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Oregon Bulletin

February 1, 2011

 

Oregon Health Authority, Public Health Division
Chapter 333

Rule Caption: Updating rules for Medical Marijuana pertaining to application documentation.

Adm. Order No.: PH 27-2010

Filed with Sec. of State: 12-28-2010

Certified to be Effective: 12-28-10

Notice Publication Date: 11-1-2010

Rules Adopted: 333-008-0045

Rules Amended: 333-008-0020, 333-008-0040

Rules Repealed: 333-008-0020(T)

Subject: The Oregon Health Authority, Public Health Division, Oregon Medical Marijuana Program is permanently amending administrative rules in chapter 333, division 8 to clarify existing rule and add guidance in order to clarify the procedures regarding acceptable documentation accompanying an application for the registry so that applicant processing time improves. Also, to distinguish Interim Changes from Annual Renewal as these require different processes.

Rules Coordinator: Brittany Sande—(971) 673-1291

333-008-0020

New Registration Application and Verification

(1) A person may apply for a registry identification card on a form prescribed by the Authority. In order for an application to be considered complete, an applicant must submit the following:

(a) An application form signed and dated by the applicant;

(b) Copies of legible, current, and valid U.S. government issued photographic identification that includes last name, first name, and date of birth from the applicant, the designated primary caregiver, and grower, as applicable. Acceptable forms of U.S. government issued photographic identification include but are not limited to:

(A) Driver’s license;

(B) State identification card;

(C) Passport; or

(D) Military identification card;

(c) Documentation, which may consist of relevant portions of the applicant’s medical record, signed by the applicant’s attending physician within 90 days of the date of receipt by the Authority, which describes the applicant’s debilitating medical condition and states that the use of marijuana may mitigate the symptoms or effects of the applicant’s debilitating medical condition;

(d) A completed and notarized “Declaration of Person Responsible for Minor” form for any person under 18 years of age, signed and dated by the person responsible for the minor; and

(e) An application fee in the form of cash, bank check, or personal check. The Authority will place a 10-day hold on the issuance of a registry identification card for an application accompanied by a personal check. An applicant will be given 14 days from Authority receipt of non-sufficient funds (NSF) or stop payment notification to submit payment in the form of a bank check or cash.

(f) The OMMP will only accept applications that are mailed or are hand-delivered.

(g) The OMMP may reject an application if the application or supporting documents appear to be altered (i.e. writing is whited out). An application will be denied in accordance with OAR 333-008-0030 if an application or supporting documents are determined to have been falsified.

(2) An applicant may only name, and the Authority will only register, one designated primary caregiver and one grower.

(3) The fee for a new application is $100.

(4) An applicant who can prove he or she is an Oregon resident and can demonstrate current eligibility in the OHP, receipt of current food stamp benefits through the Oregon SNAP program, or receipt of current SSI benefits, qualifies for a reduced application fee of $20.

(a) To qualify for a reduced fee on the basis of current eligibility in the OHP, an applicant must provide a copy of the applicant’s current eligibility statement.

(b) To qualify for a reduced fee on the basis of receipt of current SSI benefits, an applicant must provide a copy of a current monthly SSI benefit card, showing dates of coverage.

(c) To qualify for a reduced fee on the basis of receipt of current food stamp benefits, an applicant must be current in Oregon’s Food Stamp Management Information System database system and provide current proof of his or her food stamp benefits.

(d) Proof of residency may be shown through:

(A) A current Oregon driver’s license or Oregon issued identification card; and

(B) A utility bill, mortgage statement, lease payment statement or lease agreement for the previous month with the applicant’s name and an Oregon physical address.

(5) The Authority may verify information on each application and accompanying documentation, including:

(a) Contacting each applicant by telephone or by mail. If proof of identity is uncertain, the Authority may require a face-to-face meeting and may require the production of additional identification materials;

(b) Contacting a minor’s parent or legal guardian;

(c) Contacting the Oregon Board of Medical Examiners to verify that an attending physician is licensed to practice in the state and is in good standing;

(d) Contacting the attending physician to request further documentation to support a finding that the physician is the applicant’s attending physician. The Authority will notify the applicant of the intent to review the medical records and request the applicant’s authorization to conduct the review. Failure to authorize a review of medical records may result in the application being declared incomplete, or denial of an application;

(e) Contacting the OHP, DHS-Self Sufficiency, or Social Security Administration (SSA) to verify eligibility for benefits; and

(f) Conducting criminal records check under ORS 181.534 of any person whose name is submitted as a grower.

