No. 29944 (Amendment): R426-12. Emergency Medical Services Training and Certification Standards  

  • DAR File No.: 29944
    Filed: 05/15/2007, 02:02
    Received by: NL

    RULE ANALYSIS

    Purpose of the rule or reason for the change:

    A number of changes were passed through the Training Subcommittee and the Emergency Medical Services (EMS) Committee. These changes were needed to update the rules with current practices. Also, the rule changes help to make the rules more uniform between levels of certification.

    Summary of the rule or change:

    The amendments: 1) change the 90-day period to 120 days for EMS personnel to complete all certification requirements after completion of training; 2) change the FBI background investigation requirements to require all persons who have not resided in Utah for the prior five years must have an FBI background investigation; 3) clarify that the Department may not lengthen the four-year certification; 4) change the number of times a person may take an EMS certification or recertification exam to three times; 5) clarify that if a person retakes the course because of a failure to pass the examinations, the individual must pass both the practical and written test after completion of the new course; 6) clarify when the new expiration date of a lapsed EMS person will be; 7) clarify that if an individual's certification has lapsed, the individual is not authorized to provide care; 8) eliminate the ability to request a review upon failing a third test; 9) clarify that an advanced level EMT must recertify before the EMT can be certified at a higher level; 10) clarify that an individual who fails an examination at a higher level, may request in writing that he be allowed to apply for a lower level; 11) standardize the rule language among the different EMT certification levels; 12) increase Training Officer and Course Coordinator certification from one year to two years; and 13) provide that if an individual's EMS certification lapses, the training officer, course coordinator and instructor certification automatically lapses.

    State statutory or constitutional authorization for this rule:

    Section 26-8a-302

    Anticipated cost or savings to:

    the state budget:

    The Bureau will collect approximately $3,200 a year less because of the change to two-year certification for training officers and course coordinators. This amount comes from 160 people that attend the courses per year, which will drop to approximately 80 per year. The cost is $40 per course. This fee pays for the course location, instructors, and travel. The Bureau may collect approximately an additional $2,625 by allowing EMS personnel who fail certification tests twice to take an additional test. This amount is approximately 55 people who will re-take the written test a third time, multiplied by $15 per written test and 60 who will re-take some portion of the practical test, at a charge of $30. The Bureau will collect an additional $40 for people who have previously been exempt from FBI checks. At the present time, these people (returned missionaries and military personnel), only have to have a criminal background name check which is $10. The additional $40 will come into the Bureau, but is a pass through to the Bureau of Criminal Identification, Department of Public Safety. This will probably bring in an additional $3,200, which is 80 people.

    local governments:

    There will be extra charges to local government for additional employees who will be subject to FBI checks. This may affect approximately 50 people per year and cost $40 per set of fingerprints, which is $2,000. Local agencies will save approximately $2,000 per year due to the two-year training officer/course coordinator certification cycle. This would be 50 people at $40 per year. Local agencies will have to pay for the additional third tests. About 25 of the 75 people who take a third written test would likely work for local government, so this would be a cost to them of $375. Recertifications do not take practical tests from the state, so if approximately 10 people who work for local government have to take the certification practical a third time, it would cost local government $300.

    other persons:

    There will be extra charges to people who must now submit to FBI checks. This may affect approximately 50 people, at an extra cost of $40 each, which is $2,000. Anyone who is training officer/course coordinator certified will save $40 every two years because they only have to recertify every two years instead of every year. Others would be allowed to take third tests and this would be approximately 30 people who would re-take the written or an additional cost of $450 and approximately 50 who will re-take the practical test at a charge of $30 for an additional cost of $1,500.

    Compliance costs for affected persons:

    If a person chooses to take a third test, he/she would pay an extra $15 for a written or $30 for the failed portion of a practical. It will cost a person (or his hiring agency) who was previously exempt from fingerprint checks an extra $40.

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

    These rule changes are supported by the EMS Committee and will bring consistency to the rules across the categories of certification. Applicants are given an additional opportunity to pass the required exam. Fiscal impact appears to be modest and justified. David N. Sundwall, MD, Executive Director

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

    Health
    Health Systems Improvement, Emergency Medical Services
    CANNON HEALTH BLDG
    288 N 1460 W
    SALT LAKE CITY UT 84116-3231

    Direct questions regarding this rule to:

    Leslie Johnson at the above address, by phone at 801-538-6292, by FAX at 801-538-6808, or by Internet E-mail at lesliejjohnson@utah.gov

    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:

    07/02/2007

    This rule may become effective on:

    07/09/2007

    Authorized by:

    David N. Sundwall, Executive Director

    RULE TEXT

    R426. Health, Health Systems Improvement, Emergency Medical Services.

    R426-12. Emergency Medical Services Training and Certification Standards.

    R426-12-100. Authority and Purpose.

    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 of individuals who provide emergency medical service and for those providing instructions and training to pre-hospital emergency medical care providers.

     

    R426-12-101. Written and Practical Test Requirements.

    (1) The Department shall:

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

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

    (2) The Department may administer the tests or delegate the administration of any test to another entity.

    (3) 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:

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

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

     

    R426-12-102. 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 certification to perform.

     

    R426-12-103. Certification at a Lower Level.

    (1) An individual who has taken an Emergency Medical Technician-Intermediate Advanced (EMT-IA) course, but has not been recommended for certification, may request to become certified at the Emergency Medical Technician-Intermediate (EMT-I) level if:

    (a) the EMT-IA course coordinator submits to the Department a favorable letter of recommendation stating that the individual has successfully obtained the knowledge and skills of the EMT-I level as required by R426-12-300(2); and

    (b) the individual successfully completes all requirements of R426-12-301, except for R426-12-301(2)(a).

    (2) An individual who has taken a Paramedic course, but has not been recommended for certification, may request to become certified at the EMT-IA or EMT-I 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 EMT-I level as required by R426-12-300(2) or the EMT-IA level as required by R426-12-400(2), as appropriate; and

    (b) the individual successfully completes all requirements of:

    (i) R426-12-301, except for R426-12-301(2)(a) for EMT-I; or

    (ii) R426-12-401, except for R426-12-401(2)(a) for EMT-IA respectively.

    [ (3) If an individual fails either the written or practical examinations and re-examinations for:

    (a) certification at the EMT-IA level, the individual may request to be certified at the EMT-I level if all requirements of R426-12-103(1) are met; and

    (b) certification at the Paramedic level, the individual may request to be certified at the EMT-IA or EMT-I level if all requirements of R426-12-103(2) are met.

    (4) An individual certified at the EMT-IA level may request in writing to the Department to recertify at the EMT-I or EMT-B level at the time of the individual's EMT-IA recertification. The individual must complete all requirements for recertification of EMT-I as required by R426-12-303 or EMT-B as required by R426-12-202.

    (5) An individual certified at the Paramedic level may request in writing to the Department to recertify at the EMT-IA, EMT-I, or Emergency Medical Technician-Basic (EMT-B) level at the time of the individual's recertification. The individual must complete all requirements of R426-12-403, R426-12-303, or R426-12-202 as appropriate.

    ]

    R426-12-200. Emergency Medical Technician-Basic (EMT-B) in Requirements and Scope of Practice.

    (1) The Department may certify as an EMT-B an individual who meets the initial certification requirements in R426-12-201.

    (2) The Committee adopts as the standard for EMT-Basic training and competency in the state, the following affective, cognitive and psychomotor objectives for patient care and treatment from the 1994 United States Department of Transportation's "EMT-Basic Training Program: National Standard Curriculum" (EMT-B Curriculum), which is incorporated by reference, with the exceptions of Module 8: Advanced Airway and Appendices C, D, J. and K.

    (3) An EMT-B may perform the skills as described in the EMT-B Curriculum, as adopted in this section.

     

    R426-12-201. EMT-B Initial Certification.

    (1) The Department may certify an EMT-B for a four year period.

    (2) An individual who wishes to become certified as an EMT-B must:

    (a) successfully complete a Department-approved EMT-B course as described in R426-12-200(2);

    (b) be able to perform the functions listed in the objectives of the EMT-B Curriculum adopted in R426-12-200(2) as verified by personal attestation and successful accomplishment during the course of all cognitive, affective, and psychomotor skills and objectives listed in the adopted EMT-B Curriculum;

    (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 EMT-B certification;

    (d) be 18 years of age or older;

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

    (f) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student, serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to an FBI background investigation;]

    (g) maintain and submit documentation of having completed within the prior two years a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    (h) submit to the Department a statement from a physician, confirming the applicant's results of a TB examination conducted within one year prior to completing the EMT-B course;

    (i) within [90]120 days after the official course end date the applicant must[completing the EMT-B course,] successfully complete the Department written and practical EMT-B examinations, or reexaminations, if necessary.

    (3) The Department may extend the time limit in Subsection (2)(i) for an individual who demonstrates that the inability to meet the requirements within the [90]120 days was due to circumstances 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.

     

    R426-12-202. EMT-B Certification Challenges.

    (1) The Department may certify as an EMT-B, a registered nurse 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 EMT-B Curriculum 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 and objectives listed in the EMT-B Curriculum;

    (b) has a knowledge of:

    (i) medical control protocols;

    (ii) state and local protocols; and

    (iii) the role and responsibilities of an EMT-B;

    (c) maintains and submits documentation of having completed within the prior two years, a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater; and

    (d) is 18 years of age or older.

    (2) To become certified, the applicant must:

    (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 EMT-B Curriculum.

    (c) submit [an]the applicable fees and a completed application, including social security number, signature, and[ documentation of compliance with this section], proof of current Utah license as a Registered Nurse, a Physician Assistant, or a Medical Doctor;[ and all required fees;]

    (d) within [90]120 days after submitting the challenge application, successfully complete the Department written and practical EMT-B examinations, or reexaminations, if necessary;

    (e) The Department may extend the time limit in Subsection (2)(i) for an individual who demonstrates that the inability to meet the requirements within 120 days was due to circumstances beyond the applicants 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.

