202 KAR 7:601 - Training, education, and continuing education

State Regulations
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RELATES TO: KRS 311A.050, 311A.120, 311A.130, Chapter 362, Chapter 365

NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.120 and 311A.125 require the board to promulgate administrative regulations establishing standards related to the training and education of emergency medical services personnel. KRS 311A.130 requires proper in-service and in-house in-service training and education. KRS 311A.025 requires the board to establish levels of certification. This administrative regulation establishes requirements for an organization to be approved by the board as an Emergency Medical Service Training and Education Institute (EMS-TEI) and also establishes standards for the certification and recertification of emergency medical services educators and providers.

Section 1. Education Committee.

(1) The board shall create and recognize a standing committee on EMS Education.

(2) The Education Committee shall consist of seven (7) voting members representative of EMS Educators in the Commonwealth of Kentucky. The Education Committee shall consist of:

(a) One (1) voting member of the board;

(b) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI 4;

(d) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI 2;

(e) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI CE; and

(f) Two (2) EMS educators at large affiliated with a board-certified EMS-TEI.

(3) The Education Committee shall schedule on an annual basis at least six (6) regular meetings of the committee.

(4) The purpose and charge of the Education Committee shall be to:

(a) Assist the board in developing a strategic plan for EMS education in the Commonwealth of Kentucky;

(b) Act as a resource for EMS educators and EMS-TEIs in the Commonwealth of Kentucky; and

(c) Assume the lead role in formulating, drafting, and sending to the board for approval and subsequent promulgation of all administrative regulations that set the standards and requirements for EMS education and EMS provider certification in the Commonwealth of Kentucky.

Section 2. EMS-TEI Certification.

(1) Only an entity certified by the board as an EMS-TEI may conduct training and education programs in the Commonwealth of Kentucky that lead to certification or licensure by the board. Training shall include:

(a) In person, online, or hybrid; and

(b) Laboratory, clinical, or field internship if required by this administrative regulation.

(2) An applicant for certification as an EMS-TEI in the Commonwealth of Kentucky may be certified at the following levels:

(a) EMS-TEI 1, which includes EMR and continuing education;

(b) EMS-TEI 2, which includes EMR, EMT, and continuing education;

(d) EMS-TEI 4, which includes EMR, EMT, AEMT, Paramedic, and continuing education; or

(e) EMS-TEI CE, which includes continuing education only.

(3) An applicant may seek one (1) level of certification during the two (2) year certification term. A single applicant shall not hold more than one (1) identical TEI certification simultaneously.

(4) An applicant for a level of EMS-TEI certification shall meet all requirements for that level.

(5) An applicant for certification as an EMS-TEI shall electronically submit a completed Training and Educational Institution (TEI) Application, the appropriate EMS-TEI pre-inspection worksheet (Level 1-4 or CE Only), and upload all required documentation listed in the EMS-TEI pre-inspection worksheet to the EMS-TEI KEMSIS account.

(6) An applicant shall submit a nonrefundable fee pursuant to 202 KAR 7:030 with the Training and Education Institution (TEI) Application.

(7) An applicant applying for an EMS-TEI certification shall meet all requirements for that level within sixty (60) days of submitting the Training and Education Institution (TEI) Application for certification. An applicant that exceeds the sixty (60) day requirement shall reapply and resubmit all required fees.

(8) An Emergency Medical Services (EMS) training and educational entity not residing in the Commonwealth of Kentucky, but seeking to do business in Kentucky as an EMS-TEI, shall obtain EMS-TEI certification with the board before teaching any EMS courses that lead to certification or licensure by the board.

(a) These courses include:

1. Initial EMS certification or licensure courses; and

2. EMS continuing education courses.

(b) This does not include continuing education courses covered in Section 13(1) of this administrative regulation.

(9) An EMS-TEI that had its certification revoked shall be eligible to apply for certification as an EMS-TEI two (2) years after the date of revocation. This shall be enforced by name of entity holding the EMS-TEI certification and name of owner or operator listed on the TEI Application and official business license or licenses filed by the entity, owner or operator with local, county and state officials.

(10) An EMS-TEI may surrender its certification prior to the end of a certification period by notifying the board in writing of the intent to do so thirty (30) days prior to the intended effective date of the surrender.

(a) An EMS-TEI surrendering its certification while classes are underway shall notify the students impacted by the closure in writing at least thirty (30) days prior to the intended effective date of closure.

(b) An EMS-TEI surrendering its certification while courses are underway shall complete the courses underway before surrendering its EMS-TEI certification or fully refund all tuition and fees paid by the students in the courses underway that are impacted by the EMS-TEI closure.

(11) An EMS-TEI that does not comply with subsection (10) of this section shall not be eligible to reapply for EMS-TEI certification for a period of five (5) years from the date of closure. This administrative regulation shall not preclude civil action against the TEI Owner, Director, or business.

Section 3. Certification Requirements for EMS-TEIs.

(1) If an applicant is required to file as a business entity with Kentucky's Secretary of State, the applicant for EMS-TEI certification shall provide proof of registration with the Kentucky Secretary of State to the board that the EMS-TEI is legally able to conduct business in the Commonwealth of Kentucky. The applicant shall provide documentation of exemption status if not registered with the Kentucky Secretary of State and proof of registration with local, county, or state officials as an individual operator or a Doing Business As (DBA).

(2) If an applicant is required to notify, obtain permission, or obtain a license from another regulatory entity in the Commonwealth of Kentucky to operate as an educational entity, it shall be the responsibility of the applicant to make the appropriate notifications, obtain permission, or obtain license to legally operate in the Commonwealth of Kentucky. An EMS-TEI that fails to comply with subsection (1) of this section or this subsection shall be subject to disciplinary action by the board pursuant to KRS Chapter 311A.

