Current through Register Vol. 42, No. 11, August 30, 2024
(1) Education Program Specifics
(a) Any institution desiring approval as an
education program for Level 3 or Level 2 shall be an institution approved by
the Alabama Community College System (ACCS), or the ADPH OEMS. Any institution
desiring approval as an education program for Level 1 shall be an institution
approved by the OEMS and shall be accredited by the CoAEMSP.
(b) Any institution desiring approval as an
EMS education program must reserve one seat on its Advisory Board for the
Director of the OEMS or his designee. The OEMS shall be notified within a
reasonable timeframe of any Advisory Board meetings.
(c) Education programs shall be committed to
equal opportunity in employment and education and shall not discriminate on the
basis of sex, race, age, religion, or against qualified disabled
persons.
(d) Each education program
shall provide all preceptors and instructors with procedures to properly
document clinical and field evaluations and proper criteria for skills
verification. Preceptors and instructors shall be required to acknowledge
receipt of this material in writing, with the document being filed in the
education program's permanent records.
(e) Each education program shall provide all
students with EMS education, information on rules, and policies on testing and
licensure requirements by the OEMS. Students shall be required to acknowledge
receipt of this material in writing, with the document being filed in the
student's permanent records at the training facility.
(f) Each education program shall report any
evidence of academic dishonesty, dismissal, or termination from an EMS
education program due to evidence of academic dishonesty or positive drug
screen results for any currently licensed EMSP in the program. Action may also
be taken against an associate or employee of an EMS education program who
knowingly neglects to notify the OEMS of such. Evidence of academic dishonesty,
dismissal, or termination from a program may result in disciplinary action or
license revocation by the OEMS. This includes any EMSP, student, or associate
or employee of an EMS education program who knowingly participates in academic
dishonesty.
(g) Applications for
education program approval are available on the OEMS website
http://www.alabamapublichealth.gov/ems,
or upon request from the OEMS, and must be returned to the agency after
completion by the applicant. Upon review and approval of the application by the
OEMS it will, where appropriate, be forwarded to the ACCS or the ACHE for any
required co-approval. All EMS education programs will be reaccredited on a
5-year cycle. If a program is currently on a cycle with CoAEMSP, the Level 2
and Level 3 programs will coincide with that assessment. Otherwise, it will
begin with either the year of their initial application or the year in which
their next Level 2 or Level 3 class begins.
(h) All EMS education programs shall utilize
a program medical director who is licensed by the Medical Licensure Commission
of Alabama, a local member of the medical community, and experienced and
knowledgeable of emergency care of the acutely ill and traumatized patients.
The program medical director must review and approve the educational content of
the program curriculum and the quality of medical instruction and supervision
delivered by the faculty. The medical director must routinely review students'
performance to assure adequate progress toward completion of the program. The
medical director must attest that each graduating student has achieved the
desired level of competence prior to graduation.
(i) Any education program not accredited by
OEMS must notify the OEMS at least 90 days prior to the beginning of any
initial EMSP licensure level program.
(j) An approved Letter of Review from CoAEMSP
must be obtained by the sponsoring institution and must be submitted to the
OEMS at least 90 days prior to the beginning of an initial Level 1
course.
(2) Program
Accreditation
(a) Every EMS education program
is required to complete an OEMS Credentialing Application contained in the OEMS
Credentialing Manual.
(b)
Accreditation is a required process for the offering of each level of EMS
education.
1. The Level 2 and Level 3
accreditation is gained through completion of a credentialing application. The
application must be submitted to and approved by the OEMS. Submission of the
application serves as an agreement to adhere to all procedures outlined in
these rules and the requirements within the OEMS Credentialing
Manual.
2. Level 1 accreditation is
gained through completion and submission of the education program application
and attainment and maintenance of accreditation through CoAEMSP. All CoAEMSP
site visits shall be attended by an OEMS staff representative. Pending site
visits shall be communicated to the OEMS by the EMSP program.
(c) No fees are required for the
application or the accreditation process.
(d) Each approved EMS program shall receive a
letter and certificate of accreditation from the OEMS. The certificate must be
displayed in a public area of the approved program.
