Chapter 4766-4 Mobile Intensive Care Units

4766-4-01 Definitions.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) "Advanced emergency medical technician" or "AEMT" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-16-04 of the Administrative Code.

(B) "Board" means the state board of emergency medical, fire, and transportation services within the division of emergency medical services of the department of public safety set forth in section 4765.02 of the Revised Code.

(C) "Division" means the division of emergency medical services within the department of public safety.

(D) "Emergency medical technician" or "EMT" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-15-04 of the Administrative Code.

(E) "Headquarters" means the location which a licensee operates, designated by the licensee as the location where the records set forth in this chapter are maintained or readily available.

(F) "Inspection fee" means a fee required to be paid for the inspection of a permitted vehicle.

(G) "License" means a certificate of licensure issued by the board to the service, also known as the licensed mobile intensive care unit.

(H) "Medical director" means an Ohio-licensed physician who meets the requirements as set forth in Chapter 4765. of the Revised Code and rule 4765-3-05 of the Administrative Code.

(I) "Medical transportation organization" or"MTO" has the same meaning as emergency medical service organization as defined in division (H) of section 4766.01 of the Revised Code.

(J) "Mobile intensive care unit" or "MoICU" has the same meaning as mobile intensive care unit as defined in division (O) of section 4766.01 of the Revised Code.

(K) "Neonate" means a newborn beginning at birth and lasting through the twenty-eighth day of life.

(L) "Operate" means to engage in conduct or activity in furtherance of the licensed activity at or from a physical location owned, leased or maintained by the licensee where employees report to work and vehicles or aircraft are stored. Operate also includes the act of receiving a person within Ohio for transportation to a location within Ohio.

(M) "Paramedic" is a person holding a current and valid certificate to practice issued under Chapter 4765. of the Revised Code authorizing the holder to provide medical care as set forth in rule 4765-17-03 of the Administrative Code.

(N) "Permit" is the authorization to operate issued by the board as set forth in section 4766.07 of the Revised Code for a specific vehicle, known as the "permitted vehicle" and requires the issuance of a decal for the permitted vehicle by the board or its designee.

(O) "Readily available" means produced upon demand by the board or its designee.

(P) "Reinspection fee" means a fee required to conduct an inspection as a result of the issuance of a violation notification by the board, or its designee, to a licensed MoICU or license applicant, regarding a permitted MoICU or a MoICU for which a permit application is pending with the board.

(Q) "Satellite base" means a physical location other than headquarters from which a licensee operates.

(R) "Service number" or "service code" means the number assigned to the MoICU by the board for the purpose of identifying and validating the service or permitted MoICU.

(S) "Temporary vehicle" means a MoICU issued a temporary permit used to replace a permitted MoICU in accordance with rule 4766-4-12 of the Administrative Code that is out of service until the permitted MoICU is returned to service or is replaced. A temporary vehicle may be used for a time period not to exceed sixty days.

(T) "Violation notification" means a written form issued by the board or its designee during an inspection or investigation identifying deficiencies in record keeping requirements, vehicle roadworthiness requirements, or equipment requirements by a service or its vehicle(s).

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.01
Prior Effective Dates: 04/16/2012

4766-4-02 Application for initial or renewal licensure.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) A MTO applying for initial licensure shall file with the board an "Application for Ambulance or Mobile Intensive Care License" form in the English language, and shall submit the completed application to the board :

(1) Accompanied by the appropriate fees as set forth in rule 4766-4-03 of the Administrative Code and;

(2) With all required supporting documentation as set forth in this rule that must be received by the board.

(B) A MTO applying for renewal of a license shall file with the board a "Renewal Application for Ambulance or Mobile Intensive Care License" form in the English language, and shall submit the completed application to the board:

(1) Accompanied by the appropriate fees as set forth in rule 4766-4-03 of the Administrative Code and;

(2) With all required supporting documentation as set forth in this rule that must be received by the board prior to the expiration date of the license.

