Issue 50 - 12-16-2021 | Board of Emergency Medical Services | Permanent Administrative Regulations

Volume 40 - Issue 50 - December 16, 2021

State of Kansas

Board of Emergency Medical Services

Permanent Administrative Regulations

Article 1.—DEFINITIONS

109-1-1. Definitions. Each of the following terms, as used in the board’s regulations, shall have the meaning specified in this regulation:

(a) “AEMT” means advanced emergency medical technician.

(b) “Advanced life support” and “ALS” mean the statutorily authorized activities and interventions that may be performed by an advanced emergency medical technician or paramedic.

(c) “Air ambulance” means a fixed-wing or rotor-wing aircraft that is specially designed, constructed or modified, maintained, and equipped to provide air medical transportation and emergency care of patients.

(d) “Air medical director” means a physician as defined by K.S.A. 65-6112, and amendments thereto, who meets the following requirements:

(1) Is trained and experienced in care consistent with the air ambulance service’s mission statement; and

(2) is knowledgeable in altitude physiology and the complications that can arise due to air medical transport.

(e) “Air medical personnel” means the EMS providers listed on the EMS provider roster, health care personnel identified on the service health care personnel roster of the air ambulance service, specialty patient care providers specific to the mission, and the pilot or pilots necessary for the operation of the aircraft.

(f) “Airway maintenance,” as used in K.S.A. 65-6121 and amendments thereto and as applied to the authorized activities of an advanced emergency medical technician, means the use of any invasive oral equipment and procedures necessary to ensure the adequacy and quality of ventilation and oxygenation.

(g) “Attendant” means EMS provider.

(h) “Basic life support” and “BLS” mean the statutorily authorized activities and interventions that may be performed by an emergency medical responder or emergency medical technician.

(i) “CAPCE” means the commission on accreditation for pre-hospital continuing education.

(j) “Certified mechanic,” as used in K.A.R. 109-2-2, means an individual employed or contracted by the ambulance service, city or county, qualified to perform maintenance on licensed ambulances and inspect these vehicles and validate, by signature, that the vehicles meet both mechanical and safety considerations for use.

(k) “Class” means the period during which a group of students meets.

(l) “Coordination” means the submission of an application for approval of initial courses of instruction or continuing education courses and the oversight responsibility of those same courses and instructors once the courses are approved.

(m) “Course of instruction” means a body of prescribed EMS studies approved by the board.

(n) “Critical care transport” means the transport by an ambulance of a critically ill or injured patient who receives care commensurate with the care rendered by health care personnel as defined in this regulation or a paramedic with specialized training as approved by service protocols and the medical director.

(o) “Emergency” means a serious medical or traumatic situation or occurrence that demands immediate action.

(p) “Emergency call” means an immediate response by an ambulance service to a medical or trauma incident that happens unexpectedly.

(q) “Emergency care” means the services provided after the onset of a medical condition of sufficient severity that the absence of immediate medical attention could reasonably be expected to cause any of the following:

(1) Place the patient’s health in serious jeopardy;

(2) seriously impair bodily functions; or

(3) result in serious dysfunction of any bodily organ or part.

(r) “EMR” means emergency medical responder.

(s) “EMS” means emergency medical services.

(t) “EMS provider” means emergency medical service provider.

(u) “EMT” means emergency medical technician.

(v) “Ground ambulance” means a ground-based vehicle that is specially designed and equipped for emergency medical care and transport of sick and injured persons and meets the requirements in K.A.R. 109-2-8.

(w) “Health care personnel” and “health care provider,” as used in the board’s regulations, means a physician, physician assistant, licensed professional nurse, advanced practice registered nurse, or respiratory therapist.

(x) “Incompetence,” as applied to EMS providers and as used in K.S.A. 65-6133 and amendments thereto, means a demonstrated lack of ability, knowledge, or fitness to perform patient care according to applicable medical protocols or as defined by the authorized activities of the EMS provider’s level of certification.

(y) “Incompetence,” as applied to instructor-coordinators and as used in K.S.A. 65-6129b and amendments thereto, means a pattern of practice or other behavior that demonstrates a manifest incapacity, inability, or failure to coordinate or to instruct EMS provider training programs.

(z) “Incompetence,” as applied to an operator and as used in K.S.A. 65-6132 and amendments thereto, means either of the following:

(1) The operator’s inability or failure to provide the level of service required for the type of permit held; or

(2) the failure of the operator or an agent or employee of the operator to comply with a statute or regulation pertaining to the operation of a licensed ambulance service.

(aa) “Instructor-coordinator” and “I-C” mean any of the following individuals who are certified to instruct and coordinate EMS provider training programs:

(1) Emergency medical technician;

(2) physician;

(3) physician’s assistant;

(4) advanced practice registered nurse;

(5) licensed professional nurse;

(6) advanced emergency medical technician; or

(7) paramedic.

(bb) “Interoperable” means that one system has the ability to communicate or work with another.

(cc) “Lab assistant” means an individual who is assisting a primary instructor in the instruction and evaluation of students in classroom laboratory training sessions.

(dd) “Long-term provider approval” means that the sponsoring organization has been approved by the executive director to provide any continuing education program as prescribed in K.A.R. 109-5-3.

(ee) “Out of service,” as used in K.A.R. 109-2-5, means that a licensed ambulance is not immediately available for use for patient care or transport.

(ff) “Primary instructor” means an instructor-coordinator who is listed by the sponsoring organization as the individual responsible for the competent delivery of cognitive, psychomotor, and affective objectives of an approved initial course of instruction or continuing education program and who is the person primarily responsible for evaluating student performance and developing student competency.

(gg) “Prior-approved continuing education” means material submitted by a sponsoring organization, to the board, that is reviewed and subsequently approved by the executive director, in accordance with criteria established by regulations, and that is assigned a course identification number.

(hh) “Program manager” means an individual who has been appointed, employed, or designated by a sponsoring organization, as defined in K.S.A. 65-6112 and amendments thereto, to ensure that the sponsoring organization is in conformance with applicable regulations and to ensure that quality EMS education is provided by the sponsoring organization’s qualified instructors.

