KENTUCKY COMMUNITY AND TECHNICAL COLLEGE SYSTEM

Kentucky Board of Emergency Medical Services

(As Amended at ARRS, March 12, 2018)

 

      202 KAR 7:560. Ground vehicle staff.

 

      RELATES TO: KRS 189.910-189.950, 311A.030, 311A.190

      STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.190

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020 requires the Board of Emergency Medical Services[board] to exercise all administrative functions in the regulation of the emergency medical services system and the licensing of ambulance services and medical first response agencies, except those regulated by the Board of Emergency Medical Services or the Cabinet for Health and Family Services. KRS 311A.030 requires the board to promulgate administrative regulations for the licensing, inspection, and regulation of ambulance providers and medical first response agencies. This administrative regulation establishes the minimum staffing requirements for ground vehicles.

 

      Section 1. Staffing Requirements. (1) Each Class I agency BLS ambulance shall at minimum, be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) An attendant certified as an emergency medical technician (EMT).

      (2) Each Class I agency ALS ambulance shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) An attendant certified as an Advanced EMT or licensed as a paramedic.

      1. Each Class I ALS agency providing primary 911 emergency ambulance service shall ensure that an on-duty paramedic shall staff at least twenty-five (25) percent of the agency’s staffed ambulances at any time during a twenty-four (24) hour period.

      2. To ensure compliance, each agency shall maintain its work schedules from the previous twelve (12) months until reviewed during its annual inspection.

      (3) Each Class I agency operating an ALS ambulance providing a BLS level of care shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) An attendant certified as an emergency medical technician (EMT).

      (4) Each Class II agency shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) An attendant certified as an emergency medical technician (EMT).

      (5) A Class III Adult Critical Care ambulance agency shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT);

      (b) An attendant licensed as a paramedic; and

      (c) One (1) licensed:

      1. Registered nurse[with a current certification as a CCRN for adults that shall be obtained within one (1) year of hire];

      2. Advanced practice registered nurse[certified in adult acute care];

      3. Respiratory therapist;

      4. Physician assistant[specializing in critical care];

      5. Physician; or

      6. Additional paramedic.

      (6) Each Class III Pediatric Specialty Care Ambulance Agency shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) A primary attendant licensed as a registered nurse and certified as a CCRN that is obtained within one (1) year of hire; and

      (c) One (1) additional attendant licensed as a:[Two (2) attendants licensed as a:]

      1. Registered nurse[with a current certification as a CCRN for Pediatrics that is obtained within one (1) year of hire];

      2. Advanced practice registered nurse[certified in pediatric acute care];

      3. Respiratory therapist;

      4. Physician assistant;

      5. Physician; or

      6. Paramedic.[(c) A paramedic and respiratory therapist shall not simultaneously serve as attendants.]

      (7) Each Class III Neonatal Specialty Care Ambulance Agency shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); [and]

      (b) A primary[An] attendant licensed as a registered nurse with a current certification as a CCRN[in Neonatology] or RNC-NIC that is obtained within one (1) year of hire; and

      (c) One (1) additional attendant licensed as[licensed]:

      1. An advanced practice registered nurse[certified in neonatology];

      2. A respiratory therapist;

      3. A physician assistant[specializing in neonatology]; or

      4. A physician; or

      5. A registered nurse[; or

      5. Registered nurse with a current certification as a CCRN in Neonatology or RNC-NIC that is obtained within one (1) year of hire].

      (8) Each Class IV agency operating a BLS ambulance shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) An attendant certified as an emergency medical technician (EMT).

      (9) Each Class IV service operating an ALS ambulance shall at minimum be staffed by:

      (a) A driver certified as an emergency medical technician (EMT); and

      (b) An attendant certified as an Advanced EMT or licensed as a paramedic.

      1. Each Class IV ALS agency that provides emergency and nonemergency transportation for restricted locations, such as industrial sites or other sites, shall ensure an on-duty paramedic staffs at least twenty-five (25) percent of the agency’s staffed ambulances at any time during a twenty-four (24) hour period.

      2. To ensure compliance, each agency shall maintain its work schedules from the previous twelve (12) months until reviewed by board staff during its annual inspection.

      (10) Each Class VI BLS medical first response agency shall at minimum be staffed by a certified:

      (a) Emergency medical responder (EMR); or

      (b) Emergency medical technician (EMT).

      (11) Each Class VI ALS medical first response agency shall at minimum be minimally staffed by:

      (a) A certified Advanced EMT; or

      (b) A licensed paramedic.

      (12) Each Class VIII BLS agency shall be minimally staffed by a certified:

      (a) Emergency medical responder (EMR); or

      (b) Emergency medical technician (EMT).

      (13) Each Class VIII ALS agency shall be minimally staffed by:

      (a) A certified Advanced EMT; or

      (b) A licensed paramedic.

      (14) Each Class I ALS, Class III ACC, Class IV ALS, and Class VI ALS agency shall have a licensed paramedic on duty at all times.

      (15) At all times, the attendant shall monitor the patient and remain with the patient in the patient compartment.

      (16) This administrative regulation shall not prevent an agency from utilizing staff other than those required by this administrative regulation in:

      (a) Disasters;

      (b) Mass casualty incidents; or

      (c) Extraordinary scene conditions that would impair the safety of the patient or personnel operating at the scene.

      (17) A certified emergency medical responder who was[were] employed by a Class I, II, or III agency as a driver prior to January 1, 2018 may continue in that role if the emergency medical responder’s employment relationship with the Class I, II, or III agency does not lapse.

      (18) Alternative staff shall not operate a licensed vehicle unless the:

      (a) Agency administrator so directs; and

      (b) Vehicle is out of service and not subject to an emergency response[at the direction of the agency administrator and the vehicle is out of service and not subject to an emergency response].

 

      Section 2. Motor Vehicle Operator Requirements. (1) Each person operating a vehicle shall:

      (a) Be at least eighteen (18) years of age;

      (b) Hold a valid driver's license in any state or territory of the United States; and

      (c) Complete at least four (4) hours of driver training and education every two (2) years.

      (2) The driver training and education shall consist of a:

      (a) Review of driving a vehicle under emergency conditions;

      (b) Review of KRS 189.910 through 189.950 regarding operation of emergency vehicles;

      (c) Demonstration by the student of forward and back-up driving maneuvers in a controlled situation, such as in an obstacle course designed specifically for this purpose; and

      (d) Review of defensive driving techniques and procedures with hands-on experience or exposure by visual aids or planned demonstrations.

 

      Section 3. Public Notice of Negative Action. The board office shall cause to be published, on the KBEMS Web site or similar publication of the board, or otherwise disseminate, the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.

 

ANGELA EVANS, General Counsel for KBEMS

      For JIM DUKE, KBEMS Chairperson

      APPROVED BY AGENCY: February 15, 2018

      FILED WITH LRC: February 15, 2018 at 8 a.m.

      CONTACT PERSON: Angela Evans; Legal Counsel, Kentucky Board of Emergency Medical Services; McBrayer, McGinnis, Leslie & Kirkland, PLLC, 201 East Main Street Suite 900, Lexington, Kentucky 40507, phone (859) 231-8780, fax (859) 231-1175, email aevans@mmlk.com.