PRINTER'S NO. 1302
No. 1173 Session of 1981
INTRODUCED BY ITKIN, CESSAR, LETTERMAN, GALLAGHER AND PISTELLA,
APRIL 8, 1981
REFERRED TO COMMITTEE ON STATE GOVERNMENT, APRIL 8, 1981
AN ACT
1 Regulating the licensing, inspection and operation of ambulance
2 services and ambulance personnel; providing for renewal and
3 revocation of licenses; imposing powers and duties on the
4 Department of Health; creating an Advisory Board on Ambulance
5 Service and providing penalties.
6 Whereas, There is demonstrated need in the Commonwealth to
7 establish a minimum level of emergency medical care provided by
8 ambulances; and
9 Whereas, It is the concern of the General Assembly of the
10 Commonwealth that its citizens and visitors receive a basic
11 level of emergency medical care to reduce needless death and
12 disability.
13 TABLE OF CONTENTS
14 Section 1. Short title.
15 Section 2. Definitions.
16 Section 3. General provisions.
17 Section 4. License required to operate an ambulance service.
18 Section 5. Personnel required on ambulances.
19 Section 6. Equipment required on ambulances.
1 Section 7. Advisory Board on Ambulance Service.
2 Section 8. Revocation of licenses.
3 Section 9. Records and reports.
4 Section 10. Inspections.
5 Section 11. Exemptions.
6 Section 12. Making false ambulance requests.
7 Section 13. Restrictions on advertising and vehicle
8 identification.
9 Section 14. Restrictions on vendors.
10 Section 15. Penalties.
11 Section 16. Fees.
12 Section 17. Effective date.
13 The General Assembly of the Commonwealth of Pennsylvania
14 hereby enacts as follows:
15 Section 1. Short title.
16 This act shall be known and may be cited as the "Ambulance
17 Regulation and Standards Act."
18 Section 2. Definitions.
19 The following words and phrases when used in this act shall
20 have, unless the context clearly indicates otherwise, the
21 meanings given to them in this section:
22 "Advanced life support unit." Any vehicle designed and
23 equipped to render advanced life support as defined in the act
24 of November 30, 1976 (P.L.1205, No.264), referred to as the
25 Emergency Medical Technician Law, and so recognized by the
26 department based on standards developed in consultation with the
27 Pennsylvania Emergency Health Services Council.
28 "Advisory board." The Advisory Board on Ambulance Service.
29 "Ambulance." Any motor vehicle that is specially designed,
30 constructed or modified and equipped and any aircraft which is
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1 specially designed, constructed or modified and equipped and is
2 used or intended to be used, maintained or operated for the
3 purpose of rendering emergency medical care to, and
4 transportation of, patients.
5 "Ambulance attendant." An individual holding a current
6 certificate which evidences the successful completion of a
7 course in first aid, advanced life support or basic life support
8 sponsored by the American National Red Cross or the American
9 Heart Association or its equivalent as defined pursuant to 42
10 Pa.C.S. § 8332 (relating to nonmedical good samaritan civil
11 immunity).
12 "Ambulance service." Regularly engaging in the business or
13 service of providing emergency medical care and transportation
14 of patients within the Commonwealth.
15 "Department." The Department of Health of the Commonwealth
16 of Pennsylvania.
17 "Emergency Health Services Council." An organization created
18 pursuant to the act of November 30, 1976 (P.L.1207, No.265),
19 known as the "Emergency Medical Services Systems Act."
20 "Emergency medical technician." An individual who is
21 certified by the department pursuant to the act of November 30,
22 1976 (P.L.1205, No.264), referred to as the Emergency Medical
23 Technician Law.
24 "Emergency medical technician - paramedic." An individual
25 who is certified by the department pursuant to the act of
26 November 30, 1976 (P.L.1205, No.264), referred to as the
27 Emergency Medical Technician Law.
28 "Invalid coach." Any land or air vehicle that is maintained,
29 operated and intended to be used primarily to routinely
30 transport persons who are convalescent or otherwise
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1 nonambulatory and do not require emergency medical treatment
2 while in transit.
3 "Patient." Any individual who is sick, injured, wounded or
4 otherwise incapacitated and helpless.
5 "Rescue vehicle." Any motor vehicle which is designed or
6 modified and equipped for rescue operations and which is not
7 routinely used for emergency medical care and transport of
8 patients.
9 Section 3. General provisions.
10 The department shall:
11 (1) Establish and certify minimum standards pursuant to
12 this act, with the advice of the advisory board, such
13 standards not to exceed the limitations included in this act.
