(1) The purposes of the rules in this Division are to set the minimum standards with which Emergency Medical Technology (EMT) programs must comply prior to approval of courses by Emergency Medical Services Section of the Oregon Health Division (OHD-EMS) and to set forth the process of accreditation for determining if the offering institution is meeting these standards.
(2) EMT education and training programs are offered by teaching institutions pursuant to OAR 333-265-0000 through 333-265-0020 effective July 1, 1994, including community colleges, licensed private vocational schools, and institutions of higher education. If OHD-EMS determines that training is not available in a rural area through a teaching institution, hospitals licensed by the Health Division may be authorized to teach basic levels of EMT courses.
(3) The standards in OAR 581-049-0000–581-049-0040 effective (as of date rules are adopted) apply to EMT basic, intermediate, and paramedic levels of education and training offered by or through Oregon community colleges and licensed private vocational schools.
Definitions for the purposes of division 049:
(1) "Administrator" means a person responsible for all aspects of planning and managing an Emergency Medical Technology (EMT) Program.
(2) "Class" means scheduled meeting of persons for instructional purposes.
(3) "Clinical Experiences" means those experiences acquired by a student during an approved EMT program under the direct supervision of appropriate medical direction and clinical supervision. Experience must include the application of specific knowledge, assessment, and treatment skills required to meet written clinical experience competencies.
(4) "Clinical Preceptor" means a person who has been trained as a preceptor and appointed by an accredited teaching institution and approved by the EMS provider, having the responsibility of supervising and evaluating the performance of an EMT student during the clinical and field internship phases of an EMT course. A preceptor must be a physician, physician assistant, registered nurse, or certified EMT in good standing at or above level for which the student is in training.
(5) "Course" means aggregation of classes to achieve a completed set of competencies as identified by OHD-EMS and established in OAR 333-265-0000 et seq. effective July 1, 1994.
(6) "Course Director" means a person who is the principal instructor of an EMT course and is responsible for scheduling lectures and coordinating and arranging clinical rotations and field internships.
(7) "Emergency Medical Technician (EMT)" means a person who has received formal training in prehospital emergency care and is state-certified to attend a person who is ill, injured, or has a disability. (ORS 823.020) effective July 1, 1993.
(8) "Field Internship" means those hours and calls acquired by a student during an approved clinical EMT paramedic course under the direct visual supervision of a preceptor. A call shall be accepted when the clinical preceptor providing direct visual supervision has documented and verified satisfactory student performance. Calls must include the application of specific assessment and treatment skills required of a certified EMT.
(9) "Guest Lecturer" means a person who presents one or more lectures on specific topics in which the lecturer has personal expertise.
(10) "In Good Standing" means the status of a person who is currently certified or licensed, who does not have any restrictions placed on his/her certificate, and who is not on probation with the certifying or licensing agency for any reason.
(11) "Medical Director" means a licensed physician who shall provide medical direction to the didactic, clinical and field internship portions of an EMT course or serves as the medical director of an EMT, registered nurse or physician assistant associated with a licensed ambulance service. The medical director must meet the qualifications of a supervising physician as defined in OAR 847-035-0020 effective January 1, 1995.
(12) "OCCS" means the Office of Community College Services.
(13) "OHD-EMS" means the Emergency Medical Services Section of the Oregon Health Division.
(14) "OPTE" means the Office of Professional Technical Education.
(15) "Patient" means a person who is ill, injured, or has a disability who may be transported in an ambulance.
(16) "Physician" means a person licensed under ORS 677.010, actively registered and in good standing with the Board of Medical Examiners as a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO).
(17) "Private Vocational Schools Section" means the section within the Oregon Department of Education which has the responsibility for the licensure of private vocational schools (ORS 345.010 to 345.470 effective July 1, 1994).
(18) "Registered Nurse (RN)" means a person licensed under ORS 678.040 effective July 1, 1994, actively registered and in good standing with the Oregon Board of Nursing.
(19) "Scope of Practice" means the maximum level of emergency care that an EMT may provide as set forth in OAR 847-035-0030 effective July 1, 1994.
(20) "Teaching Institution" means a two-year community college or a licensed vocational school that is currently licensed and in good standing with the Private Vocational Schools Section of the Office of Professional Technical Education of the Oregon Department of Education.
Stat. Auth.: ORS 326.051
Stats. Implemented: ORS 823.130 - 823.150
Hist.: EB 22-1993, f. & cert. ef. 6-2-93; EB 19-1995, f. & cert. ef. 7-11-95; ODE 26-2008, f. 10-23-08, cert. ef. 10-24-08
(1) The standards and accreditation process in this rule pertain specifically to EMT programs offered by community colleges (including satellite courses and programs), and licensed private vocational schools.
