Why does NYS certify ambulances?

[firedude 985]

I am just wondering why New York State's Dept. of Health certifies ambulances. I see the sticker "New York State Certified" on busses and flycars. It seems that NY is the only state that does this. I am just wondering why.

Thanks in advance.

Here is the sticker, as seen on Mamaroneck EMS' 68A1

Edited April 3, 2011 by firedude

[64FFMJK 21]

$$$$$$$$$$$$$$$ the same reason NYS does anything $$$$$$$$$$$$$$$$

[STAT213 332]

I think most states do this.

In NH, all ambulances are inspected. Same for MA. Might just be wording.

[NWFDMedic 58]

And Pennsylvania as well. It's not all about money (note all). The SEMAC takes certain legal responsibility for the provision of ambulance service in New York State. They have every right to make sure the standards they write are followed. Certification is one of the methods used to do that. Otherwise, anyone could just put AMBULANCE on the side of a vehicle and go out to pick up patients.

Personally, with some of the junk I've seen running out there, they need to really take more consideration into what a safe ambulance is.

[SRS131EMTFF 471]

I am just wondering why New York State's Dept. of Health certifies ambulances. I see the sticker "New York State Certified" on busses and flycars. It seems that NY is the only state that does this. I am just wondering why.

Thanks in advance.

It also not the only state that does it. While in VT it is potentially done for the money, it is also to ensure the ambulance is in compliance with state health and transportation codes as well as any federal DOT or DOH requirements. In VT we do it here too, also anyone running lights in their POV must be authorized by the department chief, EMS district chief and the State minimum.

[helicopper 1,050]

$$$$$$$$$$$$$$$ the same reason NYS does anything $$$$$$$$$$$$$$$$

I haven't scheduled a vehicle inspection by DOH BEMS in a long time but it never cost anything back then. I'm not sure that money is the reason.

There was a time when there were both registered and certified ambulances running around. Registered meant the state knew about them but they didn't commit to abide by all the standards that a certified agency did. I don't believe you can operate an ambulance in NYS anymore without it being certified so the process is really just a way of the state making sure that the vehicle is properly equipped, meets the standards for vehicle markings, lighting, etc. and is safe to be an ambulance.

Again, there was a time when people would put rickety old pieces of junk on the road and call it an ambulance.

[38ff 250]

NYS Public Health Law Section 3005. Ambulance Service Certificates.

1. No ambulance service operating for profit, hospital ambulance service or municipal ambulance service of a city of over one million population shall operate on or after September first, nineteen hundred seventy-five unless it possesses a valid ambulance service certificate issued pursuant to this article. Effective January first, nineteen hundred ninety-seven, no ambulance service shall be operated unless it possesses a valid ambulance service operating certificate issued pursuant to this article or has been issued a statement of registration. No advanced life support first response service shall operate unless it possesses a valid advanced life support first responder service operating certificate. Effective January first, two thousand, no ambulance service shall be operated unless it possesses a valid operating certificate.

2. The department shall issue an initial certificate to an ambulance service certified prior to the effective date of this section upon submission of proof that it is the holder of a valid ambulance service certificate and is otherwise in compliance with provisions of section three thousand nine of this article.

2-a. Prior to January first, two thousand, the department shall issue an initial certificate to a registered ambulance service in possession of a valid registrationprovided that such service has been issued an exemption issued by a regional council pursuant to subdivision five-a of section three thousand three of this article.

3. The department shall issue an initial certificate to an advanced life support first response service upon submission of proof that such advanced life support first response service is staffed and equipped in accordance with rules and regulations promulgated pursuant to this article and is otherwise in compliance with provisions of section three thousand nine of this article.

4. A certificate issued to an ambulance service or advanced life support first response service shall be valid for two years. The initial certification fee shall be one hundred dollars. Thereafter the biennial fee shall be in accordance with the schedule of fees established by the commissioner pursuant to this article. However, there shall be no initial or renewal certification fee required of a voluntary ambulance service or voluntary advanced life support first response service.

5. No initial certificate (except initial certificates issued pursuant to subdivision two of this section) shall be issued unless the commissioner finds that the proposed operator or operators are competent and fit to operate the service and that the ambulance service or advanced life support first response service is staffed and equipped in accordance with rules and regulations promulgated pursuant to this article.

6. No ambulance service or advanced life support first response service shall begin operation without prior approval of the appropriate regional council, or if there is no appropriate regional council established such ambulance service or advanced life support first response service shall apply for approval from the state council as to the public need for the establishment of additional ambulance service or advanced life support first response service, pursuant to section three thousand eight of this article.

7. Applications for a certificate shall be made by the owner of an ambulance service or advanced life support first response service operating for profit or the responsible official of a voluntary ambulance service or advanced life support first response service upon forms provided by the department. The application shall state the name and address of the owner and such other information as the department may require pursuant to rules and regulations.

