Title 30 — Subtitle 02. Emergency Medical Services Providers

Chapter 01. Definitions

Regulation .01 Definitions.Link Copy Citation

In this subtitle, the following terms have the meanings indicated.

Terms Defined.

(1)

“Basic telecommunicator course” means a course specified by the Maryland 9-1-1 Board dealing with the basic skills required to function as a call taker or call allocator in a communications center.

(2)

“Communications center” means a public safety answering point (PSAP) or dispatch center, or a dispatch center operated by a licensed commercial ambulance service.

(3)

“Course approved by the EMS Board” means a course of study and training intended to prepare an individual for licensure, certification, or renewal as a Maryland EMS provider which is conducted by an education program approved by the EMS Board under COMAR 30.04.

(4)

“Curriculum” means the required educational content of an EMS training course as established by the EMS Board.

(5)

“Emergency medical services (EMS)” means:

(a)

Medical services provided prehospital to prevent imminent death or aggravation of illness or injury;

(b)

Transport from the scene of a medical emergency to a hospital or appropriate facility whether or not medical services are provided;

(c)

Medical interfacility transport services to an appropriate facility; or

(d)

Medical interfacility critical care transport to an appropriate facility.

(6)

“Licensed nurse” means an individual holding a current and valid license issued by the Board of Nursing to practice nursing in Maryland.

(7)

“Licensed physician” means an individual holding a current and valid license issued by the State Board of Physicians to practice medicine in Maryland.

(8)

“Maryland 9-1-1 Board” means the Board established by the Public Safety Article, §1-305, Annotated Code of Maryland.

(9)

“National Registry of Emergency Medical Technicians” means the not-for-profit independent nongovernment agency that provides standardized national testing and registration for emergency medical technicians based on national training standards.

(10)

“Physician assistant” means an individual licensed by the State Board of Physicians as a physician assistant to practice under a collaborative agreement.

(11)

“Proprietary emergency medical dispatch (EMD) training program” means a private corporation, organization, or other entity which provides emergency medical dispatch training and materials consistent with the standards established by the National Highway Traffic Safety Administration.

(12)

“Public safety answering point (PSAP)” has the meaning stated in Public Safety Article, §1-301(q), Annotated Code of Maryland.

(13)

“Service member” means an individual who is an active duty member of:

(a)

The Armed Forces of the United States;

(b)

A reserve component of the Armed Forces of the United States; or

(c)

The National Guard of any state.

Chapter 02. Licensure and Certification

Regulation .01 Application.Link Copy Citation

An applicant for licensure, certification, or renewal shall submit to MIEMSS a completed application on a form the EMS Board requires.

Each application shall be signed by the applicant and any other individuals required by the EMS Board.

An applicant for licensure, certification, or renewal shall submit, with the application, evidence demonstrating that the applicant has successfully met all requirements.

Regulation .02 Fees.Link Copy Citation

The fee for licensure or certification, renewal of licensure or certification, examination, and reexamination is waived for an applicant who, on the date of application, is a member or employee of a fire, rescue, public safety, or EMS agency of a unit of State or federal government or political subdivision of the State, or a volunteer fire, rescue, or ambulance company, association, or agency, or an employee of a commercial ambulance service licensed under Education Article, §13-515, Annotated Code of Maryland.

The fee for the emergency medical responder, emergency medical technician, and paramedic written examinations and each reexamination are established by the National Registry of Emergency Medical Technicians.

The fee for the practical examination for emergency medical technician is $65.

The fee for reciprocal certification or licensure is $35.

Regulation .03 Requirements.Link Copy Citation

An individual applying for reciprocal licensure or certification shall meet the requirements of Regulation .04 of this chapter.

To qualify for licensure or certification, an applicant other than an applicant under §A of this regulation shall be 18 years old or older, except an individual:

(1)

Who is between the ages of 16 and 18 may apply for emergency medical responder or emergency medical technician examination and certification with written permission from a parent or legal guardian;

(2)

Shall be 16 years old or older before participating in any BLS clinical training or internship; and

(3)

Shall be 18 years old or older before participating in any ALS clinical training or internship.

In addition to the requirements of §B of this regulation, an applicant for emergency medical responder certification shall:

(1)

Have successfully completed an emergency medical responder course approved by the EMS Board;

(2)

Submit to MIEMSS evidence of current active status registration as an emergency medical responder with the National Registry of Emergency Medical Technicians, including:

(a)

Successfully completing the practical certification examination administered in conjunction with the emergency medical responder course; and

(b)

Passing an emergency medical responder cognitive certification examination administered by the National Registry of Emergency Medical Technicians.

In addition to the requirements of §B of this regulation, an applicant for emergency medical technician certification shall:

(1)

Have successfully completed:

(a)

An emergency medical technician course approved by the EMS Board; or

(b)

If the applicant is a licensed nurse, licensed physician, or certified physician assistant, the health care provider to emergency medical technician program;

(2)

Have successfully completed an internship approved by MIEMSS;

(3)

Submit to MIEMSS evidence of current active status registration as an emergency medical technician with the National Registry of Emergency Medical Technicians, including:

(a)

Successfully completing the emergency medical technician practical certification examination administered by MIEMSS; and

(b)

Passing an emergency medical technician cognitive certification examination administered by the National Registry of Emergency Medical Technicians; and

(4)

Be currently affiliated with an EMS operational program.

In addition to the requirements of §B of this regulation, an applicant for initial paramedic licensure shall:

(1)

Have successfully completed:

(a)

A paramedic course approved by the EMS Board;

(b)

If the applicant is a licensed nurse, licensed physician, or certified physician assistant, the health care provider to paramedic program; or

(c)

If the applicant is a CRT, the paramedic bridge course;

(2)

Have successfully completed immediately before application for licensure:

(a)

At least 12 full months of experience in providing patient care as an emergency medical technician with an EMS operational program;

(b)

At least 150 documented ambulance responses providing patient care, including patient assessment, with an EMS operational program;

(c)

If the applicant is a licensed nurse, licensed physician, or certified physician assistant, the health care provider to paramedic program; or

(d)

If the applicant is a CRT, the paramedic bridge course;

(3)

Submit evidence of current active status registration as a paramedic with the National Registry of Emergency Medical Technicians;

(4)

Successfully complete a MIEMSS-approved protocol orientation; and;

(5)

Be currently affiliated with an ALS EMS operational program.

In addition to the requirements of §B of this regulation, an applicant for EMD licensure shall:

(1)

Have successfully completed:

(a)

The basic telecommunicator course or an equivalent course approved by the Maryland 9-1-1 Board; or

(b)

2,000 hours of public safety call-taking or call-allocating experience;

(2)

Have successfully completed an EMD training program approved by the EMS Board; and

(3)

Be affiliated with an EMD operational program which has been approved by the EMS Board.

In determining whether any experience or internship required for licensure or certification has been completed, the EMS Board shall give credit to the individual for all relevant experience as a service member.

The EMS Board shall credit any training and education provided by the military and completed by a service member toward any training or education requirements for licensure or certification if the training or education is determined by the EMS Board to be:

(1)

Substantially equivalent to the training or education required by the EMS Board; and

(2)

Not otherwise contrary to any other licensing requirement.

Regulation .04 Reciprocity.Link Copy Citation

To obtain reciprocal licensure or certification, an applicant shall:

(1)

Submit to MIEMSS a completed application on a form the EMS Board requires;

(2)

Be at least the minimum age required for licensure or certification as set forth in Regulation .03B(2) of this chapter; and

(3)

Be currently affiliated with an EMS operational program providing at least the level of services for which the individual is seeking reciprocal licensure or certification, unless applying for reciprocal certification as an emergency medical responder.

In addition to the requirements of §A of this regulation, an applicant for emergency medical responder reciprocal certification shall:

(1)

Submit evidence of current:

(a)

Certification as an emergency medical responder in another state; or

(b)

Registration with the National Registry of Emergency Medical Technicians as an emergency medical responder.

In addition to the requirements of §A of this regulation, an applicant for emergency medical technician reciprocal certification shall:

(1)

Submit evidence of current:

(a)

Certification as an emergency medical technician, advanced emergency medical technician, or paramedic in another state if that state follows the national educational standards; or

(b)

Registration with the National Registry of Emergency Medical Technicians as an emergency medical technician, advanced emergency medical technician, or paramedic; and

(2)

Successfully complete a:

(a)

MIEMSS-approved protocol orientation; and

(b)

MIEMSS-approved technical proficiency verification.

In addition to the requirements of §A of this regulation, an applicant for reciprocal paramedic licensure shall:

(1)

Submit evidence of active status registration as a paramedic with the National Registry of Emergency Medical Technicians; and

(2)

Successfully complete a MIEMSS-approved protocol orientation.

Expiration Date.

(1)

For an EMR or EMT who is issued a certificate by reciprocity:

(a)

Between February 1 and July 31, the expiration date shall be July 31 plus 1 year; or

(b)

Between August 1 and January 31, the expiration date shall be January 31 plus 1 year.

(2)

For a paramedic who is issued a license by reciprocity, the expiration shall be 30 days after the individual’s current National Registry of Emergency Medical Technicians certification expires.

Regulation .05 Examination and Reexamination.Link Copy Citation

An applicant for EMD licensure who has completed an approved training program which provides its own examination shall be examined and reexamined in accordance with the policies of that training program.

An applicant for emergency medical technician certification or paramedic licensure is subject to the examination and reexamination policies and procedures of the National Registry of Emergency Medical Technicians..

If an applicant for emergency medical technician fails a first or second practical certification examination, the applicant may retake the practical examination:

(1)

Within 6 months of failing the first or second practical examination as provided in this regulation; and

(2)

Only after receiving remedial instruction in the areas of practical examination deficiency.

If an applicant for emergency medical technician certification fails the third practical certification examination, the applicant shall successfully complete a minimum of 9 hours of remedial education, which shall include technical skills, and pass the National Registry of Emergency Medical Technicians certification examination, after which the applicant may attempt the practical certification examination three more times, consistent with the procedure in §C of this regulation.

If an applicant for emergency medical technician certification fails the fourth, fifth, and sixth practical certification examination authorized under §D of this regulation, then the applicant shall successfully complete an approved emergency medical technician course in its entirety and pass the National Registry of Emergency Medical Technicians certification examination before taking another emergency medical technician practical certification examination.

Regulation .06 Issuance of License or Certificate.Link Copy Citation

A license or certificate shall be issued to each applicant meeting all applicable requirements of this subtitle for the level of licensure or certification sought.

The license or certificate shall bear the emergency medical service clinician’s name, identification number, the effective date of the license or certificate, and the expiration date of the license or certificate.

An applicant may not provide patient care as an EMS clinician until the applicant has received a current license or certificate from the EMS Board, except under supervision and in the course of participating in an education program that has been approved by the EMS Board.

An EMS clinician shall, whenever possible, carry the identification card issued by MIEMSS showing the clinician is licensed or certified by the EMS Board while performing the EMS clinician’s duties.

MIEMSS shall maintain a registry of licensed or certified EMS clinicians.

An EMS provider shall notify the MIEMSS Office of Education, Licensure and Certification in writing within 30 days of any change in:

(1)

Name;

(2)

Address;

(3)

Email;

(4)

Phone number; or

(5)

Affiliation with an EMS operational program.

Unless renewed or extended, the term of a license or certificate shall expire on the expiration date shown on the license or certificate.

