CHAPTER 1023. PERSONNEL
Subchap.
A. ADMINISTRATIVE AND SUPERVISORY EMS PERSONNEL…1023.1
B. EMS PROVIDERS AND VEHICLE OPERATORS…1023.21
C. OTHER PERSONS ASSOCIATED WITH THE STATEWIDE EMS SYSTEM…1023.52Authority The provisions of this Chapter 1023 issued under the Emergency Medical Services System Act, 35 Pa.C.S. § § 8101—8157, unless otherwise noted.
Source The provisions of this Chapter 1023 adopted October 11, 2013, effective October 12, 2013, 43 Pa.B. 6093, unless otherwise noted.
Cross References This chapter cited in 28 Pa. Code § 1021.104 (relating to responsibilities of regional EMS councils).
Subchapter A. ADMINISTRATIVE AND SUPERVISORY EMS PERSONNEL
Sec.
1023.1. EMS agency medical director.
1023.2. Medical command physician.
1023.3. Medical command facility medical director.
1023.4. Regional EMS medical director.
1023.5. Commonwealth EMS Medical Director.§ 1023.1. EMS agency medical director.
(a) Roles and responsibilities. An EMS agency medical director is responsible for:
(1) Providing medical guidance and advice to the EMS agency, including:
(i) Reviewing the Statewide EMS protocols and Department-approved regional EMS protocols that are applicable to the EMS agency and ensuring that its EMS providers and other relevant personnel are familiar with the protocols applicable to the EMS agency.
(ii) Performing medical audits of EMS provided by the EMS agency’s EMS providers.
(iii) Participating in and reviewing quality improvement and peer reviews of EMS provided by the EMS agency.
(iv) Reviewing regional mass casualty and disaster plans and providing guidance to the EMS agency regarding its provision of EMS under those plans.
(v) Providing guidance to the EMS agency, when applicable, with respect to the ordering, stocking and replacement of medications, and compliance with laws and regulations impacting upon the EMS agency’s acquisition, storage and use of those medications.
(vi) Making an initial assessment of each EMS provider at or above the AEMT level to determine whether the EMS provider has the knowledge and skills to competently perform the skills within the EMS provider’s scope of practice, and a commitment to adequately perform other functions relevant to the EMS provider providing EMS at that level. This subparagraph does not apply if the EMS provider was working for the EMS agency at the same level prior to the physician becoming the medical director for the EMS agency and the EMS provider was credentialed at that EMS agency within the last 12 calendar months as being able to perform at the EMS provider’s certification level.
(vii) Making an assessment, within 12 calendar months of the last assessment, of each EMS provider at or above the AEMT level to determine whether the EMS provider has demonstrated competency in the knowledge and skills to perform the skills within the EMS provider’s scope of practice, and a commitment to adequately perform other functions relevant to the EMS provider providing EMS at that level.
(viii) Recommending to the EMS agency that an EMS provider not be permitted to provide EMS at the EMS provider’s certification level if the EMS agency medical director determines that the EMS provider has not demonstrated competency in the knowledge and skills to perform the skills within the EMS provider’s scope of practice, or a commitment to adequately perform other functions relevant to the EMS provider providing EMS at that level, and recommending restrictions on the EMS provider’s practice for the EMS agency, if appropriate, to ensure patient safety.
(ix) Providing medical direction for the EMS agency dispatch center if the EMS agency operates an EMS agency dispatch center.
(2) Maintaining a liaison with the regional EMS medical director.
(3) Participating in the regional and Statewide quality improvement programs.
(4) Recommending to the relevant regional EMS council, when appropriate, EMS protocols for inclusion in the Statewide and regional EMS protocols.
(5) Recommending to the Department the suspension, revocation or restriction of an EMS provider’s certification.
(b) Minimum qualifications. To qualify and continue to function as an EMS agency medical director, an individual shall:
(1) Be a physician.
(2) Satisfy one of the following:
(i) Have successfully completed an emergency medicine residency program accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine.
(ii) Have successfully completed a residency program in surgery, internal medicine, family medicine, pediatrics or anesthesiology, accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine. The physician shall also have successfully completed or taught the ACLS course within the preceding 2 years and have completed, at least once, the ATLS course and PALS course or APLS course, or other programs determined by the Department to meet or exceed the standards of these programs.
(iii) Have served as an ALS medical director under the Emergency Medical Services Act (35 P. S. § § 6921—6938) (repealed by the act of August 18, 2009 (P. L. 308, No. 37)) prior to February 16, 2010.
(3) Have a valid Drug Enforcement Agency number.
(4) Have completed an EMS agency medical director course or an EMS fellowship or other EMS training program that is determined by the Department to be equivalent. This training shall ensure that the EMS agency medical director has knowledge of:
(i) The scope of practice of EMS providers.
(ii) The provision of EMS under Statewide EMS protocols.
(iii) The interface between EMS providers and medical command physicians.
(iv) Quality improvement and peer review principles.
(v) Emergency medical dispatch principles and EMS agency communication capabilities.
(vi) EMS system design and operation.
(vii) Federal and State laws and regulations regarding EMS.
(viii) Regional and State mass casualty and disaster plans.
(ix) Patient and EMS provider safety principles.
Cross References This section cited in 28 Pa. Code § 1023.21 (relating to general rights and responsibilities); 28 Pa. Code § 1027.3 (relating to licensure and general operating standards); and 28 Pa. Code § 1033.2 (relating to administration, management and medical direction requirements).
§ 1023.2. Medical command physician.
(a) Roles and responsibilities. A medical command physician functions under the direction of a medical command facility medical director and the auspices of a medical command facility. A medical command physician is responsible for:
(1) Providing medical command to EMS providers whenever they seek direction.
(2) Issuing medical command consistent with Statewide protocols and protocols that are in effect either in the region in which EMS originates or the region from which the EMS providers who are providing EMS begin receiving medical command direction. For good cause, a medical command physician may give medical command that is inconsistent with these protocols.
(3) Documenting patient information received from EMS providers and medical command given to EMS providers, including when the medical command physician is providing medical command at the scene.
(b) Minimum qualifications. To qualify and continue to function as a medical command physician, an individual shall be serving as a medical command physician immediately prior to February 16, 2010, or:
(1) Complete an application for medical command physician certification on a form or through an electronic application process, as prescribed by the Department.
(2) Be a physician.
(3) Satisfy one of the following:
(i) Have successfully completed a residency program in emergency medicine accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine.
(ii) Have had an emergency medicine practice in another jurisdiction and establish to the Department that the physician has a combination of training, education and emergency medicine practice that makes the physician qualified to serve as a medical command physician.
(iii) Have successfully completed or taught the ACLS course within the preceding 2 years and have completed or taught the ATLS course and either an APLS or PALS course or other program determined by the Department to meet or exceed the standards of these programs.
(4) Have an arrangement with a medical command facility to serve as a medical command physician for that facility after receiving certification as a medical command physician.
(5) Be practicing as an emergency medicine physician, be participating as a resident in a second or subsequent year in an emergency medicine residency program accredited by an accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine or have had at least 3 years of experience as a full-time emergency medicine physician.
(6) Have a current Drug Enforcement Agency (DEA) number or be an emergency medicine resident in an emergency medicine residency program accredited by an accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine who is authorized to use a hospital’s DEA number for practice within the emergency medicine residency program.
(7) Have successfully completed the medical command course.
(c) Triennial registration. A medical command physician’s certification is deemed registered for 3 years. Thereafter, a medical command physician shall triennially register the certification on a form or through an electronic process, as prescribed by the Department. The Department will issue a new registration within 30 days after the application for registration is filed if the application demonstrates that the medical command physician:
(1) Maintains licensure as a physician.
(2) Has an arrangement with a medical command facility to serve as a medical command physician for that facility.
(3) Is practicing as an emergency medicine physician or has had at least 3 years of experience as a full-time emergency medicine physician.
(4) Has completed the most recent update or refresher course that the Department provided on Statewide and other applicable Department-approved EMS protocols.
Cross References This section cited in 28 Pa. Code § 1031.8 (relating to discipline of medical command physicians and medical command facility medical directors).
§ 1023.3. Medical command facility medical director.
(a) Roles and responsibilities. A medical command facility medical director is responsible for the following for the medical command facility:
(1) Medical command.
(2) Quality improvement.
(3) Liaison with regional EMS medical director.
(4) Participation in prehospital training activities.
(5) Clinical and continuing education training of EMS providers.
(6) Verifying to the Department that an applicant for medical command physician certification has an arrangement to serve as a medical command physician for the medical command facility under the direction of the medical command facility medical director and meets all medical command physician certification requirements.
(7) Monitoring the operation of the medical command facility and the performance of its medical command physicians to ensure that they are satisfying all statutory and regulatory requirements.
