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The Oregon Administrative Rules contain OARs filed through July 15, 2014
 
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OREGON HEALTH AUTHORITY,
PUBLIC HEALTH DIVISION

 

DIVISION 260

COUNTY AMBULANCE SERVICE AREA PLANS

 

333-260-0000

County and State Relationship

The following rules reflect the Division's interpretation of 1989 Oregon Laws Chapter 722. The adoption and amendment of ambulance service plans and the establishment of ambulance service areas are a matter for regulation by county government within the parameters of relevant statutes and these rules.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0095

333-260-0010

Definitions

As used in these rules:

(1) "Ambulance" means any privately or publicly owned motor vehicle, aircraft, or marine craft operated by a Division-licensed ambulance service and that is regularly provided or offered to be provided for the emergency and non-emergency transportation of persons suffering from illness, injury or disability.

(2) "Ambulance Service" means any individual, partnership, corporation, association, governmental agency or other entity that holds a Division-issued ambulance service license to provide emergency and non-emergency care and transportation to sick, injured or disabled persons.

(3) "Ambulance Service Area (ASA)" means a geographic area which is served by one ambulance service provider, and may include all or a portion of a county, or all or portions of two or more contiguous counties.

(4) "Ambulance Service Plan (Plan)" means a written document, which outlines a process for establishing a county emergency medical services system. A plan addresses the need for and coordination of ambulance services by establishing ambulance service areas for the entire county and by meeting the other requirements of these rules. Approval of a plan shall not depend upon whether it maintains an existing system of providers or changes the system. For example, a plan may substitute franchising for an open-market system.

(5) "Ambulance Service Provider" means a licensed ambulance service that responds to 9-1-1 dispatched calls or provides pre-arranged non-emergency transfers or emergency or non-emergency inter-facility transfers.

(6) "County Government or County Governing Body (County)" means a Board of County Commissioners or a County Court.

(7) "Division" means the Public Health Division, Oregon Health Authority.

(8) "Emergency Medical Service (EMS)" means those prehospital functions and services whose purpose is to prepare for and respond to medical and traumatic emergencies, including rescue and ambulance services patient care, communications and evaluation.

(9) "Notification Time" means the length of time between the initial receipt of the request for emergency medical service by either a provider or an emergency dispatch center (9-1-1), and the notification of all responding emergency medical service personnel.

(10) "Provider" means any public, private or volunteer entity providing EMS.

(11) "Response Time" means the length of time between the notification of each provider and the

arrival of each provider's emergency medical service unit(s) at the incident scene.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.235, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.235, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0100; OHD 8-2001, f. & cert. ef. 4-24-01

333-260-0020

Procedures for Adoption and Approval of Ambulance Service Plans

(1) A county may obtain technical assistance from the Division as available in developing and amending an ambulance service plan.

(2) A county that does not have a Division-approved plan on July 19, 1989, must adopt and submit a plan by December 31, 1990. A county that has a Division-approved plan that does not meet the requirements of these rules must adopt and submit an amended plan by June 30, 2003. This requirement may be met by a plan submitted in conjunction with another contiguous county or counties. A Division-approved plan which is currently in effect, remains in effect until one of the following occurs:

(a) An amended plan is approved by the Division;

(b) There is a failure to submit an amended plan pursuant to this subsection; or

(c) Where an amended plan was required to be submitted pursuant to this subsection and such amended plan was disapproved by the Division, if 120 days have elapsed since such disapproval and no new amended plan has been adopted and submitted to the Division for approval.

(3) After March 31, 2001, a county must submit a plan or amendment(s) to the Division using the following format:

1. CERTIFICATION BY GOVERNING BODY OF COUNTY AMBULANCE SERVICE PLAN

2. OVERVIEW OF COUNTY (DEMOGRAPHIC AND GEOGRAPHIC DESCRIPTION)

3. DEFINITIONS;

4. BOUNDARIES;

(a) ASA Map(s) with Response Time Zones:

(b) ASA Narrative Description:

(c) Map(s) Depicting "9-1-1", Fire Districts and Incorporated Cities:

(d) Alternatives Considered to Reduce Response Times.

5. SYSTEM ELEMENTS:

(a) 9-1-1 Dispatched Calls;

(b) Pre-arranged Non-emergency Transfers and Inter-facility Transfers;

(c) Notification and Response Times;

(d) Level of Care;

(e) Personnel;

(f) Medical Supervision;

(g) Patient Care Equipment;

(h) Vehicles;

(i) Training;

(j) Quality Improvement;

(A) Structure:

(B) Process:

(C) Sanctions for Non Compliant Personnel or Providers:

6. COORDINATION

(a) The Entity That Shall Administer and Revise the ASA Plan;

(b) Complaint Review Process;

(c) Mutual Aid Agreements;

(d) Disaster Response;

(A) County Resources Other Than Ambulances;

(B) Out of County Resources;

(C) Mass-Casualty Incident Plan;

(D) Response to Terrorism;

(e) Personnel and Equipment Resources;

(A) Non-transporting EMS Provider;

(B) Hazardous Materials;

(C) Search and Rescue;

(D) Specialized Rescue;

(E) Extrication;

(f) Emergency Communication and System Access;

(A) Telephone;

(B) Dispatch Procedures;

(C) Radio System;

(D) Emergency Medical Services Dispatcher Training.

7. PROVIDER SELECTION:

(a) Initial Assignment;

(b) Reassignment;

(c) Application for an ASA;

(d) Notification of Vacating an ASA;

(e) Maintenance of Level of Service;

8. COUNTY ORDINANCES AND RULES:

(4) Procedures for the Division's review of a plan submitted under section (3) of this rule are set forth in ORS 682.205(6). Except for the time frames, plans submitted prior to April 1, 2001, but not yet approved by the Division shall be processed in the same manner.