(ii) “Public call” means the request for an ambulance to respond to the scene of a medical emergency or accident by an individual or agency other than any of the following:

(1) A ground ambulance service;

(2) the Kansas highway patrol or any law enforcement officer who is at the scene of an accident or medical emergency;

(3) a physician, as defined by K.S.A. 65-6112 and amendments thereto, who is at the scene of an accident or medical emergency; or

(4) an EMS provider who has been dispatched to provide emergency first response and who is at the scene of an accident or medical emergency.

(jj) “Quality management plan” means a written plan developed by a sponsoring organization that describes all processes utilized by the sponsoring organization to ensure that the EMS education provided meets the requirements of the community’s EMS training needs assessment or meets the training needs of the intended audience. Each quality management plan shall, at a minimum, include a review and analysis by the medical director and program manager of each completed course and the instructor evaluations.

(kk) “Reinstatement” means the process by which a person may be issued a certificate at the same level of certification as that of an expired certificate.

(ll) “Retroactively approved continuing education” means credit issued to an EMS provider after attending a program workshop, conference, seminar, or other offering that is reviewed and subsequently approved by the executive director, in accordance with criteria established by the board.

(mm) “Service director” means an individual who has been appointed, employed, or designated by the operator of an ambulance service to handle daily operations and to ensure that the ambulance service is in conformance with local, state, and federal laws and ensure that quality patient care is provided by the ambulance service EMS providers.

(nn) “Service records” means the documents required to be maintained by state regulations and statutes pertaining to the operation and education within a licensed ambulance service.

(oo) “Single-program provider approval” means that the sponsoring organization has been granted approval to offer a specific continuing education program.

(pp) “Sufficient application” means that the information requested on the application form is provided in full, any applicable fee has been paid, all information required by statute or regulation has been submitted to the board, and no additional information is required to complete the processing of the application.

(qq) “Teach” means instruct or coordinate training, or both.

(rr) “Unprofessional conduct,” as applied to EMS providers and as used in K.S.A. 65-6133 and amendments thereto, means conduct that violates those standards of professional behavior that through professional experience have become established by the consensus of the expert opinion of the members of the EMS profession as reasonably necessary for the protection of the public. This term shall include any of the following:

(1) Failing to take appropriate action to safeguard the patient;

(2) performing acts beyond the activities authorized for the level at which the individual is certified;

(3) falsifying a patient’s or an ambulance service’s records;

(4) verbally, sexually, or physically abusing a patient;

(5) violating statutes or regulations concerning the confidentiality of medical records or patient information obtained in the course of professional work;

(6) diverting drugs or any property belonging to a patient or an agency;

(7) making a false or misleading statement on an application for certification renewal or any agency record;

(8) engaging in any fraudulent or dishonest act that is related to the qualifications, functions, or duties of an EMS provider; or

(9) failing to cooperate with the board and its agents in the investigation of complaints or possible violations of the EMS statutes or board regulations, including failing to furnish any documents or information legally requested by the board. EMS providers who fail to respond to requests for documents or requests for information within 30 days from the date of request shall have the burden of demonstrating that they have acted in a timely manner.

(ss) “Unprofessional conduct,” as applied to instructor-coordinators and as used in K.S.A. 65-6129b and amendments thereto, means any of the following:

(1) Engaging in behavior that demeans a student. This behavior shall include ridiculing a student in front of other students or engaging in any inhumane or discriminatory treatment of any student or group of students;

(2) verbally or physically abusing a student;

(3) failing to take appropriate action to safeguard a student;

(4) falsifying any document relating to a student or the sponsoring organization;

(5) violating any statutes or regulations concerning the confidentiality of student records;

(6) obtaining or seeking to obtain any benefit, including a sexual favor, from a student through duress, coercion, fraud, or misrepresentation, or creating an environment that subjects a student to unwelcome sexual advances, which shall include physical touching or verbal expressions;

(7) an inability to instruct because of alcoholism, excessive use of drugs, controlled substances, or any physical or mental condition;

(8) reproducing or duplicating a state examination for certification without board authority;

(9) engaging in any fraudulent or dishonest act that is related to the qualifications, functions, or duties of an instructor-coordinator;

(10) willfully failing to adhere to the course syllabus; or

(11) failing to cooperate with the board and its agents in the investigation of complaints or possible violations of the board’s statutes or regulations, including failing to furnish any documents or information legally requested by the board. Instructor-coordinators who fail to respond to requests for documents or requests for information within 30 days of the request shall have the burden of demonstrating that they have acted in a timely manner. (Authorized by K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111, K.S.A. 2020 Supp. 65-6129, K.S.A. 2020 Supp. 65-6129b, K.S.A. 65-6132, and K.S.A. 2020 Supp. 65-6133; effective May 1, 1985; amended May 1, 1986; amended, T-88-12, May 18, 1987; amended, T-88-24, July 15, 1987; amended May 1, 1988; amended July 17, 1989; amended March 16, 1992; amended Jan. 31, 1994; amended Jan. 30, 1995; amended Jan. 31, 1997; amended Nov. 12, 1999; amended Jan. 27, 2012; amended March 15, 2013; amended April 29, 2016; amended Dec. 29, 2017; amended Dec. 31, 2021.)

Article 2.—AMBULANCE SERVICES; PERMITS AND REGULATIONS

109-2-1. Ambulance service operator. (a) Each operator of an ambulance service shall perform the following:

(1) Notify the board of any change in the service director within seven days of the change; and

(2) designate a person as the ambulance service director to serve as an agent of the operator.

(b) The ambulance service director shall meet the following requirements:

(1) Be responsible for the operation of the ambulance service;

(2) be available to the board regarding permit, regulatory, and emergency matters;

(3) be responsible for maintaining a current list of the ambulance service’s attendants;

(4) notify the board of each addition or removal of an attendant from the attendant roster within seven days of the addition or removal;

(5) notify the board of any known resignation, termination, incapacity, or death of a medical adviser once known and the plans for securing a new medical director; and

(6) submit written notification of each change in the medical director within 30 days of the change. (Authorized by K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6130; effective May 1, 1985; amended July 17, 1989; amended Jan. 31, 1997; amended Jan. 27, 2012; amended April 29, 2016; amended Dec. 31, 2021.)

