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COMMONWEALTH OF PENNSYLVANIA

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PA Bulletin, Doc. No. 99-260g

[29 Pa.B. 903]

[Continued from previous Web Page]

§ 1007.4.  [Renewal of air ambulance license] (Reserved).

   [(a)  The Department will notify the applicant service at least 90 days prior to the expiration date of the license. The notification will include a renewal application.

   (b)  The applicant shall submit to the Department the renewal application postmarked at least 60 days prior to the expiration of the license.

   (c)  The criteria for license renewal are the same as the current requirements for original licensure.]

§ 1007.5.  [Inspections] (Reserved).

   [(a)  Upon the request of an agent of the Department during regular and usual business hours, or at other times when a reasonable belief that violations of this part may exist, a licensee shall:

   (1)  Produce for inspection records maintained under § 1001.41(c) (relating to data and information requirements for ambulance services).

   (2)  Produce for inspection personnel and other employment records that pertain to certification of personnel, staffing, equipment and mutual aid agreements.

   (3)  Permit the agent to examine required equipment and recordkeeping facilities for information collected under § 1001.41(c).

   (b)  The Department's agent shall advise the licensee that the inspection is being conducted under section 12(k) of the act (35 P. S. § 6932(k)) and this chapter.

   (c)  The Department reserves the right to enter and make the inspections at least quarterly, and at other times upon complaint or a reasonable belief that violations of this part may exist.

   (d)  Failure of a licensee to produce records for inspection or to permit examination of equipment and facilities is grounds for suspension, revocation or denial of license.]

§ 1007.6.  [Notification of deficiencies] (Reserved).

   [(a)  Within 30 days of an inspection, the air ambulance service and the regional EMS council shall be notified as to deficiencies found and the results of the inspection.

   (b)  The ambulance service has 30 days in which to respond to the Department with a plan to correct deficiencies and schedule a reinspection. The plan of correction shall be approved by the Department. If the plan is approved, the Department will schedule a reinspection.

   (c)  Within 30 days of the reinspection, the Department will give written notice to the service of the findings regarding the deficiencies and the results of the reinspection.]

§ 1007.7.  Licensure and general operating requirements.

   (a)  Documentation requirements. An applicant for an air ambulance service license shall have the following documents available for the inspection by the Department:

   (1)  A roster of active personnel, including certification and recognition documentation with dates of expiration and identification numbers, and the plan for staffing the air ambulance service.

   (2)  Copies of prehospital ambulance call reports, or other formats on which those records are kept on patients treated or transported, if applicable.

   (3)  Call volume records from the previous year's operations, if applicable. These records shall include a record of each call received requesting the air ambulance service to respond to an emergency, as well as a notation of whether it responded to the call and the reason if it did not respond.

   (4)  Copies of the written policies required by this section.

   (b)  [Aircraft] Air ambulance requirements. [Aircraft operated by a licensed] An air ambulance [service] shall meet the following minimum requirements:

   (1)  The [aircraft] air ambulance shall be configured to carry at least one supine patient with sufficient access to the patient in order to begin and maintain ALS and other treatment modalities.

   (2)  The [aircraft] air ambulance design may not compromise patient safety in loading, unloading or during flight, and shall be equipped with either a cargo door or an entry that will allow loading and unloading the patient without excessive maneuvering.

   (3)  The [aircraft] air ambulance shall be climate controlled for the comfort of the patient.

   (4)  The [aircraft] air ambulance shall have adequate interior lighting so that medical care can be provided and patient status monitored without interfering with the pilot's vision.

   (5)  The [aircraft] air ambulance shall be configured so that the patient is isolated from the cockpit to minimize in-flight distractions to the pilot and to prevent interference with the pilot's manipulation of the flight controls.

*      *      *      *      *

   (7)  [Survival] The air ambulance shall carry survival gear appropriate to the terrain and environment [shall be carried on flights].

   (8)  The [aircraft] air ambulance shall be equipped with appropriate patient restraints.

   (9)  The [aircraft] air ambulance shall be equipped with 110 [A] V electrical output with appropriate cabin outlets for medical equipment use.

