agency-4766•Ohio Administrative Code 4766 — Medical Transportation
Ohio Administrative Code 4766 — Medical Transportation
agency-4766Ohio Adm.Code 4766Regulation
Chapter 4766-1 Public Notices and Hearings
Ohio Adm.Code 4766-1-01 Public notice of rule adoption, amendment, or rescission.
Prior to adoption, amendment, or rescission of any rule, other than an emergency rule authorized by executive order, the board shall give public notice in accordance with section 119.03 of the Revised Code, of its intention to consider adopting, amending, or rescinding such rule or rules. The content of such public notice shall conform to the requirements of section 119.03 of the Revised Code and shall be posted on the register of Ohio web site at the time of filing. In addition, the board shall post a copy of the public hearing notice as well as any proposed rule changes on the division of EMS web site, which can be accessed at www.ems.ohio.gov.
Last updated September 13, 2023 at 1:01 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Chapter 4766-2 Ambulances
Ohio Adm.Code 4766-2-01 Definitions.
For the purposes of this chapter of the Administrative Code, except as otherwise provided, the following definitions apply:
(A) "Advanced emergency medical technician" or AEMT is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-16-04 of the Administrative Code.
(B) "Advanced life support" or "ALS" has the same meaning as defined in section 4766.01 of the Revised Code.
(C) "Ambulance" has the same meaning as defined in section 4766.01 of the Revised Code.
(D) "Basic life support" or "BLS" has the same meaning as defined in section 4766.01 of the Revised Code.
(E) "Board" means the state board of emergency medical, fire, and transportation services within the division of emergency medical services of the department of public safety set forth in section 4765.02 of the Revised Code.
(F) "Division" means the division of emergency medical services within the department of public safety.
(G) "Emergency medical technician" or EMT is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-15-04 of the Administrative Code.
(H) "Headquarters" means the location which a licensed MTO operates, designated by the licensed MTO as the location where the records set forth in this chapter are maintained or readily available.
(I) "Inspection fee" means a fee required to be paid for the inspection of a permitted vehicle.
(J) "License" means a certificate of licensure issued by the board to the service, also known as the licensed MTO.
(K) "Medical director" means an Ohio-licensed physician who meets the requirements as set forth in Chapter 4765. of the Revised Code and rule 4765-3-05 of the Administrative Code.
(L) "Medical transportation licensing system" or "MTLS online system" means a web based system for medical transportation agencies to obtain, renew, and maintain their licenses.
(M) "Medical transportation organization (MTO)" has the same meaning as emergency medical service organization as defined in section 4766.01 of the Revised Code.
(N) "Non-transport vehicle" has the same meaning as defined in section 4766.01 of the Revised Code.
(O) "Operate" means to engage in conduct or activity in furtherance of the licensed activity at or from a physical location owned, leased, or maintained by the licensed MTO where employees report to work and vehicles or aircraft are stored. Operate also includes the act of receiving a person within Ohio for transportation to a location within Ohio.
(P) "Paramedic" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-17-03 of the Administrative Code.
(Q) "Permit" is the authorization to operate issued by the board as set forth in section 4766.07 of the Revised Code for a specific vehicle, known as the "permitted vehicle" and requires the issuance of a decal for the permitted vehicle by the board or its designee.
(R) "Readily available" means produced upon demand by the board or its designee.
(S) "Reinspection fee" means a fee required to conduct an inspection as a result of the issuance of a violation notification by the board or its designee, to a licensed MTO or license applicant, regarding a permitted ambulance/non-transport vehicle or an ambulance/non-transport vehicle for which a permit application is pending with the board.
(T) "Satellite base" means a physical location other than the headquarters from which an MTO, licensed as set forth in Chapter 4766. of the Revised Code, operates.
(U) "Service" has the same meaning as "Medical Transportation Organization."
(V) "Service number" or "service code" means the number assigned to the licensed MTO by the board for the purpose of identifying and validating the service or licensed MTO.
(W) "Stairchair" means a collapsible wheeled apparatus used to transport patients up or down stairs.
(X) "Stretcher," "gurney," or "cot" means a collapsible wheeled apparatus used to move patients lying down.
(Y) "Temporary vehicle" means an ambulance or non-transport vehicle issued a temporary permit used to replace a permitted ambulance or non-transport vehicle in accordance with rule 4766-2-12 of the Administrative Code that is out of service until the permitted ambulance or non-transport vehicle is returned to service or is replaced. A temporary vehicle may be used for a time period not to exceed sixty days.
(Z) "Violation notification" means a written form issued by the board or its designee during an inspection or investigation identifying deficiencies in record keeping requirements, vehicle roadworthiness requirements, or equipment requirements by a service or its vehicle(s).
Last updated May 2, 2022 at 8:56 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4765-16-04
(A) In addition to the emergency medical services listed in rules 4765-12-04 and 4765-15-04 of the Administrative Code, and in accordance with section 4765.38 of the Revised Code, an advanced emergency medical technician may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.38 of the Revised Code:
(1) Cardiac monitor strip interpretation;
(2) Manual defibrillation;
(3) Obtaining blood specimens;
(4) Subcutaneous or intramuscular administration of epinephrine;
(5) Intravenous access and peripheral initiation;
(6) Intravenous maintenance and fluid administration;
(7) Intraosseous insertion;
(8) Saline lock.
(B) In addition to the emergency medical services described in paragraph (A) of this rule, and in accordance with section 4765.38 of the Revised Code, an advanced emergency medical technician who has completed a training program pursuant to this chapter of the Administrative Code may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.38 of the Revised Code:
(1) Administration of the following medications:
(a) Sublingual nitroglycerin (non-patient assisted);
(b) Dextrose in water;
(c) Epinephrine at the concentration of one milligram per milliliter via subcutaneous or intramuscular routes;
(d) Diphenhydramine;
(e) Benzodiazepines;
(f) Bronchodilators;
(g) Naloxone via endotracheal tube, intramuscular, intravenous, intraosseous, or subcutaneous;
(h) Glucagon;
(i) Nitrous oxide;
(j) Nalbuphine;
(k) Narcotics or other analgesics for pain relief;
(l) Lidocaine, for pain relief after intraosseous insertions;
(m) Oral ondansetron for patients twelve years or older;
(n) Ketamine;
(o) Any additional drug approved by the board.
(2) Administration of aerosolized or nebulized medications (non-patient assisted);
(3) Administration of intranasal medications;
(4) Orotracheal intubation of the apneic patient;
(5) Orotracheal intubation of the pulseless and apneic patient;
(6) Dual lumen airway of the apneic patient;
(7) Extraglottic airway of the apneic patient;
(8) Needle decompression of the chest;
(9) Tracheostomy tube replacement;
(10) Laryngoscopy for removal of airway obstruction;
(11) Set up and application of a twelve-lead electrocardiogram, in accordance with written protocols, in either of the following instances:
(a) When the advanced emergency medical technician is assisting a paramedic; or
(b) For the purpose of electronic transmission by the advanced emergency medical technician, provided the following conditions are met:
(i) The advanced emergency medical technician does not interpret the electrocardiogram;
(ii) The advanced emergency medical technician minimizes any delay of patient transport while obtaining a twelve-lead electrocardiogram;
(iii) The advanced emergency medical technician utilizes the twelve-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.
(12) Withdraw blood for the purpose of determining the alcohol, drug, controlled substance, metabolite of a controlled substance, or combination content of the whole blood, blood serum, or blood plasma as provided in division (C) of section 4765.38 of the Revised Code when performed in accordance with the criteria established in rule 4765-6-06 of the Administrative Code and the protocols established by the medical director of the emergency medical service organization with which the advanced emergency medical technician is affiliated.
(13) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code.
(14) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those advanced emergency medical technicians who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code to include the withdrawing of blood for evidence collection.
(E) An advanced emergency medical technician shall not perform emergency medical services within this rule unless the advanced emergency medical technician has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the advanced emergency medical technician scope of practice, were not included in the training specified in this paragraph, the advanced emergency medical technician must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:22 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4765-15-04
(A) In addition to the emergency medical services listed in rule 4765-12-04 of the Administrative Code and in accordance with section 4765.37 of the Revised Code, an emergency medical technician may perform the following emergency medical services:
(1) Endotracheal suctioning through a previously established airway;
(2) Endotracheal suctioning through a stoma;
(3) Oxygen administration, including the following:
(a) Partial rebreather masks;
(b) Venturi masks.
(4) Ventilation management, to include the use of a positive pressure ventilation device, including the following:
(a) Manually triggered ventilators;
(b) Automatic transportation ventilators.
(5) Traction splint;
(6) Rapid extrication procedures.
(B) In accordance with division (B) of section 4765.37 of the Revised Code, an emergency medical technician may perform the following additional emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.37 of the Revised Code:
(1) Pulse oximeter and capnography equipment application and reading;
(2) Dual lumen airway of pulseless and apneic patients only;
(3) Oxygen humidifier equipment application and monitoring;
(4) Extraglottic airway of pulseless and apneic patients only;
(5) Continuous positive airway pressure (CPAP);
(6) End tidal carbon dioxide monitoring and detecting;
(7) Chest compression assist devices;
(8) Negative impedance threshold devices;
(9) Administration of aspirin;
(10) Helmet removal;
(11) Glucose monitoring system;
(12) Administration of oral glucose;
(13) Administration of epinephrine auto-injector to a patient suffering from anaphylaxis;
(14) Assisted administration of sublingual nitroglycerin, which shall consist of either of the following:
(a) Assisting with patient's prescribed nitroglycerin upon the patient's request and with written protocol;
(b) Assisting with EMS-provided nitroglycerin with verbal medical direction.
(15) Assisted administration of aerosolized or nebulized medications, which shall consist of either of the following:
(a) Assisting with a patient's prescribed aerosolized or nebulized medications upon the patient's request and with written protocol;
(b) Assisting with EMS-provided aerosolized or nebulized medications with verbal medical direction.
(16) Prehospital advanced life support assistance, to include the setting up of an intravenous administration kit in the presence of an advanced emergency medical technician or paramedic;
(17) Transport of a central/peripheral intravenous access without an infusion;
(18) Set up and application of a cardiac monitor in the presence of an advanced emergency medical technician or paramedic;
(19) Set up and application of a twelve-lead electrocardiogram, in accordance with written protocols, in either of the following instances:
(a) When the emergency medical technician is assisting an paramedic; or
(b) For the purpose of electronic transmission by the emergency medical technician, provided the following conditions are met:
(i) The emergency medical technician does not interpret the electrocardiogram;
(ii) The emergency medical technician minimizes any delay of patient transport to obtain a twelve-lead electrocardiogram;
(iii) The EMT utilizes the twelve-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.
(20) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code;
(21) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those emergency medical technicians who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code.
(E) An emergency medical technician shall not perform emergency medical services within this rule unless the emergency medical technician has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the emergency medical technician scope of practice, were not included in the training specified in this paragraph, the emergency medical technician must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:22 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4765-3-05
(A) The medical director for each EMS organization shall meet the following minimum qualifications:
(1) Possession of a valid Ohio physician medical license in good standing;
(2) For three of the previous five years, has had active involvement in the provision of emergency care to patients or has provided medical oversight for an EMS agency;
(3) Provide evidence of one of the following:
(a) Completion of an EMS medical director course approved by the board (EMS medical director course provided by the "National Association of EMS Physicians" or the Ohio chapter of the "American College of Emergency Physicians");
(b) Completion of a residency or fellowship program that is recognized by the "American Board of Medical Specialties," the "American Osteopathic Association," or the "Accreditation Council for Graduate Medical Education" in emergency medicine or a related area;
(c) Subspecialty board certification by the "American Board of Emergency Medicine" in emergency medical services.
(4) Active participation with one or more EMS organizations, including but not limited to:
(a) Conducting performance improvement programs;
(b) Conducting education programs;
(c) Conducting protocol updates.
(5) Evidence of high ethical standards and no conflicts of interest;
(6) Utilizes aggregate data from the division in peer review and quality improvement programs at the local level.
(B) Each medical director is required to participate in trauma-related peer review and quality improvement programs as provided in section 4765.12 of the Revised Code.
Last updated August 1, 2023 at 8:26 AM
History
- Effective: August 1, 2023
- Promulgated Under: 119.03
Ohio Adm.Code 4765-17-03
(A) In addition to the skills listed in rules 4765-12-04, 4765-15-04 and 4765-16-04 of the Administrative Code, and in accordance with section 4765.39 of the Revised Code, a paramedic may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.39 of the Revised Code:
(1) Orotracheal intubation;
(2) Nasotracheal intubation;
(3) Cricothyrotomy (surgical);
(4) Cricothyrotomy (needle);
(5) Dual lumen airways;
(6) Extraglottic airways;
(7) Positive end-expiratory pressure;
(8) Bilevel positive air pressure;
(9) Ventilator management of patients sixteen years of age or older;
(10) Chest tube monitoring and management;
(11) Central line monitoring;
(12) Transcutaneous cardiac pacing;
(13) Administration of cardiac medication;
(14) Cardioversion;
(15) Twelve-lead electrocardiogram performance and interpretation;
(16) Administration of nitroglycerin;
(17) Administration of aerosolized or nebulized medication;
(18) Epinephrine administration via intravenous or intraosseous route;
(19) Placement of nasogastric or orogastric tubes;
(20) Administration of other medications pursuant to written protocols;
(21) Intravenous infusion pump;
(22) Blood chemistry analysis;
(23) Thrombolytic therapy initiation and monitoring;
(24) Immunizations for influenza to firefighters, EMTs, AEMTs, or paramedics in accordance with section 4765.391 of the Revised Code;
(25) Maintenance of medicated intravenous fluids;
(26) Maintenance of blood administration;
(27) Eye irrigation morgan lens;
(28) Withdraw blood for the purpose of determining the alcohol, drug, controlled substance, metabolite of a controlled substance, or combination content of the whole blood, blood serum, or blood plasma as provided in division (C) of section 4765.39 of the Revised Code when performed in accordance with the criteria established in rule 4765-6-06 of the Administrative Code and the protocols established by the medical director of the emergency medical service organization with which the paramedic is affiliated;
(29) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study;
(30) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code.
(B) A paramedic may perform non-emergent ambulance transport of a stable patient less than sixteen years of age who has a chronic condition requiring a tracheostomy tube and a ventilator provided the patient's caregiver accompanies the patient during transport and the patient's caregiver has received appropriate training in use of the patient's ventilator.
A caregiver is not required to accompany the patient if the patient is accompanied by an Ohio licensed registered nurse or respiratory therapist, or other appropriately trained and licensed Ohio healthcare provider.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those paramedics who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code to include the withdrawing of blood for evidence collection.
(E) A paramedic shall not perform emergency medical services within this rule unless the paramedic has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the paramedic scope of practice, were not included in the training specified in this paragraph, the paramedic must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:23 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-12
(A) In the event of a disaster situation when permitted ambulance(s) based in the locality of the disaster situation are incapacitated or insufficient in number to render services needed, a licensed MTO may utilize whatever means necessary to transport and treat patients.
(B) An ambulance or non-transport vehicle that has not been issued a permit by the board may be issued a temporary permit, for a period not to exceed sixty days, if the ambulance or non-transport vehicle is used to replace a permitted ambulance or non-transport vehicle that has been temporarily taken out of service for repair or maintenance or is being permanently replaced. In order to obtain a temporary permit, an MTO shall submit to the board a request for a temporary vehicle permit using the MTLS online system containing:
(1) Vehicle identification number of the permitted ambulance or non-transport vehicle;
(2) Date permitted ambulance or non-transport vehicle was placed out of service; and
(3) Vehicle identification number of the ambulance or non-transport vehicle to receive a temporary permit.
(C) A temporarily permitted ambulance shall not be operated unless it meets the requirements set forth in paragraph (B) of rule 4766-2-08 of the Administrative Code and the insurance requirement set forth in division (B) of section 4766.06 of the Revised Code.
Last updated May 2, 2022 at 8:57 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-02 Application for initial or renewal licensure.
(A) An MTO applying for initial licensure shall submit to the board a completed application, in the English language, using the MTLS online system:
(1) Accompanied by the appropriate fees as set forth in rule 4766-2-03 of the Administrative Code; and
(2) With all required supporting documentation as set forth in this rule.
(B) An MTO applying for renewal of a license shall submit to the board a completed application, in the English language, using the MTLS online system:
(1) Accompanied by the appropriate fees as set forth in rule 4766-2-03 of the Administrative Code; and
(2) With all required supporting documentation as set forth in this rule that must be received by the board prior to the expiration date of the license.
(C) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the MTO applicant shall provide and maintain documentation of:
(1) The name of service, organizational structure, and address of applicant as follows:
(a) Name;
(b) Identification of organizational structure as a corporation (whether for profit or not-for-profit); limited liability company; partnership; limited liability partnership; government unit; or sole proprietor (individual human);
(c) Tax identification (tax ID) number or employer identification number (EIN);
(d) All other names under which applicant plans to operate while using the same tax ID or EIN number. Business organizations with different tax ID or EIN numbers cannot operate under the same license;
(e) Copies of all trade name registrations and fictitious name registrations for all other names under which applicant plans to operate on file with the Ohio secretary of state;
(f) Address of physical location of applicant's headquarters (no post office box);
(g) Mailing address of applicant.
(2) All medicare provider numbers;
(3) All medicaid provider numbers;
(4) Highest level of service to be provided;
(5) Service areas including county and state;
(6) A list of the names of all officers, directors, and/or owners of the MTO;
(7) The name, contact information, and state of Ohio medical license number of the service's medical director;
(8) Proof that the medical director is in compliance with the requirements for a medical director as set forth in rule 4765-3-05 of the Administrative Code;
(9) For each satellite base, the MTO shall provide the physical address, city, county, state, and zip code;
(10) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number;
(11) Year of manufacture, make, model, vehicle identification number, odometer reading, and license plate number (renewal only) of each ambulance or non-transport vehicle to be permitted;
(12) A color photograph of the side of applicant's vehicle displaying color scheme, insignia, monogram, or other distinguishing characteristics. If multiple color schemes, insignias, monograms, or other distinguishing characteristics are used, a color photograph of each shall accompany application.
(a) Color photographs shall be submitted to the division:
(i) With all initial applications; and
(ii) Within thirty days of the date a change is made to the vehicle's color scheme, insignia, monogram, or other distinguishing characteristics.
(b) Digital photographs are preferred.
(13) A current certificate of liability insurance, in the name of the applicant, listing the board as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code:
(a) The actual name on the license application shall appear on the certificate of liability insurance;
(b) Each permitted vehicle with vehicle identification number (VIN) shall be listed on the certificate of liability insurance.
(D) An application that is not completed in the manner as specified on the application or does not include all required documentation shall be deemed incomplete.
(E) An application deemed incomplete shall not be considered and may be returned with the notation to the applicant indicating the reason the application is incomplete.
(F) Failure to provide the required documents within thirty days of the date the initial application is received by the division may result in the application being deemed incomplete.
