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DRAFT CHANGES Page 1 of 58 DEPARTMENT OF HUMAN SERVICES – PUBLIC HEALTH DIVISION 265 EMERGENCY MEDICAL TECHNICIANS 333-265-0000 Definitions (1) "Ambulance Service" means any individual, partnership, corporation, association, governmental agency or other entity that holds a [the Division] Public Health-issued ambulance service license to provide emergency and non-emergency care and transportation to sick, injured or disabled persons. (2) “Business day” means Monday through Friday when Public Health is open for business, this excludes holidays. (3) [(2)] "Clinical Education (Clinical)" means those hours of the curriculum to synthesize cognitive and psychomotor skills. These hours must be obtained in hospital clinical areas as prescribed by [the Division] Public Health and be performed under a preceptor. (4) [(4)] "Continuing Education" means instruction designed to provide training to EMTs for the purpose of preparing him or her for renewal of his or her EMT certification. Continuing education does not include attending EMS related business meetings, EMS Exhibits or Trade Shows. (5) [(4)] "Didactic Instruction" means the delivery of primarily cognitive material through lecture, video, discussion, and simulation by program faculty. (6) [(5)] "Direct Visual Supervision" means having a preceptor in the ambulance patient compartment or at the patient's side to monitor the EMT in training. [(6) "Division" means the Health Division of the Department of Human Services and its authorized representatives.] (7) "Emergency Care" means the performance of acts or procedures under emergency conditions in the observation, care and counsel of the ill, injured or disabled; in the administration of care or medications as prescribed by a licensed physician, insofar as any of these acts is based upon knowledge and application of D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 2 of 58 the principles of biological, physical and social science as required by a completed course utilizing an approved curriculum in prehospital emergency care. However, "emergency care" does not include acts of medical diagnosis or prescription of therapeutic or corrective measures. (8) "Emergency Medical Services (EMS) Agency" means any person, governmental unit, corporation, partnership, sole proprietorship or other entity that utilizes EMTs to provide prehospital emergency or non-emergency care. (9) "Emergency Medical Technician (EMT)" means a person who has received formal training in prehospital and non emergency care and is state-certified to attend any ill, injured or disabled person. Police officers, fire fighters, funeral home employees and other personnel serving in a dual capacity, one of which meets the definition of "emergency medical technician" are "emergency medical technicians" within the meaning of ORS chapter 682. (10) "EMS Medical Director" means a licensed physician who provides direction of emergency or non-emergency care provided by a licensed EMS Agency. The EMS medical director must meet the qualifications as defined in OAR 847-035-0020. [(10)] (11) "EMT-Basic" means a person who completes an EMT-Basic course as prescribed by these rules and is certified by [the Division] Public Health. [(11)] (12) "EMT-Intermediate" means a person who completes an EMTIntermediate course as prescribed by these rules and is certified by [the Division] Public Health. [(12)] (13) "EMT-Paramedic" means a person who completes an EMT-Paramedic course as prescribed by these rules and is certified by [the Division] Public Health. [(13)] (14) "Field Internship" means those calls acquired by a student during an approved EMT-Paramedic course under a preceptor. A call shall be accepted when the preceptor has documented and verified satisfactory student performance, which includes the application of specific assessment and treatment skills required of a certified EMT-Paramedic. [(14)] (15) "Formal Case Review" means an educational presentation in which a physician or physician designee utilizes an actual ambulance or rescue call as a basis for educating EMTs. A formal case review includes a review of the call, D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 3 of 58 review of the documentation prepared by the ambulance or rescue crew, discussion of the patient's course of care in the emergency department or hospital inpatient areas, and instruction on the clinical issues raised by the particular patient. [(15)] (16) "Endorsement" means the manner in which a person may obtain Oregon EMT certification when that person is certified and in good standing in another state or with the National Registry of EMTs. [and is in standing with that state or the National Registry of EMTs.] [(16)] (17) "In Good Standing" means a person who is currently certified or licensed, who does not have any restrictions placed on his or her certificate or license, or who is not on probation with the certifying or licensing agency for any reason. [(17) "Medical Director" or supervising physician means a medical or osteopathic a physician licensed under ORS chapter 677, actively registered and in good standing with the Board of Medical Examiners, who provides direction of emergency or non-emergency care provided emergency medical technicians, registered nurses or physician assistants associated with a licensed ambulance service. The medical director must meet the qualifications of a supervising physician as defined in OAR 847-035-0020.] (18) "Medical Emergencies - Assessment and Management" means EMT continuing education subjects that include, but are not limited to: assessment of the medical patient; acute abdomen; burns; cardiac emergencies; communicable diseases; diabetic emergencies; dyspnea; epilepsy/convulsions; emergency childbirth; emotional disturbances/mental illness; hazardous materials; ingested poisons; near-drowning emergencies; stroke; and temperature related emergencies. (19) "Non-Emergency Care" means the performance of acts or procedures on a patient who is not expected to die, become permanently disabled or suffer permanent harm within the next 24-hours, including but not limited to observation, care and counsel of a patient and the administration of medications prescribed by a physician licensed under ORS chapter 677, insofar as any of those acts are based upon knowledge and application of the principles of biological, physical and social science and are performed in accordance with scope of practice rules adopted by the Board of Medical Examiners in the course of providing prehospital care as defined by this section. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 4 of 58 (20) “Online Medical Supervision” means real-time direct communication by a physician who is providing EMS providers with direction during a patient encounter. [(20)] (21) "Patient" means an ill, injured or disabled person who may be [transported in an ambulance] cared for by an EMS Agency. [(21)] (22) "Pediatric Patient - Assessment and Management" means EMT continuing education subjects that include, but are not limited to: pediatric patient assessment; pediatric trauma; emergency care for respiratory distress; airway obstructions; febrile convulsions; cardiac arrest; shock; sudden infant death syndrome and abuse/neglect. [(22)] (23) "Person" means any individual, corporation, association, firm, partnership, joint stock company, group of individuals acting together for a common purpose, or organization of any kind and includes any receiver, trustee, assignee, or other similar representatives thereof. [(23)] (24) "Physician Designee" means an EMT-Basic, EMT-Intermediate, EMTParamedic, registered nurse, physician assistant or physician that a medical director has authorized to conduct formal case reviews, or approve audiovisual programs or EMS journal articles for EMT continuing education. [(24)] (25) "Prehospital Care" or “out of hospital care” means that care rendered by EMTs as an incident of the operation of an ambulance and that care rendered by EMTs as incidents of other public or private safety duties, and includes, but is not limited to "emergency care" as defined by this section. [(25)] (26) "Preceptor" means a person approved by an accredited teaching institution and appointed by the EMS [provider] Agency, who supervises and evaluates the performance of an EMT student during the clinical, skills lab and field internship phases of an EMT course. A preceptor must be a physician, physician assistant, registered nurse, or certified EMT in good standing at or above level for which the student is in training. [(26)] (27) “Psychomotor Skills” means those patient care skills listed in [the Division] Public Health Skill Performance Reference Guide. (28) “Public Health” means the Oregon Public Health Division within the Department of Human Services and its authorized representative, Emergency Medical Services and Trauma Systems Section. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 5 of 58 [(27) "Psychomotor Skills (Skills)" means those patient care skills listed in [the Division] Public Health's Skill Performance Reference Guide.] [(27)] (29) "Scope of Practice" means the maximum level of emergency or nonemergency care that an EMT may provide as set forth in OAR 847-035-0030. [(28)] (30) "Skills Lab[oratory]" means those hours of the curriculum that provides the student with the opportunity to develop the skills for the level of training obtained. [(29)] (31) "Special Considerations and Support Services" means EMT continuing education subjects that include, but are not limited to: operating around air ambulances; child abuse; crime scene; critical incident stress debriefing; emergency vehicle and ambulance operation; emergencies involving the handicapped; extrication techniques; hazardous materials; incident command systems; injury prevention; lifting and moving patients; medical-legal aspects of EMS; patient care report forms; procedures for triage situations; rape intervention; use of the trauma system; EMS management; and the role and responsibilities of an EMT. (31) “Standing orders” means the written detailed procedures for medical or trauma emergencies and non-emergency care to be performed by an EMT or First Responder issued by the supervising physician commensurate with the scope of practice and level of certification of the EMT or First Responder. (32) “Subject Individual” means any Oregon EMT or First Responder Applicant or Oregon EMT or First Responder certificate holder. [(30] (33)“Teaching Institution" means a two-year community college or four-year degree granting college or a licensed vocational school that is accredited by the Office of Professional Technical Education, Office of Community College Services/Oregon Department of Education. [(31)] (34) "Trauma Assessment and Management" means EMT continuing education subjects that include, but are not limited to: assessment of the trauma patient; amputation injuries; chest injuries; facial injuries; fractures/dislocations; head/neck injuries; internal injuries; multi-systems injuries; soft tissue injuries; and the control of bleeding and shock. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 6 of 58 [(32)] (35) "Unprofessional Conduct" means conduct unbecoming a person certified in prehospital emergency, and non-emergency care, or detrimental to the best interest of the public and includes conduct as defined in ORS 682.025(19). (a) Unprofessional conduct includes, but is not limited to: (A) [knowing or w] Willful violation of patient privacy or confidentiality by releasing information to persons not directly involved in the care or treatment of the patient; (B) [use of i] Illegal drug[s] use on or off duty; (C) [use of a] Alcohol use within eight hours of going on duty or while on duty or in an on-call status; (D) [violation of] Direct verbal order[s] violation from a physician who is responsible for the care of a patient; (E) [v] Violation of orders given by an on-line medical resource physician, whether delivered by radio or telephone; (F) [v] Violation of standing orders [the written detailed procedures for medical or trauma emergency to be performed by an EMT issued by the medical director commensurate with the scope of practice and level of certification or licensure of the EMT, registered nurse or physician assistant] without direction of a medical director; (G) [utilizing] Use of invasive medical procedures in violation of generally accepted standards of the medical community; (H) [a] Any action that constitutes a violation of any statute, municipal code, or administrative rule that endangers the public, or other public safety officials, or other EMTs, patients, or the general public (including improper operation of an emergency medical vehicle); (I) [I] Instructing, causing or contributing to another individual violating a statute or administrative rule, including EMT acting in a supervisory capacity; (J) Participation in the issuance of false continuing education documents or collaboration therein, including issuing continuing education verification to one who did not legitimately attend an educational event; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 7 of 58 (K) [s] Signing into an educational event of a person not actually present; (L) [a] Assisting permitting another EMT to exceed his or her lawful scope of practice; (M) [u] Unlawful use of emergency vehicle lights and sirens; (N) [p] Providing false or misleading information to [the Division] Public Health, to the State EMS Committee, to the Subcommittee on EMT Certification and Discipline, to an EMS teaching institution or clinical/field internship agency; (O) [r] Responding to which the EMT is not properly dispatched ("call-jumping"), whether in a private auto, ambulance, or other vehicle, in contravention of local protocols, procedures, or ordinances, or interfering with the safe and effective operation of an EMS system; (P) [c] Cheating on any examination used to measure EMS related knowledge or skills; (Q) [a] Assisting another person in obtaining an unfair advantage on EMT examinations; (R) [d] Defrauding [the Division] Public Health; (S) [k] Knowingly providing emergency medical care aboard an unlicensed ambulance; (T) [v] Violation of the terms of a written agreement with [the Division] Public Health; (U) [e] Engaging in sexual activity constituting a crime in Oregon or engaging in on-the-job sexual harassment which may endanger the public or a person providing emergency medical care; (V) [a] Arriving for duty in a condition whereby the EMT is likely to become impaired through fatigue, illness, or any other cause, as to make it unsafe for the employee to begin to operate an ambulance or provide patient care; and (W) [a] Any violation of these rules or any law, administrative rule, or regulation governing ambulances, or EMTs, or emergency medical service systems. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 8 of 58 (b) This section does not create any new substantive violations. It is included solely to inform EMS agencies and EMTs as to conduct that [the Division] Public Health regards as already proscribed by the statutory definition of unprofessional conduct. Stat. Auth.: ORS 682.025 & (ORS 682.215) Renumbered to 682.017 in 2003 Stats. Implemented: ORS 682.025, ORS 682.208, ORS 682.216, ORS 682.220, ORS 682.224 & ORS 682.017 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0010 Approved EMT Courses (1) [The Division] Public Health shall approve an EMT course conducted by an Oregon teaching institution which: (a) Is accredited by the Oregon Department of Education or the Oregon State Board of Higher Education as specified in OAR 581-049-0000 through 581-0490040. Where it is determined by [the Division] Public Health that in a rural area, adequate training at the EMT-Basic level or EMT Intermediate course is not available through a teaching institution, [the Division] Public Health may, in its sole discretion, authorize an organization licensed by [the Division] Public Health to conduct the EMT courses. Such authorization shall be subject to such terms and conditions as [the Division] Public Health may specify; (b) Meets the requirements prescribed by [the Division] Public Health for the EMT course for which approval is sought; [(c) No teaching institution shall begin an EMT course unless and until that teaching institution has received course approval from the Division; and] [(d)] (c) Submits an Application to Conduct Course to [the Division] Public Health, using an application form provided by [the Division] Public Health. The application to conduct a course must be received by [the Division] Public Health at least 30-days prior to beginning the course. An application which is in any way incomplete may be rejected by [the Division] Public Health; and (d) No teaching institution shall begin an EMT course unless and until that teaching institution has received course approval from Public Health. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 9 of 58 (2) A teaching institution, as specified below, may offer one or more of the [Division] Public Health-approved EMT curricula under the direction of a course medical director who is formally and currently affiliated with the teaching institution: (a) A two-year community college, four-year [c]College or a licensed vocational school may offer an Emergency Medical Technician Basic Course;[. A copy of the] EMT-Basic National Standard Curriculum, US Department of Transportation, National Highway Traffic Safety Administration, [1994, as amended and supplemented by the Division is on file at the Division office and consists of a minimum of:] Current Edition. The course provided will follow the current national emergency medical services education standards or curriculum with any supplemental objectives outlined by Public Health. The emphasis of an EMT-Basic course must be competence of the graduate. It must consist of: [(A) Didactic –140 hours; and] [(B) Clinical - eight hours in a hospital emergency department, during which skills as required by the Division are performed under a preceptor.] (A) Didactic instruction; and (B) Clinical education in a hospital emergency department or licensed ambulance service, during which skills within the EMT-Basic scope of practice are performed under the supervision of a preceptor. (b) A two-year community college, four year [c]College or a licensed vocational school may offer an Emergency Medical Technician-Intermediate Course [Current Edition.] The course provided will follow the educational standards outlined in the current Oregon EMT-Intermediate curriculum. The emphasis of an EMTIntermediate course must be competence of the graduate. [and will include:] It must include: (A) Didactic - 76 hours; and (B) Skills Laboratory - 44 hours, during which skills as required by the Division are performed under a skills laboratory preceptor. (A) Didactic instruction; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 10 of 58 (B) Skills laboratory; (C) Clinical education in hospital emergency department or a medical clinic, during which skills within the EMT-Intermediate scope of practice are performed under the supervision of a preceptor. (D) A letter of support of a student entering into an EMT-Intermediate course from a Medical Director who is knowledgeable about the individual’s skills and abilities, which documents that the EMT has demonstrated competency as a practicing EMT-Basic and is appropriate to be considered for EMT-Intermediate certification. (c) A two-year community college or a four-year [c]College may offer an Emergency Medical Technician-Paramedic Course;[. A copy of the EMTParamedic National Standard Curriculum, U.S. Department of Transportation, National Highway Traffic Safety Administration, 1999Edition, as amended and supplemented by the Division is on file at the Division office. The course provided will follow the current National Emergency Medical Services education standards or curriculum with any supplemental objectives outlined by Public Health. The emphasis of a paramedic course must be the competence of the graduate. and not just or only the number of hours of education received. In order to obtain and demonstrate the necessary competencies, it may require a student to receive approximately 1000 to 1200 hours of: It must include: [(A) Didactic instruction; (B) Skills laboratory; (C) Clinical education, hospital clinical areas as prescribed by the Division, during which skills as required by the Division are performed under a preceptor; (D) Field internship represents final evaluative phase of the paramedic program. The student must actively participate in providing care in at least 40 ambulance calls; no less than ten each in cardiac, respiratory, general medical, and trauma emergencies, during which clinical skills as required by the Division are performed under a preceptor; and] (A) Clinical education in hospital clinical areas during which skills within the EMT-Paramedic scope of practice are performed under the supervision of a preceptor; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 11 of 58 (B) “Field Internship” where the student must demonstrate the integration of all didactic, psychomotor skill s and clinical instruction into the ability to serve as entry level paramedic. During this evaluation process, the student must actively participate in providing care to patients under the direct supervision of a preceptor. The Field Internship must consist of at least 300 hours, during which time the student must demonstrate competency in providing care to patients experiencing cardiac, respiratory traumatic and general medical emergencies. [(E)] (C) The student must successfully demonstrate a skill in classroom lab or hospital clinical setting before that skill is performed and evaluated in a field internship. (3) Every approved EMT-Basic, EMT-Intermediate and EMT-Paramedic course must utilize [the Division] Public Health-approved lesson plans and supporting materials for those portions of the EMT program which address laws and regulations governing the EMS system, medical-legal issues, roles and responsibilities of EMTs and EMS professional ethics The teaching institution is responsible for replicating student handouts from master copies provided by [the Division] Public Health. (4) A [the Division] Public Health representative may attend any didactic, skills laboratory, clinical or field internship session for the purpose of observation and evaluation. (5) The EMT course director must: (a) Have each student enrolled in an approved EMT course complete a [the Division] Public Health-approved student registration form at his or her first class session and forward the completed student registration forms to [the Division] Public Health within 21-days of the course enrollment deadline; (b) Inform each student that the failure of the student to complete and submit [the Division] Public Health-approved student registration form to [the Division] Public Health within the specified time may make the student ineligible to apply for and take any certification examinations; and (c) Have written documentation that the student has: (A) Successfully completed all required didactic material; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 12 of 58 (B) Properly demonstrated all skills obtained in both the classroom laboratory and hospital setting; and (C) Successfully completed the required field internship. (6) Upon successful completion of the didactic, skills lab[oratory], clinical experience and field internship portion of an approved course and submission of a completed application and the appropriate fee, the student is eligible to take the certification examination(s). Successful completion includes, [beginning with the effective date of these rules,] completion of all objectives of the didactic curriculum, actual physical attendance of at least 85 percent of the didactic hours and 100 percent of clinical and field internship hours and completion of all required clinical and internship skills and procedures. At the discretion of the course director, scheduled class makeup sessions may be conducted under the instruction of the course director or others chosen by the course director. (7) A person applying for a non-endorsement initial certification as an EMTParamedic must present evidence that he or she possess [at least an associate level degree] from an accredited institution of higher learning: an [that includes course work equivalent to the uniform] associate of applied science degree in emergency medical technology "AAS Degree or higher" as approved by the State Board of Education and offered by Oregon's two-year community colleges or four-year colleges; or an equivalent “AAS Degree or higher” in a health-related field as approved by the State Board of Education and offered by Oregon's two-year community colleges or four-year colleges. (8) [The Division] Public Health shall be the sole agency authorized to determine equivalency of course work presented from teaching institutions not authorized to grant the Oregon AAS-EMT Degree. (9) A person who has satisfactorily completed an approved EMT-Paramedic course, including didactic, clinical, and field internship components prior to July 1, 1999 shall not be subject to the requirements specified in section (7) of this rule. Stat. Auth.: ORS 682.145 & ORS 682.217 Stats. Implemented: ORS 682.208, ORS 682.216 & ORS 682.017 Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; renumbered from 333-023-0630; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0030; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 13 of 58 333-265-0020 Approved EMT Course Faculty; Certifying Officer, Examiner Requirements (1) An Oregon teaching institution conducting EMT-Basic, EMT-Intermediate or EMT-Paramedic courses must have a program faculty consisting of a designated [p]Program [director] Administrator, course [m]EMS Medical [d]Director, [c] Course [d] Directors and guest instructors. The number of persons carrying out the responsibilities of conducting an EMT course may vary from program to program. One person, if qualified, may serve