Article 3.—STANDARDS FOR AMBULANCE ATTENDANTS, FIRST RESPONDERS, AND DRIVERS

109-3-1. (Authorized by and implementing K.S.A. 65-6110; effective July 17, 1989; amended Jan. 31, 1997; amended July 10, 2009; revoked Dec. 31, 2021.)

Article 5.—CONTINUING EDUCATION

109-5-1. Continuing education. (a) “Continuing education” shall mean a formally organized learning experience that has education as its explicit principal intent and is oriented towards the enhancement of EMS practice, values, skills, and knowledge.

(b) Continuing education credit shall be awarded in quarter-hour increments and shall not be issued for more than one hour of credit for a 60-minute period.

(1) Initial courses of instruction and prior-approved continuing education provided by a sponsoring organization;

(2) programs approved or accredited by CAPCE, which shall be presumptively accepted by the board unless the board determines that a particular program does not meet board requirements; and

(3) programs or courses approved by another state’s EMS regulatory or accrediting body, which shall be presumptively accepted by the board unless the board determines that a particular program does not meet board requirements.

(d) Any program not addressed in subsection (c) may be submitted for approval by the EMS provider as specified in K.A.R. 109-5-5.

(e) The amount of continuing education credit obtained in one calendar day shall not exceed 12 clock-hours.

(f) Each EMS provider and instructor-coordinator shall keep documentation of completion of approved continuing education for at least three years and shall provide this documentation to the board upon request by the executive director.

(g) Documentation of completion of approved continuing education shall verify the following for each continuing education course completed:

(1) The name of the provider of the continuing education course;

(2) the name of the individual being issued the continuing education credit;

(3) the title of the continuing education course;

(4) the date or dates on which the course was conducted;

(5) the location where the course was conducted;

(6) the amount of continuing education credit issued to the individual; and

(7) the course identification number. (Authorized by K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6129; effective, T-88-122, May 18, 1987; amended, T-88-24, July 15, 1987; amended May 1, 1988; amended July 17, 1989; amended Feb. 3, 1992; amended Aug. 16, 1993; amended Dec. 19, 1994; amended Nov. 1, 1996; amended Nov. 12, 1999; amended, T-109-8-8-00, Aug. 8, 2000; amended Nov. 13, 2000; amended Aug. 30, 2002; amended Sept. 10, 2010; amended, T-109-2-7-11, Feb. 7, 2011; amended June 3, 2011; amended Jan. 4, 2016; amended Dec. 29, 2017; amended March 1, 2019; amended Dec. 31, 2021.)

109-5-3. Continuing education approval for long-term providers. (a) Any sponsoring organization may submit an application to the board requesting approval as a long-term provider.

(b) Each sponsoring organization seeking long-term provider approval shall submit a continuing education training program management plan at least 30 calendar days before the first course offering as a long-term provider.

(c) Each continuing education training program management plan shall include a description of the plan and all policies or documents demonstrating how the sponsoring organization will utilize its quality management plan to ensure that each continuing education course provided meets the following requirements:

(1) Is provided in a manner that protects the health and safety of students and participants;

(2) is oriented towards the enhancement of EMS practice, values, skills, and knowledge; and

(3) issues continuing education credit as specified in K.A.R. 109-5-1. (Authorized by and implementing K.S.A. 2020 Supp. 65-6111; effective, T-88-12, May 18, 1987; amended, T-88-24, July 15, 1987; amended May 1, 1988; amended July 17, 1989; amended Nov. 12, 1999; amended May 15, 2009; amended Sept. 10, 2010; amended March 15, 2013; amended Dec. 29, 2017; amended Dec. 31, 2021.)

109-5-6. Continuing education approval for single-program provider. (a) Any sponsoring organization may submit an application to the board requesting approval as a single-program provider.

(b) Each sponsoring organization seeking single-program provider approval shall submit a complete application at least 30 days before the requested offering that provides the following:

(1) Course educational objectives that are oriented towards the enhancement of EMS practice, values, skills, and knowledge;

(2) name of each qualified instructor for the course; and

(3) date, title, and location of the course. (Authorized by and implementing K.S.A. 2020 Supp. 65-6111; effective May 15, 2009; amended Dec. 31, 2021.)

Article 6.—TEMPORARY CERTIFICATION

109-6-2. Renewal of EMS provider and instructor-coordinator certificates. (a) Each EMS provider certificate shall expire on December 31 of the second complete calendar year following the date of issuance.

(b) An EMS provider and an instructor-coordinator who is also an EMS provider may renew that person’s certificate for each biennial period upon submission of a sufficient application for renewal as specified in subsection (d).

(d) Each application for renewal shall be deemed sufficient when all of the following conditions are met:

(1) The applicant provides in full the information requested and no additional information is required by the board to complete the processing of the application.

(2) The applicant submits a renewal fee in the applicable amount specified in K.A.R. 109-7-1.

(3) The applicant has completed the requirements in K.A.R. 109-5-1, K.A.R. 109-5-1a, K.A.R. 109-5-1b, K.A.R. 109-5-1c, K.A.R. 109-5-1d, and K.A.R. 109-5-1e that are applicable to the application being submitted.

(e) The date of receipt of the renewal application shall mean the electronic time stamp indicating when the renewal application is submitted in the license management system. (Authorized by K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6129 and 65-6129b; effective Nov. 1, 1996; amended Oct. 31, 1997; amended Nov. 12, 1999; amended, T-109-8-8-00, Aug. 8, 2000; amended Nov. 13, 2000; amended Feb. 12, 2010; amended Dec. 29, 2017; amended Dec. 31, 2021.)

109-6-4. Inactive certificate. (a) Before expiration of an active certificate, any emergency medical service provider may apply for an inactive certificate on a form provided by the board. The application shall be accompanied by the inactive certificate fee specified in K.A.R. 109-7-1.

