Report No. 201
USA - Ambulance Services:
The State of Minnesota in USA in city statutes of 2004 deals with Ambulance Services. In section 144 E(1) to144 E(52) there are several provisions which can be a model for legislation in India. We do not propose to refer to all the provisions except the crucial ones.
So far as definitions are concerned, we shall refer to a few of them which are important:
001(1b) defines 'Advanced life support' as means 'rendering basic life support and rendering intravenous therapy, drug therapy, intubation, and defibrillation'.
001(2) defines 'Ambulance' as means 'any vehicle designed or intended for and actually used in providing ambulance service to ill or injured persons or expectant mothers.'
001(3) 'Ambulance service' means transportation and treatment which is rendered or offered to be rendered preliminary to or during transportation to, from, or between health care facilities for ill or injured persons or expectant mothers. The term includes all transportation involving the use of a stretcher, unless the person to be transported is not likely to require medical treatment during the course of transport.
0013a: Ambulance service personnel means individuals who are authorized by a licensed ambulance service to provide emergency care for the ambulance service and are:
(1) Emergency Medical Technicians, Emergency Medical Technician-Intemediate, or Emergency Medical TechnicianParamedic;
(2) Registered nurses who are qualified ...
(3) Registered physician assistants ...
001.4a: Basic airway management means:
(i) resuscitation by mouth-to-mouth, mouth-to-mask, bag valve mask, or oxygen powered ventilators; or
(ii) insertion of an oro-pharyngeal, nasal pharyngeal, esophageal obturator airway, esophageal tracheal airway, or esophageal gastric tube airway.
001.4b: Basic life support means rendering basic-level emergency care, including, but not limited to, basic airway management, cardiopulmonary resuscitation, controlling shock and bleeding, and splinting fractures ...
001.5b: Defibrillator means an automatic, semiautomatic, or manual device that delivers an electric shock at a preset voltage to the myocardium through the chest wall and that is used to restore the normal cardiac rhythm and rate when the heart has stopped beating or is fibrillating.
001.5c: Emergency medical technician means EMT.
001.5d: Emergency medical technician-intermediate (EMT-I) ...
001.5e: Emergency medical technician-paramedic EMT-P) ...
001.6: First Responder means an individual who is registered by the board to perform, at a minimum, basic emergency skills before the arrival of a licensed ambulance service, and is a member of an organized service ...
001.7: License means authority granted by the board for the operation of an ambulance service in the state of Minnesota.
001.9a: Part-time advance life support means rendering basic life support and advanced life support for less than 24 hours of every day.
001.9b: Physician means ...
001.9c: Physician assistant means ...
001.9d: Pre-hospital care data means information collected by ambulance service personnel about the circumstances related to an emergency response and patient care activities provided by the ambulance service personnel in a pre-hospital setting.
001.12: Registered nurse means ...
001.14: Training program coordinator ...
001.15: Volunteer ambulance assistant ...
144E.01: Emergency Medical Services Regulatory Board ...
02 to 05: Staff, Member, etc.
144E.01.6: Duties of Board.
(a) The Emergency Medical Services Regulatory Board shall:
(1) administer and enforce the provisions of this chapter and other duties as assigned to the board;
(2) advise applicants for state or federal emergency medical services funds, review and comment on such applications, and approve the use of such funds unless otherwise required by federal law;
(3) make recommendations to the legislature on improving the access, delivery, and effectiveness of the state's emergency medical services delivery system; and
(4) establish procedures for investigating, hearing, and resolving complaints against emergency medical services providers.
(b) The Emergency Medical Services Board may prepare an initial work plan, which may be updated biennially. The work plan may include provisions to:
(1) prepare an emergency medical services assessment which ddresses issues affecting the statewide delivery system;
(2) establish a statewide public information and education system regarding emergency medical services;
(3) create, in conjunction with the Department of Public Safety, a statewide injury and trauma prevention program; and
(4) designate an annual emergency medical services personnel recognition day.
144E.05 General authority.
144.E.05-1: Receiving Grants or gifts.
144E.06: Primary service areas:
The board shall adopt rules defining primary service areas under which the board shall designate each licensed ambulance service as serving a primary service area or areas.
144E.10: Ambulance service licensing.
144E.101 Ambulance service requirements.
(a) No publicly or privately owned ambulance service shall be operated in the state unless its ambulance service personnel are certified, appropriate to the type of ambulance service being provided, according to section 144E.28 or meet the staffing criteria specific to the type of ambulance service.
(b) An ambulance service shall have a medical director as provided under section 144E.265.
144E/101-2: Patient care: When a patient is being transported, at least one of the ambulance service personnel must be in the patient compartment. If advanced life support procedures are required, an EMT-P, a registered nurse qualified under section 144E.001, subdivision 3a, clause (2), item (i), or a physician assistant qualified under section 144E.001, subdivision 3a, clause (3), item (i), shall be in the patient compartment.
144E.101-3: Continual service: An ambulance service shall offer service 24 hours per day every day of the year, unless otherwise authorized under subdivisions 8 and 9.
Sub-divn. 4: Denial of service prohibited: An ambulance service shall not be denied pre-hospital care to a person needing emergency ambulance service because of inability to pay or because of the source of payment for services if the need develops within the licensee's primary service area or when responding to a mutual aid call. Transport for the patient may be limited to the closest appropriate emergency medical facility.