836 IAC 4 — ARTICLE 4. TRAINING AND CERTIFICATION

TITLE 836 INDIANA EMERGENCY MEDICAL SERVICES COMMISSION

ARTICLE 4. TRAINING AND CERTIFICATION

Rule 1

836 IAC 4-1-1 836 IAC 4-1-1 Definitions

Rule 1. Definitions

836 IAC 4-1-1 Definitions

Authority: IC 16-31-2-7

Affected: IC 16-31

Sec. 1. The definitions in 836 IAC 1-1-1 apply throughout this article.

(Indiana Emergency Medical Services Commission; 836 IAC 4-1-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2745; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2362; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3562; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

Rule 2

836 IAC 4-2-1 836 IAC 4-2-1 General requirements for training institutions; staff

Rule 2. Emergency Medical Services Training Institution

836 IAC 4-2-1 General requirements for training institutions; staff

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 4-21.5; IC 16-21; IC 16-31-3-2; IC 20-12-62-3; IC 20-12-71-8; IC 20-18-2-7

Sec. 1. (a) All institutions administering or seeking to administer emergency medical services training programs shall:

(1) be certified by the commission prior to providing such training; and

(2) comply with this section.

Any multiple campus institution administering or seeking to administer such programs shall have its training institution certified by the commission on a campus-by-campus basis.

(b) Each Indiana emergency medical services training institution of emergency medical technician programs shall be:

(1) a postsecondary institution as defined in IC 20-12-71-8 [ IC 20-12 was repealed by P.L.2-2007, SECTION 390, effective July 1, 2007.] ;

(2) a private technical, vocational, or trade school as defined in IC 20-12-62-3 [ IC 20-12 was repealed by P.L.2-2007, SECTION 390, effective July 1, 2007. See IC 21-17-1-15.] ;

(3) a high school as defined in IC 20-18-2-7;

(4) a provider organization as defined in IC 16-31; or

(5) an appropriately accredited hospital licensed under IC 16-21;

that has adequate resources and dedication to educational endeavors. Educational institutions shall be appropriately accredited by a regional accrediting association for higher education or have state licensure that assures comparable educational standards.

(c) Such an institution shall submit an application to the agency at least ninety (90) days prior to the date for which certification is requested in a manner prescribed by the agency. The application shall include the following:

(1) The name and address of the training institution.

(2) The name of the institution official.

(3) Agreement or agreements of affiliation with clinical and internship facilities.

(4) Type of emergency medical service courses conducted.

(5) Medical director approval form listing affiliated instructor or instructors.

(6) In-course standards and criteria by which the instructor is to determine successful completion of the didactic and clinical portions of the course to include the following:

(A) Attendance requirements and absentee policies.

(B) Testing procedures.

(C) Number and scope of in-course tests.

(D) Didactic pass/fail grade average and criteria.

(E) Provision for makeup test and classes.

(F) Minimal age for enrollment.

(G) Policies for provider organization reasonable accommodations under the Americans with Disabilities Act.

(H) Description of the screening and evaluation process for acceptance into any certified training program.

(7) Other information as required by the agency.

(d) Certification as an emergency medical services training institution is valid for a period of two (2) years from the date of certification.

(e) Certified emergency medical services training institutions shall be certified according to the institution's intent and ability to teach various levels of emergency medical services curricula as follows:

(1) A basic life support training institution is defined as an institution that presents one (1) or more of the following training courses:

(A) Basic emergency medical technician.

(B) Emergency medical technician-basic advanced.

(C) Emergency medical first responder training courses.

(2) An advanced life support training institution is defined as an institution that presents one (1) or more of the following training courses and may include one (1) or more of the basic life support training courses listed under subdivision (1):

(A) Emergency medical technician-intermediate.

(B) Paramedic.

(f) A certified training institution shall submit an application for recertification to the agency at least sixty (60) days prior to the date of certification expiration. The application for recertification shall indicate compliance with the requirements currently in effect at the time of the application for renewal.

(g) Certified advanced life support training institutions conducting paramedic training programs on or after July 1, 2008, shall show written proof of national accreditation of the program.

(Indiana Emergency Medical Services Commission; 836 IAC 4-2-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2747; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2364; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3564; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-2-2 836 IAC 4-2-2 Institutional responsibilities

836 IAC 4-2-2 Institutional responsibilities

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3

Sec. 2. A certified training institution seeking commission approval for administering emergency medical services training courses shall meet the following minimum requirements:

(1) Designate one (1) person as a training institution official responsible for:

(A) administering all of the activities of the emergency medical services training institution; and

(B) communicating with the agency.

(2) Submit to an inspection of training facilities and equipment.

(3) Provide a list of educational staff to meet staffing-student ratio requirements established in approved curricula.

(4) Have the necessary clinical facilities, or affiliations with clinical facilities, to conduct the required clinical phases of emergency medical service training programs.

(5) Under conditions where didactic and clinical training are to be conducted by separate institutions, program responsibility will rest with the institution that is certified by the commission. In cases where two (2) or more certified training institutions are cooperating in the presentation of an emergency medical services training program, both institutions will be held jointly responsible for the training programs.

(6) Provide classroom space to effectively present the various requirements in the curricula.

(7) The curriculum requirements for all certified training programs shall be approved by the commission. Course applications will be made in a manner prescribed by the agency. The agency or commission may disapprove a course application when it has been determined that the training institution or primary instructor has been found in noncompliance with rules and regulations.

(8) Have the training equipment and training aids (including the emergency care equipment) required by the curriculum of the courses that the training institution offers. The training institution shall have an adequate amount of the training equipment to be utilized by students to meet any equipment-to-student ratios prescribed by the curriculum being presented.

(9) Make available a minimum of twelve (12) hours, over a two (2) year period, of continuing education in educational principles and techniques for each of its affiliated primary instructors. A training institution may offer this continuing education or advise its faculty members of such continuing education at other sites. The training institution official may accept educational programs conducted at other facilities.

(10) Evaluate each course and retain a record of the evaluation.

(11) Evaluate each affiliated instructor at least one (1) time a calendar year and retain a record of the evaluation.

(12) Provide educational personnel for each approved training course, consisting of the following:

(A) A medical director.

(B) A program director for the following levels:

(i) For an emergency medical technician-basic advanced course, the program director shall be:

(AA) a physician;

(BB) a registered nurse;

(CC) an emergency medical technician-basic advanced;

(DD) an emergency medical technician-intermediate; or

(EE) a paramedic.

