| (l) 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 the formal accreditation certificate;
and
(3) any correspondence or updates to or from the accrediting
organization which impact the provider's status.
(m) Subscription or Membership Services. An EMS provider
that operates or intends to operate a subscription or membership program
for the provision of EMS within the provider's 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. 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 provide written authorizations,
if subscriptions are to be sold throughout a county.
(B) The Mayor may provide written authorization if
subscriptions are sold exclusively within the boundaries of an incorporated
town or city.
(C) If an EMS provider is not the primary emergency
provider in any area where they are going to sell a subscription plan,
written notification must be provided to the participants receiving
subscription plan stating that the EMS Provider is not the primary
emergency provider in this area. A copy of this documentation should
be provided to the primary emergency provider and the department within
30 days before the beginning of any enrollment period.
(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 30 days before 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.
(n) Responsibilities of the EMS provider. During the
license period, the EMS provider's responsibilities shall include:
(1) assuring that all response-ready and in-service
vehicles are available 24 hours a day and seven days a week, maintained,
operated, equipped and staffed in accordance with the requirements
of the provider's license, to include staffing, equipment, supplies,
required insurance and additional requirements per the current EMS
provider's medical director approved protocols and policies;
(2) each EMS provider shall develop, implement, maintain,
and evaluate an effective, ongoing, system-wide, data-driven, interdisciplinary
quality assessment and performance improvement program. The program
shall be individualized to the provider and shall, at a minimum, include:
(A) the standard of patient care as directed by the
medical director's protocols and medical director input into the provider's
policies and standard operating procedures;
(B) a complaint management system;
(C) monitoring the quality of patient care provided
by the personnel and taking appropriate and immediate corrective action
to insure that quality of care is maintained in accordance with the
existing standards of care and the provider medical director's signed,
approved protocols;
(D) the program shall include, but not be limited to,
an ongoing program that achieves measurable improvement in patient
care outcomes and reduction of medical errors;
(3) provide an attestation or provide documentation
that its management staff will or continue to participate in the local
regional advisory council;
(4) when an air ambulance is initiated through any
other method than the local 911 system the air service providing the
air ambulance is required to notify the local 911 center or the appropriate
local response system for the location of the response at time of
launch. This would not include interfacility transports or schedule
transports;
(5) ensuring that all personnel are currently certified
or licensed by the department;
(6) 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 EMS provider's 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;
(7) assuring the confidentiality of all patient information
is in compliance with all federal and state laws;
(8) assuring that Informed Treatment/Transport Refusal
forms are signed by all persons refusing service, or documenting incidents
when a signed Informed Treatment/Transport Refusal form cannot be
obtained;
(9) assuring that patient care reports are completed
accurately for all patients and meet standards as outlined in 25 Texas
Administrative Code, Chapter 103;
(10) assuring that patient care reports are provided
to facilities receiving the patient:
(A) whenever operationally feasible, the report shall
be provided to the receiving facility at the time the patient is delivered
or a full written or computer generated report shall be delivered
to the facility within 24 hours of the delivery of the patient,
(B) if in a response-pending status, an abbreviated
documented report shall be provided at the time the patient is delivered
and a completed written or computer generated report shall be delivered
to the facility within 24 hours of the delivery of the patient;
(C) the abbreviated report shall document, at a minimum,
the patient's name, patient's condition upon arrival at the scene;
the prehospital care provided; the patient's condition during transport,
including signs, symptoms, and responses to treatment during the transport;
the call initiation time; dispatch time; scene arrival time; scene
departure time; hospital arrival time; and, the identification of
the ambulance staff; and
(D) in lieu of subparagraph (C) of this paragraph,
personnel may follow the Regional Advisory Council's process for providing
abbreviated documentation to the receiving facility.
(11) assuring that all pharmaceuticals are stored according
to conditions specified in the pharmaceutical storage policy approved
by the EMS provider's medical director;
(12) assuring that staff completes a readiness inspection
as written by the EMS provider's policy;
(13) assuring that there is a preventive maintenance
plan for vehicles and equipment.
(14) assuring that staff has reviewed policies and
procedures as approved by the EMS Provider and the EMS Provider Medical
Director;
(15) Maintenance of medical reports.
(A) A licensed EMS provider shall maintain adequate
medical reports of a patient for a minimum of seven years from the
anniversary date of the date of last treatment by the EMS provider.
Cont'd... |
