836 IAC 3-2-1 Air ambulances; general requirements

Sec. 1. (a) Any organization providing, or seeking to provide, rotorcraft ambulance services utilizing rotorcraft aircraft is required to be certified as an advanced life support rotorcraft ambulance service provider organization by the commission. The advanced life support rotorcraft ambulance service provider organization shall be certified in accordance with this article under IC 16-31 as appropriate. (b) The provider organization of rotorcraft ambulance services shall ensure that the aircraft used in conjunction with the provision of advanced life support services meets the guidelines as specified in this article under IC 16-31 and is certified by the commission. Each rotorcraft ambulance service provider organization shall meet all applicable parts of F.A.A. regulation and shall hold a valid 14 CFR 135 air carrier certificate or shall have a contract with the holder of a 14 CFR 135 air carrier certificate to provide aviation services under their certificate. Either must also have current F.A.A. approved air ambulance operations specifications. (c) Advanced life support rotorcraft ambulance service provider organizations will have an agreement with one (1) or more supervising hospitals for the following services: (1) Continuing education. (2) Audit and review. (3) Medical control and direction. (4) Provide liaison and direction for supply of medications, fluids, and other items utilized by the provider organization. (5) Safety and survival programs and education. The agreement shall include a detailed description of how such services will be provided to the advanced life support rotorcraft ambulance service provider organization. In those cases where more than one (1) hospital enters into an agreement, or seeks to enter into an agreement, with an advanced life support rotorcraft ambulance service provider organization as a supervising hospital, an interhospital agreement will be provided to the commission that clearly defines the specific duties and responsibilities of each hospital to ensure medical, safety, and administrative accountability of system operation. An agreement is not required when the hospital and the provider are the same organization. (d) The advanced life support rotorcraft ambulance service provider organization will have an air-medical director provided by the advanced life support rotorcraft ambulance service provider organization, or jointly with the supervising hospital, who has knowledge of air transport problems and flight physiology. The air-medical director is responsible for providing competent medical direction and overall supervision of the medical aspects of the advanced life support rotorcraft ambulance service provider organization. The duties and responsibilities of the air-medical director include, but are not limited to, the following: (1) Assuming all medical control and authority over any and all patients treated and transported by the rotorcraft ambulance service. (2) Providing liaison with physicians. (3) Assuring that the drugs, medications, supplies, and equipment are available to the advanced life support rotorcraft ambulance service provider organization. (4) Monitoring and evaluating overall medical operations. (5) Assisting in the coordination and provision of continuing education. (6) Providing information concerning the operation of the advanced life support rotorcraft ambulance service provider organization to the commission. (7) Providing individual consultation to the air-medical personnel. (8) Participating on the medical control committee of the supervising hospital in at least quarterly audit and review of cases treated by air-medical personnel. (9) Attesting to the competency of air-medical personnel affiliated with the advanced life support rotorcraft ambulance service provider organization. (10) Designating an individual or individuals to assist in the performance of these duties. (e) Each rotorcraft ambulance service provider organization will designate one (1) person to assume responsibility for inservice training. This person shall be certified as a paramedic, a registered nurse, or a licensed physician and actively provide patient care during air ambulance transport. (f) A rotorcraft ambulance service provider organization shall not engage in conduct or practices detrimental to the health and safety of emergency patients or to members of the general public while in the course of business or service as a rotorcraft ambulance service provider organization. (g) The advanced life support rotorcraft ambulance service provider organization shall have an areawide plan to provide safety education and coordinate rotorcraft ambulance service with emergency medical services rescue, law enforcement, mutual aid backup systems, and central dispatch when available. (h) Each advanced life support rotorcraft ambulance service provider organization shall do the following: (1) Maintain an adequate number of trained personnel and aircraft to provide continuous twenty-four (24) hour advanced life support services. (2) Notify the agency in writing within thirty (30) days of a paramedic's affiliation or termination of employment, or for any reason that has prohibited a certified individual from performing the procedures required of a paramedic under 836 IAC 2. (i) Each rotorcraft ambulance service provider organization shall designate one (1) person to assume the responsibilities for establishment of a safety committee consisting of the following: (1) Pilot or pilots. (2) Air-medical personnel. (3) Aircraft maintenance technician or technicians. (4) Communications personnel. The safety committee shall meet at least quarterly and may be concurrent and in conjunction with the audit/review committee.