TITLE 836 INDIANA EMERGENCY MEDICAL SERVICES COMMISSION
Final Rule
LSA Document #24-212
DIGEST
ADVANCED EMERGENCY MEDICAL TECHNICIAN CERTIFICATION
Date of First Hearing: July 29, 2024
SUMMARY/RESPONSE TO COMMENTS
The Emergency Medical Services Commission (commission) requested public comment from June 26, 2024, through July 26, 2024, and during the public hearing on July 29, 2024. The commission received no comments in response to the Notice of First Public Comment Period.
Authority:
IC 16-31-2-7;
IC 16-31.5-3-3
Sec. 1. The following definitions apply throughout this title unless the context clearly denotes otherwise:
(1) "14 CFR 135 and 14 CFR 119" means air carriers with reference to F.A.R. 135 and 119, and holding a current F.A.A. air carrier certificate, with approved air ambulance operations-helicopter or air ambulance operation-airplane operations specifications.
(2) "Advanced life support", for purposes of
IC 16-31, means the following:
(A) Care given:
(i) at the scene of an:
(AA) accident;
(CC) illness;
(ii) during transport; or
(iii) at a hospital;
by a paramedic, emergency medical technician-intermediate, and that is more advanced than the care usually provided by an emergency medical technician or an emergency medical technician-basic advanced.
(B) The term may include any of the following:
(i) Defibrillation.
(ii) Endotracheal intubation.
(iii) Parenteral injection of appropriate medications.
(iv) Electrocardiogram interpretation.
(v) Emergency management of trauma and illness.
(3) "Advanced life support fixed wing ambulance service provider organization" means a service provider that utilizes uses fixed wing aircraft to provide airport to airport transports, where the patients involved require need to be transported on a stretcher or cot and are being transported to or from a definite definitive care medical setting.
(4) "Advanced life support nontransport vehicle" means a motor vehicle other than an ambulance, owned or leased by a certified emergency medical service provider organization, that provides advanced life support but does not supply patient transport patients from the scene of the emergency. The term does not include an employer owned or employer operated vehicle used for first aid purposes within or upon on the employer's premises.
(5) "Advanced life support rotorcraft ambulance service provider organization" means a service provider that utilizes uses rotorcraft aircraft to respond directly to the scene of a medical emergency, either as an initial first responder or as a secondary responder, and are utilized used to airlift critically ill or injured patients directly to or between definitive care facilities, or to a point of transfer with another more appropriate form of transportation.
(6) "Agency" means the state emergency management agency emergency medical services division.
(7) "Air-medical director" means a physician with an unlimited license to practice medicine in Indiana and who has an active role in the delivery of delivering emergency care. The This licensed physician shall be is ultimately responsible for patient care during each transport. The air-medical director is responsible for directly overseeing and assuring that appropriate aircraft, air-medical personnel, and equipment are provided for each patient transported by the air ambulances within the air-medical services, as well as the performance of air-medical personnel.
(8) "Air-medical personnel" means a person who is certified by the commission as a paramedic, or is a registered nurse or physician.
(9) "Ambulance" means any conveyance on land, sea, or air that is used, or is intended to be used, for the purpose of responding to emergency life-threatening situations and providing transportation of an emergency patient.
(10) "Ambulance service provider organization" means any a person certified by the commission who that engages in or seeks to:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain;
(E) advertise; or
(F) otherwise engage in;
transportation services for the transportation and emergency patient care of emergency patients as a part of a regular course of doing business, either paid or voluntary.
(11) "Auto-injector" means a spring loaded needle and syringe that:
(A) contains a single dose of medication; and
(B) automatically releases and injects the medication.
(12) "Basic life support" means the following:
(A) Assessment of emergency patients.
(B) Administration of oxygen.
(C) Use of mechanical breathing devices.
(D) Application of antishock trousers.
(E) Performance of cardiopulmonary resuscitation.
(F) Application of dressings and bandage materials.
(G) Application of splinting and immobilization devices.
(H) Use of lifting and moving devices to ensure safe transport.