(8) Reviewing a departure from the Statewide EMS protocols of one of the facility’s medical command physicians when requested by the Department and apprising the Department whether the medical command facility medical director believes there is good cause for the departure.
(b) Minimum qualifications. To qualify and continue to function as a medical command facility medical director, an individual shall be serving as a medical command facility medical director immediately prior to February 16, 2010, or:
(1) Complete an application for medical command facility medical director certification on a form or through an electronic application process, as prescribed by the Department.
(2) Currently serve as a medical command physician.
(3) Satisfy one of the following:
(i) Have completed a residency program in emergency medicine accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine.
(ii) Have completed a residency program in surgery, internal medicine, family medicine, pediatrics or anesthesiology accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine and completed or taught the ACLS course within the preceding 2 years, the ATLS course and either an APLS or PALS course or other program determined by the Department to meet or exceed the standards of these programs.
(4) Have experience in prehospital and emergency department care of the acutely ill or injured patient.
(5) Have experience in providing medical command direction to EMS providers.
(6) Have experience in the training of EMS providers above and below the AEMT level.
(7) Have experience in the medical audit, review and critique of EMS providers above and below the AEMT level.
(8) Have an arrangement with a medical command facility to serve as its medical director after receiving certification as a medical command facility medical director.
(c) Triennial registration. A medical command facility medical director’s certification is deemed registered for 3 years. Thereafter, a medical command facility medical director shall triennially register the certification on a form or through an electronic process, as prescribed by the Department. The Department will issue a new registration within 30 days after the application for registration is filed if the application demonstrates that the medical command facility medical director shall be:
(1) Serving as a medical command physician and a medical command facility medical director for a medical command facility.
(2) Providing prehospital and emergency department care of acutely ill or injured patients.
(3) Performing medical audit, review and critique of EMS providers above and below the AEMT level.
Cross References This section cited in 28 Pa. Code § 1031.8 (relating to discipline of medical command physicians and medical command facility medical directors).
§ 1023.4. Regional EMS medical director.
(a) Roles and responsibilities. A regional EMS medical director shall carry out the following duties:
(1) Maintain liaison with the Commonwealth EMS Medical Director.
(2) Assist the regional EMS council, after consultation with the regional medical advisory committee, to establish and revise, subject to Department approval, regional EMS protocols.
(3) Assist the regional EMS council to develop, subject to Department approval, criteria to recommend to PSAPs for emergency medical dispatch, including criteria for prearrival instructions, level of care to be dispatched to respond to various clinical conditions, types of EMS resources to be sent and mode of EMS resource response.
(4) Serve as a member of the regional EMS council’s quality improvement committee and as that committee’s liaison to the regional EMS council’s medical advisory committee.
(5) Serve on the State EMS Quality Improvement Committee.
(6) Serve as chairperson of the regional EMS council’s medical advisory committee.
(7) Assist, as appropriate, the regional EMS council in its investigations, analysis of investigation information and recommendations to make to the Department on actions the Department should pursue, if any, against certifications, licenses, accreditations and other authorizations issued by the Department under the act.
(8) Review regional plans, procedures and processes for compliance with State standards of EMS.
(b) Minimum qualifications. A regional EMS medical director shall have the following qualifications:
(1) Be a physician.
(2) Experience in prehospital and emergency department care of the acutely ill or injured patient.
(3) Experience as a medical command physician and as an EMS agency medical director or as an ALS service medical director under the Emergency Medical Services Act (35 P. S. § § 6921—6938) (repealed by the act of August 18, 2009 (P. L. 308, No. 37)).
(4) Completed a residency program in emergency medicine accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine or have served as a medical command physician in this Commonwealth prior to October 14, 2000.
(5) Experience in the training of EMS providers above and below the AEMT level.
(6) Experience in the medical audit, review and critique of EMS providers above and below the AEMT level.
(c) Disclosure. A regional EMS medical director shall disclose to a regional EMS council and the Department all financial or other interest in entities regulated by the Department under the act and in other matters which present a potential conflict of interest.
Cross References This section cited in 28 Pa. Code § 1021.104 (relating to responsibilities of regional EMS councils); and 28 Pa. Code § 1023.5 (relating to Commonwealth EMS Medical Director).
§ 1023.5. Commonwealth EMS Medical Director.
(a) Roles and responsibilities. The Commonwealth EMS Medical Director is responsible for:
(1) Providing medical advice and recommendations to the Department regarding the EMS system.
(2) Assisting in the development and implementation of a Statewide EMS quality improvement program.
(3) Evaluating and making recommendations on regional EMS quality improvement programs and on programs to improve patient and provider safety and provider wellness.
(4) Assisting the Department in revising or modifying the scope of practice of EMS providers.
(5) Providing advice and guidance to the Department on investigations and the pursuit of disciplinary actions against EMS providers and other persons and entities regulated by the Department under the act.
(6) Reviewing, evaluating and making recommendations for the Statewide EMS protocols.
(7) Reviewing, evaluating and making recommendations regarding regional EMS protocols that supplement Statewide EMS protocols.
(8) Providing direction and guidance to the regional EMS medical directors for training and quality improvement monitoring and assistance.
(9) Meeting with representatives and committees of regional EMS councils and the Advisory Board as necessary and as directed by the Department to provide guidance and direction.
(10) Reviewing, evaluating and making recommendations to the Department on requests, for research purposes, for data made confidential by the act.
(11) Assisting the Department in the development of regulations under the act.
(12) Providing other services relating to the Department’s administration of the act as assigned by the Department.
(b) Minimum qualifications. The Commonwealth EMS Medical Director shall possess the same qualifications as a regional EMS medical director under § 1023.4 (relating to regional EMS medical director).
(c) Disclosure. The Commonwealth EMS Medical Director shall disclose to the Department all financial or other interest in EMS agencies and other entities regulated by the Department and other matters which present a potential conflict of interest.
(d) Prohibition against dual service. A physician may not simultaneously serve as the Commonwealth EMS Medical Director and a regional EMS medical director.
Subchapter B. EMS PROVIDERS AND VEHICLE OPERATORS
Sec.
1023.21. General rights and responsibilities.
1023.22. EMS vehicle operator.
1023.23. Ambulance attendant and first responder.
1023.24. Emergency medical responder.
1023.25. Emergency medical technician.
1023.26. Advanced emergency medical technician.
1023.27. Paramedic.
1023.28. Prehospital registered nurse.
1023.29. Prehospital physician extender.
1023.30. Prehospital EMS physician.
1023.31. Continuing education requirements.
1023.32. Credit for continuing education.
1023.33. Endorsement of course or examination.
1023.34. Reciprocity.§ 1023.21. General rights and responsibilities.
(a) Change of address. An EMS provider, an EMSVO and an applicant for EMS provider or EMSVO certification shall ensure that the Department has a current address at which the person can be reached by mail. This applies to an EMS provider and an EMSVO whether or not that person maintains current registration of the EMS provider or EMSVO certification.
(b) Reports of criminal convictions, discipline and exclusions.
(1) An applicant for EMS provider or EMSVO certification shall report to the Department, on a form or through an electronic process, as prescribed by the Department, misdemeanor, felony and other criminal convictions that are not summary or equivalent offenses and disciplinary sanctions that have been imposed upon a license, certification or other authorization of the applicant to practice an occupation or profession. An applicant for an EMSVO certification shall also report to the Department any other conviction of an offense involving reckless driving or driving under the influence of alcohol or drugs. An applicant for an EMSVO certification shall also report to the Department a driver’s license suspension due to the use of drugs or alcohol or from a moving traffic violation. The applicant shall also arrange for the custodian of the criminal charging, judgment and sentencing document for each conviction and the custodian of an adjudication or other document imposing discipline against the applicant to provide the Department with a certified copy of those records. If the applicant has not been sentenced on a criminal conviction at the time of making application for certification, the applicant shall inform the Department and then arrange, within 5 days after the applicant is sentenced, for the custodian of the sentencing document to provide the Department with a certified copy of that document. If, after making application for EMS provider certification, but before the Department acts upon an application, the applicant is convicted of a reportable offense or has discipline imposed upon a license, certification or other authorization to practice an occupation or profession, the applicant shall report that information to the Department immediately in the manner prescribed in the application form.
(2) An applicant for EMS provider certification shall report to the Department, on a form or through an electronic process, as prescribed by the Department, an exclusion from a Federal or State health care program of the applicant, or of an entity in which the applicant had equity or capital, stock or profits equal to at least 5% of the value of the property or assets of the entity at the time of the exclusion. The applicant shall also provide the Department with a certified copy of the document by which the applicant is excluded from the health care program. A health care program is a program in which the State or Federal government serves as a payor for health care services, such as the Medicare and Medicaid programs. If, after making application for EMS provider certification, but before the Department acts upon an application, there is an exclusion from a Federal or State health care program that is reportable under this paragraph, the applicant shall report that information to the Department immediately in the manner prescribed in the application form.
