Chapter 4766-3 Ambulettes

“Ambulette Service” has the same meaning as nonemergency medical service organization as defined in division (O) of section 4766.01 of the Revised Code.

An applicant shall complete the application in the English language.

(A) An ambulette service applying for licensure shall file with the board an application on the form prescribed by the board and shall submit the completed application to the board accompanied by the appropriate fee as defined in rule 4766-3-02 of the Administrative Code.

(B) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the ambulette service applicant shall provide:

(1) The name of applicant to include:

(a) All names that applicant plans to operate under including but not limited to trade name(s), dba(s), registered with the Ohio secretary of state;

(b) Address of ambulette service’s headquarters;

(c) Mailing address of applicant;

(2) All medicare provider numbers, all medicaid provider numbers;

(3) Type of organization and service areas including county and state;

(4) For each satellite base, the ambulette service shall provide the street address, city, county, state, and zip code;

(5) The name of the primary contact person, business or administrative office telephone number, and if applicable, office fax number and e-mail address;

(6) A list of the names and addresses to all officers, directors, and/or owners of the ambulette service;

(7) Year of manufacture, make, model, vehicle identification number, odometer reading, license plate number (renewal only) of each ambulette to be permitted;

(8) A color photograph of the side of 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 must accompany application. (Digital photographs are encouraged.)

(9) A current certificate of liability insurance listing OMTB as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code:

The actual name on the licensure application shall appear on the certificate of liability insurance;

(10) Type of entity, including but not limited to, corporation, partnership, and sole proprietorship as registered with the Ohio secretary of state.

(C) Each ambulette service shall pay the appropriate fees as specified in rule 4766-3-02 of the Administrative Code.

(D) If an application for licensure is incomplete, the board will notify the ambulette service that the application will not be processed until it is complete. Such notification will occur via certified mail one time for each submission.

(E) No applicant or licensee shall submit false statements in order to obtain a license or permit.

(F) A license is not transferable.

Effective: 07/02/2009

R.C. 119.032 review dates: 07/02/2014

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.03, 4766.04, 4766.07

(A) Each ambulette service shall pay a license fee of one hundred dollars annually;

(B) Each ambulette service shall pay a permit fee of fifty dollars for each ambulette annually;

(C) Each ambulette service shall pay an inspection fee of fifty dollars per ambulette; and

(D) Each ambulette service shall pay a fifty dollars reinspection fee for every ambulette that requires reinspection by a designee of the Ohio medical transportation board.

(E) Each ambulette service shall pay a twenty-five dollar fee for each temporary permit to be issued.

Effective: 05/03/2007

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.05

Prior Effective Dates: 08/18/2005

(A) The board shall conduct initial and renewal inspections of any ambulette service pursuant to Chapter 4766. of the Revised Code and Administrative Code, to include the following:

(1) Ambulette service headquarters;

(2) Ambulette service satellite location(s);

(3) Ambulette(s).

(B) All satellite locations shall be inspected prior to commencing operations.

(C) Upon licensure, each licensed ambulette service shall prominently display the original certificate of licensure at the service’s headquarters and each satellite location.

(D) The board may conduct routine unannounced inspections at any time an ambulette service is in operation to determine compliance with Chapter 4766. of the Revised Code and Administrative Code to include the following:

(1) Ambulette service headquarters;

(2) Ambulette service satellite location(s);

(3) Ambulette(s).

(E) A license is not transferable.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04

(A) All ambulettes shall be inspected pursuant to Chapter 4766. of the Revised Code and Administrative Code

(B) The board shall inspect all ambulettes for roadworthiness, compliance with standard motor vehicle requirements, and appropriate equipment as defined in rule 4766-3-21 of the Administrative Code on an annual basis:

(1) All ambulettes shall pass an inspection conducted by the board prior to being placed into operation.

(a) Any deficiencies identified by the field inspector(s) must be corrected prior to the ambulette being placed in-service;

(b) Any ambulette that is not available at the time of any inspection shall be presented for inspection within sixty days, if not the vehicle will be deleted from official list:

(i) The ambulette service shall remove and return the vehicle decal to Ohio medical transportation board.

(C) Out of service ambulette(s)

(1) The licensed MTO shall place an out of service sign in a licensed ambulette(s) to be visible through the windshield with the following information included on the front of the sign:

(a) Date ambulette(s) was taken out of service;

(b) Odometer reading at time ambulette(s) was taken out of service;

(c) Reason ambulette(s) was taken out of service;

(d) Printed name and signature of person responsible for taking ambulette out of service;

(e) The words “Out of Service” utilizing not less than 3” lettering.

(D) Upon licensure, each licensed ambulette service shall apply the permit 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. An additional or replacement vehicle shall, upon successful inspection, be issued a temporary permit. This permit shall be displayed on the inside of the right rear window of the vehicle and shall be valid for not more than thirty days from date of issue.