(ii) For an emergency medical technician-intermediate course, the program director shall be:

(AA) an emergency medical technician-intermediate;

(BB) a paramedic;

(CC) a physician; or

(DD) a registered nurse.

(iii) For a paramedic course, the program director shall be:

(AA) a paramedic;

(BB) a physician; or

(CC) a registered nurse.

(C) A primary instructor.

(D) Instructional staff.

(13) Be responsible for in-course standards and criteria by which it determines a student's successful completion of the didactic and clinical portions of the course. The criteria include, but are not limited to, the following:

(A) Attendance requirements and absentee policies.

(B) In-course testing procedures.

(C) Number and scope of in-course tests.

(D) Didactic pass/fail grade average and criteria.

(E) Provision for makeup classes and tests.

(F) Minimum age for enrollment.

(G) Policies for providing reasonable accommodation under the Americans with Disabilities Act.

(14) Be responsible for the screening and evaluation criteria for admission into any certified training program.

(15) Assure a certified primary instructor, affiliated with the training institution, is present in each emergency medical technician class session unless a specialty topic instructor in:

(A) hazardous materials;

(B) terrorism;

(C) emergency vehicle operation; or

(D) extrication;

is presenting the specific session in their specialty.

(16) Have a retention schedule of seven (7) years for all training and course records.

(Indiana Emergency Medical Services Commission; 836 IAC 4-2-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2748; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2365; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3565; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-2-3 836 IAC 4-2-3 Educational staff qualifications and responsibilities

836 IAC 4-2-3 Educational staff qualifications and responsibilities

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3

Sec. 3. (a) Minimum personnel qualifications for the training institution's education staff shall be as follows:

(1) A medical director.

(2) A program director who shall:

(A) have appropriate education and experience necessary to teach in the assigned areas at the discretion of the medical director;

(B) be thoroughly and appropriately knowledgeable about all subject matter;

(C) be able to demonstrate all skills assigned to teach or evaluate;

(D) be a certified primary instructor; and

(E) hold a clinical certification or license at least equal to that of the curriculum of the course in which the individual acts as the program director.

(3) The primary instructor shall be certified by the commission.

(4) Instructional staff members will be selected from various specialties and have appropriate education and experience necessary to teach in the assigned areas at the discretion of the training institution official. The individual must be:

(A) thoroughly and appropriately knowledgeable about all subject matter; and

(B) able to demonstrate all skills that the individual is assigned to teach or evaluate.

Instructional staff members involved in the skills testing of students shall be persons who hold a clinical certification or license at least equal to that of the curriculum of the course in which the individual acts as instructional staff.

(b) Education staff responsibilities are as follows:

(1) The medical director is responsible for the following:

(A) Providing competent medical direction in the conduct of the training program by providing necessary liaison with physicians to obtain adequate instructor services.

(B) Assuring accurate and thorough presentation of the medical content of the course curriculum.

(C) Attesting on forms provided by the agency to the competency of the course graduates to perform the medical skills required by the certification for which the student has been trained.

(2) The program director for any advanced life support course is responsible for the following:

(A) Developing teaching plans.

(B) Assuring that the course of instruction meets established standards of the commission and training institution.

(C) Providing liaisons with physicians and other specialists to obtain adequate instructor services for the course.

(D) Monitoring and evaluating classroom activities, including clinical and practice sessions.

(E) Assuring that the required equipment and materials necessary for teaching the course being offered are available at each class session.

(F) Coordinating and evaluating all:

(i) didactic;

(ii) clinical;

(iii) practical; and

(iv) field/internship;

activities associated with the course.

(G) Acting as the liaison between the students and the program staff.

(H) Maintaining student class records concerning:

(i) attendance;

(ii) performance; and

(iii) grades.

(I) Fulfilling other course requirements as designated by the medical director and the training institution official.

(3) Instructional staff and primary instructors are responsible to teach and to test students during selected lessons or class sessions as assigned by the program director or medical director. The instructional staff is evaluated and held accountable prescribed by the medical director and the training institution official.

(Indiana Emergency Medical Services Commission; 836 IAC 4-2-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2749; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3566; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-2-4 836 IAC 4-2-4 Institution reporting requirements

836 IAC 4-2-4 Institution reporting requirements

Authority: IC 16-31-2-7

Affected: IC 16-31-3

Sec. 4. (a) Each training institution shall submit any changes within thirty (30) days to the agency that includes the following information:

(1) Name, address, and telephone number of the training institution official.

(2) List of affiliated educational staff, including name, certification level, and certification number.

(3) Changes in the training institutions standards and criteria.

(b) Each training institution will provide a final report on each course to the agency within fifteen (15) days following the completion of the course. These reports will be submitted in a manner prescribed by the agency.

(c) Each training institution official will complete other forms as required by the agency for purposes of course, student, or training institution evaluation. The institution will cooperate with and assist the agency in collecting statistics and evaluating performance and costs related to emergency medical services training.

(Indiana Emergency Medical Services Commission; 836 IAC 4-2-4; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2750; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3567; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-2-5 836 IAC 4-2-5 Penalties (Repealed)

836 IAC 4-2-5 Penalties (Repealed)

(Repealed by Indiana Emergency Medical Services Commission; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2372)

Rule 3

836 IAC 4-3-1 836 IAC 4-3-1 Training standards

Rule 3. First Responders

836 IAC 4-3-1 Training standards

Authority: IC 16-31-2-7

Affected: IC 16-31-2-8

Sec. 1. The minimum requirements for first responder training shall be the following:

(1) The curriculum of the first responder training course shall be the Indiana emergency medical first responder training curriculum, which is based on the current national standard curriculum for first responders, as amended and approved by the commission.

(2) Each first responder training course shall be coordinated by a primary instructor, and each class shall be conducted by approved faculty members who shall be certified at a minimum as emergency medical technicians, or appropriate nurses and physicians.

(3) To successfully complete the Indiana emergency medical first responder training course for original certification or for certification renewal, a student shall pass the commission-authorized practical and written examinations.

(Indiana Emergency Medical Services Commission; 836 IAC 4-3-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2750; readopted filed Nov 30, 2006, 9:17 a.m.: 20061213-IR-836060486RFA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-3-2 836 IAC 4-3-2 Certification standards

836 IAC 4-3-2 Certification standards

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-2-8; IC 16-31-3

Sec. 2. (a) Applicants for original certification as a first responder shall meet the following requirements:

(1) Be a minimum of fourteen (14) years of age.

(2) Have successfully completed the following:

(A) A commission-approved first responder course.

