The purpose and effect is to amend rule language as part of the agency’s rule line reduction initiative, including the initiative to remove outdated obsolete and unnecessary rule language and update rule forms. Additionally, for some of the rule ...

 

DEPARTMENT OF HEALTH

Division of Emergency Preparedness and Community Support

RULE NOS.:RULE TITLES:

64J-1.001Definitions

64J-1.004Medical Direction

64J-1.008Emergency Medical Technician

64J-1.009Paramedic

64J-1.010Voluntary Inactive Certification

64J-1.011Involuntary Inactive Certification

64J-1.020Training Programs

64J-1.0202EMS Recertification Training Programs

PURPOSE AND EFFECT: The purpose and effect is to amend rule language as part of the agency’s rule line reduction initiative, including the initiative to remove outdated obsolete and unnecessary rule language and update rule forms. Additionally, for some of the rule sections, amendment is required to implement Fla. Session Law 2013-128, and 2016-941 related to training standards, certification requirements and inactive licensure status.

SUMMARY: The proposed rule will update department forms and requirements for: EMT and Paramedic certification, recertification, certification renewal and inactive status certification; EMT and Paramedic training programs and courses related to certification and recertification; EMS medical direction requirements. The department intends to update definitions of terms used in Chapter 64J-1, Florida Administrative Code, (F.A.C.). Some of the definition terms to be updated may be incorporated in Rule 64J-2.001, F.A.C. The rulemaking makes amendments as necessary to implement Fla. Session Laws 2013-128 and 2016-230.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: Based on the SERC checklist and the information analyzed in preparing that checklist, this rulemaking will not have an adverse impact or regulatory costs in excess of $1 million within five years as established in s. 120.541(2)(a), Florida Statutes.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 381.0011, (13), 381.0034, 381.0035, 395.401, 395.4025(13), 395.405, 401.121, 401.265, 401.23, 401.27, 401.2715, 401.272, 401.35, 499.05 FS.

LAW IMPLEMENTED: 381.001, 381.0011, 395.4001, 395.401, 395.4015, 395.402, 395.4025, 395.403, 395.404, 395.4045, 395.405, 401.121, 401.211, 401.23, 401.24, 401.25, 401.26, 401.265, 401.27, 401.2715, 401.281, 401.2915, 401.30, 401.34, 401.35, 401.435, 401.41, 401.411, 401.414, 499.005 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Melia Jenkins, 4052 Bald Cypress Way, Bin A-22, Tallahassee, Florida 32399, [phone], ext. 2773, [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64J-1.001 Definitions.

In addition to the definitions provided in Sections 395.401, 395.4001, 401.107, and 401.23, F.S., the following definitions apply to these rules:

(1) Abbreviated Injury Score (AIS-90) – as defined in Rule 64J-2.001, F.A.C.

(1)(2) “Application” – means a completed application form, as specified by the department, together with all documentation required by these rules and the required fee.

(3) Burn – means a tissue injury resulting from excessive exposure to thermal, chemical, electrical or radioactive agents.

(2)(4) “Certificate of Public Convenience and Necessity” (COPCN)” means a written statement or document, issued by the governing board of a county, granting permission for an applicant or licensee to provide services authorized by a license issued under Chapter 401, Part III, F.S., for the benefit of the population of that county or the benefit of the population of some geographic area of that county. No COPCN from one county may interfere with the prerogatives asserted by another county regarding COPCN.

(3)(5) “Certification Examination” – means an examination developed or adopted by the department to be used for the purpose of testing the ability to practice as a Florida licensed emergency medical technician or paramedic.

(6) Chief – means the chief of the department’s Bureau of EMS.

(4)(7) “Controlled sSubstances” – means those drugs listed in Chapter 893, F.S., and the “designer drugs” referred to in Section 893.035, F.S.

(5)(8) “Convicted or cConviction” – means a determination of guilt of a felony in any court of competent jurisdiction which is the result of trial of the entry of a plea of guilty or a plea of nolo contendere, regardless of whether adjudication is withheld.

(6)(9) “Department” – means the Florida Department of Health (DOH DH), Bureau of Emergency Medical Services, 4052 Bald Cypress Way, Bin A22 C18, Tallahassee, Florida 32399-1738.

(7) “Electronic Patient Care Record” means an incident level electronic record in accordance with the format specified in the Emergency Medical Services Tracking and Reporting System (EMSTARS) Data Dictionary Version 1.4 or in Version 3.

(8)(10) “Emergency Medical Services Provider” or “EMS provider” – means any entity licensed in the state of Florida to provide air, or ground ambulance, whether basic life support (BLS) provider or an advanced life support (ALS) provider, and whether a non-transportation or a transportation service.

(9)(11) “Glasgow Coma Scale Score” – as defined in Rule 64J-2.001, F.A.C.

(12) ICD-9-CM – as defined in Rule 64J-2.001, F.A.C.

(13) Injury Severity Score (ISS) – as defined in Rule 64J-2.001, F.A.C.

(10)(14) “Neonatal Ambulance” – means an ALS vehicle permitted solely for Neonatal Transport.