(G) An MTO shall submit a completed renewal application, appropriate fees, and supporting documentation to the board using the MTLS online system prior to the expiration of the MTO's license in order to be considered timely.
(H) The certificate of licensure issued by the board shall indicate the highest level of service the MTO is authorized to provide.
(I) The board shall issue licenses to MTOs that meet the criteria to provide the following levels of service:
(1) Basic life support (BLS) (two levels of licensure);
(a) BLS emergency and non-emergency; or
(b) BLS non-emergency only.
(2) Intermediate life support;
(3) Advanced life support (ALS).
(J) An MTO licensed at the BLS non-emergency only level or an MTO licensed at the BLS emergency and non-emergency level, intermediate life support level, or advanced life support level operating an ambulance at the BLS non-emergency only level is subject to the following requirements:
(1) May transport an individual who requires routine transportation to or from a medical appointment or service if that person is convalescent or otherwise non-ambulatory and does not require medical monitoring en route to the destination facility, aid, care, or treatment during transport other than BLS care.
(2) May not transport an individual who:
(a) Is experiencing an acute condition or a sudden injury or illness that has not yet been stabilized;
(b) Has sustained an injury and has not yet been evaluated by a physician;
(c) Is being transported to any intensive care unit for the purposes of intensive care treatment;
(d) Is being evaluated in an emergency room and for any reason must be transported for diagnostic testing and the patient has not yet been stabilized.
(3) Nothing in this chapter prohibits a BLS non-emergency only ambulance from transporting an individual to a non-medical event or social gathering as long as the individual being transported meets the guidelines in paragraphs (J)(1) and (J)(2) of this rule.
(4) The medical protocol for the EMT in a BLS non-emergency only ambulance shall address the care, treatment, and transport of a patient whose medical condition worsens during transport.
(K) No applicant or licensed MTO shall submit false, misleading, or deceptive information in order to obtain a license or permit.
(L) A license is only valid for the MTO for which it is issued and is not transferable.
Last updated May 1, 2026 at 8:15 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-03
(A) Each MTO shall pay an initial or renewal license fee of one hundred dollars annually.
(B) Each MTO shall pay a permit fee for each ambulance or non-transport vehicle of one hundred dollars annually.
(C) Fees shall be submitted with the application.
(D) Each MTO shall pay an inspection fee of one hundred dollars per ambulance or non-transport vehicle.
(E) Each MTO shall pay a one hundred dollar reinspection fee for every ambulance or non-transport vehicle that requires reinspection as a result of a violation notification issued by the board or its designee.
(F) Each MTO shall pay a temporary permit fee of one hundred dollars for each temporary permit to be obtained.
(G) Each MTO may pay a re-print fee of five dollars for each vehicle decal that is re-printed as a result of the decal being lost, damaged, incorrectly applied, or incorrect vehicle information provided to the division by the service.
Last updated May 2, 2022 at 8:56 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-04 Physical facilities.
(A) The board or its designee shall conduct initial and renewal inspections of all MTOs pursuant to Chapter 4766. of the Revised Code and rules 4766-2-04 to 4766-2-06 of the Administrative Code, to include the following:
(1) MTO service headquarters;
(2) MTO service satellite base(s).
(B) An MTO shall not commence operations from its headquarters or satellite base(s) until the location is licensed as set forth in section 4766.04 of the Revised Code.
(C) An MTO shall ensure compliance with the inspection standards for physical facilities. Inspection standards for physical facilities of an MTO are as follows:
(1) The board issued license is prominently displayed in conspicuous location at every licensed facility (renewal inspection only);
(2) State of Ohio board of pharmacy license(s) is displayed at each location;
(3) A written sanitation plan as set forth in Chapter 4766-2 of the Administrative Code is on site for each location;
(4) The physical facilities maintain all single use supplies and equipment as set forth in the ambulance inspection form for the level of service operated.
(5) The physical facilities are clean and free of debris;
(6) Crew quarters are clean;
(7) All physical facilities are in compliance with state and local building codes;
(8) Each facility is in compliance with state and local fire codes.
(D) The board or its designee may conduct routine unannounced inspections at any location of a licensed MTO at any time, including night or weekend inspections, to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, the following:
(1) MTO service headquarters;
(2) MTO service satellite base(s);
(3) Ambulance(s) and non-transport vehicles(s).
Last updated May 2, 2022 at 8:56 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-06
(A) All licensed MTO dispatch centers shall be equipped with a base station capable of two-way communications with associated ambulance(s) and non-transport vehicle(s). The base station shall demonstrate and maintain voice communications with the device used in the permitted ambulance(s) and non-transport vehicle(s) within the declared service area.
(B) All ambulance(s) and non-transport vehicle(s), permitted as set forth in Chapter 4766. of the Revised Code, shall be equipped, while in use, with a dedicated two-way communications device, which shall have the capability to communicate with the licensed MTO's dispatch center, the receiving medical facility, and with medical control in the licensed MTO's service area.
(C) All MTOs shall maintain a detailed radio/communications log that documents, at a minimum, the following:
(1) Location of call;
(2) Nature of call;
(3) Initial dispatch time;
(4) Enroute time;
(5) On-scene time;
(6) Departure from scene time;
(7) Arrival at destination time.
(D) If an MTO contractually uses another communication center for dispatch purposes, the communication center shall provide written certification of compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code as applicable.
Last updated May 2, 2022 at 8:57 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-05 Record keeping requirements.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-2-18 of the Administrative Code.]
(A) Each licensed MTO shall maintain or have readily available the following at its headquarters:
(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;
(2) Verification of the following:
(a) Completion of emergency vehicle operator course for non-EMS certified personnel as set forth in rule 4766-2-13 of the Administrative Code;
(b) Ohio EMS certification of all personnel;
(3) A current certificate of liability insurance issued by an insurer licensed to do business in Ohio that includes a thirty day notice of cancellation to the board in compliance with the terms set forth in section 4766.06 of the Revised Code listing the board as a certificate holder.
Each scheduled vehicle must be listed on the certificate or attached on an additional page to the certificate to include the vehicle's year, make, model and vehicle identification number (VIN). If the certificate indicates "any auto" or "all owned autos," a list of vehicles does not have to be included or attached.
(4) Current copy of the MTO's written policy covering the use of lights and other warning devices;
(5) Records or other documents related to patient care or to emergency medical service personnel maintained by the licensed MTO which shall be made available for review by the board or its designee;
Such records or documents shall be made available in accordance with 45 C.F.R. 164.512;
(6) Current maintenance records for vehicles as specified in rule 4766-2-09 of the Administrative Code;
(7) Documentation of compliance with the periodic mechanical safety inspection set forth in rule 4766-2-09 of the Administrative Code;
(8) Current maintenance records for all equipment used for patient care as specified in rule 4766-2-09 of the Administrative Code;
(9) Dispatch log;
(10) Written plan for restocking of supplies or compliance with paragraph (C)(4) of rule 4766-2-04 of the Administrative Code;
(11) Ohio state board of pharmacy license and addendum;
(12) DEA registration certificate (as applicable);
(13) Clinical laboratory improvement amendments (CLIA) waiver (as applicable);
(14) Current written plan for the handling and disposal of bio-medical infectious materials (OSHA rule 29 C.F.R. part 1910.1030).
(B) A licensed MTO shall maintain or have readily available the following at each satellite base:
(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;
(2) Documentation that meets the requirements as set forth in rule 4766-2-07 of the Administrative Code;
(3) Current copy of the MTO's written policy covering the use of lights and other warning devices;
(4) Written plan for restocking of supplies or compliance with paragraph (C)(4) of rule 4766-2-04 of the Administrative Code;
(5) Ohio state board of pharmacy license(s) and addendum(s);
(6) Current written plan for the handling and disposal of bio-medical infectious materials (OSHA rule 29 C.F.R. part 1910.1030).
(C) Upon licensure, each licensed MTO shall prominently display the original certification of licensure at its headquarters and each satellite base.
(D) Patient records shall be maintained in accordance with this rule.
(1) Each licensed MTO shall maintain accurate records concerning the transportation of each patient for a minimum of seven years.
(2) Each record shall include, at a minimum, the following:
(a) Patient's name;
(b) Patient's sex;
(c) Patient's age;
(d) Patient's date of birth;
(e) Patient's address;
(f) Location address of incident or pickup;
(g) Patient's chief complaint;
(h) Patient's history including:
(i) Current medical condition;
(ii) List of current medications;
(iii) Allergies;
(iv) Vital signs and time assessed
(a) Blood pressure;
(b) Pulse;
(c) Respiration;
(i) Any responsible guardian;
(j) Advanced directives, if applicable;
(k) Final destination;
(l) Treatment rendered;
(m) The following times:
(i) Time call received;
(ii) Dispatch time;
(iii) Enroute time;
(iv) On-scene time;
(v) Departure from scene time;
(vi) Arrival at destination time;
(n) The names and level of certification for all EMS providers and other medical personnel;
(o) The names of any non-EMS certified personnel, if applicable.
(3) A copy of the record for each patient shall be provided to the receiving facility, which includes all the information required, no later than twenty-four hours from time of dispatch.
Last updated September 13, 2023 at 1:02 PM
History
- Effective: June 15, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-18
(A) "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum" can be found at http://www.nhtsa.gov/people/injury/ems/web%20site%20intro.htm.
(B) "29 C.F.R. Part 1910.1030" (April 3, 2012) covers exposure to blood or other potentially infectious materials.
(C) "45 C.F.R. Part 164.512" (January 6, 2016) specifies what information can be shared under the HIPAA laws.
(D) "Ambulance Inspection Advanced Life Support (ALS)" form or form "EMS 4016" (March 2022) can be accessed at the division's website at http://www.ems.ohio.gov/forms.aspx.
(E) "Ambulance Inspection Basic Life Support (BLS) Emergency and Non-Emergency" form or form "EMS 4036" (March 2022) can be accessed at the division's website at http://www.ems.ohio.gov/forms.aspx.
(F) "Ambulance Inspection BLS Non-Emergency Only" form or form "EMS 4027" (March 2022) can be accessed at the division's website at http://www.ems.ohio.gov/forms.aspx.
(G) The MTLS online system collects and manages information in categories including service details; medical director; call volumes; communication equipment; service areas; contact information; insurance details; vehicle liability; company executives; satellite locations; vehicle information; and facility and vehicle inspection information. MTOs register and create an account to access the MTLS online system and use it to apply for, renew, and manage a medical transportation license.
(H) "Non-transport Vehicle Inspection" form or form "EMS 4026" (July 2021) can be accessed at the division's website at http://www.ems.ohio.gov/forms.aspx.
(I) "Periodic Mechanical Safety Report" form or form "EMS 4039" (July 2021) can be accessed via the division's website at http://www.ems.ohio.gov/forms.aspx.
(J) "Violation Notification" form or form "EMS 4029" (July 2021), is issued by the board to a MTO that is in violation of Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code and a sample of the form can be viewed at http://www.ems.ohio.gov/forms.aspx.
Last updated May 2, 2022 at 8:58 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-13
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-2-18 of the Administrative Code.]
(A) Staffing compliance for an MTO licensed as basic life support, intermediate life support, or advanced life support service shall be as follows:
(1) A licensed MTO that responds to a call for medical assistance or patient transport shall ensure that in responding to the call, a minimum of one permitted ambulance and at least two certified emergency medical technicians, advanced emergency medical technicians, or paramedics, or combination thereof, are dispatched and respond to the call.
(2) A licensed MTO that responds to a call for medical assistance or patient transport shall ensure that any patient transport is done by a permitted ambulance staffed with at least two certified emergency medical technicians, advanced emergency medical technicians, or paramedics, or combination thereof, on board.
(3) When an ambulance is so staffed as contained herein, the ambulance may be operated by a person who is not certified as an emergency medical technician, advanced emergency medical technician, or paramedic, but said operator shall receive certification in an emergency vehicle operator course that meets requirements of the national highway traffic safety administration's "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum" prior to operating an ambulance.
(4) An MTO licensed at the basic life support non-emergency only level or a service licensed at the basic life support emergency and non-emergency level, intermediate life support level, or advanced life support level that utilizes ambulances that are permitted at the basic life support non-emergency only level shall be staffed with at least one certified emergency medical technician, advanced emergency medical technician, or paramedic, and a qualified driver.
(B) Any non-EMS certified personnel who drive the ambulance or non-transport vehicle shall have completed an emergency vehicle operator course that meets requirements of the national highway traffic safety administration's "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum."
(C) Each MTO must supply, on request by the board or its designee, documentation that the MTO has provided all non-EMS certified personnel who drive the ambulance permitted at the basic life support non-emergency only level with training. The training to be provided includes, at minimum:
(1) Driving the ambulance;
(2) Transferring patients to and from an ambulance stretcher;
(3) Loading and unloading the stretcher to and from the ambulance with a patient;
(4) Familiarity with the equipment and supplies in the back of the ambulance;
(5) Training on use of a stairchair or other devise to transport patients up and down stairs; and
(6) Training in bloodborne pathogens regulations as set forth by 29 C.F.R. 1910.1030.
Last updated May 2, 2022 at 8:58 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-09
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-2-18 of the Administrative Code.]
(A) Ambulances and non-transport vehicles:
(1) All licensed MTOs shall ensure performance and maintain documentation of all periodic maintenance and repairs on each permitted vehicle to include:
(a) Date of service or repair;
(b) Description of service/repair performed;
(c) Name of person who performed service/repair and the business name, if applicable.
(2) Licensed MTOs shall subject all ambulance(s) and non-transport vehicle(s) to periodic mechanical safety inspection(s), which shall be documented by the service.
(a) A periodic mechanical safety inspection shall mean an inspection conducted:
(i) Prior to a vehicle's initial permit being issued for vehicles with an odometer reading of twelve thousand miles or more, and;
(ii) Annually and completed within the six month period prior to the MTO's license expiration date, or;
(iii) Every twenty-five thousand miles for a vehicle that has an odometer reading of one hundred fifty thousand miles or more.
The mechanic shall attest that the vehicle was inspected, mechanically safe, and roadworthy at the time of inspection. The mechanic shall complete and sign a "Periodic Mechanical Safety Report" for each vehicle and these reports shall be maintained by the service in the vehicle's maintenance records.
(b) Each mechanical safety inspection shall be conducted by a mechanic with factory training and certification from an original (motor vehicle) equipment manufacturer or equivalent certification for "Emergency Vehicle Technicians" (EVT) or from the "National Institute for Automotive Service Excellence" (ASE).
(c) Each mechanical safety inspection shall be conducted in addition to the vehicle and equipment inspection by the board or its designee following the procedures adopted in rule 4766-2-08 of the Administrative Code.
(d) Vehicles with failed items found during the mechanical safety inspection shall be removed from service and not placed back into service until items are corrected. Proof of correction(s) shall be maintained by the service with the "Periodic Mechanical Safety Report" form in the vehicle's maintenance records.
(3) Out of service permitted ambulance(s) or non-transport vehicle(s):
If a licensed MTO removes a permitted ambulance or non-transport vehicle from service it shall place an "out of service" sign in the permitted ambulance or non-transport vehicle to be visible through the windshield with the following information included on the front of the sign:
(a) Date permitted ambulance or non-transport vehicle was taken out of service;
(b) Odometer reading at time permitted ambulance or non-transport vehicle was taken out of service;
(c) Reason permitted ambulance or non-transport vehicle was taken out of service;
(d) Printed name and signature of person responsible for taking permitted vehicle out of service;
(e) The words "out of service" utilizing not less than three inch lettering.
(4) If a permitted ambulance or non-transport vehicle is at a repair/maintenance shop that is not owned or operated by the licensed MTO for maintenance purposes, no "out of service" sign is required.
(B) Bio-medical equipment/patient care equipment:
(1) A licensed MTO shall ensure performance and maintain documentation of all periodic maintenance and repairs of bio-medical equipment as required by manufacturer and/or food and drug administration including but not limited to the following:
(a) Date of last inspection;
(b) Date of service or repair;
(c) Description of service/repair performed;
(d) Name of who performed inspection, service, or repair;
(e) Documentation of inspection, service, or repair performed.
(2) A licensed MTO shall maintain documentation of all periodic maintenance of patient care equipment as required by the original equipment manufacturer, including but not limited to the following.
(a) Date of last inspection;
(b) Date of service or repair;
(c) Description of service/repair performed;
(d) Name of who performed inspection, service, or repair;
(e) Documentation of inspection, service, or repair performed.
(C) Ambulance and non-transport vehicle maintenance/repair records shall be kept for a period of twelve months after the vehicle is removed from inventory.
Last updated September 13, 2023 at 1:02 PM
History
- Effective: June 15, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-07
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-2-18 of the Administrative Code.]
(A) Each licensed MTO shall comply with all occupational safety and health administration-bloodborne pathogens regulations as set forth by 29 C.F.R. 1910.1030.
(B) A licensed MTO shall ensure that sanitation procedures are provided to all personnel in a written document that conforms with current standards as set forth in occupational safety and health administration-bloodborne pathogens protocol.
(C) A licensed MTO shall maintain and follow a written sanitation plan that conforms with the latest bloodborne pathogen standards as written by the occupational safety and health administration. The following documentation shall be maintained for each vehicle:
(1) Sanitation schedule;
(2) Date the sanitation was completed;
(3) Documentation of who performed sanitation.
(D) All licensed MTOs shall establish a written policy governing the use of lights and other warning devices pursuant to section 4511.24 of the Revised Code which shall be made available for inspection by the board or its designee.
Last updated September 13, 2023 at 1:02 PM
History
- Effective: June 15, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-08 Vehicle inspections and equipment requirements.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-2-18 of the Administrative Code.]
(A) The board or its designee inspects all ambulance(s) and non-transport vehicle(s) for roadworthiness and for appropriate equipment using the ambulance inspection form for the level of service the ambulance will be operated at or the "Non-transport Vehicle Inspection" form.
(B) A permitted ambulance that is being used as an ambulance shall comply with the requirements of roadworthiness and the requirements set forth in the "Ambulance Inspection Advanced Life Support (ALS)" form, the "Ambulance Inspection Basic Life Support (BLS) Emergency and Non-Emergency" form, or the "Ambulance Inspection BLS Non-Emergency Only" form, which includes carrying the following types of equipment:
(1) Oxygen equipment;
(2) Suction equipment;
(3) Airway equipment;
(4) Bleeding control/burn equipment;
(5) Isolation equipment;
(6) Immobilization equipment;
(7) Adjunct equipment;
(8) Basic life support (BLS) onboard definitive care equipment;
(9) Intermediate onboard definitive care equipment;
(10) Advanced life support (ALS) onboard definitive care equipment; and
(11) Intravenous equipment.
(C) A permitted non-transport vehicle that is being used as a non-transport vehicle shall comply with the requirements of roadworthiness and the requirements set forth in the "Non-transport Vehicle Inspection" form, which includes carrying specified definitive equipment.
(D) All equipment and supplies shall have current expiration dates where applicable.
