Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This rule provides the requirements and
standards related to the licensure and relicensure of stretcher van
services.
PUBLISHER'S NOTE: The secretary of state has
determined that the publication of the entire text of the material which is
incorporated by reference as a portion of this rule would be unduly cumbersome
and expensive. This material as incorporated by reference in this rule shall be
maintained by the agency at its headquarters and shall be made available to the
public for inspection and copying at no more than the actual cost of
reproduction. This note applies only to the reference material. The entire text
of the rule is printed here.
(1) Application requirements for stretcher
van service licensure-
(A) Each applicant for
a stretcher van service license shall submit an application for licensure to
the Emergency Medical Services (EMS) Bureau no less than thirty (30) days or no
more than one hundred twenty (120) days prior to their desired date of
licensure or relicensure.
(B) An
application shall include, but is not limited to, the following information:
trade name of the stretcher van service; location of vehicles; number of
vehicles to be operated by the stretcher van service; name, address, telephone
numbers, and email address (if applicable) of manager; name, address, telephone
numbers, and email address (if applicable) of proposed licensee of the
stretcher van service; name, address, telephone numbers, and email address (if
applicable) of licensee's chief executive officer; all stretcher van service
licensure and related administrative licensure actions taken against the
stretcher van service or owner by any state agency in any state; and
certification by the applicant that the application contains no
misrepresentation or falsifications and that the information given by them is
true and complete to the best of their knowledge and that the stretcher van
service has both the intention and the ability to comply with the regulations
promulgated under Chapter 190, RSMo. The stretcher van application form,
included herein, is available at the EMS Bureau office or by mailing a written
request to the Missouri Department of Health and Senior Services, EMS Bureau,
PO Box 570, Jefferson City, MO 65102-0570.
(C) Each stretcher van service that meets the
requirements and standards of the statutes and regulations shall be licensed
for a period of five (5) years.
(2) Passengers may be transported in a
stretcher van provided the passenger-
(A)
Needs no medical equipment (except self-administered medications, including
oxygen);
(B) Needs no medical
monitoring; and
(C) Needs routine
transportation to or from a medical appointment or service if that passenger(s)
is convalescent or otherwise non-ambulatory and does not require medical
monitoring, aid, care, or treatment during transport.
(3) Stretcher van services shall not
transport patients currently admitted to a hospital or patients being
transported to a hospital for admission or emergency treatment. A stretcher van
shall not transport a patient or passenger whom-
(A) Is acutely ill, wounded, or medically
unstable;
(B) Is experiencing an
emergency medical condition as defined in section
190.100, RSMo, an
acute medical condition, an exacerbation of a chronic medical condition, or a
sudden illness or injury; and
(C)
Was administered a medication that might prevent the person from caring for
him/herself.
(4) Vehicle
design and specifications for stretcher vans-
(A) Delivery of each stretcher van vehicle
will include documentation that the vehicle's design and construction will
afford safety, comfort, and avoid aggravation of the passenger's(s') present
condition. The vehicle shall be complete and furnished with such modifications
and attachments as may be necessary to enable the vehicle to function reliably
and efficiently in sustained operation. All vehicles shall be constructed by a
qualified vehicle manufacturer, designed and built to meet or exceed (at date
of vehicle manufacture) Federal Motor Vehicle Safety Standards (FMVSS) and
regulations included in
49 CFR
571.1 through
571.500.
Federal regulations
49 CFR
571.1 through
571.500
revised October 1, 2007, are incorporated by reference in this rule as
published in the
Code of Federal Regulations and are available
at the United States Government Printing Office, 732 North Capitol Street NW,
Washington, DC 20401, contact center via telephone at 1-866-512-1800 or online
at
www.gpoaccess.gov. This rule
does not incorporate any subsequent amendments or additions;
(B) Stretchers and mounting must meet or
exceed KKK-A-1822 specifications or Ambulance Manufacturers Division (AMD)
