Part 1.
DEPARTMENT OF STATE HEALTH SERVICES
Chapter 157.
EMERGENCY MEDICAL CARE
The Executive Commissioner of the Health and Human Services Commission
(commission), on behalf of the Department of State Health Services (department),
adopts the repeal of §§157.14, 157.33, 157.34, and 157.40 and new §§157.14,
157.33, 157.34, and 157.40, concerning the requirements for first responder
organizations, certification, recertification and paramedic licensure. New §157.14
and §157.34 are adopted with changes to the proposed text as published
in the April 14, 2006, issue of the
Texas Register
(31 TexReg 3160). The repeal of §§157.14, 157.33, 157.34,
157.40 and new §157.33 and §157.40 are adopted without changes and,
therefore, the sections will not be republished.
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 Additionally, the repealed and new sections reflect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
adopt 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.
COMMENTS
The department, on behalf of the commission, has reviewed and prepared
responses to comments received regarding the proposed rules during the comment
period, which the commission has reviewed and accepts. The commenter was an
individual representing the City of Arlington, Texas. The commenter was not
against the rules; however, suggested recommendations for changes to new §157.14
as discussed in the summary of comments. The department, on behalf of the
commission, did not receive any public comments regarding the other proposed
rules during the comment period.
Comment: Concerning §157.14(c)(3) and §157.14(d)(4), the commenter
recommended changing "who" to "that". The result is "Applicants that meet
all the requirements shall be issued an FRO license". The word "that" should
be used because "applicants" refers to organizations rather than persons.
Response: The commission agrees and has revised the sentence to read: "Applicants
that meet all the requirements shall be issued an FRO license".
Comment: Concerning §157.14(e)(9)(B), the commenter recommended changing
"condition upon arrival at the scene" to "...patient's condition when first
contacted by FRO personnel..." The language published in the
Texas Register
requires the patient report to include the patient's
condition upon the patient's arrival at the scene rather than upon the FRO's
arrival at the scene. Further, because all patients cannot always be immediately
located as soon as the first FRO personnel arrive, the requirement should
be to report the patient's condition when contact is first made with the patient.
The commenter also recommended changing "EMS staff" to "FRO personnel who
provided care to the patient". "EMS staff is vague and could refer to FRO
or ambulance personnel". With these changes, the following sentence results:
"the report shall document, at a minimum, the patient's name, the patient's
condition when first contacted by FRO personnel; the prehospital care provided,
the dispatch time; scene arrival time; and the identification of the FRO personnel
who provided care to the patient".
Response: The commission agrees and has revised the sentence to read: "the
report shall document, at a minimum, the patient's name, the patient's condition
when first contacted by FRO personnel; the prehospital care provided, the
dispatch time; scene arrival time; and the identification of the FRO personnel
who provided care to the patient".
The following changes were made as a result of staff comments:
Change: Concerning §157.14, a correction to the reference of "paragraph"
and "subsection" for proper
Texas Register
formatting
was made to subsections (c)(1)(F) and (d)(2)(F) and (G) of the section.
Change: Concerning §157.34(b)(4)(B), a title "Recertification Course"
was added to the top of the chart; §157.34(d)(3), the word "the" was
added in the last sentence to read "a total of two times the fee shall be
necessary"; §157.34(e)(2), second sentence, added the words "times the"
after the number "1-1/2" to state "a total of 1-1/2 times the fee shall be
necessary"; and §157.34(e)(3), second sentence, the word "the" was added
after the word "times" to read "a total of two times the fee shall be necessary".
LEGAL CERTIFICATION
The Department of State Health Services, General Counsel, Cathy Campbell,
certifies that the rules, as adopted, have been reviewed by legal counsel
and found to be a valid exercise of the agencies' legal authority.
Subchapter B. EMERGENCY MEDICAL SERVICES PROVIDER LICENSES
25 TAC §157.14
STATUTORY AUTHORITY
The adopted repeal is 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 review of the sections implements Government
Code, §2001.039.
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 August 11, 2006.
TRD-200604196
Cathy Campbell
General Counsel
Department of State Health Services
Effective date: August 31, 2006
Proposal publication date: April 14, 2006
For further information, please call: (512) 458-7111 x6972
25 TAC §157.14
STATUTORY AUTHORITY
The adopted new section is 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 review of the sections implements Government
Code, §2001.039.
