202 KAR 7:601. Training, education and continuing education.

202 KAR 7:601. Training, education and continuing education.

RELATES TO: KRS 311A.110, 311A.115, 311A.120, 311A.130

STATUTORY AUTHORITY: KRS 311A.020, 311A.030, 311A.110, 311A.115, 311A.120, 311A.125, 311A.130

NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.110, 311A.115, 311A.120 and 311A.125 require the board to promulgate administrative regulations establishing standards related to the training and education of emergency medical services personnel. KRS 311A.130 relates to the provision of proper in-service and in-house in-service training. This administrative regulation establishes requirements for an organization to be approved by the board as an EMS-TEI and certification and recertification of EMS instructors.

Section 1. EMS-TEI Requirements. (1) Only an entity approved by the board as an EMS-TEI shall be authorized to conduct training and education programs that lead to certification or licensure by the board.

(2) An entity that previously was certified as an EMS-TEI and had that certification revoked may be eligible to apply for certification as an EMS-TEI one (1) year after the expiration date of revocation.

(3) An applicant shall file a completed board-approved application with the KBEMS office for certification as an EMS-TEI.

(4) Each EMS-TEI shall have:

(a) A chief administrative officer or designee who shall:

1. Be responsible for the planning, administration and oversight of the EMS-TEI;

2. Assure the quality and credentials of the program coordinator and students accepted into any program conducted by the EMS-TEI;

3. Assure the security of examination results and materials;

4. Randomly monitor the activities of the faculty and students;

5. Maintain records and documents and submit reports required by the board; and

6. Serve as a member of the course faculty, if appropriately credentialed; and

(b) A program coordinator for paramedic training courses or lead instructor for first responder or EMT training courses who shall:

1. Assure the quality of content and presentation of course material to the student body;

2. Assure the quality and credentials of the instructional staff, adjunct faculty, examiners, and proctors;

3. Assure the quality and security of student examinations;

4. Monitor the activities of the faculty and students during the didactic, skills, and clinical or field internship and summative field evaluation phases of the educational program; and

5. Serve as a member of the course faculty, if appropriately credentialed.

(5) The chief administrative officer may also simultaneously serve as the program coordinator or lead instructor.

(6) An EMS-TEI may require competency evaluations of technical skills performance, knowledge base, or presentation skills of any staff member or potential staff member.

Section 2. EMS-TEI Certification Periods. (1) The approval of an EMS-TEI shall be valid for a period of five (5) years, notwithstanding disciplinary action as discussed in this administrative regulation.

(2) At the end of the initial five (5) year approval period, an EMS-TEI may apply for recertification for a subsequent five (5) year period.

(3) An EMS-TEI may choose to surrender it’s certification prior to the end of a certification period by notifying the board in writing of the intent to do so and the intended effective date of the surrender.

Section 3. EMS-TEI Responsibilities. (1) The EMS-TEI shall maintain on file for a period of five (5) years beyond the ending date of the program:

(a) A complete, curriculum vitae that was current at the beginning date of the EMS course. The curriculum vitae shall include a listing of academic preparation, clinical experience, current certifications and licenses for each faculty member. The EMS-TEI shall be responsible for verifying information contained on an instructor's curriculum vita;

(b) Health records for students that may be required by an EMS-TEI or through written clinical, field internship, or summative field evaluation affiliation agreements;

(c) Records of all disciplinary actions taken against a faculty member, which shall include each response or action taken as a result of a complaint or grievance; and

(d) Documentation of any other requirements as may be established by the EMS-TEI.

(2) An EMS-TEI shall assure that physical resources as required by the curriculum, including classrooms, skill practice areas, textbooks, instructional aids, equipment, and supplies are:

(a) In good working condition;

(b) Available at each class session where skills are taught or practiced; and

(c) Adequate in number for the number of students enrolled in the program to have sufficient opportunity for skills practice.

(3) The health and safety of patients, students and faculty members shall be protected while participating in educational activities.

(4) A student or a faculty member shall maintain proper personal and professional conduct during classroom and clinical or field internship or summative field evaluation activities.

(5) An EMS-TEI shall develop and make available to all prospective students a clearly-defined admission policy and procedure, which shall include specific requirements for admission, including:

(a) Academic requirements;

(b) Health-related requirements; and

(6) An EMS-TEI shall disclose to an applicant for admission:

(a) Accurate information regarding program requirements;

(b) Tuition and fees including remediation fees or other costs associated with the training and education program;

(d) Course educational objectives;

(e) Classroom lecture and skill practice schedules;

(f) Clinical or field rotation locations with tentative beginning and ending dates and participation requirements for each site;

(g) Board certification or licensure requirements for the level of training and education being offered; and

(h) Prohibited actions described in KRS Chapter 311A that provide grounds for a sanction against an individual making application for certification or licensure by the board, as described at KRS 311A.050.