(E) Disposable equipment is acceptable where applicable.
(F) All equipment is to securely stored in each vehicle.
(G) An MTO shall demonstrate proof that each ambulance complies with all specifications set forth in division (C)(2) of section 4766.07 of the Revised Code, by one of the following:
(1) Placard/sticker;
(2) Certificate issued by the manufacturer;
(3) Signed affidavit by the manufacturer certifying compliance with national standards in effect at time the vehicle was manufactured.
(H) The name of the MTO shall be permanently affixed to each ambulance and non-transport vehicle with letters being a minimum height of three inches on both sides and a minimum of one and one half inches on the back.
An MTO licensed at the BLS non-emergency only level shall also have permanently affixed lettering with a minimum height of three inches on the rear and both sides of the vehicle that states, "Non-emergency transports only."
An MTO licensed at the BLS emergency and non-emergency level, intermediate life support level, or advanced life support level may operate an ambulance at the BLS non-emergency only level. When doing so, the ambulance shall have magnetic signs on both front doors that state, "Non-emergency transports only" with lettering a minimum height of three inches.
If an MTO is under contract which requires other signage or if the MTO is operating under another name, each vehicle is to have permanently affixed lettering with a minimum height of one and one half inches on the rear and both sides of the vehicle that states:
(1) Owned and operated by [MTO's name]; or
(2) Operated by [MTO's name]; or
(3) Owned by [MTO's name].
(I) All violation notifications issued by the board or its designee shall be corrected.
(J) A vehicle that receives a violation notification is to be placed out of service until:
(1) It passes reinspection by the board or its designee; or
(2) If a seventy-two hour violation notification is issued by the board or its designee, until the violation is corrected and the "Violation Notification" form is signed and returned to the division along with supporting documentation showing the violation is corrected.
(K) Vehicles not titled as ambulances are not eligible for permits as ambulances, but may be issued permits as "non-transport vehicles" pursuant to section 4766.07 of the Revised Code, provided they fall within the definition of non-transport vehicles in section 4766.01 of the Revised Code.
(L) Upon issuance of a vehicle permit, each licensed MTO shall apply the decal on the outside of the right rear window in accordance with division (B)(2) of section 4766.07 of the Revised Code on each ambulance and non-transport vehicle.
The permit is to be unobstructed at all times.
(M) A permit is not transferable.
(N) The board or its designee may conduct routine unannounced inspections at any location of licensed MTO at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, ambulance(s) and non-transport vehicle(s).
(O) A permitted ambulance or non-transport vehicle is to maintain compliance with roadworthy requirements set forth in this rule at any time it is used as an ambulance or non-transport vehicle.
(P) Each permitted vehicle is to be free from dirt, stains, impurities and/or foreign matter in driver's compartment and ambulance patient care compartments.
(Q) Permitted ambulances and non-transport vehicles shall:
(1) Bear license plates issued under section 4503.49 of the Revised Code; or
(2) Comply with residency registration requirements set forth in section 4503.111 of the Revised Code.
Last updated May 2, 2022 at 8:57 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-11 Use of lights and other warning devices.
(A) Permitted ambulance(s) and non-transport vehicles(s) bearing license plates issued under section 4503.49 of the Revised Code are considered public safety vehicles pursuant to division (E)(1) of section 4511.01 of the Revised Code.
(B) Permitted ambulance(s) and non-transport vehicle(s), when responding to emergency calls, may use emergency lights and audible warning devices pursuant to section 4511.041 of the Revised Code.
(C) Permitted ambulances and non-transport vehicles shall:
(1) Bear license plates issued under section 4503.49 of the Revised Code; or
(2) Comply with residency registration requirements set forth in section 4503.111 of the Revised Code.
(3) Permitted ambulance(s) and non-transport vehicle(s) owned and operated by a federal, state, county, city, or township or a service that qualifies for gratis license plates from the bureau of motor vehicles are not required to bear ambulance license plates or non-transport vehicle license plates.
(4) No permitted ambulance being operated at the BLS non-emergency only level may respond to emergency calls or use emergency lights and audible warning devices.
Last updated May 2, 2022 at 8:57 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-14 Regulations for out of state providers.
Division (B) of section 4766.09 of the Revised Code exempts out of state MTOs receiving a patient in Ohio for transport to a location not within Ohio or when transporting a patient received in another state. An out of state MTO that receives a patient in Ohio for transportation to a location in Ohio shall be licensed and is subject to Chapter 4766. of the Revised Code and rules under this chapter and to all applicable fines and sanctions for any violation thereof.
Last updated September 13, 2023 at 1:02 PM
History
- Effective: June 15, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-15 Changes to be reported to the board.
(A) Each licensed MTO shall use the MTLS online system when making any additions, deletions, or changes in:
(1) Executive officers or board members;
(2) Medical director, including:
(a) Contact information; and
(b) Medical license number;
(3) Ownership of a licensed MTO;
(4) Tax ID or EIN number;
(5) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number.
(B) When a permitted ambulance or non-transport vehicle is permanently withdrawn from service, the licensed MTO shall delete the vehicle using the MTLS online system and remove the decal from the right rear window and destroy it.
(C) Within ten business days of the date a licensed MTO ceases to operate, it shall return to the board all vehicle decals and the certificate of licensure.
(D) Within ten business days of the date a licensed MTO ceases to operate a satellite base, it shall return to the board the certificate of licensure.
(E) A licensed MTO may apply at any time to be licensed at a higher level. The change shall be made using the MTLS online system, which includes submitting a one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766-2-04 and 4766-2-08 of the Administrative Code. A change in level of service does not change the expiration date of the license.
(F) An MTO licensed at the intermediate or advanced life support level may apply at any time to be licensed at a lower level. The change shall be made using the MTLS online system. The MTO shall also ensure compliance with rules 4766-2-04 and 4766-2-08 of the Administrative Code. A change in level of service does not change the expiration date of the license.
(G) A licensed MTO may apply at any time for change of address of headquarters location. The change shall be made using the MTLS online system. The MTO shall also ensure compliance with rules 4766-2-04 and 4766-2-08 of the Administrative Code. A change in the headquarters address does not change the expiration date of the license.
Last updated May 2, 2022 at 8:58 AM
History
- Effective: May 1, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-16 Investigations.
(A) The division may investigate all complaints on behalf of the board and in accordance with section 4766.11 of the Revised Code.
(B) After an investigation is completed and based on the findings of such investigation, the board may initiate disciplinary proceedings in accordance with Chapter 119. of the Revised Code and this chapter.
(C) If, based on the findings of an investigation, the board determines that no further action on a complaint is warranted, then the case shall be closed accordingly.
(D) The division shall conduct all investigations and any related proceedings, in such a manner as to protect patient confidentiality and in accordance with section 4765.102 of the Revised Code.
(E) Notwithstanding paragraph (D) of this rule, a patient may consent to have the board release the patient's name or other identifying information that was collected as part of the division's investigation. Such consent shall be in writing and signed by the patient in order to be considered proper.
If a patient is less than eighteen years of age, such consent shall be in writing and signed by the patient's parent, guardian, or legal custodian in order to be considered proper.
(F) No member of the board who participates in an investigation shall participate in any further adjudication of the case.
(G) No member of the board who participates in an investigation at the local level or is involved in a case locally, shall participate in any investigation or adjudication of the same case by the board.
Last updated September 13, 2023 at 1:02 PM
History
- Effective: June 15, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-2-17 Disciplinary grounds.
(A) The board may, pursuant to an adjudicatory hearing under Chapter 119. of the Revised Code and section 4766.08 of the Revised Code, and by a vote of the majority of all members, suspend, revoke, or refuse to renew any license or permit or issue a fine not to exceed more than fifteen hundred dollars, for any of the following reasons:
(1) Any violation of Chapter 4766. of the Revised Code or any rules adopted thereunder;
(2) Refusal to permit the board or its designee to inspect a vehicle, inspect the records, or inspect the physical facilities of a licensed MTO;
(3) Failure to meet vehicle standards as set forth in Chapter 4766. of the Revised Code or any rules adopted thereunder;
(4) Violation of an order issued by the board;
(5) Failure to comply with the terms of any agreement entered into with the board.
(B) Within sixty days of receipt of a complete application for licensure, pursuant to division (F) of section 4766.04 of the Revised Code, the board shall deny an application if it determines that the applicant does not meet the requirements of Chapter 4766. of the Revised Code and rules promulgated thereunder.
Last updated September 13, 2023 at 1:02 PM
History
- Effective: June 15, 2017
- Promulgated Under: 119.03
Chapter 4766-3 Ambulettes
Ohio Adm.Code 4766-3-01 Definitions.
(A) "Advanced emergency medical technician" or "AEMT" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-16-04 of the Administrative Code.
(B) "Ambulette service" has the same meaning as "nonemergency medical service organization" as defined in section 4766.01 of the Revised Code.
(C) "Board" means the state board of emergency medical, fire, and transportation services within the division of emergency medical services of the department of public safety set forth in section 4765.02 of the Revised Code.
(D) "Client" means an individual who requires the use of a wheelchair or who is confined to a wheelchair and is transported by an ambulette in order to receive health care services at a health care facility or health practitioner's office in non-emergency circumstances.
(E) "Department of Transportation (DOT) physical" is a health examination mandated by the "Federal Motor Carrier Safety Administration" (FMCSA) for commercial motor vehicle (CMV) drivers.
(F) "Division" means the division of emergency medical services within the department of public safety.
(G) "Emergency medical responder" or "EMR" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-12-04 of the Administrative Code.
(H) "Emergency medical technician" or "EMT" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-15-04 of the Administrative Code.
(I) "Headquarters" means the location from which a licensed ambulette service operates and designated by the licensed ambulette service as the location where the records set forth in this chapter are maintained or readily available.
(J) "Inspection fee" means a fee required to be paid for the inspection of a permitted vehicle.
(K) "Medical transportation licensing system" or "MTLS online system" means a web based system for medical transportation agencies to obtain, renew, and maintain their licenses.
(L) "License" means a certificate of licensure issued by the board to the service, also known as the licensed ambulette service.
(M) "Operate" means to engage in conduct or activity in furtherance of the licensed activity at or from a physical location owned, leased or maintained by the licensed ambulette service where employees report to work and vehicles are stored. Operate also includes the act of receiving a person within Ohio for transportation to a location within Ohio.
(N) "Paramedic" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-17-03 of the Administrative Code.
(O) "Permit" is the authorization to operate issued by the board as set forth in section 4766.07 of the Revised Code for a specific vehicle, known as the "permitted vehicle" and requires the issuance of a decal for the permitted vehicle by the board or its designee.
(P) "Readily available" means produced upon demand by the board.
(Q) "Reinspection fee" means a fee required to conduct an inspection as a result of the issuance of a violation notification by the board or its designee, to a licensed ambulette service or license applicant, regarding a permitted ambulette or an ambulette for which a permit application is pending with the board.
(R) "Satellite base" means a physical location other than the headquarters from which an ambulette service, licensed as set forth in Chapter 4766. of the Revised Code operates.
(S) "Temporary vehicle" means an ambulette issued a temporary permit used to replace a permitted ambulette in accordance with rule 4766-3-12 of the Administrative Code that is out of service until the permitted ambulette is returned to service or is replaced. A temporary vehicle may be used for a time period not to exceed sixty days.
(T) "Violation notification" means a written form issued by the board or its designee during an inspection or investigation identifying deficiencies in record keeping requirements, vehicle roadworthiness requirements, or equipment requirements by a service or its vehicle(s).
Last updated June 15, 2022 at 9:51 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4765-16-04
(A) In addition to the emergency medical services listed in rules 4765-12-04 and 4765-15-04 of the Administrative Code, and in accordance with section 4765.38 of the Revised Code, an advanced emergency medical technician may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.38 of the Revised Code:
(1) Cardiac monitor strip interpretation;
(2) Manual defibrillation;
(3) Obtaining blood specimens;
(4) Subcutaneous or intramuscular administration of epinephrine;
(5) Intravenous access and peripheral initiation;
(6) Intravenous maintenance and fluid administration;
(7) Intraosseous insertion;
(8) Saline lock.
(B) In addition to the emergency medical services described in paragraph (A) of this rule, and in accordance with section 4765.38 of the Revised Code, an advanced emergency medical technician who has completed a training program pursuant to this chapter of the Administrative Code may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.38 of the Revised Code:
(1) Administration of the following medications:
(a) Sublingual nitroglycerin (non-patient assisted);
(b) Dextrose in water;
(c) Epinephrine at the concentration of one milligram per milliliter via subcutaneous or intramuscular routes;
(d) Diphenhydramine;
(e) Benzodiazepines;
(f) Bronchodilators;
(g) Naloxone via endotracheal tube, intramuscular, intravenous, intraosseous, or subcutaneous;
(h) Glucagon;
(i) Nitrous oxide;
(j) Nalbuphine;
(k) Narcotics or other analgesics for pain relief;
(l) Lidocaine, for pain relief after intraosseous insertions;
(m) Oral ondansetron for patients twelve years or older;
(n) Ketamine;
(o) Any additional drug approved by the board.
(2) Administration of aerosolized or nebulized medications (non-patient assisted);
(3) Administration of intranasal medications;
(4) Orotracheal intubation of the apneic patient;
(5) Orotracheal intubation of the pulseless and apneic patient;
(6) Dual lumen airway of the apneic patient;
(7) Extraglottic airway of the apneic patient;
(8) Needle decompression of the chest;
(9) Tracheostomy tube replacement;
(10) Laryngoscopy for removal of airway obstruction;
(11) Set up and application of a twelve-lead electrocardiogram, in accordance with written protocols, in either of the following instances:
(a) When the advanced emergency medical technician is assisting a paramedic; or
(b) For the purpose of electronic transmission by the advanced emergency medical technician, provided the following conditions are met:
(i) The advanced emergency medical technician does not interpret the electrocardiogram;
(ii) The advanced emergency medical technician minimizes any delay of patient transport while obtaining a twelve-lead electrocardiogram;
(iii) The advanced emergency medical technician utilizes the twelve-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.
(12) Withdraw blood for the purpose of determining the alcohol, drug, controlled substance, metabolite of a controlled substance, or combination content of the whole blood, blood serum, or blood plasma as provided in division (C) of section 4765.38 of the Revised Code when performed in accordance with the criteria established in rule 4765-6-06 of the Administrative Code and the protocols established by the medical director of the emergency medical service organization with which the advanced emergency medical technician is affiliated.
(13) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code.
(14) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those advanced emergency medical technicians who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code to include the withdrawing of blood for evidence collection.
(E) An advanced emergency medical technician shall not perform emergency medical services within this rule unless the advanced emergency medical technician has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the advanced emergency medical technician scope of practice, were not included in the training specified in this paragraph, the advanced emergency medical technician must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:22 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4765-12-04
(A) In accordance with section 4765.35 of the Revised Code, an emergency medical responder may perform the following emergency medical services:
(1) Open and maintain the airway;
(2) Oropharyngeal airway adjunct;
(3) Nasopharyngeal airway adjunct;
(4) Manual removal of obstructed airway;
(5) Oral suctioning;
(6) Oxygen administration, including the following:
(a) Nasal cannula;
(b) Non-rebreather mask;
(c) Mouth-to-barrier devices;
(7) Ventilation management, including the following:
(a) Bag-valve-mask;
(b) Ventilation with a flow-restricted oxygen-powered device;
(8) Cardiopulmonary resuscitation;
(9) Automated external defibrillation;
(10) Spine board (long and short);
(11) Splinting devices;
(12) Cervical immobilization device;
(13) Soft tissue management;
(14) Controlling of hemorrhaging;
(15) Taking and recording of vital signs;
(16) Patient care report documentation;
(17) Assisting in emergency childbirth management;
(18) Identifying and interacting with individuals with dementia;
(19) Trauma triage determination pursuant to rule 4765-14-02 of the Administrative Code.
(B) In accordance with division (B) of section 4765.35 of the Revised Code, an emergency medical responder may perform the following additional emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.35 of the Revised Code:
(1) Body substance isolation precaution/administration;
(2) Assisted administration of epinephrine auto-injector, which shall consist of either of the following:
(a) Patient's prescribed epinephrine upon the patient's request and with written protocol;
(b) EMS-provided epinephrine with written protocol.
(3) Administration of epinephrine auto-injector, which shall consist of either of the following:
(a) Patient's prescribed epinephrine upon the patient's request and with written protocol;
(b) EMS-provided epinephrine with written protocol.
(4) Apply and obtain readings of pulse oximeter and CO-oximeter, capnography equipment, or capnometry equipment;
(5) Administration of naloxone via intranasal route or via auto-injector with written protocol;
(6) Eye irrigation;
(7) Apply and utilize chest compression assist devices;
(8) Management of suspected fractures;
(9) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code;
(10) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.
(C) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those emergency medical responders who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code.
(D) An emergency medical responder shall not perform emergency medical services within this rule unless the emergency medical responder has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the emergency medical responder scope of practice, were not included in the training specified in this paragraph, the emergency medical responder must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:21 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4765-15-04
(A) In addition to the emergency medical services listed in rule 4765-12-04 of the Administrative Code and in accordance with section 4765.37 of the Revised Code, an emergency medical technician may perform the following emergency medical services:
(1) Endotracheal suctioning through a previously established airway;
(2) Endotracheal suctioning through a stoma;
(3) Oxygen administration, including the following:
(a) Partial rebreather masks;
(b) Venturi masks.
(4) Ventilation management, to include the use of a positive pressure ventilation device, including the following:
(a) Manually triggered ventilators;
(b) Automatic transportation ventilators.
(5) Traction splint;
(6) Rapid extrication procedures.
(B) In accordance with division (B) of section 4765.37 of the Revised Code, an emergency medical technician may perform the following additional emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.37 of the Revised Code:
(1) Pulse oximeter and capnography equipment application and reading;
(2) Dual lumen airway of pulseless and apneic patients only;
(3) Oxygen humidifier equipment application and monitoring;
(4) Extraglottic airway of pulseless and apneic patients only;
(5) Continuous positive airway pressure (CPAP);
(6) End tidal carbon dioxide monitoring and detecting;
(7) Chest compression assist devices;
(8) Negative impedance threshold devices;
(9) Administration of aspirin;
(10) Helmet removal;
(11) Glucose monitoring system;
(12) Administration of oral glucose;
(13) Administration of epinephrine auto-injector to a patient suffering from anaphylaxis;
(14) Assisted administration of sublingual nitroglycerin, which shall consist of either of the following:
(a) Assisting with patient's prescribed nitroglycerin upon the patient's request and with written protocol;
(b) Assisting with EMS-provided nitroglycerin with verbal medical direction.
(15) Assisted administration of aerosolized or nebulized medications, which shall consist of either of the following:
(a) Assisting with a patient's prescribed aerosolized or nebulized medications upon the patient's request and with written protocol;
(b) Assisting with EMS-provided aerosolized or nebulized medications with verbal medical direction.
