# COMAR Title 30 — Maryland Institute for Emergency Medical Services Systems (MIEMSS)

## Subtitle 09 — Commercial Ambulance Services

### Chapter 13 — Air Ambulance Service

**Authority:** Education Article, §§13-508 and 13-515, Annotated Code of Maryland

**Administrative History:** Effective date: October 15, 2004 (31:20 Md. R. 1486)

#### Regulation .01 Scope.

*COMAR 30.09.13.01*

This chapter governs the requirements for a commercial air ambulance service.

#### Regulation .02 In General.

*COMAR 30.09.13.02*

A. To be licensed as a commercial care air ambulance service, a commercial air ambulance service shall comply with the requirements of this chapter in addition to the other applicable requirements of this subtitle.

B. An applicant for a commercial air ambulance service license shall submit an application to SOCALR on the required form.

C. An applicant for a commercial air ambulance service license shall:

  (1) Be accredited by CAMTS; or

  (2) If ineligible to apply for CAMTS accreditation, because it has been in service for less than 1 year:

    (a) Submit to SOCALR a CAMTS consultation report indicating compliance with the CAMTS standards; and

    (b) Apply for and receive full CAMTS accreditation within 18 months of being licensed by SOCALR.

D. A licensed commercial air ambulance service shall notify SOCALR within 24 hours of any change in CAMTS accreditation status and the reason for the change.

E. A licensed commercial air ambulance service may provide ALS, critical care, or neonatal transport service, or any combination of these, if:

  (1) The equipment and personnel requirements of this subtitle are met for the specific type of transport;

  (2) The submitted service license application includes the information required, demonstrating compliance for the specific type of transport; and

  (3) The service is accredited by CAMTS at that level.

F. A licensed commercial air ambulance service may not provide services with an unlicensed air ambulance unless:

  (1) The unlicensed air ambulance is used as a temporary replacement for a licensed air ambulance that is out of service for routine maintenance or repair;

  (2) The temporary replacement air ambulance meets all FAA requirements;

  (3) The temporary replacement air ambulance has all required staffing and equipment; and

  (4) It has notified SOCALR of the use of the replacement air ambulance and provided the following information:

    (a) The unit designation number assigned for operational purposes;

    (b) The FAA registration number; and

    (c) The make, model, and year of manufacture.

G. A licensed commercial air ambulance service that provides services with an unlicensed air ambulance shall notify SOCALR when the licensed air ambulance is returned to service.

#### Regulation .03 Additional Personnel Requirements for Commercial Air Ambulance Services.

*COMAR 30.09.13.03*

A commercial air ambulance shall be staffed by:

A. A pilot who meets the requirements of licensure established by the Federal Aviation Administration 14 CFR Parts 61, 67, and 135; and

B. At least two additional individuals who meet or exceed the requirements for CAMTS accreditation at the level which the service is providing.

#### Regulation .04 Additional Equipment Requirements for Air Ambulances.

*COMAR 30.09.13.04*

A. Each air ambulance shall carry sufficient equipment and supplies listed in COMAR 30.09.10—13 to assure:

  (1) The ability to carry out all procedures in the Maryland Medical Protocols for EMS Providers; and

  (2) That when transporting specialty care patients, the additional equipment necessary to care for the patient being transported is available;

B. A list of medical equipment and supplies will be provided to SOCALR with the licensing application.

C. All medical, communications, and associated equipment on-board:

  (1) If routinely carried, shall be EMI certified for air operations; or

  (2) If not routinely used, shall be approved by the pilot.

#### Regulation .05 Operational Requirements for Air Ambulance Services.

*COMAR 30.09.13.05*

A. Pilots of rotary wing air ambulances shall remain with the aircraft when the aircraft is occupying a hospital helipad with room for landing a single aircraft.

B. SYSCOM shall coordinate the landing sequence of multiple emergency medical services aircraft in consultation with the pilots-in-command based on patient priority.

C. Commercial air ambulance services shall:

  (1) Comply with the requirements of COMAR 30.07; and

  (2) Keep SYSCOM apprised of the location of their air ambulance at all times while the aircraft is in Maryland or in geographic proximity to the Maryland border in a contiguous state.