GROUND AMBULANCE REGULATION
Emergency Health Services Act
July 15, 2020
110/2020
For information only: Made by the Minister of Health (M.O. 30/2020) on July 6, 2020 pursuant to section 48 of the Emergency Health Services Act. Table of Contents Interpretation 1 Interpretation 2 Code Provincial Director, Medical Directors and Registrar 3 Provincial Director 4 Powers, duties and functions of Provincial Director 5 Power to delegate - Provincial Director 6 Medical Directors 7 Duties and functions of Medical Directors 8 Powers, duties and functions of Registrar 9 Power to delegate - Registrar Ambulance Operator Responsible 10 Ambulance operator responsible Operator's Licence 11 Application 12 Inspection Categories of Ambulance Attendants and Ambulance Staffing Requirements 13 Prohibition 14 Ambulance attendant (dispatcher) 15 Ambulance attendant (ambulance) 16 Direction 17 Ambulance staffing requirements Dispatch Centres 18 Minister's approval of dispatch centre 19 Dispatch interruption contingency plan 20 Dispatch centre's responsibilities 21 Telephone access Ambulance Standards, Equipment and Supplies 22 Approval for use 23 Transition to Ambulance Code 24 Age restriction for ambulance 25 Out-of-province ambulances 26 Equipment and supplies Maintenance and Repair 27 Mandatory repairs 28 Maintenance program 29 Roadworthiness inspection 30 Ambulance defects 31 Replacement parts Ambulance Operations and Information 32 Ambulance records 33 Patient care report 34 Responsibility 35 Collision report 36 Record keeping 37 Provision of records, etc. 38 Ambulance insurance 39 Malpractice insurance 40 Patient information 41 Patient transportation 42 Physical or mental incapacity 43 Infection prevention and control 44 Ambulance interior temperature 45 Manufacturer's weight ratings 46 Fees for services Complaints to Registrar 47 Complaints to Registrar Other Matters 48 Display of the word "ambulance" 49 Transitional - dispatch centres 50 Transitional - Class 1, 2, 3 and 4 ambulances 51 Repeal 52 Expiry Interpretation Interpretation 1(1) In this Regulation, (a) "Act" means the Emergency Health Services Act; (b) "alternate transport device" means (i) a scoop stretcher or spine board on which a patient is secured using a combination of cross straps and shoulder straps, or (ii) any other device designated by the Registrar; (c) "ambulance" (i) does not include an ambulance that is an aircraft, and (ii) includes an ambulance that is used to provide non-emergency patient transport services in accordance with this Regulation; (d) "Ambulance Code" means the Ambulance Vehicle Standards Code adopted under section 2; (e) "approved facility" means (i) an approved hospital as defined in the Hospitals Act, (ii) a nursing home as defined in the Nursing Homes Act, (iii) a place or a part of a place designated as a facility in the Mental Health Regulation (AR 19/2004) made under the Mental Health Act, or (iv) any other facility approved by the Minister; (f) "Class 1 Ambulance" means an ambulance that is primarily dispatched in response to calls from the public for assistance in emergencies; (g) "Class 2 Ambulance" means an ambulance that is primarily dispatched to provide emergency inter-facility patient transport services; (h) "Class 3 Ambulance" means an ambulance that may be dispatched in a response, rescue, transport or support role; (i) "Class 4 Ambulance" means a vehicle that is dispatched to provide non-emergency patient transport services; (j) "Department" means the Department of Health; (k) "direction" means (i) medical consultation or advice provided by a Medical Director to an ambulance attendant or ambulance operator, including online medical consultation, and (ii) the Provincial Medical Protocols; (l) "emergency health services" includes non-emergency patient transport services in accordance with this Regulation; (m) "maintenance program" means a written maintenance and inspection program approved by the Registrar that provides for a continuous and regular program of inspection, maintenance and repair of the ambulances and equipment that are or will be used in an ambulance operator's ambulance operation; (n) "Medical Director" means a person employed or engaged as a Medical Director under section 6(1); (o) "non-emergency patient transport services" means transport services arranged, coordinated or dispatched on behalf of the Minister, when a patient may require medical assistance or monitoring during the transport; (p) "online medical consultation" means direction provided by a Medical Director to an ambulance attendant by means of a live, 2-way communication device; (q) "paramedic response unit" means an ambulance approved for use by a single ambulance attendant (ambulance) to provide emergency health services; (r) "Provincial Director" means the Provincial Director designated under section 3; (s) "Provincial Medical Protocols" means the protocols established by the