(C) In addition to the requirements set forth in section 4766.04 of the Revised Code, for each application the MTO applicant shall provide and maintain documentation of:

(1) The name of service, organizational structure and address of applicant to include as follows:

(a) Name;

(b) Identification of organizational structure as a corporation (whether for profit or not-for-profit); limited liability company; partnership; limited liability partnership; government unit; or sole proprietor (individual human);

(c) Tax identification (tax ID) number or employer identification number (EIN);

(d) All other names under which applicant plans to operate while using the same tax ID or EIN number. Business organizations with different tax ID or EIN numbers cannot operate under the same license;

(e) Copies of all trade name registrations and fictitious name registrations for all other names under which applicant plans to operate on file with the Ohio secretary of state;

(f) Address of physical location of applicant's headquarters (no post office box);

(g) Mailing address of applicant;

(2) All medicare provider numbers ;

(3) All medicaid provider numbers;

(4) Highest level of service to be provided ;

(5) Service areas including county and state;

(6) A list of the names of all officers, directors, and/or owners of the MTO;

(7) The name, contact information, and state of Ohio medical license number of the service's medical director;

(8) For each satellite base, the MTO shall provide the physical address, city, county, state, and zip code;

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

(10) Year of manufacture, make, model, vehicle identification number, odometer reading, and license plate number (renewal only) of each MoICU or non-transport vehicle to be permitted;

(11) A color photograph of the side of applicant's 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 shall accompany application.

(a) Color photographs shall be submitted to the division:

(i) With all initial "Application for Ambulance or Mobile Intensive Care License" forms; and

(ii) Within thirty days of the date a change is made to the vehicle's color scheme, insignia, monogram, or other distinguishing characteristics.

(b) Digital photographs are preferred.

(12) A current and valid certificate of liability insurance in the name of the applicant, listing the board as a certificate holder with a thirty day cancellation notice as specified in section 4766.06 of the Revised Code:

(a) The actual name on the license application shall appear on the certificate of liability insurance;

(b) Each permitted vehicle with vehicle identification number (VIN) shall be listed on the certificate of liability insurance.

(D) An application that is not completed in the manner as specified on the application or does not include all required documentation shall be deemed incomplete.

(E) An application deemed incomplete shall not be considered and may be returned with the notation to the applicant indicating the reason the application is incomplete.

(F) Failure to provide the required documents within thirty days of the date the initial "Application for Ambulance or Mobile Intensive Care License" form is received by the division may result in the application being deemed incomplete.

(G) A MTO shall submit a completed "Renewal Application for Ambulance or Mobile Intensive Care License" form, appropriate fees, and supporting documentation to the board prior to the expiration of the MTO's license in order to be considered timely.

(H) The certificate of licensure issued by the board shall indicate the highest level of service that the MTO is authorized to provide.

(I) No applicant or licensed MTO shall submit false, misleading, or deceptive information in order to obtain a license or permit.

(J) A license is not transferable.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.03 , 4766.04, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-03 Fees.

(A) Each MTO shall pay an initial or renewal license fee of one hundred dollars annually.

(B) Each MTO shall pay a permit fee for each MoICU(s) or non-transport vehicle of one hundred dollars annually;

(C) Each MTO shall pay an inspection fee of one hundred dollars per MoICU or non-transport vehicle.

(D) Each MTO shall pay a one hundred dollar reinspection fee for every MoICU or non-transport vehicle that requires reinspection as a result of a violation notification issued by the board or its designee.

(E) Each MTO shall pay a temporary permit fee of one hundred dollars for each temporary permit to be obtained.

(F) Fees shall be submitted with the application.

(G) All fees are nonrefundable.

(H) Each MTO shall pay a re-print fee of five dollars for each vehicle decal that shall be re-printed as a result of the decal being lost, damaged, incorrectly applied, or incorrect vehicle information provided to the division by the service.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.05
Prior Effective Dates: 04/16/2012

4766-4-04 Physical facilities.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) The board or its designee shall conduct initial and renewal inspections of all MTOs pursuant to Chapter 4766. of the Revised Code and rules 4766-4-04 to 4766-4-07 of the Administrative Code to include the following:

(1) MTO service headquarters;

(2) MTO service satellite location(s).

(B) A MTO shall not commence operations from its headquarters or satellite base(s) until the MTO has met all requirements set forth in section 4766.04 of the Revised Code and agency 4766 of the Administrative Code including satisfactory inspections of all physical locations.