Unless the certificate is the initial certificate issued under COMAR 30.02.02.04 or is extended, revoked, or suspended, the certificate of an emergency medical responder or emergency medical technician is valid:

(1)

In the initial certification period for at least 36 months, but not more than 42 months, as follows:

(a)

Applicants for emergency medical responder and emergency medical technician certification who successfully complete the certification requirements between February 1 and July 31 are issued a certificate which is effective from the date of successful completion of all certification requirements and expires on July 31, 3 years from the year of issuance; or

(b)

Applicants for emergency medical responder and emergency medical technician certification who successfully complete the emergency medical technician [examination] requirements between August 1 and January 31 are issued a certificate which is effective from the date of successful completion of all certification requirements and expires on January 31, 3 years from the year of issuance; and

(2)

In each subsequent certification period, for a period of 3 years from the previous expiration date.

Unless the license is extended, revoked, or suspended, the license of a CRT is valid for 2 years from the previous expiration date.

Unless the license is extended, revoked, or suspended, the license of a paramedic is valid:

(1)

In the initial licensure period, from the date of successful completion of all licensure requirements until 30 days after the expiration of the individual's registration with the National Registry of Emergency Medical Technicians; and

(2)

In each subsequent licensure period, until 30 days after the expiration of the individual’s registration with the National Registry of Emergency Medical Technicians.

Unless the license is extended, revoked, or suspended, the license of an EMD is valid:

(1)

In the initial licensure period, for at least 24 months, but not more than 32 months, as follows:

(a)

Applicants for EMD licensure who register with a national organization approved by the EMS Board between January 1 and June 30 are issued a license that is effective from the date of successful completion of all required certification examinations and expires on June 30, 2 years from the year of issuance; or

(b)

Applicants for EMD licensure who register with a national organization approved by the EMS Board between July 1 and December 31 are issued a certificate that is effective from the date of successful completion of all required certification examinations and expires on December 31, 2 years from the year of issuance; and

(2)

In each subsequent licensure period, for a period of 2 years from the previous expiration date.

Regulation .07 Renewal.Link Copy Citation

Prior to the expiration date of each license or certificate, MIEMSS shall send renewal notices to each EMS clinician whose license or certificate is expiring using the clinician’s contact information required under Regulation .06F of this chapter.

The renewal notice shall state the date the current license or certificate expires.

An EMS clinician who wishes to renew a license or certificate shall submit an application and any required supporting materials as specified in each applicable part of this chapter to MIEMSS on a form approved by MIEMSS at least 2 weeks before the expiration date.

For an emergency medical responder whose certificate, including any extension, expires after July 31, 2025, and is applying for renewal as an emergency medical responder, the individual shall submit to MIEMSS evidence of:

(1)

Current active status registration as an emergency medical responder or higher with the National Registry of Emergency Medical Technicians; or

(2)

Documentation of the successful completion of:

(a)

8 hours of continuing education in categories designated by the State EMS Medical Director during the clinician’s current certification cycle;

(b)

Three of the most recent years of Annual EMS Protocol Updates; and

(c)

A MIEMSS-approved technical proficiency verification.

For an emergency medical technician whose certificate, including any extension, expires after July 31, 2025, and is applying for renewal as an emergency medical technician, the individual shall submit to MIEMSS evidence of:

(1)

Affiliation with an EMS operational program;

(2)

Completion of the 3 most recent years of Annual EMS Protocol Updates; and

(3)

Either:

(a)

Current active status registration as an emergency medical technician or higher with the National Registry of Emergency Medical Technicians; or

(b)

Successful completion of 24 hours of continuing education in categories designated by the State EMS Medical Director during the clinician’s current certification cycle, of which a minimum of 1 hour up to a maximum of 9 hours may be devoted to technical skills, including MIEMSS-approved technical proficiency verification.

For a CRT whose license, including any extension, expires after July 31, 2025, and is applying for renewal as a CRT the individual shall submit to MIEMSS evidence of:

(1)

Affiliation with an EMS operational program;

(2)

Completion of the two most recent years of Annual EMS Protocol Updates; and

(3)

Either:

(a)

Current active status registration as a paramedic with the National Registry of Emergency Medical Technicians and completion of any MIEMSS-assigned ALS education; or

(b)

Documentation of successful completion of:

(i)

60 hours of continuing education equivalent to the requirements of a paramedic renewing with the National Registry of Emergency Medical Technicians including any MIEMSS-assigned ALS education during the clinician’s renewal cycle; and

(ii)

A MIEMSS-approved technical proficiency verification.

For a paramedic whose license, including any extension, expires after July 31, 2025, and is applying for renewal as a paramedic, the individual shall submit to MIEMSS evidence of:

(1)

Affiliation with an EMS operational program;

(2)

Completion of the two most recent years of Annual EMS Protocol Updates;

(3)

Completion of any MIEMSS-assigned ALS education during the clinician’s current renewal cycle; and

(4)

Current active status registration as a paramedic with the National Registry of Emergency Medical Technicians.

If applying for renewal as an EMD the individual shall submit evidence of:

(1)

Affiliation with an EMS operational program; and

(2)

Either:

(a)

Continued, active status certification as an EMD by a national organization approved by the EMS Board; or

(b)

Successful completion of 24 hours of approved EMD-related continuing education offered by an approved EMD educational program.

MIEMSS may extend a license or certificate for up to 6 months upon receipt of a written request for an extension before the expiration date.

Upon completion of the requirements for renewal, the individual shall receive a certificate or license valid for the appropriate certification or licensure period minus the period of any extension.

Regulation .08 Inactive Status.Link Copy Citation

The EMS Board may place an EMS clinician on inactive status if the EMS clinician:

(1)

Fails to maintain affiliation with any required EMS operational program;

(2)

Applies for inactive status by submitting an application on a form the EMS Board requires;

(3)

In the case of a paramedic [or a CRT initially licensed after June 30, 2001], fails to maintain continuous, active status registration with the National Registry of Emergency Medical Technicians [as a provider], unless the [provider] paramedic has requested and received an extension of the individual's license from MIEMSS[.]; or

(4)

Fails to complete a MIEMSS-approved technical proficiency verification for renewal.

An EMS clinician on inactive status may not provide emergency medical services in this State except in rare instances at the scene of a medical emergency.

An EMS clinician on inactive status may apply for active status if the individual:

(1)

Submits an application on a form the EMS Board requires;

(2)

Is affiliated with any required EMS operational program;

(3)

If applying for reinstatement as a paramedic, provides evidence of current active status registration as a paramedic with the National Registry of Emergency Medical Technicians; and

(4)

If the individual has been on inactive status for a period greater than 1 year, [attends a skills review session approved by MIEMSS, or conducted by an approved ALS training program.] completes the most recent protocol update course and a MIEMSS-approved technical proficiency verification.

A clinician whose license is on inactive status, as specified in §A, may apply for renewal if all other requirements for renewal are met.

Except in the instance of an EMS clinician on active military duty, inactive status does not affect the term of an EMS clinician's license or certificate.

An EMS clinician on active military duty may be granted an extended inactive status that shall end 1 year after the date of deactivation from active military duties that otherwise prevent the clinician from completing the requirements to maintain certification or licensure.

A fee is not charged to change from inactive to active status.

Regulation .09 Reinstatement.Link Copy Citation

An individual whose license or certificate has expired and who has failed to renew the license or certificate may be reinstated as an EMS clinician if all requirements for reinstatement are met.

An applicant for reinstatement as an EMS clinician shall apply for reinstatement:

(1)

As an emergency medical responder, not later than 3 years after the expiration of the applicant’s emergency medical responder certification, or at any time if the applicant has current active status registration as an emergency medical responder with the National Registry of Emergency Medical Technicians;

(2)

As an emergency medical technician, not later than 3 years after the expiration of the applicant’s emergency medical technician certification, or at any time if the applicant has active status registration as an emergency medical technician with the National Registry of Emergency Medical Technicians;

(3)

As an EMD, not later than 2 years after the expiration of the applicant’s EMD licensure, or at any time if the applicant has current active status registration with a nationally-recognized EMD program;

(4)

As a CRT, not later than 2 years after the expiration of the applicant’s CRT licensure, or at any time if the applicant has current active registration as a paramedic with the National Registry of Emergency Medical Technicians; or

(5)

As a paramedic, at any time if the applicant has current active status registration as a paramedic with the National Registry of Emergency Medical Technicians.

An applicant for reinstatement as an EMS clinician shall:

(1)

Successfully complete all requirements for renewal;

(2)

If applying for reinstatement as an EMD, emergency medical technician, CRT, or paramedic, be affiliated with an EMS operational program; and

(3)

If applying for reinstatement as an emergency medical technician, CRT, or paramedic, successfully complete a MIEMSS-approved EMS protocol orientation.

Upon fulfilling the requirements for reinstatement of a certificate or license, the date of expiration of the new certificate or license shall be:

(1)

The date of expiration of the certificate or license had not lapsed; or

(2)

The date of an initial certificate or license under Regulation .06 of this chapter if the expiration date of the lapsed certificate or license has passed.

Regulation .10 Surrender.Link Copy Citation

Subject to COMAR 30.02.05.13, an EMS provider who possesses a valid license or certificate issued by the EMS Board may surrender that license or certificate and be issued a license or certificate for a lower level of EMS provider licensure or certification which is valid for up to 1 year.

Regulation .11 Replacement.Link Copy Citation

A duplicate license or certificate shall be issued for a lost, stolen, or destroyed license or certificate upon:

Written request of the EMS provider; and

Payment of a fee of $5.

Regulation .12 Denials.Link Copy Citation

The EMS Board may deny a license or certificate to an individual who has engaged in prohibited conduct under COMAR 30.02.04.

Any proceedings concerning a complaint of misconduct by an applicant shall be in accordance with COMAR 30.02.05 and 30.02.06.

Procedures for Denial.

(1)

The EMS Board shall deny a license or certificate to individuals failing to submit the documentation or meet the standards and requirements established by statute or regulation for the licensing or certification of an EMS provider.

(2)

The EMS Board may delegate its functions under this section to MIEMSS.

(3)

Notice of denial of an application for initial licensure, certification, renewal or reinstatement of licensure or certification, or reciprocal licensure or certification under this section shall be sent to the applicant by first class mail at the address provided by the applicant on the application.

(4)

The denial notice shall inform the applicant of the:

(a)

Basis for the denial;

(b)

Applicant's right to request a hearing on the denial; and

(c)

Procedures for requesting a hearing.

Hearings under §C of this regulation shall be governed by COMAR 30.02.06.

Regulation .13 Requirements for Individuals with a Provisional License or Certificate to Obtain a Full License or Certificate.Link Copy Citation

A holder of a provisional EMS license or certificate issued pursuant to either the Executive Order Augmenting the Emergency Medical Services Workforce (Order Number 20-03-19-03) under authority of the Proclamation of March 5, 2020, as extended from time to time, in which the Governor of Maryland proclaimed that a state of emergency and catastrophic health emergency existed within the entire State of Maryland in an effort to control and prevent the spread of COVID-19, or the Executive Order Augmenting the Emergency Medical Services Workforce (Order Number 22-01-04-02) under authority of the Proclamation of January 4, 2022, as extended from time to time, in which the Governor of Maryland proclaimed that a state of emergency and catastrophic health emergency existed within the entire State of Maryland in an effort to control and prevent the spread of COVID-19, shall receive a license or certificate under Education Article, §13-516, Annotated Code of Maryland, provided the holder submits an application and completes the requirements set forth below within the required time frame and provided the holder does not have a pending disciplinary matter or is otherwise subject to denial. During the required time frame, the holder will remain provisionally licensed or certified and may continue to practice EMS. If the holder fails to submit an application or complete the requirements within the required time frame, the provisional certificate or license will expire.

Emergency Medical Technician.

(1)

Provisional EMT Certification Obtained as a Student.

(a)

A provisional EMT who obtained provisional EMT certification as a student shall complete the requirements of Regulation .03D of this chapter by May 11, 2022, if the provisional EMT certification was received prior to August 12, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022.

(b)

A provisional EMT who obtained provisional EMT certification as a student and who was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency shall have met the requirement to complete an internship under Regulation .03D(2) of this chapter.

