Title: Section 800.3 - Definitions

800.3 Definitions. The following definitions shall apply to this Chapter unless the context otherwise requires:

(a) Department means the New York State Department of Health.

(b) Commissioner means the State Commissioner of Health.

(c) Person means an individual, partnership, association, corporation or any other legal entity whatsoever.

(d) Emergency medical service means a service engaged in providing initial emergency medical assistance including, but not limited to, the treatment of trauma, burns and respiratory, circulatory and obstetrical emergencies.

(e) Ambulance means a motor vehicle, airplane, boat or other form of transport especially designed and equipped to provide emergency medical services during transit.

(f) Ambulance service means a person engaged in providing emergency medical services and the transportation of sick, disabled or injured persons by motor vehicle, aircraft or other form of transportation to facilities providing hospital services.

(g) Voluntary ambulance service means an ambulance service (i) operating not for financial profit and (ii) no part of the assets or income of which is distributable to, or enures to the benefit of, its members, directors or officers except to the extent permitted under article 30.

(h) Municipal ambulance service means an ambulance service operated by a municipality or agency thereof and staffed by municipal employees or an ambulance service operated by a county or agency thereof and staffed by county employees.

(i) Hospital ambulance service means an ambulance service owned and operated by a hospital as defined in article 28 of the Public Health Law.

(j) Certified ambulance service means an ambulance service having an ambulance service certificate issued by the department pursuant to section 3005 or 3006 of the Public Health Law.

(k) Certificate of inspection means a windshield sticker affixed to the lower right hand corner of the windshield of the ambulance. The sticker signifies that the vehicle has been inspected and approved by the department for operation in a certified ambulance service.

(l) New vehicle means a vehicle of recent manufacture placed in service for the first time.

(m) Emergency ambulance service Vehicle means a vehicle that is owned or operated by an ambulance service that is used to transport emergency medical personnel and equipment to sick or injured persons.

(n) Certified first responder means a person certified pursuant to these regulations as a first responder.

(o) Emergency medical technician means a person certified pursuant these regulations as an emergency medical technician.

(p) Advanced emergency medical technician means a person certified pursuant to these regulations as an advanced emergency medical technician, an emergency medical technician-critical care, or an emergency medical technician-paramedic.

(q) State Council means the New York State Emergency Medical Services Council established pursuant to section 3002 of article 30 of the Public Health Law.

(r) Regional council means a regional emergency medical services council established pursuant to section 3003 of article 30 of the Public Health Law.

(s) Certified instructor coordinator means a person certified pursuant to these regulations to serve as the lead instructor for courses leading to certification as a certified first responder, emergency medical technician or advanced emergency medical technician. Certified instructor coordinators must be certified, pursuant to these regulations, at or above the level at which they seek to instruct.

(t) Certified laboratory instructor means a person certified pursuant to these regulations to instruct, in psychomotor skills, candidates in courses leading to certification as an emergency medical technician or certified first responder or advanced emergency medical technician.

(u) Advanced life support system means a method for the provision of initial emergency medical assistance under medical direction and supervision including, but not limited to, one or more of the following services:

(1) administration of intravenous fluids;

(2) administration of drugs;

(3) intubation;

(4) manual defibrillation; and

(5) and other services as approved by the commissioner and council.

(v) Primary territory means that area listed on an ambulance or advanced life support first response service certificate in which the service may treat or receive (pick up) patients.

(w) Continuous Practice means a certified individual having:

(1) actively provided prehospital patient care during their period of certification, at or below their level of certification; and

(2) been a current, active member or employee of an EMS agency recognized by the department, during their period of certification.

(x) Course Sponsor means a person approved by the department to conduct EMS Educational Programs as one or more of the following specific types of course sponsor:

(1) Basic Life Support Course Sponsor - a course sponsor authorized by the department to conduct original and refresher CFR and EMT courses.

(2) Advanced Life Support Course Sponsor - a course sponsor authorized by the department to conduct all basic life support courses, AEMT and EMT-CC original and refresher courses, and the EMT-P original and refresher courses.

(3) Continuing Education Course Sponsor - a course sponsor authorized by the department to conduct one or more of the following courses, including, but not limited to: Certified Instructor Coordinator, Certified Lab Instructor, Certified Instructor Update, or other continuing education courses developed by the department. Approval as a continuing education course sponsor is specific to the EMS educational programs that the sponsor is authorized to offer and not all sponsors will be approved to offer all types of courses.

(y) Learning Contract means a written agreement between a student and a course sponsor which specifies requirements to complete the course and the policies of the sponsor.

(z) "DNR bracelet" means an item meeting the Department of Health specification in section 800.90 of this Part which may be worn by a person who has been issued a valid non-hospital order not to resuscitate.

(aa) Automated External Defibrillation (AED) means defibrillation by a certified first responder, emergency medical technician or advanced emergency medical technician using an external defibrillator that incorporates an electronic rhythm analysis system that limits the delivery of an electrical counter shock to a rhythm for which defibrillation is medically indicated. The external defibrillator may be either a fully automatic or semiautomatic (shock-advisory) type.

(ab) "Mutual aid agreement" means a written agreement, entered into by two or more ambulance services or advanced life support first response services for the organized, coordinated and cooperative reciprocal mobilization of personnel, equipment, services or facilities for back-up or support upon request as required pursuant to a written mutual aid plan.

(ac) "Call receipt interval" means the elapsed time from receipt of a request for emergency assistance by the service or its dispatch agency to the time a staffed ambulance or ALSFR vehicle is en route to the reported location of the incident.

(ad) "Advanced life support (ALS) care" means definitive acute medical care provided under medical control, by advanced emergency medical technicians within an advanced life support system.