(B) State written and practical skills examinations as approved by the commission.

(b) Certification as a first responder shall be valid for a period of two (2) years.

(c) To renew a certification, a first responder shall submit a report of continuing education every two (2) years that meets or exceeds the minimum requirement to take and report twenty (20) hours of continuing education according to the following:

(1) Participate in a minimum of sixteen (16) hours of any combination of lectures, critiques, skills proficiency examination, or audit and review that reviews subject matter presented in the Indiana first responder curriculum.

(2) Participate in a minimum of four (4) hours in defibrillation and airway management as presented in the Indiana first responder curriculum.

(d) An individual who fails to comply with the continuing education requirements described in this article:

(1) forfeits all rights and privileges of a certified first responder; and

(2) shall cease from providing the services authorized by a first responder certification as of the date of expiration of the current certificate.

(e) An individual wanting to reacquire a certification shall:

(1) complete a first responder recertification training course as approved by the commission; and

(2) successfully complete the state written and practical skills examinations as set forth and approved by the commission.

If the individual fails either certification examination, the person must retake an Indiana first responder training course.

(f) First responders shall:

(1) not perform procedures for which the first responder has not been specifically trained:

(A) in the Indiana first responder curriculum; and

(B) that have not been approved by the commission as being within the scope and responsibility of the first responder;

(2) not act negligently, recklessly, or in such a manner that endangers the health or safety of emergency patients or the members of the general public;

(3) comply with the state and federal laws governing the confidentiality of patient medical information;

(4) not delegate to a less qualified individual any skill that requires a first responder; and

(5) comply with the protocols established by the:

(A) commission;

(B) provider organization; and

(C) provider organization's medical director.

(Indiana Emergency Medical Services Commission; 836 IAC 4-3-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2751; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2366; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3567; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-3-3 836 IAC 4-3-3 Certification based upon reciprocity

836 IAC 4-3-3 Certification based upon reciprocity

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3-8; IC 16-31-3-10

Sec. 3. (a) To obtain certification based upon reciprocity, an individual shall be a minimum of fourteen (14) years of age and meet one (1) of the following requirements:

(1) Be a person who:

(A) possesses a valid certificate or license as a first responder from another state;

(B) while serving in the military of the United States, successfully completed a course of training and study equivalent to the material contained in the Indiana first responder training course;

(C) holds a valid unlimited license to practice medicine in Indiana; or

(D) successfully completed a course of training and study equivalent to the material contained in the Indiana first responder training course and successfully completes the written and practical skills certification examinations prescribed by the commission.

(2) Be a person who:

(A) holds a current first responder registration issued by the National Registry; and

(B) has completed a course equivalent to Indiana approved curriculum.

(b) Any nonresident of Indiana who possesses a certificate or license as a first responder that is valid in another state, upon affiliation with an Indiana certified provider organization, may apply to the agency for temporary certification as a first responder. Upon receipt of a valid application and verification of valid status by the agency, the agency may issue temporary certification, which shall be valid for:

(1) the duration of the applicant's current certificate or license; or

(2) a period not to exceed six (6) months from the date that the reciprocity request is approved by the agency;

whichever period of time is shorter. A person receiving temporary certification may apply for full certification using the procedure required in subsection (a).

(Indiana Emergency Medical Services Commission; 836 IAC 4-3-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2751; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3568; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

Rule 4

836 IAC 4-4-1 836 IAC 4-4-1 General certification provisions

Rule 4. Certification of Emergency Medical Technicians

836 IAC 4-4-1 General certification provisions

Authority: IC 16-31-2-7; IC 16-31.5-3-3

Affected: IC 16-31-3

Sec. 1. (a) Applicants for original certification as an emergency medical technician shall meet the following requirements:

(1) Be at least eighteen (18) years of age.

(2) Successfully complete the Indiana basic emergency medical technician training course as approved by the commission and administered by a certified training institution.

(3) Pass the emergency medical technician written and practical skills examinations as set forth and approved by the commission.

(4) submit to a national criminal history background check at the cost of the individual.

(Indiana Emergency Medical Services Commission; 836 IAC 4-4-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2752; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2366; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3568; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-4-2 836 IAC 4-4-2 Application for original certification or certification renewal

836 IAC 4-4-2 Application for original certification or certification renewal

Authority: IC 16-31-2-7

Affected: IC 16-31

Sec. 2. (a) Application for emergency medical technician certification shall be made on forms provided by the agency. Applicants shall complete the required forms and submit the forms to the agency. The application shall include the following:

(1) The name and address of the applicant.

(2) Criminal history declarations of the applicant.

(3) The name of the training institution where training was completed.

(4) Other information required by the agency.

(b) All applicants for original certification shall provide evidence of compliance with the requirements for certification.

(c) Certification as an emergency medical technician shall be valid for a period of two (2) years.

(d) To renew a certification, a certified emergency medical technician shall submit a report of continuing education every two (2) years that meets or exceeds the minimum requirement to take and report forty (40) hours of continuing education according to the following:

(1) Participate in a minimum of thirty-four (34) hours of any combination of:

(A) lectures;

(B) critiques;

(C) skills proficiency examinations;

(D) continuing education courses; or

(E) teaching sessions;

that review subject matter presented in the Indiana basic emergency medical technician curriculum.

(2) Participate in a minimum of six (6) hours of audit and review.

(3) Participate in any update course as required by the commission.

(4) Successfully complete a proficiency evaluation that tests the skills presented in the Indiana basic emergency medical technician curriculum.

(e) If a properly completed renewal application is submitted within one hundred twenty (120) calendar days after the expiration of the certification, together with the required documentation to show that the applicant has completed all required continuing education within the two (2) years prior to the expiration of the certification, and a fifty dollar ($50) reapplication fee, the certification will be reinstated on the date that the commission staff determines that the required application, documentation, and reapplication fee have been properly submitted. The expiration date will be two (2) years from the expiration of the previous, expired certification.

(f) Notwithstanding any other provisions of this article, a person also certified as an emergency medical technician-basic advanced, emergency medical technician-intermediate, or paramedic under IC 16-31 may substitute the required continuing education credits for those of subsection (d).

(g) An individual who fails to comply with the continuing education requirements described in this article shall not exercise any of the rights and privileges of an emergency medical technician and shall cease from providing the services authorized by an emergency medical technician certification as of the date of expiration of the current certificate.

(h) An individual wanting to reacquire a certification shall:

(1) complete an emergency medical technician recertification training course as approved by the commission; and

(2) successfully complete the state written and practical skills examinations as set forth and approved by the commission.

