(A) Defined terms. For the purpose of this subchapter, the following definitions shall apply unless the context clearly indicates or requires a different meaning.
ADVANCED EMERGENCY MEDIAL TECHNICIAN (AEMT). (This title is classified as EMT-I until July 1, 2014). An individual who can perform at least one, but not all of the procedure of a paramedic and who:
(a) Has completed a proscribed course in advance life support;
(b) Has been certified by the commission;
(c) Is associated with a single supervising hospital;
(d) Is affiliated with a provider organization; and
(e) Is certified under I.C. 16-31 and by the County Health Officer within 60 days of employment.
AMBULANCE. Any conveyance on land or water that is used or is intended to be used for the purpose of:
(a) Responding to emergency life-threatening situations and providing transportation of an emergency patient service; or
(b) Providing transportation service to, from, and between any convalescent, non-convalescent, hospital, residence, nursing home, medical treatment facility, etc.
(c) The definition also includes any motor vehicle equipped with facilities to convey infirm or injured persons. This does not include wheelchair vans.
AMBULANCE DRIVER. Any individual who is certified by the County Health Officer to driver and ambulance. This certification shall occur within 60 days of employment.
AMBULANCE PATIENT. Any ill, infirm, or injured person transported in an ambulance to or from a hospital, physician's office, nursing home or other healthcare facility.
AMBULANCE SERVICE SYSTEM. An organized, fully coordinated and legally established network of individuals and organizations capable of a coordinated response to an emergency medical incident. Essential components include, but are not limited to, single point termination telephone access to the system, centralized professional dispatching, and system status management by dispatchers, who are certified in emergency medical dispatch in direct radio contact with each ambulance operating in the system and who have the full authority and responsibility to manage the system response.
CLARK COUNTY OFFICE OF EMERGENCY COMMUNICATIONS (CCOEC). The countywide emergency communication center and is responsible for enhanced 911 operations such as wired, wireless, and voice-over internet protocol; seven-digit emergency reporting; primary emergency radio communication operations and emergency fire, police, first responder (this term changes to emergency medical responder [EMR] after June 30, 2014) and emergency medical communications.
COMMISSION. The Indiana Emergency Medical Services Commission.
CONVALESCENT PATIENT. A patient who does not need emergency medical services.
CONVALESCENT TRANSPORT. Transportation of a convalescent patient.
EMERGENCY MEDICAL AMBULANCE SERVICES. The transportation of emergency patients by ambulance and the administration of emergency medical care to emergency patients at the scene of an accident, illness, or during transport.
EMERGENCY MEDICAL AMBULANCE SERVICES PROVIDER (EMASP). Any person who is not a volunteer provider and who provides emergency medical ambulance services within Clark County (either VAP or VRAP). Any emergency medical ambulance services provider operating within the service area must have a minimum of four ambulances with a minimum of two EMT-BA or EMT-I/AEMT ambulances (after June 30, 2014 the classification of two non paramedic ambulances will change to two AEMT ambulances) and two paramedic ambulances operating within Clark County for 24 hours per day. One EMT-B/EMT-BA or EMT-I/AEMT ambulance and one paramedic non-transport vehicle in combination shall be considered equivalent to one paramedic ambulance. If run volume is low, one non paramedic ambulance may be removed from service for as long as eight hours between 7:00 p.m. and 7:00 a.m. each day. The CCOEC shall be notified of this change of capacity before the ambulance is removed and when it is returned to service.
EMERGENCY MEDICAL CARE.
(a) Assessment of emergency patients;
(b) Administration of medications;
(c) Utilization of mechanical breathing devices;
(d) Performance of cardiopulmonary resuscitation;
(e) Applications of dressings and bandage materials;
(f) Application of splinting and immobilization services;
(g) Utilization of lifting and moving devices to ensure safe transport;
(h) Utilization of a defibrillator, if the defibrillator is used in accordance with training procedures established by the Indiana Emergency Medical Services Commission; and
(i) Other procedures authorized by the Indiana Emergency Medical Services Commission.
EMERGENCY MEDICAL DISPATCHING. The reception, evaluation, processing, and provision of dispatch life support. It also included management of requests for emergency medical assistance, participation in ongoing evaluation and improvement of the emergency medical dispatch process. The process includes, but is not limited to, 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. It does not include call routing itself.