(I) Use of an automatic or a semiautomatic defibrillator if the defibrillator is used in accordance with under the training procedures established by the commission.
(J) Administration by An emergency medical technician or emergency medical technician-basic advanced of administering epinephrine through an auto-injector.
(K) For an emergency medical technician-basic advanced, the following:
(i) Electrocardiogram interpretation.
(ii) Manual external defibrillation.
(iii) Intravenous fluid therapy.
(L) Other procedures authorized by the commission, including procedures contained in the revised national emergency medical technician-basic training curriculum guide.
(M) Except as provided by:
(i) clause (J) and the training and certifications standards established under
IC 16-31-2-9(4);
(ii) clause (K)(iii); and
(iii) the training standards established under
IC 16-31-2-9(5);
the term does not include invasive medical care techniques or advanced life support.
(13) "Basic life support nontransport provider organization" means an organization, certified by the commission, that provides first response patient care at an emergency that includes defibrillation but does not supply patient transport patients from the scene of the emergency.
(14) "Certificate" or "certification" means authorization in written form issued by the commission to a person to:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain;
(E) advertise; or
(F) otherwise engage in providing;
emergency medical services as a part of a regular course of doing business, either paid or voluntary.
(15) "Commission" means the Indiana emergency medical services commission.
(16) "Director" means the director of the state emergency management agency.
(17) "Emergency ambulance services" means the transportation of transporting emergency patients by ambulance and the administration of administering basic life support to emergency those patients before or during such transportation. the transport.
(18) "Emergency management of trauma and illness" means the following:
(A) For a paramedic, those procedures for which the paramedic has been specifically trained and are part of the:
(i) that are a part of the curriculum prescribed by the commission; or
(ii) are a part of the continuing education program and approved by the supervising hospital and the paramedic provider organization's medical director.
(B) For an emergency medical technician-intermediate, those procedures for which the emergency medical technician-intermediate has been specifically trained:
(i) in the Indiana basic emergency medical technician and Indiana emergency medical technician-intermediate curriculums; and
(ii) that have been approved by the administrative and medical staff of the supervising hospital, the emergency medical technician-intermediate provider organization medical director, and the commission as being within the scope and responsibility of the emergency medical technician-intermediate.
(19) "Emergency medical services" means the provision of providing emergency ambulance services or other services, including extrication and rescue services, utilized used in serving an individual's need for immediate medical care in order to prevent loss of life or aggravation of aggravating a physiological or psychological illness or injury.
(20) "Emergency medical services driver" means an individual who has a certificate of completion of a commission approved driver training course.
(21) "Emergency medical services provider organization" means any a person certified by the commission who that engages in or seeks to:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain;
(E) advertise; or
(F) otherwise engage in;
services for the care of emergency patients as part of a regular course of doing business, either paid or voluntary.
(22) "Emergency medical services vehicle" means the following:
(A) An ambulance.
(B) An emergency medical service nontransport vehicle.
(23) "Emergency medical technician" means an individual who is certified under this article to provide basic life support at the scene of an accident or an illness, or during transport.
(24) "Emergency medical technician-basic advanced" means an individual
who is certified under
IC 16-31 to provide basic life support at the scene of an accident or
an illness, or during transport, and has been certified to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement.
(25) "Emergency medical technician-basic advanced provider organization" means an ambulance service provider or other provider organization certified by the commission to provide basic life support services administered by emergency medical technicians-basic advanced, and has been certified to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement, in conjunction with a supervising hospital.
(26) "Emergency medical technician-intermediate" means an individual who can perform at least one (1) but not all of the procedures of a paramedic and: who:
(A) has completed a prescribed course in advanced life support;
(B) has been certified by the commission;
(C) is associated with a single supervising hospital; and
(D) is affiliated with a provider organization.
(27) "Emergency medical technician-intermediate provider organization" means an ambulance service provider organization or other provider organization certified by the commission to provide advanced life support services administered by emergency medical technician-intermediates in conjunction with a supervising hospital.