(1) The permit must be unobstructed at all times.

(E) A permit is not transferable.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.07

(A) Any ambulette for which a permit is issued pursuant to section 4766.07 of the Revised Code shall display special issue “Ambulette” license plates issued by the bureau of motor vehicles, pursuant to section 4503.49 of the Revised Code.

(B) Upon the effective date of a final order by the board revoking an ambulette service license or decertifying a specific vehicle, the board shall notify the bureau of motor vehicles of such revocation or decertification.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.07, 4503.49

(A) Client records

(1) Each licensed ambulette service shall maintain accurate records concerning the transportation of each client;

(2) All client transportation record(s) shall be created prior to or immediately upon completion of the transport and shall include the following:

(a) Client name;

(b) Beginning location and final destination;

(c) The time the ambulette arrived at the pick-up location and the time the unit arrived at its destination;

(d) The name of driver;

(3) A licensed ambulette service shall make all client transportation record(s) and documents available to the board designee during any inspection, announced or unannounced.

(B) A 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.

(C) Maintenance and equipment documentation

(1) Provide a copy of the periodical maintenance plan for all vehicles that conform to manufacturer specifications;

(2) All licensed ambulette services shall maintain documentation of all periodical maintenance and repairs performed on each vehicle to include:

(a) Date of service or repair;

(b) Description of service/repair performed;

(c) Documentation of who performed the service/repair.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04, 4766.06

(A) The ambulette service shall be capable of two-way communication with all the ambulette(s) radios and/or cellular telephones

(1) All two-way communication devices shall maintain either a one hundred ten volt or twelve volt power source backup for each communication device

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04, 4766.07

(A) The ambulette service shall maintain and provide adequate documentation of the following driver operator requirements for each of its drivers:

(1) A valid copy of the 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:

Driver/operator must be at least eighteen years of age to operate an ambulette;

Each ambulette driver must have at least two years driving experience;

(2) A valid copy of the driver/operator’s abstract obtained from the bureau of motor vehicles 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 4510.037 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.

(3) A valid copy of certification in CPR and at least one of the following:

(a) Basic first aid;

(i) Each driver/attendant must have proof of successful completion of the “American Red Cross” or equivalent certifying organization basic course in first aid as approved by the board;

(b) First responder;

(c) Emergency medical technician;

(4) A valid copy of a program designed for transporting clients with special needs that include the following elements:

(a) Major disabling conditions;

(b) Basic considerations for functional factors;

(c) Management of wheelchairs;

(d) Assistance and transfer techniques;

(e) Environmental considerations;

(f) Emergency procedures;

(5) A valid copy of criminal background check in accordance with section 109.572 of the Revised Code conducted within sixty days before or after hire.

(6) A copy of a valid signed statement from a physician acting within their scope of practice 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;

(7) A valid copy of 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, drug of abuse, controlled substance, or metabolite of a controlled substance.

(8) 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 not to exceed sixty days pending the completion of the requirements set for in paragraphs (A)(1) to (A)(7) of this rule.

(D) No ambulette service shall employ as an ambulette driver, any person who has been convicted of or plead guilty to violations described 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 4510.037 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 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 is currently certified in CPR and one of the following:

(1) Basic first aid;

(2) First responder;

(3) Emergency medical technician.

(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 described in paragraph (A)(4) of this rule.

Effective: 07/02/2009

R.C. 119.032 review dates: 04/17/2009 and 07/02/2014

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04, 4766.15

Prior Effective Dates: 08/18/2005

(A) A licensed ambulette service shall not operate a licensed ambulette on any public way in Ohio if the licensed ambulette is not in full compliance with applicable sections 4766.01 to 4766.99 of the Revised Code. In the event of a disaster situation when licensed 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 and treat clients.

(B) An ambulette that has not been issued a permit by the board may operate, for a period not to exceed sixty days, if the ambulette is used to replace an ambulette with a permit that has been temporarily taken out of service for repair or maintenance and is in compliance with all of the following:

(1) The replacement ambulette shall meet all requirements of the licensed ambulette;

(2) Prior to placing the non-licensed ambulette in service the licensed ambulette service shall provide written documentation to the board that includes the following:

(a) Date licensed ambulette was removed from service;

(b) Non-licensed ambulette identification number;

(c) In-service date of non-licensed ambulette;

(d) Date licensed ambulette placed back into service;

(3) The licensed ambulette service shall pay the appropriate fee for each temporary permit;

(4) Upon request of the licensed service the board may at its own discretion grant an extension.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.03, 4766.04

(A) 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.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.13

(A) Ambulette service shall give written notification to the board prior to or not less than three days after changes in:

(1) Executive officers or board members;

(2) Directors;

(3) Owners;

(4) Purchase or acquisition of a licensed ambulette service

(a) With any purchase or acquisition of a licensed ambulette service, the ambulette service shall be required to submit a new application for licensure, complete appropriate inspections, and pay all applicable fees

(b) All ambulette(s) shall be retitled, rebranded in accordance with paragraph (B)(6)(e) of rule 4766-3-01 of the Administrative Code, inspected by the board, and display new ambulette license plates within sixty days.