(7) An EMS-TEI shall establish and maintain written policies to ensure that:

(a) Announcements and advertising accurately reflect the courses offered;

(b) A procedure exists that allows complaints and grievances to be processed if filed by an applicant, a student, or a faculty member;

(c) There is a process for a student to withdraw from a course, and, if allowed, obtain a refund of tuition or fees paid;

(d) Examinations are developed for each course; and

(e) There are established and maintained passing requirements and examination policies for each course offered by the EMS-TEI.

(8) An EMS-TEI shall assure that each student, while participating in a clinical or field rotation, is clearly identified by name and student status by the use of:

(a) A nameplate;

(b) A uniform; or

(9) An EMS-TEI shall maintain, for at least five (5) years beyond the date of the last classroom session of each EMS course:

(a) The student attendance sign in sheets for each course taught including:

1. Lectures;

2. Practical skill lessons; and

3. Clinical and field rotations;

(b) A master copy of written examinations and answer keys administered for each course taught;

(d) A master copy of the current course syllabus for the courses taught;

(e) Health records for students that may be required by an EMS-TEI or through written clinical, field internship, or summative field evaluation affiliation agreements;

(f) Records of all disciplinary actions taken against a student which shall include each response or action taken as a result of a complaint or grievance;

(g) Remediation activity for each student enrolled, including how the specific remediation was accomplished and if the process was successful; and

(h) A master file of the objectives and competencies to be achieved by students during each educational program. The file shall be reviewed annually by the EMS-TEI and updated as necessary.

Section 4. Disciplinary Action Against an EMS-TEI. (1) The board shall notify the chief administrative officer of an EMS-TEI, by certified mail, of any intent to pursue disciplinary action against the EMS-TEI.

(2) The board may take disciplinary action against an EMS-TEI, if:

(a) During a twenty-four (24) month period, an EMS-TEI’s cumulative pass rate for initial training and the education program’s offered falls below sixty-seven (67) percent. The pass rate percentage shall be determined by dividing the number of students that complete the certification or licensure testing process within the required time frame by the number of students who apply to participate in the certification or licensure exams;

(b) An inspection or investigation by the KBEMS office determines the EMS-TEI has not met the requirements of any section of this administrative regulation;

(d) The faculty or a staff member reproduces or reconstructs, or attempts to reproduce or reconstruct, any portion of an examination for the purpose of assisting a student to cheat or create an unfair advantage for one (1) student over another student on the examination;

(e) The faculty or a staff member disseminates information for purposes of reproduction or reconstruction of any portion of an examination in order to assist a student to cheat or create an unfair advantage for one (1) student over another student on the examination;

(f) The faculty member or a staff member cheats, or assists students to cheat or create an unfair advantage for one (1) student over another student, on an examination;

(g) The EMS-TEI falsifies a record of education, training, or continuing education;

(h) The EMS-TEI fails to pay a fee or issues a check for any fee required by administrative regulation on an invalid account or an account that does not have sufficient funds;

(i) The EMS-TEI fails to file reports required by this administrative regulation; or

(j) The EMS-TEI fails to meet the requirements of the "EMS-TEI Affidavit".

(3) A recommendation to take disciplinary action against an EMS-TEI shall be considered in executive session of the board and shall include the opportunity for the Chief Administrative Officer or designee to be present and make a presentation on behalf of the EMS-TEI.

(4) After consideration of information presented during the executive session, the board may take any of the following actions:

(a) Take no action;

(b) Restrict the certificate of the EMS-TEI;

(d) Suspend the certificate of the EMS-TEI; or

(e) Revoke the certificate of the EMS-TEI.

(5) The KBEMS office shall notify the chief administrative officer of the EMS-TEI by certified mail of the decision to take no action, restrict, probate, suspend, or revoke the certification of the EMS-TEI.

(6) The board may direct an EMS-TEI against whom disciplinary action has been taken to:

(a) Not begin new courses at that level of training or education during the term of the disciplinary action and to notify students who are currently enrolled in an affected program of the action of the board;

(b) Conduct an internal evaluation of the programs offered by the EMS-TEI. If an EMS-TEI is required to conduct an internal evaluation, it shall include a review of:

1. The qualifications, responsibilities, and performance of the program coordinator, medical director, and course faculty;

2. Student admission practices;

3. Syllabi and objectives of all courses offered;

4. Graduation requirements for all courses offered by the EMS-TEI;

5. Faculty involvement in program and course planning, serving as a liaison for clinical and field internship sites and classroom participation;

6. Clinical or field rotation requirements and activities;

7. Quality and adequacy of clinical or field rotation opportunities;

8. Textbooks, equipment, supplies and ancillary learning aids used by the EMS-TEI; and

9. The ability of the EMS-TEI to meet the stated goals and objectives of the program; and

(c) Require an EMS-TEI to provide a written report to the Executive Director of KBEMS that shall include a list of problems identified during the review process conducted pursuant to this section and a detailed corrective action plan, including a time frame for the completion of the plan.

