ORS Chapter 682

Chapter 682 — Regulationof Ambulance Services and Emergency Medical Personnel

2009 EDITION

AMBULANCESAND EMERGENCY MEDICAL PERSONNEL

OCCUPATIONSAND PROFESSIONS

GENERALPROVISIONS

682.017 Rulemakinggenerally

682.019 Receiptand disbursement of federal funds

682.025 Definitions

682.027 Definitionof “ambulance services” for ORS 682.031, 682.062 and 682.066

682.028 Falsestatements and misrepresentations regarding license or certification prohibited

682.031 Localordinances regulating ambulances and emergency medical technicians

682.035 Applicationof ORS chapter 682

682.039 StateEmergency Medical Service Committee; qualifications, terms, duties andcompensation

AMBULANCESERVICES

682.041 Legislativeintent regarding regulation of ambulance services

682.045 Licenses;form and contents; future responsibility filing

682.047 Issuanceof license; duration; transferability; display; replacement; fees; rules

682.051 Unlawfuloperation of unlicensed ambulance vehicle or unlicensed ambulance service;penalty

682.056 Informationregarding person who is subject of prehospital care event; use of information;confidentiality; fee

682.062 Countyplan for ambulance and emergency medical services; rules

682.063 Requirementsfor adoption and review of ambulance service plan by counties

682.066 Provisionof ambulance services when county plan not adopted

682.068 Rulemakingwith respect to minimum requirements for vehicles and services

682.071 Exchangeof services agreement for ambulance and emergency medical services

682.075 StateEmergency Medical Service Committee and Oregon Health Authority to adopt rulesregarding ambulance construction, maintenance and operation; compliance withrules required to obtain license

682.079 Powerof Oregon Health Authority to grant exemptions or variances; rules

682.085 Inspectionof ambulance vehicles and services; suspension or revocation of license

682.089 Replacementof one ambulance service by another

682.105 Proofof financial responsibility required to obtain license; amounts; form of proof

682.107 Formof insurance used to satisfy financial responsibility requirement; cancellationor termination; coverage; multiple insurers

682.109 Bonds,letters of credit or certificates of deposit used to prove financial responsibility

682.111 Requirementsfor bonds

682.113 Actionagainst surety on bond by judgment creditor

682.117 Methodsof satisfying financial responsibility requirements; use of deposit

EMERGENCYMEDICAL PERSONNEL

682.204 Emergencymedical technicians required to be certified; defense to charge of activity byuncertified person; exemptions from certificate requirement

682.208 Certificationfrom Oregon Health Authority; form and contents

682.212 Applicationfee; examination fee

682.216 Issuanceof certificates; fees; provisional certification; indorsement certification;continuing education; renewal; rules; driver license requirement

682.218 Substitutefor education requirements for certification by indorsement; rules

682.220 Denial,suspension or revocation of license and emergency medical techniciancertificate; investigation; confidentiality of information

682.224 Discipline;purpose; civil penalty

682.245 Rulemakingwith respect to scope of practice of EMTs and first responders; qualificationsof supervising physician

682.265 Prohibitionagainst misleading actions regarding qualifications

PENALTIES

682.991 Civiland criminal penalties

682.010 [Amended by1961 c.248 §1; 1969 c.276 §1; 1981 c.339 §6; 1983 c.486 §59; renumbered677.805]

GENERALPROVISIONS

682.015 [Formerly823.010; renumbered 682.051 in 2003]

682.017Rulemaking generally.(1) In accordance with ORS chapter 183, the Oregon Health Authority may adoptand may when necessary amend or repeal such rules as are necessary for carryingout this chapter.

(2)The authority is authorized and directed to establish appropriate rules inaccordance with the provisions of ORS chapter 183 concerning the administrationof this chapter. Such rules may deal with, but are not limited to, such mattersas criteria for requirements, types and numbers of emergency vehicles includingsupplies and equipment carried, requirements for the operation and coordinationof ambulances and other emergency care systems, criteria for the use of two-waycommunications, procedures for summoning and dispatching aid and othernecessary and proper matters. [Formerly 682.215; 2009 c.595 §1063]

682.019Receipt and disbursement of federal funds. The Oregon Health Authority mayreceive and disburse such federal funds as may be available for carrying outany of the provisions of ORS 820.330 to 820.380 or this chapter. [Formerly682.295; 2009 c.595 §1064]

682.020 [Amended by1961 c.248 §2; 1969 c.276 §2; 1983 c.486 §60; renumbered 677.810]

682.025Definitions.As used in this chapter, unless the context requires otherwise:

(1)“Ambulance” or “ambulance vehicle” means any privately or publicly owned motorvehicle, aircraft or watercraft that is regularly provided or offered to beprovided for the emergency transportation of persons who are ill or injured orwho have disabilities.

(2)“Ambulance service” means any person, governmental unit, corporation,partnership, sole proprietorship or other entity that operates ambulances andthat holds itself out as providing prehospital care or medical transportationto persons who are ill or injured or who have disabilities.

(3)“Authority” means the Oregon Health Authority.

