Current through Register Vol. 50, No. 9, September 20, 2024
A. Director of Operations
1. The director of operations (DOO), or
equivalent job title, shall be designated, in writing, to supervise:
a. all activities of professional staff and
allied health personnel; and
b.
responsible for compliance with regulatory requirements.
2. The DOO, or designee, shall be on-site or
immediately available to be on-site at all times during operating hours, and
additionally as needed. If the DOO is unavailable, he/she shall designate an
equally qualified individual to be responsible during his/her
absence.
3. The DOO shall be a
licensed EMT, or above, and shall be currently licensed to practice in the
state of Louisiana:
a. with at least three
years' experience as an EMS Practitioner; and
b. be a full-time employee of only one
ambulance service facility.
4. The department may exempt the director of
operations from the requirements of §6133.A.3 a-b if services are primarily
staffed and operated by volunteers.
5. The DOO shall supervise all patient care
activities to assure compliance with current standards of accepted EMS practice
including, but not limited to, the following:
a. supervise the employee health program and
implement policies and procedures that establish and support quality patient
care;
b. assure compliance with
local, state, and federal laws, and promote health and safety of employees,
patients and the community, using the following nonexclusive methods:
i. perform complaint
investigations;
ii. provide
orientation and in-service training to employees to promote effective ambulance
service safety of the patient, and to familiarize staff with regulatory issues,
and agency policy and procedures, including but not limited to:
iii. competency evaluation performed
biennially to coincide with renewals of licensure of health care personnel or
alternatively provide that the competency evaluation will be done through an
ambulance service'/provider's quality assurance policies and procedures that
includes a definition of competency when utilizing the quality assurance
process;
iv. assure that the care
provided by the health care personnel promotes effective emergency medical care
and the safety of the patient; and
v. assure that the ambulance service policies
are enforced.
6. The DOO shall also perform the following
duties:
a. implement personnel and employment
policies to assure that only qualified personnel are hired:
i. licensing and/or certification (as
required by law) shall be verified prior to employment and annually thereafter,
and records shall be maintained to support competency of all allied health
personnel;
b. implement
policies and procedures that establish and support quality patient
care
c. be responsible for and
direct the day-to-day operations of the ambulance service facility;
d. act as liaison among staff, patients and
the community;
e. designate, in
writing, an individual who meets the qualifications of director of operations
to assume the authority and the control of the ambulance service if the
director of operations is unavailable; and
f. designate policies governing the
day-to-day provisions of the ambulance service.
7. The DOO shall refer to the Louisiana
Emergency Medical Services Certification Commission, or other authority of
competent jurisdiction, any licensed employee who allegedly committed or is
accused of committing, or who has been proven to have committed any of the
following:
a. the selling, attempting to sell,
falsely obtaining, or furnishing any professional certification
document;
b. conviction of a crime
or offense which reflects the inability of that person to provide care with due
regard of the health and safety of the patient. This includes a plea of
nolo contendre regardless of the final outcome; or
c. is guilty in the aiding and abetting of
someone in violation of these regulations or the regulations of the Louisiana
EMS Certification Commission.
d. is
guilty in the violation of these regulations or the regulations of the
Louisiana EMS Certification Commission.
B. Medical Director
1. The medical director must be a licensed
physician (MD or DO), authorized to practice medicine in Louisiana and
knowledgeable about emergency medical care and the emergency medical services
system. The medical director is the clinical supervisor of the ambulance
service. The medical director reviews, coordinates, and is responsible for the
management of clinical and medical care for all patients. The medical director
is responsible for all aspects of patient care. The medical director may be an
employee or a volunteer of the agency. The agency may also contract for
services of the medical director.
2. The medical director or his designee shall
assume overall responsibility for the medical component of the patient care
program including, but not limited to:
a.
responsibility for all controlled dangerous substances utilized by the
ambulance service;
b. developing
and coordinating procedures for the provision of emergency medical care;
and
c. participating in the
development of the protocols or procedures for providing care;
3. The medical director shall
maintain a current list of all licensed emergency medical services personnel
that function under the medical director's supervision.
4. The medical director shall have the
authority to appointment and delegate duties to one or more associate medical
directors;
a. Associate medical directors
shall have responsibilities and authority that are delineated in writing and
shall be recognized with authority and responsibility as delegated by the
program's EMS medical director.
