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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 157EMERGENCY MEDICAL CARE
SUBCHAPTER CEMERGENCY MEDICAL SERVICES TRAINING AND COURSE APPROVAL
RULE §157.32Emergency Medical Services Education Program and Course Approval

(a) Emergency medical services (EMS) Education Program Standards. The Texas Department of State Health Services (department) shall develop and publish an EMS Education and Training Manual (manual) outlining standards for EMS education that address at least the following areas:

  (1) program sponsorship;

  (2) program direction and administration;

  (3) medical direction;

  (4) instructor personnel;

  (5) financial resources;

  (6) physical resources, including classroom and laboratory facilities, equipment and supplies, and learning resources;

  (7) clinical and field internship resources;

  (8) academic and administrative policies, procedures and records requirements;

  (9) program evaluation;

  (10) curriculum; and

  (11) delivery of instruction by distance learning technology.

(b) Consideration of training standards.

  (1) The department shall base the manual on applicable standards and guidelines for evaluation and approval of EMS education programs adopted by national accrediting organizations.

  (2) Before implementation or revision of the manual, the department shall ensure adequate time for public review and comment.

  (3) Before implementation or revision of the manual, the department shall present the manual to the advisory council for review.

(c) Curriculum.

  (1) Emergency Care Attendant (ECA)

    (A) The minimum curriculum shall include all content required by the current national Emergency Medical Responder (EMR) educational standards and competencies as defined in the National EMS Education Standards by the United States Department of Transportation (DOT).

    (B) In addition to the minimum curriculum in subparagraph (A) of this paragraph, the curriculum shall include the following subjects:

      (i) recognition and identification of hazardous materials as defined by the Federal Emergency Management Agency curriculum, "Recognizing and Identifying Hazardous Materials";

      (ii) airway/ventilation adjuncts; to include use of the bag-valve mask, oxygen administration and oral suctioning;

      (iii) measurement of baseline vital signs to include pulse, respiration and blood pressure by palpation and auscultation;

      (iv) spinal motion restriction, to include sizing and application of cervical collars and short/long spinal motion restriction devices to supine, seated, and standing patients;

      (v) patient assessment;

      (vi) bandaging, splinting, and traction splinting;

      (vii) cardiac arrest management, including use of the semi-automatic external defibrillator;

      (viii) equipment used to lift and move patients;

      (ix) communications and documentation; and

      (x) ambulance operations, to include emergency vehicle laws.

    (C) The course shall include a minimum of 40 clock hours of classroom and laboratory instruction in the approved curriculum.

  (2) Emergency Medical Technician (EMT).

    (A) The minimum curriculum shall include all content required by the current national EMT educational standards and competencies as defined in the National EMS Education Standards by DOT.

    (B) The course shall include a minimum of 140 clock hours of classroom, laboratory, clinical, and field instruction which shall include supervised experiences in the emergency department, with a licensed EMS provider and in other settings as needed to develop the competencies defined in the minimum curriculum.

  (3) Emergency Medical Technician-Intermediate (EMT-I).

    (A) The minimum curriculum shall include all content required by the current national Advanced Emergency Medical Technician (AEMT) standards and competencies as defined in the National EMS Education Standards by DOT. The following areas must be addressed as outlined in the AEMT national educational standards and the Health and Safety Code, §773.048:

      (i) roles and responsibilities of the paramedic;

      (ii) well being of the paramedic;

      (iii) illness and injury prevention;

      (iv) medical/legal issues;

      (v) ethics;

      (vi) general principles of pathophysiology;

      (vii) pharmacology;

      (viii) venous access and medication administration;

      (ix) therapeutic communications;

      (x) life span development;

      (xi) patient assessment;

      (xii) airway management and ventilation, including endotracheal intubation; and

      (xiii) trauma.

    (B) The course shall include a minimum of 160 clock hours of classroom, laboratory, clinical, and field instruction which shall include supervised experiences in the emergency department with a licensed EMS provider and in other settings as needed to develop the competencies defined in the AEMT national educational standards.

    (C) A student shall have a current EMT certification from the department or National Registry prior to beginning and throughout field and clinical rotations in an EMT-I course.

  (4) Emergency Medical Technician-Paramedic (EMT-P).

    (A) The minimum curriculum shall include all content required by the current national paramedic education standards and competencies in the National EMS Education Standards as defined by DOT.

    (B) The course shall include a minimum of 624 clock hours of classroom, laboratory, clinical and field instruction which shall include supervised experiences in the emergency department with a licensed EMS provider and in other settings as needed to develop the competencies defined in the minimum curriculum.

    (C) A student shall have a current EMT or EMT-I certification from the department or current EMT, EMT-I or AEMT certification from the National Registry prior to beginning and throughout field and clinical rotations in an EMT-P course.

