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)