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Title 202 | Chapter 007 | Regulation 410REG

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KENTUCKY BOARD OF EMERGENCY MEDICAL SERVICES
(Amended at ARRS Committee)

202 KAR 7:410.Advanced Practice Paramedics.

RELATES TO:

KRS 12.355, 72.020, 311A.025, 311A.050-311A.100, 311A.120-311A.135, 311A.142, 311A.170, 311A.185, 311A.190, 446.400

STATUTORY AUTHORITY:

KRS 311A.020, 311A.025, 311A.120, 311A.125, 311A.135, 311A.170(3)

CERTIFICATION STATEMENT:

NECESSITY, FUNCTION, AND CONFORMITY:

KRS 311A.170(3)311A.025(2) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation establishes those requirements.

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,or wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic.

Section 2.

Certification of Community Paramedics.

(1)

An individual shall be eligible to enroll as a student in a community paramedic education and training program if the applicant:

(a)

Holds a current unrestricted license as a paramedic in Kentucky or holds a current unrestricted certification with the NREMT as a Nationally Registered Paramedic (NRP);

(b)

Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and

(c)

Meets all additional requirements established by the EMS-TEI.

(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)

Successfully complete all EMS-TEI requirements for the community paramedic education and training program, which shall include all requirements of the International Board of Special Certification (IBSC) to test for IBSC certification as a community paramedic (CP-C);

(c)

Submit a course completion certification from an education and training program thatwhich minimally meets the International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline topic areas;

(d)(c)

Submit proof of currentObtain certification as a community paramedic (CP-C) by the International Board of Specialty Certification (IBSC);

(d)

If operating under a board-approved community paramedic pilot program, obtain IBSC certification as a community paramedic by no later than January 1, 2026; and

(e)

Submit a completed Initial Advanced Practice Paramedic–Community Paramedic LicenseCertification Application in KEMSIS; and.

(f)

Pay the fee required bypursuant 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 EMS ClinicianAdvanced Practice Paramedic–Community Paramedic Certification Renewal Application in KEMSIS;

(c)

Pay the renewal fee required bypursuant to 202 KAR 7:030, Section 3; and

(d)

MaintainSubmit to the board written evidence of:

1.

Current certification by the International Board of Specialty Certification (IBSC) as a community paramedic (CP-C); or

2.

At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Community Paramedic Content Outline topic areas.

2.

At least fifteen (15) hours of continuing education on the following subject areas unique to community paramedicine:

a.

Community based needs;

b.

Interdisciplinary collaboration;

c.

Patient centric care;

d.

Wellness and safety;

e.

Preventative care and education for patient or client and caregiver; or

f.

Ethical and legal consideration preventative care and patient education.

(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)

An individual seeking reciprocity as a community paramedic shall:

(a)

Meet the requirements for paramedic reciprocity in accordance with 202 KAR 7:401;

(b)

Have a current certification from the International Board of Specialty Certification (IBSC) as a community paramedic (CP-C); and

(c)

Submit to the board a completed Advanced Practice Paramedic–Community Paramedic Certification Application in KEMSIS.

Section 3.

Certification of Wilderness Paramedics.

(1)

An individual shall be eligible to enroll as a student in a wilderness paramedic education and training program if the applicant:

(a)

Holds a current unrestricted license as a paramedic in Kentucky or holds a current unrestricted certification with the NREMT as a Nationally Registered Paramedic (NRP);

(b)

Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and

(c)

Meets all additional requirements established by the EMS-TEI.

(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)

Successfully complete all EMS-TEI requirements for the wilderness paramedic education and training program, which shall include all requirements of the International Board of Specialty Certification (IBSC) to test for IBSC certification as a wilderness paramedic (WC-P), or, successfully complete a wilderness medicine upgrade course equivalent to Wilderness First Responder or higher from an organization approved by the board that provides certification in wilderness medicine;

(c)

Submit a course completion certificate from an education and training program thatwhich minimally meets the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas;

(d)(c)

Submit proof of currentObtain a certification as a wilderness paramedic (WP-C) from the International Board of Specialty Certification (IBSC); and

(e)(d)

Submit a completed Initial Advanced Practice Paramedic-Wilderness Paramedic LicenseCertification Application in KEMSIS; and.

