DAR File No. 43203

Health, Family Health and Preparedness, Emergency Medical Services

Rule R426-5

Emergency Medical Services Training and Certification Standards

Notice of Proposed Rule

(Amendment)

DAR File No.: 43203
Filed: 09/14/2018 09:01:29 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The reason for these amendments is to update language to be consistent with Title 26, Chapter 8a, requiring personnel to have new training, licensure, and certification requirements.

Summary of the rule or change:

These changes update language to be consistent with Title 26, Chapter 8a, by changing the term "licensed" to include individuals. They remove redundant training verification, change license terms to two years for individuals, and allow services to offer equivalent training in lieu of some certifications.

Statutory or constitutional authorization for this rule:

• Title 26, Chapter 8a

Anticipated cost or savings to:

the state budget:

These proposed rule changes are not expected to have any fiscal impact on state government revenues or expenditures because they are for the changing of terms, and documentation for licensed individuals providers. State expenditures and staff time are not affected. Reduced verification steps will likely offset the frequency needed to process licenses due to shortening the term from four years to two years.

local governments:

Local governments affected by these proposed rule amendments will have a fiscal impact if they pay fees for EMTs, AEMTs, EMT-IAs, Paramedics, and EMDs. A total cost estimate is based on 2,600 annual licenses issued for non-Paramedics, and 850 annual licenses for Paramedics. The net fiscal cost for each year is $32,500 + $12,750 = $45,250. Fiscal benefits for local governments include the allowance of a Department of Health (Department) approved equivalent for current certifications in the following categories: CPR, ACLS, PEP, PALS, PHTLS, and IRS. Equivalent training could save up to an estimated (3,450 X $47) = $162,150 for two years. The possible annual benefit is estimated at $81,075. Indirect benefits for local governments include time savings to verify training requirements in two systems (National Registry of EMTs and the State EMS training system).

small businesses:

Small businesses affected by these proposed rule amendments will have a fiscal impact if they pay fees for EMTs, AEMTs, EMT-IAs, Paramedics, and EMDs. A total cost estimate is based on 2,600 annual licenses issued for non-Paramedics, and 850 annual licenses for Paramedics. The net fiscal cost for each year is $32,500 + $12,750 = $45,250. An estimate cost of $150 per year for additional licensing expenses. An estimated possible benefit of $470 if providing department approved training for third party certifications is performed.

persons other than small businesses, businesses, or local governmental entities:

The non-small businesses that choose to pay for the licensing of their staff will have fiscal impacts. The Department information was used to estimate the number of employed personnel for non-small businesses. These licensed and designated EMS providers who are businesses employ approximately 432 EMTs and AEMTs along with approximately 243 paramedics. The proposed rule amendments will coincide with a lower the personnel licensure fee. The Department was able to have the Utah Legislature reduce the existing fee of $60 to $40 starting 07/01/2018. The proposed amendments will change the term of a license from four years to two year for a licensure period. The amended rule will also require all personnel are certified by the Department-approved vendor. EMT, AEMT and paramedics will be required to pay the current approved vendor (National Registry of Emergency Medical Technicians) $15 per EMT and AEMT certifications and $20 for Paramedics certifications on a two year basis. The total change in fees for certification and licensure will be $55 per 2 years and $60 for 2 years for EMTs and Paramedics respectively. Currently, the fees are $60 per 4 years for both license levels. These averages will be $27.50 per EMT/AEMT annually and $30 per Paramedic annually. Current averages are $15 annually for both types. Using the annual cost differences of $12.50 for EMT/AEMTs and $15 for paramedics the total impact is (432 X $12.50) + (243 X $15)= $9,045 per year for non-small businesses affected by the proposed rule amendments. Fiscal benefits for non-small businesses include the allowance of a Department-approved equivalent for current certifications in the following categories: CPR, ACLS, PEP, PALS, PHTLS, and IRS. Equivalent training could save up to an estimated 675 X $47 = $31,725 for 2 years. The possible annual benefit is estimated at $15,863. Indirect benefits for non-small businesses include time savings to verify training requirements in two systems (National Registry of EMTs and the State EMS training system).

Compliance costs for affected persons:

These proposed rule amendments are not expected to have any fiscal impact for persons, such as patients or hospitals, who normally pay for EMS services.

Comments by the department head on the fiscal impact the rule may have on businesses:

The total fiscal benefit of these proposed amendments outweigh the total fiscal costs resulting in a net fiscal benefit which is appropriate to implement the changes required by statute.