(2)

Provisional EMT Certification Obtained via Reciprocity. A provisional EMT who obtained EMT certification via reciprocity shall by May 11, 2022, if the provisional EMT certification was received prior to August 12, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

(a)

If registered with the National Registry of Emergency Medical Technicians (NREMT) as an EMT, successfully complete a protocol review session approved by MIEMSS; or

(b)

If not registered with the NREMT as an EMT:

(i)

Document successful completion of 24 hours of EMS continuing education within the past 12 months; and

(ii)

Successfully complete a protocol review session approved by MIEMSS.

(3)

Provisional EMT Certification Obtained Through Reinstatement. A provisional EMT who held an expired EMT certificate and was reinstated with a provisional certificate shall meet the following requirements by May 11, 2022, if the provisional EMT certification was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

(a)

If the provisional EMT has previously passed the NREMT cognitive exam, the provisional EMT shall:

(i)

Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency; and

(ii)

Document successful completion of 24 hours of EMS continuing education in the past 12 months;

(b)

If the provisional EMT has never passed the NREMT cognitive examination and was lapsed for 1 year or less, the provisional EMT shall by May 11, 2022, if the provisional EMT certification was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

(i)

Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency; and

(ii)

Document successful completion of 24 hours of EMS continuing education within the past 12 months;

(c)

If the provisional EMT has never passed the NREMT cognitive examination and was lapsed for more than 1 year but not more than 3 years, the provisional EMT shall by May 22, 2022, if the provisional EMT certification was received prior to August 5, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

(i)

Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency;

(ii)

Document successful completion of 24 hours of EMS continuing education within the past 12 months; and

(iii)

Successfully complete the cognitive reinstatement examination approved by MIEMSS; or

(d)

If the provisional EMT has never passed the NREMT cognitive examination and was lapsed for more than 3 years, the provisional EMT shall by May 11, 2022, if the provisional EMT certification was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

(i)

Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency;

(ii)

Document successful completion of 24 hours of EMS continuing education within the past 12 months; and

(iii)

Successfully complete the cognitive and psychomotor reinstatement examinations approved by MIEMSS.

Paramedic.

(1)

Provisional Paramedic License Obtained as a Student. A provisional paramedic who obtained provisional licensure as a student shall:

(a)

Pass the NREMT cognitive examination by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022; and

(b)

Pass the NREMT psychomotor examination and document current active, nonprovisional status registration as a paramedic with the NREMT by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022.

(2)

Provisional Paramedic License Obtained via Reciprocity. A provisional paramedic who obtained provisional licensure via reciprocity shall by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022:

(a)

Document current active, nonprovisional status as a paramedic with the NREMT; and

(b)

Successfully complete a protocol review session approved by MIEMSS.

(3)

Provisional Paramedic License Obtained Through Reinstatement. A provisional paramedic who obtained provisional licensure through reinstatement shall by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022, provide documentation that while holding a provisional license the provisional paramedic was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency, and documentation of:

(a)

Both of the following:

(i)

Current active, nonprovisional status as a paramedic with the NREMT; and

(ii)

Successful completion of a protocol review session approved by MIEMSS; or

(b)

All of the following:

(i)

A passing score on the NREMT cognitive examination by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022;

(ii)

A passing score on the NREMT psychomotor examination and current active, nonprovisional status registration as a paramedic with the NREMT by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022; and

(iii)

Successful completion of a protocol review session approved by MIEMSS by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received by January 4, 2022.

Emergency Medical Responder.

(1)

Provisional EMR Certification Obtained as a Student. A provisional EMR who obtained EMR certification as a student shall complete the requirements of Regulation .03C of this chapter by May 11, 2022, if the provisional EMR certificate was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMR certificate was received by January 4, 2022.

(2)

Provisional EMR Certification Obtained Through Reinstatement. A provisional EMR who obtained provisional EMR certification through reinstatement shall by May 11, 2022, if the provisional EMR certificate was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMR certificate was received after January 4, 2022, provide documentation that the provisional EMR was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency.

(3)

Provisional EMR Certification Obtained via Reciprocity. A provisional EMR who obtained provisional EMR certification via reciprocity shall by May 11, 2022, if the provisional EMR certificate was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMR certificate was received after January 4, 2022, provide documentation that while holding the provisional certificate the provisional EMR affiliated with an EMS operational program and provided EMS during the catastrophic health emergency.

Cardiac Rescue Technician. Provisional CRT License Obtained Through Reinstatement. A provisional CRT who held an expired CRT license and was reinstated with a provisional license shall by May 11, 2022, if the provisional CRT license was received prior to August 15, 2021, or by November 30, 2022, if the provisional CRT license was received after January 4, 2022:

(1)

Document successful completion of 60 hours of continuing education equivalent to the requirements for National Registry paramedic renewal within the past 24 months; and

(2)

Successfully complete a protocol review session approved by MIEMSS.

Emergency Medical Dispatcher.

(1)

Provisional EMD License Obtained as a Student. A provisional EMD who obtained provisional EMD licensure as a student shall complete the requirements of COMAR 30.02.03.03G by May 11, 2022, if the provisional EMD license was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMD license was received by January 4, 2022.

(2)

Provisional EMD License Obtained via Reciprocity. A provisional EMD who obtained provisional licensure via reciprocity shall meet the requirements of Regulation .04D of this chapter by May 11, 2022, if the provisional EMD license was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMD license was received by January 4, 2022.

(3)

Provisional EMD Licensure Obtained Through Reinstatement. A provisional EMD who held an expired EMD license and was reinstated with a provisional EMD license shall meet the requirements of Regulation .09D of this chapter by May 11, 2022, if the provisional EMD license was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMD license was received by January 4, 2022.

Chapter 03. Scope of Practice and Duties

Regulation .01 Scope of Practice.Link Copy Citation

Except as provided in §B of this regulation, an EMS provider shall provide emergency medical services in accordance with the “Maryland Medical Protocols for EMS Providers”.

The following EMS providers shall provide emergency medical services in accordance with the procedures indicated in this section:

(1)

An EMD shall provide emergency medical dispatch services in accordance with the curriculum and protocols approved by the EMS Board for the EMD program with which the EMD is affiliated;

(2)

An emergency medical responder not utilizing an AED shall provide emergency medical services in accordance with the emergency medical responder curriculum approved by the EMS Board; and

(3)

An emergency medical responder utilizing an AED shall provide emergency medical services in accordance with the emergency medical responder curriculum approved by the EMS Board and the portions of the “Maryland Medical Protocols for EMS Providers” concerning use of an AED.

An EMS provider shall provide emergency medical services under the oversight of an EMS operational program except in rare instances when an EMS provider happens upon the scene of a medical emergency.

Regulation .02 Limitations upon Delegation.Link Copy Citation

This regulation governs the delegation of medical duties by a physician to an EMS provider while providing emergency medical services.

An EMS provider shall accept only that delegation which is in accordance with the regulations of the EMS Board.

Except as provided by standing orders consistent with the “Maryland Medical Protocols for EMS Providers”, an EMS provider may not accept physician delegation of the:

(1)

Ultimate responsibility for diagnosis or therapy; and

(2)

Duty of independently administering or dispensing drugs.

Chapter 04. Prohibited Conduct

Regulation .01 Prohibited Conduct.Link Copy Citation

The following conduct is prohibited:

Fraudulently or deceptively obtaining or attempting to obtain a certificate or license for oneself or for another;

Fraudulently or deceptively using a certificate or license;

Engaging in unprofessional or immoral conduct while providing emergency medical services;

Being adjudicated incompetent;

Abandoning a patient;

Habitual intoxication;

Addiction to or abuse of any narcotic or controlled dangerous substance as defined in Criminal Law Article, Annotated Code of Maryland, or abusing any other drug or substance in a manner that is harmful;

Providing emergency medical services while:

(1)

Under the influence of alcohol, or

(2)

Using any narcotic or controlled dangerous substance, as defined in Criminal Law Article, Annotated Code of Maryland, that is in excess of therapeutic amounts or without valid medical indication;

Willfully making or filing a false report or record related to the provision of emergency medical services;

Willfully failing to file or record, willfully impeding or obstructing the filing or recording, or willfully destroying a report required to be filed by statute or regulation;

Knowingly providing emergency medical services with an unauthorized individual, or knowingly aiding an unauthorized individual in providing emergency medical services;

Being disciplined by a licensing or disciplinary authority, or convicted or disciplined by a court of any state or country, or disciplined by any branch of the United States Government for an act that would be grounds for disciplinary action under this regulation;

Failing to meet or violating appropriate protocols or standards of care for the delivery of quality emergency medical services;

Willfully submitting false statements to collect fees;

As a result of an investigation or disciplinary action by a certifying, licensing, or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under this regulation:

(1)

Surrendering the certificate or license issued by the state or country, or

(2)

Allowing the certificate or license issued by the state or country to expire or lapse;

Knowingly failing to report suspected child abuse or neglect in violation of Family Law Article, §5-704, Annotated Code of Maryland, or abuse or neglect of a vulnerable adult under Family Law Article, §14-302, Annotated Code of Maryland;

Selling, prescribing, giving away, or administering drugs for illegal purposes;

Breaching patient confidentiality in violation of Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland;

Providing emergency medical services beyond the individual's authorized scope of practice;

Being convicted of or pleading guilty or nolo contendere to or receiving probation before judgment with respect to a felony, a serious crime of violence against a person, a crime involving controlled dangerous substances, a serious crime against property, a crime involving sexual misconduct, a crime in which the victim is a patient or other individual entrusted to the care or protection of the applicant or EMS provider, or a crime involving moral turpitude, whether any appeal or other proceeding is pending to have the conviction or plea set aside, except that the individual may apply for reinstatement upon any successful appeal or upon the conviction being set aside;

Providing or attempting to provide any medical procedure without having received the required education, internship, or experience in the use of the procedure, except as authorized in COMAR 30.02.03;

Refusing, withholding from, denying, or discriminating against an individual in need of emergency medical services, with regard to the provision of services which the licensee or certificate holder is licensed or certified and qualified to render because the individual is HIV positive;

Except in a situation when it is not feasible or practicable, failing to comply with the MIEMSS' guidelines on standard precautions;

Intentionally misrepresenting the level of emergency medical services licensure or certification held by the individual;

Failing to comply with terms of probation, suspension, or a disposition agreement;

Failing to comply with any regulations in this subtitle; or

AA.

For incidents occurring before January 1, 1999, any act prohibited under the applicable regulations of the Board of Physician Quality Assurance in effect at that time.

Regulation .02 Actions Taken as a Result of Prohibited Conduct.Link Copy Citation

Subject to the hearing provisions of Education Article, §13-516, Annotated Code of Maryland, and this chapter, the EMS Board may take the following actions against an EMS provider or an applicant who has engaged in prohibited conduct:

Reprimand or place an EMS provider on probation;

Suspend or revoke the license or certificate of an EMS provider;

Deny a license or certificate to an applicant; or

Refuse to renew an applicant's license or certificate.

Chapter 05. Disciplinary Procedures

Regulation .01 Scope.Link Copy Citation

This chapter governs procedures for disciplinary, licensing, and certification matters concerning EMS providers, applicants, and individuals providing emergency medical services without a license or certificate.

Regulation .02 Definitions.Link Copy Citation

In this chapter, the following terms have the meanings indicated.

Terms Defined.

(1)

“Case resolution conference” means a committee established in MIEMSS composed of one EMS Board member, an assistant attorney general, and MIEMSS staff which is available to a respondent as a means to explore the possibility of a consent order or other resolution of a matter before the EMS Board on a voluntary, informal, and confidential basis.