EMERGENCY MEDICAL RESPONDER (EMR). (This title is classified as a first responder until July 1, 2014). An individual who is:
(a) Certified under I.C. 16-31 et seq. and who satisfies the commission's standards for first responder certification; and
(b) The first individual to respond to an incident/dispatch.
EMERGENCY MEDICAL TECHNICIANS (EMT). Exist in different levels as defined below.
(a) EMERGENCY MEDICAL TECHNICIAN (EMT). (This title is classified as EMT-B until July 1, 2014). An individual who is certified under I.C. 16-31 et seq. to provide basic life support, whether at the scene of an accident, treating an illness, or in transport. An EMT shall be certified within 60 days of employment by the County Health Officer.
(b) EMERGENCY MEDICAL TECHNICIAN - BASIC AMBULANCE. (This classification changes to EMT ambulance after June 30, 2014). An ambulance staffed by a duly state and county certified Emergency Medical Technician - Basic and shall possess all the supplies and equipment required for EMT-B level care.
(c) EMERGENCY MEDICAL TECHNICIAN - BASIC ADVANCED (EMT-BA). (This title is deleted after June 30, 2014). An individual who is certified under I.C. 16-31 et seq. to provide basic life support, whether at the scene of an accident, treating an illness, or in transport, and has been certified to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement. An EMT-BA shall be certified within 60 days of employment by the Clark County Health Officer.
(d) EMERGENCY MEDICAL TECHNICIAN - BASIC ADVANCED PROVIDER ORGANIZATION. (This term is deleted after June 30, 2014). An ambulance service provider or other provider organization certified by the commission to provide basic life support services administered by Emergency Medical Technicians - Basic Advanced and has been certified to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement in conjunction with a supervising hospital.
(e) EMERGENCY MEDICAL TECHNICIAN - INTERMEDIATE (EMT-I). (This title changes to Advanced Emergency Medical Technician (AEMT) after June 30, 2014). An individual who can perform at least one but not all of the procedure of a paramedic and who:
1. Has completed a prescribed course in advanced life support;
2. Has been certified by the commission;
3. Is associated with a single supervising hospital;
4. Is affiliated with a provider organization; and
5. Is certified under I.C. 16-31 et seq. and by the County Health Officer within 60 days of employment.
(f) EMERGENCY MEDICAL TECHNICIAN - INTERMEDIATE AMBULANCE. (This classification changes to Advanced Emergency Medical Technician (AEMT) Ambulance after June 30, 2014). An ambulance staffed by a duly state and county certified Emergency Medical Technician - Intermediate and shall possess all the supplies and equipment required for EMT-I level care. An Emergency Medical Technician - Intermediate Ambulance will become a paramedic ambulance when it is staffed by a duly state and county certified paramedic and when it contains the supplies and equipment necessary for paramedic level care.
EMERGENCY PATIENT. An individual who is acutely ill, injured, incapacitated or helpless, and who requires emergency medical services within the county. Such services include, but are not limited to the transportation of a patient in a vehicle certified as an ambulance.
FIRST RESPONDER. This title changes to emergency medical responder (EMR) after June 30, 2014) means an individual who is:
(a) Certified under I.C. 16-31 et seq.;
(b) Meets the commission's standards for first responder certification; and
(c) The first individual to respond to an accident.
LIFE-THREATENING EMERGENCY. A situation posing immediate threat to human life or of long-term disability, including, but not limited to, acute respiratory distress, shock, airway blockage, bleeding beyond control, acute poisoning, acute cardiovascular distress or central nervous system injury.
MEDICAL AUDIT. An official inquiry into the circumstances involving an ambulance run or request for service, conducted by the Health Officer or his or her duly authorized designee. No physician performing a medical audit shall have been directly involved in the care of the patient who is the subject of the audit. Any individual or board member whose actions are under review may not be excluded from the audit process and shall have the right to appear and be heard.
MEDICAL CONTROL. Direction given to ambulance personnel by a physician through direct voice contact as required by applicable medical protocols approved by the medical director of each emergency medical ambulance service provider.
MEDICAL PROTOCOL. Any diagnosis-specific or problem-oriented written statement of standard procedure or algorithm, approved by the Health Officer and the medical directors of the ambulance services as the normal standard of pre-hospital care for a given clinical condition.
MUTUAL AID. The voluntary provision of services by organizations to assist each other pursuant to a written mutual aid agreement.