Provincial Director to direct appropriate patient care by an ambulance attendant or an ambulance operator when providing emergency health services to a patient in Alberta; (t) "vehicle" means a motor vehicle within the meaning of the Traffic Safety Act. (2) A reference in this Regulation to "ambulance attendant" means an ambulance attendant (ambulance) or an ambulance attendant (dispatcher), except where the context requires otherwise. (3) The following definitions in subsection (1) apply for the purposes of the Act as it relates to this Regulation: (a) "ambulance"; (b) "emergency health services". Code 2 The Ambulance Vehicle Standards Code published by the Department and dated January 2010 is hereby declared in force as amended from time to time and forms part of this Regulation. Provincial Director, Medical Directors and Registrar Provincial Director 3 The Minister may designate a Provincial Director to serve as the provincial medical director referred to in section 48(1)(w) of the Act. Powers, duties and functions of Provincial Director 4(1) The Provincial Director shall (a) establish and maintain the Provincial Medical Protocols, (b) oversee the provision of the direction provided by Medical Directors to ambulance attendants and ambulance operators, and (c) make recommendations to the Minister, Registrar and ambulance operators on measures to improve the direction and the compliance with direction provided to ambulance attendants and ambulance operators. (2) The Provincial Director may issue directives to, and impose reporting requirements on, Medical Directors in the exercise of their powers and in the carrying out of their responsibilities under this Regulation. Power to delegate - Provincial Director 5 The Provincial Director may, with the approval of the Registrar, delegate in writing any power, duty or function of the Provincial Director under the Act or this Regulation to a qualified employee of the Department. Medical Directors 6(1) A regional health authority shall employ or engage persons as Medical Directors in accordance with this section. (2) A regional health authority shall (a) employ or engage the number of Medical Directors determined by the Registrar, and (b) ensure that online medical consultation provided by a Medical Director to an ambulance attendant or an ambulance operator is available on a 24-hours-a-day basis every day of the year. (3) To be employed or engaged by a regional health authority a Medical Director must (a) be a regulated member in good standing under the Health Professions Act who holds a practice permit issued under that Act, and (b) meet any other qualifications, experience, or requirements established by the Provincial Director. Duties and functions of Medical Directors 7 A Medical Director shall (a) consult with the Provincial Director on the development and maintenance of the Provincial Medical Protocols when requested to do so by the Provincial Director, (b) provide direction to ambulance attendants and ambulance operators, (c) monitor compliance with the direction provided to an ambulance attendant or an ambulance operator in the form and manner required by a regional health authority or the Provincial Director, and (d) comply with any directive issued or reporting requirement imposed by the Provincial Director. Powers, duties and functions of Registrar 8 The Registrar may (a) monitor the provision of emergency health services by a regional health authority and an ambulance operator, (b) make recommendations, as the Registrar considers necessary, to the Minister, a regional health authority and ambulance operators on measures to maintain and improve the provision of emergency health services, (c) act as a liaison among the Minister, a regional health authority, ambulance operators, the Provincial Director and Medical Directors in the administration of the Act and this Regulation, and (d) perform any other function or duty set out in this Regulation. Power to delegate - Registrar 9 The Registrar may, in writing, delegate any power, duty or function of the Registrar under the Act or this Regulation to a qualified employee of the Department. Ambulance Operator Responsible Ambulance operator responsible 10 Except as authorized in accordance with the Act, an ambulance operator shall comply with, and shall ensure that the ambulance operator's ambulance operation, employees and agents comply with, the requirements of this Regulation and the Act. Operator's Licence Application 11(1) A person wishing to obtain or to renew an operator's licence shall submit an application to the Registrar in the form and manner required by the Registrar. (2) Without limiting subsection (1), if an applicant for an operator's licence is not a regional health authority, the applicant shall include with the application (a) proof of an agreement under section 6 of the Act to operate an ambulance operation, and (b) a statement as to