(2)

“Complaint” means a written report prepared for the provider review panel by the incident review committee based on an incident report which sets forth information which the incident review committee considers necessary to a proper review by the provider review panel and final action by the EMS Board.

(3)

“Disposition agreement” means a formal agreement, which may be nonpublic, in which a respondent agrees to comply with certain conditions and the EMS Board foregoes further investigation or other action.

(4)

Incident Report.

(a)

“Incident report” means a written allegation that an individual has committed an act or acts which violate Education Article, §13-516, Annotated Code of Maryland, or the regulations adopted under it.

(b)

“Incident report” includes:

(i)

Notification that an applicant for a license or certificate or a renewal is alleged to have committed an act or acts which violate Education Article, §13-516, or the regulations adopted under it;

(ii)

A law enforcement report;

(iii)

A report from a hospital or other medical facility;

(iv)

A report from another country, state, the armed services of the United States, a unit of State government, or a unit of local government;

(v)

A consumer complaint;

(vi)

A news article, report, or media tape;

(vii)

A malpractice claim;

(viii)

A Maryland Ambulance Information System runsheet; or

(ix)

Other information, from any source, that warrants investigation.

(5)

“Incident review committee” means a committee established in MIEMSS and composed of the State EMS Medical Director or designee, an assistant attorney general, and MIEMSS staff, including staff investigators, which acts on incident reports.

(6)

“Noncompliance notice” means a written notice of EMS Board action issued by the EMS Board to a respondent alleged to have committed an act or acts which violate Education Article, §13-516, Annotated Code of Maryland, or the regulations adopted under it, which sets forth:

(a)

The act or acts alleged;

(b)

The reason for the action;

(c)

The statutory or regulatory basis for the action;

(d)

The right of the respondent to request a hearing within 30 days of receipt of the noncompliance notice;

(e)

Notice that, if a hearing is not requested or if a hearing is requested and the respondent does not appear, the EMS Board will take the proposed action which is final and binding on the respondent; and

(f)

Further information as State Government Article, §10-207, Annotated Code of Maryland, may require.

(7)

“Provider review panel” means the body created by Education Article, §13-516(e), Annotated Code of Maryland, and Regulation .14 of this chapter.

(8)

“Respondent” means an individual against whom action is contemplated by the EMS Board.

Regulation .03 Investigation of Incident Reports.Link Copy Citation

An incident review committee investigator shall initially investigate each incident report. Upon completion of the investigation, as may be required, the incident review committee investigator shall refer the incident report, together with the results of the investigation, to the other members of the incident review committee.

If the incident report warrants summary action in the case of an EMS provider, the investigator shall promptly refer the incident report to the incident review committee for summary action under COMAR 30.02.07 pending further action under this regulation.

If the incident report warrants immediate action in the case of an individual providing emergency medical services without a license or certificate, the investigator shall promptly refer the incident report to the EMS Board which may seek injunctive relief from a court of competent jurisdiction. If the EMS Board elects to issue a cease and desist order, it shall issue a noncompliance notice and proceed under Regulation .05 of this chapter.

The incident review committee shall:

(1)

Review each incident report referred to it by the investigator together with the investigation results; and

(2)

Conduct further investigation as may be required.

Upon completion of its review, the incident review committee may:

(1)

Determine no further action is required;

(2)

Refer the matter to the appropriate EMS operational program for further investigation or action; or

(3)

Prepare a complaint which shall be referred:

(a)

If the respondent is not a licensed or certified EMS provider and is alleged to be providing emergency medical services, directly to the EMS Board,

(b)

If the respondent is a licensed or certified EMS provider or an applicant, to the provider review panel, or

(c)

If the respondent is licensed as a registered nurse or licensed practical nurse by the Board of Nursing, to the Board of Nursing.

Complaint Notification.

(1)

Submission of Complaint to Respondent. If a complaint is referred to the provider review panel, the incident review committee shall advise the respondent of the complaint by letter and afford the respondent the opportunity to provide the provider review panel with a written statement concerning the substance of the complaint. The letter shall be sent by certified and regular mail to the address the EMS provider or applicant maintains for purposes of licensure or certification notice, or any other last known address. If certified mail is twice returned unclaimed, service may be effected by delivery to each of the provider's affiliations of record shown on the records of MIEMSS.

(2)

Right to Representation. The respondent shall be notified of the respondent's right to be represented by an attorney admitted to practice law in Maryland when the complaint is sent to the respondent.

(3)

Entry of Appearance. In order to represent a respondent at any stage of a disciplinary matter before the EMS Board, an attorney shall file an entry of appearance in the matter and include the attorney's phone number and address.

MIEMSS may notify appropriate EMS operational programs of incident reports, complaints, noncompliance notices, or hearings.

Regulation .04 Review by the Provider Review Panel.Link Copy Citation

Upon review of each complaint referred to it by the incident review committee and any written statement provided by the respondent, the provider review panel shall recommend to the EMS Board any further action it considers necessary based upon the patient care and any allegations of misconduct.

Regulation .05 Action by the EMS Board.Link Copy Citation

Upon review of the complaint and any recommendations of the provider review panel together with the results of any investigations and any further inquiry the EMS Board may require, the EMS Board may:

(1)

Dismiss the complaint;

(2)

Request that the respondent enter into a disposition agreement with the EMS Board; or

(3)

Issue a noncompliance notice.

If the provider review panel does not affirmatively recommend disciplinary action of an EMS provider in cases concerning patient care, the EMS Board shall dismiss the complaint to the extent it relates to patient care.

Noncompliance Notice.

(1)

The noncompliance notice shall specify which of the following actions the EMS Board proposes to take:

(a)

Reprimand or probation;

(b)

Suspension or revocation of a license or certificate;

(c)

Denial of a license or certificate to an applicant;

(d)

Refusal to renew an applicant's license or certificate; or

(e)

Issuance of a cease and desist order.

(2)

The noncompliance notice shall specify whether the hearing will be delegated to the Office of Administrative Hearings. If the noncompliance notice does not delegate the hearing to the Office of Administrative Hearings, the hearing shall be conducted by the EMS Board.

(3)

The EMS Board shall serve the noncompliance notice on the EMS provider or applicant by hand delivery or certified and regular mail at the address the EMS provider or applicant maintains for purposes of licensure or certification notice, or any other last known address. If certified mail is twice returned unclaimed, service on a provider may be effected by delivery to each of the provider's affiliations of record shown on the records of MIEMSS.

(4)

An individual who is not an EMS provider or applicant shall be served by hand delivery or certified and regular mail at the person's last known address.

(5)

The individual effecting service shall complete a certificate of service attesting to the method and date of service.

(6)

Upon the issuance of a noncompliance notice, the EMS Board shall refer the matter to an assistant attorney general assigned to the EMS Board.

(7)

The EMS Board shall issue a final decision under the noncompliance notice if:

(a)

A hearing is not requested by the respondent within 30 days of receipt of the noncompliance notice;

(b)

After due notice, the respondent fails to appear; or

(c)

A request for a hearing is withdrawn.

(8)

A copy of the final decision shall be served on the respondent by certified and regular mail. If certified mail is twice returned unclaimed, service on a provider may be effected by delivery to each of the provider's affiliations of record shown on the records of MIEMSS.

(9)

If the respondent makes a timely request for a hearing, the body designated to conduct the hearing shall schedule a hearing and provide notice to all parties under State Government Article, §10-208, Annotated Code of Maryland.

Regulation .06 Case Resolution Conference.Link Copy Citation

After service of the noncompliance notice and upon receipt of a request for a hearing, the EMS Board shall offer the respondent an opportunity to resolve the matter through a case resolution conference.

If the matter is resolved through a case resolution conference, the EMS Board and the respondent shall enter into a disposition agreement setting forth the terms and conditions of the resolution.

If a resolution is not achieved after opportunity for a case resolution conference, the matter shall proceed to hearing.

Regulation .07 Hearing.Link Copy Citation

Except to the extent provisions of this chapter specifically provide for a different procedure, the hearing shall be conducted under the procedures set forth in COMAR 30.02.06.

At least 6 members of the EMS Board shall be present for EMS Board hearings under this chapter.

Regulation .08 EMS Board Action.Link Copy Citation

The EMS Board shall issue a final decision based on its findings of fact and conclusions of law upon:

(1)

Receipt of the decision of the administrative law judge and upon the conclusion of the exception process provided in COMAR 30.02.06.22, if any exceptions are filed; or

(2)

The conclusion of the hearing before the EMS Board, if the matter is heard by the EMS Board.

If the hearing has been delegated to the Office of Administrative Hearings, the EMS Board is the final decision maker and is not bound by the administrative law judge's proposed findings of fact, conclusions of law, or decision.

The EMS Board shall issue any disciplinary action against a respondent who is licensed as a registered nurse or licensed practical nurse by the Board of Nursing in accordance with the recommendation of the Board of Nursing for any complaint which has been referred to the Board of Nursing under Regulation .03 of this chapter.

A copy of the EMS Board's final decision shall be served on the respondent by certified and regular mail. If certified mail is twice returned unclaimed, service on a provider may be effected by delivery to each of the provider's affiliations of record shown on the records of MIEMSS.

Within 30 days of the date of the final decision of the EMS Board, either party may file a motion for reconsideration. The motion is granted at the EMS Board's discretion. There is no automatic right to a hearing on a motion for reconsideration before the EMS Board. The EMS Board may or may not ask for a response from the opposing party. If a party moves for reconsideration, the time for seeking judicial review is calculated from the date the EMS Board rules on the reconsideration motion.

When a final decision states a time for reinstatement of or reapplication for a license or certificate, the respondent shall petition the EMS Board for reinstatement or reapplication under the final decision. The respondent shall complete the appropriate forms, include the appropriate fee, and submit these to the EMS Board with the petition. When a time is not stated in the final decision, a petition for reinstatement or reapplication may not be entertained before 1 year after the date of the final decision. When reinstatement or reapplication is made contingent upon the occurrence of an event, the respondent shall establish the occurrence to the satisfaction of the EMS Board.

Regulation .09 Judicial Review.Link Copy Citation

A respondent may seek judicial review of the EMS Board's final decision under State Government Article, §10-222, Annotated Code of Maryland.

The EMS Board shall be party to the proceeding.

Regulation .10 Subpoenas.Link Copy Citation

At any stage of investigation and at any hearing, the EMS Board may issue a subpoena requiring a person to:

(1)

Testify under oath;

(2)

Answer interrogatories under oath;

(3)

Produce documents and tangible things; or

(4)

Permit inspection and copying of documents.

A subpoena shall:

(1)

Describe generally the nature of the investigation;

(2)

Specify the date, time, and place for the taking of required testimony;

(3)

Contain a copy of any interrogatories requiring answers;

(4)

Describe with reasonable specificity any things or documents to be produced together with the date, time, and place at which production is required;

(5)

Advise of the right to representation; and

(6)

Identify the individual who may be contacted on behalf of the EMS Board in reference to the subpoena.

A subpoena shall be issued over the signature of one of the following officials on behalf of the EMS Board:

(1)

Chair of the EMS Board;

(2)

Executive Director of MIEMSS;

(3)

Chair of the provider review panel; or

(4)

State EMS Medical Director.

Subpoenas to Corporations and Other Entities. A subpoena directed to a corporation, partnership, or other entity shall:

(1)

Describe with reasonable particularity the subject matter sought by the subpoena; and

(2)

Require that the entity designate one or more authorized individuals to provide the testimony, interrogatory answers, things, or documents requested by the subpoena.

Petition to Quash or Modify Subpoena.

(1)

A person served with a subpoena under this regulation may request that the subpoena be quashed or modified by filing a request in writing with the contact person identified in the subpoena within 10 days of service or before the action required by the subpoena, whichever is earlier. The request shall set forth good cause why the subpoena should be quashed or modified.