   (10)  The [aircraft] air ambulance shall be equipped with two-way radios capable of communicating with hospital [communication] communications centers, [public safety communication centers] PSAPs and ambulances.

   [(b)] (c)  Equipment and supply requirements. [Approved] Required equipment and supplies shall be carried and readily available in working order for use on [aircraft operated by a licensed] an air ambulance [service]. The [minimum] list of required equipment and supplies for [aircraft] an air ambulance will be published by the Department [as a notice] in the Pennsylvania Bulletin on an annual basis.

   [(c)  Medications. Approved medications and drugs shall be carried and available for administration to patients on aircraft operated by a licensed air ambulance service. The minimum list of medications and drugs for aircraft will be published by the Department as a notice in the Pennsylvania Bulletin on an annual basis.

   (d)  Patient data. Air ambulance services licensed to operate in this Commonwealth shall collect, maintain and report accurate and reliable patient data and information for calls for assistance in the format prescribed or on forms provided by the Department within the specified time period.

   (1)  The information collected shall include information identified in § 1001.41 (relating to data and information requirements for ambulance services).

   (2)  Air ambulance services licensed to operate in this Commonwealth shall meet the requirements of § 1001.41 and § 1001.42 (relating to dissemination of information).]

   [(e)] (d)  Personnel requirements. [Air] An air ambulance [services] service shall meet the following requirements related to personnel and staffing:

   (1)  Air ambulance medical director. [The service] It shall [employ] have an air ambulance medical director who possesses the qualifications specified in § [1003.41(b)  (relating to air ambulance medical director) to serve as the medical director responsible for] 1003.5(b)  (relating to ALS service medical director) and performs the duties specified in § [1003.41] 1003.5(a). [If the air ambulance medical director leaves or is removed from service, a qualified replacement shall be hired within 30 days of the previous medical director's departure. The air ambulance service shall inform the Department of a change in air ambulance service medical directors within 30 days of a medical director's departure].

   (2)  Pilot and prehospital personnel. [The service] It shall assure that each air ambulance responding to a call for EMS services is staffed with at least one pilot and [two medical crew members who possess the minimum qualifications defined in §§ 1003.42(b) and 1003.43(b) (relating to air ambulance medical crew members; and air ambulance pilot)] prehospital personnel as set forth in § 1005.10(d)(1)(ii) (relating to licensure and general operating standards). At least one of the [medical crew members] responding prehospital personnel shall be [either a physician or nurse] specially trained in [aeromedical] air-medical transport.

   (3)  Other personnel requirements.

   (i)  [The service] It shall keep a pilot and two [medical crew members] prehospital personnel staff as set forth in § 1005.10(d)(ii) available for the [aircraft] air ambulance at all times to assure immediate response to emergency calls.

   [(4)  The service shall have a communications center, operational 24 hours per day, 7 days per week and staffed with a communications specialist who has the minimum qualifications in § 1003.44(b) (relating to air ambulance communications specialist).]

   [(5)  The service] (ii) It shall require [that flight crew members] prehospital personnel who staff an air ambulance to undergo annual physical examinations to assure that they are physically able to perform their jobs.

   (iii)  Minimum staffing standards are satisfied when an air ambulance service has a duty roster that identifies staff who meet minimum staff criteria 24 hours-a-day, 7 days-a-week and who have committed themselves to be available at the specified times, and when minimum required staff are present during the emergency medical treatment and transport of a patient.

   (e)  Communicating with ground PSAPs.

   (1)  If requested by a ground PSAP, an air ambulance service shall apprise the PSAP as to when it will not be in operation, when weather conditions prevent or impede flight, and when its resources are already committed.

   (2)  An air ambulance service shall apprise the dispatching ground PSAP as soon as practical after receiving a dispatch call, its estimated time of arrival at the scene of the emergency. While its air ambulance is enroute to the scene of an emergency, if an air ambulance service believes that it will not be able to have an air ambulance and required staff arrive at the emergency scene within the estimated time of arrival previously given, the air ambulance service shall contact the ground PSAP and provide its new estimated time of arrival.