(e) Accreditation for Level 2 and Level 3
will be granted through the OEMS, through a credentialing process. This process
will include a review of the completed application, a site visit, and
compliance with other pertinent aspects of these rules and the OEMS
Credentialing Manual.
(f) Level 1
accreditation will be granted by the CoAEMSP and will be concurrently approved
by the OEMS, upon submission of a complete credentialing application and
documented proof of a current accreditation through the CoAEMSP prior to
initiating a second class. In the event that this accreditation is withdrawn or
is not renewed for any reason, the program must seek accreditation from the
OEMS in order to gain a Level 2 or Level 3 status.
(g) Accreditation status must be maintained
by a training program for its students to be eligible for the OEMS approved
licensure examination.
(h) Any
student graduating from an unapproved and unrecognized EMSP course will not be
eligible for the OEMS' licensure examination.
(i) Accreditation may be granted for a
maximum of 5 years. The accredited program must apply for re-accreditation at
least 12 months prior to expiration of accreditation.
(j) An accredited program may lose its
accreditation if the program remains inactive for a period of time exceeding 2
years. Such a loss of accreditation would not prevent the program from making a
new application for accreditation.
(k) Education programs seeking accreditation
from the OEMS shall be responsible for all expenses incurred by site visit team
members. This includes, but is not limited to, transportation, hotels, and
meals.
(3) Course
Offerings
(a) Institutions gaining
accreditation may offer as many concurrent on-campus programs as needed, within
their level of accreditation.
(b)
Institutions may submit in writing a request to hold a satellite course for
Levels 1 and 2 EMS education. Dual enrollment and Level 3 courses must be
submitted to the OEMS as a notice in writing. Any satellite EMS course must
meet all of the requirements of an on-campus course. If the course is not
within a reasonable distance to be served by the host program, it must meet the
appropriate essential elements of an education program, including having the
required service agreements, medical director, qualified instructors,
equipment, internship affiliations, facilities, and any other items necessary
to offer an EMS course. All satellite courses shall be reported to the OEMS
prior to the beginning of the first-class session.
(c) All Level 1 satellite courses must meet
the requirements and have prior approval from the CoAEMSP.
(4) Curriculum
(a) Each educational program shall use the
curriculum established by the National Emergency Medical Services Education
Standards and shall conform to other stipulations as set forth in these
rules.
(b) Each educational program
shall add to its curriculum any new drugs or procedures approved by the State
Board of Health, after notice is given by the OEMS to do so.
(c) Each education program is subject to
announced or unannounced visits by personnel of the OEMS to check adherence to
lesson plans, self-study documentation, and training objectives. If the
educational program is found to be out of compliance, it may be placed on
probationary accreditation status for a period of time, or the OEMS may
withdraw the education program's accreditation if the program is found to not
be in compliance with these rules, or if program does not maintain a 70 percent
certification examination pass rate over a 3-year rotating basis.
(d) Each education program shall submit all
documentation pertaining to course offerings and instructors as required by the
OEMS. Documentation shall include, but is not limited to self-study documents,
instructor data sheets, intent to train forms, and any administrative updates
or changes made by the education program.
(e) All education programs must ensure each
graduate completes the OEMS and Alabama EMS Systems presentation.
(5) Didactic/Internship Credit
Hours
(a) Time frames designated herein are
recognized as minimum required hours. This in no way suggests that these times
may not be exceeded by an accredited education program. As new requirements in
EMS education are adopted, minimum required hours may increase to ensure that
students receive adequate instructional time. All levels of EMS education must
include current national curriculum, and current Alabama EMS Protocol
instruction for the respective level of education.
(b) The minimum time frames for Level 3
course of instruction are 140 hours for didactic and laboratory and 48 hours
for internship. Internship hours may be divided between emergency room and
prehospital experience on an ambulance.
(c) The minimum time frames for Level 2
course of instruction are 180 hours for didactic and laboratory and 96 hours
for internship. Internship hours may be divided between hospital and
prehospital experience on an ambulance.
(d) The minimum time frames for Level 1
course of instruction are 300 hours for didactic and laboratory and 440 hours
for internship. Internship hours may be divided between hospital and
prehospital experience on an ambulance.
