Title 202 | Chapter 007 | Regulation 330E
202 KAR 7:330REG
A proposed version of this document exists.
PREVIOUS VERSION
The previous document that this document is based upon is available.
STATEMENT OF EMERGENCY
202 KAR 7:330E
This emergency amendment is necessary to address the imminent threat to public health, safety, and welfare posed by the shortage of emergency medical services personnel throughout the Commonwealth. There are not enough EMS personnel in Kentucky working for EMS services. EMS agencies throughout the Commonwealth are having difficulty maintain adequate staffing levels. During the 2024 Regular Session, House Bill 57 became law. In relevant part, the Bill amended KRS 311A.142(2) to allow the Kentucky Board of Emergency Medical Services (the “Board”) to grant reciprocal certifications and licenses to individuals certified or licensed and in good standing with another state. Prior to the House Bill 57 amendments, the Board was only authorized to grant reciprocal certifications and licenses to EMS personnel holding credentials in a state contiguous to Kentucky. Consistent with the former statute, the current version of this administrative regulation only permits reciprocity to Advanced Emergency Medical Technicians (AEMTs) certified in a state contiguous to Kentucky. This emergency amendment brings the administrative regulation into conformity with House Bill 57’s amendment to KRS 311A.142(2) by making AEMTs certified and in good standing in any other state eligible for a reciprocal Kentucky AEMT certification. By promptly expanding reciprocity eligibility to AEMTs certified and in good standing with any other state, this emergency amendment will mitigate the risks posed by the shortage of EMS personnel in the Commonwealth. An ordinary administrative regulation is not sufficient to address the imminent risk posed by the continued shortage of EMS personnel. This emergency administrative regulation will be replaced by an ordinary administrative regulation. The ordinary administrative regulation is identical to this emergency administrative regulation.
ANDY BESHEAR, Governor
JOHN R. HOLDER, Chair
KENTUCKY BOARD OF EMERGENCY MEDICAL SERVICES
(Emergency Amendment)
202 KAR 7:330E.Advanced emergency medical technician.
Section 1.
Advanced Emergency Medical Technician Student Eligibility. An individual shall be eligible to enroll as a student in an Advanced Emergency Medical Technician education and training program if the applicant:(1)
Is currently certified at a minimum of an Emergency Medical Technician by the board or the NREMT;(2)
Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and(3)
Meets all additional requirements established by the EMS Training and Educational Institution (EMS-TEI).Section 2.
Certification Requirements.(1)
Individuals desiring initial certification as an Advanced Emergency Medical Technician shall:(a)
Successfully complete a board approved education and training program that conforms to the curriculum of the United States Department of Transportation, National Highway Traffic Safety Administration National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines, except that the educational curriculum shall not be satisfied by the completion of refresher or transition courses alone;(b)
Meet all educational standards established in 202 KAR 7:601;(c)
Obtain certification as a NREMT-Advanced Emergency Medical Technician;(d)
Be a citizen of the United States, a permanent resident of the United States, or otherwise lawfully present in the United States, as evidenced by submission to the board of:1.
A Social Security card;2.
Birth certificate;3.
A United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card); or4.
Other legal authorization to live and work in the United States.(e)
Submit a completed AEMT Initial Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030 for certification as an Advanced Emergency Medical Technician.(2)
An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:(a)
National in scope for an applicant not currently certified at any level in Kentucky;(b)
Statewide in scope for an applicant with current certification in Kentucky;(c)
Less than six (6) months old when the applicant submits to the board all requirements for certification; and(d)
Provided by a vendor that has been contracted through the board.(3)
An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check.Section 3.
Renewal of Certification and Continuing Education Requirements.(1)
An Advanced Emergency Medical Technician shall be eligible for certification renewal if:(a)
The applicant submits a completed AEMT Certification Renewal Application in KEMSIS;(b)
The applicant maintains written evidence of:1.
HIV/AIDS training required by KRS 311A.120;2.
Pediatric Abusive Head Trauma as required by KRS 311A.120; and3.
Awareness of Sexual Violence Training required by KRS 311A.120;(c)
The applicant pays the fee required for renewal pursuant to 202 KAR 7:030; and(2)
The applicant maintains evidence of:(a)
Current certification by the National Registry of Emergency Medical Technicians as an Advanced Emergency Medical Technician, except that if this option is used, the board may request, through a continuing education audit, proof of continuing education to verify compliance with the continuing education requirements of this section; or(b)
Successful completion of the NREMT Advanced Emergency Medical Technician National Component of the Continued Competency Program, for Continuing Education which shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.(3)
An application for certification renewal shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the applicable requirements of this section;(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application; or(c)
The applicant is delinquent on fines or fees owed to the board pursuant to KRS 311A.055, 311A.060, or 202 KAR 7:030.(4)
A certified Advanced Emergency Medical Technician, in good standing, who is a member of a branch of the United States National Guard or a military reserve unit called to active duty by presidential order pursuant to 10 U.S.C. §§ 121 and 12304, shall be renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.(5)
The board office may audit an Advanced Emergency Medical Technician's continuing education and continuing education records.(6)
The Advanced Emergency Medical Technician shall submit the documentation requested within ten (10) business days of receipt of the board's request. If documentation of continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the Advanced Emergency Medical Technician certification for the individual shall be summarily revoked and the individual shall reapply for certification through Reinstatement if eligible.(7)
The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.(8)
The Advanced Emergency Medical Technician shall maintain documentation of all continuing education for three (3) years from the date of completion.Section 4.