(6) The Authority will notify an applicant who submits a reduced fee for which the applicant is not eligible and will give the applicant 14 days from the date of notice to pay the correct fee, submit a current, valid eligibility determination statement for the OHP, current proof of food stamp benefits, or to submit a copy of a receipt for current SSI monthly benefit, as applicable. The Authority will continue to process the application pending receipt of an eligibility statement. The Authority will not grant an application fee refund for any eligibility determination made on or after the date of issuance of the applicant’s registry identification card.

(7) If an applicant does not provide all the information required and the application is considered incomplete, the Authority shall notify the applicant of the information that is missing, and shall give the applicant 14 days to submit the missing information.

(8) If the Authority is unable to verify that the applicant’s attending physician meets the definition under OAR 333-008-0010(3) the applicant will be allowed 30 days to submit written documentation or a new attending physician’s declaration from a physician meeting the requirements of these rules. Failure to submit the required attending physician documentation is grounds for denial under ORS 475.309 and OAR 333-008-0030.

(9) If an applicant does not provide the information necessary to declare an application complete, or to complete the verification process within the timelines established in sections (7) and (8) of this rule, the application will be rejected as incomplete. An applicant whose application is rejected as incomplete may reapply at any time.

(10) The application forms referenced in this rule may be obtained by contacting the: Oregon Medical Marijuana Program (OMMP) at PO Box 14450, Portland, OR 97293-0450 or calling 971-673-1234.

Stat. Auth.: ORS 475.338

Stats. Implemented: ORS 475.300 - 475.346

Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 13-2000(Temp), f. & cert. ef. 12-21-00 thru 6-15-01; OHD 18-2001, f. & cert. ef. 8-9-01; OHD 19-2001(Temp), f. & cert. ef. 8-10-01 thru 1-31-02; Administrative correction 3-14-02; OHD 6-2002, f. & cert. ef. 3-25-02; PH 9-2003, f. 6-26-03, cert. ef. 7-1-03; PH 38-2004, f. 12-22-04, cert. ef. 1-1-05; PH 17-2005, f. 11-25-05, cert. ef. 12-1-05; PH 18-2005, f. 12-30-05, cert. ef. 1-1-06; PH 15-2007, f. 12-19-07, cert. ef. 1-1-08; PH 14-2010(Temp), f. & cert. ef. 7-6-10 thru 12-31-10; PH 27-2010, f. & cert. ef. 12-28-10

333-008-0040

Annual Renewal and Interim Changes

(1) A patient shall register on an annual basis to maintain active registration status by submitting a renewal application prescribed by the Authority. A renewal application shall be submitted by mail or in person at the OMMP office.

(2) Between 60 to 90 calendar days prior to expiration, the Authority shall mail to the patient’s address of record, a letter notifying the patient of the upcoming expiration date, along with a renewal application.

(3) In addition to completing the renewal application, the patient must submit, prior to the expiration of the registry identification card:

(a) Written documentation, signed by the patient’s attending physician within 90 days prior to the expiration date of the patient’s current card, reconfirming the patient’s debilitating medical condition and that the medical use of marijuana mitigates the symptoms of the patient’s debilitating medical condition; and

(b) The information and fee required in OAR 333-008-0020(1)(a), (b), (d) and (e).

(4) If the renewal information is not received by the expiration date on the registry identification card, the patient’s registry identification card and all other associated OMMP cards, if any, will be deemed expired. The expiration date may be extended, due to personal hardship, at the discretion of the Authority. If a person fails to apply for renewal within the time period specified in this rule, that person must submit a new application.

(5) The renewal fee is $100 and an applicant may qualify for a reduced fee of $20 if the applicant meets the criteria set forth in OAR 333-008-0020(3).

(6) The Authority will verify the renewal application information in the same manner as specified in OAR 333-008-0020(4).

(7) The OMMP may reject a renewal application if the application or supporting documents appear to be altered (i.e. writing is whited out). An application will be denied in accordance with OAR 333-008-0030 if an application or supporting documents are determined to have been falsified.

Stat. Auth.: ORS 475.309 & 475.312

Stats. Implemented: ORS 475.309 & 475.312

Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; PH 9-2003, f. 6-26-03, cert. ef. 7-1-03; PH 18-2005, f. 12-30-05, cert. ef. 1-1-06; PH 15-2007, f. 12-19-07, cert. ef. 1-1-08; PH 21-2010, f. & cert. ef. 9-13-10; PH 27-2010, f. & cert. ef. 12-28-10

333-008-0045

Interim Changes

(1) A patient shall notify the Authority within 30 calendar days of any change in the patient’s name, address, telephone number, attending physician, designated primary caregiver, grower or grow site address.

(2) A patient shall notify the designated primary caregiver and the grower of any changes in status including, but not limited to:

(a) The assignment of another individual as the designated primary caregiver for the patient;

(b) The assignment of another individual as a grower for the patient; or

(c) The end of eligibility of the patient to hold a registry identification card.

