In-Field Service Level Upgrade – Rural Population

Section 515.833  In-Field Service Level Upgrade – Rural Population a) Ambulance Service Provider and Vehicle Service Provider Upgrades – Rural Population 1) An ambulance operated by a rural ambulance service provider or a specialized emergency medical services vehicle or alternate response vehicle operated by a rural vehicle service provider may be upgraded, as defined by the EMS System Medical Director in a policy or procedure, as long as the EMS System Medical Director and the Department have approved the proposal, to the highest level of EMT license (advanced life support/paramedic, intermediate life support, advanced EMT or basic life support) or Pre-Hospital RN held by any person staffing that ambulance, specialized emergency medical services vehicle, or alternate response vehicle. The ambulance service provider's proposal or rural services vehicle provider's proposal for an upgrade must include all of the following: A) The manner in which the provider will secure and store advanced life support equipment, supplies and medications. B) The type of quality assurance the provider will perform. C) An assurance that the provider will advertise only the level of care that can be provided 24 hours a day. D) A statement that the provider will have that vehicle inspected by the Department annually. 2) If a rural ambulance service provider or rural vehicle service provider is approved to provide an in-field service level upgrade based on the licensed personnel on the vehicle, all the advanced life support medical supplies, durable medical equipment, and medications must be environmentally controlled, secured, and locked with access by only the personnel who have been authorized by the EMS System Medical Director to utilize those supplies. 3) The EMS System shall routinely perform quality assurance, in compliance with the EMS System's quality assurance plan approved by the Department, on in-field service level upgrades authorized under this Section to ensure compliance with the EMS System plan. 4) The EMS System Medical Director may define what constitutes an in-field service level upgrade through an EMS System policy or procedure.  An in‑field service level upgrade may include, but need not be limited to, an upgrade to a licensed ambulance, alternate response vehicle or specialized emergency medical services vehicle. b) If the EMS System Medical Director approves a proposal for a rural in-field service level upgrade under this Section, he or she shall submit the proposal to the Department along with a statement of approval signed by him or her. Once the Department has approved the proposal, the rural ambulance service provider or rural vehicle service provider will be authorized to function at the highest level of EMT license (advanced life support/paramedic, advanced EMT, intermediate life support, or basic life support) or Pre-Hospital RN held by any person staffing the vehicle. (Section 3.87 of the Act) c)         The Department will approve or deny the request based on the Department's review          and determination of the provider's ability to comply with requirements as outlined in the Act and this Part. Any application found deficient will be returned to the provider with a request for additional information or clarification.