in multiple roles. (a) The [p]Program [director] Administrator: (A) Is responsible for course planning, organization, administration, periodic review, program evaluation, continued development, and effectiveness; and (B) Must have appropriate training and experience to fulfill the role. (b) The course [m]EMS Medical [d]Director: (A) Must meet the qualifications of an [supervising physician] EMS Medical Director as defined in OAR 847-035-0020; (B) Shall provide medical direction to the didactic, clinical and field internship portions of an EMT course; and (C) Shall act as the ultimate medical authority regarding course content, procedures and protocols. (c) The [c]Course [d]Director for a specific course (A) Must have appropriate training and experience to fulfill the role and hold credentials which demonstrate at least equivalent training and experience; (B) [Is responsible for scheduling lectures and coordinating and arranging clinical rotations and field internships;] Is responsible for course planning and organization, including scheduling lectures and coordinating the arrangement of clinical rotations and field internships.” (C) Is the primary instructor, in that the person must conduct at least 50 percent of the didactic sessions, unless waived by [the Division] Public Health; and D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 14 of 58 (D) [Must attend at least 80 percent of the didactic sessions.] Must ensure, if guest instructors are utilized, that the guest instructors present lessons that address all objectives identified in the course curriculum for the topic being presented. (d) The guest instructor: (A) Is a person that teaches a specific course subject; (B) If an EMT, the EMT must be in good standing with [the Division] Public Health; (C) Must be qualified and have the expertise in the specific course subject; and (D) Must follow the course curriculum and meet the course objectives for that specific subject. (2) An EMT-Basic [c]Course [d]Director must: (a) Be at least an Oregon EMT-Basic with three years of EMT-Basic prehospital emergency and non-emergency care experience or an approved medical director; (b) Be in good standing with [the Division] Public Health; (c) Hold a current CPR Instructor certificate from the American Heart Association or American Red Cross or equivalent as approved by Public Health; (d) Have completed one of the following: (A) National Association of EMS Educators EMS Educator Course; [(A)] (B) National Standard Curriculum for Emergency Medical Technician Instructors, U.S. Department of Transportation, [1986] Current Edition; [(B)] (C) National Fire Protection Association (NFPA) Fire Instructor 1 or Fire Service Instructor I and II programs as provided by the Department of Public Safety Standards and Training; [(C)] (D) Instructor Development Program (40 hours) as provided by the Department of Public Safety Standards and Training; or D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 15 of 58 [(D)] (E) A minimum of three college credits in adult or vocational education theory and practice presented by an accredited institution of higher learning. (e) Participate in a course director program presented by [the Division] Public Health. (f) Participate in a course director update program presented by [the Division] Public Health, biennially thereafter, unless waived by [the Division] Public Health. (3) An EMT-Intermediate [c]Course [d] Director must: (a) Be at least an Oregon EMT-Intermediate with three years of EMT-Intermediate prehospital emergency and non-emergency care experience or an approved medical director; (b) Be in good standing with [the Division] Public Health; (c) Hold a current CPR Instructor certificate from the American Heart Association, American Red Cross or equivalent as approved by [the Division] Public Health; (d) Have completed one of the following: (A) National Association of EMS Educators EMS Educator Course; [(A)] (B) National Standard Curriculum for Emergency Medical Technician Instructors, U.S. Department of Transportation, [1986] Current Edition; [(B)] (C) National Fire Protection Association (NFPA) Fire Instructor 1 or Fire Service Instructor I and II programs as provided by the Department of Public Safety Standards and Training; [(C)] (D) Instructor Development Program (40 hours) as provided by the Department of Public Safety Standards and Training; or [(D)] (E) A minimum of three college credits in adult or vocational education theory and practice presented by an accredited institution of higher learning. (e) Participate in a course director program presented by [the Division] Public Health. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 16 of 58 (f) Participate in a course director update program presented by [the Division] Public Health, biennially thereafter, unless waived by [the Division] Public Health. (4) An EMT-Paramedic [c]Course [d]Director must: (a) Possess at least an associate degree from an accredited institution of higher learning that includes course work equivalent to the uniform associate of applied science degree in emergency medical technology "AAS-EMT Degree or higher" as approved by the State Board of Education and offered by Oregon's two-year community colleges or four-year colleges; (b) Be an Oregon EMT-Paramedic with three years of EMT-Paramedic prehospital emergency and non-emergency care experience; (c) Be in good standing with [the Division] Public Health; (d) Hold a current CPR Instructor certificate from the American Heart Association or the American Red Cross; (e) Hold a current ACLS Instructor certificate from the American Heart Association or equivalent as approved by [the Division] Public Health; (f) Hold either a Basic Trauma Life Support (BTLS) or Prehospital Trauma Life Support (PHTLS) Instructor certificate or equivalent as approved by [the Division] Public Health; (g) Have completed one of the following: (A) National Association of EMS Educators EMS Educator Course; [(A)] (B) National Standard Curriculum for Emergency Medical Technician Instructors, U.S. Department of Transportation, [1986] Current Edition; [(B)] (C) National Fire Protection Association (NFPA) Fire Instructor 1 or Fire Service Instructor I and II programs as provided by the Department of Public Safety Standards and Training; [(C)] (D) Instructor Development Program (40 hours) as provided by the Department of Public Safety Standards and Training; or D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 17 of 58 [(D)] (E) A minimum of three college credits in adult or vocational education theory and practice presented by an accredited institution of higher learning. (h) Participate in a course director program presented by [The Division] Public Health. (i) Participate in a course director update program presented by [The Division] Public Health, biennially thereafter, unless waived by [The Division] Public Health. (5) [The Division] Public Health may deny course approval in accordance with the provisions of ORS 183.310 to 183.550 for failure to comply with the requirements listed in this section. (6) Certifying Officers are representatives of Public Health that oversee the EMT-Basic and EMT-Intermediate practical examinations of candidates. Certifying Officers must: (a) Possess an Oregon EMT-Intermediate or Paramedic certificate; (b) Be in good standing with Public Health; (c) Serve as a Certifying Officer for at least two practical exams per year in order to remain active; (d) Attend training as required by Public Health regarding roles and responsibilities of Certifying Officers. (7) Examination Evaluators observe and record the performance of candidates for First Responder, EMT-Basic, EMT-Intermediate, and EMTParamedic certification. Examination Evaluators must: (a) Possess an Oregon First Responder or EMT certificate equal to or higher than the level of EMT certification for which candidates are being tested; (b) Be in good standing with Public Health; (c) Attend training as required by Public Health regarding roles and responsibilities of Examination Evaluators. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 18 of 58 Stat. Auth.: ORS 682.215, Stat. Implemented: ORS 682.215, Hist.: 8-1993, f.6-2293, cert. ef. 7-1-93;HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333028-0032; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0025 Application Process to Obtain an EMT Certificate (1) A person who holds him or herself out to be an EMT or who performs EMT functions must receive an EMT certificate from [the Division] Public Health before offering such service to the public. (2) The applicant for an EMT certificate must: (a) Meet the requirements of ORS chapter 682 and these rules; (b) Be at least 18 years of age; (c) Be a high school graduate or equivalent; [(d) Be physically and mentally qualified to perform the duties of an EMT; ] [(e) Be free from addiction to controlled substances or alcoholic beverages, or currently rehabilitated; [(f) Be free from epilepsy or diabetes or, if not free, has been free from any lapses of consciousness for a period of at least 180 days; (d) Not have a disciplinary restriction placed upon scope of practice by a medical director; (e) Not have been named as a defendant in a lawsuit that alleges medical malpractice or misconduct; (f) Not have been issued a citation, arrested or convicted for driving under the influence or been admitted to a diversion program; (g) Not have been arrested or convicted for any drug related offense; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 19 of 58 (h) Not have been arrested or convicted for any sexual, violent, personal or property crime; (i) Not have any restrictions or loss of driving privileges; (j) Not have been admitted to a drug/alcohol treatment program; or (k) Not have developed any physical disability lasting more than 120 days or is a permanent condition(s) [30-days] which significantly interferes with the ability of the EMT to perform all of the duties of the level of certification held by the EMT; or (l) Not have any mental health condition that affects the ability to perform as an EMT. (m) Be free from any lapse of consciousness of unknown etiology for a period of at least 180 days; [(g)] Have an acceptable criminal record check made through the Law Enforcement Data Systems (LEDS) that is maintained by the Department of State Police or qualified vendor. If the results of the LEDS check shows "multi-state offender", or if the applicant indicates on the application they have a criminal record, then a nationwide criminal record check by fingerprint identification shall be requested of the Federal Bureau of Investigation as authorized by ORS 181.537. Any fee required by the Federal Bureau of Investigation to do a nationwide check shall be the responsibility of the applicant; and (n) Be able to perform all functions identified in the Job Task Analysis developed by the NHTSA/DOT and included in the National Standard Curriculum for EMT education. (3) An applicant for an EMT certificate must submit an application to [the Division] Public Health on a form specified by [the Division] Public Health. A completed application form must contain, at a minimum: (a) Full name; (b) Full home address; (c) Social Security Number as required by ORS 25.785; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 20 of 58 (d) EMT course number; (e) Course completion date; (f) Answers to personal history questions; (g) Work history for the last five years; (h) A nonrefundable certification fee as specified in OAR 333-265-0030(1)(a)(A), (B) or (C) or 333-265-0030(1)(e)(A) or (C); and (i) A signed statement under the penalties of perjury that certifies the following: (A) There has been no attempt to knowingly and willfully falsify, conceal, or omit a material fact, or make any false, fictitious, incomplete or fraudulent statements or representations, or make or use any false writing or document knowing the same to contain any false, fictitious, or fraudulent statement or entry for the purpose of obtaining or attempting to obtain an EMT certificate to function in the State of Oregon; (B) The applicant authorizes any persons or entities, including but not limited to hospitals, institutions, organizations, governmental or law enforcement entities to release to [the Division] Public Health any information, files, or records requested by [the Division] Public Health in connection with the processing of an application; and (C) Upon receiving an EMT certificate, the certified EMT authorizes physicians, quality assurance committees, or emergency medical service agencies to disclose information which is relevant to job performance to [the Division] Public Health. (4) If the applicant is applying for EMT certification by endorsement, the applicant must: (a) Meet the requirements specified in section (1) through section (3) of this rule; and (b) Meet the requirements specified in OAR 333-265-0050. Stat. Auth.: ORS 682.145, ORS 682.215 & ORS 682.255 Stats. Implemented: ORS 682.145, ORS 682.215 & ORS 682.255 Hist.: OHD 9-2001, f. & cert. ef. 4-24-01 