(3) If the Authority is notified by the patient that a primary caregiver or a grower has changed, the Authority shall notify the primary caregiver or the grower by mail at the address of record confirming the change in status and informing the caregiver or grower that their card is no longer valid and must be returned to the Authority within seven calendar days.

(4) A patient who has been diagnosed by an attending physician as no longer having a debilitating medical condition or whose attending physician has determined that the medical use of marijuana is contraindicated for the patient’s debilitating medical condition shall return the registry identification card and all associated OMMP cards to the Authority within 30 calendar days of notification of the diagnosis or notification of the contraindication. If, due to circumstances beyond control of the patient he or she is unable to obtain a second medical opinion about the patient’s continuing eligibility to use medical marijuana before the 30-day period has expired, the Authority may grant the patient additional time to obtain a second opinion before requiring the patient to return the registry identification card and all associated cards.

(5) Change forms may only be submitted to the OMMP via mail or in person at the OMMP office.

Stat. Auth.: ORS 475.309 & 475.312

Stats. Implemented: ORS 475.309 & 475.312

Hist.: PH 27-2010, f. & cert. ef. 12-28-10

 

Rule Caption: Ambulance Vehicle Licensing and Emergency Medical Technicians and First Responders.

Adm. Order No.: PH 1-2011

Filed with Sec. of State: 1-6-2011

Certified to be Effective: 1-6-11

Notice Publication Date: 11-1-2010

Rules Amended: 333-255-0070, 333-255-0071, 333-255-0072, 333-255-0073, 333-265-0050, 333-265-0090, 333-265-0105, 333-265-0110

Rules Repealed: 333-255-0070(T), 333-265-0090(T), 333-265-0105(T)

Subject: The Oregon Health Authority, Public Health Division is permanently amending Oregon Administrative Rules chapter 333, division 265, to streamline and clarify rules, address requirements for training, and correct errors that were unintentionally made in the last permanent rule change. The Oregon Health Authority, Public Health Division is also permanently amending Oregon Administrative Rules chapter 333, division 255 to clarify the minimum staffing requirements that must be met to operate an ambulance.

Rules Coordinator: Brittany Sande—(971) 673-1291

333-255-0070

Ground Ambulance Operating Requirements

(1) In order to operate a ground ambulance a licensee shall:

(a) Have a driver that meets the qualifications in OAR chapter 333, division 250;

(b) Have emergency medical technicians or other qualified licensed health care professionals staffing the ambulance, as required by OAR chapter 333, division 250.

(c) Ensure that the appropriate equipment is available and in satisfactory working condition, stored in a sanitary and secure manner that protects the viability and safe operation of medications and equipment, including but not limited to:

(A) Installed medical oxygen cylinder with a capacity of at least 3,000 liters and having not less than 500 psi:

(i) The installed medical oxygen cylinder must be located in a vented compartment; and

(ii) The compartment shall not be utilized for storage of any non-secured equipment. No combustible items shall be stored in the oxygen compartment.

(B) Oxygen pressure regulator:

(i) The oxygen must be delivered by a single-stage regulator which is set to at least 50 psi;

(ii) The pressure regulator controls must be accessible from inside the patient compartment; and

(iii) The pressure regulator or other display must be visible from inside the patient compartment.

(C) Oxygen flow meter, mounted — 2:

(i) The flow meter must be readable from the EMT seat and squad bench; and

(ii) The flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.

(D) Portable medical oxygen cylinder with a capacity of at least 300 liters and having not less that 500 psi:

(i) The oxygen must be delivered by a yoke regulator with a pressure gauge and non-gravity-dependent flow meter that is visible and accessible to the medical personnel; and

(ii) The flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.

(E) Spare portable oxygen cylinder that is full, tagged, sealed and securely mounted;

(F) Oxygen non-rebreathing masks with tubing:

(i) Pediatric — 2; and

(ii) Adult — 3.

(G) Oxygen nasal cannula with tubing that are transparent and disposable, adult — 3;

(H) Bag-valve-mask ventilation device with reservoir. The device must:

(i) Have a standard universal adapter;

(ii) Be operable with or without an oxygen supply;

(iii) Be manually operated and self-refilling; and

(iv) Have bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid in assorted sizes to include adult, child, and newborn/infant.

(I) Pharyngeal esophageal airway devices in assorted sizes with agency Supervising Physician approval;

(J) Oxygen Saturation Monitor;

(K) Endtidal CO2 detection device in assorted sizes;

(L) Oropharyngeal airways in assorted sizes to include adult, child, and newborn/infant;

(M) Nasopharyngeal airways in assorted sizes;

(N) Two suction apparatus. Suction apparatus:

(i) Shall be electrically powered or battery powered with pressure regulator.