(3) Facilities. Facilities where EMS-TEI courses are conducted shall be:

(a) Maintained and operated in compliance with the safety and health requirements pursuant to local, city, and county ordinances and federal and state laws;

(b) Sponsored or approved by a sponsoring agency;

(d) Offered in a controlled environment, including:

1. Temperature;

2. Humidity; and

3. Lighting; and

(e) Offered with instruction in classrooms and laboratories that shall:

1. Provide appropriate space for students to participate in classroom activities, kinematic learning, and practice activities;

2. Provide appropriate space for instructor preparation; and

3. Provide adequate and secure storage for instructional materials.

(4) An applicant shall provide the board with an organizational chart indicating, at a minimum:

(a) The names, contact information, and addresses of the owner, operator, chief administrative officer, and other personnel necessary for operation of the entity as an EMS-TEI;

(b) The name and contact information of the EMS-TEI's director;

(d) Proof that the medical director is qualified pursuant to 202 KAR 7:801;

(e) A Memorandum of understanding or contract executed between the owner of the EMS-TEI and the medical director outlining the relationship, duties, and requirements of a medical director for an EMS-TEI. The memorandum of understanding or contract shall include at a minimum that:

1. The medical director shall be responsible for medical oversight of the program;

2. The medical director shall review and approve the educational content of the program curriculum;

3. The medical director shall review and approve the instruments and processes used to evaluate students in didactic, laboratory, clinical, and field internship;

4. The medical director shall review the progress of each student throughout the program, and assist in the determination of appropriate corrective measures, if necessary;

5. The medical director shall engage in cooperative involvement with the program director; and

6. The medical director's interaction shall be in a variety of settings, such as lecture, laboratory, clinical, field internship. Interaction may be by synchronous electronic methods.

(f) The name and contact information of the EMS-TEI's program coordinator; and

(g) The names and contact information of all EMS-TEI Instructors.

(5) EMS training courses that require accreditation shall conform to the requirements of the National Registry of EMT's (NREMT). An EMS-TEI shall submit accreditation documentation to the board upon request.

(a) For programs that require national accreditation, an accreditation letter of review is acceptable in the interim for newly formed EMS-TEIs that are required by CAAHEP to obtain accreditation.

(b) Continuous accreditation status shall be maintained by the EMS-TEI as required by this administrative regulation. Failure to maintain continuous accreditation status by the TEI shall be grounds for summary revocation of the TEI certification.

(6) EMS-TEIs shall obtain and maintain professional liability malpractice insurance of a minimum of $1 million. The EMS-TEI shall provide proof of professional liability malpractice insurance upon initial certification, certification renewal, and upon application for certification upgrade.

Section 4. Certification Periods and Inspections.

(1) An EMS-TEI shall display the current certificate issued through the board:

(a) In a prominent place in the EMS-TEI's business;

(b) In the classroom if classes are being conducted away from the primary business location; and

(2) Certification of an EMS-TEI shall be valid for a period of two (2) years unless limited by disciplinary action.

(3) Prior to expiration of the two (2) years certification period, an EMS-TEI may apply for recertification for a subsequent two (2) year period.

(4) Upon application for recertification, an applicant shall electronically submit:

(a) A Training and Educational Institution (TEI), Certification Renewal Application through the EMS-TEI KEMSIS account with the board;

(b) The appropriate EMS-TEI pre-inspection worksheet (Level 1-4 or CE Only); and

(c) Upload all required documentation listed in the EMS-TEI pre-inspection worksheet (Level 1-4 or CE Only) to the EMS-TEI KEMSIS account.

(5) An EMS-TEI seeking certification renewal shall pay all applicable nonrefundable fees upon application. Failure to pay fees or subsequent rejection of a payment method shall result in denial of the Training and Educational Institution (TEI) Application.

(6) An applicant for EMS-TEI renewal shall meet all renewal requirements prior to the expiration date of the TEI certification.

(a) A TEI that does not comply with all renewal requirements prior to the certification expiration date shall expire.

(b) A TEI that allows the TEI certification to expire shall be required to apply as an initial EMS TEI.

(7) An EMS-TEI applying for initial or certification upgrade shall undergo an inspection prior to offering classes. The type of inspection, on-site or virtual, shall be determined by the office of the board and the EMS-TEI shall be responsible for establishing the virtual connection at their facility if necessary.

(8) Each inspection shall ensure that the EMS-TEI has met all applicable requirements of this administrative regulation. If the board's inspection finds that the EMS-TEI has failed to meet a requirement, the EMS-TEI shall correct all deficiencies prior to offering a class and receiving subsequent certification as an EMS-TEI.

(9) The board may conduct inspections of EMS-TEIs for initial, renewal, certification upgrade, or to monitor compliance with statutory and regulatory requirements for TEIs. Inspections may be scheduled or unscheduled.

(10) The office of the board shall conduct an application review of required documentation and inspection of the EMS-TEI applicant no later than sixty (60) days following the submission of the Training and Educational Institution (TEI) Application by the EMS-TEI applicant for initial certification and upgrades.

(11) Approval of notice of intent to upgrade shall not extend the two (2) year EMS-TEI certification period.

(12) An EMS-TEI requesting a name change or change in ownership shall notify the board in KEMSIS no later than thirty (30) days prior to the name change or change in ownership by completing:

(a) A new Training and Educational Institution (TEI) Application electronically through the EMS-TEI KEMSIS account;

(b) Legal documentation reflecting the legal name or ownership change, or registration with the Kentucky Secretary of State Office reflecting the change which shall be uploaded with the TEI application in KEMSIS; and

Section 5. EMS-TEI Operating Requirements.

