Elements of the Service Zone Plan

Local jurisdictions shall ensure that each service zone plan contains, at a minimum, the following elements: (A) A current inventory of EMS and public safety providers and resources including, but not limited to: (1) the designated primary ambulance service; (2) ambulance services that have service zone agreements with the designated primary ambulance service for primary ambulance response in the service zone, in accordance with 105 CMR 170.249; (3) all other ambulance services whose regular operating area includes in whole or in part any local jurisdiction in the service zone; (4) designated EFR service(s), if any; (5) health care facilities, including nursing homes; (6) first response agencies and locations of trained first responders; (7) others in the community trained to provide emergency response, such as ski patrols, and EMTs at schools or senior citizens’ centers; (8) emergency medical dispatch and public safety answering point (PSAP); and (9) automatic/semi-automatic defibrillators and their locations. (B) An open, fair and inclusive process for the selection and changing of EMS service delivery or designated service zone providers. (C) Criteria for the selection of designated service zone providers. Potential service zone providers shall be evaluated on their ability to meet local standards for specific EMS performance criteria. Local standards shall at minimum meet any and all relevant standards in 105 CMR 170.000. Specific EMS performance criteria include, but are not limited to, the following: (1) response time; (2) adequate backup; (3) deployment of resources; (4) level of service and level of licensure of designated service zone providers; (5) medical control; and (6) appropriate health care facility destinations, in accordance with the applicable Regional EMS Council’s point-of-entry plan, as approved by the Department. (D) Recommended service zone providers, chosen in accordance with the process and criteria established in the service zone plan, pursuant to 105 CMR 170.510(B) and (C). The local jurisdiction shall recommend for designation one primary ambulance service, and may recommend one or more EMS first response services as service zone providers. (E) Service zone agreements, pursuant to M.G.L. c. 111C, § 10(d) and 105 CMR 170.249. (F) A process for monitoring compliance with the service zone’s local standards for specific EMS performance criteria. (G) A medical control plan, which shall at a minimum, consist of collection, review and monitoring of current affiliation agreements, consistent with 105 CMR 170.300, of EMS services operating in the service zone. (H) Operational plan for coordinating the use of all first responder agencies in the service zone that are not EMS first response services, and others trained as first responders, and voluntarily providing first response services, including the location of each of these agencies and persons. (I) Operational plan for ensuring dispatch and response to emergencies of the closest, appropriate, available EMS services, in accordance with 105 CMR 170.355, including: (1) Coordination and optimal use of all licensed services for emergency response, including the following: (a) primary ambulance service; (b) ambulance services with service zone agreements with the primary ambulance service, pursuant to 105 CMR 170.249; (c) ambulance services who have backup agreements with services referenced in 105 CMR 170.510(I)(1)(a) and (b); and (d) EFR services, if any. (2) Location of all licensed EMS services; and (3) Clear criteria for determining which ambulance service has the closest appropriate ambulance, and when EFR services, if any, should be dispatched, based on factors including, but not limited to, the following: (a) type of emergency or patient condition; (b) base locations of services; (c) hours of operation; (d) number, hours and location of EMS personnel; (e) services’ capabilities; and (f) No service zone plan may include criteria for the notification and dispatch of a designated EFR service to a facility licensed pursuant to M.G.L. c. 111, § 71 or certified pursuant to M.G.L. c. 19D, where there is a licensed health care professional on-site 24 hours per day seven days per week, and where there is a provider contract in place to provide primary ambulance response, unless a licensed health care professional at such facility requests primary ambulance response by dialing the emergency telephone access number 911, or its local equivalent. Nothing herein shall bar any person from dialing 911 or its local equivalent. (J) Procedures for delivery of patient care reports and unprotected exposure forms to receiving health care facilities.