14 (2) Make inspections of ambulance services, their
15 ambulances, equipment and personnel certificates to determine
16 compliance with this act and any regulations promulgated
17 pursuant thereto.
18 (3) Promulgate rules and regulations in accordance with
19 the provisions of the act of July 31, 1968 (P.L.769, No.240),
20 referred to as the Commonwealth Documents Law, and pursuant
21 to this act.
22 Section 4. License required to operate an ambulance service.
23 (a) One year after the effective date of this act, no
24 person, either as an owner, agent or otherwise, shall furnish,
25 operate, conduct, maintain, advertise or otherwise engage in or
26 profess to be engaged in providing ambulance service upon the
27 highways or any public place in the Commonwealth of Pennsylvania
28 unless that person holds a currently valid license to operate an
29 ambulance service issued by the department pursuant to this act.
30 (b) The department shall issue a license to any person who
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1 makes application thereto within one year after the effective
2 date of this act and who was providing ambulance service on the
3 effective date of this act, when a determination has been made
4 as provided herein that the service will be in compliance with
5 the requirements of this act or any regulations adopted pursuant
6 thereto.
7 (c) Applications for ambulance service licenses hereunder
8 shall be made upon such forms prepared or prescribed by the
9 department and shall contain information deemed reasonably
10 necessary to a fair determination of compliance with this act.
11 (d) Holders of licenses to operate an ambulance service
12 shall not discontinue service until after the holder notifies
13 the department in writing that the service is to be
14 discontinued. Notice to the department shall include a notarized
15 statement that the licensee has notified the chief executive
16 officer of each political subdivision in the licensee's
17 ambulance service area of his intent to discontinue ambulance
18 service and that the intent to discontinue ambulance service has
19 been advertised in newspapers of general circulation in the
20 licensee's ambulance service area.
21 (e) A license to operate an ambulance service is not
22 transferable and shall remain valid for a period of three years,
23 unless removed or suspended by the department.
24 (f) The department shall issue a temporary license for
25 operation of an ambulance service when the department deems it
26 in the public interest to do so. Such temporary license shall be
27 valid for a period not to exceed 90 days and shall only be
28 renewable once by the department with the advice of the advisory
29 board.
30 Section 5. Personnel required on ambulances.
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1 (a) One year after the effective date of this act, each
2 licensed ambulance service shall require that an ambulance, when
3 operated in response to a call for assistance, except for
4 routine transfer of convalescent or other nonemergency cases,
5 shall be staffed by at least two persons, one of whom is at
6 least an ambulance attendant. The ambulance attendant must
7 accompany the patient in the patient compartment.
8 (b) Two years after the effective date of this act, all
9 ambulances when operated in response to a call for assistance,
10 except for routine transfer of convalescent or other
11 nonemergency cases, shall be staffed by at least two persons
12 both of whom shall be at least ambulance attendants. At least
13 one ambulance attendant must accompany the patient in the
14 patient compartment.
15 (c) Three years after the effective date of this act, all
16 ambulances, when operated in response to a call for assistance,
17 except for routine transfer or convalescent or other
18 nonemergency cases, shall be staffed by at least two persons,
19 one of whom shall be an emergency medical technician (EMT). The
20 emergency medical technician must accompany the patient in the
21 patient compartment.
22 (d) The department shall assure the availability of tuition
23 free emergency medical technician courses in sufficient number
24 to provide training for adequate number of such personnel
25 throughout the Commonwealth, such courses to be conducted at
26 locations reasonably convenient to ambulance services.
27 (e) Any ambulance attendant shall, upon request of the
28 department of its representative, produce valid evidence of
29 satisfactory completion of an appropriate training program
30 specified in this act.
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1 (f) Upon the effective date of this act, all licensed
2 ambulances in the Commonwealth shall operate with a minimum
3 staffing of two persons.
4 Section 6. Equipment required on ambulances.
5 One year after the effective date of this act, the following
6 basic equipment shall be carried on all ambulances:
7 (1) Ambulance litter with patient belts.
8 (2) Bag valve mask.
9 (3) Oropharyngeal airways.
10 (4) Portable oxygen with controlled litter flow and tank
11 pressure gauge.
12 (5) Portable suction of approved type.
13 (6) Full leg traction splint.
14 (7) Blood pressure cuff.
15 (8) Stethoscope.
16 (9) Assorted extremity splints.
17 (10) Dressings and bandages for hemorrhage control.