(2)

The EMS Board, upon any further inquiry it may require, shall act promptly on any petition to quash or modify the subpoena.

Enforcement of Subpoena. If a person fails to comply with a subpoena served under this regulation, the EMS Board may apply to a court of competent jurisdiction for punishment of contempt.

Service of Subpoena.

(1)

A subpoena may be served by hand delivery or certified mail.

(2)

The individual serving the subpoena shall complete a certificate of service attesting to the method and date of service.

Regulation .11 Oaths.Link Copy Citation

The Chair of the EMS Board, the Executive Director of MIEMSS, the Chair of the provider review panel, and the State EMS Medical Director may administer oaths in connection with any investigation or hearing under this subtitle.

If an individual, without lawful excuse, disobeys an order by the EMS Board to testify or answer a question, the EMS Board may apply to a court of competent jurisdiction for punishment for contempt.

Regulation .12 Representation.Link Copy Citation

The respondent may appear in proper person or be represented by counsel admitted to practice in Maryland in any matter before the EMS Board and during any stage of the proceedings.

An assistant attorney general shall present:

(1)

Evidence at evidentiary hearings; and

(2)

Arguments before the EMS Board.

Regulation .13 Licensure and Certification Pending EMS Board Action.Link Copy Citation

Unless the EMS Board agrees to accept the surrender of a license or certificate, a holder of a license or certificate may not surrender the license or certificate.

A license or certificate may not lapse by operation of law while:

(1)

The holder of the license or certificate is under investigation; or

(2)

Charges are pending against the holder of the license or certificate.

The EMS Board may set conditions on its agreement with the holder of the license or certificate under investigation or against whom charges are pending to accept the surrender of the license or certificate.

Regulation .14 Provider Review Panel.Link Copy Citation

The provider review panel consists of 11 voting members appointed by the EMS Board and 2 nonvoting members.

Appointed Members.

(1)

Provider Representatives.

(a)

Eight of the appointed members shall be licensed or certified emergency medical service providers who are actively providing emergency medical services at the time of their appointment.

(b)

In appointing the provider representatives, the EMS Board shall give consideration to providing for reasonable representation from throughout the State.

(c)

Three of these members shall be members of a governmental fire, rescue, or emergency medical services company.

(d)

Three of these members shall be members of a volunteer fire, rescue, or emergency services company.

(e)

One of these members shall be an employee of a commercial ambulance service.

(f)

One of these members shall be an emergency medical dispatcher.

(2)

One of the appointed members shall be a physician appointed by the Board of Physicians.

(3)

One of the appointed members shall be a medical director with emergency medical services experience.

(4)

One of the appointed members shall be a representative of the Medical and Chirurgical Faculty of the State of Maryland who has emergency medical services experience.

(5)

The appointed members shall serve terms of 4 years, except that the terms of the first appointed members shall be staggered by the Board as follows:

(a)

Four members shall serve a 4-year term;

(b)

Four members shall serve a 3-year term; and

(c)

Three members shall serve a 2-year term.

The Executive Director of MIEMSS and the State EMS Medical Director shall serve as nonvoting ex officio members.

The provider review panel shall elect a chair from among its members.

Provider Review Panel Action.

(1)

The provider review panel shall take action by majority vote when at least six voting members are present. Ordinarily at least six members shall be present in person in the same meeting room, provided that in infrequent urgent matters, with the concurrence of a majority of the provider review panel, including the PRP chair if available, the provider review panel may take action when at least six members are present in person or by phone.

(2)

When reviewing a complaint concerning an EMS provider:

(a)

At least one voting provider review panel member present shall be an EMS provider of the same level as the respondent; and

(b)

At least one voting provider review panel member present shall have the same governmental, volunteer, or commercial service affiliation as the respondent.

(3)

A tie vote on an issue is considered a recommendation that no action be taken.

The EMS Board may remove any member of the provider review panel for just cause.

Regulation .15 Right of Entry.Link Copy Citation

A duly authorized agent or investigator of the Board may enter, at any reasonable hour, a place of business of a licensed or certified emergency medical services provider or public premises if the entry is necessary to carry out a duty under this regulation or under Education Article, §13-516, Annotated Code of Maryland.

Regulation .16 Confidentiality and Admissibility of Proceedings, Records, and Files.Link Copy Citation

The incident review committee, the case review committee, the provider review panel, the case resolution conference, and, in connection with a disciplinary matter other than a hearing and the issuance of a final decision, the EMS Board, are medical review committees and committees in MIEMSS under Health Occupations Article, §1-401, Annotated Code of Maryland, and, except for formal noncompliance notices or as otherwise provided by law, their proceedings, records, and files are confidential, nondiscoverable, and nonadmissible as provided in Health Occupations Article, §§1-401 and 14-506, Annotated Code of Maryland.

To the extent possible, even after a final decision is entered by the EMS Board, the parties shall refrain from revealing legal documents, oral statements, or information that would reveal the identity of any patients referenced in the final decision.

Chapter 06. Hearings

Regulation .01 Scope.Link Copy Citation

This chapter contains procedures for administrative hearings concerning the licensure, certification, or discipline of EMS providers, applicants, and unlicensed or uncertified individuals before the EMS Board.

A hearing concerning summary suspensions shall be in accordance with COMAR 30.02.07.

A hearing before an administrative law judge of the Office of Administrative Hearings shall be conducted in accordance with the rules of procedure of the Office of Administrative Hearings in COMAR 28.02.01, and this chapter. To the extent that this chapter conflicts with COMAR 28.02.01, this chapter prevails.

Regulation .02 Definitions.Link Copy Citation

In this chapter, the following terms have the meanings indicated.

Terms Defined.

(1)

“Administrative law judge” has the meaning stated in COMAR 28.02.01.02.

(2)

“Party” means an individual or agency, including the EMS Board, named in an administrative proceeding before the EMS Board.

Regulation .03 Delegation of Hearing Authority.Link Copy Citation

The EMS Board may delegate authority to conduct a hearing to the Office of Administrative Hearings in accordance with State Government Article, §10-205(a), Annotated Code of Maryland.

Scope of Delegation. The EMS Board may delegate authority to the Office of Administrative Hearings to issue proposed findings of fact, proposed conclusions of law, or a proposed disposition.

Authority to Revoke Delegation. The EMS Board may revoke all or part of a delegation of authority to hear a contested case.

Criteria for Revocation. The EMS Board may revoke all or part of a delegation to the Office of Administrative Hearings if the case may:

(1)

Involve novel or unanticipated factual or legal issues;

(2)

Have significant social or fiscal consequences;

(3)

Involve policy issues of general applicability; or

(4)

Be likely to have precedential value.

Procedures for Revocation.

(1)

The EMS Board shall provide written notice of a revocation of hearing authority to all parties and the Office of Administrative Hearings. The written notice shall contain a brief statement of the reason for the revocation.

(2)

Delegation of authority to hear a contested case may be revoked at any time before the earlier occurrence of the following:

(a)

The issuance of a ruling by the administrative law judge on a substantive issue; or

(b)

The taking of oral testimony from the first witness.

(3)

The EMS Board shall specify whether all or part of the delegation to hear a contested case has been revoked.

(4)

If only part of the delegation has been revoked, the EMS Board shall specify in the written notice of revocation the portions of the contested case for which delegation is revoked.

(5)

A decision issued by the EMS Board shall reflect the fact that delegation to the Office of Administrative Hearings was revoked and a copy of the revocation notice shall be included as part of the record.

Procedures upon Revocation. If the EMS Board revokes the delegation to hear a contested case, the hearing shall be conducted by the EMS Board in accordance with this chapter within 90 days of the issuance of the revocation.

Regulation .04 Request for Hearing.Link Copy Citation

A written request for a hearing shall be filed with MIEMSS not later than 30 days from the date of the notice of the action.

A request for a hearing is considered filed on the earlier of the date the request is postmarked or when actually received by MIEMSS.

The request shall include the following:

(1)

The name, mailing address, and telephone number of the person filing the request and the person's attorney, if any;

(2)

The action, sanction, decision, or order being contested; and

(3)

A brief statement of the basis for the request for hearing and other information required by law.

A request for hearing shall be signed by the party or the party's attorney.

If a hearing request is received without the necessary information, or is otherwise improper, MIEMSS may:

(1)

Return the request;

(2)

Require submission of supplemental information; or

(3)

Require an amended request.

In any matter that has been delegated to the Office of Administrative hearings, within 15 days of receiving a request for a hearing, MIEMSS shall forward the request to the Office of Administrative Hearings.

In any matter that has not been delegated to the Office of Administrative Hearings, MIEMSS shall forward the request to the Chair of the EMS Board within 15 days.

Regulation .05 Notice of Hearing.Link Copy Citation

The EMS Board or Office of Administrative Hearings, as appropriate, shall give written notice of the hearing of a contested case to the respondent in accordance with State Government Article, §10-208, Annotated Code.

Regulation .06 Service.Link Copy Citation

Unless otherwise required by law, service of the following documents shall be made by personal delivery, by certified mail, or by regular mail:

(1)

Notice of the hearing;

(2)

Default orders;

(3)

Prehearing orders;

(4)

Final decisions;

(5)

Exceptions to proposed decisions; and

(6)

Appeals of final decisions.

Service upon a party to whom a certificate or license has been issued by the EMS Board may be made by delivering a copy to the:

(1)

Most recent address provided by that party to MIEMSS; or

(2)

Address of the individual's attorney of record.

Service upon or filing with the EMS Board may be made by delivering the document to the Office of the Executive Director at MIEMSS.

Proof of Service. The individual serving a document shall certify:

(1)

To whom the document was sent or delivered;

(2)

The address to which the copy was sent or delivered;

(3)

The date the copy was sent or delivered;

(4)

The manner of service; and

(5)

The name of the person who sent or delivered the document.

Absent evidence to the contrary, it is presumed that any document served by mail in accordance with these regulations was received by the addressee 3 days after the date the document was mailed.

Regulation .07 Representation.Link Copy Citation

The respondent may appear in proper person or be represented by counsel who is authorized to practice law in Maryland.

Regulation .08 Discovery.Link Copy Citation

Not later than 20 days before the scheduled hearing, each party shall provide all other parties with a list of all witnesses, including expert witnesses, who are expected to testify for that party at the hearing.

With respect to any matter which is relevant to the subject matter of the hearing and which is not privileged or otherwise nondiscoverable, a party, by written request served upon all other parties and filed with the EMS Board or Office of Administrative Hearings, as appropriate, not later than 30 days before the scheduled hearing, may require any other party to:

(1)

Produce within 15 days, for inspection or copying, any file, memorandum, correspondence, document, expert report, object, or tangible thing; and

(2)

Respond to not more than 15 interrogatories, which will be counted separately irrespective of the manner in which they are grouped, combined, or arranged.

Stipulations. The parties by written stipulation may modify the discovery procedures provided by this chapter, except that the parties may not modify any discovery procedure if the effect of the modification would be to impair or delay:

(1)

A prehearing conference;

(2)

An order specifying the time for filing a motion or other paper; or

(3)

The hearing.

Sanctions.

(1)

The EMS Board or administrative law judge, as appropriate, may impose sanctions against any party for failing to:

(a)

Provide all other parties with a list of all witnesses, including expert witnesses; and

(b)

Fully comply with a discovery request.

(2)

The sanctions may include, but are not limited to:

(a)

Refusing to admit the testimony of a witness who was not disclosed as required by this chapter;

(b)

Refusing to admit a report prepared by an expert;

(c)

Refusing the failing party the ability to support or oppose designated claims, defenses, or matters by introducing any documentary or testimonial evidence that was not disclosed under a discovery request; and

(d)

Dismissing the contested case.

Unless otherwise provided by law or by agreement of the parties, no other discovery procedure may be noticed.