Joseph K. Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Family Health and Preparedness, Emergency Medical Services
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Guy Dansie at the above address, by phone at 801-273-6671, by FAX at 801-273-4165, or by Internet E-mail at [email protected]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

10/31/2018

This rule may become effective on:

11/07/2018

Authorized by:

Joseph Miner, Executive Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2019	FY 2020	FY 2021
State Government	$0	$0	$0
Local Government	$45,250	$45,250	$36,205
Small Businesses	$150	$150	$1500
Non-Small Businesses	$9,045	$9,045	$9,045
Other Person	$0	$0	$0
Total Fiscal Costs:	$54,445	$54,445	$54,445
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$81,705	$81,705	$81,705
Small Businesses	$470	$470	$470
Non-Small Businesses	$15,863	$15,863	$15,863
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$98,038	$98,038	$98,038
Net Fiscal Benefits:	$43,593	$43,593	$43,593

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described in the narrative. Inestimable impacts for Non - Small Businesses are described in Appendix 2.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

The non-small businesses that choose to pay for the licensing of their staff will have fiscal impacts. The Department of Health (Department) information was used to estimate the number of employed personnel for non-small businesses. These licensed and designated EMS provider who are businesses employ approximately 432 EMTs and AEMTs along with approximately 243 Paramedics. These proposed rule amendments will coincide with a lower the personnel licensure fee. The Department was able to have the Utah Legislature reduce the existing fee of $60 to $40 starting 07/01/2018. These proposed amendments will change the term of a license from four years to two years for a licensure period. The amended rule will also require all personnel to be certified by a Department-approved vendor. EMTs, AEMTs, and Paramedics will be required to pay the current approved vendor (National Registry of Emergency Medical Technicians)$15 per EMT and AEMT certifications and $20 for Paramedics certifications on a 2-year basis.

 

The total change in fees for certification and licensure will be $55 per 2 years and $60 for 2 years for EMTs and Paramedics respectively. Fees were $60 per 4 years for both license levels. These averages will be $27.50 per EMT/AEMT annually and $30 per Paramedic annually. Current averages are $15 annually for both types.

 

Using the annual cost differences of $12.50 for EMT/AEMTs and $15 for Paramedics the total impact is (432 X $12.50)+(243 X $15.00)= $9,045 per year for non-small businesses affected by the proposed rule amendments.

 

Indirect fiscal benefits include time savings for training officers employed by licensed and designated EMS providers and the State will reduce considerable time verifying personnel training records. The amendments will consolidate two different sets of training requirements and processes for verification by the National Registry of Emergency Medical Technicians and the Utah Department of Health. These proposed rule amendments will eliminate duplicate verification procedures previously performed by the licensed and designated EMS providers.

 

The Executive Director of the Department of Health, Joseph K. Miner, MD, has reviewed and approved this fiscal analysis.

 

 

R426. Health, Family Health and Preparedness, Emergency Medical Services.

R426-5. Emergency Medical Services Training , [ and ]Certification , and Licensing Standards.

R426-5-100. Authority and Purpose.

(1) This rule is established under [Title 26, Chapter 8a ]to provide uniform minimum standards to be met by those providing emergency medical services in the State of Utah; and for the training, certification, and [recertification]licensing of individuals who provide emergency medical service and for those providing instructions and training to pre-hospital emergency medical care providers.

[(2) The definitions in Title 26, Chapter 8a are adopted and incorporated by reference into this rule.]

 

R426-5-200. Scope of Practice.

(1) The Department may [certify]license an individual as an EMR, EMT, AEMT, EMT-IA Paramedic, or EMD [an individual ]who meets the [initial certification ]requirements in this rule.

(2) The Committee adopts as the standard for EMR, EMT, AEMT, EMT-IA, or Paramedic training and competency in the state, the [following ]United States Department of Transportation's National Emergency Medical Services Education Standards.

(3) An EMR, EMT, AEMT, or Paramedic may perform the skills as described in the EMS National Education Standards, to their level of [certification]licensure, as adopted in this section.

[(4) Per Utah Code section 41-6a-523 persons authorized to draw blood/immunity from liability and section 53-10-405 DNA specimen analysis -- Saliva sample to be obtained -- Blood sample to be drawn by a professional. Acting at the request of a peace officer a paramedic may draw field blood samples to determine alcohol or drug content and for DNA analysis. Acting at the request of a peace officer an AEMT may draw field blood samples to determine alcohol or drug content and for DNA analysis if they have received certification pursuant to administrative rule R438-12. A person authorized by this section to draw blood samples may not be held criminally or civilly liable if drawn in a medically acceptable manner.]

 

R426-5-300. [Certification.]EMS Individual Licensure for EMR, EMT, AEMT, EMT-IA, and Paramedic.

(1) The Department may [certify]license an EMR, EMT, EMT-IA, AEMT, or Paramedic[, or EMD] for a [four]two-year period.

(2) An individual who wishes to become [certified]licensed as a EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] shall:

(a) successfully complete a Department-approved EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] course as described in this rule;

(b) be able to perform the functions listed in the National EMS Education Standards adopted in this rule as verified by personal attestation and successful accomplishment by certified EMS Instructors during the course;

(c) achieve a favorable recommendation from the course coordinator and course medical director stating technical competence during field and clinical training and successful completion of all training requirements for an EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] certification;

(d) submit the applicable fees and a completed application, including social security number[and signature], to the Department;

(e) submit to and pass a background investigation, including an FBI background investigation[if the applicant has not resided in Utah for the past consecutive five years];

(f) [maintain and submit]retain documentation of having completed a Department approved CPR course within the prior two years that is consistent with the most current [version of the ]American Heart Association Guidelines for the level of Healthcare [Provider ]Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) Basic Life Support (BLS); and

(g) [submit]retain TB test results[as per R426-5-700].

(3) Age requirements:

(a) EMR may certify at 16 years of age or older; and

(b) EMT, AEMT, EMT-IA and Paramedic may certify at 18 years of age or older.

