6 Colo. Code Regs. § 1015-3-4-2

Current through Register Vol. 47, No. 11, June 10, 2024

Section 6 CCR 1015-3-4-2 - Definitions

2.1 Administrator: For purposes of these rules, the term "administrator" means a person who the ambulance service identifies to operate the ambulance service and designates to be responsible for the day-to-day operations of a licensed ambulance service.

2.2 Advanced Life Support (ALS): Means the provision of care by EMS providers who are licensed or certified as an Advanced EMT, EMT-Intermediate or Paramedic by the Department in an ambulance that is staffed and equipped with appropriate oversight to provide ALS services pursuant to Sections 12 and 13 of these rules.

2.3 Ambulance: Any licensed ground vehicle especially constructed or modified and equipped, intended to be used and maintained or operated by, ambulance services for the transportation, upon the streets and highways of this state, of individuals who are sick, injured, or otherwise incapacitated or helpless.

2.4 Ambulance Service: The furnishing, operating, conducting, maintaining, advertising, or otherwise engaging in or professing to be engaged in the transportation of patients by ambulance. Taken in context, it also means the person so engaged or professing to be so engaged.

2.5 Ambulance Service License: A legal document issued to an ambulance service by the Department to an applicant that meets the requirements for licensure to operate an ambulance service as defined by these rules.

2.6 Authorization to Operate or Authorized to Operate as set forth in Section 16 of these rules: A local authorizing authority's approval of or act of approving an ambulance service to operate within the jurisdiction of the local authorizing authority. Licensed ambulance services are authorized to operate in a county or city-and-county if the local authorizing authority opts out of participating in the issuance of authorizations to operate an ambulance service.

2.7 Basic Life Support (BLS): Means the provision of care by EMS providers who are licensed or certified as an emergency medical technician (EMT) by the Department in an ambulance that is staffed and equipped with appropriate oversight to provide BLS services pursuant to Sections 12 and 13 of these rules.

2.8 Behavioral Health: As used in these rules, refers to an individual's mental and emotional well-being and actions that affect an individual's overall wellness. Behavioral health issues and disorders include substance use disorders, mental health disorders, serious psychological distress, serious mental disturbance, and suicide and range from unhealthy stress or subclinical conditions to diagnosable and treatable diseases.

2.9 Contractor: Means a worker, under contract, who provides transport, treatment, or operational services for the ambulance service for an hourly fee or on a per project basis. For purposes of these rules, "contractor" does not include external business entities such as corporations, partnerships, and limited liability corporations that ambulance services hire in the course of business to provide independent professional services.

2.10 Department: The Colorado Department of Public Health and Environment.

2.11 EMS Medical Director (hereinafter referred to as "medical director"): For purposes of these rules, means a physician licensed in Colorado and in good standing who authorizes and directs, through medical protocols, guidelines, or standing orders, EMS providers of an ambulance service or the performance of students-in-training enrolled in Department-recognized EMS education programs, graduate AEMTs, or graduate Paramedics, and who is specifically identified as being responsible to assure the competency of the performance of those acts by such EMS providers as described in the physician's quality assurance program.

2.12 EMS Compact: means the multi-state privilege to practice for EMS personnel established by the Recognition of EMS Personnel Licensure Interstate Compact (REPLICA) in Section 24-60-3502, C.R.S.

2.13 Facility: For the purpose of these rules, means any entity required to be licensed by the Department pursuant to Section 25-1.5-103(1)(a)(I)(A), C.R.S. A facility also includes a licensed behavioral health entity.

2.14 Inspection: An assessment by the Department of the ground ambulance service's compliance with all applicable statutes and regulations governing licensed ambulance services. An inspection may include an onsite inspection of the service's medical equipment and ambulances to assure compliance with these rules and to protect the public health and safety.

2.15 Interfacility Transport: For purposes of these rules, means the movement of a patient from one licensed health-care facility to another licensed health-care facility.

2.16 License Application Review: Upon application for initial licensure, licensure renewal, or change of ownership, the Department's assessment of the applicant ground ambulance service's ability to meet the requirements for licensure as set forth in these rules.

2.17 Licensee: The person, entity, or agency that is granted a license to operate a ground ambulance service and that bears legal responsibility for compliance with all applicable federal and state statutes and regulations. For purposes of this chapter, the term licensee is synonymous with the term "owner or operator." If an entity is the licensee, it must provide the Department with the name of the executive in charge of the overall management of the licensee-private entity's service area(s) whose ultimate responsibility includes the licensee-private entity's compliance with all applicable federal and state statutes and regulations.

2.18 Local Licensing Authority: Referred to as "local authorizing authority" in these rules, means the governing body of a city-and-county or the board of county commissioners in a county in the state that authorizes state-licensed ambulance services to operate on a regular basis within the jurisdiction.

2.19 Medical Direction: As used in these rules, medical direction has the same meaning as set forth in Section 25-3.5-103 (8.8), C.R.S., and Section 2.32 of 6 CCR 1015-3, Chapter Two.