§157.14.Requirements for a First Responder Organization License.
(a)
A First Responder Organization (FRO) is a group or association
of certified emergency medical services personnel that works in cooperation
with a licensed emergency medical services provider to:
(1)
routinely respond to medical emergency situations;
(2)
utilize personnel who are emergency medical services (EMS)
certified by the Texas Department of State Health Services (department); and
(3)
provide on-scene patient care to the ill and injured and
does not transport patients.
(b)
Individuals or organizations meeting the description in
subsection (a) of this section must comply with the requirements outlined
in this section including submission of an application for a license.
(c)
Application requirements for an FRO affiliated with a
licensed EMS Provider.
(1)
A Basic Life Support (BLS) or Advanced Life Support (ALS)
First Responder Organization affiliated with a Texas licensed EMS Provider
must apply for an FRO license by submitting a completed application to the
department. A complete application consists of the following:
(A)
provider license application form;
(B)
personnel list including social security number or EMS
personnel identification (ID) number and certification/licensure level;
(C)
description and map of the service area;
(D)
staffing plan including days of the week and hours of
the day the FRO will be available for response;
(E)
written affiliation agreement with the primary licensed
EMS provider in the service area. The primary licensed EMS provider must provide
a letter attesting that the following items have been reviewed and approved
by the director and medical director of the EMS provider:
(i)
level(s) of certification/licensure of FRO personnel providing
care;
(ii)
response, dispatch and treatment protocols including
an equipment and supply list approved by the medical director of the licensed
EMS provider;
(iii)
description of how the FRO receives notification of
calls;
(iv)
patient care reporting procedures;
(v)
process for the assessment of care provided by the FRO
personnel;
(vi)
response code policies for FRO personnel;
(vii)
on-scene chain-of-command policies;
(viii)
policies regarding FRO personnel canceling en route
EMS units;
(ix)
policies regarding FRO personnel accompanying patients
in EMS providers vehicles including when FRO personnel hold the highest certification
or licensure on the scene; and
(x)
patient confidentiality.
(F)
It is not necessary to submit the individual items in
subparagraph (E)(i) - (x) of this paragraph with the application, if each
is referenced in the affiliation agreement. All items listed in this paragraph
must be immediately available for review by department personnel upon request
during unannounced site visits or complaint investigations.
(2)
Any FRO which is, or has a contract with, an entity such
as a business, corporation or department and whose first responder employees
or members are compensated by that entity for providing first responder service
shall pay a nonrefundable $60 application fee. If the license is issued for
less than 12 months, the nonrefundable fee shall be $30. The FRO personnel
described in this paragraph are not exempt from the payment of certification
or license application fees.
(3)
Applicants that meet all the requirements shall be issued
an FRO license. The license may be valid for up to 2 years, but may be issued
for less than 2 years for administrative purposes.
(4)
Although not required, the FRO license application may
be submitted with the license application of the affiliated EMS provider.
The FRO is responsible for submitting fees, if applicable.
(5)
An affiliation agreement between a licensed EMS provider
and a licensed FRO does not automatically imply any legal liability beyond
the agreements listed in paragraph (1)(E) of this subsection.
(6)
A violation of statute or rule by an FRO will not implicate
the affiliated EMS provider unless both organizations are involved in the
violation. Likewise, a violation of statute or rule by an affiliated EMS provider
does not implicate the FRO unless both organizations are involved in the violation.
(d)
Application requirements for an FRO not affiliated with
a licensed EMS provider.
(1)
A BLS first responder organization not affiliated with
a licensed EMS provider may apply for an FRO License by submitting a completed
application to the department. A complete application consists of the following:
(A)
application form;
(B)
personnel list including social security number or personnel
ID number and certification/licensure level;
(C)
description and map of the service area;
(D)
staffing plan including days of the week and hours of
the day the FRO will be available for response;
(E)
response, dispatch and treatment protocols including an
equipment and supply list approved by the FRO medical director;
(F)
letter of recognition from the primary licensed 911 EMS
Provider or from the highest elected city/county official in the service area
and a written explanation why the EMS provider will not enter into an agreement
with the FRO;
(G)
description of how the FRO receives notification of calls;
and
(H)
process for the assessment of care provided by the FRO
personnel.