the class or classes of ambulance that the applicant proposes to operate. Inspection 12 Before issuing or renewing an operator's licence, an authorized person may exercise powers of inspection in accordance with Part 5 of the Act. Categories of Ambulance Attendants and Ambulance Staffing Requirements Prohibition 13 No person shall be employed or engaged to provide emergency health services for an ambulance operation unless that person is an ambulance attendant and meets the requirements of the Act and this Regulation. Ambulance attendant (dispatcher) 14(1) The category of ambulance attendant (dispatcher) is established and consists of ambulance attendants who receive requests for emergency health services in a dispatch centre and direct responses to the requests. (2) An ambulance attendant (dispatcher) shall have the qualifications established by the Provincial Director. Ambulance attendant (ambulance) 15(1) The category of ambulance attendant (ambulance) is established and consists of the persons approved by the Registrar who hold the following qualifications: (a) registration as an emergency medical responder under the Health Professions Act; (b) registration as a primary care paramedic under the Health Professions Act; (c) registration as an advanced care paramedic under the Health Professions Act. (2) A person who holds the qualifications referred to in subsection (1)(a) to (c) may act as an ambulance attendant (ambulance) only as authorized under this Regulation and in any circumstances further specified by the Registrar in the terms and conditions of an operator's licence. Direction 16 Despite any other enactment, an ambulance attendant and an ambulance operator shall comply with the direction provided to the ambulance attendant or ambulance operator. Ambulance staffing requirements 17(1) A Class 1 ambulance shall be staffed with a minimum of 2 ambulance attendants (ambulance), (a) one of whom shall be a primary care paramedic, and (b) one of whom shall be either a primary care paramedic or an advanced care paramedic. (2) A Class 2 ambulance shall be staffed with a minimum of 2 ambulance attendants (ambulance), (a) one of whom shall be a primary care paramedic, and (b) one of whom shall be either a primary care paramedic or an advanced care paramedic. (3) A Class 3 ambulance that is transporting a patient on a multi-level cot shall be staffed with a minimum of 2 ambulance attendants (ambulance), (a) one of whom shall be a primary care paramedic, and (b) one of whom shall be either a primary care paramedic or an advanced care paramedic. (4) A Class 3 ambulance that is functioning as a paramedic response unit shall be staffed with one ambulance attendant who is an advanced care paramedic. (5) A Class 3 ambulance that is dispatched as the first response to a request for emergency health services and transports only patients seated in a mobility aid or a standard passenger seat shall be staffed with one ambulance attendant who is either a primary care paramedic or an advanced care paramedic. (6) A Class 4 ambulance shall be staffed with a minimum of 2 ambulance attendants, one of whom is a primary care paramedic. (7) A Class 4 ambulance that is transporting a patient in a recumbent position shall be staffed with a minimum of 2 ambulance attendants. (8) A Class 4 ambulance that is transporting only patients seated in a standard passenger seat shall be staffed with a minimum of one ambulance attendant who is an emergency medical responder. Dispatch Centres Minister's approval of dispatch centre 18(1) A person seeking approval under section 14(1) of the Act to operate a dispatch centre shall submit to the Registrar, in the form and manner specified by the Registrar, (a) a dispatch interruption contingency plan in respect of the proposed dispatch centre, and (b) any other information specified or requested by the Minister in the form and manner specified by the Registrar. (2) The Minister may (a) approve the dispatch centre in whole or in part and on any terms and conditions that the Minister considers appropriate, or (b) decline to approve the dispatch centre, providing notice in writing of that fact to the person referred to in subsection (1) and the regional health authority. Dispatch interruption contingency plan 19 The operator of a dispatch centre shall submit to the Registrar, in the form and manner specified by the Registrar, an updated dispatch interruption contingency plan (a) every 5 calendar years, (b) if the dispatch centre is to be relocated, before the relocation occurs, or (c) at any time as requested by the Registrar. Dispatch centre's responsibilities 20 An operator of a dispatch centre shall comply with, and shall ensure that the operator's dispatch centre, employees and agents comply with, the requirements of the Act and this Regulation. Telephone access 21 In areas of the province where a 911 service is not available, the regional