048-14 Wyo. Code R. §§ 14-6 - Agency Approval Requirements

(a) EMS Agencies may apply for approval to provide services at one of the following levels:

(i) Community EMS Technician (CET) Agency. The activities of these agencies are directed towards reducing the burden of patients accessing the larger health care system through the emergency medical system. Community EMS Technician Agencies may utilize either Community EMS Technicians or Community EMS Clinicians to perform the following activities:

(A) Appropriately treating and releasing patients, rather than providing transport to a hospital or emergency department;

(B) Treating and transporting patients to appropriate destinations other than a hospital or an emergency department if the Community EMS Technician Agency is operated under a valid Ambulance Business License;

(C) Treatment and referral to a primary care or urgent care facility;

(D) Assessment of the patient and reporting to a primary care provider to determine an appropriate course of action.

(ii) Community EMS Clinician (CEC) Agency. The activities of these programs are directed toward the integration of EMS personnel in addressing specific gaps in a community's primary and public health care systems, and may incorporate the activities of a Community EMS Technician program. Community EMS Clinician Agencies may utilize Community EMS Clinicians for the purpose of integrating EMS personnel in addressing specific gaps in a community's primary and public health care systems. Community EMS Clinician Agencies may also utilize either Community EMS Technicians or Clinicians for activities listed in Section 4(c).

(b) Prior to initiation of operations as a Community EMS Agency, proposals for programs shall be submitted to the Division for approval. Proposals shall contain and describe:

(i) The area and population to be served;

(ii) The conclusions or recommendations of a healthcare gap assessment in the area and population;

(iii) The healthcare goals and objectives;

(iv) The benchmarks and performance measures that will be utilized to measure the efficacy of the program;

(v) The treatment protocols intended to meet the healthcare goals and objectives;

(vi) The name and contact information of the Physician Medical Director providing clinical oversight to the program;

(vii) The name and contact information of the person serving as the administrator of the program; and

(A) A Memorandum of Agreement with the local ambulance service or services operating in the same area if the Community EMS Agency is not the ambulance service typically providing transport. Memoranda of Agreement must address:

(B) An acknowledgement by the local ambulance service or services that a Community EMS Agency is operating in the same service area;

(C) Coordination for the transport of a patient seen by the Community EMS Agency in the event of a real or perceived emergency;

(D) Coordination for the continuance of care in the event that a patient of the Community EMS Agency requires transport. If the Community EMS Technician or Clinician is licensed at the same level or lower than the EMT of the ambulance service, the ambulance service Agency shall assume control of the patient for transport. If the Community EMS Technician or Clinician is licensed at a level higher than that of the attending EMT of the ambulance service, the Community EMS Technician or Clinician may continue as the primary caregiver, assuming that the ambulance service has agreed to relinquish care in the Memorandum of Agreement; and

(E) Memoranda of Agreement must contain the signatures of the Ambulance Service Administrator, the Community EMS Agency Director or administrator, and the Physician Medical Directors of both the ambulance service and the Community EMS Agency.

(c) If a patient has a care plan, then the Community EMS Technician or Clinician may provide services of the care plan only if the plan has been developed by the patient's primary care provider and there is no duplication of services to the patient from another provider.

(d) The Community EMS Technician or Clinician shall provide only those services listed in a care plan that are within the scope of services and practice of the Community EMS Agency, and that are approved in protocols or standing orders by the medical director of the Community EMS Agency.

(e) The Division may approve the Community EMS Agency proposal when the Division is satisfied that the proposal adequately addresses the requirements of this section. The Division may request supplemental information or clarification of any information contained in the proposal prior to approval.

(f) Approval as a Community EMS Agency shall remain valid for a period of five (5) years from the date of approval.

(g) No later than one hundred and twenty (120) days prior to the expiration of the current approval, the Community EMS Agency must submit a request for continuation as a Community EMS Agency utilizing the requirements specified under paragraph (b) of this section. Requests for continued approval must include an evaluation of the efficacy of the Community EMS Agency in meeting its stated goals and objectives, supported by valid clinical and financial data.

(h) An approved Community EMS Agency may request an amendment to its proposal and functions at any time by a submitting the requested amendment in writing to the Division.

(i) The Division may revoke a Community EMS Agency's approval for:

(i) Failure to operate the Community EMS Agency in accordance with the approved proposal;

(ii) Failure to utilize EMTs endorsed at the appropriate level for the Community EMS Agency; or

(iii) Failure to maintain compliance with any of these rules or the Wyoming Emergency Medical Services Act of 1977.

Notes

048-14 Wyo. Code R. §§ 14-6

Adopted, Eff. 7/25/2016. Amended, Eff. 8/11/2023.