(6) Skills Requirements
(a) The instruments used to measure validity
and reliability of the internship experience should be standardized documents
reflecting the practical skills of the curriculum and be approved by the
accrediting agencies.
(b) The Level
3 student shall successfully perform patient assessments and
management.
(c) The Level 2 student
shall successfully perform, at a minimum:
1.
Two documented BIAD insertions.
2.
Ten successful IV procedures.
3.
Ten blood procedures (drawing for lab).
4. Twenty BLS assessments.
5. Twenty ALS assessments.
6. Ten pediatric assessments.
(d) The Level 1 student shall
successfully perform all requirements for the CoAEMSP.
(7) Internship Requirements
(a) Licensed emergency medical provider
services may enter into an agreement with EMS educational institutions to
provide field internships for EMSP students.
(b) Licensed provider services shall ensure
that all designated preceptors are informed of educational requirements for the
EMSP student.
(c) Field internship
experiences shall include supervised instruction and practice of emergency
medical skills and shall be evaluated by the designated preceptors.
(d) Licensed provider services are
responsible to ensure that no EMSP student exceeds his or her current level of
scope or privilege unless supervised by a designated preceptor in a designated
field internship.
(8) EMS
Student Requirements and Standards
(a) The
Level 3 student shall:
1. Meet all
institutional admission requirements.
2. Maintain a current Health Care Provider
CPR certification.
3. Meet the
"Essential Functions" as set forth by the OEMS and can be found on the
Essential Job Function Analysis Form located at
https://www.alabamapublichealth.gov/ems/forms.html
or attach documentation to the program application from those essential
functions of which the student is not in compliance (for review by the
institution's ADA Coordinator).
4.
Provide an acceptable physical examination by a licensed physician, nurse
practitioner, or physician assistant to include written documentation (on a
form provided by the program).
5.
Possess verification on file with the educational institution of the following:
(i) Professional liability
insurance.
(ii) Current health,
hospitalization, accident insurance, or waiver of liability.
(b) The Level 2 student
shall:
1. Complete all entry requirements for
Level 3 students.
2. Possess a high
school diploma or General Equivalency Diploma (GED), or dual
enrollment.
3. Possess a current
Alabama EMT license, or have successfully completed an EMT course approved by
the State Board of Health within the past 12 months (student must possess an
Alabama EMT license prior to entering the internship portion or exit the
program until the license is obtained).
(c) The Level 1 student shall:
1. Complete all entry requirements for Level
3 students.
2. Possess a current
Alabama EMT or AEMT license, or have successfully completed a Level 2 or Level
3 course approved by the State Board of Health within the last 12 months
(student must possess an Alabama EMT or AEMT license prior to entering the
internship portion or exit the program).
(d) The Registered Nurse (RN) shall:
1. Complete all entry requirements for Level
3 students.
2. Possess an
Associate's Degree or higher in nursing from a regionally accredited
institution.
3. Possess a license
as an unencumbered RN license in Alabama or an RN license accepted through the
Nursing Compact.
4. Possess a
current NREMT or NRAEMT certification prior to entering the internship portion
or exit the program.
5.
Successfully complete all Level 3 course work from an accredited
institution.
(e) All
education programs must inform students of the specific requirements for
progression through each level of EMS education. No student will be allowed to
sit for the state approved certification exam if the student attempts to
circumvent the matriculation requirements set by the education program in which
they are enrolled.
(f) All EMS
students must maintain current professional liability insurance while enrolled
in an education program.
(g) All
EMS students must maintain current health and hospitalization insurance or have
a waiver on file while enrolled in a program.
(h) All EMS students must comply with all
institution and program rules, policies, and procedures.
(9) Instructor Requirements
(a) EMR Instructor
1. Course Instructor
(i) Current Alabama license as an EMT or
above, or currently licensed in Alabama as a physician.
(ii) High school diploma or GED.
(iii) Certification from an EMS instructor
course approved by the OEMS, i.e. Level 1 National Association of Emergency
Medical Services Educators (NAEMSE), Department of Transportation (DOT)
Instructor Course, Alabama Fire College Instructor Course, Department of
Defense (DoD) Instructor Course, AHA Core Instructor Course.
