Ala. Admin. Code r. 420-2-1-.32

Current through Register Vol. 43, No. 1, October 31, 2024

Section 420-2-1-.32 - Education Standards And Procedures

(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.

Ala. Admin. Code r. 420-2-1-.32

New Rule: Filed September 20, 1996; effective October 24, 1996. Amended: Filed March 20, 2001; effective April 24, 2 001. Repealed and New Rule: Filed December 17, 2007; effective January 21, 2008. Repealed and New Rule: Filed April 20, 2011; effective May 25, 2011. Amended: January 17, 2013; effective February 21, 2013.

Amended by Alabama Administrative Monthly Volume XXXV, Issue No. 06, March 31, 2017, eff. 4/30/2017.

Adopted by Alabama Administrative Monthly Volume XXXVII, Issue No. 05, February 28, 2019, eff. 4/7/2019.

Adopted by Alabama Administrative Monthly Volume XXXVIII, Issue No. 07, April 30, 2020, eff. 6/14/2020.

Adopted by Alabama Administrative Monthly Volume XL, Issue No. 05, February 28, 2022, eff. 4/14/2022.

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.