In this subtitle, the following terms have the meanings indicated. Terms Defined. “Advanced life support (ALS)” means the level of care which may be rendered by an individual licensed under Education Article, §13-516, Annotated Code of Maryland, as an: Emergency medical technician-paramedic; or Cardiac rescue technician licensed. “Automated external defibrillator (AED)” means a medical heart monitor and defibrillator device that: Is cleared for market by the federal Food and Drug Administration; Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia; Determines, without intervention by the operator, whether defibrillation should be performed; On determining that defibrillation should be performed, automatically charges; and Either: Requires operator intervention to deliver the electrical impulse; or Automatically continues with delivery of electrical impulse. “Advanced life support (ALS) education program” means an individual, agency, corporation, association, or other entity that prepares individuals for Maryland emergency medical services (EMS) licensure at the ALS level. “Basic life support (BLS)” means the level of care which may be rendered by an individual certified under Education Article, §13-516, Annotated Code of Maryland, as: An emergency medical technician (EMT); or An emergency medical responder. “Basic life support (BLS) education program” means an individual, agency, corporation, association, or other entity that prepares individuals for Maryland EMS certification at the BLS level. “BLS instructor” means an individual who meets the requirements of COMAR 30.04.03.09A or .11. “CAPCE” means the Commission on Accreditation for Pre-Hospital Continuing Education, which is a national organization designed to approve continuing education. “CoAEMSP” means the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions which is a national committee that accredits programs instructing EMS curricula. “Commercial ambulance service” means a commercial ambulance service required to be licensed under Education Article, §13-515, Annotated Code of Maryland. “Continuing education” means education used for renewal of EMS licensure or certification. “Continuing education program” means a program offering continuing education courses for EMS providers in conjunction with and through an EMS operational program. “Curriculum” means the required educational content of an EMS course approved by the EMS Board for licensure or certification as an EMS provider under Education Article, §13-516(a), Annotated Code of Maryland. “Distance education” means a method of acquiring knowledge and skills through mediated information and instruction, encompassing all technologies and other forms of learning at a distance. “Emergency medical dispatcher (EMD)” means an individual licensed by the EMS Board as an emergency medical dispatcher. “EMD education program” means an individual, agency, corporation, association, or other entity that prepares individuals for licensure as a Maryland EMD. “EMD instructor” means an individual who is currently approved by MIEMSS to teach an approved EMD education program and approved continuing education. “Emergency medical responder instructor” means an individual who is currently approved by MIEMSS to teach FR courses and approved continuing education. “Emergency medical services (EMS) operational program” means: A jurisdictional EMS operational program; or An institution, agency, corporation, or other entity that is licensed by MIEMSS as a commercial service. “Emergency medical technician instructor” means an individual who can teach emergency medical technician or EMR courses and meets the requirements of COMAR 30.04.03.09A. “FR instructor” means an individual who is currently approved by MIEMSS to teach FR courses and approved continuing education. “JCAHO” means the Joint Commission on Accreditation of Healthcare Organizations. “MDH” means the Maryland Department of Health. “MFRI” means the Maryland Fire and Rescue Institute, University of Maryland. “MICRB” means the Maryland Instructor Certification Review Board as defined in COMAR 13B.03.01.02B(6). “Nationally recognized EMD education program” means an individual, agency, corporation, association, or other entity which conducts EMD education courses and has: Nationally recognized expertise and resources to: Set minimum standards for EMD instruction; and Provide adequate quality assurance of its instruction and instructors; and A valid and reliable instrument for the evaluation of EMD students. “NHTSA” means the National Highway Transportation Safety Administration. “Proprietary education program” means an individual, agency, corporation, association, or other entity which conducts EMS education and has: The expertise and resources to: Set minimum standards for the instruction of EMS content; and Provide adequate quality assurance of its instruction and instructors; and A valid and reliable instrument for the evaluation of participants. “Person” includes an individual, agency, corporation, association, or other entity. “Refresher course” means a continuing education course which provides continuing education requirements required for renewal of an EMS license or certificate under COMAR 30.02.07. “Skills course” means a continuing education course which fulfills the skills requirements required for renewal of an EMS license or certificate under COMAR 30.02.07. “Specialty care transport” has the meaning stated in COMAR 30.09.01.02B(1). Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) Regulation .01B amended effective September 27, 2004 (31:19 Md. R. 1434); December 12, 2013 (40:24 Md. R. 2017); April 9, 2018 (45:7 Md. R. 347) Regulation .10B amended effective January 15, 2005 (32:16 Md. R. 1866) This chapter governs ALS education programs approved by the EMS Board. Each ALS education program shall have written criteria for: Admission; Frequent evaluation of each student during the course of study including evaluation of competency in providing patient care; Student requirements for: Attendance; Educational performance including: Attitudes; Knowledge; and Skills; and Behavior; Student access to program information including: Fees; Requirements; Policies; Procedures; and Support services; Selection of: A medical director; A program coordinator; Faculty; and Other necessary personnel; Nondiscrimination and fair practices with regard to students, faculty, and program personnel; and Review and improvement of the effectiveness of student evaluation techniques. Each ALS education program shall require that each student wear distinctive identification during field and clinical internship that clearly identifies the: Student's name; Student's status; and ALS education program. Each ALS education program shall maintain an organizational chart that shows the relationship among students, faculty, medical director, program coordinator, and other personnel for each ALS course. Each ALS education program shall maintain accurate and appropriate records of: Students; Faculty; Courses including: Course statistics; and Demographics of applicants; and Written agreements with facilities and agencies providing clinical and field experience which include: Liability policies; Scope of practice for the student; Evaluation criteria; and The responsibility for and level of supervision of students. Records shall be maintained for at least 5 years following course completion in a manner to prevent loss, destruction, or unauthorized use. Each ALS education program shall teach the appropriate ALS curriculum. Each ALS education program shall provide: Didactic