No. 28038 (Amendment): R426-15-200. Staffing

DAR File No.: 28038
Filed: 06/20/2005, 12:03
Received by: NL

 

RULE ANALYSIS

Purpose of the rule or reason for the change:

The proposed amendment codifies the practice of having one paramedic transport a patient in certain situations. It will not diminish the responsibility for paramedic providers to have two paramedics on-scene at all emergencies, but will enable them to transport the patient to the emergency patient receiving facility using either one or two paramedics according to instructions received from on-line medical control.

 

Summary of the rule or change:

This change eliminates the requirement for a paramedic ambulance to always have two paramedics transport a patient to a patient receiving facility regardless of the condition of the patient. It enables on-line medical control to determine whether either one or two paramedics can provide the transport. If there is only one paramedic required for transport, there will also be an Emergency Medical Technician (EMT)-Basic, EMT-Intermediate, or EMT-Intermediate Advanced to accompany the single paramedic during the transport.

 

State statutory or constitutional authorization for this rule:

Section 26-8a-105

 

Anticipated cost or savings to:

the state budget:

There will be no cost or savings to the state budget since this will not diminish the need for certification and recertification of paramedics since there is still the requirement for two paramedics to be at the scene of all ambulance calls.

 

local governments:

There will be no cost or savings to local government paramedic ambulance providers because the staffing at the scene of all ambulance calls will not be reduced. It may reduce the need to call back paramedics for subsequent calls but that can only be determined after a time period of evaluation once the rule is effective.

 

other persons:

There will be no cost or savings to private paramedic ambulance providers because the staffing at the scene of all ambulance calls will not be reduced. It may reduce the need to call back paramedics for subsequent calls but that can only be determined after a time period of evaluation once the rule is effective. Since there is no change in the rate structure attached to this rule, there will be no savings or cost to any patients or third-party payers.

 

Compliance costs for affected persons:

There will be no compliance costs since all affected persons will still be required to have the same number of paramedics respond. This proposed rule carries no new licensure level or any increased obligations for affected persons.

 

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule change is supported by most emergency medical services. The rule change places the decision-making responsibility with the responders on scene and on-line medical control rather then having transport staffing mandated by rule without regard to patient needs. The fiscal impact will be neutral or positive on businesses. David N. Sundwall, MD, Executive Director

 

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Systems Improvement, Emergency Medical Services
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

 

Direct questions regarding this rule to:

Paul Patrick at the above address, by phone at 801-538-6291, by FAX at 801-538-6808, or by Internet E-mail at [e-mail]

 

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

08/15/2005

 

This rule may become effective on:

08/16/2005

 

Authorized by:

David N. Sundwall, Executive Director

 

 

RULE TEXT

R426. Health, Health Systems Improvement, Emergency Medical Services.

R426-15. Licensed and Designated Provider Operations.

R426-15-200. Staffing.

(1) EMT ground ambulances, while providing ambulance services, shall have the following minimum complement of personnel:

(a) two attendants, each of whom is a certified EMT-Basic, EMT-Intermediate, EMT-Intermediate Advanced, or Paramedic.

(b) a driver, 18 years of age or older, who is the holder of a valid driver's license. If the driver is also an EMT-Basic, EMT-Intermediate, EMT-Intermediate Advanced, or Paramedic, the driver qualifies as one of the two required attendants.

(c) EMT ground ambulance services authorized by the Department to provide Intermediate or Intermediate Advanced services shall assure that at least one EMT-Intermediate or EMT-Intermediate Advanced responds on each call along with another certified EMT.

(d) if on-line medical control determines the condition of the patient to be "serious or potentially critical," at least one paramedic shall accompany the patient on board the ambulance to the hospital, if a Paramedic rescue is on scene.

(e) if on-line medical control determines the condition of the patient to be "critical," the ambulance driver and two Paramedics shall accompany the patient on board the ambulance to the hospital, if Paramedics are on scene.

(2) Quick response units, while providing services, shall have the following minimum complement of personnel:

(a) one attendant, who is an EMT-Basic, EMT-Intermediate, EMT-Intermediate Advanced, or Paramedic.

(b) quick response units authorized by the Department to provide Intermediate services shall assure that at least one EMT-Intermediate, EMT Intermediate Advanced or Paramedic responds on each call.

(3) Paramedic ground ambulance or rescue services shall have the following minimum complement of personnel:

(a) staffing at the scene of an accident or medical emergency shall be no less than two persons, each of whom is a Paramedic;

(b) a paramedic ground ambulance service, while providing paramedic ambulance services, shall have:[ two attendants, each of whom is a Paramedic;]

([c]i) a driver, 18 years of age or older, who is the holder of a valid driver's license[. If the driver is also a Paramedic, the driver qualifies as one of the two required attendants]; [and

(d) if a paramedic ground ambulance has been requested by a transferring physician for inter-facility movement of a patient, the staffing shall be as follows:]

(ii) if on-line medical control determines[the physician describes] the condition of the patient as "serious or potentially critical," a minimum staffing [shall be]of one Paramedic, and one EMT-Basic, EMT-Intermediate, or EMT Intermediate Advanced; and

(iii) if on-line medical control determines[the physician describes] the condition of the patient as "critical," a minimum staffing [shall be]of an ambulance driver and two Paramedics.

(4) Paramedic inter-facility transfer services shall have the following minimum complement of personnel:

(a) if the physician describes the condition of the patient as "serious or potentially critical," minimum staffing shall be one Paramedic, and one EMT-Basic, EMT-Intermediate, or EMT-Intermediate Advanced;

(b) if the physician describes the condition of the patient as "critical," minimum staffing shall be two Paramedics and an ambulance driver.

(5) Each licensee shall maintain a personnel file for each certified individual. The personnel file must include records documenting the individual's qualifications, training, certification, immunizations, and continuing medical education.

(6) An EMT or Paramedic may only perform to the service level of the licensed or designated service, regardless of the certification level of the EMT or Paramedic.

 

KEY: emergency medical services

[February 1, ]2005

Notice of Continuation October 1, 2004

26-8a