(ii) If battery powered, shall have enough back-up batteries to maintain suction during routine transport.

(O) Adequate supply of wide-bore tubing, commercial rigid pharyngeal curved suction tips and flexible suction catheters sized from infant to adult;

(P) Collection canisters, either disposable or sealable liners, with adequate capacity.

(Q) Cardiac monitoring equipment including, at a minimum, a portable battery operated automatic or semi-automatic defibrillator (AED), with pediatric capabilities and sufficient pediatric accessories for proper operation on a pediatric patient.

(R) A wheeled stretcher:

(i) Capable of securely fastening to the ambulance body;

(ii) Having a minimum of three restraining devices and an upper torso (over the shoulder) restraint;

(iii) Containing a standard size waterproof foam mattress; and

(iv) Capable of having the head of the stretcher tilted upwards to a 60-degree semi-sitting position.

(S) At lease one folding stretcher, the number required based on the stretcher-carrying capacity of the ambulance, or an additional long backboard:

(i) Capable of securely fastening to the squad bench when carrying a patient; and

(ii) Having a minimum of three restraining devices and an upper torso (over the shoulder) restraint.

(T) Fracture immobilization equipment, including but not limited to:

(i) Traction splints in assorted adult sizes and/or adult child combination;

(ii) Extremity splints in assorted sizes;

(iii) Extrication collars in assorted pediatric through adult sizes;

(iv) Scoop stretcher, folding or non-folding type with necessary restraining devices with sufficient supplies for head immobilization;

(v) Short backboard or equivalent with necessary restraining devices with sufficient supplies for head immobilization;

(vi) Long backboard with necessary restraining devices with sufficient supplies for head immobilization;

(vii) Pediatric backboard with necessary restraining straps with sufficient supplies for head immobilization;

(viii) Bandages and dressings in assorted sizes, sterile and non-sterile; and

(ix) Adhesive or hypo-allergenic tape in assorted sizes.

(U) Miscellaneous equipment, including but limited to:

(i) Emesis containers;

(ii) Stethoscope, pediatric and adult;

(iii) Aneroid sphygmomanometer in assorted sizes;

(iv) Bandage shears;

(v) Hypothermia thermometer;

(vi) Disposable obstetrical kit;

(vii) Chemical heat and cold packs assorted;

(viii) Urinals, female and male, one each;

(ix) Bedpan;

(x) Set of extremity restraining devices;

(xi) Blood glucose level testing kit or blood glucose level test strips;

(xii) Medications and fluids authorized for Basic Life Support use as required by the EMS Medical Director; and

(xiii) Linen supplies and replacements sufficient to cover wheeled stretchers.

(V) Personal protection equipment sufficient for crew and patient(s), including but not limited to:

(i) Non-latex disposable gloves;

(ii) Disposable face masks;

(iii) Protective eyewear;

(iv) Disposable isolation gowns;

(v) Commercial antimicrobial hand cleanser;

(vi) Surface cleaning disinfectant;

(vii) Sharps container for the patient care compartment and a separate container for each kit that contains needles; and

(viii) Infectious waste disposal bags.

(W) Security and rescue equipment, including but not limited to:

(i) Fire extinguisher, 5lb. (2A-10BC type) — mounted and readily accessible in either the driver’s or patient compartment;

(ii) Road flares, red colored chemical lights, the number and burning time to equal at least 180 minutes, or a minimum of six reflective triangles;

(iii) Flashlight;

(iv) Leather gloves sufficient for crew;

(v) Reflective vests for each crew member;

(vi) HEPA mask for each crew member; and

(vii) Adequate extrication equipment for agencies that provide initial response without the response of other rescue apparatus or equipment.

(X) The 2008 Department of Transportation Emergency Response Guidebook, (Initial Response to Hazardous Materials Incidents);

(Y) Triage tags — 25;

(Z) Oregon Trauma Systems Identification Bracelets — 5;

(AA) Prehospital Care Report Forms or electronic field data form;

(BB) A copy of BLS standing orders for dated within one year and signed by the EMS Medical Director;

(CC) A universal “No Smoking” sign conspicuously displayed in the driver’s and patient compartment; and

(DD) A universal “Fasten Seatbelt” sign conspicuously displayed in the driver’s compartment.

(2) An ambulance shall have two-way radio communication equipment to provide reliable contact between the ambulance and central dispatch, the receiving hospital, and online medical direction.

