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Comprehensive Assessment of Emergency Medical Services 49 and 911 /Communications Center Operations Study 2.1 HISTORICAL & STATUTORY REFERENCES As a means of introduction to the information and issues discussed in this report section, the references that follow are provided for context and background. They are excerpted from several sources; including the North Carolina General Statutes EMS In 1971 the General Assembly directed the Legislative Research Commission to study emergency medical care in North Carolina. The Commission's study resulted in the Emergency Medical Services Act of 1973 (G.S. 143, Article 56). The Act established the State's Emergency Medical Services (EMS) Program within the State Department of Human Resources (now the Department of Health and Human Services). The Office of Emergency Medical Services administers the State's EMS program, which is placed in the Division of Facility Services of the Department of Health and Human Services (G.S. 143- 508). Two state agencies regulate the program. The North Carolina Medical Care Commission adopts the rules and standards that govern ambulance licensure and basic life support services, and the North Carolina Medical Board adopts rules and standards governing advanced life support services.' The Office of Emergency Medical Services (GEMS) is responsible for ensuring that emergency treatment centers are available throughout the state, inspecting and permitting ambulances, licensing ambulance service providers, certifying ambulance personnel, designating trauma centers and a state poison - control center, and assisting in the development of a statewide EMS communications system. Neither the State nor the regional EMS offices are engaged in the actual delivery of emergency medical services in North Carolina. That responsibility is taken on by agencies and organizations at the local level, the principal being County government. G.S. 153A -250 identifies County responsibilities and authority in this regard. Counties may franchise ambulance services via adopted ordinance(s), or operate its ambulance services directly. The following North Carolina Administrative Code subsections provide the most current definition and explanation of EMS System Requirements. .0102(25) EMS System- a coordinated arrangement of local resources under the authority of the county government (including all agencies, personnel, equipment, and facilities) organized to respond to medical emergencies and integrated with other health care providers and networks including public health, community health monitoring activities, and special needs populations. G.S. 143 -517 Each county shall ensure that emergency medical services are provided to its citizens. 10A NCAC 13P.0201 EMS SYSTEM REQUIREMENTS .0201(a) County governments shall establish EMS Systems. Each EMS System shall have: • A defined geographical service area for the EMS System. • The minimum service area for an EMS System shall be one county. • There may be multiple EMS Provider service areas within the service area of an EMS System. • The highest level of care offered within any EMS Provider service area must be available to the citizens within that service area 24 hours per day. 1 A. Fleming Bell and Warren Jake Wicker; County Government in North Carolina; Inst. of Government, UNC at Chapel Hill; 1998. Solutions for Local Government, Inc. 5