Texas Register

TITLE 25 HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 157EMERGENCY MEDICAL CARE
SUBCHAPTER CEMERGENCY MEDICAL SERVICES TRAINING AND COURSE APPROVAL
RULE §157.32Emergency Medical Services Education Program and Course Approval
ISSUE 02/03/2017
ACTION Final/Adopted
Preamble Texas Admin Code Rule

(a)Emergency medical services (EMS) Education Program Standards. An EMS Education Program shall meet national education training standards 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. The department shall base the education and training standards on applicable national standards and guidelines for evaluation and approval of EMS education programs adopted by national accrediting organizations.

(c)Curriculum

  (1)Emergency Care Attendant (ECA).

    (A)The minimum curriculum shall include all content required by the current national Emergency Medical Responder (EMR) educational standards and competencies as defined in the National EMS Education Standards 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 60 clock hours of classroom and laboratory instruction in the approved curriculum.

  (2)Emergency Medical Technician (EMT).

    (A)The minimum curriculum shall include all content required by the current national EMT educational standards and competencies as defined in the National EMS Education Standards by DOT.

    (B)The course shall include a minimum of 150 clock hours of classroom, laboratory, clinical, and field instruction which shall include supervised experiences in the emergency department and with a licensed EMS provider and in other settings as needed to develop the competencies defined in the minimum curriculum.

  (3)Advanced Emergency Medical Technician (AEMT).

    (A)The minimum curriculum shall include all content required by the current national Advanced Emergency Medical Technician (AEMT) standards and competencies as defined in the National EMS Education Standards by DOT. The following areas must be addressed as outlined in the AEMT national educational standards and the Health and Safety Code, §773.048:

      (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 250 clock hours of classroom, laboratory, clinical, and field instruction which shall include supervised experiences in the emergency department and with a licensed EMS provider and in other settings as needed to develop the competencies defined in the AEMT national educational standards.

    (C)A student shall have a current EMT certification from the department or National Registry prior to beginning and throughout field and clinical rotations in an AEMT 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 in the National EMS Education Standards as defined by DOT.

    (B)The course shall include a minimum of 1000 clock hours of classroom, laboratory, clinical and field instruction which shall include supervised experiences in the emergency department and with a licensed EMS provider and in other settings as needed to develop the competencies defined in the minimum curriculum.

    (C)A student shall have a current EMT or AEMT certification from the department or current EMT, EMT-I or AEMT certification from the National Registry prior to beginning and throughout 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:

    (A)are educationally and fiscally sound;

    (B)meet the responsibilities listed in subsection (o) of this section; and

    (C)has the required equipment and resources to conduct the program.

(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)AEMT 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.

  (5)The education programs must have the authority or ownership to provide the program.

  (6)Approval of a program by the department is not transferable.

(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. Paramedic programs must provide proof of accreditation by the Commission on Accreditation of Allied Health Education Programs (CAAHEP)/Committee on Accreditation of Emergency Medical Services Professions (CoAEMSP), or a national accrediting organization recognized by the department. Alternatively, the program may provide a letter of review from CAAHEP/CoAEMSP or a national accrediting organization recognized by the department stating the education program has submitted the appropriate documentation that indicates it being in pursuit of accreditation as defined by that organization.

(g)Basic approval requirements. To receive approval for 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 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;

  (8)demonstrate substantial compliance with the EMS education standards by successfully completing the self-study/on site review process; and

  (9)provide a name and contact information for the designated infection control officer and document education for the designated infection control officer based on U.S. Code, Title 42, Chapter 6A, Subchapter XXIV, Part G, §300ff-136.

(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, or any other entity meeting standards and criteria for sponsoring advanced EMS courses;

  (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;

    (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;

  (9)demonstrate substantial compliance with the EMS education standards by successfully completing the self-study/on-site review process outlined in the national education and training standards; and

  (10)provide a name and contact information for the designated infection control officer and document education for the designated infection control officer based on U.S. Code, Title 42, Chapter 6A, Subchapter XXIV, Part G, §300ff-136.

(i)Self-study requirements.

  (1)A self-study is a self-evaluation and compilation of documents that describes the proposed or existing program’s overall process. It shall explain and/or document the program’s organizational structure, resources, facilities, record keeping, personnel and their qualifications, policies and procedures, text books, course delivery methods used, clinical and field affiliations, student to patient contact matrix, psychomotor competency evaluations, a copy of all advertisements, documents provided to students and describe what is necessary for students to complete the program.

  (2)All proposed and/or existing programs must provide a self-study at the basic (ECA and EMT) and/or advanced (AEMT and Paramedic) level. Programs that offer paramedic education may submit a copy of a self-study submitted to national accrediting organizations to meet this requirement. However, they must submit supplemental documentation to demonstrate substantial compliance with the EMS education standards of this section.

    (A)Each applicant for an EMS Program must submit a self-study that contains the following items:

      (i)an organizational chart;

      (ii)a description of the ownership and sponsorship of the proposed or existing program;

      (iii)a description of financial resources;

      (iv)a description of the record keeping process for maintaining program, course, and student records;

      (v)a description of the facilities;

      (vi)a description of learning resources;

      (vii)a description of equipment and supplies;

      (viii)a description of personnel (faculty and staff) and qualifications;

      (ix)a description of the instructor /faculty credentialing, evaluation and continuing education process.

      (x)a description of the clinical and field internship affiliations;

      (xi)a description of the student to patient contact ratio and how it will be tracked and monitored. If an existing program at renewal, include a student patient contact ratio report;

      (xii)a description of the text books and curriculum;

      (xiii)a description of the psychomotor competency evaluation process;

      (xiv)a copy of any policies and procedures used for faculty, staff and students, that address the following:

        (I)attendance, tardiness, and participation;

        (II)program medical director change;

        (III)cheating;

        (IV)clinical and field internship;

        (V)complaint resolution;

        (VI)conduct, safety and health;

        (VII)counseling and coaching of students;

        (VIII)dress and hygiene requirements;

        (IX)grading;

        (X)grievance and appeals;

        (XI)immunizations;

        (XII)policies for the prevention of sexual harassment;

        (XIII)policies for the prevention of discrimination based on race, sex, creed, national origin, sexual preference, age, handicap or medical problems;

        (XIV)psychomotor competency evaluation;

        (XV)record keeping and access to records;

        (XVI)student faculty relationships;

        (XVII)student screening and enrollment;

        (XVIII)test review and makeup; and

        (XIX)tuition and/or fee reimbursement.

        (XX)Provide a name and contact information for the designated infection control officer, and document education for the designated infection control officer based on U.S. Code, Title 42, Chapter 6A, Subchapter XXIV, Part G, §300ff-136.

      (xv)a sample of all advertisements and any documents given to potential students, students and exiting students; and

Cont'd...

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