
Article 1 
Implementing Decision (EU) 2019/570 is amended as follows:

1.. Article 1 is amended as follows:

((a)) point (b) is replaced by the following:
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((b)) the financing of capacities during the transitional period referred to in Article 35 of Decision No 1313/2013/EU;';
((b)) the following points (c) and (d) are added:
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((c)) total estimated costs of medical aerial evacuation rescEU capacities;
((d)) total estimated costs of emergency medical team type 3 rescEU capacities.';
2.. the following Article 1a is inserted:
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Article 1a 
For the purposes of this Decision, the following definitions shall apply:

((1)) “medical aerial evacuation capacity (‘Medevac” means a response capacity that can be used for aerial evacuation of patients with highly infectious diseases as well as non-infectious diseases, such as patients in need of intensive care, patients who need to be immobilized during transport on stretchers and lightly injured patients;
((2)) “EMT type 3” means a deployable emergency team of medical and other key personnel trained and equipped to treat patients affected by a disaster and which provides complex inpatient referral surgical care, including intensive care capacity.’;')
3.. in Article 2, paragraphs 1 and 2 are replaced by the following :
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1.. rescEU shall consist of the following capacities:

— aerial forest firefighting capacities,
— medical aerial evacuation capacities,
— emergency medical team capacities.
2.. The capacities referred to in paragraph 1 shall include:

((a)) aerial forest firefighting capacities using airplanes;
((b)) aerial forest firefighting capacities using helicopters;
((c)) medical aerial evacuation capacities for highly infectious disease patients;
((d)) medical aerial evacuation capacities for disaster victims;
((e)) emergency medical team type 3 capacities: Inpatient Referral Care.';
4.. The following Articles 3a and 3b are inserted:
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Article 3a 

1. All cost categories referred to in Annex IA of Decision No 1313/2013/EU shall be taken into account when calculating the total estimated cost of rescEU medical aerial evacuation capacities.
2. The category referred to in point 1 of Annex IA to Decision No 1313/2013/EU of the total estimated cost for medical aerial capacities evacuation for highly infectious disease patients and medical aerial evacuation capacities for disaster victims shall be calculated based on market prices at the time when the capacities are acquired, rented or leased in accordance with Article 12(3) of Decision No 1313/2013/EU. Where Member States acquire, rent or lease rescEU capacities, they shall provide the Commission with documentary evidence of the actual market prices or, where there are no market prices for certain components of those capacities, with equivalent evidence.
3. The categories referred to in points 2 to 8 of Annex IA to Decision No 1313/2013/EU of the total estimated cost for medical aerial evacuation capacities for highly infectious disease patients and medical aerial evacuation capacities for disaster victims shall be calculated at least once during the period of each multiannual financial framework, taking into account information available to the Commission, including inflation. This cost shall be used by the Commission for the purpose of providing annual financial assistance.
4. The total estimated cost referred to in paragraphs 2 and 3 shall be calculated where at least one Member State expresses interest to acquire, rent or lease such a rescEU capacity.
Article 3b 

1. All cost categories referred to in Annex IA of Decision No 1313/2013/EU shall be taken into account when calculating the total estimated cost of emergency medical team type 3: Inpatient Referral Care.
2. The category referred to in point 1 of Annex IA to Decision No 1313/2013/EU of the total estimated cost for emergency medical team type 3: Inpatient Referral Care shall be calculated based on market prices at the time when the capacities are acquired, rented or leased in accordance with Article 12(3) of Decision No 1313/2013/EU. Where Member States acquire, rent or lease rescEU capacities, they shall provide the Commission with documentary evidence of the actual market prices or, where there are no market prices for certain components of those capacities, with equivalent evidence.
3. The categories referred to in points 2 to 8 of Annex IA to Decision No 1313/2013/EU of the total estimated cost for emergency medical team type 3: Inpatient Referral Care shall be calculated at least once during the period of each multiannual financial framework, taking into account information available to the Commission, including inflation. This cost shall be used by the Commission for the purpose of providing annual financial assistance.
4. The total estimated cost referred to in paragraph 2 and paragraph 3 shall be calculated where at least one Member State expresses interest to acquire, rent or lease such a rescEU capacity.';
5.. Annex I is amended as set out in the Annex to this Decision.
Article 2 
This Decision is addressed to the Member States.
Done at Brussels, 18 November 2019.
For the Commission
Christos STYLIANIDES
Member of the Commission
ANNEX

In Annex I, the following Sections 3, 4 and 5 are added:
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3. 

Tasks 
— Aerial transport, including in-flight treatment of highly infectious disease (HID) patients to specialised health facilities in the Union.
Capacities 
— Aircraft with a capacity to transport one or more HID patient per flight;
— Ability to fly day and night.
Main components 
— System for safe in-flight medical treatment of HID patients, including intensive care:
— Appropriately trained medical personnel to provide care for one or more HID patient;
— Dedicated on-board technical and medical equipment to provide care to HID patients during the flight;
— Appropriate procedures ensuring isolation and treatment of HID patients during the aerial transport.
— Support:
— Aircrew adapted to the number of HID patients and the timeframe of the flight;
— Appropriate procedures ensuring the handling of equipment and waste as well as decontamination according to established international standards, including, where applicable, relevant Union legislation.
Self-sufficiency 
— Equipment storage and maintenance of the equipment of the module;
— Equipment for communication with the relevant partners, notably those in charge of the coordination on site.
Deployment 
— Availability for departure maximum 24 hours after the acceptance of the offer;
— For intercontinental evacuations, ability to perform a 12-hour flight without refuelling.


4. 

Tasks 
— Aerial transport of disaster victims to health facilities in the Union.
Capacities 
— Aircraft with an overall capacity to transport at least six patients in need of intensive care and with a capacity to transport patients on stretchers or sitting patients, or both;
— Ability to fly day and night.
Main components 
— In-flight medical treatment, including intensive care:
— Appropriately trained medical personnel capable of providing on-board medical treatment for the different types of patients;
— Dedicated on-board technical and medical equipment to provide continuous appropriate care for the different types of patients during the flight;
— Appropriate procedures ensuring transport and in-flight treatment of patients.
— Support:
— Aircrew and medical personnel adapted to the number and types of patients and the timeframe of the flight.
Self-sufficiency 
— Equipment storage and maintenance of the equipment of the module;
— Equipment for communication with relevant partners, notably those in charge of the coordination on site.
Deployment 
— Availability for departure maximum 24 hours after the acceptance of the offer;
— For airplanes, an ability to perform a 6-hour flight without refuelling.

5. 

Tasks 
— Provide inpatient referral care and complex surgery as described by the WHO global EMT initiative.
Capacities 
— Minimum treatment capability in accordance with the standards of the WHO global EMT initiative;
— Day and night services (covering 24/7 if necessary).
Main components 
— In accordance with the standards of the WHO global EMT initiative.
Self-sufficiency 
— The team should ensure self-sufficiency during the entire deployment time. Article 12 of Implementing Decision 2014/762/EU applies and, in addition, the standards of the WHO global EMT initiative.
Deployment 
— Availability for departure in maximum 48-72 hours after the acceptance of the offer, and ability to be operational on site within 5-7 days.
— Ability to be operational for at least 8 weeks outside the Union and for at least 14 days inside the Union.
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