[29 Pa.B. 903]
[Continued from previous Web Page]
CHAPTER 1011. ACCREDITATION OF TRAINING INSTITUTES § 1011.1. BLS and ALS training institutes.
(a) Eligible entity. A BLS and an ALS training institute shall be accredited by the Department. A [BLS] training institute shall be a secondary or postsecondary institution, hospital, regional EMS council or another entity which meets the criteria in this part.
(b) [Accreditation criteria. To qualify for accreditation as a BLS training institute, an entity shall demonstrate compliance with the following:
(1) Criteria] Training programs.
(1) [The] A BLS training institute shall evidence the ability to conduct one or more of the following training programs approved by the Department:
(i) Emergency Medical Technician[-Ambulance] Course[, National Standard Curriculum.
(ii) Emergency Medical Technician Refresher Course, National Standard Curriculum.
(iii) Emergency Medical Services (] (iii) EMS[)] First Responder Course[, First Edition or amendments and revisions thereto].
[(iv) EMS First Responder Refresher Course.
(v) EMT Instructor Training Program, National Standard Curriculum].
(2) An ALS training institute shall evidence the ability to conduct one or more of the following training programs approved by the Department:
(i) Emergency Medical Technician-Paramedic Course.
(ii) Prehospital Registered Nurse Course.
[(2)] (c) Personnel.
[(i)] (1) Medical director.
[(A) An] (i) A training institute shall have a medical director who is a physician [licensed in this Commonwealth]. The medical director shall be experienced in emergency medical care, and shall have demonstrated ability in education[/] and administration.
[(B)] (ii) The responsibilities of the medical director shall include:
[(I) Assuring that the] (A) Reviewing course content [is in] to ensure compliance with this part.
[(II) Assisting with] (B) Reviewing and approving the training institute's criteria for the recruitment, selection and orientation of training institute faculty.
[(III)] (C) ***
(D) Reviewing the quality and medical content of the education, and compliance with protocols.
(E) Participating in the review of new technology for training and education.
(iii) Additional responsibilities for a medical director of an ALS training institute include:
(A) Approving the content of course written and practical skills examinations.
(B) Identifying and approving facilities where students are to fulfill clinical and field internship requirements.
(C) Identifying and approving individuals to serve as field and clinical preceptors to supervise and evaluate student performance when fulfilling clinical and field internship requirements.
(D) Signing skill verification forms for students who demonstrate the knowledge and skills required for successful completion of the training course and entry level competency for the prehospital practitioner for which the training course is offered.
[(ii)] (d) Administrative director.
[(A)] (1) A BLS training institute shall have an administrative director who [is a currently certified EMT and] has at least 1 year experience in administration and 1 year experience in prehospital care.
(2) An ALS training institute shall have an administrative director who has at least 1 year experience in administration and 1 year experience in ALS prehospital care.
[(B)] (3) Responsibilities of the administrative director include ensuring:
[(I) Application] (i) The adequacy of the system for processing student applications and [oversight] of the student selection process.
[(II) Class scheduling and assignment] (ii) The adequacy of the process for the screening and selection of instructors for the training institute.
[(III) Preparation, maintenance and] (iii) The institute maintains an adequate inventory of necessary training equipment and that the training equipment is properly prepared and maintained.
[(IV) Administration] (iv) The adequate administration of the course and written and practical skills examinations involved in the course.
[(V) Maintenance] (v) There is an adequate system for the maintenance of student records and files.
[(VI)] (vi) [Student/faculty liaison] There is an appropriate mechanism to resolve disputes between students and faculty.
[(iii)] (e) Course coordinator.
[(A)] (1) The [BLS] training institute shall designate a course coordinator for each training course [of instruction] conducted by the training institute. [The coordinator shall possess certification as an EMT instructor, and shall have other qualifications as prescribed by the Department's Prehospital Personnel Training Manual.]
(2) A course coordinator shall have:
(i) Reading and language skills commensurate with the resource materials to be utilized in the course.
(ii) Knowledge of the Statewide BLS medical treatment protocols.