(I)
The application for a FRO license will be considered incomplete
if any items listed in subparagraphs (A) - (H) of this paragraph are not enclosed
with the application.
(J)
All items listed in subparagraphs (A) - (H) of this paragraph
must be immediately available for review by department personnel if requested
during unannounced site visits or complaint investigations.
(2)
An ALS first responder organization not affiliated with
a licensed EMS provider may apply for an FRO License by submitting a completed
application to the department. A complete application consists of the following:
(A)
application form;
(B)
personnel list including social security number or personnel
ID number and certification/licensure level;
(C)
description and map of the service area; and
(D)
staffing plan including days of the week and hours of
the day the FRO will be available for response.
(E)
The FRO shall have an agreement with all licensed EMS
providers and their medical directors who routinely transport patients treated
by the FRO's personnel. Each agreement shall be approved by the person responsible
for the FRO, director and medical director of each licensed EMS provider.
At a minimum, the agreements shall address:
(i)
the level(s) of certification/licensure of FRO personnel
providing care;
(ii)
the response, dispatch and treatment protocols including
an equipment and supply list approved by the FRO medical director and a letter
of approval from the medical director(s) of the licensed transporting providers
with whom the FRO has agreements;
(iii)
a description of how the FRO receives notification of
calls;
(iv)
patient care reporting procedures;
(v)
a process for the assessment of care provided by FRO personnel;
(vi)
response code policies for FRO personnel;
(vii)
on-scene chain-of-command policies;
(viii)
policies regarding FRO personnel canceling en route
EMS units;
(ix)
policies regarding FRO personnel accompanying patients
in provider's vehicles including when FRO personnel hold the highest certification
or licensure on the scene; and
(x)
patient confidentiality.
(F)
The application for a FRO license is incomplete if any
items listed in this paragraph are not enclosed with the application.
(G)
All items listed in this paragraph must be immediately
available for review by department personnel if requested during unannounced
site visits or complaint investigations.
(3)
Any FRO which is, or has a contract with, an entity such
as a business, corporation or department and whose first responder employees
or members are compensated by that entity for providing first responder services
shall pay a nonrefundable $60 application fee. If the license is issued for
less than 12 months, the nonrefundable fee shall be $30. The FRO personnel
described in this paragraph are not exempt from the payment of certification
and license application fees.
(4)
Applicants that meet all the requirements for a license
shall be issued an FRO license. The license is issued for 2 years. For administrative
purposes, it may be issued for less than 2 years.
(e)
Responsibilities of the FRO. During the license period
the FRO's responsibilities shall include:
(1)
assuring ongoing compliance with the terms of all EMS
provider agreement(s);
(2)
assuring the existence of and adherence to a quality assurance
plan which shall, at a minimum, include:
(A)
the standard of patient care and the medical director's
protocols;
(B)
pharmaceutical storage;
(C)
readiness inspections;
(D)
preventive maintenance of medical equipment and vehicles
owned by the FRO;
(E)
policies and procedures;
(F)
complaint management; and
(G)
patient care reporting and documentation;
(3)
ensuring that all medical personnel are currently certified
or licensed by the department;
(4)
assuring that all personnel on the scene of an emergency
are prominently identified by, at least, the last name and the first initial
of the first name, the certification or license level and the FRO name. An
FRO may utilize an alternative identification system in incident specific
situations that pose a potential for danger if the individuals are identified
by name;
(5)
assuring that all vehicles utilized by FRO personnel carry
proof of first responder registration or have the name of the FRO prominently
displayed and visible from the outside of the vehicle while on the scene of
an emergency;
(6)
assuring the confidentiality of all patient information
in compliance with all federal and state laws;
(7)
developing and adhering to an agreement between the primary
transport provider and first responder organization concerning the use of
patient refusal forms and documentation for incidents when an informed treatment
refusal form cannot be obtained;
(8)
developing and adhering to an agreement between the primary
transport provider and first responder organization concerning the maintenance
of FRO records;
(9)
assuring that patient care reports are completed accurately
for all patients:
(A)
the report shall be accurate, complete and clearly written;
and
(B)
the report shall document, at a minimum, the patient's
name, the patient's condition when first contacted by FRO personnel; the prehospital