    ([e]f) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years; [however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation; ]and

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

     

    R426-12-203. EMT-B Reciprocity.

    (1) The Department may certify an individual as an EMT-B an individual certified 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 in Utah based on out-of-state training and experience must:

    (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[one year] of submitting the application;

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to an FBI background investigation;]

    (c) maintain and submit documentation of having completed within the prior two years, a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    (d) submit a statement from a physician, confirming the applicant's results of a TB examination conducted within the prior year;

    (e) successfully complete the Department written and practical EMT-B examinations, or reexaminations, if necessary;

    (f) submit a current certification 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.

     

    R426-12-204. EMT-B Recertification Requirements.

    (1) The Department may recertify an EMT-B for a four year period or for a shorter period as modified by the Department to standardize recertification cycles.

    (2) An individual seeking recertification must:

    (a) [complete all EMT-B recertification requirements;

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

    ([c]b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    ([d]c) maintain and submit documentation of having completed within the prior two years, a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    ([e]d) submit a statement from the applicant's EMS provider organization or a physician, confirming the applicant's results of a TB examination; and

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

    ([g]f) provide documentation of completion of 100 hours of Department-approved CME meeting the requirements of subsections (3), (4), (5), (6), and (7).

    (3) The EMT-B must complete the CME throughout each of the prior four years.

    (4) The EMT-B must take at least 25 elective hours and the following 75 required CME hours by subject:

    (a) Well being of the EMT - 2 hours;

    (b) Infection Control - 2 hours;

    (c) Airway - 4 hours;

    (d) Patient Assessment - 10 hours;

    (e) Communications and Documentation - 4 hours;

    (f) Pharmacology and Patient Assisted Medications - 8 hours;

    (g) Medical Emergencies: Cardiac and Automatic External Defibrillation - 6 hours;

    (h) Medical Emergencies - 7 hours;

    (i) Trauma (must include simulated bleeding, shock, soft tissue, burns, kinetics, musculoskeletal, head and spine, eyes, face, chest, splinting and bandaging - 12 hours;

    (j) Pediatric Patients - 8 hours;

    (k) Obstetrics and Gynecology - 4 hours;

    (l) Operations (must include lifting and moving, ambulance operations, extrication, triage - 4 hours; and

    (m) HAZMAT awareness - 4 hours.

    (5) An EMT-B may complete CME hours through the methodologies listed in this subsection. All CME must be related to the required skills and knowledge of an EMT. Instructors need not be EMS instructors, but must be knowledgeable in the field of instruction. Limitations and special requirements are listed with each methodology.

    (a) Workshops and seminars related to the required skills and knowledge of an EMT and approved for CME credit by the Department or the Continuing Education Coordinating Board for EMS (CECBEMS).

    (b) Local medical training meetings.

    (c) Demonstration or practice sessions.

    (d) Medical training meetings where a guest speaker presents material related to emergency medical care.

    (e) Actual hours the EMT-B is involved in community emergency exercise and disaster drills. Up to 20 hours are creditable during a recertification period for participation in exercises and drills.

    (f) Teaching the general public (schools, scouts, clubs, or church groups) on any topic within the scope of the EMT-B practice. Up to 15 hours are creditable during a certification period for teaching classes.

    (g) Viewing audiovisuals (films, videotapes, etc.) which illustrate and review proper emergency care procedures. The EMT-B must view the audiovisual material in the presence of a training officer. Up to 10 hours are creditable during a certification period using audiovisuals.

    (h) Completing college courses in topics such as biology, chemistry, anatomy and physiology. Other college courses relating to the scope and practice of an EMT-B may be creditable, but only with the approval of the Department. If in doubt, the EMT-B should contact the Department. Up to 10 hours are creditable during a certification period for college courses.

    (i) Up to 16 hours of CPR training are creditable during a certification period.

    (j) Computer and internet-based training that illustrates, drills, provides interactive use, or demonstrates proper emergency care procedures. The training must be approved by the [Continuing Education Coordinating Board of Emergency Medical Services]CECBEMS or the Department. Up to 25 hours are creditable during a certification period using computer and internet-based training.

    (k) Completing tests related to the EMT-B scope of practice in EMS-related journals or publications. Up to [5]five hours are creditable during a certification period for completing tests from journals and publications.

    (6) The EMT-B must complete the following skills at least two times as part of the CME training listed in subsections (4) and (5):

    (a) bandaging of the arm, elbow, shoulder, neck, top of head, cheek, protruding eye, ear, and open chest wound;

    (b) splinting using hare traction or sager splint (choice based upon availability of equipment);

    (c) splinting of at least one upper and lower extremity;

    (d) cervical and spinal immobilization using c-collar, long board, head stabilization equipment (utilize available equipment) and straps;

    (e) patient assisted medications: nitroglycerin, pre-loaded epinephrine, inhaler, glucose, activated charcoal, and aspirin;

    (f) pediatric immobilization: in a car seat and backboard;

    (g) insertion of nasopharyngeal and oropharyngeal airways; and

    (h) defibrillation of a simulated patient in cardiac arrest using an AED.

    (7) An EMT-B who is affiliated with an EMS organization should have the training officer from the EMS organization submit a letter verifying the EMT-B's completion of the recertification requirements. An EMT-B who is not affiliated with an agency must submit verification of all recertification requirements directly to the Department.

    (8) Each EMT-B is individually responsible to complete and submit the required recertification material to the Department. Each EMT-B should submit all recertification materials to the Department at one time, no later than 30 days and no earlier than one year prior to the EMT-B's current certification expiration date. 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 material in the order received.

    (9) An EMS provider or an entity that provides CME may compile and submit recertification materials on behalf of an EMT-B; however, the EMT-B remains responsible for a timely and complete submission.

    ([9]10) The Department may shorten recertification periods. An EMT-B whose recertification period is shortened must meet the CME requirements in each of the required and elective subdivisions on a prorated basis by the expiration of the shortened period.

    (11) The Department may not lengthen certification periods more than the four year 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 expired. If this happens, the individual shall recertify in accordance with Utah Code 39-1-64.

     

    R426-12-205. EMT-B Lapsed Certification.

    (1) An individual whose EMT-B certification has expired for less than one year may, within one year after expiration, complete all recertification requirements and pay a late recertification fee to become certified. The individual's new expiration date will be four years from the old expiration date.

    (2) An individual whose certification has expired for more than one year must take an EMT-B course and reapply [as if there were no prior]for initial certification.

    (3) An individual whose certification has lapsed, is not authorized to provide care as an EMT until the individual completes the recertification process.

     

    R426-12-206. EMT-B Testing Failures.

    (1) An individual who fails any part of the EMT-B certification or recertification written or practical examination may retake the EMT-B examination [once]twice without further course work.

    ([a]2) If the individual fails [on the]both [re-examination]re-examinations, he must take a complete EMT-B training course to be eligible for further examination.

    ([b]3) The individual may retake the course as many times as he desires, but may only take the examinations [twice]three times for each completed course. If an individual retakes the course because of failure to pass the examinations, the individual must pass both the practical and written test administered after completion of the new course.

    [ (2) If an EMT-B fails the written or practical recertification examination after two attempts, he may, within 30 days following mailing of written notification of this second failure, submit a written request to take the test a third time.

    (3) Within 30 days of receipt of the request, the Department shall convene a review panel consisting of

    (a) the training officer of the individual's EMS provider organization or a certified EMS training officer or certified EMS instructor who would mentor a remediation plan; and

    (b) one or more representatives from the Department.

    (4) The review panel shall allow the individual to appear and provide information.

    (5) The Department shall determine whether a program of re-education and reexamination would likely result in successful completion of the examinations and shall recommend a course of action to the Department.

    (6) The Department shall consider the review panel's recommendation and provide one opportunity for reexamination if it determines that re-education and reexamination within that time would likely result in successful completion of the examinations.

    (7) If the Department does not allow the third examination, the EMT-B may file a request for agency action within 30 days of issuance of the Department's determination.

    ]

    R426-12-300. Emergency Medical Technician-Intermediate (EMT-I) Requirements and Scope of Practice.

    (1) The Department may certify [an EMT-B ]as an EMT-I, an EMT-B who:

    (a) meets the initial certification requirements in R426-12-301; and

    (b) has 12 months of field experience as a certified EMT-B, six months of which the Department may waive upon a written request from the off-line medical director showing that there is a shortage of EMT-Is to serve the area.

    (2) The Committee adopts as the standard for EMT-I training and competency in the state the following affective, cognitive, and psychomotor objectives for patient care and treatment from the 1998 United States Department of Transportation's "Emergency Medical Technician-Intermediate Training Program: National Standard Curriculum" (EMT-I Curriculum): 1-1, 1-3, 1-4, 2-1, 3-2, 3-3, 3-5, 4-2, 5-1, 5-2, 5-3, 5-4, 5-5, 6-3, which is incorporated by reference, with the exception of the following objectives : 1-1.18-24, 1-1.54, 1-3.14-15, 1-3.17, 1-4.18, 1-4.24-25, 1-4.38, 2-1.7-8, 2-1.21, 2-1.33, 2-1.82-83, 2-1.92, 2-1.94, 2-1.96, 4-2.14-16, 5-1.3-5, 5-2.6-11, 5-2.13-14, 5-2.16-18, 5-2.20, 5-2.22-33, 5-2.39, 5-2.41, 5-2.44-46, 5-3.5-16, 5-4.3-5, 5-4.8-11, 5-5.3, 5-5.8-9, and 5-5.13,

    (3) In addition to the skills that an EMT-B may perform, an EMT-I may perform the adopted skills described in section R426-12-300(2).

     

    R426-12-301. EMT-I Initial Certification.

    (1) The Department may certify an EMT-I for a four year period.