(3) A course coordinator for an ALS training course shall also satisfy the following requirements:
(i) One year experience in ALS prehospital care.
(ii) One year experience as an EMT-paramedic or a health professional, or as a supervisor of ALS prehospital care.
(iii) Have knowledge of the ALS transfer and medical treatment protocols for the region.
[(B) The] (4) A course coordinator is responsible for the management and supervision of each [BLS] training course offered by the training institute for which he serves as a course coordinator.
[(C)] (5) Specific duties of [the] a course coordinator [also include:
(I) Scheduling and supervising course instructors.
(II) Scheduling and supervising student clinical observation activities.
(III) Completing course records, including individual student performance summaries and scores.
(IV) Providing counseling services to students] shall be assigned by the training institute.
(6) One person may serve both as the administrative director and a course coordinator.
[(iv)] (f) Instructors.
[(A)] (1) A [BLS] training institute shall ensure the availability of qualified and responsible instructors for each training course. [Instructors shall meet the qualifications required by § 1003.23(e) (relating to EMT).]
(2) An instructor shall be 18 years of age or older, and possess a high school diploma or GED equivalent.
(3) At least 75% of the instruction provided in training courses shall be provided by instructors who are health professional physicians or prehospital personnel and who have at least 1 year of experience as a health professional physician or a prehospital practitioner above the level of a first responder and at or above the level they are teaching, and have completed an EMS instructor course approved by the Department or possess a bachelor's degree in education or a teacher's certification in education; or be determined by a review body of the training institute to meet or exceed these standards.
(4) An instructor who does not satisfy the requirements in paragraph (3) shall be qualified to provide the instructional services offered as determined by the training institute after consulting the Prehospital Practitioner Manual and with the appropriate regional EMS council.
[(B)] (5) ***
[(v) Other faculty. A BLS training institute may use the instructional services of other personnel as may be deemed appropriate, subject to approval by the regional EMS council.]
(g) Clinical preceptors.
(1) An ALS training institute shall ensure the availability of clinical preceptors for each training course.
(2) A clinical preceptor is responsible for the supervision and evaluation of students while fulfilling clinical requirements for a training program.
(h) Field preceptors.
(1) An ALS training institute shall ensure the availability of field preceptors for each student.
(2) A field preceptor is responsible for the supervision and evaluation of students while fulfilling a field internship for a training program.
[(3)] (i) Facilities and equipment. A training institute shall:
[(i) The institute shall maintain] (1) Maintain facilities necessary for the provision of [BLS] training courses. The facilities shall include classrooms and space for equipment storage, and shall be of sufficient size to conduct didactic and practical skill performance sessions. [The regional EMS council is responsible for determining the appropriateness of the facilities provided.]
[(ii) The institute shall provide] (2) Provide and maintain the essential equipment and supplies [as] to administer the course. These shall be identified in the [Department's] Prehospital Personnel [Training] Manual.
[(4)] (j) Operating procedures. A training institute shall:
[(i) The institute shall adopt] (1) Adopt and implement [the Department's] a nondiscrimination policy with respect to student selection and faculty recruitment.
[(ii) A file shall be maintained] (2) Maintain a file on each enrolled student [to include] which includes class performance, practical and written examination results, and reports made concerning the progress of the student during the training program.
[(iii) The institute shall provide] (3) Provide a mechanism by which students may grieve decisions made by the institute regarding dismissal or other disciplinary action. [The grievance procedure shall be subject to approval by the regional EMS council.]
[(iv) Students shall be provided] (4) Provide students with a clear description of the program and its content, including learning goals, course objectives and competencies to be attained.
[(v) The institute shall evidence compliance with policies contained in the Department's Prehospital Personnel Training Manual.]
(5) Have a policy regarding the transfer of a student into or out of a training program from one training institute to another.
(6) Have a continuing quality improvement process in place for students, instructors, and clinical evaluation.
§ 1011.2. [ALS training institutes] (Reserved).
[(a) Eligible entity. An ALS training institute shall be accredited by the Department. An ALS training institute shall be a secondary or a postsecondary institution, hospital, EMS council or another entity which meets the criteria in this part.
