TITLE
7 HEALTH
CHAPTER
27 EMERGENCY MEDICAL SERVICES
PART
10 CERTIFICATION OF
EMERGENCY MEDICAL SERVICES AGENCIES
7.27.10.1 ISSUING AGENCY: New
Mexico Department of Health, Division of Epidemiology and Response, Emergency
Medical Systems Bureau.
[7.27.10.1 NMAC - N, 3/15/2010]
7.27.10.2 SCOPE:
A. This
rule applies to any emergency medical service (EMS) agency that provides
emergency medical services within the state of New Mexico, including but not
limited to special event EMS agencies; emergency medical dispatch agencies, and
transport and non-transport medical rescue agencies. This rule also applies to out-of-state EMS
agencies (including but not limited to seasonal agencies) that routinely
respond within or transport patients into or out of the state of New Mexico to
provide emergency medical care or to pick up or deliver patients.
B. This
rule does not apply to ambulance services regulated by the transportation
division of the New Mexico public regulation commission or its successor agency
(see 18.3.14 NMAC); federal agencies; the NM department of military affairs;
tribal agencies and organizations that provide EMS entirely within the
boundaries of tribal lands; ski patrols providing first aid pursuant to the Ski
Safety Act, NMSA 1978, Section 24-15-1; search and rescue operations conducted
pursuant to the Search and Rescue Act, NMSA 1978, Section 24-15A-1; private
businesses providing emergency response teams and initial first aid solely for
their employees; or EMS agencies from adjoining states (properly licensed in
their respective jurisdictions) that are either 1) responding into New Mexico
to assist in a mass casualty or disaster situation that exceeds the capacity or
capability of the NM EMS agency in an affected area, or 2) responding into New Mexico
on a non-routine basis for emergency mutual aid assistance when requested to do
so by a certified EMS agency whose service area includes areas along a mutual
state border.
[7.27.10.2 NMAC - N, 3/15/2010]
7.27.10.3 STATUTORY AUTHORITY: This
rule is promulgated pursuant to the New Mexico Department of Health Act at NMSA
1978, Section 9-7-6 E, and the Emergency Medical Services Act at NMSA 1978,
Section 24-10B-4 L.
[7.27.10.3 NMAC - N, 3/15/2010]
7.27.10.4 DURATION: Permanent.
[7.27.10.4 NMAC - N, 3/15/2010]
7.27.10.5 EFFECTIVE DATE:
3/15/2010, unless a later date is cited at the end of a section.
[7.27.10.5 NMAC - N, 3/15/2010]
7.27.10.6 OBJECTIVE: The
purpose of this rule is to establish standards for the certification of EMS
agencies that conduct operations within New Mexico, and to identify the process
and procedures for certification and enforcement. Administration and enforcement of this rule
is the responsibility of the emergency medical systems bureau of the division
of epidemiology and response, department of health.
[7.27.10.6 NMAC - N, 3/15/2010]
7.27.10.7 DEFINITIONS:
A. “Air ambulance service” means any governmental or private service that provides air
transportation specifically designed to accommodate the medical needs of a
person who is ill, injured or otherwise mentally or physically incapacitated
and who requires in-flight medical supervision.
B. “Applicant”
means an applicant for EMS agency certification under this rule.
C. “Bureau”
means the emergency medical systems bureau of the epidemiology and response
division, of the department of health.
D. “Call routing” means the reception of emergency calls where the purpose is to only
determine the course of direction of routing (police, fire, and medical)
resulting in rapid transfer of medical callers to the emergency medical
dispatch agency or the emergency medical dispatch call taker for emergency
medical dispatching.
E. “Certificated
ambulance service” means a publicly or
privately owned entity holding a current certificate from the New Mexico public
regulation commission that identifies it as an emergency response ambulance
service, and that is subject to the rules of the public regulation commission
or its successor agency.
F. “Commission on the accreditation of ambulance services
(CAAS)” means the national
accrediting organization that establishes ambulance industry standards and
evaluates ambulance services based upon those standards.
G. “Committee on accreditation of educational programs
for the EMS professions (CoAEMSP)” means the national accrediting
organization that establishes standards for educational programs for EMS
professions, and that evaluates training programs based on those standards.
H. “Commission on the accreditation of medical transport
systems (CAMTS)” means the
national accrediting organization that establishes industry standards and
evaluates air and ground ambulance services based upon those standards.
I. “Conviction” means a plea or adjudication of guilt, a plea of nolo contendre, an Alford
plea, or any plea or adjudication that results in a conditional discharge or a
suspended or deferred conviction.
J. “Days” means calendar days, unless otherwise specified.
K. “Department” means the New Mexico department of health.
L. “Department of transportation (DOT)”
means the federal department of transportation.
M. “Emergency” means an individual’s need for immediate
medical care to prevent loss of life or aggravation of physical or
psychological illness or injury.
N. “Emergency medical dispatch” means the reception, evaluation, processing,
and provision of dispatch life support, management of requests for emergency
medical assistance, and participation in ongoing evaluation and improvement of
the emergency medical dispatch process.
The emergency medical dispatch process is not limited to call routing
only, but includes identifying the nature of the request, prioritizing the
severity of the request, dispatching the necessary resources, providing medical
aid and safety instructions to the callers, and coordinating the responding
resources as needed.
O. “Emergency medical dispatch agency (EMDA)” means any organization, or a combination of
organizations working cooperatively, that routinely accepts calls for emergency
medical assistance and employs emergency medical dispatch priority reference
system (EMDPRS) techniques.
P. “Emergency medical dispatch priority reference system
(EMDPRS)” means a bureau
approved reference system used by an emergency medical dispatch agency (EMDA)
to dispatch aid to medical emergencies, which includes systemized caller
interrogation; systemized pre-arrival instructions to the caller based upon
protocols matching the dispatcher’s evaluation of injury or illness severity;
and prioritized vehicle response.
Q. “Emergency medical dispatcher (EMD)” means a provider who is trained and licensed
pursuant to the EMS Act, NMSA 1978, Section 24-10B-4 F, to receive calls for
emergency medical assistance, provide pre-arrival medical instructions,
dispatch emergency medical assistance and coordinate its response.
R. “Emergency medical service(s) (EMS)” means the medical services rendered by
licensed providers in response to an emergency.
S. “Emergency medical services agency
(EMS agency, agency)” means an organization that provides
emergency medical services. EMS agencies
include emergency medical dispatch agencies, pre-hospital agencies with defined
geographical boundaries for their response, inter-facility care agencies, and
special event EMS agencies organized to provide emergency medical
services. For the purposes of
disciplinary actions taken pursuant to the enforcement provisions of this rule,
unless otherwise specified, actions taken by an “EMS agency” shall include
actions taken by EMS agency personnel and its medical director(s).
T. “Emergency
medical technician (EMT)” means a provider
who has been licensed by the department to provide patient care in accordance
with the current EMS scopes of practice (7.27.2.14 NMAC).
U. “Emergency medical service agency
certification (EMS agency certification, certification, certificate)” means a
legal document issued to an EMS agency by the department as evidence that the
applicant meets the requirements for certification to operate an EMS agency in
accordance with this rule.
V. “EMS bureau (bureau)” means the emergency medical systems bureau of the epidemiology and
response division of the New Mexico department of health, and includes the
bureau’s agents.
W. “EMS first responder (first responder)” means a
provider who has been licensed by the department to provide initial patient
care in accordance with the current EMS scopes of practice (7.27.2.14 NMAC).
X. “EMS Act (Act)” means the Emergency Medical Services Act, NMSA 1978, Section 24-10B-1 et seq.
Y. “EMS fund” means the fund established by the EMS Fund Act, NMSA 1978, Section 24-10A-1 et seq., that is administered by the department of health.
Z. “EMS Fund Act” means the Emergency Medical Services Fund Act, NMSA 1978, Section 24-10A-1 et seq.
AA. “EMS medical director (medical director)” means a physician licensed in New Mexico who is responsible for all aspects of patient care for an EMS system or EMS agency, including providing for or ensuring the medical control of EMS providers; the development, implementation, and evaluation of medical protocols; emergency medical dispatch; and oversight of quality assurance activities.
BB. “GSA standards” means the minimum standards and specifications for ambulances contained
in the United States general services administration (GSA) standard KKK-A-1822F
or most current GSA standard.
CC. “Level of care” means the most
advanced level of emergency medical services that an emergency medical technician
(EMT) is permitted to administer in accordance with the most current NM EMS
scopes of practice.
DD. “Level of service” means the most advanced level of emergency
medical service at which an EMS agency is certified to function in accordance
with this rule.
EE. “Medical
control” means EMS supervision
provided by or under the direction of physicians to providers by written
protocol or direct communication.
FF. “Medical direction” means guidance or supervision provided by a physician
to an agency, provider or emergency medical services system and includes
authority over and responsibility for emergency medical dispatch, direct
patient care and transport of patients, arrangements for medical control and
all other aspects of patient care delivered by an EMS provider or agency.
GG. “Medical direction committee” means the committee of physicians and
emergency medical technicians created under the EMS Act, at NMSA 1978, Section
24-10B-7 C, whose members are appointed by the secretary to advise the bureau
on all matters relating to medical control and medical direction.
HH. “Medical protocol” means a predetermined, written medical care
plan and includes standing orders from a medical director.
II. “Mutual aid” means aid provided pursuant to a written agreement between one municipality, county or private EMS agency and one or more other municipalities, counties or private EMS agencies for the purpose of ensuring that adequate emergency medical services exist locally or throughout the state in order to assure a timely response to the call for emergency medical care. Mutual aid agreements may be utilized to address (among other things) coordinated response to catastrophic events, as well as common system demand and staffing situations.
JJ. “National EMD standard-setting and certification
organization (NESSCO)” means the organization that provides and maintains a comprehensive EMD protocol
and training system development process.
Organizations accredited under NESSCO are required to maintain current
and up-to-date emergency medical dispatch priority reference system (EMDPRS)
curriculum, training, testing, certification, recertification, instructor,
quality improvement and accreditation programs and standards.
KK. “Non-transport medical rescue vehicle”
means any EMS agency representative vehicle (motor vehicle or watercraft) that
is not a privately owned vehicle and that carries EMS equipment that is not
included in the EMS agency’s medical protocols to transport patients.
LL. “Non-transport medical rescue agency” means an EMS agency that does not transport
patients and is organized under a New Mexico political subdivision or a private
entity performing services solely for its employees.
MM. “Out-of-state EMS agency” means an EMS agency that is
organized under the laws of another state, or whose principal place of business
is located in another state.
NN. “Patient care report” means a medical record of an encounter between any patient and a provider of medical care.
OO. “Personnel” means any employee,
agent, representative, volunteer, or intern of an EMS agency who provides
emergency medical services.