(7) If a corrective action plan is required, the executive director, within sixty (60) days of receipt shall review the plan and notify the chief administrative officer, by certified mail, of the planned action, which may include:

(a) Approving the entire plan;

(b) Approving a portion or portions of the plan;

(d) Forwarding the report to the board with or without a recommendation for action by the board.

(8) The executive director of the board or a designee shall monitor compliance and may conduct announced or unannounced site visits to determine if all requirements established for any level of disciplinary action are being met.

(9) The board upon recommendation of the executive director may:

(a) Terminate disciplinary action and reinstate an EMS-TEI; or

(b) Take action to pursue additional disciplinary action against an EMS-TEI.

(10) Any EMS-TEI against whom the board takes disciplinary action may file an appeal pursuant to KRS Chapter 13B.

(11) Any disciplinary action taken against an EMS-TEI may also be commensurate with their status as an EMS-TA.

Section 5. Public Notice of Negative Action. The KBEMS office shall cause to be published, in the EMS Newsletter, or similar publication of the board, or otherwise disseminate the name of an EMS-TEI that:

(1) Has had no action taken based on the results of an investigation conducted as a result of a complaint;

(2) Is placed on probationary status;

(3) Is placed on restrictive status;

(4) Is suspended; or

(5) Has had certification revoked.

Section 6. Reporting Requirements for EMS-TEI. (1) Approved EMS-TEIs shall submit an "EMS Course Notification Report" for all courses that lead to licensure or certification by the board to the KBEMS office within ten (10) working days of the commencement of each course, which report shall contain:

(a) The type of course to be offered;

(b) The location for the course;

(d) A nine (9) digit number and alpha indicator for each EMS course conducted, which shall be assigned in the following manner:

1. The first three (3) digits shall correspond to the EMS-TEI approval number assigned by the board;

2. The fourth and fifth digits shall correspond to the fiscal, (July 1 - June 30) academic year. For example, if a course is taught between July 1, 2000 through June 30, 2001, the academic year number assigned shall be zero one (01);

3. The sixth and seventh digits shall correspond to the sequential number of courses begun between July 1 and June 30 of each year; and

4. An alpha designator that shall follow the seventh digit shall be:

a. FR for first responder courses;

b. B for EMT-Basic courses;

c. P for paramedic courses;

d. EI for EMS Instructor courses;

e. CE for continuing education offerings; or

f. Z for other educational offering;

(e) The maximum number of students to be accepted into the program; and

(f) Contact information for:

1. The chief administrative officer of the EMS-TEI;

2. The medical director, if required, for the training and education program; and

3. The lead program coordinator for the training and education program.

(2) Approved EMS-TEIs shall:

(a) Within two (2) weeks following an EMS course completion date, submit to the board a Student Testing Eligibility Form; and

(b) Submit to the board by no later than July 31, of each year an "EMS-TEI Annual Summary Report". If courses were not taught during the last reporting period an EMS-TEI shall file an annual report with the board stating that no courses were taught during the reporting period.

Section 7. Requirements For All Training and Education Courses. EMS training and education courses shall meet the following instructional staff requirements:

(1) The EMS-TEI shall have instructional staff who are certified by the board as EMS instructors and are minimally certified or licensed at the level at which the course is being offered.

(2) The EMS-TEI may also utilize adjunct faculty that meet one (1) of the requirements of Section 12 of this administrative regulation.

(3) The EMS-TEI shall have additional skill instructors for classroom sessions where skills are practiced. These sessions shall not proceed without the presence of:

(a) An instructor for the first ten (10) students; and

(b) An additional instructor for each one (1) to ten (10) additional students. The additional instructor shall not be required to be certified as an EMS instructor but shall be certified by the board minimally at the level for the course being taught.

(4) The EMS-TEI, if providing initial training programs or continuing education programs that encompass invasive skills or procedures that routinely require medical oversight, shall have a medical director who:

(a) Is employed by or under contract with the EMS-TEI to serve as the medical director of the program;

(b) Is routinely available to the EMS-TEI to provide consult regarding issues related to the training and education program;

(d) Provides medical consultation and guidance to the course faculty; and

(e) Meets other requirements established by the board.