(b) Criteria. To qualify for accreditation as an ALS training institute, an entity shall demonstrate compliance with the following:
(1) Training programs. The institute shall evidence the ability to conduct one or more of the following training programs approved by the Department.
(i) Emergency Medical Technician-Paramedic Course, National Standard Curriculum.
(ii) Emergency Medical Technician-Paramedic Refresher Course, National Standard Curriculum.
(iii) Health professional.
(2) Administration.
(i) Medical director.
(A) An institute shall have a medical director who is a physician licensed in this Commonwealth. The medical director shall be experienced in emergency medical care, and shall have demonstrated ability in education/ administration.
(B) The responsibilities of the medical director include:
(I) Assuring that the course content is in compliance with this part.
(II) Assisting with the recruitment, selection and orientation of training institute faculty.
(III) Providing technical advice and assistance to training institute faculty and students.
(IV) Approving the content of written and practical skills examinations.
(V) Identifying and approving facilities and ALS services where students can fulfill clinical and field internship requirements.
(VI) Identifying and approving individuals who will serve as field and clinical preceptors for supervising and evaluating student performance when fulfilling clinical and field internship requirements.
(ii) Administrative director.
(A) The administrative director shall have at least 1 year of experience in administration and 1 year of experience in ALS prehospital care education.
(B) Responsibilities of the administrative director include:
(I) Application processing and oversight of the student selection process.
(II) Class scheduling and assignment of instructors.
(III) Preparation, maintenance and inventory of necessary training equipment.
(IV) Administration of written and practical skill examinations.
(V) Maintenance of student records and files.
(VI) Student/faculty liaison.
(iii) Course coordinator.
(A) The ALS training institute shall designate a course coordinator for each course of instruction conducted by the training institute. The coordinator shall be a currently certified EMT-paramedic or health professional as defined in this part, and shall have other qualifications prescribed by the Department's Prehospital Personnel Training Manual.
(B) The course coordinator is responsible for the management and supervision of each ALS training course offered by the training institute.
(C) Specific duties of the course coordinator also include:
(I) Scheduling and supervising course instructors.
(II) Scheduling and supervising student clinical observation activities and field internships.
(III) Completing course records, including individual student performance summaries and scores.
(IV) Providing counseling services for students.
(iv) Instructors.
(A) The ALS training institute shall ensure the availability of instructors for each course.
(B) An instructor shall be experienced in the education of individuals at the ALS level, and approved by the course medical director as qualified to teach those sections of the course to which the instructor is assigned.
(C) An instructor is responsible for presenting course materials in accordance with the curriculum established by this part.
(v) Clinical preceptors.
(A) The ALS training institute shall ensure the availability of clinical preceptors for each course.
(B) The clinical preceptor is responsible for the supervision and evaluation of paramedic students while fulfilling clinical requirements in an approved facility.
(vi) Field preceptors.
(A) The ALS training institute shall ensure the availability of field preceptors for each student.
(B) The field preceptor is responsible for supervision and evaluation of paramedic students while fulfilling field internships with an approved ALS service.
(vii) Other faculty. An ALS training institute may use the instructional services of other personnel as may be deemed appropriate, subject to approval by the regional EMS council.
(3) Facilities and equipment.
(i) The institute shall maintain facilities appropriate to conduct ALS training courses. Facilities include classrooms and space for equipment storage, and shall be of sufficient size to conduct didactic and practical skill performance sessions. The regional EMS council is responsible for determining the appropriateness of the facilities.
(ii) The institute shall provide and maintain the essential equipment and supplies as identified in the Department's Prehospital Personnel Training Manual. The equipment includes items necessary to perform skills required by the course curriculum, as defined in this part.
(4) Operating procedures.
(i) The institute shall adopt and implement the Department's nondiscrimination policy with respect to student selection and faculty recruitment.
(ii) A file shall be maintained on each enrolled student to include class performance, practical and written examination results and reports made concerning the progress of the student during the training program.