(16) Prehospital advanced life support assistance, to include the setting up of an intravenous administration kit in the presence of an advanced emergency medical technician or paramedic;
(17) Transport of a central/peripheral intravenous access without an infusion;
(18) Set up and application of a cardiac monitor in the presence of an advanced emergency medical technician or paramedic;
(19) Set up and application of a twelve-lead electrocardiogram, in accordance with written protocols, in either of the following instances:
(a) When the emergency medical technician is assisting an paramedic; or
(b) For the purpose of electronic transmission by the emergency medical technician, provided the following conditions are met:
(i) The emergency medical technician does not interpret the electrocardiogram;
(ii) The emergency medical technician minimizes any delay of patient transport to obtain a twelve-lead electrocardiogram;
(iii) The EMT utilizes the twelve-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.
(20) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code;
(21) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those emergency medical technicians who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code.
(E) An emergency medical technician shall not perform emergency medical services within this rule unless the emergency medical technician has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the emergency medical technician scope of practice, were not included in the training specified in this paragraph, the emergency medical technician must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:22 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4765-17-03
(A) In addition to the skills listed in rules 4765-12-04, 4765-15-04 and 4765-16-04 of the Administrative Code, and in accordance with section 4765.39 of the Revised Code, a paramedic may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.39 of the Revised Code:
(1) Orotracheal intubation;
(2) Nasotracheal intubation;
(3) Cricothyrotomy (surgical);
(4) Cricothyrotomy (needle);
(5) Dual lumen airways;
(6) Extraglottic airways;
(7) Positive end-expiratory pressure;
(8) Bilevel positive air pressure;
(9) Ventilator management of patients sixteen years of age or older;
(10) Chest tube monitoring and management;
(11) Central line monitoring;
(12) Transcutaneous cardiac pacing;
(13) Administration of cardiac medication;
(14) Cardioversion;
(15) Twelve-lead electrocardiogram performance and interpretation;
(16) Administration of nitroglycerin;
(17) Administration of aerosolized or nebulized medication;
(18) Epinephrine administration via intravenous or intraosseous route;
(19) Placement of nasogastric or orogastric tubes;
(20) Administration of other medications pursuant to written protocols;
(21) Intravenous infusion pump;
(22) Blood chemistry analysis;
(23) Thrombolytic therapy initiation and monitoring;
(24) Immunizations for influenza to firefighters, EMTs, AEMTs, or paramedics in accordance with section 4765.391 of the Revised Code;
(25) Maintenance of medicated intravenous fluids;
(26) Maintenance of blood administration;
(27) Eye irrigation morgan lens;
(28) Withdraw blood for the purpose of determining the alcohol, drug, controlled substance, metabolite of a controlled substance, or combination content of the whole blood, blood serum, or blood plasma as provided in division (C) of section 4765.39 of the Revised Code when performed in accordance with the criteria established in rule 4765-6-06 of the Administrative Code and the protocols established by the medical director of the emergency medical service organization with which the paramedic is affiliated;
(29) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study;
(30) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code.
(B) A paramedic may perform non-emergent ambulance transport of a stable patient less than sixteen years of age who has a chronic condition requiring a tracheostomy tube and a ventilator provided the patient's caregiver accompanies the patient during transport and the patient's caregiver has received appropriate training in use of the patient's ventilator.
A caregiver is not required to accompany the patient if the patient is accompanied by an Ohio licensed registered nurse or respiratory therapist, or other appropriately trained and licensed Ohio healthcare provider.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those paramedics who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code to include the withdrawing of blood for evidence collection.
(E) A paramedic shall not perform emergency medical services within this rule unless the paramedic has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the paramedic scope of practice, were not included in the training specified in this paragraph, the paramedic must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:23 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-12
(A) In the event of a disaster situation when permitted ambulette(s) based in the locality of the disaster situation are incapacitated or insufficient in number to render ambulette(s) needed, a licensed ambulette service may utilize whatever means necessary to transport.
(B) An ambulette that has not been issued a permit by the board may be issued a temporary permit, for a period not to exceed sixty days, if the ambulette is used to replace a permitted ambulette that has been temporarily taken out of service for repair or maintenance or is being permanently replaced. In order to obtain a temporary permit, an ambulette service shall submit to the board a request for a temporary ambulette permit using the MTLS online system containing:
(1) Vehicle identification number of the permitted ambulette;
(2) Date permitted ambulette was placed out of service; and
(3) Vehicle identification number of the ambulette to receive a temporary permit.
(C) A temporarily permitted ambulette shall not be operated unless it meets the requirements set forth in paragraph (B) of rule 4766-3-08 of the Administrative Code and the insurance requirement set forth in division (B) of section 4766.06 of the Revised Code.
Last updated June 15, 2022 at 9:52 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-02 Application for initial or renewal licensure.
(A) An ambulette service applying for initial licensure shall submit to the board a completed application, in the English language, using the MTLS online system:
(1) Accompanied by the appropriate fees as set forth in rule 4766-3-03 of the Administrative Code; and
(2) With all required supporting documentation as set forth in this rule.
(B) An ambulette service applying for renewal of a license shall submit to the board a completed renewal application, in the English language, using the MTLS online system:
(1) Accompanied by the appropriate fees as set forth in rule 4766-3-03 of the Administrative Code; and
(2) With all required supporting documentation as set forth in this rule that must be received by the board prior to the expiration date of the license.
(C) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the ambulette service applicant shall provide and maintain documentation of:
(1) The name of service, organizational structure and address of applicant as follows:
(a) Name;
(b) Identification of organizational structure as a corporation (whether for profit or not-for-profit); limited liability company; partnership; limited liability partnership; government unit; or sole proprietor (individual human);
(c) Tax identification (tax ID) number or employer identification number (EIN);
(d) All other names under which applicant plans to operate while using the same tax ID or EIN number. Business organizations with different tax ID or EIN numbers cannot operate under the same license;
(e) Copies of all trade name registrations and fictitious name registrations for all other names under which applicant plans to operate on file with the Ohio secretary of state;
(f) Address of physical location of applicant's headquarters (no post office box);
(g) Mailing address of applicant; and
(h) List of all ambulette drivers working for the service and the date of hire for each ambulette driver.
(2) All medicaid provider numbers, if applicable;
(3) Service areas including county and state;
(4) For each satellite base, the ambulette service shall provide the physical address, city, county, state, and zip code;
(5) The name of the primary contact person(s), business or administrative office telephone number, email address of applicant, and if applicable, office fax number;
(6) A list of the names of all officers, directors, and/or owners of applicant/ambulette service;
(7) Year of manufacture, make, model, vehicle identification number, service's vehicle number, odometer reading, and license plate number (renewal only) of each ambulette applicant seeks to be permitted;
(8) A color photograph of the side of applicant's ambulette displaying color scheme, insignia, monogram, or other distinguishing characteristic. If multiple color schemes, insignias, monograms, or other distinguishing characteristics are used, a color photograph of each shall accompany application.
(a) Color photographs shall be submitted to the division:
(i) With all initial applications; and
(ii) Within thirty days of the date a change is made to the vehicle's color scheme, insignia, monogram, or other distinguishing characteristics.
(b) Digital photographs are preferred.
(9) A current and valid certificate of liability insurance in the name of applicant, listing the board as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code;
(a) The actual name on the license application shall appear on the certificate of liability insurance;
(b) Each permitted vehicle with vehicle identification number (VIN) shall be listed on the certificate of liability insurance.
(D) An application that is not completed in the manner specified on the application or does not include all required documentation shall be deemed incomplete.
(E) An application deemed incomplete shall not be considered and may be returned with the notation to the applicant indicating the reason the application is incomplete.
(F) Failure to provide the required documents within thirty days of the date the initial application is received by the division may result in the application being deemed incomplete.
(G) An ambulette service shall submit a completed renewal application, appropriate fees, and supporting documentation to the board using the MTLS online system prior to the expiration of the ambulette service's license in order to be considered timely.
(H) No applicant or licensed ambulette service shall submit false, misleading, or deceptive information in order to obtain a license or permit.
(I) A license is only valid for the ambulette service for which it is issued and is not transferable.
Last updated June 15, 2022 at 9:51 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-03
(A) Each ambulette service shall pay an initial or renewal license fee of one hundred dollars annually.
(B) Each ambulette service shall pay a permit fee for each ambulette of fifty dollars annually;
(C) Each ambulette service shall pay an inspection fee of fifty dollars per ambulette annually;
(D) Each ambulette service shall pay a fifty dollar reinspection fee for every ambulette that requires reinspection as a result of a violation notification issued by the board or its designee.
(E) Each ambulette service shall pay a fifty dollar fee for each temporary vehicle permit to be issued.
(F) Fees shall be submitted with the application.
(G) Each ambulette service may pay a re-print fee of five dollars for each vehicle decal that shall be re-printed as a result of the decal being lost, damaged, incorrectly applied, or incorrect vehicle information provided to the division by the service.
Last updated June 15, 2022 at 9:51 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-04 Physical facilities.
(A) The board or its designee shall conduct initial and renewal inspections of all ambulette services pursuant to Chapter 4766. of the Revised Code and rules 4766-3-04 to 4766-3-06 of the Administrative Code to include the following:
(1) Ambulette service headquarters;
(2) Ambulette service satellite base(s).
(B) An ambulette service shall not commence operations from its headquarters or satellite bases until the ambulette service has met all requirements set forth in Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code including satisfactory inspections of all physical locations.
(C) An ambulette service shall ensure compliance with the inspection standards for physical facilities. Inspection standards for physical facilities of an ambulette service are:
(1) The board issued license shall be prominently displayed in a conspicuous location at every licensed facility (renewal inspection only);
(2) The physical facilities shall be clean and free of debris.
(D) The board or its designee may conduct routine unannounced inspections at any location of licensed ambulette service at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, the following:
(1) Ambulette service headquarters;
(2) Ambulette service satellite base(s);
(3) Ambulettes.
Last updated June 15, 2022 at 9:51 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-06
(A) The ambulette service shall be capable of two-way communication with all the service's permitted ambulette(s):
(B) All portable communication devices shall maintain either a one hundred ten volt or twelve volt power source backup for each communication device.
Last updated September 13, 2023 at 1:03 PM
History
- Effective: April 16, 2012
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-05 Record keeping requirements.
(A) Each licensed ambulette service shall maintain or have readily available at its headquarters accurate records concerning the transportation of each client;
All client transportation records shall be generated and completed immediately upon completion of the transport and shall include, at minimum, the following:
(1) Client name;
(2) Address of:
(a) Client pick up location; and
(b) Client destination (drop off location);
(3) Date and time of:
(a) Ambulette arrival at client pick up location; and
(b) Ambulette arrival at client destination (drop off location);
(4) Name or ID number of ambulette driver;
(5) Service vehicle number.
(B) Each licensed ambulette service shall maintain a current and valid certificate of liability insurance issued by an insurer licensed to do business in this state that includes a thirty day notice of cancellation to the board in compliance with the terms set forth in Chapter 4766. of the Revised Code listing the board as certificate holder. Each scheduled vehicle must be listed on the certificate or attached on an additional page to the certificate to include the vehicles year, make, model and vehicle identification number, (VIN). If the certificate lists, "any auto" or "all owned autos" a list of vehicles does not have to be included or attached.
(C) A licensed ambulette service shall make all client transportation record(s) and ambulette maintenance/repair records available to the board or its designee, upon demand, during any inspection, announced or unannounced.
(D) A licensed ambulette service shall maintain documentation of compliance with the periodic mechanical safety inspection set forth in rule 4766-3-09 of the Administrative Code.
(E) Client transportation records shall be maintained by the licensee for a period of seven years after the date of transport.
Last updated September 13, 2023 at 1:03 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-09
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-3-18 of the Administrative Code.]
(A) All licensed ambulette services shall maintain documentation of all periodic maintenance and repairs performed on each permitted ambulette to include:
(1) Date of service or repair;
(2) Description of service/repair performed;
(3) Documentation of who performed service/repair and the business name, if applicable;
(4) VIN number of the vehicle being repaired;
(5) Odometer reading of ambulette at the time of repair.
(B) Licensed ambulette services shall subject all permitted ambulettes to periodic mechanical safety inspection(s), which shall be documented by the service.
(1) A periodic mechanical safety inspection shall mean an inspection conducted:
(a) Prior to a vehicle's initial permit being issued for vehicles with an odometer reading of twelve thousand miles or more, and;
(b) Annually and completed within the six month period prior to the ambulette service's license expiration date, or;
(c) Every twenty-five thousand miles for a vehicle that has an odometer reading of one hundred fifty thousand miles or more.
The mechanic shall attest that the vehicle was inspected, mechanically safe, and roadworthy at the time of inspection. The mechanic shall complete and sign a "Periodic Mechanical Safety Report" for each vehicle and these reports shall be maintained by the service in the vehicle's maintenance records.
(2) Each mechanical safety inspection shall be conducted by a mechanic with factory training and certification from an original (motor vehicle) equipment manufacturer or equivalent certification for "Emergency Vehicle Technicians" (EVT) or from the "National Institute for Automotive Service Excellence" (ASE).
(3) Each mechanical safety inspection shall be conducted in addition to the vehicle and equipment inspection by the board or its designee following the procedures adopted in rule 4766-3-08 of the Administrative Code.
(4) Vehicles with failed items found during the mechanical safety inspection shall be removed from service and not placed back into service until items are corrected. Proof of correction(s) shall be maintained by the service with the "Periodic Mechanical Safety Report" form in the vehicle's maintenance records. Licensed ambulette services shall subject all licensed ambulettes to periodic mechanical safety inspection(s), which shall be documented by the service.
(C) All licensed ambulette services shall maintain documentation of all periodic maintenance, repairs and cleaning performed on passenger compartment of the vehicle to include:
(1) Daily inspection and cleaning of the interior passenger compartment of each vehicle and lift/ramp to include:
(a) Ramp/lift clean and free of debris;
(b) Ramp/lift properly secured to the vehicle with no excess movement;
(c) Ramp/lift overall operating condition, including operating the ramp to verify that it is working properly;
(d) Vehicle interior is clean, floors are clean and free of debris;
(e) Floor or wall wheelchair locking mechanism and/or floor rails or fasteners and straps and locks for securing wheelchair are clean and in proper working order;
(f) Passenger restraint belts in proper working order;
(g) Properly functioning heat and air conditioning.
(h) Elastic straps, such as bungee cords, are prohibited from being used to secure equipment or supplies.
(2) Date of inspection, service/repair and cleaning;
(3) Description of service/repair performed;
(4) Documentation of who performed service/repair and the business name, if applicable.
(D) Out of service permitted ambulettes:
(1) If a licensed ambulette service removes a permitted ambulette from service it shall place an "out of service" sign in the permitted ambulette to be visible through the windshield with the following information included on the sign:
(a) Date permitted ambulette was taken out of service;
(b) Odometer reading at time permitted ambulette was taken out of service;
(c) Reason permitted ambulette was taken out of service;
(d) Printed name and signature of person responsible for taking permitted ambulette out of service;
(e) The words "out of service" utilizing not less than three inch lettering on front of sign.
(2) If the permitted ambulette is off premises at a repair/maintenance shop for maintenance purposes, no "out of service" sign is required.
(E) Ambulette maintenance/repair records shall be kept for a period of twelve months after the vehicle is removed from inventory.
Last updated September 13, 2023 at 1:03 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-07 Ambulette license plates.
Permitted ambulette vehicles shall bear "Ambulette" license plates issued as set forth in section 4503.49 of the Revised Code, or shall comply with:
(A) Residency registration requirements set forth in section 4503.111 of the Revised Code.
(B) Vehicle specific BMV license plate requirements for vehicles with a gross vehicle weight rating (GVWR) of ten thousand pounds or more.
(C) Permitted ambulette(s) owned and operated by a federal, state, county, city, or township or a service that qualifies for gratis license plates from the bureau of motor vehicles are not required to bear ambulette license plates.
Last updated September 13, 2023 at 1:03 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-08 Vehicle inspections and equipment requirements.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-3-18 of the Administrative Code.]
(A) The board or its designee shall inspect all ambulettes for roadworthiness and for appropriate equipment as set forth in the "Ambulette Inspection" form.
(B) A permitted ambulette that is being used as an ambulette shall comply with the requirements of roadworthiness and the requirements set forth in the "Ambulette Inspection" form, which shall include carrying the following types of equipment:
(1) Fire extinguisher;
(2) Blanket;
(3) Disinfectants;
(4) Oxygen equipment;
(5) Isolation equipment; and
(6) First aid equipment.
(C) The name of the ambulette service shall be permanently affixed to each ambulette with letters being a minimum height of three inches on both sides and a minimum height of one and one half inches on the back.
If an ambulette service is under contract which requires other signage or if the ambulette service is operating under another name, each vehicle shall have permanently affixed lettering with a minimum height of one and one half inches on the rear and both sides of the vehicle that states:
(1) Owned and operated by [ambulette service's name]; or
(2) Operated by [ambulette service's name]; or
(3) Owned by [ambulette service's name].
(D) All violation notifications issued by the board or its designee shall be corrected. Each vehicle that receives a violation notification shall be placed out-of-service until:
(1) It passes reinspection by the board or its designee; or
(2) For seventy-two hour violation notifications, the violation has been corrected and the "Violation Notification" form is signed and returned to the division along with supporting documentation showing the violation has been corrected.
(E) Ambulette configuration:
(1) For vehicles in excess of twenty-two feet in length, the overhead clearance between the top of the door opening and the raised lift platform, or highest point of a ramp, shall be a minimum of sixty-eight inches. For vehicles of twenty-two feet in length or less, the overhead clearance between the top of the door opening and the raised lift platform, or highest point of a ramp, shall be a minimum of fifty-six inches;
(2) Each vehicle shall be specifically designed to transport one or more patients sitting in wheelchairs and have four point permanent fasteners to secure the wheelchair to the floor or side of the vehicle to prevent wheelchair movement;
(3) Each vehicle shall have safety restraints in the vehicle for the purpose of restraining the patient in the wheelchair;
(4) Each vehicle shall be equipped with a stable access ramp or hydraulic lift;
(5) Each vehicle shall have provisions for secure storage of removable equipment and passenger property in order to prevent projectile injuries to passengers and driver in the event of an accident. Containers and/or straps must be secured and permanently mounted to the vehicle and in proper working order. Elastic straps, such as bungee cords, are prohibited.
(F) Upon issuance of a vehicle permit, each licensed ambulette service shall apply the decal on the outside of the right rear window in accordance with division (B)(2) of section 4766.07 of the Revised Code on each ambulette.
The permit shall be unobstructed at all times.
(G) A permit is not transferable.
(H) The board or its designee may conduct routine unannounced inspections at any location of licensed ambulette service at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, ambulettes.
(I) A permitted ambulette shall maintain compliance with roadworthiness requirements set forth in this rule at any time it is used as an ambulette.
(J) Each permitted ambulette shall be free from dirt, stains, impurities, and/or foreign matter in driver's compartment and ambulette client compartments.