   (f)  [Policy requirements. The air ambulance service shall have in place written policies as follows:

   (1)]  Access to air ambulance service.

   [(i)] (1)  The air ambulance service shall have [in place a written policy which describes its policy regarding access to its service. This policy shall include the following information] a policy which addresses the following:

   [(A)] (i)  Who, in addition to a PSAP, may request air ambulance service.

   [(B)] (ii)  How its air ambulance services should be accessed.

   [(C)] (iii)  General and medical guidelines for personnel to consider prior to requesting its air ambulance services.

   [(D)] (iv)  ***

   [(E)] (v)  What level of EMS [are] is provided by the air ambulance service.

   [(F)] (vi)  ***

   [(G)] (vii)  ***

   [(ii)  This] (2)  The air ambulance service shall disseminate this policy [shall be disseminated] to relevant health care providers in the air [ambulances's] ambulance service area.

   [(2)  Air ambulance pilot operational] (g)  Flight requirements. [This] The air ambulance service shall [have in place a written policy governing pilot operational procedures which includes the following requirements] ensure that:

   [(i) The pilot shall make a] (1) A determination to accept the flight is based solely on safety procedures and weather conditions.

   [(ii)] (2)  The [pilot shall proceed] air ambulance proceeds expeditiously and as directly as possible to the flight destination, considering the weather, appropriate safety rules, noise abatement procedures and flight path and altitude clearances.

   [(iii)] (3) The [pilot shall] air ambulance engages in flight [follow] following with [a] an air communications center at intervals not to exceed 15 minutes. If the [aircraft] air ambulance is outside of radio range of the base communications center, adequate flight following shall be planned and executed.

   [(iv)] (4)  The [pilot is responsible for assuring that the aircraft air] ambulance is ready for flight at all times when the air ambulance service has not reported to ground PSAPs that the air ambulance is unavailable to respond to emergencies.

   [(3)] (h)  Medical [crew members' operational] service requirements. The air ambulance service shall [have in place a written policy governing medical crew members operational procedures which includes the following requirements] ensure that:

   [(i)] (1)  [Medical crew members are responsible for assuring that equipment/] Equipment and supplies required for an air ambulance flight are on the [aircraft] air ambulance and in working order prior to takeoff for patient transport.

   [(ii)] (2)  Medical [crew members shall provide] care and intervention is provided according to direct medical command or written protocols/standing orders.

   [(iii) Medical crew members shall maintain a] (3) A patient treatment record is maintained, documenting medical care rendered by the medical flight crew and the disposition of the patient at the receiving medical facility. The patient treatment record shall be maintained at the base hospital.

   [(iv)  Medical crew members shall evaluate each] (4) Each patient is evaluated for potential adverse effects from flight operations.

   [(v) Medical crew members shall assure that the] (5) The patient and equipment are secured during flight.

   [(4)] (i)  Air ambulance medical director's operational requirements. The air ambulance service shall have [in place] a [written] policy setting forth the air ambulance medical director's operational procedures which shall include procedures for at least the following:

   [(i)] (1)  [To assure that the medical condition or history of the patient is made known only to medical crew members, and other EMS providers who have participated in the delivery of patient care] The performance of responsibilities set forth in § 1003.5(a)  (relating to ALS service medical director).

   [(ii)  To assure adequate training and experience of medical flight crew members.

   (iii) For developing] (2) The development of medical treatment protocols for [use by medical crew members] the air ambulance service, [and] submitting them [for approval] to the regional EMS council medical [direction] advisory committee for its review and recommendations, and securing approval of the medical treatment protocols from the Department.

   [(iv)  For establishing and operating a quality assurance program whereby the quality and appropriateness of patient care provided by the air ambulance service can be continuously documented, reviewed and evaluated.

   (5)] (j)  Communication center [operational requirements] arrangements. The air ambulance service shall [have in place a written policy governing communication center operational procedures which includes the requirements that the communications center shall] ensure that it has access to an air communications center that meets the following standards:

   [(i) Have] (1)  Has a designated person--communications specialist--assigned to receive and dispatch requests for emergency air medical services and charged with the relay of information between the flight crew, requesting agency and receiving hospital.