(iii) The institute shall provide a mechanism by which students may grieve decisions made by the institute regarding dismissal or other disciplinary action. The grievance procedure shall be subject to approval by the regional EMS council.
(iv) Students shall be provided with a clear description of the program and its content, including learning goals, course objectives and competencies to be attained.
(v) The institute shall evidence compliance with policies contained in the Department's Prehospital Personnel Training Manual.]
§ 1011.3. Accreditation process.
For an ALS or BLS institute to be accredited by the Department, the following are required:
* * * * * (2) The regional EMS council shall review the application for completeness[,] and accuracy [and conformance with the regional EMS plans and protocols].
* * * * * (5) Within 150 days of receipt, the Department will review the application and make one of the following determinations:
(i) Full accreditation. The training institute [currently] meets the criteria in [§]§ 1011.1 [or 1011.2] (relating to BLS and ALS training institutes[; and ALS training institutes)] as applicable, and will be accredited to operate for 3 years.
(ii) Conditional accreditation. The training institute does not [currently] meet criteria in [§]§ 1011.1 [or 1011.2] as applicable, but the deficiencies identified are deemed correctable by the Department. The program will be allowed to proceed or continue with close observation by the Department. Deficiencies which prevent full accreditation shall be enumerated and corrected within a time period specified by the Department. Conditional accreditation may not exceed 1 year, and may not be renewed.
(iii) Nonaccreditation. The institute does not [currently] meet criteria in [§]§ 1011.1 [or 1011.2] and the deficiencies identified are deemed to be serious enough to preclude any type of accreditation. [The applicant may request a hearing from the Department under 2 Pa.C.S. §§ 501--508 and 701--704 (relating to Administrative Agency Law).]
* * * * * (7) Prior to and during accreditation, training institutes are subject to review, including inspection of records, facilities and equipment by the Department. An authorized representative of the Department [or its designee has the right to] may enter, visit and inspect an accredited training institute or a facility operated by or in connection with the training institute, with or without prior notification.
[(8) A training institute accredited by the American Medical Association shall be considered to have met the requirements in this part, and shall be accredited by the Department for a period to coincide with that of the American Medical Association's certification.] The Department may accept the survey results of another accrediting body if the Department determines that the accreditation standards of the other accrediting body are equal to or exceed the standards in this chapter, and that the survey process employed by the other accrediting body is adequate to gather the information necessary for the Department to make an accreditation decision.
[(9)] (8) ***
§ 1011.4. [Suspension/revocation] Denial, restriction or withdrawal of accreditation.
(a) The Department may [suspend or revoke] deny, withdraw or condition the accreditation of a training institute [upon written complaint and investigation] for one or more of the following:
(1) Failure to maintain compliance with the applicable criteria in [§]§ 1011.1 [or 1011.2] (relating to BLS and ALS training institutes[; and ALS training institutes]) [and standards and policies in the Department's Prehospital Personnel Training Manual].
* * * * * (b) Before denying or withdrawing accreditation, or granting conditional accreditation, the Department will give written notice to the institute's administrative director and the regional EMS council that the action is contemplated. The notice will identify reasons for [withdrawal of accreditation] the intended decision and will provide sufficient time for response [and a request for appeal and review of the Department's determination].
(c) [A revocation or suspension of accreditation may be appealed under 2 Pa.C.S. §§ 501--508 and 701--704 (relating to administrative agency law).] If an institute that applies for accreditation, or has its accreditation withdrawn or conditioned, disagrees with the decision of the Department, it may appeal the decision under 1 Pa. Code § 35.20 (relating to appeals from actions of the staff) if the decision was not issued by the agency head as defined in 1 Pa. Code § 31.3 (relating to definitions) and, if it disagrees with the decision of the agency head, it may file an appeal under 2 Pa.C.S. §§ 501--508 and 701--704 (relating to Administrative Agency Law).
(d) Upon receipt of a written complaint describing conduct for which the Department may withdraw training facility accreditation, the Department will:
(1) Initiate an investigation of the specific charges.