Copies of requested documents and records shall be made at the expense of the party making the request.

Regulation .09 Prehearing Conference.Link Copy Citation

The EMS Board or the administrative law judge, as appropriate, may hold a prehearing conference to resolve matters preliminary to the hearing.

The EMS Board or the administrative law judge, as appropriate, may require the parties to submit information before the prehearing conference.

The EMS Board or the administrative law judge, as appropriate, may order that each party make available to the other parties the names and written reports of experts and other witnesses the party expects to call as well as copies of the documents that will be used for direct examination during the hearing. Failure to comply in good faith with this order is grounds to refuse to admit:

(1)

A report of that expert; or

(2)

Any document not furnished to the other parties.

A prehearing conference may be convened to address the following matters:

(1)

Factual and legal issues;

(2)

Stipulations and admissions of fact;

(3)

Stipulations as to the authenticity and admissibility of documents;

(4)

Requests for official notice;

(5)

Identification and exchange of documentary evidence;

(6)

Admissibility of evidence;

(7)

Identification and qualification of witnesses;

(8)

Motions;

(9)

Discovery disputes;

(10)

Order of presentation;

(11)

Scheduling;

(12)

Settlement possibilities or conferences; and

(13)

Any other matter than will promote the orderly and prompt conduct of the hearing.

Conduct.

(1)

At the discretion of the EMS Board or the administrative law judge, as appropriate, all or part of the prehearing conference may be recorded.

(2)

The prehearing conference may be conducted by telephone, video, or other electronic means.

Prehearing Orders.

(1)

The EMS Board or the administrative law judge, as appropriate, may issue a prehearing order addressing any matter raised at the prehearing conference.

(2)

The prehearing order is part of the record.

(3)

Whether or not a prehearing conference is held, the EMS Board or the administrative law judge, as appropriate, may issue a prehearing order to regulate the conduct of the proceedings.

All parties shall be bound by the EMS Board's or administrative law judge's prehearing order regardless of whether a party attends a prehearing conference.

Regulation .10 Stipulations and Affidavits.Link Copy Citation

Stipulations.

(1)

The parties, by stipulation, may agree to any substantive or procedural matter.

(2)

A stipulation may be filed in writing or entered on the record at the hearing.

Affidavits. The EMS Board or the administrative law judge, as appropriate, may admit an affidavit as evidence.

Regulation .11 Subpoenas.Link Copy Citation

Issuance of Subpoenas. In addition to any authority to issue subpoenas in COMAR 30.02.05.10, upon the request of a party, the EMS Board or Office of Administrative Hearings, as appropriate, may issue subpoenas requiring the attendance and testimony of witnesses and production of documents or tangible items at any hearing.

Request for Subpoenas.

(1)

A request for issuance of a subpoena shall:

(a)

Be made in writing to the EMS Board or Office of Administrative Hearings, as appropriate; and

(b)

State:

(i)

The name and address of the individual to be subpoenaed,

(ii)

If production of documents or tangible items is sought, a particular description of the documents or tangible items sought, and

(iii)

The name, address, and telephone number of the party requesting the subpoena; and

(c)

Be mailed to each party.

(2)

To the extent practicable, a request for subpoena shall be filed at least 30 days before:

(a)

A prehearing conference, if one has been scheduled; or

(b)

The hearing, if no prehearing conference has been scheduled.

Service of Subpoenas. A subpoena may be served by personal service, by certified mail, or by mail.

If the subpoena is served by an individual other than the Office of Administrative Hearings, a certificate of service attesting to the method of service and date of service shall be filed with the EMS Board or Office of Administrative Hearings, as appropriate.

Objections to Subpoenas. A party or an individual who has been served a subpoena may object to the subpoena by filing a motion to modify or quash the subpoena within 10 days of service of the subpoena or by the date of the hearing, whichever is earlier.

Regulation .12 Motions.Link Copy Citation

Process.

(1)

Unless otherwise provided by this chapter, a party:

(a)

May move for appropriate relief before or during a hearing; and

(b)

Shall submit all motions in writing in accordance with §A(2) of this regulation, or orally at a hearing.

(2)

A written motion shall:

(a)

Be filed not later than:

(i)

10 days before the date of a prehearing conference, or

(ii)

20 days before the date of the hearing;

(b)

State concisely the question to be determined;

(c)

Be accompanied by all supporting documentation;

(d)

Be accompanied by a memorandum of points and authorities; and

(e)

Be served on each party.

(3)

A response to a written motion shall be filed on the earlier of:

(a)

10 days after service of the motion; or

(b)

The date of the hearing.

(4)

The EMS Board or the administrative law judge, as appropriate, may schedule a hearing to consider a written motion.

(5)

Decision.

(a)

The EMS Board or the administrative law judge, as appropriate, may reserve ruling on a motion until after a hearing.

(b)

The EMS Board may issue a written decision or state the decision on the record.

(c)

The administrative law judge may issue a ruling on the motion.

(d)

If a ruling on a motion is reserved, the ruling shall be in writing and may be included in the final decision.

(6)

Failure of a party to attend a scheduled hearing may be grounds for a decision adverse to that party.

(7)

The filing or pendency of a motion does not alter or extend any time limit otherwise established by this chapter.

Motion to Dismiss. Upon motion, the EMS Board or the administrative law judge, as appropriate, may issue a proposed decision or final decision dismissing:

(1)

An agency action; or

(2)

A request for hearing which fails to state a claim for which agency relief may be granted.

Motion for Summary Decision.

(1)

A party may move for summary decision on any substantive issue in the case.

(2)

Upon written motion, a proposed decision or a final decision may dismiss a request for hearing if the EMS Board or the administrative law judge, as appropriate, finds that:

(a)

There is no genuine issue as to any material fact; and

(b)

The moving party is entitled to prevail as a matter of law.

Motion for Postponement.

(1)

The EMS Board or the administrative law judge, as appropriate, may postpone or continue a hearing:

(a)

For good cause; or

(b)

Upon a joint request of the parties.

(2)

Absent extenuating circumstances, a hearing may be postponed only upon written request filed not later than 10 days before the hearing and served on all parties.

(3)

The failure of the respondent to retain counsel or to timely request a subpoena is not considered good cause for the purposes of a postponement.

(4)

Upon postponement, the hearing shall be rescheduled for a date certain.

Regulation .13 Conduct of Hearings.Link Copy Citation

On a genuine issue in a contested case, each party is entitled to:

(1)

Call witnesses;

(2)

Offer evidence, including rebuttal evidence;

(3)

Cross-examine opposing witnesses; and

(4)

Make opening and closing statements.

Telephone Hearings.

(1)

The EMS Board or the administrative law judge, as appropriate, may conduct all or part of the hearing by telephone, video conferencing, or other electronic means, by consent of all parties.

(2)

All substantive and procedural rights apply to telephone, video or other electronic hearings, subject only to the limitations of the physical arrangement.

(3)

Documentary Evidence. For a telephone hearing, a party shall provide documentary evidence to be offered to all parties so that it is received by each party and the EMS Board or the administrative law judge, as appropriate, at least 5 days before the hearing.

(4)

Default. For a telephone hearing, the following may be considered a failure to appear and grounds for a default:

(a)

Failure to answer the telephone for 15 minutes;

(b)

Failure to free the telephone for a hearing; or

(c)

Any other failure without good cause to be ready to proceed with the hearing as scheduled.

At least 6 members of the EMS Board shall be present for EMS Board hearings.

Regulation .14 Evidence.Link Copy Citation

Evidence shall be admitted in accordance with this chapter and State Government Article, §10-213, Annotated Code of Maryland.

Evidence may not be excluded solely on the grounds that it is hearsay.

Exclusion of Witnesses.

(1)

Upon request by a party, the EMS Board or the administrative law judge, as appropriate, may exclude witnesses other than parties from the hearing room.

(2)

The EMS Board or the administrative law judge, as appropriate, may order the witnesses, parties, attorneys, and all others present in the hearing room not to disclose to any witness excluded under this section the nature, substance, or purpose of testimony, exhibits, or other evidence introduced during the witness' absence.

(3)

An expert witness who is to render an opinion based on testimony given at the hearing may remain during the testimony.

Prefiled Testimony.

(1)

In the discretion of the EMS Board or the administrative law judge, as appropriate, testimony may be received in written form.

(2)

The testimony shall be filed with the EMS Board or the administrative law judge, as appropriate, and served on opposing parties so that it is received at least 5 days before the hearing.

Regulation .15 Expert Testimony.Link Copy Citation

Expert testimony may be accepted by the EMS Board or the administrative law judge, as appropriate, if the testimony, as proffered, would aid in an understanding of the case.

Regulation .16 Appointment of Interpreter.Link Copy Citation

If a party or witness cannot readily hear, speak, or understand the spoken or written English language, on motion timely submitted, the EMS Board or the administrative law judge, as appropriate, shall appoint a qualified interpreter to provide assistance during the hearing.

An interpreter shall take an oath or affirmation that the interpreter will accurately translate.

Regulation .17 Failure to Attend Hearing and Default.Link Copy Citation

If, after receiving notice, a party fails to attend a prehearing conference, hearing, or other scheduled proceeding, the EMS Board may issue a final decision or the administrative law judge may issue a proposed decision, as appropriate, against the defaulting party.

Within 7 days after service of a default order, the party may file a written motion:

(1)

Requesting that the default order be vacated or modified; and

(2)

Stating the grounds for the request.

If the EMS Board or administrative law judge, as appropriate, finds that there is a substantial and sufficient basis for an actual controversy on the merits and that there is good cause to excuse the default, the EMS Board or administrative law judge, as appropriate, may vacate the default order.

A final default order is:

(1)

A final decision; and

(2)

Reviewable as a final decision.

Regulation .18 Burdens of Going Forward and Persuasion.Link Copy Citation

In any proceeding under this chapter, the EMS Board bears the burden of going forward to establish a prima facie case as to the existence of grounds for its action.

In a proceeding following notice by the EMS Board that the EMS Board intends to suspend or revoke a certificate or license, the EMS Board bears the burden or persuasion that the certificate or license should be revoked or suspended.

In a proceeding to issue an order for sanctions, the EMS Board bears the burden of persuasion that the order be issued.

In a proceeding following notice that the EMS Board intends to deny licensure or certification or renewal of a license or certificate, the individual has the burden of persuasion that the license or certificate should be issued or renewed.

The EMS Board or the administrative law judge, as appropriate, shall find against a party with the burden of:

(1)

Going forward if that party has not presented sufficient evidence to establish a prima facie case for the party's claim or defense; or

(2)

Persuasion if that party has not presented evidence sufficient to establish the correctness of the party's claim or defense by a preponderance of the evidence.

Regulation .19 Record of Hearings.Link Copy Citation

The EMS Board or the Office of Administrative Hearings, as appropriate, shall prepare an official record of each hearing.

The record shall consist of:

(1)

Any document giving rise to the proceeding;

(2)

Any request for the hearing;

(3)

Notices of all proceedings;

(4)

Any prehearing order;

(5)

Motions, pleadings, briefs, petitions, requests, and intermediate rulings;

(6)

Evidence received or considered;

(7)

A statement of each fact officially noticed;

(8)

Proffers of proof, objections, and rulings on them;

(9)

Proposed and final findings of fact, conclusions of law, and requested orders;

(10)

Matters placed on the record after an ex parte communication;

(11)

A recording of the hearing, any transcript of the recording, or any transcript prepared by a court reporting service; and

(12)

Any order.

Regulation .20 Ex Parte Communications.Link Copy Citation

A party or a party's representative may not communicate ex parte with members of the EMS Board or an administrative law judge regarding the merits of any issue in the hearing.

Members of the EMS Board may communicate with:

(1)

MIEMSS staff or the Office of Administrative Hearings staff who otherwise do not participate in the contested case; or

(2)

Any counsel for the EMS Board who otherwise does not participate in the contested case.

