Rule 511-9-2-.09 - Licensure of Medical First Responder Services(1) Applicability. (a) No person shall operate, advertise, or hold themselves out to be a Medical First Responder Service, or advertise as such in the state of Georgia without first meeting the following requirements and being duly licensed by the Department.(b) However, the provisions of this chapter shall not apply to: 1. Any first responder unit operated by an agency of the United States government.2. Any rescue organization licensed by the Georgia Emergency Management and Homeland Security Agency, including its individual members.3. Any person or designated first responder unit directly requested to the scene of an emergency by an appropriate public safety agency or ambulance service for the purpose of rendering on-site care, rescue or extrication, until the arrival of a duly licensed Ground Ambulance Service, Air Ambulance Service, or duly licensed Medical First Responder Service. This includes agencies routinely requested to the scene in this manner that cannot or choose not to meet the requirements of these rules.4. Any supervisory vehicle of a licensed ambulance service.5. A person rendering assistance temporarily in the case of a major catastrophe, disaster, or public health emergency which is beyond the capability of licensed Medical First Responder Services or licensed Ground Ambulance Services.(2) Application for a License. Application for a license or provisional license shall be made to the license officer in the manner and on the forms approved by the Department to include at a minimum the name, address, email address, and employer identification number of the owner(s).(3) Renewal of License. Renewal of any license issued under the provisions of the rules shall require conformance with all the requirements of these rules as upon original licensing.(4) Standards for Medical First Responder Vehicles.(a) General. 1. Registered Medical First Responder Vehicles must be maintained on suitable premises that meet the county health code and the Department's specifications. The Department is authorized to establish policy to define minimum standards for suitable premises and base of operations. The registered Medical First Responder Vehicle must be properly equipped, maintained, and operated in accordance with other Rules and Regulations contained herein.2. All registered Medical First Responder Vehicles must be equipped with approved safety belts for all seats.3. Registered Medical First Responder Vehicles must be inspected and approved by the Department and so designated by affixing a Department decal at a location specified by the Department.4. Prior to disposal by sale or otherwise, a registered Medical First Responder Vehicle removed from service must be reported to the Department.(b) Insurance. 1. Every registered Medical First Responder Vehicle shall have at least $1,000,000 combined single limit (CSL) insurance coverage.2. No Medical First Responder Vehicle shall be registered nor shall any registration be renewed unless the vehicle has insurance coverage in force as required by this section. A certificate of insurance or satisfactory evidence of self-insurance shall be submitted to the license officer for approval prior to the issuance or renewal of each Medical First Responder Service license. Satisfactory evidence that such insurance is at all times in force and effect shall be furnished to the Department, in a manner and on forms specified by the Department, by all licensees required to provide proof of such insurance under this section. Any lapse in insurance coverage will lead to immediate revocation of the Medical First Responder Service license.3. Medical First Responder Services must maintain a file, as defined in departmental policy, of all maintenance records on each vehicle registered by the Department.4. The Medical First Responder Service must list the Georgia Office of EMS and Trauma as an additional certificate holder for the vehicle insurance with the insurance company.(c) Communication.1. All Medical First Responder Services shall have two-way communication between the vehicle and the location receiving requests for emergency service.(d) Infectious Disease Exposure Control. 1. Each Medical First Responder Service shall have a written infectious disease exposure control plan approved by the local Medical Director.2. Medical First Responder Services and Emergency Medical Services Personnel shall comply with all applicable local, state and federal laws and regulations in regard to infectious disease control procedures.(e) Equipment and Supplies. 1. All equipment and supplies must be maintained in working order and shall be stored in an orderly manner and shall be readily accessible when needed.2. Supplies may not be used after their expiration date.3. In order to substitute any item from the required items written approval must be obtained from the Department. The Department shall have authority to grant exceptions and substitutions and shall maintain and distribute an up-to-date policy listing of all approved exceptions and substitutions.4. The Department shall through policy establish the minimum equipment and supplies required on Medical First Responder Vehicles; however, other equipment and supplies may be added as desired.(5) General Provisions: Medical First Responder Services. (a) Each registered Medical First Responder Vehicle when on an emergency call shall be manned by at least one Medic. If Advanced Life Support is being rendered, there must be at least one Emergency Medical Technician - Intermediate, Advanced Emergency Medical Technician, Cardiac Technician or Paramedic responsible for patient care.(b) Medical First Responder Services shall be provided on a twenty-four hour, seven day a week basis.(c) Personnel shall be available at all times to receive emergency telephone calls and provide two-way communications.