(11)(15) “Neonatal Transport” – means critical critial care interfacility transport of any neonate from a hospital licensed under Chapter 395, F.S., to a hospital licensed under Chapter 395, F.S., to deliver Level II or Level III neonatal intensive care services as defined in Rule 59C-1.042, F.A.C.

(12)(16) “Neonate” – means an infant less than 28 days of life or 5 kg in weight.

(13)(17) “Out-of-state or military trained emergency medical technician or paramedic” means an applicant for certification as an EMT or paramedic in Florida who received his or her initial training either in the military or in a program located in another state a person with a current certification or registration as an emergency medical technician or paramedic from any state or territory of the United States, other than Florida, that was conditioned upon that person being a trained emergency medical technician or paramedic.

(14)(18) “Patient Care Record” – means an electronic or written the record used by each EMS provider to document patient care, treatment and transport activities that at a minimum includes the information required under Rules paragraphs 64J-1.003(5)(a), (b), and Rule 64J-1.014, subsections 64J-2.002(5), 64J-2.004(5), (6) and (7), 64J-2.005(4), F.A.C.

(19) Pediatric Trauma Patient – as defined in Rule 64J-2.001, F.A.C.

(15)(20) No change.

(16) “Subject matter expert” means someone with specialized knowledge, education or experience in a particular area or topic, for example, a labor and delivery nurse teaching the childbirth section of a program or an attorney teaching the medical legal portion of a program.

(17)(21) “Trained emergency medical technician or paramedic” means an emergency medical technician or paramedic who has successfully completed either of the United States Department of Transportation emergency medical technician or paramedic training curricula curriculum described at Rule 64J-1.008(1)(a)2., F.A.C. (for EMT’s) or 64J-1.009(1)(a)2., F.A.C. (for paramedics) (which training may have occurred in any state or territory of the United States, including Florida), which is incorporated by reference and is available for purchase from the Government Printing Office by telephoning [phone].

(18)(22) “Training Program” – means an educational institution having one designated program director, one designated medical director, and single budget entity; for the purposes of providing EMT or paramedic education programs, as approved by the department.

(19)(23) “Training Program Medical Records” – means the medical records of the student.

(20)(24) No change.

(21)(25) “Transfer or transport” – means aAir, land or water vehicle transportation, by vehicles not exempted under Section 401.33, F.S., of sick or injured persons requiring or likely to require medical attention during such transportation.

(22)(26) “Trauma” – as defined in Rule 64J-2.001, F.A.C.

(27) Trauma Alert – as defined in Rule 64J-2.001, F.A.C.

(23)(28) “Trauma Alert Patient” – as defined in Rule 64J-2.001, F.A.C.

(24)(29) “Trauma Patient” – as defined in Rule 64J-2.001, F.A.C.

(30) Trauma Registry – as defined in Rule 64J-2.001, F.A.C.

(25)(31) “Trauma Transport Protocols” (TTPs) – as defined in Rule 64J-2.001, F.A.C.

Rulemaking Authority 381.0011(13), 395.401, 395.4025(13), 395.405, 401.121, 401.35 FS. Law Implemented 381.0011, 395.4001, 395.401, 395.4015, 395.402, 395.4025, 395.403, 395.404, 395.4045, 395.405, 401.121, 401.211, 401.23, 401.25, 401.35, 401.435 FS. History–New 4-26-84, Amended 3-11-85, Formerly 10D-66.485, Amended 11-2-86, 4-12-88, 8-3-88, 8-7-89, 6-6-90, 12-10-92, 11-30-93, 10-2-94, 1-26-97, Formerly 10D-66.0485, Amended 8-4-98, 7-14-99, 2-20-00, 11-3-02, 6-9-05, 10-24-05, 4-22-07, Formerly 64E-2.001, Amended 1-12-09, 11-5-09, 2-16-10, 5-27-10,            .

 

64J-1.004 Medical Direction.

(1) Each ALS, BLS or air ambulance provider shall maintain on file for inspection and copying by the department its current contract for a medical director by which it procures the services of employs or independently contracts with a physician qualified pursuant to this section to be its medical director.

(2) There is no standard format for a medical director’s contract, however, in drafting such an instrument, the following provisions may be addressed:

(a) Name and relationship of the contracting parties.

(b) A list of contracted services inclusive of medical direction, administrative responsibilities, professional membership, basic and advanced life support review responsibilities, and reporting requirements.

(c) Monetary consideration inclusive of fees, expenses, reimbursement, fringe benefits, clerical assistance and office space.

(d) Termination clause.

(e) Renewal clause.

(f) Provision for liability coverage.

(g) Effective dates of the contract.

(2)(3) Qualifications:

(a) through (b) No change.

(c) A medical director shall be board certified and active in a broad-based clinical medical specialty with demonstrated experience in prehospital care and hold an ACLS certificate or equivalent as determined in Chapter 64J-1.022, F.A.C. Prehospital care experience shall be documented by the provider.

(d) A medical director shall demonstrate and have available for review by the department documentation of active participation in a regional or statewide physician group involved in prehospital care.

(3)(4) The dDuties and rResponsibilities of the licensed EMS provider mMedical dDirector include:.

(a) through (b) No change.