(1) Each EMS-TEI shall maintain files for a period of three (3) years beyond the end date of each EMS Course program that contains the following documentation:

(a) For courses requiring accreditation, all documents necessary for the EMS-TEI to have met the accrediting agency's standards, policies, and guidelines;

(b) A copy of the last accreditation self-study and letter of accreditation;

1. Lectures;

2. Practical skills lessons; and

3. Clinical and field rotations;

(d) A master copy of each set of examinations administered and answer keys for the exams;

(e) A master copy of practical skills examination forms;

(f) A master copy of each course syllabus;

(g) Current, written affiliation agreements executed between hospitals or EMS agencies and the EMS-TEI;

(h) Health records for students as may be required by the EMS-TEI or as expressly required in written affiliation agreements and determined necessary for students to complete clinical assignments, field-internships, or summative field evaluations;

(i) Records of all disciplinary actions taken against a student, if applicable. Records shall include notification to students of the complaint; responses, if applicable, made by or on behalf of the student; and actions taken as a result of a complaint or other documented incident, grievance, or deficiency;

(j) For students requiring remediation, documentation of specific activities or procedures requiring remediation and actions taken in response to deficiencies, including how the specific remediation was accomplished and the success or failure of remediation;

(k) A master file of the objectives and competencies to be achieved by students during each educational program; and

(l) Documentation of other requirements that the EMS-TEI has established as part of the offered courses.

(2) Failure of an EMS-TEI to maintain records required by the board shall result in disciplinary action against an EMS-TEI.

(3) The board shall require an EMS-TEI to submit a copy of the EMS-TEI's annual accreditation report electronically through the EMS-TEI's KEMSIS account if accreditation is necessary for licensure or certification of the students taking the EMS-TEI's offered course.

(4) EMS-TEIs shall conduct an annual review and revision of all courses and programs to ensure the EMS-TEI has complied with necessary updates to courses, programs, and accepted educational standards. The participants involved with the annual review shall include:

(a) The program director;

(b) Course coordinator;

(d) An instructor or a faculty member that was actively involved in teaching courses during the preceding twelve (12) months of the annual review; and

(e) A student that successfully completed a course offered through the EMS-TEI during the preceding twelve (12) months of the annual review.

(5) An EMS-TEI shall document in writing the required annual review and updates resulting from the annual assessment.

(6) Documentation of the annual review shall be in writing, signed by the program director, program coordinator, and medical director. The annual review shall be maintained in the course or TEI program files and submitted to the board electronically with the TEI renewal application.

(7) An EMS-TEI shall assure that all physical resources required by the curriculum, including classrooms, skill practice areas, notices of where to purchase or access textbooks, instructional aides, equipment, and supplies shall be:

(a) Available at each class session where skills are taught or practiced;

(b) Adequate in number to allow for practice by students enrolled; and

(8) An EMS-TEI shall maintain and protect the privacy of all records pertaining to the health and safety of patients, students, and faculty members that are obtained or developed through or as a result of participation in training and educational activities with the EMS-TEIs.

(9) The EMS-TEI shall be responsible for knowing and following all federal and state laws relevant to safeguarding privacy of records, including educational and health records.

(10) The EMS-TEI shall develop and make available to all prospective students a clearly defined admissions policy.

(11) An EMS-TEI's admission policy shall include specific requirements for students to gain admission, maintain enrollment, and all academic requirements necessary to successfully complete the offered course or program. The admission policy shall be provided to the student at the start of the course and a verified receipt by signature shall be kept in the student's file including any changes to the admission policy while the student is enrolled in the course. Admissions policies shall include at a minimum:

(a) Tuition rates and fees associated with the training and education program;

(b) Fees and other costs associated with remediation;

(d) Any credit for previous educational, experimental learning, certifications, or transfer hours;

(e) A descriptive synopsis of the curriculum for each type of course taught;

(f) Course educational objectives;

(g) Classroom lecture and skills practice schedules;

(h) Clinical or field rotation locations with beginning and ending dates;

(i) Participation requirements for each clinical or field rotation site;

(j) Continued course competency and course completion requirements; and

(k) Citations to and language of prohibited actions pursuant to KRS 311A.050 that provide grounds for sanctions against or denial of individuals making application for certification or licensure by the board.

(12) EMS-TEIs shall establish written policies that provide for:

(a) The creation and use of course or program advertising that accurately portrays the course or program content as offered by the EMS-TEI;

(b) A uniform process for filing, investigating, and resolving complaints or grievances by applicants, students, preceptor sites, patients, members of the general public, or faculty members;

(c) A procedure for a student to withdraw from a course and a clear statement of refund policies and the steps necessary for a student to obtain a refund of tuition or fees already paid;

(d) Faculty to acquire or develop examinations for each course offered;

(e) The establishment of and adherence to examination procedures and policies;

(f) The requirements for a student to take and pass examinations in courses the EMS-TEI offers including requirements that shall be met during the course for the student to be eligible to take the National Registry of EMTs certification exam; and

(g) Public disclosure, using Web-based materials, concerning the EMS-TEI student cumulative pass rate on the NREMT certification exam for the calendar year. The disclosure shall be updated by January 31 of each year and shall include at a minimum:

1. All provider levels tested;

2. Date range for which the report was calculated;

3. EMS-TEI name, number, and physical address;

4. Number of students that took the exam; and

5. Cumulative pass rate calculated by percentage.

(13) An EMS-TEI shall assure that each student, while participating in a clinical or field rotation, is clearly identified as a student. Identification shall be accomplished by use of:

(a) Nameplate;

(b) A uniform; or

(14) A student or a faculty member shall maintain proper personal and professional conduct during classroom, clinical, and field internship activities.