(d) Sufficient licensed personnel shall be immediately available to respond with at least one registered Medical First Responder Vehicle. When the first registered Medical First Responder Vehicle is on a call, Medical First Responder Services shall respond to each additional emergency call within their designated geographic territory as requested providing a Medic and a registered Medical First Responder Vehicle are available. If a Medic and a registered Medical First Responder Vehicle are not available, the Medical First Responder Service shall request mutual aid assistance. If mutual aid assistance is not available the Medical First Responder Service shall respond with its next available registered Medical First Responder Vehicle.(e) The driver of a registered Medical First Responder Vehicle, when responding to an emergency call, is authorized to operate the vehicle as an emergency vehicle pursuant to the provisions of O.C.G.A. § 40-6-6.(f) Medical Direction for Medical First Responder Services. 1. To enhance the provision of emergency medical care, each Medical First Responder Service shall be required to have a Medical Director. The Medical Director shall be a physician licensed to practice medicine in this state and subject to approval by the Department. The local Medical Director must agree in writing to provide medical direction to that particular Medical First Responder Service.2. The local Medical Director shall serve as the medical authority for the Medical First Responder Service, serving as a liaison between the service and the medical community, medical facilities and governmental entities.3. It will be the responsibility of the local Medical Director to provide medical direction and training for the Medical First Responder Service personnel in conformance with acceptable emergency medical practices and procedures.4. Duties of the local Medical Director shall include but not be limited to the following: (i) The approval of policies and procedures affecting patient care;(ii) The formulation of medical protocols and communication protocols;(iii) The formulation and evaluation of training objectives;(iv) Performance evaluation;(v) Continuous quality improvement of patient care; and(vi) Development and implementation of policies and procedures for requesting air ambulance transport.5. The Medical Director of a Medical First Responder Service must coordinate the medical protocols and procedures of the service with the Medical Director of the designated Ground Ambulance Service in the Regional Ambulance Zoning Plan.6. All Emergency Medical Services Personnel shall comply with appropriate policies, protocols, requirements, and standards of local Medical Director for that service, provided that such policies and protocols are not in conflict with these Rules and Regulations, the Department-specified Scope of Practice, or other state statutes.(g) Control of patient care at the scene of an emergency shall be the responsibility of the individual in attendance most appropriately trained and knowledgeable in providing prehospital emergency care and transportation. When a Medic arrives at the scene of a medical emergency, the Medic may act as an agent of a physician when a physician-patient relationship has been established. 1. For purposes of this section, a physician-patient relationship has been established when: (i) A Medic utilizes medical control, either through direct on-line medical control or off-line medical control, by the use of medical protocols established by the local Medical Director; or(ii) A physician is on the scene and demonstrates a willingness to assume responsibility for patient management or purports to be the patient's personal physician and the Medic takes reasonable steps to immediately verify the medical credentials of the physician.2. Once a physician-patient relationship has been established, the Medic must follow the medical direction of that physician. In the event of a conflict between the medical direction given and the medical protocols established by the local Medical Director, the Medic should immediately contact their local Medical Director.(h) Medical First Responder Services and applicants for Medical First Responder Services shall not misrepresent or falsify any information, applications, forms or data filed with or submitted to the Department.(i) Medical First Responder Services shall not employ, continue in employment, or use as Medics, individuals who are not properly licensed under the applicable provisions of O.C.G.A. Chapter 31-11 and these Rules and Regulations.(j) Medical First Responder Services are required to notify the dispatch center designated by the Regional Ambulance Zoning Plan as responsible for distributing Ground Ambulance calls prior to departure on any direct calls received.(6) CLIA Certification (a) All Medical First Responder Services must maintain current CLIA certification as a laboratory that is permitted to perform waived tests, as defined in 42 CFR § 493.2. 1. Documentation regarding this certification must be submitted to the Department in a manner and on forms specified by the Department.2. Medical First Responder Services who do not hold additional licensure as a Ground Ambulance Service, Air Ambulance Service, or Neonatal Transport Service, shall be exempt from the requirement to maintain a current CLIA certificate, provided that: (i) The Medical First Responder Service submits an attestation that no Medic or other person employed by or acting on behalf of the Medical First Responder Service will be permitted to examine materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of the health of, human beings.Ga. Comp. R. & Regs. R. 511-9-2-.09
O.C.G.A. §§ 31-2A-3, 31-2A-6, 31-11-5 to 31-11-7, 31-11-30 to 31-11-36, 31-11-50, 31-11-53 to 31-11-55, 31-11-59, 31-11-60, 31-11-60.1, 31-12-8, 40-6-6.
Original Rule entitled "Licensure of Medical First Responder Services" adopted. F. December 14, 2011; eff. January 3, 2012.Amended: F. Apr. 27, 2016; eff. May 17, 2016.Amended: F. Sep. 29, 2021; eff. Oct. 27, 2021, as specified by the Agency.