(C) A MTO shall ensure compliance with the inspection requirements for physical facilities. The inspection requirements for physical facilities of a MTO are as follows:

(1) The board issued license shall be prominently displayed in a conspicuous location at every licensed facility (renewal inspection only);

(2) Ohio state board of pharmacy license(s) shall be displayed at each location;

(3) A written sanitation plan as set forth in Chapter 4766-4 of the Administrative Code shall be on site for each location;

(4) The physical facilities shall maintain all single use supplies and equipment as set forth in the "MoICU Inspection" form.

(5) The physical facilities shall be clean and free of debris;

(6) Crew quarters shall be clean;

(7) All physical facilities shall be in compliance with state and local building codes;

(8) Each facility shall be in compliance with state and local fire codes.

(D) The board or its designee may conduct routine unannounced inspections at any location(s) of licensed MTO at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, the following:

(1) MTO service headquarters;

(2) MTO service satellite location(s);

(3) MoICU(s) and non-transport vehicle(s).

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04
Prior Effective Dates: 04/16/2012

4766-4-05 Record keeping requirements.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) Each licensed MTO shall maintain or have readily available the following at its headquarters:

(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;

(2) Verification of the following:

(a) Completion of emergency vehicle operator course for non-EMS certified personnel as set forth in rule 4766- 4-13 of the Administrative Code;

(b) Certification or license of all personnel;

(3) A current and valid certificate of liability insurance issued by an insurer licensed to do business in Ohio that includes a thirty day notice of cancellation to the board in compliance with the terms set forth in section 4766.06 of the Revised Code listing the board as a certificate holder;

Each scheduled vehicle must be listed on the certificate or attached on an additional page to the certificate to include the vehicle's year, make, model and vehicle identification number (VIN). If the certificate indicates "any auto" or "all owned autos," a list of vehicles does not have to be included or attached.

(4) Current copy of the MTO's written policy covering the use of lights and audible warning devices;

(5) Records or other documents related to patient care or to emergency medical service personnel maintained by the licensed MTO which shall be made available for review by the board or its designee;

Such records or documents shall be made available in accordance with 45 C.F.R.164.512;

(6) Current maintenance records for vehicles as specified in rule 4766-4-09 of the Administrative Code;

(7) Documentation of compliance with the periodic mechanical safety inspection set forth in rule 4766-4-09 of the Administrative Code;

(8) Current maintenance records for all equipment used for patient care as specified in rule 4766-4-09 of the Administrative Code;

(9) Dispatch log;

(10) Written plan for restocking of supplies or compliance with paragraph (C)(4) of rule 4766-4-04 of the Administrative Code;

(11) Ohio state board of pharmacy license and addendum;

(12) DEA registration certificate (as applicable);

(13) Clinical laboratory improvement amendments (CLIA) waiver (as applicable);

(14) Current written plan for the handling and disposal of bio-medical infectious materials (OSHA rule 29 C.F.R. 1910.1030 ).

(B) A licensed MTO shall maintain or have readily available the following at each satellite base:

(1) Current copy of the organization's operating medical protocol(s) as filed with the Ohio state board of pharmacy;

(2) Documentation that meets the requirements as set forth in rule 4766-4-07 of the Administrative Code;

(3) Current copy of the MTO's written policy covering the use of lights and other warning devices;

(4) Written plan for restocking of supplies or compliance with paragraph (C)(4) of rule 4766-4-04 of the Administrative Code;

(5) Ohio state board of pharmacy license(s) and addendum(s);

(6) Current written plan for the handling and disposal of bio-medical infectious materials (OSHA rule 29 C.F.R. 1910.1030 ).

(C) Upon licensure, each licensed MTO shall prominently display the original certification of licensure at its headquarters and each satellite base.

(D) Patient records shall be maintained in accordance with this rule.