instruction which imparts fundamental knowledge, skills, and attitudes which contribute to the delivery of state-of-the-art prehospital emergency medical care, including: Assessment of signs and symptoms; Performance of therapeutic interventions; and Evaluation of response to interventions; Supervised clinical experience which includes practice of skills within clinical education facilities; and Supervised field internship which includes practice of skills while functioning in a prehospital ALS environment. Distance Education. Training programs may utilize distance education for cognitive components of initial training leading to EMS licensure if the program: Demonstrates the methods of distance education utilized are educationally and technically appropriate for the content and audience; and Ensures the quality of the distance education method including: Learning and teaching considerations; Communication; Educational and technology design; and Program and system management. There shall be written agreements and position descriptions stating the roles and responsibilities of the individuals who have the responsibilities listed in this regulation. Medical Director. Each ALS education program shall have a medical director who: Is a physician licensed to practice medicine in Maryland; Has current knowledge and experience in emergency medical care of acutely ill or injured patients; Has knowledge of the Maryland EMS System; and Has knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers. The medical director shall: Be responsible for oversight of the medical educational content of the ALS education program curriculum; Play an active role and participate in the delivery and evaluation of the education program; and Oversee with the recruitment and selection of faculty. Program Coordinator. Each ALS education program shall have a program coordinator who may be the medical director and who has: At least 2 years experience instructing and evaluating ALS students; Experience with the development and administration of an education program; An ALS license or equivalent; and Knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers. The program coordinator shall: Have overall responsibility for the success of the ALS education program including continuous quality review and improvement of the ALS education program; Assist the medical director with the recruitment and selection of faculty; Serve as the education program student/faculty liaison; and Identify sites where students can fulfill clinical and field internship requirements. Faculty. Each ALS education program shall have faculty and guest lecturers with the education and experience necessary to teach in the ALS course. All faculty shall have: Experience instructing and evaluating students; Working knowledge of current Maryland Medical Protocols for Emergency Medical Services Providers; The express written endorsement of the program's medical director and program coordinator to teach designated lessons; Working knowledge of the Maryland EMS system; and An annual written evaluation by the program medical director or program coordinator. Clinical Preceptor. Each ALS education program shall have clinical preceptors who shall supervise and evaluate each student's performance in approved clinical education facilities. Clinical preceptors shall have: Working knowledge of: ALS curricula; and The Maryland Medical Protocols for Emergency Medical Services Providers; The expertise to supervise required clinical skills; and Completed a local clinical preceptor orientation program. The ratio of students to preceptor shall be adequate to assure effective learning. Field Preceptor. Each ALS education program shall have a field preceptor who shall supervise and evaluate each student's performance in an approved EMS operational program setting or equivalent as approved by MIEMSS. The ratio of students to field preceptor shall be one to one to assure effective learning and supervision. A field preceptor shall: Have working knowledge of: ALS curricula; and The Maryland Medical Protocols for Emergency Medical Services Providers; Have the expertise to supervise required skills; Have been licensed to perform the skills supervised for at least 2 years; Have completed a local field preceptor orientation program; and Be approved by an EMS operational program. Instructional Facilities. Each ALS education program shall have adequate space at instructional facilities to accommodate the program. Clinical Facilities. Each ALS education program shall have access to clinical facilities that provide necessary clinical experience with appropriate medical oversight and supervision. The clinical facilities shall have a patient population representative of that encountered in the delivery of prehospital emergency medical care. The clinical facilities shall provide adequate educational experiences to meet the program's clinical objectives. If clinical facilities are located outside of Maryland, the ALS program shall comply with the laws of the state where the facilities are located. Field Internships. Each ALS education program shall provide students access to field internships with appropriate medical oversight and supervision within any ALS component of an EMS operational program. The field internships shall have a patient population representative of that encountered in the delivery of prehospital emergency medical care. The field internships shall provide adequate educational experiences to meet the program's clinical objectives. If field internships are located outside of Maryland, the ALS program shall: Comply with the laws of the state where the field internships are located; and Notify the appropriate EMS officials in the state where the field internships are located of the presence of program students in those internships. Each ALS education program shall have sufficient financial resources to assure complete ALS course delivery for all enrolled students. Each ALS education program shall advise MIEMSS in writing of any students requesting accommodations for documented disabilities at least 5 days before the scheduled licensure examinations. Each ALS education program shall have a written policy and procedure for evaluation of the ALS education program. The evaluation shall be annually and provide written objective evidence that the program is meeting its objectives and the changing needs of EMS care. The evaluation plan shall include methods for gathering and analyzing data on the effectiveness of the: Program; Resources; Responsiveness to recommendations for change; Faculty; and Students' ability to function as entry-level providers upon successful completion of the ALS course. The results of evaluations shall provide the basis for continuous quality improvement and future direction of the program. Each ALS education program shall submit an annual report to MIEMSS in an approved format. The EMS Board shall establish standard curricula and learning objectives for ALS education programs. Each ALS education program shall prepare the student for entry-level practice. The amount of time devoted to the delivery of the ALS course may vary depending on the students' ability to demonstrate proficiency in the educational objectives utilizing: Written examinations; Oral examinations; and Practical examinations. An ALS education program may apply for approval by submitting a MIEMSS-approved application to MIEMSS, Office of Education, Licensure, and Certification, ALS Program, 653 West Pratt Street, Baltimore, Maryland 21201-1528. An ALS education program providing ALS