(b) An inactive certificate may be renewed upon submission of a sufficient renewal application and the inactive certificate renewal fee specified in K.A.R. 109-7-1.

(c) The inactive certificate of a person may be reinstated to an active certificate by the board if the person meets the following requirements:

(1) Submits a completed application to the board on forms provided by the executive director;

(2) pays the applicable fee specified in K.A.R. 109-7-1;

(3) has completed any training necessitated by changes to the authorized activities specific to the person’s level of certification that occurred after issuance of the inactive certificate; and

(4) meets either of the following requirements:

(A) Completed continuing education in an amount to meet or exceed the number of clock-hours specified for renewal of a certificate in K.A.R. 109-5-1a for EMR, K.A.R. 109-5-1b for EMT, K.A.R. 109-5-1c for AEMT, or K.A.R. 109-5-1d for paramedic for each two-year period after issuance of the inactive certificate; or

(B) successfully completed the cognitive and psychomotor assessment for the person’s level of certification, within three attempts. (Authorized by K.S.A. 2020 Supp. 65-6110 and 65-6111; implementing K.S.A. 2020 Supp. 65-6129d; effective Dec. 31, 2021.)

Article 7.—FEES

109-7-1. Schedule of fees. (a) Attendant, I-C, and ambulance service application fees shall be nonrefundable.

(b) Emergency medical responder fees:

(1) Application for certification fee $15.00
(2) certification renewal application fee if received before certificate expiration 20.00
(3) certification reinstatement application fee if received within 31 calendar days after certificate expiration 40.00
(4) certification reinstatement application fee if received on or after the 32nd calendar day after certificate expiration 80.00

(1) Application for certification fee 65.00
(2) certification renewal application fee if received before certificate expiration 50.00
(3) certification reinstatement application fee if received within 31 calendar days after certificate expiration 100.00
(4) certification reinstatement application fee if received on or after the 32nd calendar day after certificate expiration 200.00

(d) EMT and AEMT fees:

(1) Application for certification fee 50.00
(2) certification renewal application fee if received before certificate expiration 30.00
(3) certification reinstatement application fee if received within 31 calendar days after certificate expiration 60.00
(4) certification reinstatement application fee if received on or after the 32nd calendar day after certificate expiration 120.00

(e) Inactive certificate fees:

(1) Application for inactive certificate 10.00
(2) inactive certificate renewal fee 25.00
(3) application fee for reinstatement of inactive certificate 20.00

(f) Instructor-coordinator fees:

(1) Application for certification fee 65.00
(2) certification renewal application fee if received before certificate expiration 30.00
(3) certification reinstatement application fee if received within 31 calendar days after certificate expiration 60.00
(4) certification reinstatement application fee if received on or after the 32nd calendar day after certificate expiration 120.00

(g) Ambulance service fees:

(1) Service permit application fee 100.00
(2) service permit renewal fee if received on or before permit expiration 100.00
(3) service permit renewal fee if received after permit expiration 200.00
(4) vehicle license application fee 40.00
(5) Temporary license for an ambulance 10.00

(h) Each application for certification shall include payment of the prescribed application for certification fee to the board.

(i) Payment of fees may be made by either of the following:

(1) An individual using a personal, certified, or cashier’s check, a money order, a credit card, or a debit card; or

(2) an ambulance service, fire department, or municipality using warrants, payment vouchers, purchase orders, credit cards, or debit cards.

(j) Payment submitted to the board for application for certification fee, reinstatement fee, or renewal fee for more than one attendant or I-C shall not be accepted, unless the fee amount is correct. (Authorized by K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111, K.S.A. 2020 Supp. 65-6127, K.S.A. 2020 Supp. 65-6129, and K.S.A. 2020 Supp. 65-6129b; implementing K.S.A. 2020 Supp. 65-6111, K.S.A. 2020 Supp. 65-6127, K.S.A. 65-6128, K.S.A. 2020 Supp. 65-6129, and K.S.A. 2020 Supp. 65-6129b; effective July 1, 1990; amended Feb. 3, 1992; amended Nov. 1, 1996; amended, T-109-8-8-00, Aug. 8, 2000; amended Nov. 13, 2000; amended Oct. 31, 2003; amended March 9, 2012; amended April 29, 2016; amended Dec. 29, 2017; amended Dec. 31, 2021.)

Article 10.—CURRICULA

109-10-3. (Authorized by and implementing K.S.A. 2016 Supp. 65-6111; effective Jan. 31, 1994; amended Sept. 2, 2011; amended Dec. 29, 2017; revoked Dec. 31, 2021.)

109-10-6. (Authorized by and implementing K.S.A. 65-6110 and K.S.A. 2009 Supp. 65-6111, as amended by L. 2010, ch. 119, sec. 1; effective Nov. 12, 1999; amended, T-109-2-7-11, Feb. 7, 2011; amended June 3, 2011; revoked Dec. 31, 2021.)

109-10-7. (Authorized by and implementing K.S.A. 2016 Supp. 65-6110 and 65-6111; effective Feb. 12, 2010; amended May 1, 2015; amended Dec. 29, 2017; revoked Dec. 31, 2021.)

Article 11.—COURSE APPROVALS

109-11-1a. Emergency medical responder (EMR) course approval. (a) EMR initial courses of instruction pursuant to K.S.A. 65-6144, and amendments thereto, may be approved by the executive director and shall be conducted only by sponsoring organizations.

(b) Each sponsoring organization requesting approval to conduct an EMR initial course of instruction shall submit a complete application at least 30 calendar days before the first scheduled course session.

(1) Name of the primary instructor;

(2) name of each ambulance service and medical facility utilized for field or clinical training; and

(3) a course schedule that identifies the following:

(A) The date and time of each class session;

(B) the title of the subject matter of each class session;

(D) the number of psychomotor skills laboratory hours for each class session.

(d) Each approved EMR initial course shall meet or exceed each of the educational standards specified in K.A.R. 109-10-1a.

(e) Any approved course may be monitored by the executive director.