Reinstatement of Certification.(1)
An Advanced Emergency Medical Technician whose Kentucky certification has lapsed shall be eligible for reinstatement of certification if the applicant submits:(a)
A completed AEMT Reinstatement Certification Application in KEMSIS; and(b)
Evidence of:1.
Previous certification as an Advanced Emergency Medical Technician in the Commonwealth of Kentucky;2.
Proof of current training in:a.
Pediatric Abusive Head Trauma as required by KRS 311A.120;b.
Awareness of Sexual Violence Training required by KRS 311A.120; andc.
HIV/AIDS training required by KRS 311A.120.(2)
The applicant shall pay the fee pursuant to 202 KAR 7:030.(3)
The applicant for reinstatement of certification shall undergo a national background check provided by a vendor that has been contracted through the board.(a)
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.(b)
Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of reinstatement of certification.(4)
The applicant for reinstatement of certification shall bear the burden of proof of previous certification in Kentucky if the previous certification is in issue or dispute.(5)
An applicant for reinstatement of an Advanced Emergency Medical Technician certification shall submit to the board evidence of successful completion of the NREMT Advanced Emergency Medical Technician National Component of the Continued Competency Program for Continuing Education within the twelve (12) months preceding application for reinstatement of the Advanced Emergency Medical Technician.(6)
An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.Section 5.
Advanced Emergency Medical Technician Reciprocity.(1)
An individual who is certified in another state or by the NREMT as an Advanced Emergency Medical Technician or any member of the United States Armed Forces, or veteran who has transitioned within the past six (6) years from the United States Armed Forces, and has been registered by the National Registry as an Advanced Emergency Medical Technician or EMT and has successfully completed a board-approved United States Armed Forces medical training course shall be eligible for reciprocity for certification as an Advanced Emergency Medical Technician in Kentucky if the applicant submits:(a)
A completed AEMT Reciprocity Certification Application in KEMSIS;(b)
Proof of the applicant's current unrestricted NREMT certification as an Advanced Emergency Medical Technician or current Advanced Emergency Medical Technician certification in another state or proof of completing a board-approved United States Armed Forces medical training course which included NREMT-Emergency Medical Technician certification; and(c)
Proof of current training in:1.
HIV/AIDS training required by KRS 311A.120;2.
Pediatric Abusive Head Trauma training required by KRS 311A.120; and3.
Awareness of Sexual Violence Training required by KRS 311A.120.(2)
An applicant shall pay the fee required for certification through reciprocity pursuant to 202 KAR 7:030.(3)
An applicant for Advanced Emergency Medical Technician reciprocity shall undergo a national background check provided by a vendor that has been contracted through the board. An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check. Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of certification through reciprocity.(4)
An applicant shall not have been convicted of offenses described in KRS 311A.050.(5)
An applicant shall not have been subjected to discipline that would prevent reciprocity at the time of application.(6)
An Advanced Emergency Medical Technician certified pursuant to Section 2 of this administrative regulation shall not perform any procedures or skill on which the Advanced Emergency Medical Technician has not been trained. An Advanced Emergency Medical Technician who performs a skill for which the Advanced Emergency Medical Technician does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.050.(7)
An Advanced Emergency Medical Technician certified pursuant to this section shall complete the Kentucky supplemental Advanced Emergency Medical Technician curricula for the procedures listed in 202 KAR 7:701 prior to beginning work for a licensed agency in Kentucky.(8)
Kentucky supplemental Advanced Emergency Medical Technician curricula consistent with 202 KAR 7:701 shall be provided during employee orientation, or by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.(9)
Verification of competency on the supplemental curricula procedures in 202 KAR 7:701 shall be maintained by the Advanced Emergency Medical Technician for a minimum of three (3) years. Failure to submit the AEMT Supplemental Curriculum Training Verification Report shall result in revocation of Advanced Emergency Medical Technician certification.(10)
If an Advanced Emergency Medical Technician certified pursuant to this section fails to supply verification of competency as required by subsection (7) of this section the Advanced Emergency Medical Technician shall be ineligible to apply for and receive Advanced Emergency Medical Technician reciprocity certification until the applicant has submitted the AEMT Supplemental Curriculum Training Verification Report as required pursuant to 202 KAR 7:701, and shall reapply for Reciprocity through the process set forth in this section.Section 6.
