For the purpose of this part, the following terms are defined:

1. (1) “Advanced emergency medical technician (AEMT)” means a provider certified by the National Registry of Emergency Medical Technicians who is licensed in Arkansas at the advanced EMT level;
2. (2) “Advanced response service” means a licensed nontransporting service that is requested to respond to the scene of an emergency;

3. (3) “Air ambulance” means a fixed-wing or rotor-wing aircraft:

   1. (A) Utilized for responses or transports deemed necessary by a physician; and
   2. (B) Licensed by the Department of Health;
4. (4) “Air ambulance communication specialist” means personnel assigned to receive and coordinate all requests for the air ambulance service;
5. (5) “Air ambulance service” means a service operating an aircraft used for air transportation that is specifically designed to accommodate the air medical needs of persons who are ill, injured, wounded, or otherwise mentally or physically incapacitated or helpless who may require emergency medical care in-flight;

6. (6) “Air ambulance service medical director” means an Arkansas-licensed medical doctor or doctor of osteopathy who:

   1. (A) Provides medical oversight for any licensed air ambulance service;
   2. (B) Is either American Board of Emergency Medicine-certified or American Board of Emergency Medicine or General Surgery-eligible; and
   3. (C) Is on file with the Department of Health as the medical director;

7. (7)

   1. (A) “Air ambulance service medical director (specialty)” means an Arkansas-licensed medical doctor or doctor of osteopathy who provides medical oversight for any licensed air ambulance service that solely provides specialty air transport services (for example, pediatrics, neonatal, or high-risk obstetrics), rotor-wing or fixed-wing aircraft.
   2. (B) The individual requires licensure or board eligibility in the specialty designation of the air ambulance service for which they have medical oversight;
8. (8) “Air medical personnel” means personnel responsible for patient care on an air ambulance;

9. (9)

   1. (A) “Ambulance (ground)” means vehicles used for transporting any person by stretcher or gurney upon the streets or highways of Arkansas, excluding vehicles intended solely for personal use.
   2. (B) All ambulances shall be issued a permit by the Department of Health;
10. (10) “Ambulance service” means services authorized and licensed by the Department of Health to provide care and transportation of patients upon the streets and highways of Arkansas;

11. (11) “Community paramedic” means a paramedic who:

    1. (A) Is licensed by the Department of Health;

    2. (B) Provides care or services, or both, to patients:

       1. (i) Not qualified for home health services; or
       2. (ii) Who are qualified but have rejected home health services; and
    3. (C) Meets all additional licensure requirements;
12. (12) “Controlled drugs” means drugs identified as Schedule II – V as designated by federal law;

13. (13) “Coordination point” means a fixed location or locations where:

    1. (A) Information about an air ambulance service may be obtained; and
    2. (B) Activities such as dispatch, resource allocation, and flight operations are conducted;
14. (14) “Emergency medical responder (EMR)” means a provider certified by the National Registry of Emergency Medical Technicians who is licensed in Arkansas at the EMR level;

15. (15) “Emergency medical services (EMS)” means the:

    1. (A) Transportation and medical care provided to the ill or injured prior to arrival at a medical facility by licensed emergency medical services personnel or other healthcare providers and continuation of the initial emergency care within a medical facility subject to the approval of the medical staff and governing board of that facility; and
    2. (B) Comprehensive integrated medical care in emergency and nonurgent settings with the oversight of a physician;
16. (16) “Emergency medical services advisory council” means the individuals appointed by the Governor to assist and advise the Department of Health concerning matters dealing with emergency medical services;
17. (17) “Emergency medical services education program (EEP)” means those organizations authorized and accredited by the Department of Health and the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) to provide EMS education in Arkansas;
18. (18) “Emergency medical services education program training site authorization and accreditation” means authorization and accreditation issued by the Department of Health or the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) to an organization for the purpose of engaging in EMS education in the State of Arkansas;

19. (19)

    1. (A) “Emergency medical services provider (EMSP)” means an individual licensed by the Department of Health at any level established by the rules adopted by the State Board of Health and authorized to perform those services set forth in the rules.