(4) Within [120 days]two years after the official course end date the applicant shall successfully complete the Department 's approved National Registry of Emergency Medical Technician's written and practical EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] examinations, or reexaminations, if necessary.

(5) Licensed personnel shall retain and submit upon request by the Department any documentation required for licensure.

[(5) Test development, the Department shall:

(a) develop or approve written and practical tests for each certification;

(b) establish the passing score for certification and recertification written and practical tests;

(c) the Department may administer the tests or delegate the administration of any test to another entity; and

(d) the Department may release only to the individual who took the test and to persons who have a signed release from the individual who took the test:

(i) whether the individual passed or failed a written or practical test; and

(ii) the subject areas where items were missed on a written or practical test.

(6) An individual who fails any part of the EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD certification or recertification written or practical examination may retake the examination twice without further course work.

(7) If the individual fails both re-examinations, they shall take a complete EMR, EMT, AEMT, Paramedic, or EMD training course respective to the certification level sought to be eligible for further examination.

(8) The individual may retake the course as many times as they desire, but may only take the examinations three times for each completed course. If an individual retakes the course because of failure to pass the examinations, the individual shall pass both the practical and written test administered after completion of the new course.]

([9]6) An individual who wishes to enroll in an AEMT, EMT-IA, or Paramedic course shall have as a minimum a Utah EMT [certification]license. This [Certification]license or other equivalent state license or certification approved by the Department shall remain current until new [certification]license level is obtained.

([10]7) The Department may extend [the ]time limits for an individual who [demonstrates that the inability to meet the requirements within the 120 days was due to]has unusual circumstances or hardships.[beyond the applicant's control, such as for documented medical circumstances that prevent completion of testing, military deployment out of the state, extreme illness in the immediate family, or the like.]

 

R426-5-310. Emergency Medical Dispatcher (EMD) Individual Licensure.

(1) The Department may license an EMD for a two-year period.

(2) An individual who wishes to become licensed as an EMD shall:

(a) successfully complete and become certified in a Department approved EMD protocol system by the system vendor no later than July 1, 2020;

(b) submit to and pass a criminal background investigation and screening clearance;

(c) retain documentation of having completed a Department approved CPR course within the prior two years. CPR training shall be kept current during licensure.

(3) An EMD may be licensed at 18 years of age or older.

 

R426-5-400. [Certification]Licensure at a Lower Level.

(1) An individual who has taken a Paramedic course, but has not been recommended for [certification]licensure, may request to become [certified]licensed at the AEMT levels if:

(a) the paramedic course coordinator submits to the Department a favorable letter of recommendation stating that the individual has successfully obtained the knowledge and skills of the AEMT level as required by this rule; and

(b) the individual successfully completes all other application and testing requirements for an AEMT.

 

R426-5-500. [Certification]License Challenges.

(1) The Department may [certify]license as an EMT or AEMT; a registered nurse licensed in Utah, a nurse practitioner licensed in Utah, a physician assistant licensed in Utah, or a physician licensed in Utah who:

(a) is able to demonstrate knowledge, proficiency and competency to perform all the functions listed in the National EMS Education Standards as verified by personal attestation and successful demonstration to a currently certified course coordinator and an off-line medical director[of all cognitive, affective, and psychomotor skills listed in the National EMS Education Standards];

(b) has a knowledge of:

(i) medical control protocols;

(ii) state and local protocols; and

(iii) the role and responsibilities of an EMT or AEMT respectively[.];

(c) maintain and submit documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for adult and [p]Pediatric [h]Healthcare [provider]Professional CPR and ECC BLS; and

(d) is 18 years of age or older.

[(e) each level shall be challenged sequentially and individually]

(2) To become [certified]licensed, the applicant shall:

(a) submit three letters of recommendation from health care providers attesting to the applicant's patient care skills and abilities;

(b) submit a favorable recommendation from a currently certified course coordinator attesting to competency of [all ]knowledge and skills contained within the National EMS Education Standards;

(c) submit the applicable fees and a completed application, including social security number, signature, and, proof of current Utah license as a Registered Nurse, a Physician Assistant, or a Medical Doctor;

(d) [within 120 days after submitting the challenge application, ]successfully complete the Department approved written and practical EMT or AEMT examinations, or reexaminations, if necessary;

[(e) the Department may extend the time limit for an individual who demonstrates the inability to meet the requirements within 120 days was due to circumstances beyond the applicant's control;]

([f]e) submit to and pass a background screening clearance as per R426-5-[2700]3100; and

([g]f) [submit]retain a statement from a physician, confirming the applicant's results of a TB examination conducted within one year prior to submitting the application.

 

R426-5-600. [ Recertification ] License Renewal Requirements for EMR, EMT, AEMT, EMT-IA, and Paramedic .

(1) The Department may [recertify]renew an individual license for a [four]two-year period or for a shorter period as modified by the Department to standardize [recertification]renewal cycles.