(1) Each licensed MTO shall maintain accurate records concerning the transportation of each patient for a minimum of seven years;

(2) Each record shall include, at minimum, the following:

(a) Patient's name;

(b) Patient's sex;

(c) Patient's age;

(d) Patient's date of birth;

(e) Patient's address;

(f) Location address of incident or pickup;

(g) Patient's chief complaint;

(h) Patient's history including:

(i) Current medical condition;

(ii) List of current medications;

(iii) Allergies;

(iv) Vital signs and time assessed:

(a) Blood pressure;

(b) Pulse;

(c) Respiration;

(i) Any responsible guardian;

(j) Advanced directives, if applicable;

(k) Final destination;

(l) Treatment rendered;

(m) The following times:

(i) Time call received;

(ii) Dispatch time;

(iii) Enroute time;

(iv) On-scene time;

(v) Departure from scene time;

(vi) Arrival at destination time;

(n) The names and level of certification or licensure for all EMS providers and other medical personnel;

(o) The names of any non-EMS certified personnel, if applicable.

(3) A copy of the record for each patient shall be provided to the receiving facility, which includes all the information required no later than twenty-four hours from time of dispatch.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.06
Prior Effective Dates: 04/16/2012

4766-4-06 Communication requirements.

(A) All licensed MTO dispatch centers shall be equipped with a base station capable of two-way communications with associated MoICU(s) and non-transport vehicle(s). The base station shall demonstrate and maintain voice communications with the devices used in the permitted MoICU(s) and non-transport vehicle(s) within the declared service area:

(B) All MoICU(s) and non-transport vehicle(s), permitted as set forth in Chapter 4766. of the Revised Code, shall be equipped, while in use, with a dedicated two-way communications device, which shall have the capability to communicate with the licensed MTO's dispatch center, the receiving medical facility, and with medical control in the licensed MTO's service area.

(C) All MTOs shall maintain a detailed radio/communications log that documents, at a minimum, the following:

(1) Location of call;

(2) Nature of call;

(3) Initial dispatch time;

(4) Enroute time;

(5) On-scene time;

(6) Departure from scene time;

(7) Arrival at destination time;

(D) If a MTO contractually uses another communication center for dispatch purposes, the communication center shall provide written certification of compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code as applicable.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-07 Health and safety requirements.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) Each licensed MTO shall comply with all occupational safety and health administration-bloodborne pathogens regulations as set forth by 29 C.F.R. 1910.1030.

(B) A licensed MTO shall ensure that sanitation procedures are provided to all personnel in a written document that conforms with current standards as set forth in occupational safety and health administration -bloodborne pathogens protocol.

(C) A licensed MTO shall maintain and follow a written sanitation plan that conforms with the latest bloodborne pathogen standards as written by the occupational safety and health administration. The following documentation shall be maintained for each vehicle:

(1) Sanitation schedule;

(2) Date the sanitation was completed;

(3) Documentation of who performed sanitation.

(D) All licensed MTOs shall establish a written policy governing the use of lights and other warning devices pursuant to section 4511.24 of the Revised Code which shall be made available for inspection by the board or its designee.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-08 Vehicle inspections and equipment requirements.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) The board or its designee shall inspect all MoICU(s) and non-transport vehicle(s) for roadworthiness and for appropriate equipment using the "MoICU Inspection" form or "Non-transport Vehicle Inspection" form.

(B) A permitted MoICU that is being used as a MoICU shall comply with the requirements of roadworthiness and the requirements set forth in the "MoICU Inspection" form, which shall include carrying the following types of equipment:

(1) Isolation equipment;

(2) Airway equipment:

(3) Onboard definitive care equipment;

(4) Bleeding control/burn equipment;

(5) Suction equipment;

(6) Medical gas and equipment;

(7) Adjunct equipment;

(8) Intravenous equipment;

(9) Neonatal specific equipment; and

(10) Immobilization equipment for MoICUs dually certified to provide advanced life support.

(C) A permitted non-transport vehicle that is being used as a non-transport vehicle shall comply with the requirements of roadworthiness and the requirements set forth in the "Non-Transport Vehicle Inspection" form, which shall include carrying specified definitive equipment.

(D) All equipment and supplies shall have current expiration dates where applicable.

(E) Disposable equipment is acceptable where applicable.

(F) All equipment shall be securely stored in each vehicle.

