WSR 03-15-069

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed July 15, 2003, 10:53 a.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 03-09-125.

     Title of Rule: WAC 246-976-021 EMS and trauma training course requirements.

     Purpose: The purpose of the rule change is to eliminate incorrect references, redundant language, unnecessary lessons, and provide more clear and concise rule language.

     Statutory Authority for Adoption: RCW 18.71.205, 18.73.081, 70.168.060.

     Statute Being Implemented: Same.

     Summary: The proposed changes will properly identify the EMT training course curriculum within the WAC, remove unnecessary lessons from the IV technician and airway technician curriculums, which are not pertinent to those levels of care, and remove excess verbiage in describing training course requirements, which is redundant and can become confusing to providers.

     Reasons Supporting Proposal: The proposed rule change will eliminate incorrect references, unnecessary lessons, and provide more and clear and concise rule language. In addition it will reduce costs for IV technician and airway technician training.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Dane Kessler, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-2842.

     Name of Proponent: Department of Health, governmental.

     Rule is not necessitated by federal law, federal or state court decision.

     Explanation of Rule, its Purpose, and Anticipated Effects: The department is proposing making three housekeeping changes. These changes will correct a current discrepancy between the identifying title of the current emergency medical technician (EMT) training course curriculum as printed and its reference in WAC 246-976-021, remove unnecessary lessons from IV technician and airway technician curriculums, and remove excess verbiage in describing training course requirements. These changes will eliminate incorrect references, unnecessary lessons, and provide more clear and concise rule language for all EMS personnel affected.

     Proposal Changes the Following Existing Rules: The proposal makes three changes to WAC 246-976-021:

     (1) The current EMT course curriculum is misidentified in WAC 246-976-021 (3)(b) as "The emergency medical technician -- Basic training course published 1994, amended by the department February 1999." That curriculum is properly entitled "The emergency medical technician -- Basic training course published 1994, amended by the department September 1996." This typographical error needs to be corrected so the correct course curriculum will be properly identified within the WAC.

     (2) Eliminate the requirements of lessons, 3-2, 3-3, 4-1, and 4-2 for IV technicians and airway technicians. In addition, eliminate all listing of specific lesson plans that are already detailed in reference to the IV technician course curriculum in subsection (3)(c) and airway technician course curriculum in subsection (3)(d).

     (3) Eliminate the listing of specific lesson plans that are already detailed in reference to the ILS technician course curriculum in subsection (3)(e).

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has reviewed and analyzed this proposal and has determined that no small business economic impact statement (SBEIS) is required. The Regulatory Fairness Act, under RCW 19.85.030 requires agencies to conduct an SBEIS if a rule imposes more than minor costs on businesses within an industry. This proposal reduces costs to businesses by eliminating unnecessary lessons from the IV technician and airway technician course curriculums within WAC 246-976-021. Since this proposal does not impose costs to businesses the department has not completed an SBEIS on this proposal.

     RCW 34.05.328 applies to this rule adoption. The proposed rule changes set criteria that are necessary for an individual to comply with in order to obtain certification.

     Hearing Location: Department of Health, Point Plaza East, 310 Israel Road S.E., Room 139, Tumwater, WA 98501, on August 27, 2003, at 1:00 p.m.

     Assistance for Persons with Disabilities: Tami Schweppe, (360) 236-2859, fax (360) 236-2829, by August 13, 2003, TDD (800) 833-6388 or (360) 236-2829.

     Submit Written Comments to: Tami Schweppe, P.O. Box 47853, Olympia, WA 98504-7853, fax (360) 236-2829, by August 27, 2003.

     Date of Intended Adoption: August 28, 2003.

July 14, 2003

M. C. Selecky

Secretary

OTS-6203.2


AMENDATORY SECTION(Amending WSR 00-08-102, filed 4/5/00, effective 5/6/00)

WAC 246-976-021   Training course requirements.   (1) Department responsibilities: The department will publish procedures for agencies to conduct EMS training courses, including:

     (a) The registration process;

     (b) Requirements, functions, and responsibilities of course instructional and administrative personnel;

     (c) Necessary information and administrative forms to conduct the course;

     (2) Training agency responsibilities:

     (a) General. Agencies providing initial training of certified EMS personnel at all levels (except advanced first aid) must:

     (i) Have MPD approval for the course content;

     (ii) Have MPD approval for all instructional personnel, who must be experienced and qualified in the area of training;

     (iii) Have local EMS/TC council recommendation for each course;

     (iv) Have written approval from the department to conduct each course;

     (v) Approve or deny applicants for training consistent with the prerequisites for applicants in WAC 246-976-041 and 246-976-141.

