secure cloud-based system established by the Department to allow hospitals and
				CMED centers access to real-time information regarding the code black status of
				all appropriate health care facilities in Massachusetts licensed to provide
				emergency services.
Commission on Accreditation of Allied Health
				Education Programs (CAAHEP)
means the national accrediting
				organization for educational programs in allied health professions, which
				reviews and accredits EMS programs in collaboration with its Committee on
				Accreditation of Educational Programs for the Emergency Medical Services
				Professions (CoAEMSP).
Commission on Accreditation of Medical Transport
				Systems (CAMTS)
means the national accrediting organization for
				air medical and ground transport systems providing critical care
				services.
Commissioner
means the Commissioner of
				Public Health.
Company
means a corporation, a
				partnership, a business trust, an association, or an organized group of
				persons, whether incorporated or not; or any receiver, trustee, or other
				liquidating agent of any of the foregoing while acting in such capacity.
Critical Care Services
means the
				provision by an ambulance service of prehospital or interfacility patient care,
				stabilization, and transport services to critically ill and injured patients,
				using medical techniques, pharmacology, and technological life support systems
				that exceed those in the Statewide Treatment Protocols, including the ALS
				Interfacility Transfer Protocol, and as set out by the ambulance service and
				approved by the Department.
Continuing Education
means
				instructional courses for certified EMS personnel to meet training requirements
				for maintenance of certification.
Department
means the Department of
				Public Health.
Emergency
means a condition or
				situation in which an individual has a need for immediate medical attention, or
				where the potential for such need is perceived by the individual, a bystander
				or an emergency medical services provider.
Emergency Medical Services (EMS)
means
				the pre-hospital assessment, treatment and other services utilized in
				responding to an emergency or provided during the emergency or interfacility
				transport of patients to appropriate health care facilities.
EMS First Responder (EFR)
means a
				person certified pursuant to
				105 CMR
				170.000 who has, at a minimum, successfully completed
				a course in emergency medical care approved by the Department pursuant to
				M.G.L. c. 111, § 201 and
				105 CMR
				171.000:
Massachusetts First Responder
				Training
and who provides emergency medical care through employment by
				or in association with a licensed EFR service.
EMS First Response
means the dispatch
				and response by the closest, most appropriate EMS personnel or EMS vehicle in
				the shortest practicable amount of time by a qualified EMS first response
				service.
EMS First Response Service (EFR
				Service)
means the business or regular activity, whether for
				profit or not, by a licensed EMS provider, designated as a service zone
				provider pursuant to a Department-approved service zone plan for the purpose of
				providing rapid response and EMS.
EMS First Response Vehicle (EFR
				Vehicle)
means any aircraft, boat, motor vehicle or any other
				means of transportation, whether privately or publicly owned, that is intended
				and is maintained and operated for the rapid response of EMS personnel,
				equipment and supplies to emergencies by an EFR service or by an ambulance
				service and is not utilized for patient transport.
EMS Personnel
means EFRs and
				EMTs.
EMS Plan
means a plan that includes an
				inventory and assessment of EMS resources and a plan for the optimal
				maintenance, coordination and utilization of those resources:
(1) to improve the EMS system and its
			 component elements; and
(2) to
			 coordinate with all state and municipal public safety agencies' mass casualty
			 and other public emergency plans.
EMS Provider
means the
				following:
(1) an EFR service, an
			 ambulance service, or a hospital or facility approved by the Department to
			 provide EMS including, without limitation, a trauma center, or
(2) any individual associated with an EFR
			 service, an ambulance service, or a hospital or facility approved by the
			 Department to provide EMS, who is engaged in providing EMS. Such individuals
			 include, without limitation, an EMT, an EFR, a medical communications system
			 operator and a medical control physician, to the extent such physician provides
			 EMS.
EMS System
means all EMS providers and
				equipment; communications systems linking them to each other; training and
				education programs; the Regional EMS Councils and all of their operations; EMS
				plans, protocols, statutes, regulations, administrative requirements and
				guidelines; and all other components of such system, and their interaction with
				each other and with patients, providing equally for all patients quality care,
				operating under the leadership and direction of the Department.
EMS Vehicle
means an ambulance or an
				EMS first response vehicle.
Emergency Medical Technician (EMT)
means a person who has successfully completed a full course in emergency
				medical care approved by the Department, and who is certified by the Department
				in accordance with
				105 CMR
				170.000 to provide emergency medical services to sick
				or injured persons in accordance with the Statewide Treatment Protocols. The
				term EMT shall include EMT-Basic, Advanced EMT, and Paramedic.
