<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 30.09.07.04" title_num="30" subtitle_num="09" chapter_num="07" heading="Interface with Jurisdictional EMS Operational Programs—Commercial Ground Ambulance Services.">
  <paragraph num="A.">
    <text>Unless requested to do so by a jurisdiction's communications center or unless standing by under contract with the organizer of an event, a commercial ambulance service may not respond to an emergency incident which:</text>
    <paragraph num="(1)">
      <text>Occurs on a public street, public alley, public way, or public place of the State, where emergency units of a jurisdictional EMS operational program have the responsibility for rendering emergency service;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Involves mass casualties or requires care of more than one individual as a result of the same incident;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Involves hazardous, incendiary, or explosive materials;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Involves a trapped person who requires extrication or forcible entry;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Involves an uncontained fire;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Involves imminent danger to parties or property other than the patient for which the commercial ambulance service is being called upon to render service; or</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Requires resources that the commercial ambulance service does not have.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>If a commercial ambulance service and jurisdiction units respond to a call for assistance for the same patient or incident, the commercial ambulance service shall defer to the jurisdictional EMS operational unit unless the patient, or the patient's legal guardian, when competent to do so, expressly requests care or transport, or both, from the commercial ambulance service instead of the jurisdictional EMS operational unit.</text>
  </paragraph>
  <paragraph num="C.">
    <text>If an uncommitted commercial ambulance crew chooses to render assistance or medical care at an emergency, such as those described under §A of this regulation and can do so without the crew members themselves becoming victims, and no jurisdictional EMS providers are immediately available, the following procedure applies:</text>
    <paragraph num="(1)">
      <text>The commercial ambulance service shall immediately contact the jurisdiction's communications center by the most expeditious means available to the ambulance service, and advise the communications center of the:</text>
      <paragraph num="(a)">
        <text>Nature and location of the emergency,</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Identity of the commercial ambulance service and ambulance, and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Level of care capability of the ambulance;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>If a jurisdiction dispatches units to the scene, the commercial ambulance crew shall care for the patient or patients within the scope of the ambulance crew's health care certification or license for the ambulance they are operating until representatives of the jurisdiction's emergency medical services arrive;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A jurisdiction may request the commercial ambulance service to effect the transport; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A commercial ambulance service electing to comply with a jurisdiction's request may only charge the patient for services or transport rendered if the jurisdiction would have charged the patient.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>A commercial ambulance service that requests a jurisdiction to assist them with manpower or equipment shall:</text>
    <paragraph num="(1)">
      <text>If requested by jurisdictional authorities immediately defer patient care and scene control to jurisdictional authorities on scene; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>At the discretion of the local jurisdiction authorities on the scene, complete the call after the assistance requested has been provided.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Voluntary Service during Disasters.</text>
    <paragraph num="(1)">
      <text>A jurisdictional EMS operational program may directly, or through MIEMSS, request assistance from commercial ambulance services licensed under this subtitle.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A commercial ambulance service may, but is not required to, provide assistance in response to a request from a jurisdictional EMS operational program.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A commercial ambulance service electing to respond to an incident in response to a request for assistance shall:</text>
      <paragraph num="(a)">
        <text>Respond to a staging site established by the jurisdictional EMS operational program; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Operate under the command and control of the jurisdictional EMS operational program.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>