(a) Air ambulance service classifications standards. Each vehicle of a licensed air ambulance service shall be issued a permit in one (1) of the classifications set forth below:

1. (1) Air medical rotor-wing;
2. (2) Air medical rotor-wing specialty; or
3. (3) Air medical fixed-wing.

(b) General standards.

1. (1) A vehicle may not be operated as an air ambulance prior to the:

   1. (A) Application;
   2. (B) Required documentation;
   3. (C) Payment of fees; and
   4. (D) Receipt of a permit issued by the Department of Health.
2. (2) Permits shall be for a period not to exceed one (1) year.
3. (3) Each licensee shall have a current Federal Aviation Administration FAR Part 135 Air Carrier Certificate.
4. (4) Refueling of an aircraft shall follow the Federal Aviation Administration standards outlined in the certificate holder’s operation manual.
5. (5) Air ambulance services based outside of Arkansas that do hospital-to-hospital transports, including emergency scene flights and hospital-to-hospital transfers within the State of Arkansas, shall be subject to the requirements of this part in conjunction with other states’ applicable rules when appropriate.
6. (6) Each air ambulance service shall have and maintain a coordination point twenty-four (24) hours a day, seven (7) days a week.

7. (7)

   1. (A) Each air ambulance shall contact the referring and receiving medical facilities or ground scene personnel once within radio range, giving them:

(i) The estimated time of arrival; and

1. (ii) When on final approach.

   1. (B) Otherwise, the coordination point shall have this responsibility.

2. (8) The following information shall be logged for all flights:

   1. (A) Time the call was received;
   2. (B) Time the aircraft was dispatched;
   3. (C) Time the aircraft departed;
   4. (D) Name of the party requesting the flight with verification telephone number; and
   5. (E) Pertinent medical and logistical support information.

3. (9)

   1. (A) Each air ambulance operator must maintain a patient encounter record from each patient flight for seven (7) years.
   2. (B) This record may be electronic or printed copy.
4. (10) All air ambulance services must coordinate aircraft departures and arrivals with required surface transportation to avoid delays.

5. (11)

   1. (A) Each air ambulance service shall have a medical director.
   2. (B) This medical director shall provide the Drug Enforcement Administration registration for the service.
   3. (C) The medical director shall ensure:
   4. (A) That all EMSPs for which direction is provided are properly educated and licensed pursuant to this part, including skills verification;
   5. (B) That each EMSP for which direction is provided follows service protocols.
   6. (C) The licensed services for which direction is provided are following this part.
   7. (D) The service’s written protocols are reviewed annually and prior to the implementation of any changes and review of the duty readiness policy.
6. (12) Each service shall maintain a register of legend drugs as outlined in 20 CAR § 81-114.
7. (13) Each service shall maintain a copy of the Department of Health-approved medication policy and procedures that meets the requirements of the Division of Pharmacy Services and Drug Control.

8. (14)

   1. (A) Each permitted aircraft shall always keep a current copy of the service’s approved offline medical control protocols in the aircraft.
   2. (B) These can be printed or electronic.

9. (15) Quality assurance program for licensed ambulance services. Documentation for the quality assurance program and review shall include the following:

   1. (A) The criteria used to select audited runs;
   2. (B) Ambulance encounter form review;
   3. (C) Problem identification and resolution;
   4. (D) Investigation of complaints or incident reports;
   5. (E) Date of review;
   6. (F) Attendance at the review; and
   7. (G) A summary of the review discussion.

10. (16)

    1. (A) Any authorized representative of the Department of Health shall have the right to enter the premises of any service or permitted ambulance at any time to make whatever inspection necessary in accordance with the minimum standards and rules prescribed herein.

    2. (B) Each service shall maintain and make available to the Department of Health for inspection all patient encounter forms.

       1. (c) Specific air medical service standards.

11. (1) Each air medical rotor-wing and air medical rotor-wing specialty ambulance shall:

    1. (A) Provide twenty-four-hour emergency ambulance service coverage;
    2. (B) Meet the ten-minute reaction time with the exception of hazardous weather conditions that would preclude response;
    3. (C) Have a minimum of one (1) incoming telephone line dedicated to emergency requests for the air ambulance service;

    4. (D) Have an air ambulance communication specialist that is an EMT licensed and certified by the state where the communications center is located and:

       1. (i) Present in the communication center; and
       2. (ii) Actively involved in the communications process;

    5. (E) A communication center with the following:

       1. (i)

(b) (b) The system must have time-encoding and playback capabilities.

1. (c) (c) Recordings shall be kept for a minimum of sixty (60) days; and

   1. (ii)

(b) (b) Maps:

1. (1) (1) Shall be a Department of Transportation General Highway Map for Counties or the equivalent; and

2. (2) (2) Can be electronic or a printed copy;

   1. (F) Have personnel capable of plotting scene coordinates and directing the helicopter to a scene location twenty-four (24) hours a day;

   2. (G) Each air rotor-wing aircraft must have:

      1. (i) Radio capability to communicate air-to-ground; and
      2. (ii) The ability to communicate with:

(b) (b) Ground personnel who coordinate the transfer of the patient;

1. (H) Have a policy addressing post-accident or incident plan; and

   1. (I)

      1. (i) Arrange for flight following at least every fifteen (15) minutes.
      2. (ii) Documentation of such flight following must be maintained during all phases of flight.

2. (2) Each air medical fixed-wing ambulance shall have:

   1. (A) A minimum of one (1) incoming telephone line dedicated to requests for the air ambulance service; and
   2. (B) An air ambulance communication specialist assigned to receive all dispatch and flight request information on behalf of the air ambulance service.