Law Summary
Objective
- To protect the public by setting minimum standards for safe and quality ambulance services.
Scope and Coverage
- Applies to all government and private land ambulances and ambulance service providers in the Philippines.
Definition of Terms
- Ambulance, Ambulance Service Provider (ASP), ACLS, ALS, BLS, DOH License to Operate (DOH-LTO), EMT, Standard First Aid, Land Ambulance, Medical Direction, Medical emergencies, Patient Transport Vehicle (PTV), Regional Office Regulation Licensing and Enforcement Division (RO-RLED), among others.
General Guidelines
- Ambulance vehicles must be registered with LTO under the ASP's name before licensing.
- Licensed ambulances must only be used for their licensed purpose.
- Only duly licensed ambulances may bear the "AMBULANCE" marking.
- ASPs must provide continuous, safe, and quality services.
- Private ambulance services must be registered with DTI or SEC; government-owned ambulances require local government proof of ownership.
- ASPs must have an operations control/dispatch center and parking for ambulances.
- ASPs must be part of a functional referral network.
- Different licensing requirements exist for institution-based and non-institution-based ambulances.
- Vehicles without BLS or ALS equipment are classified and labeled as Patient Transport Vehicles and are not licensed by HFSRB.
Specific Guidelines
Classification of Land Ambulances
- Ownership: Government or Private.
- Institutional Character: Institution-based (owned by health facilities) or Non-institution-based (independent but servicing facilities through MOA).
Categorization
- Type I: Basic Life Support capable ambulances.
- Type II: Advance Life Support capable ambulances.
Categories Required by Health Facilities
- Specialty and Level 3 Hospitals: Type II (ALS) ambulances required.
- Level 2 and 1 Hospitals and Infirmaries: Type I (BLS) ambulances or MOA with licensed ASPs.
- Birthing facilities must have MOA with licensed ASPs and may own ambulances.
- MOAs must ensure reasonable response time and service capability.
Ambulance Body Standards
- Must accommodate patient, personnel, and required equipment.
- Non-porous partition between driver and ambulance body.
- Prescribed DOH markings including reflectorized and capitalized "AMBULANCE" on front (mirror image), sides, and rear with official DOH logo.
- Equipment storage cabinets must be secure and accessible.
- Equipped with emergency warning light system and siren-public address system.
Personnel
- Minimum two qualified personnel besides the driver per ambulance.
- Training requirements vary by ambulance type with specific qualifications such as EMT, BLS, ACLS, and Paramedic Training.
- Continuing education programs mandated.
Equipment, Medicines, and Supplies
- Ambulances must have operational prescribed equipment, medicines, and supplies.
- Maintenance, calibration, disinfection, and contingency plans must be in place.
- Proper management of temperature sensitive medications required.
Service Delivery
- Policies and procedures for ambulance operations and referral systems must be documented.
- Communication devices to connect ambulance with dispatch and referral hospitals required.
- Medical direction guidance shall be implemented as needed.
Information Management
- Confidential and comprehensive patient information must be recorded and maintained in accordance with Data Privacy laws.
- Maintenance of a logbook containing essential patient transfer details.
- Annual statistical reports submitted by March 31 each year.
Environmental Management
- Ambulances must be ventilated, clean, and safe.
- Written disinfection and maintenance programs.
- Compliance with PPE use and infection control policies.
- Proper disposal procedures for infectious, toxic, and hazardous wastes as per relevant laws.
Procedural Guidelines
Application Processing
- Separate procedures for institution-based and non-institution-based ambulances.
- Complete applications are reviewed within 30 days.
- Inspection conducted for compliance; deficiencies must be corrected within 30 days or application denied.
- Issuance of DOH License to Operate (DOH-LTO) upon compliance.
- DOH ambulance logo issued for each licensed ambulance.
Renewal of License
- Renewal follows similar procedure as initial application.
- Automatic cancellation if renewal not filed within 30 days after expiration.
- Reapplication required after cancellation.
Monitoring
- Regular monitoring and inspections by HFSRB or RO-RLED.
- Immediate issuance of Notice of Violation for non-compliance.
Validity of License
- Institution-based ambulance licenses: valid for 1 year.
- Non-institution-based ambulance licenses: valid for 3 years.
Schedule of Fees
- Non-refundable fees for applications and renewals as prescribed by DOH.
- Payment to DOH through accepted methods.
Violations and Penalties
- Violations may result in license suspension or revocation.
- Preventive suspension possible pending investigation for up to 90 days.
- Revocation mandatory in case of death or serious injury caused by negligence or misuse.
- Revoked ASPs barred from reapplication for at least one year.
Appeals Process
- Appeals to Head of Office for Health Regulation within 10 days.
- Final appeal to Secretary of Health whose decision is final and executory.
Transitory Provisions
- For 2018 application cycle, applications accepted at both HFSRB and RO-RLED until December 15, 2017.
- Subsequent applications follow established procedures.
Repealing Clause
- Inconsistent prior provisions are repealed or amended.
Separability Clause
- Invalid provisions do not affect remaining provisions.
Effectivity
- Order effective 15 days after publication in two newspapers of general circulation.