Section 515.320  Scope of EMS Service

a)         All BLS, ILS, and ALS services, and CCT, as defined in the Act, shall be provided through EMS Systems.  An individual System shall operate at one or more of those levels of service, as specified in its Program Plan and the Department's letter of approval, using vehicles licensed by the Department pursuant to the Act and this Part.

b)         All pre-hospital, inter-hospital and non-emergency medical care, as defined in the Act, shall be provided through EMS Systems, using the levels of Department licensed or approved personnel required by the Act and this Part.

c)         An EMS System shall designate a Resource Hospital, which shall have the authority and responsibility for the System, through the EMS MD, as described in the Act, this Part and the System Program Plan.

d)         All other hospitals that are located within the geographic boundaries of a System and that have standby, basic or comprehensive level emergency departments must function in that System as either an Associate Hospital or Participating Hospital and follow all System policies specified in the System Program Plan, including, but not limited to, the replacement of drugs and equipment used by providers who have delivered patients to their emergency departments. (Section 3.20(b) of the Act)

1)         All hospitals shall be formally affiliated with a System.  A hospital may have a secondary affiliation with another System or may request a waiver to participate in a System other than that in which the hospital is geographically located.  (See Section 515.150(d)(5).)

2)         Every System Hospital shall identify the level of its emergency department services in its letter of commitment, which is part of the EMS System Program Plan to be submitted to the Department.

3)         An "Associate Hospital" shall provide the same clinical and communications services as the Resource Hospital, but shall not have the primary responsibility for personnel education and System operations.  It shall have a basic or comprehensive emergency department with 24-hour physician coverage and a functioning intensive care and/or cardiac care unit.

4)         All "Participating Hospitals" shall maintain ambulance to hospital communications capabilities that, at a minimum, include MERCI radio and comply with the Resource Hospital's communication plan.

5)         All System Hospitals shall agree to replace medical supplies and provide for equipment exchange for System vehicles.

6)         All Resource and Associate Hospitals monitoring telecommunications from EMS field personnel shall provide voice orders by the EMS MD, a physician appointed by the EMS MD, or an ECRN.

7)         All System Hospitals shall allow the Department, EMS MD and EMS System Coordinator access to all records, equipment, vehicles and personnel during their activities evaluating the Act and this Part.

e)         The Resource Hospital shall appoint an EMS MD. The EMS MD for an ILS or ALS or CCT level EMS System shall be a physician licensed to practice medicine in all of its branches in Illinois, and shall be certified by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine, and, for a BLS level EMS System, the EMS MD shall be a physician licensed to practice medicine in all of its branches in Illinois, with regular and frequent involvement in pre-hospital emergency medical services.  In addition, all EMS MDs shall:

1)         Have experience on an EMS vehicle at the highest level available within the System, or make provision to gain such experience within 12 months prior to the date responsibility for the System is assumed or within 90 days after assuming the position;

2)         Be thoroughly knowledgeable of all skills included in the scope of practices of all levels of EMS Personnel within the System; and

3)         Have or make provision to gain experience instructing students at a level similar to that of the levels of EMS Personnel within the System; and

4)         For ILS and ALS EMS MDs, successfully complete a Department-approved EMS MD's Course.  (Section 3.20(c)(1 through 6) of the Act)

f)         The EMS MD shall appoint an alternate EMS MD and establish a written protocol addressing the functions to be carried out in his or her absence. (Section 3.35(b) of the Act)

g)         An EMS System utilizing SEMSVs shall appoint and approve SEMSV Medical Directors to manage and direct the use of SEMSVs and their personnel within the System.  He or she shall be a physician who has met at least the following qualifications:

1)         One or more of the following:

A)        Certified by the American Board of Emergency Medicine (ABEM) or American Osteopathic Board of Emergency Medicine (AOBEM) through the American Osteopathic Association (AOA);

B)        Completion of a residency in emergency or osteopathic emergency medicine as prescribed by one of the Boards listed in subsection (g)(1)(A); or

C)        Completion of a 12-month internship followed by 60 months plus 7,000 hours of hospital based emergency or osteopathic emergency medicine (2,800 of the 7,000 hours must be completed within one 24-month period), and documentation of 50 hours of related continuing education for each complete year of practice; and

2)         Completion of advanced cardiac life support and advanced trauma life support courses;

3)         For aircraft programs, completion of education covering inflight treatment modalities, altitude physiology, and infection; and

4)         For watercraft programs, completion of education covering diving accident physiology and treatment and drowning in cold, warm, fresh and salt water.

h)         The Resource Hospital shall appoint a full-time EMS System Coordinator, who shall be responsible for coordinating the educational and functional aspects of the System, as described in the Program Plan.  He or she shall be an RN or Paramedic licensed in the State of Illinois, and meet at least the following qualifications:

1)         Be educated and knowledgeable in all principles of the National EMS Education Standards;

2)         Have a diverse background in emergency care.  For EMS Systems with CCT program plans, the System Coordinator shall have knowledge of or obtain education regarding critical care standards within six months; and

3)         Within one year after being appointed, complete in-field observation and/or participation on at least 10 ambulance runs at the highest level of service provided by the System.

i)          The Resource Hospital shall appoint an EMS Administrative Director, who shall be responsible for administrative leadership of the System as described in the Program Plan.

j)          To avoid any conflict of interest, the EMS MD, EMS System Coordinator and EMS Administrative Director shall notify the Department in writing of any association with an ambulance service provider through employment, contract, ownership, or otherwise specifying how he or she is answerable to or directed by the ambulance service provider concerning any matter falling within the scope of the Act or this Part.  The Department shall review and address potential or actual conflicts of interest on a case-by-case basis.

k)         The Resource Hospital must identify the EMS System in the facility's budget, with sufficient funds to support the EMS MD, EMS Administrative Director, EMS System Coordinator, and support staff and to provide for the operation of the EMS System.

l)          All EMS Resource Hospitals shall obtain recognition as an SEDP, EDAP or PCCC.  All Illinois hospitals are encouraged to obtain and maintain SEDP or EDAP status.

(Source:  Amended at 42 Ill. Reg. 17632, effective September 20, 2018)