(G) A MTO shall demonstrate proof that each MoICU complies with all specifications set forth in division (C)(2) of section 4766.07 of the Revised Code, by one of the following:

(1) Placard/sticker;

(2) Certificate issued by the manufacturer;

(3) Signed affidavit by the manufacturer certifying compliance with national standards in effect at time the vehicle was manufactured.

(H) The name of the MTO shall be permanently affixed to each MoICU and non-transport vehicle with letters being a minimum height of three inches on both sides and a minimum height of one and one half inches on the back.

If a MTO is under contract which requires other signage or if the MTO is operating under another name, each vehicle shall have permanently affixed lettering with a minimum height of one and one half inches on the rear and both sides of the of vehicle that states:

(1) Owned and operated by [MTO's name]; or

(2) Operated by [MTO's name]; or

(3) Owned by [MTO's name].

(I) All violation notifications issued by the board or its designee shall be corrected.

(J) Each vehicle that receives a violation notification shall be placed out-of-service until:

(1) It passes reinspection by the board or its designee; or

(2) For seventy-two hour violation notifications, the violation has been corrected and the "Violation Notification" form is signed and returned to the division along with supporting documentation showing the violation has been corrected.

(K) Upon issuance of a vehicle permit, each licensed MTO shall apply the 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 MoICU and non-transport vehicle.

The permit shall be unobstructed at all times.

(L) A permit is not transferable.

(M) The board or its designee may conduct routine unannounced inspections at any location of licensed MTO at any time, including night or weekend inspections to determine compliance with Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code to include, but not limited to, MoICU(s) and non-transport vehicle(s).

(N) A permitted MoICU or non-transport vehicle shall maintain compliance with roadworthiness requirements set forth in this rule at any time it is used as an MoICU or non-transport vehicle.

(O) Each permitted vehicle shall be free from dirt, stains, impurities and/or foreign matter in driver's compartment and MoICU patient care compartments.

(P) Permitted MoICUs and non-transport vehicles shall:

(1) Bear license plates issued under section 4503.49 of the Revised Code; or

(2) Comply with residency registration requirements set forth in section 4503.111 of the Revised Code.

Replaces: Former 4766-4-08 and part of former 4766-4-10

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.03 , 4766.04, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-09 Maintenance documentation.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) MoICU and non-transport vehicles

(1) All licensed MTOs shall ensure performance and maintain documentation of all periodic maintenance and repairs on each permitted vehicle to include:

(a) Date of service or repair;

(b) Description of service/repair performed;

(c) Name of person who performed service/repair and the business name, if applicable.

(2) Licensed MTOs shall subject all permitted MoICU(s) and non-transport vehicle(s) to periodic mechanical safety inspection(s), which shall be documented by the service.

(a) A periodic mechanical safety inspection shall mean an inspection conducted:

(i) Prior to a vehicle's initial permit being issued for vehicles with an odometer reading of five thousand miles or more, and;

(ii) Annually and completed within the six month period prior to the MTO's license expiration date, or;

(iii) Every twenty thousand miles for a vehicle that has an odometer reading of one hundred fifty thousand miles or more.

(b) Each mechanical safety inspection shall be conducted by a mechanic with factory training and certification from an original (motor vehicle) equipment manufacturer or equivalent certification for "Emergency Vehicle Technicians" (EVT) or from the "National Institute for Automotive Service Excellence" (ASE).

(c) Each mechanical safety inspection shall be conducted in addition to the vehicle and equipment inspection by the board or its designee following the procedures adopted in rule 4766-4-08 of the Administrative Code.

(d) Vehicles with failed items found during the mechanical safety inspection shall be removed from service and not placed back into service until items are corrected. Proof of correction(s) shall be maintained by the service with the "Periodic Mechanical Safety Report" form in the vehicle's maintenance records.

(3) Out of service permitted MoICU(s) or non-transport vehicle(s):

If a licensed MTO removes a permitted MoICU or non-transport vehicle from service it shall place an "out of service" sign in the permitted MoICU or non-transport vehicle to be visible through the windshield with the following information included on the front of the sign:

(a) Date permitted MoICU or non-transport vehicle was taken out of service;

(b) Odometer reading at time permitted MoICU or non-transport vehicle was taken out of service;

(c) Reason permitted MoICU or non-transport vehicle was taken out of service;

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

(e) The words "out of service" utilizing not less than three inch lettering.

