Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 173.000 - Mobile Integrated Health Care and Community Ems Programs › Section 173.020 - Definitions

Current through Register 1525, July 5, 2024
As used in
				105 CMR 173.000, the
				following definitions shall apply unless the context requires otherwise:
911 EMS Patient
. An individual who has
				activated a Primary Ambulance Response by dialing the emergency telephone
				access number 911, or its local equivalent.
Ambulance Service
. An entity licensed
				by the Department pursuant to
				105 CMR 170.000:
Emergency Medical Services System
to provide emergency medical
				services.
Applicant
. A Community EMS Applicant
				or an MIH Applicant as further defined.
Authorization to Practice
. The
				approval granted to EMS Personnel by the medical director of the MIH or
				Community EMS Program approved by the Department pursuant to
				105 CMR 173.000.
Certificate of Approval
. Written
				approval to operate an MIH or Community EMS Program pursuant to
				105 CMR 173.000, subject to
				all terms and conditions contained in the Certificate of Approval.
Commissioner
. The Commissioner of
				Public Health or his or her designee.
Community EMS Applicant
. A local
				public health authority seeking an initial Certificate of Approval or renewal
				thereof to operate a Community EMS Program in partnership with the local
				jurisdiction's designated primary ambulance service.
Community EMS Program
. A program
				operated by the local public health authority and developed in coordination
				with the local jurisdiction's designated primary ambulance service(s) and which
				utilizes the primary ambulance service's EMS Personnel to provide community
				outreach and assistance in order to advance illness or injury prevention within
				the local jurisdiction(s) in accordance with
				105 CMR
				173.060. The Community EMS Program shall be
				approved by the local jurisdiction, in the manner required by such
				jurisdiction, and the ambulance service's affiliate hospital medical
				director.
Community Paramedic
. A person
				who:
(1) is certified as a paramedic pursuant to M.G.L. c 111C and
				105 CMR 170.000:
Emergency Medical Services System
;
(2) has successfully completed an education program developed
				or selected by the medical director of the MIH Program for which the community
				paramedic is employed, as well as any additional training required by
				Department guidelines; and
(3) is dispatched by an MIH Program to provide services or
				treatment to a patient within his or her scope of practice in accordance with
				Department-issued Statewide Treatment Protocols and clinical protocols of the
				program.
Department
. The Department of Public
				Health, pursuant to M.G.L. c. 17, § 1.
Duplication of Services
. A proposed
				service which does not address a gap in service delivery, pursuant to
				105 CMR
				173.040(A).
ED Avoidance
. A component of an MIH
				Program pursuant to 173.050 that includes the applicable local
				jurisdiction(s)'s designated primaryambulance service(s) and, following primary
				ambulance response, assessment and consultation with on-line medical direction,
				utilizes paramedics with advanced training to manage the patient as an MIH
				patient in accordance with the provisions of
				105 CMR 173.100(A)
				 and Department guidelines.
EmergencyMedical Technician (EMT)
. An
				EMT-Basic, Advanced EMT or Paramedic certified by the Department pursuant to
				105 CMR 170.000:
Emergency Medical Services System
.
EmergencyService Program (ESP)
. A
				designated program under the direction of the Department of Mental Health and
				MassHealth Office of Behavioral Health that provides behavioral health crisis
				assessment, intervention and stabilization services through four service
				components:
(1) Mobile Crisis Intervention (MCI) services for youth;
(2) adult mobile services;
(3) ESP community based locations;
(4) and community crisis stabilization (CCS) services for 18
				years of age and older.
EMS. Emergency medical services, as defined in
				105 CMR 170.000:
Emergency Medical Services System
.
EMS First Responder (EFR)
. A person
				certified pursuant to
				105 CMR 170.000:
Emergency Medical Services System
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 at the first responder level.
EMS First Response Service (EFR
				Service)
. An entity licensed by the Department pursuant to
				105 CMR 170.000:
Emergency Medical Services System
to provide rapid response
				and EMS.
EMS Personnel
. EFRs and EMTs.
Entity or Person
. An individual or his
				or her estate upon his or her death, or a corporation, a government agency, a
				partnership, a 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.
Health Care Entity
. A health care
				facility, health care provider, local public health authority, provider
				organization, carrier, or any combination thereof, including, but not limited
				to, an ambulance service licensed under M.G.L. c. 111C, a visiting nurse
				association, an accountable care organization, or a home health agency.
Health Care Facility
. A licensed
				institution providing health care services or a health care setting, including,
				but not limited to, hospitals and other licensed inpatient centers, ambulatory,
				surgical or treatment centers, skilled nursing centers, residential treatment
				centers, diagnostic, laboratory and imaging centers, and rehabilitation and
				other therapeutic health settings.