   [(ii) Be] (2)  Is operational 24 hours [per]-a-day, 7 [days a week] days-a-week and [have] has radio capabilities to transmit to and receive from the air ambulance [aircraft]. At a minimum, 123.05 MHz, radio frequency shall be available.

   [(iii) Have] (3)  Has at least one incoming telephone line that is dedicated to the air ambulance service.

   [(iv) Have] (4)  Has a system for recording incoming and outgoing telephone and radio transmissions. The system shall have an inherent time recording capability and recordings shall be kept for a minimum of 30 days.

   [(v) Have] (5)  Has the capability of communicating with the flight crew so that the [aircraft] air ambulance may take off within the scheduled takeoff time.

   [(vi) Have] (6)  Has a backup emergency power source.

   [(vii) Maintain] (7)  Maintains a status board listing flight crew names and other pertinent operational information.

   [(viii) Have] (8)  Has copies of operational protocols and procedures, including emergency operation plans in the event of overdue, missing or downed aircraft.

   [(ix) Have] (9)  Has posted or displayed applicable licenses and permits.

   [(x) Maintain] (10)  Maintains current maps and navigational aids.

   [(6)  Communications specialist operational requirements. The service shall have in place a written policy governing communication specialist operational procedures. The written policy shall include a requirement that the communication specialist document contains, at a minimum, the following information:]

   (11)  Collects and maintains records of the following data:

*      *      *      *      *

   (ix)  Other data pertinent to the air ambulance service's specific needs for completing activity review reports.

   [(g)] (k)  Community education program requirements.

*      *      *      *      *

   (2)  The educational program shall include the following:

   (i)  [The service shall communicate] Communication to the public that the [emergency] air [medical] ambulance service accepts medically necessary calls from authorized personnel and does not discriminate against a person because of race, creed, sex, color, age, religion, [National] national origin, ancestry, medical problem, handicap or ability to pay.

   (ii)  A safety program covering landing site designation and safe conduct around the [aircraft] air ambulance, which shall be offered to appropriate agencies and individuals.

   (iii)  Training regarding stabilization and preparation of the patient for airborne transport, which shall be provided to prehospital [EMS] personnel.

   (iv)  [The service shall institute a] An active community relations program.

   (l)  Medical command notification. An air ambulance service shall identify, to the regional EMS council having responsibility in the region out of which it operates, the prehospital personnel used by it that have medical command authorization in the region for that air ambulance service. The service shall also notify the regional EMS council when a prehospital practitioner loses medical command authorization for that air ambulance service.

   (m)  Monitoring compliance. An air ambulance service shall monitor compliance with the requirements that the act and this part impose upon the air ambulance service and its staff.

   (n)  Policies and procedures. An air ambulance service shall maintain written policies and procedures addressing each of the requirements imposed by this section, as well as the requirements imposed by §§ 1001.41, 1001.42 and 1001.65 (relating to data and information requirements for ambulance services; dissemination of information; and cooperation), and shall also maintain written policies and procedures addressing infection control, management of personnel safety, and the placement and operation of its air ambulances.

§ 1007.8.  [Grounds for suspension, revocation or refusal of an air ambulance license] Disciplinary and corrective actions.

   (a)  The Department may, in compliance with proper administrative procedure, reprimand, or suspend, revoke or refuse to issue a license, or issue a provisional or temporary license as permitted by §§ 1005.8 and 1005.9 (relating to provisional license; and temporary license) for the following reasons:

   (1)  A serious violation of the act or this part. A serious violation is one which poses a continued significant threat to the health and safety of the public.

*      *      *      *      *

   (4)  Fraud or deceit in obtaining or attempting to obtain a license [or permit].

*      *      *      *      *

   (7)  Failure to secure an air ambulance medical director and ensure that the air ambulance medical director [meets the roles and] exercises the responsibilities in § [1003.41(a) (relating to air ambulance medical director)] 1003.5(a) (relating to ALS service medical director).

   (8)  Failure to have appropriate medical equipment and supplies required for licensure as identified in § 1007.7(b) (relating to licensure and general operating requirements).