Section 8. First-responder Training and Education Course Requirements. (1) Each first-responder training and education course shall utilize the United States Department of Transportation, National Highway Traffic Safety Administration, 1995 EMT-First Responder-National Standard Curriculum and the "Emergency Medical Technician First Responder Instructor Manual Initial Training Curricula - Kentucky Required Mandatory Supplemental Curricula for the Emergency Medical Technician First Responder"; and include training and education in:

(a) Acquired immune deficiency syndrome, as required by KRS 214.610 and 311A.110; and

(b) The appropriate use of:

1. AEDs;

2. Oxygen-therapy delivery devices, including bag-valve-mask;

3. Cervical collar and long spine board immobilization; and

4. The sphygmomanometer and stethoscope for obtaining blood pressure.

(2) Each first-responder training and education program shall be a minimum of forty-seven and one-half (47 1/2) hours in duration.

Section 9. EMT Training and Education Course Requirements. (1) Each EMT training and education course shall:

(a) Be a minimum of 119 hours in duration;

(b) Utilize the 1994 version of the United States Department of Transportation, National Highway Traffic Administration, Emergency Medical Technician Basic: National Standard Curriculum;

(d) Utilize the "Kentucky Required Mandatory Supplemental Curriculum for Emergency Medical Technician Basic (EMT-B)" for:

1. Initial training in the monitoring, maintaining, and discontinuing of preestablished patient intravenous infusions in prehospital, interfacility and facility to home encounters; and

2. Initial training in advanced airway management to provide assistance to those licensed to perform advanced airway procedures.

(2) Each student shall, in order to be eligible for certification in Kentucky, be required to complete a clinical or field rotation that meets the following minimum requirements:

(a) A clinical or field internship, which shall consist of at least ten (10) hours;

(b) A clinical or field internship, which shall be conducted in a hospital emergency department or a licensed ambulance service or ALS medical first-response agency;

(d) Record of patient history and assessment on a prehospital care report form for each of the five (5) patients required in (2)(c) of this section.

(3) The EMS-TEI Chief Administrative Officer may require the student to repeat clinical or field rotation experience, as necessary, until the EMS instructor deems the student to have achieved the goals established for the EMS education program.

(4) If, in an extreme circumstance, an EMS-TEI is unable to obtain clinical or field rotation experiences for their students, the EMS-TEI shall file with the KBEMS office a request for approval for a variance from the requirement. The written request shall include:

(a) Written evidence of a good faith effort to obtain a clinical or field rotation site, within forty (40) miles from the location of the EMT course site, by contacting at least three (3) board-licensed ambulance services, ALS medical first response agencies; or hospital emergency departments; and

(b) A description of proposed alternatives to the clinical or field rotation.

(5) An EMT student may begin the field internship required in this section after completion of the patient-assessment module of the training and education course.

Section 10. Paramedic Training and Education Programs. (1) Each paramedic training and education program shall:

(a) Utilize the 1998 version of the United States Department of Transportation, National Highway Traffic Administration, Paramedic: National Standard Curriculum, incorporated by reference in this administrative regulation requiring as a minimum, the mean number of hours for didactic, clinical laboratory, and summative field evaluation hours as recommended by the curriculum;

(b) Provide training and education in AIDS as required by KRS 311A.110, for which the printed curriculum has been reviewed, approved and assigned an approval number by the HIV and AIDS Branch of the Cabinet for Health Services unless all students are credentialed currently;

(c) Provide training and education in determination of death and preservation of evidence as required by administrative regulation;

(d) Have a medical director who conducts or supervises a minimum of three (3) oral examinations with each student;

1. One (1) during the didactic portion of the course;

2. One (1) during the clinical portion of the course; and

3. One (1) during the final 100 hours of the field summative evaluation.

(2) As a part of each paramedic program, the EMS-TEI shall provide sufficient opportunities and locations for students to complete clinical rotations that shall:

(a) Be conducted at hospitals, clinics, physician offices, or other health care facilities. The EMS-TEI shall have a written contract, affiliation agreement or memorandum of agreement with each clinical rotation site, which at a minimum, outlines the responsibilities of each entity and reporting requirements for students while involved in clinical training and education;

(b) Be supervised by faculty from the paramedic training and education program or by clinical coordinators or supervisors employed by or under contract with the EMS-TEI to monitor student activity while in the clinical setting; and

(c) Require that a specified number of the following procedures be accomplished under supervision during the clinical rotation:

1. ALS patient assessments;

2. Intubations and other airway management techniques;

3. Placement of I.V. and I.O. lines;

4. Administration of medications utilizing I.V., I.M., I.O., endotracheal, subcutaneous, inhalation, oral and rectal routes;

