144E.101 AMBULANCE SERVICE REQUIREMENTS.
Subdivision 1. Personnel.
(a) No publicly or privately owned ambulance service shall be
operated in the state unless its ambulance service personnel are certified, appropriate to the type
of ambulance service being provided, according to section
or meet the staffing criteria
specific to the type of ambulance service.
(b) An ambulance service shall have a medical director as provided under section
Subd. 2. Patient care.
When a patient is being transported, at least one of the ambulance
service personnel must be in the patient compartment. If advanced life support procedures are
required, an EMT-P, a registered nurse qualified under section
144E.001, subdivision 3a
(2), item (i), or a physician assistant qualified under section
144E.001, subdivision 3a
, clause (3),
item (i), shall be in the patient compartment.
Subd. 3. Continual service.
An ambulance service shall offer service 24 hours per day every
day of the year, unless otherwise authorized under subdivisions 8 and 9.
Subd. 4. Denial of service prohibited.
An ambulance service shall not deny prehospital
care to a person needing emergency ambulance service because of inability to pay or because
of the source of payment for services if the need develops within the licensee's primary service
area or when responding to a mutual aid call. Transport for the patient may be limited to the
closest appropriate emergency medical facility.
Subd. 5. Types of service.
The board shall regulate the following types of ambulance service:
(1) basic life support;
(2) advanced life support;
(3) part-time advanced life support; and
(4) specialized life support.
Subd. 6. Basic life support.
(a) Except as provided in paragraph (e), a basic life support
ambulance shall be staffed by at least two ambulance service personnel, at least one of which
must be an EMT, who provide a level of care so as to ensure that:
(1) life-threatening situations and potentially serious injuries are recognized;
(2) patients are protected from additional hazards;
(3) basic treatment to reduce the seriousness of emergency situations is administered; and
(4) patients are transported to an appropriate medical facility for treatment.
(b) A basic life support service shall provide basic airway management.
(c) By January 1, 2001, a basic life support service shall provide automatic defibrillation,
as provided in section
144E.103, subdivision 1
, paragraph (b).
(d) A basic life support service licensee's medical director may authorize the ambulance
service personnel to carry and to use medical antishock trousers and to perform intravenous
infusion if the ambulance service personnel have been properly trained.
(e) Upon application from an ambulance service that includes evidence demonstrating
hardship, the board may grant a variance from the staff requirements in paragraph (a) and may
authorize a basic life support ambulance to be staffed by one EMT and one first responder. The
variance shall apply to basic life support ambulances operated by the ambulance service until
the ambulance service renews its license. When a variance expires, an ambulance service may
apply for a new variance under this paragraph. For purposes of this paragraph, "ambulance
service" means either an ambulance service whose primary service area is located outside the
metropolitan counties listed in section
473.121, subdivision 4
, and outside the cities of Duluth,
Mankato, Moorhead, Rochester, and St. Cloud; or an ambulance service based in a community
with a population of less than 1,000.
Subd. 7. Advanced life support.
(a) An advanced life support ambulance shall be staffed
by at least:
(1) one EMT and one EMT-P;
(2) one EMT and one registered nurse who is an EMT, is currently practicing nursing,
and has passed a paramedic practical skills test approved by the board and administered by a
training program; or
(3) one EMT and one physician assistant who is an EMT, is currently practicing as a
physician assistant, and has passed a paramedic practical skills test approved by the board and
administered by a training program.
(b) An advanced life support service shall provide basic life support, as specified under
subdivision 6, paragraph (a), advanced airway management, manual defibrillation, and
administration of intravenous fluids and pharmaceuticals.
(c) In addition to providing advanced life support, an advanced life support service may staff
additional ambulances to provide basic life support according to subdivision 6. When routinely
staffed and equipped as a basic life support service according to subdivision 6 and section
144E.103, subdivision 1
, the vehicle shall not be marked as advanced life support.
(d) An ambulance service providing advanced life support shall have a written agreement
with its medical director to ensure medical control for patient care 24 hours a day, seven days a
week. The terms of the agreement shall include a written policy on the administration of medical
control for the service. The policy shall address the following issues:
(i) two-way communication for physician direction of ambulance service personnel;
(ii) patient triage, treatment, and transport;
(iii) use of standing orders; and
(iv) the means by which medical control will be provided 24 hours a day.
The agreement shall be signed by the licensee's medical director and the licensee or the
licensee's designee and maintained in the files of the licensee.
(e) When an ambulance service provides advanced life support, the authority of an EMT-P,
Minnesota registered nurse-EMT, or Minnesota registered physician assistant-EMT to determine
the delivery of patient care prevails over the authority of an EMT.
Subd. 8. Part-time advanced life support.
(a) A part-time advanced life support service
shall meet the staffing requirements under subdivision 7, paragraph (a); provide service as
required under subdivision 7, paragraph (b), for less than 24 hours every day; and meet the
equipment requirements specified in section
(b) A part-time advanced life support service shall have a written agreement with its medical
director to ensure medical control for patient care during the time the service offers advanced
life support. The terms of the agreement shall include a written policy on the administration of
medical control for the service and address the issues specified in subdivision 7, paragraph (d).
Subd. 9. Specialized life support.
A specialized ground life support service providing
advanced life support shall be staffed by at least one EMT and one EMT-P, registered nurse, or
physician assistant. A specialized life support service shall provide basic or advanced life support
as designated by the board, and shall be restricted by the board to:
(1) operation less than 24 hours of every day;
(2) designated segments of the population;
(3) certain types of medical conditions; or
(4) air ambulance service that includes fixed-wing or rotor-wing.
Subd. 10. Driver.
A driver of an ambulance must possess a current driver's license issued by
any state and must have attended an emergency vehicle driving course approved by the licensee.
The emergency vehicle driving course must include actual driving experience.
Subd. 11. Personnel roster and files.
(a) An ambulance service shall maintain:
(1) at least two ambulance service personnel on a written on-call schedule;
(2) a current roster of its ambulance service personnel, including the name, address, and
qualifications of its ambulance service personnel; and
(3) files documenting personnel qualifications.
(b) A licensee shall maintain in its files the name and address of its medical director and
a written statement signed by the medical director indicating acceptance of the responsibilities
specified in section
144E.265, subdivision 2
Subd. 12. Mutual aid agreement.
A licensee shall have a written agreement with at least
one neighboring licensed ambulance service for coverage during times when the licensee's
ambulances are not available for service in its primary service area. The agreement must specify
the duties and responsibilities of the agreeing parties. A copy of each mutual aid agreement
shall be maintained in the files of the licensee.
Subd. 13. Service outside primary service area.
A licensee may provide its services outside
of its primary service area only if requested by a transferring physician or ambulance service
licensed to provide service in the primary service area when it can reasonably be expected that:
(1) the response is required by the immediate medical need of an individual; and
(2) the ambulance service licensed to provide service in the primary service area is
unavailable for appropriate response.
Subd. 14. Trauma triage and transport guidelines.
By July 1, 2009, a licensee shall have
written age appropriate trauma triage and transport guidelines consistent with the criteria issued
by the Trauma Advisory Council established under section
and approved by the board.
The board may approve a licensee's requested deviations to the guidelines due to the availability
of local or regional trauma resources if the changes are in the best interest of the patient's health.
History: 1999 c 245 art 9 s 24; 2000 c 313 s 1; 2001 c 74 s 1; 1Sp2005 c 4 art 6 s 34;
2007 c 147 art 16 s 11