Emergency Response
means the dispatch
				and response of the closest appropriate ambulance, EMS personnel and other EMS
				vehicle to an emergency in the shortest practicable amount of time in
				conformance with the service zone plan.
EMT-Basic
means the level "Emergency
				Medical Technician," or "EMT" as set forth, at a minimum, in the U.S.
				Department of Transportation's National Highway Traffic Safety Administration's
National EMS Scope of Practice Model
and as used in its
National EMS Education Standards
. The term also includes
				EMT-Basics who are taking the supplemental training required to meet the EMT
				level of the
National EMS Scope of Practice Model
, in
				accordance with administrative requirements of the Department. The EMT-Basic's
				clinical practice is defined by the Statewide Treatment Protocols.
First Responder
means a member of any
				of the following entities: a police or fire department; state police
				participating in highway patrol; an emergency reserve unit of a volunteer fire
				department or fire protection district, and any persons appointed permanent or
				temporary lifeguards by the Commonwealth or any of its political subdivisions.
				A first responder shall not mean a police officer, firefighter or person
				engaged in police and fire work whose duties are primarily clerical or
				administrative. First responders are required to successfully complete, at a
				minimum, the course of emergency medical care that meets the standards of
				M.G.L. c. 111, § 201 and
				105 CMR
				171.000:
Massachusetts First Responder
				Training
.
First Responder Agency
means a police
				department, a fire department, the state police participating in highway
				patrol, an emergency reserve unit of a volunteer fire department or fire
				protection district, or the Commonwealth or any of its political subdivisions
				that appoints permanent or temporary lifeguards. A first responder agency shall
				not mean a service that is a licensed EFR service.
Headquarters
means the principal place
				of business of an Ambulance or EFR service.
Hospital
means a hospital that is
				licensed or certified by the Department pursuant to M.G.L. c. 111, § 51 or
				other applicable law, with an emergency department, and which is established or
				maintained for the purpose of caring for persons admitted thereto for
				diagnosis, medical, surgical or restorative treatment which is rendered within
				said institution
Immediate Dispatch
means dispatching,
				or toning out or calling for an ambulance, to be sent out, without any delay,
				when a call to respond to an emergency is received. Immediate dispatch includes
				the toning out for on-call or volunteer personnel to respond to and staff an
				ambulance.
Initial Training
means an educational
				program that meets or exceeds the current U.S. Department of Transportation's
National EMS Education Standards and Instructional Guidelines for
				EMT-Basic, Advanced EMT or Paramedic
, and any additional standards
				established by the Department, and consists of didactic, clinical and field
				training, to prepare students to become certified EMTs at the applicable level
				of care.
Instructor/Coordinator (I/C)
means a
				person approved by the Department to organize and teach the EMT-Basic or
				Advanced EMT course.
License
means an authorization to
				provide ambulance or EMS first response service, pursuant to the provisions of
				105 CMR
				170.000.
Local Jurisdiction
means an entity
				empowered by the legislative body within a city, town, fire district or water
				district to select service zone providers including, but not limited to, a city
				council, board of selectmen, board of aldermen, mayor or town manager.
Massachusetts Emergency Medical Care Advisory Board
				(EMCAB)
means the EMS System Advisory Board established under
				M.G.L. c. 111C, § 13.
Medical Control
means the clinical
				oversight by a qualified physician to all components of the EMS system
				including, without limitation, the Statewide Treatment Protocols, medical
				direction, training of and authorization to practice for EMS personnel, quality
				assurance and continuous quality improvement.
Medical Direction
means the
				authorization for treatment established in the Statewide Treatment Protocols
				provided by a qualified medical control physician to EMS personnel, whether
				on-line,
via
direct communication or telecommunication, or
				off-line,
via
standing orders.
National Registry of Emergency Medical Technicians
				(NREMT)
means the national organization that tests and provides
				NREMT certification to EMTs at all levels, on the basis of which EMTs apply to
				states for state certification or licensure to work as an EMT.
Paramedic
means the level of EMS
				personnel that has replaced "EMT-paramedic" as set forth, at a minimum, in the
				U.S. Department of Transportation's
National Highway Traffic Safety
				Administration S National EMS Scope of Practice Model
and as used in
				its
National EMS Education Standards
. The Paramedic's clinical
				practice is defined by the Statewide Treatment Protocols.
Patient
means an individual who is
				sick or injured and requires EMS and/or transportation in an ambulance.