(2) Each EMT course shall follow, without substantial variation, the OHD-EMS prescribed curriculum for the level of EMT course being presented. The curriculum consists of three components: Didactic instruction, including laboratory skills; supervised clinical experience in health care facilities; and supervised field internship. Didactic instruction and supervised clinical experience are required for Basic and Intermediate level EMT courses. A supervised field internship is required as well as didactic instruction and supervised clinical experience for EMT paramedic level courses. Each curriculum component shall comply with all OHD-EMS requirements for the particular level of EMT certification involved. All psycho-motor skills shall be taught in accordance with the Health Division/OHD-EMS EMT Skills Manual:
(a) Didactic Instruction: Each EMT course shall have a written planned course statement that contains course goals and objectives stated in terms of the competencies students will be expected to achieve upon successful completion of the course;
(b) Clinical Experiences: Clinical affiliations shall be established and confirmed in written affiliation agreements between the teaching institution and hospitals and other institutions and agencies that provide clinical experiences for students under appropriate medical direction and clinical supervision:
(A) Goals and identified competencies to be attained shall be written for each clinical rotation site. Students shall be provided a copy of the clinical rotation site goals and competencies prior to each clinical experience;
(B) Students shall be assigned to clinical settings where experiences are educationally efficient and effective in achieving the program's goals and objectives;
' (C) Students in clinical settings shall be supervised by appropriate medical personnel or by an instructor from the program as outlined in the written affiliation agreement. The ratio of students to instructors in the clinical facilities shall be adequate to ensure effective learning.
(c) Field Internship: A field internship shall be established for each student for whom such is required by OHD-EMS. The internship shall meet requirements established by OHD-EMS and defined in OAR 333-265-0010(f)(C)(iii) effective July 1, 1994.
(A) The school shall enter into written agreements for clinical experiences and field internships that provide sufficient clinical experiences and field internships to permit every student enrolled to complete these requirements within the timeframe of the approved course;
(B) All field internships will occur within an emergency medical system which demonstrates medical accountability. A clinical preceptor shall be assigned to supervise each student intern. The preceptor's qualifications shall meet guidelines set by OHD-EMS;
(C) Written goals and competencies to be attained shall be established for all field internships. Copies shall be provided the student and the student's assigned preceptor. These competencies shall meet requirements of OHD-EMS as stated in OAR 333-265-0010 effective July 1, 1994.
(3) Program Administrator: Each program shall have a qualified program administrator primarily responsible for managing all aspects of the program, whose responsibilities include, but are not limited to, the organization, administration, and evaluation of the program. Acquisition of adequate resources and staff to assure a quality program is a primary responsibility of the program administrator.
(4) The intent of section (3) of this rule is to assure that appropriate officials of the sponsoring teaching institution are directly involved in program planning and management and to provide OHD-EMS and OPTE-OCCS with a single focus for resolution of problems arising as a result of EMT program delivery.
(5) The program administrator shall be a senior manager or administrative officer with general managerial responsibility who has training and experience in education administration and evaluation (i.e., dean, associate dean, administrator, or associate administrator).
(6) Course Director: Each course shall have a course director who shall be the principle teacher for the course. The course director shall be responsible for all aspects of course planning and delivery. The course director shall meet the requirements as outlined in OAR 333-265-0020(f)(C)(iii) effective July 1, 1994.
(7) Guest Lecturers: These are individuals who do not regularly assist in the delivery of EMT education and training who present one or more lectures on specific topics in which they possess personal expertise. Guest lecturers do not need to have any particular level of certification. It is the responsibility of the course director to establish that each guest lecturer possesses the necessary expertise and teaches in compliance with all course standards.
(8) Medical Director: Each EMT education and training program shall have a medical director, who shall advise the program administrator and course director on medical aspects of the EMT program. The medical director shall currently be approved by OHD-EMS as an EMT supervising physician.
(9) Continuing Education for Faculty and Staff. It is recommended that financial support be provided for faculty education required to keep mandatory certifications current.
(10) Financial Resources: The operational budget for the program shall be sufficient to maintain the continuous operation of the EMT program.
(11) Facilities: Classroom, laboratories, administrative, and faculty offices shall be provided with sufficient space to accommodate the number of students enrolled in the program and the program faculty:
(a) Classrooms shall be clean and have adequate lighting, ventilation, and storage for instructional materials and equipment. Furniture should be in good repair and comfortable with appropriate writing surfaces;
(b) Laboratory space shall be available for students to practice skills. This may be the same room as the classroom, providing there is adequate space for students to perform the required skills (e.g., CPR, patient packaging, splinting, etc.). Floors, where skills are practiced, shall be covered with carpet or other appropriate protective materials. Running water shall be available in the class/lab facility. The room should meet all Oregon Occupational Safety and Health Administrative standards for safety;
(c) Each classroom site shall have sufficient toilet facilities to reasonably accommodate the number of students enrolled in the course;
(d) Administrative staff and faculty shall be provided adequate office space to manage the program, keep adequate records and instructional materials, and prepare lesson plans. Space should also be provided for confidential faculty/student conferences.
