Title 202 | Chapter 007 | Regulation 410REG
PROPOSED
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PREVIOUS VERSION
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Kentucky Board of Emergency Medical Services
(Amendment)
202 KAR 7:410.Advanced Practice Paramedics.
Section 1.
Licensure of Advanced Practice Paramedics. In accordance with this administrative regulation, the board office shall issue an advanced practice paramedic license to an individual certified as a community paramedic,Section 2.
Certification of Community Paramedics.(1)
(a)
(b)
(c)
(1)(2)
Individuals desiring initial board certification as a community paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(b)
(c)
Submit a course completion certification from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline topic areas;(d)(c)
Submit proof of current (d)
(e)
Submit a completed Advanced Practice Paramedic(f)
Pay the fee pursuant to 202 KAR 7:030.(2)(3)
To be eligible for renewal of a community paramedic certification, a community paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain1.
Current certification by the International Board of Specialty Certification (IBSC) as a community paramedic (CP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Community Paramedic Content Outline topic areas.2.
a.
b.
c.
d.
e.
f.
(3)(4)
An application for renewal of community paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.(5)
(a)
(b)
(c)
Section 3.
Certification of Wilderness Paramedics.(1)
(a)
(b)
(c)
(1)(2)
Individuals desiring initial board certification as a wilderness paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(b)
(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas;(d)(c)
Submit proof of (e)(d)
Submit a completed Advanced Practice Paramedic(f)
Pay the fee pursuant to 202 KAR 7:030.(2)(3)
To be eligible for renewal of a wilderness paramedic certification, a wilderness paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain1.
Current2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas.(3)(4)
An application for renewal of a wilderness paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.(5)
(a)
(b)
(c)
(d)
Section 4.
Certification of Critical Care Paramedics.(1)
Individuals desiring initial board certification as a critical care paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline topic areas;(d)
Submit proof of current certification as a critical care paramedic (CCP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a critical care paramedic certification, a critical care paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a critical care paramedic (CCP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline topic areas.(3)
An application for renewal of a critical care paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification at the time of application.Section 5.
Certification of Flight Paramedics.(1)
Individuals desiring initial board certification as a flight paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline topic areas;(d)
Submit proof of current certification as a flight paramedic (FP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a flight paramedic certification, a flight paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a flight paramedic (FP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline topic areas.(3)
An applicant for renewal of a flight paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.Section 6.
Certification of Tactical Paramedics.(1)
Individuals desiring initial board certification as a tactical paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline topic areas;(d)
Submit proof of current certification as a tactical paramedic (TP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a tactical paramedic certification, a tactical paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a tactical paramedic (TP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline topic areas.(3)
An application for renewal of a tactical paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.Section 7.
Transition for Currently Certified Providers.(1)
Notwithstanding sections 2(1)(c), 3(1)(c), 4(1)(c), 5(1)(c), or 6(1)(c) of this administrative regulation, proof of a successful course completion certification shall not be required for initial licensure and certification if:(a)
At the time of application, the applicant is certified as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic by the International Board of Specialty Certification (IBSC); and(b)
The application is submitted on or before September 30, 2026.(2)
Notwithstanding section 2(1)(d) of this administrative regulation, proof of current certification as a community paramedic (CP-C) by the International Board of Specialty Certification (IBSC) shall not be required for initial licensure and certification as a community paramedic if:(a)
At the time of application, the applicant is operating under a board-approved community paramedic pilot program; and(b)
The application is submitted on or before September 30, 2026.(3)
Notwithstanding section 4(1)(d) of this administrative regulation, proof of current certification as a critical care paramedic (CCP-C) from the International Board of Specialty Certification (IBSC) shall not be required for initial licensure and certification as a critical care paramedic if:(a)
At the time of application, the applicant has a board-issued critical care paramedic endorsement; and(b)
The application is submitted on or before September 30, 2026.Section 8.