(c) With the exception of BLS medical directors, each ALS or air ambulance service medical director shall possess proof of current registration as a medical director, either individually or through a hospital, with the U.S. Department of Justice, Drug Enforcement Administration (DEA), to provide controlled substances to an EMS provider. DEA registration shall include each address at which controlled substances are stored. Proof of such registration shall be maintained on file with each ALS or air ambulance provider and shall be readily available for inspection.

(d) Ensure and certify that security procedures of the EMS provider for medications, fluids and controlled substances are in compliance with Chapters 499 and 894, F.S., and Cchapter 61N-1 64F-12, F.A.C.

(e) through (g) No change.

(h) An EMT employed by a licensed ALS provider is authorized to start a non-medicated IV under the following conditions:

1. No change.

2. If the licensed ALS provider elects to utilize EMTs in this capacity, the licensed EMS provider shall ensure that the medical director provides IV Therapy training deemed sufficient by the medical director at least equivalent to that required by the 1999 U.S. D.O.T. EMT-Intermediate National Standard Curriculum relating to IV therapy which is incorporated by reference and available from the Superintendent of Documents, Post Office Box 371954, Pittsburg, PA 15250-7954. The licensed EMS provider shall document successful completion of such training in each EMTs training file and make documentation available to the department upon request.

(i) through (k) No change.

(4)(l) Medical dDirectors of a training program shall:

(a)1. Be responsible for the instruction of the Department of Transportation (DOT) approved training programs program for EMTs and paramedics that are adopted by Rules 64J-1.008(1)(a)1. and 64J-1.009(1)(a)1., F.A.C., respectively.

2. through 5. renumbered (b) through (e) No change.

(f)6. The EMS training center shall by contract, require such medical director to Bbe available 4 hours per month for classroom teaching or review of student performance, and participate in direct contact time with EMS field level providers for a minimum of 10 hours per year. Notwithstanding the number of training centers or EMS providers served by the medical director, direct contact time shall be a minimum of 10 hours per year per medical director, not per training center.

(g)7. The training program shall Pprovide written documentation to the dDepartment that confirms the mMedical dDirector has reviewed and approved all policies, procedures, and methods used for the orientation of instructors and preceptors.

(h)8. The training program shall Pprovide written documentation to the dDepartment that confirms the mMedical dDirector has reviewed and approved all student testing procedures, evaluators and assessment tools used for each comprehensive final written (cognitive) and practical examination (psychomotor skills) for EMT and paramedic students. The mMedical dDirector shall review each student’s performance on the comprehensive final written (cognitive) and practical examination (psychomotor skills) before certifying a student has successfully completed all phases phase of the educational program and EMTs are proficient in BLS basic life support techniques and paramedics are proficient in ALS advanced life support techniques.

(5) The medical director of a licensed EMS provider may authorize paramedics under his or her supervision to perform immunizations pursuant to a written agreement with a County Health Department in the county in which the immunizations are to be performed. Should the medical director elect to utilize paramedics in this capacity, he or she shall verify on DH Form 1256, Certification of Training, December 12/2008, which is incorporated by reference and available from the department at http://www.flrules.org/Gateway/reference.asp?No=Ref-#####, that each paramedic authorized to administer immunizations has received sufficient completed training and experience to administer immunizations, as determined by the medical director consistent with that of other staff giving immunizations in the County Health Department as required by the Director of that County Health Department.

Rulemaking Authority 381.0011, 395.405, 401.265, 401.272, 401.35, 499.05 FS. Law Implemented 401.23, 401.24, 401.25, 401.26, 401.265, 401.27, 401.272, 401.281, 401.2915, 401.30, 401.34, 401.35, 401.41, 401.411, 499.005 FS. History–New 8-7-89, Amended 6-6-90, 12-10-92, 1-26-97, Formerly 10D-66.0505, Amended 8-4-98, 1-3-99, 2-20-00, 4-15-01, 11-19-01, 10-24-05, 12-18-06, Formerly 64E-2.004, Amended 5-27-10,            .

 

64J-1.008 Emergency Medical Technician.

(1) Qualifications and Procedures for Certification pursuant to Section 401.27, F.S. To be qualified for EMT certification, an individual must:

(a)1. Successfully complete an initial Florida EMT training program conducted in accordance with the January 2009 U.S. DOT EMT National EMS Education Standards 1994 U.S. DOT EMT-Basic National Standard Curriculum, which are is incorporated by reference and is available at www.ems.gov/educationstandards.htm and http://www.flrules.org/Gateway/reference.asp?No=Ref-##### for purchase from the Government Printing Office by telephoning [phone], or writing to the Government Printing Office, Superintendent of Documents, Post Office Box 371954, Pittsburg, PA 15250-7954, or

2. If out of state or military trained in accordance with either the 1994 U.S. DOT EMT-Basic National Standard Curriculum or the January 2009 U.S. DOT EMT National EMS Education Standards, currently hold a valid EMT certification from the National Registry of Emergency Medical Technicians (NREMT). The 1994 U.S. DOT EMT-Basic National Standard Curriculum is incorporated herein by reference and available at www.ems.gov/educationstandards.htm and http://www.flrules.org/Gateway/reference.asp?No=Ref-#####.