(3) The Department will not act upon an application for certification that reports information under paragraph (1) or (2) until it receives a certified copy of each document that is required to be provided under those paragraphs, unless the applicant establishes that the document from which a certified copy would be made does not exist.
(4) An EMS provider and an EMSVO shall report the same type of information and arrange for the same documents to be provided to the Department, as required under paragraphs (1) and (2), within 30 days after each conviction, discipline and exclusion. This applies to an EMS provider and an EMSVO whether or not the person maintains current registration of the EMS provider’s or EMSVO’s certification.
(c) Certification examinations.
(1) An applicant for EMS provider certification shall take the required certification examinations within 1 year after completing the education required for the EMS provider certification.
(2) Except as otherwise provided in this section, a person who fails a written or practical skills certification examination may repeat the failed examination without retaking a passed certification examination.
(3) A person who fails a written certification examination three times shall complete a refresher course approved by the Department or repeat the education required for the EMS provider certification before retaking a written certification examination.
(4) A person who fails a practical skills certification examination three times shall complete a remedial course approved by the Department or repeat the education required for the EMS provider certification before retaking a practical skills certification examination.
(5) A person who either fails an EMS provider certification examination six times or does not pass all required EMS provider certification examinations within 2 years after completing the EMS provider education required for the EMS provider certification may not receive credit for an examination previously passed. If that person elects to continue to pursue EMS provider certification, that person will be required to repeat the EMS provider education program and take the EMS provider certification examinations in accordance with paragraphs (1)—(4).
(6) If the standards a person needs to satisfy to take a certification examination change after the person has failed the examination, the person may not retake the examination unless the person meets the new standards.
(d) Exceptions to certification registration requirements for members of armed forces. An EMS provider or EMSVO who returns from active military service and who had a certification registration expire during a tour of duty or will have a certification registration expire within 12 months after returning from active military service may secure an exception to the certification registration requirements as follows:
(1) An EMS provider who chooses to secure registration of the EMS provider’s certification by satisfying continuing education requirements may apply for an exception to the period of time in which the EMS provider was required or would be required to satisfy the continuing education requirements, and the Department will grant the EMS provider an extended period of time to satisfy those requirements as the Department deems appropriate under the circumstances. If the EMS provider is certified at an AEMT level or higher, before the EMS provider may begin work for an EMS agency without a current registration, the EMS provider needs to be approved by the EMS agency’s medical director, under § 1023.1(a)(1)(viii) (relating to EMS agency medical director) as having current competency in the knowledge and skills required to provide the level of EMS the EMS agency intends to assign to the EMS provider.
(2) An EMS provider who chooses to secure registration of the EMS provider’s certification by satisfying continuing education requirements may ask the Department to endorse the EMS provider’s relevant military training as satisfying some or all of the continuing education requirements.
(3) An EMSVO may apply for an exception to the period of time in which the EMSVO was required or would be required to satisfy the continuing education requirements, and the Department will grant the EMSVO an extended period of time to satisfy those requirements as the Department deems appropriate under the circumstances. An EMSVO may also ask the Department to endorse the EMSVO’s relevant military training as satisfying some or all of the continuing education requirements.
(e) Lapse of registration.
(1) An EMS provider who does not secure a new registration of an EMS provider certification before a registration expires may secure a new registration within 2 years after the registration expires by completing a registration form or through an electronic process, as prescribed by the Department, if the information provided establishes that the EMS provider has passed the written certification registration examination as well as the clinical patient care and other core continuing education requirements that would have been needed to timely secure the registration by satisfying the continuing education requirements for registering the certification.
(2) An EMS provider who does not secure a new registration of an EMS provider certification before a registration expires may secure a new registration more than 2 years after the registration expires by completing a registration form or through an electronic process, as prescribed by the Department, if the information provided establishes that the EMS provider has passed both the written and practical skills certification registration examinations and the clinical patient care and other core continuing education requirements for each registration of a certification that was missed.
(3) The paramedic certification registration examinations are the certification registration examinations for a PHPE, a PHRN or a PHP who seeks to register a certification after the registration of that certification lapses.
(4) A registration secured under this subsection will expire when the registration would have expired if past registrations would have been secured on a timely basis.
(f) Authority derived from protocols and medical command. An EMS provider shall provide EMS for an EMS agency within the EMS provider’s scope of practice and, other than a PHP, under Statewide and regional EMS protocols and medical command.
(g) Downgraded certification or practice. An EMS provider who is certified at or above the AEMT level who chooses not to practice at that level or who is not permitted to practice at that level for an EMS agency by its EMS agency medical director under § 1023.1(a)(1)(vi) or (vii) and § 1027.3(m) (relating to licensure and general operating standards) has the following options with respect to EMS provider certification and registration of that certification:
(1) Upon expiration of the biennial registration period, the EMS provider may choose to maintain EMS provider certification at the EMS provider’s current certification level, in which case the EMS provider would need to satisfy the requirements for the registration of that EMS provider certification to renew registration of that certification.
(2) Prior to or upon expiration of the registration period, the EMS provider may choose to transition to a lower level EMS provider certification than the EMS provider’s current certification level, in which case the EMS provider would need to satisfy the requirements for the registration of that EMS provider certification to secure registration of that lower level EMS provider certification. If the EMS provider satisfies the registration requirements for that lower level of EMS provider certification, the Department will issue the EMS provider an EMS provider certification at that level, which will be deemed registered for 3 years or 2 years, depending upon the level of certification.
(3) When providing EMS, an EMS provider who transitions to a lower level EMS provider certification may not display a higher level insignia, patch, registration card or other indicia of the EMS provider’s certification at the higher EMS provider level.
(4) An EMS provider who, for any period of time, has been precluded from practicing for an EMS agency at the EMS provider’s certification level under § 1027.3(m) shall report the action to other EMS agencies for which the EMS provider is providing or seeks to provide EMS and to all regional EMS councils having responsibility for the EMS regions in which those EMS agencies are headquartered.
(5) An EMS provider who transitions to a lower level EMS provider certification may later renew registration of the EMS provider’s certification at the higher level by satisfying the requirements in subsection (e).
(h) Identification. If an EMS provider is asked to provide proof of authority to practice as an EMS provider when the EMS provider is providing EMS, or an EMSVO is asked to provide proof of authority to operate a ground EMS vehicle when the EMSVO is operating a ground EMS vehicle, the EMS provider or EMSVO shall present a card or certificate issued by the Department that shows current registration of the EMS provider’s or EMSVO’s certification.
(i) Interaction with law enforcement officers.
(1) If a law enforcement officer is at the scene of a police incident when an EMS provider arrives, the EMS provider may not enter the scene to provide EMS if the law enforcement officer so directs until the law enforcement officer advises that it is safe for the EMS provider to enter.
(2) An EMS provider shall have access to a patient at a police incident scene before the patient is removed from the scene by or at the direction of a law enforcement officer.
(3) If, under a medical treatment protocol or medical command, an EMS provider is required to transport to a receiving facility a patient whom a law enforcement officer has taken or wants to take into custody or whom the law enforcement officer believes needs to be spoken to immediately by the law enforcement officer, the EMS provider shall transport the patient to a receiving facility by ambulance. The EMS provider and EMSVO shall allow the law enforcement officer to accompany the patient in the ambulance if the law enforcement officer so chooses and may not interfere with the law enforcement officer employing security precautions deemed necessary by the law enforcement officer to ensure the safety of the officer and others. A law enforcement officer is not permitted to implement security precautions that unreasonably interfere with the provision of EMS to the patient.
Cross References This section cited in 28 Pa. Code § 1023.22 (relating to EMS vehicle operator); 28 Pa. Code § 1023.24 (relating to emergency medical responder); 28 Pa. Code § 1023.25 (relating to emergency medical technician); 28 Pa. Code § 1023.26 (relating to advanced emergency medical technician); 28 Pa. Code § 1023.27 (relating to paramedic); 28 Pa. Code § 1023.28 (relating to prehospital registered nurse); 28 Pa. Code § 1023.29 (relating to prehospital physician extender); 28 Pa. Code § 1023.30 (relating to prehospital EMS physician); 28 Pa. Code § 1025.1 (relating to accreditation and operational requirements of EMS educational institutes); 28 Pa. Code § 1027.2 (relating to license and registration applications); 28 Pa. Code § 1027.3 (relating to licensure and general operating standards); 28 Pa. Code § 1027.14 (relating to management companies); and 52 Pa. Code § 29.503 (relating to age restrictions).
§ 1023.22. EMS vehicle operator.
(a) Roles and responsibilities. An EMSVO operates ground EMS vehicles for an EMS agency, as authorized by an EMS agency.