(28) "Emergency patient" means an individual who is acutely ill, injured, or otherwise incapacitated or helpless and
who requires needs emergency care. The term includes an individual who
requires transportation needs to be transported on a litter or cot, or
is transported in a vehicle certified as an ambulance under
IC 16-31-3.
(29) "Extrication service" means any actions that disentangle and frees free from entrapment.
(30) "F.A.A." means the Federal Aviation Administration.
(31) "F.A.R." means the federal aviation regulations, including, but not limited to, 14 CFR.
(32) "First responder" means an individual who is:
(A) certified under
IC 16-31 and
who meets the commission's standards for first responder certification; and
(B) the first individual to respond to an incident requiring emergency medical services.
(33) "Fixed wing ambulance" means a propeller or jet airplane.
(34) "Flight physiology" means the physiological stress of flight encountered during air medical operations, to include, but not be limited to: including:
(A) temperature;
(B) pressure;
(C) stresses of barometric pressure changes;
(D) hypoxia;
(E) thermal and humidity changes;
(F) gravitational forces;
(G) noise;
(H) vibration;
(I) fatigue; and
(J) volume and mass of gases.
(35) "Medical director" means a physician with an unlimited license to practice medicine in Indiana and who has an active role in the delivery of delivering emergency care.
(36) "National criminal history background check" means a criminal history background check that:
(B) is conducted by the Indiana state police or a state vendor approved by the department; and
(C) has the results released to the department.
(36) (37) "Nontransporting emergency medical services vehicle" or "emergency medical service nontransport vehicle" means a motor vehicle, other than an ambulance, used for emergency medical services. The term does not include an employer owned or employer operated vehicle used for first aid purposes within or upon on the employer's premises.
(37) (38) "Paramedic" means an individual who:
(A) is:
(i) affiliated with a certified paramedic provider organization;
(ii) employed by a sponsoring hospital approved by the commission; or
(iii) employed by a supervising hospital with a contract for inservice education with a sponsoring hospital approved by the commission;
(B) has completed a prescribed course in advanced life support; and
(C) has been certified by the commission.
(38) (39) "Paramedic provider organization" means an ambulance service provider organization or other provider organization certified by the commission to provide advanced life support services administered by paramedics or physicians with an unlimited license to practice medicine in Indiana in conjunction with supervising hospitals.
(39) (40) "Person" means any:
(A) natural person or persons;
(B) partnership;
(C) corporation;
(D) association;
(E) joint stock association; or
(F) governmental entity other than an agency or instrumentality of the United States. "Agency or instrumentality of the United States" does not include a person operating under a contract with the government of the United States.
(40) (41) "Physician" means an individual who currently holds a valid unlimited license to practice medicine in Indiana under
IC 25-22.5-1-1.1.
(41) (42) "Program director" means a person employed by a certified training institution to coordinate the emergency medical services training programs.
(42) (43) "Provider organization" means an ambulance service or other emergency care organization certified by the commission to provide emergency medical services.
(43) (44) "Provider organization operating area" means the geographic area in which where an emergency medical technician-basic advanced, affiliated with a specific emergency medical technician-basic advanced provider organization, is able to can maintain two-way voice communication with the provider organization's supervising hospitals.
(44) (45) "Registered nurse" means a person licensed under
IC 25-23-1-1.1.
(45) (46) "Rescue services" means the provision of providing basic life support, except it does not include excluding the following:
(A) Administration of oxygen.
(B) Use of mechanical breathing devices.
(C) Application of antishock trousers.
(D) Application of splinting devices.
(E) Use of an automatic or a semiautomatic defibrillator.
(F) Electrocardiogram interpretation.
(G) Manual external defibrillation.
(H) Intravenous fluid therapy.
(I) Invasive medical care techniques.
(46) (47) "Rescue squad organization" means an organization that holds a voluntary certification to provide extrication, rescue, or emergency medical services.
(47) (48) "Supervising hospital" means a hospital licensed under
IC 16-21-2 or
under the licensing laws of another state that has been certified by the commission to supervise:
(A) paramedics;
(B) emergency medical technicians-intermediate;
(C) emergency medical technician-basic technicians-basic advanced; and
(D) provider organizations;
in providing emergency medical care.