(15) EMS-TEIs shall have a program director who shall be responsible for:

(a) All aspects of the program, including administration, organization, and supervision of the educational program;

(b) Assuring the quality and credentials of the program coordinator, EMS educators, EMS educator adjuncts, and students accepted into the EMS-TEI's programs or courses;

(d) Monitoring the activities of the EMS-TEI's faculty and students;

(e) Maintaining records and documents and submit reports;

(f) Continuously reviewing the quality and improvement of the educational program;

(g) Long range planning and ongoing development of the program;

(h) The orientation, training, and supervision of clinical and field internship preceptors; and

(i) The effectiveness and quality of fulfillment of responsibilities delegated to another qualified individual.

(16) EMS-TEIs shall include faculty and instructional staff who shall be responsible for:

(a) Didactic, clinical instruction, or supervised practice in each location where students are assigned; and

(b) Coordination, supervision, and frequent assessment of the students' progress in achieving acceptable program requirements.

(17) A certified EMS-TEI shall maintain an ongoing level of competence, evidenced by a minimum pass rate for each level of instruction of sixty (60) percent calculated upon a cumulative pass rate of students who have taken the National Registry of EMTs and other board-approved exam(s) within the twenty-four (24) months immediately preceding the EMS-TEI's renewal date.

(a) The minimum pass rate shall be calculated, and compliance determined by, the office of the board.

(b) An EMS-TEI that fails to maintain a sixty (60) percent pass rate for each level of instruction as required by this subsection shall notify all students enrolled in courses offered by the EMS-TEI that the EMS-TEI is not in compliance with testing standards.

(18) If an EMS-TEI fails to meet an ongoing level of competence determined according to this administrative regulation and demonstrated by compliance with KRS Chapter 311A and 202 KAR Chapter 7, the EMS-TEI shall be subject to a plan of correction mediated through the office of the board. An EMS-TEI that cannot maintain an ongoing level of competence may be subject to discipline pursuant to KRS Chapter 311A.

(19) If requested by the office of the board, the EMS-TEI shall submit graduate data to the Kentucky Center for Education and Workforce Statistics including:

(a) Student's name;

(b) Date of birth;

(d) Gender;

(e) Ethnicity;

(f) Residency at point of graduation; and

(g) The Classification of Instructional Programs (CIP) code, if applicable.

(20) The EMS-TEI director shall keep the EMS-TEI KEMSIS account information updated, including:

(a) The EMS-TEI demographics;

(b) The EMS-TEI personnel roster; and

(21)

(a) The program director of EMS-TEIs offering initial certification courses shall create and maintain, with current information, a National Registry of EMTs educational program account.

(b) The EMS education program name, director name, address, and contact information listed with NREMT shall match the EMS-TEI program information listed in KEMSIS.

Section 6. Disciplinary Action.

(1) As certified entities under the board's jurisdiction, all EMS-TEIs shall be subject to the disciplinary procedures and sanctions established in KRS Chapter 311A.

(2) Discipline of an EMS-TEI as a certified entity shall not prevent the board from taking disciplinary action against a certified or licensed individual associated with the EMS-TEI at any level of certification or licensure applicable.

Section 7. Reporting Requirements for EMS-TEI.

(1) An EMS-TEI shall submit electronically to the board the documents as required by this section for all EMS courses or psychomotor skill verification that lead to certification by The National Registry of EMTs or certification or licensure by the board.

(2) An EMS-TEI shall submit the following documents to the board office:

(a) Course Notification Application submitted no less than fourteen (14) days prior to the course start date;

1. An EMS-TEI shall notify the board within fourteen (14) days of any changes to a board approved class start and end date using Course Change Notification Application.

2. All EMR courses shall utilize the EMR Portfolio Skills Form for evaluation of psychomotor skills in the initial courses.

3. All EMT courses shall utilize the EMT Portfolio Skills Form for evaluation of psychomotor skills in the initial courses.

(b) A Final Educational Course Roster within thirty (30) days of course completion date listed on the Course Notification Application.,

(3) Upon submission of all documents required by this section for courses that lead to certification by The National Registry of EMTs and licensure or certification by the board, the TEI shall be assigned a course number or other identifier.

(4) An EMS-TEI that fails to provide documents as required by subsection (2) of this section shall be subject to disciplinary action pursuant to KRS Chapter 311A up to and including revocation of the TEI.

(5) A course shall not commence until the EMS-TEI has obtained an identification code and notified the board as required in this section.

(6) A course that does not meet all requirements of this administrative regulation may not lead to certification or licensure for the EMS students enrolled in the course.

(7) An EMS-TEI shall notify the board within seven (7) days of any changes to the lead instructor of an initial course that leads to certification or licensure by the board.

(8)

(a) An EMS-TEI shall notify the board within seven (7) days of cancellation of an initial certification or licensure course.

(b) An EMS-TEI that cancels an initial certification or licensure course that is underway or planned shall fully refund all tuition and fees paid by the students in the course that are impacted by the course cancellation.

Section 8. Requirements for All Training and Education Courses.

(1) All EMS educational programs in Kentucky that lead to EMS Provider certification by The National Registry of Emergency Medical Technicians (NREMT) and certification or licensure by the board shall:

(a) Comply with this administrative regulation;

(b) Not begin until the EMS-TEI has filed all documents required pursuant to Section 7 of this administrative regulation;

(d) Use the National Emergency Medical Services Education Standards that are appropriate for the level of EMS provider course being offered;

(e) Teach students the Kentucky and National EMS Scope of Practice Models;

(f) Meet the course administrative and faculty requirements in this administrative regulation, if applicable, as established by the NREMT approved accrediting agency; and

(g) Use educators certified by the board as EMS educators who are minimally certified or licensed at the level of the offered course.

(h)

1. An EMS-TEI shall ensure that all student course work including lectures, practical skills lessons, and clinical or field rotations for courses that lead to certification by the National Registry of EMTs and certification and licensure by the board be completed within sixty (60) days of the course completion date listed on the Course Notification Application.

