“Rule 185. (1) A ground ambulance, rotary ambulance, and aircraft transport vehicle shall be equipped with equipment and patient care supplies as prescribed by the department including temperature control in the patient compartment. The agency shall require that equipment is available and in working order on each vehicle.
(2) A nontransport and medical first response vehicle shall be equipped with patient care equipment and patient care supplies as prescribed by the department. The agency shall require that equipment is available and in working order on each vehicle.
(3) Each life support vehicle shall be equipped with communication capability in accordance with the medcom requirements.”
Minnesota.
The Minnesota emergency medical services regulatory Board inspects ambulances. Under Minn. Stat. 144E.10:
“Subdivision 1. License required. No natural person, partnership, association, corporation, or unit of government may operate an ambulance service within this state unless it possesses a valid license to do so issued by the board. The license shall specify the base of operations, the primary service area, and the type or types of ambulance service for which the licensee is licensed. The licensee shall obtain a new license if it wishes to expand its primary service area, or to provide a new type or types of service.
Subd. 2.Requirements for new licenses. The board shall not issue a license authorizing the operation of a new ambulance service, provision of a new type or types of ambulance service by an existing service, or an expanded primary service area for an existing service unless the requirements of this section and sections 144E.101 to 144E.127 and 144E.18 are met.”
Minn. Stat. 144E.130 describes the minimum patient care equipment necessary for ambulances:
“Subdivision 1. General requirements. Every ambulance in service for patient care shall carry, at a minimum:
(1) oxygen;
(2) airway maintenance equipment in various sizes to accommodate all age groups;
(3) splinting equipment in various sizes to accommodate all age groups;
(4) dressings, bandages, commercially manufactured tourniquets, and bandaging equipment;
(5) an emergency obstetric kit;
(6) equipment to determine vital signs in various sizes to accommodate all age groups;
(7) a stretcher;
(8) a defibrillator; and
(9) a fire extinguisher.
Subd. 2. Advanced life-support requirements. In addition to the requirements in subdivision 1, an ambulance used in providing advanced life support must carry drugs and drug administration equipment and supplies as approved by the licensee's medical director.
Subd. 2a. Maintenance, sanitation, and testing of equipment, supplies, and drugs. Equipment carried on every ambulance in service for patient care must be maintained in full operating condition. Patient care equipment, supplies, and drugs must be stored and maintained within manufacturer's recommendations and:
(1) all equipment and supplies must be maintained in full operating condition and in good repair;
(2) all equipment, supplies, and containers used for storage of equipment or supplies must be kept clean so as to be free from dirt, grease, and other offensive matter;
(3) sheets and pillowcases must be changed after each use;
(4) single-service equipment and supplies must be wrapped, stored, and handled so as to prevent contamination and must be disposed of after use;
(5) reusable equipment and supplies must be cleaned after each use so as to be free from dirt, grease, and other offensive matter;
(6) equipment and supplies, soiled or otherwise not free from dirt, grease, and other offensive matter, must be kept in plastic bags or securely covered containers until disposed of or prepared for reuse; and
(7) procedures for the periodic performance testing of mechanical equipment must be developed, maintained, and followed, and records of performance testing must be kept in the licensee's files. Testing must occur within the manufacturer's recommendations.
Subd. 3. Storage. All equipment carried in an ambulance must be securely stored.
Subd. 4. Safety restraints. An ambulance must be equipped with safety straps, including shoulder harnesses, for the stretcher and seat belts in the patient compartment for the patient and ambulance personnel.
Subd. 5. Communication equipment. An ambulance must be equipped with a two-way radio that is programmed and operating according to the most recent version of the statewide radio board shared radio and communication plan or its equivalent as determined by the Emergency Medical Services Regulatory Board.”