5. Mixing, if applicable, and administration of I.V. piggyback medications;

6. Electrocardiographic monitoring and dysrhythmia interpretation; and

7. Other procedures as may be required by the program medical director.

(3) As a part of each paramedic program, the EMS-TEI shall provide sufficient opportunities and locations for students to complete a field internship and summative field evaluation that shall be:

(a) Conducted at Class I, Class III, or Class VII locations licensed as ALS providers by the board. An EMS-TEI may apply to the board for consideration of other field internship or summative field evaluation sites where a portion of the field internship or summative field evaluation requirement may be obtained. The EMS-TEI shall have a written contract, affiliation agreement or memorandum of agreement with each field internship or summative field evaluation site which as a minimum, outlines the responsibilities of each entity and reporting requirements for students while involved in field internship or summative field evaluation training;

(b) Monitored by preceptors; and

Section 11. Continuing Education. (1) Continuing education offerings shall:

(a) Contain material relevant to the job duties and professional development of EMS personnel; and

(b) Be conducted at a level appropriate for the discipline of the participants.

(2) Continuing education offerings may consist of:

(a) Those provided by an EMS-TEI or EMS provider;

(b) National or international programs;

(d) On line or distance education, which shall not to exceed fifty (50) percent of the total required continuing education as established by the board; or

(e) Other education approved by the ambulance service’s medical director.

(3) Organizations other than EMS-TEIs that provide emergency medical services continuing education to the general public shall complete a board approved application.

(4) Organizations certified to provide continuing education may utilize the Kentucky "Optional Training Curriculum" for use in service-specific continuing education for it’s employees or other EMTs receiving such training and education. Each student shall complete training and education and competency-based evaluations for each of the following procedures prior to being authorized to perform each respective procedure:

(a) "Application of End Tidal CO2 Monitoring";

(b) "Use of an Automated Blood Glucose Analysis Device";

(d) "Application of Electrocardiogram Electrodes and Monitor".

(5) An organization certified to provide continuing education that desires to conduct training and education for EMTs who were initially certified before the implementation of the Kentucky supplemental curricula established in this administrative regulation may:

(a) Use the printed documents available from the board; or

(b) Use service-developed printed curricula documents that have been submitted to, reviewed and approved by the board.

Section 12. Continuing Education Instructor Requirements. (1) The following persons shall be qualified to conduct continuing education courses for persons certified or licensed by the board:

(a) A physician licensed in Kentucky or another state, who has specific expertise in an area of a prehospital discipline;

(b) A registered nurse licensed in Kentucky or another state, who has specific expertise in an area of a prehospital discipline;

(d) An EMSI certified in Kentucky; or

(e) An individual who:

1. Is certified by a state or federal agency to teach or perform subject matter relevant to the National Standard Curriculum for a prehospital discipline;

2. Is certified by a nationally-recognized entity to provide EMS related training and education;

3. Is a presenter at a National Symposium which has been accredited by the Continuing Education Coordinating Board for EMS; or

4. Is a presenter approved by EMS medical director or EMS-TEI as uniquely qualified by experience or education.

(2) Individuals shall not hold themselves out to be an approved continuing education instructor if they do not meet the qualifications of this section.

Section 13. Pilot Programs. (1) An EMS-TEI, Class I, Class III, or Class VII provider may apply to the KBEMS office for authorization to perform field pilot testing of specialized training and education and associated procedures not otherwise provided for in administrative regulations.

(2) An entity seeking authorization to execute a field pilot test shall submit a written request to the board with a written description of:

(a) How the pilot program shall be implemented and monitored;

(b) The proposed training and education curriculum;

(d) The beginning and ending dates of the field pilot testing program;

(e) How the procedure shall benefit or improve the quality of patient care; and

(f) The methods to be used to evaluate the proposed training and education and procedure.

(3) An authorized entity approved by the board to conduct a pilot program shall agree, in writing:

(a) To submit periodic reports related to the progress of the pilot program, as required by the board; and

(b) To abide by the requirements established by the board for the pilot program.

(4) An individual otherwise certified or licensed by the board who successfully completes an approved pilot program may perform the procedures relevant to the training and education received in the pilot program subject to protocols established by the medical director.

(5) The board may establish pilot program limitations on:

(a) The geographic area or service location where the procedure may be performed; or

(b) The performance of the procedure related to:

1. A specific event;

2. A disaster; or

3. A designated directive.

(6) The board may authorize and utilize physicians, other than EMS medical directors to supervise and monitor training and education and students involved in a pilot program.

(7) The board may restrict or limit actions that involve the performance of an invasive procedure or the administration of medication subject to:

(a) Required physician or medical director oversight; or

(b) The establishment of protocols that have been reviewed and approved by the state medical advisor and the board.

