Seneca County Prosecutor’s Office legal opinion re: EMS rule 4767.43

This legal opinion was rendered by Seneca County Assistant Prosecutor Eleanor Anderson on April 14, 2021. The opinion was in response to a request from Seneca County Emergency Services Director Ken Majors regarding a recent change to the law via Ohio House Bill 444, which was enacted on April 12. 

The language of ORC 4765.43 controls how an ambulance of an “emergency medical service organization” must be staffed when completing an “emergency run” and when equipped for “emergency medical services.” Note, 4765.01(H) defines “emergency medical service organization” (as a) public or private organization using first responders, EMTs-basic, EMTs-I, or paramedics, or a combination of first responders, EMTs-basic, EMTs-I, and paramedics, to provide emergency medical services.”

4765.43(D)(1) outlines the following requirements:

(D) With respect to the component of an emergency run during which a patient is being transported, the ambulance shall be staffed as follows:

(1) If the “emergency medical service organization” utilizes only paid individuals or utilizes volunteers on a basis that is not considered to be substantially utilizing volunteers (paid = more than 192 hrs/week), the ambulance shall be staffed by at least two EMTs, AEMTs, or paramedics. One of these individuals may serve as the driver.

Your email below indicates that Seneca County fits the above description and Seneca County is NO LONGER an emergency medical service organization substantially utilizing volunteers. Therefore, the lesser requirements of 4756.43(D)(2), which would allow the staffing of EMRs for transport, are no longer authorized thru the statute.

As I understand it, the “emergency medical service organization” of Seneca County is multifaceted and not consistently structured throughout its separate districts and services, some entities having more volunteer hours and others having less, but nonetheless, the majority of such entities having more than 192 hrs paid per week and all using the same Seneca County ambulances and other combined services. As such, I would err on the side of best care practices and interpret the law as you are – Seneca County, through its districts and services, is not substantially utilizing volunteers to service its ambulances and as such an ambulance transporting a patient must be staffed by at least two EMTs, AEMTS, or paramedics.

You note an emergency provision allowing the use of one EMT, AEMT or paramedic with an EMR at time of “dire need.” ORC 4765.43 does not reference this allowance during an emergency transport when the organization does not substantially utilize volunteers. If contemplating staffing as such, confirm hours of staffing to confirm compliance with the statute. In the end the statute outlines the parameters that are to be followed.

Note, if services are not rendered appropriately, according to ORC 4765.43, then ORC 4765.48 indicates that “the attorney general, the prosecuting attorney of the county, or the city director of law shall, upon complaint of the state board of emergency medical, fire, and transportation services, prosecute to termination or bring an action for injunction against any person violating this chapter or the rules adopted under it. The common pleas court in which an action for injunction is filed has the jurisdiction to grant injunctive relief upon a showing that the respondent named in the complaint is in violation of this chapter or the rules adopted under it.