If the individual fails either certification examination, the person must retake an Indiana basic emergency medical technician training course.

(Indiana Emergency Medical Services Commission; 836 IAC 4-4-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2752; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3569; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; filed Mar 25, 2011, 10:24 a.m.: 20110420-IR-836100361FRA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-4-3 836 IAC 4-4-3 Certification based upon reciprocity

836 IAC 4-4-3 Certification based upon reciprocity

Authority: IC 16-31-2-7

Affected: IC 16-31-3-8; IC 16-31-3-10

Sec. 3. (a) To obtain certification based upon reciprocity, an individual shall be a minimum of eighteen (18) years of age and meet one (1) of the following requirements:

(1) Be a person who:

(A) possesses a valid certificate or license as an emergency medical technician from another state; and

(B) successfully completes the written and practical skills certification examinations as prescribed by the commission.

(2) Be a person who:

(A) while serving in the military of the United States, successfully completed a course of training and study equivalent to the material contained in the Indiana basic emergency medical technician training course; and

(B) successfully completes the written and practical skills certification examinations prescribed by the commission.

(3) Be a person who:

(A) holds a valid unlimited license to practice medicine in Indiana; and

(B) successfully completes the written and practical skills certification examinations prescribed by the commission.

(4) Be a person who:

(A) successfully completed a course of training and study equivalent to the material contained in the Indiana basic emergency medical technician training course; and

(B) successfully completes the written and practical skills certification examinations prescribed by the commission.

(5) Be a person who:

(A) holds a current emergency medical technician registration from the National Registry; and

(B) has completed a course equivalent to the Indiana approved curriculum.

(b) Any nonresident of Indiana who possesses a certificate or license as an emergency medical technician that is valid in another state, or a valid registration issued by the National Registry, upon affiliation with an Indiana certified provider organization may apply to the agency for temporary certification as an emergency medical technician. Upon receipt of a valid application and verification of valid status by the agency, the agency may issue temporary certification, which shall be valid for the duration of the applicant's current certificate or license or for a period not to exceed six (6) months from the date that the reciprocity request is approved by the agency, whichever period of time is shorter. A person receiving temporary certification may apply for full certification using the procedure required in section 1 of this rule.

(Indiana Emergency Medical Services Commission; 836 IAC 4-4-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2753; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3570; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

Rule 5

836 IAC 4-5-1 836 IAC 4-5-1 Student qualifications to enter training

Rule 5. Emergency Medical Services Primary Instructor Certification

836 IAC 4-5-1 Student qualifications to enter training

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3-14

Sec. 1. An applicant for Indiana primary instructor training shall meet the following requirements:

(1) Have been certified, registered, or licensed as an emergency medical technician for a period of not less than one (1) year.

(2) Have at least one (1) year of experience in the delivery of emergency medical care in the prehospital setting.

(3) Submit a letter of intent to affiliate from at least one (1) Indiana certified training institution.

(Indiana Emergency Medical Services Commission; 836 IAC 4-5-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2754; readopted filed Nov 30, 2006, 9:17 a.m.: 20061213-IR-836060486RFA; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-5-2 836 IAC 4-5-2 Certification and recertification; general

836 IAC 4-5-2 Certification and recertification; general

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3-14

Sec. 2. (a) Application for certification will be made on forms and according to procedures prescribed by the agency. In order to be certified as an emergency medical services primary instructor, the applicant shall meet one (1) of the following requirements:

(1) Successfully complete a commission-approved Indiana emergency medical services primary instructor training course and complete all of the following:

(A) Successfully complete the primary instructor written examination.

(B) Successfully complete the primary instructor training program.

(C) Be currently certified as an Indiana emergency medical technician.

(D) Successfully pass the Indiana basic emergency medical services written and practical skills examinations within one (1) year prior to applying for certification as a primary instructor.

(2) Successfully complete a training course equivalent to the material contained in the Indiana emergency medical service primary instructor course and complete all of the following:

(A) Successfully complete the primary instructor written examination.

(B) Successfully complete the primary instructor training program.

(C) Be currently certified as an Indiana emergency medical technician.

(D) Successfully pass the Indiana basic emergency medical services written and practical skills examinations within one (1) year prior to applying for certification as a primary instructor.

(b) Certification as an emergency medical services primary instructor is valid for two (2) years.

(c) In order to retain certification as a primary instructor, a person shall meet the following requirements:

(1) Retain affiliation with at least one (1) Indiana certified training institution.

(2) Conduct a minimum of eighty (80) hours of educational sessions based upon the emergency medical service curricula, which in content are either less than or equal to the primary instructor's level of clinical certification.

(3) Complete a minimum of twelve (12) hours of continuing education that specifically addresses the topic of educational philosophy and techniques, offered or approved by the affiliating training institution.

(4) Be evaluated by the training institution in regard to instructional skills and compliance with existing standards of the training institution and the commission at least once per course.

(5) Every two (2) years present, to the agency, evidence of compliance with this subsection during the period of certification as prescribed by the commission.

(6) Maintain the prerequisite certification described in subsection (a)(1)(C).

(d) The minimum requirements for emergency medical services primary instructor training is the current version of the Indiana primary instructor course, based upon the current national standard curriculum as amended and approved by the commission.

(e) A primary instructor shall comply with the following:

(1) All state and federal laws governing the confidentiality of student information.

(2) The material taught by the primary instructor shall not conflict with the curriculum approved by the commission.

(3) Not negligently, recklessly, or willfully endanger the health or safety of emergency patients or students.

(4) All course standards as established by the training institution course policies and procedures.

(f) Individuals who have failed to comply with the continuing education requirements shall not exercise any of the rights and privileges of a primary instructor.

(g) An individual wanting to reacquire a primary instructor certification shall do the following:

(1) Meet all prerequisites of an Indiana emergency medical services primary instructor training course.

(2) Successfully complete the primary instructor written examination.

(3) Successfully complete the primary instructor recertification evaluation.

(4) Successfully pass the Indiana basic emergency medical services written and practical skills examinations within one (1) year prior to applying for certification as a primary instructor.