PP. “Privately owned vehicle” (POV) means a
privately owned vehicle not registered to a governmental entity or EMS agency.
QQ. “Physician” means a doctor of medicine or doctor of
osteopathy who is licensed or otherwise authorized to practice medicine or
osteopathic medicine in New Mexico.
RR. “Post-dispatch instructions” means case-specific advice, warnings, and
treatments given by trained EMDs to responders whenever possible and
appropriate after dispatch of field responders.
SS. “Pre-arrival instructions” means the scripted medical instructions
provided to callers in emergency situations by licensed emergency medical
dispatchers prior to the arrival of EMS agency personnel.
TT. “Primary response area” means the specific primary geographic area
designated or prescribed by a jurisdiction in which an EMS agency provides
emergency medical service.
UU. “Provider” means a person who has been licensed by the
department to provide patient care pursuant to the EMS Act, NMSA 1978, Section
24-10B-1 et seq.
VV. “Quality assurance” means a retrospective review or inspection of EMS records to determine
if appropriate care is being provided.
WW. “Regional office” means an emergency medical services planning
and development organization formally recognized and contracted by the bureau.
XX. “Required records” means records, logs, data sets, forms, agreements, plans, procedures,
policies, titles, certificates and other documents required to be retained by
an EMS agency under this rule, whether in electronic or printed form.
YY. “Scope of practice” means the skills, techniques, medications, and procedures identified by rule of the department (7.27.2.14 NMAC) that are allowed for the practice of emergency medical services in New Mexico, that apply to all EMS personnel, EMS services, and EMS medical directors.
ZZ. “Secondary response area” means a geographic area in which an EMS agency provides emergency medical service beyond their primary response area, established by local jurisdictions or mutual aid agreements.
AAA. “Secretary” means the secretary of the New Mexico
department of health.
BBB. “Special event emergency medical services (special event EMS)” means emergency medical services provided
outside the emergency response system at scheduled, contractual events. Special event services include but are not
limited to: medical services provided at movie sets, sporting events, mass
gatherings, concert venues, adventure programs, religious events, guest ranches
and wild-land fires.
CCC. “Special event EMS agency” means an organization that provides special event emergency medical
services to the public by licensed EMS providers.
DDD. “Special skill”
means a set of procedures or therapies that are beyond the usual scope of
practice for a given level of licensure and that have been approved by the
medical direction committee for use by a specified provider.
EEE. “Standing orders” means defined written orders for actions, techniques or drug
administration, signed by the medical director, to be utilized when
communication has not been made with an on-line medical control physician.
FFF. “Transport capable medical rescue”
means any vehicle (motor vehicle or watercraft) that carries EMS protocols for
transporting patients in a patient care compartment.
GGG. “Transport medical rescue agency” means an EMS agency that transports patients
under certain circumstances and without compensation, and is organized under a
New Mexico political subdivision or a private entity.
[7.27.10.7 NMAC - N, 3/15/2010]
7.27.10.8 USE OF TERMS AND ADVERTISING: It
shall be prohibited for any EMS agency to advertise or perform emergency
medical services, or to use the title “certified emergency medical services
agency,” in New Mexico, unless the EMS agency has been certified by the bureau
in accordance with this rule.
[7.27.10.8 NMAC - N, 3/15/2010]
7.27.10.9 DISCLOSURE TO THE PUBLIC: If
requested by a potential client, a patient or a member of the public, a
certified emergency medical services agency shall disclose its current level of
New Mexico certification and what level of service it can provide.
[7.27.10.9 NMAC - N, 3/15/2010]
7.27.10.10 EMS BUREAU CERTIFICATION REQUIRED: An
EMS agency shall, prior to beginning emergency medical services operations
within the state of New Mexico, obtain either a temporary or full emergency
medical services certification from the bureau.
Certification by the EMS bureau shall not in itself qualify an EMS
agency for EMS fund distribution.
[7.27.10.10 NMAC - N, 3/15/2010]
7.27.10.11 FULL CERTIFICATION PERIOD:
Certification periods are twenty-four months in length except for the
initial period, which shall vary according to the date of initial
certification. The second or subsequent period of certification shall be for a
full twenty-four month period, regardless of the date of application for
renewal or the date for processing of the renewal certificate. This period
shall begin on January 1 of the renewal year.
Requirements for renewal of licensure shall be completed by the December
1st that occurs prior to expiration of certification. The certification period for emergency
medical agencies may be adjusted by the bureau to correspond with the CAMTS,
CAAS or other bureau-approved accreditation period. EMS agencies may be subject to audit. EMS agencies shall complete an annual report
form that contains the same elements as the annual service report required of
ambulance services by PRC rule (18.3.14.22 NMAC). The bureau shall issue the annual report form
to EMS agencies by November 1 of each year, and EMS agencies shall complete the
form and return it to the bureau no later than January 15 of the following
year.
[7.27.10.11 NMAC - N, 3/15/2010]
7.27.10.12 RECORDS AND DATA COLLECTION:
A. Patient care reports. All certified EMS agencies except special event EMS shall complete in a timely manner and keep on file a clearly written or computer-generated patient care report for each patient who is provided with emergency medical care or transported. Each patient care report shall be authored by the provider(s) actually responsible for the patient care, and shall be completed within forty-eight hours of the provision of care to the patient.
B. Submission
of minimum pre-hospital data. An EMS
agency shall compile and submit minimum data required pursuant to this rule on
a quarterly basis, or as required by the bureau.
C. Minimum data elements; general EMS agency information. An EMS agency shall submit the following general data to the EMS bureau:
(1) EMS agency number;
(2) EMS agency state;
(3) EMS agency county;
(4) level of service;
(5) organizational type;
(6) organization status;
(7) statistical year;
(8) total service size
area;
(9) total service area
population;
(10) 911 call volume per
year;
(11) EMS dispatch volume
per year;
(12) EMS transport volume
per year;
(13) EMS patient contact
volume per year;
(14) EMS agency time
zone;
(15) national provider
identifier;
(16) EMS agency contact
zip code.
D. Minimum
pre-hospital data elements: An EMS
agency shall compile and submit to the EMS bureau the following minimum
pre-hospital data for every instance that patient care is provided by the EMS
agency:
(1) vehicle type;
(2) patient care report
number;
(3) software creator;
(4) software name;
(5) software version;
(6) EMS agency number;
(7) incident number;
(8) type of service
requested;
(9) primary role of the
unit;
(10) type of dispatch
delay;
(11) type of response
delay;
(12) type of scene delay;
(13) type of transport
delay;
(14) type of turn-around
delay;
(15) EMS unit call sign
(radio number);
(16) response mode to
scene;
(17) complaint reported
by dispatch;
(18) EMD performed;
(19) crew member role;
(20) crew member level;
(21) PSAP call date/time;
(22) dispatch notified
date/time;
(23) unit notified by
dispatch date/time;
(24) unit en route
date/time;
(25) unit arrived on
scene date/time;
(26) arrived at patient
date/time;
(27) unit left scene
date/time;
(28) patient arrived at
destination date/time;
(29) unit back in service
date/time;
(30) unit back at home
location date/time;
(31) patient’s last name;
(32) patient’s first
name;
(33) patient’s home zip
code;
(34) patient’s home
country;
(35) patient’s social
security number;
(36) patient’s gender;
(37) patient’s race;
(38) patient’s ethnicity;
(39) patient’s age;
(40) patient’s age units;
(41) patient’s date of
birth;
(42) patient’s primary
method of payment;
(43) patient’s insurance
company ID/name;
(44) CMS service level;
(45) condition code number;
(46) number of patients
at scene;
(47) mass casualty
incident;
(48) incident location
type;
(49) scene GPS location;
(50) incident address;
(51) incident city;
(52) incident county;
(53) incident state;
(54) prior aid;
(55) person who performed
prior aid;
(56) outcome of the prior
aid;
(57) possible injury;
(58) patient’s chief
complaint;
(59) chief complaint
anatomic location;
(60) chief complaint
organ system;
(61) primary symptom;
(62) other associated
symptoms;
(63) provider’s primary
impression;
(64) provider’s secondary
impression;
(65) cause of injury;
(66) whether injury was
caused intentionally;
(67) mechanism of injury;
(68) use of occupant
safety equipment;
(69) airbag deployment;
(70) height of fall;
(71) cardiac arrest;
(72) cardiac arrest
etiology;
(73) resuscitation
attempted;
(74) barriers to patient
care;
(75) alcohol/drug use
indicators;
(76) run report
narrative;
(77) total Glasgow coma
score;
(78) medication given;
(79) medication
complication;
(80) procedure;
(81) number of procedure
attempts;
(82) procedure
successful;
(83) procedure
complication;
(84) destination/transferred to, name;
(85)
destination/transferred to, code;
(86) destination zip
code;
(87) incident/patient
disposition;
(88) transport mode from
scene;
(89) reason for choosing
destination;
(90) type of destination;
(91) emergency department
disposition;
(92) hospital
disposition.
E. Updates. An EMS agency shall maintain current operational information by providing regular updates to the bureau through the EMS reporting software and the application and renewal process. Review of completed patient care reports may be required during initial and subsequent inspections.
F. Location of records. An EMS agency shall maintain
all required records at the agency’s principal place of business within the
state of New Mexico. All required
records are subject to inspection by the bureau and shall be maintained so that
they are reasonably accessible. The EMS
bureau may, upon a showing of good cause, allow an EMS agency to maintain
required records at a location outside the state of New Mexico, provided that
the EMS agency demonstrates to the satisfaction of the EMS bureau that the
records will be reasonably accessible for the bureau’s inspection.
G. Completed patient care records. An EMS agency that transports a patient
shall, upon delivery of the patient to the hospital, deliver a copy of the
completed pre-hospital patient care record to the receiving facility’s
emergency department for inclusion in the patient's permanent medical
record. In the event that the
transporting unit is dispatched on another call before the pre-hospital patient
care record can be transmitted, the pre-hospital patient care record shall be
delivered to the receiving hospital’s emergency department no later than
forty-eight hours after the transportation and treatment of the patient.
H. Current records requirements.
(1) Current records for all EMS agencies. An EMS agency shall at all times maintain
current copies of the following records:
(a)
medical protocols signed by the EMS agency’s medical director;
(b) operation plans and standard operating
procedures and guidelines for the EMS agency;
(c)
rosters of EMS agency personnel;
(d)
applications of EMS agency employees and other personnel;
(e)
copies of certification and licensure documentation for all EMS agency
personnel;
(f)
HIPAA documentation for all EMS agency personnel;
(g)
service area maps with global positioning system (GPS) coordinates of
EMS agency stations;
(h)
board of pharmacy clinic license and pharmacy license, if applicable;
(i)
federal drug enforcement administration (DEA) license, if applicable;
(j)
driver’s license and driver certification copies for each employee /
volunteer; and
(k)
infection control policy.