Advanced Practice Paramedic License and Certification Renewal for Active-Duty Members of the Armed Forces. A licensed advanced practice paramedic, in good standing, who is a member of the Armed Forces of the United States and called to active duty by presidential order pursuant to 10 U.S.C. 121 and 12304 shall have his or her advanced practice paramedic license and certification renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.Section 9.
Certification and Continuing Education Validation and Audits.(1)
All continuing education for advanced practice paramedics shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.(2)
The board office may audit an advanced practice paramedic's continuing education record and IBSC certification. The advanced practice paramedic shall submit the documentation requested within ten (10) business days of receipt of the board office's request.(3)
If documentation of IBSC certification or continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days upon receipt of the board's request, the advanced practice paramedic license and certification shall be deemed to have lapsed and the individual shall reapply for licensure and certification through reinstatement, if eligible.(4)
The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.(5)
Each advanced practice paramedic shall maintain documentation of all IBSC certifications and all continuing education for three (3) years from the date of completion.Section 10.Section 4.
Expiration of Advanced Practice Paramedic License and Certification.(1)
A board-issued advanced practice paramedic license and a board-issued certification as a community paramedic,(2)
An individual whose board-issued advanced practice paramedic license and board-issued certification as a community paramedic,Section 11.Section 5.
Scope of Practice.(1)
An advanced practice paramedic may perform(2)
Assessment of techniques, skills, and procedures of an advanced practice paramedic shall be subject to the board-approved agency medical protocols adopted by the advance practice paramedic's agency.(3)
Each agency that adopts skills, procedures, and techniques established in the current board-approved EMS Advanced Practice Paramedic Scope of Practice document shall implement and maintain a policy requiring annual clinical competency assessments for employees licensed as advanced practice paramedics.Section 12.Section 6.
Exemptions to this Administrative Regulation. The advanced practice paramedic licensure and certification requirements established by this administrative regulation shall not apply to: United States military members, National Guard personnel, or employees of the United States government if the individual provides services:(1)
On land owned by the United States government;(2)
In facilities owned by the United States government;(3)
In the performance of official duties under federal law; or(4)
As part of assistance for a mass casualty or disaster incident pursuant to federal law or an official state assistance request.Section 13.Section 7.
Public Notice of Negative Action. The board office shall cause to be published on the board's Web site the name of an advanced practice paramedic who:(1)
Is fined;(2)
Is placed on probationary status;(3)
Is placed on restricted status;(4)
Is suspended; or(5)
Has had their license or certification revoked.Section 14.Section 8.
Surrender of Advanced Practice Paramedic License and Certification.(1)
An advanced practice paramedic surrendering his or her license as an advanced practice paramedic and certification as a community paramedic,(a)
Submit(b)
Pay the fee pursuant to 202 KAR 7:030.(2)
Upon surrendering an advanced practice paramedic license and applicable certification, the surrendering individual shall immediately give notice to his or her agency's chief operations or service director.Section 15.