18 (11) Blankets, pillows.
19 (12) Road flares and handlights.
20 (13) Activated charcoal and syrup of ipecac.
21 (14) One quart or more of drinking water.
22 (15) Granulated sugar or its equivalent.
23 (16) Sterile water or normal saline for irrigation.
24 (17) Sterile sheets or equivalent.
25 (18) Short and long spineboards with accessories.
26 (19) Cervical collars.
27 (20) Public safety service band land mobile transceiver.
28 (21) Adequately equipped jump kit.
29 (22) Mouth gag.
30 (23) OB kit.
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1 (24) Aluminum foil.
2 (25) Adhesive tape.
3 (26) Bandage shears.
4 Section 7. Advisory Board on Ambulance Service.
5 (a) For the purpose of assisting the department in
6 developing standards for use in the administration of this act,
7 the department shall appoint an Advisory Board on Ambulance
8 Service. Such advisory board shall consist of 15 members, all of
9 whom shall be experienced in prehospital emergency medical care.
10 Of the members, one shall be a physician; one shall be a nurse;
11 three shall be representatives of volunteer fire department
12 ambulance services; three shall be representatives of volunteer
13 ambulance services not affiliated with fire companies; two shall
14 be representatives of paid fire department ambulance services;
15 two shall be representatives of commercial ambulance services;
16 two shall be representatives of ambulance service provided by
17 local government; and one shall be representatives of ambulance
18 services provided by hospitals. The numbers representing
19 volunteer and paid fire department ambulance services shall be
20 selected by the department upon submission of a multiple list of
21 names from each of the following organizations:
22 (1) One name to be selected from the Firemen's
23 Association of Pennsylvania.
24 (2) One name to be selected from the Firemen's
25 Legislative Federation of Pennsylvania.
26 (3) One name to be selected from the Keystone Fire
27 Chief's Association.
28 (4) Two names to be selected from the Pennsylvania State
29 Fire Fighters Association.
30 (b) The department shall insure maximum geographic and
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1 demographic representation when selecting the three
2 representatives of the volunteer ambulance services not
3 affiliated with fire companies.
4 (c) The advisory board shall choose its own chairman and
5 shall meet at the call of the department or the chairman or in
6 his absence or incapacity, at the call of any member designated
7 by the advisory board to act as chairman: Provided, however,
8 That the advisory board shall not meet less than annually.
9 (d) A majority of members of the advisory board shall
10 constitute a quorum for transacting business and a majority vote
11 of those present at any meeting shall be sufficient for any
12 official action taken by the advisory board.
13 (e) Advisory board members shall serve without compensation,
14 save for mileage and expenses, for which they shall be
15 reimbursed.
16 (f) Upon passage of this act, five members of the advisory
17 board shall be appointed to a one-year term; four members shall
18 be appointed to a two-year term; and four shall be appointed to
19 a three-year term. Thereafter, members shall be appointed to a
20 three-tear term in the same manner as provided herein initially.
21 Members may not be reappointed for more than one succeeding
22 term. The advisory board shall provide for removal of members
23 not attending meetings.
24 Section 8. Revocation of licenses.
25 (a) The department may and is hereby authorized to suspend
26 or revoke a license issued hereunder. Upon determining that a
27 violation of this act or rules and regulations promulgated
28 thereunder exists, the department shall issue a notice of
29 violation. Such notice shall specify the nature of the
30 violation, order the violation abated and shall specify a
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1 reasonable time for compliance. If, after such reasonable time
2 for compliance, the department determines that such violation
3 persists, the department shall afford the holder of the license
4 an opportunity for an administrative hearing to be conducted by
5 the department. If, after the departmental hearing, the
6 department rules that the license shall be suspended or revoked,
7 appeals may be taken as provided by law.
8 (b) Upon suspension, revocation or termination of a license,
9 the ambulance service shall cease operations and no person shall
10 permit or cause such ambulance service to continue, except in
11 cases where no reasonable alternative is available, the
12 department may place such service on probation and shall put
13 forth full effort to assist such service to comply with the
14 provisions of this act.
15 Section 9. Records and reports.
16 (a) The licensee of an ambulance service shall maintain a
17 written summary of trips upon such form and in such manner as
18 the department, with the advice of the advisory board, shall
19 provide. Summary information shall be submitted to the
20 department annually.
21 (b) The provisions of this section shall take effect one
22 year after the effective date of this act.