    2. (B) These shall include without limitation:

       1. (i) EMR;
       2. (ii) EMT;
       3. (iii) AEMT;
       4. (iv) Paramedic;
       5. (v) Community paramedic; and
       6. (vi) EMSP instructor;
20. (20) “Emergency medical services provider instructor” means a person who has been licensed to teach an emergency medical services provider course after completing a Department of Health-approved EMSP — Instructor course and completion of all the instructor requirements;
21. (21) “Emergency medical technician (EMT)” means a provider certified by the National Registry of Emergency Medical Technicians who is licensed in Arkansas at the EMT level;
22. (22) “Emergency request” means a request for assistance to an incident that is perceived to have created an actual threat to human life or wellbeing where immediate medical intervention by any EMSP or other health professional is needed;

23. (23) “Emergency vehicle operator (EVO)” means a person who:

    1. (A) Is certified by the Department of Health; and
    2. (B) Has successfully completed a nationally recognized first responder course with a minimum of forty (40) hours of training and an emergency vehicle operator course;

24. (24)

    1. (A) “Encounter form” means a patient care report (PCR) that includes all state-required data elements and has been approved by the Department of Health that describes the EMS encounter, and is submitted to the destination facility at time of service or within twenty-four (24) hours after transfer of care.

    2. (B) This form:

       1. (i) May be electronic or a printed copy; and
       2. (ii) Must include a patient narrative;
25. (25) “Federal Aviation Administration FAR Part 135” means Federal Aviation Administration regulations governing air taxi operations and commercial operations of fixed-wing and rotor-wing aircraft;

26. (26) “Fixed-wing aircraft” means a fixed-wing air ambulance licensed by the Department of Health that is:

    1. (A) Specially constructed and equipped; and
    2. (B) Intended to be used for transportation of patients;

27. (27)

    1. (A) “Flight nurse” means a registered nurse (RN) licensed to practice in Arkansas who holds a current Arkansas EMSP license.

    2. (B) An RN that solely provides air ambulance specialty services (for example, pediatrics, neonatal, or high-risk obstetrics), or fixed-wing transports the flight nurse shall not:

       1. (i) Be required to be an Arkansas-licensed EMSP; and
       2. (ii) Participate in air ambulance service prehospital transports;

28. (28)

    1. (A) “Flight physician” means a physician assigned to flight duty.
    2. (B) The physician must be a postgraduate year 3 or above, with a current and valid license to practice medicine as a medical doctor or doctor of osteopathy in Arkansas or in the state of primary operation of the air ambulance service.
    3. (C) This physician must be American Board of Emergency Medicine or General Surgery-certified or eligible in emergency medicine or general surgery or certified in a specialty (for example, neonatal, pediatrics, high-risk obstetrics, etc.) served by the transport service.
    4. (D) This physician must be certified in at least one (1) of the following, Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Neonatal Resuscitation Program (NRP), or their equivalents for the patient population served;

29. (29)

    1. (A) “Ground ambulance service area” means the contiguous land area within a county defined by city or identifiable geographical landmarks or county boundaries, for which area the ground ambulance service has an operational base and commits to providing all emergency medical services requested.
    2. (B) Service area maps shall be kept on file and renewed annually with the service’s license renewal;
30. (30) “Intercept” means instances where a transporting service requests assistance from an ambulance service that provides an equal or higher level of medical care and/or transport;
31. (31) “Legend drug” means any drug that requires a prescription by a licensed physician as required by federal law;
32. (32) “Licensure” means official acknowledgment by the Department of Health that an individual has demonstrated competence to perform the emergency medical services required for licensure under the rules and standards adopted by the State Board of Health upon the recommendation of the Emergency Medical Services Advisory Council;

33. (33)

    1. (A) “Mass casualty incident” means an event involving a number of people who are suddenly injured or become ill that overwhelms the local ambulance services, where the number of casualties vastly exceeds the local resources and capabilities in a short period of time.
    2. (B) If two (2) or more additional ambulance services are required to respond to the same event and/or assistance from the Department of Health is needed to assist in the coordination of medical resources, then the Department of Health shall be notified;
34. (34) “Medical director (community paramedic service)” means an Arkansas-licensed medical doctor or doctor of osteopathy who is either American Board of Emergency Medicine-certified or eligible in a specialty that is involved in direct patient contact;
35. (35) “Medical director (EMT or AEMT)” means an Arkansas-licensed medical doctor or doctor of osteopathy who is either an emergency department physician or a physician who is either American Board of Emergency Medicine-certified or eligible in their specialty;

36. (36)

    1. (A) “Medical director (paramedic)” means an Arkansas-licensed medical doctor or doctor of osteopathy who shall be registered with the Department of Health who is familiar with the design and operation of EMS systems and experienced in prehospital emergency care and emergency management of ill and injured patients.