Reinstatement of Advanced Practice Paramedic License and Certification.(1)
An advanced practice paramedic whose license and certification has lapsed or expired may reinstate his or her advanced practice paramedic license and certification by submitting to the board:(a)
A completed Advanced Practice Paramedic License and Certification Reinstatement Application in KEMSIS;(b)
The reinstatement fee pursuant to 202 KAR 7:030;(c)
Proof of current unrestricted license as a paramedic in Kentucky;(d)
Proof of previous licensure as an advanced practice paramedic in Kentucky; and(e)
Proof of current IBSC certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic.(2)
The applicant for reinstatement shall undergo a background check pursuant to KRS 311A.100, which shall be:(a)
Statewide in scope for an applicant with a current license or 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 approved by the board.(3)
The applicant for reinstatement shall bear the burden of proof of previous licensure and certification in Kentucky if previous certification or licensure is in dispute.(4)
An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.Section 16.Section 9.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Advanced Practice Paramedic Certification Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(b)
"Advanced Practice Paramedic License and Certification Reinstatement Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(c)
"Advanced Practice Paramedic License and Certification Surrender Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(d)
"Advanced Practice Paramedic Renewal Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(a)
(b)
(c)
(d)
(e)
(e)(f)
"EMS Advanced Practice Paramedic Scope of Practice", document, (10/2024), kbems.ky.gov;(f)
"International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline", (2019);(g)
"International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline", (2016);(h)
"International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline", (2020);(i)
"International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline", (2016);(j)
"International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline", (2022).(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, Monday through Friday, 8 a.m. to 4:30 p.m.JOHN R. HOLDER, Chair, Board of Emergency Medical Services
APPROVED BY AGENCY: December 12, 2024
FILED WITH LRC: January 8, 2025 at 1:07 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on March 26, 2025, at 1:00 PM 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 March 31, 2025. 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, Legal Counsel, Kentucky Board of Emergency Medical Services, 163 E. Main Street, Suite 200, Lexington, Kentucky 40507, Phone: (859) 225-4714, Fax: (859) 225-1493, 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.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation establishes those requirements.
(b) The necessity of this administrative regulation:
KRS 311A.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation is necessary to establishes those requirements.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation conforms to the content of KRS 311A.070 and 311A.030 by establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
KRS 311A.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation will assist in the effective administration of the foregoing statute by establishing those requirements.
(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 establishes the licensure and certification requirements for critical care paramedics, flight paramedics, and tactical paramedics. This amendment also removes the existing prerequisites to be eligible to enroll in a community paramedic or wilderness paramedic education and training program. To be eligible for initial licensure and certification under this amendment, applicants must complete an education and training program covering the topic areas outlined by the International Board of Specialty Certification (IBSC) for the applicable type of advanced practice paramedic. To be eligible for renewal under this amendment, an advanced practice paramedic must either maintain current IBSC certification or take at least 50 hours of continuing education covering the applicable IBSC topic areas. For paramedics who are currently certified by the IBSC, who are operating under a community paramedic pilot program, or who have a critical care endorsement, this amendment provides a process to transition those paramedics to licensed and certified advanced practice paramedics. Paramedics who are currently certified by the IBSC as a community, wilderness, critical care, flight, or tactical paramedic are not required to submit a course completion certificate for initial licensure and certification, so long as they apply for an advanced practice paramedic license and certification by September 30, 2026. Paramedics operating under a board-approved community paramedic pilot program are not required to submit proof of current IBSC certification as a community paramedic for initial certification and licensure, so long as they apply for an advanced practice paramedic certification by September 30, 2026. Paramedics who have a critical care endorsement are not required to submit proof of current IBSC certification as a critical care paramedic for initial licensure and certification, so long as they apply for an advanced practice paramedic certification by September 30, 2026. Finally, this amendment includes a renewal provision for active duty military in accordance with KRS 12.355, provisions governing validation and audits of certifications and continuing education, a requirement that agencies adopt a policy requiring annual clinical competency assessments for their advanced practice paramedics, and establishes requirements for reinstating and surrendering an advanced practice paramedic license and certification.
(b) The necessity of the amendment to this administrative regulation:
This amendment is necessary to establish the requirements for advanced practice paramedics.
(c) How the amendment conforms to the content of the authorizing statutes:
KRS 311A.170 requires the Board to promulgate administrative regulations establishing the requirements of advanced practice paramedics, including community, critical care, flight, tactical, and wilderness paramedics. This amendment conforms to the content of KRS 311A.170 by establishing those requirements.
(d) How the amendment will assist in the effective administration of the statutes:
This amendment will assist in the effective administration of KRS 311A.170 by establishing the requirements for licensure and certification as advanced practice paramedic.
(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 advanced practice paramedics and paramedics seeking licensure and certification as an advanced practice paramedic.