2. The board shall not accept any changes made to course completion documents listed in Section 7 of this administrative regulation if submitted more than sixty (60) days after the course completion date as listed on the Course Notification Application.

3. In exceptional circumstances, as determined by the board in instances such as if there is an emergent medical condition or a death in the immediate family, the EMS-TEI may submit a Final Course Roster of students approved by the EMS-TEI program director and medical director for course work extension required in Section 5 of this administrative regulation.

(i) The EMS-TEI director shall approve all students to test with the National Registry of EMTs within seven (7) days of successful completion of an initial certification course and completion of all necessary documents and applications by the student.

(2) The EMS-TEI may use an assistant instructor who is not a board-certified educator to instruct no more than forty (40) percent of the classroom education time for initial certification or licensure courses.

(3) The EMS-TEI shall maintain an instructor to student ratio of no more than 1:20 for classroom sessions where skills are practiced. These sessions shall not proceed without the presence of:

(a) A certified educator for the first twenty (20) students; and

(b) An additional educator or adjunct faculty for each one (1) to twenty (20) additional students. Additional adjunct faculty used shall:

1. Not be required to be certified as an EMS educator, but shall be certified by the board as an EMS provider at or above the level for the course being taught; or

2. Be a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA); and

(4) The EMS-TEI program director and medical director shall approve any assistant instructor or adjunct faculty before the individual may assist in instruction.

(5) The EMS-TEI shall have a medical director qualified pursuant to 202 KAR 7:801, who shall:

(a) Be employed by or under memorandum of understanding or a written contract with the EMS-TEI to serve as the medical director of the program;

(b) Be routinely available to the EMS-TEI to provide consultation regarding issues related to the training and education program;

(d) Meets the applicable accrediting agency standards, policies, and guidelines;

(e) Provide medical consultation and guidance to the course faculty; and

(f) Certify the skills of all EMS-TEI students who are enrolled in courses leading to EMS Provider certification by The National Registry of Emergency Medical Technicians (NREMT) or certification or licensure by the board.

(6) An EMS-TEI shall maintain a written contractual affiliation agreement or memorandum of understanding with each clinical rotation site that outlines, at a minimum, the responsibilities of each entity and reporting requirements for students involved in clinical and field training and education.

(7) An EMS-TEI shall provide faculty from the EMS-TEI training and education program, clinical coordinators, or designees under contract with the EMS-TEI to oversee student activity while in the clinical or field internship setting.

(8) The EMS-TEI shall provide clinical or field preceptor training to all clinical or field preceptors overseeing students during clinical or field internship rotations.

Section 9. Emergency Medical Responder Training and Education Course Requirements.

(1) Each Emergency Medical Responder (EMR) training and education course shall:

(a) Include all training and education requirements established in KRS Chapter 311A, 202 KAR 7:201, and 202 KAR 7:701;

(b) Use the National Emergency Medical Services Education Standards - Emergency Medical Responder Instructional Guidelines for the duration of course including individual class segments; and

(2) To be eligible for certification as an EMR, a student shall also receive instruction covering the National and Kentucky EMS Scope of Practice for an EMR.

(3) EMR candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:201.

Section 10. Emergency Medical Technician Training and Education Course Requirements.

(1) Each Emergency Medical Technician (EMT) training and education course shall:

(a) Include all training and education requirements established in KRS Chapter 311A, 202 KAR 7:301, and 202 KAR 7:701;

(b) Use the National Emergency Medical Services Education Standards - Emergency Medical Technician Instructional Guidelines for duration of course and individual class segments; and

(2) To be eligible for certification as an EMT, a student shall receive instruction covering the National and Kentucky EMS Scope of Practice for an EMT.

(3) Each student shall complete clinical and field rotation that meets the requirements for EMT education as determined by this administrative regulation, including the National and Kentucky EMS Scope of Practice for an EMT student as approved by the applicable accrediting agency's minimum requirements.

(4) Clinical or field rotations for EMTs shall be conducted at a licensed ambulance service or other licensed health care facility selected by the EMS-TEI director and medical director that, if applicable, meets nationally accepted accreditation standards or EMS-TEI requirements to verify EMT course competency.

(5) If a student fails to achieve the goals established by the EMS-TEI for the EMT education program, the EMS-TEI program director and medical director shall require the student to repeat the failed portion of the EMT education program.

(6) If a student is required to repeat a portion of the EMT education program, the program director and medical director shall have a written procedure for remediation that ensures the student shall be provided with adequate due process protections that include at a minimum:

(a) Notification of allegations or academic issues;

(b) A right for the student to be heard on the subject of the allegations or academic issues;

(c) A right for the student to appeal the decision of the EMS-TEI to the director and medical director about the allegations or academic issues; and

(d) The notification to the student shall be in writing and signed by:

1. The student;

2. The TEI Administrator;

3. The Medical Director; and

4. The Course Coordinator.

(7) EMT candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:301.

(8) EMT students shall meet health and immunization standards as required through established TEI policy, or policies established by contracted TEI clinical sites.

Section 11. Advanced-Emergency Medical Technician Training and Education Programs.

(1) Advanced-Emergency Medical Technician (AEMT) training and education course requirements. Each AEMT training and education course shall:

(a) Include all training and education pursuant to KRS Chapter 311A, 202 KAR 7:330, and 202 KAR 7:701;

(b) Use the National Emergency Medical Services Education Standards - Advanced Emergency Medical Technician Instructional Guidelines for duration of course and individual class segments; and

(2) To be eligible for certification as an AEMT, a student shall complete a clinical and field rotation that meets the requirements for AEMT education as determined by this administrative regulation including the National and Kentucky EMS Scope of Practice for an AEMT student as approved by the applicable accrediting agency's minimum requirements.