(4) If permitted MoICU or non-transport vehicle is at a repair/maintenance shop that is not owned or operated by the licensed MTO for maintenance purposes, no "out of service" sign is required.

(B) Bio-medical equipment/patient care equipment:

(1) A licensed MTO shall ensure performance and maintain documentation of all periodic maintenance and repairs of bio-medical equipment as required by manufacturer and/or food and drug administration including but not limited to the following:

(a) Date of last inspection;

(b) Date of service or repair;

(c) Description of service/repair performed;

(d) Name of person who performed inspection, service, or repair;

(e) Documentation, if any, of inspection, service, or repair performed.

(2) A licensed MTO shall maintain documentation of all periodic maintenance of patient care equipment as required by the original equipment manufacturer, including but not limited to the following:

(a) Date of last inspection;

(b) Date of service or repair;

(c) Description of service/repair performed;

(d) Name of who performed inspection, service, or repair;

(e) Documentation of inspection, service, or repair performed.

(C) MoICU and non-transport vehicle maintenance/repair records and bio-medical maintenance/repair records shall be kept for a period of twelve months after the vehicle/equipment is removed from inventory.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-10 [Rescinded].

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.03 , 4766.04, 4766.07
Prior Effective Dates: 08/18/2005, 04/16/2012

4766-4-11 Use of lights and other warning devices.

(A) Permitted MoICU(s) and non-transport vehicle(s) are considered public safety vehicles pursuant to division (E)(1) of section 4511.01 of the Revised Code.

(B) Permitted MoICU(s) and non-transport vehicle(s), when responding to emergency calls, may use emergency lights and audible warning devices pursuant to section 4511.24 of the Revised Code.

(C) Permitted MoICU(s) and non-transport vehicle(s) shall:

(1) Bear license plates issued under section 4503.49 of the Revised Code; or

(2) Comply with residency registration requirements set forth in section 4503.111 of the Revised Code.

(3) Permitted MoICU(s) and non-transport vehicle(s) owned and operated by a federal, state, county, city, or township or a service that qualifies for gratis license plates from the bureau of motor vehicles are not required to bear ambulance license plates or non-transport vehicle license plates.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4503.111, 4503.49, 4511.01, 4511.24, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-12 Temporary and disaster operations.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) In the event of a disaster situation when permitted MoICU(s) based in the locality of the disaster situation are incapacitated or insufficient in number to render services needed, a licensed MTO may utilize whatever means necessary to transport and treat patients.

(B) A MoICU or non-transport vehicle that has not been issued a permit by the board may be issued a temporary permit, for a period not to exceed sixty days, if the MoICU or non-transport vehicle is used to replace a permitted MoICU or non-transport vehicle that has been temporarily taken out of service for repair or maintenance or is being permanently replaced. In order to obtain a temporary permit, a MTO shall submit a "Temporary Ambulance / MOICU / Non-transport Vehicle" form to the board containing:

(1) Vehicle identification number of the permitted MoICU or non-transport vehicle;

(2) Date permitted MoICU or non-transport vehicle was placed out of service;

(3) Vehicle identification number of the non-permitted MoICU or non-transport vehicle;

(4) Date temporarily permitted MoICU or non-transport vehicle is to be placed in service;

(5) Brief description of reason the permitted MoICU or non-transport vehicle was taken out of service.

(C) The licensed MTO shall ensure that the one hundred dollar fee prescribed in paragraph (E) of rule 4766-4-03 of the Administrative Code shall be received by the board within seven days of issuance of a temporary permit.

(D) The MTO shall note the date of return to service of the permitted MoICU or non-transport vehicle on the temporary permit.

(E) The licensed MTO shall return the temporary permit to the board within two days after the permitted MoICU or non-transport vehicle is returned to service.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.09
Prior Effective Dates: 04/16/2012

4766-4-13 Staffing compliance.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

MoICU transport team shall consist of three personnel: a driver operator and two other healthcare personnel as described herein:

(A) Driver operator means:

(1) A person who has successfully completed and passed an emergency vehicle operator course that meets requirements of national highway and traffic safety administration's "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum"; or

(2) A person who is certified as an Ohio emergency medical technician.

