TIER 1 — EXECUTIVE LEADERSHIP
Chief Executive Officer / Owner
Incumbent / Staffing Ernst Appolon FTE 1 (existing)
Requirement Required
Certifications: Business license, NPI registration
 Key Responsibilities
􀀀 Overall strategic direction and accountability for BLS license acquisition
􀀀 Sign affiliation agreements with affiliate hospital(s) (MGH, BMC) per 105 CMR 170.300
􀀀 Authorize capital expenditures for ambulance vehicle, equipment, and personnel
􀀀 Execute contracts with MA Office of Emergency Medical Services (OEMS)
Serve as primary liaison to OEMS during licensure review
Operations / Compliance Manager
Incumbent / Staffing To be assigned / Ernst Appolon (interim) FTE 1 FTE
  Requirements required before license issuance
Certifications EMS operations background preferred; MA OEMS familiarity
Key Responsibilities
􀀀 Compile and submit BLS license application to MA OEMS (Form OEMS-1)
􀀀 Maintain all required documentation (vehicle inspection, insurance, policies)
􀀀 Ensure 105 CMR 170.000 ongoing compliance post-licensure
􀀀 Coordinate QA/QI program required under affiliation agreement
􀀀 Manage scheduling to maintain 24/7 BLS coverage per 105 CMR 170.385
􀀀 Track personnel certifications and renewals
TIER 2 — MEDICAL OVERSIGHT
Affiliate Hospital Medical Director
Incumbent / Staffing To be contracted — MGH or BMC FTE Contracted / Part-time
Requirement MANDATORY — License cannot be issued without this
Certifications Licensed MA physician with EMS medical director authority
Key Responsibilities
􀀀 Execute written affiliation agreement with Epoch Health Care LLC per 105 CMR 170.300
􀀀 Approve and oversee all clinical protocols for BLS operations
􀀀 Assess and certify EMT-Basic skill competencies per 105 CMR 170.305(B)(1)(a)
􀀀 Provide medical oversight and sign off on QA/QI reviews
􀀀 Authorize EMT/First Responder staffing configurations if applicable
􀀀 Act as point of contact for OEMS for all medical issues
TIER 3 — CLINICAL FIELD STAFF
EMT-Basic — Lead (Patient Care Responsible)
Incumbent / Staffing Minimum 1 per vehicle on every call FTE Minimum 2 FTEs for coverage rotation
Regulatory
Requirement MANDATORY per 105 CMR 170.305(B)(1)
Required
Certifications Current MA EMT-Basic cert; BLS CPR; valid MA driver's license; Hazmat & MCI training
Key Responsibilities
􀀀 Responsible for all patient care at the BLS level on every call
􀀀 Assess patient condition and administer BLS interventions (CPR, O2, AED, splinting, bleeding control)
􀀀 Complete electronic Patient Care Reports (ePCR) for every transport
􀀀 Ensure ambulance is stocked, clean, and OEMS-inspection-ready at all times
􀀀 Participate in QA/QI program reviews under affiliation agreement
􀀀 Meet minimum experience and skill competency levels set by Medical Director
􀀀 Report any discipline, conviction, or license issue to agency within 5 days (105 CMR 170.305)
EMT-Basic — Second Crew / Driver
Incumbent / Staffing
Minimum 1 per vehicle OR qualified First
Responder driver FTE Minimum 2 FTEs for full coverage
Regulatory
Requirement MANDATORY — 2 EMTs required unless FR driver conditions met
Required
Certifications Current MA EMT-Basic OR First Responder per 105 CMR 171.000; valid MA driver's license in good standing
Key Responsibilities
􀀀 Drive the ambulance safely and operate within MA traffic law
􀀀 Assist lead EMT-Basic with patient care and equipment
􀀀 Ensure driving record remains clean; disclose any violations per 105 CMR 170.305(B)(1)(b)
􀀀 Complete required annual continuing education
􀀀 Respond as second EMT-Basic when patient acuity requires per agency protocol
􀀀 Support QA/QI documentation requirements
TIER 4 — ADMINISTRATIVE & SUPPORT
Billing & Revenue Cycle Coordinator
Incumbent / Staffing 1 (part-time / contracted initially) FTE 0.5 – 1 FTE
Regulatory
     Requirement Strongly recommended 
Certifications Medical billing experience; MassHealth & Medicare billing familiarity
Key Responsibilities
􀀀 Submit ambulance transport claims to MassHealth (ID #110177982A) and Medicare (ID #S301319456)
􀀀 Ensure compliance with ambulance billing regulations (CMS A-0001 form)
􀀀 Track authorization requirements and denied claims
􀀀 Maintain transport documentation supporting medical necessity
􀀀 Coordinate with EMTs for accurate ePCR data to support billing
Vehicle & Equipment Coordinator
Incumbent / Staffing
1 (can be dual-hatted with Operations
Manager) FTE 0.25 FTE initially
Requirement Required before license issuance
Certifications Clean driver record; familiarity with OEMS vehicle standards
Key Responsibilities
􀀀 Ensure ambulance vehicle meets MA OEMS Class I or II certification standards
􀀀 Coordinate scheduled vehicle inspections with OEMS
􀀀 Maintain inventory of required BLS equipment per 105 CMR 170.430
􀀀 Manage vehicle maintenance logs, insurance certificates, and registration
􀀀 Track and replenish medical supplies (O2, AED pads, PPE, etc.)
BLS LICENSE ACQUISITION CHECKLIST (105 CMR 170.000)
Complete these steps to obtain the MA OEMS BLS Ambulance Service License. Items marked Critical Path must be resolved before any other step can advance.
# Action Item Owner Priority
1 Obtain signed Affiliation Agreement with hospital Medical Director OEMS Form / Hospital Legal Critical Path
2 Submit BLS Ambulance Service License Application (OEMS-1) to MA
OEMS MA OEMS Critical Path
3 Certify ambulance vehicle as Class I or II with OEMS MA OEMS Vehicle Inspection Critical Path