    (2) An individual who wishes to become certified as an EMT-I must:

    (a) successfully complete a Department-approved EMT-I course as described in R426-12-300(2);

    (b) be able to perform the functions listed in the objectives of the EMT-I Curriculum adopted in R426-12-300(2) as verified by personal attestation and successful accomplishment during the course of all cognitive, affective, and psychomotor skills and objectives.

    (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 EMT-I certification;

    (d) be currently certified as an EMT-B;

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

    (f) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (g) maintain and submit documentation of having completed within the prior two years a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    (h) submit to the Department a statement from a physician, confirming the applicant's results of a TB examination conducted within one year prior to completing the EMT-I course; and

    (i) within [90]120 days after [completing the EMT-I course]the official course end date the applicant must, successfully complete the Department written and practical EMT-I examinations, or reexaminations, if necessary.

    (3) The Department may extend the time limit in Subsection (2)(i) for an individual who demonstrates that the inability to meet the requirements within the [90]120 days was due to circumstances 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.

    (4) If an individual's basic EMT certification lapses before he has completed all course requirements for an EMT-I, the individual must recertify as an EMT-B, including a practical test and CME documentation, before he can certify as an EMT-I. The individual may take the EMT-I written certification test to satisfy the written EMT-Basic recertification and EMT-I written certification requirements.

     

    R426-12-302. EMT-I Reciprocity.

    (1) The Department may certify as an EMT-I an individual certified 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 to than what is required in Utah.

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

    (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[one year] of submitting the application;

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) maintain and submit documentation of having completed within the prior two years, a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    (d) submit a statement from a physician, confirming the applicant's results of a TB examination conducted within the prior year;

    (e) successfully complete the Department written and practical examinations, or reexaminations, if necessary;

    (f) submit a current certification 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;

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

     

    R426-12-303. EMT-I Recertification Requirements.

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

    (2) An individual seeking recertification must:

    (a) [complete all EMT-I recertification requirements;

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

    ([c]b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    ([d]c) maintain and submit documentation of having completed within the prior two years, a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    ([e]d) submit a statement from the EMS provider organization or a physician, confirming the applicant's results of a TB examination

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

    ([g]f) submit a letter from a certified [the ]off-line medical director recommending the individual for recertification and verifying the individual's demonstrated proficiency in the following EMT-I skills:

    (i) initiating and terminating intravenous infusion;

    (ii) completion of pediatric vascular access skills station;

    (iii) insertion and removal of intraosseous needle;

    (iv) insertion and removal of endotracheal tube;

    (v) administration of medications via intramuscular, subcutaneous, and intravenous routes; and

    (vi) EKG rhythm recognition; and

    ([h]g) provide documentation of completion of 100 hours of Department-approved CME meeting the requirements of subsections (3), (4), (5), (6), (7) and (8).

    (3) The EMT-I must complete the CME throughout each of the prior four years.

    (4) The EMT-I must take at least 25 elective hours and the following 75 required CME hours by subject:

    (a) Foundations of EMT-Intermediate - 4 hours;

    (b) Pharmacology - 5;

    (c) Venous Access and Medication Administration - 5 hours;

    (d) Airway - 8 hours;

    (e) Techniques of Physical Examination - 4 hours;

    (f) Patient Assessment - 2 hours;

    (g) Clinical Decision Making - 4 hours

    (h) Trauma Systems and Mechanism of Injury - 3 hours;

    (i) Hemorrhage and Shock - 4 hours;

    (j) Burns - 3 hours;

    (k) Thoracic Trauma - 3 hours;

    (l) Respiratory - 2 hours;

    (m) Cardiac - 6 hours;

    (n) Diabetic - 2 hours;

    (o) Allergic Reactions - 2 hours;

    (p) Poisoning - 2 hours;

    (q) Environmental Emergencies - 2 hours;

    (r) Gynecology - 2 hours;

    (s) Obstetrics - 2 hours;

    (t) Neonatal resuscitation - 4 hours; and

    (u) Pediatrics - 6 hours.

    (5) The Department strongly suggests that the 25 elective hours be in the following topics:

    (a) Anatomy and Physiology;

    (b) Assessment Based Management;

    (c) Behavioral Emergencies;

    (d) Communication;

    (e) Documentation;

    (f) Geriatrics;

    (g) HAZMAT;

    (h) History Taking;

    (i) Mass Casualty Incident;

    (j) Medical Incident Command;

    (k) Neurological Emergencies;

    (l) Non-Traumatic Abdominal Emergencies; and

    (m) Trauma Practical Lab.

    (6) An EMT-I may complete CME hours through the methodologies listed in this subsection. All CME must be related to the required skills and knowledge of an EMT. Instructors need not be EMS instructors, but must be knowledgeable in the field of instruction. Limitations and special requirements are listed with each methodology.

    (a) Workshops and seminars related to the required skills and knowledge of an EMT and approved for CME credit by the Department or the CECBEMS.

    (b) Local medical training meetings.

    (c) Demonstration or practice sessions.

    (d) Medical training meetings where a guest speaker presents material related to emergency medical care.

    (e) Actual hours the EMT-I is involved in community emergency exercise and disaster drills. Up to 20 hours are creditable during a recertification period for participation in exercises and drills.

    (f) Teaching the general public (schools, scouts, clubs, or church groups) on any topic within the scope of the EMT-I practice. Up to 15 hours are creditable during a certification period for teaching classes.

    (g) Viewing audiovisuals (films, videotapes, etc.) which illustrate and review proper emergency care procedures. The EMT-I must view the audiovisual material in the presence of a training officer. Up to 10 hours are creditable during a certification period using audiovisuals.

    (h) Completing college courses in topics such as biology, chemistry, anatomy and physiology. Other college courses relating to the scope and practice of an EMT-I may be creditable, but only with the approval of the Department. If in doubt, the EMT-I should contact the Department. Up to 10 hours are creditable during a certification period for college courses.

    (i) Up to 16 hours of CPR training are creditable during a certification period.

    (j) Computer and internet-based training that illustrates, drills, provides interactive use, or demonstrates proper emergency care procedures. The training must be approved by the [Continuing Education Coordinating Board of Emergency Medical Services]CECBEMS or the Department. Up to 25 hours are creditable during a certification period using computer and internet-based training.

    (k) Completing tests related to the EMT-I scope of practice in EMS-related journals or publications. Up to [5]five hours are creditable during a certification period for completing tests from journals and publications.

    (7) The EMT-I must complete the following skills at least two times as part of the CME training listed in subsections (4) and (6):

    (a) bandaging of the arm, elbow, shoulder, neck, top of head, cheek, protruding eye, ear, and open chest wound;

    (b) splinting using hare traction or sager splint (choice based upon availability of equipment);

    (c) splinting of at least one upper and lower extremity;

    (d) cervical and spinal immobilization using c-collar, long board, head stabilization equipment (utilize available equipment) and straps;

    (e) patient assisted medications: nitroglycerin, pre-loaded epinephrine, inhaler, glucose, activated charcoal, and aspirin;

    (f) pediatric immobilization: in a car seat and backboard;

    (g) insertion of nasopharyngeal and oropharyngeal airways; and

    (h) defibrillation of a simulated patient in cardiac arrest using an AED.

    (8) An EMT-I who is affiliated with an EMS organization should have the training officer from the EMS organization submit a letter verifying the EMT-I's completion of the recertification requirements. An EMT-I who is not affiliated with an agency must submit verification of all recertification requirements directly to the Department.

    (9) Each EMT-I is individually responsible to complete and submit the required recertification material to the Department. Each EMT-I should submit all recertification materials to the Department at one time, no later than 30 days and no earlier than one year prior to the EMT-I's current certification expiration date. 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 material in the order received.

    (10) An EMS provider or an entity that provides CME may compile and submit recertification materials on behalf of an EMT-I; however, the EMT-I remains responsible for a timely and complete submission.

    [(10)](11) The Department may shorten recertification periods. An EMT-I whose recertification period is shortened must meet the CME requirements in each of the required and elective subdivisions on a prorated basis by the expiration of the shortened period.

    (12) The Department may not lengthen recertification periods more than the four year 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 expires. If this happens, the individual shall recertify following Utah Code 39-1-64.

     

    R426-12-304. EMT-I Lapsed Certification.

    (1) An individual whose EMT-I certification has expired for less than one year, may, within one year after expiration, complete all recertification requirements and pay a late recertification fee to become certified. The individual's new expiration date will be four years from the individual's old expiration date.

    (2) An individual whose certification has expired for more than one year must take the EMT-B and EMT-I courses and reapply [as if there were no prior]for initial certification.

    (3) An individual whose certification has lapsed, is not authorized to provide care as an EMT-I until the individual completes the recertification process.

     

    R426-12-305. EMT-I Testing Failures.

    (1) An individual who fails any part of the EMT-I certification or recertification written or practical examination may retake the EMT-I examination [once]twice without further course work.

    (2) If the individual fails both re-examinations, he must take a complete EMT-I training course to be eligible for further examination.

    ([a]3) The individual may retake the course as many times as he desires, but may only take the examinations [twice]three times for each completed course. If an individual retakes the course because of failure to pass the examinations, the individual must pass both the practical and written test administered after completion of the new course.

    [ (2) If an EMT-I fails the written or practical recertification examination after two attempts, he may, within 30 days following mailing of written notification of this second failure, submit a written request to take the test a third time.

    (3) Within 30 days of receipt of the request, the Department shall convene a review panel consisting of:

    (a) the training officer of the individual's EMS provider organization or a certified EMS training officer or certified EMS instructor who would mentor a remediation plan; and

    (b) one or more representatives from the Department.

    (4) The review panel shall allow the individual to appear and provide information.

    (5) The Department shall determine whether a program of re-education and reexamination would likely result in successful completion of the examinations and shall recommend a course of action to the Department.

    (6) The Department shall consider the review panel's recommendation and provide one opportunity for reexamination if it determines that re-education and reexamination within that time would likely result in successful completion of the examinations.

    (7) If the Department does not allow the third examination, the EMT-I may file a request for agency action within 30 days of issuance of the Department's determination.