The Minnesota emergency medical services regulatory board sets standards for ambulance vehicles. Under Minn. R. 4690.3300:
“Subpart 1. Land ambulances purchased after June 30, 1981. All new land ambulances purchased by a licensee after June 30, 1981, must comply with the following standards:
A. the size of the patient compartment must be a minimum of 116 inches long and 52 inches high from floor to ceiling and must provide in width not less than 69 inches wall to wall; or attendant walkway of not less than 12 inches between the stretcher and fixed bench and between stretchers;
B. the door opening to the patient compartment must be a minimum of 30 inches wide and 42 inches high and the door to the patient compartment must be operable from inside the ambulance, and must be capable of being fully opened and held open by a mechanical device;
C. the interior storage areas must provide a minimum of 30 cubic feet of storage space to accommodate all required equipment and other equipment carried and must be located to provide easy access to all equipment;
D. the interior lighting in the patient compartment must include overhead or dome lighting, be designed so that no glare can be reflected to the driver's line of vision while the ambulance is transporting the patient; and provide sufficient lighting to allow visual determination of patient vital signs;
E. environmental equipment must include a heater for the patient compartment that has a minimum output of 21,000 Btu's;
F. the ambulance must:
(1) have an overall height, including roof-mounted equipment except for radio antenna, of 110 inches or less;
(2) have fuel capacity to provide no less than 175-mile range;
(3) have ground clearance of at least six inches when loaded to gross vehicle weight rating; and
(4) be capable of full performance at ambient temperatures of minus 30 degrees Fahrenheit to 110 degrees Fahrenheit; and
G. the ambulance must be marked to show the name of the service as shown in the current license issued by the board, in letters not less than three inches in height and in a position and color to allow identification of the service from the sides and rear of the vehicle.
Subp. 2. Compliance with General Services Administration standards. Land ambulances that comply with the standards issued by the General Services Administration in Federal Specification KKK-A-1822 A for Emergency Medical Care Surface Vehicle dated April 1, 1980, with the exception of sections 3.14, 3.15, and 3.16, are deemed to comply with the standards contained in subparts 1, 3, and 4.
…
Subp. 4. Siren and light. All land ambulances must be equipped with a siren capable of emitting sound that is audible under normal conditions from a distance of not less than 500 feet and at least one light capable of displaying red light that is visible under normal atmospheric conditions from a distance of 500 feet from the front of the ambulance.”
Summary of the Factual Data and Analytical Methodologies:
In 2012, a National Highway Transportation Safety Administration (NHTSA) recommended that the department “[c]onsolidate ambulance inspection and licensing authority within the Department of Health Services with sufficient funding and personnel to support the function.”
NHTSA further stated that “[t]here is a standardized list of ambulance equipment, including pediatric equipment, listed in the administrative rule Trans 309. The EMS Unit has worked with DOT to develop licensing rules and makes suggestions regarding qualifications for inspection personnel. However, the equipment list has not been updated for over 12 years and the language resides in the DOT administrative rule. Both Dot and the EMS Unit will be reviewing the list for updates but constituents expressed the desire to have this inspection function within the EMS Unit.”
The department promulgated CR 19-074 in late 2020. That rule updated inspection standards and medical equipment standards with the assumption that DHS would have statutory authority to promulgate rules relating to medical equipment standards, set out subch. III of ch. Trans 309. To date, DHS still does not have authority to promulgate such rules. Therefore, the department must move the repeal date set forth in s. Trans 309.25 back. Analysis Regarding Rule’s Effect on Small Businesses:
This rulemaking does not make substantive changes to current ch. Trans 309, therefore there is no effect on small businesses. The agency contact person listed below is also the small business regulatory coordinator for this proposed rule. This proposed rule, fiscal estimate, and other related documents may be viewed at https://docs.legis.wisconsin.gov/code. Agency Contact Person:
Capt. Karl Mittelstadt
State of Wisconsin Department of Transportation
Division of State Patrol
4822 Madison Yards Way Room
Madison, Wisconsin 53705
(608) 215-2804
Place Where Comments Should Be Submitted and Deadline: Comments may be submitted to the agency contact person listed above or through the Legislature’s Administrative Rules website http://docs.legis.wisconsin.gov/code until the deadline given in the forthcoming notice of public hearing. TEXT OF RULE
Section 1. Trans 309.25 is amended to read:
Trans 309.25 Subchapter III is repealed on July 15, 2023 or upon promulgation by the Department of Health Services of administrative rules establishing standards and inspections, as well as legislative appropriation of resources for such inspections, whichever comes sooner.
(END OF RULE TEXT)