(5) The Division's approval of a plan or amendments is limited to determining whether there has been compliance with these rules.

(6) A county is required to amend their plan, if necessary, to comply with any amendments made in ORS chapter 682 or OAR chapter 333, divisions 250, 255 or 260. The Division shall notify the county in writing each time an amendment is made in either the statute or administrative rules that may affect the plan. Anytime a county plan is amended, the county must submit a copy of the amended plan to the Division.

(7) The Division shall review each county plan no less than once every five years to ensure compliance with the statutes and administrative rules pertaining to a county ambulance service area plan. The Division shall notify the county of the results of the review.

(8) The Division may seek the advice of the State Emergency Medical Service Committee concerning plan compliance with these rules.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0105; OHD 8-2001, f. & cert. ef. 4-24-01

333-260-0030

Subjects to be Considered in an Ambulance Service Plan

(1) A county is required to include in a plan, each of the subjects or items set forth in these rules and to address and consider each of those subjects or items in the adoption process.

(2) The plan submitted to the Division for approval must contain a certification signed by the governing body of the county that:

(a) Each subject or item contained in the plan was addressed and considered in the adoption of the plan;

(b) In the governing body's judgment, the ASAs established in the plan provides for the efficient and effective provision of ambulance services; and

(c) To the extent they are applicable, the county has complied with ORS 682.205(2)(3) and 682.335 and existing local ordinances and rules.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0110; OHD 8-2001, f. & cert. ef. 4-24-01

333-260-0040

Boundaries

(1) The entire county must be included in a plan. One or more ASAs may be established in a plan. The county or contiguous counties are solely responsible for establishing all ASA boundaries within the county's jurisdiction.

(2) A map showing ASA boundaries and response time zones must be included in the plan, along with a narrative description of each ASA.

(3) A map depicting all "9-1-1", fire district and incorporated city boundaries within the county must be included in the plan.

(4) The plan must describe the major alternatives considered, if any, for reducing the effects of artificial and geographical barriers on response times.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0115; OHD 8-2001, f. & cert. ef.

333-260-0050

System Elements

(1) The following system elements must be addressed and considered in the county's plan for each ASA:

(a) 9-1-1 dispatched calls;

(b) Pre-arranged non-emergency transfers and inter-facility transfers, by June 30, 2003;

(c) Notification and response times;

(d) Level of care, ranging from basic life support to advanced life support;

(e) Personnel for first response vehicles and ambulances;

(f) Medical supervision of all medically trained emergency response personnel;

(g) Patient care equipment for first response vehicles and ambulances;

(h) Vehicle, vehicle equipment and safety requirements;

(i) Initial and continuing education training for emergency response personnel; and

(j) Quality improvement.

(2) Notification and response times must be addressed and considered in the plan as follows:

(a) Notification times must be expressed in terms of percent of calls which do not exceed a specified number of minutes;

(b) Response times must be expressed in terms of percent of calls which do not exceed a specified number of minutes; and

(c) Multiple response time standards may be established within the ASA to accommodate climate, weather, access, terrain, staffing and other factors as determined by the county.

(3) The plan must address and consider a quality improvement program which at a minimum:

(a) Monitors compliance with pertinent statutes ordinances and rules;

(b) Monitors compliance with standards for prehospital provider notification times, response times and patient care; and

(c) Provides for problem resolution and legal sanctions for non compliant personnel or providers of the plan provisions.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0125; OHD 8-2001, f. & cert. ef. 4-24-01

333-260-0060

Coordination

The county may delegate authority for development and administration of the plan to an intergovernmental body. The plan must address and consider:

(1) A process for the county to receive input from prehospital care consumers, providers and

the medical community.

(2) Mutual aid agreements for ambulance responses from outside of the service area and responses to other service areas to meet the need for service in unusual circumstances.

(3) Ambulance service providers' responsibilities in the event of a disaster, including: coordination with county resources and determination of methods for obtaining out-of-county resources other than ambulances, a process for adoption of a mass-casualty incident plan that is recognized and approved by the county's emergency management administration.

(4) Personnel and equipment resources in addition to the ambulance provider for response to incidents involving but not limited to:

(a) Hazardous Materials;

(b) Search and Rescue;

(c) Specialized Rescue; and

(d) Extrication.

(5) Emergency radio and telephone communications systems for the county. Mechanisms for the following must be in operation or scheduled for implementation:

(a) Access to the Emergency Medical Services System centralized emergency telephone numbers;

(b) Dispatch of ambulances staffed in accordance with the plan and other emergency resources based on emergency medical protocols; and

(c) U.S. Department of Transportation, National Highway Traffic Safety Administration, Emergency Medical Services Dispatcher: National Standard Curriculum or equivalent training for all emergency medical services dispatchers.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0125

333-260-0070

Provider Selection

(1) The county is solely responsible for designating and administering the process of selecting an ambulance service provider.

(2) The plan must address and consider a process for:

(a) Assigning and reassigning of an ambulance service provider to an ASA;

(b) Responding to an application by a provider for an ASA;

(c) Responding to notification that an ASA is being vacated; and

(d) Maintaining the existing level of service after notification that a provider is vacating an ASA.

(3) The county shall designate one emergency ambulance provider for each ASA. The county may designate one or more non-emergency ambulance provider for each ASA.

Stat. Auth.: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Stats. Implemented: ORS 682.205, ORS 682.215, ORS 682.275, ORS 682.315, ORS 682.325, ORS 682.335 & ORS 682.345
Hist.: HD 16-1986, f. & ef. 9-9-86; HD 11-1990, f. & cert. ef. 5-7-90; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0130; OHD 8-2001, f. & cert. ef. 4-24-01

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