The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Bureau of Quality Assurance and Control
99 Chauncy Street, 2nd Floor, Boston, MA 02111
617-753-8000

DEVAL L. PATRICK
GOVERNOR
TIMOTHY P. MURRAY
LIEUTENANT GOVERNOR
JUDYANN BIGBY, MD
SECRETARY
JOHN AUERBACH
COMMISSIONER	

Circular Letter:  DHCQ 07-06 476

TO:		Hospital Chief Executive Officers, Acute Care Hospitals

FROM: 	Paul I. Dreyer, Ph.D., Director, Bureau of Quality Assurance and Control

RE:		Medical Control Service Update

DATE:  	June 22, 2007

The Department of Public Health amended hospital licensure regulations effective 
February 27, 2007, to create a “Medical Control Service,” which is the organized provision of medical control by a hospital to a licensed Emergency Medical Services (EMS) provider (ambulance service or EMS first response service).  The Department deemed all existing providers of medical control in compliance with all requirements set forth in 105 CMR 130.1500 through 130.1504 until June 30, 2007.  However, at this time the Department is extending the deemed status date until October 30, 2007.  Medical Control Services will continue to be provided under the existing system until that date.  As of October 31, 2007, no hospital may provide Medical Control Services unless the service is licensed by the Department.

Hospital applications for licensure of Medical Control Services submitted to the Department are being reviewed to assess each facility’s compliance with regulatory requirements.  We have noted that many of the protocols filed with the applications lacked sufficient detail and clarity, specifically those pertaining to: (1) the operation of an effective QA/QI program, (2) hospital pharmacy protocols for the provision of medications to EMS Services, (3) orientation of physicians providing on-line medical direction, and (4) methods to ensure that the medical direction is in conformance with Statewide Treatment Protocols.  The Department is preparing materials to assist hospitals in the further development of their protocols.  Information will be posted on the Department website when complete (see website address below).

Department representatives will be contacting hospitals that have submitted an application for a Medical Control Service to discuss application review findings.  Subsequent on-site reviews may be conducted to verify implementation of protocols submitted to the Department.  When the hospital is determined to meet regulatory requirements, the hospital will receive written notification of licensure of the Medical Control Service.

We appreciate your continued cooperation with the development of this regulatory initiative.
If you have questions regarding this correspondence please contact Ms. Gail Palmeri at 
617-753-8230 or email gail.palmeri@state.ma.us .  

Website References:

* Medical Control Service regulations and related information are available on the Department of Public Health, Division of Health Care Quality website.  The URL address for the Division's home page is: http://www.mass.gov/dph/dhcq

Statewide Treatment Protocols and Office of Emergency Medical Services regulations are available on the Department of Public Health, Office of Emergency Medical Services (OEMS) website.  The URL address for the OEMS home page is: http://www.mass.gov/dph/oems.