(Indiana Emergency Medical Services Commission; 836 IAC 4-5-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2754; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2367; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3570; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

Rule 6

836 IAC 4-6-1 836 IAC 4-6-1 Advanced emergency medical technician training (Repealed)

Rule 6. Advanced Emergency Medical Technician Training

836 IAC 4-6-1 Advanced emergency medical technician training (Repealed)

(Repealed by Indiana Emergency Medical Services Commission; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3579)

Rule 6.1

836 IAC 4-6.1-1 836 IAC 4-6.1-1 Advanced emergency medical technician intermediate training

Rule 6.1. Advanced Emergency Medical Technician Intermediate Training

836 IAC 4-6.1-1 Advanced emergency medical technician intermediate training

Authority: IC 16-31-2-7

Affected: IC 16-31-3-20

Sec. 1. (a) All institutions administering or seeking to administer training programs for advanced emergency medical technician intermediates who engage in the provision of advanced life support services are required to be certified by the commission.

(b) An institution certified by the commission to conduct training programs for advanced emergency medical technician intermediates must:

(1) be a training institution certified under 836 IAC 4-2; and

(2) operate according to the procedures described in 836 IAC 4-2.

(c) The minimum curriculum requirements for advanced emergency medical technician intermediate training shall be the Indiana advanced emergency medical technician intermediate training curriculum based upon the current national standard curriculum as amended and approved by the commission.

(d) The program director shall be a physician, a registered nurse, a paramedic, or an advanced emergency medical technician intermediate responsible for the duties of 836 IAC 4-2.

(Indiana Emergency Medical Services Commission; 836 IAC 4-6.1-1; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2368; readopted filed Aug 21, 2009, 1:31 p.m.: 20090916-IR-836090381RFA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

Rule 7

836 IAC 4-7-1 836 IAC 4-7-1 Student qualification to enter training

Rule 7. Emergency Medical Technicians-Basic Advanced; Certification

836 IAC 4-7-1 Student qualification to enter training

Authority: IC 16-31-2-7

Affected: IC 16-31-3-14

Sec. 1. (a) An applicant for Indiana advanced emergency medical technician training shall: (1) hold a valid certificate as an emergency medical technician; (2) be at least eighteen (18) years of age; and (3) have a high school or general education diploma.

(b) Individuals who have successfully completed an Indiana basic emergency medical technician course or are accepted for basic reciprocity and have taken the Indiana basic written and practical certification examinations may hold a provisional spot in the advanced emergency medical technician course.

(Indiana Emergency Medical Services Commission; 836 IAC 4-7-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2755; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3571; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7-2 836 IAC 4-7-2 Certification provisions; general

836 IAC 4-7-2 Certification provisions; general

Authority: IC 16-31-2-7

Affected: IC 4-21.5; IC 16-31-3-14

Sec. 2. (a) An applicant for certification as an advanced emergency medical technician shall meet the following requirements:

(1) Be an Indiana certified emergency medical technician.

(2) Be affiliated with a certified advanced emergency medical technician provider organization or a supervising hospital.

(3) Successfully complete the Indiana advanced emergency medical technician training course as approved by the commission and administered by a certified training institution.

(4) Pass the advanced emergency medical technician written and practical skills examinations and assessments as approved by the commission.

(b) An applicant shall apply for certification on forms provided by the agency postmarked within two (2) years after the date the course was concluded, as shown on the course report and examination results not older than two (2) years.

(c) An applicant shall submit verification of all affiliated provider organizations and supervising hospitals.

(d) Certification exemptions identified under 836 IAC 1-1-4 apply to advanced emergency medical technician certification.

(e) Advanced emergency medical technicians are prohibited from having in their possession, or maintaining on board emergency response vehicles, equipment or supplies that have not been approved by the advanced emergency medical technician provider organization medical director.

(f) Advanced emergency medical technicians shall comply with the following:

(1) An advanced emergency medical technician shall function within their scope of practice and perform only those procedures and treatments:

(A) in the Indiana emergency medical technician and Indiana advanced emergency medical technician curriculums; or

(B) that have been approved by the commission as being within the scope and responsibility of the advanced emergency medical technician.

(2) An advanced emergency medical technician shall not act negligently, recklessly, or in a way that endangers the health or safety of emergency patients or the members of the general public.

(3) An advanced emergency medical technician shall comply with the state and federal laws governing the confidentiality of patient medical information.

(4) An advanced emergency medical technician shall not delegate to a less qualified individual any skill requiring an advanced emergency medical technician.

(5) An advanced emergency medical technician shall comply with the protocols established by the commission, provider organization, and provider organization's medical director.

(6) An advanced emergency medical technician shall comply with any investigations performed by the agency, including being interviewed and timely providing any requested paperwork.

(7) An advanced emergency medical technician shall keep the provider's online portal account up to date, including current address, phone number, and email.

(8) If at any time an advanced emergency medical technician certificate holder is no longer actively affiliated with either an advanced emergency medical technician provider organization or a supervising hospital, the advanced emergency medical technician certification automatically becomes inactive once the advanced emergency medical technician is notified, and the agency shall update the portal status as inactive once notified, until new verification of both affiliations is received by the agency as follows:

(A) The advanced emergency medical technician certificate holder must meet the requirements of section 5 of this rule.

(B) The advanced emergency medical technician certificate holder shall notify the agency within forty-eight (48) hours after becoming unaffiliated with either an advanced emergency medical technician provider organization or a supervising hospital.

(C) An advanced emergency medical technician certificate holder needs only one (1) provider agency and supervising hospital affiliation. Secondary affiliations do not need to be reported if there is a provider and supervising hospital affiliation still active.

(9) An advanced emergency medical technician should function at the highest certification level, but may function at the underlying emergency medical technician certification level if:

(A) working for a provider that is not certified at an advanced emergency medical technician level;

(B) the required advanced emergency medical technician equipment is not available sufficiently to provide advanced emergency medical technician care;

(C) assigned to a basic life support certified ambulance; or

(D) there is not enough staffing to provide an emergency medical technician during transport.

(Indiana Emergency Medical Services Commission; 836 IAC 4-7-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2755; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2368; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3571; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7-3 836 IAC 4-7-3 Application for certification

836 IAC 4-7-3 Application for certification

Authority: IC 16-31-2-7

Affected: IC 16-31-3-8; IC 16-31-3-20

Sec. 3. (a) Application for certification as an advanced emergency medical technician is made on forms provided by the agency, and the applicant shall submit the forms to the agency.

(b) Applicants for original certification shall provide evidence of compliance with the requirements for certification.

(c) Certification as an advanced emergency medical technician is valid for two (2) years.

(d) Individuals who have failed to comply with continuing education requirements shall not exercise the rights and privileges of an advanced emergency medical technician or administer advanced life support to an emergency patient.