(K) Permitted ambulettes shall bear license plates issued as set forth in rule 4766-3-07 of the Administrative Code.
Last updated September 13, 2023 at 1:03 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-18
(A) "Ambulette Inspection" form or form "EMS 4019" (February 2021) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(B) The MTLS online system collects and manages information in categories including service details; medical director; call volumes; communication equipment; service areas; contact information; insurance details; vehicle liability; company executives; satellite locations; vehicle information; and facility and vehicle inspection information. MTOs register and create an account to access the MTLS online system and use it to apply for, renew, and manage a medical transportation license.
(C) "Periodic Mechanical Safety Report" form or form "EMS 4039" (July 2021) can be accessed via the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(D) "Violation Notification" form or form "EMS 4029" (July 2021) is issued by the board to an ambulette service/non-emergency medical services organization that is in violation of Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code and a sample of the form can be viewed at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
Last updated June 15, 2022 at 9:52 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-13 Driver training and qualifications.
(A) The ambulette service shall maintain and provide adequate documentation of the following driver/operator requirements for each of its drivers:
(1) A copy of a valid driver/operator license issued pursuant to Chapter 4506. or 4507. of the Revised Code or its equivalent if the applicant is a resident of another state:
(a) Driver/operator shall be at least eighteen years of age to operate an ambulette;
(b) Each ambulette driver shall have at least two years driving experience;
(2) A copy of a valid driver/operator's abstract obtained from the bureau of motor vehicles from the state in which the driver's license was issued at the time of the application for employment and annually thereafter;
(a) The date of the driving abstract submitted at the time of application shall be no more than fourteen calendar days prior to the date of application for employment;
(b) Driver/operators having six points or more on their driving abstract in accordance with section 4510.036 of the Revised Code cannot be an ambulette service driver;
(c) Ambulette service may use documentation from their commercial insurance carrier as proof the standard in this paragraph has been met. This document must include the names of all insured drivers verifying the eligibility of the driver.
(3) A copy of a current and valid certification in adult cardiopulmonary resuscitation (CPR) and shall include hands on training from the "American Red Cross," "American Heart Association," or "American Safety and Health Institute," (ASHI) or equivalent certifying organization approved by the board;
(4) A copy of a current and valid certification in basic first aid and shall include hands on training from the "American Red Cross," "American Heart Association," or "American Safety and Health Institute," (ASHI) or equivalent certifying organization approved by the board; or a current and valid certification as a/an:
(a) Emergency medical responder;
(b) Emergency medical technician;
(c) Advanced emergency medical technician; or
(d) Paramedic.
(5) At least once every three years, satisfactory completion of a passenger assistance training course to include the following elements:
(a) Sensitivity to aging:
(b) Overview of diseases and functional factors commonly affecting older adults;
(c) Environmental considerations affecting consumers;
(d) Consumer assistance and transfer techniques;
(e) Management of a wheelchair, including the proper methods for securing a wheelchair in the vehicle and the client in the wheelchair;
(f) Inspection and operation of a wheelchair lift and other types of assistive equipment, and;
(g) Emergency procedures.
(6) Services can use commercially designed courses approved by the board or develop their own training course as long as required elements are met. All courses shall include hands on training for loading and unloading the client in the wheelchair, securing the client in the wheelchair, and securing the wheelchair in the vehicle.
(a) Services that use a commercially developed training course for their employees shall also show documentation of hands on training.
(b) Services that develop their own training course shall make available to the board, upon request, a written course outline documenting all course elements, all course training material used, and documentation of hands on training. Training course developed by the service is subject to prior approval by the board.
(7) A copy of a valid criminal background check:
(a) Conducted by the bureau of criminal identification and investigation in accordance with section 109.572 of the Revised Code; or
(b) Conducted by the federal bureau of investigations (FBI) for an individual who has not lived in the state of Ohio for at least five years immediately prior to application.
(8) A copy of a valid signed statement from a physician, nurse practitioner, or physician's assistant acting within their scope of practice or a department of transportation (DOT) physical declaring that the driver/operator does not have a medical condition, physical condition, including vision impairment (not corrected), which could interfere with safe driving, passenger assistance, the provision of emergency treatment activity, or could jeopardize the health and welfare of client and/or general public;
(9) A copy of valid test results from an alcohol and controlled substances test to be conducted by a laboratory certified for such testing under "CLIA" and determined to be free of alcohol, amphetamines, cannabinoids (THC), cocaine, opiates, and phencyclidines (PCP).
(a) The tests shall be performed and the results placed in the employee's file as provided in paragraph (C) of this rule;
(b) Repeat drug and alcohol testing shall be performed at a minimum whenever the driver has been involved in a motor vehicle accident for which he/she was the driver.
(10) The ambulette service shall provide each driver/operator with an identification card visible to the client identifying their first name and last initial or a unique identifier and ambulette service affiliation.
(B) An ambulette service shall at all times maintain staffing of ambulette(s) by an ambulette driver who meets the requirements of division (A) of section 4766.15 of the Revised Code.
(C) An ambulette service may employ an applicant on a temporary provisional basis pending completion of the requirements of this rule pursuant to section 4766.15 of the Revised Code.
(1) The provisional period for completion of requirements set forth in paragraphs (A)(3) to (A)(7) of this rule shall be no more than sixty days.
(2) The provisional period for completion of requirements set forth in paragraphs (A)(1) and (A)(2) and paragraphs (A)(8) to (A)(10) of this rule shall be no more than fourteen days.
(D) No ambulette service shall employ as an ambulette driver, any person who has been convicted of or plead guilty to violations as set forth in divisions (A)(1)(a), (A)(2)(a), (A)(4)(a), and/or (A)(5)(a) of section 109.572 of the Revised Code or their equivalent in any jurisdiction unless the exceptions set forth in paragraphs (A) and (B) of rule 3701-13-06 of the Administrative Code apply.
(E) No ambulette service shall employ as an ambulette driver any person who has six points or more on their driving abstract in accordance with section 4510.036 of the Revised Code.
(F) No ambulette service shall employ any person as an ambulette driver unless that person has a valid driver/operator license issued pursuant to Chapter 4506. or Chapter 4507. of the Revised Code or its equivalent if the person is a resident of another state.
(G) No ambulette service shall employ any person as an ambulette driver unless the person is at least eighteen years of age and has at least two years driving experience.
(H) No ambulette service shall employ any person as an ambulette driver unless the person holds a current and valid certification in CPR and one of the following:
(1) Basic first aid;
(2) Emergency medical responder;
(3) Emergency medical technician;
(4) Advanced emergency medical technician;
(5) Paramedic.
(I) No ambulette service shall employ any person as an ambulette driver unless the person has successfully completed a program designed for transporting clients with special needs as set forth in paragraph (A)(5) of this rule.
Last updated June 15, 2022 at 9:52 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-14 Regulations for out of state providers.
The exemption from licensure in division (B) of section 4766.09 of the Revised Code exempts out of state ambulette services receiving a client in Ohio for transport to a location not within Ohio or when transporting a client received in another state to an Ohio destination. An out of state ambulette service that receives a client in Ohio for transportation to a location in Ohio shall be licensed and is subject to Chapter 4766. of the Revised Code and rules under this chapter and to all applicable fines and sanctions for any violation thereof.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: April 16, 2012
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-15 Changes to be reported to the board.
(A) Ambulette service shall notify the board using the MTLS online system prior to or not less than ten days after changes in:
(1) Executive officers or board members;
(2) Directors;
(3) Ownership of a licensed ambulette service;
(4) Purchase or acquisition of a licensed ambulette service;
(a) The purchaser shall be required to submit a new application for licensure, complete appropriate inspections, and pay all applicable fees if operating as a separate business (different tax ID number); or
(b) The purchaser shall report to the board that the acquired service and vehicles will be absorbed into his or her existing licensed service (same tax ID number).
(5) Tax ID or EIN number;
(6) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number.
(B) When a permitted ambulette is permanently withdrawn from service, the licensed ambulette service shall delete the vehicle using the MTLS online system and remove the decal from the right rear window and destroy it.
(C) Within ten days of the date a licensed ambulette service ceases to operate, it shall return to the board all vehicle permits and the certificate of licensure.
(D) Within ten days of the date a licensed ambulette service ceases to operate a satellite location, it shall return to the board the certificate of licensure.
(E) A licensed ambulette service may apply at any time for change of address of headquarters location. The change shall be made using the MTLS online system . The ambulette service shall also ensure compliance with rule 4766-3-04 of the Administrative Code. A change in the headquarters address does not change the expiration date of the license.
Last updated June 15, 2022 at 9:52 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-16 Investigations.
(A) The division may investigate all complaints on behalf of the board and in accordance with section 4766.11 of the Revised Code.
(B) After an investigation is completed and based on the findings of such investigation the board may initiate disciplinary proceedings in accordance with Chapter 119. of the Revised Code and this chapter.
(C) If, based on the findings of an investigation, the board determines that no further action on a complaint is warranted, then the case shall be closed accordingly.
(D) The division shall conduct all investigations and any related proceedings, in such a manner as to protect patient confidentiality and in accordance with section 4765.102 of the Revised Code.
(E) Notwithstanding paragraph (D) of this rule, a patient may consent to have the board release the patient's name or other identifying information that was collected as part of the division's investigation. Such consent shall be in writing and signed by the patient in order to be considered proper.
If a patient is less than eighteen years of age, such consent shall be in writing and signed by the patient's parent, guardian, or legal custodian in order to be considered proper.
(F) No member of the board who participates in an investigation shall participate in any further adjudication of the case.
(G) No member of the board who participates in an investigation at the local level or is involved in a case locally, shall participate in any investigation or adjudication of the same case by the board.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-3-17 Disciplinary grounds.
(A) The board may, pursuant to an adjudicatory hearing under Chapter 119. of the Revised Code and section 4766.08 of the Revised Code, and by a vote of the majority of all members, suspend, revoke, or refuse to renew any license or permit or issue a fine not to exceed more than fifteen hundred dollars, for any of the following reasons:
(1) Any violation of Chapter 4766. of the Revised Code or any rules adopted thereunder;
(2) Refusal to permit the board or its designee to inspect a vehicle, inspect the records, or inspect the physical facilities of a licensed ambulette service;
(3) Failure to meet vehicle standards as set forth in Chapter 4766. of the Revised Code or any rules adopted thereunder;
(4) Violation of an order issued by the board;
(5) Failure to comply with the terms of any agreement entered into with the board.
(B) Within sixty days of receipt of a complete application for licensure, pursuant to division (F) of section 4766.04 of the Revised Code, the board shall deny an application if it determines that the applicant does not meet the requirements of Chapter 4766. of the Revised Code and rules promulgated thereunder.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Chapter 4766-4 Mobile Intensive Care Units
Ohio Adm.Code 4766-4-01 Definitions.
(A) Advanced life support" or "ALS" has the same meaning as defined in section 4766.01 of the Revised Code.
(B) "Ambulance" has the same meaning as defined in section 4766.01 of the Revised Code.
(C) "Basic life support" or "BLS" has the same meaning as defined in section 4766.01 of the Revised Code.
(D) "Board" means the state board of emergency medical, fire, and transportation services within the division of emergency medical services of the department of public safety set forth in section 4765.02 of the Revised Code.
(E) "Computed tomography" or "CT" refers to a computerized x-ray imaging procedure.
(F) "Division" means the division of emergency medical services within the department of public safety.
(G) "Emergency medical technician" or "EMT" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-15-04 of the Administrative Code.
(H) "Headquarters" means the location which a licensee operates, designated by the licensee as the location where the records set forth in this chapter are maintained or readily available.
(I) "Inspection fee" means a fee required to be paid for the inspection of a permitted vehicle.
(J) "License" means a certificate of licensure issued by the board to the service, also known as the licensed mobile intensive care unit.
(K) "Medical director" means an Ohio-licensed physician who meets the requirements as set forth in Chapter 4765. of the Revised Code and rule 4765-3-05 of the Administrative Code.
(L) "Medical transportation organization" or "MTO" has the same meaning as emergency medical service organization as defined in section 4766.01 of the Revised Code.
(M) "Mobile intensive care unit" or "MoICU" has the same meaning as mobile intensive care unit as defined in section 4766.01 of the Revised Code.
(N) "Mobile stroke unit" is an MoICU specifically designed to treat and transport individuals experiencing a cerebral vascular incident.
(O) "Medical transportation licensing system" or "MTLS online system" means a web based system for medical transportation agencies to obtain, renew, and maintain their licenses.
(P) "Operate" means to engage in conduct or activity in furtherance of the licensed activity at or from a physical location owned, leased or maintained by the licensee where employees report to work and vehicles or aircraft are stored. Operate also includes the act of receiving a person within Ohio for transportation to a location within Ohio.
(Q) "Paramedic" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-17-03 of the Administrative Code.
(R) "Permit" is the authorization to operate issued by the board as set forth in section 4766.07 of the Revised Code for a specific vehicle, known as the "permitted vehicle" and requires the issuance of a decal for the permitted vehicle by the board or its designee.
(S) ) "Radiologic technologist" is a health care professional skilled in the theory and practice of the technical aspects of the use of x-rays and radioisotopes in the diagnosis and treatment of disease.
(T) "Readily available" means produced upon demand by the board or its designee.
(U) "Reinspection fee" means a fee required to conduct an inspection as a result of the issuance of a violation notification by the board, or its designee, to a licensed MoICU or license applicant, regarding a permitted MoICU or a MoICU for which a permit application is pending with the board.
(V) "Satellite base" means a physical location other than headquarters from which a licensee operates.
(W) "Temporary vehicle" means a MoICU issued a temporary permit used to replace a permitted MoICU in accordance with rule 4766-4-12 of the Administrative Code that is out of service until the permitted MoICU is returned to service or is replaced. A temporary vehicle may be used for a time period not to exceed sixty days.
(X) "Violation notification" means a written form issued by the board or its designee during an inspection or investigation identifying deficiencies in record keeping requirements, vehicle roadworthiness requirements, or equipment requirements by a service or its vehicle(s).
Last updated June 15, 2022 at 9:52 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4765-15-04
(A) In addition to the emergency medical services listed in rule 4765-12-04 of the Administrative Code and in accordance with section 4765.37 of the Revised Code, an emergency medical technician may perform the following emergency medical services:
(1) Endotracheal suctioning through a previously established airway;
(2) Endotracheal suctioning through a stoma;
(3) Oxygen administration, including the following:
(a) Partial rebreather masks;
(b) Venturi masks.
(4) Ventilation management, to include the use of a positive pressure ventilation device, including the following:
(a) Manually triggered ventilators;
(b) Automatic transportation ventilators.
(5) Traction splint;
(6) Rapid extrication procedures.
(B) In accordance with division (B) of section 4765.37 of the Revised Code, an emergency medical technician may perform the following additional emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.37 of the Revised Code:
(1) Pulse oximeter and capnography equipment application and reading;
(2) Dual lumen airway of pulseless and apneic patients only;
(3) Oxygen humidifier equipment application and monitoring;
(4) Extraglottic airway of pulseless and apneic patients only;
(5) Continuous positive airway pressure (CPAP);
(6) End tidal carbon dioxide monitoring and detecting;
(7) Chest compression assist devices;
(8) Negative impedance threshold devices;
(9) Administration of aspirin;
(10) Helmet removal;
(11) Glucose monitoring system;
(12) Administration of oral glucose;
(13) Administration of epinephrine auto-injector to a patient suffering from anaphylaxis;
(14) Assisted administration of sublingual nitroglycerin, which shall consist of either of the following:
(a) Assisting with patient's prescribed nitroglycerin upon the patient's request and with written protocol;
(b) Assisting with EMS-provided nitroglycerin with verbal medical direction.
(15) Assisted administration of aerosolized or nebulized medications, which shall consist of either of the following:
(a) Assisting with a patient's prescribed aerosolized or nebulized medications upon the patient's request and with written protocol;
(b) Assisting with EMS-provided aerosolized or nebulized medications with verbal medical direction.
(16) Prehospital advanced life support assistance, to include the setting up of an intravenous administration kit in the presence of an advanced emergency medical technician or paramedic;
(17) Transport of a central/peripheral intravenous access without an infusion;
(18) Set up and application of a cardiac monitor in the presence of an advanced emergency medical technician or paramedic;
(19) Set up and application of a twelve-lead electrocardiogram, in accordance with written protocols, in either of the following instances:
(a) When the emergency medical technician is assisting an paramedic; or
(b) For the purpose of electronic transmission by the emergency medical technician, provided the following conditions are met:
(i) The emergency medical technician does not interpret the electrocardiogram;
(ii) The emergency medical technician minimizes any delay of patient transport to obtain a twelve-lead electrocardiogram;
(iii) The EMT utilizes the twelve-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.
(20) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code;
(21) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those emergency medical technicians who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code.
(E) An emergency medical technician shall not perform emergency medical services within this rule unless the emergency medical technician has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the emergency medical technician scope of practice, were not included in the training specified in this paragraph, the emergency medical technician must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:22 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4765-3-05
(A) The medical director for each EMS organization shall meet the following minimum qualifications:
(1) Possession of a valid Ohio physician medical license in good standing;
(2) For three of the previous five years, has had active involvement in the provision of emergency care to patients or has provided medical oversight for an EMS agency;
(3) Provide evidence of one of the following:
(a) Completion of an EMS medical director course approved by the board (EMS medical director course provided by the "National Association of EMS Physicians" or the Ohio chapter of the "American College of Emergency Physicians");
(b) Completion of a residency or fellowship program that is recognized by the "American Board of Medical Specialties," the "American Osteopathic Association," or the "Accreditation Council for Graduate Medical Education" in emergency medicine or a related area;
(c) Subspecialty board certification by the "American Board of Emergency Medicine" in emergency medical services.
(4) Active participation with one or more EMS organizations, including but not limited to:
(a) Conducting performance improvement programs;
(b) Conducting education programs;
(c) Conducting protocol updates.
(5) Evidence of high ethical standards and no conflicts of interest;
(6) Utilizes aggregate data from the division in peer review and quality improvement programs at the local level.
(B) Each medical director is required to participate in trauma-related peer review and quality improvement programs as provided in section 4765.12 of the Revised Code.