    ] (4) If an EMT-I fails the recertification written or practical tests three times, he may request in writing, within 30 days of the date of the third failure notification letter, that he be allowed to apply for EMT-Basic recertification. If he applies for EMT-Basic recertification in this circumstance, he has three opportunities to test to that level. He has 120 days from the date of his request to complete recertification requirements at the EMT-Basic level.

     

    R426-12-400. Emergency Medical Technician-Intermediate Advanced (EMT-IA) Requirements and Scope of Practice.

    (1) The Department may certify as an EMT-IA, an EMT-B or an EMT-I [as an EMT-IA] who:

    (a) meets the initial certification requirements in R426-12-401; and

    (b) has 12 months of field experience as a certified EMT-B or EMT-I, six months of which the Department may waive upon a written request from the off-line medical director showing that there is a shortage of EMT-IAs to serve the area.

    (2) The Committee adopts as the standard for EMT-IA training and competency in the state the following affective, cognitive, and psychomotor objectives for patient care and treatment from the 1998 United States Department of Transportation's "Emergency Medical Technician-Intermediate Training Program: National Standard Curriculum" (EMT-I Curriculum) which is incorporated by reference, with the exception of the following objectives: 1-1.18-24,1-1.54,2-1.8, 2-1.31(f), 2-1.33, 2-1.75(c), (e), and (f), 6-3.1, 6-3.102-106.

    (3) In addition to the skills that an EMT-B and an EMT-I may perform, an EMT-IA may perform the adopted skills described in section R426-12-400(2).

     

    R426-12-401. EMT-IA Initial Certification.

    (1) The Department may certify an EMT-IA for a four-year period.

    (2) An individual who wishes to become certified as an EMT-IA must:

    (a) successfully complete a Department-approved EMT-IA course as described in R426-12-400(2);

    (b) be able to perform the functions listed in the objectives of the EMT-I Curriculum adopted in R426-12-400(2) as verified by personal attestation and successful accomplishment during the course of all cognitive, affective, and psychomotor skills and objectives;

    (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 EMT-IA certification;

    (d) be currently certified as an EMT-B or EMT-I;

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

    (f) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (g) maintain and submit verification of completion of a Department-approved course in adult and pediatric advanced cardiac life support and maintain current status as set by the entity sponsoring the course;

    (h) submit a statement from a physician, confirming the applicant's results of a TB examination conducted within the prior year; and

    (i) within [90]120 days after [completing the EMT-IA course]the official course end, the applicant must, successfully complete the Department written and practical EMT-IA examinations, or reexaminations, if necessary;

    (3) The Department may extend the time limit in Subsection (2)(i) for an individual who demonstrates that the inability to meet the requirements within the [90]120 days was due to circumstances 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.

    (4) If an individual's basic EMT or intermediate EMT certification lapses before he has completed all course requirements for an EMT-IA, the individual must recertify at his current certification level, including a practical test and CME documentation, before he can certify as an EMT-IA. The individual may take the EMT-IA written certification test to satisfy the written EMT-Basic or EMT-Intermediate recertification and EMT-IA written certification requirements.

     

    R426-12-402. EMT-IA Reciprocity.

    (1) The Department may certify as an EMT-IA an individual certified 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 in Utah based on out-of-state training and experience must:

    (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[one year] of submitting the application;

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) maintain and submit verification of completion of a Department-approved course in adult and pediatric advanced cardiac life support and maintain current status as set by the entity sponsoring the course;

    (d) submit a statement from a physician, confirming the applicant's results of a TB examination conducted within the prior year;

    (e) successfully complete the Department written and practical EMT-IA examinations, or reexaminations, if necessary;

    (f) submit a current certification 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.

     

    R426-12-403. EMT-IA Recertification Requirements.

    (1) The Department may recertify an EMT-IA for a four year period or for a shorter period as modified by the Department to standardize recertification cycles.

    (2) An individual seeking recertification must:

    (a) [complete all EMT-IA recertification requirements;

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

    ([c]b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    ([d]c) maintain and submit verification of completion of a Department-approved course in adult and pediatric advanced cardiac life support and maintain current status as set by the entity sponsoring the course;

    ([e]d) submit a statement from the applicant's EMS provider organization or a physician, confirming the applicant's results of a TB examination;

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

    ([g]f) submit a letter from a certified off-line medical director recommending the individual for recertification and verifying the individual's demonstrated proficiency in the following EMT-IA skills:

    (i) initiating and terminating intravenous infusion;

    (ii) completion of pediatric vascular access skills station;

    (iii) insertion and removal of intraosseous needle;

    (iv) insertion and removal of endotracheal tube;

    (v) administration of medications via intramuscular, subcutaneous, and intravenous routes; and

    (vi) EKG rhythm recognition; and

    ([h]g) provide documentation of completion of 100 hours of Department-approved CME meeting the requirements of subsections (3), (4), (5), (6), (7) and (8).

    (3) The EMT-IA must [have ]complete[d] the CME throughout each of the prior four years.

    (4) The EMT-IA must have taken at least 25 elective hours and the following 75 required CME hours by subject:

    (a) Foundations of EMT-Intermediate - 4 hours;

    (b) Pharmacology - 5;

    (c) Venous Access and Medication Administration - 5 hours;

    (d) Airway - 8 hours;

    (e) Techniques of Physical Examination - 4 hours;

    (f) Patient Assessment - 2 hours;

    (g) Clinical Decision Making - 4 hours

    (h) Trauma Systems and Mechanism of Injury - 3 hours;

    (i) Hemorrhage and Shock - 4 hours;

    (j) Burns - 3 hours;

    (k) Thoracic Trauma - 3 hours;

    (l) Respiratory - 2 hours;

    (m) Cardiac - 6 hours;

    (n) Diabetic - 2 hours;

    (o) Allergic Reactions - 2 hours;

    (p) Poisoning - 2 hours;

    (q) Environmental Emergencies - 2 hours;

    (r) Gynecology - 2 hours;

    (s) Obstetrics - 2 hours;

    (t) Neonatal resuscitation - 4 hours; and

    (u) Pediatrics - 6 hours.

    (5) The Department strongly suggests that the 25 elective hours be in the following topics:

    (a) Anatomy and Physiology;

    (b) Assessment Based Management;

    (c) Behavioral Emergencies;

    (d) Communication;

    (e) Documentation;

    (f) Geriatrics;

    (g) HAZMAT;

    (h) History Taking;

    (i) Mass Casualty Incident;

    (j) Medical Incident Command;

    (k) Neurological Emergencies;

    (l) Non-Traumatic Abdominal Emergencies; and

    (m) Trauma Practical Lab.

    (6) An EMT-IA may complete CME hours through the methodologies listed in this subsection. All CME must be related to the required skills and knowledge of an EMT-IA. Instructors need not be EMS instructors, but must be knowledgeable in the field of instruction. Limitations and special requirements are listed with each methodology.

    (a) Workshops and seminars related to the required skills and knowledge of an EMT-IA and approved for CME credit by the Department or the CECBEMS.

    (b) Local medical training meetings.

    (c) Demonstration or practice sessions.

    (d) Medical training meetings where a guest speaker presents material related to emergency medical care.

    (e) Actual hours the EMT-IA is involved in community emergency exercise and disaster drills. Up to 20 hours are creditable during a recertification period for participation in exercises and drills.

    (f) Teaching the general public (schools, scouts, clubs, or church groups) on any topic within the scope of the EMT-IA practice. Up to 15 hours are creditable during a certification period for teaching classes.

    (g) Viewing audiovisuals (films, videotapes, etc.) which illustrate and review proper emergency care procedures. The EMT-IA must view the audiovisual material in the presence of a training officer. Up to 10 hours are creditable during a certification period using audiovisuals.

    (h) Completing college courses in topics such as biology, chemistry, anatomy and physiology. Other college courses relating to the scope and practice of an EMT-IA may be creditable, but only with the approval of the Department. If in doubt, the EMT-IA should contact the Department. Up to 10 hours are creditable during a certification period for college courses.

    (i) Up to 16 hours of CPR training are creditable during a certification period.

    (j) Computer and internet-based training that illustrates, drills, provides interactive use, or demonstrates proper emergency care procedures. The training must be approved by the CECBEMS or the Department. Up to 25 hours are creditable during a certification period using computer and internet-based training.

    (k) Completing tests related to the EMT-IA scope of practice in EMS-related journals or publications. Up to [5]five hours are creditable during a certification period for completing tests from journals and publications.

    (7) The EMT-IA must complete the following skills at least two times as part of the CME training listed in subsections (4) and (6):

    (a) bandaging of the arm, elbow, shoulder, neck, top of head, cheek, protruding eye, ear, and open chest wound;

    (b) splinting using hare traction or sager splint (choice based upon availability of equipment);

    (c) splinting of at least one upper and lower extremity;

    (d) cervical and spinal immobilization using c-collar, long board, head stabilization equipment (utilize available equipment) and straps;

    (e) patient-assisted medications: nitroglycerin, pre-loaded epinephrine, inhaler, glucose, activated charcoal, and aspirin;

    (f) pediatric immobilization: in a car seat and backboard;

    (g) insertion of nasopharyngeal and oropharyngeal airways; and

    (h) initiating and terminating intravenous infusion;

    (i) completion of pediatric vascular access skills station;

    (j) insertion and removal of intraosseous needle;

    (k) insertion and removal of endotracheal tube;

    (l) administration of medications via intramuscular, subcutaneous, and intravenous routes;

    (m) transcutaneous pacing;

    (n) synchronized cardioversion;

    (o) insertion and removal of a nasal gastric tube;

    (p) external jugular vein cannulation;

    (q) needle decompression of a chest;

    (r) administration of the following medications: adenosine, activated charcoal, aspirin, atropine, albuterol, D50, diazepam, epinephrine 1:1000, epinephrine 1:10,000, furosemide, lidocaine, morphine, naloxone, and nitroglycerin; and;

    (s) EKG rhythm recognition of the following rhythms: ventricular fibrillation, ventricular tachycardia, atrial flutter, atrial fibrillation, sinus tachycardia, paroxysmal supraventricular tachycardia, pulseless electrical activity, asystole, premature ventricular contraction, atrioventricular blocks:1st degree, 2nd degree types I and II, and 3rd degree.