(iv) Minimum of 3 years of prehospital field
experience.
(v) Current CPR
certification.
(b) Level 1, 2, and 3 Instructor Positions
1. Internship Preceptor
(i) High school diploma or GED.
(ii) Current Alabama license at the level
being supervised, a current Alabama license as a Registered Nurse (RN), or a
current Alabama license as a physician.
(iii) Be familiar with prehospital patient
care.
(iv) Supervise students in
the internship and field setting and accurately document their
performance.
2. Level 2
and 3 Course Instructor
(i) High school
diploma or GED.
(ii) Current
Alabama license as the level being taught or above, or currently licensed in
Alabama as a physician.
(iii)
Certification from an EMS instructor course approved by the OEMS, i.e. Level 1
NAEMSE, DOT Instructor Course, Alabama Fire College Instructor Course, DoD
Instructor Course, AHA Core Instructor Course.
(iv) Minimum of 3 years of prehospital field
experience.
(v) Current CPR
Instructor certification.
(vi)
Supervised probationary teaching experience for one entire course at the
instruction level being taught.
(vii) Approved by the Program Director and
Medical Director.
3.
Level 1 Course Instructor
(i) Must meet all
requirements for Level 2 and 3 Course Instructor.
(ii) Instructor certifications appropriate
for the curriculum being taught, e.g. ACLS instructor certification.
(iii) Hold an Associate's Degree or
higher.
4. Field
Preceptor
(i) High school diploma or
GED.
(ii) Current Alabama license
at or above the level being supervised.
(iii) Minimum of 2 years of
experience.
(iv) Be familiar with
prehospital patient care.
(v)
Supervise students in the internship and field setting and accurately document
their performance.
5.
Guest Lecturer
(i) High school diploma or
GED.
(ii) Expert knowledge in the
subject matter.
(iii) Program
Director and Medical Director approval for the topic to be presented.
6. Medical Director
(i) Licensed physician by the Medical
Licensure Commission of Alabama.
(ii) Experience and knowledge of emergency
care of acutely ill and traumatized patients.
(iii) Review and approve adherence to the
program curriculum and quality of medical instruction and supervision delivered
by the faculty.
(iv) Routinely
review student performance to assure adequate progress toward completion of the
program.
(v) Knowledgeable in EMS
education programs and legislative issues regarding the EMS programs and
prehospital providers.
7.
Practical Skills Preceptor
(i) High school
diploma or GED.
(ii) Minimum of 3
years of prehospital care experience as a licensed practitioner at the level
being instructed.
(iii) Current CPR
certification.
(iv) Program
Director and Medical Director approval to assist with practical skills
instruction.
8. Program
Director, Regional Director, or Designee
(i)
Meet all Course Instructor requirements.
(ii) Hold a Bachelor's Degree or
higher.
(iii) Assume ultimate
responsibility for the administration of all phases of the program.
(iv) Collaborate with the Medical
Director.
(v) Full time employee
with the institution's EMS program or Regional EMS Office.
10. EMS Essential Functions
(a) To ensure that properly qualified
individuals enter and participate in EMS education programs, the OEMS requires
that each educational program verify that each student meets the minimum
essential functions requirements outlined by the "Functional Job Analysis"
available at
https://one.nhtsa.gov/people/injury/ems/EMT-P/diskl%5Bl%5D/Intro-C.pdf
in the National Highway Traffic and Safety Administration, National Standard
Curriculum.
Rule
420-2-1-.17 was repealed as per
certification Filed March 20, 2001; effective April 24, 2001. As a result of
this Rule
420-2-1-.29 was renumbered to
420-2-1-.28. Rule
420-2-1-.28 was renumbered
420-2-1-.27 as per certification
filed December 17, 2007; effective January 21, 2008. Rule
420-2-1-.27 was renumbered
420-2-1-.32 as per certification Filed February 20, 2019; effective April 7,
2019.
Authors: William Crawford, M.D.; Jamie
Gray
Statutory Authority:
Code of Ala.
1975, §
22-18-1, et seq.