North Dakota Administrative Code

An application for a basic life support ambulance service or advanced life support ambulance service license shall be submitted on a form or through an electronic process, as prescribed by the department. The application must contain the following information as well as additiona…

1. The department or its authorized agent may inspect the service. If minimum standards for either basic life support ground ambulance services or advanced life support ground ambulance services are met, the department may issue a license and designate its service area. The depar…

1. Based on each individual case, the department may waive any provisions of this chapter. 2. The waiver provision must only be used for a specific period in specific instances, provided such a waiver does not adversely affect the health and safety of the individual transported, …

Repealed effective April 1, 2024.

In addition to requirements as listed in the remainder of chapter 33-11-01.2, the following items apply to headquarter ambulance services and substations: 1. Application for licensure by a headquarter ambulance service shall be made as described in section 33-11-01.2-03 and shall…

1. A headquarters ambulance service shall be available twenty-four hours per day and seven days per week, except as exempted through waiver by the department. 2. A substation ambulance service may be available intermittently. When the substation ambulance is not available it is t…

Repealed effective April 1, 2024.

Repealed effective April 1, 2024.

Repealed effective April 1, 2024.

1. Operators licensed in another state may pick up patients within this state for transportation to locations within this state under the following circumstances: a. When there is a natural disaster, such as a tornado, earthquake, or other disaster, which may require all availabl…

1. Specialty care transport is necessary when a patient's condition requires ongoing care that must be provided by one or more health care professionals in an appropriate specialty area, for example, nursing, emergency medicine, respiratory care, cardiovascular care, or paramedic…

1. All ground ambulances must have a vehicle manufactured to be an ambulance. 2. A ground ambulance must have a patient care compartment that is designed to carry at least one patient on a stretcher that is securely mounted to the ambulance and that enables transportation in both…

Ambulance services shall transport patients to the nearest appropriate licensed health care facility according to their hospital transport plan except for: 1. Interfacility transports must be made in accordance with the referring physician's orders. 2. In the following specific i…

When it would not delay transport time, basic life support ambulance services shall call for a rendezvous with an advanced life support capable agency, paramedic, or its equivalent if the basic life support ambulance is unable to provide the advanced life support interventions ne…

To ensure responder safety and a seamless integration with the broader public safety response system, ground ambulance services shall have the following elements to their communications system: 1. They shall have a radio call sign issued by state radio. 2. They shall be dispatche…

Ground ambulances shall meet the following time standards ninety percent of the time when dispatched to an emergency request as determined by public safety answering point protocols or to an emergency interfacility transport as determined by the transferring health care provider.…

Repealed effective April 1, 2024.

Repealed effective April 1, 2024.

To ensure reasonably adequate ambulance service coverage and to prevent competition that would impair the long-term availability of services to the public, the department shall designate service areas when requested or at the department's discretion. 1. Upon request by a licensed…

Each licensed ambulance service shall be aware of its role as defined by local, county, and state emergency operations plans and shall be able to access the emergency operations plan as needed. History: Effective July 1, 2010; amended effective April 1, 2024. General Authority: N…

Failure to meet standards outlined in article 33-11 may result in sanctions based on the severity of the noncompliance. Based on each individual case, the department may impose the following sanctions on licensed ambulance services: 1. Require the ambulance service to submit a de…

An operator of a ground ambulance service intended for industrial site use may be issued a special license by the department. 1. The ambulance service may not advertise or offer service to the general public. 2. The ambulance service may provide advanced life support intervention…

An operator of a ground ambulance service intended for federal or state government emergency operations may be issued a special license by the department. 12 1. The ambulance service may offer service to the general public and special populations during emergency operations. 2. T…

1. Documentation requirements for licensure. An applicant for an emergency medical service agency license shall have the following documents available, paper or online, for inspection by the department: a. A roster of active personnel, including the emergency medical service agen…

Regardless of the type of service through which an emergency medical service agency is providing emergency medical services, the following standards apply to the emergency medical service agency and its emergency medical service providers when functioning as an emergency medical …

An emergency medical service agency that operates a basic life support ambulance service employs one or more basic life support ambulances staffed by an ambulance crew capable of providing medical assessment, observation, triage, monitoring, treatment, and transportation of patie…

The emergency medical service vehicle operator shall have a current driver's license, cardiopulmonary resuscitation certification, and emergency vehicle operators training. History: Effective March 1, 1985; amended effective January 1, 1986; August 1, 2003; July 1, 2010; April 1,…

The primary care provider must have current emergency medical technician license or its equivalent and must have current cardiopulmonary resuscitation certification. 1. The minimum staffing for a basic life support ambulance crew when responding to a call to provide emergency med…