(3) Clinicals or field rotations for AEMTs shall be conducted at a licensed ambulance service or other licensed health care facility selected by the EMS-TEI director and medical director that, if applicable, meets nationally accepted accreditation standards or EMS-TEI requirements to verify AEMT course competency.

(4) If a student fails to achieve the goals established by the EMS-TEI for the AEMT education program, the EMS-TEI program director and medical director shall require the student to repeat the failed portion of the AEMT education program.

(5) If a student is required to repeat a portion of the AEMT education program, the program director and medical director shall have a written procedure for remediation that ensures the student shall be provided with adequate due process protections that include at a minimum:

(a) Notification of allegations or academic issues;

(b) A right for the student to be heard on the subject of the allegations or academic issues;

(c) A right for the student to appeal the decision of the EMS-TEI to the director and medical director about the allegations or academic issues; and

(d) The notification to the student shall be in writing and signed and dated by the:

1. Student;

2. TEI Administrator;

3. Medical Director; and

4. Course Coordinator.

(6) AEMT candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:330.

(7) AEMT students shall meet health and immunization standards as required through established TEI policy, or policies established by contracted TEI clinical sites.

Section 12. Paramedic Training and Education Programs. Paramedic training and education course requirements.

(1) Each Paramedic training and education course shall:

(a) Include all training and education as required by this administrative regulation, KRS Chapter 311A, 202 KAR 7:401, 202 KAR 7:701, and any other Kentucky statutes or administrative regulations that place mandates upon paramedic students;

(b) Use the National Emergency Medical Services Education Standards - Paramedic Instructional Guidelines for duration of course and individual class segments; and

(2) To be eligible for licensure as a paramedic, a student shall complete a clinical or field rotation that meets the requirements for paramedic education as determined by this administrative regulation including the National and Kentucky EMS Scope of Practice for a Paramedic student as approved by the applicable accrediting agency's minimum requirements.

(3) The minimum requirements of clinical or field rotations for paramedics shall include:

(a) Clinicals or field rotations conducted at a licensed ambulance service or other licensed health care facility selected by the EMS-TEI director and medical director that, if applicable, meets nationally accepted accreditation standards or EMS-TEI requirements to verify paramedic course competency; and

(b) A record of patient history and assessment on a care report form for each of the patients required in this section.

(4) If a student fails to achieve the goals established by the EMS-TEI for the EMS education program, the EMS-TEI program director and medical director shall require the student to repeat the failed portion of the paramedic education program.

(5) If a student is required to repeat a portion of the paramedic education program, the program director and medical director shall have a written procedure for remediation that ensures the student shall be provided with adequate due process protections that include at a minimum:

(a) Notification of allegations or academic issues;

(b) A right for the student to be heard on the subject of the allegations or academic issues;

(c) A right for the student to appeal the decision of the EMS-TEI to the director and medical director about the allegations or academic issues; and

(d) The notification to the student shall be in writing and signed and dated by the:

1. Student;

2. TEI Administrator;

3. Medical Director; and

4. Course Coordinator.

(6) Paramedic candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:401.

(7) Paramedic students shall meet health and immunization standards as required through established TEI policy, or policies established by contracted TEI clinical sites.

Section 13. Continuing Education.

(1) Training and education courses provided to individuals that fulfill the continuing education requirements necessary to receive a certification or licensure from the board shall be provided by:

(a) An entity certified by the board as an EMS-TEI;

(b) An agency or department having contractual agreements with a board certified EMS-TEI that is in good standing and not subject to disciplinary action;

(d) A board approved or nationally accredited online or distance education provider with up to 100 percent of the total continuing education hours to fulfill the continuing education requirements for renewal pursuant to KRS Chapter 311A or 202 KAR Chapter 7; or

(e) One (1) or more of the approved continuing education entities listed below:

1. The Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE);

2. Kentucky Board of Nursing;

3. Kentucky Board of Medical Licensure;

4. Kentucky Board of Respiratory Care;

5. Department of Homeland Security and all department components;

6. U.S. Fire Administration and all department components;

7. Kentucky Department of Criminal Justice (DOCJT);

8. Kentucky Cabinet for Health and Family Services; or

9. Courses approved by any State EMS Office that are offered and or completed outside the Commonwealth of Kentucky.

(2) Continuing education courses shall:

(a) Contain material relevant to the job specifications and professional development of EMS personnel; and

(b) Be conducted at an EMS level appropriate for the discipline of the participants.

(3) EMS-TEIs that provide continuing education shall provide course completion documentation by hardcopy or electronically to all participants that successfully complete the continuing education course. The course completion documentation shall contain at a minimum the following items:

(a) Official name of the EMS-TEI as listed in the EMS-TEI KEMSIS account and certification number of the EMS-TEI issued by the board;

(b) Name of primary instructor and state EMS office EMS provider number;

(d) Breakdown of completed hours and subject categories instructed that meet the continuing education requirements established by 202 KAR 7:201, 202 KAR 7:301, 202 KAR 7:330, and 202 KAR 7:401; and

(e) Signature of one (1) of the following EMS-TEI representatives:

1. Director;

2. Course coordinator; or

3. Course instructor.

Section 14. Continuing Education Instructor Requirements.