(2) Additional current records for all medical rescue agencies. Additionally, a medical rescue agency shall
at all times maintain a current, valid copy of the title for each vehicle owned
by the medical rescue agency.
(3) Additional current records for all emergency medical dispatch agencies. Additionally, an emergency medical dispatch
agency shall at all times maintain current copies of the following documents:
(a)
training records (rosters, course outlines, etc.);
(b)
E-911 updates street mapping / maps; and
(c)
a public safety answering points (PSAP) directory.
I. Other records required (extended retention).
(1) Medical records. An EMS
agency other than special event EMS shall retain all adult medical records
(including patient care reports) for at least ten years. An EMS agency other than special event EMS
shall retain all medical records of minors (including patient care reports) for
at least ten years, or at least one year after the person reaches the age of
majority, whichever period of time is greater.
(2) Other records. An EMS agency
shall retain the following records for a period of not less than seven years:
(a)
a copy of the EMS agency’s application for certification from the EMS
bureau;
(b)
certificate of insurance for the EMS agency;
(c)
business license and incorporation documents for the EMS agency, as
applicable, or documentation verifying the EMS agency’s status as a
governmental entity;
(d)
all current and expired mutual aid agreements and memoranda of agreement
entered into by the EMS agency;
(e)
medical director contract or professional agreement;
(f)
criminal background check documentation for EMS agency personnel, as
applicable;
(g)
copies of EMS agency certification updates; and
(h)
quality assurance documentation.
(3) Additional
medical rescue agency records.
Additionally, a medical rescue agency shall retain the following records
for a period of not less than seven years:
(a)
vehicle maintenance records;
(b) annual safety inspection certificates for
each vehicle operated by the EMS agency; and
(c)
consultant pharmacist contract or professional agreement.
(4) Additional emergency medical dispatch agency records. Additionally, an emergency medical dispatch
agency shall retain the following records for a period of not less than seven
years:
(a)
telephone and radio audio recordings, including magnetic tapes and
digital file format recordings (DAT, CD, DVD, etc.);
(b)
911 system and call records (printed output, electronic files, etc.);
(c)
CAD files; and
(d)
hand-written (manual) reports.
J. Extension
of retention period; contingencies.
If at the end of a stated retention period an EMS agency is involved in
or is aware of pending legal obligations (contractual or otherwise), litigation,
administrative action, governmental investigation, insurance claims, or court
orders that relate in whole or in part to a required record, the EMS agency
shall continue to retain the required record for at least six months after said
contingency has been resolved or concluded.
K. Protection of records. An EMS agency shall take reasonable precautions to protect required records from destruction and damage. If an EMS agency’s required records are destroyed or damaged prior to the end of the retention period established in this rule, the EMS agency shall immediately notify the bureau.
[7.27.10.12 NMAC - N, 3/15/2010]
7.27.10.13 EMERGENCY INFORMATION REQUIRED: When
applying for initial certification or renewal of certification, an EMS agency
shall provide to the bureau emergency contact information for the EMS
agency. This information shall be used
by the bureau to provide effective communications and resource management in
the event of a statewide or localized disaster or emergency situation.
[7.27.10.13 NMAC - N, 3/15/2010]
7.27.10.14 GENERAL STANDARDS:
A. Personnel licensure required. An
EMS agency shall ensure that EMS providers at all times maintain current EMS
licensure in accordance with 7.27.2 NMAC (“Licensing of Emergency Medical Services
Personnel”).
B. Scopes of practice. An EMS agency providing
emergency medical services shall ensure that EMS providers comply with the
current EMS scopes of practice in accordance with 7.27.2 NMAC (“Licensing of
Emergency Medical Services Personnel”).
C. Other required personnel for emergency medical services. An
EMS agency shall designate an EMS medical director, a designated training
coordinator, and a service director, as provided below:
(1) training coordinator: each
EMS agency shall designate a training coordinator, who shall coordinate the
availability of appropriate training programs and continuing education for EMS
providers;
(2) medical direction required:
each EMS agency shall retain a medical director, who shall provide
medical direction to the agency that is consistent with the requirements of
7.27.3 NMAC (“Medical Direction for Emergency Medical Services”);
(3) service director: each EMS
agency shall designate a service director who shall serve as the single point
of contact for the EMS agency, who shall provide operational oversight for the
entire EMS agency; the EMS agency’s service director shall be responsible for
the EMS agency’s adherence to the standards of this rule.
D. Pharmaceutical license.
An EMS agency shall
comply with NM board of pharmacy requirements regarding all medications
utilized and stored, including oxygen.
An EMS agency shall maintain and display copies of its federal drug
enforcement administration license, NM board of pharmacy clinic license, and NM
board of pharmacy license in plain sight at its primary business location.
E. Proof of financial responsibility. An
EMS agency shall maintain at a minimum both vehicle and general liability insurance,
either through self-indemnity or an insurance company. Proof of insurance shall be filed with the
bureau, along with the application for EMS agency certification as required by
this rule. At any time that said
insurance is required to be renewed, proof of renewal shall be submitted to the
bureau.
F. Communications. An EMS agency shall maintain
EMS communication capabilities sufficient to ensure interoperability and
interconnectivity with dispatch centers, hospitals and other EMS and rescue providers.
G. Quality assurance review.
An EMS agency shall
implement a quality assurance program, which shall be planned, developed and
implemented by the EMS agency’s medical director in a manner consistent with
7.27.3 NMAC (“Medical Direction for Emergency Medical Services”). The quality assurance program shall include
review of documentation of patient care in a pre-determined set of
circumstances to ensure a feedback and training loop for the EMS providers.
H. Personnel
hours and safety. An EMS agency
shall adopt rules consistent with applicable federal employment standards
(e.g., Fair Labor Standards Act (FLSA), 29 USC Section 201 et seq., Occupational Safety and Health Act (OSHA), 29 USC Section
651 et seq.).
I. Internships. An EMS agency may provide clinical internships only through a bureau-approved or CoAEMSP accredited EMS training program.
[7.27.10.14 NMAC - N, 3/15/2010]
7.27.10.15 DUTY TO PROVIDE SERVICE:
A. An EMS
agency and any of its personnel or agents shall provide service to a person in
need of emergency medical treatment or transportation.
B. An EMS
agency shall, in accordance with the EMS agency’s level of care, transport a
patient requiring medical treatment and transport to the closest appropriate
facility capable of providing appropriate care and treatment, as determined by
the EMS agency’s medical director.
C. An EMS
agency shall give priority to emergency response calls.
D. An EMS
agency shall be available 24 hours a day, 365 days a year unless the provision
of services is otherwise addressed within mutual aid agreements or a memorandum
of understanding. Certified special
event EMS agencies may address the provision of duty hours based upon the EMS
agency’s contracts or agreements.
[7.27.10.15 NMAC - N, 3/15/2010]
7.27.10.16 MEDICAL RESCUE AGENCIES:
A. General requirements for all medical rescue agencies:
(1) Certification required. A
medical rescue agency shall not provide treatment to any patient, nor shall a
transport medical rescue agency transport any patient, unless the medical
rescue agency holds a valid certificate in accordance with this rule.
(2) Level of service. Any medical rescue agency that represents itself
as providing any EMS level of service shall make that level of service
available.
(3) Fees prohibited. Medical
rescue agencies shall not charge a fee to the patient. Nothing in this rule
shall be construed to prevent a medical rescue agency from negotiating
reimbursement agreements.
(4) Hygiene and cleanliness.
Medical rescue agencies shall maintain clean and hygienic work
environments, and shall adopt and implement reasonable infection control practices
to prevent the spread of communicable diseases.
Medical rescue agencies shall properly maintain and dispose of all
biohazard material.
(5) Medical rescue emergency motor vehicles. Medical rescue emergency motor vehicles shall
provide safe and adequate service, and shall utilize equipment, supplies and
facilities that are safe and adequate for the provision of emergency medical
services and otherwise consistent with the requirements of this rule. Motor vehicles shall be safe, dependable and
suitable for the services rendered. Each
motor vehicle shall be maintained in good mechanical and operating
condition. The bureau may remove from
operation any medical rescue agency vehicle that the bureau determines to be
either not road worthy or not response worthy.
Transport-capable medical rescue vehicles shall be equipped with a
heating, cooling and ventilation system capable of providing a reasonable level
of comfort inside the motor vehicle.
(6) Documentation. EMS agencies
certified under this rule shall annually submit to the bureau a certificate of
safety for each of their medical rescue vehicles, to include the date, name,
contact telephone number and location of the certified mechanic performing the
inspection.
(7) Drivers. Any person who
regularly drives a certified medical rescue (transport or non-transport)
vehicle shall:
(a)
be at least 18 years of age;
(b)
hold a valid New Mexico driver’s license or equivalent out-of-state
driver's license, equivalent to a class “D” or higher;
(c)
be in compliance with bureau requirements for an emergency vehicle
operator’s course;
(d)
not have received a driving while intoxicated, driving under the
influence, or reckless driving conviction within the past year;
(e)
not be prohibited by law from driving without a breath alcohol ignition
interlock device;
(f)
not be prohibited by law from operating a motor vehicle for any other
reason;
(g)
annually provide to their EMS agency a copy of the person’s motor
vehicle driving record; the medical rescue agency shall validate and submit to
the bureau a list of all drivers authorized by the agency together with the
agency’s annual report; all driver infractions resulting in the loss or
potential loss of driving privileges shall be reported to the bureau.
(8) Safety belts. Safety belts
shall be utilized by all persons in the forward compartment of emergency motor
vehicles. Attending personnel shall wear
seat belts when feasible. Safety belts
or other safety restraining devices shall be available for patients being
transported, and shall be utilized for patients at all times during patient
transport, unless extenuating circumstances prevent their usage.
(9) Child restraint systems.
Attending personnel shall utilize child restraint systems when feasible
and necessary. Child restraint systems
shall satisfy all federal and state requirements when in use.
(10) Minimum personnel requirements.
All medical rescue agencies (transport and non-transport) shall maintain
the following minimum personnel requirements during patient treatment and
transportation:
(a)
a minimum of one New Mexico licensed EMS provider shall be present at
the scene of an emergency;
(b)
for transport of a patient, a minimum of one qualified New
Mexico-licensed EMS provider shall be present in the patient compartment of the
medical rescue vehicle at all times while the compartment is occupied by a
patient;
(c)
healthcare personnel not licensed as an EMS provider may accompany and
monitor a patient in the patient compartment of a medical rescue vehicle,
provided that at least one qualified New Mexico-licensed EMS provider is also
present in the patient compartment, subject to the policies of the EMS agency.