Actions taken by the EMS Board or an administrative law judge following an ex parte communication shall be governed by State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland.

Regulation .21 Transcripts, Costs.Link Copy Citation

The hearing shall be recorded by tape recording.

Transcript. If a party requests a transcript of the hearing, the requesting party shall bear the cost of transcription.

Regulation .22 Proposed Orders; Exceptions.Link Copy Citation

In any matter which has been delegated to the Office of Administrative Hearings, the administrative law judge shall issue proposed findings of fact and conclusions of law and a proposed decision which shall be served upon the parties.

In any matter which has been delegated to the Office of Administrative Hearings, the parties may file exceptions with the EMS Board within 20 days of receiving the proposed decision. A response to the exceptions may be filed within 15 days from the filing of the exceptions. If either party orders a transcript of the hearing before the Office of Administrative Hearings within 10 days of receiving the proposed decision, the time for filing exceptions is automatically extended to 20 days from the date the transcript is received.

The exceptions or response shall:

(1)

Contain the legal and factual basis for the exceptions or response; and

(2)

Be accompanied by copies of any portions of the record referred to in the exceptions.

A party who desires a transcript to be made a part of the proceedings shall, at the party's own expense, file a copy of the transcript with the EMS Board.

Upon a showing of good cause, the EMS Board may grant an extension for the filing of exceptions or any response.

The parties may request oral argument on the exceptions.

If oral argument is requested, a hearing shall be set as soon as practicable and all parties shall be notified of the date, time, and place for oral argument.

The presiding officer, ordinarily the Chair or Vice-Chair of the EMS Board, may limit the time given to each party for oral argument.

The presiding officer, ordinarily the Chair or Vice-Chair of the EMS Board, shall determine all procedural issues and may make any rulings necessary to facilitate the effective and efficient consideration of the exceptions.

If oral argument is not requested the EMS Board shall:

(1)

Consider the matter as soon as practicable; and

(2)

Notify all parties of the date that the matter will be considered.

The entire record shall be provided to the Chair of the EMS Board before consideration of the exceptions.

Copies of the exceptions, responses, and any accompanying documents shall be provided to the EMS Board at least 5 days before the matter is to be considered.

Additional evidence may not be introduced upon consideration of exceptions unless the party seeking to introduce it:

(1)

Requests leave to submit the evidence at least 15 days before the EMS Board considers the exceptions; and

(2)

Demonstrates to the satisfaction of the EMS Board that the new evidence:

(a)

Is relevant and material,

(b)

Was not discovered before the hearing, and

(c)

Could not have been discovered before the hearing with the exercise of due diligence.

A majority of the EMS Board shall be present to consider the exceptions.

Regulation .23 Final Decision.Link Copy Citation

In any matter which has been delegated to the Office of Administrative Hearings after considering the record and any exceptions, the EMS Board by majority vote of those present shall:

(1)

Adopt the proposed decision as the final decision of the agency;

(2)

Modify the proposed findings of fact, proposed conclusions of law, or proposed disposition, in whole or in part, and then adopt the modified proposed decision as the final decision of the agency;

(3)

Reverse the proposed decision and issue its own findings of fact, conclusions of law, or order; or

(4)

Remand the matter for further proceedings.

In any matter which has not been delegated to the Office of Administrative Hearings as soon as practicable after the conclusion of the hearing, the EMS Board shall issue a written decision.

The decision of the EMS Board is the final decision of the agency for purposes of judicial review. Unless the matter is remanded for further proceedings, or a motion for reconsideration is filed, the date of the written decision of the EMS Board is the date of the final decision of the agency for purposes of judicial review.

A final decision shall:

(1)

Be in writing;

(2)

Be served on all parties; and

(3)

Contain:

(a)

Findings of fact and conclusions of law, separately stated,

(b)

An order, and

(c)

A statement of the available procedures and time limitations for review.

Regulation .24 Reconsideration.Link Copy Citation

In the event of fraud, mistake, or irregularity, a final decision may be reconsidered and corrected at any time.

Regulation .25 Judicial Review.Link Copy Citation

A party who is aggrieved by a final decision is entitled to judicial review in accordance with State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. The EMS Board shall be a party to the proceeding.

Chapter 07. Summary Suspension of License or Certification

Regulation .01 Scope.Link Copy Citation

This chapter governs summary procedures for suspending an EMS provider license or certificate to protect the public health, safety, or welfare.

Regulation .02 Summary Action.Link Copy Citation

State Government Article, §10-226(c), Annotated Code of Maryland, governs summary suspension of a license or certificate.

If the incident review committee finds, based on information gathered during an investigation, that the public health, safety, or welfare imperatively requires emergency action pending further action under COMAR 30.02.05:

(1)

The incident review committee shall notify the chair of the provider review panel, the State EMS Medical Director, the Executive Director of MIEMSS, and the Chair of the EMS Board, or their designees, of that finding on an expedited basis; and

(2)

Upon the recommendation of the Chair of the provider review panel or the Chair's designee and the recommendation of the State EMS Medical Director or the Director's designee and upon any further inquiry as they may require, the license or certification of an EMS provider may be summarily suspended pending further action under COMAR 30.02.05.

Regulation .03 Procedure for Summary Suspension after Notice and an Opportunity To Be Heard.Link Copy Citation

The Executive Director of MIEMSS or the Director's designee and the Chair of the EMS Board or the Chair's designee shall issue a written summary suspension notice to the respondent that:

(1)

Includes the proposed summary suspension order which shall state the:

(a)

Statutory and regulatory authority upon which it is based,

(b)

Facts upon which it is based, and

(c)

Summary action which is to be taken;

(2)

Provides the respondent the right to show cause why the proposed summary suspension order should not be issued;

(3)

Advises the respondent of the right:

(a)

To a summary suspension hearing within 5 business days of receipt of the summary suspension notice and how to request a hearing,

(b)

To a full evidentiary hearing to review any summary suspension which is ordered following a summary suspension hearing and how to request a hearing,

(c)

To review by a circuit court if the respondent has exhausted the administrative remedies provided in this regulation,

(d)

To representation by counsel,

(e)

To call witnesses and submit documents under State Government Article, §10-213(f), Annotated Code of Maryland,

(f)

To subpoena witnesses and other evidence subject to payment of the actual cost of service, and

(g)

Of the parties to agree on the evidence and waive the right to appear at the hearing;

(4)

Advises the respondent that if a summary suspension hearing is not requested or if a hearing is requested and the respondent does not appear, the summary suspension will be entered as provided in the proposed summary suspension order and will be final and binding until further action by the EMS Board under COMAR 30.02.05; and

(5)

Provides further information as required by State Government Article, §10-207, Annotated Code of Maryland.

Service of the summary suspension notice and proposed summary suspension order shall be by personal delivery.

Regulation .04 Procedure for Summary Suspension before Notice and an Opportunity To Be Heard.Link Copy Citation

The Executive Director of MIEMSS or the Director's designee and the Chair of the EMS Board or the Chair's designee, after consultation with the EMS Board's counsel, may order immediate suspension of a license or certification before notice and the opportunity for a hearing if:

(1)

They determine that the health, safety, and welfare of the public or the respondent imperatively requires immediate suspension;

(2)

The respondent is provided the opportunity for a summary suspension hearing within 5 business days of notice of the summary suspension; and

(3)

Notice of the summary suspension and the summary suspension order is served on the respondent as soon as reasonably practical.

The Executive Director of MIEMSS or the Director's designee and the Chair of the EMS Board or the Chair's designee may issue an order that suspends the respondent's license or certification pending further action by the EMS Board under COMAR 30.02.05. The order shall include the:

(1)

Statutory and regulatory authority upon which it is based;

(2)

Facts upon which it is based; and

(3)

Summary action which has been taken.

The Executive Director of MIEMSS or the Director's designee and the Chair of the EMS Board or the Chair's designee shall then issue a written summary suspension notice to the respondent that:

(1)

Includes a copy of the order for summary suspension;

(2)

Provides the respondent the right to show cause why the summary suspension order should be rescinded;

(3)

Advises the respondent of the right:

(a)

To a summary suspension hearing within 5 business days of receipt of the summary suspension notice and how to request a hearing,

(b)

To a full evidentiary hearing to review any summary suspension which is ordered or reaffirmed following a summary suspension hearing and how to request a hearing,

(c)

To review by a circuit court if the respondent has exhausted the administrative remedies provided in this regulation,

(d)

To representation by counsel,

(e)

To call witnesses and submit documents under State Government Article, §10-213(f), Annotated Code of Maryland,

(f)

To subpoena witnesses and other evidence subject to payment of the actual cost of service, and

(g)

Of the parties to agree on the evidence and waive the right to appear at the hearing;

(4)

Advises the respondent that if a summary suspension hearing is not requested or if a hearing is requested and the respondent does not appear, the summary suspension order will be final and binding until further action by the EMS Board under COMAR 30.02.05; and

(5)

Provides further information as required by State Government Article, §10-207, Annotated Code of Maryland.

Service of the summary suspension notice and order shall be as soon as reasonably practical by personal delivery.

Regulation .05 Representation.Link Copy Citation

The respondent may appear in proper person or be represented by counsel admitted to practice in Maryland in any matter before the EMS Board and during any stage of the proceedings.

An assistant attorney general shall present the case.

Regulation .06 Summary Suspension Hearing.Link Copy Citation

If a respondent requests a summary suspension hearing, the hearing shall be held within 5 business days of the receipt of the summary suspension notice by the respondent unless all parties agree to a later hearing date. The Executive Director of MIEMSS shall give all parties notice of the summary suspension hearing date and other information as required by State Government Article, §10-208, Annotated Code of Maryland.

The summary suspension hearing shall be conducted by:

(1)

The Executive Director of MIEMSS or in the absence of the Executive Director of MIEMSS, the State EMS Medical Director; or in the absence of both the Executive Medical Director of MIEMSS and the State EMS Medical Director, the administrative officer of MIEMSS; and

(2)

The Chair of the EMS Board or, in the absence of the Chair of the EMS Board, some other member of the EMS Board.

Unless otherwise ordered by the individuals conducting the summary suspension hearing, the presentation of each side shall be limited to 30 minutes.

Oral presentation and documents shall be relevant and not unduly repetitious.

The individuals conducting the summary suspension hearing may question the parties and any witnesses.

After the hearing the individuals conducting the summary suspension hearing shall:

(1)

Order or reaffirm a summary suspension if it is established by a preponderance of the evidence that the health, safety, and welfare of the public imperatively requires that the provider's license or certificate be suspended;

(2)

Deny or rescind a summary suspension;

(3)

Enter any order to which the parties may agree; or

(4)

Enter an interim order as the circumstances may warrant.

Copies of the action taken shall be served on all parties by certified and regular mail at their addresses of record. If certified mail is twice returned unclaimed, service may be effected by delivery to each of the provider's affiliations of record shown on the records of MIEMSS.

All records, files, and other documents exchanged between parties in the course of a summary suspension hearing and preparation for a summary suspension hearing are considered subject to a confidentiality order prohibiting disclosure to anyone except the parties and their counsels of record unless otherwise agreed in writing by the parties.

Regulation .07 Evidentiary Hearing.Link Copy Citation

A respondent who has requested a summary suspension hearing may, within 10 days of the issuance of a summary suspension order or order reaffirming a summary suspension, request a full evidentiary hearing.

At least 6 members of the EMS Board shall be present for a full evidentiary hearing before the EMS Board.

If a full evidentiary hearing is requested, the EMS Board, if it so elects, may expedite the pending proceeding under COMAR 30.02.05 so that the hearing under COMAR 30.02.05.07 is combined with the full evidentiary hearing on the summary suspension order. The EMS Board may issue a final decision on the merits.