(4)“Board” means the Oregon Medical Board.

(5)“Emergency care” means the performance of acts or procedures under emergencyconditions in the observation, care and counsel of persons who are ill orinjured or who have disabilities; in the administration of care or medicationsas prescribed by a licensed physician, insofar as any of these acts is basedupon knowledge and application of the principles of biological, physical andsocial science as required by a completed course utilizing an approvedcurriculum in prehospital emergency care. However, “emergency care” does notinclude acts of medical diagnosis or prescription of therapeutic or correctivemeasures.

(6)“Emergency medical technician” or “EMT” means a person who has received formaltraining in prehospital and emergency care, and is state certified to attendany person who is ill or injured or who has a disability. Police officers,firefighters, funeral home employees and other personnel serving in a dualcapacity one of which meets the definition of “emergency medical technician”are “emergency medical technicians” within the meaning of this chapter.

(7)“First responder” means a person who has successfully completed a firstresponder training course approved by the authority and:

(a)Has been examined and certified as a first responder by an authorizedrepresentative of the authority to perform basic emergency and nonemergencycare procedures; or

(b)Has been otherwise designated as a first responder by an authorizedrepresentative of the authority to perform basic emergency and nonemergencycare procedures.

(8)“Fraud or deception” means the intentional misrepresentation or misstatement ofa material fact, concealment of or failure to make known any material fact, orany other means by which misinformation or false impression knowingly is given.

(9)“Governmental unit” means the state or any county, municipality or otherpolitical subdivision or any department, board or other agency of any of them.

(10)“Highway” means every public way, thoroughfare and place, including bridges,viaducts and other structures within the boundaries of this state, used orintended for the use of the general public for vehicles.

(11)“Nonemergency care” means the performance of acts or procedures on a patientwho is not expected to die, become permanently disabled or suffer permanentharm within the next 24 hours, including but not limited to observation, careand counsel of a patient and the administration of medications prescribed by aphysician licensed under ORS chapter 677, insofar as any of those acts arebased upon knowledge and application of the principles of biological, physicaland social science and are performed in accordance with scope of practice rulesadopted by the Oregon Medical Board in the course of providing prehospital careas defined by this section.

(12)“Owner” means the person having all the incidents of ownership in an ambulanceservice or an ambulance vehicle or where the incidents of ownership are indifferent persons, the person, other than a security interest holder or lessor,entitled to the possession of an ambulance vehicle or operation of an ambulanceservice under a security agreement or a lease for a term of 10 or moresuccessive days.

(13)“Patient” means a person who is ill or injured or who has a disability and whois transported in an ambulance.

(14)“Person” means any individual, corporation, association, firm, partnership,joint stock company, group of individuals acting together for a common purposeor organization of any kind and includes any receiver, trustee, assignee orother similar representative thereof.

(15)“Prehospital care” means that care rendered by emergency medical technicians asan incident of the operation of an ambulance as defined by this chapter andthat care rendered by emergency medical technicians as incidents of otherpublic or private safety duties, and includes, but is not limited to, “emergencycare” as defined by this section.

(16)“Scope of practice” means the maximum level of emergency or nonemergency carethat an emergency medical technician may provide.

(17)“Standing orders” means the written protocols that an emergency medicaltechnician follows to treat patients when direct contact with a physician isnot maintained.

(18)“Supervising physician” means a medical or osteopathic physician licensed underORS chapter 677, actively registered and in good standing with the board, whoprovides direction of emergency or nonemergency care provided by emergencymedical technicians.

(19)“Unprofessional conduct” means conduct unbecoming a person certified inemergency care, or detrimental to the best interests of the public andincludes:

(a)Any conduct or practice contrary to recognized standards of ethics of themedical profession or any conduct or practice which does or might constitute adanger to the health or safety of a patient or the public or any conduct,practice or condition which does or might impair an emergency medicaltechnician’s ability safely and skillfully to practice emergency ornonemergency care;

(b)Willful performance of any medical treatment which is contrary to acceptablemedical standards; and

(c)Willful and consistent utilization of medical service for treatment which is ormay be considered inappropriate or unnecessary. [Formerly 823.020; 1997 c.249 §208;1997 c.637 §§1,1a; 2007 c.70 §308; 2009 c.595 §1065]

682.027Definition of “ambulance services” for ORS 682.031, 682.062 and 682.066. As used in ORS682.031, 682.062 and 682.066, “ambulance services” includes the transportationof an individual who is ill or injured or who has a disability in an ambulanceand, in connection therewith, the administration of prehospital andout-of-hospital medical, emergency or nonemergency care, if necessary. [Formerly682.043; 2007 c.70 §309]

682.028False statements and misrepresentations regarding license or certificationprohibited.(1) It is unlawful for any person or governmental unit to:

(a)Intentionally make any false statement on an application for an ambulanceservice license, ambulance vehicle license or for certification as an emergencymedical technician or first responder or on any other documents required by theOregon Health Authority; or

(b)Make any misrepresentation in seeking to obtain or retain a certification orlicense.