*      *      *      *      *

   (11)  Failure to employ a sufficient number of certified, recognized or licensed personnel to provide service 24 hours [per]-a-day, 7 [days a week] days-a-week.

   (12)  Failure of the air [medical] ambulance service to be available 24 hours [per]-a-day, 7 [days a week] days-a-week to authorized callers within the service area. Exceptions to this requirement include unsafe weather conditions, commitment to another flight, grounding due to maintenance or other reasons that would prevent response. The air [medical] ambulance service shall maintain a record of each failure to respond to a request for service, and make the record available upon request to the Department. Financial inability to pay does not constitute sufficient grounds to deny response for emergency air service.

   (13)  Failure [of an air ambulance service licensee] to notify the Department of the change of ownership or aircraft operation.

*      *      *      *      *

   (18)  Refusal to render EMS because of a patient's race, sex, creed, [National] national origin, sexual preference, age, handicap, medical problem or financial inability to pay.

   (19)  Failure to comply with regional EMS council transfer and medical treatment protocols.

*      *      *      *      *

   (21)  [Other reasons as determined by the Department which pose a significant threat to the health and safety of the public] Repeated failure to communicate with a PSAP as required by § 1007.7(e).

   (b)  Upon receipt of a written complaint describing [specific violations of this chapter] conduct for which the Department may take disciplinary action against an air ambulance service, the Department will:

*      *      *      *      *

   (2)  [Notify] Provide the air ambulance service with a copy of the [charges] complaint and [investigation procedures] request a response unless the Department determines that disclosure to the air ambulance service of the complaint will compromise the investigation or would be inappropriate for some other reason.

   (3)  [Conduct and develop] Develop a written report of the investigation.

   (4)  Notify the [air ambulance service] complainant of the results of the investigation of the complaint, as well as the air ambulance service if the air ambulance service has been officially apprised of the complaint or investigation. This notification does not include providing a copy of the written report developed under paragraph (3).

   [(c)  The Department will immediately suspend the license for the violations specified in § 1005.12(a)(1), (6), (11), (15) and (17) (relating to grounds for suspension, revocation or refusal of an ambulance service license). This suspension shall be for a period of up to 90 days. A second offense during the same license period shall result in the automatic revocation of the license.

   (d)  The Department will suspend the license for other violations for a period to be determined by the Department. The Department may revoke a license for repeated violations.

   (e)  Upon suspension or revocation of an air ambulance license, the service shall cease operations and no person may permit or cause the service to continue.

   (f)] (c)  The Department will provide public notification of [suspension, including the length of suspension period or revocation of] sanctions it imposes upon an air ambulance service license.

   [(g)  Upon suspension or revocation of an air ambulance license, the service shall cease operations and no person may permit or cause the service to continue.]

§ 1007.9.  [Voluntary discontinuation of service] (Reserved).

   [(a)  Air ambulance service licenses may not voluntarily discontinue service until 90 days after the licensee notifies the Department in writing that the service is to be discontinued.

   (b)  Notice to the Department shall include a statement that the licensee has notified the chief executive officer of each political subdivision in the licensee's ambulance service area and that the intent to discontinue service has been advertised in a newspaper of general circulation in the service area.

   (c)  The air ambulance service licensee shall notify the Department in advance of anticipated temporary discontinuance of service expected to last for at least 7 consecutive days.]

CHAPTER 1009.  [EMS] MEDICAL COMMAND [MEDICAL] FACILITIES

§ 1009.1.  [Accreditation and operational] Operational criteria.

   [Medical command facilities shall be accredited by the Department]. To qualify [for accreditation] as [an EMS] a medical command facility, an institution shall [demonstrate that it complies] comply with the following criteria [related to personnel, capabilities, procedures and programs by]:

   (1)  [Employing] Employ a [physician] medical command facility medical director who meets the requirements specified [at] in § 1003.3(b) (relating to medical command facility medical director)  [for a medical command facility medical director].

   (2)  [Employing] Employ sufficient staff to ensure that at least one approved medical command physician, meeting the requirements [of] in § 1003.4(b) (relating to medical command physician), is present in the facility 24 hours [per]-a-day, 7 days [per]-a-week.