(b) Certification. The Department will certify as an EMSVO an individual who meets the following qualifications:
(1) Completes an application for EMSVO certification on a form or through an electronic process, as prescribed by the Department.
(2) Is 18 years of age or older.
(3) Has a current driver’s license.
(4) Is not addicted to alcohol or drugs.
(5) Is free from physical or mental defect or disease that may impair the person’s ability to drive a ground EMS vehicle.
(6) Has successfully completed an emergency vehicle operator’s course of instruction approved by the Department.
(7) Has not:
(i) Been convicted within the last 4 years prior to the date of application of driving under the influence of alcohol or drugs.
(ii) Within the last 2 years prior to the date of application been convicted of reckless driving or had a driver’s license suspended due to use of drugs or alcohol or a moving traffic violation.
(8) Has successfully completed an EVOC following a disqualification from certification under paragraph (7), regardless of whether the person successfully completed the course previously.
(c) Transition for operators of ground ambulances and squad vehicles. A person who drove an ambulance or squad vehicle prior to April 10, 2014, and who satisfies the certification requirements under subsection (b), may serve as an EMSVO until July 9, 2014, without having secured a certification as an EMSVO.
(d) Registration.
(1) Except as otherwise provided in this subsection, an EMSVO’s certification is deemed registered for 3 years. Thereafter, an EMSVO shall triennially register the certification by completing a form or through an electronic process, as prescribed by the Department. An EMSVO shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the EMSVO certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the EMSVO completes the form or the electronic process if the information provided establishes that the EMSVO has a current driver’s license and has successfully completed the continuing education requirements for registration of an EMSVO certification in § 1023.31(a) (relating to continuing education requirements).
(2) If an EMSVO also has an EMS provider’s certification, the registration of the EMSVO’s certification will expire at the same time as the registration of the EMS provider’s certification. If the EMSVO does not maintain current registration of the EMS provider’s certification, the registration of the EMSVO’s certification will continue on the same renewal cycle. If an EMSVO who is an EMS provider becomes certified as a higher-level EMS provider, the registration of the EMSVO’s certification will expire at the same time as the registration of the higher-level EMS provider’s certification.
(3) An EMSVO who attempts to secure a new registration of an EMSVO certification more than 2 years after the registration expires may secure a new registration by completing a registration form or through an electronic process, as prescribed by the Department, if the information provided establishes that the EMSVO has completed an EVOC within the preceding 2 years. An EMSVO who attempts to secure a new registration of an EMSVO certification within 2 years after the registration expires may secure a new registration by completing a registration form or through an electronic process, as prescribed by the Department, if the information provided establishes that the EMSVO has completed the continuing education requirements for the missed registration period.
(4) An EMSVO who is a member of the armed forces who is returning from active military service and whose EMSVO registration has expired or will expire within 12 months after returning from active military service may secure an exception to the registration requirements under § 1023.21(d) (relating to general rights and responsibilities).
(5) An EMSVO who operates a ground EMS vehicle exclusively for a QRS operated by an EMS agency does not have registration requirements.
Source The provisions of this § 1023.22 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
§ 1023.23. Ambulance attendant and first responder.
An individual who is an ambulance attendant or who is certified as a first responder on April 10, 2014, will be deemed to be an EMR with a current registration and shall thereafter be subject to § 1023.24 (relating to emergency medical responder). The Department will issue an EMR certification to an individual who is certified as a first responder on April 10, 2014. The Department will issue an EMR certification to an individual who is qualified as an ambulance attendant on April 10, 2014, if that individual submits an application for EMR certification on a form or through an electronic process, as prescribed by the Department, which documents that the individual was qualified as an ambulance attendant under rescinded § 1003.21(b). An individual who qualifies for EMR certification by virtue of having been an ambulance attendant may serve as an EMR until April 11, 2016, without having obtained an EMR certification. The initial registration of an EMR certification of a person who qualified for that certification by having been a first responder will expire when that person’s first responder certification would have expired. The initial registration of an EMR certification of a person who qualified for that certification by having been an ambulance attendant will expire when that person’s qualifications as an ambulance attendant would have expired.
Source The provisions of this § 1023.23 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
§ 1023.24. Emergency medical responder.
(a) Roles and responsibilities. An EMR performs for an EMS agency BLS skills involving basic interventions with minimum EMS equipment as follows:
(1) As a member of a QRS to stabilize and improve a patient’s condition until a higher level EMS provider arrives at the scene. The EMR may then assist the higher level EMS provider if requested to do so.
(2) As a member of the crew of an ambulance or squad vehicle.
(3) As a member of a special operations EMS service.
(b) Certification.
(1) The Department will certify as an EMR an individual who meets the following qualifications:
(i) Completes an application for EMR certification on a form or through an electronic process, as prescribed by the Department.
(ii) Is 16 years of age or older.
(iii) Has successfully completed an EMS provider educational course for EMRs or by October 12, 2013, a first responder educational course previously approved by the Department as an educational course leading to first responder certification.
(iv) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(v) Has passed a written examination for EMR certification prescribed by the Department or passed an examination which the Department has determined to be equivalent in both content and manner of administration to the written examination for EMR certification.
(vi) Has passed a practical test of EMR skills for EMR certification prescribed by the Department or passed an examination which the Department has determined to be equivalent in both content and manner of administration to the practical test of EMR skills for EMR certification.
(2) The Department will also certify as an EMR an individual who completes an application on a form or through an electronic process, as prescribed by the Department, and who applies for EMR certification under § 1023.21(g) (relating to general rights and responsibilities).
(c) Triennial registration.
(1) An EMR’s certification is deemed registered for 3 years. Thereafter, an EMR shall triennially register the certification by completing a form or through an electronic process, as prescribed by the Department. An EMR shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the EMR certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the EMR completes the form or the electronic process if the information provided establishes that the EMR has successfully completed one of the following:
(i) The EMR practical skills and written knowledge triennial registration examinations prescribed by the Department.
(ii) The continuing education requirements for triennial registration of an EMR certification in § 1023.31(b) (relating to continuing education requirements).
(2) An EMR who is a member of the armed forces who is returning from active military service and whose EMR registration has expired or will expire within 12 months after returning from active military service may secure an exception to the triennial registration requirements under § 1023.21(d).
(d) Scope of practice.
(1) An EMR’s scope of practice includes skills in the following skill areas, as published in the Pennsylvania Bulletin, if the EMR has been educated to perform the following skills:
(i) Airway/ventilation/oxygenation.
(ii) Cardiovascular circulation.
(iii) Immobilization.
(2) An EMR’s scope of practice may be expanded to include BLS skills in other skill areas as the Department publishes in a notice in the Pennsylvania Bulletin. An EMR may not perform those additional skills unless the EMR has received education to perform those skills and is able to document having received the education in one of the following:
(i) A course approved by the Department that covers the complete curriculum for certification as an EMR.
(ii) A course which is determined by the Department to meet or exceed the standards of a course approved by the Department under subparagraph (i).
(iii) A course for which the EMR may receive continuing education credit towards triennial registration of the EMR’s certification or, if the EMR was previously certified as a first responder, a course for which the EMR received continuing education credit towards first responder recertification prior to October 12, 2013.
(3) The Department will publish in the Pennsylvania Bulletin, at least biennially, a list of the skills the Department has approved as being within the scope of practice of an EMR.
Source The provisions of this § 1023.24 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.23 (relating to ambulance attendant and first responder); and 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.25. Emergency medical technician.
(a) Roles and responsibilities. An EMT performs basic EMS skills involving basic interventions and equipment found on an EMS vehicle or within an EMT’s scope of practice as follows:
(1) For an EMS agency as a member of the crew of an ambulance or squad vehicle.
(2) For an EMS agency as a member of a QRS to stabilize and improve a patient’s condition in an out-of-hospital setting until an ambulance arrives. The EMT may then assist the ambulance crew.
(3) As a member of a special operations EMS service.
(4) As a first aid or safety officer, or in a similar capacity, for or independent of an EMS agency. When serving in this capacity independent of an EMS agency, the EMT does not function under the direction of an EMS agency medical director or a medical command physician. The EMT shall perform skills as prescribed by applicable Statewide and regional EMS protocols and may not perform any skill for which the EMT is required to secure medical command direction under those protocols.
(b) Certification.
(1) The Department will certify as an EMT an individual who meets the following qualifications:
(i) Completes an application for EMT certification on a form or through an electronic process, as prescribed by the Department.
(ii) Is 16 years of age or older.
(iii) Has successfully completed an EMS provider educational course for EMTs.
(iv) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(v) Has passed a written examination for EMT certification prescribed by the Department.
(vi) Has passed a practical test of EMT skills for EMT certification prescribed by the Department.