(2) An individual seeking recertification shall:

(a) submit the applicable fees and a completed application, including social security number [and signature, ]to the Department;

(b) submit to and pass a background screening clearance as per R426-5-[2700]3100;

(c) [maintain and submit]retain documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for the level of Adult and Pediatric Healthcare [Provider]Professional CPR and ECC BLS. CPR shall be kept current during [certification]licensure;

(d) [submit]retain TB test results as per R426-5-[700]800; and

[(e) successfully complete the Department applicable written and practical recertification examinations, or reexaminations if necessary, within one year prior to expiration; and]

([f]e) provide documentation of completion of Department-approved CME requirements.

(3) The EMR, EMT, AEMT, EMT-IA and Paramedic shall complete the required CME hours, as outlined in the [d]Department's [Recertification]Renewal Protocol for EMS Personnel [m]Manual .[and in accordance with the National EMS Education Standards.] The hours shall be completed throughout the prior [four]two years.

[(4) As well as requirements in (2)(c) The following course completion documentation is required for the specific certification level and may be included in the CME required hours:

(a) EMR 52 hours of CME.

(b) EMT 98 hours of CME.

(c) AEMT 108 hours of CME.

(d) EMT-IA 108 hours of CME.

(e) Paramedic 144 hours of CME; and,

(f) EMD 48 hours of CME.

(5) An EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD may complete CME hours through various methodologies, but 30 percent of the CME hours shall be practical hands-on training.

(6) All CME shall be related to the required skills and knowledge of the EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD's level of certification.

(7) The CME Instructors need not be certified EMS instructors, but shall be knowledgeable in the subject matter.]

([8]4) The EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] shall complete and provide documentation upon request of demonstrating the psychomotor skills listed in the current National EMS Education Standards at their level of [certification]licensure.

([9]5) An EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] who is affiliated with [an EMS organization]a licensed or designated EMS provider [should]shall have the [organization's designated]licensed or designated EMS provider's training officer submit a letter verifying the completion of the [recertification]renewal requirements. An EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] who is not affiliated with a licensed or designated EMS provider shall [submit]provide upon the request of the Department verification of all [recertification]renewal requirements directly to the Department.

([10]6) An AEMT, EMT-IA or Paramedic shall [submit a letter]obtain verification from a certified off-line medical director recommending the individual for [recertification]renewal [and ]verifying the individual has demonstrated proficiency in the psychomotor skills listed in the current National EMS Education Standards at their license level[of certification].

([11]7) [Each EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD is individually]Individuals are responsible to complete and submit all required [recertification]renewal material to the Department at one time, no later than 30 days and no earlier than [one year]six months prior to the individual's current [certification]license expiration date. Renewal material submitted less than 30 days may result in a license expiration.[If the Department receives incomplete or late recertification materials, the Department may not be able to process the recertification before the certification expires.] The Department processes [recertification]renewal material in the order received.

([12]8) A [licensed or designated EMS provider, or a ]Department approved entity who provides CME may compile and submit [recertification]renewal materials on behalf of an EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD]; however, the individual EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD remains] is responsible for a timely and complete submission.

[(13) The Department may shorten recertification periods. An EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD whose recertification period is shortened shall meet the CME requirements in each of the required and elective subdivisions on a prorated basis by the expiration of the shortened period.]

([14]9) The Department may not lengthen [certification]an individual's license period[s] to more than the [four]two-year s[certification], unless the individual is a member of the National Guard or reserve component of the armed forces and is on active duty when [certification]the license expired.[If this happens, the individual shall recertify in accordance with Utah Code 39-1-64.]

 

R426-5-700. License Renewal Requirements for EMD.

(1) The Department may renew an individual license for a two-year period or for a shorter period as modified by the Department to standardize renewal cycles.

(2) An individual seeking renewal shall:

(a) submit the applicable fees and a completed application, including social security number to the Department;

(b) submit to and pass a background screening clearance as per R426-5-3100;

(c) retain documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for the level of Adult and Pediatric Healthcare Professional CPR and ECC BLS. CPR shall be kept current during licensure;

(d) a minimum of a two-hour course in critical incident stress management (CISM);

(e) successfully complete certification in a Department approved EMD protocol system; and

(3) An EMD applying for renewal shall have the communications center supervisor or Department certified training officer of the designated medical dispatch center submit a letter verifying the completion of renewal requirements.

(4) Individuals are responsible to complete and submit all required renewal material to the Department at one time, no later than 30 days and no earlier than one year prior to the individual's current license expiration date. Renewal material submitted less than 30 days may result in license expiration. The Department processes renewal material in the order received.

(5) The Department may shorten an individual's license period.

(6) The Department may not lengthen an individual's license period to more than two years unless the individual is a member of the National Guard or reserve component of the armed forces and was on active duty when their license expired.

 

R426-5-[700]800 . TB Test Requirements for EMR, EMT, AEMT, EMT-IA, and Paramedic Licensure and Renewals.

(1) [All levels of certification and recertification except EMD]Individuals applying for a license or the renewal of a license for EMR, EMT, AEMT, EMT-IA, or Paramedic shall be able to provide upon request [shall submit ]a statement from a physician or other health care provider, confirming the applicant's negative results of a Tuberculin Skin Test or equivalent (TB test) examination conducted within the prior three year s, or complete the following requirements:

(a) if the test is positive, and there is no documented history of prior Latent TB Infection (LTBI) treatment, the applicant shall see his primary care physician for a chest x-ray (CXR) in accordance with current Center for Disease Control and Prevention (CDC) guidelines and further evaluation; and

(b) Results of CXR and medical history shall be submitted to the Department.