(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:
Paramedics will be required to satisfy all requirements of this administrative regulation to obtain and maintain an advanced practice paramedic license and specialty certification. Advanced practice paramedics will be required to comply with the requirements of this administrative regulation to maintain their advanced practice paramedic license and certification(s).
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
Compliance with this administrative regulation will cost advanced practice paramedics seeking to renew their specialty certification(s) $10 for each certification, as established in 202 KAR 7:030.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
This administrative regulation will enable paramedics to become licensed advanced practice paramedics and certified community, wilderness, critical care, flight, and/or tactical paramedics if the requirements of this administrative regulation are satisfied. Paramedics will benefit from being able to obtain specialty certifications and the public will benefit from having access to care provided by advanced practice paramedics.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
There will be no additional cost to the administrative body to implement this administrative regulation.
(b) On a continuing basis:
There will be no additional cost to the administrative body to implement this administrative regulation.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Board’s general appropriations will be used to implement and enforce this administrative regulation.
(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:
There is currently no fee for initial licensure and certification as an advanced practice paramedic. However, under 202 KAR 7:030, there is a $10 renewal fee for each advanced practice paramedic certification. No additional funding will be necessary to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
By referencing the renewal fee established in the amendment to 202 KAR 7:030 filed contemporaneously with this administrative regulation, this regulation indirectly establishes a $10 renewal fee for each advanced practice paramedic certification. Additional fees may be added in a future amendment to 202 KAR 7:030.
(9) TIERING: Is tiering applied?
Tiering is not applied to this administrative regulation because this amendment applies equally to all advanced practice paramedics and paramedics seeking licensure and certification as an advanced practice paramedic.
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.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation establishes those requirements.
(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:
None
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.
(4) Identify additional regulated entities not listed in questions (2) or (3):
Advanced Practice Paramedics
(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 administrative regulation will require an expenditure of $10 to renew each advanced practice paramedic certification.
(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 personnel.
Kentucky Board of Emergency Medical Services
(Amendment)
202 KAR 7:410.Advanced Practice Paramedics.
Section 1.
Licensure of Advanced Practice Paramedics. In accordance with this administrative regulation, the board office shall issue an advanced practice paramedic license to an individual certified as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic.Section 2.
Certification of Community Paramedics.(1)
Individuals desiring initial board certification as a community paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certification from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline topic areas;(d)
Submit proof of current certification as a community paramedic (CP-C) by the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a community paramedic certification, a community paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a community paramedic (CP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Community Paramedic Content Outline topic areas.(3)
An application for renewal of community paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.Section 3.
Certification of Wilderness Paramedics.(1)
Individuals desiring initial board certification as a wilderness paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas;(d)
Submit proof of certification as a wilderness paramedic (WP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a wilderness paramedic certification, a wilderness paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a wilderness paramedic (WP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas.(3)
An application for renewal of a wilderness paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.Section 4.
Certification of Critical Care Paramedics.(1)
Individuals desiring initial board certification as a critical care paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline topic areas;(d)
Submit proof of current certification as a critical care paramedic (CCP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a critical care paramedic certification, a critical care paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a critical care paramedic (CCP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline topic areas.(3)
An application for renewal of a critical care paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification at the time of application.Section 5.
Certification of Flight Paramedics.(1)
Individuals desiring initial board certification as a flight paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline topic areas;(d)
Submit proof of current certification as a flight paramedic (FP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a flight paramedic certification, a flight paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a flight paramedic (FP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline topic areas.(3)
An applicant for renewal of a flight paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.Section 6.
Certification of Tactical Paramedics.(1)
Individuals desiring initial board certification as a tactical paramedic shall:(a)
Hold a current unrestricted license as a paramedic in Kentucky;(b)
Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;(c)
Submit a course completion certificate from an education and training program which minimally meets the International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline topic areas;(d)
Submit proof of current certification as a tactical paramedic (TP-C) from the International Board of Specialty Certification (IBSC);(e)
Submit a completed Advanced Practice Paramedic Certification Application in KEMSIS; and(f)
Pay the fee pursuant to 202 KAR 7:030.(2)
To be eligible for renewal of a tactical paramedic certification, a tactical paramedic shall:(a)
Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;(b)
Submit a completed Advanced Practice Paramedic Renewal Application in KEMSIS;(c)
Pay the renewal fee pursuant to 202 KAR 7:030; and(d)
Maintain written evidence of:1.