   (3)  [Possessing communication capabilities and recordkeeping protocols that provide for the following] Satisfy the following communication and recordkeeping requirements:

*      *      *      *      *

   (ii)  Communication by way of telecommunications equipment/radios with BLS and ALS units within the [respective medical service] area in which medical command is exercised.

*      *      *      *      *

   (iv)  Maintenance of a medical command record, containing [specific] appropriate information on patients for whom medical command is sought.

*      *      *      *      *

   (4)  [Demonstrating the capacity to accurately] Accurately and promptly relay information regarding patients to the appropriate receiving [hospital] facility.

   (5)  [Adhering] Adhere to [transportation instruction and hospital assignment] transfer and medical treatment protocols established by the regional EMS council, or, when dealing with an air ambulance service, as approved by the Department.

   (6)  [Establishing] Establish a program of regular case audit conferences involving the medical command facility medical director or [his] the director's designee and prehospital personnel for purposes of problem identification, and a process to correct identified problems.

   (7)  [Obtaining] Obtain a contingency agreement with at least one other medical command facility to assure availability of medical command.

   (8)  [Establishing] Establish internal procedures that comply with regional EMS transfer and medical treatment protocols [developed by the respective regional EMS council].

   (9)  Notify PSAPs, through which it routinely receives requests for medical command, when it will not have a medical command physician available to provide medical command.

   (10)  Establish a plan to ensure that medical command is available at all times during mass casualty situations, natural disasters and declared states of emergency.

   (11)  [Participating] Participate in the [respective] regional EMS council's quality [assurance programs] improvement program for monitoring the delivery of EMS.

   [(10) Adopting] (12) Adopt procedures for maintaining medical command communication records and tapes under § 117.43 (relating to medical records).

   [(11) Employing] (13) Employ sufficient administrative support staff to enable the institution to carry out its essential duties which include, but are not limited to: audits, [continuing education,] equipment maintenance and processing and responding to complaints.

   [(12) Establishing] (14) Establish a program of training [and continuing education] for medical command physicians, prehospital personnel and emergency department staff.

   (15)  Provide medical command to prehospital personnel whenever they seek direction.

§ 1009.2. [Accreditation] Recognition process.

   (a)  [Regional EMS councils shall recommend to the Department those facilities which meet the criteria for accreditation. If the applying facility disagrees with the recommendation of the regional EMS council, it may submit a written request for reconsideration by the council.

   (b)  The Department has 60 days to accredit or deny accreditation from the time of receipt of the regional EMS council's recommendation.

   (c)  Denial of accreditation shall be based on cause.

   (d)  The Department may review and inspect facilities to aid in accreditation decisions.

   (e)  If the applying facility disagrees with the decision by the Department, an appeal may be filed under 2 Pa.C.S. §§ 501--508 and 701--704 (relating to Administrative Agency Law).]

   To qualify for the civil immunity protection afforded by section 11(j)(4) of the act (35 P. S. § 6931(j)(4)), a facility shall secure recognition as a medical command facility from the Department. To secure recognition as a medical command facility, a facility shall submit an application to the Department through a regional EMS council exercising responsibility for an EMS region in which the applicant intends to provide medical command through medical medical command physicians who function under its auspices. Application for medical command facility recognition shall be made on forms prescribed by the Department.

   (b)  The regional EMS council shall review the application for completeness.

   (c)  If the application is complete, the regional EMS council shall conduct an onsite inspection of the applying facility to verify information contained within the application and to complete a physical inspection of the medical command area.

   (d)  After completing its review, the regional EMS council shall forward a copy of its recommendation to the Department and to the applying facility. If the applying facility disagrees with the recommendation of the regional EMS council, it may submit a written rebuttal to the Department.

   (e)  The Department will review the application, information and recommendation submitted by the regional EMS council, and the rebuttal statement, if any, submitted by the applying facility, and will make a decision within 60 days from the time of its receipt of the regional EMS council's recommendation to grant or deny recognition.

   (f)  The Department may review and inspect facilities to aid it in making medical command facility recognition decisions.

