Application and Licensure Requirements for the Licensure and Relicensure of Emergency Medical Response Agencies That Provide Advanced Life Support

PURPOSE: This rule provides the requirement and standards related to the licensure and relicensure of emergency medical response agencies. (1) Application Requirements for Emergency Medical Response Agency Licensure. (A) Each applicant for an emergency medical response agency license or relicense shall submit an application for licensure to the Bureau of Emergency Medical Services (EMS) no less than thirty (30) days or no more than one hundred twenty (120) days prior to their desired date of licensure or relicensure. (B) An application shall include the following information: trade name of the emergency medical response agency; location of vehicles; name, address, telephone numbers and e-mail address (if applicable) of operator of the emergency medical response agency; name of manager; name, address, whether a medical doctor or doctor of osteopathy, telephone numbers, e-mail address (if applicable), and signature of medical director and date signed; certification by the medical director that they are aware of the qualification requirements and the responsibilities of an emergency medical response agency medical director and agree to serve as medical director; name, address, telephone numbers and e-mail address (if applicable) of proposed licensee of the emergency medical response agency; name of licensee’s chief executive officer; all emergency medical response agency licensure and related administrative licensure actions taken against the emergency medical response agency or owner by any state agency in any state; and certification by the applicant that the application contains no misrepresentations or falsifications and that the information given by them is true and complete to the best of their knowledge, and that the emergency medical response agency has both the intention and the ability to comply with the regulations promulgated under the Comprehensive Emergency Medical Service Systems Act, Chapter 190, RSMo Supp. 1998. (C) Each emergency medical response agency that meets the requirements and standards of the statute and regulations shall be licensed and relicensed for a period of five (5) years. (D) A political subdivision or corporation that is licensed as an ambulance service cannot be licensed as an emergency medical response agency. (2) Operational Standards. (A) Emergency medical response agencies shall ensure prompt response to all requests to that service for emergency care originating from their service area, in accordance with a memorandum of understanding with the local ambulance services. (B) In accordance with the memorandum of understanding with local ambulance services, emergency medical response agencies shall provide services, personnel and supplies to meet the emergency call volume which can be reasonably anticipated. (C) The emergency medical response agency shall have a policy and provide for the effective maintenance, storage, usage and replacement of its medical equipment, devices and medications. (3) Each emergency medical response agency shall maintain accurate records and forms that include the following: (A) A report to record information on each emergency medical call; (B) Medical director protocol and policy authorization; (C) Equipment maintenance records; and (D) Record. required by other regulatory agencies. (4) Each emergency medical response agency shall have a medical control plan that has been approved by their medical director and agency manager. The medical control plan is that portion of the medical protocols which specifically addresses the transfer of patient care between agencies. (5) Each emergency medical response agency that provides advanced life support shall have a designated medical director, working under an agreement, who is trained and meets the requirements for a medical director in accordance with 19 CSR 30-40.303. (6) Each emergency medical response agency shall have the capability to communicate by voice with the agency’s own dispatching agency and when possible, local hospital(s), trauma centers, and local ambulance services. (7) Each emergency medical response agency shall have a memorandum of understanding with each ambulance service that is a 911 provider or recognized emergency provider in areas not covered by 911 ambulance services in the agency’s jurisdictional boundaries and will include the following: (A) Triage protocols; (B) Do-not-resuscitate requests; (C) Air utilization requests; (D) Medical and trauma treatment protocols; (E) Quality assurance and improvement program; and (F) Response capabilities of the emergency medical response agency. (8) There shall be an ongoing quality improvement program designed to objectively and systematically monitor, review and evaluate the quality and appropriateness of patient care, pursue opportunities to improve patient care and resolve identified problems. (9) Each emergency medical response agency shall maintain policies and procedures that include the following: (A) Safety program, including infection control program; (B) Communications procedures; (C) Standards of clinical care (medical protocols); (D) Equipment maintenance; (E) Disaster/multiple casualty protocols; and (F) Quality improvement program. AUTHORITY: sections 190.103, 190.133, 190.160, 190.165, 190.175, 190.176 and 190.185, RSMo Supp. 1998.* Emergency rule filed Aug. 28, 1998, effective Sept. 7, 1998, expired March 5, 1999. Original rule filed Sept. 1, 1998, effective Feb. 28, 1999. ** SENIOR SERVICES *Original authority: 190.103 and 190.133, RSMo 1998; 190.160, RSMo 1973, amended 1998; 190.165, RSMo 1973, amended 1978, 1998; 190.175, RSMo 1973, amended 1998, 190.176, RSMo 1998; and 190.185, RSMo 1973, amended 1989, 1993, 1995, 1998. **Pursuant to Executive Orders 20-04 and 20-10, 19 CSR 30-40.333, subsections (1)(A) and (1)(C) was suspended from April 29, 2020 through June 15, 2020.