Current certification by the International Board of Specialty Certification (IBSC) as a tactical paramedic (TP-C); or2.
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline topic areas.(3)
An application for renewal of a tactical paramedic certification shall be denied if:(a)
Prior to the certification expiration date, the applicant has not met the requirements of this section; or(b)
The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.Section 7.
Transition for Currently Certified Providers.(1)
Notwithstanding sections 2(1)(c), 3(1)(c), 4(1)(c), 5(1)(c), or 6(1)(c) of this administrative regulation, proof of a successful course completion certification shall not be required for initial licensure and certification if:(a)
At the time of application, the applicant is certified as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic by the International Board of Specialty Certification (IBSC); and(b)
The application is submitted on or before September 30, 2026.(2)
Notwithstanding section 2(1)(d) of this administrative regulation, proof of current certification as a community paramedic (CP-C) by the International Board of Specialty Certification (IBSC) shall not be required for initial licensure and certification as a community paramedic if:(a)
At the time of application, the applicant is operating under a board-approved community paramedic pilot program; and(b)
The application is submitted on or before September 30, 2026.(3)
Notwithstanding section 4(1)(d) of this administrative regulation, proof of current certification as a critical care paramedic (CCP-C) from the International Board of Specialty Certification (IBSC) shall not be required for initial licensure and certification as a critical care paramedic if:(a)
At the time of application, the applicant has a board-issued critical care paramedic endorsement; and(b)
The application is submitted on or before September 30, 2026.Section 8.
Advanced Practice Paramedic License and Certification Renewal for Active-Duty Members of the Armed Forces. A licensed advanced practice paramedic, in good standing, who is a member of the Armed Forces of the United States and called to active duty by presidential order pursuant to 10 U.S.C. 121 and 12304 shall have his or her advanced practice paramedic license and certification renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.Section 9.
Certification and Continuing Education Validation and Audits.(1)
All continuing education for advanced practice paramedics shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.(2)
The board office may audit an advanced practice paramedic's continuing education record and IBSC certification. The advanced practice paramedic shall submit the documentation requested within ten (10) business days of receipt of the board office's request.(3)
If documentation of IBSC certification or continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days upon receipt of the board's request, the advanced practice paramedic license and certification shall be deemed to have lapsed and the individual shall reapply for licensure and certification through reinstatement, if eligible.(4)
The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.(5)
Each advanced practice paramedic shall maintain documentation of all IBSC certifications and all continuing education for three (3) years from the date of completion.Section 10.
Expiration of Advanced Practice Paramedic License and Certification.(1)
A board-issued advanced practice paramedic license and a board-issued certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic shall lapse or expire upon lapse or expiration of the individual's board-issued paramedic license pursuant to KRS 311A.095.(2)
An individual whose board-issued advanced practice paramedic license and board-issued certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic has lapsed or expired shall cease providing the specialty care authorized by the lapsed or expired license and certification.Section 11.
Scope of Practice.(1)
An advanced practice paramedic may perform care consistent with the skills, procedures, and techniques established in the current board-approved EMS Advanced Practice Paramedic Scope of Practice document.(2)
Assessment of techniques, skills, and procedures of an advanced practice paramedic shall be subject to the board-approved agency medical protocols adopted by the advance practice paramedic's agency.(3)
Each agency that adopts skills, procedures, and techniques established in the current board-approved EMS Advanced Practice Paramedic Scope of Practice document shall implement and maintain a policy requiring annual clinical competency assessments for employees licensed as advanced practice paramedics.Section 12.