(48) (49) "Training institution" means an institution certified by the commission to administer emergency medical services training programs.
(Indiana Emergency Medical Services Commission; 836 IAC 1-1-1; Emergency Medical Services Preliminary; filed Jun 5, 1975, 11:57 a.m.: Rules and Regs. 1976, p. 84; filed Nov 3, 1980, 3:55 p.m.: 3 IR 2191; filed Dec 13, 1985, 9:13 a.m.: 9 IR 1035; filed Aug 18, 1986, 1:00 p.m.: 10 IR 23; filed May 15, 1998, 10:25 a.m.: 21 IR 3865; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2718; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2333; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3507; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
836 IAC 4-4-1 General certification provisions
Authority:
IC 16-31-2-7;
IC 16-31.5-3-3
Sec. 1. (a) Applicants for original certification as an emergency medical technician shall meet the following requirements:
(1) Be a minimum of at least eighteen (18) years of age.
(2) Successfully complete the Indiana basic emergency medical technician training course as approved by the commission and administered by a certified training institution.
(3) Pass the emergency medical technician written and practical skills examinations as set forth and approved by the commission.
(4) submit to a national criminal history background check at the cost of the individual.
(b) The applicant shall apply for certification on forms provided by the agency postmarked within one (1) year of the date that the course was concluded as shown on the course report.
(c) The minimum requirement for basic emergency medical technicians training shall be as follows:
(1) The current version of the Indiana basic emergency medical technician training course as amended and approved by the commission.
(2) Each Indiana basic emergency medical technician course shall be supervised by a program director who is affiliated with the course sponsoring training institution as described in this article.
(d) No course shall be approved as equivalent to subsection (c) unless the course meets the training standards in effect on the date an equivalency determination is requested.
(e) Emergency medical technicians shall comply with the following:
(1) An emergency medical technician shall not perform procedures for which the emergency medical technician has not been specifically trained:
(A) in the Indiana basic emergency medical technician curriculum; and
(B) that have not been approved by the commission as being within the scope and responsibility of the emergency medical technician.
(2) An emergency medical technician shall not act negligently, recklessly, or in such a manner that endangers the health or safety of emergency patients or the members of the general public.
(3) An emergency medical technician shall comply with the state and federal laws governing the confidentiality of patient medical information.
(4) An emergency medical technician shall not delegate to a less qualified individual any skill that requires an emergency medical technician.
(5) An emergency medical technician shall comply with the protocols established by the commission, the provider organization, and the provider organization's medical director.
(Indiana Emergency Medical Services Commission; 836 IAC 4-4-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2752; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2366; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3568; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
Rule 7. Advanced Emergency Medical Technician Certification
836 IAC 4-7-1 Student qualification to enter training
Authority:
IC 16-31-2-7
Sec. 1. (a) An applicant for Indiana advanced emergency medical technician basic advanced training shall:
(1) hold a valid certificate as an emergency medical technician;
(2) be at least eighteen (18) years of age; and
(3) have a high school or general education diploma.
(b) Individuals who have successfully completed an Indiana basic emergency medical technician course, or are accepted for basic reciprocity and have taken the Indiana basic written and practical certification examinations, may hold a provisional spot in the advanced emergency medical technician basic advanced course.
(Indiana Emergency Medical Services Commission; 836 IAC 4-7-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2755; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3571; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
836 IAC 4-7-2 Certification provisions; general
Authority:
IC 16-31-2-7
Sec. 2. (a) An applicant for certification as an advanced emergency medical technician basic advanced shall meet the following requirements:
(1) Be an Indiana certified emergency medical technician.
(2) Be affiliated with a certified advanced emergency medical technician basic advanced provider organization or a supervising hospital.
(3) Successfully complete the Indiana advanced emergency medical technician basic advanced training course as approved by the commission and administered by a certified training institution.
(4) Pass the advanced emergency medical technician basic advanced written and practical skills examinations and assessments as approved by the commission.
