The purpose of this rule change is to update forms, renumber the medical equipment and supplies tables, remove outdated equipment, and add equipment that will improve the quality of care and outcomes of adult and pediatric patients. This change will require all permitted ground and air transport vehicles, available for call, to maintain at least one of each item indicated on the equipment lists. This will allow the local service’s medical director to increase the quantity required in order to best serve their community, and shift the inspections process to a Quality Assurance/Quality Improvement process to identify the needs of the community and the patient. Medical Director involvement will also be enhanced, as the process will require periodic review and updating of medical protocols to improve outcomes. To aide with the Medical Director’s increased involvement, he/she will be required to attend additional training sessions to enhance skills that pertain to prehospital care. EMS transport safety will also be enhanced by requiring all licensed providers, applying for an initial air ambulance aircraft permit, to submit a valid airworthiness certificate issued by the Federal Aviation Administration for each permitted aircraft.