Last updated August 1, 2023 at 8:26 AM
History
- Effective: August 1, 2023
- Promulgated Under: 119.03
Ohio Adm.Code 4765-17-03
(A) In addition to the skills listed in rules 4765-12-04, 4765-15-04 and 4765-16-04 of the Administrative Code, and in accordance with section 4765.39 of the Revised Code, a paramedic may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician, physician assistant designated by a physician, or registered nurse designated by a physician, or in accordance with written protocols as specified in division (B) of section 4765.39 of the Revised Code:
(1) Orotracheal intubation;
(2) Nasotracheal intubation;
(3) Cricothyrotomy (surgical);
(4) Cricothyrotomy (needle);
(5) Dual lumen airways;
(6) Extraglottic airways;
(7) Positive end-expiratory pressure;
(8) Bilevel positive air pressure;
(9) Ventilator management of patients sixteen years of age or older;
(10) Chest tube monitoring and management;
(11) Central line monitoring;
(12) Transcutaneous cardiac pacing;
(13) Administration of cardiac medication;
(14) Cardioversion;
(15) Twelve-lead electrocardiogram performance and interpretation;
(16) Administration of nitroglycerin;
(17) Administration of aerosolized or nebulized medication;
(18) Epinephrine administration via intravenous or intraosseous route;
(19) Placement of nasogastric or orogastric tubes;
(20) Administration of other medications pursuant to written protocols;
(21) Intravenous infusion pump;
(22) Blood chemistry analysis;
(23) Thrombolytic therapy initiation and monitoring;
(24) Immunizations for influenza to firefighters, EMTs, AEMTs, or paramedics in accordance with section 4765.391 of the Revised Code;
(25) Maintenance of medicated intravenous fluids;
(26) Maintenance of blood administration;
(27) Eye irrigation morgan lens;
(28) Withdraw blood for the purpose of determining the alcohol, drug, controlled substance, metabolite of a controlled substance, or combination content of the whole blood, blood serum, or blood plasma as provided in division (C) of section 4765.39 of the Revised Code when performed in accordance with the criteria established in rule 4765-6-06 of the Administrative Code and the protocols established by the medical director of the emergency medical service organization with which the paramedic is affiliated;
(29) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study;
(30) Any other services approved by the board pursuant to rule 4765-6-01 of the Administrative Code.
(B) A paramedic may perform non-emergent ambulance transport of a stable patient less than sixteen years of age who has a chronic condition requiring a tracheostomy tube and a ventilator provided the patient's caregiver accompanies the patient during transport and the patient's caregiver has received appropriate training in use of the patient's ventilator.
A caregiver is not required to accompany the patient if the patient is accompanied by an Ohio licensed registered nurse or respiratory therapist, or other appropriately trained and licensed Ohio healthcare provider.
(C) The utilization of waveform capnography is mandatory for all patients requiring invasive airway devices with the exception of stable patients with no cardiac or pulmonary complaints or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device is any airway device inserted or pre-positioned into a patient's airway by means of the mouth, directly into the trachea, or into the trachea by means of a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways, even though they are blindly inserted into the hypopharynx or the esophagus, are considered invasive airway devices.
(D) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed, the scope of practice for those paramedics who provide emergency medical services under the auspices of the physician's certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code to include the withdrawing of blood for evidence collection.
(E) A paramedic shall not perform emergency medical services within this rule unless the paramedic has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the paramedic scope of practice, were not included in the training specified in this paragraph, the paramedic must have received training regarding such services approved by the local medical director before performing those services.
Last updated January 2, 2024 at 9:23 AM
History
- Effective: January 1, 2024
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-12
(A) In the event of a disaster situation when permitted MoICU(s) based in the locality of the disaster situation are incapacitated or insufficient in number to render services needed, a licensed MTO may utilize whatever means necessary to transport and treat patients.
(B) A MoICU or non-transport vehicle that has not been issued a permit by the board may be issued a temporary permit, for a period not to exceed sixty days, if the MoICU or non-transport vehicle is used to replace a permitted MoICU or non-transport vehicle that has been temporarily taken out of service for repair or maintenance or is being permanently replaced. In order to obtain a temporary permit, an MTO shall submit to the board a request for a temporary vehicle permit using the MTLS online system containing:
(1) Vehicle identification number of the permitted MoICU or non-transport vehicle;
(2) Vehicle identification number of the MoICU or non-transport vehicle to receive a temporary permit;
(3) Date permitted MoICU or non-transport vehicle was placed out of service.
(C) A temporarily permitted MoICU or non-transport vehicle shall not be operated unless it meets the requirements set forth in paragraph (B) of rule 4766-4-08 of the Administrative Code and the insurance requirement set forth in division (B) of section 4766.06 of the Revised Code.
Last updated June 15, 2022 at 9:53 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-02 Application for initial or renewal licensure.
(A) ) An MTO applying for initial licensure shall submit to the board a completed MoICU application, in the English language, using the MTLS online system:
(1) Accompanied by the appropriate fees as set forth in rule 4766-4-03 of the Administrative Code and;
(2) With all required supporting documentation as set forth in this rule that must be received by the board.
(B) An MTO applying for renewal of a license shall submit to the board a completed renewal application, in the English language, using the MTLS online system:
(1) Accompanied by the appropriate fees as set forth in rule 4766-4-03 of the Administrative Code and;
(2) With all required supporting documentation as set forth in this rule that must be received by the board prior to the expiration date of the license.
(C) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the MTO applicant shall provide and maintain documentation of:
(1) The name of service, organizational structure and address of applicant to include as follows:
(a) Name;
(b) Identification of organizational structure as a corporation (whether for profit or not-for-profit); limited liability company; partnership; limited liability partnership; government unit; or sole proprietor (individual human);
(c) Tax identification (tax ID) number or employer identification number (EIN);
(d) All other names under which applicant plans to operate while using the same tax ID or EIN number. Business organizations with different tax ID or EIN numbers cannot operate under the same license;
(e) Copies of all trade name registrations and fictitious name registrations for all other names under which applicant plans to operate on file with the Ohio secretary of state;
(f) Address of physical location of applicant's headquarters (no post office box);
(g) Mailing address of applicant;
(2) All medicare provider numbers;
(3) All medicaid provider numbers;
(4) Highest level of service to be provided;
(5) Service areas including county and state;
(6) A list of the names of all officers, directors, and/or owners of the MTO;
(7) The name, contact information, and state of Ohio medical license number of the service's medical director;
(8) For each satellite base, the MTO shall provide the physical address, city, county, state, and zip code;
(9) The name of the primary contact person(s), business or administrative office telephone number, e-mail address, and if applicable, office fax number;
(10) Year of manufacture, make, model, vehicle identification number, odometer reading, and license plate number (renewal only) of each MoICU or non-transport vehicle to be permitted;
(11) A color photograph of the side of applicant's vehicle displaying color scheme, insignia, monogram, or other distinguishing characteristic. If multiple color schemes, insignias, monograms, or other distinguishing characteristics are used, a color photograph of each shall accompany application.
(a) Color photographs shall be submitted to the division:
(i) With all initial MoICU applications; and
(ii) Within thirty days of the date a change is made to the vehicle's color scheme, insignia, monogram, or other distinguishing characteristics.
(b) Digital photographs are preferred.
(12) A current and valid certificate of liability insurance in the name of the applicant, listing the board as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code:
(a) The actual name on the license application shall appear on the certificate of liability insurance;
(b) Each permitted vehicle with vehicle identification number (VIN) shall be listed on the certificate of liability insurance.
(D) An application that is not completed in the manner as specified on the application or does not include all required documentation shall be deemed incomplete.
(E) An application deemed incomplete shall not be considered and may be returned with the notation to the applicant indicating the reason the application is incomplete.
(F) Failure to provide the required documents within thirty days of the date the initial application is received by the division may result in the application being deemed incomplete.
(G) An MTO shall submit a completed renewal application, appropriate fees, and supporting documentation to the board prior to the expiration of the MTO's license in order to be considered timely.
(H) The board shall issue a certificate of licensure to the MTOs that meet the criteria to provide MoICU level of service.
The certificate of licensure issued by the board shall indicate the highest level of service that the MTO is authorized to provide.
An MTO licensed at the MoICU level is permitted to operate ambulances at the ALS and BLS levels as set forth in Chapter 4766-2 of the Administrative Code.
(I) No applicant or licensed MTO shall submit false, misleading, or deceptive information in order to obtain a license or permit.
(J) A license is not transferable.
Last updated June 15, 2022 at 9:52 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-03
(A) Each MTO shall pay an initial or renewal license fee of one hundred dollars annually.
(B) Each MTO shall pay a permit fee for each MoICU or non-transport vehicle of one hundred dollars annually;
(C) Each MTO shall pay an inspection fee of one hundred dollars per MoICU or non-transport vehicle.
(D) Each MTO shall pay a one hundred dollar reinspection fee for every MoICU or non-transport vehicle that requires reinspection as a result of a violation notification issued by the board or its designee.
(E) Each MTO shall pay a temporary permit fee of one hundred dollars for each temporary permit to be obtained.
(F) Fees shall be submitted with the application.
(G) Each MTO may pay a re-print fee of five dollars for each vehicle decal that shall be re-printed as a result of the decal being lost, damaged, incorrectly applied, or incorrect vehicle information provided to the division by the service.
Last updated June 15, 2022 at 9:53 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-04 Physical facilities.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]
(A) The board or its designee shall conduct initial and renewal inspections of all MTOs pursuant to Chapter 4766. of the Revised Code and rules 4766-4-04 to 4766-4-07 of the Administrative Code to include the following:
(1) MTO service headquarters;
(2) MTO service satellite location(s).
(B) An MTO shall not commence operations from its headquarters or satellite base(s) until the MTO has met all requirements set forth in section 4766.04 of the Revised Code and agency 4766 of the Administrative Code including satisfactory inspections of all physical locations.
(C) An MTO shall ensure compliance with the inspection requirements for physical facilities. The inspection requirements for physical facilities of an MTO are as follows:
(1) The board issued license shall be prominently displayed in a conspicuous location at every licensed facility (renewal inspection only);
(2) Ohio state board of pharmacy license(s) shall be displayed at each location;
(3) A written sanitation plan as set forth in Chapter 4766-4 of the Administrative Code shall be on site for each location;
(4) The physical facilities shall maintain all single use supplies and equipment as set forth in the "MoICU Inspection" form.
(5) The physical facilities shall be clean and free of debris;
(6) Crew quarters shall be clean;
(7) All physical facilities shall be in compliance with state and local building codes;
(8) Each facility shall be in compliance with state and local fire codes.
(D) The board or its designee may conduct routine unannounced inspections at any location(s) of licensed MTO at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, the following:
(1) MTO service headquarters;
(2) MTO service satellite location(s);
(3) MoICU(s) and non-transport vehicle(s).
Last updated June 15, 2022 at 9:53 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-18
(A) "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum" can be found at http://www.nhtsa.gov/people/injury/ems/web%20site%20intro.htm.
(B) "29 C.F.R. 1910.1030" (April 3, 2012) covers exposure to blood or other potentially infectious materials.
(C) "45 C.F.R. 164.512" (January 6, 2016) specifies what information can be shared under the HIPAA laws.
(D) "Mobile Intensive Care Unit - Mobile Stroke Unit Inspection" form or form EMS 4054 (June 2022) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(E) "MoICU Inspection" form, or "Mobile Intensive Care Unit Inspection" form, or form "EMS 4022" (February 2017) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(F) The MTLS online system collects and manages information in categories including service details; medical director; call volumes; communication equipment; service areas; contact information; insurance details; vehicle liability; company executives; satellite locations; vehicle information; and facility and vehicle inspection information. MTOs register and create an account to access the MTLS online system and use it to apply for, renew, and manage a medical transportation license.
(G) "Non-transport Vehicle Inspection" form or form "EMS 4026" (July 2021) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(H) "Periodic Mechanical Safety Report" form or form "EMS 4039" (July 2021) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(I) "Violation Notification" form or form "EMS 4029" (July 2021) is issued by the board to a MTO that is in violation of Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code and a sample of the form can be viewed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
Last updated June 15, 2022 at 9:54 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-07
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]
(A) Each licensed MTO shall comply with all occupational safety and health administration-bloodborne pathogens regulations as set forth by 29 C.F.R. 1910.1030.
(B) A licensed MTO shall ensure that sanitation procedures are provided to all personnel in a written document that conforms with current standards as set forth in occupational safety and health administration -bloodborne pathogens protocol.
(C) A licensed MTO shall maintain and follow a written sanitation plan that conforms with the latest bloodborne pathogen standards as written by the occupational safety and health administration. The following documentation shall be maintained for each vehicle:
(1) Sanitation schedule;
(2) Date the sanitation was completed;
(3) Documentation of who performed sanitation.
(D) All licensed MTOs shall establish a written policy governing the use of lights and other warning devices pursuant to section 4511.24 of the Revised Code which shall be made available for inspection by the board or its designee.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-05 Record keeping requirements.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]
(A) Each licensed MTO shall maintain or have readily available the following at its headquarters:
(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;
(2) Verification of the following:
(a) Completion of emergency vehicle operator course for non-EMS certified personnel as set forth in rule 4766-4-13 of the Administrative Code;
(b) Certification or license of all personnel;
(3) A current and valid certificate of liability insurance issued by an insurer licensed to do business in Ohio that includes a thirty day notice of cancellation to the board in compliance with the terms set forth in section 4766.06 of the Revised Code listing the board as a certificate holder;
Each scheduled vehicle must be listed on the certificate or attached on an additional page to the certificate to include the vehicle's year, make, model and vehicle identification number (VIN). If the certificate indicates "any auto" or "all owned autos," a list of vehicles does not have to be included or attached.
(4) Current copy of the MTO's written policy covering the use of lights and audible warning devices;
(5) Records or other documents related to patient care or to emergency medical service personnel maintained by the licensed MTO which shall be made available for review by the board or its designee;
Such records or documents shall be made available in accordance with 45 C.F.R. 164.512;
(6) Current maintenance records for vehicles as specified in rule 4766-4-09 of the Administrative Code;
(7) Documentation of compliance with the periodic mechanical safety inspection set forth in rule 4766-4-09 of the Administrative Code;
(8) Current maintenance records for all equipment used for patient care as specified in rule 4766-4-09 of the Administrative Code;
(9) Dispatch log;
(10) Written plan for restocking of supplies or compliance with paragraph (C)(4) of rule 4766-4-04 of the Administrative Code;
(11) Ohio state board of pharmacy license and addendum;
(12) DEA registration certificate (as applicable);
(13) Clinical laboratory improvement amendments (CLIA) waiver (as applicable);
(14) Current written plan for the handling and disposal of bio-medical infectious materials (OSHA rule 29 C.F.R. 1910.1030).
(B) A licensed MTO shall maintain or have readily available the following at each satellite base:
(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;
(2) Documentation that meets the requirements as set forth in rule 4766-4-07 of the Administrative Code;
(3) Current copy of the MTO's written policy covering the use of lights and other warning devices;
(4) Written plan for restocking of supplies or compliance with paragraph (C)(4) of rule 4766-4-04 of the Administrative Code;
(5) Ohio state board of pharmacy license(s) and addendum(s);
(6) Current written plan for the handling and disposal of bio-medical infectious materials (OSHA rule 29 C.F.R. 1910.1030).
(C) Upon licensure, each licensed MTO shall prominently display the original certification of licensure at its headquarters and each satellite base.
(D) Patient records shall be maintained in accordance with this rule.
(1) Each licensed MTO shall maintain accurate records concerning the transportation of each patient for a minimum of seven years;
(2) Each record shall include, at minimum, the following:
(a) Patient's name;
(b) Patient's sex;
(c) Patient's age;
(d) Patient's date of birth;
(e) Patient's address;
(f) Location address of incident or pickup;
(g) Patient's chief complaint;
(h) Patient's history including:
(i) Current medical condition;
(ii) List of current medications;
(iii) Allergies;
(iv) Vital signs and time assessed:
(a) Blood pressure;
(b) Pulse;
(c) Respiration;
(i) Any responsible guardian;
(j) Advanced directives, if applicable;
(k) Final destination;
(l) Treatment rendered;
(m) The following times:
(i) Time call received;
(ii) Dispatch time;
(iii) Enroute time;
(iv) On-scene time;
(v) Departure from scene time;
(vi) Arrival at destination time;
(n) The names and level of certification or licensure for all EMS providers and other medical personnel;
(o) The names of any non-EMS certified personnel, if applicable.
(3) A copy of the record for each patient shall be provided to the receiving facility, which includes all the information required no later than twenty-four hours from time of dispatch.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-13
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]
MoICU transport team shall consist of three personnel: a driver/operator and two other healthcare personnel as described herein:
(A) Driver/operator means:
(1) A person who has successfully completed and passed an emergency vehicle operator course that meets requirements of national highway and traffic safety administration's "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum"; or
(2) A person who is certified as an Ohio emergency medical technician.
(B) Healthcare personnel means one each of the following:
(1) A registered nurse whose training meets or exceeds the training required for a paramedic; and
(2) A physician or another person designated by a physician, who holds a valid license or certificate to practice in a health care profession in one of the following areas: paramedic, registered nurse, respiratory therapist, advanced practice nurse, or physician's assistant.
(C) When operating as a mobile stroke unit, staffing shall consist of a minimum of three providers whose licenses, registrations, and/or certifications include a registered radiologic technologist to operate the computed tomography (CT) machine; a registered nurse or advanced practice nurse or physician assistant or physician; and at a minimum, one certified EMT and one certified paramedic. One of the providers may hold dual certifications.
Last updated June 15, 2022 at 9:54 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-09
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]
(A) MoICU and non-transport vehicles
(1) All licensed MTOs shall ensure performance and maintain documentation of all periodic maintenance and repairs on each permitted vehicle to include:
(a) Date of service or repair;
(b) Description of service/repair performed;
(c) Name of person who performed service/repair and the business name, if applicable.
(2) Licensed MTOs shall subject all permitted MoICU(s) and non-transport vehicle(s) to periodic mechanical safety inspection(s), which shall be documented by the service.
(a) A periodic mechanical safety inspection shall mean an inspection conducted:
(i) Prior to a vehicle's initial permit being issued for vehicles with an odometer reading of five thousand miles or more, and;
(ii) Annually and completed within the six month period prior to the MTO's license expiration date, or;
(iii) Every twenty-five thousand miles for a vehicle that has an odometer reading of one hundred fifty thousand miles or more.
(b) Each mechanical safety inspection shall be conducted by a mechanic with factory training and certification from an original (motor vehicle) equipment manufacturer or equivalent certification for "Emergency Vehicle Technicians" (EVT) or from the "National Institute for Automotive Service Excellence" (ASE).
(c) Each mechanical safety inspection shall be conducted in addition to the vehicle and equipment inspection by the board or its designee following the procedures adopted in rule 4766-4-08 of the Administrative Code.
(d) Vehicles with failed items found during the mechanical safety inspection shall be removed from service and not placed back into service until items are corrected. Proof of correction(s) shall be maintained by the service with the "Periodic Mechanical Safety Report" form in the vehicle's maintenance records.
(3) Out of service permitted MoICU(s) or non-transport vehicle(s):
If a licensed MTO removes a permitted MoICU or non-transport vehicle from service it shall place an "out of service" sign in the permitted MoICU or non-transport vehicle to be visible through the windshield with the following information included on the front of the sign:
(a) Date permitted MoICU or non-transport vehicle was taken out of service;
(b) Odometer reading at time permitted MoICU or non-transport vehicle was taken out of service;
(c) Reason permitted MoICU or non-transport vehicle was taken out of service;
(d) Printed name and signature of person responsible for taking permitted vehicle out of service;
(e) The words "out of service" utilizing not less than three inch lettering.