8. For purposes of this article, competent means that any proposed operator of any ambulance service or advanced life support first response service who is already or had been within the last ten years an incorporator, director, sponsor, principal stockholder, or operator of any ambulance service, hospital, private proprietary home for adults, residence for adults, or non-profit home for the aged or blind which has been issued an operating certificate by the state department of social services, or a halfway house, hostel, or other residential facility or institution for the care, custody, or treatment of the mentally disabled subject to the approval by the department of mental hygiene, or any invalid coach service subject to approval by the department of transportation, is rendering or did render a substantially consistent high level of care. For purposes of this subdivision, the state emergency medical services council shall adopt rules and regulations, subject to the approval of the commissioner, to establish the criteria to be used to define substantially consistent high level of care with respect to ambulanceservices, advanced life support first response services, and invalid coaches, except that the commissioner may not find that a consistently high level of care has been rendered where there have been violations of the state EMS code, or other applicable rules and regulations, that

(i) threatened to directly affect the health, safety, or welfare of any patient, and

(ii) were recurrent or were not promptly corrected. For purposes of this article, the rules adopted by the state hospital review and planning council with respect to subdivision three of section twenty-eight hundred one-a of this chapter shall apply to other types of operators. Fit means that the operator or proposed operator

(a) has not been convicted of a crime or pleaded nolo contendere to a felony charge involving murder, manslaughter, assault, sexual abuse, theft, robbery, fraud, embezzlement, drug abuse, or sale of drugs and

( is not or was not subject to a state or federal administrative order relating to fraud or embezzlement, unless the commissioner finds that such conviction or such order does not demonstrate a present risk or danger to patients or the public.

[bad box 371]

Back in 1977 -1978 I worked for a private ambulance company in Brooklyn. They maintained one complete set of equipment that met the N.Y.S. requirement for certification. When an ambulance was due to be inspected, they would equip it. As soon as it passed, the equipment was removed and placed into storage. Many of their units carried no B.V.M., no medical kit, just a stretcher, an 'E' tank with a regulator, a medium concentration O2 mask & cannula, 'chuck pads', emesis basin, urinal and a few gauze pads. I carried my own kit which was stocked with supplies provided by friendly ER nurses. Back then it didn't appear that being N.Y.S. Certified meant anything at all.

[dmc2007 17]

IIRC, MA requires a certificate to be displayed in the patient compartment. While not an exterior sticker like in NY, it has the meaning.

[PEMO3 523]

Back in 1977 -1978 I worked for a private ambulance company in Brooklyn. They maintained one complete set of equipment that met the N.Y.S. requirement for certification. When an ambulance was due to be inspected, they would equip it. As soon as it passed, the equipment was removed and placed into storage. Many of their units carried no B.V.M., no medical kit, just a stretcher, an 'E' tank with a regulator, a medium concentration O2 mask & cannula, 'chuck pads', emesis basin, urinal and a few gauze pads. I carried my own kit which was stocked with supplies provided by friendly ER nurses. Back then it didn't appear that being N.Y.S. Certified meant anything at all.

Bad box, over time things have surely changed. Since the late 1980's DOH has been known to do surprise vehicle inspections at ERs on ambulances and placing them out of service for deficiencies. The simple fixes would be met with short out of service time to correct them with either an agency warning or fine. The major ones received the dreaded red "Out of Service" sticker placed on the outside of the right side windshield over the yellow and blue DOH sticker.

[bad box 371]

Bad box, over time things have surely changed. Since the late 1980's DOH has been known to do surprise vehicle inspections at ERs on ambulances and placing them out of service for deficiencies. The simple fixes would be met with short out of service time to correct them with either an agency warning or fine. The major ones received the dreaded red "Out of Service" sticker placed on the outside of the right side windshield over the yellow and blue DOH sticker.

It's good to hear that this was corrected as it was a common practice back then. As a matter of fact, it was also being done by N.Y.C. (H.H.C.) E.M.S. back then (I worked for them as a Corpsman from 1978 -1981). I also found it necessary while working for H.H.C. - E.M.S. to make friends with the ER nurses in order to stock my kit with 'luxury items' such as B.V.M.'s, non-re-breathers, kling and combine dressings. And then it was off to save lives driving my 'Bread Box' Ambulance Truck ... Ha-ha-ha ...

[64FFMJK 21]

I haven't scheduled a vehicle inspection by DOH BEMS in a long time but it never cost anything back then. I'm not sure that money is the reason.

Again, there was a time when people would put rickety old pieces of junk on the road and call it an ambulance.

I don't know about the actual certification however I was referring to the fines that are imposed in the ever increasing surprise inspections at local ER's when a bus drops off or picks up. I do know that if you want to take a unit out of service and not replace it there is a small fee involved since that seems to be the trend locally with a lot of FD's that have manpower issues.

and I have seen some real crap on the road lately that are being called an Ambulance since as long as there are no exhaust leaks into the patient compartment and the ambulance has a valid NYS vehicle inspection sticker they consider it mechanically sufficient.

[EMTF469 9]

NYS DOH requires ambulances to be certified for quality of patient care. It does not cost the service any money unless there are deficiencies noted. In most cases deficiencies are taken care of on the spot or an invoice from a repair shop is forwarded to The DOH as proof that the deficiency has been corrected. NYS is not out to put ambulance services out of business, they just want to make them safe. If part 800 of the NYS DOH BLS protocol is followed any inspection is more like a social visit than an inspection. I have been involved in EMS for over 40 years and have never had a surprise inspection. The usual mode of operation is to make an appointment at everyone's convenience. I have been the Captain over 16 years of the corps that I volunteer for and have never failed an inspection. Think back at what a BLS unit used to be able to do, we were nothing but a load and go transport with administration of 1st aid. Today we carry defibrillators, medications such as Albuterol, Epinephrin, etc. including Atropine for chemical WMD if the members of the corps has been certified in its use. We can give the patient with chest pain Nitro if they are prescribed it. We are also trained to assist ALS units in the set up of equipment in the field. BLS in NYS is not what it was 10 years ago, that is why the EMT-B certification has been changed to simply EMT, because we are no longer just basic as it was once known to be. Would you want an ambulance arriving on scene of a family member or friend in cardiac arrest with out a defibrillator? I hope this gives you an insight as to why NYS ambulances are certified. You can be a non-certified service, however you can't carry a defibrillator or medications. I don't know of any ambulance corps that would want to do that.