Patient Care Report
means a report or
				other written record, such as a dispatch record, generated by all services to
				document every response to an EMS call including each time an EMS vehicle is
				dispatched, whether or not a patient is encountered or ultimately transported
				by an ambulance service.
Person
means an individual, a company,
				or an entity or an agency or political subdivision of the Commonwealth.
Place of Business
means the locations
				owned, leased or used pursuant to an agreement by an EMS provider for EMS
				purposes including headquarters, branch offices and garages.
Point-of-entry Plan
means a plan that
				is designed to ensure that EMTs transport a patient(s) in their care to the
				closest appropriate health care facility.
Primary Ambulance Response
means
				first-line ambulance response, pre-hospital treatment and transportation by an
				ambulance service designated as a service zone provider or recognized in the
				service zone plan to provide first-line ambulance response, pre-hospital
				treatment and transportation pursuant to a provider contract.
Primary Ambulance Service
means the
				business or regular activity, whether for profit or not, by a licensed
				ambulance service, designated under a service zone plan for the purpose of
				providing rapid response and pre-hospital EMS including, without limitation,
				patient assessment, patient treatment, patient preparation for transport and
				patient transport to appropriate health care facilities, in conformance with
				the service zone plan.
Professional Boundaries
means the
				limits of the professional relationship to ensure a safe interface between a
				professional, such as EMS personnel, EMS training providers and EMS Examiners
				and Chief Examiners, and their respective patients, candidates or students. A
				violation of Professional Boundaries includes an action that is harmful to or
				exploitative of the patient, student or, candidate and can be either sexual or
				nonsexual in nature.
Provider Contract
means an agreement,
				written or verbal, with an ambulance service to provide primary ambulance
				response to facilities with health care professionals on site, or to special
				events or functions with a dedicated ambulance on site. This definition shall
				not preclude any other category of provider contract that is recognized by the
				local jurisdiction in the service zone plan.
Recertification Year
means April
				1st of one calendar year through March
				31st of the next calendar year.
Region
means a geographic area of the
				state defined by the Department as an EMS planning area.
Regional EMS Council
means an entity
				created pursuant to M.G.L. c. 111C, § 4 and designated by the Department
				to assist the Department in coordinating, maintaining and improving the EMS
				system in a region.
Regular Operating Area
means any local
				jurisdiction or part thereof in which the ambulance service:
(1) is the designated primary ambulance
			 service;
(2) has an agreement with
			 the primary ambulance service;
(3)
			 has an agreement to provide backup service;
(4) has a provider contract; or
(5) has a base location.
Service
means an EFR service or an
				ambulance service.
Service Zone
means a geographic area
				defined by and comprised of one or more local jurisdictions, in which a local
				jurisdiction may select, and the Department shall designate, an EFR service and
				an ambulance service to provide EMS first response and primary ambulance
				response to the public within that defined geographic area, pursuant to M.G.L.
				c. 111C, § 10.
Service Zone Provider
means an EMS
				provider, selected by a local jurisdiction and designated by the Department to
				provide primary ambulance service or EMS first response, or both, to the public
				within a service zone. A service zone provider shall be staffed and equipped to
				be available for primary ambulance service or EMS first response 24 hours per
				day, seven days per week.
Special Population
means any person or
				group of persons with unique medical, physical or social problems that require
				other than customary emergency medical care.
Statewide Treatment Protocols
means
				the Emergency Medical Services Pre-hospital Treatment Protocols approved by the
				Department for application statewide.
Trained to the First Responder Level
means successful completion, at a minimum, of the course of emergency medical
				care that meets the standards of M.G.L. c. 111, § 201 and
				105 CMR
				171.000:
Massachusetts First Responder
				Training
.
Training Institution
means a school or
				other entity that offers initial training and/or continuing education, and
				refers to such school or other organization only with regard to its provision
				of EMS training programs.
Training Program
means an EMS
				instructional course, offered either as initial training, or continuing
				education.
Transportation
means the conveyence of
				a patient by ambulance because of medical necessity or extenuating
				circumstances to prevent significant aggravation or deterioration of the
				patient's condition, or because the condition of the patient is unknown and
				could reasonably be suspected to warrant the use of an ambulance, or because
				the patient could not be moved by any other means.
Trauma
means tissue injury due to the
				direct effects of externally applied mechanical, thermal, electrical,
				electromagnetic or nuclear energy, as further defined in the Statewide
				Treatment Protocols. Trauma shall not mean toxic ingestion, poisoning or
				foreign body ingestion.
Unique Population
means the population
				of a state institution, an industrial plant or a
				university.