(4) If permitted MoICU or non-transport vehicle is at a repair/maintenance shop that is not owned or operated by the licensed MTO for maintenance purposes, no "out of service" sign is required.
(B) Bio-medical equipment/patient care equipment:
(1) A licensed MTO shall ensure performance and maintain documentation of all periodic maintenance and repairs of bio-medical equipment as required by manufacturer and/or food and drug administration including but not limited to the following:
(a) Date of last inspection;
(b) Date of service or repair;
(c) Description of service/repair performed;
(d) Name of person who performed inspection, service, or repair;
(e) Documentation, if any, of inspection, service, or repair performed.
(2) A licensed MTO shall maintain documentation of all periodic maintenance of patient care equipment as required by the original equipment manufacturer, including but not limited to the following:
(a) Date of last inspection;
(b) Date of service or repair;
(c) Description of service/repair performed;
(d) Name of who performed inspection, service, or repair;
(e) Documentation of inspection, service, or repair performed.
(C) MoICU and non-transport vehicle maintenance/repair records and bio-medical maintenance/repair records shall be kept for a period of twelve months after the vehicle/equipment is removed from inventory.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: April 1, 2020
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-06 Communication requirements.
(A) All licensed MTO dispatch centers shall be equipped with a base station capable of two-way communications with associated MoICU(s) and non-transport vehicle(s). The base station shall demonstrate and maintain voice communications with the devices used in the permitted MoICU(s) and non-transport vehicle(s) within the declared service area:
(B) All MoICU(s) and non-transport vehicle(s), permitted as set forth in Chapter 4766. of the Revised Code, shall be equipped, while in use, with a dedicated two-way communications device, which shall have the capability to communicate with the licensed MTO's dispatch center, the receiving medical facility, and with medical control in the licensed MTO's service area.
(C) All MTOs shall maintain a detailed radio/communications log that documents, at a minimum, the following:
(1) Location of call;
(2) Nature of call;
(3) Initial dispatch time;
(4) Enroute time;
(5) On-scene time;
(6) Departure from scene time;
(7) Arrival at destination time;
(D) If an MTO contractually uses another communication center for dispatch purposes, the communication center shall provide written certification of compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code as applicable.
Last updated June 15, 2022 at 9:53 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-08 Vehicle inspections and equipment requirements.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]
(A) The board or its designee shall inspect all MoICU(s) and non-transport vehicle(s) for roadworthiness and for appropriate equipment using the "MoICU Inspection" form, the "Mobile Intensive Care Unit - Mobile Stroke Unit Inspection" form, or the "Non-transport Vehicle Inspection" form.
(B) A permitted MoICU that is being used as an MoICU shall comply with the requirements of roadworthiness and the requirements set forth in the "MoICU Inspection" form or the "Mobile Intensive Care Unit - Mobile Stroke Unit Inspection" form, which shall include carrying the following types of equipment:
(1) Isolation equipment;
(2) Airway equipment:
(3) Onboard definitive care equipment;
(4) Bleeding control/burn equipment;
(5) Suction equipment;
(6) Medical gas and equipment;
(7) Adjunct equipment;
(8) Intravenous equipment;
(9) Neonatal specific equipment; and
(10) Immobilization equipment for MoICUs dually certified to provide advanced life support.
(C) A permitted non-transport vehicle that is being used as a non-transport vehicle shall comply with the requirements of roadworthiness and the requirements set forth in the "Non-Transport Vehicle Inspection" form, which shall include carrying specified definitive equipment.
(D) All equipment and supplies shall have current expiration dates where applicable.
(E) Disposable equipment is acceptable where applicable.
(F) All equipment shall be securely stored in each vehicle.
(G) An MTO shall demonstrate proof that each MoICU complies with all specifications set forth in division (C)(2) of section 4766.07 of the Revised Code, by one of the following:
(1) Placard/sticker;
(2) Certificate issued by the manufacturer;
(3) Signed affidavit by the manufacturer certifying compliance with national standards in effect at time the vehicle was manufactured.
(H) The name of the MTO shall be permanently affixed to each MoICU and non-transport vehicle with letters being a minimum height of three inches on both sides and a minimum height of one and one half inches on the back.
MoICU vehicles operated at the mobile stroke unit level shall have permanently affixed lettering being a minimum height of three inches on both sides and rear of the vehicle indicating the vehicle is a mobile stroke unit.
If an MTO is under contract which requires other signage or if the MTO is operating under another name, each vehicle shall have permanently affixed lettering with a minimum height of one and one half inches on the rear and both sides of the of vehicle that states:
(1) Owned and operated by [MTO's name]; or
(2) Operated by [MTO's name]; or
(3) Owned by [MTO's name].
(I) All violation notifications issued by the board or its designee shall be corrected.
(J) Each vehicle that receives a violation notification shall be placed out-of-service until:
(1) It passes reinspection by the board or its designee; or
(2) For seventy-two hour violation notifications, the violation has been corrected and the "Violation Notification" form is signed and returned to the division along with supporting documentation showing the violation has been corrected.
(K) Upon issuance of a vehicle permit, each licensed MTO shall apply the decal on the outside of the right rear window in accordance with division (B)(2) of section 4766.07 of the Revised Code on each MoICU and non-transport vehicle.
The permit shall be unobstructed at all times.
(L) A permit is not transferable.
(M) The board or its designee may conduct routine unannounced inspections at any location of licensed MTO at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, MoICU(s) and non-transport vehicle(s).
(N) A permitted MoICU or non-transport vehicle shall maintain compliance with roadworthiness requirements set forth in this rule at any time it is used as an MoICU or non-transport vehicle.
(O) Each permitted vehicle shall be free from dirt, stains, impurities and/or foreign matter in driver's compartment and MoICU patient care compartments.
(P) Permitted MoICUs and non-transport vehicles shall:
(1) Bear license plates issued under section 4503.49 of the Revised Code; or
(2) Comply with residency registration requirements set forth in section 4503.111 of the Revised Code.
Last updated June 15, 2022 at 9:53 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-11 Use of lights and other warning devices.
(A) Permitted MoICU(s) and non-transport vehicle(s) are considered public safety vehicles pursuant to division (E)(1) of section 4511.01 of the Revised Code.
(B) Permitted MoICU(s) and non-transport vehicle(s), when responding to emergency calls, may use emergency lights and audible warning devices pursuant to section 4511.24 of the Revised Code.
(C) Permitted MoICU(s) and non-transport vehicle(s) shall:
(1) Bear license plates issued under section 4503.49 of the Revised Code; or
(2) Comply with residency registration requirements set forth in section 4503.111 of the Revised Code.
(3) Permitted MoICU(s) and non-transport vehicle(s) owned and operated by a federal, state, county, city, or township or a service that qualifies for gratis license plates from the bureau of motor vehicles are not required to bear ambulance license plates or non-transport vehicle license plates.
Last updated September 13, 2023 at 1:04 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-14 Regulations for out of state providers.
The exemption from licensure in division (B) of section 4766.09 of the Revised Code exempts out of state providers receiving a patient in Ohio for transport to a location not within Ohio or when transporting a patient received in another state. An out of state provider that receives a patient in Ohio for transportation to a location in Ohio shall be licensed and is subject to Chapter 4766. of the Revised Code and rules under this chapter and to all applicable fines and sanctions for any violation thereof.
Last updated September 13, 2023 at 1:05 PM
History
- Effective: April 16, 2012
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-15 Changes to be reported to the board.
(A) Each licensed MTO shall notify the board using the MTLS online system of any additions, deletions or changes in:
(1) Executive officers or board members;
(2) Medical director, including:
(a) Contact information; and
(b) Medical license number;
(3) Ownership of a licensed MTO;
(4) Tax ID or EIN number;
(5) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number.
(B) When a permitted MoICU or non-transport vehicle is permanently withdrawn from service, the licensed MTO shall delete the vehicle using the MTLS online system and remove the decal from the right rear window and destroy it.
(C) Within ten business days of the date a licensed MTO ceases to operate, it shall return to the board all vehicle decals and the certificate of licensure.
(D) Within ten business days of the date a licensed MTO ceases to operate a satellite base, it shall return to the board the certificate of licensure.
(E) An MTO licensed at the MoICU level may apply at any time to be licensed at a lower level. The change shall be made using the MTLS online system which includes a one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766-4-04 and 4766-4-08 of the Administrative Code. A change in level of service does not change the expiration date of the license.
(F) A licensed MTO may apply at any time for change of address of headquarters location. The change shall be made using the MTLS online system which includes a one hundred dollar license fee. The MTO shall also ensure compliance with rule 4766-4-04 of the Administrative Code. A change in headquarters address does not change the expiration date of the license.
Last updated June 15, 2022 at 9:54 AM
History
- Effective: June 15, 2022
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-16 Investigations.
(A) The division shall investigate all complaints on behalf of the board and in accordance with section 4766.11 of the Revised Code.
(B) After an investigation is completed and based on the findings of such investigation, the board may initiate disciplinary proceedings in accordance with Chapter 119. of the Revised Code and this chapter.
(C) If, based on the findings of an investigation, the board determines that no further action on a complaint is warranted, then the case shall be closed accordingly.
(D) The division shall conduct all investigations and any related proceedings, in such a manner as to protect patient confidentiality and in accordance with section 4765.102 of the Revised Code.
(E) Notwithstanding paragraph (D) of this rule, a patient may consent to have the board release the patient's name or other identifying information that was collected as part of the division's investigation. Such consent shall be in writing and signed by the patient in order to be considered proper.
If a patient is less than eighteen years of age, such consent shall be in writing and signed by the patient's parent, guardian, or legal custodian in order to be considered proper.
(F) No member of the board who participates in an investigation shall participate in any further adjudication of the case.
(G) No member of the board who participates in an investigation at the local level or is involved in a case locally, shall participate in any investigation or adjudication of the same case by the board.
Last updated September 13, 2023 at 1:05 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Ohio Adm.Code 4766-4-17 Disciplinary grounds.
(A) The board may, pursuant to an adjudicatory hearing under Chapter 119. of the Revised Code and section 4766.08 of the Revised Code, and by a vote of the majority of all members, suspend, revoke, or refuse to renew any license or permit or issue a fine not to exceed more than fifteen hundred dollars, for any of the following reasons:
(1) Any violation of Chapter 4766. of the Revised Code or any rules adopted thereunder;
(2) Refusal to permit the board or its designee to inspect a vehicle, inspect the records, or inspect the physical facilities of a licensed MTO;
(3) Failure to meet vehicle standards as set forth in Chapter 4766. of the Revised Code or any rules adopted thereunder;
(4) Violation of an order issued by the board;
(5) Failure to comply with the terms of any agreement entered into with the board.
(B) Within sixty days of receipt of a complete application for licensure, pursuant to division (F) of section 4766.04 of the Revised Code, the board shall deny an application if it determines that the applicant does not meet the requirements of Chapter 4766. of the Revised Code and rules promulgated thereunder.
Last updated September 13, 2023 at 1:05 PM
History
- Effective: August 1, 2017
- Promulgated Under: 119.03
Chapter 4766-5 Medical Transportation
Ohio Adm.Code 4766-5-01 Definitions.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) "Air operator" means holder of a "14 C.F.R. Part 135 Certificate."
(B) "Aircraft" means either or both of the following:
(1) Fixed wing air ambulance;
(2) Rotorcraft air ambulance.
(C) "AMSO" means air medical service organization as defined in division (B) of section 4766.01 of the Revised Code.
(D) "Board" means the state board of emergency medical, fire, and transportation services as described in section 4765.02 of the Revised Code.
(E) "C.F.R." means the "Code of Federal Regulations," which is a codification of the general and permanent rules and regulations published in the Federal Register by the executive departments and agencies of the federal government of the United States.
(F) "DEA" means the United States drug enforcement administration.
(G) "FAA" means the federal aviation administration.
(H) "FCC" means the federal communication commission.
(I) "Headquarters" means the location which a licensee operates, designated by the licensee as the location where the records described in this chapter are required to be maintained or readily available.
(J) "HIPAA" or "Title 45 of the Code of Federal Regulations (C.F.R.) subtitle A, section 160.103 of the health insurance portability and accountability act (HIPAA) of 1996" protects the fundamental rights of nondiscrimination and health information privacy.
(K) "Inspection fee" means a fee required to be paid for the inspection of an aircraft.
(L) "License fee" means a fee required to be paid to obtain a license to operate an AMSO in the state of Ohio.
(M) "Operate" means to engage in conduct or activity in furtherance of the licensed activity at or from a physical location, owned, leased, or maintained by the licensee where employees report to work and aircraft are stored. Operate also includes the act of receiving a person within Ohio for transportation to a location within Ohio.
(N) "Part 135 Certificate" means a certificate issued to the air operator by the FAA setting forth the air operating requirements for commuter and on-demand air operations and rules governing persons on board such aircraft.
(O) "Permit fee" means a fee required to be paid to obtain a permit for each aircraft owned by AMSO.
(P) "Primary aircraft" means an aircraft permitted in accordance with section 4766.07 of the Revised Code.
(Q) "Reinspection fee" means a fee required to conduct an inspection as a result of the issuance of a violation notification.
(R) "Satellite base" means a physical location other than headquarters from which a licensee operates.
(S) "Temporary aircraft" means an aircraft used to temporarily replace a primary aircraft that is out-of-service until the primary aircraft is returned to service.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-18
(A) "14 C.F.R. 21" (March 5, 2018), "14 C.F.R. 43" (March 5, 2018), and "14 C.F.R. 91" (July 18, 2019) establish the FAA airworthiness standards requiring aircraft to be in a condition for safe operation and maintenance.
(B) "14 C.F.R. Part 135 Certificate" or "14 C.F.R. Part 135 Air Carrier and Operator Certification" (August 26, 2019) is the certificate that an air medical service must obtain, via the federal aviation administration to operate. Information to obtain the certification can be accessed at https://www.faa.gov/about/initiatives/atos/135_certification/.
(C) "29 C.F.R. 1910.1030" (April 3, 2012) covers exposure to blood or other potentially infectious materials.
(D) "42 C.F.R. 493," "Clinical Laboratory Improvement Amendments (CLIA)" (October 20, 2017) is a program that regulates laboratories performing testing on patient specimens in order to ensure accurate and reliable test results.
(E) "45 C.F.R. 164.512" (January 6, 2016) specifies what information can be shared under the HIPAA laws.
(F) "47 C.F.R 90.203" (June 5, 1979) covers regulations for radio equipment.
(G) "Rotor Wing Aircraft Inspection" form or form "EMS 4025" (February 2026) can be accessed at the division's website at https://ems.ohio.gov/forms-and-applications.
(H) "Fixed Wing Aircraft Inspection" form or form "EMS 4035" (July 2024) can be accessed at the division's website at https://ems.ohio.gov/forms-and-applications.
(I) The MTLS online system collects and manages information in categories including service details; medical director; call volumes; communication equipment; service areas; contact information; insurance details; vehicle liability; company executives; satellite locations; vehicle information; and facility and vehicle inspection information. MTOs register and create an account to access the MTLS online system and use it to apply for, renew, and manage a medical transportation license.
(J) "Violation Notification" or form "EMS 4029" (July 2021) is issued by the board to an air medical services organization that is in violation of Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code. A sample of the form can be viewed at https://ems.ohio.gov/forms-and-applications.
Last updated May 1, 2026 at 8:16 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-02 Application for initial or renewal licensure.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) An AMSO applying for initial licensure shall file with the board an "Application for Air Medical License" form in the English language and shall submit the completed application to the board:
(1) Accompanied by the appropriate fees as set forth in rule 4766-5-03 of the Administrative Code; and
(2) With all required supporting documentation as set forth in this rule.
(B) An AMSO applying for renewal of a license shall file with the board a "Renewal Application for Air Medical License" form in the English language, and shall submit the completed application to the board:
(1) Accompanied by the appropriate fees as set forth in rule 4766-5-03 of the Administrative Code; and
(2) With all required supporting documentation as set forth in this rule that must be received by the board prior to the expiration date of the license.
(C) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the AMSO applicant shall provide:
(1) The name of the service, organizational structure, and address of AMSO applicant to include as follows:
(a) Name;
(b) Identification of organizational structure as a corporation (whether for profit or not-for-profit); limited liability company; partnership; limited liability partnership; government unit; or sole proprietor (individual human);
(c) Tax identification (tax ID) number or employer identification number (EIN);
(d) All other names under which applicant plans to operate while using the same tax ID or EIN number. Business organizations with different tax ID or EIN numbers cannot operate under the same license;
(e) Copies of all trade name registrations and fictitious name registrations for all other names under which applicant plans to operate on file with the Ohio secretary of state;
(f) Address of physical location of applicant's headquarters (no post office box) shall be located in Ohio or another state ;
(g) Mailing address of applicant.
(2) All medicare provider numbers;
(3) All medicaid provider numbers;
(4) Ohio service areas including county;
(5) A list of the names of all officers, directors, and/or owners of the AMSO;
(6) The name, contact information, and state of Ohio medical license number of the service's medical director;
(7) For each satellite base, the AMSO shall provide the physical address, city, county, state, and zip code;
(8) The name of the primary contact person(s), business or administrative office telephone number, e-mail address, and if applicable, office fax number;
(9) Year of manufacture, make, model, tail number, and aircraft hours on airframe;
(10) A color photograph of the side of the applicant's aircraft displaying color scheme insignia, monogram, or other distinguishing characteristic. If multiple color schemes, insignias, monograms, or other distinguishing characteristics are used, a color photograph of each shall accompany application;
(a) Color photographs shall be submitted to the division:
(i) With all initial "Application for Air Medical License" forms; and
(ii) Within thirty days of the date a change is made to the aircraft's color scheme, insignia, monogram, or other distinguishing characteristics.
(b) Digital photographs are preferred.
(11) A certificate of insurance with current vehicle (aircraft) and general liability insurance in the name of the applicant, listing state board of emergency medical, fire, and transportation services as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code;
(a) The actual name on the license application shall appear on the certificate of liability insurance;
(b) Each permitted aircraft with year, make, model, and tail number shall be listed on the certificate of liability insurance.
(D) An application that is not completed in the manner as specified on the application or does not include all required documentation shall be deemed incomplete.
(E) An application deemed incomplete shall not be considered and may be returned with the notation to the applicant indicating the reason the application is incomplete.
(F) Failure to provide the required documents within thirty days of the date the initial "Application for Air Medical License" form is received by the division may result in the application being deemed incomplete.
(G) An AMSO shall submit a completed "Renewal Application for Air Medical License" form, appropriate fees, and supporting documentation to the board prior to the expiration of the AMSO's license in order to be considered timely.
(H) No applicant or licensed AMSO shall submit false information in order to obtain a license or permit.
(I) A license is only valid for the AMSO for which it is issued and is not transferable.
Last updated May 1, 2026 at 8:15 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-03
(A) Each AMSO shall pay an initial or renewal license fee of one hundred dollars annually.