health authority responsible for providing emergency health services in the area shall ensure that (a) the public can call for emergency health services in the area through a dedicated telephone line on a 24-hour basis, and (b) the telephone number for calling for emergency health services is advertised in a manner that provides notice of the telephone number in the communities in which the services are provided. Ambulance Standards, Equipment and Supplies Approval for use 22(1) A regional health authority or an ambulance operator shall not use a vehicle to provide emergency health services unless the vehicle is approved by the Registrar for regular use as an ambulance. (2) Despite subsection (1), the Registrar may authorize the use of an ambulance in the situations specified by the Registrar, subject to any terms or conditions the Registrar considers appropriate. (3) An ambulance operator shall apply to the Registrar in the form and manner required by the Registrar for an approval for use of an ambulance that will be used in providing emergency health services. (4) The Registrar may inspect an ambulance or cause it to be inspected on receipt of an application under subsection (3). Transition to Ambulance Code 23(1) An ambulance that was approved for use on or after March 15, 2010 must meet the requirements of the Ambulance Code. (2) If an ambulance was approved for use on or before March 14, 2010 and was reapproved for use on or after March 15, 2010 because the ambulance's original patient compartment was mounted on a new chassis, the ambulance must meet the requirements of section 16 of the Ambulance Code. Age restriction for ambulance 24(1) No ambulance operator shall operate an ambulance whose chassis or patient compartment is 12 or more years old unless the ambulance operator has obtained an exemption from the Registrar. (2) The Registrar may authorize an exemption of not more than 2 years to an ambulance operator to operate an ambulance that is 12 or more years old. Out-of-province ambulances 25 An ambulance that is approved for use in another jurisdiction and that meets the requirements for operating as an ambulance in that other jurisdiction is authorized to enter Alberta for the purpose of (a) transporting a patient from the jurisdiction into Alberta, (b) transporting a patient from an approved facility located in Alberta to another jurisdiction, or (c) aiding Alberta in providing emergency health services to Albertans in exceptional circumstances, as determined by the Registrar. Equipment and supplies 26(1) An ambulance operator shall ensure that every ambulance is equipped with the equipment and supplies required by the Provincial Medical Protocols. (2) Ambulance operators and ambulance attendants shall ensure that all equipment, supplies and medications used to provide emergency health services that have a specified shelf life are removed from the ambulance on or before the expiry date and (a) disposed of in accordance with any waste management guidelines and standards prescribed by any enactment of Alberta or Canada, or (b) in the case of sterile reusable equipment, cleaned, resterilized and repackaged. (3) Ambulance operators and ambulance attendants shall ensure that all equipment and supplies in an ambulance are properly secured when an ambulance is moving. Maintenance and Repair Mandatory repairs 27 The Registrar may establish criteria or requirements for mandatory repairs and may, in addition to any other consequence or penalty authorized by the Act that applies with respect to an ambulance or ambulance operator, require that an ambulance be removed from service until the mandatory repairs are completed to the satisfaction of the Registrar. Maintenance program 28(1) An ambulance shall be maintained and inspected in accordance with an ambulance operator's maintenance program. (2) An ambulance operator shall ensure that the ambulance attendants (ambulance) and vehicle maintenance personnel of the ambulance operator's ambulance operation are informed of and familiar with the requirements of the maintenance program. Roadworthiness inspection 29 An ambulance shall be inspected for roadworthiness at intervals established by the Registrar by a person who is a certified journeyperson in the trade of automotive service technician or by a certified journeyperson in the truck and transport mechanic branch of the trade of heavy equipment technician under the Apprenticeship and Industry Training Act. Ambulance defects 30(1) In this section and sections 31, 32 and 33, "ambulance" includes the equipment for an ambulance as required by the Provincial Medical Protocols. (2) An ambulance attendant, employee or agent of an ambulance operator shall immediately notify the ambulance operator if the person becomes aware of (a) a defect that may affect the safe operation of an ambulance, or (b) the need for a mandatory repair referred to in section 