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)