    (8) An EMT-IA who is affiliated with an EMS organization should have the training officer from the EMS organization submit a letter verifying the EMT-IA's completion of the recertification requirements. An EMT-I who is not affiliated with an agency must submit verification of all recertification requirements directly to the Department.

    (9) Each EMT-IA is individually responsible to complete and submit the required recertification material to the Department. Each EMT-IA should submit all recertification materials to the Department at one time, no later than 30 days and no earlier than one year prior to the EMT-IA's current certification expiration date. 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 material in the order received.

    (10) An EMS provider or an entity that provides CME may compile and submit recertification materials on behalf of an EMT-IA; however, the EMT-IA remains responsible for a timely and complete submission.

    ([10]11) The Department may shorten recertification periods. An EMT-IA whose recertification period is shortened must meet the CME requirements in each of the required and elective subdivisions on a prorated basis by the expiration of the shortened period.

    (12) The Department may not lengthen recertification periods more than the four year 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 expires. If this happens, the individual shall recertify following Utah Code 39-1-64.

     

    R426-12-404. EMT-IA Lapsed Certification.

    (1) An individual whose EMT-IA certification has lapsed for less than one year, and who wishes to become recertified as an EMT-IA must complete all recertification requirements and pay a recertification late fee to become certified. The individual's new expiration date will be four years from the old expiration date.

    (2) An individual whose EMT-IA certification has expired for more than one year, and who wishes to become recertified as a EMT-IA must:

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

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) submit to the Department evidence of having completed 100 hours of Department-approved continuing medical education within the prior four years following R426-12-403 EMT-IA Recertification Requirements;

    (d) submit a statement from a physician, confirming the applicant's results of a TB examination;

    (e) submit verification of current completion of a Department-approved course in adult and pediatric advanced life support;

    (f) submit a letter of recommendation including results of an oral examination, from a certified off-line medical director, verifying proficiency in [paramedic]EMT-IA skills;

    (g) successfully complete the applicable Department written and practical examinations; and

    (h) pay all applicable fees.

    (3) The individual's new expiration date will be four years from the completion of all recertification materials.

    (4) An Individual whose certification has lapsed is not authorized to provide care as an EMT-IA until the individual completes the recertification process.

     

    R426-12-405. EMT-IA Testing Failures.

    (1) [If a]An individual who fails any part of the EMT-IA[the] written or practical certification or recertification examination may retake the EMT-IA examination twice without further course work.[ after two attempts, he may, within 30 days following mailing of written notification of this second failure, submit a written request to take the test a third time.]

    (2) If the individual fails on both re-examinations, he must take a complete EMT-IA training course to be eligible for further examination at the EMT-IA level.[Within thirty days of receipt of the request, the Department shall convene a review panel consisting of:

    (a) the chairman of the Paramedic Advisory Sub-Committee;

    (b) the off-line medical director for the individual's EMS provider organization or a certified EMS training officer or certified EMS instructor who would mentor a remediation plan; and

    (c) one or more representatives from the Department; and

    (3) The review panel shall allow the individual to appear and provide information.

    (4) The panel shall review whether a program of re-education and reexamination would likely result in successful completion of the examinations and shall recommend a course of action to the Department.

    (5) The Department shall consider the review panel's recommendation and provide one opportunity for reexamination if it determines that re-education and reexamination within that time would likely result in successful completion of the examinations.

    (6) If the Department does not allow the third examination, the EMT-IA may file a request for agency action within 30 days of issuance of the Department's determination.]

    (3) The individual may retake the course as many times as he desires, 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 must pass both the practical and written tests administered after completion of the new course.

    (4) If an EMT-IA fails the recertification written or practical test three times, he may request in writing, within 30 days of the date of the third failure notification letter, that he be allowed to apply for EMT-I or EMT-B recertification. He has 120 days from the date of his request to complete recertification requirements at a lower level.

     

    R426-12-500. Paramedic Requirements and Scope of Practice.

    (1) The Department may certify as a paramedic, an EMT-B, an EMT-I or an EMT-IA [as a paramedic] who:

    (a) meets the initial certification requirements in R426-12-501; and

    (b) has 12 months of field experience as a certified EMT-B, EMT-I or EMT-IA, six months of which the Department may waive upon a written request from the off-line medical director showing that there is a shortage of paramedics to serve the area[, and];

    (2) The Committee adopts as the standard for paramedic training and competency in the state the following affective, cognitive and psychomotor objectives for patient care and treatment from the 1998 United States Department of Transportation's "EMT-Paramedic Training Program: National Standard Curriculum" (Paramedic Curriculum) which is incorporated by reference.

    (3) In addition to the skills that an EMT-B, an EMT-I and an EMT-IA may perform, a Paramedic may perform the adopted skills described in section R426-12-500(2).

     

    R426-12-501. Paramedic Initial Certification.

    (1) The Department may certify a paramedic for a four year period.

    (2) An individual who wishes to become certified must:

    (a) successfully complete a Department-approved Paramedic course as described in R426-12-500(2);

    (b) be able to perform the functions listed in the objectives of the Paramedic Curriculum adopted in R426-12-500(2) as verified by personal attestation and successful accomplishment during the course of all cognitive, affective, and psychomotor skills and objectives;

    (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 paramedic certification;

    (d) be currently certified as an EMT-B, EMT-I, or EMT-IA;

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

    (f) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (g) maintain and submit verification of completion of a Department-approved course in adult and pediatric advanced cardiac life support and maintain current status as set by the entity sponsoring the course;

    (h) submit [to the Department ]a statement from a physician, confirming the applicant's results of a TB examination conducted within [one year]the prior [to completing the paramedic course]year; and

    (i) within [90]120 days after [completing the paramedic course]the official end date, the applicant must, successfully complete the Department written and practical paramedic examinations, or reexaminations, if necessary.

    (3) The Department may extend the time limit in Subsection (2)(i) for an individual who demonstrates that the inability to meet the requirements within the [90]120 days was due to circumstances 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.

    (4) If an individuals EMT-B, EMT-I, or EMT-IA certification lapses before he has completed all course requirements for a paramedic, the individual must recertify at his current certification level, including a practical test and CME documentation, before he can be certified as a paramedic. The individual may take the paramedic written test to satisfy the written EMT-Basic, EMT-Intermediate, or EMT-Intermediate Advanced recertification and paramedic written certification requirements.

     

    R426-12-502. Paramedic Reciprocity.

    (1) The Department may certify as a Paramedic an individual certified 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 [to ]than what is required in Utah.

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

    (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[one year] of submitting the application;

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) maintain and submit verification of completion of a Department-approved course in adult and pediatric advanced cardiac life support and maintain current status as set by the entity sponsoring the course;

    (d) submit a statement from a physician, confirming the applicant's results of a TB examination conducted within the prior year;

    (e) successfully complete the Department written and practical [EMT-I]Paramedic examinations, or reexaminations, if necessary;

    (f) submit a current certification 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.

     

    R426-12-503. Paramedic Recertification Requirements.

    (1) The Department may recertify a paramedic for a four year period or for a shorter period as modified by the Department to standardize recertification cycles.

    (2) An individual seeking recertification must:

    (a) [complete all paramedic recertification requirements;

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

    ([c]b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    ([d]c) maintain and submit verification of completion of a[current] Department-approved course [completion ]in Adult and Pediatric Advanced Cardiac Life Support;

    ([e]d) submit a statement from the applicant's EMS provider organization or a physician, confirming the applicant's results of a TB examination;

    ([f]e) successfully complete the applicable Department paramedic recertification examinations, or reexaminations if necessary, within one year prior to expiration[ of the certification to be renewed];

    (g) submit a letter from a certified off-line medical director recommending the individual for recertification and verifying the individual's demonstrated proficiency in the following paramedic skills; and

    (h) provide documentation of completion of 100 hours of Department-approved CME meeting the requirements of subsections (3), (4), (5), (6), (7), and (8).

    (3) The Paramedic must complete the CME throughout each of the prior four years.

    (4) The Paramedic must take at least 20 elective hours and the following 80 required CME hours by subject:

    (a) EMS system roles and responsibilities - 2 hours;

    (b) Well being of the paramedic - 2 hours;

    (c) Pathophysiology - 1 hour;

    (d) Medical legal - 1 hour;

    (e) Pharmacology - 1 hour;

    (f) Venous access and medication administration - 1 hour;

    (g) Airway management and ventilation - 5 hours;

    (h) Patient assessment - 3 hours;

    (i) Communication - 1 hour;

    (j) Documentation - 1 hour;

    (k) Trauma Systems and Mechanism of injury - 1 hour;

    (l) Hemorrhage and shock - 2 hours;

    (m) Burns - 3 hours;

    (n) Head and facial - 3 hours;

    (o) Spinal trauma - 1 hour;

    (p) Thoracic trauma - 2 hours;

    (q) Abdominal trauma - 2 hours;

    (r) Pulmonary - 1 hour;

    (s) Cardiology - 9 hours;

    (t) Neurology - 4 hours;

    (u) Endocrinology - 3 hours;

    (v) Allergies and anaphylaxis - 1 hour;

    (w) Gastroenterology - 4 hours;

    (x) Toxicology - 2 hours;

    (y) Environmental emergencies - 4 hours;

    (z) Infectious and communicable diseases - 3 hours;

    (aa) Behavioral/psychiatric disorders - 1 hour;

    (bb) Obstetrics and gynecology - 2 hours;

    (cc) Neonatology - 3 hours;

    (dd) Pediatrics - 5 hours;

    (ee) Geriatrics - 2 hours;

    (ff) Assessment based management - 1 hour;

    (gg) Medical incident command - 2 hours; and

    (hh) Hazardous materials incidents - 1 hour;

    (5) The Department strongly suggests that the [25]20

    elective hours be in the following topics:

    (a) Ethics, Illness and injury prevention;

    (b) Therapeutic communications;

    (c) Life span development;

    (d) Clinical decision making;

    (e) Soft tissue trauma;

    (f) Renal/urology;

    (g) Hematology;

    (h) Abuse and assault;

    (i) Patients with special challenges;

    (j) Acute intervention for chronic care patients;

    (k) Ambulance operations;

    (l) Rescue awareness and operations; and

    (m) Crime scene awareness.