care provided; the dispatch time; scene arrival time; and the identification
of the FRO personnel who provided care to the patient;
(10)
assuring that all relevant patient care information is
supplied in writing to the licensed EMS provider at the time the patient is
transferred to the provider;
(11)
assuring that a full written report is provided, upon
request, within 1 business day to the transport provider and/or hospital facility
where the patient was delivered;
(12)
assuring that all requested patient records are made
promptly available to the first responder organization's medical director;
(13)
assuring that current protocols are available to all
certified or licensed personnel;
(14)
monitoring and enforcing compliance with all policies;
(15)
assuring provisions for the appropriate disposal of medical
and/or biohazardous waste materials;
(16)
assuring that all documents, reports or information provided
to the department are current, accurate and complete;
(17)
assuring compliance with all federal and state laws and
regulations and all local ordinances, policies and codes at all times;
(18)
assuring that the department is notified within 5 business
days whenever there is a change:
(A)
in the level of service;
(B)
in the declared service area;
(C)
in the official business mailing address;
(D)
in the physical location of the first responder organization;
(E)
in the physical location of patient report file storage,
to assure that the department has access to these records at all times;
(F)
of the administrator;
(G)
of the e-mail address; or
(H)
of the EMS providers associated with the FRO.
(19)
assuring that the department is notified within 1 business
day when a change of the medical director has occurred;
(20)
assuring the FRO has written operating policies, procedures
and medical protocols and provides all medical personnel a copy initially
and whenever such policies, procedures and/or medical protocols are changed.
A copy of the written operating policies, procedures and medical protocols
shall be made available to the department upon request. At a minimum, policies
shall adequately address:
(A)
personal protective equipment;
(B)
immunizations available to personnel;
(C)
infection control procedures;
(D)
communicable disease exposure;
(E)
credentialing of new response personnel before being assigned
to respond to emergencies. The credentialing process shall include, at minimum:
(i)
a comprehensive orientation session of the FRO's policies
and procedures, safety precautions, and quality management process; and
(ii)
an internship period in which all new personnel practice
under the supervision of, and are evaluated by, another more experienced person,
if operationally feasible; and
(F)
appropriate documentation of patient care;
(21)
assuring that all documents, reports or information provided
to the department are current, truthful and correct;
(22)
assuring that the department is notified within 1 business
day of a collision involving an FRO vehicle responding to a scene or while
at the scene of an emergency and resulting in personal injury or death of
any person;
(23)
maintaining motor vehicle liability insurance as required
by the Texas Transportation Code under Subchapter D, §601.071 and §601.072,
for all vehicles owned or operated by the FRO;
(24)
providing continuous coverage for the service area as
defined in the staffing plan; and
(25)
responding to requests for assistance from the highest
elected official of a political subdivision or from the department during
a declared emergency or mass casualty situation.
(f)
License renewal.
(1)
The department may notify the FRO at least 90 days before
the expiration date of the current license at the address shown in the current
records of the department. If a notice of expiration is not received, it is
the responsibility of the FRO to notify the department and request license
renewal application information.
(2)
FROs shall submit a completed application and nonrefundable
fee, if applicable, and must verify compliance with the requirements of the
license.
(g)
License denial. A license may be denied for, but not limited
to, the following reasons:
(1)
failure to meet requirements for an FRO license in accordance
with this section;
(2)
previous failure to meet the responsibilities of an FRO
as described in this section;
(3)
falsifying any information, record or document required
for an FRO license;
(4)
misrepresenting any requirements for an FRO license or
renewal of an FRO license;
(5)
history of criminal activity while licensed as an FRO;
(6)
history of disciplinary action relating to the FRO license;
and/or
(7)
issuing a check for application for an FRO license which
is subsequently returned to the department unpaid.
(h)
License revocation criteria. An FRO license may be revoked
or suspended for failure to meet the responsibilities of a licensed FRO as
described in this section.
(i)
For all applications and renewal applications, the department
is authorized to collect subscription and convenience fees, in amounts determined
by the Texas Online Authority to recover costs associated with application
and renewal application processing through Texas Online.