(e) An individual wanting to be recertified shall:

(1) reapply within four (4) years after the date the earlier certification expired;

(2) participate in and complete one (1) certification requirement cycle, including continuing education, practical skills, and requirements under section 5 of this rule at the advanced emergency medical technician curriculum level as a refresher, with those requirements being documented on an agency approved form for the certification being applied for; and

(3) successfully complete the state written and practical skills examinations as set forth and approved by the commission. If the individual fails either certification examination, they must retake an Indiana advanced emergency medical technician training course, including the commission approved written and practical examinations.

(f) Advanced emergency medical technicians failing to satisfy the requirements of subsection (e) shall satisfy the requirements for certification renewal by fulfilling the requirements for original certification as outlined in this article.

(Indiana Emergency Medical Services Commission; 836 IAC 4-7-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2756; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3572; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7-3.5 836 IAC 4-7-3.5 Continuing education requirements (Repealed)

836 IAC 4-7-3.5 Continuing education requirements (Repealed)

(Repealed by Indiana Emergency Medical Services Commission; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7-4 836 IAC 4-7-4 Advanced emergency medical technician certification based on reciprocity

836 IAC 4-7-4 Advanced emergency medical technician certification based on reciprocity

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3-2; IC 16-31-3-20

Sec. 4. (a) To obtain advanced emergency medical technician certification based upon reciprocity, an individual shall meet the following requirements:

(1) Be affiliated with an Indiana certified advanced emergency medical technician provider organization or a supervising hospital.

(2) Possess a valid certificate or license as an advanced emergency medical technician from another state or successfully complete a course of training and study equivalent to the material contained in the Indiana advanced emergency medical technician training course.

(3) Successfully pass the Indiana advanced emergency medical technician written and practical skills examinations as set forth and approved by the commission.

(b) An application for certification must be postmarked or delivered to the agency office within six (6) months after a request for reciprocity.

(c) A nonresident of Indiana who possesses a certificate or license as an advanced emergency medical technician that is valid in another state or a valid registration with the National Registry and is affiliated with an Indiana certified advanced emergency medical technician provider organization may apply to the agency for temporary certification as an advanced emergency medical technician. After the agency receives a valid application and verification of valid status, the agency may issue temporary certification valid for:

(1) the duration of the applicant's current certificate or license; or

(2) a period not to exceed six (6) months after the date the reciprocity request is approved by the director;

whichever is shorter. A temporary license automatically expires and becomes inactive when an advanced emergency medical technician provider becomes nonaffiliated, which the advanced emergency medical technician shall notify the agency of within forty-eight (48) hours after becoming nonaffiliated. A person receiving temporary certification may apply for full certification using section 1 of this rule.

(Indiana Emergency Medical Services Commission; 836 IAC 4-7-4; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2756; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3573; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7-5 836 IAC 4-7-5 Advanced emergency medical technician recertification and continuing education requirements

836 IAC 4-7-5 Advanced emergency medical technician recertification and continuing education requirements

Authority: IC 16-31-2-7

Affected: IC 16-31-3

Sec. 5. (a) To renew a certification, a certified advanced emergency medical technician shall keep a written report of continuing education on a form approved by the agency, or in another format approved by the agency, for every two (2) years meeting or exceeding the minimum requirement in subsection (b).

(b) An applicant shall report the following:

(1) At least fifty (50) hours of continuing education consisting of the following:

(A) At least twenty-five (25) hours of advanced emergency medical technician national continued competency education curriculum continuing education in the following national component categories:

(i) Airway, respiration, ventilation: 2.5 hours.

(ii) Cardiovascular: 7 hours.

(iii) Trauma: 3 hours.

(iv) Medical: 7.5 hours.

(v) Operations: 5 hours.

(B) At least twelve and one-half (12.5) state component hours of advanced emergency medical technician national continued competency education curriculum continuing education, with ten (10) hours being advanced life support audit and review sessions. The commission may direct additional state component training. The affiliated provider organization, or without a designated provider, the supervising hospital, shall approve any additional hours to meet the state component.

(C) At least twelve and one-half (12.5) hours of individual or local, or both, continuing education that covers material from the emergency medical technician or advanced emergency medical technician curricula and is approved by the provider organization, or without a designated provider, the supervising hospital.

(2) Written evidence of certification in cardiopulmonary resuscitation at the health care provider level that is valid on the date of the emergency medical services recertification.

(3) Skill competency without a specified hour requirement. The individual must comply with the skills competencies process as approved by the affiliated provider organization medical director. The medical director's signature verifying the advanced emergency medical technician skills competencies for the individual is required at recertification.

(c) An applicant for recertification shall complete the online recertification verification, in the individual's online portal account, including the following:

(1) The recertification requirements in this section must be met before the online verification, including using agency approved forms to record continuing education, obtaining required signatures, and submitting within the current certification expiration period, but not more than ninety (90) days before the expiration.

(2) The recertification personnel are subject to random audits and, if selected with notification by the online portal for an audit, the applicant must supply written verifications with signatures to the agency within seventy-two (72) hours or the recertification is considered untimely filed and the initial certification expired. The applicant is also subject to a sanction or sanctions for failure to comply within the seventy-two (72) hour period.

(d) A National Registry of Emergency Medical Technicians provider may use a current provider card as prima facie evidence of compliance with the national and individual components of the national continued competency program certification requirements for the certification or licensure level at which the provider is certified or licensed. However, the following requirements must be met for recertification:

(1) The required affiliation signatures for the individual must be obtained on the agency approved recertification forms.

(2) The state component hours, including audit and review, must be listed on the agency approved recertification form.

(3) The required cardiopulmonary certification or certifications for the individual level must be kept and attached to the agency approved recertification form.

(4) The proof of skills competency section of the agency approved recertification form must be completed with verifying signatures.

(e) If a properly completed renewal application is submitted within one hundred twenty (120) calendar days after a certification expires, together with the documentation needed to show that the applicant has completed the required continuing education within the two (2) years before the certification expired and a fifty dollar ($50) reapplication fee, the certification is reinstated on the date the commission staff determines the application, documentation, and reapplication fee have been properly submitted. The expiration date shall be two (2) years after the previously expired certification expires.

(f) The advanced emergency medical technician certification includes emergency medical technician certification, and the emergency medical technician certificate is considered renewed with an online portal renewal of the advanced emergency medical technician certification. However, the portal system may take up to thirty (30) days to update for the lower level certification after renewal submission.