(11) Mutual aid. All medical
rescue agencies (transport and non-transport) shall develop mutual aid plans
with appropriate EMS agencies and PRC regulated ambulance services. A medical rescue agency may provide mutual
aid to another EMS agency pursuant to a mutual aid agreement only in the event
that the other agency cannot respond to a call for service, and only in the
following circumstances:
(a)
in mass casualty or disaster situations, when requested by state or
local authorities in accordance with established local emergency plans;
(b)
when requested by another EMS agency or a licensed EMS provider during
an emergency and in accordance with established mutual aid agreements;
(c)
when requested by a law enforcement agency or officer; or
(d)
in a non-emergency, when the responsible local provider’s resources are
exhausted, pursuant to arrangements made by the responsible local provider for
(and for the coordination of) such necessary mutual aid.
(12) Unauthorized persons. A
medical rescue agency shall not transport any person who is not a patient
(including but not limited to a hitchhiker), other than an on-duty employee of
the medical rescue agency, a person authorized by the medical rescue agency to
be transported, or a bureau representative on official business, unless the
person’s transport is necessitated by an emergency.
(13) Accident reports. Every
medical rescue agency shall report to the bureau every accident that occurs in
the course of the medical rescue agency’s operations within the state on either
public or private property that results in the death of a person, injury to a
person that requires treatment by a physician, or damage to property belonging
to either the medical rescue agency or any other person to an apparent extent
of two thousand five hundred dollars ($2,500.00) or more.
(a)
In the event that an EMS vehicle operated by a medical rescue agency is
involved in a collision that results in a person’s death, the medical rescue
agency shall, within twenty-four hours of learning of the person’s death,
submit a copy of the police report of the collision to the bureau.
(b)
Police reports of all other collisions involving an EMS vehicle operated
by a medical rescue agency shall be submitted to the bureau by the medical
rescue agency no later than fifteen days after the date of the collision.
(c)
If a medical rescue agency learns after submitting a police report to
the bureau that an individual who was involved in a collision involving an EMS
vehicle operated by the agency has died, the agency shall file an amended copy
of the police report with the bureau no later than fifteen days after learning
of the person’s death.
(d)
For the purposes of this section, a medical rescue agency that has
submitted a uniform accident report of the collision to the motor vehicle
division of the New Mexico taxation and revenue department may submit a copy of
that report to the bureau instead of a police report; provided that the
deadline for the submission to the bureau of a uniform accident report shall be
the same as the deadline for the submission of a police report.
B. Additional requirements for transport medical rescue agencies. Transport medical rescue agencies shall meet the following requirements in order to be certified by the bureau.
(1) All transport medical
rescue vehicles shall carry appropriate supplies and equipment, including the
minimum required equipment identified in this rule.
(2) Patient transport is
allowed in two distinct situations:
(a)
saving of life or limb: when a
transport medical rescue agency is dispatched without the intent to transport,
but transports patient(s) due to life or limb-saving necessity;
(b)
system demand: a transport
medical rescue agency may transport a patient when there is no ambulance
service available, or may intercept with any air or ground ambulance service
when it is beneficial for the patient.
(3) All transport medical
rescue agencies shall additionally maintain the following agreements and
protocols:
(a)
a fully executed written agreement between the public regulation
commission-certificated ambulance service serving the area and the transport
medical rescue agency that describes the transport protocol to be followed;
(b)
a written medical protocol that clearly specifies situations when
transport is allowed and has been approved by the transport rescue agency
medical director.
[7.27.10.16 NMAC - N, 3/15/2010]
7.27.10.17 MINIMUM REQUIRED EQUIPMENT FOR
NON-TRANSPORT MEDICAL RESCUE VEHICLES: All non-transport medical
rescue agencies shall stock and equip non-transport medical rescue vehicles
with the following minimum required equipment and supplies. Supplies shall be maintained in sufficient
quantities to assure the safe and adequate provision of emergency medical
services in response to one or multiple incidents.
A. Forward compartment:
(1) vehicle registration;
(2) U.
S. department of transportation emergency response guidebook (most current
edition);
(3) maps or navigational equipment;
(4) service specific protocols and resource
guides;
(5) patient care reports or reporting system;
(6) hand sanitizer;
(7) flashlight (battery powered, hand crank, with mounted battery charging system);
(8) fire extinguisher (ten pounds, ABC type or functional
equivalent, charged);
(9) spotlight or auxiliary lighting system;
(10) roadway warning devices (safety flares, emergency lights, safety
cones);
(11) vehicle jack;
(12) spare tire; and
(13) tire wrench.
B. Communications equipment:
(1) radio communications (portable or
affixed);
(2) equipment sufficient to establish and
maintain direct or repeated communications with area dispatch and secondary
providers; and
(3) N.M. EMSCOM radio system capable of
cellular and text/data transmissions (optional), spare batteries / charger system.
C. Personal protective equipment (PPE):
(1) EMS turnout gear;
(2) helmets with face shield;
(3) gloves (work gloves or leather gloves);
(4) eye protection (glasses or goggles);
(5) hearing protection;
(6) safety vest / jacket (ANSI 2008 compliant;
break-away, reflective, high
visibility coloration);
(7) exam gloves (assorted sizes);
(8) disposable splash protection (gowns, scrubs, eye shielding, etc.);
(9) tyvex coveralls (optional); and
(10) N-95 mask (or a mask better than a
particulate mask).
D. Diagnostic equipment:
(1) aneroid sphygmomanometer, blood pressure cuffs (with infant, pediatric, adult, and obese sizes);
(2) stethoscope (more than one);
(3) glucose monitoring instrument (portable);
(4) pulse oximeter (portable);
(5) end-tidal CO2 monitoring device (disposable, colormetric);
(6) penlights; and
(7) shears (trauma or equivalent).
E. Cardiac equipment:
(1) semi-auto external defibrillator;
(2) defibrillator pads (extra); and
(3) defibrillator batteries (extra).
F. Bandages/dressings:
(1) triangular bandages;
(2) universal dressings (approximately ten inches by thirty inches);
(3) gauze pads (four inches by four inches);
(4) bandages - soft roller (self-adhering);
(5) bandages - elastic (band aids, assorted sizes);
(6) occlusive dressings (sterile, individually wrapped);
(7) adhesive tape (various sizes: one inch, two inch, duct
tape ('medical' - white);
(8) cold packs;
(9) heat packs; and
(10) burn sheets.
G. Respiratory equipment:
(1) mounted electric or manifold operation
suction aspirator (that meets GSA standard);
(2) portable suction aspirator (as approved by the bureau);
(3) sterile suction catheters and tubing
(rigid and soft, if applicable; assorted
sizes);
(4) bag-valve-mask resuscitator (BVM) (disposable, with transparent adult mask);
the BVM shall be capable of operation in cold weather, shall be capable of use
with an oxygen supply and shall be capable of delivering approximately 100%
oxygen;
(5) pediatric bag-valve-mask resuscitator (disposable,
with transparent child and infant mask); the pediatric BVM shall be capable of
operation in cold weather, shall be capable of use with an oxygen supply, and
shall be capable of delivering 100% oxygen;
(6) adult oxygen masks with reservoir
(non-rebreather or partial non-rebreather);
(7) adult oxygen masks (simple);
(8) pediatric oxygen masks with reservoir
(non-rebreather or partial non-rebreather);
(9) pediatric oxygen masks (simple);
(10) nasal cannulas;
(11) oxygen supply tubing;
(12) oropharyngeal airways (with adult, child and infant sizes);
(13) nasopharyngeal airways (with adult, child and infant sizes);
(14) laryngeal, supraglottic, multi-lumen or
laryngeal airway devices (device
not intended to be placed into the trachea);
(15) oxygen: fixed system (minimum of two
wall-mounted oxygen outlets and one flow meter); system shall include a
yoke-type pressure reducer gauge and an approved cylinder retaining device that
meets DOT standards; the system shall be capable of delivering an oxygen flow
of at least 15 liters per minute; if oxygen source is of a size less than “M”
cylinder, an additional full spare cylinder for the fixed system shall be
carried in the ambulance; and
(16) oxygen: two portable cylinders; each unit
shall consist of at least a “D” cylinder or equivalent, yoke, pressure gauge,
flowmeter and cylinder wrench; the unit shall be capable of delivering an
oxygen flow of at least 15 liters per minute; cylinder holders with a quick-release
fitting shall be furnished to allow the use of the portable unit outside the
vehicle.
[7.27.10.17 NMAC - N, 3/15/2010]
7.27.10.18 MINIMUM REQUIRED EQUIPMENT FOR
TRANSPORT MEDICAL RESCUE VEHICLES: All transport medical rescue
agencies shall stock and equip transport medical rescue vehicles with the
minimum equipment and supplies required in this rule to be stocked in
non-transport medical rescue vehicles by non-transport medical rescue
agencies. Additionally, all transport
medical rescue agencies shall stock and equip transport medical rescue vehicles
with the following minimum equipment and supplies. Supplies shall be maintained in sufficient
quantities to assure the safe and adequate provision of emergency medical
services in response to one or multiple incidents.
A. Patient compartment:
(1) multi-level stretcher (may be power assisted, two-person);
(2) shoulder / chest and lower
extremity straps (capable of securing adult and pediatric patients);
(3) pillow (disposable, with a vinyl cover or a rolled blanket);
(4) blankets;
(5) stretcher pad (bed) covers (e.g., sheets);
(6) patient restraints (two ankle and two wrist, leather or nylon);
(7) sharps container;
(8) emesis basins (emesis bags or equivalent); and
(9) body bags.
B. Pharmocological equipment for first response through ALS:
(1) appropriate
medications with the contents established and approved by the service medical
director, within applicable N.M. scopes of practice, with a list of contents
and earliest expiration dates affixed to the outside of the kit; drug kits must
be maintained in a temperate, controlled environment and shall not be left
unsecured; and
(2) mark I plus kit.
C. Pediatrics:
(1) pediatric restraint system or car seat (may be a fold-down jumpseat with a child
restraint system);
(2) obstetrical kit (sterile package), to
include at a minimum: a receiving blanket, a sterile bulb aspirator, a wrapped
sanitary napkin, a sterile pair of scissors or scalpel blade, four-inch gauze
pads, one pair of sterile gloves, two cord clamps and a plastic bag for
placenta; all items shall be kept in a container with an identifying label that
specifies the contents;
(3) foil blanket; and
(4) pediatric drug dosage tape or chart.
D. Intravenous therapy:
(1) intravenous solution (normal saline) (1000 ml);
(2) intravenous catheters (various sizes);
(3) intraosseous needles;
(4) tubing/infusion kits;
(5) pediatric fluid volume control device
(i.e., burretrol or volutrol); and
(6) arm boards (for pediatrics).