(2) If the CXR is negative, the applicant's medical history will be reviewed by the State EMS Medical Director. For individuals at high risk for developing active TB, treatment will be strongly recommended.

(3) If the CXR is positive, the applicant is considered to be suspect Active TB. Should the diagnosis be confirmed:

(a) Completion of treatment or release by an appropriate physician will be required prior to certification; and

(b) each such case will be reviewed by the State EMS Medical Director.

(4) If an applicant who is required to get treatment refuses the treatment, the Department may deny certification.

(5) A TB test should not be performed on a person who has a documented history of either a prior positive TB test or prior treatment for tuberculosis. The applicant shall instead have a CXR in accordance with current CDC guidelines and provide documentation of negative CXR results to the department.

(6) If the applicant has had prior treatment for active TB or LTBI, the applicant shall provide documentation of this treatment prior to certification. Documentation of this treatment will be maintained by the [Department]employer or individual if not employed.[, and needs only to be provided once.]

(7) Each such case will be reviewed by the State EMS Medical Director.

 

R426-5-[800]900 . Reciprocity for EMR, EMT, AEMT, and Paramedic.

(1) The Department may [certify]license an individual as an EMR, EMT, AEMT, or Paramedic[, or EMD an individual certified] who is licensed or certified by another state or certifying body [outside of the State of Utah ]if the applicant can demonstrate the applicant's out-of-state training and experience requirements are equivalent to or greater than what is required in Utah.

(2) An individual seeking reciprocity for [certification]licensure in Utah based on out-of-state training and experience shall:

(a) Submit the applicable fees and a completed application, including social security number [and signature, ]to the Department and complete all of the following within [120 days]two years of submitting the application;

(b) submit to and pass a background screening clearance as per R426-5-[2700]3100;

(c) [maintain and submit]retain documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for the level of Healthcare [Provider]Professional CPR and ECC and BLS. A Paramedic candidate shall also retain documentation of successful completion of ACLS or equivalent. All AMET, EMT-IA, and Paramedic licensed personnel shall retain documentation of PEPP, PALS, or equivalent courses within the prior two years;

(d) [submit]retain TB test results as per R426-5-[700]800;

(e) successfully complete the [Department]National Registry of Emergency Medical Technician's written and practical EMR, EMT, AEMT, or Paramedic[, or EMD] examinations, or reexaminations, if necessary; and

(f) submit a current certification or license from one of the states of the United States or its possessions, or current registration and the name of the training institution if registered with the National Registry of EMTs .[; and

(g) provide documentation of completion of 25 hours of continuing medical education (CME) within the prior year. EMDs shall provide documentation of completion of 12 hours of CME within the prior year

(3) The Department may certify as an EMD an individual certified by the National Academy of Emergency Medical Dispatch (NAEMD) or equivalent. An individual seeking reciprocity for certification in Utah based on NAEMD or equivalent certification shall:

(a) Submit documentation of current NAEMD or equivalent certification.

(b) maintain and submit documentation of having completed within the prior two years;

(i) a Department approved CPR course that is consistent with the most current version of the American Heart Association Guidelines for CPR and ECC; and

(ii) a minimum of a two-hour course in critical incident stress management (CISM).

(4) An individual who fails the written or practical EMR, EMT, or AEMT examination three times will be required to complete a Department approved EMR, EMT, or AEMT, course respective to the certification level sought.

(5) A candidate for paramedic reciprocity who fails the written or practical examinations three times can request further consideration of reciprocity after five years if the candidate has worked for an out of state EMS provider and can verify steady employment as a paramedic for at least three of the five years.]

 

R426-5-[900]1000 . Lapsed [Certification]Licenses.

(1) An individual whose EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD [certification]license has expired for less than one year may, within one year after expiration, complete all [recertification]renewal requirements, pay a late [recertification]licensure fee[,]. Individuals applying for EMR, EMT, AEMT, or Paramedic licensure also may be required to [and ]successfully pass the Department's approved written [certification ]examination to become [certified]licensed. The individual's new expiration date will be [four]two years from the previous expiration date.

(2) An individual whose [certification]license for EMR, EMT, AEMT, EMT-IA, or Paramedic has expired for more than one year shall:

(a) submit a letter of recommendation including results of an oral examination, from a certified off-line medical director, verifying proficiency in patient care skills at the [certification]licensure level;

(b) successfully complete the applicable Department 's approved written [and practical ]examination[s];

(c) complete all [recertification]renewal requirements; and

(d) the individual's new expiration date will be [four]two years from the completion of all [recertification]renewal materials.

(3) An individual whose certification has lapsed, is not authorized to provide care as an EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD until the individual completes the [recertification]renewal process.

 

[R426-5-1000. Transition to 2009 National EMS Education Standards.

(1) The Department adopts the 2009 National Education Standards as noted in this rule resulting in a need for specific dates for a transition period. These dates shall be as follows:

(a) EMT Basic to EMT January 1, 2012 to January 1, 2016; and

(b) EMT Intermediate to Advanced EMT, October 1, 2011 to September 30, 2013.