Scope of Practice. An Advanced Emergency Medical Technician shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model and 202 KAR 7:701.Section 7.
Expiration of Certification.(1)
Certification periods and expiration dates shall be pursuant to KRS 311A.095.(2)
If an Advanced Emergency Medical Technician's certification lapses or expires, the Advanced Emergency Medical Technician shall cease provision of emergency medical services.(3)
An Advanced Emergency Medical Technician who has allowed his or her certification to lapse or expire shall be required to reinstate certification pursuant to Section 4 of this administrative regulation.Section 8.
Downgrading Certification.(1)
An Advanced Emergency Medical Technician currently certified as an Advanced Emergency Medical Technician by the board shall be eligible for certification downgrade if:(a)
The certification is in good standing with no pending disciplinary action;(b)
The applicant submits a completed AEMT Certification Downgrade Application in KEMSIS; and(c)
The applicant pays the fee established in 202 KAR 7:030.(2)
An Advanced Emergency Medical Technician is only eligible to downgrade his or her certification to an Emergency Medical Technician or Emergency Medical Responder certification.(3)
Certification periods and expiration dates shall be pursuant to KRS 311A.095.(4)
An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:(a)
Statewide in scope for an applicant with current certification in Kentucky;(b)
Less than six (6) months old when the applicant submits to the board all requirements for certification; and(c)
Provided by a vendor that has been contracted through the board.(5)
Downgrade shall be denied if the applicant has not met the requirements of this section or has been subject to disciplinary action that prevents certification at the time of application.(6)
The applicant shall be responsible for meeting the renewal requirements of the downgraded certification level issued prior to expiration of that certification.(7)
To reinstate the certification or license that was previously held, the applicant shall meet the regulatory requirements for that level of certification or licensure.(8)
The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon downgrading his or her certification.(9)
Once the applicant has downgraded his or her certification or license, the applicant is no longer permitted to provide emergency medical services at the previous certification or license level held.(10)
An applicant applying for downgrade who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.(11)
All endorsements, certifications, or licenses held at the previous certification or license level shall be void at the completion of the downgrade.Section 9.
Surrender of Certification.(1)
An Advanced Emergency Medical Technician surrendering certification shall:(a)
Submit a completed AEMT Certification Surrender Application in KEMSIS; and(b)
Pay the fee established in 202 KAR 7:030.(2)
The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon surrendering his or her certification.Section 10.
Reporting Requirements.(1)
An Advanced Emergency Medical Technician shall maintain current demographic information in KEMSIS including:(a)
Legal name;1.
Any changes to an AMET's legal name shall be submitted using the Name Change Application in KEMSIS; and2.
One (1) of the following documents as verification of name change:a.
Social Security card;b.
Driver's license; orc.
Passport;(b)
Mailing address;(c)
Email address; and(d)
Phone number.(2)
An Advanced Emergency Medical Technician who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.Section 11.
Exemptions from Advanced Emergency Medical Technician Administrative Regulations. Certification requirements for an Advanced Emergency Medical Technician shall not apply to:(1)
United States military members, state National Guard personnel, or employees of the United States government if the individual provides emergency medical services:(a)
On land owned by the United States government;(b)
In facilities owned by the United States government;(c)
In the performance of official duties under federal law; or(d)
As part of assistance for a mass casualty or disaster incident pursuant to federal law or official state assistance request; or(2)
An Advanced Emergency Medical Technician certified in another state or territory of the United States who:(a)
Enters Kentucky with a patient being transported to a medical facility or other final destination in Kentucky; or(b)
Travels through Kentucky during the course of a patient transport from an out-of-state location to a destination outside of Kentucky.Section 12.
Public Notice of Negative Action. The board office shall cause to be published on the board Web site the name of an Advanced Emergency Medical Technician who:(1)
Is fined;(2)
Is placed on probationary status;(3)
Is placed on restricted status;(4)
Is suspended; or(5)
Has had his or her certification revoked.Section 13.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines", The United States Department of Transportation, National Highway Traffic Safety Administration, DOT HS 811 077D, January 2009;(b)
"AEMT Initial Certification Application" in KEMSIS, July 2019;(c)
"AEMT Certification Renewal Application" in KEMSIS, July 2019;(d)
"AEMT Reciprocity Certification Application" in KEMSIS, July 2019;(e)
"AEMT Reinstatement Certification Application" in KEMSIS, July 2019;(f)
"AEMT Supplemental Curriculum Training Verification Report", July 2019;(g)
"National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;(h)
"National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;(i)
"AEMT Certification Downgrade Application" in KEMSIS, July 2019;(j)
"AEMT Certification Surrender Application" in KEMSIS, July 2019;(k)
"National Registry of Emergency Medical Technicians National Continued Competency Program AEMT", October 2016;(l)
"Name Change Application" in KEMSIS, July 2019;(m)
"Military Extension Application" in KEMSIS, July 2019; and(n)
"United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card)", July 2019.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.(3)
This material is also available on the board's Web site at: kyems.com.JOHN R. HOLDER, Chair
APPROVED BY AGENCY: August 8, 2024
FILED WITH LRC: September 3, 2024 at 3 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on October 23, 2024, at 1:00 p.m. ET at the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five (5) workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through October 31, 2024. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: John K. Wood, counsel for the Kentucky Board of Emergency Medical Services, 163 East Main Street, Suite 200, Lexington, Kentucky 40507, phone (859) 225-4714, email administrativeregulations@wgmfirm.com.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
John K. Wood
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation establishes requirements for Advanced Emergency Medical Technicians.
