Application and Licensure Requirements; Standards for the Licensure and Relicensure of Stretcher Van Services

PURPOSE: This rule provides the requirements and standards related to the licensure and relicensure of stretcher van services. PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome and expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here. (1) Application requirements for stretcher van service licensure— (A) Each applicant for a stretcher van service license shall submit an application for licensure to the Emergency Medical Service. (EMS) Bureau 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, but is not limited to, the following information: trade name of the stretcher van service; location of vehicles; number of vehicles to be operated by the stretcher van service; name, address, telephone numbers, and email address (if applicable) of manager; name, address, telephone numbers, and email address (if applicable) of proposed licensee of the stretcher van service; name, address, telephone numbers, and email address (if applicable) of licensee’s chief executive officer; all stretcher van service licensure and related administrative licensure actions taken against the stretcher van service or owner by any state agency in any state; and certification by the applicant that the application contains no misrepresentation or falsifications and that the information given by them is true and complete to the best of their knowledge and that the stretcher van service has both the intention and the ability to comply with the regulations promulgated under Chapter 190, RSMo. The stretcher van application form, included herein, is available at the EMS Bureau office or by mailing a written request to the Missouri Department of Health and Senior Services, EMS Bureau, PO Box 570, Jefferson City, MO 65102-0570. (C) Each stretcher van service that meets the requirements and standards of the statutes and regulations shall be licensed for a period of five (5) years. (2) Passengers may be transported in a stretcher van provided the passenger— (A) Needs no medical equipment (except self-administered medications, including oxygen); (B) Needs no medical monitoring; and (C) Needs routine transportation to or from a medical appointment or service if that passenger(s) is convalescent or otherwise non-ambulatory and does not require medical monitoring, aid, care, or treatment during transport. (3) Stretcher van services shall not transport patients currently admitted to a hospital or patients being transported to a hospital for admission or emergency treatment. A stretcher van shall not transport a patient or passenger whom— (A) Is acutely ill, wounded, or medically unstable; (B) Is experiencing an emergency medical condition as defined in section 190.100, RSMo, an acute medical condition, an exacerbation of a chronic medical condition, or a sudden illness or injury; and (C) Was administered a medication that might prevent the person from caring for him/herself. (4) Vehicle design and specifications for stretcher vans— (A) Delivery of each stretcher van vehicle will include documentation that the vehicle’s design and construction will afford safety, comfort, and avoid aggravation of the passenger’s(s’) present condition. The vehicle shall be complete and furnished with such modifications and attachments as may be necessary to enable the vehicle to function reliably and efficiently in sustained operation. All vehicles shall be constructed by a qualified vehicle manufacturer, designed and built to meet or exceed (at date of vehicle manufacture) Federal Motor Vehicle Safety Standards (FMVSS) and regulations included in 49 CFR 571.1 through 571.500. Federal regulations 49 CFR 571.1 through 571.500 revised October 1, 2007, are incorporated by reference in this rule as published in the Code of Federal Regulations and are available at the United States Government Printing Office, 732 North Capitol Street NW, Washington, DC 20401, contact center via telephone at 1-866512-1800 or online at www.gpoaccess.gov. This rule does not incorporate any subsequent amendments or additions. (B) Stretchers and mounting must meet or exceed KKKA-1822 specifications or Ambulance Manufacturers Division (AMD) Standards 004 – litter retention system. The KKK-A1822 specifications are incorporated by reference in this rule as published in 2007 by the General Services Administration and are available at Chief, Automotive Engineering & Commodity Management Branch (QMDAA), Office of Motor Vehicle Management, General Services Administration, 2200 Crystal Drive, Suite 1006, Arlington, VA 22202. This rule does not incorporate any subsequent amendments or additions. The Ambulance Manufacturers Division Standards are incorporated by reference in this rule as published in 2007 by the Ambulance Manufacturers Division and are available at Ambulance Manufacturers Division, 37400 Hills Tech Drive, Farmington Hills, MI 48331-3414. This rule does not incorporate any subsequent amendments or additions. The operation of the stretcher shall follow manufacturer’s specifications and guidelines; (C) No emergency warning lights are allowed on vehicle; (D) No “ambulance” lettering or “Star of Life” may be displayed on vehicle; (E) Store or secure all equipment, including passengers’ own oxygen delivery system, in a readily accessible and protected manner to limit its movement during a crash; and (F) To facilitate cleaning and disinfecting, the stretcher compartment shall be impervious to soap and water, disinfectants, mildew, fire resistant, and comply with FMVSS 302; be easily cleaned/disinfected (carpeting, cloth, and fabrics are not acceptable); and all exposed surfaces shall be free of vent devices that would permit the entrapment of biological contaminates. (5) Vehicle and equipment operation and maintenance standards— (A) Each service shall ensure that all vehicle drivers possess a valid Class E, Missouri chauffeurs driver license; (B) Each service shall ensure that all vehicle drivers complete a driver safety education program or vehicle operations course and be able to provide documentation of completion. These records shall be available for inspection by the EMS Bureau during normal business hours; (C) Each vehicle shall maintain a current motor vehicle safety inspection from a certified inspector mechanic; (D) Each service shall establish a preventive maintenance program for their vehicles, and each vehicle shall receive periodic maintenance as recommended by the qualified vehicle manufacturer. The records shall be available for inspection by the EMS Bureau during normal business hours; and (E) Each service shall comply with the stretcher manufacturer’s guidelines for maintenance of the stretchers. (6) Vehicle staffing requirements— (A) Each vehicle shall be staffed with a minimum of two (2) persons when transporting a passenger(s). (B) At a minimum, stretcher van personnel shall have completed a nationally recognized course in cardiopulmonary resuscitation (CPR) and be certified at the community and workplace level. (7) Vehicle communications requirements—Each service shall establish a policy for notification of 911 in an emergency and each vehicle shall be equipped to allow stretcher van personnel to communicate by voice with the service’s own dispatching agency or 911 operator. (8) On-board equipment standards—Each vehicle shall be equipped with body substance isolation (BSI) supplies in accordance with section 191.694, RSMo. (9) Each service shall maintain accurate records and reports on the following— (A) A passenger transport report to record information on each request for service and transportation; (B) Stretcher van service license; (C) Vehicle maintenance records; (D) Vehicle driver education records; (E) Equipment maintenance records; (F) Records required by other regulatory agencies; and (G) Each service shall be able to produce these records for inspection during normal business hours. (10) Each service shall have public liability insurance or proof of self-insurance, conditioned to pay losses and damage caused by or resulting from the negligent operation, maintenance, or use of stretcher van services under the service’s operating authority or for loss or damage to property of others. Documents submitted as proof of insurance shall specify the limits of coverage and include the stretcher van service license number. Liability coverage for stretcher van services shall meet or exceed— (A) Two hundred fifty thousand dollars ($250,000) for bodily injury to, or death of, one (1) person; (B) Five hundred thousand dollars ($500,000) for bodily injury to, or death of, all persons injured or killed in any one (1) accident, subject to a minimum of two hundred fifty thousand dollars ($250,000) per person; and (C) One hundred thousand dollars ($100,000.00) for loss or damage to property of others in one (1) accident, excluding cargo. SENIOR SERVICES AUTHORITY: sections 190.528 and 190.537, RSMo Supp. 2007.* Original rule filed May 19, 2008, effective Jan. 30, 2009. ** *Original authority: 190.528, RSMo 2002 and 190.537, RSMo 2002. **Pursuant to Executive Orders 20-04 and 20-10, 19 CSR 30-40.528, subsections (1)(A) and (1)(C) was suspended from April 29, 2020 through June 15, 2020.