TITLE 25.HEALTH SERVICES

Part 5. CENTER FOR RURAL HEALTH INITIATIVES

Chapter 500. EXECUTIVE COMMITTEE FOR THE CENTER FOR RURAL HEALTH INITIATIVES

Subchapter H. RURAL EMERGENCY MEDICAL SERVICES SCHOLARSHIP INCENTIVE PROGRAM

25 TAC §§500.501, 500.503, 500.505, 500.507, 500.509, 500.511, 500.513, 500.515, 500.517, 500.519, 500.521, 500.523, 500.525, 500.527

The Center for Rural Health Initiatives (center) adopts new §§500.501, 500.503, 500.505, 500.507, 500.509, 500.511, 500.513, 500.515, 500.517, 500.519, 500.521, 500.523, 500.525, 500.527 concerning a state grant program to match funds committed by qualified rural communities to cover training of Emergency Medical Services (EMS) providers. Section 500.505 and §500.519 are adopted with changes to the proposed text as published in the April 7, 2000 issue of the Texas Register (25 TexReg 2906). Sections 500.501, 500.503, 500.507, 500.509, 500.511, 500.513, 500.515, 500.517, 500.521, 500.523, 500.525, 500.527 are adopted without changes and will not be republished.

These rules implement a component of the Medicare Rural Hospital Flexibility Program, under 42 United States Code §1395i-4. The Center received federal funds to develop and implement the Critical Access Hospital Program in the State of Texas, of which emergency services are a critical component. The federal program specifically includes EMS as one of the stakeholders in the Critical Access Hospital program; in the State of Texas, EMS representatives have been involved in the program development. In order to assist Critical Access Hospitals and the rural communities in their efforts to maintain EMS services, the availability of trained, qualified EMS personnel was reported as a major concern. This program will allow these entities to "grow their own" EMS professionals and retain them in their rural communities, thus helping to ensure the availability of EMS services in those communities.

The sections accomplish the following: define terms; provide the center's philosophy in making the grants; discuss the sources and allocation of funds; establish who is eligible to receive the grants; provide the requirements for receiving the grants; establish the procedures for grant announcements; establish the procedures for grant applications; describe the competitive review process; and outline the selection criteria for awarding grants.

The center's definition for a rural county is one that has a population in the most recent decennial United States census of 50,000 or less, or with respect to a county that has a population of more than 50,000 and contains a geographic area that is not delineated as urbanized by the federal census bureau, that part of the county that is not delineated as urbanized.

Regional Advisory Councils are not eligible for this program as they do not qualify as a political subdivision, nor are they able to provide for the community service requirement, which is a requirement for accepting program funds. Volunteer Emergency Medical Service groups who meet the qualifications in §500.505 would be eligible. Also, this fund is meant only to train Emergency Medical Technicians, Emergency Medical Technician-Intermediate and Emergency Medical Technician-Paramedic, not to assist existing Emergency Medical Service professionals in maintaining their required Continuing Medical Education hours. First responder personnel would be eligible, so long as they are supported by an eligible community and the candidate's training results in at least an Emergency Medical Technician certificate. Emergency Care Attendant training would not be sufficient for the purposes of this program.

Staff changes were made regarding the amount of matching funds required to participate in the program. Section 500.505(2)(C) and §500.519 were changed to reflect that a dollar for dollar match may not be required and that the amount of matching funds required will be based on need and left to the discretion of the director of the center.

No comments were received on the proposal during the comment period.

The new sections are adopted under the Health and Safety Code, §106.021(j) which provides the center with the authority to adopt rules to implement chapter 106.

The new sections affect the Health and Safety Code, §106.025.

§500.505.Eligibility Criteria for a Rural EMS Scholarship Incentive Program Applicant.

To be eligible to participate in this program, an applicant must:

(1)

be located in a rural county;

(2)

exist in perpetuity as a political subdivision of the state or a non-profit entity governed by council members, commissioners, or a board of trustees that:

(A)

is responsible to and serves the community in which it is located;

(B)

is legally authorized to raise funds and/or accept grants and financial gifts from citizens, scholarship funds, or private foundations;

(C)

assures a commitment from the community of up to $2,000 or an amount determined by the center, whichever is less, in contributions toward EMT training;

(D)

assures that applicant contributions will include no federal or state funds; and

(E)

assures the availability of an emergency medical services position for a candidate;

(3)

apply for state matching funds available through this program; and

(4)

contract with a candidate to complete the training program and to provide emergency medical services in the community for at least one year following disbursement of the state funds and to reimburse the center and the community for all funds if the candidate breaches the contract.

§500.519.Contribution Procedures.

The center may provide up to $2,000 in scholarship funds per candidate to the neediest communities as determined under §500.517 of this title (relating to Methodology For Prioritizing Neediest Communities).

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2000.

TRD-200004185

Robt. J. "Sam" Tessen

Executive Director

Center for Rural Health Initiatives

Effective date: July 4, 2000

Proposal publication date: April 7, 2000

For further information, please call: (512) 479-8891