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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 157EMERGENCY MEDICAL CARE
SUBCHAPTER BEMERGENCY MEDICAL SERVICES PROVIDER LICENSES
RULE §157.11Requirements for an EMS Provider License

  (18) assuring that, whenever there is a change in the name of the provider or the service's operational assumed name, the printed name on the vehicles are changed accordingly within 30 days of the change;

  (19) assuring that the department is notified in five business days whenever:

    (A) a vehicle is substituted or replaced;

    (B) there is a change in the level of service;

    (C) there is a change in the declared service area;

    (D) there is a change in the official business mailing address;

    (E) there is a change in the physical location of the business;

    (F) there is a change in the physical location of patient report file storage, to assure that the department has access to these records at all times; and

    (G) there is a change of the administrator.

  (20) assuring that when a change of the medical director has occurred the department be notified within one business day;

  (21) develop, implement and enforce written operating policies and procedures required under this chapter and/or adopted by the licensee. Assure that each employee is provided a copy upon employment and whenever such policies and/or procedures are changed. A copy of the written operating policies and procedures shall be made available to the department on request. Policies at a minimum shall adequately address:

    (A) personal protective equipment;

    (B) immunizations available to staff;

    (C) infection control procedures;

    (D) communicable disease exposure;

    (E) emergency vehicle operation;

    (F) credentialing of new response personnel before being assigned primary care responsibilities. The credentialing process shall include as a minimum:

      (i) a comprehensive orientation session of the services policies and procedures, treatment and transport protocols, safety precautions, and quality management process; and

      (ii) an internship period in which all new personnel practice under the supervision of, and are evaluated by, another more experienced person, if operationally feasible.

    (G) appropriate documentation of patient care; and

    (H) vehicle checks, equipment, and readiness inspections.

  (22) assuring that manufacturers' operating instructions for all critical patient care electronic and/or technical equipment utilized by the provider are available for all response personnel;

  (23) assuring that the department is notified within five business days of a collision involving an in-service or response ready EMS vehicle that results in vehicle damage whenever:

    (A) the vehicle is rendered disabled and inoperable at the scene of the occurrence; or

    (B) there is a patient on board.

  (24) assuring that the department is notified within 1 business day of a collision involving an in-service or response ready EMS vehicle that results in vehicle damage whenever there is personal injury or death to any person;

  (25) maintaining motor vehicle liability insurance as required under the Texas Transportation Code;

  (26) maintaining professional liability insurance coverage in the minimum amount of $500,000 per occurrence, with a company licensed or deem eligible by the Texas Department of Insurance to do business in Texas in order to secure payment for any loss or damage resulting from any occurrence arising out of, or caused by the care, or lack of care, of a patient;

  (27) insuring continuous coverage for the service area defined in documents submitted with the EMS provider application;

  (28) responding to requests for assistance from the highest elected official of a political subdivision or from the department during a declared emergency or mass casualty situation;

  (29) assuring all EMS personnel receive continuing education training on the provider's anaphylaxis treatment protocols. The provider shall maintain training records to include date, time, and location of such training for all it's EMS personnel;

  (30) immediately notify the department in writing when operations cease in any service area;

  (31) assure that all patients transported by stretcher must be in a department authorized EMS vehicle; and

  (32) develop or adopt and then implement policies, procedures and protocols necessary for its operations as an EMS provider, and enforce all such policies procedures and protocols.

(n) License renewal process.

  (1) It shall be the responsibility of the provider to request license renewal application information.

  (2) Providers shall submit a completed application, all other required documentation and a nonrefundable license renewal fee, no later than 90 days prior to the expiration date of the current license.

    (A) If a complete application is received by the department 90 or more days prior to the expiration date of the current license that is to be renewed, the applicant shall submit a nonrefundable application fee of $400 per provider plus $180 for each EMS vehicle.

    (B) If a complete application is received by the department 60 or more days, but less than 90 days, prior to the expiration date of the current license that is to be renewed, the applicant shall submit a nonrefundable application fee of $450 per provider plus $180 for each EMS vehicle.

    (C) If a complete application is received by the department less than 60 days prior to the expiration of the current license the applicant shall submit a nonrefundable application fee of $500 per provider plus $180 for each EMS vehicle.

    (D) If the application for renewal is received by the department after the expiration date of the current license, a notice will be sent to the provider explaining they are not eligible to renew, but the license application will be processed and new provider license number issued after satisfying all requirements.

    (E) An EMS provider may not operate after the license has expired.

(o) Provisional License.

  (1) The department may issue a provisional license if an urgent need exists in a service area if the department finds that the applicant is in substantial compliance with the provisions of this section and if the public interest would be served. A provisional license shall be effective for no more than 45 days from the date of issuance.

    (A) A provider may apply for a provisional license by submitting a written request and a nonrefundable fee of $30.

    (B) A provisional license issued by the department may be revoked at any time by the department, with written notice to the provider, if the department finds that the provider is failing to provide appropriate service in accordance with this section or that the provider is in violation of any of the requirements of this title.

  (2) An EMS provider may not operate after the license has expired.

(p) Advertisements.

  (1) Any advertising by an EMS provider shall not be misleading, false, or deceptive. If an EMS provider advertises in Texas and/or conducts business in Texas by regularly transporting patients to, from, or within Texas, the provider shall be required to have a Texas EMS Provider License.

  (2) An EMS provider shall not advertise levels of patient care which cannot be provided at all times. The provider shall not use a name, phrase or language that could mislead the public to believe a higher level of care is being provided.

  (3) An EMS provider that has more than five paid staff, but is composed of at least 75% volunteer EMS personnel may advertise as a volunteer service.

(q) Surveys/Inspections.

  (1) All initial applicants shall be required to have an initial compliance survey by the department that evaluates all aspects of an applicant's proposed operations including clinical care components and an inspection of all vehicles prior to the issuance of a license.

  (2) At renewal, or randomly, or in response to a complaint, or for other good reason the department may conduct an unannounced compliance survey to include inspection of a provider's vehicles, operations, and/or records to insure compliance with this title at any time, including nights or weekends.

  (3) If a re-survey/inspection to insure correction of a deficiency is conducted, the provider shall pay a nonrefundable fee of $30 per vehicle needing a re-inspection.

Cont'd...

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