2.20 Medical Protocol: A written standard or guideline for patient medical assessment and management, approved and authorized by the ambulance service's medical director.

2.21 Operate on a Regular Basis: A patient transport from a point originating in a county or city-and-county that satisfies one or more of the conditions specified in Section 16.2.1.

2.22 Owner or Operator: Means the person, entity, or agency in whose name the license is issued. For the purposes of this chapter,an owner or operator may also serve as the administrator of a licensed ground ambulance service if qualified, as required by these rules.

2.22.1 If the license is issued in the name of a private entity that is owned by one (1) or more individuals, the owner or operator means the person or persons who have a direct or indirect ownership interest in the private entity and who bears legal responsibility for compliance with all applicable federal and state statutes and regulations.

2.22.2 If the license is issued in the name of a private entity that is owned by domestic and/or foreign entities as defined in Sections 7-90-102(13) & (23), C.R.S., the owner or operator means the executive in charge of the overall management of the private entity's service area(s) whom the private entity has designated as bearing ultimate responsibility for the private entity's compliance with all applicable federal and state statutes and regulations.

2.22.3 If the license is issued in the name of a governmental agency, including special districts, the owner or operator means the individual who is appointed, elected, or employed to direct and oversee the overall day-to-day management of the ambulance service and who bears legal responsibility for compliance with all applicable federal and state statutes and regulations.

2.23 Patient Care Report: For purposes of these rules, "patient care report" is the documentation of interactions with and of services performed for the patient by, the ambulance service. Patient care reports include the data as required in 6 CCR 1015-3, Chapter Three - Rules Pertaining to Emergency Medical Services Data and Information Collection and Record Keeping.

2.24 Permit: The authorization issued by the Department with respect to an ambulance used or to be used to provide ambulance service in the state.

2.25 Prehospital Setting: Means one of the following settings in which an emergency medical service provider performs patient care, which care is subject to medical direction by a medical director:

2.25.1 At the site of an emergency;

2.25.2 During emergency transport; or

2.25.3 During interfacility transport.

2.26 Quality Assurance Program: For purposes of these rules, a quality assurance program means a process undertaken by the ambulance service medical director consistent with the Rules Pertaining to EMS Practice and Medical Director Oversight at 6 CCR 1015-3, Chapter Two, used to objectively, systematically, and continuously monitor, assess, and improve the quality and appropriateness of care provided by the EMS providers operating on an ambulance service. For purposes of these rules, a quality management program, as defined in Section 25-3.5-903(4), C.R.S., also constitutes a quality assurance program.

2.27 Regional Emergency Medical and Trauma Services Advisory Council (RETAC) - The representative body appointed by the governing bodies of counties or cities-and-counties for the purpose of providing recommendations concerning regional area emergency medical and trauma service plans for such counties or cities and counties.

2.28 Rescue Unit: Means any organized group chartered by this state as a corporation, not for profit, or otherwise existing as a nonprofit organization whose purpose is the search for and the rescue of lost or injured persons and includes, but is not limited to, such groups as search and rescue, mountain rescue, ski patrols (either volunteer or professional), law enforcement posses, civil defense units, or other organizations of governmental designation responsible for search and rescue.

2.29 Reserve Ambulance: Means a permitted ambulance that is not currently used by an ambulance service to provide patient care, but in accordance with a licensed ambulance service's policies may be equipped and staffed on short notice to meet the requirements in Sections 12 and 13.

2.30 Secure Transportation Services: Means urgent transportation services provided to individuals experiencing a behavioral health crisis as defined in Section 25-3.5-103 (11.4), C.R.S.

2.31 Service Area: Means a geographically defined area in which an ambulance service has been authorized to provide ambulance transport services for calls originating therein. Service area can include a multi-county geographical area as long as the ambulance service is authorized to operate in every county or city-and-county within that defined geographical area.

2.32 Specialized Services: Means services other than 911 response, interfacility transport, or critical care services, and may include, but are not limited to, stroke care, bariatric care, and pediatric care.

2.33 Waiver: A Departmentapproved exception to these rules granted to a licensed ambulance service. This is also referred to as an administrative waiver in these rules.

6 CCR 1015-3-4-2

37 CR 12, June 25, 2014, effective 5/21/2014

37 CR 12, June 25, 2014, effective 7/15/2014

37 CR 22, November 25, 2014, effective 12/15/2014

38 CR 24, December 25, 2015, effective 1/14/2016

40 CR 10, May 25, 2017, effective 7/1/2017

40 CR 20, October 25, 2017, effective 1/1/2018

40 CR 21, November 10, 2017, effective 1/1/2018

41 CR 23, December 10, 2018, effective 1/14/2019

43 CR 22, November 25, 2020, effective 1/1/2021

44 CR 23, December 10, 2021, effective 12/30/2021

45 CR 10, May 25, 2022, effective 6/14/2022

47 CR 02, January 25, 2024, effective 2/14/2024