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 August 11, 2006.
TRD-200604197
Cathy Campbell
General Counsel
Department of State Health Services
Effective date: August 31, 2006
Proposal publication date: April 14, 2006
For further information, please call: (512) 458-7111 x6972
25 TAC §§157.33, 157.34, 157.40
STATUTORY AUTHORITY
The adopted 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 review of the sections implements Government
Code, §2001.039.
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 August 11, 2006.
TRD-200604198
Cathy Campbell
General Counsel
Department of State Health Services
Effective date: August 31, 2006
Proposal publication date: April 14, 2006
For further information, please call: (512) 458-7111 x6972
25 TAC §§157.33, 157.34, 157.40
STATUTORY AUTHORITY
The adopted new sections 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 review of the sections implements Government
Code, §2001.039.
§157.34.Recertification.
(a)
Recertification requirements.
(1)
Not later than the 30th day before the date a person's
certificate is scheduled to expire, the Department of State Health Services
(department) may send to the person a notice of expiration at the address
shown in the current records of the department.
(2)
If a certificant has not received a notice of expiration
from the department 30 days prior to the expiration, it is the duty of the
certificant to notify the department and to request an application for recertification
or download an application from the Internet.
(3)
To maintain certification status without a lapse, an applicant
shall submit a completed application for recertification and shall meet all
requirements for renewal of the current certification prior to the expiration
date of the current certificate, but no earlier than one year prior to the
expiration date.
(4)
The certificant shall submit the following non-refundable
fees as applicable:
(A)
$60 for Emergency Care Attendant (ECA) or Emergency Medical
Technician (EMT);
(B)
$90 for EMT-Intermediate (EMT-I) or EMT-Paramedic (EMT-P);
and
(C)
EMS volunteer--no fee. However, if such an individual
receives compensation during the certification period, the exemption ceases
and the individual shall pay a prorated fee to the department based on the
number of years remaining in the certification period when employment begins.
The non-refundable fee for ECA or EMT certification shall be $15 per each
year remaining in the certification. The non-refundable fee for EMT-I or EMT-P
shall be $22.50 per each year remaining in the certification. Any portion
of a year will count as a full year.
(5)
Recertification by voluntary downgrade. An individual
who holds a Texas EMS certification or paramedic license may renew at a lower
level by meeting the requirements of this subsection. The applicant must meet
the requirements for the lower level of certification requested as described
in subsection (b) or (f) of this section. On the date the downgrade is final,
the previous higher level of certification becomes invalid. To regain the
original higher level of certification, the candidate shall meet the late
recertification requirements outlined in subsection (f) of this section, within
one year after the expiration date.
(6)
A certificate is not transferable.
(7)
Military personnel. A person certified by the department
who is deployed in support of military, security, or other action by the United
Nations Security Council, a national emergency declared by the president of
the United States, or a declaration of war by the United States Congress is
eligible for recertification under timely recertification requirements from
the person's date of demobilization until one calendar year after the date
of demobilization but will not be certified during that period.
(A)
In addition to requirements described in this subsection,
the candidate shall submit a copy of deployment and demobilization orders.
(B)
The four-year certification will commence on issue date
of the certificate.
(C)
If all requirements are not completed within one year
after date of demobilization, the candidate must meet the requirements of
late recertification within one additional year, as described in subsection
(f) of this section.
(b)
Recertification options. Upon submission of a completed
application for recertification, the applicant shall commit to, and recertify
through one of the options described in paragraphs (1)-(5) of this subsection.
(1)
Option 1--Written Examination Recertification Process.
(A)
The applicant shall pass the National Registry assessment
exam. An overall score of 70 is considered to be passing.
(B)
If the applicant fails the examination for recertification,
the applicant may attempt two retests of the examination after:
(i)
submitting a retest application for each attempt at any
eligible level; and
(ii)
submitting a non-refundable retest fee of $30 for each
attempt.
(C)
For each subsequent retest attempt, an applicant may apply
for and retest at a lower level by complying with paragraph (1)(B) of this
subsection, if applicable.
(D)
An applicant who selects option 1 and attempts the exam
but does not pass the National Registry assessment examination may not gain
recertification by any other option and shall not qualify for inactive certification
addressed in §157.33(h) of this title (relating to Certification) or
subsection (e) or (f) of this section.