   (g)  If the applying facility disagrees with the decision by the Department, it may appeal the decision under 1 Pa. Code § 35.20 (relating to appeals from actions of the staff) if the decision was not issued by the agency head as defined in 1 Pa. Code § 31.3 (relating to definitions)  and, if it disagrees with the decision of the agency head, it may file an appeal under 2 Pa.C S. §§ 501--508 and 701--704 (relating to Administrative Agency Law).

   (h)  Recognition as a medical command facility will be valid for 3 years. A facility shall file an application for renewal of its recognition as a medical command facility 60 days prior to expiration of the medical command facility's recognition from the Department. Failure to apply for renewal of recognition in a timely manner may result in the facility having a lapse in the civil immunity protection afforded by section 11(j)(4) of the act.

§ 1009.3.  [Continuity of medical command] (Reserved).

   [A facility recognized by the regional EMS council as a medical command facility as of July 1, 1989 shall continue to be accredited until July 1, 1991, or until surveyed by the Department, whichever comes first.]

§ 1009.4.  [Suspension/revocation of accreditation] Withdrawal of medical command facility recognition.

   (a)  The Department may [suspend accreditation for up to 90 days for the following reasons:

   (1)  Failure to comply with regional EMS council protocols or guidelines.

   (2)  Violation of accreditation criteria in § 1009.1 (relating to accreditation and operational criteria).

   (3)  Failure to cooperate in the data collection and retrieval procedures required by the Department.

   (4)  Other reasons deemed appropriate by the Department.

   (b)  A medical command facility shall correct the deficiencies that were cited by the Department as reasons for suspension by the end of the suspension period set by the Department.

   (c)  The Department may revoke accreditation for failure to correct deficiencies within the suspension period] withdraw medical command facility recognition if the facility fails to continue to meet the standards for a medical command facility in § 1009.1 (relating to operational criteria).

   (b)  The Department will conduct inspections of a medical command facility from time to time, as deemed appropriate and necessary, including when necessary to investigate a complaint or a reasonable belief that violations of this part may exist.

   (c)  If the facility fails to continue to meet the standards for a medical command facility in § 1009.1, as an alternative to rescinding medical command facility recognition, the Department may request the facility to submit a plan of correction to correct the deficiencies. The procedures are as follows:

   (1)  The Department will give written notice to the facility and the regional EMS council of the deficiencies.

   (2)  The facility shall have 30 days in which to respond to the Department with a plan to correct the deficiencies.

   (3)  The Department will review the plan of correction and, if the plan is found to be acceptable, the Department may make an onsite reinspection in accordance with the time frame given in the plan of correction.

   (4)  Within 30 days after the review of the plan of correction, as well as 30 days after the reinspection, the Department will give written notice to the facility and the regional EMS council of the results of the Department's review of the plan of correction and reinspection.

   (d)  Upon receipt of a written complaint describing conduct for which the Department may withdraw medical command facility recognition, the Department will:

   (1)  Initiate an investigation of the specific charges.

   (2)  Provide the medical command facility with a copy of the complaint and request a response unless the Department determines that disclosure to the medical command facility of the complaint will compromise the investigation or would be inappropriate for some other reason.

   (3)  Develop a written report of the investigation.

   (4)  Notify the complainant of the results of the investigation of the complaint, as well as the medical command facility if the medical command facility has been officially apprised of the complaint or investigation. This notification does not include providing a copy of the written report developed under paragraph (3).

§ 1009.5.  [Biennial review] Review of [accredited] medical command facilities.

   The regional EMS councils shall conduct a [biennial] review of medical command facilities as requested by the Department, and at other times may inspect [accredited], medical command facilities. These reviews and inspections shall be conducted to audit for continued compliance with, at a minimum, the criteria in § 1009.1 (relating to [accreditation and] operational criteria) as directed by the Department.

§ 1009.6.  Discontinuation of service.

   A medical command facility may not discontinue medical command operations without providing 60 days advance written notice to the Department, regional EMS councils responsible for regions in which the medical command facility routinely provides medical command and providers of EMS for which it routinely provides medical command.

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