DEPARTMENT OF HEALTH

[Filed March 31, 2026, 8:45 a.m.]

Preproposal statement of inquiry was filed as WSR 25-21-026.

Title of Rule and Other Identifying Information: Emergency medical responder (EMR) or emergency medical technician (EMT) training courses; expanding enrollment for initial training to students who are 16 years of age. The department of health (department) is proposing updates in response to new legislative requirements under section 2 of HB 1722 (chapter 98, Laws of 2025), codified as RCW 18.73.165, authorizing a student who is 16 years of age to enroll in an initial EMR or EMT training course. The department is proposing amendments to WAC 246-976-022 and 246-976-041.

Hearing Location(s): On May 5, 2026, at 10:00 a.m. Register in advance for this webinar at https://us02web.zoom.us/webinar/register/WN_IY2wg7VQTt2rvG-YrZsMwg. After registering, you will receive a confirmation email containing information about joining the webinar.

Date of Intended Adoption: May 12, 2026.

Submit Written Comments to: Dawn Felt, EMS Program Manager, P.O. Box 47853, Olympia, WA 98504-7853, email HSQA.EMS@doh.wa.gov, fax 360-236-2830, web https://fortress.wa.gov/doh/policyreview/, beginning the date and time of this filing, by May 5, 2026, at 11:59 p.m.

Assistance for Persons with Disabilities: Contact Martravia Reed, phone 360-236-2805, fax 360-236-2830, TTY 711, email martravia.reed@doh.wa.gov, by April 21, 2026.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HB 1722 requires the department to develop a process to allow 16 year olds to enroll in initial EMR or EMT courses. Training courses must be administered by a department-approved skills center or be a vocational education program approved by the office of the superintendent of public instruction (OSPI). Training programs must provide students with continuing emergency medical services (EMS) medical education from the time they enroll in the course until they graduate from high school or turn 18, whichever is earlier.

In response, the department is proposing amendments to WAC 246-976-022 to add state-approved skill centers and other bona fide vocational education programs approved by OSPI as acceptable training organization types. The department is also proposing amendments to WAC 246-976-041 that would allow 16-year-old applicants to enroll in training programs from these organization types.

Reasons Supporting Proposal: In addition to fulfilling the intent of HB 1722, the proposed rules should ensure regulations and standards are clear, concise, and reflect current standards of care and best practice for the benefit and safety of the public.

Statutory Authority for Adoption: RCW 18.73.081, 43.70.040, and 18.73.165.

Statute Being Implemented: HB 1722 (chapter 98, Laws of 2025), codified as RCW 18.73.165.

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

Name of Proponent: Department of health, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Dawn Felt, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-2842.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is not required under RCW 34.05.328. This rule is exempt from analysis according to RCW 34.05.328 (5)(b)(iii) because the proposed rules incorporate by reference, without change, requirements from RCW 18.73.165, existing Washington state rules, and the EMS Training Program and Instructor Manual (DOH 530-126) as established in chapter 246-976 WAC.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(3) as the rules are adopting or incorporating by reference without material change federal statutes or regulations, Washington state statutes, rules of other Washington state agencies, shoreline master programs other than those programs governing shorelines of statewide significance, or, as referenced by Washington state law, national consensus codes that generally establish industry standards, if the material adopted or incorporated regulates the same subject matter and conduct as the adopting or incorporating rule.

Explanation of exemptions: The proposed rules incorporate by reference, without change, requirements from RCW 18.73.165, existing Washington state rules, and the EMS Training Program and Instructor Manual (DOH 530-126) as established in chapter 246-976 WAC.

Scope of exemption for rule proposal:

Kristin Peterson, JD

for Dennis E. Worsham

AMENDATORY SECTION(Amending WSR 24-15-104, filed 7/22/24, effective 9/30/24)

WAC 246-976-022EMS training program requirements, approval, reapproval, discipline.

(1) To apply for initial department approval as an EMS training program, applicants ((must))shall:

(a) Contact the Washington workforce training and education board to determine if the EMS training program is subject to private vocational school requirements;

(b) Submit a completed application on forms provided by the department and provide supplemental information that:

(i) Demonstrates the need for a new or additional training program; and

(ii) Demonstrates how the training program will maintain the resources needed to sustain a quality education program;

(i) A local EMS and trauma care council or county office responsible for EMS training for the county. This includes organizations established by local ordinance and approved by the county medical program director to coordinate and conduct EMS training programs;

(ii) A regional EMS and trauma care council providing EMS training throughout the EMS and trauma care region that it serves;

(iii) An accredited institution of higher education or a private educational business licensed as a private vocational school; ((or))

(iv) A state-approved skill center or other bona fide vocational education program approved by the office of superintendent of public instruction; or

(v) An optional organization. If the organizations listed above do not exist or are unable to provide an EMS training program, the local EMS and trauma care council may recommend to the department another entity that is able to provide training. In the absence of a local EMS council, the regional EMS and trauma care council may provide such recommendation;

(d) Identify the training program director for the training program. The training program director must meet the minimum requirements listed in the EMS Training Program and Instructor Manual (DOH 530-126);