    (6) A Paramedic may complete CME hours through the methodologies listed in this subsection. All CME must be related to the required skills and knowledge of a paramedic. Instructors need not be EMS instructors, but must be knowledgeable in the field of instruction. Limitations and special requirements are listed with each methodology.

    (a) Workshops and seminars related to the required skills and knowledge of a paramedic and approved for CME credit by the Department or the CECBEMS.

    (b) Local medical training meetings.

    (c) Demonstration or practice sessions.

    (d) Medical training meetings where a guest speaker presents material related to emergency medical care.

    (e) Actual hours the Paramedic is involved in community emergency exercise and disaster drills. Up to 20 hours are creditable during a recertification period for participation in exercises and drills.

    (f) Teaching the general public (schools, scouts, clubs, or church groups) on any topic within the scope of the Paramedic practice. Up to 15 hours are creditable during a certification period for teaching classes.

    (g) Viewing audiovisuals (films, videotapes, etc.) which illustrate and review proper emergency care procedures. The Paramedic must view the audiovisual material in the presence of a training officer. Up to 10 hours are creditable during a certification period using audiovisuals.

    (h) Completing college courses in topics such as biology, chemistry, anatomy and physiology. Other college courses relating to the scope and practice of a paramedic may be creditable, but only with the approval of the Department. If in doubt, the Paramedic should contact the Department. Up to 10 hours are creditable during a certification period for college courses.

    (i) Up to 16 hours of CPR training are creditable during a certification period.

    (j) Computer and internet-based training that illustrates, drills, provides interactive use, or demonstrates proper emergency care procedures. The training must be approved by the Continuing Education Coordinating Board of Emergency Medical Services or the Department. Up to 25 hours are creditable during a certification period using computer and internet-based training.

    (k) Completing tests related to the Paramedic scope of practice in EMS-related journals or publications. Up to [5]five hours are creditable during a certification period for completing tests from journals and publications.

    (7) A Paramedic who is affiliated with an EMS organization should have the training officer from the EMS organization submit a letter verifying the Paramedic's completion of the recertification requirements. A Paramedic who is not affiliated with an agency must submit verification of all recertification requirements directly to the Department.

    (8) Each Paramedic is individually responsible to complete and submit the required recertification material to the Department. Each Paramedic should submit all recertification materials to the Department at one time, no later than 30 days and no earlier than one year prior to the Paramedic's current certification expiration date. 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 material in the order received.

    (9) An EMS provider or an entity that provides CME may compile and submit recertification materials on behalf of a Paramedic; however, the Paramedic remains responsible for a timely and complete submission.

    ([9]10) The Department may shorten recertification periods. A paramedic whose recertification period is shortened must meet the CME requirements in each of the required and elective subdivisions on a prorated basis by the expiration of the shortened period.

    (11) The Department may not lengthen recertification periods more than the four year 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 expires. If this happens, the individual shall recertify following Utah Code 39-1-64.

     

    R426-12-504. Paramedic Lapsed Certification.

    (1) An individual whose paramedic certification has lapsed for less than one year, and who wishes to become recertified as a paramedic must complete all recertification requirements and pay a recertification late fee.

    (2) An individual whose paramedic certification has expired for more than one year, and who wishes to become recertified as a paramedic must:

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

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) submit to the Department evidence of having completed 100 hours of Department-approved continuing medical education within the prior four years[.], following R426-12-503 Paramedic Recertification Requirements;

    (d) submit a statement from a physician, confirming the applicant's results of a TB examination;

    (e) submit verification of current completion of a Department-approved course in adult and pediatric advanced life support;

    (f) submit a letter of recommendation including results of an oral examination, from a certified off-line medical director, verifying proficiency in paramedic skills;

    (g) successfully complete the applicable Department written and practical examinations; and

    (h) pay all applicable fees.

    (3) The individuals new expiration date will be four years from the completion of all recertification materials.

    (4) An individual whose certification has lapsed is not authorized to provide care as a paramedic until the individual completes the recertification process.

     

    R426-12-505. Paramedic Testing Failures.

    (1) An individual who fails any part of the paramedic certification or recertification written or practical examination may retake the Paramedic examination twice without further course work.

    (2) If the individual fails both re-examinations, he must take a complete Paramedic course to be eligible for further examination at the paramedic level.

    (3) The individual may retake the course as many times as he desires, 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 must pass both the practical and written test administered after completion of the new course.

    [ (1) If an individual fails the written or practical certification or recertification examination after two attempts, he may, within 30 days following mailing of written notification of this second failure, submit a written request to take the test a third time.

    (2) Within thirty days of receipt of the request, the Department shall convene a review panel consisting of:

    (a) the chairman of the Paramedic Advisory Sub-Committee;

    (b) the off-line medical director for the individual's EMS provider organization or a certified EMS training officer or certified EMS instructor who would mentor a remediation plan;

    (c) one or more representatives from the Department; and

    (d) a representative from the entity that provided training, but if the training was not provided in-state, then a representative of an in-state paramedic training program.

    (3) The review panel shall allow the individual to appear and provide information.

    (4) The panel shall review whether a program of re-education and reexamination would likely result in successful completion of the examinations and shall recommend a course of action to the Department.

    (5) The Department shall consider the review panel's recommendation and provide one opportunity for reexamination if it determines that re-education and reexamination within that time would likely result in successful completion of the examinations.

    ] (4) If a paramedic fails the recertification written or practical tests three times, he may request in writing, within 30 days of the date of the third failure notification letter, that he be allowed to apply for EMT-IA, EMT-I, or EMT-B certification. He has 120 days to complete recertification requirements at a lower level.

     

    R426-12-600. Emergency Medical Dispatcher (EMD) Requirements and Scope of Practice.

    (1) The Department may certify as an EMD an individual who meets the initial certification requirements in R426-12-601.

    (2) The Committee adopts the 1995 United States Department of Transportation's "EMD Training Program: National Standard Curriculum" (EMD Curriculum) as the standard for EMD training and competency in the state, which is incorporated by reference.

    (3) An EMD may perform the job functions as described in the EMD curriculum, as adopted in this section.

     

    R426-12-601. EMD Initial Certification.

    (1) The Department may certify an EMD for a four year period.

    (2) An individual who wishes to become certified as an EMD must:

    (a) successfully complete a Department-approved EMD course as described in R426-12-600(2);

    (b) be able to perform the functions listed in the objectives of the EMD Curriculum adopted in R426-12-600(2)as verified by personal attestation and successful accomplishment during the course of all cognitive, affective and psychomotor skills and objectives listed in the EMD Curriculum;

    (c) achieve a favorable recommendation from the course coordinator and course medical director stating technical competence and successful completion of all training requirements for EMD certification;

    (d) be 18 years of age or older;

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

    (f) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation] and;

    (g) maintain and submit documentation of having completed within the prior two years a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater; and

    (h) within [90]120 days after [completing the EMD course,]the official course end date, the applicant must successfully complete the Department written and practical EMD examinations, or reexaminations, if necessary.

    (3) The Department may extend the time limit in Subsection (2)(h) for an individual who demonstrates that the inability to meet the requirements within the [90]120 days was due to circumstances 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.

     

    R426-12-602. EMD Reciprocity.

    (1) The Department may certify as an EMD an individual certified 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 in Utah based on out-of-state training and experience must:

    (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[one year] of submitting the application;

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) maintain and submit documentation of having completed within the prior two years, a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    (d) successfully complete the Department written and practical EMD examination, or re-examinations, if necessary;

    (e) submit a current certification from one of the states of the United States or its possessions[ or the National Academy of EMDs]; and

    (f) provide documentation of completion of 12 hours of continuing medical education within the prior year.

    (3) The Department may certify as an EMD an individual certified by the National Academy of Emergency Medical Dispatch (NAEMD).[

    (4)] An individual seeking reciprocity for certification in Utah based on NAEMD certification must:

    (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 one year of submitting the application;

    (b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (c) maintain and submit documentation of having completed within the prior two years:

    (i) a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater; and

    (ii)[ a course in CISM;

    (d) as part of meeting the EMD's continuing medical education requirements, take ]a minimum of a two-hour course in critical incident stress management (CISM);

    ([e]d) submit documentation of current NAEMD certification[; and

    (f) if the individual's NAEMD certification is based on a course offered in Utah; and successfully pass a class that follows the CISM section of the Department-established EMD curriculum;].

     

    R426-12-603. EMD Recertification.

    (1) The Department may recertify an EMD for a four year period or for a shorter period as modified by the Department to standardize recertification cycles.

    (2) An individual seeking recertification must:

    (a) [complete all EMD recertification requirements;

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

    ([c]b) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    ([d]c) maintain and submit documentation of having completed within the prior two years a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater;

    ([e]d) successfully complete the applicable Department recertification examinations, or reexaminations if necessary, within one year prior to expiration of the certification to be renewed[.]; and

    ([f]e) provide documentation of completion of 48 hours of Department-approved CME meeting the requirements of subsections (3), (4), and (5).

    (3) The EMD must complete the CME throughout each of the prior four years.