(B) Healthcare personnel means one each of the following:

(1) A registered nurse whose training meets or exceeds the training required for a paramedic; and

(2) A physician or another person designated by a physician, who holds a valid license or certificate to practice in a health care profession in one of the following areas: paramedic, registered nurse, respiratory therapist, advanced practice nurse, or physician's assistant.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.03 , 4766.04
Prior Effective Dates: 04/16/2012

4766-4-14 Regulations for out of state providers.

The exemption from licensure in division (B) of section 4766.09 of the Revised Code exempts out of state providers receiving a patient in Ohio for transport to a location not within Ohio or when transporting a patient received in another state. An out of state provider that receives a patient 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.

Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.13
Prior Effective Dates: 04/16/2012

4766-4-15 Changes to be reported to the board.

[Comment: For dates and availability of material incorporated by reference in this chapter of the Administrative Code, see rule 4766-4-18 of the Administrative Code.]

(A) Each licensed MTO shall give written notification to the board within ten business days of any additions, deletions or changes in:

(1) Executive officers or board members;

(2) Medical director, including:

(a) Contact information; and

(b) Medical license number;

(3) Ownership of a licensed MTO;

(4) Tax ID or EIN number;

(5) The name of the primary contact person(s), business or administrative office telephone number, email address, and if applicable, office fax number.

(B) Within ten days of the date a permitted MoICU or non-transport vehicle is permanently withdrawn from service, the licensed MTO shall return to the board a "Deletion of Vehicle" form and the decal from the right rear window.

(C) Within ten business days of the date a licensed MTO ceases to operate, it shall return to the board all vehicle decals and the certificate of licensure.

(D) Within ten business days of the date a licensed MTO ceases to operate a satellite base, it shall return to the board the certificate of licensure.

(E) A MTO licensed at the MoICU level may apply at any time to be licensed at a lower level. The application shall be made on a "Change in Level of Service Medical Transportation Organization" form and include the one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766- 4-04 and 4766- 4-08 of the Administrative Code. A change in level of service does not change the expiration date of the license.

(F) A licensed MTO may apply at any time for change of address of headquarters location. The application shall be made on the "Headquarters Change of Address" form and include the one hundred dollar license fee. The MTO shall also ensure compliance with rules 4766-4-04 of the Administrative Code. A change in headquarters address does not change the expiration date of the license.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/17/2017 and 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/16/2012

4766-4-16 Investigations.

(A) The division shall investigate all complaints on behalf of the board and in accordance with section 4766.11 of the Revised Code.

(B) After an investigation is completed and based on the findings of such investigation, the board may initiate disciplinary proceedings in accordance with Chapter 119. of the Revised Code and this chapter.

(C) If, based on the findings of an investigation, the board determines that no further action on a complaint is warranted, then the case shall be closed accordingly.

(D) The division shall conduct all investigations and any related proceedings, in such a manner as to protect patient confidentiality and in accordance with section 4765.102 of the Revised Code.

(E) Notwithstanding paragraph (D) of this rule, a patient may consent to have the board release the patient's name or other identifying information that was collected as part of the division's investigation. Such consent shall be in writing and signed by the patient in order to be considered proper.

If a patient is less than eighteen years of age, such consent shall be in writing and signed by the patient's parent, guardian, or legal custodian in order to be considered proper.

(F) No member of the board who participates in an investigation shall participate in any further adjudication of the case.

(G) No member of the board who participates in an investigation at the local level or is involved in a case locally, shall participate in any investigation or adjudication of the same case by the board.

Replaces: Replaces former 4766-4-16.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.08, 4766.11, 4765.102
Prior Effective Dates: 04/16/2012

4766-4-17 Disciplinary grounds.

