The Executive Commissioner of the Health and Human Services Commission, on behalf of the Department of State Health Services (department), proposes the repeal of §157.14 and new §157.14, concerning First Responder Organizations; the repeal of §157.33 and new §157.33, concerning Certification; the repeal of §157.34 and new §157.34, concerning Recertification; and the repeal of §157.40 and new §157.40, concerning Paramedic Licensure.

BACKGROUND AND PURPOSE

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 Procedure Act). Sections 157.14, 157.33, 157.34 and 157.40 have been reviewed and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed.

Revisions of these sections were necessary to comply with the mandatory four-year rule review. Additionally, the repealed and new sections reflect consensus achieved by the stakeholder group (Governor's EMS and Trauma Advisory Council) and department staff. These sections also reflect organizational changes in the department mandated by House Bill 2292 of the 78th Texas Legislature, Regular Session, 2003.

SECTION-BY-SECTION SUMMARY

The decision to repeal §§157.14, 157.33, 157.34 and 157.40 and propose new §§157.14, 157.33, 157.34 and 157.40 was due to extensive formatting changes and changes within the rules to make these sections more uniform.

New §157.14 strengthens regulation of First Responder Organizations using certified or licensed Emergency Medical Services (EMS) personnel to provide prehospital emergency medical care. Under new §157.14, the organizations will be required to be licensed, have medical direction, and work cooperatively with the EMS Providers who transport the patients.

New §157.33 provides clarification to the rules, allows more flexibility to candidates for EMS certification, including those coming from other states or other health care disciplines, and parallels requirements that candidates must meet to be eligible for taking the credentialing exam with the National Testing Service.

New §157.34 provides clarification to the rules, allows more flexibility to candidates completing EMS recertification requirements, and provides an option for candidates with inactive certifications or certifications that have lapsed for more than one year.

New §157.40 provides clarification to the rules, allows more flexibility to candidates for EMS paramedic licensure, parallels requirements that candidates must meet to be eligible for taking the credentialing exam with the National Testing Service, and provides an option for candidates with inactive licensure or a license that has lapsed for more than one year.

FISCAL NOTE

Kathryn C. Perkins, Section Director, Health Care Quality Section, has determined that for each calendar year of the first five years that §157.14 is in effect, there will be fiscal implications to the state as a result of enforcing or administering the section as proposed. The effect on state government will be an increase in revenue to the state of $1200 the first fiscal year, $2400, the second fiscal year, $1200 the third fiscal year, $2400 the fourth fiscal year, and $1200 in the fifth fiscal year due to the increase in numbers of licenses and the two-year license requirement. Implementation of proposed §157.14 will have a fiscal impact on local governments operating First Responder Organizations that would fall under requirements of the new §157.14. The First Responder Organization fee is $60 for a two-year license. Volunteer First Responder Organizations are exempt from fees.

Ms. Perkins has determined that for each year of the first five-year period that the sections will be in effect, there will be no fiscal implications to state or local governments as a result of enforcing and administering §§157.33, 157.34 and 157.40 as proposed.

SMALL AND MICRO-BUSINESS IMPACT ANALYSIS

Ms. Perkins has also determined that there are minor anticipated economic costs to small businesses or micro-businesses required to comply with §157.14 as proposed. There will be a licensing fee for businesses or organizations required to apply for licensure as First Responder Organizations. The economic cost to organizations required to comply with the fee is $60 every two years. There is no anticipated negative impact on local employment.

Ms. Perkins has also determined that there will be no effect on small businesses or micro-businesses required to comply with §§157.33, 157.34 and 157.40 as proposed. This was determined by interpretation of the rules that small businesses and micro-businesses will not be required to alter their business practices in order to comply with the sections. There are no anticipated economic costs to persons who are required to comply with the sections as proposed. There is no anticipated negative impact on local employment.

PUBLIC BENEFIT

In addition, Ms. Perkins has also determined that for each year of the first five years the sections are in effect, the public will benefit from adoption of the sections. The public benefit anticipated as a result of enforcing or administering the sections is ensuring the health and safety of the public.

REGULATORY ANALYSIS

The department has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environment exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. This proposal is not specifically intended to protect the environment or reduce risks to human health from environment exposure.

TAKINGS IMPACT ASSESSMENT

The department has determined that the proposed repeals and new rules do not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposal may be submitted to Kathryn C. Perkins, Section Director, Health Care Quality Section, Department of State Health Services, 1100 West 49th Street, Austin, Texas 78756, (512) 834-6700 or by email to kathy.perkins@dshs.state.tx.us. Comments will be accepted for 30 days following publication of the proposal in the Texas Register.

LEGAL CERTIFICATION

The Department of State Health Services General Counsel, Cathy Campbell, certifies that the proposed rules have been reviewed by legal counsel and found to be within the state agencies' authority to adopt.

STATUTORY AUTHORITY

The repeals are authorized by Health and Safety Code, §12.0111, which requires the department to charge fees for issuing or renewing a license; §773.050(e) which authorizes the department to adopt minimum standards of first responder organizations; §773.050(b) and §773.0495 which authorize the department to adopt minimum standards for certified and licensed EMS personnel; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.

The repeals affect the Health and Safety Code, §773. The review of the sections implements Government Code, §2001.039.