D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 21 of 58 333-265-0030 Fees for the Certification and Recertification of an EMT; Examination Policy (1) In order for a person to be eligible for EMT certification, the person must submit a completed application to [the Division] Public Health accompanied by a nonrefundable fee as authorized in ORS [682.155]: 682.212 (a) The initial application fee includes the first attempt and any eligible same-day practical re-examinations: (A) EMT-Basic - $70, which includes a $15 National Registry of EMTs fee; (B) EMT-Intermediate - $75; and (C) EMT-Paramedic - $200, which includes a $35 National Registry of EMTs fee. (D) Effective January 1, 2007 the National Registry will conduct written examinations for the EMT-Basic and EMT-Paramedic via computer based testing. Applicants must follow National Registry procedures and protocols to participate in the written examination. Written examination fees will be determined by the National Registry. (E) Effective XXX, 2006 Industrial/Organizational Solutions, Inc. (I/O Solutions) will provide written examinations for the EMT-Intermediate via computer-based testing. Applicants must follow I/O Solutions procedures and protocols to participate in the written examination. Written examination fees will be determined by I/O Solutions (F) EMT-Basic candidates must have completed an Oregon-based initial or refresher EMT-Basic course to be eligible to participate in an EMT-Basic practical examination in Oregon. (G) Effective January 1, 2007 EMT-Paramedic candidates will be eligible to participate in the practical examination upon successful completion of the didactic and clinical portions of the EMT-Paramedic program. Candidates will be eligible to sit for the written exam upon successful completion of the internship portion of the EMT-Paramedic program. (H) Effective XXX, 2006 Industrial/Organizational Solutions, Inc. (I/O Solutions) will provide written examinations for the EMT-Intermediate via D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 22 of 58 computer-based testing. Applicant fees to Oregon [the Division] Public Health will remain the same and will be applied toward the practical examination. Applicants must follow I/O Solutions procedures and protocols to participate in the written examination. Written examination fees will be determined by I/O Solutions (b) Written re-examination fees: (A) EMT-Basic - $40, which includes a $15 National Registry of EMTs fee; (B) EMT-Intermediate - $50; and (C) EMT-Paramedic - $70, which includes a $35 National Registry of EMTs fee. (D) Effective January 1, 2007 the National Registry will conduct written examinations for the EMT-Basic and EMT-Paramedic via computer based testing. Applicants must follow National Registry procedures and protocols to participate in the written examination. Written examination fees will be determined by the National Registry. (E) Effective XXX, 2006 Industrial/Organizational Solutions, Inc. (I/O Solutions) will provide written examinations for the EMT-Intermediate via computer-based testing. Applicants must follow I/O Solutions procedures and protocols to participate in the written examination. Written examination fees will be determined by I/O Solutions. (c) Practical re-examination fees: (A) EMT Basic - $30 (B) EMT-Intermediate - $50; and (C) EMT-Paramedic - $70 (d) Provisional certification fees. Only EMT-Paramedic applicants are eligible to apply for and receive a provisional certificate. The fee is $25 in addition to the fee listed in paragraph (1) (a) (C) of this rule. (e) [I] Endorsement certification fees: (A) EMT-Basic - $25; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 23 of 58 (B) EMT-Intermediate - no [I]endorsement certification available; [and] (C) EMT-Paramedic - $200. (f) A person who fails to appear for a scheduled written or practical examination shall forfeit their examinations fee(s); or (g) If a person fails to appear due to circumstances that are beyond the control of the applicant, [the Division] Public Health reserves the right to waive a subsequent examination fee. (2) A person eligible for EMT recertification must submit a completed application to [the Division] Public Health accompanied by a nonrefundable fee as authorized in ORS 682.155 and 682.157: (a) Recertification fees for certification periods of 12 months or less: (A) EMT-Basic - $20; (B) EMT-Intermediate - $35; and (C) EMT-Paramedic - $60. (b) Recertification fees for certification periods of 13 to 24 months: (A) EMT-Basic - $40; (B) EMT-Intermediate - $65; and (C) EMT-Paramedic - $120. (c) A person who submits an application for recertification that is postmarked after May 31, the person must pay in addition to the recertification fee, a late renewal fee in the amount of $20 as authorized in ORS 682.155 and 682.157. (3) An ambulance or rescue service which utilizes volunteers for the provision of a majority of its services may request that [the Division] Public Health waive the EMT recertification fee for its volunteers by making application to [the Division] Public Health, using forms provided by [the Division] Public Health, certifying that: D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 24 of 58 (a) The ambulance or rescue service is unable to maintain an adequate number of volunteer EMTs due to the required EMT recertification fee. A volunteer is a person who gives of their time freely to staff an ambulance or rescue, but who may receive reimbursement for personal expenses incurred; and (b) A copy of a signed agreement between the volunteer service and the volunteer EMT is attached to the EMT's application for recertification specifying that the EMT: (A) Is not employed as an EMT elsewhere; (B) Must remain affiliated with the volunteer service for the entire upcoming certification period; (C) Must be scheduled monthly to staff the ambulance or rescue; and (D) Must immediately reimburse [the Division] Public Health the required current EMT recertification fee if the EMT is not scheduled monthly or is no longer affiliated with a volunteer ambulance or rescue service and wants to remain certified as an EMT. (4) An Oregon-certified EMT wishing to obtain a duplicate EMT certificate, must submit a written request to [the Division] Public Health in the form required by [the Division] Public Health and pay a fee in the amount of $10 as authorized in ORS 682.155 and 682.157. (5) A $25 fee will be assessed for any checks that are returned for nonsufficient funds. Stat. Auth.: ORS 682.155, ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.155, ORS 682.157 & ORS 682.215 Hist.: HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-28-017; HD 8-1995, f. & cert. ef. 11-6-95; OHD 2-1999, f. & cert. ef. 2-4-99; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0040 Certification as an EMT D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 25 of 58 (1) A person must apply to take and pass both the written and practical certification examinations within 24-months after the completion of the didactic, clinical and field internship portion of an approved course as specified by the course completion date listed on the course application submitted to [the Division] Public Health. If more than 24-months have passed, the person must successfully complete [A the Division approved refresher course for the specific level prior to taking or retaking both the written and practical certification examinations. A copy of the refresher course curricula is on file at the Division office.] another Public Health-approved initial EMT course for that certification level to be eligible to re-enter the certification process. (2) [The Division] Public Health or the National Registry of EMTs shall establish the passing scores of all certification examinations. (3) A person must pass a written certification examination. (a) An oral examination, having [a reader or] any other type of assistance to complete the written examination is not permitted. (b) [The Division] Public Health will offer reasonable and appropriate accommodations for the written component of the examination for those persons with a documented learning disability. The documentation must include a diagnosis of learning comprehension based upon the results of standardized psycho-educational assessment including an appropriate standardized measure of intelligence and an appropriate standardized measure of achievement in reading decoding and reading comprehension. The acceptable tests are: (A) The General Aptitude Test Battery or Differential Aptitude Test; and (B) Woodcock-Johnson Revised Tests of Achievement or Wide Range Achievement Test-Revised. (c) A person requesting accommodations for the written component of the examination may contact [the Division] Public Health for a copy of the examination accommodation policy. (d) The accommodation shall consist of up to 150 percent of the normally allotted amount of time in which to complete the written examination. (4) A person must also pass the practical portion of the certification examination, when applicable: D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 26 of 58 (a) There shall be no accommodation in the practical portion of the certification examination; (b) A person failing not more than two skill stations of the EMT-Basic or EMTIntermediate practical examination or not more than five skill stations of the EMTParamedic practical examination is entitled to a no-cost same-day practical reexamination; (c) A person taking the same-day practical re-examination must retake only those skill stations failed; (d) A person failing any skill station(s) of the practical examination on the sameday second attempt must submit the necessary re-examination fee and be scheduled to retake only those skill stations failed; (e) A person has one additional attempt to pass that portion of the practical examination not passed on either the first or second attempt; and (f) A person failing more than two skill stations of the EMT-Basic or EMTIntermediate practical examination or more than five skill stations of the EMTParamedic practical examination is not eligible for a no-cost same-day reexamination. A person must submit the necessary re-examination fee and be scheduled for another complete practical examination. (5) The passing results of the written and practical certification examinations for each level of certification shall remain valid for a 12-month period from the date the examination was successfully completed. A person not successfully completing the failed portion of an examination within that 12-month period shall be required to repeat the entire written and practical examination. (6) If a person fails either the written or practical examination three times, he or she must successfully complete a [the Division] Public Health-approved refresher course for that specific training level to become eligible to re-enter the certification process. A person must retake and pass both the written and practical examinations within three additional attempts. (7) If a person does not become certified, by either failing the written or practical examination six times or not completing the examination process within 24-months of the completion date of the initial EMT course, the person must successfully complete another [the Division] Public Health-approved initial EMT course for that certification level to be eligible to re-enter the certification process. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 27 of 58 (8) A person must be certified at least at the Oregon EMT-Basic level before being eligible to enroll in an EMT-Intermediate or EMT-Paramedic course and apply for and take any certification examinations. (9) Where [the Division] Public Health utilizes the examinations of the National Registry of EMTs for the purpose of certification, all policies and rules of the National Registry of EMTs shall apply in lieu of this section. (10) A person seeking to obtain or retain Oregon EMT certification must be a resident of Oregon. If not a resident, the person must be employed, either in a paid or volunteer capacity, with an Oregon EMS agency. Stat. Auth.: ORS 682.145, ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.145, ORS 682.157 & ORS 682.215 Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0615; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0015; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0050 333-265-0050 EMT Certification by [I]Endorsement (1) [The Division] Public Health shall issue a person an EMT-Basic certificate by [i]endorsement when that person meets the requirements in section (3) of this rule. (2) [The Division] Public Health shall issue a person an EMT-Paramedic certificate by [i]endorsement when that person meets the requirements in sections (3), (5) and (6) of this rule. (3) A person applying for Oregon EMT certification by [i]endorsement must: (a) Submit a completed application to the Division accompanied by a nonrefundable fee; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 28 of 58 (b) Submit documentation of EMT training which meets or exceeds the requirements for Oregon EMT certification at the level of certification for which the person is applying; (c) Be verified to be in good standing with the certifying agency; and (d) Have a criminal records check made through the Law Enforcement Data System (LEDS) that is maintained by the Department of State Police or qualified vendor. If the results of the LEDS check shows "multi-state offender", or if the applicant indicates on the application they have a criminal record, then a nationwide criminal record check by fingerprint identification shall be requested of the Federal Bureau of Investigation as authorized by ORS 181.537. Any fee required by the Federal Bureau of Investigation to do a nationwide check shall be the responsibility of the applicant. [(4) Successful completion of the EMT-Basic written and practical examinations may be waived for a person certified in a state with comparable requirements, as determined by the Division.] [(5)] (4) The Division shall require a person applying for Oregon EMT-Paramedic certification that is currently state-certified, but is not currently certified by the National Registry of EMTs[,] to[: (a) M] meet all of the requirements of the National Registry of EMTs.