(b) The An applicant shall apply for certification on forms provided by the agency postmarked within one (1) year of two (2) years after the date that the course was concluded, as shown on the course report and examination results not older than two (2) years.
(c) The An applicant shall submit verification of all affiliated provider organizations and supervising hospitals.
(d) Certification exemptions identified under
836 IAC 1-1-4 shall apply to
the certification of advanced emergency medical technician
basic advanced certification.
(e) Advanced emergency medical technicians basic advanced are prohibited from having in their possession, or maintained maintaining on board emergency response vehicles, any equipment or supplies that have not been approved by the advanced emergency medical technician basic advanced provider organization medical director.
(f) Advanced emergency medical technicians basic advanced shall comply with the following:
(1) An advanced emergency medical technician basic advanced shall not function within their scope of practice and perform a procedure for which the emergency medical technician-basic advanced has not been specifically trained only those procedures and treatments:
(A) in the Indiana emergency medical technician basic and the Indiana advanced emergency medical technician basic advanced curriculums; or
(B) that have not been approved by the commission as being within the scope and responsibility of the advanced emergency medical technician. basic advanced
(2) An advanced emergency medical technician basic advanced shall not act negligently, recklessly, or in such a manner way that endangers the health or safety of emergency patients or the members of the general public.
(3) An advanced emergency medical technician basic advanced shall comply with the state and federal laws governing the confidentiality of patient medical information.
(4) An advanced emergency medical technician basic advanced shall not delegate to a less qualified individual any skill that requires requiring an advanced emergency medical technician. basic advanced
(5) An advanced emergency medical technician basic advanced shall comply with the protocols established by the commission, the provider organization, and the provider organization's medical director.
(6) An advanced emergency medical technician shall comply with any investigations performed by the agency, including being interviewed and timely providing any requested paperwork.
(7) An advanced emergency medical technician shall keep the provider's online portal account up to date, including current address, phone number, and email.
(8) If at any time an advanced emergency medical technician certificate holder is no longer actively affiliated with either an advanced emergency medical technician provider organization or a supervising hospital, the advanced emergency medical technician certification automatically becomes inactive once the advanced emergency medical technician is notified, and the agency shall update the portal status as inactive once notified, until new verification of both affiliations is received by the agency as follows:
(A) The advanced emergency medical technician certificate holder must meet the requirements of section 5 of this rule.
(B) The advanced emergency medical technician certificate holder shall notify the agency within forty-eight (48) hours after becoming unaffiliated with either an advanced emergency medical technician provider organization or a supervising hospital.
(C) An advanced emergency medical technician certificate holder needs only one (1) provider agency and supervising hospital affiliation. Secondary affiliations do not need to be reported if there is a provider and supervising hospital affiliation still active.
(9) An advanced emergency medical technician should function at the highest certification level, but may function at the underlying emergency medical technician certification level if:
(A) working for a provider that is not certified at an advanced emergency medical technician level;
(B) the required advanced emergency medical technician equipment is not available sufficiently to provide advanced emergency medical technician care;
(C) assigned to a basic life support certified ambulance; or
(D) there is not enough staffing to provide an emergency medical technician during transport.
(Indiana Emergency Medical Services Commission; 836 IAC 4-7-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2755; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2368; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3571; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
836 IAC 4-7-3 Application for certification
Authority:
IC 16-31-2-7
Sec. 3. (a) Application for certification as an advanced emergency medical technician basic advanced shall be is made on forms provided by the agency, and the applicant shall submit the forms to the agency.
(b) All Applicants for original certification shall provide evidence of compliance with the requirements for certification.
(c) Certification as an advanced emergency medical technician basic advanced shall be is valid for two (2) years.
(d) Emergency medical technicians-basic advanced are authorized to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement. These procedures may only be performed when affiliated with a certified emergency medical technician-basic advanced provider organization and while operating under written protocols or the direct supervision of a physician of the supervising hospital or an individual authorized in writing by the medical staff to act in the behalf of a physician of the approved supervising hospital. Emergency medical technicians-basic advanced are prohibited from performing any advanced life support procedure other than manual or automated defibrillation, rhythm interpretation, and intravenous line placement as prescribed in the Indiana emergency medical technician-basic advanced course, with or without physician direction, for which certification by the commission has not been granted.