(e) Identify additional training program personnel who meet the minimum requirements and would perform roles listed in the EMS Training Program Instructor Manual (DOH 530-126);

(f) Indicate what levels of initial EMS training courses (EMR, EMT, AEMT, paramedic), endorsements and other courses the training program is seeking approval to conduct;

(g) If the training program is conducting a paramedic program, provide proof of accreditation by a national accrediting organization approved by the department;

(h) Provide a list of clinical and field internship sites available to students. Include information that clearly depicts a formal relationship between the training organization and the clinical site;

(i) Provide an operations manual that includes:

(i) Training program policies and procedures that meet the requirements listed in the EMS Training Program and Instructor Manual (DOH 530-126); and

(ii) The training program handbook that is provided to students. The handbook must meet the requirements listed in the EMS Training Program and Instructor Manual (DOH 530-126);

(j) Provide a list of equipment and supplies on hand or accessible for use in the training program;

(k) Provide an example of a certificate or letter of completion meeting the department requirements listed in the EMS Training Program and Instructor Manual (DOH 530-126);

(l) Obtain the recommendation from the county medical program director in each county where the training program will reside; and

(m) Obtain the recommendation from each local EMS and trauma council in each county where the training program will reside. In the absence of a local EMS and trauma care council, the regional EMS and trauma care council may provide such a recommendation.

(2) Approved training programs shall:

(a) Conduct courses in accordance with department requirements;

(b) Collaborate with the course instructor to ensure course applicants meet the course application requirements in WAC 246-976-041;

(c) Maintain clinical and field internship sites to meet course requirements. Students conducting field internship rotations on EMS vehicles may not replace required staff on the vehicle;

(d) Provide the department, MPD, or MPD delegate access to all course related materials upon request;

(e) Conduct examinations over course lessons and other Washington state required topics;

(f) Participate in educational planning conducted by local and regional EMS and trauma care councils;

(g) Coordinate certification examination activities with the department-approved certification examination provider. This includes:

(i) Registering the training program with the examination provider;

(ii) Assisting students in registering with the examination provider and scheduling the cognitive examination. Students who successfully pass the course must be provided an opportunity to take the certification examination;

(iii) Provide verification to the examination provider of cognitive knowledge and psychomotor skills for students successfully completing the EMS course; and

(iv) For BLS, ILS, and ALS level courses, the training program must conduct psychomotor examinations and competence assessments as required by the department;

(h) Maintain student records for a minimum of seven years in a retrievable electronic or paper format;

(i) Monitor and evaluate the quality of instruction for the purposes of quality improvement, including course examination scores for each level taught;

(j) Provide students access to the Washington state EMS student survey;

(k) Provide continuous training until the student graduates from high school or turns 18 years of age, whichever is earlier, if they are a program identified in subsection (1)(c)(iv) of this section. Continuous training topics must align with WAC 246-976-161 and the EMS Training Program and Instructor Manual (DOH 530-126);

(1) Maintain an overall pass rate of 75 percent on department-approved state certification examinations;

(((l)))(m) Submit a report to the department annually that includes:

(i) Attrition rates;

(ii) Annual certification examination rates;

(iii) Postgraduation survey results; and

(((m)))(n) Seek reapproval of the training program as follows:

(i) For BLS or ILS level courses training programs must be reapproved every three years.

(ii) For ALS level courses, training programs must be renewed every five years.

(iii) If the training program is approved to conduct multiple levels of training, the program is required to renew in accordance with the higher training level requirement.

(3) Training program approval is effective on the date the department issues the certificate. The expiration date is indicated on the approval letter. To apply for reapproval, an EMS training program ((must))shall:

(a) Complete the requirements in subsection (1) of this section;

(b) Be in compliance with the requirements in subsection (2) of this section;

(c) Be in good standing with the department, have no violations of the statute and rules, and no pending disciplinary actions; and

(d) Have an overall pass rate of 75 percent on department-approved state certification examinations.

(4) Discipline of EMS training programs.

(a) The secretary may deny, suspend, modify, or revoke the approval of a training program when it finds any of the following:

(i) Violations of chapter 246-976 WAC.

(ii) Pending disciplinary actions.

(iii) Falsification of EMS course documents.

(iv) Failure to maintain EMS course documents as required.

(((iv)))(v) Failure to update training program information with the department as changes occur.

(b) The training program may request a hearing to contest the secretary's decisions regarding denial, suspension, modification, or revocation of training program approval in accordance with the Administrative Procedure Act (APA) (chapter 34.05 RCW) and chapter 246-10 WAC.

AMENDATORY SECTION(Amending WSR 24-15-104, filed 7/22/24, effective 9/30/24)

WAC 246-976-041To apply for training.

(1) An applicant for EMS training must be at least 17 years old at the beginning of the course. Variances will not be allowed for the age requirement except for applicants under subsection (2) of this section.

(2) An applicant who is 16 years of age may enroll in a state-approved skill center or other bona fide vocational education program approved by the office of superintendent of public instruction.

(3) An applicant for training at the intermediate (AEMT) level ((must))shall meet all entry requirements of the state approved AEMT program.

(((3)))(4) An applicant for training at the advanced life support (paramedic) level ((must))shall meet all entry requirements of the state approved paramedic training program.