Authority: IC 16-31-2-7; IC 16-31-3-20

Affected: IC 16-31-3-20

Sec. 1. (a) Any organization based in Indiana providing, or seeking to provide, fixed-wing air ambulance services utilizing fixed-wing aircraft is required to be certified as an advanced life support fixed-wing air ambulance service provider organization by the commission. The advanced life support fixed-wing air ambulance service provider organization shall be certified in accordance with this article under IC 16- 31 as appropriate.

(b) The provider organization of fixed-wing air ambulance services shall ensure that the aircraft used in conjunction with the provision of advanced life support services meets the guidelines as specified in this article under IC 16-31 and is certified by the commission. Each fixed-wing air ambulance service provider organization shall meet all applicable parts of F.A.A. regulation and shall hold a valid 14 CFR 135 air carrier certificate or shall have a contract with the holder of a 14 CFR 135 air carrier certificate to provide aviation services under their certificate. Either must also have current F.A.A. approved air ambulance operations specifications.

(c) Advanced life support fixed-wing air ambulance service provider organizations will have an agreement with one (1) or more supervising hospitals for the following services:

1. (1) Continuing education.
2. (2) Audit and review.
3. (3) Medical control and direction.
4. (4) Provide liaison and direction for supply of medications, fluids, and other items utilized by the provider organization.
5. (5) Safety and survival programs and education.

The agreement will include a detailed description of how such services will be provided to the advanced life support fixed-wing air ambulance service provider organization. In those cases where more than one (1) hospital enters into an agreement, or seeks to enter into an agreement, with an advanced life support fixed-wing air ambulance service provider organization as a supervising hospital, an interhospital agreement will be provided to the agency that clearly defines the specific duties and responsibilities of each hospital to ensure medical, safety, and administrative accountability of system operation. An agreement is not required when the hospital and the provider are the same organization.

(d) The advanced life support fixed-wing air ambulance service provider organization will have an air-medical director provided by the advanced life support fixed-wing air ambulance service provider organization, or jointly with the supervising hospital, who has knowledge of air transport problems and flight physiology. The air-medical director is responsible for providing competent medical direction and overall supervision of the medical aspects of the advanced life support fixed-wing air ambulance service provider organization. The duties and responsibilities of the air-medical director include, but are not limited to, the following:

1. (1) Assume all medical control and authority over any and all patients treated and transported by the fixed-wing air ambulance service.
2. (2) Providing liaison with physicians.
3. (3) Assuring that the drugs, medications, supplies, and equipment are available to the advanced life support fixed-wing air ambulance service provider organization.
4. (4) Monitoring and evaluating overall operations.
5. (5) Assisting in the coordination and provision of continuing education.
6. (6) Providing information concerning the operation of the advanced life support fixed-wing air ambulance service provider organization to the agency.
7. (7) Providing individual consultation to the air-medical personnel.
8. (8) Participating on the assessment committee of the supervising hospital in at least quarterly audit and review of cases treated by air- medical personnel.
9. (9) Attesting to the competency of air crewmembers affiliated with the advanced life support fixed-wing air ambulance service provider organization.
10. (10) Designating an individual or individuals to assist in the performance of these duties.

(e) Each fixed-wing air ambulance service provider organization shall designate one (1) person to assume responsibility for inservice training. This person shall be certified as a paramedic, a registered nurse, or a licensed physician and actively provide patient care during air transport.

(f) A fixed-wing air ambulance service provider organization shall not engage in conduct or practices detrimental to the health and safety of emergency patients or to members of the general public while in the course of business or service as a fixed-wing air ambulance service provider organization.

(g) Each advanced life support fixed-wing air ambulance service provider organization shall maintain an adequate number of trained personnel and aircraft to provide advanced life support services as advertised and specified in the fixed-wing air ambulance service provider organization's application for certification or certification renewal.

(h) Each fixed-wing air ambulance service provider organization shall designate one (1) person to assume the responsibilities for establishment of a safety committee consisting of the following:

1. (1) Pilot or pilots.
2. (2) Air-medical personnel.
3. (3) Aircraft maintenance technician or technicians.
4. (4) Communications personnel.

The safety committee shall meet at least quarterly and may be concurrent and in conjunction with the audit/review committee.

(Indiana Emergency Medical Services Commission; 836 IAC 3-3-1; filed Oct 11, 1988, 11:05 a.m.: 12 IR 374; filed May 15, 1998, 10:25 a.m.: 21 IR 3924; filed Apr 4, 2002, 9:08 a.m.: 25 IR 2498; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3556; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR- 836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)