Section 14. EMS Instructors. (1) An applicant for certification as a Kentucky certified EMS instructor shall be certified or licensed as a first responder, an EMT, or a paramedic. Unless certified as a first responder or EMT, an RN or EMS medical director may only be certified as a Level III EMS instructor.

(2) An individual seeking certification as an EMS instructor shall:

(a) Complete a United States Department of Transportation National Standard Curriculum for EMS instructor course or other board-authorized methods of Instruction program conducted by an entity approved by the board;

(b) Have been certified at the level for which they are applying for a minimum of two (2) years and shall provide documentation of a minimum of two (2) years experience with:

1. An ambulance service;

2. A medical first response agency such as a fire department or rescue squad;

3. A hospital emergency department as a caregiver;

an industrial emergency response team or service in an industrial first-aid station; or

4. Another environment determined by the Executive Director to have met this requirement;

(c) If teaching a first responder or EMT course, applicants shall provide documentation that they have assisted with a basic training course at the level for which they are making application during which they have made a minimum of five (5) lecture and five (5) skill presentations under the supervision of a certified instructor. The certified instructor of the basic training course shall have served as a course coordinator or lead instructor for at least three (3) separate basic training courses and shall not have been subject to disciplinary action or reprimand by the board within the previous thirty-six (36) months;

(d) Provide evidence of completion of a Board sponsored curriculum orientation program for the appropriate level of certification;

(e) Submit a completed "Application for EMS Instructor Initial Certification";

(f) Not be an individual who has been convicted of, entered a guilty plea or Alford plea to a felony offense, or has completed a diversion program for a felony offense;

(g) Not have been disciplined or ever subject to discipline pursuant to KRS Chapter 311A that would prevent current certification, or have an action pending against or had a certificate or license in the field of health care denied, limited, suspended, or probated by a certifying or licensing entity in Kentucky or other state or territory under the jurisdiction of the United States; and

(h) Pay any fees required by 202 KAR 7:030.

(3) The expiration date of an EMS instructor shall be the same as those of other certificates or licenses issued by the board.

(4) EMS instructors shall be certified as:

(a) Level I, which qualifies the individual to teach first responder courses or continuing education;

(b) Level II, which certifies the individual to teach EMT and first responder courses or continuing education; or

(5) No individual shall be certified as an EMS instructor at a level greater than the level at which they are certified or licensed.

Section 15. Renewal of EMS Instructor Certification. (1) A person certified by the board as an EMS instructor shall be eligible to renew the EMS instructor certification if the person:

(a) Maintains state certification or licensure as a provider, which as a minimum is at the level at which they are certified to instruct;

(b) Presents written evidence of completion of current HIV/AIDS training and education required by KRS 311A.110;

(c) During the preceding two (2) years, obtains a minimum of fifty-two (52) contact hours, providing documented evidence of completion of each hour, in the following categories:

1. A minimum of four (4) contact hours on topics related to methods of instruction (MOI);

2. Conducts a minimum of twenty-four (24) hours, or one (1) hour per each full month of certification if a certificate has been in effect for less than twenty-four (24) months, of instruction on at least three (3) different topics that are within the training and education requirements and the scope of practice for a level at which they are authorized to instruct; and

3. Presents evidence of participatory involvement in a minimum of twenty-four (24) hours, or one (1) hour per each full month of certification if a certificate has been in effect for less than twenty-four (24) months, of patient care experience with an ambulance service or other organization having an EMS mission, fire department, rescue squad, mining or other industrial health setting providing emergency medical services to their employees or members of the general public in any of the following roles of participation:

a. Actual patient emergency responses;

b. Agency quality assurance activities related to EMS; or

c. Enrolled as a participant or instructor for continuing education or agency-specific in-service training and education sponsored by the agency. Any hours obtained by participation as the instructor of this in-service training and education shall be in addition to the twenty-four (24) hours of instruction referenced in this administrative regulation; or

(d) Is not an individual who has been convicted of, entered a guilty plea or Alford plea to a felony offense, or has completed a diversion program for a felony offense;

(e) Has not been disciplined pursuant to KRS Chapter 311A that would prevent renewal certification, or has action pending against or had a certificate or license in the field of health care denied, limited, suspended, or probated by a certifying or licensing entity in Kentucky or other state or territory under the jurisdiction of the United States;

(f) Pays any fee required by 202 KAR 7:030; and

(g) Submits to the board a completed application for EMS instructor recertification that shall:

1. Be signed by the EMS instructor; and

2. Include a statement in which the EMS instructor certifies the truth of the information supplied.

(2) An application for renewal of certification as an EMS instructor shall not be considered if:

(a) The application is postmarked to the board after the certification expiration date of the applicant; or

(b) Prior to the certification expiration date, the EMS instructor applicant has not met the recertification requirements of this administrative regulation.