(2) Transition for EMT-B to EMT will be accomplished through the Department's written examination as part of the Individual's recertification process during the transition period.

(3) Transition for EMT-I and EMT-IA to AEMT will be accomplished through the Department's written AEMT transition examination during the transition period.

(4) Transition will not change the Individual's recertification date.

(5) During the transition period:

(a) EMT-I and EMT-IA will be deemed equivalent to AEMT certification, in accordance with the respective licensed or designated EMS provider's waivers; and

(b) EMT-B will be deemed equivalent to EMT certification.

(c) EMT-IA may maintain level of certification as long as employed by a licensed EMT-IA provider.

(6) After the deadline of September 31, 2013 of the AEMT transition period:

(a) an EMT-I who has not yet transitioned will be deemed an EMT, and;

(b) an EMT-IA who is not working for a licensed EMT-IA provider shall be deemed an AEMT.]

 

R426-5-1100. Emergency Medical Care During Clinical Training.

A student enrolled in a Department-approved training program may, under the direct supervision of the course coordinator, an instructor in the course, or a preceptor for the course, perform activities delineated within the training curriculum that otherwise require s [certification]licensure to perform.

 

R426-5-1200. Instructor Requirements.

(1) The Department may certify as an EMS Instructor an individual who:

(a) meets the initial certification requirements in R426-5-1300; and

(b) is currently [certified ]in Utah as an EMR, EMT, AEMT,EMT-IA, or Paramedic[, or EMD].

(2) The [Committee]Department adopts the United States Department of Transportation's "EMS Instructor Training Program as the standard for EMS Instructor training and competency in the state, which is adopted and incorporated by reference.

(3) An EMS instructor may only teach up to the [certification]license level to which the instructor is [certified]licensed.[An EMS instructor who is only certified as an EMD may only teach EMD courses.]

(4) An EMS instructor shall comply with the teaching standards and procedures in the EMS Instructor Manual.

(5) An EMS instructor shall maintain the EMS [certification]license for the level the instructor is certified to teach. If an individual's EMS [certification]license lapses, the instructor certification is invalid until EMS [certification]license is renewed.

(6) The Department may waive a particular instructor certification requirement if the applicant can demonstrate the applicant's training and experience requirements are equivalent or greater to what are required in Utah.

 

R426-5-1300. Instructor Certification.

(1) The Department may certify an individual who is an EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] as an EMS Instructor for a two-year period.

(2) An individual who wishes to become certified as an EMS Instructor shall:

(a) Submit an application and pay all applicable fees;

(b) submit three letters of recommendation regarding EMS skills and teaching abilities;

(c) submit documentation of 15 hours of teaching experience;

(d) successfully complete all required examinations; and

(e) successfully complete the Department-sponsored initial EMS instructor training course , or equivalent.

(3) An individual who wishes to become certified as an EMS Instructor to teach EMR, EMT, AEMT, or [p]Paramedic courses shall [also:

(a) P]provide documentation of 30 hours of patient care within the prior year.

(4) The Department may waive portions of the initial EMS instructor training courses for previously completed Department-approved instructor programs.

(5) An individual shall submit every two years a completed and signed "instructor contract" to the Department agreeing to abide by the standards and procedures in the current Instructor Manual.

 

R426-5-1400. Instructor Recertification.

(1) An EMS instructor who wishes to recertify as an instructor shall:

(a) maintain current EMS [certification]licensure;[and]

(b) attend the required Department-approved [recertification training]instructor seminar at least once in the two year recertification cycle; and

([2]c) [S]submit an application and pay all applicable fees.

 

R426-5-1500. Instructor Lapsed Certification.

(1) An EMS instructor whose instructor certification has expired for less than two years may again become certified by completing the recertification requirements.

(2) An EMS instructor whose instructor certification has expired for more than two years shall complete all initial instructor certification requirements and reapply as if there were no prior certification , however the Department may waive portions of the initial EMS instructor training courses if the individual is able to demonstrate competency to the Department.

 

R426-5-1600. Training Officer Certification.

(1) The Department may certify an individual who is a certified EMS instructor as a training officer for a two-year period.

(2) An individual who wishes to become certified as an EMS Training officer shall:

(a) Be currently certified as an EMS instructor;

(b) successfully complete the Department's course for new training officers;

(c) submit an application and pay all applicable fees; and

(d) submit biennially a completed and signed "Training Officer Contract" to the Department agreeing to abide by the standards and procedures in the then current Training Officer Manual.

(3) A training officer shall maintain EMS instructor certification to retain training officer certification.

(4) An EMS training officer shall abide by the terms of the Training Officer Contract, and comply with the standards and procedures in the Training Officer Manual as incorporated into the respective Training Officer Contract.

 

R426-5-1700. Training Officer Recertification.

(1) A training officer who wishes to recertify as a training officer shall:

(a) Attend a training officer seminar at least once in the two year recertification cycle;

(b) maintain current EMS instructor and EMS [certification]license;

(c) submit an application and pay all applicable fees;

(d) successfully complete any Department-examination requirements; and

(e) submit [biennially ]a completed and signed new "Training Officer Contract" to the Department agreeing to abide by the standards and procedures in the current training officer manual.