Stat. Auth.: ORS 682.017

Stats. Implemented: ORS 682.017 - 682.117, 682.991

Hist. HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650; HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert. ef. 10-18-91, Former 333-028-0050(3) Renumbered to 333-028-0051, former 333-028-0050(4) & (5) Renumbered to 333-028-0052; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0050; OHD 5-2001, f. & cert. ef. 2-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10, cert. ef. 7-1-10; PH 16-2010(Temp), f. & cert. ef. 7-16-10 thru 1-1-11; PH 1-2011, f. & cert. ef. 1-6-11

333-255-0071

Ground Ambulance Operating Requirements When Providing Intermediate Level Care

(1) A ground ambulance in operation and providing intermediate life support care must have a minimum staff of two certified emergency medical technicians:

(a) A driver who complies with the requirements specified in OAR chapter 333, division 250; and

(b) A person who is at or above the Advanced Emergency Medical Technician or EMT-Intermediate certification level must be in the patient compartment when a patient is receiving intermediate level life support care. If the driver is not a certified EMT, then a second EMT, Basic or above, must be available for patient care both in the ambulance and on scene.

(2) Must meet all requirements specified in OAR 333-255-0070.

(3) A ground ambulance in operation and providing intermediate level care must have the following items in satisfactory working condition, kept in a sanitary manner, stored in a secure manner and be readily accessible to the medical personnel:

(a) All items specified in OAR 333-255-0070;

(b) Cardiac Monitoring Equipment:

(A) A portable battery powered manual monitor defibrillator capable of recording ECG reading;

(B) ECG electrodes, adult and pediatric;

(C) Hands-free defibrillation patches, adult and pediatric or defibrillation paddles, adult and pediatric;

(D) Contact gel if using paddles;

(E) Patient cables — 2; and

(F) ECG paper.

(c) Any physiologic isotonic crystalloid solution or combinations thereof — 6000 cc in any size containers;

(d) Medications and fluids authorized for use by an EMT-Advanced or Intermediate as required by the EMS Medical Director. Storage of controlled substances in an ambulance must adhere to the signed and dated procedures as specified in OAR 333-250-0047(3)(a) and (b);

(e) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 24-gauge through 14-gauge; and

(B) Specifically-designed needles or device with needles for intraosseous infusions.

(f) A copy of standing orders for EMT-Advanced or Intermediates dated within one year and signed by the EMS Medical Director.

Stat. Auth.: ORS 682.017

Stats. Implemented: ORS 682.017 - 682.117, 682.991

Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11

333-255-0072

Ground Ambulance Operating Requirements When Providing Advanced Level Care

(1) A ground ambulance in operation and providing advanced life support level care must have a minimum staff of two persons:

(a) A driver who complies with the requirements specified in OAR chapter 333, division 250; and

(b) A person who is at the EMT-Paramedic certification level, or an RN, PA or physician who is trained in prehospital emergency medical care must be in the patient compartment when a patient is receiving advanced life support care. If the driver is not a certified EMT, then a second EMT, Basic or above, must be available for patient care both in the ambulance and on scene. The EMT, RN, PA or physician must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(c) When a RN, PA or physician is staffing an ambulance in lieu of an EMT-Paramedic and providing advanced level life support care he or she must have:

(A) A current American Heart Association “Health Care Provider,” American Red Cross “Basic Life Support for the Professional Rescuer” or other Division-approved equivalent CPR course completion document;

(B) A current Advanced Cardiac Life Support course or other Division-approved equivalent completion document;

(C) A pediatric advanced life support course or other Division-approved equivalent completion document;

(D) A Prehospital Trauma Life Support, Basic Trauma Life Support, Trauma Emergency Assessment Management or Trauma Nurse Core Course completion document. The Trauma Emergency Assessment Management and Trauma Nurse Core Course must include a supplemental prehospital rapid extrication training session; and

(E) The ability to properly assist in extricating, lifting and moving a patient.

(2) Must meet all requirements specified in OAR 333-255-0070.(3) Advanced life support patient care equipment. A ground ambulance in operation and providing advanced level care must have the following advanced life support equipment in satisfactory working condition, kept in a sanitary manner and which is readily accessible to medical personnel:

(a) All items specified in OAR 333-255-0070;

(b) Nasogastric tubes in assorted sizes;

(c) Cardiac monitoring equipment as specified in OAR 333-255-0071(2)(b);

(d) Advanced airway care equipment:

(A) Laryngoscope handle and assorted blade sizes, adult and pediatric;

(B) Spare dated batteries for the laryngoscope handle;

(C) Spare bulbs for the laryngoscope blades;

(D) Endotracheal tubes in assorted sizes, adult and pediatric;

(E) Magill Forceps — adult and child;

(F) Intubation stylettes — adult and child;

(G) Endtidal CO2 detection device;

(H) Oxygen saturation monitor; and

(I) Chest decompression equipment.

