1. (1) The licensed ambulance service must ensure that the service, employees, volunteers, qualified drivers, ambulance-based clinicians, agents and emergency medical services (EMS) medical directors comply with all of the requirements of these rules, ORS chapter 682, ORS 820.300 through 820.380, OAR division 333, chapter 255, and other applicable federal, state and local laws and regulations governing the operation of a licensed ambulance service.

2. (2) Prior to an employee, volunteer, qualified driver, or ambulance-based clinician staffing an ambulance, the licensed ambulance service shall:

   1. (a) Provide and require the completion of an initial orientation program that includes but is not limited to:

      1. (A) Ambulance service standing orders;
      2. (B) Ambulance service policies and procedures;
      3. (C) Driving and operating requirements for ambulance vehicles;
      4. (D) Operations of equipment; and
      5. (E) An overview of ORS chapter 682, OAR chapter 333, divisions 250 and 255 relating to ambulance services and vehicles, and OAR chapter 333, division 265 and OAR chapter 847, division 035 relating to EMS providers;

   2. (b) Ensure the successful completion of the following:

      1. (A) A training course that meets or exceeds the Basic Life Support (BLS) provider American Heart Association (AHA) Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) guidelines (this course must include a practical skills evaluation);
      2. (B) Air medical crew training in accordance with chapter 333, division 255 when operating an air ambulance;
      3. (C) Training in the proper operation of all ambulances and equipment that they use or are authorized to use;
      4. (D) Training in the proper use of any new equipment, procedure or medication prior to being placed into operation on an ambulance;
      5. (E) Training on how to properly lift and move a patient;
      6. (F) Training on the secure transportation of patients in custody in accordance with OAR chapter 309, division 033, if the licensed ambulance service performs or has been authorized to perform this service;
      7. (G) Hepatitis B immunization series unless there is a signed statement of declination; and
      8. (H) Tuberculosis screening; and

   3. (c) At least every two years, obtain a signed attestation from a qualified driver or ambulance-based clinician that the qualified driver or ambulance-based clinician:

      1. (A) Is free from any condition that would impair their ability to safely perform the functions of staffing or operating an ambulance; and
      2. (B) Will not staff or operate an ambulance while impaired.

3. (3) If a licensed ambulance service contracts with or employs an ambulance-based clinician for the purpose of providing advanced level care, the licensed ambulance service shall ensure that the ambulance-based clinician meets all of the training requirements in section (2) of this rule and have documentation that the clinician has completed the following:

   1. (a) A current AHA, Advanced Cardiac Life Support course or equivalent and a current AHA, Pediatric Advanced Life Support course or equivalent; and either
   2. (b) A current Prehospital Trauma Life Support course;
   3. (c) A current Basic Trauma Life Support course;
   4. (d) A current Trauma Emergency Assessment Management (TEAM) course; or
   5. (e) A Trauma Nurse Core Course (TNCC).
4. (4) The TEAM and TNCC courses referenced in section (3) of this rule must include a supplemental prehospital rapid extrication training session.

5. (5) In order to operate a ground ambulance vehicle, the licensed ambulance service must ensure the licensed ambulance service and its employees, volunteers, qualified drivers or ambulance-based clinicians:

   1. (a) Comply with all applicable Oregon Motor Vehicle Code statutes relating to motor vehicle and emergency vehicle operations and ORS 820.300 through 820.380;
   2. (b) Complete an emergency vehicle operator's course of instruction prior to independently operating an ambulance vehicle. The course must meet or be equivalent to the National Safety Council for Emergency Vehicle Operators Course (EVOC 3) or National Fire Protection Agency (NFPA) Fire and Emergency Service Vehicle Operations Training standards;
   3. (c) Have a valid driver's license; and
   4. (d) Have a certified copy of driving records from the Oregon Driver and Motor Vehicle (DMV) Services Division, Automated Reporting Service (ARS) program or equivalent for each person that may drive an ambulance vehicle. If the driver has an out-of-state driver’s license, the licensed ambulance service must obtain an equivalent certified copy driving record from that state if available, and if not available, conduct an annual driving record check. The latest copy must be kept in the driver’s personnel file.

6. (6) In addition to the requirements specified under sections (1), (2) and (5) of this rule, a qualified driver must:

   1. (a) Have a criminal background check conducted by the licensed ambulance service that determined the driver was suitable to operate a ground ambulance vehicle; or
   2. (b) Have been certified by the Department of Public and Safety Standards and Training within the last 365 days.

7. (7) A licensed ambulance service may not permit an employee, qualified driver, volunteer or ambulance-based clinician to operate an ambulance, equipment, or have contact with a patient if the employee, qualified driver, volunteer or ambulance-based clinician:

   1. (a) Is taking any medication that could impair safe operation and handling of the ambulance, equipment, or patient; or
   2. (b) Has consumed any alcoholic beverages within the last eight hours.

8. (8) In order to provide air ambulance service, the licensed ambulance service must ensure that the licensed ambulance service, employee, volunteer or ambulance-based clinician:

   1. (a) Comply with the Federal Aviation Regulation (FAR), 14 CFR Part 135; and
   2. (b) Successfully complete the 2004 Association of Air Medical Services (AAMS) Guidelines or equivalent. There must also be an annual review of the Air Medical Crew course material, the length of which must be established by the EMS medical director.

9. (9) The licensed ambulance service must submit a completed service reportable action form to the Oregon Health Authority (Authority), within 14 business days for any of the following actions:

   1. (a) Terminating or suspending an employee or volunteer for cause; and
   2. (b) Disciplinary action taken by the licensed ambulance service or the EMS medical director for unprofessional conduct as defined in OAR 333-265-0000.
10. (10) A licensed ambulance service that sponsors a Transitional Paramedic in accordance with OAR 333-250-0265(1)(s) must notify the Authority within 10 calendar days of the Paramedic's separation from employment or if the service otherwise elects to no longer sponsor the Paramedic.
11. (11) A licensed ambulance service must reflect any change to staffing, including addition or separation of, in the electronic licensing management system roster, within 30 calendar days.
12. (12) A licensed ambulance service must not schedule or allow an employee, volunteer or ambulance-based clinician to serve on an ambulance who is impaired by excessive fatigue, illness, injury or other factors that may reasonably be anticipated to constitute a threat to the health and safety of patients or the public.

Statutory/Other Authority

ORS 682.017 & 682.068

Statutes/Other Implemented

ORS 682.017 - 682.117 & 682.991

History

PH 19-2025, amend filed 09/24/2025, effective 01/01/2026
PH 52-2023, amend filed 11/07/2023, effective 12/01/2023
PH 87-2021, amend filed 12/09/2021, effective 01/01/2022
PH 55-2021, minor correction filed 10/05/2021, effective 10/05/2021
Renumbered from 333-250-0041, PH 7-2017, f. & cert. ef. 3-21-17
PH 14-2016, f. & cert. ef. 4-28-16
PH 1-2013, f. & cert. ef. 1-25-13
PH 11-2010, f. 6-30-10, cert. ef. 7-1-10
PH 2-2007, f. & cert. ef. 2-1-07
OHD 7-2001, f. & cert. ef. 4-24-01