Okla. Admin. Code § 310:641-3-15

Current through Vol. 41, No. 19, June 17, 2024

Section 310:641-3-15 - Ground ambulance service - personnel staffing

(a) Each licensed ground ambulance service shall be staffed and available to respond to any request for service within the primary service area twenty-four (24) hours per day.

(b) Each ground ambulance service shall have on staff an adequate number of emergency medical personnel and a sufficient number of ambulances available in order to be en route to 90% of all emergency calls within five (5) minutes of the time the call is received in dispatch at the highest level of care for which the service is licensed.

(1) The request for emergency medical services shall be considered "received in dispatch" as soon as the licensed agency receives sufficient information to allow an appropriate response, i.e., location of the emergency and nature of the call.

(2) Staff licensed below the level of the ambulance service may be utilized provided one or more of the following conditions have been met:

(A) The request for service has been screened by a Department approved emergency medical dispatch system, or

(B) The patient is to be transported from a higher to a lower level of care, or

(C) The transport is approved in writing by the transferring physician at a specified lower level of care and scheduled in advance.

(D) An agency that screens emergency calls through an emergency medical prioritization program shall establish en route times for the priority levels established by the agency. The en route times established by the agency shall be included in the agency's policy and/or procedure manual.

(c) Under no circumstance during the transport of an ambulance patient shall the attendant be less than a licensed emergency medical technician.

(d) In addition to the requirement of licensed emergency medical technicians, each ground ambulance service shall have drivers who, at a minimum, are certified as an Emergency Medical Responder. All drivers of a ground ambulance service shall successfully complete an emergency vehicle operator course approved by the Department within 120 days of employment. Emergency vehicle operators shall successfully complete a refresher course approved by the Department every two (2) years.

(e) In a unique and unexpected circumstance, including a disaster, the minimum driver requirement may be altered to facilitate a transport of an ambulance patient. The attendant, who is in charge of the vehicle while a patient is on board, may request a law enforcement officer or a firefighter, familiar with the operation of an authorized emergency vehicle, to drive the vehicle. If this option is utilized, a written report of the circumstances, reason, and any other pertinent information regarding the call shall be forwarded to the Division within ten (10) working days. Abuse and/or re-occurring incidents of this nature shall require a reassessment of the service's staff and staffing patterns. The service may be required to obtain additional personnel or other action by the Department may result.

(f) Only emergency personnel authorized by this Act, except for a physician, shall be utilized by an ambulance service for pre-hospital, or on-scene, patient care and transport. In some cases, involving inter-hospital transfer of an ambulance patient(s), a physician, physician assistant (PA), nurse practitioner, respiratory care practitioner, registered nurse, or licensed practical nurse may be required to assist the emergency medical technician because the medical care required exceeds the level of the ambulance service personnel. If this option is utilized, written orders by a physician and/or documentation of orders given via radio or telephone contact with a physician, shall become a part of the ambulance patient run report.

(g) Each agency will maintain training records demonstrating competency in medical skills and interventions, patient handling, and emergency vehicle operations for all personnel utilized by the agency.

(h) An agency that is unable to fulfill the twenty-four (24) hours staffing requirement may contract with another ground ambulance service to provide personnel to meet the staffing requirement. Contracts will contain but not be limited to the following information:

(1) how and from what location personnel will respond;

(2) procedure for notifying the contractor that personnel are needed;

(3) communication policy to ensure coverage is in place for the licensed service area;

(4) contingency plan for system overload;

(5) copies of contracts will be provided to the Department as part of application requirements in 310:641-3-10;

(6) scope of practice and protocol requirements for the contractual response; and

(7) emergency plan in the event a contracted service is unable to respond within the contracted requirements, and how the request for service will be answered.

(i) An agency may enter into a contract or other memorandum of agreement with a non-transport agency or entity that is not a certified emergency medical response agency. The purpose of this contract or agreement is to improve emergency medical system responses. The agreement is to allow for interested individuals, who are certified and/or licensed by the Department, at the non-transport agency to respond with ground ambulance services using non-transport agency equipment. The result will be for these individuals to serve as an extension of the ambulance service through the contract or agreement.

(1) The Contract or Memorandum of Agreement will address the following topics:

(A) Name of the non-certified Emergency Medical Response Agency;

(B) The specific vehicles and equipment to be used by the personnel for ambulance service responses;

(C) the parties that supply or maintain the supplies and equipment;

(D) communication arrangements.

(2) The personnel will be authorized to perform procedures under the ambulance services medical director. The ambulance service medical director will establish the scope of practice for the non-transport agency personnel.

(3) The ambulance service will be responsible for all quality assurance activities.

Okla. Admin. Code § 310:641-3-15

Added at 8 Ok Reg 3143, eff 7-18-91 (emergency); Added at 9 Ok Reg 1495, eff 5-1-92; Amended at 17 Ok Reg 392, eff 11-1-99 (emergency); Amended at 17 Ok Reg 2948, eff 7-13-00; Amended at 18 Ok Reg 2501, eff 6-25-01; Amended at 19 Ok Reg 386, eff 11-19-01 (emergency); Amended at 19 Ok Reg 1053, eff 5-13-02; Amended at 20 Ok Reg 2368, eff 7-11-03; Amended at 21 Ok Reg 2755, eff 7-12-04; Amended at 22 Ok Reg 2418, eff 7-11-05; Amended at 23 Ok Reg 2386, eff 6-25-06; Amended at 24 Ok Reg 1991, eff 6-25-07

Amended by Oklahoma Register, Volume 33, Issue 24, September 1, 2016, eff. 9/11/2016

Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/11/2022