(b) Each applicant must or another U.S. state or territory which has the certifying authority to submit to the department DH Form 1583, 04/2017 12/08, Application for EMT/Examination for Emergency Medical Technician (EMT) & Paramedic Certification, which is incorporated by reference and available from the department, as defined by Rule subsection 64J-1.001(6)(9), F.A.C., or at http://www.FLhealthsource.com and http://www.flrules.org/Gateway/reference.asp?No=Ref-#####.

(c) Applicants who are subject to subparagraph (1)(a)1. must pass or otherwise have passed the department required EMT Certification Examination within 2 years of completing the initial Florida training program.

(b) Apply for and pass Florida EMT certification examination on DH Form 1583, 12/08, Application for Examination for Emergency Medical Technician (EMT) & Paramedic Certification; and

(c) Possess a high school diploma or a General Education Development (GED) diploma.

(2) Renewal Certification – To maintain an active certificate, the EMT shall pay the recertification fee and affirm continued compliance with all applicable requirements contained in paragraph 64J-1.008(2)(a), (b) or (c), F.A.C., complete and submit the applicable certification renewal notice, Certificate Renewal Notice DH-MQA 1212, 06/17 7/09, which is incorporated by reference and mailed by the department, or apply for renewal online at www.flhealthsource.gov www.flhealthsource.com, where the form may also be obtained as well as at http://www.flrules.org/Gateway/reference.asp?No=Ref-#####; and within 2 years prior to the expiration date of his or her EMT certification complete one of the following:

(a) Complete 30 hours of EMT refresher training based on criteria in the January 2009 1996 U.S. DOT EMT-Basic National Standard Refresher Curriculum EMS Education Standards, to include adult and pediatric education with a minimum of 2 two hours in pediatric emergencies, an additional 2 hours of HIV AIDS refresher training, in accordance with Section 381.0034, F.S.; and maintain a current CPR card as described provided in Section 401.27(4)(e)2., F.S., and Rule 64J-1.022, F.A.C., CPR training may shall be included in the 30 hours of refresher training, provided that the CPR training is taken with a continuing education provider recognized by the department pursuant to Section 401.2715, F.S. The 1996 U.S. DOT EMT-Basic National Standard Refresher Curriculum shall be the criteria for department approval of refresher training courses. The department shall accept either the affirmation of a licensed EMS provider’s medical director; or a certificate of completion of refresher training from a department approved Florida training program or a department approved continuing education provider as proof of compliance with the above requirements;. The 1996 U.S. DOT EMT-Basic National Standard Refresher Curriculum is incorporated by reference and available for purchase from the Government Printing Office by telephoning [phone] or writing to the Government Printing Office, Superintendent of Documents, Post Office Box 371954, Pittsburg, PA 15250-7954.

(b) Successfully pass the EMT certification examination required by the department during the current certification cycle; and complete 2 hours of HIV AIDS refresher training, in accordance with Section 381.0034, F.S.; and maintain a current CPR BLS card for the professional rescuer;. Prior to taking the examination, a candidate must request approval to sit for the examination. Such approval is requested by submitting DH Form 1583, 12/08, Application for Examination for Emergency Medical Technician (EMT) & Paramedic Certification to the department.

(c) Satisfactorily complete the first semester of the paramedic training course at a department approved Florida training center pursuant to Section 401.2701, F.S., within the current 2-year certification cycle. Complete 2 hours of HIV AIDS refresher training in accordance with Section 381.0034, F.S., and also maintain a current CPR card for the professional rescuer.; or

(d) No change.

(3) No change.

(4) Individuals who document their possession of the following in their application shall be deemed to satisfy subsection 64J-1.012(3), F.A.C., for certification as an EMT only while these criteria are applicable:

(a) Status as a member of the United States military;

(b) Valid EMT certification from the National Registry of Emergency Medical Technicians; and

(c) Assignment to Florida as part of a training program to operate as an EMT.

Rulemaking Authority 381.0011, 381.0034, 381.0035, 401.23, 401.27, 401.35, 456.013 FS. Law Implemented 381.001, 401.23, 401.2715, 401.27, 401.34, 401.35, 401.41, 401.411, 401.414 456.013(1) FS. History–New 11-29-82, Amended 4-26-84, 3-11-85, Formerly 10D-66.56, Amended 11-2-86, 4-12-88, 8-3-88, 12-10-92, 11-30-93, 12-10-95, 1-26-97, Formerly 10D-66.056, Amended 8-4-98, 1-3-99, 9-3-00, 4-15-01, 6-3-02, 11-3-02, 10-24-05, 1-11-06, 1-23-07, 10-16-07, Formerly 64E-2.008, Amended 11-22-09, 5-27-10,            .

 

64J-1.009 Paramedic.