(f) Course approval may be withdrawn by the board if the sponsoring organization fails to comply with or violates any regulation or statute that governs sponsoring organizations. (Authorized by K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111, K.S.A. 2020 Supp. 65-6129, and K.S.A. 65-6144; effective, T-109-2-7-11, Feb. 7, 2011; effective June 3, 2011; amended Dec. 29, 2017; amended Jan. 24, 2020; amended Dec. 31, 2021.)

109-11-3a. Emergency medical technician (EMT) course approval. (a) EMT initial courses of instruction pursuant to K.S.A. 65-6121, and amendments thereto, may be approved by the executive director and shall be conducted only by sponsoring organizations.

(b) Each sponsoring organization requesting approval to conduct an EMT initial course of instruction shall submit a complete application at least 30 days before the first scheduled course session.

(1) Name of the primary instructor;

(2) name of each ambulance service and medical facility utilized for field or clinical training; and

(3) a course schedule that identifies the following:

(A) The date and time of each class session;

(B) the title of the subject matter of each class session;

(D) the number of psychomotor skills laboratory hours for each class session.

(d) In the absence of participatory field or clinical training, contrived experiences may be substituted. As used in this regulation, “contrived experience” shall mean a simulated ambulance call and shall include dispatch communications; responding to the scene; assessment and management of the scene and the patient or patients; communications with medical control; ongoing assessment, care and transportation of the patient or patients; the transfer of the patient or patients to the staff of the receiving facility; completion of records; and preparation of the ambulance for return to service.

(e) Each approved EMT initial course shall meet or exceed each of the educational standards specified in K.A.R. 109-10-1b.

(f) Any approved course may be monitored by the executive director.

(g) Course approval may be withdrawn by the board if the sponsoring organization fails to comply with or violates any regulation or statute that governs sponsoring organizations. (Authorized by K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111, and K.S.A. 65-6121; effective, T-109-2-7-11, Feb. 7, 2011; effective June 3, 2011; amended May 1, 2015; amended Dec. 31, 2021.)

109-11-4a. Advanced emergency medical technician (AEMT) course approval. (a) AEMT initial courses of instruction pursuant to K.S.A. 65-6120, and amendments thereto, may be approved by the executive director and shall be conducted only by sponsoring organizations.

(b) Each sponsoring organization requesting approval to conduct an AEMT initial course of instruction shall submit a complete application at least 30 calendar days before the first scheduled course session.

(1) Name of the primary instructor;

(2) name of each ambulance service and medical facility utilized for field or clinical training; and

(3) a course schedule that identifies the following:

(A) The date and time of each class session;

(B) the title of the subject matter of each class session;

(D) the number of psychomotor skills laboratory hours for each class session.

(d) Each approved AEMT initial course shall meet or exceed each of the educational standards specified in K.A.R. 109-10-1c.

(e) Any approved course may be monitored by the executive director.

(f) Course approval may be withdrawn by the board if the sponsoring organization fails to comply with or violates any regulation or statute that governs sponsoring organizations. (Authorized by K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111, and K.S.A. 2020 Supp. 65-6129a; effective March 2, 2012; amended May 1, 2015; amended Dec. 31, 2021.)

109-11-6a. Paramedic course approval. (a) Paramedic initial courses of instruction pursuant to K.S.A. 65-6119, and amendments thereto, may be approved by the executive director and shall be conducted only by sponsoring organizations that are accredited postsecondary educational institutions.

(b) Each sponsoring organization requesting approval to conduct a paramedic initial course of instruction shall submit a complete application at least 30 calendar days before the first scheduled class session.

(1) Name of the primary instructor;

(2) name of each ambulance service and medical facility utilized for field internship or clinical training; and

(3) a course schedule that identifies the following:

(A) The date and time of each class session;

(B) the title of the subject matter of each class session;

(D) the number of psychomotor skills laboratory hours for each class session.

(d) Each approved paramedic course shall meet or exceed each of the educational standards specified in K.A.R. 109-10-1d.

(e) Any approved course may be monitored by the executive director.

(f) Course approval may be withdrawn by the board if the sponsoring organization fails to comply with or violates any regulation or statute that governs sponsoring organizations. (Authorized by K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6110, K.S.A. 2020 Supp. 65-6111, and K.S.A. 2020 Supp. 65-6129a; effective, T-109-2-7-11, Feb. 7, 2011; effective June 3, 2011; amended May 1, 2015; amended March 1, 2019; amended Dec. 31, 2021.)

109-11-7. Instructor-coordinator course approval. (a) Instructor-coordinator initial courses of instruction may be approved by the executive director and shall be conducted only by sponsoring organizations.

(b) Each sponsoring organization requesting approval to conduct an instructor-coordinator initial course of instruction shall submit a complete application at least 30 calendar days before the first scheduled class session.

(1) Name of the primary instructor; and

(2) a course schedule that identifies the following:

(A) The date and time of each class session;

(B) the title of the subject matter of each class session;

(D) the number of psychomotor skills laboratory hours for each class session.

(d) Each approved instructor-coordinator course shall meet or exceed each of the standards specified in K.A.R. 109-10-1e.

(e) Any approved course may be monitored by the executive director.

(f) Course approval may be withdrawn by the board if the sponsoring organization fails to comply with or violates any regulation or statute that governs sponsoring organizations. (Authorized by and implementing K.S.A. 2020 Supp. 65-6110 and K.S.A. 2020 Supp. 65-6111; effective, T-109-1-19-89, Jan. 19, 1989; effective July 17, 1989; amended Dec. 31, 2021.)

109-11-8. Successful completion of a course of instruction. (a) To successfully complete an initial course of instruction for EMS provider or instructor-coordinator, each student shall meet the following requirements:

(1) Demonstrate application of a cognitive understanding of each EMS educational standard;

(2) demonstrate all practical skills to the satisfaction of the primary instructor;

(3) for an EMT initial course of instruction, demonstrate successful completion of each of the following:

(A) One complete patient assessment; and

(B) one nebulized breathing treatment during clinical training or field internship training;

(4) for an AEMT initial course of instruction, demonstrate successful completion of the following:

(A) 20 venipunctures, of which at least 10 shall be for the purpose of initiating intravenous infusions;

(B) five intraosseous infusions;

(D) 10 ambulance calls while being directly supervised by an AEMT, a paramedic, a physician, an advanced practice registered nurse, or a professional nurse;

(E) 10 intramuscular or subcutaneous injection procedures;

(F) 10 completed patient charts or patient care reports, or both; and

(G) eight electrocardiogram applications and interpretations during clinical training and field internship training; and

(5) for a paramedic initial course of instruction, demonstrate each of the following:

(A) Successful completion of both clinical and field internship components; and

(B) confirmation of eligibility to be conferred, at a minimum, an associate degree in applied science by the postsecondary institution.