Exemptions to this Administrative Regulation. The advanced practice paramedic licensure and certification requirements established by this administrative regulation shall not apply to: United States military members, National Guard personnel, or employees of the United States government if the individual provides services:(1)
On land owned by the United States government;(2)
In facilities owned by the United States government;(3)
In the performance of official duties under federal law; or(4)
As part of assistance for a mass casualty or disaster incident pursuant to federal law or an official state assistance request.Section 13.
Public Notice of Negative Action. The board office shall cause to be published on the board's Web site the name of an advanced practice paramedic who:(1)
Is fined;(2)
Is placed on probationary status;(3)
Is placed on restricted status;(4)
Is suspended; or(5)
Has had their license or certification revoked.Section 14.
Surrender of Advanced Practice Paramedic License and Certification.(1)
An advanced practice paramedic surrendering his or her license as an advanced practice paramedic and certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic shall:(a)
Submit a completed Advanced Practice Paramedic License and Certification Surrender Application in KEMSIS; and(b)
Pay the fee pursuant to 202 KAR 7:030.(2)
Upon surrendering an advanced practice paramedic license and applicable certification, the surrendering individual shall immediately give notice to his or her agency's chief operations or service director.Section 15.
Reinstatement of Advanced Practice Paramedic License and Certification.(1)
An advanced practice paramedic whose license and certification has lapsed or expired may reinstate his or her advanced practice paramedic license and certification by submitting to the board:(a)
A completed Advanced Practice Paramedic License and Certification Reinstatement Application in KEMSIS;(b)
The reinstatement fee pursuant to 202 KAR 7:030;(c)
Proof of current unrestricted license as a paramedic in Kentucky;(d)
Proof of previous licensure as an advanced practice paramedic in Kentucky; and(e)
Proof of current IBSC certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic.(2)
The applicant for reinstatement shall undergo a background check pursuant to KRS 311A.100, which shall be:(a)
Statewide in scope for an applicant with a current license or 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 approved by the board.(3)
The applicant for reinstatement shall bear the burden of proof of previous licensure and certification in Kentucky if previous certification or licensure is in dispute.(4)
An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.Section 16.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Advanced Practice Paramedic Certification Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(b)
"Advanced Practice Paramedic License and Certification Reinstatement Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(c)
"Advanced Practice Paramedic License and Certification Surrender Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(d)
"Advanced Practice Paramedic Renewal Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;(e)
"EMS Advanced Practice Paramedic Scope of Practice", document, (10/2024), kbems.ky.gov;(f)
"International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline", (2019);(g)
"International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline", (2016);(h)
"International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline", (2020);(i)
"International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline", (2016);(j)
"International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline", (2022).(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, Monday through Friday, 8 a.m. to 4:30 p.m.JOHN R. HOLDER, Chair, Board of Emergency Medical Services
APPROVED BY AGENCY: December 12, 2024
FILED WITH LRC: January 8, 2025 at 1:07 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on March 26, 2025, at 1:00 PM 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 March 31, 2025. 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, Legal Counsel, Kentucky Board of Emergency Medical Services, 163 E. Main Street, Suite 200, Lexington, Kentucky 40507, Phone: (859) 225-4714, Fax: (859) 225-1493, 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.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation establishes those requirements.
(b) The necessity of this administrative regulation:
KRS 311A.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation is necessary to establishes those requirements.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation conforms to the content of KRS 311A.070 and 311A.030 by establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
KRS 311A.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation will assist in the effective administration of the foregoing statute by establishing those requirements.