(1) Qualifications and Procedures for Certification pursuant to Section 401.27, F.S. To be qualified for paramedic certification, an individual must:

(a)1. Successfully complete an initial Florida paramedic training program that was conducted in accordance with the January 2009 1998 U.S. DOT EMT-Paramedic (EMT-P) National EMS Education Standards Standard Curriculum, (NSC), which is incorporated by reference and is available at www.ems.gov/educationstandards.htm and http://www.flrules.org/Gateway/reference.asp?No=Ref-##### for purchase from the Government Printing Office by telephoning [phone], or

2. If out of state or military trained in accordance with the 1998 U.S. DOT EMT-Paramedic (EMT-P) NSC or the January 2009 U.S. DOT Paramedic National EMS Education Standards, currently hold a valid paramedic certification from the National Registry of Emergency Medical Technicians (NREMT). The 1998 U.S. DOT EMT-Paramedic (EMT-P) NSC is incorporated herein by reference and available at www.ems.gov/educationstandards.htm and http://www.flrules.org/Gateway/reference.asp?No=Ref-#####.

(b) Each applicant must or be currently certified in another U.S. state or territory which has the certifying authority to submit to the department DH Form 1583, 6/16 12/08, Application for EMT/Examination for Emergency Medical Technician (EMT) & Paramedic Certification (see Rule 64J-1.008 F.A.C.).

(c) For those applicants subject to subparagraph (1)(a)1., file the completed application form described in paragraph (1)(b) to apply for certification and pass or otherwise have passed the Florida required paramedic certification examination within two years of completing the Florida initial training program.

(b) Apply for and pass Florida paramedic certification examination on DH form 1583, 12/08, Application for Examination for Emergency Medical Technician (EMT) & Paramedic Certification; and

(c) Possess a high school diploma or a General Education Development (GED) diploma.

(2) Renewal Certification – To maintain an active certificate the paramedic shall pay the recertification fee and affirm continued compliance with all applicable requirements contained in Rules paragraph 64J-1.009(2)(a) or (b), F.A.C., complete and submit the applicable certification renewal notice, Certificate Renewal Notice DH- MQA 1212, 06/17 7/09, which is incorporated by reference in Rule 64J-1.008, F.A.C., and mailed by the department, or apply for renewal online at www.flhealthsource.gov www.flhealthsource.com, where the form may also be obtained or at http://www.flrules.org/Gateway/reference.asp?No=Ref-#####, and within 2 years prior to the expiration date of his or her paramedic certification complete one of the following:

(a) Complete 30 hours of paramedic refresher training based on criteria in the January 2009 1998 U.S. DOT Paramedic National EMS Education Standards D.O.T. EMT-Paramedic NSC, to include adult and pediatric education with a minimum of 2 two hours in pediatric emergencies, an additional 2 hours of HIV AIDS refresher training in accordance with Section 381.0034, F.S., and also maintain a current Advanced Cardiac Life Support (ACLS) card as provided in Section 401.27(4)(e)2., F.S., and Rule 64J-1.022, F.A.C. ACLS training may shall be included in the 30 hours of refresher training, provided that the ACLS training includes the continuing education criteria recognized by the department pursuant to Section 401.2715, F.S. The department shall accept either the affirmation of a licensed EMS provider’s medical director,; or a certificate of completion of refresher training from a department approved Florida training program, or a department approved continuing education provider as proof of compliance with the above requirements; or.

(b) Successfully pass a the paramedic certification examination required by the department during the current certification cycle; complete 2 hours of HIV/AIDS refresher training in accordance with Section 381.0034, F.S.; and also maintain a current ACLS card. Prior to taking the examination, a candidate must request approval to sit for the examination. Such approval is requested by submitting DH Form 1583, 12/08, Application for Examination for Emergency Medical Technician (EMT) & Paramedic Certification to the department.

(3) through (4) No change.

Rulemaking Authority 381.0011, 381.0034, 381.0035, 401.27, 401.35, 456.013 FS. Law Implemented 381.001, 401.23, 401.27, 401.2715, 401.34, 401.35, 401.41, 401.411, 401.414, 456.013 FS. History–New 11-29-82, Amended 4-26-84, 3-11-85, Formerly 10D-66.57, Amended 4-12-88, 8-3-88, 12-10-92, 11-30-93, 12-10-95, 1-26-97, Formerly 10D-66.057, Amended 8-4-98, 1-3-99, 9-3-00, 4-15-01, 6-3-02, 11-3-02, 10-24-05, 1-23-07, 10-16-07, Formerly 64E-2.009, Amended 11-22-09, 5-27-10,            .

 

64J-1.010 Voluntary Inactive Certification.

An EMT or paramedic who is currently certified can place their certificate on inactive status by sending a written request to the department and paying a fee of $50. Any EMT or paramedic whose certificate has been placed on inactive status shall not function as an EMT or paramedic until such time as he or she has completed the following requirements for reactivating the certificate:

(1) A certificate holder whose certificate has been on inactive status for 12 months or less can activate his or her certificate by submitting a written request to the department for activation and receiving written approval. The certificate holder must pPay a late renewal fee of $50.

(a) through (b) No change.

(2) An EMT whose certificate has been on inactive status for more than 1 year can activate his or her certificate by completing the following:

(a) 30 hours of EMT refresher training which shall meet the requirements of Rule 64J-1.008(2)(a) be based on the 1996 U.S. DOT EMT-Basic National Standard Refresher Curriculum and 2 hours of human immunodeficiency virus and acquired immune deficiency syndrome (HIV AIDS) training. The 1996 U.S. DOT EMT-Basic National Standard Refresher Curriculum is incorporated by reference in Rule 64J-1.008, F.A.C. The training:

1. through 2. No change.