(b) The necessity of this administrative regulation:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation is necessary to establish requirements for Advanced Emergency Medical Technicians.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation conforms to the content of KRS 311A.025 by establishing the requirements for Advanced Emergency Medical Technicians.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation assists in the effective administration of KRS 311A.025(2) by establishing requirements for Advanced Emergency Medical Technicians.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment brings this administrative regulation into conformity with House Bill 57’s amendment to KRS 311A.142(2) by making AEMTs certified and in good standing in any other state eligible for a reciprocal Kentucky certification. Prior to House Bill 57 becoming law, only EMS personnel in states contiguous to Kentucky were eligible for reciprocity.
(b) The necessity of the amendment to this administrative regulation:
This emergency amendment is necessary to bring this administrative regulation into conformity with House Bill 57’s amendment to KRS 311A.142(2) and to mitigate the staffing shortages that EMS agencies across the Commonwealth are facing.
(c) How the amendment conforms to the content of the authorizing statutes:
This administrative regulation conforms to the content of KRS 311A.025 by establishing requirements for Advanced Emergency Medical Technicians. This amendment also conforms to the recent amendment to KRS 311A.142(2) permitting reciprocity to EMS personnel licensed or certified and in good standing with another state.
(d) How the amendment will assist in the effective administration of the statutes:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This amendment will assist in the effective administration of KRS 311A.025(2) by establishing requirements for Advanced Emergency Medical Technician.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This administrative regulation will affect the Kentucky Board of Emergency Medical Services, emergency medical services providers, individuals seeking Advanced Emergency Medical Technician reciprocity, and local governments.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
This amendment does not establish any new requirements. Advanced Emergency Medical Technicians certified in any other state may seek a reciprocal Kentucky certification by meeting the existing requirements set forth in Section 5 of this administrative regulation.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There will be no cost to any entity identified in question (3), other than administrative costs that may be incurred in recruiting and maintaining personnel.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Advanced Emergency Medical Technicians certified in states not contiguous to Kentucky will benefit from this amendment by now being eligible for a reciprocal Kentucky certification. EMS agencies and local governments will benefit from the expanded pool of individuals eligible for a reciprocal Kentucky Advanced Emergency Medical Technician certification.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(b) On a continuing basis:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Kentucky Board of Emergency Medical Services is a state agency that receives its annual budget from the state government.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increase in fees or funding will be necessary.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This regulation does not establish any fees.
(9) TIERING: Is tiering applied?
Tiering is not applied to this administrative regulation because the amendment applies to all Advanced Emergency Medical Technicians.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation establishes requirements for Advanced Emergency Medical Technicians.
(2) Identify the promulgating agency and any other affected state units, parts, or divisions:
Kentucky Board of Emergency Medical Services.
(a) Estimate the following for the first year:
Expenditures:
None.
Revenues:
None.
Cost Savings:
None.
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
This amendment should not affect the Board’s expenditures, revenues, or costs.
(3) Identify affected local entities (for example: cities, counties, fire departments, school districts):
All cities and counties.
(a) Estimate the following for the first year:
Expenditures:
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining personnel.
Revenues:
None
Cost Savings:
None
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining required personnel.
(4) Identify additional regulated entities not listed in questions (2) or (3):
All EMS services.
(a) Estimate the following for the first year:
Expenditures:
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining personnel.
Revenues:
None
Cost Savings:
None
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining personnel.
(5) Provide a narrative to explain the:
(a) Fiscal impact of this administrative regulation:
No fiscal impact is anticipated as a result of this administrative regulation, other than the administrative costs that may be incurred in recruiting and maintaining personnel.
(b) Methodology and resources used to determine the fiscal impact:
No fiscal impact is anticipated as a result of this administrative regulation, other than the administrative costs that may be incurred in recruiting and maintaining personnel.
(6) Explain:
(a) Whether this administrative regulation will have an overall negative or adverse major economic impact to the entities identified in questions (2) - (4). ($500,000 or more, in aggregate)
This administrative regulation will not have an overall negative or adverse major economic impact to the affected entities.