(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 establishes the licensure and certification requirements for critical care paramedics, flight paramedics, and tactical paramedics. This amendment also removes the existing prerequisites to be eligible to enroll in a community paramedic or wilderness paramedic education and training program. To be eligible for initial licensure and certification under this amendment, applicants must complete an education and training program covering the topic areas outlined by the International Board of Specialty Certification (IBSC) for the applicable type of advanced practice paramedic. To be eligible for renewal under this amendment, an advanced practice paramedic must either maintain current IBSC certification or take at least 50 hours of continuing education covering the applicable IBSC topic areas. For paramedics who are currently certified by the IBSC, who are operating under a community paramedic pilot program, or who have a critical care endorsement, this amendment provides a process to transition those paramedics to licensed and certified advanced practice paramedics. Paramedics who are currently certified by the IBSC as a community, wilderness, critical care, flight, or tactical paramedic are not required to submit a course completion certificate for initial licensure and certification, so long as they apply for an advanced practice paramedic license and certification by September 30, 2026. Paramedics operating under a board-approved community paramedic pilot program are not required to submit proof of current IBSC certification as a community paramedic for initial certification and licensure, so long as they apply for an advanced practice paramedic certification by September 30, 2026. Paramedics who have a critical care endorsement are not required to submit proof of current IBSC certification as a critical care paramedic for initial licensure and certification, so long as they apply for an advanced practice paramedic certification by September 30, 2026. Finally, this amendment includes a renewal provision for active duty military in accordance with KRS 12.355, provisions governing validation and audits of certifications and continuing education, a requirement that agencies adopt a policy requiring annual clinical competency assessments for their advanced practice paramedics, and establishes requirements for reinstating and surrendering an advanced practice paramedic license and certification.
(b) The necessity of the amendment to this administrative regulation:
This amendment is necessary to establish the requirements for advanced practice paramedics.
(c) How the amendment conforms to the content of the authorizing statutes:
KRS 311A.170 requires the Board to promulgate administrative regulations establishing the requirements of advanced practice paramedics, including community, critical care, flight, tactical, and wilderness paramedics. This amendment conforms to the content of KRS 311A.170 by establishing those requirements.
(d) How the amendment will assist in the effective administration of the statutes:
This amendment will assist in the effective administration of KRS 311A.170 by establishing the requirements for licensure and certification as advanced practice paramedic.
(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 advanced practice paramedics and paramedics seeking licensure and certification as an advanced practice paramedic.
(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:
Paramedics will be required to satisfy all requirements of this administrative regulation to obtain and maintain an advanced practice paramedic license and specialty certification. Advanced practice paramedics will be required to comply with the requirements of this administrative regulation to maintain their advanced practice paramedic license and certification(s).
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
Compliance with this administrative regulation will cost advanced practice paramedics seeking to renew their specialty certification(s) $10 for each certification, as established in 202 KAR 7:030.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
This administrative regulation will enable paramedics to become licensed advanced practice paramedics and certified community, wilderness, critical care, flight, and/or tactical paramedics if the requirements of this administrative regulation are satisfied. Paramedics will benefit from being able to obtain specialty certifications and the public will benefit from having access to care provided by advanced practice paramedics.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
There will be no additional cost to the administrative body to implement this administrative regulation.
(b) On a continuing basis:
There will be no additional cost to the administrative body to implement this administrative regulation.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Board’s general appropriations will be used to implement and enforce this administrative regulation.
(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:
There is currently no fee for initial licensure and certification as an advanced practice paramedic. However, under 202 KAR 7:030, there is a $10 renewal fee for each advanced practice paramedic certification. No additional funding will be necessary to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
By referencing the renewal fee established in the amendment to 202 KAR 7:030 filed contemporaneously with this administrative regulation, this regulation indirectly establishes a $10 renewal fee for each advanced practice paramedic certification. Additional fees may be added in a future amendment to 202 KAR 7:030.
(9) TIERING: Is tiering applied?
Tiering is not applied to this administrative regulation because this amendment applies equally to all advanced practice paramedics and paramedics seeking licensure and certification as an advanced practice paramedic.
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.070 requires the board to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation establishes those requirements.
(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:
None
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.
(4) Identify additional regulated entities not listed in questions (2) or (3):
Advanced Practice Paramedics
(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 administrative regulation will require an expenditure of $10 to renew each advanced practice paramedic certification.
(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 personnel.