(d) Sponsorship.

  (1) EMS Education programs shall be sponsored by organizations or individuals with adequate resources and dedication to carry out successful educational endeavors.

  (2) Program sponsors shall provide appropriate oversight and supervision to ensure that programs are:

    (A) educationally and fiscally sound; and

    (B) meet the responsibilities listed in subsection (o) of this section.

(e) Levels of program approval.

  (1) A program may be approved as a basic EMS training program or an advanced training program.

  (2) ECA and EMT training shall be conducted by a basic program and may be conducted by an advanced program.

  (3) EMT-I and EMT-P training shall be conducted by an advanced program.

  (4) An advanced program shall be considered to have met the requirements for approval as a basic program.

(f) Currently approved programs. Programs that have obtained approval as of the effective date of this rule shall be considered to have met the requirements of subsections (g) or (h) of this section appropriate to their current level of approval. Paramedic programs must become accredited by December 31, 2012, and provide proof of accreditation by the Commission on Accreditation of Allied Health Education Programs (CAAHEP)/Committee on Accreditation of Educational Programs (CoAEMSP), or a national accrediting organization recognized by the department. Alternatively, the program may provide a letter from CAAHEP/ CoAEMSP or a national accrediting organization recognized by the department stating the education program has submitted the appropriate documentation that indicates it being in pursuit of accreditation as defined by that organization.

(g) Basic approval requirements. To approve a basic program, an applicant shall:

  (1) submit a letter of sponsorship;

  (2) submit letters of intent from qualified providers of clinical and field internship experience appropriate to the level of training;

  (3) have at least one course coordinator certified as an EMT or higher;

  (4) have a program director who contributes an adequate amount of time to assure the success of the program. In addition to other responsibilities, the program director shall be responsible for the development, organization, administration, periodic review and effectiveness of the program. In addition to other duties, the program director may function as a course coordinator if appropriately certified; and shall:

    (A) routinely review student performance to assure adequate progress toward completion of the program;

    (B) review and supervise the quality of instruction provided by the program; and

    (C) document that each graduating student has achieved the desired level of competence prior to graduation;

  (5) have a medical director if appropriate to the level or content of training. The medical director shall be a licensed physician approved by the department with experience in and current knowledge of emergency care. The medical director shall be knowledgeable about educational programs for EMS personnel. In addition to other duties assigned by the program, the medical director shall:

    (A) review and approve the educational content of the program's curricula;

    (B) review and approve the quality of medical instruction provided by the program; and

    (C) attest that each graduating student has achieved the desired level of competence prior to graduation;

  (6) have an advisory committee representing the program's communities of interest (individuals, groups of individuals, or institutions impacted by the program) designated and charged with assisting the program director and medical director in formulating appropriate goals and standards, monitoring needs and expectations and ensuring program responsiveness to change;

  (7) submit a completed application to the appropriate regional office; and

  (8) demonstrate substantial compliance with the EMS education standards by successfully completing the self study/on-site review process outlined in the manual.

(h) Advanced approval requirements. To approve an advanced program, an applicant shall:

  (1) have successfully operated a basic program;

  (2) submit documentation of sponsorship by a regionally accredited post-secondary educational institution or a health care institution accredited by an organization recognized by the department, or any other entity meeting standards and criteria for sponsoring advanced EMS courses;

  (3) submit letters of intent from qualified providers of clinical and field internship experience appropriate to the level of training offered;

  (4) have at least one advanced course coordinator certified at or above the highest level of training to be offered by the program;

  (5) have a program director who contributes an adequate amount of time to assure the success of the program. In addition to other responsibilities, the program director shall be responsible for the development, organization, administration, periodic review and effectiveness of the program; and shall:

    (A) routinely review student performance to assure adequate progress toward completion of the program; and

    (B) review and supervise the quality of instruction provided by the program; and

    (C) document that each graduating student has achieved the desired level of competence prior to graduation;

  (6) have a medical director who shall be a licensed physician approved by the department with experience in and current knowledge of emergency care. The medical director shall be knowledgeable about educational programs for EMS personnel. In addition to other duties assigned by the program, the medical director shall:

    (A) review and approve the educational content of the program's curricula;

    (B) review and approve the quality of medical instruction provided by the program; and

    (C) attest that each graduating student has achieved the desired level of competence prior to graduation;

  (7) have an advisory committee representing the program's communities of interest (individuals, groups of individuals, or institutions impacted by the program) designated and charged with assisting the program director and medical director in formulating appropriate goals and standards, monitoring needs and expectations and ensuring program responsiveness to change;

  (8) submit a completed application to the appropriate regional office; and

Cont'd...

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