(A) The board may, pursuant to an adjudicatory hearing under Chapter 119. of the Revised Code and section 4766.08 of the Revised Code, and by a vote of the majority of all members, suspend, revoke, or refuse to renew any license or permit or issue a fine not to exceed more than fifteen hundred dollars, for any of the following reasons:

(1) Any violation of Chapter 4766. of the Revised Code or any rules adopted thereunder;

(2) Refusal to permit the board or its designee to inspect a vehicle, inspect the records, or inspect the physical facilities of a licensed MTO;

(3) Failure to meet vehicle standards as set forth in Chapter 4766. of the Revised Code or any rules adopted thereunder;

(4) Violation of an order issued by the board;

(5) Failure to comply with the terms of any agreement entered into with the board.

(B) Within sixty days of receipt of a complete application for licensure, pursuant to division (F) of section 4766.04 of the Revised Code, the board shall deny an application if it determines that the applicant does not meet the requirements of Chapter 4766. of the Revised Code and rules promulgated thereunder.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.08

4766-4-18 Incorporated by reference.

(A) "1995 Emergency Vehicle Operators Course (Ambulance): National Standard Curriculum" can be found at http://www.nhtsa.gov/people/injury/ems/web%20site%20intro.htm.

(B) " 29 C.F.R. 1910.1030," (September 12, 2016), covers exposure to blood or other potentially infectious materials and can be accessed at the e-CFR Web site main page, http://www.ecfr.gov/cgi-bin/ECFR?page=browse.

(C) " 45 C.F.R. 164.512," (September 12, 2016), specifies what information can be shared under the HIPAA laws and can be accessed at the e-CFR Web site main page, http://www.ecfr.gov/cgi-bin/ECFR?page=browse.

(D) "Application for Ambulance or Mobile Intensive Care License" form or form "EMS 4001" (May, 2016) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

(E) "Change in Level of Service Medical Transportation Organization" form or form "EMS 4011" (July, 2013) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

(F) "Deletion of Vehicle" form or form "EMS 4012" (April, 2016) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

(G) "Headquarters Change of Address" form or form "EMS 4004" (April, 2016) can be accessed at the division's website athttp://www.ems.ohio.gov/medical-transportation-forms.aspx.

(H) "MoICU Inspection" form, or "Mobile Intensive Care Unit Inspection" form, or form "EMS 4022" (February, 2017) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

(I) "Non-transport Vehicle Inspection" form or form "EMS 4026" (January, 2017) can be accessed at the division's website athttp://www.ems.ohio.gov/medical-transportation-forms.aspx.

(J) "Periodic Mechanical Safety Report" form or form "EMS 4039" (May, 2016) can be accessed at the division's website athttp://www.ems.ohio.gov/medical-transportation-forms.aspx.

(K) "Renewal Application for Ambulance or Mobile Intensive Care License" form or form "EMS 4040" (May, 2016) can be viewed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

(L) "Temporary Ambulance / MOICU / Non-transport Vehicle" form or form "EMS 4009" (April, 2016) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

(M) "Violation Notification" form or form "EMS 4029" (April, 2015), is issued by the board to a MTO that is in violation of Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code and can be viewed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.

Effective: 8/1/2017
Five Year Review (FYR) Dates: 03/15/2022
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.03

4766-4-19 [Rescinded] Grounds for suspension, revocation, or denial of license or permit.

Effective: 04/16/2012
R.C. 119.032 review dates: 12/22/2011
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.05, 4766.06, 4766.07, 4766.08, 4766.13, 4766.99
Prior Effective Dates: 04/18/2005

4766-4-20 [Rescinded] Summary suspension.

Effective: 04/16/2012
R.C. 119.032 review dates: 12/22/2011
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.11
Prior Effective Dates: 04/18/2005

4766-4-21 [Rescinded] Equipment for adult MoICU.

Effective: 04/16/2012
R.C. 119.032 review dates: 12/22/2011
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/18/2005

4766-4-22 [Rescinded] Equipment for pediatric MoICU.

Effective: 04/16/2012
R.C. 119.032 review dates: 12/22/2011
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/18/2005

4766-4-23 [Rescinded] Equipment for neonatal MoICU.

Effective: 04/16/2012
R.C. 119.032 review dates: 12/22/2011
Promulgated Under: 119.03
Statutory Authority: 4766.03
Rule Amplifies: 4766.04, 4766.07
Prior Effective Dates: 04/18/2005