(e) (d) Individuals who have failed to comply with the continuing education requirements shall not exercise any of the rights and privileges of an advanced emergency medical technician basic advanced or administer advanced life support to any an emergency patient.
(f) (e) An individual wanting to reacquire a certification be recertified shall: complete an emergency medical technician-basic advanced recertification training course and
(1) reapply within four (4) years after the date the earlier certification expired;
(2) participate in and complete one (1) certification requirement cycle, including continuing education, practical skills, and requirements under section 5 of this rule at the advanced emergency medical technician curriculum level as a refresher, with those requirements being documented on an agency approved form for the certification being applied for; and
(3) successfully complete the state written and practical skills examinations as set forth and approved by the commission. If the individual fails the either certification examinations, the person shall examination, they must retake an entire Indiana advanced emergency medical technician basic advanced training course, including the commission approved written and practical examinations.
(g) (f) Advanced emergency medical technicians basic advanced failing to satisfy the requirements of subsection (f) (e) shall satisfy the requirements for certification renewal by fulfilling the requirements for original certification as outlined in this article.
(Indiana Emergency Medical Services Commission; 836 IAC 4-7-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2756; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3572; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
836 IAC 4-7-4 Advanced emergency medical technician certification based on reciprocity
Authority:
IC 16-31-2-7;
IC 16-31-3-14;
IC 16-31-3-14.5;
IC 16-31-3-20
Sec. 4. (a) To obtain advanced emergency medical technician basic advanced certification based upon reciprocity, an individual shall meet the following requirements:
(1) Be affiliated with an Indiana certified advanced emergency medical technician basic advanced provider organization or a supervising hospital.
(2) Possess a valid certificate or license as an advanced emergency medical technician basic advanced from another state or successfully complete a course of training and study equivalent to the material contained in the Indiana advanced emergency medical technician basic advanced training course.
(3) Successfully pass the Indiana advanced emergency medical technician basic advanced written and practical skills examinations as set forth and approved by the commission.
(b) An application for certification shall must be postmarked or delivered to the agency office within six (6) months after the a request for reciprocity.
(c) Any A nonresident of Indiana who possesses a certificate or license as an advanced emergency medical technician basic advanced, or intermediate that is valid in another state or a valid registration with the National Registry upon affiliation and is affiliated with an Indiana certified advanced emergency medical technician basic advanced provider organization may apply to the agency for temporary certification as an advanced emergency medical technician. basic advanced Upon receipt of After the agency receives a valid application and verification of valid status, by the agency, the agency may issue temporary certification that shall be valid for:
(1) the duration of the applicant's current certificate or license; or
(2) a period not to exceed six (6) months from after the date that the reciprocity request is approved by the director;
whichever period of time is shorter. A temporary license automatically expires and becomes inactive when an advanced emergency medical technician provider becomes nonaffiliated, which the advanced emergency medical technician shall notify the agency of within forty-eight (48) hours after becoming nonaffiliated. A person receiving temporary certification may apply for full certification using section 1 of this rule.
(Indiana Emergency Medical Services Commission; 836 IAC 4-7-4; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2756; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3573; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
836 IAC 4-7-5 Advanced emergency medical technician recertification and continuing education requirements
Authority:
IC 16-31-2-7
Sec. 5. (a) To renew a certification, a certified advanced emergency medical technician shall keep a written report of continuing education on a form approved by the agency, or in another format approved by the agency, for every two (2) years meeting or exceeding the minimum requirement in subsection (b).
(b) An applicant shall report the following:
(1) At least fifty (50) hours of continuing education consisting of the following:
(A) At least twenty-five (25) hours of advanced emergency medical technician national continued competency education curriculum continuing education in the following national component categories:
(i) Airway, respiration, ventilation: 2.5 hours.