 

R426-5-1800. Training Officer Lapsed Certification.

(1) An individual whose training officer certification has expired for less than two years may again become certified by completing the recertification requirements. The individual's new expiration date will be two years from the old expiration date.

(2) An individual whose training officer certification has expired for more than two year shall complete all initial training officer certification requirements and reapply as if there were no prior certification.

 

R426-5-1900. Course Coordinator Certification.

(1) The Department may certify an individual as an EMS course coordinator for a two-year period.

(2) An individual who wishes to certify as a course coordinator shall:

(a) Be certified as an EMS instructor;

(b) be a co-coordinator of record for one Department-approved course with a certified course coordinator;

(c) submit a written evaluation and recommendation from the course coordinator in the co-coordinated course;

(d) complete certification requirements within one year of completion of the Department's course for new course coordinators;

(e) submit an application and pay all applicable fees;

(f) complete the Department's course for new course coordinators;

(g) sign and submit [annually ]the "Course Coordinator Contract" to the Department agreeing to abide to the standards and procedures in the then current Course Coordinator Manual; and

(h) maintain EMS instructor certification.

(3) A Course Coordinator may only coordinate courses up to the [certification]licensure level to which the course coordinator is [certified]licensed.[A course coordinator, who is only certified as an EMD, may only coordinate EMD courses.]

(4) A course coordinator shall abide by the terms of the "Course Coordinator Contract" and comply with the standards and procedures in the Course Coordinator Manual as incorporated into the "Course Coordinator Contract."

(5) A Course Coordinator shall maintain an EMS Instructor certification and the EMS [certification]license for the level that the course coordinator is certified to coordinate. If an individual's EMS [certification]license lapses, the Course Coordinator certification is invalid until EMS [certification]license is renewed.

 

R426-5-2000. Course Coordinator Recertification.

(1) A course coordinator who wishes to recertify as a course coordinator shall:

(a) Maintain current EMS instructor and EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD certification]license;

(b) coordinate or co-coordinate at least one Department-approved course every two years;

(c) attend a course coordinator seminar at least once in the two year recertification cycle;

(d) submit an application and pay all applicable fees; and

(e) sign and submit [biannually ]a Course Coordinator Contract to the Department agreeing to abide by the policies and procedures in the then current Course Coordinator Manual.

 

R426-5-2100. Course Coordinator Lapsed Certification.

(1) An individual whose course coordinator certification has expired for less than two year may again become certified by completing the recertification requirements. The individual's new expiration date will be two years from the recertification date.

(2) An individual whose course coordinator certification has expired for more than two year[

must]shall complete all initial course coordinator certification requirements and reapply as if there were no prior certification. The Department may waive portions of the initial course coordinator requirements such as the co-coordinator requirements if the candidate has coordinated or co-coordinated a course within the past three years.

 

R426-5-2200. Course Approvals.

(1) A course coordinator offering EMS training to individuals who wish to become [certified]licensed as an EMR, EMT, AEMT, EMT-IA, or Paramedic[, or EMD] shall obtain Department approval prior to initiating an EMS training course. The Department shall approve a course if:

(a) The applicant submits the course application and fees no earlier than 90 days and no later than 30 days prior to commencing the course;

(b) the applicant has sufficient equipment available for the training or if the equipment is available for rental from the Department;

(c) the Department finds the course meets all the Department rules and contracts governing training;

(d) the course coordinators and instructors hold current respective course coordinator and EMS instructor certifications; and

(e) the Department has the capacity to offer the applicable examinations in a timely manner after the conclusion of the course.

 

R426-5-2300. Paramedic Training Institutions Standards Compliance.

(1) A person shall be authorized by the Department to provide training leading to the [certification]licensure of a [p]Paramedic.

(2) To become authorized and maintain authorization to provide [p]Paramedic training, a person shall:

(a) Enter into the Department's standard [p]Paramedic training contract; and

(b) adhere to the terms of the contract, including the requirement to provide training in compliance with the Course Coordinator Manual and the Utah Paramedic Training Program Accreditation Standards Manual.

 

R426-5-2400. Off-line Medical Director Requirements.

(1) The Department may certify an off-line medical director for a four-year period.

(2) An off-line medical director shall be:

(a) a physician actively engaged in the provision of emergency medical care;

(b) familiar with the Utah EMS Systems Act, Title 26, Chapter 8a, and applicable state rules; and

(c) familiar with medical equipment and medications required.

 

R426-5-2500. Off-line Medical Director Certification.

(1) An individual who wishes to certify as an off-line medical director shall:

(a) have completed an American College of Emergency Physicians or National Association of Emergency Medical Services Physicians medical director training course or the Department's medical director training course within twelve months of becoming a medical director;

(b) submit an application and;

(c) pay all applicable fees.

(2) An individual who wishes to recertify as an off-line medical director shall:

(a) attend the medical directors annual workshop at least once every four years ;

(b) submit an application; and

(c) pay all applicable fees.

 

R426-5-2600. Epinephrine Auto-Injector Use.