(E)
An applicant who does not pass the third attempt at the
National Registry assessment examination:
(i)
shall successfully complete a Formal Recertification Course
as described in paragraph (4) of this subsection; and
(ii)
shall submit a course completion certificate of the Formal
recertification course, reflecting that the course was completed after the
2nd retest failure; and
(iii)
shall pass the National Registry assessment examination
in accordance with the provisions in subparagraphs (A) - (D) of this paragraph.
(iv)
shall not qualify for more than a total of six attempts
at the exam, in any combination of levels attempted.
(F)
The certification status of an applicant who does not
successfully complete the examination recertification process as described
in paragraph (1)(A) - (E) of this subsection shall expire on the date of the
current certificate.
(i)
The applicant will have until 90 days after expiration
date of the current certificate to submit the application, pay the renewal
fee of 1-1/2 times the amount described in subsection (a)(4) of this section
and successfully complete the examination recertification process. If the
applicant has already submitted an application and fee prior to the expiration
of the certificate, another application will not be required, but an additional
one-half fee shall be necessary. If applicable, the retest process, including
appropriate retest applications and fees, may continue during the 90-day period.
(ii)
If applicant does not apply for and successfully complete
the Option 1 recertification process within 90 days following expiration,
applicant shall meet requirements of late recertification described in subsection
(d)(3) of this section. Another application and a non-refundable renewal fee
that is equal to two times the amount designated in subsection (a)(4) of this
section shall be required. Successful completion of the late recertification
process must be accomplished within one year of expiration.
(iii)
A candidate whose certificate has been expired for one
year or more may not renew the certificate. The candidate may become certified
by complying with the requirements of §157.33(a) or (j) of this title.
(2)
Option 2--Continuing Education Recertification Process.
The certificant shall attest to accrual of department approved EMS continuing
education as specified in §157.38 of this title (relating to Continuing
Education).
(3)
Option 3--National Registry Recertification Process. The
applicant shall attest to and hold current National Registry certification
at the time of applying for recertification.
(4)
Option 4--Formal Course Recertification Process. The applicant
shall attest to successful completion of a department approved recertification
course.
(A)
The recertification course, as prescribed by the Education
and Training Manual, shall be a formal structured interactive training course
as approved by the department and conducted within the four-year certification
period.
(B) The minimum contact hours required for recertification courses are:
Figure: 25 TAC §157.34(b)(4)(B)
(5) Option 5--CCMP Recertification Process. An applicant affiliated
with an EMS provider that has a department-approved Comprehensive Clinical
Management Program (CCMP) may be recertified if:
(A) the applicant is currently credentialed in the provider's CCMP;
(B) the applicant has been enrolled in the provider's CCMP
for at least six continuous months; and
(C) the applicant submits to the department a signed written
statement by the CCMP's medical director, attesting to the applicant's successful
participation in and completion of the provider's CCMP.
(6)
If a candidate wishes to change options (other than option
1), another application form must be submitted. An additional fee is not required
if the candidate completes all requirements within the same time period of
the original submission.
(c)
After verification by the department of the information
submitted by the applicant, that the information is true, correct and complete
with regard to the applicant meeting recertification requirements by the certification
expiration date, the department shall recertify the applicant for four years,
commencing on the day following the expiration date of the most recent certificate.
A candidate must verify current certification before staffing an EMS vehicle.
Certification may be verified by the applicant's receipt of the official department
identification card, by using the department's certification website, or by
contacting the department directly.
(d)
Late recertification.
(1)
The candidate whose certification has expired shall be
considered late, non-certified and shall not function in the capacity of an
EMS certificant or represent that he is EMS certified until recertification
is issued.
(2)
A candidate whose certificate has been expired for 90
days or less may renew the certificate by submitting an application accompanied
by a non-refundable renewal fee that is equal to 1-1/2 times the normally
required application renewal fee for that level as listed in subsection (a)(4)
of this section. Applicant shall meet one of the recertification options described
in subsection (b)(1) - (5) of this section and submit verification of skills
proficiency from an approved education program. If the applicant has already
submitted an application and fee, but has not met all of the requirements
prior to expiration, another application will not be required, but a total
of 1-1/2 times the normally required application renewal fee shall be necessary.