(e) Sterile intravenous agents and medications authorized by the EMS Medical Director;

(f) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 24-gauge through 14-gauge; and

(B) Specifically-designed needles or device designed for intraosseous infusions.

(g) Storage of controlled substances in an ambulance must adhere to the signed and dated procedures as specified in OAR 333-250-0047(3)(a) and (b); and

(h) A copy of standing orders for paramedics or ambulance based clinicians dated within one year and signed by the EMS Medical Director.

Stat. Auth.: ORS 682.017

Stats. Implemented: ORS 682.017 - 682.117, 682.991

Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11

333-255-0073

Ground Ambulance Operating Requirements When Providing Only Specialty Level Care

(1) A ground ambulance in operation and providing only specialty level care during inter-facility transfers must have a minimum staff of two qualified persons as defined by the Center for Medicare Services or additional staff, the number and type, requested by the transferring physician:

(a) A driver who complies with the requirements specified in OAR chapter 333, division 250; and

(b) A person who is at the EMT-Paramedic certification level, RN, PA, physician or other qualified persons who have additional specialty care training and who must be in the patient compartment when a patient is receiving specialty level care.

(2) Must meet all requirements specified in OAR 333-255-0072.

(3) The EMT-Paramedics, RNs, PAs, physicians or other qualified persons must have the:

(a) Training to properly operate all patient care equipment carried on an ambulance, including specialty care equipment necessary to care for the patient during the transfer;

(b) Training to do titration of intravenous medications necessary to care for the patient during transfer; and

(c) Ability to properly assist in lifting and moving a patient.

(3) The personnel staffing an ambulance must not:

(a) Have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(b) Be taking any medications that could impair the giving of proper patient care.

(4) A ground ambulance in operation and providing only specialty level care must have the following patient care equipment in a satisfactory working condition, stored in a sanitary and secure manner, and be readily accessible to the medical personnel:

(a) All patient care equipment specified in OAR 333-255-0072; and

(b) Any other patient care equipment or supplies anticipated or required for patient care.

Stat. Auth.: ORS 682.017

Stats. Implemented: ORS 682.017 - 682.117, 682.991

Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11

333-265-0050

First Responder and EMT Certification by Indorsement

(1) A person certified with another state as a First Responder, EMT-Basic, Advanced EMT, EMT-Intermediate, or EMT-Paramedic and registered with the National Registry of EMT’s as a First Responder, EMT-Basic, Advanced EMT, EMT-Intermediate I-99, EMT-Intermediate I-85, or EMT-Paramedic may apply to the Division for a certificate by indorsement.

(a) A National Registry EMT-Intermediate I-99 may apply for an Oregon EMT-Intermediate certificate by indorsement.

(b) A National Registry EMT-Intermediate I-85 may apply for an EMT-Basic certificate by indorsement.

(2) A person applying for Oregon First Responder or EMT certification by indorsement shall:

(a) Submit a completed application on a form prescribed by the Division along with the applicable nonrefundable fee;

(b) Submit documentation of the First Responder or EMT training which meets or exceeds the requirements for Oregon First Responder or EMT certification at the level of certification for which the person is applying;

(c) If applying for EMT-Paramedic certification by indorsement, submit proof of having received an associate’s degree or higher from an accredited institution of higher learning or submit proof of having worked for at least three years out of the last five years as a paramedic in either another state or in the United States military at the National Registry Paramedic level.

(d) Be in good standing with the applicant’s current certifying agency and with the National Registry of EMTs; and

(e) Consent to a criminal background check in accordance with OAR 333-265-0025(3).

(3) The Division shall review an application for certification by indorsement and shall conduct a criminal background check.

(4) If there are no issues that arise during the review of the application and the applicant meets all the applicable requirements of ORS chapter 682 and these rules, the Division shall grant the applicant a certificate by indorsement.

(5) If the applicant does not meet the standards for certification, or there are criminal history or personal history issues that call into question the ability of the applicant to perform the duties of a certified first responder or EMT, in accordance with ORS chapter 682 or these rules, the Division may deny the application on the basis of the information provided, or conduct an additional investigation in accordance with OAR 333-265-0085. Following such an investigation the Division may take any action as specified in OAR 333-265-0040(4).

(6) The Division shall be the sole agency authorized to determine equivalency of course work presented from an out of state accredited institution of higher learning.

(7) The Division shall be the sole agency authorized to determine equivalency of work experience in lieu of the associate degree requirement for EMT-Paramedics.

(8) The Division shall return any application that is incomplete, or can not be verified.