(12) Instructional Aids, Supplies, and Materials: Sufficient up-to-date instructional aids, supplies, and materials shall be provided to facilitate learning for the number of students in the program and the level of EMT course being offered:
(a) Teaching aids and instructional materials shall be readily available to the instructor;
(b) Adequate AV materials and equipment shall be available for instructor and student use;
(c) Independent study areas with TV monitors/audio outlets shall be available for student use as needed for make-up work and independent study;
(d) The budget shall provide for supplies and annual updating of instructional materials.
(13) Equipment: Each EMT course shall be supported by the prescribed quantity of equipment necessary to support the level of EMT education and training being provided. Required equipment shall be specified by OHD-EMS:
(a) Equipment shall be technologically up-to-date and readily accessible to faculty and students;
(b) All equipment shall be kept in good repair;
(c) An annual and long-term budget for capital equipment shall be in place to maintain and provide for replacement of equipment.
(14) Support Services: Support services necessary to ensure student success shall be made available to students in the EMT program. These services include, but are not limited to:
(a) A library with appropriate up-to-date periodicals and books open during hours which will provide maximum accessibility to students;
(b) Counseling staff available for academic and career planning;
(c) Tutoring assistance available on an "as needed" basis;
(d) Funding and staff time available for student recruitment, selection, and placement procedures. It is required that students pass reading and math placement tests at appropriate levels for each course prior to acceptance into the program.
(15) Admission Policies and Procedures: Admission of students shall be made in accordance with clearly defined and published practices of the institution. Specific academic and technical requirements for admission shall also be clearly defined and published. The standards and prerequisites shall be made known to all potential program applicants.
(16) Program Information: Accurate information regarding program requirements, tuition and fees, institutional and programmatic policies, procedures and supportive services shall be available upon request to all prospective students and be provided to all enrolled students. It is recommended that this information be compiled in an EMT student handbook.
(17) Program Descriptions: A description of each EMT course, a statement outlining course competencies, course outlines, class and laboratory schedules, clinical and field internship experience schedules, and teaching plans shall be on file and available to candidates and enrolled students;
(18) Equal Opportunity: The program shall comply with ORS 659.850 and shall not discriminate with respect to race, color, religion, sex, sexual orientation, marital status, age, disability, or national origin.
(19) Evaluation: Each approved course shall provide the number of written and practical examinations prescribed by OHD-EMS. The content of examinations for each level of EMT course shall be prescribed by OHD-EMS:
(a) Each approved course shall culminate in written and practical certification examinations prescribed by the OHD-EMS. For academic purposes, a teaching institution may administer its own final written and practical examination prior to the conduct of OHD-EMS certification examinations;
(b) The written certification examination shall be administered by a proctor provided by the teaching institution. The proctor shall be subject to the approval of the OHD-EMS, shall not be certified as an EMT at any level, and shall not be otherwise involved in the delivery of EMT training;
(c) Evaluators for the final practical examination shall be individuals meeting the requirements prescribed by OHD-EMS to serve as final practical examination evaluators. An OHD-EMS representative shall be present at final practical examinations and shall provide evaluation instruments to be used in the conduct of all final practical evaluations.
(20) Job Search and Placement: Students who successfully complete the program shall be provided access to job search and placement services.
(21) Advisory Committee: Each program shall have an advisory committee to provide guidance and information regarding local community practices and needs:
(a) The advisory committee shall consist of representatives from local employers of EMT personnel, current or former students, and other community members as appropriate. The medical director shall be a member of the advisory committee and serve as a primary source of information. A roster of the advisory committee members, their place of employment and phone numbers shall be kept on file and easily accessible;
(b) The advisory committee shall meet a minimum of three times each year and minutes of the meeting shall be recorded and kept on file.
(22) A safe working and learning environment shall be provided to all students and staff so that students learn to be safety conscious in the classroom and carry that consciousness into practice in clinical and internship experiences and ultimately into the profession:
(a) Safety Policy: The teaching institution shall have a safety policy that meets all state and federal requirements. The teaching institution shall identify an administrator who is responsible for monitoring the safety policy and assures that regular safety inspections are made and documented;
(b) Instructional Activities: All instructional activities (i.e., didactic, clinical, and internship) shall be carried on in accordance with the Oregon Safe Employment Act, OR-OSHA standards, and ORS 656.046 effective January 1, 1995, which requires coverage of persons in college work experience and vocational educational programs;
(c) Curriculum: Occupational safety shall be an integral part of the curriculum;
(d) Insurance: Each student enrolled in the program shall be covered by professional liability insurance in the amount of not less than $1,000,000 per occurrence. Copies of insurance policies documenting the coverage shall be on file at the institution.