(2) Provide the training facility with a copy of the complaint and request a response unless the Department determines that disclosure to the training facility of the complaint will compromise the investigation or would be inappropriate for some other reason.
(3) Develop a written report of the investigation.
(4) Notify the complainant of the results of the investigation of the complaint, as well as the training facility if the training facility has been officially apprised of the complaint or investigation. This notification does not include providing a copy of the written report developed under paragraph (3).
CHAPTER 1013. SPECIAL EVENT EMS § 1013.1. Special event EMS planning requirements.
(a) Procedure for obtaining required plan approval. A person, agency or organization responsible for the management and administration of special events, as defined in § 1001.2 (relating to definitions), [shall] may submit a plan for EMS to the Department, through the regional EMS council assigned responsibility for the region in which the special event is to occur, to secure a determination from the Department as to whether the plan is adequate to address the EMS needs presented by a special event or a series of special events conducted at the same location. The plan shall be [approved] submitted prior to the start of the special event.
(1) Persons, agencies or organizations, managing facilities or locations which are involved in special events as defined in § 1001.2, who seek the Department's approval of an EMS plan for a special event or series of special events conducted at the same location, shall submit an annual plan to the [Department] appropriate regional EMS council at least [60] 90 days prior to the date of the first scheduled event of each calendar year.
(2) The Department will approve or disapprove a special event EMS plan within [30] 60 days [of its receipt] after a complete plan is filed with the regional EMS council.
(b) Plan content. The special event EMS plan shall contain information[,] including[, but not limited to]:
* * * * * (11) Measures that have and will be taken to coordinate EMS for the special event with local emergency care services and public safety agencies--such as ambulance, police, fire, rescue and hospital agencies or organizations.
(c) Plan approval. To secure Department approval of an EMS plan for a special event, the applicant shall satisfy the requirements of this chapter.
§ 1013.2. Administration, management and medical direction requirements.
(a) Special event EMS director. [Emergency medical services] EMS provided at a special event shall be supervised by an individual identified as the special event EMS director.
(1) Responsibilities. The responsibilities of the special event EMS director include[, but are not limited to]:
* * * * * (iii) [Coordination of special event EMS, with local emergency care services and public safety entities--such as ambulance, police, fire rescue and hospital agencies or organizations] Ensuring implementation of the EMS coordination measures contained in the special event EMS plan.
* * * * * (b) Special event emergency supervisory physician.
(1) Requirement. A special event EMS system shall be directed and supervised by a [licensed] medical command physician for events involving more than [30,000] 25,000 actual or anticipated participants or attendees, or both.
(2) Qualifications. A special event emergency supervisory physician shall possess the following qualifications:
* * * * * (ii) [A valid license to practice medicine in this Commonwealth as a Doctor of Medicine or Doctor of Osteopathy] Be licensed as a physician.
§ 1013.3. Special event EMS personnel and capability requirements.
* * * * * (b) One staffed and Pennsylvania licensed ambulance vehicle shall be stationed onsite of a special event with a known or estimated population of between [10,000] 5,000 and [30,000] 25,000 participants or attendees, or both.
(c) Two staffed and Pennsylvania licensed ambulance vehicles shall be stationed onsite of a special event with a known or estimated population greater than [30,000] 25,000 but less than [60,000] 55,000 participants or attendees, or both.
(d) Three staffed and Pennsylvania licensed ambulance vehicles shall be stationed onsite of any special event with a known or estimated population greater than [60,000] 55,000 participants or attendees, or both.
* * * * * § 1013.5. Onsite facility requirements.
A special event for which greater than [30,000] 25,000 participants or spectators, or both, will be involved shall require the use of onsite treatment facilities. The onsite treatment facilities shall provide:
* * * * * (2) Sufficient beds, cots and [BLS] equipment to provide for evaluation and treatment of at least four simultaneous patients.
* * * * * § 1013.6. Communications system requirements.
(a) A special event EMS system shall have onsite communications capabilities to insure:
* * * * * (3) Communication with existing community [emergency communications centers] PSAPs.
* * * * * § 1013.8. Special event report.