(2) The Department will also certify as an EMT an individual who completes an application on a form or through an electronic process, as prescribed by the Department and who applies for EMT certification under § 1023.21(g) (relating to general rights and responsibilities).
(c) Triennial registration.
(1) An EMT’s certification is deemed registered for 3 years. Thereafter, an EMT shall triennially register the certification by completing a form or through an electronic process, as prescribed by the Department. An EMT shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the EMT certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the EMT completes the form or the electronic process if the information provided establishes that the EMT has successfully completed one of the following:
(i) The EMT practical skills and written knowledge triennial registration examinations prescribed by the Department.
(ii) The continuing education requirements for triennial registration of an EMT certification in § 1023.31(c) (relating to continuing education requirements).
(2) An EMT who is a member of the armed forces who is returning from active military service and whose EMT registration has expired or will expire within 12 months after returning from active military service may secure an exception to the triennial registration requirements under § 1023.21(d).
(d) Scope of practice.
(1) An EMT’s scope of practice incorporates the scope of practice of an EMR and additional skills in the following skill areas, as published in the Pennsylvania Bulletin, if the EMT has been educated to perform the following skills:
(i) Airway/ventilation/oxygenation.
(ii) Cardiovascular circulation.
(iii) Immobilization.
(iv) Medication administration—routes.
(2) An EMT’s scope of practice may be expanded to include basic EMS skills in other skill areas as the Department publishes in a notice in the Pennsylvania Bulletin. An EMT may not perform those additional skills unless the EMT has received education to perform those skills, and is able to document having received the education, in one of the following:
(i) A course approved by the Department that covers the complete curriculum for certification as an EMT.
(ii) A course which is determined by the Department to meet or exceed the standards of course approved by the Department under subparagraph (i).
(iii) A course for which the EMT may receive continuing education credit towards recertification.
(3) The Department will publish in the Pennsylvania Bulletin, at least biennially, a list of the skills the Department has approved as being within the scope of practice of an EMT.
Source The provisions of this § 1023.25 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.26. Advanced emergency medical technician.
(a) Roles and responsibilities. An AEMT performs basic and advanced EMS skills which include interventions and administration of medications and vaccines with basic and advanced equipment found on an EMS vehicle or within an AEMT’s scope of practice, as follows:
(1) For an EMS agency as a member of the crew of an ambulance or squad vehicle.
(2) For an EMS agency as a member of a QRS to stabilize and improve a patient’s condition in an out-of-hospital setting until an ambulance arrives. The AEMT may then assist the ambulance crew.
(3) As a member of a special operations EMS service.
(4) As a first aid or safety officer, or in a similar capacity, for or independent of an EMS agency. When serving in this capacity independent of an EMS agency, an AEMT does not function under the direction of an EMS agency medical director or a medical command physician. The AEMT shall perform skills as prescribed by applicable Statewide and regional EMS protocols and may not perform the following:
(i) Skills other than those permitted at the EMT level of care.
(ii) A skill for which the EMT is required to secure medical command direction under those protocols.
(b) Certification.
(1) The Department will certify as an AEMT an individual who meets the following qualifications:
(i) Completes an application for AEMT certification on a form or through an electronic process, as prescribed by the Department.
(ii) Is 18 years of age or older.
(iii) Has successfully completed one of the following:
(A) An EMS provider educational course for AEMTs.
(B) An EMS provider educational course for EMTs and education, through continuing education courses, in skills required in the scope of practice of an AEMT for which the applicant did not receive education in the EMT course.
(iv) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(v) Has passed a written examination for AEMT certification prescribed by the Department.
(vi) Has passed a practical test of AEMT skills for AEMT certification prescribed by the Department.
(2) The Department will also certify as an AEMT an individual who completes an application on a form or through an electronic process, as prescribed by the Department and who applies for AEMT certification under § 1023.21(g) (relating to general rights and responsibilities).
(c) Biennial registration.
(1) When an AEMT certification is issued it is deemed registered through December 31 of that year if it is issued in an odd-numbered year, or through December 31 of the next odd-numbered year if it is issued in an even-numbered year. Thereafter, an AEMT shall biennially register the certification by completing a form or through an electronic process, as prescribed by the Department. An AEMT shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the AEMT certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the AEMT completes the form or the electronic process if the information provided establishes that the AEMT has successfully completed one of the following:
(i) The AEMT practical skills and written knowledge biennial registration examinations prescribed by the Department.
(ii) The continuing education requirements for biennial registration of an AEMT certification in § 1023.31(d) (relating to continuing education requirements).
(2) An AEMT who is a member of the armed forces who is returning from active military service and whose AEMT registration has expired or will expire within 12 months after returning from active military service may secure an exception to the biennial registration requirements under § 1023.21(d).
(d) Scope of practice.
(1) An AEMT’s scope of practice incorporates the scope of practice of an EMT and additional skills in the following skill areas, as published in the Pennsylvania Bulletin, if the AEMT has been educated to perform the following skills:
(i) Airway/ventilation/oxygenation.
(ii) Cardiovascular circulation.
(iii) Immobilization.
(iv) Medication administration—routes.
(v) IV initiation/maintenance fluids.
(2) An AEMT’s scope of practice may be expanded to include ALS skills in other skill areas as the Department publishes in a notice in the Pennsylvania Bulletin. An AEMT may not perform those additional skills unless the AEMT has received education to perform those skills and is able to document having received the education in one of the following:
(i) A course approved by the Department that covers the complete curriculum for an AEMT.
(ii) A course which is determined by the Department to meet or exceed the standards of a course approved by the Department under subparagraph (i).
(iii) A course for which an AEMT may receive continuing education credit towards biennial registration of the AEMT certification.
(3) The Department will publish in the Pennsylvania Bulletin, at least biennially, a list of the skills the Department has approved as being within the scope of practice of an AEMT.
Source The provisions of this § 1023.26 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.27. Paramedic.
(a) Roles and responsibilities. A paramedic performs basic and advanced EMS skills which include interventions and administration of medications and vaccines with basic and advanced equipment found on an EMS vehicle found or within a paramedic’s scope of practice, as follows:
(1) For an EMS agency as a member of the crew of an ambulance or squad vehicle.
(2) For an EMS agency as a member of a QRS to stabilize and improve a patient’s condition in an out-of-hospital emergency until an ambulance arrives at the scene. The paramedic may then assist the ambulance crew.
(3) As a member of a special operations EMS service.
(4) As a first aid or safety officer, or in a similar capacity, for or independent of an EMS agency. When serving in this capacity independent of an EMS agency, a paramedic does not function under the direction of an EMS agency medical director or a medical command physician. The paramedic shall perform skills as prescribed by applicable Statewide and regional EMS protocols, and may not perform the following:
(i) Skills other than those permitted at the EMT level of care.
(ii) A skill for which the EMT is required to secure medical command direction under those protocols.
(b) Certification. The Department will certify as a paramedic an individual who meets the following qualifications:
(1) Completes an application for paramedic certification on a form or through an electronic process, as prescribed by the Department.
(2) Is certified as an EMT or an AEMT by the Department or possesses an equivalent certification issued by another state.
(3) Is 18 years of age or older.
(4) Has a high school diploma or its equivalent.
(5) Has successfully completed an EMS provider educational course for paramedics.
(6) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(7) Has passed a practical test of paramedic skills for paramedic certification approved by the Department.
(8) Has passed a written examination for paramedic certification approved by the Department.
(c) Biennial registration.
(1) When a paramedic certification is issued it is deemed registered through December 31 of that year if it is issued in an odd-numbered year, or through December 31 of the next odd-numbered year if it is issued in an even-numbered year. Thereafter, a paramedic shall biennially register the certification by completing a form or through an electronic process, as prescribed by the Department. A paramedic shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the paramedic certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the paramedic completes the form or the electronic process if the information provided establishes that the paramedic has successfully completed one of the following:
(i) The paramedic practical skills and written knowledge biennial registration examinations prescribed by the Department.
(ii) The continuing education requirements for biennial registration of a paramedic certification in § 1023.31(e) (relating to continuing education requirements).
(2) A paramedic who is a member of the armed forces who is returning from active military service and whose paramedic registration has expired or will expire within 12 months after returning from active military service may secure an exception to the triennial registration requirements under § 1023.21(d) (relating to general rights and responsibilities).
(d) Scope of practice.
(1) A paramedic’s scope of practice incorporates the scope of practice of an AEMT and additional skills in the following skill areas, as published in the Pennsylvania Bulletin, if the paramedic has been educated to perform the following skills:
(i) Airway/ventilation/oxygenation.
(ii) Cardiovascular circulation.
(iii) Immobilization.
(iv) Medication administration—routes.
(v) IV initiation/maintenance fluids.