(Indiana Emergency Medical Services Commission; 836 IAC 4-7-5; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7-6 836 IAC 4-7-6 Inactive status for certified advanced emergency medical technician

836 IAC 4-7-6 Inactive status for certified advanced emergency medical technician

Authority: IC 16-31-2-7

Affected: IC 16-31-3

Sec. 6. (a) An advanced emergency medical technician requesting inactive advanced emergency medical technician status shall be:

(1) currently certified in Indiana as an advanced emergency medical technician; and

(2) an individual who has previously recertified as an advanced emergency medical technician in Indiana at least one (1) time. The individual's certification must be in good standing with the commission at the time inactive status is requested. Applicants for inactive status do not have to be affiliated with an advanced emergency medical technician provider organization. Applicants wanting inactive status shall submit a request in writing to the commission.

(b) If an advanced emergency medical technician wants to maintain an active emergency medical technician certification, the advanced emergency medical technician shall meet the requirements set forth in this rule.

(c) Advanced emergency medical technicians on inactive status shall collect the following continuing education hours during the inactive period, and those hours must be reported to the commission before the certificate expires:

(1) Collect and report continuing education requirements listed in section 5 of this rule.

(2) Collect and report twelve (12) additional continuing education hours.

(d) Advanced emergency medical technicians with an inactive status wishing to return to active status shall meet the following requirements:

(1) Comply with subsection (b) during inactive status.

(2) Be affiliated with an Indiana certified advanced emergency medical technician provider organization and an Indiana certified advanced emergency medical technician supervising hospital by submitting a signed application for advanced life support.

(3) Submit in writing a verified statement attesting to the applicant's competency in skills listed in section 5(b)(3) of this rule signed by the advanced emergency medical technician provider medical director.

(e) An advanced emergency medical technician is automatically placed in inactive status once the individual is notified by either the affiliate provider organization or supervising hospital that they are no longer affiliated, and no other advanced emergency medical technician affiliates exist for the individual that provide for both a provider and supervising hospital affiliation. The following requirements apply to an emergency medical technician automatically placed in inactive status under this subsection:

(1) An advanced emergency medical technician losing affiliation shall notify the agency within forty-eight (48) hours after being notified of not having an advanced life support affiliation with either an ambulance provider or a medical director.

(2) An advanced emergency medical technician in inactive status may not practice under their certification as an advanced emergency medical technician.

(3) An advanced emergency medical technician's status remains inactive until they provide the agency with appropriate affiliation paperwork demonstrating they have both a provider agency and supervising hospital.

(4) An advanced emergency medical technician may function as an emergency medical technician under that scope of practice while their advanced certification is inactive as long as the emergency medical technician certification requirements are met.

(Indiana Emergency Medical Services Commission; 836 IAC 4-7-6; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-7.1

(Repealed by Indiana Emergency Medical Services Commission; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

Rule 8

836 IAC 4-8-1 836 IAC 4-8-1 Paramedic training (Repealed)

Rule 8. Paramedic Training

836 IAC 4-8-1 Paramedic training (Repealed)

(Repealed by Indiana Emergency Medical Services Commission; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3579)

Rule 9

836 IAC 4-9-1 836 IAC 4-9-1 Student qualifications to enter training

Rule 9. Emergency Paramedics; Certification

836 IAC 4-9-1 Student qualifications to enter training

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3-2

Sec. 1. (a) An applicant for Indiana paramedic training shall meet the following requirements:

(1) Hold a valid certificate as an emergency medical technician.

(2) Be at a minimum of eighteen (18) years of age.

(3) Have a high school diploma or general education diploma.

(b) Individuals who have successfully completed an Indiana basic emergency medical technician course or are accepted for basic reciprocity and have taken the Indiana basic written and practical skills certification examinations may hold a provisional spot in a paramedic course.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-1; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2757; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3576; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-9-2 836 IAC 4-9-2 Registered nurses; qualification to enter training

836 IAC 4-9-2 Registered nurses; qualification to enter training

Authority: IC 16-31-2-7

Affected: IC 16-31-3-2

Sec. 2. (a) A registered nurse can challenge the paramedic course if they meet the following:

(1) Be a registered nurse in Indiana.

(2) Be an Indiana certified emergency medical technician.

(3) Be able to document one (1) year of experience in an emergency department or as a flight nurse with an air ambulance service.

(4) Hold an advanced cardiac life support certification.

(5) Hold either an American Heart Association or American Red Cross Health care provider card or equivalent.

(6) Be able to meet prerequisites required by the commission, the emergency medical technician paramedic curriculum, and the local training institution course.

(b) For successful completion of the paramedic training course, a registered nurse must meet all of the requirements set forth by the training institution for all students or meet the prerequisites as described in subsection (a) and the following:

(1) May earn credit by written examination for individual modules of the paramedic course.

(2) Test out of a module to be completed prior to the beginning of that module by completing:

(A) the written examination with a passing score; and

(B) the practical skills examination with a passing score.

Failure of any module exam will require the students to participate in the entire module.

(3) Successfully complete the paramedic program comprehensive final examination.

(4) Demonstrate skill proficiency by completing the paramedic level skills with course proficiency.

(5) May earn credit of clinical hours by review of the student's past experience in the clinical areas.

(6) Complete all field internship and required hospital clinical hours.

(7) Pass the paramedic written and practical skills examinations as approved by the commission.

(8) Meet general certification requirements in section 3 of this rule.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-2; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2757; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3576; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-9-2.5 836 IAC 4-9-2.5 Inactive status for an Indiana certified paramedic

836 IAC 4-9-2.5 Inactive status for an Indiana certified paramedic

Authority: IC 16-31-2-7

Affected: IC 16-31-3

Sec. 2.5. (a) A paramedic requesting inactive paramedic status shall be currently certified in Indiana as a paramedic and be an individual who has previously recertified as a paramedic in Indiana at least one (1) time. The individual's certification must be in good standing with the commission at the time inactive status is granted. Applicants for inactive status do not have to be affiliated with a paramedic provider organization. Applicants wanting inactive status shall submit a request in writing to the commission.

(b) If a paramedic wants to keep an active emergency medical technician certification, the paramedic shall meet the requirements set forth in 836 IAC 4.4 [sic., 836 IAC 4-4] .

(c) Paramedics on inactive status must collect the following continuing education hours during the inactive period, and the continuing education hours must be reported to the commission prior to the expiration date of the certificate:

(1) Collect and report continuing education requirements listed in section 5(b)(1) through (5)(b)(3) of this rule.

(2) Collect and report twelve (12) additional continuing education hours.

(d) Paramedics with an inactive status wishing to return to active status must meet the following requirements:

(1) Comply with subsection (b) during inactive status.