    2. (B) The medical director shall:

       1. (i) Be American Board of Emergency Medicine-certified or eligible in emergency medicine; or
       2. (ii) Have current experience in emergency medicine.
    3. (C) For paramedic services that currently have a medical director that is not American Board of Emergency Medicine-certified but holds a current Advanced Cardiac Life Support certification, they shall be authorized to utilize that medical director until such time as they change or replace medical directors;

37. (37) “Medical facility” means any:

    1. (A) Hospital;
    2. (B) Medical clinic;
    3. (C) Physician’s office;
    4. (D) Nursing home; or
    5. (E) Other healthcare facility;

38. (38)

    1. (A) “Mutual aid” means an agreement between services to lend assistance across jurisdictional boundaries.
    2. (B) This may occur due to an emergency response that exceeds local resources;

39. (39)

    1. (A) “National Registry of Emergency Medical Technicians (NREMT)” means a not-for-profit, independent, nongovernmental agency that functions as a registration agency that issues certificates of competency verified by the achievement of minimal competencies of EMRs, EMTs, AEMTs, and paramedics.
    2. (B) The NREMT provides a valid, uniform process to assess the knowledge and skills required for competent practice required by licensed EMSPs;

40. (40)

    1. (A) “Of unsound mind” means and includes the inability to perceive all relevant facts related to one’s condition and proposed treatment, whether the inability is only temporary or has existed for an extended period of time or occurs or has occurred only intermittently and whether or not it is due to:

       1. (i) A natural state;
       2. (ii) Age;
       3. (iii) Shock or anxiety;
       4. (iv) Illness;
       5. (v) Injury;
       6. (vi) Drugs or sedation;
       7. (vii) Intoxication; or
       8. (viii) Other cause of whatever nature.
    2. (B) See Arkansas Code § 20-9-601;

41. (41) “Operational base” means a facility within the service area of the ground or air ambulance service or services designated to house the:

    1. (A) Ground or air ambulances;
    2. (B) Crew members;
    3. (C) Supplies; and
    4. (D) Communication equipment;
42. (42) “Paramedic” means a provider certified by the National Registry of Emergency Medical Technicians who is licensed in Arkansas at the paramedic level;
43. (43) “Probation” means an administrative action imposed on an EMS service, any EMSP license, or Department of Health-authorized and Department of Health-accredited training site for violations of this part;

44. (44)

    1. (A) “Program director” means an individual responsible for oversight of a Department of Health-approved EMS education program.
    2. (B) Program directors are authorized to verify the successful completion of EMS education;
45. (45) “Protocols” means written standing orders authorized by ambulance services, approved and signed by the ambulance service medical director of the licensed ambulance service;

46. (46)

    1. (A) “Reaction time” means the time from when the emergency call is received by the ambulance services’ dispatch and adequate information is made available that identifies the location and nature of the call, until the ambulance is en route.
    2. (B) This time shall be two (2) minutes or less for ground ambulances and ten (10) minutes or less for rotor-wing (excluding specialty rotor-wing and fixed-wing);
47. (47) “Receiving facility” means a hospital emergency department, hospital, or medical facility capable of receiving and treating patients;
48. (48) “Revocation” means an administrative action imposed by the Department of Health that terminates any EMS service license, EMSP license, or Department of Health-authorized training site for violating this part;

49. (49) “Rotor-wing aircraft” means a rotor-winged air ambulance permitted by the Department of Health that is:

    1. (A) Specially constructed and equipped; and
    2. (B) Intended to be used for the transportation of emergency medical patients;
50. (50) “Service license” means a license issued by the Department of Health to a person, firm, corporation, association, county, municipality, or other legal entity for the purpose of engaging in care and/or transport of patients in the State of Arkansas;
51. (51) “Short form” means an abbreviated, Department of Health-approved patient care report that is left at the medical facility at time of transfer of care when a completed encounter form is not available;

52. (52) “Specialty mission” means an assignment for an air ambulance where the specified needs of a particular patient may require the substitution of particular:

    1. (A) Medical care providers;
    2. (B) Medical direction; and/or
    3. (C) Equipment;

53. (53) “Specialty purpose service” means a licensed service that:

    1. (A) Provides a specific medical service to a limited population group and emergency evacuation services only; and
    2. (B) Does not participate in the business of providing continuous general population response for emergency medical services;

54. (54)

    1. (A) “Stretcher” means any apparatus that is used to transport individuals in the supine or Fowler’s position.
    2. (B) This includes all devices that can be transformed from wheelchair to stretcher;
55. (55) “Suspension” means an administrative action imposed by the Department of Health that temporarily removes an EMS service license, any EMSP license, or training site authorization and accreditation for violating this part;
56. (56) “Training site representative” means an individual responsible for the organization, coordination, and day-to-day operations of the EMS education programs designated by the program director; and
57. (57) “Volunteer ambulance service” means an ambulance service operating an EMT — Volunteer permitted ambulance that is staffed by personnel who perform and give services without expectation of compensation.