     (b) Basic life support (first responder, EMT). Agencies providing initial training of basic life support personnel must identify a senior EMS instructor to be responsible for the quality of instruction and the conduct of the course.

     (c) Intermediate life support (IV, airway and ILS technicians). Agencies providing initial training of intermediate life support personnel must:

     (i) Have a written agreement with the clinical facility, if it is separate from the academic facility;

     (ii) Ensure that clinical facilities provide departments or sections, personnel, and policies, including:

     (A) Written program approval from the administrator and chief of staff;

     (B) A written agreement to participate in continuing education;

     (C) Supervised clinical experience for students during the clinical portion of the program;

     (D) An orientation program.

     (d) Paramedics. Agencies training paramedics must be accredited by a national accrediting organization approved by the department.

     (3) Course curriculum. The department recognizes the following National Standard EMS training courses published by the United States Department of Transportation as amended by the department:

     (a) First responder: The first responder training course published 1996, amended by the department March 1998;

     (b) EMT: The emergency medical technician -- Basic training course published 1994, amended by the department ((February 1999)) September 1996;

     (c) IV technician: Those ((parts of)) sections and lessons identified in the emergency medical technician --Intermediate course published 1999 ((which relate to intravenous therapy lessons 1-1, 1-2, 1-3, 2-1, 2-2, 2-3, 2-6, 2-7, 3-2, 3-3, 4-1, and 4-2;)), amended by the department ((February 1999)) April 2000;

     (d) Airway technician: Those ((parts of)) sections and lessons identified in the emergency medical technician --Intermediate course published 1999 ((which relate to airway management lessons 1-1, 1-2, 1-3, 2-1, 2-2, 2-3, 2-5, 3-2, 3-3, 4-1, and 4-2;)), amended by the department ((February 1999)) April 2000;

     (e) ILS technician: Those ((parts of)) sections and lessons identified in the emergency medical technician --Intermediate course published 1999 ((which relate to IV therapy and intraosseous infusion, the use of multi-lumen airway adjuncts, and)), amended by the department April 2000 which includes the following medications:

     (i) Epinephrine for anaphylaxis administered by a commercially preloaded measured-dose device;

     (ii) Albuterol administered by inhalation;

     (iii) Dextrose 50% and 25%;

     (iv) Nitroglycerine, sublingual and/or spray;

     (v) Naloxone;

     (vi) Aspirin PO (oral), for suspected myocardial infarction ((lessons 1-1, 1-2, 1-3, 2-1, 2-2, 2-3, 2-4, 2-6, 2-7, 3-1, 3-2, 3-3, 4-1, and 4-2; amended by the department February 1999));

     (f) Paramedic: The emergency medical technician --Paramedic training course published 1999, as amended by the department January 2000.

     (4) Initial training for first responders and EMTs must also include approved infectious disease training that meets the requirements of chapter 70.24 RCW.

     (5) Specialized training. The department, in conjunction with the advice and assistance of the L&C committee, may approve specialized training for certified EMS personnel to use skills, techniques, or equipment that is not included in standard course curricula. Agencies providing specialized training must have MPD and department approval of:

     (a) Course curriculum;

     (b) Lesson plans;

     (c) Course instructional personnel, who must be experienced and qualified in the area of training;

     (d) Student selection criteria;

     (e) Criteria for satisfactory completion of the course, including student evaluations and/or examinations;

     (f) Prehospital patient care protocols that address the specialized skills.

     (6) Local government agencies: The department recognizes county agencies established by ordinance and approved by the MPD to coordinate EMS training. These agencies must comply with the requirements of this section.

[Statutory Authority: Chapters 18.71, 18.73, and 70.168 RCW. 00-08-102, § 246-976-021, filed 4/5/00, effective 5/6/00.]

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