5. Documentation of the medical director's
credentials shall be kept on file with the service at its
headquarters.
C.
Licensed Emergency Medical Services Personnel
1. A licensed emergency medical responder
(EMR) must be licensed by the Louisiana Bureau of Emergency Medical Services. A
licensed emergency medical responders drive the ambulance and assist the EMT.
He may not attend the patient in the back of the ambulance by himself.
a. A licensed emergency medical responder
shall: i. drive the ambulance; or
ii. assist
the EMT, AEMT or the paramedic on an ambulance; or
iii. provide on-scene patient care to the EMR
level (see Louisiana Scope of Practice).
2. A licensed emergency medical
technician may:
a. drive the
ambulance;
b. assist another
licensed EMS practitioner;
c. may
attend the patient by himself provided the patient does not require advanced
life support (ALS) services, and the assessment and interventions fall within
the scope of practice of the licensed EMT.
3. A licensed advanced emergency medical
technician may:
a. drive the
ambulance;
b. assist another
licensed EMS practitioner; or
c.
attend the patient by himself as long as the assessment and interventions fall
within his established Louisiana scope of practice.
4. A licensed paramedic may:
a. drive the ambulance;
b. assist another licensed EMS practitioner;
or
c. attend the patient by himself
provided the medical procedures being performed, (see Louisiana Scope
of Practice).
D. Pediatric Emergency Care Coordinator
(PECC)
1. A PECC is recommended for the
purpose of:
a. staying abreast of and
advocating for the most current evidence-based, best practices, and model
guidelines in out-of-hospital emergency care.
b. advocating for the ambulance service to
collect and submit EMS data to be utilized for quality improvement
purposes.
c. collaborate with the
ambulance service's leadership and external partners to improve all aspects of
pediatric care, education, and training.
d. maintaining knowledge of pediatric
capabilities within regional hospitals and destinations of care.
e. dedicating the quality improvement efforts
focused on pediatric patients.
E. Certified Ambulance Operator:
1. A certified ambulance operator must be
certified by the Louisiana Bureau of Emergency Medical Services.
a. A certified ambulance operator shall:
i. drive the ambulance; or
ii. assist the EMT, AEMT or the paramedic
with lifting and moving patients and cardiopulmonary resuscitation while
responding to calls for assistance on an ambulance.
F. Other Medical
Personnel. Other medical personnel such as physicians, registered nurses, etc.,
may function in an ambulance in accordance with
R.S.
40:1135.1 et seq., and within the scope of
practice in accordance with the licensed practitioner's professional licensing
board.
G. All medical personnel
providing services in any capacity on an ambulance shall have either a current
Health Care Provider or a Professional Rescuer CPR certification from the
American Heart Association or the American Red Cross, or the equivalent
cardiopulmonary resuscitation certification.
H. All drivers shall successfully complete
and hold a valid current defensive driving certificate issued by the National
Safety Council or its equivalent.
I. Pilots
1.
Pilots shall not participate in patient care activities, except for loading and
unloading the patient, and incidental duties.
2. Pilots shall:
a. hold a valid appropriate commercial
pilot's license from the Federal Aviation Administration;
b. have a valid physical examination
certificate from an FAA flight surgeon.
NOTE: Copies of these documents listed in a. and b. above
shall be made available to the department.
c. be qualified to operate the specific
aircraft; and
d. have an
appropriate instrument flight rating as necessary.
J. Identification and Credentials
1. All personnel working on an ambulance
and/or sprint vehicle shall carry with them their current driver's license at
the level required by the Louisiana Highway Regulatory Act
2. All medical personnel working on a ground
transportation ambulance, air ambulance, or emergency medical response vehicle
(sprint), shall have their level of licensure readily identifiable to the
public utilizing the appropriate designated patch or name tag issued by the
ambulance service/provider.
K. Criminal History Reports
1. In accordance with
R.S.
40:1203.2 et seq., all ambulance service
personnel shall have a state of Louisiana criminal history report and sexual
offender checks conducted prior to an offer of employment or a contract. No
personnel shall be employed in violation of those statutes.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254,
R.S.
40:1135.1 and R.S. 40:
1135.2.