[; and (b) Successfully complete the certification examinations as specified in OAR 333265-0040. In addition, the Division may require any EMT-Paramedic applicant to successfully complete written and practical examination stations which are not required by the National Registry of EMTs.] [(6)] (5) A person from another state who obtained their EMT-Paramedic certification after July 1, 1999, and who applies to obtain Oregon EMT-Paramedic certification by [i]endorsement, must meet all other certification requirements as specified in these rules and possess: (a) [a] An associates degree or higher as specified in OAR 333-265-0010(7) and (8); or (b) An equivalent associates degree or higher in emergency medical technology from another state; or D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 29 of 58 (c) An equivalent associates degree or higher in a health-related discipline that is equivalent to (a); or (d) An equivalent associates degree or higher in a non-health-related discipline with an agreement that: (A) Within two years the applicant will complete 12 hours in Anatomy and Physiology plus e hours of Medical Terminology at an approved educational institution. [and meet all other certification requirements as specified in these rules.] (6) Public Health shall be the sole agency authorized to determine equivalency of course work presented from teaching institutions not authorized to grant the Oregon AAS-EMT Degree. (7) An application for EMT certification by [i]endorsement which is incomplete or can not be verified may be denied and the nonrefundable fee forfeited. (8) If the Division determines that a person is not eligible for EMT-Paramedic certification by [i]endorsement due to not meeting the required AAS-EMT Degree requirements, the person may apply for EMT-Paramedic provisional certification as specified in OAR 333-265-0060. Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0620; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 18-1990(Temp), f. & cert. ef. 6-19-90; HD 19-1991, f. & cert. ef. 10-18-91; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0020; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0060 EMT Provisional Certification (1) As authorized by ORS [682.157(2)] 682.216(2), [the Division] Public Health may issue a provisional EMT-Paramedic certification to an out-of-state certified D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 30 of 58 EMT-Paramedic who meets the requirements as specified in OAR 333-2650050(3)(a) through [(d), (4) and (5)(a) and (b) and] (6), and who wishes to function as an EMT-Paramedic while waiting to either take the National Registry EMTParamedic written and practical examinations or complete {a maximum of 12credit hours] the necessary requirements to obtain an AAS Degree or equivalent. The person must submit: (a) A letter of recommendation from his or her most recent medical director; (b) A letter from an Oregon EMS agency specifying that the person shall be immediately employed, whether in a paid or volunteer capacity; and (c) A letter from the person's prospective medical director stating that the medical director shall serve as his or her medical director while being provisionally certified. (2) An application for provisional EMT-Paramedic certification which is incomplete or can not be verified may be denied and the nonrefundable fee forfeited. (3) An EMT-Paramedic provisional certification shall become invalid immediately if the person: (a) Ceases active involvement in emergency medical services; (b) Does not take, when necessary, the National Registry of EMTs' written or practical examination within 180-days of receiving provisional certification; (c) Fails the written or practical examination; (d) Has his or her EMT scope of practice revoked or restricted by his or her medical director; or (e) Does not submit written documentation of the successful completion of any [AAS-EMT Degree hours that were missing within 365-days] missing credit hours required of OAR 333-265-0050(5)(d)(A), if applicable, from the time of submitting an application for provisional certification. Stat. Auth.: ORS 682.216 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; OHD 9-2001, f. & cert. ef. 4-24-01 D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 31 of 58 333-265-0070 Certification as an EMT of Any Person in Adjoining States (1) Any person who provides prehospital emergency or non-emergency care in Oregon must be certified as an Oregon EMT and function under a [Division] Public Health-approved medical director. (2) Oregon EMT certification is not required when: (a) Specifically exempted by ORS [682.035] 682.204; (b) An out-of-state certified EMT is transporting a patient through the state; (c) An out-of-state certified EMT is caring for and transporting a patient from an Oregon medical facility to an out-of-state medical facility or other out-of-state location; (d) An out-of-state certified EMT is caring for and transporting a patient originating from outside of Oregon to a medical facility or other location in Oregon; or (e) A disaster has been declared by either federal, state or local officials and which results in the need to mobilize and utilize all available resources to provide patient care and transportation in the affected area. Stat. Auth.: ORS 682.204 & ORS 682.215 Stats. Implemented: ORS 682.135 & ORS 682.215 Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0625; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0025; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-???? New number needed here. Criminal History Check (1) Pursuant to ORS 187.537 and 682.220 [the Division] Public Health shall conduct a criminal history check for every EMT or First Responder Applicant through the Law Enforcement Data System maintained by the Oregon State Police or a qualified vendor. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 32 of 58 (2) [the Division] Public Health may additionally conduct periodic criminal history checks for EMT or First Responder certificate holders. (3) In addition to a criminal history check through LEDS, a national criminal history check may be required by [the Division] Public Health under the following circumstances: (a) The subject individual has lived or been employed outside of Oregon for 60 or more consecutive days during the previous five years. (b) Multi-state Offender. The LEDS check, or any other information obtained by the Department, indicates there may be criminal history outside of Oregon, or the subject individual self-discloses criminal history outside of Oregon. (c) Identity or History Questioned. The social security number appears not to be valid or is not provided to [the Division] Public Health, the subject individual has no Oregon Driver License or Oregon Identification card, or the Department has other reason to question the identity or history of the subject individual. (4) If a nationwide check is necessary, [the Division] Public Health will request the State Police to conduct the check, including fingerprint identification, through the Federal Bureau of Investigation. [the Division] Public Health will follow procedures set forth in ORS 181.537 regarding the transmission, use, and retention, of fingerprint cards. (5) Criminal offender records provided by the FBI may not be released to the subject individual or any qualified entity as defined under ORS 181.533(1)(b) (6) Costs associated with a national criminal history check, to be paid by the subject individual, may not exceed the actual fee charged for the check. (7) In determining whether to deny or revoke certification on the basis of criminal history, [the Division] Public Health will generally consider the following factors: (a) Nature of the crime; (b) Facts supporting the conviction; (c) Relevancy of the crime to the requirements for EMT certification; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 33 of 58 (d) Intervening circumstances, including but not limited to the passage of time since the commission of the crime, age of the person at the time of the crime; likelihood of a repetition of the offenses; subsequent commission of another relevant crime, and the recommendation of an employer. (8) If a subject individual refuses to consent to a criminal history check or fingerprint check, the application will be deemed incomplete and will not be processed. If a subject individual submits false information regarding criminal history, or fails to submit a complete criminal history, the applicant will be denied certification under ORS 183 or disciplined under ORS 682.220. (9) ) A subject individual who has been convicted of Driving Under the Influence of Intoxicants or who has received a diversionary sentence or a criminal conviction after being charged with Driving Under the Influence of Intoxicants may be required to have an addiction assessment performed by a physician whom is Board certified in addiction medicine. (a) The subject individual must choose a physician from a list provided by [the Division] Public Health. (b) [the Division] Public Health will obtain a copy of the physician’s findings for review and consideration. (c) The subject individual will be responsible for the cost of the assessment. (10) A subject individual will be denied certification or recertification if the individual is: (a) A registered sex offender in any jurisdiction; (b) A the subject of an outstanding arrest warrant. (11) A subject individual may be denied certification or recertification if the individual: (a) Has been convicted of a crime, but has had the sentence deferred; (b) Is currently participating in a diversion program (c) Has failed to complete a required diversion program D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 34 of 58 (d) Is currently on probation (e) Has failed to meet all terms of probation 333-265-???? New number needed here. Personal History Check (1) Public Health may conduct an investigation of a subject individual for the following reasons: (a) Alleged illegal use or addiction to drugs within the past 10 years; (b) Alleged addiction to alcohol within the past 10 years; (c) Alleged conviction of theft or fraud, which is the intentional misrepresentation or misstatement of a material fact, concealment of or failure to make known any material fact or any other means by which misinformation or false impression is knowingly given, within the past five years; (d) Alleged involvement in any judicial proceeding in which an EMT is accused of a sexual or violent crime; (e) Alleged dysfunctional mental illness within the past five years; or (f) Any other reason specified in ORS 682.220. (2) If requested, the subject individual must sign a Release of Information so that information ordinarily deemed confidential may be obtained by the Department in the course of an investigation. Failure to sing the release will result in a denial of certification or imposition of discipline under ORS 682.220. (3) In the course of conducting an investigation, the Department may request relevant information from any individual or entity, including but not limited to current and former employers, treatment providers, including mental health, and addiction services providers, laboratory testing facilities, and pharmacies. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 35 of 58 (g) Complaint of unprofessional conduct from a patient, health care professional, or the general public. 