27. (3) An ambulance operator shall immediately address any defect or mandatory repair of which the ambulance operator is aware so that the ambulance may be operated safely. (4) If the manufacturer of an ambulance has provided specific instructions regarding a defect or mandatory repair of an ambulance, the defect or mandatory repair shall be addressed in accordance with those instructions. Replacement parts 31 A person who repairs an ambulance shall ensure that a replacement part used in the repair of an ambulance (a) is designed for the particular purpose for which it is used, and (b) is installed in accordance with the manufacturer's instructions. Ambulance Operations and Information Ambulance records 32(1) An ambulance operator shall retain the following records in respect of each of the ambulance operator's ambulances: (a) the identifying information for each ambulance, including (i) the manufacturer and model number of the chassis and patient compartment, (ii) the year of manufacture of the chassis and patient compartment, (iii) the vehicle identification number, and (iv) any ambulance identification provided by the Department; (b) a record of the inspection, repair and maintenance of each ambulance, including (i) the nature of the inspection, repair or maintenance performed on it, (ii) the date on which the inspection, repair or maintenance took place and the odometer reading of the ambulance at that time, and (iii) the name and contact information of the individual who carried out the inspection, repair or maintenance; (c) any notification under section 30 or any notice of a manufacturer's defect received with respect to an ambulance and the corrective work done as a result of the notification or notice. (2) For every ambulance, a copy of the records set out in subsection (1) shall be retained (a) in the case of the ambulance itself, for a period of 10 years from the date they are recorded or for a shorter period approved by the Registrar, and (b) in the case of the equipment for the ambulance, for a period of 5 years from the date they are recorded or for a shorter period approved by the Registrar. (3) If an ambulance is transferred to a new owner, the new owner shall be provided with a copy of the records described in subsection (1)(b). (4) The records shall be retained or made available at the ambulance operator's main place of business in Alberta in accordance with section 36. Patient care report 33(1) An ambulance operator shall ensure that (a) an ambulance attendant (ambulance) who attends a patient completes a patient care report in the form approved by the Registrar immediately after attending the patient, (b) if the patient is transported to an approved facility, one copy of the patient care report is given for inclusion in the patient's medical chart to a person at that facility who has the authority to receive patient information, (c) if requested by the Registrar, a completed patient care report must be forwarded to the Department at a place and within the time specified by the Registrar, and (d) the patient care data set specified by the Registrar is submitted to the Department in a manner and within the time specified by the Registrar. (2) An ambulance operator shall retain for a period of 10 calendar years from the date the patient was attended to (a) a copy of the patient care report, and (b) the patient care data set referred to in subsection (1)(d). Responsibility 34 A regional health authority with which an ambulance operator has an agreement to operate an ambulance operation shall ensure that provision is made for the custody and control of the ambulance operator's patient care reports in the event that an ambulance operator ceases to provide emergency health services. Collision report 35(1) A person who is driving an ambulance and who is involved in a collision shall complete a collision report in the form approved by the Registrar and submit the report to the Registrar within the time specified by the Registrar, if any of the following circumstances occur: (a) any person is injured or dies as a result of the collision; (b) the ambulance's emergency lights or sirens are on at the time of the collision; (c) the collision causes damage to the ambulance above the amount established by the Registrar; (d) any other circumstance as may be specified by the Registrar. (2) An ambulance operator shall retain a copy of a collision report for a period of 10 calendar years from the date the collision occurs. Record keeping 36 The contents of a record required to be maintained (a) under section 32(2), or (b) for 10 calendar years under sections 33, 34 and 35 may be stored electronically, and the original record may be destroyed not less than 2 years after the record is created. Provision of records, etc. 37 An ambulance operator shall, as required by the Registrar, provide the Registrar with records and other information in the