(2) A paramedic’s scope of practice may be expanded to include advanced EMS skills in other skill areas as the Department publishes in a notice in the Pennsylvania Bulletin. A paramedic may not perform those additional skills unless the paramedic has received education to perform those skills, and is able to document having received the education, in one of the following:
(i) A course approved by the Department that covers the complete curriculum for certification as a paramedic.
(ii) A course which is determined by the Department to meet or exceed the standards of a course approved by the Department under subparagraph (i).
(iii) A course for which the paramedic may receive continuing education credit towards biennial registration of the paramedic certification.
(3) The Department will publish in the Pennsylvania Bulletin, at least biennially, a list of the skills the Department has approved as being within the scope of practice of a paramedic.
Source The provisions of this § 1023.27 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.28 (relating to prehospital registered nurse); 28 Pa. Code § 1023.29 (relating to prehospital physician extender); and 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.28. Prehospital registered nurse.
(a) Roles and responsibilities. A PHRN performs for an EMS agency basic and advanced EMS skills and additional skills within the scope of practice of a registered nurse under The Professional Nursing Law (63 P. S. § § 211—225.5) as follows:
(1) As a member of the crew of an ambulance or squad vehicle.
(2) As a member of a QRS to stabilize and improve a patient’s condition in an out-of-hospital emergency until an ambulance arrives at the scene. The PHRN may then assist the ambulance crew.
(3) As a member of a special operations EMS service.
(4) As a first aid or safety officer, or in a similar capacity.
(b) Certification. The Department will certify as a PHRN an individual who meets the following qualifications:
(1) Completes an application for PHRN certification on a form or through an electronic process, as prescribed by the Department.
(2) Has a current license as a registered nurse with the State Board of Nursing.
(3) Is 18 years of age or older.
(4) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(5) Has passed a practical test of PHRN skills for PHRN certification approved by the Department.
(6) Has passed a written test of PHRN skills for PHRN certification approved by the Department.
(c) Biennial registration.
(1) When a PHRN certification is issued it is deemed registered through December 31 of that year, if it is issued in an odd-numbered year, or through December 31 of the next odd-numbered year, if it is issued in an even-numbered year. Thereafter, a PHRN shall biennially register the certification by completing a form or through an electronic process, as prescribed by the Department. A PHRN shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the PHRN certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the PHRN completes the form or the electronic process if the information provided establishes that the PHRN has satisfied the following:
(i) Has a current registered nurse license or current registration of that license.
(ii) Has completed the continuing education requirements for biennial registration of a PHRN certification in § 1023.31(f) (relating to continuing education requirements).
(2) A PHRN who is a member of the armed forces who is returning from active military service and whose PHRN registration has expired or will expire within 12 months after returning from active military service may secure an exception to the biennial registration requirements under § 1023.21(d) (relating to general rights and responsibilities).
(d) Scope of practice. A PHRN may perform skills within a paramedic’s scope of practice and other skills authorized by The Professional Nursing Law, when authorized by a medical command physician or the applicable Statewide or Department-approved EMS protocol. A PHRN who has not been educated in a skill within a paramedic’s scope of practice may not perform that skill unless and until the PHRN has received education to perform the skill and is able to document having received the education as required under § 1023.27(d)(2) (relating to paramedic) or otherwise documents having received the education to competently perform the skill.
Source The provisions of this § 1023.28 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.29. Prehospital physician extender.
(a) Roles and responsibilities. A PHPE performs for an EMS agency basic and advanced EMS skills, and additional skills within the scope of practice of a physician assistant under the Medical Practice Act of 1985 (63 P. S. § § 422.1—422.51a) or the Osteopathic Medical Practice Act (63 P. S. § § 271.1—271.18), or a successor act, as follows:
(1) As a member of the crew of an ambulance or squad vehicle.
(2) As a member of a QRS to stabilize and improve a patient’s condition in an out-of-hospital emergency until an ambulance arrives at the scene. The PHPE may then assist the ambulance crew.
(3) As a member of a special operations EMS service.
(4) As a first aid or safety officer, or in a similar capacity.
(b) Certification. The Department will certify as a PHPE an individual who meets the following qualifications:
(1) Completes an application for PHPE certification on a form or through an electronic process, as prescribed by the Department.
(2) Has a currently registered license as a physician assistant with the State Board of Medicine or the State Board of Osteopathic Medicine.
(3) Is 18 years of age or older.
(4) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(5) Has passed a practical test of PHPE skills for PHPE certification approved by the Department.
(6) Has passed a written test of PHPE skills for PHPE certification approved by the Department.
(c) Biennial registration.
(1) When a PHPE certification is issued it is deemed registered through December 31 of that year, if it is issued in an odd-numbered year, or through December 31 of the next odd-numbered year, if it is issued in an even-numbered year. Thereafter, a PHPE shall biennially register the certification by completing a form or through an electronic process, as prescribed by the Department. A PHPE shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the PHPE certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the PHPE completes the form or the electronic process if the information provided establishes that the PHPE has satisfied the following:
(i) Has a current physician assistant license or current registration of that license.
(ii) Has completed the continuing education requirements for biennial registration of a PHPE certification in § 1023.31(g) (relating to continuing education requirements).
(2) A PHPE who is a member of the armed forces who is returning from active military service and whose PHPE registration has expired or will expire within 12 months after returning from active military service may secure an exception to the biennial registration requirements under § 1023.21(d) (relating to general rights and responsibilities).
(d) Scope of practice. A PHPE may perform skills within a paramedic’s scope of practice and other skills a physician assistant is authorized to perform by the Medical Practice Act of 1985 or the Osteopathic Medical Practice Act, whichever applies to the physician assistant, when authorized by a medical command physician or an applicable Statewide or Department-approved EMS protocol. When a PHPE functions in this capacity, the physician supervision requirements under the Medical Practice Act of 1985 and the Osteopathic Medical Practice Act do not apply. A PHPE who has not been educated in a skill within a paramedic’s scope of practice may not perform that skill unless and until the PHPE has received education to perform the skill and is able to document having received the education as required under § 1023.27(d)(2) (relating to paramedic) or otherwise documents having received the education to competently perform the skill.
Source The provisions of this § 1023.29 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.30. Prehospital EMS physician.
(a) Roles and responsibilities. A PHP performs for an EMS agency basic and advanced EMS skills within the scope of practice of a physician under the Medical Practice Act of 1985 (63 P. S. § § 422.1—422.51a) or the Osteopathic Medical Practice Act (63 P. S. § § 271.1—271.18) as follows:
(1) As a member of the crew of an ambulance or squad vehicle.
(2) As a member of a QRS to stabilize and improve a patient’s condition in an out-of-hospital setting.
(3) As a member of a special operations EMS service.
(4) As a first aid or safety officer, or in a similar capacity.
(b) Certification. The Department will certify as PHP a physician who meets the following qualifications:
(1) Completes an application for PHP certification on a form or through an electronic process, as prescribed by the Department.
(2) Has successfully completed one of the following:
(i) A residency program in emergency medicine accredited by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine.
(ii) The first year of a residency program that satisfies the requirements in subparagraph (i) and the ACLS course, the ATLS course, the APLS or PALS course or, for each of these courses, a course that the Department determines meets or exceeds the requirements of the course.
(iii) A residency program in anesthesia, general surgery, internal medicine or family medicine, by a residency program accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine, and the ACLS course, the ATLS course, the APLS or PALS course or, for each of these courses, a course that the Department determines meets or exceeds the requirements of the course.
(3) Has a current certificate evidencing successful completion of a CPR course acceptable to the Department.
(4) Has passed a practical test of EMS skills prescribed by the Department for a PHP or served as a prehospital health professional physician prior to October 12, 2013.
(c) Transition for prehospital health professional physicians. A physician who served as a prehospital health professional physician prior to April 10, 2014, and who satisfies the certification requirements under subsection (b)(2), may serve as a PHP until July 9, 2014, without having secured a certification as a PHP.
(d) Biennial registration.
(1) When a PHP certification is issued it is deemed registered through December 31 of that year, if it is issued in an odd-numbered year, or through December 31 of the next odd-numbered year, if it is issued in an even-numbered year. Thereafter, a PHP shall biennially register the certification by completing a form or through an electronic process, as prescribed by the Department. A PHP shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the PHP certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the PHP completes the form or the electronic process if the information provided establishes that the PHP has satisfied the following:
(i) Has a current physician license or current registration of that license.
(ii) Has completed the continuing education requirements for biennial registration of a PHP certification in § 1023.31(h) (relating to continuing education requirements).
(2) A PHP who is a member of the armed forces who is returning from active military service and whose PHP registration has expired or will expire within 12 months after returning from active military service may secure an exception to the biennial registration requirements under § 1023.21(d) (relating to general rights and responsibilities).