E. Immobilization devices:
(1) extremity immobilization devices (two full arms and two full legs, or equivalent);
(2) short spinal extrication device (KED or equivalent), infant or pediatric
immobilization; equipment shall be identified for the safe transport of infant
/ pediatric patients, as approved by the EMS agency’s medical director with
guidelines and operating procedures provided by the agency / department;
(3) pediatric immobilization device (as approved by the department); equipment
shall be identified for the safe transport of infant / pediatric patients, as
approved by the EMS agency’s medical director with guidelines and operating
procedures provided by the agency / department;
(4) spine boards (long; at least 16" wide by 72" in
length with a minimum of three straps);
(5) lateral cervical immobilization devices (commercial devices, foam blocks, blanket
rolls);
(6) cervical immobilization collars (hard type, minimum two adult, two medium, two
child); and
(7) traction splint (lower extremity, adjustable).
F. Rescue/extrication equipment:
(1) tarp or blankets;
(2) seatbelt cutter or trauma
shears;
(3) spring loaded center punch / window punch;
(4) rescue ax or halligan tool;
(5) flathead screwdriver (minimum six inches);
(6) three-pound hammer;
(7) hacksaw with extra bimetal-type
blades;
(8) duct tape;
(9) one ton “come-a-long” winch;
(10) rescue-rated chains or straps (minimum of
two);
(11) hydraulic spreader / cutter / ram
(combi-tool);
(12) air chisel-air cylinder, regulator, air
hose (optional);
(13) air bags-air cylinder, regulator, air hose
(optional);
(14) winch with recovery straps and
blocking equipment; and
(15) stabilization equipment (cribbing,
blocks, struts).
[7.27.10.18 NMAC - N, 3/15/2010]
7.27.10.19 SPECIAL EVENT EMS:
A. Certification
required. A special event EMS agency shall not provide
medical treatment or transport to any patient unless the special event EMS
agency holds a valid certificate in accordance with this rule. A special event EMS agency shall not charge a
fee to the patient for services provided.
Nothing in this rule shall be construed to prevent a special event EMS
agency from negotiating reimbursement agreements.
B. Minimum personnel requirements. The exact number and licensure of New Mexico-licensed EMS personnel to
be utilized at any event shall be established and approved by the special event
EMS agency and the agency’s medical director, based on estimated attendance,
geography, venue and environmental factors for each event. At a minimum, one medical team consisting of
two New Mexico-licensed EMS personnel equipped with a defibrillator shall be
provided for every 5,000 participants and spectators. EMS providers assigned to a patient transport
unit shall not be included in the staffing levels required at an event.
C. Level of service. The
highest level of care that may be practiced under the licensure of special
event EMS providers shall determine the level of service provided by a medical
team.
D. Special event EMS agency transport. Special event EMS may be provided by an EMS agency irrespective of whether the EMS agency is transport capable. If an EMS agency that provides special event EMS is not transport capable, transport shall be provided by a public regulation commission-certificated ambulance service for the territory where the event takes place. Medical rescue agencies performing special event EMS shall follow the appropriate section in this rule.
E. Minimum supplies, equipment,
medications and kits required. All special event EMS agencies shall have
available and utilize supplies and equipment appropriate to the level of
service to be provided, per the direction of the EMS agency’s service director
and medical director. At a minimum, a
medical team shall be equipped with a defibrillator and trauma and airway supplies.
[7.27.10.19 NMAC - N, 3/15/2010]
7.27.10.20 EMERGENCY MEDICAL DISPATCH:
A. Certification required. An emergency medical dispatch
agency shall not operate within the state of New Mexico, nor dispatch calls
within or from the state of New Mexico, nor represent itself to be an emergency
medical dispatch agency operating in the state of New Mexico or dispatching
calls within or from the state of New Mexico, unless the emergency medical
dispatch agency holds a valid certificate in accordance with this rule.
B. Minimum requirements for medical dispatch agencies. A certified medical dispatch agency shall
utilize an emergency medical dispatch priority reference system that is
published by a bureau-approved source and that is used by licensed emergency medical
dispatchers. A medical dispatch agency
shall utilize only licensed EMDs for emergency medical dispatch.
C. Exceptions for medical
dispatch agencies. In the event of a large scale emergency or
mass casualty incident, emergency
medical dispatch agencies may suspend emergency medical dispatch for the
duration of the incident to accommodate the unusual increase in call volume.
D. Emergency medical dispatch agency performance and certification. A medical dispatch agency shall be operated in a safe, efficient, and effective manner in accordance with this rule, and shall further comply with the following minimum standards:
(1) an emergency medical dispatch agency shall, in accordance with any applicable requirements of this rule, implement and ensure that the agency’s medical director reviews, approves, and oversees:
(a) an emergency medical dispatch priority reference system;
(b) an emergency medical dispatch training program;
(c) a quality assurance program;
(d) an emergency medical dispatch oversight committee; and
(e) an emergency medical dispatch continuing education program;
(2) any emergency medical dispatch priority reference system, including but not limited to its questions, instructions, codes, and protocols, shall be utilized in its entirety, rather than in limited parts;
(3) an emergency medical dispatch agency shall ensure that emergency medical dispatchers follow the questions and decision-making processes (flowcharts) within their emergency medical dispatch priority reference system in compliance with the written policies and procedures of their emergency medical dispatch agency, and as approved by the agency’s medical director;
(4) an emergency medical dispatch agency shall use a bureau-approved emergency medical dispatch priority reference system on every request for medical assistance;
(5) an emergency medical dispatch agency shall ensure that each emergency medical dispatcher provides dispatch life support (including but not limited to pre-arrival instructions) in compliance with the written text or scripts and other processes within the approved emergency medical dispatch priority reference system;
(6) an emergency medical dispatch agency shall maintain and utilize policies and procedures for the safe and effective use of the agency’s approved emergency medical dispatch priority reference system;
(7) an emergency medical dispatch agency shall ensure that emergency medical dispatchers maintain valid licensure in accordance with 7.27.2 NMAC (“Licensing of Emergency Medical Services Personnel”);
(8) an emergency medical dispatch agency shall set minimum training requirements that meet state standards for emergency medical dispatcher certification;
(9) an emergency medical dispatch agency shall, with the written approval and supervision of the agency’s medical director and with the input of the agency’s emergency medical dispatch oversight committee, establish a continuous quality assurance program that measures various areas of compliance with the emergency medical dispatch priority reference system;
(10) an emergency medical dispatch agency shall maintain and utilize the most current version of the bureau-approved emergency medical dispatch priority reference system selected for use by the emergency medical dispatch agency within six months of its publication; the most current version of the priority reference system shall also be approved in writing by the emergency medical dispatch medical director;
(11) an emergency medical dispatch agency’s emergency medical dispatch oversight committee shall:
(a) establish local medical standards for dispatch procedures to assure the appropriate EMS response units are dispatched to the medical emergency scene;
(b) develop a relevant emergency medical dispatch system;
(c) develop relevant local standing orders and protocol as needed;
(d) establish and monitor training standards for initial and continuing education; and
(e) plan, develop and implement the EMS agency’s quality assurance program.
E. Pre-approved EMD priority reference systems. The bureau shall identify pre-approved standardized emergency medical dispatch priority reference systems for selection and use by local emergency medical dispatch agencies.
[7.27.10.20 NMAC - N, 3/15/2010]
7.27.10.21 APPLICATION FOR CERTIFICATION:
A. Application. An EMS agency shall apply for
certification using an approved application form, and shall provide completed
and legible responses to every applicable element of the application form.
B. Application form. Applications for certification shall include at a minimum the following elements:
(1) name and contact
information of the applicant EMS agency, including at a minimum the EMS
agency’s mailing and physical addresses, primary telephone number, facsimile
number, and e-mail address;
(2) name and contact
information of the applicant EMS agency’s medical director, including at a
minimum the medical director’s mailing address, primary telephone number,
facsimile number, and e-mail address;
(3) name and contact
information of the director or chief/chief or individual primarily responsible
for the operation of the applicant EMS agency, including at a minimum the
person’s mailing address, primary telephone number, facsimile number, and
e-mail address;
(4) name and contact
information of the applicant EMS agency’s dispatch center, including at a
minimum the dispatch center’s mailing address, primary telephone number,
facsimile number, and e-mail address;
(5) name and contact
information of the applicant EMS agency’s insurance carrier, including at a
minimum the insurance carrier’s mailing address, primary telephone number,
facsimile number, and e-mail address;
(6) the county in which
the applicant EMS agency wishes to be certified, and the number of medical
rescue units operated by the applicant EMS agency; and
(7) a notarized
attestation by the individual who submits the application that certifies that
the information provided in the submitted application form is true and correct
to the best of the individual’s knowledge.
[7.27.10.21 NMAC - N, 3/15/2010]
7.27.10.22 CERTIFICATION PROCESS:
A. Temporary certification. The bureau may issue a temporary certification to an EMS agency for a period not to exceed three continuous months upon submission of a fully completed initial certification application and payment of appropriate fees. The bureau may in its sole discretion grant a temporary certification to an EMS agency in order to:
(1) allow the EMS agency
to begin or continue operations while awaiting full certification;
(2) provide the EMS
agency additional time to submit information requested by the bureau;
(3) provide the EMS
agency additional time to meet other certification standards; or
(4) provide the EMS
agency time to appeal an initial determination or denial of certification.
B. Full certification. To become fully certified, an
EMS agency shall:
(1) comply with applicable
federal, state, and local laws regarding the operation of a business in the
state of New Mexico or the counties or municipalities thereof;
(2) if the agency is an
out-of-state EMS agency, submit to the bureau a copy of a bureau-approved
accreditation certificate;
(3) complete an initial
or renewal certification application and submit it to the bureau along with the
required application fee;
(4) submit to any
inspections that may be conducted by the bureau;
(5) comply with all
applicable federal and state regulatory requirements, including but not limited
to insurance requirements, state board of pharmacy permitting requirements ,
and drug enforcement administration permitting requirements;
(6) verify the driving
records of the EMS agency personnel;
(7) conduct criminal
background checks of the EMS agency personnel, if requested by the bureau;
(8) furnish insurance
documentation as required in this rule;
(9) if the EMS agency is an emergency medical
dispatch agency, provide documentation that the agency is using the most
current version of its bureau-approved EMDPRS by submitting the name, version
number, and date of last revision of the EMDPRS used by the dispatch agency;
and
(10) satisfy all other certification
requirements applicable under this rule.
C. Renewal of certification. An EMS
agency shall submit a certification renewal package to the bureau at least
thirty calendar days prior to the expiration of the EMS agency’s certification.