(1) The following persons shall be qualified to conduct continuing education courses for persons certified or licensed by the board:

(a) An EMS provider licensed or certified by the board that holds a CE, EMR, EMT, AEMT, or Paramedic Educator credential;

(b) A physician (DO or MD) or Physician Assistant (PA) licensed in Kentucky or another state, who has specific expertise in an area of a prehospital discipline;

(c) A registered nurse (RN) or Advanced Practice Registered Nurse (APRN) licensed in Kentucky or another state, who has specific expertise in an area of a prehospital discipline; or

(d) An individual who is at least one (1) of the following and who shall be limited to teaching the specific subject approved by the EMS-TEI director and medical director:

1. Certified by a state or federal agency to teach or perform subject matter relevant to the National Emergency Medical Services Education Standards and National and Kentucky EMS Scope of Practice for a prehospital discipline;

2. Certified by a nationally recognized entity to provide EMS related training and education;

3. A presenter at a National or State Symposium accredited by an agency or other board approved entity; or

4. A presenter approved by an EMS medical director who has specific expertise in an area of a prehospital discipline.

(2) The EMS-TEI or other approved contractual department or agency providing continuing education shall be required to:

(a) Maintain a roster, objectives, and outline for every continuing education course taught on file for a period of three (3) years beyond the end date of each EMS course;

(b) Maintain all documentation to have met the applicable accreditation agency standards, policies, and guidelines established in this administrative regulation; and

(3) If requested by the board, the EMS-TEI shall submit to the board the required documents for EMS continuing education courses taught within the preceding three (3) years that lead to re-certification or re-licensure by the board, including:

(a) Contractual agreements;

(b) The continuing education instructor curriculum vitae or resume that includes at a minimum the educator's name, address, phone number, email address, education history, and employment history documenting the qualifications listed in subsection (1) of this section have been met;

(c) A completed Continuing Education Course Student Roster. The course roster shall include the participants name, signature or digital equivalent, participant KEMSIS number, and board EMS credential held. If rosters are created or stored electronically, there shall be a verification of attendance component that may be verified by the board if requested; and

(d) Objectives, syllabi, outline, and a list of instructor resources used for each continuing education course.

Section 15. Pilot Programs.

(1) A board certified TEI that is in good standing may apply for an Educational Pilot Program.

(2) A pilot program shall involve specialized training and education, as well as associated procedures not otherwise provided for in 202 KAR Chapter 7.

(3) Educational Pilot Programs shall be subject to the provisions of 202 KAR 7:565.

Section 16. EMS Educators.

(1) An EMS Educator may be certified at the following levels:

(a) EMR Educator, which certifies the individual to teach EMR initial certification and continuing education courses;

(b) EMT Educator, which certifies the individual to teach EMR and EMT initial certification and continuing education courses;

(c) AEMT Educator, which certifies the individual to teach EMR, EMT, and AEMT initial certification and continuing education courses;

(d) Paramedic Educator, which certifies the individual to teach EMR, EMT, AEMT, and Paramedic initial certification and continuing education courses; or

(e) CE Educator, which certifies the individual to teach continuing education courses at or below the level of EMS provider certification or license issued by the board.

(2) Depending on the level of certification sought, an applicant for certification as a Kentucky EMS educator shall:

(a) Already hold a certificate or license in Kentucky as an Emergency Medical Responder (EMR), an Emergency Medical Technician (EMT), an Advanced Emergency Medical Technician (AEMT), or a paramedic; or

(b)

1. Hold a license in Kentucky or another state as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA);

2. A Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA) shall be considered an advanced EMS provider at the paramedic level only for the purpose of credentialing the individual as an EMS educator;

(c) Not be issued a certificate as an EMS educator for a level of instruction higher than his or her EMS provider certification or license;

(d) Have successfully completed:

1. A board-approved EMS educator course that meets the objectives of the National Highway Traffic Safety Administration National Guidelines for Educating EMS Instructors and the National Emergency Medical Services Education Standards which is designed to represent a common core for teaching knowledge and skills to assist in the education of adult learners; or

2. Holds an unrestricted and current license or certification as a teacher or educator through a state board of education in the United States;

(e) Submit a completed:

1. CE Educator Initial Application;

2. EMR Educator Initial Application;

3. EMT Educator Initial Application;

4. AEMT Educator Initial Application; or

5. Paramedic Educator Initial Application;

(f) Pay all fees pursuant to 202 KAR 7:030; and

(g) Undergo a background check pursuant to KRS 311A.050 and 311A.100.

1. The background check shall be:

a. National in scope for an applicant not currently certified or licensed at any level in Kentucky;

b. Statewide in scope for an applicant with current certification or licensure in Kentucky;

c. Less than six (6) months old when the applicant submits to the board all requirements for Educator certification; and

d. Provided by a vendor that has been contracted through the board.

2. An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.

(3) Applicants applying for CE Educator shall present documented proof of completing a board approved nationally recognized or EMS-TEI instructor course.

(4) The expiration date of an EMS educator certification shall correspond to those established in KRS Chapter 311A and 202 KAR Chapter 7.

Section 17. Renewal of EMS Educator Certification.

(1) An EMS educator shall be eligible to renew the EMS educator certification if the applicant for renewal:

(a) Has maintained state certification or licensure as an EMS provider or as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA) at a level equal to or greater than the level at which they are certified as an EMS educator;

(b) Retains evidence of completing all training and education pursuant to KRS Chapter 311A;

(d) Has paid fees pursuant to 202 KAR 7:030; and

(e) Has submitted to the board a completed Educator Renewal Application.

(2) The EMS educator shall maintain all training and education documentation outlined in this administrative regulation for three (3) years from the date of completion.

(3) The board office may audit an EMS educator's continuing education and EMS provider continuing education records.

Section 18. EMS Educator reinstatement. An EMS Educator whose certification has lapsed may reinstate. To reinstate a certificate, the EMS educator shall:

(1) Submit a completed:

(a) Application for CE Educator Reinstatement;

(b) Application for EMR Educator Reinstatement;

(d) Application for AEMT Educator Reinstatement; or

(e) Application for Paramedic Educator Reinstatement;

(2) Pay the reinstatement fee pursuant to 202 KAR 7:030;

(3) Submit evidence of previous certification as an EMS Educator in Kentucky; and

(4) Undergo a background check pursuant to KRS 311A.050 and 311A.100.