(e) Scope of practice. A PHP may perform skills within a paramedic’s scope of practice and other skills within the practice of medicine or osteopathic medicine. A PHP may not perform a skill that the PHP has not been educated to perform. A regional EMS medical director shall verify that a PHP who is also an EMS agency medical director and who qualifies for PHP certification by satisfying the requirements in subsection (b)(2)(iii) has the competency to perform all skills within a paramedic’s scope of practice.
Source The provisions of this § 1023.30 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.31 (relating to continuing education requirements).
§ 1023.31. Continuing education requirements.
(a) EMSVOs. Beginning with the first full registration period an EMSVO begins following October 12, 2013, an EMSVO whose certification is currently registered shall, prior to the expiration of the registration period, successfully complete three continuing education credits if the registration is on a 3-year renewal cycle and two continuing education credits if the registration is on a 2-year renewal cycle in subjects regarding the scope of practice of an EMSVO regarding effective driving of a ground EMS vehicle, as specified in a notice the Department publishes in the Pennsylvania Bulletin. The continuing education requirements imposed by this subsection for registration of an EMSVO certification are in addition to those imposed upon an EMS provider for registration of an EMS provider certification.
(b) EMRs. Beginning with the first full registration period an EMR begins following October 12, 2013, an EMR whose certification is currently registered and who elects to qualify for triennial registration of the certification by fulfilling continuing education requirements shall, prior to the expiration of the 3-year registration period, successfully complete the following:
(1) Sixteen credits in instruction in subjects related to the scope of practice of an EMR as set forth in § 1023.24(a) and (d) (relating to emergency medical responder) and which have been approved by the Department for continuing education credit. At least 12 of the credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin. During an initial registration period that goes into effect on October 12, 2013, an EMR who has transitioned from a first responder certification to an EMR certification shall satisfy the continuing education requirements that had been imposed upon a first responder under rescinded § 1003.29(a) to renew a first responder certification.
(2) A CPR course completed or taught biennially.
(c) EMTs. Beginning with the first full registration period an EMT begins following October 12, 2013, an EMT whose certification is currently registered and who elects to qualify for triennial registration of the certification by fulfilling continuing education requirements shall, prior to the expiration of the 3-year registration period, successfully complete the following:
(1) Twenty-four credits in instruction in subjects related to the scope of practice of an EMT as set forth in § 1023.25(a) and (d) (relating to emergency medical technician) and which have been approved by the Department for continuing education credit. At least 18 of the credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin. During an initial registration period that goes into effect on October 12, 2013, an EMT shall satisfy the continuing education requirements that had been imposed upon an EMT under rescinded § 1003.29(b) to renew an EMT certification.
(2) A CPR course completed or taught biennially.
(d) AEMTs. An AEMT whose certification is currently registered and who elects to qualify for biennial registration of the certification by fulfilling continuing education requirements shall, prior to the expiration of the 2-year registration period, successfully complete the following:
(1) Effective with the registration period beginning January 1, 2014, 36 credits in instruction in subjects related to the scope of practice of an AEMT as set forth in § 1023.26(a) and (d) (relating to advanced emergency medical technician) and which have been approved by the Department for continuing education credit. At least 27 of the credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin, beginning with the first full registration period the AEMT begins following the initial registration period.
(2) A CPR course completed or taught biennially.
(e) Paramedics. A paramedic whose certification is currently registered and who elects to qualify for biennial registration of the certification by fulfilling continuing education requirements shall, prior to the expiration of the 2-year registration period, successfully complete the following:
(1) Effective with the registration period beginning January 1, 2014, 36 credits in instruction in subjects related to the scope of practice of a paramedic as set forth in § 1023.27(a) and (d) (relating to paramedic) and which have been approved by the Department for continuing education credit. At least 27 of the credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin, beginning with the first full registration period the paramedic begins following the initial registration period.
(2) A CPR course completed or taught biennially.
(3) Prior to January 1, 2014, a paramedic shall satisfy the continuing education requirements that had been imposed upon a paramedic under rescinded § 1003.29(c) to renew medical command authorization.
(f) PHRNs. A PHRN whose certification is currently registered shall, prior to the expiration of the 2-year registration period, successfully complete the following:
(1) Effective with the registration period beginning January 1, 2014, 36 credits in instruction in subjects related to the scope of practice of a PHRN as set forth in § 1023.28(a) and (d) (relating to prehospital registered nurse) and which have been approved by the Department for continuing education credit. At least 27 of those credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin, beginning with the first full registration period the PHRN begins following the initial registration period.
(2) A CPR course completed or taught biennially.
(3) Prior to January 1, 2014, a PHRN shall satisfy the continuing education requirements that had been imposed upon a PHRN under rescinded § 1003.29(d) to renew medical command authorization.
(g) PHPEs. A PHPE whose certification is currently registered shall, prior to the expiration of the 2-year registration period, successfully complete the following:
(1) Effective with the registration period beginning January 1, 2014, 36 credits in instruction in subjects related to the scope of practice of a PHPE as set forth in § 1023.29(a) and (d) (relating to prehospital physician extender) and which have been approved by the Department for continuing education credit. At least 27 of the credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin, beginning with the first full registration period the PHPE begins following the initial registration period.
(2) A CPR course completed or taught biennially.
(3) Prior to January 1, 2014, a PHPE shall satisfy the continuing education requirements that had been imposed upon a paramedic under rescinded § 1003.29(c) to renew medical command authorization.
(h) PHPs. A PHP whose certification is currently registered shall, prior to the expiration of the 2-year registration period, successfully complete the following:
(1) Effective with the registration period beginning January 1, 2014, 36 credits in instruction in subjects related to the scope of practice of a PHP as set forth in § 1023.30(a) and (e) (relating to prehospital EMS physician) and which have been approved by the Department for continuing education credit. At least 27 of the credits shall be in clinical patient care and other core continuing education courses as specified in a notice the Department publishes in the Pennsylvania Bulletin, beginning with the first full registration period the PHP begins following the initial registration period.
(2) A CPR course completed or taught biennially.
(i) Conditional continuing education requirements. This section does not prohibit an EMS agency from requiring EMS providers or EMSVO to satisfy continuing education requirements it may choose to impose as a condition of employment, provided that the EMS agency may not excuse an EMS provider or EMSVO from meeting continuing education requirements imposed by this section.
(j) Proration of continuing education requirements. The continuing education requirements for EMS providers on a 2-year registration cycle will be prorated for the first registration period based upon the month in which the EMS provider became certified, with a fractional requirement rounded down. Proration of continuing education requirements will apply for the first registration period of an EMSVO certification of an EMS provider on a 2-year registration cycle.
Source The provisions of this § 1023.31 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1023.22 (relating to EMS vehicle operator); 28 Pa. Code § 1023.24 (relating to emergency medical responder); 28 Pa. Code § 1023.25 (relating to emergency medical technician); 28 Pa. Code § 1023.26 (relating to advanced emergency medical technician); 28 Pa. Code § 1023.27 (relating to paramedic); 28 Pa. Code § 1023.28 (relating to prehospital registered nurse); 28 Pa. Code § 1023.29 (relating to prehospital physician extender); and 28 Pa. Code § 1023.30 (relating to prehospital EMS physician).
§ 1023.32. Credit for continuing education.
(a) Credit. An EMS provider and an EMSVO shall receive one credit for each 60 minutes of instruction approved by the Department for continuing education credit presented in a classroom setting by a continuing education sponsor. Credit may not be received if attendance or other participation in the course is not adequate to meet the educational objectives of the course as determined by the course sponsor. Credit may not be received if the EMS provider or EMSVO misses more than 15% of the time assigned for the course. Credit may not be received for other than 30- or 60-minute units of instruction. The course must be at least 30 minutes. An EMS provider and an EMSVO will receive credit for a specific course only one time per registration cycle, even if the EMS provider or EMSVO has repeated the course in a different year of the same registration cycle. Continuing education credits may not be carried over from one certification period to another. For completing a continuing education course that is not presented in a classroom setting, or that is not presented by a continuing education sponsor, the EMS provider or EMSVO shall receive the number of credit hours assigned by the Department to the course.
(b) Course completion. An EMS provider or EMSVO may not receive credit for a continuing education course not completed, as evidenced by satisfaction of the check-in/check-out process for a course presented in a classroom setting by a continuing education sponsor, which reflects that the EMS provider or EMSVO met the continuing education attendance requirement for receiving credit, and the continuing education sponsor’s report to the Department verifying that the EMS provider or EMSVO has completed the course. The course will not be considered completed if the EMS provider or EMSVO does not satisfy other course completion requirements imposed by this chapter and the continuing education sponsor.