(1) To obtain renewal
certification, an EMS agency shall:
(a) submit to the bureau
a completed renewal certification application form;
(b)
submit to the bureau the applicable certification fee;
(c)
comply with all applicable federal and state regulatory requirements,
including but not limited to insurance requirements, state board of pharmacy
permitting requirements, and drug enforcement administration permitting
requirements;
(d)
if the agency is an out-of-state EMS agency, submit to the bureau a copy
of a bureau-approved accreditation certificate;
(e)
comply with all other
certification requirements applicable under this rule.
D. Determinations regarding certification renewal. The
bureau shall review a certification renewal application in the order in which
it is received, provided that the application is complete and is submitted by
the EMS agency in a timely manner.
(1) If there is a delay
by the bureau in notifying an EMS agency of whether the agency’s certification
renewal application is approved or denied, and if that delay extends beyond the
expiration date of the EMS agency’s existing certification, that certification
shall continue in effect beyond its expiration date until either:
(a)
the bureau issues a written notice to the EMS agency stating that the
renewal certification application has been denied; or
(b)
the bureau issues a renewed certificate to the EMS agency.
(2) If an EMS agency’s
renewal packet is incomplete, the department shall notify the EMS agency in
writing.
E. Certification updates. An EMS agency shall provide updates to the bureau of any organizational
changes in the following areas within thirty days of said change:
(1) changes in management
structure;
(2) changes in the EMS
agency’s medical direction;
(3) additions to or
removals from the EMS agency’s service vehicle fleet;
(4) changes of address
for the EMS agency and changes in EMS agency contact information;
(5) any change that
impacts the EMS agency’s certification status.
F. Change of ownership. Any change of an EMS agency’s
ownership shall require the EMS agency to reapply with the bureau for
certification, which shall require the EMS agency’s submission of of any fees associated
with a new certification application.
The sale or exchange of fifty percent (50%) or more of the total
outstanding stock of a corporation shall be deemed a change of ownership for
purposes of this rule.
G. Issuance of EMS agency certificate. Upon the bureau’s approval of an EMS agency’s application for certification, the bureau shall provide the EMS agency with a certificate that authorizes the EMS agency to operate in New Mexico. The EMS agency shall prominently display the certificate at the EMS agency’s primary business location so that it is in full public view at all times.
H. Identification of vehicles. The bureau shall provide certification decals to the EMS agency for each of the EMS agency’s vehicles, which the EMS agency shall prominently display on the vehicle(s) so that the decals are in plain sight at all times.
I. Transfer of certificate or decal prohibited. An
EMS agency shall not assign, sell or otherwise transfer a bureau-issued
certificate, decal or other symbol that signifies the EMS agency’s
certification to any other person or entity.
J. Reciprocal certification. An
out-of-state EMS agency that holds a valid accreditation from the commission on
accreditation of ambulance services (CAAS), the commission on accreditation of
medical transport systems (CAMTS), the national EMD standard setting
certification organization (NESSCO), or another organization approved by the
bureau as having equivalent expertise and competency in the accreditation of
EMS agencies, shall be deemed to meet the standards for EMS agency
certification in the state of New Mexico under this rule.
(1) The bureau shall
certify an out-of-state EMS agency that holds a bureau-approved accreditation
or certification following the review and approval of the certification
application, bureau verification of the EMS agency’s liability insurance
coverage, and payment of appropriate fees by the EMS agency.
(2) An accredited or
certified out-of-state EMS agency shall attach to its initial or renewal
certification application evidence of current accreditation. Accreditation of an out-of-state EMS agency
shall not preclude the bureau from conducting a certification inspection or from
requesting additional information from the agency to ensure compliance with
this rule.
K. Exemptions to certification requirements.
(1) Federal agencies and
entities, including but not limited to the United States department of defense,
shall be exempt from this rule.
(2) The New Mexico
department of military affairs shall be exempt from this rule.
(3) Tribal agencies and
organizations that provide EMS services entirely within the boundaries of
tribal lands shall be exempt from this rule.
(4) An EMS agency from
any state adjoining the state of New Mexico shall be exempt from this rule if
that agency responds into New Mexico to assist in a mass casualty or disaster
situation that exceeds the capacity or capability of the New Mexico EMS agency
in the affected area, or if that agency responds into New Mexico on a
non-routine basis for emergency mutual aid assistance when requested to do so
by the certified EMS agency whose service area includes areas along the mutual
state line. The out-of-state EMS agency
shall hold a valid certificate or authorization issued by the EMS regulatory
authority that has jurisdiction in the adjoining state where the agency is
located, and may provide emergency medical care, emergency medical
communication and transport commensurate with that existing authority.
(5) Ambulance services
regulated by the transportation division of the New Mexico public regulation
commission (see 18.3.14 NMAC) shall be exempt from this rule.
L. Inspections and audits. Inspections or audits of an EMS
agency shall be conducted and reviewed by the bureau or the bureau’s
agent(s). Only individuals who hold
valid NM emergency medical technician licensure shall be assigned to conduct an
investigation of an EMS agency on behalf of the bureau.
(1) The bureau may
conduct on-site inspections or audits of an EMS agency at any time, at the
bureau’s discretion.
(2) The bureau may
investigate and inspect the land, buildings, improvements to real property,
vehicles, equipment, records, or documents of an EMS agency as the bureau deems
necessary to determine an EMS agency’s compliance or non-compliance with this
rule.
(3) An EMS agency shall
provide the bureau complete access at all times to the land, buildings,
improvements to real property, vehicles, and equipment owned by or within the
control of the EMS agency.
(4) An EMS agency shall
allow the bureau at any time to freely inspect and copy all records and
documents in the agency’s possession.
(5) An EMS agency that
has been certified by the bureau shall submit ongoing annual reports that shall
be completed via a self-assessment method, and that shall affirm that the
agency meets all standards identified in this rule.
(6) Bureau investigations
or audits of an EMS agency may be conducted with or without notice.
(7) An EMS agency that
applies for certification from the bureau and that fails an initial inspection
may be subject to additional inspections by the bureau to determine whether the
EMS agency satisfies certification requirements in accordance with this rule. An EMS agency that fails an initial
inspection shall reimburse the bureau for each additional inspection made by
the bureau to determine the EMS agency’s compliance with certification
requirements, in an amount equivalent to the per diem and mileage rates
permitted for nonsalaried public officers in the NM Per Diem and Mileage Act,
NMSA 1978, Section 10-8-1 et seq. Per diem and mileage rates shall be assessed
to the EMS agency per each individual bureau employee or agent assigned to
inspect the EMS agency.
M. Changes of name and address. An
EMS agency shall notify the bureau of any change of the EMS agency’s name or
address no later than ten business days after said change is made.
[7.27.10.22 NMAC - N, 3/15/2010]
7.27.10.23 FEES:
A. Determination and assessment. The
bureau shall determine and assess fees for the certification of EMS
agencies. An agency shall register for
only one category of EMS certification, based upon its primary scope of
responsibility. However, an agency that
qualifies under more than one category of EMS certification shall pay the
greater of the applicable fees; for example, a fire department that has more
than three vehicles and that also has an in-house dispatch center shall pay the
fee applicable to an EMS agency.
B. Applicable fees.
(1) The following table
identifies the certification fees applicable to EMS agencies for both initial
and renewal certification. These fees
are non-refundable.
|
DESCRIPTION |
APPLICATION
FEE (INITIAL and RENEWAL) |
|
|
|
|
EMS
AGENCY (transport-capable medical rescue and non-transport medical rescue )
WITH: |
|
|
Up to 3 vehicles |
$100.00 |
|
4-10 vehicles |
$150.00 |
|
More than 11 vehicles |
$200.00 |
|
|
|
|
SPECIAL
EVENT EMS |
$100.00 |
|
|
|
|
EMERGENCY
MEDICAL DISPATCH |
$100.00 |
|
|
|
|
LATE
FEE (postmarked or hand-delivered after January 15) |
25% increase over the primary fee |
(2) An out-of-state EMS
agency that applies for certification (reciprocal or otherwise) under this rule
shall pay the same fee applicable to an in-state EMS agency.
(3) If an EMS agency adds
an additional vehicle to its fleet, and if that addition increases the fee
applicable to that agency, the increased fee shall not be assessed until the
time of the EMS agency’s next certification renewal.
(4) EMS agency vehicles
that have a gross vehicle weight rating (GVWR) of less than 5,000 pounds (motor
vehicles, utility carts, etc.) shall not be included among the total number of
EMS agency vehicles in assessing fees under this section.
(5) Privately owned
vehicles shall not be included among the total number of EMS agency vehicles in
assessing fees under this section.
C. Fee exemptions and reductions.
(1) Any EMS agency
seeking certification that can document that it will incur a financial hardship
in meeting the fee requirements of this rule may request a fee reduction from
the bureau, if either of the following criteria is met:
(a)
the service is entirely staffed by volunteer EMS providers; or
(b)
the total fees to be paid by the EMS agency pursuant to this rule
comprise more than 5% of the EMS agency’s annual EMS operational budget.
(2) The bureau may waive
or reduce certification fees at its sole discretion. Requested waivers shall be considered by the
bureau on a case by case basis.
D. Use
of fees. Certification fees
collected by the bureau under this rule shall be used expressly to improve the
EMS system.
E. Payment of fees. An EMS agency shall submit
payment for certification fees along with the agency’s application for
certification. The EMS agency shall
submit payment in a form approved by the bureau. An EMS agency’s certification application
shall not be processed unless and until full payment of the required fees is
made.
[7.27.10.23 NMAC - N, 3/15/2010]
7.27.10.24 ENFORCEMENT:
A. Complaint/incident procedures.
(1) Any person may
communicate a written complaint or knowledge of an incident concerning an EMS
agency or applicant to the bureau.
(2) Complaints shall be
submitted in signed, written form to the bureau as soon as practical.
(3) The bureau shall
notify in a timely manner an affected EMS agency or applicant that the bureau
is conducting an investigation, unless extenuating circumstances reasonably
preclude notification.
B. Investigations. Investigations shall be
conducted by the bureau or its agent(s).
The bureau shall issue to any person whom it designates as an inspector
or investigator credentials to evidence the person's authority that shall bear the
person's photograph. The bureau may
initiate an investigation if an inspection reveals, or if the bureau otherwise
becomes aware of, facts indicating a possible violation of this rule. Upon completion of the investigation, the
bureau may pursue further appropriate action.
(1) Preliminary investigations.
When the bureau receives information that might form the basis for
disciplinary action against an EMS agency or applicant, it may begin a
preliminary investigation. A preliminary
investigation is a fact-finding/information-gathering investigation that will
attempt to determine whether justification exists to initiate an action or to
conduct a formal investigation.