courses on the effective date of this regulation may continue to offer ALS courses for not more than 3 years from that date unless the program is approved under this chapter. CoAEMSP Accredited Programs. CoAEMSP accredited programs shall apply for approval under this regulation. Sections of the application approval process that parallel the CoAEMSP accreditation process may be waived if a MIEMSS representative participates in the CoAEMSP site visit as an observer and the ALS education program: Complies with COMAR 30.04.02; Remains an accredited program in good standing with CoAEMSP; and Provides MIEMSS a copy of the self study submitted to CoAEMSP and a copy of documentation provided to the program by CoAEMSP. Application Deadlines. Application for ALS education program approval shall be received at least 6 months before the first ALS course begins. Site Visit. After a completed application is accepted by MIEMSS, a site visit shall be scheduled at a mutually convenient time. The site review team shall be selected by MIEMSS and consist of: A system medical director or an ALS education program medical director; ALS faculty or ALS program coordinator; MIEMSS representative; and Others as necessary. If an applicant can demonstrate a reasonable basis for concern, MIEMSS shall consider allegations that conflicts of interest exist between a site reviewer and an applicant. The site review team shall send a written report to MIEMSS within 30 days after the site visit. The site review team and MIEMSS shall finalize the site visit and report and MIEMSS shall submit a recommendation to the EMS Board. EMS Board Action. Five-Year Approval. If the EMS Board determines that the applicant meets the requirements of this chapter, the EMS Board shall grant the applicant a 5-year approval as an ALS education program. To maintain approval, the ALS education program shall: Comply with COMAR 30.04.02; Advise MIEMSS in writing within 30 days of any changes in: Program personnel other than instructional faculty; Organizational changes; or Programmatic changes; Maintain a process of continuous quality improvement; Conduct at least one full length ALS course every 2 years. Provisional Approval. If the EMS Board determines that the application and the site visit indicate limitations in meeting requirements for full approval, it may approve the application provisionally on the conditions and for the provisional period, including any extensions, which the EMS Board deems appropriate. An applicant receiving provisional approval shall submit written progress reports to MIEMSS as required by the EMS Board. MIEMSS may conduct one or more additional site visits to verify the resolution of limitations. Before any additional site visit, the applicant shall prepare a revised report that includes changes made since the prior site visit. Upon satisfactory resolution of limitations, or at the end of the provisional period, including any extensions, the EMS Board shall: Confer approval for the remainder of the 5-year period if the applicant has satisfied all requirements for approval; or Deny or revoke approval. Denial or Revocation of Approval. The EMS Board may deny or revoke program approval if an ALS education program is not in compliance with this chapter. The program shall be notified by mail of the EMS Board's decision. If the decision is other than a 5-year approval, the notice shall: State the reasons for the decision; Advise the ALS education program of appeal rights; and Otherwise comply with State Government Article, §10-207, Annotated Code of Maryland. MIEMSS personnel may attend course sessions for quality assurance. National Registry. To be state approved for purposes of the National Registry for Emergency Medical Technicians, an ALS education program must obtain approval under this chapter. ALS education programs shall apply for renewal of approval at least 6 months before the expiration of current approval. Each ALS course shall have a number assigned by MIEMSS. Each ALS education program approved under this chapter shall notify MIEMSS and request a course number at least 45 days before the first class of each ALS course which it proposes to provide. Requests for a course number shall: Be sent to MIEMSS in an approved format; and Be signed by the: Medical director; and Program director. An ALS course may not have more than 25 students without prior written approval from MIEMSS. This chapter does not relieve the ALS education program from the requirements of any statute or regulation that would otherwise apply. Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) Regulation .12C amended effective September 27, 2004 (31:19 Md. R. 1434) Regulation .12F amended effective October 3, 2011 (38:20 Md. R. 1205) This chapter governs BLS education programs approved by the EMS Board. Each BLS education program shall have written criteria for: Admission; Frequent evaluation of each student during the course of study including evaluation of competency in providing patient care; Student requirements for: Attendance; Educational performance including: Attitudes; Knowledge; and Skills; and Behavior; Student access to program information including: Fees; Requirements; Policies; Procedures; and Support services; Selection of: A medical director; A program coordinator; Faculty; and Other necessary personnel; Nondiscrimination and fair practices with regard to students, faculty, and program personnel; and Review and improvement of the effectiveness of student evaluation techniques. Each BLS education program shall require that each student wear distinctive identification during field and clinical internship that clearly identifies the: Student's name; Student's status; and BLS education program. Each BLS education program shall maintain an organizational chart that shows the relationships among students, the program coordinator, the medical director, and the instructors for each BLS course. Each BLS education program shall maintain accurate and appropriate records of: Students; Faculty; Courses including: Course statistics; and Demographics of applicants; and Written agreements with facilities and agencies providing clinical and field experience which include: Liability policies; Scope of practice for the student; Evaluation criteria; and The responsibility for and level of supervision of students. Records shall be maintained for at least 5 years following course completion in a manner to prevent loss, destruction, or unauthorized use. Each BLS education program shall teach the appropriate BLS curriculum. Each BLS education program shall provide: Didactic instruction which shall impart fundamental knowledge, skills, and attitudes which contribute to the delivery of state-of-the-art prehospital emergency medical care including: Assessment of signs and symptoms; Performance of therapeutic interventions; and Evaluation of response to interventions; and Supervised field internship which includes practice of skills while functioning in a prehospital BLS environment. Distance Education. Training programs may utilize distance education for cognitive components of initial training leading to EMS certification if the program: Demonstrates the methods of distance education utilized are educationally and technically appropriate for the content and audience; and Ensures the quality of the distance education method including: Learning and teaching considerations; Communication; Educational and technology design; and Program and system management. There shall be written agreements and position descriptions stating the roles and responsibilities of