(c) Continuing education credit for instruction. An EMS provider or EMSVO shall receive credit for serving as an instructor in a continuing education course offered by a continuing education sponsor, or in a course that satisfies requirements for EMS provider or EMSVO certification conducted by an EMS educational institute. An EMS provider or EMSVO shall receive credit for teaching a continuing education course equal to the amount of credit for which a continuing education course is approved by the Department, and shall receive credit for teaching a course that satisfies requirements for EMS provider or EMSVO certification equal to the number of hours served as an instructor in that course. An EMS provider or EMSVO shall receive credit for teaching the same course only once during a registration renewal cycle.
(d) Continuing education credit through endorsement. An EMS provider or EMSVO who attends or teaches a course offered by an organization with National or State accreditation to provide education may apply to the Department to receive credit for the course. The EMS provider or EMSVO shall have the burden of demonstrating to the Department that the course meets standards substantially equivalent to the standards imposed in this chapter.
(e) Continuing education credit assigned to courses not conducted by a continuing education sponsor. If a course is offered by an organization with National or State accreditation to provide education, which is not a continuing education sponsor, the Department will assign credit to the course, including the possibility of no credit or partial credit, based upon considerations of whether the course is based entirely upon appropriate subject matter and whether the method of presenting the course meets standards substantially equivalent to those prescribed in this chapter.
(f) Continuing education credit assigned to self-study courses. Credit may be sought from the Department for a self-study continuing education course. The EMS provider or EMSVO shall submit an application to the Department to approve the self-study course for credit prior to beginning the course and supply the Department with the materials the Department requests to conduct the evaluation. The Department will assign credit to the course, including the possibility of no credit or partial credit, based upon considerations of whether the course addresses appropriate subject matter and whether the method of completing the course meets standards substantially equivalent to those prescribed in this chapter. The Department may require modifications to the proposed self-study as a precondition to approving it for credit.
(g) Continuing education credit assigned to courses not presented in a classroom setting. An EMS provider or EMSVO shall be awarded credit for completing a course without the EMS provider or EMSVO physically attending the course in a classroom setting, provided the course has been approved by the Department for credit when presented in that manner.
(h) Department record of continuing education credits. A record of the continuing education credits received by EMS providers and EMSVOs shall be maintained by the Department in a Statewide registry that may be accessed by an EMS provider or EMSVO through a secure access process provided by the Department.
(i) Resolution of discrepancies. It is the responsibility of an EMS provider and an EMSVO to review the record of continuing education credits in the Statewide registry for that individual and to notify the appropriate regional EMS council of any discrepancy. The Department will resolve all discrepancies between the number of continuing education credits reported and the number of continuing education credits an EMS provider or EMSVO alleges to have earned, which are not resolved by the regional EMS council. An EMS provider and an EMSVO will not receive credit for completing the same continuing education course more than once during a registration renewal cycle.
Source The provisions of this § 1023.32 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
§ 1023.33. Endorsement of course or examination.
(a) When acting upon an application for EMS provider certification, the Department may endorse as satisfying the education or examination requirement for the certification a National course or examination taken by the applicant, or a course or examination taken by the applicant in another state to meet that state’s course or examination requirement for the same or equivalent certification, if the Department determines that the course or examination meets or exceeds the standards for the course or examination requirement for the EMS provider certification issued by the Department.
(b) When acting upon an application for registration of an EMS provider certification, the Department may endorse as satisfying the continuing education or examination requirement for registration of the certification a National course or examination taken by the applicant, or a course or examination taken by the applicant in another state to meet that state’s course or examination requirement for renewal or registration of the same or equivalent certification, if the Department determines that the course or examination meets or exceeds the standards for the course or examination requirement for registration of the EMS provider certification issued by the Department.
§ 1023.34. Reciprocity.
(a) If the Department, upon review of the criteria for certification or equivalent authorization of a type of EMS provider in another state determines that the criteria is substantially equivalent to the criteria for a type of EMS provider certification it issues, the Department may enter into a reciprocity agreement with its counterpart agency in the other state to certify the same type of provider in this Commonwealth based solely upon the other state’s certification of the EMS provider, provided:
(1) The agreement provides that the counterpart authority in the other state will accord the equivalent EMS provider certified by the Department the same treatment in the other state.
(2) The agreement does not deprive the Department of its authority to deny a certification based upon disciplinary considerations.
(b) The Department will publish in the Pennsylvania Bulletin, and update as appropriate, a notice listing the states with which it has entered into a reciprocity agreement and, for each state, the type of EMS provider covered by the reciprocity agreement.
Subchapter C. OTHER PERSONS ASSOCIATED WITH THE STATEWIDE EMS SYSTEM
Sec.
1023.51. Certified EMS instructors.
1023.52. Rescue personnel.§ 1023.51. Certified EMS instructors.
(a) Certification. The Department will certify as an EMS instructor an individual who meets the following qualifications:
(1) Has completed an application for EMS instructor certification on a form or through an electronic process, as prescribed by the Department.
(2) Is 18 years of age or older.
(3) Has successfully completed an EMS instructor’s course approved by the Department or possesses a bachelor’s degree in education, a teacher’s certification in education, a doctorate or master’s degree.
(4) Has provided at least 20 hours of instruction time in an EMS provider educational course monitored by a certified EMS instructor designated by the EMS educational institute’s administrative director.
(5) Possesses current certification as an EMT or higher level EMS provider.
(6) Possesses current certification in CPR or current certification as a CPR instructor.
(7) Possesses at least 1 year of experience in providing EMS as an EMT or higher level EMS provider.
(b) Triennial registration. An EMS instructor certification is deemed registered for 3 years. Thereafter, an EMS instructor shall triennially register the certification by completing a form or through an electronic process, as prescribed by the Department. An EMS instructor shall submit the form or complete the electronic process at least 30 days prior to the expiration of a current registration. Failure to do so in a timely manner may result in the EMS instructor certification not being registered again before the prior registration expires. The Department will issue a new registration within 30 days after the EMS instructor completes the form or the electronic process if the information provided establishes that the EMS instructor has met the following requirements:
(1) Has provided documentation to the Department to establish that the individual conducted at least 60 hours of teaching EMS provider or rescue courses during the previous 3 years.
(2) Possesses current registration of a certification as an EMT or higher level EMS provider.
(3) Possesses current certification in CPR or a current certification as a CPR instructor.
(c) Standards for providing instruction. An EMS instructor shall satisfy the following in providing instruction in an EMS educational institute:
(1) Present EMS educational program course materials as required under § 1025.1(h)(6) (relating to accreditation and operational requirements of EMS educational institutes).
(2) Utilize a variety of instructional strategies, adapting to students with diverse backgrounds and different learning styles.
(3) Establish and clearly communicate to students the goals and objectives for the certification class being taught and administer periodic evaluations to assess whether those goals and objectives are being met.
(4) Maintain class order and discipline, manage the classroom learning environment and monitor the effectiveness of instruction.
(5) Ensure proper class time management with particular attention to completion of required class hours.
§ 1023.52. Rescue personnel.
(a) Vehicle rescue technician.
(1) Roles and responsibilities. A vehicle rescue technician is an individual certified by the Department as possessing the training and skills to perform rescue skills in accordance with the vehicle rescue course approved by the Department in consultation with the State Fire Commissioner. The program provides the student with the knowledge and skills necessary to achieve the rescue of persons involved in automobile accidents.
(2) Minimum qualifications. To secure certification as a vehicle rescue technician, an applicant shall make application for vehicle rescue practices technician certification on a form or through an electronic process, as prescribed by the Department, and shall have successfully completed a training program for vehicle rescue approved by the Department and a written vehicle rescue practices test developed by the Department.
(b) Special vehicle rescue technician.
(1) Roles and responsibilities. A special vehicle rescue technician is an individual certified by the Department as possessing the training and skills to perform rescues in accordance with the specialized rescue training course approved by the Department in consultation with the State Fire Commissioner.
(2) Minimum qualifications. To secure certification as a special vehicle rescue technician, an applicant shall make application for special vehicle rescue practices technician certification on a form or through an electronic process, as prescribed by the Department, and shall have successfully completed a training program for specialized vehicle rescue approved by the Department and a written special vehicle rescue technician test developed by the Department.
(c) Rescue instructor. The Department will develop a program in consultation with the State Fire Commissioner providing for the certification of rescue instructors. Courses that seek Department approval as a rescue training course for a vehicle rescue technician or special vehicle rescue technician shall be taught by certified rescue instructors.
(d) Certificates. The rescue technician certifications issued by the Department under this section do not constitute a legal prerequisite for the performance of rescues. The rescue instructor certifications issued by the Department under this section do not constitute a legal prerequisite for serving as a rescue instructor in programs other than rescue training courses approved by the Department. The Department approves the rescue programs and issues the certifications referenced within this section to promote the Statewide EMS system having personnel with sufficient education and skills to perform rescues.
Source The provisions of this § 1023.52 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
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