Under Iowa Admin. Code 641-132.3 (147A), the department of public health oversees service program operations. Each service program must have a designated medical director at all times. Iowa Admin. Code 641-132.3 (2).
All service programs must be inspected and approved by the department. Under Iowa Admin. Code 641-
132.3 (9):
“a. Effective January 1, 2022, all service programs, regardless of their designation as governmentally owned, not-for-profit, or privately operated, shall annually systematically inspect, repair, and maintain, or cause to be systematically inspected, repaired, and maintained, all ambulances operated by the service program.
b. A service program shall utilize a vehicle inspection report approved by the department to record the results of an annual ambulance safety inspection. Annual safety inspection forms which comply with the requirements of 49 CFR 396 shall be approved by the department. A sample annual vehicle inspection form which complies with the reporting requirements of 49 CFR 396 can be found on the BETS website (www.idph.iowa.gov/BETS/EMS/provider-information). …
g. Effective January 1, 2022, new ambulances manufactured and placed into service shall meet at a minimum either the Commission on Accreditation of Ambulance Services (CAAS) Ground Vehicle Standard for Ambulances or the National Fire Protection Association (NFPA) Standard for Automotive Ambulances (NFPA 1917).”
Michigan.
The Michigan department of health and human services inspects life support vehicles. Under Mich. Admin. Code r. 325.22190:
“Life support vehicles shall be inspected as follows:
(a) The department may conduct random renewal inspections of life support vehicles, including medical first response vehicles. Inspections shall be unannounced unless circumstances warrant notifying a life support agency in advance that an inspection of its life support vehicles will be conducted. The department shall determine if prior notification of an inspection is warranted. A vehicle license may be renewed without an inspection.
(b) Submission of a licensure renewal application shall be considered an attestation by the life support agency that the vehicle meets all licensure requirements.
(c) A life support agency that is adding a new or higher licensure level for a life support vehicle shall submit an application, on forms provided by the department, and include the required fee. New and higher level of care vehicles shall be inspected before being placed into service. Upon receipt of the application and required fee, the department shall inspect new or upgrade vehicles within 15 days of receipt of application.
(d) A life support agency that is replacing a life support vehicle shall submit an application, on forms provided by the department, and include the required fee. A replacement vehicle means a life support agency has removed a vehicle from service and has replaced the vehicle with another.
(e) Replacement vehicles may be placed into service upon submission of an application and the required fee to the department. Upon receipt of the application and required fee, the department shall inspect the replacement vehicle within 15 days of receipt of the application.”
The department is also responsible for determining what equipment and patient care supplies ambulances must have. Under Mich. Admin. Code r. 325.22185:
“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.