(b) The methodology and resources used to reach this conclusion:
No fiscal impact is anticipated as a result of this administrative regulation, other than the administrative costs that may be incurred in recruiting and maintaining required personnel.
STATEMENT OF EMERGENCY
202 KAR 7:330E
This emergency amendment is necessary to address the imminent threat to public health, safety, and welfare posed by the shortage of emergency medical services personnel throughout the Commonwealth. There are not enough EMS personnel in Kentucky working for EMS services. EMS agencies throughout the Commonwealth are having difficulty maintain adequate staffing levels. During the 2024 Regular Session, House Bill 57 became law. In relevant part, the Bill amended KRS 311A.142(2) to allow the Kentucky Board of Emergency Medical Services (the “Board”) to grant reciprocal certifications and licenses to individuals certified or licensed and in good standing with another state. Prior to the House Bill 57 amendments, the Board was only authorized to grant reciprocal certifications and licenses to EMS personnel holding credentials in a state contiguous to Kentucky. Consistent with the former statute, the current version of this administrative regulation only permits reciprocity to Advanced Emergency Medical Technicians (AEMTs) certified in a state contiguous to Kentucky. This emergency amendment brings the administrative regulation into conformity with House Bill 57’s amendment to KRS 311A.142(2) by making AEMTs certified and in good standing in any other state eligible for a reciprocal Kentucky AEMT certification. By promptly expanding reciprocity eligibility to AEMTs certified and in good standing with any other state, this emergency amendment will mitigate the risks posed by the shortage of EMS personnel in the Commonwealth. An ordinary administrative regulation is not sufficient to address the imminent risk posed by the continued shortage of EMS personnel. This emergency administrative regulation will be replaced by an ordinary administrative regulation. The ordinary administrative regulation is identical to this emergency administrative regulation.
ANDY BESHEAR, Governor
JOHN R. HOLDER, Chair
KENTUCKY BOARD OF EMERGENCY MEDICAL SERVICES
(Emergency Amendment)
202 KAR 7:330E.Advanced emergency medical technician.
Section 1.
Advanced Emergency Medical Technician Student Eligibility. An individual shall be eligible to enroll as a student in an Advanced Emergency Medical Technician education and training program if the applicant:(1)
Is currently certified at a minimum of an Emergency Medical Technician by the board or the NREMT;(2)
Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and(3)
Meets all additional requirements established by the EMS Training and Educational Institution (EMS-TEI).Section 2.
Certification Requirements.(1)
Individuals desiring initial certification as an Advanced Emergency Medical Technician shall:(a)
Successfully complete a board approved education and training program that conforms to the curriculum of the United States Department of Transportation, National Highway Traffic Safety Administration National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines, except that the educational curriculum shall not be satisfied by the completion of refresher or transition courses alone;(b)
Meet all educational standards established in 202 KAR 7:601;(c)
Obtain certification as a NREMT-Advanced Emergency Medical Technician;(d)
Be a citizen of the United States, a permanent resident of the United States, or otherwise lawfully present in the United States, as evidenced by submission to the board of:1.
A Social Security card;2.
Birth certificate;3.
A United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card); or4.
Other legal authorization to live and work in the United States.(e)
Submit a completed AEMT Initial Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030 for certification as an Advanced Emergency Medical Technician.(2)
An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:(a)
National in scope for an applicant not currently certified at any level in Kentucky;(b)
Statewide in scope for an applicant with current certification in Kentucky;(c)
Less than six (6) months old when the applicant submits to the board all requirements for certification; and(d)
Provided by a vendor that has been contracted through the board.(3)
An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check.Section 3.
Renewal of Certification and Continuing Education Requirements.(1)
An Advanced Emergency Medical Technician shall be eligible for certification renewal if:(a)
The applicant submits a completed AEMT Certification Renewal Application in KEMSIS;(b)
The applicant maintains written evidence of:1.
HIV/AIDS training required by KRS 311A.120;2.
Pediatric Abusive Head Trauma as required by KRS 311A.120; and3.
Awareness of Sexual Violence Training required by KRS 311A.120;(c)
The applicant pays the fee required for renewal pursuant to 202 KAR 7:030; and(2)
The applicant maintains evidence of:(a)
Current certification by the National Registry of Emergency Medical Technicians as an Advanced Emergency Medical Technician, except that if this option is used, the board may request, through a continuing education audit, proof of continuing education to verify compliance with the continuing education requirements of this section; or(b)
Successful completion of the NREMT Advanced Emergency Medical Technician National Component of the Continued Competency Program, for Continuing Education which shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.(3)
An application for certification renewal shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the applicable requirements of this section;(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application; or(c)
The applicant is delinquent on fines or fees owed to the board pursuant to KRS 311A.055, 311A.060, or 202 KAR 7:030.(4)
A certified Advanced Emergency Medical Technician, in good standing, who is a member of a branch of the United States National Guard or a military reserve unit called to active duty by presidential order pursuant to 10 U.S.C. §§ 121 and 12304, shall be renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.(5)
The board office may audit an Advanced Emergency Medical Technician's continuing education and continuing education records.(6)
The Advanced Emergency Medical Technician shall submit the documentation requested within ten (10) business days of receipt of the board's request. If documentation of continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the Advanced Emergency Medical Technician certification for the individual shall be summarily revoked and the individual shall reapply for certification through Reinstatement if eligible.(7)
The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.(8)
The Advanced Emergency Medical Technician shall maintain documentation of all continuing education for three (3) years from the date of completion.Section 4.