(b) Hold a current CPR card pursuant to Section 401.27(4)(e)1., F.S., and Rule 64J-1.022, F.A.C., or equivalent pursuant to Rule 64E-2.038, F.A.C.

(c) No change.

(d) Pass the EMT certification examination required by the department. Should the applicant fail the examination, he or she must meet requirements for initial certification.

(e) After completion of the above requirements, submit to the department:

1. The required fee and affirmation of all applicable requirements contained in subsection 64J-1.010(2), F.A.C., to the department.

2. DH Form 1583, 12/08, Application for Examination for Emergency Medical Technician (EMT) & Paramedic Certification.

(3) A paramedic whose certificate has been on inactive status for more than 1 year can activate his or her certificate by completing the following:

(a) 30 hours of paramedic refresher training which shall meet the requirements of Rule 64J-1.009(2)(a), F.A.C. be based on the 1998 U.S. DOT EMT-Paramedic NSC, which is incorporated by reference in Rule 64J-1.009, F.A.C., and 2 hours of human immunodeficiency virus and acquired immune deficiency syndrome (HIV AIDS) training. The training:

1. through 2. No change.

(b) Hold a current ACLS card pursuant to Section 401.27(4)(e)2., F.S., and Rule 64J-1.022, F.A.C., or equivalent pursuant to Rule 64J-1.022, F.A.C.

(c) No change.

(d) Pass the paramedic certification examination required by the department. Should the applicant fail the examination, he or she must meet the requirements for initial certification.

(e) After completion of the above requirements, submit to the department:

1. The required fee and affirmation of all applicable requirements contained in subsection 64J-1.010(3), F.A.C. to the department.

2. DH Form 1583, 12/08, Application for Examination for Emergency Medical Technician (EMT) & Paramedic Certification.

Rulemaking Authority 401.27, 401.35, 456.036 FS. Law Implemented 401.27, 401.34, 401.35, 456.036 FS. History–New 8-4-98, Amended 1-3-99, 9-3-00, 4-21-02, 6-3-02, 11-3-02, 10-24-05, 1-23-07, 10-16-07, Formerly 64E-2.0094, Amended 11-22-09,            .

 

64J-1.011 Involuntary Inactive Certification.

(1) An EMT or paramedic certificate that is not renewed at the end of the 2-year certification period shall automatically revert to an inactive status for a period of no more than two additional 2-year renewal cycles 180 days.

(2) EMT Such certificates may be reactivated if the applicant submits the renewal certification fee required by Section 401.34, F.S., and a late renewal fee of $25 and the following items to the department:

(a) if applying for reactivation of the certificate within the first additional 2-year renewal cycle, The required fees and affirmation of all applicable requirements, contained in subsection 64J-1.008(2) or 64J-1.009(2), F.A.C.

(b) vVerification of having met one of the recertification requirements contained in Rule subsection 64J-1.008(2)(a) or 64J-1.009(2), F.A.C., or The requirements for recertification shall be completed before the end of the 180-day inactive certification period.

(b) if applying for reactivation of the certificate within the second additional 2-year renewal cycle, the applicant must verify having met the recertification requirements contained in Rule 64J-1.008(2)(a), F.A.C., including an additional 30 hours of the refresher course training described in that rule paragraph, and must pass the department approved certification examination before the end of the second additional 2-year renewal cycle.

(3) Paramedic certificates may be reactivated if the applicant submits the renewal certification fee required by Section 401.34 F.S., a late renewal fee of $25, and:

(a) if applying for reactivation of the certificate within the first additional 2-year renewal cycle, verification of having met the recertification requirements contained in Rule 64J-1.009(2)(a), F.A.C., or

(b) if applying for reactivation of the certificate within the second additional 2-year renewal cycle, the applicant must verify having met the recertification requirements contained in Rule 64J-1.009(2)(a), F.A.C., including an additional 30 hours of the refresher course training described in that rule paragraph, and must pass the department approved certification examination before the end of the second additional 2-year renewal cycle.

(4) All recertification training requirements required for reactivation of a certificate under this rule section must be completed before the application is filed.

(5) Application for reactivation of a certificate under this rule must be made on Form DH 5023-MQA, 06/2017, Request for EMT/Paramedic Reactivation of Expired Certification, which is incorporated by reference and available at www.flhealthsource.gov and http://www.flrules.org/Gateway/reference.asp?No=Ref-#####.

(6)(3) An application for reactivation recertification received by the department more than four years 180 days after the expiration date of the certificate shall be denied. Such applicant certificate holder is ineligible for recertification or reactivation and must meet the requirements for initial certification.

Rulemaking Authority 401.27, 401.35 FS. Law Implemented 401.27, 401.34, 401.35 FS. History–New 8-4-98, Amended 1-3-99, 9-3-00, 4-15-01, 10-24-05, Formerly 64E-2.0095, Amended 11-22-09,            .

 

64J-1.020 Training Programs.

(1) No change.