the following program positions: Medical director; Program coordinator; and BLS instructors. All education programs shall have adequate clerical and support staffing. Each BLS education program offering emergency medical technician courses or emergency medical responder courses, which include the automated external defibrillator module, shall have a medical director who: Is a physician licensed to practice medicine in Maryland; Has current working knowledge and experience in emergency medical care of acutely ill or injured patients; Has working knowledge of the Maryland EMS system; and Has working knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers. The medical director is responsible for oversight of the medical educational content of the BLS curriculum. Each education program offering emergency medical technician courses shall have a program coordinator who has: At least 2 years experience instructing and evaluating EMT-B students; Experience with administration of educational programs; A BLS certification or equivalent; and Knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers. The emergency medical technician program coordinator shall: Have overall responsibility for the success of the emergency medical technician education program, including continuous quality review and improvement of the education program; Serve as the education program student/faculty liaison; and Identify sites where students can fulfill field internship requirements. Each emergency medical technician course shall be taught by an emergency medical technician instructor, or an interim instructor under the supervision of an emergency medical technician instructor, who: Is currently certified as an MICRB Level II emergency services instructor who has successfully: Completed at least 12 hours of an emergency medical technician instructor skills development course; Completed two practice teachings (one didactic and one practical) evaluated by an emergency medical technician instructor who is also approved as an MICRB evaluator; and Taught one emergency medical technician course as an interim instructor, and been twice successfully evaluated by an emergency medical technician instructor who is also approved as an MICRB evaluator; and Has at least 3 consecutive years of experience as an emergency medical technician or higher; Maintains a Maryland EMS certification or license as an emergency medical technician or higher; and Has current knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers. The emergency medical technician instructor is responsible for: The course instruction; and Any interim or additional emergency medical technician instructors assisting with the course. An emergency medical technician instructor shall remain current by: Completing requirements as an MICRB instructor and: Receiving a satisfactory emergency medical technician course teaching evaluation and no subsequent unsatisfactory evaluations from an emergency medical technician instructor who is also an approved MICRB evaluator; and One of the following: Instructing at least 60 hours of emergency medical technician course material; or If a training supervisor, instructing at least 9 hours of emergency medical technician course material; Maintaining a valid Maryland EMS certification of emergency medical technician or higher; and Attending mandatory protocol updates. If qualified, the emergency medical technician instructor may also function as the emergency medical technician program coordinator. Emergency Medical Technician Instructor Reinstatement. A former emergency medical technician instructor whose approval has lapsed may apply to the sponsoring agency for reinstatement within 3 years of expiration. The emergency medical technician instructor reinstatement candidate shall: Be certified as an MICRB Level II emergency services instructor; Maintain Maryland EMS certification or licensure as an emergency medical technician or higher; and Maintain current working knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers. An emergency medical technician instructor whose approval status has been expired for more than 3 years shall meet initial emergency medical technician instructor requirements. Emergency Medical Technician Field Training Coaches. Each BLS education program shall have access to emergency medical technician field training coaches who shall supervise and evaluate each student's internship performance in an approved prehospital setting or MIEMSS-approved equivalent. An emergency medical technician field training coach shall possess appropriate: Working knowledge of the emergency medical technician curriculum; Working knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers; and Expertise to supervise students during the emergency medical technician internship. The ratio of students to emergency medical technician field training coach shall be one to one to ensure effective learning and supervision. Each emergency medical technician field training coach shall complete emergency medical technician field training coach orientation, and be approved by the local EMS operational program. Each education program offering EMR courses shall have a program coordinator who: Has a current EMS certification at least equivalent to the level of education being taught; and Is experienced with the administration of education programs. The EMR program coordinator shall have overall responsibility for the success of the education program including: Administration; Program planning; Effectiveness; Evaluation; Supervision; Quality of the: Didactic instruction; and Practical instruction; Organization; The competency of each graduate at the time of course completion; and Continuous quality review and improvement of the EMR education program. The emergency medical technician program coordinator can also be the EMR program coordinator. EMR courses shall be taught by: EMR instructors; Interim EMR instructors under the supervision of an EMR instructor; or Emergency medical technician instructors. An EMR instructor who is not an emergency medical technician instructor shall: Successfully complete a MIEMSS-approved instructor training course; Successfully complete a MIEMSS EMR instructor course and a MIEMSS-approved EMR written examination, with a minimum score as approved by MIEMSS; Successfully complete 2 hours of supervised practice teaching consisting of 1 hour didactic and 1 hour practical skills, and receive a satisfactory evaluation from a MIEMSS-approved EMR instructor evaluator or an emergency medical technician instructor who is also an approved MICRB evaluator; Teach 40 hours as an interim instructor and receive two consecutive satisfactory evaluations from a MIEMSS-approved EMR instructor evaluator, or an emergency medical technician instructor who is also an approved MICRB evaluator; and Submit to MIEMSS at the end of the interim teaching: All course paperwork; and A completed EMR instructor application showing two consecutive successful evaluations and practice teaching dates. Approval as an EMR instructor shall be for up to 3 years. Maintaining EMR Instructor Approval. To maintain EMR instructor approval, an individual during the 3-year period of approval shall: Satisfy all of the following: Teach at least: 20 hours of EMR instruction with 6 hours devoted to skills; or 14 hours of EMR instruction and attend an approved skills refresher; Receive at least one satisfactory teaching evaluation with no subsequent unsatisfactory evaluation by a MICRB evaluator who is an emergency medical technician instructor or MIEMSS-approved EMR