| (4) Applicants that meet all the requirements for a
license shall be issued an FRO license. The license is issued for
2 years. For administrative purposes, it may be issued for less than
2 years.
(e) Responsibilities of the FRO. During the license
period the FRO's responsibilities shall include:
(1) assuring ongoing compliance with the terms of all
EMS provider agreement(s);
(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 of medical equipment and
vehicles owned by the FRO;
(E) policies and procedures;
(F) complaint management; and
(G) patient care reporting and documentation;
(3) ensuring that all medical personnel are currently
certified or licensed by the department;
(4) assuring that all personnel 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 FRO name. An FRO may utilize an alternative identification
system in incident specific situations that pose a potential for danger
if the individuals are identified by name;
(5) assuring that all vehicles utilized by FRO personnel
carry proof of first responder registration or have the name of the
FRO prominently displayed and visible from the outside of the vehicle
while on the scene of an emergency;
(6) assuring the confidentiality of all patient information
is in compliance with all federal and state laws;
(7) developing and adhering to an agreement between
the primary transport provider and first responder organization concerning
the use of patient refusal forms and documentation for incidents when
an informed treatment refusal form cannot be obtained;
(8) developing and adhering to an agreement between
the primary transport provider and first responder organization concerning
the maintenance of FRO records;
(9) assuring that patient care reports are completed
accurately for all patients:
(A) the report shall be accurate, complete and clearly
written; and
(B) the report shall document, at a minimum, the patient's
name, the patient's condition when first contacted by FRO personnel;
the prehospital care provided; the dispatch time; scene arrival time;
and the identification of the FRO personnel who provided care to the
patient;
(10) assuring that all relevant patient care information
is supplied in writing to the licensed EMS provider at the time the
patient is transferred to the provider;
(11) assuring that a full written report is provided,
upon request, within 1 business day to the transport provider and/or
hospital facility where the patient was delivered;
(12) assuring that all requested patient records are
made promptly available to the first responder organization's medical
director;
(13) assuring that current protocols are available
to all certified or licensed personnel;
(14) monitoring and enforcing compliance with all policies;
(15) assuring provisions for the appropriate disposal
of medical and/or biohazardous waste materials;
(16) assuring that all documents, reports or information
provided to the department are current, accurate and complete;
(17) assuring compliance with all federal and state
laws and regulations and all local ordinances, policies and codes
at all times;
(18) assuring that the department is notified within
5 business days whenever there is a change:
(A) in the level of service;
(B) in the declared service area;
(C) in the official business mailing address;
(D) in the physical location of the first responder
organization;
(E) in the physical location of patient report file
storage, to assure that the department has access to these records
at all times;
(F) of the administrator;
(G) of the e-mail address; or
(H) of the EMS providers associated with the FRO.
(19) assuring that the department is notified within
1 business day when a change of the medical director has occurred;
(20) assuring the FRO has written operating policies,
procedures and medical protocols and provides all medical personnel
a copy initially and whenever such policies, procedures and/or medical
protocols are changed. A copy of the written operating policies, procedures
and medical protocols shall be made available to the department upon
request. At a minimum, policies shall adequately address:
(A) personal protective equipment;
(B) immunizations available to personnel;
(C) infection control procedures;
(D) contact information for the designated infection
control officer for whom education based on U.S. Code, Title 42, Chapter
6A, Subchapter XXIV, Part G, §300ff-136 has been documented;
(E) management of possible exposure to communicable
disease;
(F) credentialing of new response personnel before
being assigned to respond to emergencies. The credentialing process
shall include, at minimum:
(i) a comprehensive orientation session of the FRO's
policies and procedures, 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; and
(G) appropriate documentation of patient care;
(21) assuring that all documents, reports or information
provided to the department are current, truthful and correct;
(22) assuring that the department is notified within
1 business day of a collision involving an FRO vehicle responding
to a scene or while at the scene of an emergency and resulting in
personal injury or death of any person;
(23) maintaining motor vehicle and professional liability
insurance as required by the Texas Transportation Code under Subchapter
D, §601.071 and §601.072, for all vehicles owned or operated
by the FRO;
(24) providing continuous coverage for the service
area as defined in the staffing plan; and
(25) 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.
(f) License renewal.
(1) The department may notify the FRO at least 90 days
before the expiration date of the current license at the address shown
in the current records of the department. If a notice of expiration
is not received, it is the responsibility of the FRO to notify the
department and request license renewal application information.
(2) FROs shall submit a completed application and nonrefundable
fee, if applicable, and must verify compliance with the requirements
of the license.
(g) License denial. A license may be denied for, but
not limited to, the following reasons:
(1) failure to meet requirements for an FRO license
in accordance with this section;
(2) previous failure to meet the responsibilities of
an FRO as described in this section;
(3) falsifying any information, record or document
required for an FRO license;
(4) misrepresenting any requirements for an FRO license
or renewal of an FRO license;
(5) history of criminal activity while licensed as
an FRO;
(6) history of disciplinary action relating to the
FRO license; and/or
(7) issuing a check for application for an FRO license
which is subsequently returned to the department unpaid.
(h) License revocation criteria. An FRO license may
be revoked or suspended for failure to meet the responsibilities of
a licensed FRO as described in this section.
(i) For all applications and renewal applications,
the department is authorized to collect subscription and convenience
fees, in amounts determined by the Texas Online Authority to recover
costs associated with the application and renewal application processing
through Texas Online.
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