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(a)Emergency medical services (EMS) Education Program Standards. The Bureau of Emergency Management (bureau) shall develop and publish an EMS Education and Training Manual (manual) outlining standards for EMS education that address at least the following areas: (1)program sponsorship; (2)program direction and administration; (3)medical direction; (4)instructor personnel; (5)financial resources; (6)physical resources, including classroom and laboratory facilities, equipment and supplies, and learning resources; (7)clinical and field internship resources; (8)academic and administrative policies, procedures and records requirements; (9)program evaluation; (10)curriculum; and (11)delivery of instruction by distance learning technology. (b)Consideration of training standards. (1)The Texas Department of Health (department) shall base the manual on applicable standards and guidelines for evaluation and approval of EMS education programs adopted by national accrediting organizations. (2)Before implementation or revision of the manual, the department shall ensure adequate time for public review and comment. (3)Before implementation or revision of the manual, the department shall present the manual to the advisory council for review. (c)Curriculum. (1)Emergency Care Attendant (ECA) (A)The minimum curriculum shall include all content required by the current national EMS First Responder educational standards and competencies as defined by the United States Department of Transportation (DOT). (B)In addition to the minimum curriculum in subparagraph (A) of this paragraph, the curriculum shall include the following subjects: (i)recognition and identification of hazardous materials as defined by the Federal Emergency Management Agency curriculum, "Recognizing and Identifying Hazardous Materials"; (ii)airway/ventilation adjuncts; to include use of the bag-valve mask, oxygen administration and oral suctioning; (iii)measurement of baseline vital signs to include pulse, respiration and blood pressure by palpation and auscultation; (iv)spinal motion restriction, to include sizing and application of cervical collars and short/long spinal motion restriction devices to supine, seated, and standing patients; (v)patient assessment; (vi)bandaging, splinting, and traction splinting; (vii)cardiac arrest management, including use of the semi- automatic external defibrillator; (viii)equipment used to lift and move patients; (ix)communications and documentation; and (x)ambulance operations, to include emergency vehicle laws. (C)The course shall include a minimum of 40 clock hours of classroom and laboratory instruction in the approved curriculum. (2)Emergency Medical Technician-Basic (EMT-B). (A)The minimum curriculum shall include all content required by the current national EMT-B educational standards and competencies as defined by DOT. (B)The course shall include a minimum of 140 clock hours of classroom, laboratory, clinical, and field instruction which shall include supervised experiences in the emergency department, with a licensed EMS provider and in other settings as needed to develop the competencies defined in the minimum curriculum. (3)Emergency Medical Technician-Intermediate (EMT-I). (A)The minimum curriculum shall include all content required by the portions of the current national paramedic education standards and competencies as defined by DOT which address the following areas: (i)roles and responsibilities of the paramedic; (ii)well being of the paramedic; (iii)illness and injury prevention; (iv)medical/legal issues; (v)ethics; (vi)general principles of pathophysiology; (vii)pharmacology; (viii)venous access and medication administration; (ix)therapeutic communications; (x)life span development; (xi)patient assessment; (xii)airway management and ventilation, including endotracheal intubation; and (xiii)trauma. (B)The course shall include a minimum of 160 clock hours of classroom, laboratory, clinical, and field instruction which shall include supervised experiences in the emergency department with a licensed EMS provider, and in other settings as needed to develop the competencies defined in the minimum curriculum. (C)Certification as an EMT-Basic shall be required prior to beginning field and clinical rotations in an EMT-I course. (4)Emergency Medical Technician-Paramedic (EMT-P). (A)The minimum curriculum shall include all content required by the current national paramedic education standards and competencies as defined by DOT. (B)The course shall include a minimum of 624 clock hours of classroom, laboratory, clinical and field instruction which shall include supervised experiences in the emergency department with a licensed EMS provider and in other settings as needed to develop the competencies defined in the minimum curriculum. (C)Certification as an EMT-Basic shall be required prior to beginning field and clinical rotations in an EMT-P course. (d)Sponsorship. (1)EMS Education programs shall be sponsored by organizations or individuals with adequate resources and dedication to carry out successful educational endeavors. (2)Program sponsors shall provide appropriate oversight and supervision to ensure that programs are: (A)educationally and fiscally sound; and (B)meet the responsibilities listed in subsection (o) of this section. (e)Levels of program approval. (1)A program may be approved as a basic EMS training program or an advanced training program. (2)ECA and EMT training shall be conducted by a basic program and may be conducted by an advanced program. (3)EMT-I and EMT-P training shall be conducted by an advanced program. (4)An advanced program shall be considered to have met the requirements for approval as a basic program. (f)Currently approved programs. Programs that have obtained approval as of the effective date of this rule shall be considered to have met the requirements of subsections (g) or (h) of this section appropriate to their current level of approval. (g)Basic approval requirements. To approve a basic program, an applicant shall: (1)submit a letter of sponsorship; (2)submit letters of intent from qualified providers of clinical and field internship experience appropriate to the level of training; (3)have at least one course coordinator certified as an EMT or higher; (4)have a program director who contributes an adequate amount of time to assure the success of the program. In addition to other responsibilities, the program director shall be responsible for the development, organization, administration, periodic review and effectiveness of the program. In addition to other duties, the program director may function as a course coordinator if appropriately certified; and shall: (A)routinely review student performance to assure adequate progress toward completion of the program; (B)review and supervise the quality of instruction provided by the program; and (C)document that each graduating student has achieved the desired level of competence prior to graduation; (5)have a medical director if appropriate to the level or content of training. The medical director shall be a licensed physician approved by the department with experience in and current knowledge of emergency care. The medical director shall be knowledgeable about educational programs for EMS personnel. In addition to other duties assigned by the program, the medical director shall: (A)review and approve the educational content of the program's curricula; (B)review and approve the quality of medical instruction provided by the program; and (C)attest that each graduating student has achieved the desired level of competence prior to graduation; (6)have an advisory committee representing the program's communities of interest (individuals, groups of individuals, or institutions impacted by the program) designated and charged with assisting the program director and medical director in formulating appropriate goals and standards, monitoring needs and expectations and ensuring program responsiveness to change; (7)submit a completed application to the appropriate regional office; and (8)demonstrate substantial compliance with the EMS education standards by successfully completing the self study/on-site review process outlined in the manual. (h)Advanced approval requirements. To approve an advanced program, an applicant shall: (1)have successfully operated a basic program; (2)submit documentation of sponsorship by a regionally accredited post- secondary educational institution or a health care institution accredited by an organization recognized by the department; (3)submit letters of intent from qualified providers of clinical and field internship experience appropriate to the level of training offered; (4)have at least one advanced course coordinator certified at or above the highest level of training to be offered by the program; (5)have a program director who contributes an adequate amount of time to assure the success of the program. In addition to other responsibilities, the program director shall be responsible for the development, organization, administration, periodic review and effectiveness of the program; and shall: (A)routinely review student performance to assure adequate progress toward completion of the program; and (B)review and supervise the quality of instruction provided by the program; and (C)document that each graduating student has achieved the desired level of competence prior to graduation; (6)have a medical director who shall be a licensed physician approved by the department with experience in and current knowledge of emergency care. The medical director shall be knowledgeable about educational programs for EMS personnel. In addition to other duties assigned by the program, the medical director shall: (A)review and approve the educational content of the program's curricula; (B)review and approve the quality of medical instruction provided by the program; and (C)attest that each graduating student has achieved the desired level of competence prior to graduation; (7)have an advisory committee representing the program's communities of interest (individuals, groups of individuals, or institutions impacted by the program) designated and charged with assisting the program director and medical director in formulating appropriate goals and standards, monitoring needs and expectations and ensuring program responsiveness to change; (8)submit a completed application to the appropriate regional office; and (9)demonstrate substantial compliance with the EMS education standards by