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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

  (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.


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

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