Stat. Auth.: ORS 682.017, 682.216

Stats. Implemented: ORS 682.017, 682.216

Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0620; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 18-1990(Temp), f. & cert. ef. 6-19-90; HD 19-1991, f. & cert. ef. 10-18-91; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD 18-1994, 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0020; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01; PH 10-2008, f. & cert. ef. 6-16-08; PH 13-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11

333-265-0090

Reverting to a Lower Level of EMT Certification

(1) An EMT may revert to a lower level of certification at any time during a certification period if the EMT:

(a) Submits a written request to the Division specifying the reason for the change in the certification level;

(b) Submits an application for recertification for the lower level of certification sought with the appropriate fee;

(c) Surrenders his or her current EMT certificate to the Division;

(d) Is in good standing with the Division;

(e) Adequately documents appropriate continuing education hours and courses for the certification level the individual would revert to; and

(f) Receives written approval from the Division for a change in certification level.

(2) If an EMT requests reinstatement of the higher level of certification within one year of reverting to a lower level of certification the EMT must complete the requirements specified in OAR 333-265-0100(3) and 333-265-0105.

(3) If an EMT requests reinstatement of the higher level of certification after one year, but less than two years the EMT must complete the requirements specified in OAR 333-265-0105.

Stat. Auth.: ORS 682.017, 682.216

Stats. Implemented: ORS 682.017, 682.216

Hist.: HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0037; OHD 9-2001, f. & cert. ef. 4-24-01; PH 10-2008, f. & cert. ef. 6-16-08; PH 13-2010, f. 6-30-10, cert. ef. 7-1-10; PH 16-2010(Temp), f. & cert. ef. 7-16-10 thru 1-1-11; PH 1-2011, f. & cert. ef. 1-6-11

333-265-0105

Reinstatement of First Responder and EMT Certification

(1) To reinstate an expired Oregon First Responder, EMT-Basic, Advanced EMT, EMT-Intermediate, or EMT-Paramedic certificate that has been expired for less than one year, an applicant must:

(a) Submit a completed application for recertification;

(b) Submit the appropriate recertification fee plus a late fee; and

(c) Provide evidence of completion of continuing education requirements as specified in Appendix 1, incorporated by reference, and courses completed from the certificate holder’s last successful application through the date of the present application for recertification, as specified in this rule.

(2) To reinstate an Oregon First Responder, EMT-Basic, EMT-Intermediate, or EMT Paramedic certificate that has been expired for more than one year, but less than two years, a certificate holder must submit a completed application for certification with the appropriate fee and successfully complete a Division approved reinstatement program described in these rules.

(3) Reinstatement program for a certified First Responder:

(a) Obtain an American Heart Association “Health Care Provider,” or American Red Cross “Basic Life Support for the Professional Rescuer,” or other Division approved equivalent CPR course completion document;

(b) Complete the First Responder refresher course approved by the Division;

(c) Pass the First Responder cognitive and practical examinations within three attempts, including a same-day re-examination; and

(d) Complete the above listed program requirements within six months of applying for reinstatement.

(4) Reinstatement program for an EMT-Basic:

(a) Obtain an American Heart Association “Health Care Provider,” or American Red Cross “Basic Life Support for the Professional Rescuer,” or other Division approved equivalent CPR course completion document;

(b) Complete the EMT-Basic Refresher Training Program, U.S. Department of Transportation, National Highway Traffic Safety Administration, 1995, incorporated by reference;

(c) Pass the EMT-Basic cognitive and practical examinations within three attempts, including a same-day re-examination; and

(d) Complete the above listed program requirements within six months of applying for reinstatement.

(5) Reinstatement program for an EMT-Intermediate:

(a) Obtain an American Heart Association “Health Care Provider,” or American Red Cross “Basic Life Support for the Professional Rescuer,” or other Division approved equivalent CPR course completion document;

(b) Complete a Division approved EMT-Intermediate refresher course consisting of at least:

(A) Thirty six hours of didactic instruction; and

(B) Demonstration of five supervised and documented successful pharyngeal esophageal airway device placements (mannequin permitted) and five supervised and documented successful intravenous line placements (mannequin permitted).

(c) Pass the EMT-Intermediate cognitive and practical examination within three attempts, including the same day re-examination; and

(d) Complete the above listed program requirements within one year of applying for reinstatement.

