The Texas Department of Health (department) proposes amendments to §§157.1, 157.11, 157.14, 157.32-157.34, 157.38, 157.40, 157.43, 157.44, 157.49, 157.122, and 157.125, concerning regulation of EMS certificants, licensees, providers, training institutions, educators and EMS/Trauma systems, the repeal of §157.4, concerning request for EMS training at the local level, the repeal of §157.31, concerning automated external defibrillator training course, §157.123, concerning regional emergency medical services/trauma systems, and §157.129, concerning state trauma registry, new §157.4 concerning regulatory audit activities by the Bureau of Emergency Management and new §157.123, concerning regional emergency medical services/trauma systems. Specifically, the sections cover purpose; audits; provider licenses; disciplinary actions; training and course approval; personnel certification, Regional/EMS trauma systems, trauma facility designation and the trauma care system fund.

Rule amendments regarding licensing fees are required as a result of revisions to Chapter 12 of the Texas Health and Safety Code, §12.0111 and §12.0112, pursuant to House Bill (HB) 2292 of the 78th Regular Session of the Texas Legislature. Rule amendments for the clarification of standards for regional advisory councils are required as a result of revisions to Chapter 773 of the Texas Health and Safety Code, §773.113, pursuant to Senate Bill 530 of the 78th Regular Session of the Texas Legislature. Rule amendments for clarification of standards for emergency care attendants are required as a result of revisions to Chapter 773 of the Texas Health and Safety Code, §773.046, pursuant to HB 861 of the 78th Regular Session of the Texas Legislature.

Government Code, §2001.039, requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedures Act). The sections have been reviewed and the department has determined that reasons for adopting the sections continue to exist; however, revisions to the sections are necessary and described in this preamble. Authority for the board to propose and adopt rules in this section is found in the Health and Safety Code, Chapter 773.

The department published a Notice of Intention to review and consider for readoption, revision, or repeal Chapter 157, Emergency Medical Care, Subchapter A, Emergency Medical Services - Part A, §§157.1 - 157.4; Subchapter B, Emergency Medical Services Provider Licenses, §§157.11 - 157.14, 157.16, and 157.25; Subchapter C, Emergency Medical Services Training and Course Approval, §§157.31 - 157.34, 157.36 - 157.38, 157.40, and 157.41; Subchapter D, Emergency Medical Services Personnel Certification, §§157.43, 157.44, and 157.49; and Subchapter G, Emergency Medical Services Trauma Systems, §§157.122, 157.123, 157.125, and 157.128 - 157.130 in the September 12, 2003, issue of the Texas Register (28 TexReg 8013). There were no comments received due to the publication of the notice.

Kathryn C. Perkins, Bureau Chief of the Bureau of Emergency Management, has determined that for first five years the sections are in effect, there will be fiscal implications to state and local government as a result of administering the sections as proposed. The impact is related to proposed fee increases as authorized by HB 2292 in the 78th Regular Session of the Texas Legislature. Proposed fees represent a 20% increase which will result in an estimated increase of $280,000 per year in revenue.

Kathryn C. Perkins has also determined that for each year of the first five years the proposed sections are in effect the public health benefit anticipated as a result of these amendments and repeal will be increased standards for the certification or licensure of EMS personnel, providers, training institutions and educators. There is an anticipated cost to small businesses, micro-businesses and to persons who are required to comply with the sections as proposed, because the rules make additional requirements of providers, except those that are exempt under the given rules. There is an increase in the fee charged for a certification or license. One proposed section also authorizes an increase on administrative penalties that may be imposed on course coordinators for violations of the Health and Safety Code. There is no anticipated effect on local employment.

Comments on the proposal may be submitted to Kathryn C. Perkins, Chief, Bureau of Emergency Management, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756, telephone (512) 834-6700, or kathy.perkins@tdh.state.tx.us. Comments will be accepted for 30 days after publication of the proposal in the Texas Register.

The amendments are proposed under the Texas Health and Safety Code, Chapter 773, which provides the department with the authority to adopt rules concerning certification and licensing of EMS certificants, providers, training institutions and educators; and §12.001, which provides the Texas Board of Health (board) with the authority to adopt rules for its procedure and for the performance of each duty imposed by law on the board, the department or the commissioner of health.

The amendments affect the Health and Safety Code, Chapter 773. The review of the rules implements Government Code, §2001.039.