instructor evaluator; Maintain current Maryland EMS provider certification or licensure; Attend EMR instructor workshops as necessary; Provide MIEMSS with documentation of hours taught; and Apply to MIEMSS for renewal as an EMR instructor; or Maintain current MIEMSS approval as an emergency medical technician instructor and attend EMR instructor workshops as necessary. The EMR instructor may also function as the EMR program coordinator if qualified. EMR Instructor Reinstatement. A former EMR instructor whose approval has expired may apply to MIEMSS for reinstatement within 3 years of expiration. The EMR instructor reinstatement candidate shall: Be certified or licensed as a Maryland EMR or higher level EMS provider; Have successfully completed, within the last 3 years, 1 hour didactic and 1 hour practical skills supervised practice teaching with a satisfactory evaluation from a MIEMSS-approved EMR instructor evaluator or an emergency medical technician instructor who is an approved MICRB evaluator; and A completed EMR instructor application showing two consecutive successful evaluations from practice teaching. Approval as an EMR instructor shall be for 3 years or concurrent with the EMR, the emergency medical technician, or the MICRB certification period. An EMR instructor whose lapsed approval status is in excess of 3 years is required to meet initial EMR instructor requirements. Instructional Facilities. Each BLS education program shall have adequate space at facilities to accommodate the program. Emergency Medical Technician Internships. Each BLS education program shall provide students access to internships with appropriate medical oversight and supervision within any MIEMSS-approved EMS operational program which shall include: Patient assessments; EMS orientation; and Additional components as approved by MIEMSS. If field internships are located outside Maryland, the BLS program shall: Comply with the laws of the state where the field internships are located; and Notify the appropriate EMS officials in the state where the field internships are located of the presence of program students in those internships. Each emergency medical technician education program shall have sufficient financial resources to ensure complete course delivery for all enrolled students. Each BLS education program shall advise MIEMSS in writing of any students requiring accommodations for documented disabilities at least 5 days before the scheduled certification examinations. Each BLS education program shall have a written policy and procedure for evaluation of the BLS education program. The evaluation shall be at least annually and provide written evidence that the program is meeting its objectives and the changing needs of EMS care. The evaluation plan shall include methods for gathering and analyzing data on the effectiveness of the following: Instruction; Resources; Responsiveness to recommendations for change; Instructors; and Students' ability to function as entry-level providers upon successful completion of the course. The results of the evaluations shall provide the basis for continuous quality improvement and future direction of the BLS courses. Annual Report. Each BLS education program shall submit an annual report to MIEMSS in an approved format to: Update program information; and Identify any major changes in the program during the year. The EMS Board shall establish standard curricula and learning objectives for the BLS courses. Each BLS course shall prepare the student for entry-level practice. The amount of time devoted to the delivery of the course may vary depending on the students' ability to demonstrate proficiency in the educational objectives utilizing: Written examinations; Oral examinations; and Practical examinations. A BLS education program may apply for approval by submitting a MIEMSS-approved application to MIEMSS, Office of Education, Licensure, and Certification, BLS Program, 653 West Pratt Street, Baltimore, Maryland 21201-1528. A BLS education program providing BLS courses on the effective date of this regulation may continue to offer BLS courses for not more than 3 years from that date unless the program is approved under this chapter. Maryland Police and Correctional Training Commission approved programs shall apply for approval under this regulation. Sections of the approval process that parallel the Commission approval process may be waived if the FR program: Complies with COMAR 30.04.02; and Remains an accredited program in good standing with the Commission. Application Deadlines. Applications for BLS education program approval shall be received at least 6 months before the first BLS course begins. Site Visit. After a completed application is accepted by MIEMSS, a site visit shall be scheduled at a mutually convenient time. The site review team shall be selected by MIEMSS and consist of: A system medical director or an BLS education program medical director; A BLS educator or BLS program director; MIEMSS representative; and Others as necessary. If an applicant can demonstrate a reasonable basis for concern, MIEMSS shall consider allegations that conflicts of interest exist between a site reviewer and an applicant. The site review team shall send a written report to MIEMSS after the site visit. The site review team shall send a written report to MIEMSS within 30 days after the site visit. The site review team and MIEMSS shall finalize the site visit and report and MIEMSS shall submit a recommendation to the EMS Board. EMS Board Action. Five-Year Approval. If the EMS Board determines that the applicant is in compliance with this chapter, the EMS Board shall grant the applicant a 5-year approval as a BLS education program. To maintain approval the BLS education program shall: Comply with COMAR 30.04.03; Advise MIEMSS in writing within 30 days of any changes in: Program personnel other than instructional faculty; Organizational changes; or Programmatic changes; Maintain a process of continuous quality improvement; and Conduct at least one full length BLS course every 3 years. Provisional Approval. If the EMS Board determines that the application and the site visit indicate limitations in meeting requirements for full approval, it may approve the application provisionally on the conditions and for the provisional period, including any extensions, which the EMS Board deems appropriate. An applicant receiving provisional approval shall submit written progress reports to MIEMSS as required by the EMS Board. MIEMSS may conduct one or more additional site visits to verify the resolution of limitations. Before any additional site visit, the applicant shall prepare and submit a revised report that includes changes made since the prior site visit. Upon satisfactory resolution of limitations, or at the end of the provisional period, including any extensions, the EMS Board shall: Confer approval for the remainder of the 5-year period if the applicant has satisfied all requirements for approval; or Deny or revoke approval. Denial or Revocation of Approval. The EMS Board may deny or revoke program approval if a BLS education program is not in compliance with this chapter. The program shall be notified by mail of the EMS Board's decision. If the decision is other than a 5-year approval, the notice shall: State the reasons for the decision; Advise the BLS education program of appeal rights; and Otherwise comply with State Government Article, §10-207, Annotated Code of Maryland. MIEMSS may approve out-of-State BLS education programs that meet the standards set by the EMS Board to allow