333-265-0080 Denial, Suspension, Revocation, or Surrender of an EMT's Certification or Placing an EMT on Probation (1) The certification of an EMT may be denied, suspended or revoked in accordance with the provisions of ORS 183.310 to 183.550 for the reasons specified in ORS [682.175(2)] 682.220(2).. (2) An EMT may be placed on probation as specified in ORS [682.185(2)] 682.224(2) and in accordance with the provisions of ORS 183.310 to 183.550. The terms of probation shall be established by [the Division] Public Health. (3) [The Division] Public Health may impose a fine not to exceed $5000 and recover the costs incurred from an EMT applicant or certified EMT who either has admitted to the facts of the complaint or has been found, through a formal contested case proceeding, to have committed one or more violations of the regulatory statutes or rules. Costs may include, but are not limited to charges for: (a) Urine and blood tests; (b) Inpatient or outpatient treatments for drug or alcohol abuse; (c) Other tests, treatments, or examinations; (d) Costs incurred by the [the Division] Public Health in conducting the investigation; or (e) Attorney fees. (4) The Division may conduct an investigation of any EMT applicant or certified EMT for the following reasons: (a) Alleged illegal use or addiction to drugs within the past 10 years; (b) Alleged addiction to alcohol within the past 10 years; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 36 of 58 (c) Alleged conviction of theft or fraud, which is the intentional misrepresentation or misstatement of a material fact, concealment of or failure to make known any material fact or any other means by which misinformation or false impression is knowingly given, within the past five years; (d) Alleged involvement in any judicial proceeding in which an EMT is accused of a sexual or violent crime; (e) Alleged dysfunctional mental illness within the past five years; or (f) Any other reason specified in ORS 682.175. [(5)] (4) The fact that an investigation is conducted by Public Health does not imply that an EMT certificate shall be denied, suspended or revoked or that the EMT will be placed on probation. [(6)] (5) A person may only voluntarily surrender his or her EMT certification during a certification period if the EMT: (a) Submits a written request to Public Health specifying the reason for the surrender of the certificate; (b) Is found to be in good standing with Public Health; and (c) Has received written approval from Public Health to surrender their EMT certificate. [(7)] (6) If Public Health finds that a person who voluntarily surrendered their EMT certification had committed an act that would have resulted in the denial, suspension or revocation of their certification or being placed on probation while they were certified, [that person may not be eligible to reinstate their certification or apply for certification at a later date] the Department may refuse to reinstate their certification or deny a new application for certification. (7) If a subject individual is denied certification or has their certification revoked, they may not submit an application to the Department for consideration within two years of the effective date appearing on the Final Order. Stat. Auth.: ORS 682.175, ORS 682.185 & ORS 682.215 Stats. Implemented: ORS 682.175, ORS 682.185 & ORS 682.215 D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 37 of 58 Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0635; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 1018-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0035; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0090 Reverting to a Lower Level of EMT Certification (1) An EMT-Intermediate or EMT-Paramedic may revert to an EMT-Basic, or an EMT-Paramedic may revert to an EMT-Intermediate, at any time during a certification period if the EMT-Intermediate or EMT-Paramedic: (a) Submits a written request to [the Division] Public Health specifying the reason for the change in the certification level; (b) Surrenders his or her current EMT certificate to [the Division] Public Health; (c) Is found to be in good standing with [the Division] Public Health; and (d) Has received written approval from [the Division] Public Health for a change in certification level. (2) An EMT-Intermediate or EMT-Paramedic may revert to an EMT-Basic at the time of recertification if the EMT-Intermediate or EMT-Paramedic: (a) Submits an application for EMT-Basic recertification with the appropriate fee; (b) Is found to be in good standing with [the Division] Public Health; (c) Adequately documents appropriate continuing education hours and courses for EMT-Basic; and (d) Has received approval from [the Division] Public Health. (3) If, within one year, an EMT requests reinstatement of the higher level of certification after a voluntary drop in level, the EMT must complete the requirements specified in OAR 333-265-0100(3)(a) through (3)(c). D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 38 of 58 (4) If, more than one year and less than two years, an EMT requests reinstatement of the higher level of certification after a voluntary drop in level, the EMT must complete the requirements specified in OAR 333-265-0100(4) through (7). [(5) An EMT-Paramedic may revert to an EMT-Intermediate unless that person applies for and successfully completes [the Division] Public Health's EMTIntermediate written and practical certification examinations.] Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0037; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0100 Expiration, Renewal and Reinstatement of EMT Certification (1) The initial certification as an EMT, unless suspended or revoked, shall expire on June 30 of an odd-numbered year. The initial certification period must not exceed 30-months. (2) [The Division] Public Health shall issue a new certificate to a certified EMT who successfully meets the requirements for recertification as outlined in these rules. The new certificate shall be valid for a period not to exceed 24-months. (3) To reinstate an expired Oregon EMT-Basic, EMT-Intermediate or EMTParamedic certificate of not more than one year, a person must: (a) Submit a completed application for recertification (b) Submit the appropriate recertification fee; [and] (c) Successfully complete an audit of continuing education hours and courses completed during the previous certification period and up to the time the application for recertification was submitted; and (d) If the application materials are incomplete, Public Health shall notify both the certificate holder and the agency that the application packet is incomplete and the EMT’s certification has expired. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 39 of 58 (4) To reinstate an expired Oregon EMT-Basic certificate of more than one year, but less than two years, a person must submit a completed application for certification with the appropriate fee after successfully completing a [Division] Public Health-approved reinstatement program as specified below: (a) Obtain an American Heart Association "Health Care Provider" or American Red Cross "Basic Life Support for the Professional Rescuer" or other [Division] Public Health-approved equivalent CPR course completion document;] (b) Complete the EMT Ambulance Refresher Training Program, National Standard Curriculum, U.S. Department of Transportation, National Highway Traffic Safety Administration, [September 1988] Current Edition. A copy of the curriculum is available at the [Division] Public Health office[and consists of a minimum of 32 hours]; (c) Pass the EMT-Basic: (A) Written examination within three attempts; and (B) Practical examination within three attempts, this includes the no-cost same-day re-examination. (d) Complete the above listed program requirements within six months of starting the program. (5) To reinstate an Oregon EMT-Intermediate certificate which has been expired for more than one year, but less than three years, a person must submit a completed application for certification with the appropriate fee after successfully completing a [Division] Public Health-approved reinstatement program as specified below: (a) Obtain an American Heart Association "Health Care Provider" or American Red Cross "Basic Life Support for the Professional Rescuer" or other [Division] Public Health-approved equivalent CPR course completion document;] (b) Pass the EMT-Basic: (A) Written examination within three attempts; and D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 40 of 58 (B) Practical examination within three attempts, this includes the no-cost same-day re-examination. (c) Upon passing the EMT-Basic examinations, be issued an EMT-Basic certificate; (d) Complete a [Division] Public Health-approved EMT-Intermediate refresher course, a copy of the curriculum is available at the [Division] Public Health office . [and consists of a minimum of:] [(A) Didactic - 36 hours; (B) Clinical - 16 hours in a hospital emergency department in which the following skills are evaluated; patient assessment, eliciting a concise and focused medical history, oxygenation and ventilatory management, intravenous therapy, and medication preparation and administration; and (C) Skills Demonstration - five supervised and documented successful pharyngeal esophageal airway device placements, mannequin permitted, and five supervised and documented successful intravenous line placements, live persons only.] (e) Pass the EMT-Intermediate: (A) Written examination within three attempts; and (B) Practical examination within three attempts, this includes the no-cost same-day re-examination. (f) Complete the above listed program requirements within one year of starting the program and before the beginning of the 3rd year. (6) To reinstate an expired Oregon EMT-Paramedic certificate of more than one year, but less than [five] four years, a person must successfully complete a [Division] Public Health -approved reinstatement program as specified below: (a) Obtain an American Heart Association "Health Care Provider" or American Red Cross "Basic Life Support for the Professional Rescuer" or other [Division] Public Health -approved equivalent CPR course completion document; (b) Pass the EMT-Basic: D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 41 of 58 (A) Written examination within three attempts; and (B) Practical examination within three attempts, this includes the no-cost same-day re-examination. (c) Upon passing the EMT-Basic examinations, be issued an EMT-Basic certificate; (d) Obtain an ACLS course completion document or equivalent course completion; (e) Obtain a BTLS or PHTLS course completion document or equivalent course completion; (f) Obtain an ALS Pediatric Prehospital Care, or PALS or APLS course completion document or equivalent course completion; (g) Complete a [Division] Public Health-approved EMT-Paramedic refresher course, a copy of the curriculum is available at the [Division] Public Health office [and consisting of a minimum of:] [(A) Didactic - 12 hours;] [(B) Clinical - 16 hours in a hospital emergency department in which the following skills are evaluated; patient assessment, eliciting a concise and focused medical history, oxygenation and ventilatory management, ECG monitoring and interpretation, intravenous therapy, and medication preparation and administration; and ] [(C) Field internship - 24 ambulance or rescue runs under direct visual supervision; no less than five each in cardiac, trauma, respiratory and general medical emergencies. ] (h) Pass the EMT-Paramedic: (A) Written examination within three attempts; and (B) Practical examination within three attempts, this includes the no-cost same-day re-examination. (i) Complete[s] the above listed program requirements within two years of starting program and before the beginning of the [6th] 5th year. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 42 of 58 (7) To reinstate an EMT-Basic certificate which has been expired for more than two years, an EMT-Intermediate certificate which has been expired for more than three years, and an EMT-Paramedic certificate which has been expired for more than [five] four years, a person must meet the requirements specified in OAR 333265-0010(2)(a)(b) or (c). (8) An EMT-Intermediate or EMT-Paramedic that voluntarily reverted to, and is currently certified as an EMT-Basic, or an EMT-Paramedic that voluntarily reverted to, and is currently certified as an EMT-Intermediate; may reinstate his or her EMT-Intermediate or EMT-Paramedic certificate, if: (a) The EMT-Intermediate meets the requirements as specified in subsection (5)(d) through subsection (5)(f) of this rule; or (b) The EMT-Paramedic meets the requirements as specified in subsection (6)(d) through subsection (6)(i) of this rule. (9) A person wishing to recertify or reinstate an expired National Registry of EMTs certification must meet the requirements of the National Registry of EMTs and recertify or reinstate directly with the National Registry of EMTs. Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0640; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0040; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0110 EMT-Basic Continuing Education Requirements for Recertification (1) An EMT-Basic, regardless of affiliation, is required to complete the following continuing education requirements to retain his or her EMT-Basic certification: (a) All requirements to obtain National Registry of EMT-Basic re-registration as evidenced by submitting a copy of their current National Registry of EMT-Basic certificate to[the Division] Public Health; or D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 43 of 58 (b) Maintain a certificate of course completion that the EMT has demonstrated knowledge and skills in the performance of SQ injections, AED operations, one and two-person rescuer cardiopulmonary resuscitation (adult, child and infant) and relief of foreign body airway obstruction. The course must meet published standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care; and (c) Obtain a total of 25 hours of continuing education as specified below: EMT Basic Trauma 5 hours Medical/Behavioral 5 hours Patient Assessment 2 hours Pharmacology 1 hour Airway 2 hours OB, Infants, Children 5 hours Operational 3 hours Case Reviews 2 hours Skill competency evaluation for: Hands on o Cardiac arrest mgmt/AED operation o Assessment/mgmt – Medical & Trauma o Airway management o Spinal immobilization o SQ Injection o CPR o Pt. lifts, carries & packaging methods without spinal immobilization o Protocol Knowledge o Knowledge of Oregon Rules for EMTs. [(A) Trauma Assessment and Management - 4 hours;] [(B) Formal trauma case reviews conducted by a physician or a physician designee - 1 hour; ] [(C) Medical Emergencies Assessment and Management - 4 hours;] [(D) Formal medical case reviews conducted by a physician or a physician designee - 1 hour;] D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 44 of 58 [(E) Special Considerations and Support Services - 5 hours;] [(F) Pediatric Patient Assessment and Management - 2 hours;] [(G) Medications. Indications, contraindications and complications of any medication within the EMT-Basic's scope of practice and authorized by the medical director - 1 hour;] [(H) Use of Automatic or Semi Automatic Defibrillator in Sudden Cardiac Arrest – 2 hours; and] [(I) The balance of the required hours can be obtained in any of the areas specified in paragraph (1)(c)(A) through paragraph (1)(c)(H) of this rule - 7 hours.] (2) If the certification period is: (a) Six to 12 months, the EMT-Basic must obtain 25 percent of the hours specified in paragraph (1)(c) [(A) through paragraph (1)(c)(H)] of this rule; (b) 13 to 23 months, the EMT-Basic must obtain 50 percent of the hours specified in paragraph (1)(c) [(A) through paragraph (1)(c)(H)] of this rule; or (c) 24 to 30 months, the EMT-Basic must obtain 100 percent of the hours specified in paragraph (1)(c) [(A) through paragraph (1)(c)(H)] of this rule. (3) Distributive Education [Audiovisual Programs]. An EMT-Intermediate may receive hour-for-hour credit, up to 100% of required hours, for subjects specified in paragraph (1)(c) [(b)(C) and (D)] of this rule, when viewing video tapes, CDROMs or computer on-line programs. [The EMT-Intermediate must pass a written examination approved by the medical director or medical director designee.] (4) An EMT-Intermediate can receive a maximum of 25 percent credit ([5] 6.25 hours) of the hours specified in paragraph (1)(c) [(b)(C) and (D)] of this rule for EMS teaching, being an EMT practical certification examination evaluator or for reading EMS journals or articles. [The EMT-Intermediate must pass a written examination approved by the medical director or medical director designee.] (5) Continuing education credit shall be granted on an hour-for-hour basis for EMS training seminars, educational conferences, continuing education classes, EMTIntermediate or EMT-Paramedic course, as long as the hours obtained fall within D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 45 of 58 the EMT-Basic to ensure the hours obtained meet [the Division’s] Public Health recertification requirements. (6) The EMT-Basic must: (a) Ensure all training being used for continuing education credit is approved by the medical director; (b) Pass a hands-on competency examination supervised by the medical director or designee; and (c) Keep documentation of continuing education attended and examinations passed. Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 63, f. 6-6-74, ef. 6-25-74; HD 11981, f. & ef. 1-14-81; Renumbered from 333-023-0645; HD 19-1984, f. & ef. 910-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HE 181994, f. 6-30-94, cert. ef. 7-1-94; Renumbered from 333-028-0045; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0120 EMT-Intermediate Continuing Education Requirements for Recertification (1) An EMT-Intermediate, regardless of affiliation, is required to complete the following continuing education requirements to retain his or her EMT-Intermediate certification: (a) Maintain a certificate of course completion that the EMT has demonstrated knowledge and skills in the performance of SQ injections, AED operations, one and two-person rescuer cardiopulmonary resuscitation (adult, child and infant) and relief of foreign body airway obstruction. The course must meet published standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care; and (b) Obtain a total of [14] 42 hours of continuing education as specified below: D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 46 of 58 EMT Intermediate Trauma 6 hours Medical 6 hours Obstetric & Pediatric 6 hours Pharmacology 8 hours Airway, breathing, Cardiology 8 hours Operational 6 hours Case Reviews (any type) 2 hours Skill competency evaluation for: Hands on o Knowledge of Oregon rules for EMTS o Protocol Knowledge o Pt. lifts, carries & packaging methods without spinal immobilization o All other skills already listed. [(A) Formal trauma case reviews conducted by a physician or a physician designee - 3 hours; (B) Formal medical case reviews conducted by a physician or a physician designee - 3 hours; (C) Indications, contraindications and complications of any medication within the EMT-Intermediate's scope of practice and authorized by the medical director - 4 hours; and (D) Review of current medical issues relating to prehospital emergency and nonemergency care at the EMT-Intermediate level - 4 hours.] (2) If the certification period is: (a) Six to 12 months, the EMT-Intermediate must obtain 25 percent of the hours for each category specified in paragraph (1)(b) [(A) through paragraph (1)(b)(D] of this rule; (b) 13 to 23 months, the EMT-Intermediate must obtain 50 percent of the hours for each category specified in paragraph (1)(b) [(A) through paragraph (1)(b)(D] of this rule; or D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 47 of 58 (c) 24 to 30 months, the EMT-Intermediate must obtain 100 percent of the hours for each category specified in paragraph (1)(b) [(A) through paragraph (1)(b)(D] of this rule. (3) Distributive Education [Audiovisual Programs]. An EMT-Intermediate may receive hour-for-hour credit, up to 100% of required hours, for subjects specified in paragraph (1)(b) [(b)(C) and (D)] of this rule, when viewing video tapes, CDROMs or computer on-line programs. [The EMT-Intermediate must pass a written examination approved by the medical director or medical director designee.] (4) An EMT-Intermediate can receive a maximum of 25 percent credit ([5] 10.5 hours) of the hours specified in paragraph (1)(b) [(b)(C) and (D)] of this rule for EMS teaching, being an EMT practical certification examination evaluator or for reading EMS journals or articles. [The EMT-Intermediate must pass a written examination approved by the medical director or medical director designee.] (5) Continuing education credit shall be granted on an hour-for-hour basis for EMS training seminars, educational conferences, continuing education classes, EMTIntermediate or EMT-Paramedic course, as long as the hours obtained fall within the EMT-Basic to ensure the hours obtained meet [the Division’s] Public Health recertification requirements. (6) The EMT-Intermediate must: (a) Ensure all training being used for continuing education credit is approved by the medical director; (b) Pass a hands-on competency examination supervised by the medical director or designee; and (c) Keep documentation of continuing education attended and examinations passed. (6) An EMT-Intermediate, regardless of affiliation, is required to have verification of competencies by a Board-approved medical director in the following essential psychomotor skill categories to retain his or her EMT-Intermediate certification: (a) Patient assessment and interviewing; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 48 of 58 (b) Airway care, including the use of bag-mask ventilation device with reservoir and insertion of a dual lumen airway device; (c) Vascular access, including intravenous drug infusion and intraosseous cannulation and administration of medications authorized for use by an EMTIntermediate; (d) Trauma management, including rapid extrication and spinal immobilization; (e) Management of cardiac emergencies in accordance with EMT-Intermediate treatment protocols; and (f) Application of local protocols, standing orders, and trauma system entry criteria. (7) Verification of the psychomotor skills specified in subsection (6)(a) through subsection (6)(e) of this rule must be based on: (a) The medical director's personal observation in the filed or in a hospital or medical facility clinical setting; (b) A demonstration in a classroom or laboratory session; or (c) By reliance upon documented successful field performance as demonstrated by agency quality improvement data. Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0130 EMT-Paramedic Continuing Education Requirements for Recertification (1) [Beginning with the recertification cycle ending June 30, 2001, a] An EMTParamedic, regardless of affiliation, is required to have completed the following D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 49 of 58 continuing education requirements to retain his or her Oregon EMT-Paramedic certification: (a) All requirements to obtain National Registry of EMT-Paramedic re-registration as evidenced by submitting a copy of their current National Registry of EMTParamedic certificate to [the Division] Public Health; or (b) Obtain a total of [24] 50 hours of continuing education in the following topics: Paramedic Airway, Breathing, Cardiology 10 hours Medical emergencies 10 hours Obstetrics and pediatrics 12 hours Operations 8 hours Case Reviews (any type) 2 hours Skill competency evaluation for: Hands on o Knowledge of Oregon rules for EMTs o Pt. lifts, carries & packaging methods without spinal immobilization o All other skills already listed. (A) Preparatory 6 hours; (B) Airway Management & Ventilation 6 hours (C) Trauma 10 hours (D) Medical 18 hours (E) Special Considerations (pediatrics, geriatrics, abuse, special needs etc.) 6 hours (F) Operations (incident command, rescue, hazmat, time scene, ambulance operations, etc.) 2 hours, or successfully complete a Public Health approved exam. (2) If the initial certification period is less than 12 months, the EMT-Paramedic must obtain 50 percent of the hours specified in paragraph (1)(b) [(A)(B) or (C)] of this rule. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 50 of 58 (3) An EMT-Paramedic may receive a maximum of 25 percent credit of the total required hours for teaching EMT courses or EMT continuing education classes. A single topic or lecture may be counted only once in fulfillment of this requirement, even if taught multiple times. (4) Continuing education credit shall be granted on an hour-for-hour basis for EMS training seminars, educational conferences, or continuing education classes. It shall be the responsibility of each EMT-Paramedic to ensure the hours obtained meet [the Division’s] Public Health recertification requirements. (5) Distributive Education. [Audiovisual Programs] An EMT-Paramedic may receive a maximum of 25 percent ([(6 hours)] of the hours specified in paragraph (1)(b) [(A) through paragraph (1)(b)(C)] of this rule, when viewing video tapes, CD-ROMs or computer on-line programs. The EMT-Paramedic must pass a written examination approved by the medical director or medical director designee. (6) An EMT-Paramedic may receive a maximum of 25 percent ([(6 hours)] of the hours specified in paragraph (1)(b) [(A) through paragraph (1)(b)(C)] of this rule for being an EMT practical certification examination examiner or for reading EMS journals or articles. The EMT-Paramedic must pass a written examination approved by the medical director or medical director designee. (7) The EMT-Paramedic must: (a) Ensure all training being used for continuing education credit is approved by the medical director; (b) Pass a hands-on competency examination supervised by the medical director or designee; and (c) Keep documentation of continuing education attended and examinations passed. (8) While 25 percent of continuing education credits can be satisfied in each of (3), (5), and (6) above, the total hours used in all three categories to satisfy credit requirements can not total more than 25 percent. A maximum number of 12 hours can be applied to any one topic area. A maximum number of 16 hours can be applied to each of the following courses: ABLS, ACLS, AMLS, BTLS, NALS, PALS, PEPP, PHLTS, PPC, or AE. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 51 of 58 A maximum number of 12 hours can be applied from each of the following courses: Teaching CPR, Emergency Driving, or Dispatch training. A maximum number of 12 hours can be applied from Distributive Education towards this section and must be state or CECBEMS approved. The following are maximum hours per college course that can be applied towards additional continuing educations hours. A maximum number of 12 hours can be applied from Anatomy, Cellular Biology, Chemistry, Microbiology, Pharmacology, Physiology, and Psychology. A maximum number of 3 hours can be applied from Communication and Sociology. (7) An EMT-Paramedic, regardless of affiliation, is required to have verification of competencies by a Board-approved medical director in the following essential psychomotor skill categories to retain his or her EMT-Paramedic certification: (a) Patient assessment and interviewing; (b) Airway management, including use of bag-mask ventilation device with reservoir, endotracheal intubation (adult and pediatric), needle cricothyrotomy (adult and pediatric), and decompression of pneumothorax; (c) Vascular access and medication administration, including intravenous drug infusion and intraosseous cannulation; (d) Trauma management, including rapid extraction and spinal immobilization; (e) Management of obstetric emergencies, including uncomplicated prehospital delivery; (f) Management of cardiac emergencies in accordance with the standards of the American Heart Association, including the performance of one and two-person rescuer cardiopulmonary resuscitation (adult, child and infant), relief of foreign body airway obstruction, and advanced cardiac life support measures. This skill verification must include a minimum of two complete cardiac arrest management scenarios managed in accordance with local EMS treatment protocols; and (g) Application of local protocols, standing orders, and trauma system entry criteria. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 52 of 58 (8) Verification of the psychomotor skills specified in subsection (7)(a) through subsection (7)(f) of this rule must be based on: (a) The medical director's personal observation in the field or in a hospital or medical facility clinical setting; (b) A demonstration in a classroom or laboratory session; or (c) By reliance upon documented successful field performance as demonstrated by agency quality improvement program data. [(9) An EMT Paramedic, regardless of affiliation, is required to complete a written knowledge assessment examination during every second recertification cycle (every fourth year), irrespective of the date of the initial certification, beginning with the recertification cycle ending June 30, 1999. The EMT Paramedic written knowledge assessment examination shall:] [(a) Consist of questions drawn from a bank of questions that have been created by the Division and provided to each EMT Paramedic not later than July 1, of the year preceded the scheduled knowledge assessment;] [(b) Consist of no more than 200 questions. The passing grade shall be established by the Division prior to administering the examination; and] [(c) Be provided by the Division to the following individuals, who shall be authorized to administer the examinations locally in accordance with instructions provided by the Division.] [(A) EMS training directors of ambulance services and non transporting EMS agencies;] [(B) EMT Program directors from teaching institutions; or] [(C) Board approved medical directors] [(10) The completed assessment answer sheet must be returned to the Division for grading. The Division shall provide the results to the individual EMT Paramedic and the individual administering the written knowledge assessment examinations.] [(11) An EMT Paramedic shall be allowed two attempts to successfully complete the written examinations without additional requirement. An EMT Paramedic D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 53 of 58 failing the written examinations on the first two attempts must complete a Division approved 48 hours National Standard Paramedic Refresher Course or a Division approved equivalent to be eligible for additional attempts to successful complete the written assessment examinations.] Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0140 Maintaining EMT Continuing Education Records (1) It shall be the responsibility of each EMT to retain proof of successful completion of all required continuing education for the two previous certification periods. (2) Proof of completion of continuing education classes must be in any of the following formats: (a) A class roster that contains: (A) The name of the teaching institution or EMS agency; (B) The date of the class; (C) The class topic; (D) The length of the class; (E) The full name of the EMT attending the class; (F) The full name of the instructor; and (G) The following statement added to the roster and signed by the EMT: "I certify by my signature that I attended and participated in the complete class described on this roster. I understand that if any information on this roster is false, I may be subject to discipline for unprofessional conduct pursuant to ORS 682.175(2)(i) as well as such criminal penalties as may be provided by law." D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 54 of 58 (b) A computer-generated printout history of an individual EMT's continuing education record that contains: (A) The full name of the EMT; (B) The name of the teaching institution or EMS agency conducting the classes; (C) The dates of the classes; (D) The class topics; (E) The length of each class; (F) The full name of each instructor; and (G) The following statement added to the computer printout and signed by the EMT: "I certify by my signature that I attended and participated in all the classes described on this printout. I understand that if any information on this printout is false, I may be subject to discipline for unprofessional conduct pursuant to ORS 682.175(2)(i) as well as such criminal penalties as may be provided by law."; or (c) A certificate of course completion for one or more topics that contains: (A) The name of the teaching institution or EMS agency conducting the course; (B) The date(s) of the course; (C) The course topic(s); (D) The length of the course; (E) The full name of the EMT attending the course; and (F) If the certificate does not list each course topic, then a copy of the program listing each course topic and length of each course topic must be attached to the certificate." Stat. Auth.: ORS 682.157 & ORS 682.215 Stats. Implemented: ORS 682.157 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; OHD 9-2001, f. & cert. ef. 4-24-01; OHD 9-2001, f. & cert. ef. 4-24-01 D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 55 of 58 333-265-0150 EMT Continuing Education Records Audit (1) [the Division] Public Health may conduct an audit of an EMT's continuing education records for one or two preceding certification periods, or any parts thereof: (a) [the Division] Public Health shall notify the EMT by certified mail that he or she is being audited and provide him or her with the necessary audit forms and the date the completed forms are to be returned to [the Division] Public Health; and (b) Upon the return of the completed audit forms to [the Division] Public Health, [the Division] Public Health shall begin the process of verifying the continuing education records. (2) If, in the course of an audit of continuing education records, [the Division] Public Health learns that, contrary to the sworn statement in the application for recertification or in the official audit form, the EMT has not completed all necessary continuing education requirements, [the Division] Public Health may impose discipline which includes any of the following or a combination of the following: (a) Suspend the EMT's certification for the longer of 60 days or until the continuing education deficiencies are corrected; (b) Assess a monetary penalty in the amount of $10 per each hour of deficient continuing education. (c) Require the EMT to demonstrate their knowledge and psychomotor skills by taking and passing a written and practical examination conducted by [the Division] Public Health; or (d) Revoke the EMT certificate if it is found that the EMT has submitted a forged, altered or otherwise falsified documents to [the Division] Public Health. (3) If the EMT does not agree to take the examinations, the monetary penalty, suspension, or revocation, the EMT has the right to a contested case hearing as prescribed in ORS 183.310 to 183.550. D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 56 of 58 Stat. Auth.: ORS 682.157, ORS 682.175, ORS 682.185 & ORS 682.215 Stats. Implemented: ORS 682.157, ORS 682.175, ORS 682.185 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0160 EMT Responsibility to Notify [the Division] Public Health (1) A certified EMT must notify [the Division] Public Health, using an E-4 form within: [the Division’s EMS Personnel Action Report Form within:] (a) 14-days of occurrence, if any of the following occurs: (A) Disciplinary restriction placed upon scope of practice by the medical director; (B) Being named as a defendant in a lawsuit which alleges medical malpractice or misconduct; (C) Issued a citation, arrested or convicted for driving under the influence or being admitted to a diversion program; (D) Arrested or convicted for any drug related offense; (E) Arrested or convicted for any sexual, violent, personal or property crime; (F) Restriction or loss of driving privileges; (H) Admission to a drug/alcohol treatment program; or (G) A change in medical director. This notification is not necessary when the EMT is affiliated with an EMS agency that is on file with [the Division] Public Health. (b) 30-days of occurrence, if any of the following occurs: (A) A change in legal name; (B) A change in home address; (C) A change in EMS affiliation; D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 57 of 58 (D) Develops any physical disability lasting more than 120 days or is a permanent condition(s) [30-days] which significantly interferes with the ability of the EMT to perform all of the duties of the level of certification held by the EMT; or (E) Any change in mental health which affects the ability to perform as an EMT. (2) Failure to notify [the Division] Public Health of any items specified in this rule, may lead to suspension or revocation of an EMT certificate or the EMT being placed on probation. (3) [the Division] Public Health may, in its discretion, initiate an investigation based upon being notified of any of the items specified in this rule. Stat. Auth.: ORS 682.145, ORS 682.175, ORS 682.185 & ORS 682.215 Stats. Implemented: ORS 682.145, ORS 682.175, ORS 682.185 & ORS 682.215 Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01 333-265-0170 Displaying EMT Certification Level (1) A First Responder or EMT providing patient care must display his or her level of certification on the outmost garment of his or her usual work uniform. [(2) The following methods of displaying EMT certification levels are acceptable: (a) Official Oregon Health Division or National Registry of EMTs shoulder patch on street-type work jackets and uniform dress shirts, specifying: Emergency Medical Technician-Basic or EMT-Basic; Emergency Medical TechnicianIntermediate or EMT-Intermediate; or Emergency Medical Technician-Paramedic or EMT-Paramedic; (b) On the breast area of T-shirts or polo-style shirts; (c) On helmets of fire fighter turnout gear via reflective decals of the type normally utilized by structural fire fighting agencies; and (d) Name-tags on the outer garment of any type, such as coveralls, jumpsuits, etc.] D:\478181674.doc 6/30/2017 DRAFT CHANGES Page 58 of 58 (2) First Responder or EMT-certification levels need not be displayed on emergency work apparel not normally worn during the provision of prehospital patient care, such as haz-mat suits, anti-contamination or radiation suits, wildland firefighting apparel, etc. (3) First Responder or EMT responding from home or other off-duty locations shall make a reasonable effort to display his or her certification level. Baseballtype hats, T-shirts, safety vests, etc. are accepted for this purpose. Stat. Auth.: ORS 682.135, 682.175, 682.215 & 682.265 Stats. Implemented: ORS 682.135, 682.175, 682.215 & 682.265 Hist.: OHD 9-2001, f. & cert. ef. 4-24-01 The official copy of an Oregon Administrative Rule is contained in the Administrative Order filed at the Archives [the Division] Public Health, 800 Summer St. NE, Salem, Oregon 97310. Any discrepancies with the published version are satisfied in favor of the Administrative Order. The Oregon Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon Secretary of State. Terms and Conditions of Use Alphabetical Index by Agency Name Numerical Index by OAR Chapter Number Search the Text of the OARs Questions about Administrative Rules? Link to the Oregon Revised Statutes (ORS) Return to Oregon State Archives Home Page D:\478181674.doc 6/30/2017