Reinstatement of Certification.(1)
An Advanced Emergency Medical Technician whose Kentucky certification has lapsed shall be eligible for reinstatement of certification if the applicant submits:(a)
A completed AEMT Reinstatement Certification Application in KEMSIS; and(b)
Evidence of:1.
Previous certification as an Advanced Emergency Medical Technician in the Commonwealth of Kentucky;2.
Proof of current training in:a.
Pediatric Abusive Head Trauma as required by KRS 311A.120;b.
Awareness of Sexual Violence Training required by KRS 311A.120; andc.
HIV/AIDS training required by KRS 311A.120.(2)
The applicant shall pay the fee pursuant to 202 KAR 7:030.(3)
The applicant for reinstatement of certification shall undergo a national background check provided by a vendor that has been contracted through the board.(a)
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.(b)
Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of reinstatement of certification.(4)
The applicant for reinstatement of certification shall bear the burden of proof of previous certification in Kentucky if the previous certification is in issue or dispute.(5)
An applicant for reinstatement of an Advanced Emergency Medical Technician certification shall submit to the board evidence of successful completion of the NREMT Advanced Emergency Medical Technician National Component of the Continued Competency Program for Continuing Education within the twelve (12) months preceding application for reinstatement of the Advanced Emergency Medical Technician.(6)
An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.Section 5.
Advanced Emergency Medical Technician Reciprocity.(1)
An individual who is certified in another(a)
A completed AEMT Reciprocity Certification Application in KEMSIS;(b)
Proof of the applicant's current unrestricted NREMT certification as an Advanced Emergency Medical Technician or current Advanced Emergency Medical Technician certification in another(c)
Proof of current training in:1.
HIV/AIDS training required by KRS 311A.120;2.
Pediatric Abusive Head Trauma training required by KRS 311A.120; and3.
Awareness of Sexual Violence Training required by KRS 311A.120.(2)
An applicant shall pay the fee required for certification through reciprocity pursuant to 202 KAR 7:030.(3)
An applicant for Advanced Emergency Medical Technician reciprocity shall undergo a national background check provided by a vendor that has been contracted through the board. An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check. Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of certification through reciprocity.(4)
An applicant shall not have been convicted of offenses described in KRS 311A.050.(5)
An applicant shall not have been subjected to discipline that would prevent reciprocity at the time of application.(6)
An Advanced Emergency Medical Technician certified pursuant to Section 2 of this administrative regulation shall not perform any procedures or skill on which the Advanced Emergency Medical Technician has not been trained. An Advanced Emergency Medical Technician who performs a skill for which the Advanced Emergency Medical Technician does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.050.(7)
An Advanced Emergency Medical Technician certified pursuant to this section shall complete the Kentucky supplemental Advanced Emergency Medical Technician curricula for the procedures listed in 202 KAR 7:701 prior to beginning work for a licensed agency in Kentucky.(8)
Kentucky supplemental Advanced Emergency Medical Technician curricula consistent with 202 KAR 7:701 shall be provided during employee orientation, or by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.(9)
Verification of competency on the supplemental curricula procedures in 202 KAR 7:701 shall be maintained by the Advanced Emergency Medical Technician for a minimum of three (3) years. Failure to submit the AEMT Supplemental Curriculum Training Verification Report shall result in revocation of Advanced Emergency Medical Technician certification.(10)
If an Advanced Emergency Medical Technician certified pursuant to this section fails to supply verification of competency as required by subsection (7) of this section the Advanced Emergency Medical Technician shall be ineligible to apply for and receive Advanced Emergency Medical Technician reciprocity certification until the applicant has submitted the AEMT Supplemental Curriculum Training Verification Report as required pursuant to 202 KAR 7:701, and shall reapply for Reciprocity through the process set forth in this section.Section 6.
Scope of Practice. An Advanced Emergency Medical Technician shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model and 202 KAR 7:701.Section 7.
Expiration of Certification.(1)
Certification periods and expiration dates shall be pursuant to KRS 311A.095.(2)
If an Advanced Emergency Medical Technician's certification lapses or expires, the Advanced Emergency Medical Technician shall cease provision of emergency medical services.(3)
An Advanced Emergency Medical Technician who has allowed his or her certification to lapse or expire shall be required to reinstate certification pursuant to Section 4 of this administrative regulation.Section 8.
