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RULE §157.11Requirements for an EMS Provider License

    (B) operable emergency warning devices;

    (C) personal protective equipment for the crew to include at least:

      (i) protective, non-porous gloves;

      (ii) medical eye protection;

      (iii) medical respiratory protection;

      (iv) medical protective gowns or equivalent; and

      (v) personal cleansing supplies;

    (D) sharps container;

    (E) biohazard bags;

    (F) portable, battery-powered flashlight (not a pen-light);

    (G) a mounted fire extinguisher;

    (H) "No Smoking" signs posted in the patient compartment and cab of vehicle; and

    (I) emergency response guide book (for hazardous materials).

  (8) As justified by specific patient needs, and when qualified personnel are available, providers may appropriately utilize equipment in addition to that which is required by their designation levels. Equipment used must be consistent with protocols and/or patient-specific orders and must correspond to personnel qualifications.

(k) National accreditation. If a provider has been accredited through a national accrediting organization approved by the department and adheres to Texas staffing level requirements, the department may exempt the provider from portions of the license process. In addition to other licensing requirements, accredited providers shall submit:

  (1) an accreditation self-study;

  (2) a copy of formal accreditation certificate; and

  (3) any correspondence or updates to or from the accrediting organization which impact the provider's status.

(l) Subscription or Membership Services. An EMS provider who operates or intends to operate a subscription or membership program for the provision of EMS within the provider service area shall meet all the requirements for an EMS provider license as established by the Health and Safety Code, Chapter 773, and the rules adopted thereunder, and shall obtain department approval prior to soliciting, advertising or collecting subscription or membership fees. In order to obtain department approval for a subscription or membership program, the EMS provider shall:

  (1) Obtain written authorization from the highest elected official (County Judge or Mayor) of the political subdivision(s) where subscriptions will be sold. Written authorization must be obtained from each County Judge if subscriptions are to be sold in multiple counties.

    (A) The County Judge must provider written authorizations if subscriptions sold across an entire county.

    (B) The Mayor may provide written authorization if subscriptions are sold exclusively within the boundaries of an incorporated town or city.

  (2) Submit a copy of the contract used to enroll participants.

  (3) The EMS provider shall maintain a current file of all advertising for the service. Submit a copy of all advertising used to promote the subscription service within ten days after the beginning of any enrollment period.

  (4) Comply with all state and federal regulations regarding billing and reimbursement for participants in the subscription service.

  (5) Provide evidence of financial responsibility by:

    (A) obtaining a surety bond payable to the department in an amount equal to the funds to be subscribed. The surety bond must be on a department bond form and be issued by a company licensed by or eligible to do business in the State of Texas; or

    (B) submitting satisfactory evidence of self-insurance an amount equal to the funds to be subscribed if the provider is a function of a governmental entity.

  (6) Not deny emergency medical services to non-subscribers or subscribers of non-current status.

  (7) Be reviewed at least every year; and the subscription program may be reviewed by the department at any time.

  (8) Furnish a list after each enrollment period with the names, addresses, dates of enrollment of each subscriber, and subscription fee paid by each subscriber.

  (9) Furnish the department beginning and ending dates of enrollment period(s). Subscription service period shall not exceed one year. Subscribers shall not be charged more than a prorated fee for the remaining subscription service period that they subscribe for.

  (10) Furnish the department with the total amount of funds collected each year.

  (11) Not offer membership nor accept members into the program who are Medicaid clients.

(m) Responsibilities of the EMS provider. During the license period, the provider's responsibilities shall include:

  (1) assuring that all response-ready and in-service vehicles are maintained, operated, equipped and staffed in accordance with the requirements of the provider's license;

  (2) assuring the existence of and adherence to a quality assurance plan which shall, at a minimum, include:

    (A) the standard of patient care and the medical director's protocols;

    (B) pharmaceutical storage;

    (C) readiness inspections;

    (D) preventive maintenance;

    (E) policies and procedures;

    (F) complaint management; and

    (G) patient care reporting and documentation.

  (3) monitoring the quality of patient care provided by the service and personnel and taking appropriate and immediate corrective action to insure that quality of service is maintained in accordance with the existing standards of care;

  (4) ensuring that all personnel are currently certified or licensed by the department;

  (5) assuring that all personnel, when on an in-service vehicle or when on the scene of an emergency, are prominently identified by, at least, the last name and the first initial of the first name, the certification or license level and the provider name. A provider may utilize an alternative identification system in incident specific situations that pose a potential for danger if the individuals are identified by name;

  (6) assuring the confidentiality of all patient information in compliance with all federal and state laws;

  (7) assuring that Informed Treatment/Transport Refusal forms are obtained from all patients refusing service, or documenting incidents when an Informed Treatment/Transport Refusal form cannot be obtained;

  (8) assuring that patient care reports are completed accurately on all patients;

  (9) assuring that patient care reports are provided to emergency facilities receiving the patients:

    (A) the report shall be accurate, complete and clearly written or computer generated;

    (B) the report shall document, at a minimum, the patient's name, condition upon arrival at the scene; the prehospital care provided; the patient's status during transport, including signs, symptoms, and responses during the transport; the call initiation time; dispatch time; scene arrival time; scene departure time; hospital arrival time; and, the identification of the EMS staff;

    (C) whenever operationally feasible, the report shall be provided to the receiving facility at the time the patient is delivered; and/or

    (D) if in a response-pending status, an abbreviated written report shall be provided at the time the patient is delivered and a full written or computer generated report shall be delivered to the facility within one business day of the delivery of the patient.

  (10) assuring that all requested patient records are made promptly available to the medical director or department when requested;

  (11) assuring that current protocols, current equipment, supply and medication lists, and the correct original Vehicle Authorization at the appropriate level are maintained on each response-ready and in-service vehicle;

  (12) monitoring and enforcing compliance with all policies;

  (13) assuring provisions for the appropriate disposal of medical and/or biohazardous waste materials;

  (14) assuring ongoing compliance with the terms of first responder agreements;

  (15) assuring that all documents, reports or information provided to the department are current, accurate and complete;

  (16) assuring compliance with all federal and state laws and regulations and all local ordinances, policies and codes at all times;

  (17) assuring that all response data required by the department is submitted in accordance with the department's requirements;


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