(a) The background check shall be:

1. National in scope for an applicant not currently certified or licensed at any level in Kentucky;

2. Statewide in scope for an applicant with current certification or licensure in Kentucky;

3. Less than six (6) months old when the applicant submits to the board all requirements for Educator certification; and

4. Provided by a vendor that has been contracted through the board.

(b) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.

Section 19. Transition for Currently Certified Educators. An educator certified prior to the effective date of this administrative regulation shall be transitioned as follows:

(1) Level I Educator shall be certified as an EMR Educator;

(2) Level II Educator shall be certified as an EMT Educator or AEMT Educator;

(3) Level III Educator shall be certified as a Paramedic Educator; and

(4) Level IIIR Educator shall be certified as a Paramedic Educator.

Section 20. EMS Educator Reciprocity. A person certified as an EMS Educator or board approved equivalent in another state or United States territory shall be eligible for Kentucky EMS Educator certification upon:

(1) Submission of a completed:

(a) Application for CE Educator Reciprocity;

(b) Application for EMR Educator Reciprocity;

(d) Application for AEMT Educator Reciprocity; or

(e) Application for Paramedic Educator Reciprocity;

(2) Payment of the educator fee pursuant to 202 KAR 7:030;

(3)

(a) Submission of proof that the applicant is certified as an EMS Educator or board approved equivalent or certified as a teacher or educator through a state board of education in another state or United States territory;

(b) The applicant may only apply for educator certification at the same level of Educator certification currently held in another state or United States territory;

(4) Submission of certification or license by the board as an EMS provider or license as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA); and

(5) Submission to a background check pursuant to KRS 311A.050 and 311A.100.

(a) The background check shall be:

1. National in scope for an applicant not currently certified or licensed at any level in Kentucky;

2. Statewide in scope for an applicant with current certification or licensure in Kentucky;

3. Less than six (6) months old when the applicant submits to the board all requirements for Educator certification; and

4. Provided by a vendor that has been contracted through the board.

Section 21. Educator Oversight. The board may conduct unscheduled visits to an EMS educator's classroom or to an EMS psychomotor examination site to verify compliance with KRS Chapter 311A and 202 KAR Chapter 7, instructional quality, and evaluative standards required by this administrative regulation.

Section 22. Incorporation by reference.

(1) The following material is incorporated by reference:

(a) "Training and Educational Institution (TEI) Application in KEMSIS", 2019 July;

(b) "Course Notification Application in KEMSIS", July 2019;

(d) "National Emergency Medical Services Education Standards", National Highway Traffic Safety Administration, DOT HS 811 077A, January 2009;

1. "National Emergency Medical Services Education Standards-Emergency Medical Responder Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077B, January 2009;

2. "National Emergency Medical Services Education Standards-Emergency Medical Technician Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077C, January 2009;

3. "National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077D, January 2009;

4. "National Emergency Medical Services Education Standards-Paramedic Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077E, January 2009.

(e) "National EMS Scope of Practice Model 2007", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;

(f) "National EMS Scope of Practice Model 2019", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;

(g) "2002 National Guidelines for Educating EMS Instructors", National Highway Traffic Safety Administration, August 2002;

(h) CoAEMSP Interpretations of the CAAHEP 2015 Standards and Guidelines for the Accreditation of Educational Programs in the EMS Professions", February 2019;

(i) "Final Educational Course Roster", September 2012;

(j) "Continuing Education Course Student Roster", September 2012;

(k) "Course Change Notification Application" in KEMSIS, July 2019;

(l) "Psychomotor Exam Application" in KEMSIS, July 2019;

(m) "Comprehensive Skill Evaluation Report", July 2019;

(n) "CE Educator Initial Application" in KEMSIS, February 2013;

(o) "EMR Educator Initial Application" in KEMSIS, July 2019;

(p) "EMT Educator Initial Application" in KEMSIS, July 2019;

(q) "AEMT Educator Initial Application" in KEMSIS, July 2019;

(r) "Paramedic Educator Initial Application" in KEMSIS, July 2019;

(s) "Application for CE Educator Reciprocity" in KEMSIS, July 2019;

(t) "Application for EMR Educator Reciprocity" in KEMSIS, July 2019;

(u) "Application for EMT Educator Reciprocity" in KEMSIS, July 2019;

(v) "Application for AEMT Educator Reciprocity" in KEMSIS, July 2019;

(w) "Application for Paramedic Educator Reciprocity" in KEMSIS, July 2019;

(x) "Application for CE Educator Reinstatement" in KEMSIS, July 2019;

(y) "Application for EMR Educator Reinstatement" in KEMSIS, July 2019;

(z) "Application for EMT Educator Reinstatement" in KEMSIS, July 2019;

(aa) "Application for AEMT Educator Reinstatement" in KEMSIS, July 2019;

(bb) "Application for Paramedic Educator Reinstatement" in KEMSIS, July 2019;

(cc) "Application for Educator Renewal" in KEMSIS, July 2019;

(dd) "EMR Portfolio Skills Form", December 2022; and

(ee) "EMT Portfolio Skills Form", December 2022.

(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office for the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8:00 a.m. to 4:30 p.m.

(3) This material is also available on the board's Web site at: kyems.com.

Notes

202 KAR 7:601

30 Ky.R. 167; 935; 1233; 1495; eff. 11-19-2003; 38 Ky.R. 1770; 39 Ky.R. 40; 754; 952; 1981; eff. 10-17-2012; Crt eff. 2-19-2019; 47 Ky.R. 2455, 48 Ky.R. 416; eff. 9-22-2021; 49 Ky.R. 1506; eff. 6/21/2023.

STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.060, 311A.120, 311A.125, 311A.130

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