Standards 004 - litter retention system. The KKK-A-1822 specifications are
incorporated by reference in this rule as published in 2007 by the General
Services Administration and are available at Chief, Automotive Engineering
& Commodity Management Branch (QMDAA), Office of Motor Vehicle Management,
General Services Administration, 2200 Crystal Drive, Suite 1006, Arlington, VA
22202. This rule does not incorporate any subsequent amendments or additions.
The Ambulance Manufacturers Division Standards are incorporated by reference in
this rule as published in 2007 by the Ambulance Manufacturers Division and are
available at Ambulance Manufacturers Division, 37400 Hills Tech Drive,
Farmington Hills, MI 48331-3414. This rule does not incorporate any subsequent
amendments or additions. The operation of the stretcher shall follow
manufacturer's specifications and guidelines;
(C) No emergency warning lights are allowed
on vehicle;
(D) No "ambulance"
lettering or "Star of Life" may be displayed on vehicle;
(E) Store or secure all equipment, including
passengers' own oxygen delivery system, in a readily accessible and protected
manner to limit its movement during a crash; and
(F) To facilitate cleaning and disinfecting,
the stretcher compartment shall be impervious to soap and water, disinfectants,
mildew, fire resistant, and comply with FMVSS 302; be easily
cleaned/disinfected (carpeting, cloth, and fabrics are not acceptable); and all
exposed surfaces shall be free of vent devices that would permit the entrapment
of biological contaminates.
(5) Vehicle and equipment operation and
maintenance standards-
(A) Each service shall
ensure that all vehicle drivers possess a valid Class E, Missouri chauffeurs
driver license;
(B) Each service
shall ensure that all vehicle drivers complete a driver safety education
program or vehicle operations course and be able to provide documentation of
completion. These records shall be available for inspection by the EMS Bureau
during normal business hours;
(C)
Each vehicle shall maintain a current motor vehicle safety inspection from a
certified inspector mechanic;
(D)
Each service shall establish a preventive maintenance program for their
vehicles, and each vehicle shall receive periodic maintenance as recommended by
the qualified vehicle manufacturer. The records shall be available for
inspection by the EMS Bureau during normal business hours; and
(E) Each service shall comply with the
stretcher manufacturer's guidelines for maintenance of the
stretchers.
(6) Vehicle
staffing requirements-
(A) Each vehicle shall
be staffed with a minimum of two (2) persons when transporting a
passenger(s).
(B) At a minimum,
stretcher van personnel shall have completed a nationally recognized course in
cardiopulmonary resuscitation (CPR) and be certified at the community and
workplace level.
(7)
Vehicle communications requirements- Each service shall establish a policy for
notification of 911 in an emergency and each vehicle shall be equipped to allow
stretcher van personnel to communicate by voice with the service's own
dispatching agency or 911 operator.
(8) On-board equipment standards-Each vehicle
shall be equipped with body substance isolation (BSI) supplies in accordance
with section
191.694,
RSMo.
(9) Each service shall
maintain accurate records and reports on the following-
(A) A passenger transport report to record
information on each request for service and transportation;
(B) Stretcher van service license;
(C) Vehicle maintenance records;
(D) Vehicle driver education
records;
(E) Equipment maintenance
records;
(F) Records required by
other regulatory agencies; and
(G)
Each service shall be able to produce these records for inspection during
normal business hours.
(10) Each service shall have public liability
insurance or proof of self-insurance, conditioned to pay losses and damage
caused by or resulting from the negligent operation, maintenance, or use of
stretcher van services under the service's operating authority or for loss or
damage to property of others. Documents submitted as proof of insurance shall
specify the limits of coverage and include the stretcher van service license
number. Liability coverage for stretcher van services shall meet or exceed-
(A) Two hundred fifty thousand dollars
($250,000) for bodily injury to, or death of, one (1) person;
(B) Five hundred thousand dollars ($500,000)
for bodily injury to, or death of, all persons injured or killed in any one (1)
accident, subject to a minimum of two hundred fifty thousand dollars ($250,000)
per person; and
(C) One hundred
thousand dollars ($100,000.00) for loss or damage to property of others in one
(1) accident, excluding cargo.
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*Original authority: 190.528, RSMo 2002 and 190.537, RSMo
2002.