(2) Formal investigations. The
bureau may undertake a formal investigation for the purpose of obtaining
additional information to allow the bureau to determine whether to initiate an
action. The bureau shall notify the EMS
agency that is the subject of the formal investigation of the pendency of that
investigation, unless doing so could substantially impair the bureau’s
investigation, or unless other extenuating circumstances exist that would
reasonably preclude notification.
(3) Confidentiality. The bureau
shall take precautions to ensure that investigations are conducted in a
confidential manner.
(4) Records. An official record
shall be maintained for every EMS agency certified under this rule. If the bureau begins an investigation, a
separate confidential record shall be created containing all investigative
material. If the bureau initiates an
action, all records not exempt from disclosure under the Inspection of Public
Records Act, NMSA 1978, 14-2-1 et seq.,
shall be placed in the EMS agency’s official record. Any request for records maintained by the
bureau shall be processed in accordance with the Inspection of Public Records
Act.
C. Waivers. The bureau, upon a showing of good cause or extenuating circumstances
by an EMS agency, may waive any portion of this rule in whole or in part.
(1) An EMS agency that
requests a waiver shall submit written justification to the bureau explaining
what good cause or extenuating circumstances exist to grant the waiver. The EMS agency shall include any supporting
documentation relevant to the request.
(2) The bureau shall
determine whether to grant a requested waiver as soon as practicable. The bureau shall evaluate the request and any
pertinent attached documentation. The
bureau may request additional documentation in support of the EMS agency’s
request as the bureau deems necessary.
(3) Upon determining
whether to grant or deny a waiver request, the bureau shall notify the requesting
EMS agency of the bureau’s decision in writing within twenty calendar days.
D. Disciplinary action; other action. The
bureau may take disciplinary action against an EMS agency or applicant,
including denial, suspension, or revocation of certification, or imposition of
any lesser restriction or condition upon certification, in accordance with the
following:
(1) if the bureau takes
final disciplinary action against an EMS agency or applicant, the bureau may
publish notice of the action in a periodical, internet website, or other medium
that has statewide distribution;
(2) the bureau may take
immediate action to suspend an EMS agency’s certification to prevent the EMS
agency from operating in New Mexico if the bureau determines that the health
and safety of the public would be jeopardized if it did not take such action;
the suspended EMS agency shall be afforded the right to an expedited hearing in
accordance with this rule;
(3) the bureau may take
disciplinary action against an EMS agency, or may refuse to distribute EMS fund
monies to an EMS agency, for any of the following reasons:
(a)
knowingly allowing a person to perform emergency medical services in the
state of New Mexico when the person is not licensed or otherwise authorized by
the department of health to perform emergency medical services;
(b)
any instance of inappropriate billing practices, including but not limited to the following:
(i)
administering unnecessary treatment or supplies to a patient for the
purpose of increasing the patient’s bill;
(ii)
charging for treatment or supplies not actually provided to a patient;
and
(iii) engaging in medicare or medicaid fraud;
(c)
financial insolvency of the EMS agency;
(d)
fraud, deceit, or
misrepresentation by an EMS agency in obtaining certification, including but
not limited to misrepresentation during the initial or renewal certification
process;
(e)
expenditure of EMS fund monies in any manner or for any purpose not
authorized by the bureau, or in any manner prohibited by the EMS Fund Act, NMSA
1978, Section 24-10A-1 et seq., or
applicable rules (see 7.27.4 NMAC);
(f)
loss of federal drug enforcement administration or NM board of pharmacy
licensure or failure to notify the bureau of such loss of licensure;
(g)
failure to ensure that the EMS agency receives and complies with medical
direction that conforms to applicable medical direction guidelines (see 7.27.3
NMAC);
(h)
failure to pay required certification fees or to pay an outstanding
balance owed to the bureau;
(i)
operating as an EMS agency in the state of New Mexico for any period of
time without holding valid certification from the bureau, unless the EMS agency
previously obtained an applicable waiver from the bureau;
(j)
failure to implement reasonable infection control practices, failure to
maintain a clean and hygienic work environment, or failure to properly maintain
and dispose of biohazard material;
(k)
failure to make a required submission to the bureau, including but not
limited to the submission of patient run report data;
(l)
permitting an individual who is not a student at bureau-approved or
CoAEMSP-accredited EMS training program to perform as an intern with the EMS
agency;
(m)
the conviction of an EMS agency’s principals of a felony or a
misdemeanor, as shown by a copy of the record of the court conviction;
(n)
failure of an EMS agency’s principals to notify the bureau upon learning
that an EMS provider has been convicted of a felony or misdemeanor while
employed by the EMS agency;
(o)
failure of an EMS agency to cooperate with a bureau investigation,
including but not limited to failure to furnish the bureau with requested
information, or failure of agency personnel to appear at an interview as
requested;
(p)
attempting, either directly or through an agent, to intimidate,
threaten, injure or take any adverse action against a person for providing
information to the bureau;
(q) conduct on the part of EMS agency
personnel that constitutes a significant threat to the health or safety of
individuals receiving emergency care;
(r) negligence on the
part of EMS agency personnel in the delivery of emergency medical services,
including but not limited to the following:
(i)
malpractice or substandard medical care or treatment;
(ii)
incompetence;
(iii) abandonment;
(iv)
practicing without a valid NM EMT license; or performing outside an
applicable standard of care/scope of practice;
(v)
failure to retain, transport or use required equipment, or inappropriate
use of equipment during treatment or transport of patients; or
(vi)
unauthorized disclosure of medical or other confidential information;
(s)
unprofessional conduct on the part of EMS agency personnel, including
but not limited to the following:
(i)
dissemination of a patient’s health information to individuals not
entitled to such information where such information is protected by law from
disclosure;
(ii) falsification or alteration of patient
records or EMS agency records;
(iii) misappropriation of money, drugs or
property;
(iv)
obtaining or attempting to obtain any fee for patient services for one’s
self or for another through fraud, misrepresentation, or deceit;
(v)
aiding, abetting, assisting or hiring an individual to violate the EMS
Act or these duly promulgated rules;
(vi)
failure to follow established procedure and documentation regarding
controlled substances;
(vii) failure to make or keep accurate, intelligible
entries in records as required by law, policy and standards for the practice of
pre-hospital emergency care;
(viii) failure to report an EMT who is suspected
of violating the New Mexico EMS Act (NMSA 1978, Section 24-10B-4 ) or New
Mexico licensing rules for EMS personnel (7.27.2 NMAC);
(ix)
intentionally engaging in sexual contact with or toward a patient;
(t)
failure of EMS agency personnel to report revocation, suspension,
denial, or other adverse action relating to a license, permit, designation or
certification taken in any other state or jurisdiction affecting the ability to
provide emergency medical services in that state;
(u)
the making of any false, fraudulent, or deceptive statement by EMS
agency personnel in any document connected with EMS agency operations;
(v)
the dispensation, administration, or distribution of any controlled
substance (as defined in the New Mexico Controlled Substances Act, NMSA 1978,
Section 30-31-1 et seq., other than a
controlled substance authorized in an applicable scope of practice, by EMS
agency personnel;
(w) willful and
deliberate failure of EMS agency personnel to respond to a call;
(x)
willful and deliberate failure of EMS agency personnel to transport a
patient when required;
(y) except as otherwise provided in this rule,
failure of EMS agency personnel to deliver a patient to the most appropriate
medical facility as determined by the medical director, dependent upon the
patient’s medical needs; and
(z) failure to comply with any requirement of
this rule;
(4) denial of
certification for failure to properly apply or failure to pay a required fee
shall not constitute a disciplinary action for purposes of this section, and
shall not entitle an applicant to a hearing;
(5) the bureau’s refusal
to distribute EMS fund monies to an EMS agency shall not constitute a
“disciplinary action” for purposes of this section, and an EMS agency that is
refused a distribution of EMS fund monies shall not be entitled to a hearing
under this section; an EMS agency may appeal the bureau’s determination to
refuse a distribution of EMS fund monies by following the appeal provisions of
the EMS Fund Act rule, 7.27.4 NMAC.
E. Records management. A certification record is
maintained for every certified EMS agency in New Mexico; any request for
records maintained by the bureau shall be processed in accordance with the
Inspection of Public Records Act, NMSA 1978, Section 14-2-1 et seq.
(1) Confidentiality of investigations.
The bureau shall take every precaution to ensure that preliminary and
formal investigations are conducted in a confidential manner. If the bureau initiates an action, all records
not exempt from disclosure under the Inspection of Public Records Act, NMSA
1978, Section 14-2-1 et seq., shall
be placed in the EMS agency’s certification record, if one exists.
(2) Records confidentiality. Any
files or records in the possession of the bureau, a regional office or a
provider containing identifying information about individuals requesting or
receiving treatment or other health services and any unsubstantiated complaints
received by the bureau regarding any provider shall be confidential and not
subject to public inspection; such files, records and complaints may be subject
to subpoena for use in any pending cause, in any administrative proceeding, or
in any of the courts of this state, unless otherwise provided by state or
federal law.
F. Notice of contemplated action. When
the bureau contemplates taking disciplinary action against an EMS agency or
applicant, it shall serve upon the EMS agency or applicant a written notice
containing a statement of the grounds or subject upon which the proposed action
is based and identifying any rule(s) violated.
G. Injunctions. The department may apply to a district court
of New Mexico to enjoin an EMS agency from engaging in business in the state.
[7.27.10.24 NMAC - N, 3/15/2010]
7.27.10.25 HEARINGS:
A. Right to appeal. An EMS agency or applicant may
appeal a decision by the department to take a disciplinary action against the
EMS agency or applicant under this rule.
B. Right to hearing. An EMS agency or applicant may
request a hearing before a hearing officer appointed by the secretary to
contest a proposed action or immediate suspension under this rule, by mailing a
certified letter, return receipt requested, to the bureau within twenty days
after service of the notice of the contemplated action or immediate suspension.
C. Scheduling the hearing.
(1) Appointment of hearing officer.
Upon the bureau’s receipt of a timely request for a hearing, the
department shall appoint a hearing officer and schedule a hearing.
(2) Hearing date. The hearing
shall be held not more than sixty days and not less than fifteen days from the
date of service of the notice of hearing.
Exception for immediate
suspensions: in the event that the bureau immediately suspends an EMS
agency’s certification, the department shall afford the suspended EMS agency an
expedited hearing within twenty days of the bureau’s timely receipt of the EMS
agency’s request for a hearing, unless the suspended EMS agency waives this
provision.
(3) Notice of hearing. The
department shall notify the EMS agency or applicant of the date, time, and
place of the hearing and the identity of the hearing officer within twenty days
of the bureau’s timely receipt of the request for hearing. Exception
for immediate suspensions: in the
event that the bureau immediately suspends an EMS agency’s certification, the
department shall notify the suspended EMS agency of the expedited hearing not
less than seven days prior to the scheduled date of the expedited hearing.