(3) Upon expiration of certification as an EMS instructor, the person may not perform any authorized function restricted by KRS or KAR to a Kentucky EMS instructor.

Section 16. Transition for Currently-certified Instructors. Instructors certified on the effective date of this administrative regulation shall be transitioned as follows:

(1) First responder instructors shall be certified as Level I EMS instructors;

(2) EMT instructors shall be certified as Level I and Level II EMS instructors; and

(3) Licensed paramedics, RNs or EMS medical directors who can provide documentation no later than December 31, 2004, from a Kentucky approved EMS-TEI of having served as a paramedic course coordinator or as an instructor for a Kentucky-approved paramedic program, during the period between January 1, 1999, and December 31, 2004 during which they can document instruction in a minimum of fifty (50) classroom hours in a minimum of five (5) different subject areas which must include instruction in pharmacology, cardiac emergencies, and traumatic injuries shall be certified as Level III EMS instructors.

Section 17. EMS Instructor Reciprocity. A person certified in another state as an EMS instructor shall be eligible for Kentucky certification as an EMS instructor after the person meets the requirements established in this administrative regulation.

Section 18. EMS Evaluator. (1) An applicant for endorsement as an EMS evaluator shall:

(a) Be certified as a Level I, Level II or Level III EMS instructor; or

(b) Hold current unrestricted licensure in Kentucky as:

1. A registered nurse who has specific expertise for the discipline in which they are serving as an evaluator; or

2. A physician who has specific expertise for the discipline in which they are serving as an evaluator;

(d) Have a minimum of two (2) years patient care experience prior to serving as an evaluator;

(e) Submit a completed "Application for EMS Evaluator";

(f) Not be an individual who has been convicted of, entered a guilty plea or Alford plea to a felony offense, or has completed a diversion program for a felony offense; and

(g) Not have been disciplined or subject to discipline pursuant to KRS Chapter 311A that would prevent endorsement, or have an action pending against or had a certificate or license in the field of health care denied, limited, suspended, or probated by a certifying or licensing entity in Kentucky or other state or territory under the jurisdiction of the United States.

(2) The endorsement of an EMS evaluator shall be commensurate with the expiration date of a certificate or license issued by the board, the KBN or KBML.

(3) EMS evaluators shall be certified as:

(a) Level I, which qualifies the individual to evaluate first responder courses;

(b) Level II, which certifies the individual to evaluate EMT and first responder courses; or

(4) An individual shall not be given an endorsement as an EMS evaluator at a level greater than the level at which the individual is certified or licensed.

Section 19. Renewal of EMS Evaluator Endorsement. (1) A person who holds an endorsement as an EMS evaluator shall be eligible to renew the EMS evaluator endorsement if the person:

(a) Maintains state certification or licensure as a provider, which as a minimum is at the level at which they are certified to instruct. This includes certification or licensure by the board, licensure as a RN by the KBN, or licensure as a physician by the KBML;

(b) Attends board-required update training;

(c) Is not an individual who has been convicted of, entered a guilty plea or Alford plea to a felony offense, or has completed a diversion program for a felony offense;

(d) Has not been disciplined pursuant to KRS Chapter 311A that would prevent a renewal endorsement, or does not have an action pending against or had a certificate or license in the field of health care denied, limited, suspended, or probated by a certifying or licensing entity in Kentucky or other state or territory under the jurisdiction of the United States; and

(e) Submits to the board a completed Application for Renewal of EMS Evaluator Endorsement that shall:

1. Be signed by the EMS evaluator; and

2. Include a statement in which the EMS evaluator certifies the truth of the information supplied.

(2) An Application for Renewal of Endorsement as an EMS evaluator shall not be considered if:

(a) The application is postmarked to the board after the endorsement expiration date of the applicant; or

(b) Prior to the endorsement expiration date, the EMS evaluator applicant has not met the recertification requirements of this administrative regulation.

(3) Upon expiration of endorsement as an EMS evaluator, the person shall not function as a Kentucky EMS evaluator.

Section 20. Instructor and Evaluator Oversight. The board may direct and assign the KBEMS office or other qualified individuals to conduct scheduled or unscheduled visits to an EMS instructor's classroom or to an EMS evaluator’s testing site to verify compliance with the instructional or evaluation quality and performance outlined in the administrative regulation. KBEMS office staff conducting any visit shall be certified or licensed at or above the level of the training or education program being visited.

