| (10) The department inspector will inform the provider's
chief executive officer, designee, or person in charge at the time
of the inspection, of the provider's right to an informal compliance
group review, when there is disagreement with deficiencies cited by
the inspector or investigator, that the provider was unable to resolve
through submission of information to the inspector or additional information
bearing on the deficiencies cited.
(11) The department shall refer issues and complaints
relating to the conduct or actions by licensed professionals to their
appropriate licensing boards.
(12) All initial applicants and their medical director
shall be required to have an initial compliance survey by the department
that evaluates all aspects of the applicant's proposed operations
including clinical care components and an inspection of all vehicles
prior to the issuance of a license.
(13) At renewal, randomly, or in response to a complaint,
the department may conduct an unannounced compliance survey that includes
inspection of a provider's vehicles, operations and/or records to
ensure compliance with this title at any time, including nights or
weekends.
(14) If a re-survey/inspection to ensure correction
of a deficiency is conducted, the provider shall pay a nonrefundable
fee of $30 per vehicle needing a re-inspection.
(s) Specialty Care Transports. A Specialty Care Transport
is defined as the interfacility transfer by a department licensed
EMS provider of a critically ill or injured patient requiring specialized
interventions, monitoring and/or staffing. To qualify to function
as a Specialty Care Transport the following minimum criteria shall
be met:
(1) Qualifying Interventions:
(A) patients with one or more of the following IV infusions:
vasopressors; vasoactive compounds; antiarrhythmics; fibrinolytics;
tocolytics; blood or blood products and/or any other parenteral pharmaceutical
unique to the patient's special health care needs; and
(B) one or more of the following special monitors or
procedures: mechanical ventilation; multiple monitors; cardiac balloon
pump; external cardiac support (ventricular assist devices, etc);
any other specialized device, vehicle or procedure unique to the patient's
health care needs.
(2) Equipment. All specialized equipment and supplies
appropriate to the required interventions shall be available at the
time of the transport.
(3) Minimum Required Staffing. One currently certified
EMT-Basic and one currently certified or licensed paramedic with the
additional training as defined in paragraph (4) of this subsection;
or, a currently certified EMT-Basic and a currently certified or licensed
paramedic accompanied by at least one of the following: a Registered
Nurse with special knowledge of the patient's care needs; a certified
Respiratory Therapist; a licensed physician; or, any other licensed
health care professional designated by the transferring physician.
(4) Additional Required Education and Training for
Certified/Licensed Paramedics: Evidence of successful completion of
post-paramedic education, training and appropriate periodic skills
verification in management of patients on ventilators, 12 lead EKG
and/or other critical care monitoring devices, drug infusion pumps,
and cardiac and/or other critical care medications, or any other specialized
procedures or devices determined at the discretion of the EMS provider's
medical director.
(t) For all initial applications and renewal applications,
the department is authorized to collect subscription and convenience
fees, in amounts determined by the Texas Online Authority, to recover
costs associated with the initial application and renewal application
processing through Texas Online.
(u) Complaint Investigations.
(1) Upon request, all licensed EMS Providers shall
make available for a patient or its legal guardian a written statement
supplied by the department, identifying the department as the responsible
agency for conducting EMS provider and EMS personnel complaint investigations.
The statement shall inform persons that they may direct a complaint
to the Department of State Health Services, EMS Compliance Group,
by phone, or by email. The statement shall provide the most current
contact information, including the appropriate department group, address,
local and toll-free telephone number, and email address for filing
a complaint.
(2) The department evaluates all complaints made against
EMS providers and/or EMS personnel. Any complaint submitted to the
department shall be submitted by telephone, electronically, or in
writing, using the department's current contact information for that
purpose, as described in paragraph (1) of this subsection.
(3) The department will document, evaluate and prioritize
complaints and information received, based on the seriousness of the
alleged violation and the level of risk to patients, personnel and/or
the public.
(A) Allegations determined to be within the department's
regulatory jurisdiction relating to emergency medical services are
authorized for investigation under this chapter. Complaints received
that are outside the department's jurisdiction may be referred to
another appropriate agency for response.
(B) The investigation is conducted on-site, by telephone
and/or through written correspondence.
(4) The department conducts a prompt and thorough investigation
of all reports or complaint allegations that may pose a threat of
harm to the health and safety of patients or participants. Reports
or complaints received by the department concerning alleged abuse,
neglect and exploitation will be addressed in accordance with Human
Resources Code, Chapter 48 and Family Code, §261.101(d).
(5) The department evaluates complaint allegations
that do not pose a significant risk of harm to patients. Based on
the nature and severity of the alleged incident, the department determines
whether to investigate the complaint directly or to require the provider
to conduct an internal investigation and submit its findings and supporting
evidence to the department.
(A) The findings of an EMS provider's internal investigation
will be reviewed by the department and may result in an additional
investigation by the department, a request for a plan of correction
to be completed by the provider in accordance with subsection (q)
of this section (relating to inspections and investigations) and/or
a proposal to take action against the provider under §157.16
of this title.
(B) The EMS provider under investigation shall provide
department staff access to all documents, evidence and individuals
related to the alleged violation, including all evidence and documentation
relating to any internal investigations.
(6) Once an internal EMS provider investigation and/or
department investigation is complete, the department reviews the evidence
from the investigation to evaluate whether the evidence substantiates
the complaint and what corrective action, if any, is needed.
|
| Source Note: The provisions of this §157.11 adopted to be effective August 17, 2008, 33 TexReg 6395; amended to be effective August 10, 2014, 39 TexReg 5951; amended to be effective February 12, 2017, 42 TexReg 430; amended to be effective September 13, 2022, 47 TexReg 5484 |