out-of-State BLS students enrolled in these programs to participate in Maryland internship and ride along programs in the course of their training under Education Article, §13-516(b)(1)(ii), Annotated Code of Maryland. MIEMSS personnel may attend course sessions for quality assurance. BLS education programs shall make application for renewal of approval at least 6 months before the expiration of current approval. Each BLS education course shall have a number assigned by MIEMSS. Each BLS education program approved under this chapter shall notify MIEMSS and request a course number at least 20 days before the first class of each BLS course which it proposes to provide. Requests for a course number shall: Be sent to MIEMSS in an approved format; and Be signed by the program director. ALS Education Program. Approved ALS education programs may offer BLS courses. The ALS education program shall request MIEMSS approval of BLS courses and request a course number at least 20 days before the first class. Sections of the course application that parallel the ALS education program approval process may be waived if the ALS education program complies with COMAR 30.04.03. ALS education program requests for BLS course approval and a course number shall be sent to MIEMSS in an approved format and signed by the program director. This chapter does not relieve the BLS education program from the requirements of any statute or regulation which would otherwise apply. Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) Regulation .07A amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .08 amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .09 amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .10 amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .11 amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .12B amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .13 amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .17F amended effective October 3, 2011 (38:20 Md. R. 1205) This chapter governs EMD education programs and EMD courses approved by the EMS Board. Each EMD education program shall have written criteria for: Admission; Frequent evaluation of each student during the course of study including evaluation of competency in providing patient care; Student requirements for: Attendance; Educational performance including: Attitudes; Knowledge; and Skills; and Behavior; Student access to program information including: Fees; Requirements; Policies; Procedures; and Support services; Selection of: A medical director; A program coordinator; Faculty; and Other necessary personnel; Nondiscrimination and fair practices with regard to students, faculty and program personnel; and Review and improvement of the effectiveness of student evaluation techniques. An EMD education program shall maintain an organizational chart that shows the relationship among students, the program coordinator, the medical director, and the instructors for each EMD course. Each EMD education program shall maintain accurate and appropriate records of: Students; Faculty; and Courses including: Course statistics; and Demographics of applicants. Records shall be maintained for at least 5 years following course completion in a manner to prevent loss, destruction, or unauthorized use. Each EMD education program shall teach the appropriate EMD curriculum. Distance Education. A training program may utilize distance education for cognitive components of initial training leading to EMS licensure if the program: Demonstrates the methods of distance education utilized are educationally and technically appropriate for the content and audience; and Ensures the quality of the distance education method including: Learning and teaching considerations; Communication; Educational and technology design; and Program and system management. There shall be written agreements and position descriptions stating the roles and responsibilities of the following program positions: Medical director; Program coordinator; Instructor. All education programs shall have adequate clerical and support staffing to provide for the program needs. Each EMD education program shall have a medical director who: Is a physician licensed to practice medicine in Maryland; Has current working knowledge and experience in emergency medical care of acutely ill or injured patients; Has working knowledge of the Maryland EMS system; Has working knowledge of the Maryland Medical Protocols for Emergency Medical Services Providers; and Has current working knowledge of EMD operations. The medical director is responsible for oversight of the medical educational content of the EMD education program curriculum. Each EMD education program shall have a program coordinator with: At least 3 years public safety call taking and call allocating experience; Experience in EMD education programs; and An EMD license. The program coordinator shall: Have overall responsibility for the success of the EMD education program including quality review and improvement; and Assist the medical director with the recruitment and selection of instructors. Each EMD course shall be taught by an EMD instructor, or an interim instructor under the supervision of an EMD instructor, who: Satisfies all of the following: Is certified as an MICRB Level II emergency services instructor who has successfully: Completed one didactic and one practical teaching session evaluated by an EMD instructor approved as an MICRB evaluator; and Taught one EMD course as an interim instructor and been twice successfully evaluated by an EMD instructor approved as an MICRB evaluator; Has at least 3 years of public safety call taking and call allocating experience; and Is licensed as a Maryland EMD and ALS provider; or Is approved by a nationally recognized EMD education program approved by the EMS Board or the equivalent. An EMD instructor is responsible for: The education program instruction; and Any interim or additional EMD instructors assisting with the course. The EMD instructor approval period shall be concurrent with the MICRB emergency services certification or the instructor approval period of a nationally recognized EMD education program approved by the EMS Board or the equivalent. EMD Instructor Renewal. An EMD instructor shall remain current by: Satisfying all of the following: Completing requirements as an MICRB instructor including: Receiving a satisfactory EMD course teaching evaluation and no subsequent unsatisfactory evaluations from an EMD instructor who is also an approved MICRB evaluator; and Instructing at least 16 hours in an EMD course or, if a training supervisor, at least 4 hours in an EMD course; and Maintaining a Maryland EMD and ALS license; or Maintaining instructor approval by a nationally recognized EMD education program approved by the EMS Board or the equivalent. If qualified, the EMD instructor may also function as the EMD program coordinator. Each EMD education program shall have adequate space at instructional facilities to accommodate the program. Each EMD education program shall have sufficient financial resources to ensure complete EMD course delivery for all enrolled students. Each EMD education program shall advise MIEMSS in writing of any students requiring accommodations for documented disabilities at least 5 days before a scheduled licensure examination. Each EMD education program shall have a written policy and procedure for evaluation of the EMD courses. The evaluation shall be annually and provide written evidence the program is meeting its objectives and changing needs of EMS care. The evaluation