Section 21. EMS-TA. (1) An entity approved by the board or an authorized EMS-TEI may conduct skills and practical examinations for certification or licensure.

(2) An applicant shall file a completed application for certification as an EMS-TA.

(3) A previously certified EMS-TA whose certification has been revoked may be eligible for certification as an EMS-TA after one (1) year from the date of revocation.

(4) Each certified EMS-TA shall have a chief administrative officer who shall:

(a) Be responsible for the planning, administration and oversight of the EMS-TA;

(b) Assure the quality and credentials of students accepted into examination conducted by the EMS-TA;

(c) Coordinate scheduling of examination dates and the need for appropriate proctors or representatives with the KBEMS office;

(d) Assure the security of examination results and materials; and

(e) Maintain records and documents and submit reports required by the board.

(5) A person shall not function as an examiner or proctor for certification or licensure examination if the person:

(a) Served as the chief administrative officer, program coordinator or lead instructor, or course instructor for more than ten (10) percent of the total scheduled hours of instruction for an educational program for which candidates are being tested as described in this administrative regulation;

(b) Served as a clinical or field preceptor for the individual being tested;

(d) Is a family member of the candidate; or

(e) Has a conflict of interest that may potentially bias the examiner or examination representative of the practical skills portion of the certification examination toward or against the candidate.

(6) The EMS-TA shall:

(a) Prior to January 1, 2005, be responsible for securing examiners for the practical skill portion of the certification examination who shall:

1. Have current certification or licensure from the board to perform the skills at or above the level of training and education at which the candidate being tested or is a physician or RN that has specific expertise for the discipline in which they are serving as an evaluator;

2. Have completed a board-approved evaluator orientation program prior to serving as an evaluator;

3. Meet other requirements of the NREMT; and

4. Have a minimum of two (2) years patient care experience prior to serving as an examiner.

(b) After January 1, 2005, be responsible for securing examiners for the practical skill portion of the certification examination who shall be certified pursuant to Section 18 of this administrative regulation;

(d) Verify the eligibility of a candidate applying to initially test or retest for the practical skills portion of the certification examination. Eligibility for testing or retesting shall follow the guidelines of the National Registry of Emergency Medical Technicians.

(7) A representative designated by the board may attend practical test sites.

(8) The KBEMS office shall schedule and conduct all written examinations and may conduct practical examinations at any level certified or licensed by the board. The board shall be exempt from maintaining certification as an EMS-TEI or EMS-TA in order to conduct written or practical testing.

(9) The board may require retesting of any candidate participating in an examination process if the examination site or examiners utilized are found to be noncompliant with administrative regulations.

Section 22. EMS-TA Certification Periods. (1) An EMS-TA certification shall be valid for a period of five (5) years, unless modified by a disciplinary action.

(2) An EMS-TA may surrender certification prior to the end of a certification period by written notification, which shall include providing the intended effective date of such surrender.

Section 23. Disciplinary Action Against an EMS-TA The board may take disciplinary action against an EMS-TA, if:

(1) An inspection or investigation by the KBEMS office determines the EMS-TA has not met the requirements of any section of this administrative regulation;

(2) An EMS-TA is on probationary status and fails to meet requirements established by the board;

(3) An agent of EMS-TA reproduces or reconstructs, or attempts to reproduce or reconstruct, any portion of an examination for the purpose of assisting another to cheat on the examination;

(4) An agent of EMS-TA disseminates information for purposes of reproduction or reconstruction of any portion of an examination in order to assist another to cheat on the examination;

(5) An agent of EMS-TA cheats, or assists another to cheat, on an examination;

(6) The EMS-TA or agent falsifies a record or document;

(7) The EMS-TA or agent fails to pay a fee or issues a check for any fee required by administrative regulation on an invalid account or an account that does not have sufficient funds;

(8) The EMS-TA or agent fails to file reports required by this administrative regulation; or

(9) The EMS-TA or agent fails to meet the requirements of the "EMS-TA Affidavit".

Section 24. Incorporated by Reference. (1) The following documents are incorporated by reference:

(a) The "EMS-TEI-Affidavit" (June 2003);

(b) The "EMS-TEI Annual Summary Report" (June 2003);

(d) The "Use of an Automated Blood Glucose" (June 2003);

(e) The "Application of Pulse Oximetry" (June 2003);

(f) The "Application of Electrocardiogram Electrodes and Monitor" (June 2003);

(g) The "Application of EMS Instructor Initial Certification" (June 2003);

(h) The "Application for EMS Evaluator" (June 2003); and

(i) The "Student Eligibility Form" (June 2003).

(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 2545 Lawrenceburg Road, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (30 Ky.R. 167; Am. 935; 1233; 1495; eff. 11-19-2003.)