In addition to a vehicle as described in section 33-11-01-15, the ambulance shall have the following, unless otherwise approved by the department: 1. Patient transport: a. Mounted ambulance cot with retaining straps. b. Stretchers with retaining straps. Vehicle design dictates qu…

1. Each ground ambulance service shall have a signed agreement on file with the department with a North Dakota licensed physician who shall serve as official medical director and whose duties include establishing written medical protocols, recommending optional equipment, oversig…

Basic life support ambulance services may provide advanced life support interventions on an as-needed basis if the following requirements are met: 1. The primary care provider is licensed to provide the level of care required. 2. The service complies with the equipment list as se…

An emergency medical service agency that operates an advanced life support ambulance service employs one or more advanced life support ambulances staffed by an ambulance crew capable of providing medical assessment, observation, triage, monitoring, treatment, and transportation o…

1. The minimum staffing requirement for an advanced life support licensed ground ambulance must consist of a paramedic or equivalent and an emergency medical technician or equivalent. If the crew consists of three or more personnel, the paramedic and emergency medical technician …

The ambulance must contain all the equipment requirements as found in section 33-11-02-03, except for having an automated external defibrillator, unless the required manual cardiac monitor is not able to function as an automated external defibrillator, plus the following, unless …

The ambulance must carry the following functional classification of medications in pediatric and adult dosages: 1. Alkalinizer agent. 2. Bronchodilator - adrenergic intravenous or subcutaneous. 3. Bronchodilator for nebulized delivery. 4. Antidysrhythmic or antiarrhythmic. 5. Ant…

1. Each ground ambulance service shall have a signed agreement on file with the department with a North Dakota licensed physician who shall serve as official medical director and whose duties include establishing written medical protocols, recommending optional equipment, oversig…

One advanced life support ambulance must be staffed. Additional ambulances may be required to meet community needs, demand, or the response time standards as defined in section 33-11-01.2-17 and may be staffed and equipped at the basic life support level. History: Effective March…

No ambulance service may advertise itself as an advanced life support ambulance service unless it is so licensed. History: Effective March 1, 1985. General Authority: NDCC 23-27-04 Law Implemented: NDCC 23-27-04 4

1. "Air ambulance run" means the response of an aircraft and personnel to an emergency or nonemergency for the purpose of rendering medical care or transportation, or both, to someone who is sick or injured. Includes canceled calls, no transports, and standby events where medical…

1. No air ambulance service as defined in North Dakota Century Code chapter 23-27 shall be advertised or offered to the public or any person unless the operator of such air ambulance service is licensed by the department. 2. The license shall expire midnight on October thirty-fir…

An application for an air ambulance service license shall be submitted on a form or through an electronic process, as prescribed by the department. The application must contain the following information as well as additional information and documents that may be solicited by the …

1. The department or its authorized agent may inspect the air ambulance service. If minimum standards are met, the department shall issue a license. 2. A service may request that the department consider it in compliance with this chapter if it is fully accredited by the commissio…

Critical care air ambulance services shall be available twenty-four hours per day and seven days per week, except as limited by weather or aircraft maintenance or by unscheduled pilot duty limitations in accordance with federal aviation administration regulations. History: Effect…

For a licensed critical care air ambulance service, the minimum number of personnel required is two providers as defined in chapter 33-11-07 and one pilot. History: Effective August 1, 2003; amended effective March 24, 2004; January 1, 2006; April 1, 2024. General Authority: NDCC…

1. Operators licensed in another state may pick up patients within North Dakota for transportation to locations within this state under the following circumstances: a. When there is a disaster or incident which may require elevated response to transport the injured. b. When an ou…

An air ambulance service must have a certificate of airworthiness from the federal aviation administration for each aircraft it uses as an air ambulance, which is maintained current by compliance with all required federal aviation administration inspections as defined by federal …

All equipment and materials used in an air ambulance must be secured in accordance with title 14, Code of Federal Regulations, part 135. History: Effective August 1, 2003; amended effective April 1, 2024. General Authority: NDCC 23-27-04 Law Implemented: NDCC 23-27-04

Aircraft doors must accommodate passage of a patient lying on a stretcher with no more than thirty degrees rotation or forty-five degrees pitch. History: Effective August 1, 2003. General Authority: NDCC 23-27-04 Law Implemented: NDCC 23-27-04

Lighting of at least forty foot-candles of illumination must be available in the patient care area to afford observation by medical personnel. Lighting must be shielded from the pilot of the aircraft so as not to interfere with operation of the aircraft. History: Effective August…

The aircraft will be equipped with a federal aviation administration approved electrical power source that will accommodate commonly carried medical equipment, both AC and DC powered, and that is not dependent upon a portable battery. History: Effective August 1, 2003. General Au…