(23) The institution shall maintain complete, accurate student records in a safe, secure place within the educational institution:
(a) The following records shall be maintained until the student has been certified by OHD-EMS at the level corresponding to the education program or for a minimum of five years following the student's enrollment in the program:
(A) Student admission into the program;
(B) Class attendance;
(C) Evidence of competencies attained throughout the program;
(D) Copies of examinations and assessments throughout the program;
(E) Evidence of satisfactory completion of all didactic, clinical, and field internship requirements.
(b) A record of all grades and credits earned by each student shall be kept permanently by the institution;
(c) All records shall be confidentially maintained in accordance with Family Education Rights and Privacy Act.
(24) To assure a high quality program it is essential that all aspects of the program be evaluated on both an ongoing and periodic basis:
(a) The teaching institution shall establish processes to evaluate on an ongoing basis the effectiveness of the instructional program. These will include gathering evaluative data from students, administrators, clinical supervisors, intern preceptors and advisory committee members. Follow-up surveys of graduates and the employers of graduates shall be conducted to evaluate the effectiveness of the curriculum, teaching, and the services offered by the institution. Data gathered through these processes should be analyzed and utilized for program improvement;
(b) Every EMT program shall be evaluated through a process of accreditation at least once every five years. This process shall occur as outlined in OAR 581-049-0030 effective (date these rules are adopted).
Stat. Auth.: ORS 326.051
Stats. Implemented: ORS 823.130 - 823.150
Hist.: EB 22-1993, f. & cert. ef. 6-2-93; EB 28-1993, f. & cert. ef. 9-29-93; EB 19-1995, f. & cert. ef. 7-11-95; ODE 13-2008, f. & cert. ef. 5-23-08
Process of Accreditation
The purpose of the accreditation process is to assure quality Emergency Medical Technology Educational programs and to provide recognition for those programs which meet or exceed the minimum standards as outlined in these rules. The accreditation process shall consist of two components, an internal self-study conducted by the teaching institution, and an external evaluation conducted by an accreditation team:
(1) Self-Study: The teaching institution shall complete an internal review of the EMT program that will result in a self-study which documents that the program meets the minimum requirements as outlined in these rules. The self-study will be sent to the OPTE at least 30 days prior to the date set for the external team visit. Guidelines for preparing the self-study can be obtained from the OPTE-OCCS.
(2) External Evaluation Review Team: The review team shall consist of at least three people, an OPTE-OCCS assigned coordinator, and EMT 4 who has had active field patient care experience and is knowledgeable regarding educational needs and issues related to EMT training, and an education curriculum person designated by the OPTE-OCCS. The team will:
(a) Review the self-study completed by the institution prior to the site visit;
(b) Participate in a site visit where the team will confirm that the information in the self-study is accurate and meets the minimum requirements set forth in these rules; and
(c) Report to the associate superintendent, OPTE-OCCS, the team findings, specifically identifying strengths, weaknesses, and any deficiencies of the program. The associate superintendent shall send a copy of the report, along with a letter of accreditation status, to the chief administrative officer of the institution in which the program is located. A copy of the letter and report also will be sent to OHD-EMS.
(3) Site Team Coordinator: The role of the coordinator will be to:
(a) Work with the institution's program administrator to schedule the site visit;
(b) Select and orient the review team members;
(c) Serve as a team leader on the site visit;
(d) Conduct an exit interview summarizing the team's findings;
(e) Coordinate the writing of the team report and provide it to the associate superintendent who will send a copy to the chief administrative officer of the institution within 30 days of the site visit; and
(f) Conduct follow-up activities as necessary.
(1) If deficiencies are reported by the External Evaluation Review Team, the program has 90 days from the date the report was received by the chief administrative officer to correct the deficiencies. The institution shall not start any new courses until the deficiencies are corrected or a detailed plan to correct each deficiency has been submitted reviewed and accepted by OPTE/OCCS.
(2) If the chief administrative officer disputes the reported deficiencies, he or she may request, within ten days from the date the report was received, a hearing which shall be held in accordance with ORS Chapter 183 effective January 1, 1995.
(3) If deficiencies are not corrected within 90 days or an approved plan to correct the deficiency(s) has not been submitted to OPTE/OCCS, the program accreditation shall be revoked after a hearing held in accordance with ORS Chapter 183 effective January 1, 1995.
(4) The associate superintendent may issue an interim order prohibiting the teaching institution from starting any new classes or accepting any new students until either the deficiencies are corrected or a hearings officer determines that the alleged deficiencies did not occur.