    (4) The EMD must take at least [8]eight elective hours and the following 40 required CME hours by subject:

    (a) Roles and Responsibilities - 5 hours;

    (b) Obtaining Information from callers - 7 hours;

    (c) Resource allocation - 4 hours;

    (d) Providing emergency care instruction - 2 hours;

    (e) Legal and Liability Issues - 5 hours;

    (f) Critical Incident Stress Management - 5 hours;

    (g) Basic Emergency Medical Concepts - 5 hours; and

    (h) Chief complaint types - 7 hours.

    (5) An EMD may complete CME hours through the methodologies listed in this subsection. All CME must be related to the required skills and knowledge of an EMD. Instructors need not be EMS instructors, but must be knowledgeable in the field of instruction. Limitations and special requirements are listed with each methodology.

    (a) Workshops and seminars related to the required skills and knowledge of an EMD and approved for CME credit by the Department or the CECBEMS.

    (b) Local medical training meetings.

    (c) Demonstration or practice sessions.

    (d) Medical training meetings where a guest speaker presents material related to emergency medical care.

    (e) Actual hours the EMD is involved in community emergency exercise and disaster drills. Up to [8]eight hours are creditable during a recertification period for participation in exercises and drills.

    (f) Teaching the general public (schools, scouts, clubs, or church groups) on any topic within the scope of the EMD practice.

    (g) Viewing audiovisuals (films, videotapes, etc.) which illustrate and review proper emergency care procedures. The EMD must view the audiovisual material in the presence of a training officer. Up to 10 hours are creditable during a certification period using audiovisuals.

    (h) Completing college courses relating to the scope and practice of an EMD may be creditable, but only with the approval of the Department. Up to [8]eight hours are creditable during a certification period for college courses.

    (i) Telephone scenarios of practical training and role playing.

    (j) Riding with paramedic or ambulance units to understand the EMS system as a whole. Up to [6]six hours are creditable during a certification period for ride-alongs.

    (k) Computer and internet-based training that illustrates, drills, provides interactive use, or demonstrates proper emergency care procedures. The training must be approved by the Continuing Education Coordinating Board of Emergency Medical Services or the Department. Up to 12 hours are creditable during a certification period using computer and internet-based training.

    (6) Notwithstanding the provisions of subsections (2), (3), (4), and (5), an EMD who has been certified or recertified by the National Academy of Emergency Medical Dispatch (NAEMD) may be recertified by the Department upon the following conditions:

    (a) the EMD must, as part of meeting the EMD's continuing medical education requirements, take a minimum of a two-hour course in critical incident stress management (CISM);

    (b) an individual who takes a NAEMD course offered in Utah must successfully pass a class that follows the CISM section of the Department-established EMD curriculum; and

    (c) the individual must:

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

    (ii) submit to and pass a background investigation, including an FBI background investigation if the applicant has not resided in Utah[not a Utah resident] for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation;]

    (iii) maintain and submit documentation of having completed within the prior two years a CPR course offered by the National Safety Council, the American Red Cross, or the American Heart Association or a course that the applicant can demonstrate to the Department to be equivalent or greater; and

    (iv) submit documentation of current NAEMD certification.

    (7) An individual who is affiliated with an EMS organization should have the training officer from the EMS organization submit a letter verifying the EMD's completion of the recertification requirements. An EMD who is not affiliated with an EMS agency must submit verification of all recertification requirements directly to the Department.

    ([7]8) Each EMD is individually responsible to complete and submit the required recertification material to the Department. Each EMD should submit all recertification materials to the Department at one time and no later than 30 days and no earlier than one year prior to the EMD's current certification expiration date. 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 material in the order received.

    (9) An EMS provider or an entity that provides CME may compile and submit recertification materials on behalf of an EMD; however, the EMD remains responsible for a timely and complete submission.

    (10) The Department may shorten recertification periods. An EMD whose recertification period is shortened must meet the CME requirements in each of the required and elective subdivisions on a prorated basis by the expiration of the shortened period.

    (11) The Department may not lengthen recertification periods more than the four year 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 expired. If this happens, the individual shall recertify in accordance with Utah Code 39-1-64.

     

    R426-12-604. EMD Lapsed Certification.

    (1) An individual whose EMD certification has expired for less than one year may, within one year after expiration, complete all recertification requirements and pay a late recertification fee to become recertified.

    (2) An individual whose certification has expired for more than one year must take an EMD course and reapply [as if there were no prior]for initial certification.

    (3) The individuals new expiration date will be four years from the old expiration date.

    (4) An individual whose certification has lapsed, is not authorized to provide dispatch services until he has completed the recertification process.

     

    R426-12-605. EMD Testing Failures.

    (1) An individual who fails any part of the EMD certification or recertification written or practical examination may retake the EMD examination [once]twice without further course work.

    ([a]2) If the individual fails both [on the re-examination]re-examinations, he must take a complete EMD training course to be eligible for further examination at the EMD level.

    ([b]3) The individual may retake the course as many times as he desires, but may only take the examinations [twice]three times for each completed course. If an individual retakes the course because of failure to pass the examinations, the individual must pass both the practical and written tests administered after completion of the new course.

    [ (2) If an EMD fails the written or practical recertification examination after two attempts, he may, within 30 days following notification in writing of this second failure, submit a written request to take the test a third time.

    (3) Within 30 days of receipt of the request, the Department shall convene a review panel consisting of:

    (a) The training officer of the individual's EMS provider organization or a certified training officer who would mentor a remediation plan; and

    (b) one or more representatives from the Department.

    (4) The review panel shall allow the individual to appear and provide information regarding a remediation plan.

    (5) The hearing panel shall review whether a program of re-education and reexamination within 30 days would likely result in successful completion of the examinations and shall recommend a course of action to the Department.

    (6) The Department shall consider the review panel's recommendation and provide one opportunity for reexamination within 30 days of its decision if it determines that re-education and reexamination within that time would likely result in successful completion of the examinations.

    (7) If the Department does not allow the third examination, the EMD may file a request for agency action within 30 days of issuance of the Department's determination.

    ]

    R426-12-700. Emergency Medical Services Instructor Requirements.

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

    (a) meets the initial certification requirements in R426-12-701; and

    (b) is currently certified in Utah and has been certified [in Utah EMS ]as an EMT-B, EMT-I, EMT-IA, Paramedic, or Dispatcher for 12 months.

    (2) The Committee adopts the 1995 United States Department of Transportation's "EMS Instructor Training Program: National Standard Curriculum" (EMS Instructor Curriculum) 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 level to which the instructor is certified. An EMS instructor who is only certified as an EMD may only teach EMD courses.

    (4) An EMS instructor must abide by the terms of the "EMS Instructor Contract," teach according to the contract, and comply with the teaching standards and procedures in the EMS Instructor Manual or EMD Instructor Manual as incorporated into the respective "EMS Instructor Contract" or "EMD Instructor Contract."

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

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

     

    R426-12-701. EMS Instructor Certification.

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

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

    (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;

    (e) submit biennially a completed and signed "EMS Instructor Contract" to the Department agreeing to abide by the standards and procedures in the [then ]current EMS Instructor Manual or EMD Instructor Manual; and

    (f) successfully complete the Department-sponsored initial EMS instructor training course.

    (3) An individual who wishes to become certified as an EMS Instructor to teach EMT-B, EMT-I, EMT-IA, or paramedic courses must also:

    (a) provide documentation of 30 hours of patient care within the prior year; and

    (b) submit verification that the individual is recognized as a CPR instructor by the National Safety Council, the American Red Cross, or the American Heart Association; and

    (4) An individual who wishes to become certified as an EMS Instructor to teach EMD courses must also successfully complete the Department-sponsored initial EMS instructor training course.

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

     

    R426-12-702. EMS Instructor Recertification.

    An EMS instructor who wishes to recertify as an instructor must:

    (1) maintain current EMS certification;

    (2) attend the required Department-approved recertification training;

    (3) submit verification of 30 hours of EMS teaching experience in the prior two years;

    (4) [if teaching an EMT-B,EMT-I, EMT-IA, paramedic course,] submit verification that the instructor is currently recognized as a CPR instructor by the National Safety Council, the American Red Cross, or the American Heart Association[;], if teaching an EMT-B, EMT-I, EMT-IA, or Paramedic course;

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

    (6) successfully complete any Department-required examination; and

    (7) submit biennially a completed and signed "EMS Instructor Contract" to the Department agreeing to abide by the standards and procedures in the current EMS Instructor Manual.

     

    R426-12-703. EMS 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 in R426-12-702.

    (2) An EMS instructor whose instructor certification has expired for more than two years must complete all initial instructor certification requirements and reapply as if there were no prior certification.

     

    R426-12-800. Emergency Medical Services Training Officer Requirements.

    (1) [The Department may certify an individual as a training officer for a one year period.

    (2) A training officer must 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 "Training Officer Contract."]The Department may certify as an EMS Training Officer an individual who:

    (a) meets the initial certification requirements in R426-12-801; and

    (b) is currently certified in Utah and has been certified as an EMT-B, EMT-I, EMT-IA, Paramedic, or Dispatcher for 12 months.

    (2) An EMS training officer must 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.

     

    R426-12-801. [Emergency Medical Services]EMS Training Officer Certification.

    (1) The Department may certify an individual who is certified as an EMT-B, EMT-I, EMT-IA, Paramedic, or EMD as a training officer for a two year period.

    (2) An individual who wishes to become certified as an EMS [t]Training officer must:

    (a) be currently certified as an EMS instructor;

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

    (c) successfully complete any Department examinations;

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

    (e) submit bie[a]nnually 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.

    ([2]3) A training officer must maintain EMS instructor certification to retain training officer certification.

     

    R426-12-802. [Emergency Medical Services]EMS Training Officer Recertification.

    A training officer who wishes to recertify as a training officer must:

    (1) attend a training officer seminar every two years;

    (2) maintain current EMS instructor and EMT-B, EMT-I, EMT-IA, Paramedic, or EMD certification;

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

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

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

     

    R426-12-803. [Emergency Medical Services]EMS Training Officer Lapsed Certification.