(f)

Pay the fee required bypursuant 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 EMS ClinicianAdvanced Practice Paramedic-Wilderness Paramedic Certification Renewal Application in KEMSIS;

(c)

Pay the renewal fee required bypursuant to 202 KAR 7:030, Section 3; and

(d)

MaintainSubmit to the board written evidence of:

1.

Currentcurrent certification by the International Board of Specialty Certification (IBSC) as a wilderness paramedic (WP-C); or

2.

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)

An individual seeking reciprocity as a wilderness paramedic shall:

(a)

Meet the requirements for paramedic reciprocity in accordance with 202 KAR 7:401;

(b)

Have a current certification from the International Board of Specialty Certification (IBSC) as a wilderness paramedic (WP-C);

(c)

Satisfy the requirements of subsection (2) of this section; and

(d)

Submit to the board a completed Advanced Practice Paramedic-Wilderness Paramedic Certification Application in KEMSIS.

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 thatwhich 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 Initial Advanced Practice Paramedic LicenseCertification Application in KEMSIS; and

(f)

Pay the fee required bypursuant 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 EMS ClinicianAdvanced Practice Paramedic Renewal Application in KEMSIS;

(c)

Pay the renewal fee required bypursuant to 202 KAR 7:030, Section 3; and

(d)

Maintain written evidence of:

1.

Current certification by the International Board of Specialty Certification (IBSC) as a critical care paramedic (CCP-C); or

2.

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 thatwhich 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 Initial Advanced Practice Paramedic LicenseCertification Application in KEMSIS; and

(f)

Pay the fee required bypursuant 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 EMS ClinicianAdvanced Practice Paramedic Renewal Application in KEMSIS;

(c)

Pay the renewal fee required bypursuant to 202 KAR 7:030, Section 3; and

(d)

Maintain written evidence of:

1.

Current certification by the International Board of Specialty Certification (IBSC) as a flight paramedic (FP-C); or

2.

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 thatwhich 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 Initial Advanced Practice Paramedic LicenseCertification 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 EMS ClinicianAdvanced 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); or

2.

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. Upon request, the advanced practice paramedic shall submit the requested 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 required byconsistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days ofupon 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 conducted 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,or 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,or 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.Section 5.

Scope of Practice.

(1)

An advanced practice paramedic may performshall provide 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.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,or wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic shall:

(a)

Submitsubmit 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 Certification/License Application in KEMSIS;

(b)

The reinstatement fee pursuant to 202 KAR 7:030, Section 4;

(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)

"Initial Advanced Practice Paramedic LicenseCertification Application", (12/2024), in KEMSIS, http://kemsis.ky.gov;

(b)

"ReinstatementAdvanced Practice Paramedic License and Certification/LicenseReinstatement 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)

"EMS ClinicianAdvanced Practice Paramedic Renewal Application", (04/2025)(12/2024), in KEMSIS, http://kemsis.ky.gov;

(a)

"Advanced Practice Paramedic - Community Paramedic Certification Application", in KEMSIS, http://kemsis.ky.gov;

(b)

"Advanced Practice Paramedic - Community Paramedic Certification Renewal Application", in KEMSIS, http://kemsis.ky.gov;

(c)

"Advanced Practice Paramedic License and Certification Surrender Application", in KEMSIS, http://kemsis.ky.gov;

(d)

"Advanced Practice Paramedic - Wilderness Paramedic Certification Application", in KEMSIS, http://kemsis.ky.gov;

(e)

"Advanced Practice Paramedic - Wilderness Paramedic Certification Renewal Application", in KEMSIS, http://kemsis.ky.gov; and

(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. This material is also available on the agency's Web site at http://kbems.ky.gov or in KEMSIS at http://kemsis.ky.gov.
FILED WITH LRC: April 14, 2025
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.

7-Year Expiration: 2/16/2031

Last Updated: 4/28/2025

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