23 Section 10. Inspections.
24 (a) Each ambulance service, its ambulance, equipment and
25 personnel certifications shall be inspected by the department or
26 its representative, such inspections to be conducted from time
27 to time as deemed appropriate and necessary but not less than
28 once every three years.
29 (b) When an inspection report shows that an ambulance
30 service is in compliance with the requirements of this act and
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1 rules and regulations promulgated pursuant hereto, the
2 department shall issue or renew a license as provided for in
3 this act. When the inspection report shows that an ambulance
4 service is not in compliance with this act and rules and
5 regulations promulgated pursuant hereto, the department shall
6 notify the ambulance service of such noncompliance and shall
7 reinspect that ambulance service within 30 days of its receipt
8 of such noncompliance. When a reinspection report shows that the
9 ambulance service is in compliance with this act and rules and
10 regulations promulgated pursuant hereto, the department shall
11 issue or renew a license as provided for in this act. When a
12 reinspection report shows continued noncompliance, the
13 department shall issue a notice of violation as provided for in
14 section 8.
15 Section 11. Exemptions.
16 The following vehicles are exempted from the provisions of
17 this act:
18 (1) Privately owned vehicles not ordinarily used in the
19 business of transporting patients.
20 (2) A vehicle rendering temporary service as an
21 ambulance in care of an emergency when ambulances based in
22 the locality of the emergency are insufficient to render
23 services required.
24 (3) Ambulances located or headquartered outside the
25 Commonwealth transporting patients from locations beyond the
26 limits of the Commonwealth to locations within the
27 Commonwealth.
28 (4) Ambulances and ambulance services owned and operated
29 by an agency of the United States Government.
30 (5) Invalid coaches.
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1 (6) Rescue vehicles.
2 Section 12. Making false ambulance requests.
3 (a) It shall be unlawful for any person to willfully summon
4 an ambulance or willfully report that an ambulance is needed
5 when such person does not have good cause to believe that the
6 services of an ambulance are needed. Every person convicted of
7 willfully violating this section shall, upon conviction in a
8 summary proceeding, be sentenced to pay a fine not exceeding
9 $300 or imprisonment not exceeding 90 days, or both.
10 (b) It shall be unlawful for any person to willfully impede
11 or obstruct any ambulance attendant, emergency medical
12 technician or emergency medical technician-paramedic in the
13 performance of his duty: Provided, That such ambulance
14 attendants, emergency medical technicians or emergency medical
15 technician-paramedic displays accepted Red Cross or department
16 identification or insignia. Every person convicted of willfully
17 violating this section shall, upon conviction in a summary
18 conviction, be sentenced to pay a fine not exceeding $500 or
19 imprisonment not exceeding 90 days, or both.
20 (c) It shall be unlawful for any person not holding a valid
21 certificate of course completion of the American Red Cross or
22 the department to display such insignia or act in any manner
23 that would lead reasonable persons to conclude he is an
24 ambulance attendant or emergency medical technician. Every
25 person convicted of willfully violating this section shall, upon
26 conviction in a summary conviction be sentenced to pay a fine
27 not exceeding $100 or imprisonment not exceeding 90 days.
28 Section 13. Restrictions on advertising and vehicle
29 identification.
30 One year after the effective date of this act, any use of the
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1 terms "ambulance" or "advanced life support unit" in referring
2 to any service, vehicle or person shall be restricted to any
3 vehicle or service as has been duly licensed by the department
4 as defined in this act.
5 Section 14. Restrictions on vendors.
6 Effective one year after the effective date of this act, no
7 person shall sell or cause to be sold any new ambulance vehicle
8 which does not meet design standards promulgated by the
9 department as regulations for such vehicles. Such standards
10 shall be developed by the department in consultation with the
11 Pennsylvania Emergency Health Services Council. The seller shall
12 provide proof of compliance to the buyer.
13 Section 15. Penalties.
14 Any person convicted of operating any ambulance service which
15 does not have a currently valid license, has a license which is
16 under suspension or revocation, or violates any other provisions
17 of this act except as otherwise specified, shall upon conviction
18 thereof in a summary proceeding, be sentenced to pay a fine of
19 not more than $100 and costs of prosecution and, in default of
20 such fine and costs, the person shall undergo imprisonment of
21 not more than 30 days. Violations on separate days are
22 considered separate and distinct offenses. All fines recovered
23 under the provisions of this act shall be paid to the State
24 Treasurer of the Commonwealth.
25 Section 16. Fees.
26 There shall be no fee for licenses.
27 Section 17. Effective date.
28 This act shall take effect immediately.
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