successfully completing the self-study/on-site review process outlined in the manual. (i)Provisional approval. If following the department's review of the self-study, the applicant is found to be in substantial compliance with established EMS education standards outlined in the manual, the department shall issue a provisional approval. (j)Lack of substantial compliance. If following the department's review of the self- study, the applicant is not found in substantial compliance with EMS education standards established outlined in the manual, the program director and sponsor shall receive a written report detailing: (1)any deficiencies; and (2)specific recommendations for improvement that will be necessary before provisional approval may be granted. (k)On-site review. After the completion of a provisionally-approved program's first course, an on-site review shall be conducted as outlined in the manual. (1)If the program is found to be in substantial compliance with established EMS education standards and all fees and expenses associated with the self-study and on-site review have been paid, the department shall approve the program for a period of years as set forth in the manual and issue an approval number. The program director and sponsor shall receive a written report of the site-review team's findings, including areas of exceptional strength, areas of weakness and recommendations for improvement. (2)If the program is not in substantial compliance with established EMS education standards, the program director and sponsor shall receive a written report detailing deficiencies and specific requirements for improvement. Depending on the nature and severity of the identified deficiencies within the program, the program may or may not be allowed to continue training activities. In all cases the department in consultation with program officials shall devise a remedial plan for the deficiencies. (3)Upon completion of a remedial plan a program shall be approved for a period of years as outlined by the manual. (l)Exception to sponsorship requirements for advanced programs. (1)If an urgent need for an advanced program or an EMS operator instructor program exists in an area and cannot be met by an entity that meets the sponsorship requirements defined in subsection (h)(2) of this section, a licensed EMS provider may request the department to grant an exception to allow the EMS provider to sponsor an advanced program. (2)Such request must be submitted in writing and must include the following: (A)documentation of the need for an advanced program and of the urgency of the situation; (B)documentation that the EMS provider has successfully operated a basic program; (C)documentation of attempts by the EMS provider to affiliate with an entity that meets the requirements of subsection (h)(2) of this section; (D)a letter from the EMS provider agreeing to assume all responsibilities of advanced program sponsorship; (E)letters of intent from qualified providers of clinical and field internship experience appropriate to the level of training to be offered; and (F)a letter of intent from a medical director who will agree to perform the responsibilities listed in subsection (h)(6) of this section. (3)In determining whether the request for an exception is to be approved or denied, the department shall consider, but not be limited to, the following issues: (A)the quality of the basic program previously operated by the EMS provider; (B)evidence that the EMS provider possesses the resources and dedication necessary to operate an advanced program that complies with the EMS education standards; (C)the efforts of the EMS provider to affiliate with an entity that meets the requirements of subsection (h)(2) of this section; (D)the availability of an approved advanced program within a reasonable distance of the affected area; (E)the availability of an approved advanced program that will provide training to the affected area by outreach or distance learning technology; (F)the probable impact on existing approved advanced programs if the exception is approved; and (G)the probable adverse consequences to the public health or safety if the exception is not approved. (4)After evaluation by the department, the EMS provider shall be notified in writing of the approval or denial of the request. (5)An exception to the requirements of subsection (h)(2) of this section shall meet all other requirements of subsection (h) of this section, including completion of the self-study and the on-site review process, and shall demonstrate substantial compliance with the EMS education standards as outlined in the manual before being granted approval by the department. (m)National accreditation. (1)If a program has been accredited through a national accrediting organization recognized by the department, the department may exempt the program from the program approval or re-approval process. If a program is denied, the program has an opportunity to request a hearing in accordance with §§1.21-1.34 of this title (relating to Formal Hearing Procedures). (2)Nationally accredited programs shall provide the department with copies of: (A)the accreditation self study; (B)the accreditation letter or certificate; and Cont'd...
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