(B) Within ten days of the date a licensed ambulette is permanently withdrawn from service, the licensed ambulette service shall return to the board a deletion form prescribed by the board and the permit decal from the right rear window

(C) Each licensed ambulette service shall give written notification to the board thirty days prior to changing headquarter or satellite locations or opening any satellite location. The notification shall include:

(1) Street address;

(2) City;

(3) County;

(4) Medicare provider number, if applicable;

(5) Ohio state board of pharmacy number, if applicable.

(D) Within ten days of the date a licensed ambulette service ceases to operate it shall return to the board all ambulette permits and the certificate of licensure

(E) 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.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04, 4766.07

(A) The board may investigate alleged violations of Chapter 4766. of the Revised Code and the rules promulgated thereunder.

(B) Board investigations may include but not be limited to the following:

(1) Interviews:

(a) Employer;

(b) Employees;

(c) Client;

(d) Health care workers;

(e) Public safety personnel;

(f) General public;

(2) Record review:

(a) Transportation documentation;

(b) Incident report;

(c) Crash and/or injury report;

(d) First report of injury;

(e) Employee records;

(3) Physical inspection;

(4) Photographs;

(5) Audio recording;

(6) Physician and/or coroner findings;

(7) Written and/or verbal complaints;

(8) Factual evidence;

(9) Any other item(s) deemed appropriate for specific investigation.

(C) The board may issue a violation notification during any inspection or investigation.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.08, 4766.11

The board may, in compliance with Chapter 119. of the Revised Code, suspend, revoke, or refuse to issue a license or permit for any of the following reasons:

(A) Any violation of Chapter 4766. of the Revised Code or the rules promulgated thereunder;

(B) Failure of the ambulette service to correct deficiency(s) and violation(s) cited by the inspectors of the board or provide sufficient documentation that ambulette service is correcting said deficiency(s) and violation(s).

(C) Making a false statement on the application for a license or permit.

(D) Fraud or deceit in obtaining or attempting to obtain a license or permit.

(E) Lending a license or permit or borrowing or using the license or permit of another, or knowingly aiding or abetting such improper use or transfer of a license or permit.

(F) Incompetence, negligence or misconduct in operating the ambulette service.

(G) Failure to have all equipment required in rule 4766-3-21 of the Administrative Code each ambulette at all times.

(H) Failure to staff ambulette with properly trained personnel.

(I) Failure of the ambulette service to notify the board of a change of ownership within three days of purchase or acquisition.

(J) Abuse or abandonment of a client.

(K) Unauthorized disclosure of medical or other confidential information.

(L) Willful preparation or filing of false reports or records, or the inducement of another to do so.

(M) Alteration or inappropriate destruction of transport records.

(N) Discrimination in the rendering medical transportation services because of client race, sex, creed, national origin, sexual preference, age, handicap, medical problem.

(O) Action by the licensed ambulette service that is reckless or negligent so as to endanger the health or safety of client or members of the general public while in the course of business as a licensed ambulette service.

(P) The existence of a continuing pattern of violations.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04, 4766.05, 4766.06, 4766.07, 4766.08, 4766.13, 4766.15, 4766.99

The board may, at its discretion, summarily suspend a license under the authority of section 4766.11 of the Revised Code

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.11

(A) Equipment requirements

(1) Each ambulette shall maintain the following on-board at all times:

(a) One five pound ABC fire extinguisher

(i) Permanently installed;

(b) One blanket;

(c) Disinfectant for surfaces & equipment;

(d) Waterless disinfectant for hands;

(e) Permanent mount oxygen cylinder securement device;

(f) One isolation/bio-hazard disposal kit

(i) Permanently installed and/or secured in cabinet

(ii) Isolation/biohazard may be combined with first aid kit to create combination box;

(g) One first aid kit

(i) Permanently installed and/or secured in cabinet;

(ii) First aid kit shall include an adequate supply of the following: bandaids, gauze, bandage, scissors, CPR mask, antiseptic/alcohol preps, 4×4’s or equivalent.

(B) 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 must be specifically designed to transport one or more patients sitting in wheelchairs and have permanent fasteners to secure the wheelchair to the floor or side of the vehicle to prevent wheelchair movement;

(3) Each vehicle must have safety restraints in the vehicle for the purpose of restraining the patient in the wheelchair;

(4) Each vehicle must be equipped with a stable access ramp or hydraulic lift;

(5) Each vehicle must 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.

Effective: 08/18/2005

R.C. 119.032 review dates: 08/18/2010

Promulgated Under: 119.03

Statutory Authority: 4766.03

Rule Amplifies: 4766.04, 4766.07