(ae) "Advanced life support first responder (ALSFR) service" means any person or organization which provides advanced life support care, but does not transport patients.

(af) "Advanced life support first response (ALSFR) vehicle" means a designated vehicle or conveyance operated by an ALSFR service, which brings advanced life support equipment and personnel authorized to provide ALS care to a location to provide such care.

(ag) "Quality improvement program" means a system which seeks to improve and enhance the quality and appropriateness of patient care and clinical performance of the service.

(ah) "Governing authority" means in the case of a fire district, the board of fire commissioners; or in the case of a municipality, the municipality's legislative body; or in the case of a corporation, the board of directors; or in the case of a hospital, the governing body; or in the case of a partnership, each of the partners; or in the case of a sole proprietorship, the proprietor; or in the case of an unincorporated association, all the members of the association.

(ai) "EMS service" means an ambulance service or an advanced life support first response service.

(aj) "Authorized EMS response vehicle" means any vehicle, conveyance, boat or aircraft meeting the requirements of this part authorized by the governing authority and operated by an EMS service for the purpose of providing certified personnel and equipment to an event dispatched as an EMS response.

(ak) Criminal offense means, except in exceptional circumstances as determined by the agency, convictions in any jurisdiction for felonies involving murder, manslaughter, assault, sexual abuse, theft, robbery, fraud, embezzlement, drug abuse, or sale of drugs.

(al) Incompetence means a lack of, or loss of, skill or knowledge to practice the profession, and/or practicing with negligence, as negligence is defined in this part, on one or more occasions while treating a patient.

(am) Negligence means a failure to perform, on one or more EMS calls, as an ordinary, reasonable, similarly situated certificate holder certified at the same level would, based upon the standard of care in the region, as delineated in controlling protocols, curricula, and policies, and as demonstrated by an ordinary, reasonable certificate holder’s general standards of practice.

(an) Non-criminal offense means findings of inappropriate conduct or misconduct not constituting a criminal offense in any jurisdiction, including, but not limited to, findings by either a designated governmental authority or a court of law of patient abuse, neglect, mistreatment, or misappropriation of patient property; Family Court findings of spousal and/or intimate partner violence; Family Court or other designated governmental entity findings of child abuse, neglect or abandonment; vehicle and traffic findings involving reckless and/or aggressive driving; findings by any governmental entity of diversion of controlled substances from any health care facility, health care provider, or pharmacy; and any governmental findings involving dishonesty and/or other unethical conduct evincing unfitness to serve the public.

(ao) Patient Abandonment means a certificate holder’s willful termination of patient contact prior to delivering the patient for medical evaluation and/or treatment, or securing a proper refusal of medical attention in accordance with applicable protocol. Patient abandonment may be effected through means including, but not limited to, leaving a patient unattended after establishing patient contact, leaving a patient to the care of an EMT certified at a lower level when the certificate holder knew or should have known that the patient required a higher level of care, and/or encouraging the patient and/or bystanders to reject transport to a hospital by ambulance unless it occurs within an organized multi patient/agency response.

(ap) Patient abuse means any inappropriate and/or offensive physical, sexual or verbal contact or interaction with a patient, irrespective of whether the certificate holder is specifically acting in his/her capacity as an EMT when (s)he engages in the abuse, including but not limited to the following:

(1) Physical abuse means conduct by a certificate holder which causes, by physical contact, physical injury, or serious or protracted impairment of the physical, mental or emotional condition of a patient, or which causes the likelihood of such injury or impairment. Such conduct may include, but shall not be limited to, slapping, hitting, kicking, biting, chocking, smothering, shoving, dragging, pinching, punching, shaking, sitting upon, burning, cutting, strangling, striking, using corporal punishment, or throwing objects at a patient. Physical abuse shall not include reasonable emergency interventions necessary to protect the safety of any person.

(2) Psychological abuse means verbal or non-verbal conduct by a certificate holder, directed to a patient, which insults, denigrates, humiliates, shocks, mocks, threatens, harasses, or alarms the patient. Psychological abuse shall not include verbal or non-verbal conduct which has medical or therapeutic purpose or justification.

(3) Sexual abuse means conduct by a certificate holder, which subjects a patient to any offense defined in article one hundred thirty, two hundred forty-five of the penal law; or any conduct or communication by a certificate holder that allows, permits, uses or encourages a patient to engage in any act described in two hundred sixty-three of the penal law. Offensive sexual contact or conduct may include, but shall not be limited to, engaging in, or facilitating sexual contact, exposure, performances, photography or any other form of sexual image collection and/or dissemination, irrespective of the patient’s receptiveness to the conduct.

(aq) Patient contact means that the certificate holder has assessed, the patient and the circumstances in which the patient is found, when responding to a request for emergency medical services and that the patient has either accepted care or the patient’s acceptance of care is implied from the circumstances or from his (her) inability to respond.

(ar) Statutory and/or regulatory violation means any finding or determination by a court or governmental agency holding jurisdiction to adjudicate allegations of violations of EMS laws, regulations and/or protocols.

(as) Scope of practice means the psychomotor skills and knowledge necessary for the minimum competence for each level of New York State EMT certification as approved by the Commissioner.

(at) State-approved protocols means Basic Life Support (BLS) patient care protocols which apply throughout New York State and which are distributed to every certificate holder certified at every level, and protocols established by the Regional Emergency Medical Advisory Committees (REMACs) which are approved and distributed to every certificate holder credentialed by the REMAC.

(au) Treatment means the pre-hospital administration or application of a remedy or remedies by a certificate holder to a patient for a condition, disease or injury when rendering emergency medical services.