(2) To be approved as an EMT Training Program, an entity shall submit a completed DH Form 1698, 04/2017 December 2008, Application for Approval of an Emergency Medical Services (EMS) Training Program, which is incorporated by reference and available from the department, at www.floridahealth.gov and at http://www.flrules.org/Gateway/reference.asp?No=Ref-##### as defined by subsection 64J-1.001(9), F.A.C., or at http://www.fl-ems.com.

(3) To be approved as a Paramedic Training Program, an entity shall submit a completed DH Form 1698, 04/2017 December 2008, Application for Approval of an Emergency Medical Services (EMS) Training Program, which is incorporated by reference and available from the department, as defined by subsection 64J-1.001(9), F.A.C., or at http://www.fl-ems.com.

(4) No change.

(5) Approved training programs that wish to offer EMT or Paramedic training programs after their approval expiration date must apply to the department. An entity shall submit a completed DH Form 1698, 04/2017, December 2008, Application for Approval of an Emergency Medical Services (EMS) Training Program, which is available from the department, as defined by subsection 64J-1.001(9), F.A.C., or at http://www.fl-ems.com. The application must be received by the department not less than 90 days before the training program programs approval expiration date and no earlier  than 180 days prior to the approval expiration date.

(6) Emergency Medical Technician (EMT) training program course length shall be a minimum of 300 250 hours. EMT students shall not have less than five (5) patient contacts resulting in the student accompanying the patient to the hospital. Student-to-Instructor ratios shall not exceed 6:1 during the skills laboratory phase of the program.

(7) Paramedic training program course length shall be a minimum of 1100 hours that includes the recommended hours listed in the United States Department of Transportation, National Highway Traffic Safety Administration’s, 1998 EMT-Paramedic National Standard Curriculum for classroom, skills laboratory, hospital clinical, and field internship.

(8) Florida approved EMT and paramedic Emergency Medical Technician tTraining pPrograms must have, at a minimum, the equipment and supplies listed in DH Form 1698, 04/2017, Application for Approval of an Emergency Medical Services (EMS) Training Program Table I.

(9) Florida approved paramedic Training Programs must have at a minimum the equipment and supplies listed in Table I and Table II.

(9)(10) No change.

 

TABLE I

EMERGENCY MEDICAL TECHNICIAN BASIC TRAINING PROGRAM

REQUIRED EQUIPMENT AND SUPPLIES

 

AIRWAY

Oral pharyngeal airways(Adult, Child, & Infant)

Nasal pharyngeal airways(Adult, Child, & Infant)

Bag valve mask(Adult, Child, & Infant)

Pocket mask with one way valve(Adult)

 

SUCTION

Portable suction unit Connecting tubing(Battery Powered & Manual)

Soft tip suction catheters(Sizes 6 - 18 French)

Rigid suction tip

Meconium Aspirator

Bulb syringe

 

Oxygen (O2) and Supplies

O2 tank with wrench

Regulator with high flow port

Demand valve **

Bite sticks

High concentration mask(Adult, Child, & Infant)

Simple face mask(Adult, Child, & Infant)

Nasal cannulas(Adult, Child, & Infant)

Venturi mask(Adult)

O2 tubing

Nebulizer

 

DIAGNOSTIC EQUIPMENT

Blood pressure cuffs(Thigh, Large Adult, Adult, Child, and Infant)

Stethoscopes(Adult & Pediatric)

Teaching stethoscopes

Thermometer

Penlights

 

INFECTION CONTROL

Gloves (latex, non-latex, & powder free)(All Sizes)

Disinfectant

Biohazard trash bags

Sharps container**

Personal protective equipment(Gown, Eye & Face Shields)

 

PHARMACEUTICALS

Insta glucose

Epi Pen trainer

Activated charcoal

Placebo inhalers

Nitroglycerin(May be simulated)

 

MEDICAL TRAINING EQUIPMENT

AED trainer with pads**(Adult & Child)

CPR manikins(Adult, Child & Infant)

Airway manikins **(Adult, Child & Infant)

Childbirth manikins**

Full body basic life support manikins(Adult & Child)

Moulage kit **

 

IMMOBILIZATION AND EXTRICATION

Non-wood long spine board with straps(Adult & Pediatric)

Short board(Adult & Pediatric)

Vest style immobilization device with straps(Adults)

C-collars(Adult Child & Pediatric)

Head immobilizers(Adult & Pediatric)

Basket stretcher**

Scoop stretcher**

Car seat**(Child & Infant)

Flexible stretcher **

Patient restraints

 

SPLINTS

Traction splints (two out of the three)(Adult & Pediatric)

Vacuum(Assorted sizes)

Air(Assorted sizes)

Padded board splints(Assorted sizes)

 

PATIENT TRANSPORT EQUIPMENT

Stretcher with straps(Must be capable of multi level positioning)

Stair chair with straps

 

BANDAGES AND DRESSINGS

Elastic bandage

Roller gauze

Non-sterile or sterile sponges

Abdominal pads

Multi trauma dressing

Non-adherent dressing

Petroleum gauze

Triangular bandages

Eye pads

Band-aids

Tape (Assorted sizes)

Cold packs

Burn sheets (May be simulated)

OB kits

Tongue depressors

 

MISCELLANEOUS

Trauma shears

Ring cutter with extra blades

Emergency/Survival blanket

Jump bag

Helmets (Open & Full face)

Football Helmet and Shoulder Pads **

 

Items marked with a double asterisk are not required to be present at all sites during active classes. The program must demonstrate that these items are available from other sites within the program or by written contract with another agency.