(2)Any violation described in subsection (1) of this section is also grounds fordenial, suspension or revocation of a certification or license under ORS682.220. [Formerly 682.255; 2009 c.595 §1066]

682.030 [Renumbered677.815]

682.031Local ordinances regulating ambulances and emergency medical technicians. (1) As used inthis section, “political subdivision” includes counties, cities, districts,authorities and other public corporations and entities organized and existingunder statute or charter.

(2)An ordinance of any political subdivision regulating ambulance services oremergency medical technicians shall not require less than is required under ORS820.300 to 820.380, or this chapter or the rules adopted by the Oregon HealthAuthority under this chapter.

(3)When a political subdivision enacts an ordinance regulating ambulance services oremergency medical technicians, the ordinance must comply with the county planfor ambulance services and ambulance service areas adopted under ORS 682.062 bythe county in which the political subdivision is situated and with the rules ofthe Oregon Health Authority relating to such services and service areas. Thedetermination of whether the ordinance is in compliance with the county planshall be made by the county governing body. [Formerly 682.275; 2009 c.595 §1067]

682.035Application of ORS chapter 682. ORS 820.330 to 820.380 and this chapterdo not apply to:

(1)Ambulances owned by or operated under the control of the United StatesGovernment.

(2)Vehicles being used to render temporary assistance in the case of a majorcatastrophe or emergency with which the ambulance services of the surroundinglocality are unable to cope, or when directed to be used to render temporaryassistance by an official at the scene of an accident.

(3)Vehicles operated solely on private property or within the confines ofinstitutional grounds, whether or not the incidental crossing of any highwaythrough the property or grounds is involved.

(4)Vehicles operated by lumber industries solely for the transportation of lumberindustry employees.

(5)Any person who drives or attends an individual who is ill or injured or who hasa disability, if the individual is transported in a vehicle mentioned insubsections (1) to (4) of this section.

(6)Any person who otherwise by license is authorized to attend patients. [Formerly823.030; 2007 c.70 §310]

682.037 [1997 c.208 §1;renumbered 682.056 in 2003]

682.039State Emergency Medical Service Committee; qualifications, terms, duties andcompensation.(1) The Oregon Health Authority shall appoint a State Emergency Medical ServiceCommittee composed of 18 members as follows:

(a)Seven physicians licensed under ORS chapter 677 whose practice consists ofroutinely treating emergencies such as cardiovascular illness or trauma,appointed from a list submitted by the Oregon Medical Board.

(b)Four emergency medical technicians whose practices consist of routinelytreating emergencies, including but not limited to cardiovascular illness ortrauma, at least one of whom is at the lowest level of emergency medicaltechnician certification established by the authority at the time ofappointment. EMTs appointed pursuant to this paragraph shall be selected fromlists submitted by each area trauma advisory board. The lists shall includenominations from entities including but not limited to organizations thatrepresent emergency care providers in Oregon.

(c)One volunteer ambulance operator, one person representing governmental agenciesthat provide ambulance services and one person representing a private ambulancecompany.

(d)One hospital administrator.

(e)One nurse who has served at least two years in the capacity of an emergencydepartment nurse.

(f)One representative of an emergency dispatch center.

(g)One community college or licensed career school representative.

(2)The committee shall include at least one resident but no more than threeresidents from each region served by one area trauma advisory board at the timeof appointment.

(3)Appointments shall be made for a term of four years in a manner to preserveinsofar as possible the representation of the organization described insubsection (1) of this section. Vacancies shall be filled for any unexpiredterm as soon as the authority can make such appointments. The committee shallchoose its own chairperson and shall meet at the call of the chairperson or theDirector of the Oregon Health Authority.

(4)The State Emergency Medical Service Committee shall:

(a)Advise the authority concerning the adoption, amendment and repeal of rulesauthorized by this chapter;

(b)Assist the Emergency Medical Services and Trauma Systems Program in providingstate and regional emergency medical services coordination and planning;

(c)Assist communities in identifying emergency medical service system needs andquality improvement initiatives;

(d)Assist the Emergency Medical Services and Trauma Systems Program inprioritizing, implementing and evaluating emergency medical service systemquality improvement initiatives identified by communities;

(e)Review and prioritize rural community emergency medical service fundingrequests and provide input to the Rural Health Coordinating Council; and

(f)Review and prioritize funding requests for rural community emergency medicalservice training and provide input to the Area Health Education Center program.

(5)The chairperson of the committee shall appoint a subcommittee on EMTcertification and discipline, consisting of five physicians and four EMTs. Thesubcommittee shall advise the authority and the board on the adoption,amendment, repeal and application of rules concerning ORS 682.204 to 682.220and 682.245. The decisions of this subcommittee shall not be subject to thereview of the full State Emergency Medical Service Committee.

(6)Members are entitled to compensation as provided in ORS 292.495. [Formerly682.195; 2009 c.595 §1068]

682.040 [Amended by1961 c.248 §3; 1969 c.276 §3; 1973 c.827 §70; renumbered 677.820]

AMBULANCESERVICES

682.041Legislative intent regarding regulation of ambulance services. The LegislativeAssembly declares that the regulat