(1) Any qualified entities or qualified adults as defined in 26-41-102 in accordance with 26-41-107 shall receive training approved by the Department.[

(a)] The training shall include:

([i]a) recognition of life threatening symptoms of anaphylaxis;

([ii]b) appropriate administration of an epinephrine auto-injector;

([iii]c) proper storage of an epinephrine auto-injector;

([iv]d) disposal of an epinephrine auto-injector; and

([v]e) an initial and annual refresher course.

(2) The annual refresher course requirement may be waived if:

(a) [T]the qualified entities or qualified adults are currently licensed [or certified ]at the EMR or higher level by the State of Utah, or

(b) [T]the approved trainings are the Red Cross and American Heart Association epinephrine auto-injector modules.

(3) Training in the school setting shall be based on approved Department trainings found on http://www.choosehealth.utah.gov/prek-12/school-nurses.php and provided in accordance with 26-41-104.

(4) All epinephrine auto injectors shall be stored and disposed of following the manufacturer's specifications.

 

R426-5-2700. Law Enforcement Blood Draws Authorized Individual Qualifications.

(1) Individuals who are not authorized to draw blood pursuant to Utah Code Title 41-6a-523(1)(b), or individuals who are not [certified]licensed by the Department such as [EMTs, ]AEMTs, EMT-IAs, or Paramedics [pursuant to Utah Code Title 26-8a-302 ]shall meet one of the following requirements as a prerequisite for authorization to withdraw blood for the purpose of determining its alcohol[ic] or drug content when requested to do so by a peace officer:

([1]a) training in blood withdrawal procedures obtained as a defined part of a successfully completed college or university course taken for credit, or

([2]b) training in blood withdrawal procedures obtained as a defined part of a successfully completed training course which prepares individuals to function in routine clinical or emergency medical situations, or

([3]c) training of no less than three weeks duration in blood withdrawal procedures under the guidance of a licensed physician.

 

R426-5-2800. Permits for Blood Draws.

(1) [Pursuant Utah Code Title 41-6a-523(1)(b), the]The Department may issue permits to withdraw blood for the purpose of determining the alcohol[ic] or drug content therein, when requested by a peace officer, to qualified applicants, as determined by the Department. Individuals described in R426-5-2700 are exempt from permit requirements.

[(2) The permit shall be of a size suitable for framing and a wallet-sized permit card shall be issued with the permit. Permits for blood draws are not required for people.]

([3]2) Application to obtain a permit shall be made to the [Director, Division of Epidemiology and Laboratory Services]BEMSP on forms provided by the Department.

([4]3) [The permit shall be prominently displayed in the facility where the permit holder is employed. ]When the permit holder is requested to withdraw blood for the above stated purpose at a location other than the facility indicated above, [he must]they shall possess [have ]a valid permit card[on his person].

([5]4) [The effective date of a permit shall be the date the application is approved by the Department, which date shall appear on the permit and on the wallet-sized permit card. Permits shall be valid for a three year period on a calendar year basis. The date the permit expires shall appear on the permit and on the wallet-sized permit card. Permits shall be subject to termination or revocation pursuant to R426-5-2900.]Permits shall be valid for a three year period. The date the permit expires shall appear on the permit.

([6]5) Application to renew permits shall be made to the [Director, Division of Epidemiology and Laboratory Services]Department [before the end of each three year permit period]within three months prior to the expiration date to ensure that it will not lapse. Such application shall be made on forms provided by the Department. The permit holder shall either certify that he has been engaged in performing blood withdrawal procedures during the current permit period or submit a certificate signed by a physician attesting to his competence to perform blood withdrawal procedures.

([7]6) Permit holders [must]shall notify the [Director, Division of Epidemiology and Laboratory Services]Department within 15 days of a change in name or mailing address.[Permits or permit cards that are destroyed or lost may be replaced upon written request from the permit holder.]

 

R426-5-2900. Cause for Blood Draw Permit Termination or Revocation.

[Violation of this rule is a class B misdemeanor under Utah Code Title 26-23-6 and is cause to cancel any permit issued under this rule.]

(1) Permits shall be subject to termination or revocation under any one of the following:

([1]a) [T]the permit holder has made any misrepresentation of a material fact in his application, or any other communication to the Department or its representatives, which misrepresentation was material to the eligibility of the permit holder;

([2]b) [T]the permit holder is not qualified [under R426-5-2700 ]to hold a permit;

([3]c) [T]the permit holder after having received a permit has been convicted of a felony or of a misdemeanor which misdemeanor involves moral turpitude; or

([4]d) [T]the permit holder does not comply with the [display or ]possession requirements[stated in R426-5-2800(3)].

 

R426-5-3000. Published List of Authorized Individuals Permitted to Draw Blood.

(1) The Department [shall publish annually,]will make available to the public a list of individuals authorized to withdraw blood for determination of its alcohol[ic] or drug content[, when requested to do so by a peace officer. This list shall include the individual's name, mailing address, and permit number. The list shall be made available to all state and local law enforcement agencies, all local health departments, and any other person or agency requesting the information.]

(2) The Department may publish amended lists when deemed necessary.

 

KEY: emergency medical services

Date of Enactment or Last Substantive Amendment: [April 26, 2017]2018

Notice of Continuation: December 6, 2016

Authorizing, and Implemented or Interpreted Law: 26-1-30; 26-8a-302