If a full evidentiary hearing is requested by the respondent, the EMS Board shall give all parties notice of the hearing date and other information as required by State Government Article, §10-208, Annotated Code of Maryland. The notice shall also state whether the EMS Board has expedited the COMAR 30.02.05.07 hearing so that the matter is finally resolved with a single EMS Board hearing if the EMS Board has so elected.

The full evidentiary hearing is conducted under COMAR 30.02.06, except that the provisions of this chapter govern if there is any conflict between this chapter and COMAR 30.20.06.

The full evidentiary hearing shall take place within 60 days of the request for a full evidentiary hearing unless the parties agree to a later date.

The EMS Board may delegate the full evidentiary hearing to the Office of Administrative Hearings by written notice to the respondent within 10 days of the respondent's request for an evidentiary hearing.

If the full evidentiary hearing is before the Office of Administrative Hearings, after the hearing, the administrative law judge shall provide the EMS Board with proposed findings of fact and conclusions of law and a proposed disposition.

The EMS Board is the final decision maker and is not bound by the proposed decision of the administrative law judge.

Upon receipt of the decision of the administrative law judge and upon the conclusion of the exception process provided in COMAR 30.02.06.22, if any exceptions are filed, or, if the hearing is before the EMS Board, upon the conclusion of the hearing before the EMS Board, the EMS Board shall issue a final decision based on its findings of fact and conclusions of law which shall be served on the respondent by certified and regular mail.

Within 30 days of the final decision of the EMS Board, either party may file a motion for reconsideration which is granted at the EMS Board's discretion.

There is no automatic right to a reconsideration hearing before the Board.

The EMS Board may or may not ask for a response from the opposing party.

If a party moves for reconsideration, the time for seeking judicial review of the EMS Board's final decision is calculated from the date the EMS Board rules on the reconsideration motion.

The EMS Board shall rule promptly on a motion for reconsideration.

Regulation .08 Judicial Review.Link Copy Citation

A respondent who has exhausted the administrative remedies under this chapter may seek judicial review of EMS Board action under State Government Article, §10-222, Annotated Code of Maryland.

The EMS Board shall be a party to the proceeding.

Regulation .09 Notice.Link Copy Citation

Except as otherwise provided in this chapter, notice shall be by certified and regular mail.

Notice to an EMS provider shall be mailed to:

(1)

The address the EMS provider maintains for purposes of licensure or certification notice; or

(2)

Any other last known address.

Notice to any other person shall be to the person's last known address.

Regulation .10 Confidentiality.Link Copy Citation

Summary suspension proceedings are subject to the confidentiality provisions of this chapter and COMAR 30.02.05.16.

Title 30 — Subtitle 02. Emergency Medical Services Providers

Chapter 01. Definitions

Regulation .01 Definitions.LinkCopy Citation

Chapter 02. Licensure and Certification

Regulation .01 Application.LinkCopy Citation

Regulation .02 Fees.LinkCopy Citation

Regulation .03 Requirements.LinkCopy Citation

Regulation .04 Reciprocity.LinkCopy Citation

Regulation .05 Examination and Reexamination.LinkCopy Citation

Regulation .06 Issuance of License or Certificate.LinkCopy Citation

Regulation .07 Renewal.LinkCopy Citation

Regulation .08 Inactive Status.LinkCopy Citation

Regulation .09 Reinstatement.LinkCopy Citation

Regulation .10 Surrender.LinkCopy Citation

Regulation .11 Replacement.LinkCopy Citation

Regulation .12 Denials.LinkCopy Citation

Regulation .13 Requirements for Individuals with a Provisional License or Certificate to Obtain a Full License or Certificate.LinkCopy Citation

Chapter 03. Scope of Practice and Duties

Regulation .01 Scope of Practice.LinkCopy Citation

Regulation .02 Limitations upon Delegation.LinkCopy Citation

Chapter 04. Prohibited Conduct

Regulation .01 Prohibited Conduct.LinkCopy Citation

Regulation .02 Actions Taken as a Result of Prohibited Conduct.LinkCopy Citation

Chapter 05. Disciplinary Procedures

Regulation .01 Scope.LinkCopy Citation

Regulation .02 Definitions.LinkCopy Citation

Regulation .03 Investigation of Incident Reports.LinkCopy Citation

Regulation .04 Review by the Provider Review Panel.LinkCopy Citation

Regulation .05 Action by the EMS Board.LinkCopy Citation

Regulation .06 Case Resolution Conference.LinkCopy Citation

Regulation .07 Hearing.LinkCopy Citation

Regulation .08 EMS Board Action.LinkCopy Citation

Regulation .09 Judicial Review.LinkCopy Citation

Regulation .10 Subpoenas.LinkCopy Citation

Regulation .11 Oaths.LinkCopy Citation

Regulation .12 Representation.LinkCopy Citation

Regulation .13 Licensure and Certification Pending EMS Board Action.LinkCopy Citation

Regulation .14 Provider Review Panel.LinkCopy Citation

Regulation .15 Right of Entry.LinkCopy Citation

Regulation .16 Confidentiality and Admissibility of Proceedings, Records, and Files.LinkCopy Citation

Chapter 06. Hearings

Regulation .01 Scope.LinkCopy Citation

Regulation .02 Definitions.LinkCopy Citation

Regulation .03 Delegation of Hearing Authority.LinkCopy Citation

Regulation .04 Request for Hearing.LinkCopy Citation

Regulation .05 Notice of Hearing.LinkCopy Citation

Regulation .06 Service.LinkCopy Citation

Regulation .07 Representation.LinkCopy Citation

Regulation .08 Discovery.LinkCopy Citation

Regulation .09 Prehearing Conference.LinkCopy Citation

Regulation .10 Stipulations and Affidavits.LinkCopy Citation

Regulation .11 Subpoenas.LinkCopy Citation

Regulation .12 Motions.LinkCopy Citation

Regulation .13 Conduct of Hearings.LinkCopy Citation

Regulation .14 Evidence.LinkCopy Citation

Regulation .15 Expert Testimony.LinkCopy Citation

Regulation .16 Appointment of Interpreter.LinkCopy Citation

Regulation .17 Failure to Attend Hearing and Default.LinkCopy Citation

Regulation .18 Burdens of Going Forward and Persuasion.LinkCopy Citation

Regulation .19 Record of Hearings.LinkCopy Citation

Regulation .20 Ex Parte Communications.LinkCopy Citation

Regulation .21 Transcripts, Costs.LinkCopy Citation

Regulation .22 Proposed Orders; Exceptions.LinkCopy Citation

Regulation .23 Final Decision.LinkCopy Citation

Regulation .24 Reconsideration.LinkCopy Citation

Regulation .25 Judicial Review.LinkCopy Citation

Chapter 07. Summary Suspension of License or Certification

Regulation .01 Scope.LinkCopy Citation

Regulation .02 Summary Action.LinkCopy Citation

Regulation .03 Procedure for Summary Suspension after Notice and an Opportunity To Be Heard.LinkCopy Citation

Regulation .04 Procedure for Summary Suspension before Notice and an Opportunity To Be Heard.LinkCopy Citation

Regulation .05 Representation.LinkCopy Citation

Regulation .06 Summary Suspension Hearing.LinkCopy Citation

Regulation .07 Evidentiary Hearing.LinkCopy Citation

Regulation .08 Judicial Review.LinkCopy Citation

Regulation .09 Notice.LinkCopy Citation

Regulation .10 Confidentiality.LinkCopy Citation

Regulation .01 Definitions.Link Copy Citation

Regulation .01 Application.Link Copy Citation

Regulation .02 Fees.Link Copy Citation

Regulation .03 Requirements.Link Copy Citation

Regulation .04 Reciprocity.Link Copy Citation

Regulation .05 Examination and Reexamination.Link Copy Citation

Regulation .06 Issuance of License or Certificate.Link Copy Citation

Regulation .07 Renewal.Link Copy Citation

Regulation .08 Inactive Status.Link Copy Citation

Regulation .09 Reinstatement.Link Copy Citation

Regulation .10 Surrender.Link Copy Citation

Regulation .11 Replacement.Link Copy Citation

Regulation .12 Denials.Link Copy Citation

Regulation .13 Requirements for Individuals with a Provisional License or Certificate to Obtain a Full License or Certificate.Link Copy Citation

Regulation .01 Scope of Practice.Link Copy Citation

Regulation .02 Limitations upon Delegation.Link Copy Citation

Regulation .01 Prohibited Conduct.Link Copy Citation

Regulation .02 Actions Taken as a Result of Prohibited Conduct.Link Copy Citation

Regulation .01 Scope.Link Copy Citation

Regulation .02 Definitions.Link Copy Citation

Regulation .03 Investigation of Incident Reports.Link Copy Citation

Regulation .04 Review by the Provider Review Panel.Link Copy Citation

Regulation .05 Action by the EMS Board.Link Copy Citation

Regulation .06 Case Resolution Conference.Link Copy Citation

Regulation .07 Hearing.Link Copy Citation

Regulation .08 EMS Board Action.Link Copy Citation

Regulation .09 Judicial Review.Link Copy Citation

Regulation .10 Subpoenas.Link Copy Citation

Regulation .11 Oaths.Link Copy Citation

Regulation .12 Representation.Link Copy Citation

Regulation .13 Licensure and Certification Pending EMS Board Action.Link Copy Citation

Regulation .14 Provider Review Panel.Link Copy Citation

Regulation .15 Right of Entry.Link Copy Citation

Regulation .16 Confidentiality and Admissibility of Proceedings, Records, and Files.Link Copy Citation

Regulation .01 Scope.Link Copy Citation

Regulation .02 Definitions.Link Copy Citation

Regulation .03 Delegation of Hearing Authority.Link Copy Citation

Regulation .04 Request for Hearing.Link Copy Citation

Regulation .05 Notice of Hearing.Link Copy Citation

Regulation .06 Service.Link Copy Citation

Regulation .07 Representation.Link Copy Citation

Regulation .08 Discovery.Link Copy Citation

Regulation .09 Prehearing Conference.Link Copy Citation

Regulation .10 Stipulations and Affidavits.Link Copy Citation

Regulation .11 Subpoenas.Link Copy Citation

Regulation .12 Motions.Link Copy Citation

Regulation .13 Conduct of Hearings.Link Copy Citation

Regulation .14 Evidence.Link Copy Citation

Regulation .15 Expert Testimony.Link Copy Citation

Regulation .16 Appointment of Interpreter.Link Copy Citation

Regulation .17 Failure to Attend Hearing and Default.Link Copy Citation

Regulation .18 Burdens of Going Forward and Persuasion.Link Copy Citation

Regulation .19 Record of Hearings.Link Copy Citation

Regulation .20 Ex Parte Communications.Link Copy Citation

Regulation .21 Transcripts, Costs.Link Copy Citation

Regulation .22 Proposed Orders; Exceptions.Link Copy Citation

Regulation .23 Final Decision.Link Copy Citation

Regulation .24 Reconsideration.Link Copy Citation

Regulation .25 Judicial Review.Link Copy Citation

Regulation .01 Scope.Link Copy Citation

Regulation .02 Summary Action.Link Copy Citation

Regulation .03 Procedure for Summary Suspension after Notice and an Opportunity To Be Heard.Link Copy Citation

Regulation .04 Procedure for Summary Suspension before Notice and an Opportunity To Be Heard.Link Copy Citation

Regulation .05 Representation.Link Copy Citation

Regulation .06 Summary Suspension Hearing.Link Copy Citation

Regulation .07 Evidentiary Hearing.Link Copy Citation

Regulation .08 Judicial Review.Link Copy Citation

Regulation .09 Notice.Link Copy Citation

Regulation .10 Confidentiality.Link Copy Citation