plan shall include methods for gathering and analyzing data on the effectiveness of the following: Instruction; Resources; Responsiveness to recommendations for change; EMD instructors; and Students' ability to function as entry-level providers upon successful completion of the EMD education program. The results of the evaluations shall provide the basis for continuous quality improvement and future direction of the EMD courses. Annual Report. Each EMD education program shall submit an annual report to MIEMSS in an approved format. The EMS Board shall establish standard curricula and learning objectives for the EMD education programs. Each EMD course shall prepare the student for entry-level practice. The amount of time devoted to the delivery of the EMD course may vary depending on the students' ability to demonstrate proficiency in the educational objectives utilizing: Written examinations; Oral examinations; and Practical examinations. An EMD education program shall apply for approval by submitting a MEIMSS-approved application and a copy of the course curriculum to MIEMSS, Office of Education, Licensure, and Certification, EMD Program, 653 West Pratt Street, Baltimore, Maryland 21201-1528. An EMD education program providing EMD courses on the effective date of this regulation may continue to offer EMD courses for not more than 3 years from that date unless the program is approved under this chapter. Site Visit. After a completed application is accepted by MIEMSS, a site visit shall be scheduled at a mutually convenient time. The site review team shall be selected by MIEMSS and consist of: A system medical director or an EMD education program medical director; A BLS instructor or EMD program director; MIEMSS representative; and Others as necessary. If an applicant can demonstrate a reasonable basis for concern, MIEMSS shall consider allegations that conflicts of interest exist between a site reviewer and an applicant. The site review team shall send a written report to MIEMSS within 30 days after the site visit. The site review team and MIEMSS shall finalize the site visit and report and MIEMSS shall submit a recommendation to the EMS Board. EMS Board Action. Five-Year Approval. If the EMS Board determines that the applicant meets the requirements of this chapter, the EMS Board shall grant the applicant a 5-year approval as an EMD education program. To maintain approval the EMD education program shall: Comply with COMAR 30.04.04; Advise MIEMSS in writing within 30 days of any changes in: Program personnel other than instructors; Organizational changes; or Programmatic changes; Maintain a process of continuous quality improvement; and Conduct at least one full length EMD course every 2 years. Provisional Approval. If the EMS Board determines that the application and the site visit indicate limitations in meeting requirements for full approval, it may approve the application provisionally on the conditions and for the provisional period, including any extensions, which the EMS Board deems appropriate. An applicant receiving provisional approval shall submit written progress reports to MIEMSS as required by the EMS Board. MIEMSS may conduct one or more additional site visits to verify the resolution of limitations. Before any additional site visit, the applicant shall prepare a revised report that includes changes made since the prior site visit. Upon satisfactory resolution of limitations, or at the end of the provisional period, including any extensions, the EMS Board shall: Confer approval for the remainder of the 5-year period if the applicant has satisfied all requirements for approval; or Deny or revoke approval. Denial or Revocation of Approval. The EMS Board may deny or revoke program approval if an EMD education program is not in compliance with this chapter. The program shall be notified by mail of the EMS Board's decision. If the decision is other than a 5-year approval, the notice shall: State the reasons for the decision; Advise the EMD education program of appeal rights; and Otherwise comply with State Government Article, §10-207, Annotated Code of Maryland. MIEMSS personnel may attend course sessions for quality assurance. EMD education programs shall make application for renewal of approval at least 6 months before the expiration of current approval. Each EMD course shall have a number assigned by MIEMSS. An EMD education program approved under this chapter shall apply for EMD course approval and a course number for each course it proposes to provide by submitting a MIEMSS-approved application at least 20 days before the first class to MIEMSS, Office of Education, Licensure, and Certification, EMD Programs, 653 West Pratt Street, Baltimore, Maryland 21201-1528. Requests for approval of EMD courses shall be signed by the program director. ALS and BLS Education Programs. EMS Board approved ALS and BLS education programs may offer EMD education courses in accordance with this chapter. The ALS or BLS education program shall request MIEMSS approval of an EMD course and request a course number at least 20 days before the first class of each course which the program purposes to provide. Sections of the course application that parallel the ALS or BLS education program approval process may be waived if the ALS or BLS education program complies with COMAR 30.04.04. ALS or BLS education program requests for EMD course approval and a course number shall be signed by the program director and sent to MIEMSS in a MIEMSS-approved format. Nationally Recognized Programs. An EMS Board approved nationally recognized EMD education program or the equivalent as determined by the EMS Board may offer EMD education courses. The nationally recognized EMD education program or equivalent shall request an EMD course number at least 20 days before the first class of each course it proposes to provide. The request shall be filed with MIEMSS in a format approved by MIEMSS. This chapter does not relieve the EMD education program from the requirements of any statute or regulation which would otherwise apply. Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) Regulation .15D amended effective October 3, 2011 (38:20 Md. R. 1205) This chapter governs MIEMSS-approved continuing education courses for renewal of licensure or certification for Maryland EMS providers. Skills and full refresher courses eligible for credit under COMAR 30.02.02.07 shall be provided under the requirements of this chapter by EMS Board approved: ALS education programs; BLS education programs; EMD education programs; or Programs listed in COMAR 30.04.05.02C which: Complete an application approved by MIEMSS; Have policies and procedures in place which address: Student attendance; Nondiscrimination and fair practices with regard to students, faculty, and program personnel; Selection of a medical director, coordinator, and faculty; Evaluation of the courses and evidence to demonstrate continuous quality improvement; and Record maintenance for at least 5 years following course completion in a manner to prevent loss, destruction, or unauthorized use; Have adequate physical resources to effectively deliver courses including necessary equipment; Have sufficient financial resources to ensure complete course delivery for all enrolled students; Have faculty or instructors approved by the medial director; Utilize only emergency medical technician refresher or skills courses instructors who meet the requirements under COMAR 30.04.03.09; and Submit an annual report to MIEMSS in an approved format. The period for which EMS Board approval for