(6) Reinstatement program for an EMT-Paramedic:

(a) Complete an Advanced Cardiac Life Support (ACLS) course, provider or instructor course;

(b) Complete a Basic Trauma Life Support (BTLS) course, or Pre-Hospital Trauma Life Support (PHTLS) course, provider or instructor course;

(c) Complete an Advanced Pediatric Life Support (APLS), Pediatric Advanced Life Support (PALS), Pediatric Education for Pre-hospital Professionals (PEPP), or Neonatal Advance Life Support (NALS) course, provider or instructor course;

(d) Complete the U.S. Department of Transportation, National Highway Traffic Safety Administration 2001 EMT-Paramedic: National Standard Curriculum Refresher Training Program, incorporated by reference;

(e) Pass the EMT-Paramedic cognitive and practical examinations within three attempts, including the same-day re-examination;

(f) Complete the above listed program requirements within two years of applying for reinstatement; and

(g) Document completion of a DOT EMT-Paramedic Training Program taken after January 1, 1977.

Stat. Auth.: ORS 682.216

Stats. Implemented: ORS 682.017, 682.216

Hist.: PH 13-2010, f. 6-30-10, cert. ef. 7-1-10; PH 16-2010(Temp), f. & cert. ef. 7-16-10 thru 1-1-11; PH 1-2011, f. & cert. ef. 1-6-11

333-265-0110

Certified First Responder and EMT Continuing Education Requirements for Recertification

(1) A First Responder is required to:

(a) Complete 12 hours of continuing education as specified in Appendix 1, incorporated by reference; or

(b) Complete all requirements of the National Registry of Emergency Medical Technicians for First Responder re-registration.

(2) An EMT-Basic is required to:

(a) Complete 24 hours of continuing education as specified in Appendix 1, incorporated by reference; or

(b) Complete all requirements of the National Registry of EMT-Basic or Emergency Medical Technician re-registration.

(3) An Advanced EMT is required to:

(a) Complete 36 hours of continuing education as specified in Appendix 1, incorporated by reference; or

(b) Complete all requirements of the National Registry of EMT Advanced EMT re-registration.

(4) An EMT-Intermediate is required to:

(a) Complete a course with published standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care in which the EMT has demonstrated knowledge and skills in the performance of subcutaneous (SQ) injections, automated external defibrillator (AED) operation, one and two person rescuer cardiopulmonary resuscitation (adult, child, and infant) and relief of foreign body airway obstruction; and

(b) Obtain at least 36 hours of continuing education as specified in Appendix 1, incorporated by reference.

(5) An EMT-Paramedic is required to:

(a) Complete all requirements of the National Registry of EMT-Paramedic re-registration; or

(b) Obtain at least 48 hours of continuing education as specified in Appendix 1, incorporated by reference.

(6) All continuing education credits specified in sections (1) through (5) of this rule shall be completed between the date of the certificate holder’s last successful application to the date of the certificate holder’s current recertification application.

(7) Continuing education credit shall be granted for:

(a) Attending training seminars, educational conferences, and continuing education classes within the certificate holder’s scope of practice;

(b) Attending approved courses for the same or higher level of certification; and

(c) Online continuing education that provides a certificate of completion and is approved by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS).

(8) Up to 50 percent of the hours of continuing education credits for each subject listed in section 1 of Appendix 1 may be obtained by:

(a) Watching a video, CD-ROM, or other visual media;

(b) Being an EMT practical certification exam evaluator, if the certificate holder is qualified as such;

(c) Reading EMS journals or articles; and

(d) Teaching any of the topics listed in Appendix 1, if the certificate holder is qualified to teach the subject.

(9) In addition to the hours of continuing education required in this rule, an EMT-Intermediate or EMT-Paramedic certificate holder must, as specified in section 2 of Appendix 1, incorporated by reference, demonstrate skills proficiency through a hands-on competency examination supervised by the EMS Medical Director or his or her designee. An EMS Medical Director may require successful performance in a minimum number of clinical skills in these areas on either human subjects or mannequins (e.g. venipunctures, endotracheal intubations, etc.).

(10) An EMS Medical Director may require additional continuing education requirements and skill competency.

(11) When a certificate holder obtains an initial certificate and there is:

(a) Less than six months until recertification, no continuing education credits are required to obtain recertification;

(b) More than six months but less than one year until recertification, the certificate holder must complete 50 percent of the continuing education credits in each category; or

(c) More than one year until recertification, the certificate holder must complete all continuing education credits.

(12) Continuing education credits are granted on an hour-for-hour basis.

(13) It shall be the responsibility of each certificate holder to ensure the hours obtained meet the Division’s recertification requirements.

(14) A certificate holder must submit proof, in a manner prescribed in OAR 333-265-0140 that the continuing education requirements have been met.

(15) Education programs, journals and articles used towards continuing education must be approved by the EMS Medical Director or the Division.

[ED. NOTE: Appendices referenced are available from the agency.]

Stat. Auth.: ORS 682.017, 682.216

Stats. Implemented: ORS 682.017, 682.216

Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0645; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0045; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01; PH 10-2008, f. & cert. ef. 6-16-08; PH 13-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11

Notes
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