ambulance operator's possession or under the ambulance operator's control that are relevant to the provision of emergency health services. Ambulance insurance 38 An ambulance operator shall maintain, in respect of an ambulance used in the provision of emergency health services, automobile insurance that (a) includes an endorsement giving the ambulance operator permission to carry passengers for compensation, and (b) insures, to a limit in respect of each collision of not less than $2 000 000 exclusive of interest and costs, against liability resulting from bodily injury to or the death of one or more persons and loss of or damage to property. Malpractice insurance 39 An ambulance operator shall have malpractice insurance under which (a) the ambulance operator and each ambulance attendant engaged by the ambulance operator are insured against liability for personal injury resulting from negligent acts or omissions in carrying out their duties, (b) the minimum liability for which the ambulance operator and each ambulance attendant is insured is $2 000 000 for each negligent act or omission, and (c) the policy includes an annual aggregate limit of at least $3 000 000. Patient information 40 When an ambulance is used to transfer a patient from one approved facility to another, the sending facility shall provide the ambulance attendant (ambulance) with the following: (a) the patient's name; (b) a summary of the patient's medical history prior to the transfer, including information that is relevant to complications that may arise during the transfer; (c) any orders by the attending physician for treatment of the patient during transportation; (d) the reason for the transfer; (e) the name of the receiving physician, the receiving facility and confirmation that the receiving facility has been notified of the transfer. Patient transportation 41(1) A patient who is being transported in a Class 1 or 2 ambulance shall be transported only in the patient compartment of the ambulance. (2) A patient who is to be transported in a recumbent position in a Class 1, 2 or 3 ambulance shall be transported on a multi-level cot. (3) Despite subsections (1) and (2), but subject to subsection (4), a patient may be transported in a recumbent position on an alternate transport device in an ambulance if (a) the ambulance is designed, equipped and tested to secure an alternate transport device, and (b) the alternate transport device is secured to the ambulance. (4) A patient shall not be transported in a recumbent position on an alternate transport device in a Class 3 ambulance except when it is necessary to move the patient from a location where a Class 1 ambulance cannot access the patient to a location where a Class 1 ambulance can access the patient. (5) The siren and warning lights of a Class 4 ambulance shall not be operated when the ambulance is being used to transport a patient. (6) A patient shall be secured with a safety device appropriate to the patient's condition and size. (7) A patient who is being transported on a cot shall at all times be secured using a restraint system that includes 3 cross straps and 2 shoulder straps, in accordance with the instructions supplied by the manufacturer of the cot, unless (a) access to the patient's upper torso is required for medical or resuscitative procedures, or (b) the patient's size or health condition is such that the restraint system described in this subsection is not appropriate for transporting the patient. (8) An ambulance may transport more than one patient at the same time when the ambulance operator or ambulance attendant (ambulance) considers it safe to do so. Physical or mental incapacity 42 No ambulance attendant shall provide or attempt to provide emergency health services if the ambulance attendant (a) is unable to meet the physical requirements of providing the emergency health services in question, or (b) is suffering from diminished capacity by reason of injury, illness, fatigue, drugs, alcohol or any other factor in such a way that the safety of a patient or any other person may be endangered. Infection prevention and control 43(1) An ambulance operator shall (a) keep every ambulance that the ambulance operator operates and all equipment and supplies required in the operation of the ambulance in a hygienic and safe condition, and (b) develop and post in a conspicuous location an infection prevention and control program. (2) The Registrar may establish criteria or requirements for the infection prevention and control programs referred to in subsection (1), either generally or as to specific classes of ambulances or ambulance operators. (3) An infection prevention and control program referred to in subsection (1) shall comply with any criteria or requirements established by the Registrar that apply to the ambulance operator. Ambulance interior temperature 44(1) An ambulance shall not be used to respond to a request