Downgrading Certification.(1)
An Advanced Emergency Medical Technician currently certified as an Advanced Emergency Medical Technician by the board shall be eligible for certification downgrade if:(a)
The certification is in good standing with no pending disciplinary action;(b)
The applicant submits a completed AEMT Certification Downgrade Application in KEMSIS; and(c)
The applicant pays the fee established in 202 KAR 7:030.(2)
An Advanced Emergency Medical Technician is only eligible to downgrade his or her certification to an Emergency Medical Technician or Emergency Medical Responder certification.(3)
Certification periods and expiration dates shall be pursuant to KRS 311A.095.(4)
An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:(a)
Statewide in scope for an applicant with current certification in Kentucky;(b)
Less than six (6) months old when the applicant submits to the board all requirements for certification; and(c)
Provided by a vendor that has been contracted through the board.(5)
Downgrade shall be denied if the applicant has not met the requirements of this section or has been subject to disciplinary action that prevents certification at the time of application.(6)
The applicant shall be responsible for meeting the renewal requirements of the downgraded certification level issued prior to expiration of that certification.(7)
To reinstate the certification or license that was previously held, the applicant shall meet the regulatory requirements for that level of certification or licensure.(8)
The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon downgrading his or her certification.(9)
Once the applicant has downgraded his or her certification or license, the applicant is no longer permitted to provide emergency medical services at the previous certification or license level held.(10)
An applicant applying for downgrade who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.(11)
All endorsements, certifications, or licenses held at the previous certification or license level shall be void at the completion of the downgrade.Section 9.
Surrender of Certification.(1)
An Advanced Emergency Medical Technician surrendering certification shall:(a)
Submit a completed AEMT Certification Surrender Application in KEMSIS; and(b)
Pay the fee established in 202 KAR 7:030.(2)
The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon surrendering his or her certification.Section 10.
Reporting Requirements.(1)
An Advanced Emergency Medical Technician shall maintain current demographic information in KEMSIS including:(a)
Legal name;1.
Any changes to an AMET's legal name shall be submitted using the Name Change Application in KEMSIS; and2.
One (1) of the following documents as verification of name change:a.
Social Security card;b.
Driver's license; orc.
Passport;(b)
Mailing address;(c)
Email address; and(d)
Phone number.(2)
An Advanced Emergency Medical Technician who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.Section 11.
Exemptions from Advanced Emergency Medical Technician Administrative Regulations. Certification requirements for an Advanced Emergency Medical Technician shall not apply to:(1)
United States military members, state National Guard personnel, or employees of the United States government if the individual provides emergency medical services:(a)
On land owned by the United States government;(b)
In facilities owned by the United States government;(c)
In the performance of official duties under federal law; or(d)
As part of assistance for a mass casualty or disaster incident pursuant to federal law or official state assistance request; or(2)
An Advanced Emergency Medical Technician certified in another state or territory of the United States who:(a)
Enters Kentucky with a patient being transported to a medical facility or other final destination in Kentucky; or(b)
Travels through Kentucky during the course of a patient transport from an out-of-state location to a destination outside of Kentucky.Section 12.
Public Notice of Negative Action. The board office shall cause to be published on the board Web site the name of an Advanced Emergency Medical Technician who:(1)
Is fined;(2)
Is placed on probationary status;(3)
Is placed on restricted status;(4)
Is suspended; or(5)
Has had his or her certification revoked.Section 13.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines", The United States Department of Transportation, National Highway Traffic Safety Administration, DOT HS 811 077D, January 2009;(b)
"AEMT Initial Certification Application" in KEMSIS, July 2019;(c)
"AEMT Certification Renewal Application" in KEMSIS, July 2019;(d)
"AEMT Reciprocity Certification Application" in KEMSIS, July 2019;(e)
"AEMT Reinstatement Certification Application" in KEMSIS, July 2019;(f)
"AEMT Supplemental Curriculum Training Verification Report", July 2019;(g)
"National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;(h)
"National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;(i)
"AEMT Certification Downgrade Application" in KEMSIS, July 2019;(j)
"AEMT Certification Surrender Application" in KEMSIS, July 2019;(k)
"National Registry of Emergency Medical Technicians National Continued Competency Program AEMT", October 2016;(l)
"Name Change Application" in KEMSIS, July 2019;(m)
"Military Extension Application" in KEMSIS, July 2019; and(n)
"United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card)", July 2019.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.(3)
This material is also available on the board's Web site at: kyems.com.JOHN R. HOLDER, Chair
APPROVED BY AGENCY: August 8, 2024
FILED WITH LRC: September 3, 2024 at 3 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on October 23, 2024, at 1:00 p.m. ET at the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five (5) workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through October 31, 2024. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: John K. Wood, counsel for the Kentucky Board of Emergency Medical Services, 163 East Main Street, Suite 200, Lexington, Kentucky 40507, phone (859) 225-4714, email administrativeregulations@wgmfirm.com.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
John K. Wood
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation establishes requirements for Advanced Emergency Medical Technicians.