Health Care Personnel or Personnel
. An
				individual or individuals employed by or affiliated with a health care
				provider, who provide direct patient care. Health Care Personnel may include,
				but not be limited to, CommunityParamedics, EMS Personnel, EMS First
				Responders, nurses, Nurse Practitioners, Physician Assistants, or social
				workers.
Health Care Provider
. A provider of
				medical, behavioral or health services or any other person or organization that
				furnishes bills or is paid for health care services delivery in the normal
				course of business.
Injury
. Harm that results in
				exacerbation, complication or other deterioration of a patient's
				condition.
Local Jurisdiction
. A city or town or
				multiple cities or towns.
Local Public Health Authority
. The
				appropriate and legally designated health authority of the city, town, or other
				legally constituted governmental unit within the Commonwealth having the usual
				powers and duties of the board of health or health department of a city or
				town.
Medical Control
. The clinical
				oversight provided by a physician or existing primary care provider to all
				components of the MIH Program, including, but not limited to, medical
				direction, training, scope of practice and authorization to practice of EMS
				Personnel, which may include community paramedics, continuous quality assurance
				and improvement and clinical protocols.
Medical Direction
. The authorization
				for treatment provided by a physician or existing primary care provider in
				accordance with clinical protocols, whether on-line through direct
				communication or telecommunication, or off-line through standing orders.
Medical Director
. The physician or
				physicians appropriately trained to meet the unique social/cultural,
				linguistic, medical and population health needs of an MIH Program's patient
				population and designated by the MIH Program to carry out any supervisory
				medical control responsibilities for the MIH Program.
MIH Applicant
. A health care entity or
				entities seeking an initial Certificate of Approval or renewal thereof to
				operate an MIH Program.
MIH Patient
. An individual identified
				by a health care entity as warranting MIH Program services.
Mobile Integrated Health Care Program (MIH
				Program)
. A Department-approved program, including MIH Programs
				with an ED Avoidance Component, that utilizes EMS Personnel, which may include
				community paramedics to deliver healthcare services to patients in an
				out-ofhospital environment in coordination with health care facilities or other
				health care providers, which may include, but not be limited to, primary care
				providers, home care agencies, visiting nurse associations, or other in-home
				services; provided, that the medical care and services may include, but not be
				limited to, chronic disease management, behavioral health, preventative care,
				post-discharge follow-up visits, or transport or referral to facilities other
				than hospital emergency departments.
Nurse Practitioner
. A licensed
				registered nurse authorized by the Massachusetts Board of Registration in
				Nursing to practice in the Commonwealth of Massachusetts as an Advanced
				Practice Registered Nurse pursuant to
				244 CMR 4.00:
Advanced
				Practice Registered Nursing
and whose scope of practice includes the
				provision of primary care services.
Physician
. A physician duly licensed
				to practice medicine in the Commonwealth of Massachusetts by the Massachusetts
				Board of Registration in Medicine, pursuant to M.G.L. c. 112, § 2 and 243
				CMR:
Board of Registration in Medicine
.
Physician Assistant
. A person who is
				registered pursuant to 263 CMR:
Board of Registration of Physician
				Assistants
and who may provide medical services appropriate to his or
				her training, experience and skills under the supervision of a registered
				physician.
Primary Ambulance Response
. First-line
				ambulance response, pre-hospital treatment and, if applicable, transportation
				by an ambulance service designated as a service zone provider or recognized in
				a service zone plan to provide first-line ambulance response, pre-hospital
				treatment and transportation pursuant to a provider contract.
Primary Ambulance Service
. The
				business or regular activity, whether for profit or not, by an ambulance
				service licensed pursuant to
				105 CMR 170.000:
Emergency Medical Services System
, 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.
PrimaryCare Provider
. A physician,
				physician assistant or nurse practitioner qualified to provide general medical
				care who:
(1) supervises, coordinates, prescribes, or otherwise provides
				or proposes health care services;
(2) initiates referrals for specialist care; and
(3) maintains continuity of care within the scope of practice.
Provider Organization
. Any
				corporation, partnership, business trust, association or organized group of
				persons, which is in the business of health care delivery or management,
				whether incorporated or not, that represents one or more health care providers
				in contracting with carriers or third-party administrators for the payment of
				health care services; provided that the definition shall include, but not be
				limited to, physician organizations, physician-hospital organizations,
				independent practice associations, provider networks, accountable care
				organizations, and any other organization that contracts with carriers or
				third-partyadministrators for payment for health care services.
Scope of Practice
. The clinical skills
				or functions that:
(1) are defined by applicable state laws and regulations
				governing certification, licensure or registration of each individual providing
				services or treatment in the MIH or Community EMS Program approved by the
				Department pursuant to
				105 CMR 173.000; and
(2) the clinical protocols developed by such programs.
Serious Incident
. An incident that
				results in injury to a patient not ordinarily expected as a result of the
				patient's condition.