The applicant shall be recertified for a period of four years beginning on
the date of issuance.
(3)
A candidate whose certificate has been expired for more
than 90 days but less than one year may renew the certificate by submitting
an application accompanied by a non-refundable renewal fee that is equal to
two times the normally required application renewal fee as listed in subsection
(a)(4) of this section. Applicant shall meet one of the recertification options
described in subsection (b)(2) - (6) of this section and submit verification
of skills proficiency from an approved education program. If the applicant
has already submitted an application and fee, but has not met all of the requirements
prior to the 90th day after expiration, another application will not be required,
but a total of two times the fee shall be necessary.
(4)
The applicant shall be recertified for a period of four
years beginning on the date of issuance.
(5)
A candidate whose certificate has been expired for one
year or more may not renew the certificate. The candidate may become certified
by complying with the requirements of §157.33(a) or (j) of this title.
(6)
A candidate who was certified in this state, moved to
another state, and is currently certified or licensed and has been in practice
in the other state for two years preceding the date of application may become
certified without reexamination. The candidate may gain recertification by:
(A)
submitting to the department a non-refundable fee that
is equal to two times the normally required renewal fee for certification
as listed in subsection (a)(4) of this section; and
(B)
attesting to regular practice of emergency medical care
in the other state for the two years preceding the date of application.
(e)
Renewal of inactive certification.
(1)
To renew inactive certification, an applicant holding
inactive certification shall submit an application and the non-refundable
fee as described in §157.33(a)(4) of this title. The $30 inactive fee
is not required for renewal when renewing inactive certification. A candidate
who meets requirements for inactive renewal shall be awarded inactive certification
for a period of four years beginning on the first day after the expiration
of the previous inactive certification.
(2)
A candidate whose inactive certification has been expired
for 90 days or less may renew the inactive certification during the 90 day
period after expiration of the certification upon submitting a fee of 1-1/2
times the normally required renewal fee as described in subsection (a)(4)
of this section. If the applicant has already submitted an application and
fee, but has not met all of the requirements prior to expiration, another
application will not be required, but a total of 1-1/2 times the fee shall
be necessary. The applicant shall be recertified for a period of four years
beginning on the date of issuance.
(3)
A candidate whose inactive certification has been expired
more than 90 days but less than one year may renew the inactive certification
upon submitting a fee of two times the normally required renewal fee as described
in subsection (a)(4) of this section. If the applicant has already submitted
an application and fee, but has not met all of the requirements prior to the
90th day after expiration, another application will not be required, but a
total of two times the fee shall be necessary. The applicant shall be recertified
for a period of four years beginning on the date of issuance.
(4)
A candidate whose inactive certificate has been expired
more than one year must regain active certification before reapplying for
inactive certification as described in subsection (f) of this section.
(f)
Inactive to active certification.
(1)
An inactive certificant prior to the expiration of the
first four-year inactive certification period may obtain active certification
by submitting an application and the non-refundable fee to the department,
as described in subsection (a)(4) of this section and by completing one of
the following options:
(A)
Option 1--meet the normal 4 year continuing education
requirement for certification renewal as listed in subsection (b)(2) of this
section, submit verification of skills proficiency from an approved education
program, and pass the national registry assessment exam.
(B)
Option 2--complete a department approved recertification
course, and pass the national registry assessment exam.
(2)
A certificant who has held inactive certification for
more than four years may return to active certification only by completing
requirements described in §157.33(a) or (j) of this title.
(g)
For all applications and renewal applications, the department
is authorized to collect subscription and convenience fees, in amounts determined
by the Texas Online Authority, to recover costs associated with application
and renewal application processing through Texas Online.
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 August 11, 2006.
TRD-200604199
Cathy Campbell
General Counsel
Department of State Health Services
Effective date: August 31, 2006
Proposal publication date: April 14, 2006
For further information, please call: (512) 458-7111 x6972
Subchapter N. CURRENT GOOD MANUFACTURING PRACTICE AND GOOD WAREHOUSING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD
Subchapter C. EMERGENCY MEDICAL SERVICES TRAINING AND COURSE APPROVAL
Chapter 229.
FOOD AND DRUG