(b) The primary instructor shall provide written verification, within 15 days of the final class and at least seven days before the state examination for certification, that the primary instructor’s students have met the requirements of subsection (a). (Authorized by K.S.A. 2020 Supp. 65-6110; implementing K.S.A. 2020 Supp. 65-6111, K.S.A. 2020 Supp. 65-6129; effective, T-109-1-19-89, Jan. 19, 1989; effective July 17, 1989; amended Jan. 31, 1994; amended Dec. 31, 2021.)

109-11-9. (Authorized by and implementing K.S.A. 2016 Supp. 65-6110 and 65-6111; effective Feb. 3, 1992; amended Dec. 29, 2017; revoked Dec. 31, 2021.)

Article 15.—CERTIFICATION

109-15-1. Reinstating EMS provider certificate after expiration. (a) The certificate of a person who applies for EMS provider certification after the person’s certificate has expired may be reinstated by the board if the person meets the following requirements:

(1) Submits a completed application to the board on forms provided by the executive director;

(2) pays the applicable fee specified in K.A.R. 109-7-1;

(3) provides validation of completed education requirements; and

(4) if the applicant is either currently certified or licensed in another jurisdiction or has been certified or licensed in another jurisdiction, provides information adequate for the board to determine the applicant’s current status of certification or licensure for the level of certification being sought and confirm that the applicant is in good standing with that jurisdiction.

(b) For the purposes of this regulation, the date of expiration for the certificate shall be one of the following:

(1) The expiration date of the person’s Kansas EMS provider certificate;

(2) 31 calendar days after the expiration date of the person’s certificate or license, if the person is currently certified or licensed in another jurisdiction; or

(3) the most recent expiration date of the person’s certificate or license in another jurisdiction, if the person is not currently certified or licensed in another jurisdiction but previously held a certificate or license in that jurisdiction.

(1) For applications submitted less than two years from the date of expiration and not more than three years from the last date of issuance of the person’s Kansas EMS provider certificate, documentation of continuing education from that last date of issuance to the date of application in sufficient quantity to meet or exceed the following:

(A) For applications submitted not more than 31 calendar days from the date of expiration, the number of clock-hours specified for renewal of a certificate in K.A.R. 109-5-1a for EMR, K.A.R. 109-5-1b for EMT, K.A.R. 109-5-1c for AEMT, or K.A.R. 109-5-1d for paramedic; and

(B) for applications submitted more than 31 calendar days but less than two years from the date of expiration, two times the number of clock-hours specified for renewal of a certificate in K.A.R. 109-5-1a for EMR, K.A.R. 109-5-1b for EMT, K.A.R. 109-5-1c for AEMT, or K.A.R. 109-5-1d for paramedic;

(2) for applications submitted less than two years from the date of expiration and three or more years from the last date of issuance of the person’s Kansas EMS provider certificate, documentation of continuing education for the three years before the date of application in sufficient quantity to meet or exceed the following:

(3) for applications submitted more than two years from the date of expiration, validation of cognitive and psychomotor competency by the following:

(A) Successful completion of a cognitive assessment for the level of certification being sought, within three attempts;

(B) successful completion of a psychomotor assessment for the level of certification being sought, within three attempts; and

(d) Each person who applies for reinstatement of certification two or more years after the date of expiration shall take an entire initial course of instruction if the person is unable to provide validation of cognitive or psychomotor competency by one of the following, whichever occurs first:

(1) The person has exhausted the allowed attempts.

(2) One year has passed from the date of application. (Authorized by K.S.A. 2020 Supp. 65-6111; implementing K.S.A. 2020 Supp. 65-6129; effective May 15, 2009; amended Sept. 2, 2011; amended March 15, 2013; amended Jan. 2, 2015; amended Dec. 31, 2021.)

109-15-2. Recognition of non-Kansas credentials. (a) Any individual who is currently or was previously licensed or certified as an EMS provider in another jurisdiction may apply for Kansas certification through recognition of non-Kansas credentials by submitting the following:

(1) A completed application for recognition of non-Kansas credentials on a form provided by the board;

(2) application for certification fee for the level of certification sought, as specified in K.A.R. 109-7-1;

(3) documentation from another state or jurisdiction verifying one of the following:

(A) That the applicant is currently licensed or certified for the level of certification sought and is in good standing; or

(B) that the applicant was previously licensed or certified for the level of certification being sought and was in good standing at the time of expiration of that credential;

(4) documentation from another state or jurisdiction verifying that the applicant has successfully completed coursework that is substantially equivalent to the curriculum prescribed by the board for the level of certification sought, in accordance with subsection (b);

(5) documentation from another state or jurisdiction verifying that the applicant has successfully completed an examination prescribed by the board for the level of certification sought, in accordance with subsection (b); and

(6) a fingerprint card and criminal history record check fee of $50 for the board to successfully perform a state and national criminal history record check.

(b) Any applicant may validate successful completion of coursework in another state or jurisdiction that is substantially equivalent to the curriculum prescribed by the board for the level of certification sought by submitting one of the following:

(1) Documentation that the applicant is currently registered with the national registry of emergency medical technicians at the level for which certification is sought; or

(2) documentation that the applicant has successfully completed the following within four years before the date of application:

(A) The national registry of emergency medical technicians’ cognitive assessment or examination for the level of certification being sought; and

(B) the psychomotor skills examination prescribed by the national registry of emergency medical technicians or by the board for the level of certification being sought.

(c) Information obtained from the state and national criminal history record check may be used to verify the identity of each applicant and to assist in determining the qualifications and fitness of the applicant seeking issuance of an EMS provider certificate.

