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.