(ii) Cardiovascular: 7 hours.
(iii) Trauma: 3 hours.
(iv) Medical: 7.5 hours.
(v) Operations: 5 hours.
(B) At least twelve and one-half (12.5) state component hours of advanced emergency medical technician national continued competency education curriculum continuing education, with ten (10) hours being advanced life support audit and review sessions. The commission may direct additional state component training. The affiliated provider organization, or without a designated provider, the supervising hospital, shall approve any additional hours to meet the state component.
(C) At least twelve and one-half (12.5) hours of individual or local, or both, continuing education that covers material from the emergency medical technician or advanced emergency medical technician curricula and is approved by the provider organization, or without a designated provider, the supervising hospital.
(2) Written evidence of certification in cardiopulmonary resuscitation at the health care provider level that is valid on the date of the emergency medical services recertification.
(3) Skill competency without a specified hour requirement. The individual must comply with the skills competencies process as approved by the affiliated provider organization medical director. The medical director's signature verifying the advanced emergency medical technician skills competencies for the individual is required at recertification.
(c) An applicant for recertification shall complete the online recertification verification, in the individual's online portal account, including the following:
(1) The recertification requirements in this section must be met before the online verification, including using agency approved forms to record continuing education, obtaining required signatures, and submitting within the current certification expiration period, but not more than ninety (90) days before the expiration.
(2) The recertification personnel are subject to random audits and, if selected with notification by the online portal for an audit, the applicant must supply written verifications with signatures to the agency within seventy-two (72) hours or the recertification is considered untimely filed and the initial certification expired. The applicant is also subject to a sanction or sanctions for failure to comply within the seventy-two (72) hour period.
(d) A National Registry of Emergency Medical Technicians provider may use a current provider card as prima facie evidence of compliance with the national and individual components of the national continued competency program certification requirements for the certification or licensure level at which the provider is certified or licensed. However, the following requirements must be met for recertification:
(1) The required affiliation signatures for the individual must be obtained on the agency approved recertification forms.
(2) The state component hours, including audit and review, must be listed on the agency approved recertification form.
(3) The required cardiopulmonary certification or certifications for the individual level must be kept and attached to the agency approved recertification form.
(4) The proof of skills competency section of the agency approved recertification form must be completed with verifying signatures.
(e) If a properly completed renewal application is submitted within one hundred twenty (120) calendar days after a certification expires, together with the documentation needed to show that the applicant has completed the required continuing education within the two (2) years before the certification expired and a fifty dollar ($50) reapplication fee, the certification is reinstated on the date the commission staff determines the application, documentation, and reapplication fee have been properly submitted. The expiration date shall be two (2) years after the previously expired certification expires.
(f) The advanced emergency medical technician certification includes emergency medical technician certification, and the emergency medical technician certificate is considered renewed with an online portal renewal of the advanced emergency medical technician certification. However, the portal system may take up to thirty (30) days to update for the lower level certification after renewal submission.
(Indiana Emergency Medical Services Commission; 836 IAC 4-7-5; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
836 IAC 4-7-6 Inactive status for certified advanced emergency medical technician
Authority:
IC 16-31-2-7
Sec. 6. (a) An advanced emergency medical technician requesting inactive advanced emergency medical technician status shall be:
(1) currently certified in Indiana as an advanced emergency medical technician; and
(2) an individual who has previously recertified as an advanced emergency medical technician in Indiana at least one (1) time. The individual's certification must be in good standing with the commission at the time inactive status is requested. Applicants for inactive status do not have to be affiliated with an advanced emergency medical technician provider organization. Applicants wanting inactive status shall submit a request in writing to the commission.
(b) If an advanced emergency medical technician wants to maintain an active emergency medical technician certification, the advanced emergency medical technician shall meet the requirements set forth in this rule.
(c) Advanced emergency medical technicians on inactive status shall collect the following continuing education hours during the inactive period, and those hours must be reported to the commission before the certificate expires:
(1) Collect and report continuing education requirements listed in section 5 of this rule.
(2) Collect and report twelve (12) additional continuing education hours.