(4) Hearing venue. The hearing
shall be held in Santa Fe, New Mexico.
D. Method
of service. Any notice or decision
required to be served under this section may be served either personally or by
certified mail, return receipt requested, directed to the EMS agency or
applicant at the last known mailing address (or, if service is made personally,
by the last known physical address) shown by the records of the bureau. If the notice or decision is served
personally, service shall be made in the same manner allowed by the rules of
civil procedure for the state district courts of New Mexico. Where the notice
or decision is served by certified mail, it shall be deemed to have been served
on the date borne by the return receipt showing delivery, or the date of the
last attempted delivery of the notice or decision, or the date of the
addressee’s refusal to accept delivery.
E. Excusal of hearing officer for good cause shown. A party may request that a hearing officer be excused for good cause by submitting to the secretary a motion of excusal for good cause at least twenty days prior to the date of the hearing, or at least five days prior to an expedited hearing concerning the immediate suspension of an EMS agency’s certification.
F. Hearing officer duties. The hearing officer shall conduct the hearing, rule on any motions or other matters that arise prior to the hearing, and issue a written report and recommendation(s) to the secretary following the close of the hearing.
G. Official file. Upon appointment, the hearing officer shall establish an official file which shall contain all notices, hearing requests, pleadings, motions, written stipulations, evidence, briefs, and correspondence received in the case. The official file shall also contain proffered items not admitted into evidence, which shall be so identified and shall be separately maintained. Upon conclusion of the proceeding and following issuance of the final decision, the hearing officer shall tender the complete official file to the department for its retention as an official record of the proceedings.
H. Powers of hearing officer. The hearing officer shall have all the powers necessary to conduct a hearing and to take all necessary action to avoid delay, maintain order, and assure development of a clear and complete record, including but not limited to the power to: administer oaths or affirmations; schedule continuances; direct discovery; examine witnesses and direct witnesses to testify; limit repetitious and cumulative testimony; set reasonable limits on the amount of time a witness may testify; decide objections to the admissibility of evidence or receive the evidence subject to later ruling; receive offers of proof for the record; direct parties to appear and confer for the settlement or simplification of issues, and otherwise conduct pre-hearing conferences; take notice of judicially cognizable facts or take notice of general, technical or scientific facts within the hearing officer’s specialized knowledge (provided that the hearing officer notifies the parties beforehand and offers the parties an opportunity to contest the fact so noticed); dispose of procedural requests or similar matters; and enter proposed findings of fact and conclusions of law, orders, reports and recommendations. The hearing officer may utilize his or her experience, technical competence or specialized knowledge in the evaluation of evidence presented.
I. Minimum discovery; inspection and copying of documents. Upon written request to another party, any party shall have access to documents in the possession of the other party that are relevant to the subject matter of the appeal, except confidential or privileged documents.
J. Minimum discovery; witnesses. The parties shall each disclose to each other and to the hearing officer, either orally or in writing, the names of witnesses to be called, together with a brief summary of the testimony of each witness. In situations where written statements will be offered into evidence in lieu of a witness’s oral testimony, the names of the persons making the statements and a brief summary of the statements shall be disclosed.
K. Additional discovery. At the hearing officer's discretion, upon a written request by a party that explains why additional discovery is needed, further discovery in the form of production and review of documents and other tangible things, interviews, depositions or written interrogatories may be ordered. In exercising his authority to determine whether further discovery is necessary or desirable, the hearing officer should consider whether the complexity of fact or law reasonably requires further discovery to ensure a fair opportunity to prepare for the hearing, and whether such request will result in unnecessary hardship, cost, or delay in holding the hearing. Depositions shall not be allowed, except by order of the hearing officer upon a showing that the deposition is necessary to preserve the testimony of persons who are sick or elderly, or who will not be able to attend the hearing.
L. Pre-hearing disposition. The subject matter of any hearing may be disposed of by stipulation, settlement or consent order, unless otherwise precluded by law. Any stipulation, settlement or consent order reached between the parties shall be written and shall be signed by the hearing officer and the parties or their attorneys.
M. Postponement or continuance. The hearing officer, at his or her discretion, may postpone or continue a hearing upon his or her own motion, or upon the motion of a party, for good cause shown. Notice of any postponement or continuance shall be given in person, by telephone, or by mail to all parties within a reasonable time in advance of the previously scheduled hearing date.
N. Conduct of hearing. Pursuant to the NM Open Meetings Act, NMSA 1978, Section 10-15-1 et seq., hearings shall be open to the public; provided, however, that hearings may be closed in part to prevent the disclosure of confidential information, including but not limited to health information protected by state and federal laws.
O. Telephonic testimony. Upon timely notice to the opposing party and the hearing officer, and with the approval of the hearing officer, the parties may present witnesses by telephone or live video (if available).
P. Legal representation. The department and EMS agencies or applicants may appear by an officer or employee, or may be represented by an attorney licensed to practice in New Mexico.
Q. Recording. The hearing officer or a designee shall record the hearing by means of a mechanical sound recording device provided by the department for a record of the hearing. Such recording need not be transcribed, unless requested by a party who shall arrange and pay for the transcription.
R. Burden of proof.
The department has the burden of proving by a preponderance of the
evidence the basis for the proposed action.
Exception: in cases
arising from the proposed denial of initial certification, the applicant for
initial certification shall bear the initial burden of proving by a
preponderance of the evidence that the application was improperly denied by the
department and should be approved.
S. Order of presentation; general rule. Except as provided in an exception in this rule, the order of presentation for hearings in all cases shall be:
(1)
appearances: opening of proceeding and taking of
appearances by the hearing officer;
(2) pending
matters: disposition by the hearing
officer of preliminary and pending matters;
(3)
opening statements: the opening statement of the department; and
then the opening statement of the party challenging the department's action or
proposed action;
(4)
cases: the department's case-in-chief, and then the
case-in-chief of the party challenging the department's action;
(5)
rebuttal: the department's case-in-rebuttal;
(6)
closing argument: the department's closing statement, which may
include legal argument; and then the closing statement of the party opposing
the department’s action or proposed action, which may include legal argument;
and
(7) close: close of proceedings
by the hearing officer.
T. Order of presentation in initial certification cases. The order of presentation in cases arising from the proposed denial of initial certification shall be:
(1) appearances: opening of proceeding and taking of
appearances by the hearing officer;
(2)
pending matters: disposition by the hearing officer of
preliminary and pending matters;
(3)
opening statements: applicant's opening statement; and then the
opening statement of the department;
(4)
cases: the applicant's case-in-chief, and then the
department’s case-in-chief;
(5) rebuttal: the applicant's case-in-rebuttal.
U. Closing argument. The applicant's closing statement, which may include legal argument; and then the department’s closing statement, which may include legal argument.
V. Close. Close of proceedings by the hearing officer.
W. Admissible evidence; rules of evidence not applicable. The hearing officer may admit any evidence and may give probative effect to evidence that is of a kind commonly relied on by reasonably prudent persons in the conduct of serious affairs. Rules of evidence, such as the New Mexico rules of evidence for the district courts, shall not apply but may be considered in determining the weight to be given any item of evidence. The hearing officer may at his or her discretion, upon his or her motion or the motion of a party or a party’s representative, exclude incompetent, irrelevant, immaterial or unduly repetitious evidence, including testimony, and may exclude confidential or privileged evidence.
X. Objections. A party may timely object to evidentiary offers by stating the objection together with a succinct statement of the grounds for the objection. The hearing officer may rule on the admissibility of evidence at the time an objection is made or may receive the evidence subject to later ruling.
Y. Official notice. The hearing officer may take notice of any facts of which judicial notice may be taken, and may take notice of general, technical or scientific facts within his or her specialized knowledge. When the hearing officer takes notice of a fact, the parties shall be notified either before or during the hearing of the fact so noticed and its source, and the parties shall be afforded an opportunity to contest the fact so noticed.
Z. Record content. The record of a hearing shall include all documents contained in the official file maintained by the hearing officer, including all evidence received during the course of the hearing, proposed findings of fact and conclusions of law, the recommendations of the hearing officer, and the final decision of the secretary.
AA. Written evidence from witnesses. The hearing officer may admit evidence in the form of a written statement made by a witness, when doing so will serve to expedite the hearing and will not substantially prejudice the interests of the parties.
BB. Failure to appear. If a party who has requested a hearing or a party’s representative fails to appear on the date, time or location announced for a hearing, and if no continuance was previously granted, the hearing officer may proceed to hear the evidence of such witnesses as may have appeared or may accept offers of proof regarding anticipated testimony and other evidence, and the hearing officer may further proceed to consider the matter and issue his report and recommendation(s) based on the evidence presented; and the secretary may subsequently render a final decision. Where a person fails to appear at a hearing because of accident, sickness or other cause, the person may within a reasonable time apply to the hearing officer to reopen the proceeding, and the hearing officer may, upon finding sufficient cause, fix a time and place for a hearing and give notice to the parties.
CC. Hearing officer written report and recommendation(s). The hearing officer shall submit a written report and recommendation(s) to the secretary that contains a statement of the issues raised at the hearing, proposed findings of fact and conclusions of law, and a recommended determination. Proposed findings of fact shall be based upon the evidence presented at the hearing or known to all parties, including matters officially noticed by the hearing officer. The hearing officer's recommended decision is a recommendation to the secretary of the New Mexico department of health and is not a final order.
DD. Submission for final decision. The hearing officer's report and recommendation(s) shall be submitted together with the complete official file to the secretary of the New Mexico department of health for a final decision no later than thirty days after the hearing.
EE. Secretary’s final decision. The
secretary shall render a final decision within forty-five calendar days of the
receipt of the hearing officer’s written report. A copy of the final decision shall be mailed
to the appealing party by certified mail, return receipt requested, within
fifteen days after the final decision is rendered and signed. A copy shall be provided to legal counsel for
the bureau. Exception for immediate suspensions: In the event that the EMS agency’s
certification has been immediately suspended, the secretary shall render a
final decision within ten business days of the receipt of the hearing officer’s
written report, and a copy of the final decision shall be mailed to the
appealing party by certified mail, return receipt requested, within five
business days after the final decision is rendered and signed.
FF. Right to judicial review. Pursuant to NMSA 1978, Section 39-3-1.1, an EMS agency or applicant that is entitled to a hearing under this rule and that is aggrieved by an adverse final decision may obtain a judicial review of the decision by filing in state district court a notice of appeal within thirty days of the rendition and signing of the final decision by the secretary.
GG. Court-ordered stay. Filing for judicial review shall not itself stay enforcement of the final decision. Any party may petition the court whose jurisdiction has been properly invoked for an order staying enforcement.
[7.27.10.25 NMAC - N, 3/15/2010]
HISTORY
OF 7.27.10 NMAC: [RESERVED]