(2) Be affiliated with an Indiana certified paramedic provider organization or an Indiana certified paramedic supervising hospital by submitting a signed application for advanced life support.

(3) Submit in writing a verified statement attesting to the applicant's competency in skills listed in section 5(b)(5) of this rule signed by the paramedic provider medical director.

Upon completion of these requirements, the emergency medical technician certification will become active.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-2.5; filed Apr 4, 2002, 9:15 a.m.: 25 IR 2517; readopted filed Jul 29, 2008, 8:50 a.m.: 20080820-IR-836080410RFA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-9-3 836 IAC 4-9-3 General certification

836 IAC 4-9-3 General certification

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20; IC 16-31.5-3-3

Affected: IC 4-21.5; IC 16-31-3-14

Sec. 3. An applicant for certification as a paramedic shall meet the following requirements:

(1) Be a certified emergency medical technician.

(2) Be affiliated with a certified paramedic provider organization or supervising hospital.

(3) Successfully complete the Indiana paramedic training course as approved by the commission and administered by an Indiana certified training institution.

(4) Pass the paramedic written and practical skills examinations as approved by the commission.

(5) Submit to a national criminal history background check at the cost of the individual.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-3; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2757; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2372; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3577; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; filed Aug 30, 2024, 11:24 a.m.: 20240925-IR-836240212FRA)

836 IAC 4-9-4 836 IAC 4-9-4 Application for certification; renewal

836 IAC 4-9-4 Application for certification; renewal

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3

Sec. 4. (a) Application for certification as a paramedic shall be made on forms provided by the agency. An applicant shall:

(1) complete the required forms; and

(2) submit the forms to the agency.

(b) All applicants for original certification shall provide evidence of compliance with the requirements for certification.

(c) Certification as a paramedic shall be valid for two (2) years.

(d) Individuals who have failed to comply with the continuing education requirements shall not exercise any of the rights and privileges nor administer advanced life support services to emergency patients.

(e) If a properly completed renewal application is submitted within one hundred twenty (120) calendar days after the expiration of the certification, together with the required documentation to show that the applicant has completed all required continuing education within the two (2) years prior to the expiration of the certification, and a fifty dollar ($50) reapplication fee, the certification will be reinstated on the date that the commission staff determines that the required application, documentation, and reapplication fee have been properly submitted. The expiration date will be two (2) years from the expiration of the previous, expired certification.

(f) An individual wanting to reacquire a certification shall complete a paramedic recertification training course and successful completion of state written and practical skills examinations as set forth and approved by the commission. If the individual fails the certification examinations, the person shall retake an entire paramedic training course.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-4; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2758; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3577; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; filed Mar 25, 2011, 10:24 a.m.: 20110420-IR-836100361FRA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-9-5 836 IAC 4-9-5 Continuing education requirements

836 IAC 4-9-5 Continuing education requirements

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3-8; IC 16-31-3-20

Sec. 5. (a) To renew a certification, a certified paramedic shall submit a report of continuing education every two (2) years that meets or exceeds the minimum requirements in subsection (b).

(b) An applicant shall report a minimum of seventy-two (72) hours of continuing education consisting of the following:

(1) Section IA, forty-eight (48) hours of continuing education through a formal paramedic refresher course as approved by the commission or forty-eight (48) hours of supervising hospital-approved continuing education that includes the following:

(A) Sixteen (16) hours in airway, breathing, and cardiology.

(B) Eight (8) hours in medical emergencies.

(C) Six (6) hours in trauma.

(D) Sixteen (16) hours in obstetrics and pediatrics.

(E) Two (2) hours in operations.

(2) Section IB, attach a current copy of cardiopulmonary resuscitation certification for the professional rescuer. The certification expiration date shall be concurrent with the paramedic certification expiration date.

(3) Section IC, attach a current copy of advanced cardiac life support certification. The certification expiration date shall be concurrent with the paramedic certification expiration date.

(4) Section II, twenty-four (24) additional hours of emergency medical services related continuing education; twelve (12) of these hours shall be obtained from audit and review. The participation in any course as approved by the commission may be included in this section.

(5) Section III, skill maintenance (with no specified hour requirement). All skills shall be directly observed by the emergency medical service medical director or emergency medical service educational staff of the supervising hospital either at an in-service or in an actual clinical setting. The observed skills include, but are not limited to, the following:

(A) Patient medical assessment and management.

(B) Trauma assessment and management.

(C) Ventilatory management.

(D) Cardiac arrest management.

(E) Bandaging and splinting.

(F) Medication administration, intravenous therapy, intravenous bolus, and intraosseous therapy.

(G) Spinal immobilization.

(H) Obstetrics and gynecological scenarios.

(I) Communication and documentation.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-5; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2758; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3578; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

836 IAC 4-9-6 836 IAC 4-9-6 Paramedic certification based upon reciprocity

836 IAC 4-9-6 Paramedic certification based upon reciprocity

Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3

Sec. 6. (a) To obtain paramedic certification based upon reciprocity, an applicant shall be affiliated with a certified paramedic provider organization and be a person who, at the time of applying for reciprocity, meets one (1) of the following requirements:

(1) Possesses a valid certificate or license as a paramedic from another state and who successfully passes the paramedic practical and written certification examinations as set forth and approved by the commission. Application for certification shall be postmarked or delivered to the agency office within six (6) months after the request for reciprocity.

(2) Has successfully completed a course of training and study equivalent to the material contained in the Indiana paramedic training course and successfully completes the written and practical skills certification examinations prescribed by the commission.

(3) Possesses a valid National Registry paramedic certification.

(b) Notwithstanding subsection (a), any nonresident of Indiana who possesses a certificate of license as a paramedic that is valid in another state, upon residing at an Indiana address, may apply to the agency for temporary certification as a paramedic. Upon receipt of a valid application and verification of valid status by the agency, the agency may issue temporary certification that shall be valid for:

(1) the duration of the applicant's current certificate or license; or

(2) a period not to exceed six (6) months from the date that the reciprocity request is approved by the director;

whichever period of time is shorter. A person receiving temporary certification may apply for full certification using the procedure required in section 1 of this rule.

(Indiana Emergency Medical Services Commission; 836 IAC 4-9-6; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2759; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3578; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)

Rule 10

836 IAC 4-10-1 836 IAC 4-10-1 Penalties (Repealed)

Rule 10. Penalties

836 IAC 4-10-1 Penalties (Repealed)

(Repealed by Indiana Emergency Medical Services Commission; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2372)