(d) The results from each applicant’s criminal history record check shall be received by the board before the issuance of Kansas certification. (Authorized by and implementing K.S.A. 2020 Supp. 65-6111 and K.S.A. 2020 Supp. 65-6129; effective May 15, 2009; amended Sept. 2, 2011; amended Jan. 17, 2014; amended Dec. 31, 2021.)

109-15-3. EMS provider certification. (a) Any individual who successfully completed an approved initial course of instruction may apply for Kansas EMS provider certification.

(b) An application for certification shall not be considered complete unless all requested information has been provided and the applicable application for certification fee, as specified in K.A.R. 109-7-1, has been submitted.

(c) Each applicant shall have 15 days to correct all identified deficiencies and submit a complete application. If the applicant fails to correct the deficiencies and submit a complete application within 15 days, the application may be considered by the board as withdrawn. All fees shall be nonrefundable.

(d) Each applicant shall be at least 17 years of age and meet the following requirements before the date of application:

(1) Have successfully completed an approved initial course of instruction at the level of certification being sought and within the previous 24 months;

(2) have passed both the cognitive and psychomotor examinations for the level of certification being sought after the date of the last class of the approved initial course of instruction completed and as specified in K.A.R. 109-8-1;

(3) if the level of certification being sought is AEMT, currently hold EMS provider certification as an EMT;

(4) if the level of certification being sought is paramedic, currently hold EMS provider certification as an EMT or AEMT; and

(5) if the applicant has not previously held an EMS provider certificate in Kansas, have submitted a fingerprint card and criminal history record check fee of $50 for the board to successfully perform a state and national criminal history record check.

(e) Information obtained from the state and national criminal history record check may be used to verify the identity of each applicant and to assist in determining the qualifications and fitness of the applicant seeking issuance of an EMS provider certificate.

(f) The results from each applicant’s criminal history record check shall be received by the board before the issuance of an initial EMS provider certificate. (Authorized by and implementing K.S.A. 2020 Supp. 65-6111 and K.S.A. 2020 Supp. 65-6129; effective Dec. 31, 2021.)

Article 17.—SPONSORING ORGANIZATIONS

109-17-1. Sponsoring organization; general requirements; program manager. (a) Each sponsoring organization, as defined in K.S.A. 65-6112 and amendments thereto, shall perform the following:

(1) Designate a person as the program manager to serve as an agent of the sponsoring organization;

(2) notify the board of any change in the program manager within seven days of the change;

(3) designate a physician to serve as the medical director of the sponsoring organization;

(4) maintain training program records for at least three years from the last date of class;

(5) develop and maintain a quality management plan;

(6) ensure that EMS training equipment and supplies, including simulation models and empty pharmaceutical packages or containers for pharmaceutical training that are necessary to facilitate the teaching of all psychomotor skills being provided, meet the following requirements:

(A) Are available for use with the class;

(B) are functional, clean, serviceable, and in sufficient quantity to ensure that no more than six students are practicing together on one piece of equipment at any one time; and

(C) are functional, clean, and provided in sufficient quantity for each student to utilize without sharing if the equipment or supplies are for the purpose of protecting the student from exposure to bloodborne or airborne pathogens;

(7) select qualified instructors as determined by training and knowledge of subject matter as follows:

(A) Each didactic instructor and each instructor for medical skills shall possess certification, registration, or licensure in the subject matter or medical skills being taught;

(B) each instructor for nonmedical skills shall have technical training in and shall possess knowledge and expertise in the skill being taught;

(C) each instructor of clinical training being conducted in a clinical health care facility shall be a licensed physician or a licensed professional nurse; and

(D) each instructor of field internship training being conducted with a prehospital emergency medical service shall be an emergency medical services provider certified at or above the level of training being conducted; and

(8) maintain records of all individuals used as instructors or lab assistants to provide training for at least three years from the last date of class. These records shall include the following:

(A) The individual’s name and qualifications;

(B) the subject matter that the individual taught, assisted in teaching, or evaluated;

(D) the students’ evaluation of the individual.

(b) Each program manager shall meet the following requirements:

(1) Be responsible for the EMS education provided by the sponsoring organization;

(2) be available to the board regarding regulatory and emergency matters;

(3) be responsible for maintaining a current list of the sponsoring organization’s qualified instructors;

(4) submit written notification of each addition or removal of a qualified instructor to the board within seven days of the addition or removal;

(5) submit written notification and the content of each change in the quality management plan to the board no later than seven days after the effective date of the change;

(6) submit written notification and the content of each change in the long-term provider continuing education program management plan to the board no later than seven days after the effective date of the change;

(7) submit written notification of any known resignation, termination, incapacity, or death of a medical director once known and the plans for securing a new medical director to the board; and

(8) submit written notification of each change in the medical director to the board within seven days of the change. (Authorized by K.S.A. 2020 Supp. 65-6110; implementing K.S.A. 2020 Supp. 65-6111; effective Dec. 31, 2021.)

109-17-2. Sponsoring organization; application for approval; approval renewal. (a) Each applicant for sponsoring organization approval shall indicate the EMS education that the applicant requests to provide as one or both of the following:

(1) Initial course of instruction; and

(2) continuing education.

(b) All sponsoring organization approval application and renewal forms shall be submitted in a format required by the executive director.

(c) Each applicant that submits an insufficient initial application or renewal application for a sponsoring organization approval shall have 30 days to correct all identified deficiencies and submit a sufficient application. If the applicant or operator fails to correct the deficiencies and submit a sufficient application, the application may be considered by the board as withdrawn.

(d) Each initial application for sponsoring organization approval shall meet the following requirements:

(1) Designate a program manager;

(2) designate a medical director;

(3) designate an office address where all training program records shall be maintained;

(4) provide a list of training equipment and supplies, or a copy of each equipment-sharing agreement, necessary to support training requirements; and

(5) provide a copy of the quality management plan, as defined in K.A.R. 109-1-1.

(e) Each sponsoring organization approval shall expire on April 30 of each year. Any approval may be renewed annually in accordance with this regulation.

