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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 157EMERGENCY MEDICAL CARE
SUBCHAPTER CEMERGENCY MEDICAL SERVICES TRAINING AND COURSE APPROVAL
RULE §157.39Comprehensive Clinical Management Program Approval

(a) Purpose and Scope. This section establishes eligibility requirements and minimum training standards that a Texas licensed emergency medical services (EMS) provider must have and maintain to receive approval by the department for the provider to conduct a Comprehensive Clinical Management Program for Texas certified or licensed EMS personnel employed by or affiliated with that EMS provider, such that those personnel can become recertified or relicensed pursuant to §157.34(b)(5) of this title (relating to Recertification). The program will assure that EMS personnel affiliated with the EMS provider conducting the program will receive continuing EMS education, quality improvement, intensified individualized monitoring, mentoring, assessment and ongoing professional development as required by the standards outlined in this section.

(b) Definitions.

  (1) CCMP--A comprehensive clinical management program is a recertification training program conducted by a licensed EMS provider for EMS personnel employed by or affiliated with the EMS provider such that the EMS personnel can meet recertification or relicensure requirements as outlined in §157.34(b)(5) of this title.

  (2) CCMP Coordinator--Person responsible for the administrative functions of the CCMP program. However, the EMS provider, approved to conduct a CCMP, is the person or entity having the ultimate and overall responsibility for continually meeting state requirements for CCMP approval.

  (3) Credentialing Process--The process by which an EMS provider continually verifies and assesses the qualifications and competencies of EMS personnel to provide patient care services.

  (4) CCMP Survey Organization--A department recognized organization, which manages a CCMP survey team comprised of members as described and referenced in subsection (f) of this section for the purpose of conducting a survey, based upon the standards outlined in this section, of EMS providers seeking CCMP approval.

  (5) Preceptor--A person who holds a department EMS personnel certificate or license or other licensed medical professional approved by the medical director and who is employed by or volunteers for an EMS provider to train and evaluate EMS personnel.

  (6) Quality Improvement Process--An ongoing system that includes retrospective review, concurrent review, and prospective forecasting of clinical care. Quality improvement also combines a circular response through measurement of identified goals and sentinel events identifying opportunities for improvement, reeducation, process design, and measurement of corrective efforts.

  (7) Self Study--A document developed by the EMS provider that outlines its planning, preparation and qualifications to conduct a CCMP and include 6 months of operational data.

  (8) Survey--The onsite visit(s) conducted by a department recognized CCMP survey organization that evaluates an EMS provider applying for department approval to conduct a CCMP.

  (9) Sentinel Event--An unexpected event that triggers, or has the potential to trigger, an immediate investigation and/or response. This event usually relates to the care of a patient or the well-being of EMS personnel, such that the event causes or has the potential to cause death, serious physical or psychological injury to either the patient or the EMS personnel or the public.

(c) CCMP Eligibility Requirements.

  (1) The applicant must hold a current Texas EMS provider license, continuously valid for at least 5 years prior to the date of the application.

  (2) The applicant must not have received a department disciplinary sanction as an EMS provider, not including a reprimand or an administrative penalty of $2000 or less, during the 2 years immediately preceding the application filing date.

  (3) Any physician who the applicant has employed or contracted with to function as its medical director or as its full-time or part-time consultant, must be in good standing with the Texas Medical Board or predecessor agency to practice medicine in Texas.

  (4) A person holding more than one EMS provider license that is applying for department approval to conduct a CCMP shall be required to apply separately for each of its licenses. A CCMP approval will only be allowed per one EMS provider license. A CCMP may not extend beyond one EMS provider license and its affiliated First Responder Organization(s).

  (5) Although an EMS provider approved to conduct a CCMP may require the EMS personnel, employed by or affiliated with that provider, to participate in and to meet the objectives of its own CCMP, those personnel may still utilize another option, listed in §157.34(b) of this title, to achieve individual EMS personnel state recertification or relicensure.

  (6) The applicant must have submitted no less than two years of required data, prior to the initial CCMP survey, to the Texas EMS/Trauma Registry.

(d) Application Process for CCMP Approval.

  (1) A sufficiently complete application shall include:

    (A) a full non-refundable CCMP approval application fee payment of $60.00;

    (B) department application form with all fields correctly and legibly filled in, dated, and signed with original signatures of the EMS director, CCMP coordinator, and EMS provider's medical director; and

    (C) all required documents to include an accurate and complete CCMP self-study. This self-study shall be submitted in an electronic format as required and described by the department and shall sufficiently and accurately address those topics outlined in subsection (h) of this section.

  (2) Initial Application Form Review Period. Within 30 days from the date the department receives an initial written application for CCMP approval from an applicant, the department will send to the applicant a written notice that either the application form is complete and accepted for filing, or the application form is incomplete, and noting the application's deficiencies and the additional information required for the application to be accepted for filing.

  (3) Continuing Application Form Review Period. Within 14 days from the date that the department receives any written information from the applicant that attempts to respond to an earlier department notice of any application deficiencies and notice of the need for additional information to resolve the deficiencies, the department will send the applicant a written notice that either the application form is finally complete and accepted for filing or that the application form is still incomplete, and specifying any remaining application deficiencies and the additional information required for it to be accepted for filing.

  (4) Final Application Form Review Period. Within 14 days from the date that the department receives from the applicant the last item or piece of information to resolve all previously noted deficiencies necessary to complete the application, the department will send written notice to the applicant that the application is finally complete and accepted for filing.

  (5) Failure to Correct Application Form Deficiencies. If the department does not receive from an applicant the items or information requested by the department to correct the deficiencies in the application form by the 10th day after the date that the department has sent written notice to the applicant noting that the application form is incomplete for filing and noting the application's deficiencies and the additional information required for it to be accepted for filing, then the application is deemed to be withdrawn and void. The application fee will not be refunded.

  (6) Initiation of Survey. After the department notifies applicant that the application form is sufficiently complete and is accepted for filing, the EMS provider can initiate the survey process to be conducted by a department recognized CCMP survey organization.

  (7) Final Period for Full Application Review. The final period for full application review will begin on the date that the department timely receives from the applicant's survey organization a true and correct written survey report, the department's review of which will be the last stage of the application review process, and end on the date that the department sends written notice to the applicant that the application for CCMP approval is granted, or that it proposes to deny the application. This period is 60 days.

  (8) CCMP Approval Period. The department's grant of approval to an EMS provider to conduct a CCMP will be valid for four years from the date that approval is granted, unless the EMS provider later surrenders its CCMP approval or the department revokes the approval.

(e) Application Process to Renew CCMP Approval.

  (1) No later than the 120th day prior to the expiration date of the existing CCMP approval, an EMS provider, who is requesting renewal of CCMP approval, shall:

    (A) timely file a sufficiently completed renewal application form according to the application filing process, as described in subsection (d) of this section;

Cont'd...

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