| (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.
(r) 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 licensed health
care professional designated by the transferring physician.
(4) Additional Required Training for Certified/Licensed
Paramedics: Evidence of successful completion of post-paramedic 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 provider's medical director.
(s) For all applications and renewal applications,
the department (or the board) is authorized to collect subscription
and convenience fees, in amounts determined by the Texas Online Authority,
to recover costs associated with application and renewal application
processing through Texas Online.
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