 

PARAMEDIC TRAINING PROGRAM EQUIPMENT AND SUPPLIES

In addition to equipment and supplies required for EMT Training Programs

 

AIRWAY

Esophageal intubation detector (Two out of three)

Colorimetric CO2 detector(Adult & Pediatric)

Bulb type intubation detector(Adult)

Syringe type intubation Detector(Adult)

Endotracheal tubes(Sizes 2.5-8)

Naso-gastric tubes(Assorted sizes)

Commercial manufactured tube holder(Adult & Pediatric)

Laryngoscope handles with batteries (Adult & Pediatric)

Laryngoscope with Macintosh and miller blades(Complete set of each)

Replacement laryngoscope light bulbs

Stylettes(Assorted sizes)

Lighted stylettes(Adult)

Cricothyrotomy kit**

Pneumothorax kit**

Superglotic airways

 

OXYGEN AND SUPPLIES

Continuous Positive Airway Pressure (CPAP) with Circuits and Mask **(Adult)

Automatic Ventilator with Circuits Mask and Peep Valve**(Adult & Pediatric)

 

DIAGNOSTIC EQUIPMENT

Glucometer with lancets and test strips

 

CARDIOLOGY SUPPLIES

Cardiac monitor capable of defibrillation with cables

Cardiac monitor capable of defibrillation, 12 lead EKG, and pacing, with cables. and wave form end title carbon

dioxide detector capable of printing.

Battery support system with spare batteries

EKG paper

Rhythm generator capable of generating 3 or 4 lead displays

Rhythm generator capable of generating 12 lead rhythms

 

IV AND PHARMACEUTICALS SUPPLIES

IV catheters(Sizes 22 – 14 gauges)

Butterfly needles(Assorted Sizes)

Blood collection tubes

Vacutainer device with luer adapter

Syringes(Sizes 3-20cc)

Hypodermic needles(Sizes 25-18 gauge)

Intraosseous Needles

Practice medication ampoules, vials, and premeasured syringes

Macrodrips IV sets

Microdrips IV sets

IV extension sets

3 way stop cocks

Buretrol solution set

IV fluids

IV start kits

 

ADVANCED LIFE SUPPORT PHARMACOLOGICAL DRUGS

(May be commercially packaged or simulated)

Atropine

Dextrose

Furosemide

Magnesium

Nalaxone

Sodium Bicarbonate

Epinephrine 1:10000

Epinephrine 1:1000

Lidocaine

Amiodarone

Dopamine

Vasopressin

Procinamide

Adenosine

Digoxin

Verapamil

Cardizem

Morphine Sulfate

Nitroglycerin

Aspirin

Lidocaine drip

Dopamine drip

 

MEDICAL TRAINING EQUIPMENT

IV trainer(Adult)

Cricothyrotomy manikins**(Adult)

Intraosseous trainer**(Pediatric)

IM and Sub-Q injection trainer**(Adult & Pediatric)

Pneumothorax trainer**(Adult)

Full body advanced life support manikins**(Adult, Child, & Infant)

Consumable parts for all trainers **(Adult, Child, & Infant)

 

MISCELLANEOUS ITEMS

Triage tags

Two-way communication radios or walkie-talkie

Length-Base resuscitation device

**Items marked with a double asterisk are not required to be present at all sites during active classes. The program must demonstrate that these items are available from other sites within the program or by written contract with another agency.

Rulemaking Authority 401.27, 401.2715 FS. Law Implemented 401.27, 401.2715 FS. History–New 9-3-00, Amended 4-15-01, 4-21-02, 11-3-02, 12-18-06, 10-16-07, Formerly 64E-2.036, Amended 8-12-10,            .

 

64J-1.0202 EMS Recertification Training Programs.

(1) Commencing with the effective date of this rule and expiring December 1 of even numbered years thereafter, entities not licensed as an emergency medical services provider or a department approved Florida training program shall be approved to conduct EMT or paramedic recertification training providing they meet the requirements contained in Section 401.2715, F.S., and this section. To be approved as an EMS Recertification Training Program, each applicant shall:

(a) through (b) No change.

(c) Submit the following for each course offering:

1. Behavioral objectives:

a. Describe expected learner outcomes in terms that can be evaluated, are obtainable and are relevant to the January 2009 1996 U.S. DOT EMT-Basic National EMS Education Standards Standard Refresher Curriculum referenced in Rule 64J-1.008, F.A.C., and to the January 2009 1998 U.S. DOT EMT-Paramedic (EMT-P) National EMS Education Standards Standard Curriculum referenced in Rule 64J-1.009, F.A.C.

b. No. change.

2. through 7.  No change.

(2) through (5) No change.

Rulemaking Authority 401.27, 401.2715 FS. Law Implemented 401.27, 401.2715 FS. History–New 5-27-10,            .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Melia Jenkins

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Celeste Philip, MD, MPH, State Surgeon General

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: June 19, 2017

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: July 5, 2016