for an emergency health service until the interior temperature of the ambulance is 10§C or more. (2) The interior temperature of an ambulance shall be kept within the temperature range specified by the manufacturer of any and all equipment and supplies in an ambulance. Manufacturer's weight ratings 45 An ambulance shall not be operated in any situation if the manufacturer's ratings for gross axle weight or gross vehicle weight are exceeded. Fees for services 46(1) Subject to subsection (2), an ambulance operator may charge a patient the fees established by the Minister for the services provided. (2) An ambulance operator shall not directly bill a patient who is enrolled in a Government of Alberta program that is identified by the Minister. Complaints to Registrar Complaints to Registrar 47(1) A person may submit a complaint to the Registrar regarding the provision of an emergency health service by an ambulance operator. (2) The complaint shall be made in writing to the Registrar and shall include (a) the name and contact information of the complainant, (b) the particulars of the complaint, (c) any information or facts supporting the complaint, (d) the signature of the complainant or of the complainant's authorized representative, and (e) any other information as required by the Registrar. (3) On receipt of a complaint, the Registrar may (a) dismiss the complaint, (b) investigate the complaint, or (c) if the complaint relates to a matter that is also within the jurisdiction of another person or body, refer the complaint to that person or body. (4) If the Registrar dismisses the complaint or refers the complaint to another person or body under subsection (3), the Registrar shall notify the complainant and the ambulance operator of that fact and, in the case of a referral, provide the complainant and the ambulance operator with the name of the person or body. (5) If the Registrar commences an investigation, the Registrar shall (a) notify the complainant, and (b) notify the ambulance operator who is the subject of the complaint of the nature of the complaint and that an investigation will be conducted. (6) On completing an investigation, the Registrar may (a) dismiss the complaint, (b) exercise any of the powers set out in section 30(2) of the Act, or (c) refer the complaint to another person or body described in subsection (3). (7) The Registrar shall notify the complainant and the ambulance operator as to the outcome of an investigation referred to in subsection (6) and, in the case of a referral, provide the complainant and the ambulance operator with the name of the person or body. Other Matters Display of the word "ambulance" 48 No vehicle shall display the word "ambulance" unless (a) the vehicle is operated by a licensed ambulance operator, and (b) the Registrar has authorized the display of the word "ambulance" for that type of vehicle. Transitional - dispatch centres 49 The operator of a dispatch centre that was approved before the coming into force of this Regulation shall, within 3 months after the coming into force of this Regulation, submit to the Registrar a dispatch interruption contingency plan in respect of the dispatch centre. Transitional - Class 1, 2, 3 and 4 ambulances 50(1) Subject to this section, an ambulance operator may continue to operate a Class 1, 2, 3 or 4 ambulance that does not meet the requirements of this Regulation for 180 days after the coming into force of this Regulation. (2) An ambulance operator who wishes to operate a Class 1, 2, 3 or 4 ambulance referred to in subsection (1) must apply to the Registrar in the form and manner specified by the Registrar for permission to operate the ambulance. (3) An application under subsection (2) must include proof that the ambulance (a) passes a mechanical safety inspection, the criteria for which are set out in the Ambulance Safety Inspection Manual published by the Department, (b) complies with the testing standards set out in the Ambulance Code for any patient restraint devices, (c) complies with the requirements of the Canadian Standards Association for any mobility aid lifts, ramps and access doors, and (d) meets the requirements for exterior color and graphics set out in section 16 of the Ambulance Code. (4) Sections 10, 11, 12 and 13 of the Act apply with respect to (a) an application under this section, and (b) the Registrar's approval given under this section, as if the approval were a licence. Repeal 51 The following regulations are repealed: (a) Emergency Health Services (Interim) Regulation (AR 76/2009); (b) Licensing and Ambulance Maintenance Regulation (AR 46/99); (c) Staff, Vehicle and Equipment Regulation (AR 45/99). Expiry 52 For the purpose of ensuring that this Regulation is reviewed for ongoing relevancy and necessity, with the option that it may be repassed in its present or an amended form following a review, this Regulation expires on June 30, 2030.