(B) Each AMSO shall pay a permit fee for each aircraft of one hundred dollars annually.
(C) Each AMSO shall pay an inspection fee of one hundred dollars per aircraft annually.
(D) Fees shall be submitted with the application.
(E) All fees are nonrefundable.
(F) Each AMSO shall pay a one hundred dollar reinspection fee for every aircraft that requires reinspection as a result of a violation notification issued by the board.
(G) Each AMSO shall pay a temporary permit fee of one hundred dollars for each temporary permit to be obtained.
(H) If an AMSO adds an aircraft to the service within thirty days of the service's expiration date, the permit and inspection fees will be waived at the time of renewal.
(I) Each AMSO shall pay a re-print fee of five dollars for each decal that shall be re-printed as a result of the decal being lost, damaged, incorrectly applied, or incorrect aircraft information provided to the division by the service.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-04 Physical facilities.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) The board or its designee shall conduct initial and renewal inspections of all AMSOs pursuant to Chapter 4766. of the Revised Code and rules 4766-5-04, 4766-5-05, and 4766-5-06 of the Administrative Code to include the following:
(1) AMSO service headquarters;
(2) AMSO service satellite base(s).
(B) An AMSO shall not commence operations from its headquarters or satellite bases until the AMSO has met all requirements as set forth in section 4766.04 of the Revised Code and agency 4766 of the Administrative Code including satisfactory inspections of all physical locations.
(C) An AMSO shall ensure compliance with the inspection requirements for physical facilities. The inspection requirements for physical facilities of an AMSO are as follows:
(1) The physical facilities shall be clean and free of debris;
(2) The board issued license(s) shall be prominently displayed in conspicuous location(s) at every licensed facility (renewal inspection only);
(3) Crew quarters shall be clean;
(4) The physical facilities shall be compliant with state and local building codes;
(5) The physical facilities shall be compliant with state and local fire codes;
(6) The physical facilities shall maintain all single use supplies and equipment as set forth in the "Rotor Wing Aircraft Inspection" and "Fixed Wing Aircraft Inspection" forms;
(7) Ohio state board of pharmacy license(s) shall be displayed at each location;
(8) A written sanitation plan as set forth in Chapter 4766-5 of the Administrative Code shall be on site for each location.
(D) The board or its designee may conduct announced and unannounced inspections at any location a licensed AMSO operates at any time, including night or weekend inspections, to determine compliance with Chapter 4766. of the Revised Code and rules promulgated thereunder, including but not limited to:
(1) AMSO service headquarters;
(2) AMSO service satellite base(s);
(3) Aircraft.
Last updated May 1, 2026 at 8:15 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-05
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) Each licensed AMSO shall maintain or have readily available the following at its headquarters:
(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy (as applicable);
(2) Verification of certification or license of all personnel;
(3) A current and valid certificate of liability insurance issued by an insurer licensed to do business in Ohio that includes a thirty day notice of cancellation to the board in compliance with the terms set forth in section 4766.06 of the Revised Code listing the state board of emergency medical, fire, and transportation services as a certificate holder;
(4) Records or other documents related to patient care or to emergency medical service personnel maintained by the licensed AMSO which shall be made available for review by the board or its designee in accordance with "45 C.F.R. 164.512";
(5) Documentation as required under rule 4766-5-07 of the Administrative Code;
(6) Current maintenance records for aircraft as specified in rule 4766-5-09 of the Administrative Code;
(7) Current maintenance records for all equipment used for patient care as specified in rule 4766-5-09 of the Administrative Code;
(8) Dispatch log;
(9) Written plan for restocking of supplies or compliance with paragraph (C)(6) of rule 4766-5-04 of the administrative Code;
(10) Ohio state board of pharmacy license and addendum (as applicable);
(11) DEA registration certificate (as applicable);
(12) Clinical laboratory improvement amendments (CLIA) waiver (as applicable) in accordance with "42 C.F.R. 493";
(13) Current written plan for the handling and disposal of bio-medical infectious materials in accordance with "29 C.F.R. 1910.1030";
(14) "14 C.F.R. 135 Part Certificate";
(15) Statutorily required permits and licenses such as fuel, oil, or hazardous waste;
(16) Emergency contact list with telephone numbers;
(17) Copy of written sanitation plan as described in rule 4766-5-07 of the Administrative Code.
(B) A licensed AMSO shall maintain or have readily available the following at each satellite base:
(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;
(2) Documentation that meets the requirements set forth in rule 4766-5-07 of the Administrative Code;
(3) Written plan for restocking of supplies or compliance with paragraph (C)(6) of rule 4766-5-04 of the Administrative Code;
(4) Ohio state board of pharmacy license(s) and addendum(s);
(5) Current written plan for the handling and disposal of bio-medical infectious materials in accordance with "29 C.F.R. 1910.1030";
(6) DEA registration(s);
(7) "14 C.F.R. Part 135 Certificate";
(8) Statutorily required permits and licenses such as fuel, oil, or hazardous waste;
(9) Emergency contact list with telephone numbers;
(10) Copy of written sanitation plan as described in rule 4766-5-07 of the Administrative Code.
(C) Upon licensure, each licensed AMSO shall prominently display the original certificate of licensure at its headquarters and each satellite base.
(D) Patient records shall be maintained in accordance with this rule.
(1) Each licensed AMSO shall maintain accurate records that contain the information set forth in paragraph (D)(2) of this rule concerning the transportation of each patient for a period of seven years from the date of the transport;
(2) Each record shall include, at minimum, the following:
(a) Patient's name;
(b) Patient's gender;
(c) Patient's age;
(d) Patient's date of birth;
(e) Patient's address;
(f) Location address of incident or pickup;
(g) Patient's chief complaint;
(h) Patient's history, including:
(i) Current medical condition;
(ii) List of current medications;
(iii) Allergies;
(iv) Vital signs and time assessed:
(a) Blood pressure;
(b) Pulse;
(c) Respiration;
(i) Any responsible guardian;
(j) Advanced directives, if applicable;
(k) Final destination;
(l) Treatment rendered;
(m) The following times:
(i) Time call received;
(ii) Dispatch time;
(iii) Enroute time;
(iv) On-scene time;
(v) Departure from scene time;
(vi) Arrival at destination time;
(n) The names and level of certification or licensure for all EMS providers and other medical personnel;
(o) The names of any non-EMS certified personnel, if applicable.
(3) A copy of the record for each patient shall be provided to the receiving facility, which includes all the information required, no later than twenty-four hours from time of dispatch.
Last updated May 1, 2026 at 8:15 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-06
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) All licensed AMSO communication centers shall comply with the following:
(1) Shall be equipped with a base station capable of two-way communications .
(2) The base station shall be staffed during all phases of aircraft operations.
(3) The communication center shall demonstrate and maintain a voice communications linkage with the radios used in the permitted aircraft within the declared service area.
(4) All in-coming and out-going telephone and radio transmissions regarding medical transports shall be recorded on a system with time recording and playback capabilities.
(a) Recordings shall be kept for at least thirty days from the day of recording;
(b) Recordings shall be made available to the board upon request.
(5) An emergency plan for communications during power outages and in disaster situations shall be established.
(6) Service area maps and/or navigational charts or mapping software shall be readily available.
(B) All permitted aircraft shall be equipped with two-way communications capable of communication with the licensed AMSO's communication center, air traffic control, and medical control.
(1) The pilot shall be able to control and override radio transmissions from the cockpit in the event of an emergency situation;
(2) Medical team members shall be able to communicate with each other during flight. Rotorcraft air ambulance medical personnel shall wear headsets and/or helmets with communication capabilities during medical transports.
(C) All licensed AMSOs shall maintain a detailed radio/communications log that documents, at a minimum, the following:
(1) Time call received;
(2) Location of call, requesting agency;
(3) Nature of call;
(4) Initial dispatch time;
(5) Time enroute, as applicable;
(6) Estimated time of arrival (ETA), as applicable;
(7) Time of arrival on-scene, as applicable;
(8) Departure from scene time;
(9) Arrival at destination time;
(10) Souls on-board;
(11) Pilot(s) name(s);
(12) Date of service;
(13) Fuel on-board;
(14) Estimated flight time, as applicable;
(15) Time in-service, as applicable.
(D) Radio equipment used in permitted aircraft shall meet the FCC requirements specified in "47 C.F.R. 90.203" and all FAA rules and regulations.
(E) If an AMSO contractually uses another communication center for dispatch purposes, the communication center shall provide written certification of compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code as applicable.
Last updated May 1, 2026 at 8:16 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-07
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) Each licensed AMSO shall comply with all occupational safety and health administration bloodborne pathogens regulations as set forth in "29 C.F.R. part 1910.1030."
(B) A licensed AMSO shall ensure that sanitation procedures are provided to all personnel in a written document that conforms to current standards as set forth in occupational safety and health administration bloodborne pathogens protocol.
(C) A licensed AMSO shall maintain and follow a written sanitation plan that conforms to the latest bloodborne pathogens standards as written by the occupational safety and health administration. The following documentation shall be maintained for each aircraft:
(1) Sanitation schedule;
(2) Date the sanitation was completed;
(3) Documentation of who performed sanitation.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-09
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) A licensed AMSO shall ensure that all permitted aircraft are in compliance at all times with FAA regulations pertaining to safety and maintenance operating specifications set forth in "14 C.F.R. Part 135 Certificate" under which the AMSO operates.
(B) A licensed AMSO shall ensure performance and maintain documentation of all periodic maintenance and repairs of bio-medical equipment as required by the manufacturer and/or the food and drug administration for a period of two years from date of repair or maintenance. Information shall include but not be limited to the following:
(1) Date of last bio-medical inspection;
(2) Date of service or repair;
(3) Description of service or repair performed;
(4) Documentation of who performed inspection, service, or repair;
(5) Documentation of inspection, service, or repair performed.
(C) A licensed AMSO shall maintain documentation of all periodic maintenance of patient care equipment as required by the original equipment manufacturer, including but not limited to the following:
(1) Date of last inspection;
(2) Date of service or repair;
(3) Description of service/repair performed;
(4) Name of who performed inspection, service, or repair;
(5) Documentation of inspection, service, or repair performed.
(D) Aircraft records shall be kept for a period of twelve months after the aircraft is removed from inventory.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-08 Inspection of aircraft and equipment requirements.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) All aircraft to be permitted shall be made available for inspection.
(B) Except as otherwise provided in this chapter, no AMSO shall operate an aircraft without obtaining a permit from the board. In addition to submitting the appropriate fee and application to obtain a permit, an aircraft shall meet or comply with the following inspection requirements:
(1) The name of the AMSO shall be permanently affixed to each aircraft with letters being a minimum height of three inches on both sides and a minimum height of one and one half inches on the back.
If an AMSO is under contract which requires other signage or if the AMSO is operating under another name, each aircraft shall have permanently affixed lettering with a minimum height of one and one half inches on the rear and both sides of the of aircraft that states:
(a) Owned and operated by [AMSO's name];
(b) Operated by [AMSO's name]; or
(c) Owned by [AMSO's name].
(2) A current and valid FAA certificate which demonstrates airworthiness, in compliance with "14 C.F.R. 21," "14 C.F.R. 43," and "14 C.F.R. 91" shall be readily available at the time of the inspection or upon request of the board or its designee.
(3) An aircraft used as a medical aircraft shall contain all equipment and supplies set forth in the "Rotor Wing Aircraft Inspection" form and "Fixed Wing Aircraft Inspection" forms to include the following types of equipment:
(a) Isolation equipment;
(b) Airway equipment;
(c) Onboard definitive care equipment;
(d) Bleeding control/burn equipment;
(e) Suction equipment;
(f) Medical gas and equipment;
(g) Adjunct equipment; and
(h) Intravenous equipment.
(C) An AMSO shall ensure that all aircraft permits are displayed in a manner that complies with all applicable federal aviation regulations and on each aircraft in accordance with division (B)(3) of section 4766.07 of the Revised Code.
(D) A permitted aircraft that is being used as an air medical aircraft shall comply with the requirements of airworthiness in compliance with "14 C.F.R. 21," "14 C.F.R. 43," and "14 C.F.R. 91" and with the requirements set forth in the "Rotor Wing Aircraft Inspection" and "Fixed Wing Aircraft Inspection" forms, which shall include carrying specified definitive equipment.
(E) All equipment and supplies shall have current expiration dates where applicable.
(F) Disposable equipment is acceptable where applicable.
(G) All equipment shall be securely stored in each aircraft.
(H) All violation notifications issued by the board or its designee shall be corrected.
(I) Each aircraft that receives a violation notification shall be placed out-of-service until:
(1) It passes reinspection by the board or its designee; or
(2) For seventy-two hour violation notifications, the violation has been corrected and the "Violation Notification" form is signed and returned to the division along with supporting documentation showing the violation has been corrected.
(J) A permit is not transferable.
(K) Each permitted aircraft shall be free from dirt, stains, impurities and/or foreign matter in pilot's compartment and patient care compartments.
Last updated May 1, 2026 at 8:16 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-12 Temporary use of aircraft and disaster operations.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) No AMSO shall operate an aircraft without a permit issued in accordance with section 4766.07 of the Revised Code except as provided in paragraph (E) of this rule.
(B) An AMSO aircraft that has not been issued a permit by the board may be issued a temporary permit, for a period not to exceed sixty days, if the aircraft is used to replace a permitted AMSO aircraft that has been temporarily taken out of service for repair or maintenance or is being permanently replaced. In order to obtain a temporary permit, an AMSO shall submit a request for a temporary aircraft permit using the MTLS online system containing:
(1) Identification number of the permitted AMSO aircraft;
(2) Date permitted AMSO aircraft was placed out of service;
(3) Identification number of the AMSO aircraft to receive a temporary permit;
(4) Date temporarily permitted AMSO aircraft is to be placed in service.
(C) The AMSO shall clearly and conspicuously display the temporary aircraft permit in any temporary aircraft used by the AMSO.
(D) A temporarily permitted aircraft shall not be operated unless it meets the requirements set forth in paragraph (B) of rule 4766-5-08 of the Administrative Code and the insurance requirement set forth in division (B) of section 4766.06 of the Revised Code.
(E) In the event of a disaster situation when permitted aircraft based in the locality of the disaster situation are incapacitated or insufficient in number to render services needed, a licensed AMSO may utilize whatever means necessary to transport and treat patients.
Last updated May 1, 2026 at 8:16 AM
History
- Effective: May 1, 2026
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-13 Staffing compliance.
(A) All AMSOs must comply with the staffing requirements under section 4766.17 of the Revised Code.
(B) An AMSO, licensed under this chapter, that operates a permitted rotorcraft or fixed wing air ambulance shall staff the aircraft with, at a minimum, a physician who holds a current and valid license issued under Chapter 4731. of the Revised Code or a registered nurse who holds a current and valid license issued under Chapter 4723. of the Revised Code, and a paramedic or one other person, designated by the medical director of the AMSO, who holds a current and valid certificate or license to practice a health care profession in this state.
(C) An AMSO, licensed under this chapter, that operates a permitted rotorcraft or fixed wing air ambulance shall employ as a medical director an individual who holds a current and valid license issued under Chapter 4731. of the Revised Code authorizing the practice of medicine and surgery or osteopathic medicine and surgery.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-15 Changes to be reported to the board.
[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-5-18 of the Administrative Code.]
(A) Each licensed AMSO shall give written notification to the board within ten business days of any additions, deletions, or changes in:
(1) Executive officers or board members;
(2) Medical director, including:
(a) Contact information; and
(b) Medical license number;
(3) Ownership of a licensed AMSO;
(4) Tax ID or EIN number;
(5) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number;
(6) FCC license modifications;
(7) Certificate of insurance for general liability or aircraft liability.
(B) Within ten days of the date a permitted aircraft is permanently withdrawn from service, the licensed AMSO shall return to the board a completed "Deletion of Aircraft" form and the decal that was required to be displayed on the aircraft.
(C) If an AMSO operates or plans to operate in more than one location under the same or different identities, the AMSO shall apply for licensure on the "Application for New Satellite" form and meet all requirements for licensure or renewal of a license, except payment of a license fee or renewal fee for operating at each separate location.
(D) Within ten business days of the date a licensed AMSO ceases to operate a satellite base, it shall return to the board the certificate of licensure.
(E) Within ten business days of the date a licensed AMSO ceases to operate, it shall return to the board all decals, temporary aircraft permits, and certificates of licensure.
(F) A licensed AMSO may apply at any time for change of address of headquarters location. The application shall be made on the "Headquarters Change of Address" form and include the one hundred dollar license fee. The AMSO shall also ensure compliance with rule 4766-5-04 of the Administrative Code. A change in headquarters address does not change the expiration date of the license.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-16 Investigations.
(A) The division shall investigate all complaints on behalf of the board and in accordance with section 4766.11 of the Revised Code.
(B) After an investigation is completed and based on the findings of such investigation, the board may initiate disciplinary proceedings in accordance with Chapter 119. of the Revised Code and this chapter.
(C) If, based on the findings of an investigation, the board determines that no further action on a complaint is warranted, then the case shall be closed accordingly.
(D) The division shall conduct all investigations and any related proceedings, in such a manner as to protect patient confidentiality and in accordance with section 4765.102 of the Revised Code.
(E) Notwithstanding paragraph (D) of this rule, a patient may consent to have the board release the patient's name or other identifying information that was collected as part of the division's investigation. Such consent shall be in writing and signed by the patient in order to be considered proper.
If a patient is less than eighteen years of age, such consent shall be in writing and signed by the patient's parent, guardian, or legal custodian in order to be considered proper.
(F) No member of the board who participates in an investigation shall participate in any further adjudication of the case.
(G) No member of the board who participates in an investigation at the local level or is involved in a case locally, shall participate in any investigation or adjudication of the same case by the board.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
Ohio Adm.Code 4766-5-17 Disciplinary grounds.
(A) The board may, pursuant to an adjudicatory hearing under Chapter 119. of the Revised Code and section 4766.08 of the Revised Code, and by a vote of the majority of all members, suspend, revoke, or refuse to renew any license or permit or issue a fine not to exceed more than fifteen hundred dollars, for any of the following reasons:
(1) Any violation of Chapter 4766. of the Revised Code or any rules adopted thereunder;
(2) Refusal to permit the board or its designee to inspect an aircraft, inspect the records, or inspect the physical facilities of a licensed AMSO;
(3) Failure to meet aircraft standards as set forth in Chapter 4766. of the Revised Code or any rules adopted thereunder;
(4) Violation of an order issued by the board;
(5) Failure to comply with the terms of any agreement entered into with the board.
(B) Within sixty days of receipt of a complete application for licensure, pursuant to division (F) of section 4766.04 of the Revised Code, the board shall deny an application if it determines that the applicant does not meet the requirements of Chapter 4766. of the Revised Code and rules promulgated thereunder.
Last updated March 10, 2026 at 8:03 AM
History
- Effective: December 15, 2019
- Promulgated Under: 119.03
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