The person or organization that filed the special event EMS plan shall complete a special event report form prepared by the Department and provided to it by the relevant regional EMS council, and shall file the completed report with that regional EMS council within 30 days following a special event.
CHAPTER 1015. QUICK RESPONSE SERVICE RECOGNITION PROGRAM Sec.
1015.1. Quick response service. 1015.2. Discontinuation of service. § 1015.1. Quick response service.
(a) Criteria. An applicant for recognition as a QRS shall file an application in which it shall commit to the following conditions to receive Department recognition as a QRS:
(1) The applicant will maintain essential equipment and supplies for a QRS, as published by the Department at least annually in the Pennsylvania Bulletin, for immediate use when dispatched.
(2) The applicant has capabilities to be dispatched and to communicate with a responding ambulance service.
(3) EMS it provides will be performed by prehospital personnel or other persons authorized by law to perform the services.
(4) The applicant shall satisfy the requirements applicable to ambulance services in §§ 1001.41 and 1001.42 (relating to data and information requirements for ambulance services; and dissemination of information), for data elements included in an ambulance call report which the Department designates for completion by a QRS.
(5) The applicant shall provide EMS in compliance with regional medical treatment protocols and the Statewide BLS medical treatment protocols.
(b) Recognition process.
(1) An applicant for Department recognition as a QRS shall submit an application on forms prescribed by the Department to the regional EMS council having jurisdiction over the area in which the applicant intends to locate. The application shall contain the following information:
(i) The name and address of the applicant.
(ii) The physical location of the applicant.
(iii) Service affiliations (police department, fire department, ambulance service, or other).
(iv) The service area.
(v) The types and number of vehicles it will employ, if any.
(vi) Communication access and capabilities of the applicant.
(vii) A roster of persons who have committed to serve as QRS members, and their qualifications.
(viii) A summary of how the QRS will interface with ambulance services.
(ix) Verification that the applicant will satisfy the requirements of subsection (a).
(x) A statement attesting to the veracity of the application, which shall be signed by the principal official of the applicant.
(2) The regional EMS council shall review the application for completeness and accuracy. It shall return an incomplete application to the applicant within 14 days of receipt.
(3) Upon receipt of a complete application, the regional EMS council shall conduct, within 45 days, an onsite inspection of the applicant to determine whether the applicant satisfies the regulatory criteria for QRS recognition. Deficiencies identified during the inspection shall be documented and made known to the applicant. A reinspection shall be scheduled when the applicant notifies the regional EMS council that the deficiencies have been corrected. The results shall be forwarded to the Department.
(c) Recognition.
(1) A certificate of recognition as a QRS will be issued by the Department when it has been determined that requirements for recognition have been met.
(2) The certificate of recognition will specify the name of the QRS, the date of issuance, the date of expiration, the regional EMS council through which the application was processed and the recognition number assigned by the Department.
(3) The QRS may identify a vehicle being utilized for response by applying to the outside of the vehicle a QRS decal issued by the Department
(4) The QRS decal issued by the Department may not be displayed on a vehicle not utilized for response by the QRS.
(5) A certificate of recognition is nontransferable and remain valid for 3 years unless withdrawn by the Department due to the QRS failing to continue to meet the standards for recognition as a QRS in subsection (a).
(d) Renewal of recognition. A QRS may continue to participate in the Quick Response Service Recognition Program by resubmitting an application in a format prescribed by the Department to the appropriate regional EMS council at least 60 days prior to the expiration date of its certificate of recognition.
§ 1015.2. Discontinuation of service.
A QRS may not discontinue service, except upon order of the Department, without providing each regional EMS council and the chief executive officer of each political subdivision within its service area 90 days advance notice. The QRS shall also advertise notice of its intent to discontinue service in a newspaper of general circulation in its service area at least 90 days in advance of discontinuing service, and shall provide the Department with written notice that it has met these responsibilities at least 90 days in advance of discontinuing service.
[Pa.B. Doc. No. 99-260. Filed for public inspection February 12, 1999, 9:00 a.m.]
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