PARAMEDIC. An individual who has completed a prescribed course in advance life support, has been licensed by the commission under I.C. 16-31 et seq., is certified by the County Health Officer and who is:
(a) Affiliated with a certified paramedic provider organization;
(b) Affiliated with a supervising hospital approved by the commission; or
(c) Employed by an ambulance provider who has a contract for in-service education with a hospital approved by the commission.
PARAMEDIC AMBULANCE. An ambulance staffed by a duly state and county certified paramedic and shall possess all the supplies and equipment required for paramedic level care. An EMT-I/AEMT Ambulance will become a paramedic ambulance when it is staffed by a duly state and county certified paramedic and when it contains the supplies and equipment necessary for paramedic level care. One EMT-B/EMT-BA/EMT or EMT-I/AEMT ambulance and one paramedic non-transport vehicle in combination shall be considered equivalent to one paramedic ambulance as long as both units are stationed within their service area.
PARAMEDIC NON-TRANSPORT VEHICLE. A motor vehicle, other than an ambulance, used for emergency medical services, transports a duly state and county certified paramedic, and contains the supplies and equipment necessary for paramedic level care.
PERSON. Any natural person or persons, firm, partnership, corporation, company, association or joint stock association or a governmental entity other than an agency or instrumentality of the United States.
PRIMARY PROVIDER. An emergency medical ambulance services provider or a volunteer ambulance provider who has a contract with the Commissioners to serve a particular service area.
PUBLIC SAFETY OFFICIALS. Any persons associated with emergency services organizations such as police, fire and EMS.
RESPONSE TIME. The actual elapsed time between notification of the emergency medical ambulance services provider by the CCOEC that an ambulance is needed at a location and the arrival of that ambulance at the location.
SENIOR PARAMEDIC IN CHARGE. That individual among the personnel assigned to a paramedic ambulance within their service area, who is a paramedic designated as the individual in command of the ambulance, its operation and any other persons assigned to the ambulance on a given shift, or is assigned to a paramedic non-transport vehicle. The emergency medical ambulance services provider shall designate the senior paramedic in charge.
SERVICE AREA. The particular township, district or municipality served by an EMASP or VAP contracted with the County Board of Commissioners.
SPECIAL AMBULANCE PROVIDER. Hospitals and other institutions that provide specialized mobile intensive care services.
STATION. The standby location within their service area from which an ambulance or paramedic non-transport vehicle respond.
VOLUNTEER AMBULANCE PROVIDER (VAP). A non-profit organization which provides ambulance service for emergency patients who need emergency medical service. This provider is the primary emergency ambulance for their service area established by a contract with the County Commissioners. If the service area has a population of less than 30,000 persons and a land area less than 200 square miles, then the provider is required to operate three ambulances for 24 hours a day. One shall be a paramedic ambulance and two shall be an EMT-I/AEMT level or higher. The combination of one EMT-B/EMT-BA/EMT or EMT-I/AEMT ambulance and one paramedic non-transport vehicle shall be considered equivalent to one paramedic ambulance. If either of the above population or land area limits is exceeded, then the ambulance number requirements are the same as for an emergency medical ambulance services provider.
VOLUNTEER RESERVE AMBULANCE PROVIDER (VRAP). Any non-profit organization which provides ambulance service for emergency patients, who needs emergency medical services. Majority of the manpower furnished by the volunteer provider shall not receive any salary, wages, or other pay for their work for the VRAP. A VRAP shall have available one EMT/EMT-BA ambulance. This ambulance functions in a reserve role and is only used when the primary ambulance provider will have a long response time or needs assistance with multiple emergency transports. The VRAP shall have a mutual aid agreement with the contractually designated primary provider for their service area. This agreement shall be approved by the Health Officer. The VRAP shall not make convalescent transports. When possible, the CCOEC should notify the VRAP, when the primary provider does not have an ambulance available within the VRAP response area for more than one hour.
(B) Other terms. All terms which are not defined in this subchapter will have the meanings as such terms are defined in I.C. 16-31 et. seq., I.C. 36-8-16, and any statutes, rules, or regulations promulgated thereunder by the Emergency Medical Services Commission of the State of Indiana or by the Indiana Legislature.
(Ord. 9-2008, passed 12-8-2008; Ord. 2-2014, passed 1-30-2014)