Section 170.330 - Written Policies and Procedures for Services(A) Each ambulance service shall have written policies and procedures consistent with 105 CMR 170.000, the accepted standards of care for EMTs and applicable laws. These policies shall set out guidelines for operating and maintaining the service and ambulances, and shall be provided to EMTs. These policies shall be comprehensive, reflect current day-to-day operations, and address at minimum the following:(1) Certification and recertification of EMTs;(2) Orientation of all ambulance service employees;(3) Responsibility to dispatch, treat and transport in accordance with 105 CMR 170.355;(4) Duties of transportation and policies relating to delivery of patients to appropriate health care facilities in accordance with 105 CMR 170.020;(6) Backup services including provisions for when such services are to be used and timely dispatch in accordance with standards set out in the applicable Department-approved service zone plan, to backup services when needed;(7) Arrangements for securing additional EMS personnel at appropriate certification levels, in order to staff ambulances in accordance with 105 CMR 170.305;(10) Stocking of supplies;(11) Use of lights and warning signals;(12) Staffing of ambulances;(13) Conduct of personnel;(14) Acquisition, security and disposal of controlled substances and other drugs, in accordance with 105 CMR 700.000: Implementation of M.G.L. c. 94C;(15) Maintenance of biomedical equipment and devices according to manufacturers' recommendations;(16) Ensuring timely leaving/transmission of patient care reports at receiving hospitals;(17) Arrangements for securing additional appropriately trained personnel to assist EMTs, whether in providing ALS services in accordance with 105 CMR 170.305(C) or for other purposes;(18) For ALS services, the hours during which ALS service will be provided, if the service is not yet operating 24 hours per day, seven days per week, in accordance with 105 CMR 170.385(C);(19) For ALS-Paramedic services that staff with one paramedic and one other certified EMT, all policies required by 105 CMR 170.305(C)(2);(20) Mechanical failures;(21) Inspection authorities;(22) Infection control procedures including designated infection control officer;(23) Compliance with the Statewide Treatment Protocols;(24) Training and skill competency assurance of EMS personnel for new or updated equipment; changes and updates to 105 CMR 170.000, the Statewide Treatment Protocols; administrative requirements, advisories and memoranda issued by the Department; and as otherwise required by any provision of 105 CMR 170.000 or the Statewide Treatment Protocols;(25) Rights of parents of patients who are minors, including the right to accompany the patient in the ambulance in accordance with M.G.L. c. 111C, § 17;(27) EMT use of patient restraints in accordance with 105 CMR 170.373 and the Statewide Treatment Protocols;(28) Sanitary practices; and(29) Disposal of hazardous waste.(B) Each EFR service shall have written policies and procedures consistent with 105 CMR 170.000 and 105 CMR 171.000: Massachusetts First Responder Training, the accepted standards of care for EMTs and EFRs and applicable laws. The policies shall establish guidelines for operating and maintaining the EFR service and shall be made available to all EMTs and EFRs working for or with the service. These policies shall address the following: (1) Certification and recertification of EMTs;(2) Orientation of all EMTs and EFRs;(3) Service's responsibility for its EFRs meeting certification and recertification requirements;(4) Transfer of patient care and patient care information from the EFR service to the transporting ambulance service;(7) Stocking of supplies;(8) Conduct of EMS personnel;(9) EMS inspection authorities;(10) Infection control procedures;(11) EMT compliance with the Statewide Treatment Protocols;(12) Maintenance of biomedical equipment and devices according to manufacturers' recommendations; and(13) Use of visible and audible warning signals.(C) In addition to the policies and procedures required under 105 CMR 170.330(A), each service licensed at the critical care services level must maintain comprehensive critical care services policies, procedures, protocols and standing orders for patient care, as required by CAMTS or an accreditation program the Department approves as substantially equivalent to CAMTS. All clinical policies, procedures, protocols and standing orders must be: (1) Developed in conjunction with, and approved by, the affiliate hospital medical director providing oversight for the critical care services provided by the service;(2) Reviewed and updated as appropriate, with at minimum an annual review and approval of the affiliate hospital medical director, and(3) Submitted to the Department on an annual basis.(D) Standards for the contents of the procedures and policies are established separately by the Department as administrative requirements.Amended, Mass Register Issue 1257, eff. 3/28/2014.Amended by Mass Register Issue 1486, eff. 1/6/2023.