programs offering skills and full refresher courses is valid: Coincides with the program approval for approved ALS, BLS, or EMD education programs; and Is 5 years for other programs. Other continuing education courses eligible for credit under COMAR 30.02.02.07 shall be provided by: EMS operational programs; Hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations; EMS Board approved proprietary education programs; Entities accredited by the Emergency Numbers Systems Board; or Education programs listed in §A of this regulation. Distance Education. Scope. Training programs may use distance education for cognitive components of continuing education leading to EMS relicensure or recertification if the program: Demonstrates the methods of distance education used are educationally and technically appropriate for the content and audience; and Ensures the quality of the distance education method including: Learning and teaching considerations; Communication; Educational and technology design; and Program and system management. Distance education programs may apply for a course number and approval as outlined in Regulation .06 of this chapter. Each continuing education program shall maintain accurate and appropriate records including: Student attendance records; Names of instructors; Presentation outlines; Objectives; Handouts; and An evaluation mechanism. Records shall be securely maintained to prevent loss, destruction, or unauthorized use for at least 5 years following course completion. All non-distance education continuing education courses shall be taught by: An ALS faculty member of an ALS education program; An EMS Board approved proprietary education program instructor; An EMS operational program medical director or designee who has experience or knowledge with the topic to be presented; An EMD, emergency medical technician, or EMR instructor; or A certified MICRB emergency services instructor. The following continuing education instructors shall teach skills at the level for which they are approved: EMD instructors may only teach EMD material; EMR instructors may only teach EMR material; Emergency medical technician instructors may only teach BLS material; ALS faculty may only teach material they are approved to teach in their ALS education program; and MICRB-certified instructors may only teach the material they are approved to teach with their education program. Each continuing education course shall have a number assigned by MIEMSS. Except as provided in §E of this regulation, each person shall apply for approval of each continuing education course they propose to offer, and for a course number, by submitting a MIEMSS-approved application at least 14 days before the course begins to MIEMSS, Office of Education, Licensure, and Certification, Continuing Education, 653 West Pratt Street, Baltimore, Maryland 21201-1528. If MIEMSS determines that the continuing education course is in compliance with this chapter, MIEMSS shall assign: The course's continuing education category; The number of credit hours which can be obtained from the course; and A course number. Continuing education courses that are statewide or nationally recognized may be assigned a permanent course number by MIEMSS. A course with a permanent number may be offered without further approval from MIEMSS if it continues to meet the requirements of this chapter. Continuing education courses developed, designed, and used at or within an EMS operational program shall be coordinated through that EMS operational program. The request for MIEMSS approval of these courses shall be reviewed by the EMS operational program. MIEMSS may deny or revoke course approval if a continuing education course is not in compliance with this chapter. The continuing education course shall be notified by mail of MIEMSS' decision. The notice shall: State the reasons for the decision; Advise the continuing education course of appeal rights; and Otherwise comply with State Government Article, §10-207, Annotated Code of Maryland. MIEMSS personnel may attend course sessions for quality assurance. Requests for approval of credit for continuing education courses for other courses attended shall be submitted to MIEMSS accompanied by: Documentation of successful completion; and Course content. CAPCE-approved continuing education shall be submitted to MIEMSS for approval. Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) Regulation .02 amended effective September 27, 2007 (31:19 Md. R. 1434) Regulation .02A amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .04 amended effective December 12, 2013 (40:24 Md. R. 2017) Regulation .06B amended effective April 9, 2018 (45:7 Md. R. 347) This chapter governs EMS Board approval of curricula for Maryland EMS licensure, certification, or renewal. To be eligible for approval, a curriculum shall: Be submitted to MIEMSS; Contain cognitive, psychomotor, and affective learning objectives specific to EMS providers; and Conform with, and instruct, current acceptable EMS standards. EMS Board Action. Upon the recommendation of MIEMSS concerning a curriculum, the EMS Board shall: Approve the curriculum for a particular level of EMS education; Approve the curriculum for a pilot program; or Deny or revoke approval of the curriculum. To maintain approval by the EMS Board, a curriculum shall be updated to remain current with nationally accepted healthcare provider standards. All EMS Board approved curricula used for training EMS providers as of the effective date of these regulations are deemed approved by the EMS Board under this regulation. Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) A person may appeal to the EMS Board from a decision by MIEMSS or the EMS Board under this subtitle by filing a notice of appeal with MIEMSS within 15 days after receipt of the decision. A person who files an appeal will be granted a hearing before the EMS Board or, if the Board so elects and notifies the appellant, the Office of Administrative Hearings. An appeal hearing shall be governed by COMAR 28.02.01. If the hearing is conducted by the Office of Administrative Hearings, the hearing procedures of COMAR 30.02.06.22 and .23 also apply. The EMS Board may make the final decision in any appeal as provided by COMAR 30.02.06.23. A person may seek judicial review of the EMS Board's final decision under the State Government Article, §10-222, Annotated Code of Maryland. The EMS Board shall be party to the proceeding. Education Article, §13-516(d), Annotated Code of Maryland Effective date: October 15, 2001 (28:20 Md. R. 1784) This chapter governs ALS education programs approved by the EMS Board which have been approved to provide education in specialty care transport. In order to be approved to provide a specialty care transport education course, an education program shall: Meet all requirements for an ALS education program found in COMAR 30.04.02 except for the requirement in COMAR 30.04.02.12F(2)(d) to conduct at least one full length ALS course every 2 years; Have a medical director who, in addition to the other requirements for medical directors in COMAR 30.04.02.06B: Has education and experience in the care of critically ill patients; and Uses specialty physicians as appropriate; Use a curriculum which has been approved by the EMS Board; and Use instructors who: Meet the requirements of COMAR 30.04.02; and Have additional education, experience, and expertise in the care and transport of a critically ill patient. Education Article, §§13-509 and 13-516, Annotated Code of Maryland Effective date: January 15, 2005 (31:26 Md. R. 1866)