(d) Advanced emergency medical technicians with an inactive status wishing to return to active status shall meet the following requirements:
(1) Comply with subsection (b) during inactive status.
(2) Be affiliated with an Indiana certified advanced emergency medical technician provider organization and an Indiana certified advanced emergency medical technician supervising hospital by submitting a signed application for advanced life support.
(3) Submit in writing a verified statement attesting to the applicant's competency in skills listed in section 5(b)(3) of this rule signed by the advanced emergency medical technician provider medical director.
(e) An advanced emergency medical technician is automatically placed in inactive status once the individual is notified by either the affiliate provider organization or supervising hospital that they are no longer affiliated, and no other advanced emergency medical technician affiliates exist for the individual that provide for both a provider and supervising hospital affiliation. The following requirements apply to an emergency medical technician automatically placed in inactive status under this subsection:
(1) An advanced emergency medical technician losing affiliation shall notify the agency within forty-eight (48) hours after being notified of not having an advanced life support affiliation with either an ambulance provider or a medical director.
(2) An advanced emergency medical technician in inactive status may not practice under their certification as an advanced emergency medical technician.
(3) An advanced emergency medical technician's status remains inactive until they provide the agency with appropriate affiliation paperwork demonstrating they have both a provider agency and supervising hospital.
(4) An advanced emergency medical technician may function as an emergency medical technician under that scope of practice while their advanced certification is inactive as long as the emergency medical technician certification requirements are met.
(Indiana Emergency Medical Services Commission; 836 IAC 4-7-6; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
Authority:
IC 16-31-2-7;
IC 16-31-3-14;
IC 16-31-3-14.5;
IC 16-31-3-20;
IC 16-31.5-3-3
Sec. 3. (a) An applicant for certification as a paramedic shall meet the following requirements:
(1) Be a certified emergency medical technician.
(2) Be affiliated with a certified paramedic provider organization or a supervising hospital.
(3) Successfully complete the Indiana paramedic training course as approved by the commission and administered by an Indiana certified training institution.
(4) Pass the paramedic written and practical skills examinations as approved by the commission.
(5) Submit to a national criminal history background check at the cost of the individual.
(b) The applicant shall do the following:
(1) Apply for certification on forms provided by the agency postmarked within one (1) year of the date of successful completion of the required certification examinations.
(2) Submit verification of all affiliated provider organizations and supervising hospitals.
(c) Certification exemptions identified under 836 IAC 1-1-4 apply to the certification of paramedics.
(d) Paramedics are prohibited from having in their possession, or maintained on board emergency response vehicles, any advanced life support equipment or supplies that have not been approved in writing by the paramedic provider organization medical director.
(e) Paramedics shall:
(1) not perform a procedure for which the emergency medical technician paramedic has not been specifically trained:
(A) in the Indiana emergency medical technician basic and the Indiana emergency medical technician paramedic curriculums; or
(B) that have not been approved by the commission as being within the scope and responsibility of the emergency medical technician paramedic;
(2) not act negligently, recklessly, or in such a manner that endangers the health or safety of emergency patients or the members of the general public;
(3) comply with the state and federal laws governing the confidentiality of patient medical information;
(4) not delegate to a less qualified individual any skill that requires a paramedic; and
(5) comply with the protocols established by the:
(A) commission;
(B) provider organization; and
(C) provider organization's medical director.
(Indiana Emergency Medical Services Commission; 836 IAC 4-9-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2757; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2372; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3577; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)
Approved by Attorney General: August 21, 2024
Approved by Governor: August 25, 2024
Filed with Publisher: August 30, 2024, 11:24 a.m.
Documents Incorporated by Reference: None Received by Publisher
Small Business Regulatory Coordinator: Alyssa Schroeder, Legislative Director, Indiana Department of Homeland Security, 302 West Washington Street, Room E208, Indianapolis, IN 46204, (317) 775-2607
Posted: 09/25/2024 by Legislative Services Agency
DIN: 20240925-IR-836240212FRA
Composed: Nov 20,2024 8:36:11AM EST
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