(b) The necessity of this administrative regulation:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation is necessary to establish requirements for Advanced Emergency Medical Technicians.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation conforms to the content of KRS 311A.025 by establishing the requirements for Advanced Emergency Medical Technicians.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation assists in the effective administration of KRS 311A.025(2) by establishing requirements for Advanced Emergency Medical Technicians.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment brings this administrative regulation into conformity with House Bill 57’s amendment to KRS 311A.142(2) by making AEMTs certified and in good standing in any other state eligible for a reciprocal Kentucky certification. Prior to House Bill 57 becoming law, only EMS personnel in states contiguous to Kentucky were eligible for reciprocity.
(b) The necessity of the amendment to this administrative regulation:
This emergency amendment is necessary to bring this administrative regulation into conformity with House Bill 57’s amendment to KRS 311A.142(2) and to mitigate the staffing shortages that EMS agencies across the Commonwealth are facing.
(c) How the amendment conforms to the content of the authorizing statutes:
This administrative regulation conforms to the content of KRS 311A.025 by establishing requirements for Advanced Emergency Medical Technicians. This amendment also conforms to the recent amendment to KRS 311A.142(2) permitting reciprocity to EMS personnel licensed or certified and in good standing with another state.
(d) How the amendment will assist in the effective administration of the statutes:
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This amendment will assist in the effective administration of KRS 311A.025(2) by establishing requirements for Advanced Emergency Medical Technician.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This administrative regulation will affect the Kentucky Board of Emergency Medical Services, emergency medical services providers, individuals seeking Advanced Emergency Medical Technician reciprocity, and local governments.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
This amendment does not establish any new requirements. Advanced Emergency Medical Technicians certified in any other state may seek a reciprocal Kentucky certification by meeting the existing requirements set forth in Section 5 of this administrative regulation.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There will be no cost to any entity identified in question (3), other than administrative costs that may be incurred in recruiting and maintaining personnel.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Advanced Emergency Medical Technicians certified in states not contiguous to Kentucky will benefit from this amendment by now being eligible for a reciprocal Kentucky certification. EMS agencies and local governments will benefit from the expanded pool of individuals eligible for a reciprocal Kentucky Advanced Emergency Medical Technician certification.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(b) On a continuing basis:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Kentucky Board of Emergency Medical Services is a state agency that receives its annual budget from the state government.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increase in fees or funding will be necessary.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This regulation does not establish any fees.
(9) TIERING: Is tiering applied?
Tiering is not applied to this administrative regulation because the amendment applies to all Advanced Emergency Medical Technicians.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the advanced emergency medical technician (AEMT). This administrative regulation establishes requirements for Advanced Emergency Medical Technicians.
(2) Identify the promulgating agency and any other affected state units, parts, or divisions:
Kentucky Board of Emergency Medical Services.
(a) Estimate the following for the first year:
Expenditures:
None.
Revenues:
None.
Cost Savings:
None.
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
This amendment should not affect the Board’s expenditures, revenues, or costs.
(3) Identify affected local entities (for example: cities, counties, fire departments, school districts):
All cities and counties.
(a) Estimate the following for the first year:
Expenditures:
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining personnel.
Revenues:
None
Cost Savings:
None
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining required personnel.
(4) Identify additional regulated entities not listed in questions (2) or (3):
All EMS services.
(a) Estimate the following for the first year:
Expenditures:
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining personnel.
Revenues:
None
Cost Savings:
None
(b) How will expenditures, revenues, or cost savings differ in subsequent years?
There will be no costs to affected entities other than administrative costs that may be incurred in recruiting and maintaining personnel.
(5) Provide a narrative to explain the:
(a) Fiscal impact of this administrative regulation:
No fiscal impact is anticipated as a result of this administrative regulation, other than the administrative costs that may be incurred in recruiting and maintaining personnel.
(b) Methodology and resources used to determine the fiscal impact:
No fiscal impact is anticipated as a result of this administrative regulation, other than the administrative costs that may be incurred in recruiting and maintaining personnel.
(6) Explain:
(a) Whether this administrative regulation will have an overall negative or adverse major economic impact to the entities identified in questions (2) - (4). ($500,000 or more, in aggregate)
This administrative regulation will not have an overall negative or adverse major economic impact to the affected entities.
(b) The methodology and resources used to reach this conclusion:
No fiscal impact is anticipated as a result of this administrative regulation, other than the administrative costs that may be incurred in recruiting and maintaining required personnel.