    [A training officer whose training officer certification has expired must complete all initial training officer certification requirements and reapply as if there were no prior certification.](1) An individual whose training officer certification has expired for less than one year may again become certified by completing the recertification requirements in R426-12-802. The individuals new expiration date will be two years from the old expiration date.

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

     

    R426-12-900. Course Coordinator Certification.

    (1) The Department may certify [an individual ]as a course coordinator [for a one year period]an individual who:[.]

    (a) meets the initial certification requirements in R426-12-901; and

    (b) has been certified in Utah as an EMS Instructor and as an EMT-B, EMT-I, EMT-IA, Paramedic or Dispatcher for 12 months.

    (2) A Course Coordinator may only coordinate courses up to the certification level to which the course coordinator is certified. An course coordinator who is only certified as an EMD, may only coordinate EMD courses.

    ([2]3) A course coordinator must 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."

    (4) A Course Coordinator must maintain an EMS Instructor certification and the EMS certification for the level that the course coordinator is certified to coordinate. If an individuals EMS certification lapses, the Course Coordinator certification is invalid until EMS certification is renewed.

     

    R426-12-901. Course Coordinator Certification.

    The Department may certify an individual who is an EMT-B, EMT-I, EMT-IA, Paramedic, or EMD as a course coordinator for a two year period. An individual who wishes to certify as a course coordinator must:

    (1) be certified as an EMS instructor for one year;

    (2) be an instructor of record for at least one Department-approved course;

    (3) have taught a minimum of 15 hours in a Department-approved course;

    (4) have co-coordinated one Department-approved course with a certified course coordinator;

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

    (6) complete certification requirements prior to application to the Department's course for new course coordinators;

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

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

    (9) successfully complete all examination requirements;

    (10) 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

    (11) maintain EMS instructor certification.

     

    R426-12-902. Course Coordinator Recertification.

    A course coordinator who wishes to recertify as a course coordinator must:

    (1) maintain current EMS instructor and EMT-B, EMT-I, EMT-IA, Paramedic, or EMD certification;

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

    (3) attend a course coordinator seminar every two years;

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

    (5) successfully complete all examination requirements; and

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

     

    R426-12-903. Emergency Medical Services Course Coordinator Lapsed Certification.

    [A course coordinator whose course coordinator certification has expired must complete all initial course coordinator certification requirements and reapply as if there were no prior certification.](1) An individual whose course coordinator certification has expired for less than one year may again become certified by completing the recertification requirements in R426-12-802. The individuals new expiration date will be two years from the old expiration date.

    (2) An individual whose course coordinator certification has expired for more than one year must complete all initial course coordinator certification requirements and reapply as if there were no prior certification.

     

    R426-12-1000. Paramedic Training Institutions Standards Compliance.

    (1) A person must be authorized by the Department to provide training leading to the certification of a paramedic.

    (2) To become authorized and maintain authorization to provide paramedic training, a person must:

    (a) enter into the Department's standard 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.

     

    R426-12-1100. Course Approvals.

    A course coordinator offering EMS training to individuals [to]who wish to become certified as an EMT-B, EMT-I, EMT-IA, Paramedic, or EMD, must obtain Department approval prior to initiating an EMS training course. The Department shall approve a course if:

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

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

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

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

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

     

    R426-12-1200. 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 must 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 under "R426 Equipment, Drugs and Supplies List."

     

    R426-12-1201. Off-line Medical Director Certification.

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

    (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 must:

    (a) retake the medical director training course every four years;

    (b) submit an application; and

    (c) pay all applicable fees.

     

    R426-12-1300. Refusal, Suspension or Revocation of Certification.

    (1) The Department shall exclude from EMS certification an individual who may pose an unacceptable risk to public health and safety, as indicated by his criminal history. The Department shall conduct a background check on each individual who seeks to certify or recertify as an EMS personnel, including an FBI background investigation if not a Utah resident for the past consecutive five years;[ however a Utah resident whose reason for being out of state was due to being a foreign exchange student or serving a religious mission, in the military, as a Peace Corps volunteer, or the like need not submit to the FBI background investigation.]

    (a) An individual convicted of certain crimes presents an unreasonable risk and the Department shall deny all applications for certification or recertification from individuals convicted of any of the following crimes:

    (i) sexual misconduct if the victim's failure to affirmatively consent is an element of the crime, such as forcible rape;

    (ii) sexual or physical abuse of children, the elderly or infirm, such as sexual misconduct with a child, making or distributing child pornography or using a child in a sexual display, incest involving a child, assault on an elderly or infirm person;

    (iii) abuse, neglect, theft from, or financial exploitation of a person entrusted to the care or protection of the applicant, if the victim is an out-of-hospital patient or a patient or resident of a health care facility; and

    (iv) crimes of violence against persons, such as aggravated assault, murder or attempted murder, manslaughter except involuntary manslaughter, kidnapping, robbery of any degree; or arson; or attempts to commit such crimes;

    (b) Except in extraordinary circumstances, established by clear and convincing evidence that certification or recertification will not jeopardize public health and safety, the Department shall deny applicants for certification or recertification in the following categories:

    (i) persons who are convicted of any crime not listed in (a) and who are currently incarcerated, on work release, on probation or on parole;

    (ii) conviction of crimes in the following categories, unless at least three years have passed since the conviction or at least three years have passed since release from custodial confinement, whichever occurs later:

    (A) crimes of violence against persons, such as assault;

    (B) crimes defined as domestic violence under Section 77-36-1;

    (C) crimes involving controlled substances or synthetics, or counterfeit drugs, including unlawful possession or distribution, or intent to distribute unlawfully, Schedule I through V drugs as defined by the Uniform Controlled Dangerous Substances Act; and

    (D) crimes against property, such as grand larceny, burglary, embezzlement or insurance fraud.

    (c) The Department may deny certification or recertification to individuals convicted of crimes, including DUIs, but not including minor traffic violations chargeable as infractions after consideration of the following factors:

    (i) the seriousness of the crime;

    (ii) whether the crime relates directly to the skills of pre-hospital care service and the delivery of patient care;

    (iii) the amount of time that has elapsed since the crime was committed;

    (iv) whether the crime involved violence to or abuse of another person;

    (v) whether the crime involved a minor or a person of diminished capacity as a victim;

    (vi) whether the applicant's actions and conduct since the crime occurred are consistent with the holding of a position of public trust;

    (vii) the total number of arrests and convictions; and

    (viii) whether the applicant was truthful regarding the crime on his or her application.

    (2) Certified EMS personnel must notify the Department of any arrest, charge, or conviction within 30 days of the arrest, charge or conviction.

    (3) The Department may require EMS personnel to submit to a background examination or a drug test upon Department request.

    (4) The Department may refuse to issue a certification or recertification, or suspend or revoke a certification, or place a certification on probation, for any of the following causes:

    (a) any of the reasons for exclusion listed in Subsection (1);

    (b) a violation of Subsection (2);

    (c) a refusal to submit to a background examination pursuant to Subsection (3);

    (d) habitual or excessive use or addiction to narcotics or dangerous drugs;

    (e) refusal to submit to a drug test administered by the individual's EMS provider organization or the Department;

    (f) habitual abuse of alcoholic beverages or being under the influence of alcoholic beverages while on call or on duty as an EMS personnel or while driving any Department-permitted vehicle;

    (g) failure to comply with the training, certification, or recertification requirements for the certification;

    (h) failure to comply with a contractual agreement as an EMS instructor, a training officer, or a course coordinator;

    (i) fraud or deceit in applying for or obtaining a certification;

    (j) fraud, deceit, incompetence, patient abuse, theft, or dishonesty in the performance of duties and practice as a certified individual;

    (k) unauthorized use or removal of narcotics, drugs, supplies or equipment from any emergency vehicle or health care facility;

    (l) performing procedures or skills beyond the level of certification or agency licensure;

    (m) violation of laws pertaining to medical practice, drugs, or controlled substances;

    (n) conviction of a felony, misdemeanor, or a crime involving moral turpitude, excluding minor traffic violations chargeable as infractions;

    (o) mental incompetence as determined by a court of competent jurisdiction;

    (p) demonstrated inability and failure to perform adequate patient care;

    (q) inability to provide emergency medical services with reasonable skill and safety because of illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or as a result of any other mental or physical condition, when the individual's condition demonstrates a clear and unjustifiable threat or potential threat to oneself, coworkers, or the public health, safety, or welfare that cannot be reasonably mitigated; and

    (r) misrepresentation of an individual's level of certification;

    (s) failure to display a state-approved emblem with level of certification during an EMS response, and

    (t) other or good cause, including conduct which is unethical, immoral, or dishonorable to the extent that the conduct reflects negatively on the EMS profession or might cause the public to lose confidence in the EMS system.

    (5)(a) The Department may suspend an individual for a felony or misdemeanor arrest or charge pending the resolution of the charge if the nature of the charge is one that, if true, the Department could revoke the certification under subsection (1); and

    (b) The Department may order EMS personnel not to practice when an active criminal or administrative investigation is being conducted.

     

    R426-12-1400. Penalties.

    As required by Subsection 63-46a-3(5): Any person that violates any provision of this rule may be assessed a civil money penalty not to exceed the sum of $5,000 or be punished for violation of a class B misdemeanor for the first violation and for any subsequent similar violation within two years for violation of a class A misdemeanor as provided in Section 26-23-6.

     

    KEY: emergency medical services

    Date of Enactment or Last Substantive Amendment: [February 1, 2005]2007

    Notice of Continuation: September 20, 2004

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

     

Document Information

Effective Date:
7/9/2007
Publication Date:
06/01/2007
Filed Date:
05/15/2007
Agencies:
Health,Health Systems Improvement, Emergency Medical Services
Rulemaking Authority:

Section 26-8a-302

Authorized By:
David N. Sundwall, Executive Director
DAR File No.:
29944
Related Chapter/Rule NO.: (1)
R426-12. Emergency Medical Services Training and Certification Standards.