(f) Each renewal application for sponsoring organization approval shall affirm that the following information is current and accurate:

(1) Personnel affiliated with the sponsoring organization, including the program manager, medical director, and qualified instructors;

(2) the EMS education that the sponsoring organization requests approval to provide;

(3) the business address where all training program records shall be maintained;

(4) list of training equipment and supplies, or a copy of each equipment-sharing agreement, necessary to support training requirements;

(5) quality management plan; and

(6) all of the following that are applicable to the sponsoring organization:

(A) Initial course of instruction course policies;

(B) clinical and field training agreements; and

(C) long-term provider continuing education program management plan. (Authorized by K.S.A. 2020 Supp. 65-6110; implementing K.S.A. 2020 Supp. 65-6111; effective Dec. 31, 2021.)

109-17-3. Sponsoring organization; initial course of instruction. (a) Any sponsoring organization may conduct an approved initial course of instruction through in-person instruction or distance learning, or a combination of both.

(b) Each sponsoring organization shall provide an enrollment roster listing each student enrolled in the course to the executive director within 20 days of the date of the first scheduled class session.

(c) Each sponsoring organization providing an initial course of instruction shall permit each student and the board access at each scheduled class session for in-person inspection of the course syllabus and all policies or documents addressing the following:

(1) Student evaluation of course;

(2) student attendance;

(3) student discipline;

(4) student and participant safety;

(5) student requirements for successful course completion;

(6) Kansas requirements for certification;

(7) student dress and hygiene;

(8) student progress conferences;

(9) equipment use;

(10) infection control; and

(11) acknowledgement of the commitment to provide the support as defined in the course curriculum from each of the following:

(A) Educational medical director;

(B) ambulance service director for each ambulance service utilized for field training; and

(d) The course syllabus shall include at least the following information:

(1) A summary of course goals and objectives;

(2) student prerequisites, if any, for admission into the course;

(3) instructional and any other materials required to be purchased by the student;

(4) a description of the clinical and field training requirements, if applicable; and

(5) instructor information, which shall include the following:

(A) Instructor name;

(B) office hours or hours available for consultation; and

(e) Each sponsoring organization providing an initial course of instruction shall provide confirmation of each student’s successful course completion to the board.

(f) Each sponsoring organization shall schedule a psychomotor skills examination for the student’s initial examination as specified in K.A.R. 109-8-2.

(g) Each sponsoring organization shall maintain the following course records for each initial course of instruction for at least three years from the last date of class:

(1) Course syllabus;

(2) all policies or documents addressing the listed items in subsection (c);

(3) student attendance;

(4) student grades;

(5) student conferences;

(6) course curriculum;

(7) lesson plans for all lessons;

(8) clinical training objectives;

(9) field training objectives;

(10) completed clinical and field training preceptor evaluations for each student;

(11) a copy of each student’s psychomotor skills evaluations;

(12) a completed copy of each student’s evaluations of each course, all instructors for the course, and all lab instructors for the course; and

(13) a completed copy of the outcome assessment and outcome analyses tools used for the course that address at least the following:

(A) Each student’s ability to perform competently in a simulated or actual field situation, or both; and

(B) each student’s ability to integrate cognitive and psychomotor skills to appropriately care for sick and injured patients.

(h) Each sponsoring organization providing initial courses of instruction shall maintain an average pass rate of at least 70 percent on the cognitive examination for certification at each level of certification that the sponsoring organization instructs for all attempts made by the students in the preceding calendar year. Each sponsoring organization that fails to meet or exceed this average pass rate shall submit to the board a plan for ensuring that future cognitive examination pass rates meet or exceed this average no later than March 1.

(i) Any sponsoring organization may allow a student to enroll late in an initial course of instruction upon submitting to the executive director a make-up schedule that includes the provision of educational standards that the late enrollee missed, within seven days of the student’s enrollment.

(j) Each sponsoring organization providing a paramedic initial course of instruction shall provide one of the following:

(1) Evidence that the sponsoring organization has been issued and maintains a current letter-of-review from the committee on accreditation of educational programs for emergency medical services professions; or

(2) evidence that the sponsoring organization holds accreditation from the committee on accreditation of allied health education programs.

(k) Each sponsoring organization shall provide any course documentation requested by the executive director within 30 days of the request.

(l) Violation of any provision of this regulation may subject the sponsoring organization to a civil fine and may result in a suspension of sponsoring organization approval. (Authorized by K.S.A. 2020 Supp. 65-6110; implementing K.S.A. 2020 Supp. 65-6111; effective Dec. 31, 2021.)

109-17-4. Sponsoring organization; continuing education. (a) Any sponsoring organization may provide prior-approved continuing education as a long-term provider or a single-program provider through in-person instruction or distance learning, or a combination of both.

(b) Each sponsoring organization providing prior-approved continuing education shall submit a training report on a form provided by the board.

(1) The date or dates, title, and location of the class;

(2) a list of all qualified instructors used in the class;

(3) the name and certification number of each attendee; and

(4) the amount of continuing education awarded to each attendee.

(d) Each sponsoring organization shall maintain the following course records for each prior-approved continuing education class for at least three years from the last date of class:

(1) Course educational objectives;

(2) completed course attendance sheet;

(3) a completed copy of each student’s evaluation of the class and each instructor; and

(4) a copy of the submitted training report.

(e) Each completed course attendance sheet shall have the name and signature of each attendee of the prior-approved continuing education class.

(f) Each sponsoring organization providing prior-approved continuing education as a long-term provider shall develop and maintain a long-term continuing education program management plan.

(g) Each sponsoring organization shall provide any continuing education documentation requested by the executive director within 30 days of the request.

(h) Violation of any provision of this regulation may subject the sponsoring organization to a civil fine and may result in a suspension of sponsoring organization approval. (Authorized by K.S.A. 2020 Supp. 65-6110; implementing K.S.A. 2020 Supp. 65-6111; effective Dec. 31, 2021.)

Joseph House
Executive Director

Doc. No. 049649

Scott Schwab
Kansas Secretary of State

Kansas Register