title-202•Title 202 KAR — Independent Administrative Bodies
Chapter 2 Kentucky Housing Corporation
202 KAR 2:020 Rural Housing Trust Fund {#sec-202-kar-2-020 omnilex-key=us-ky-regs-official--title-202--202 KAR 2:020}
Section 1. Qualification Criteria.
(1) Applications shall be prioritized based on the priorities established in KRS 198A.748(6).
(2) Single-family project applications shall be competitively ranked based on the following criteria:
(a) Willingness to serve those in a federally declared disaster area or displaced by an event triggering a federal disaster declaration within twenty-four (24) months of the event triggering the federal disaster declaration;
(b) Readiness to proceed;
(c) Number of units to be addressed by the project;
(d) Demonstrated experience in development or repair of housing;
(e) Projects to house disaster survivors still living in shelters, doubled up with family, or in another unsustainable housing situation;
(f) Established relationships and mechanisms to ensure a pipeline of moderate-income homebuyer referrals;
(g) Demonstrated expansion of capacity to develop at scale;
(h) Demonstrated financial capacity to carry out larger-scale housing projects;
(i) Creation of new housing supply;
(j) Location in rural areas with significant job growth;
(k) Location in counties shown to have a housing supply gap; or
(l) Projects awarded contributions from local government, a local employer, or a combination of local sources.
(3) Multifamily project applications shall be competitively ranked based on the following criteria:
(a) Willingness to serve those in a federally declared disaster area or displaced by an event triggering a federal disaster declaration within twenty-four months of the event triggering the federal disaster declaration;
(b) Readiness to proceed;
(c) Experience in development of multifamily housing utilizing Kentucky Housing Corporation financing resources;
(d) Demonstrated financial capacity to carry out larger-scale housing projects;
(e) Projects awarded under the Kentucky Housing Corporation tax exempt bond notice of funding availability in accordance with the terms of the notice of funding availability;
(f) Creation of new housing supply;
(g) Location in rural areas with significant job growth;
(h) Location in counties shown to have a housing supply gap; or
(i) Projects awarded contributions from local government, a local employer, or a combination of local sources.
(4) Approval of applications shall be based on the numerical ranking received and the availability of funds.
Section 2. Relocation Costs. In the development of rural housing under the Rural Housing Trust Fund, displacement of moderate-income individuals or families shall not be permitted unless the project pays all reasonable relocation costs. Reasonable relocation costs shall be determined on a case-by-case basis based on the following criteria:
(1) Provision of relocation advisory services to displaced tenants and owner occupants;
(2) Provision of a minimum of ninety (90) days written notice to vacate prior to requiring possession;
(3) Reimbursement for moving expenses; and
(4) Provision of payments for the added cost of renting or purchasing comparable replacement housing.
History
- RELATES TO: KRS 198A.740 - 198A.750
- STATUTORY AUTHORITY: KRS 198A.744, 198A.746(5), 198A.748(5)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 198A.744 authorizes Kentucky Housing Corporation to administer the Rural Housing Trust Fund by providing loans or grants for eligible activities, as established in KRS 198A.746, to create new sources of funding or to supplement existing sources of funding for the development of housing for moderate-income individuals or families in rural areas. KRS 198A.746 authorizes Kentucky Housing Corporation to define relocation costs to be paid if the development of rural housing displaces moderate-income individuals or families. This administrative regulation establishes additional criteria to qualify for the loans and grants and establishes the procedures to be followed in paying relocation costs.
- History: 50 Ky.R. 529, 1066; eff. 1-30-2024; 51 Ky.R. 538; eff. 3-4-2025.
Chapter 3 Kentucky Lottery Corporation
202 KAR 3:010 Code of ethics {#sec-202-kar-3-010 omnilex-key=us-ky-regs-official--title-202--202 KAR 3:010}
Section 1. Code of Ethics. An officer or employee of the Kentucky Lottery Corporation shall comply with the Kentucky Lottery Corporation Code of Ethics.
Section 2. Incorporation by Reference.
(1) The "Kentucky Lottery Corporation Code of Ethics", April 15, 2019, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Lottery Corporation, 1011 West Main Street, Louisville, Kentucky 40202-2623, Monday through Friday, 8 a.m. to 5 p.m.
History
- RELATES TO: KRS 154A.060(2)(e)
- STATUTORY AUTHORITY: KRS 154A.050(1)(d), 154A.060 (2)(e)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 154A.060(2)(e) requires the Kentucky Lottery Corporation to promulgate an administrative regulation establishing a code of ethics for officers and employees of the corporation. This administrative regulation establishes the Code of Ethics of the Kentucky Lottery Corporation.
- History: 24 Ky.R. 2782; Am. 25 Ky.R. 299; eff. 4-28-1999; 45 Ky.R. 3259; eff. 9-6-2019; Crt eff. 8-12-2026.
202 KAR 3:020 Procurement procedures {#sec-202-kar-3-020 omnilex-key=us-ky-regs-official--title-202--202 KAR 3:020}
Section 1. Procurement Procedures. The procurement procedures of the Kentucky Lottery Corporation are established in the Kentucky Lottery Corporation Procurement Procedures. These procedures shall apply in lieu of the Kentucky Model Procurement Code, unless otherwise specifically indicated.
Section 2. Incorporation by Reference.
(1) "Kentucky Lottery Corporation Procurement Procedures", May 14, 2021, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Lottery Corporation, 1011 West Main Street, Louisville, Kentucky 40202-2623, Monday through Friday, 8 a.m. to 5 p.m. This material may also be viewed on the Kentucky Lottery Corporation's Web site at www.kylottery.com.
History
- RELATES TO: KRS 154A.060(2)(a), 154A.120
- STATUTORY AUTHORITY: KRS 154A.050(1)(d)9, 154A.120(1)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 154A.120(1) authorizes the Kentucky Lottery Corporation to promulgate an administrative regulation establishing its procurement procedures. This administrative regulation establishes the procurement procedures of the Kentucky Lottery Corporation.
- History: 22 Ky.R. 1746; 1995; eff. 5-16-1996; 25 Ky.R. 2933; 26 Ky.R. 1119; eff. 12-16-1999; 48 Ky.R. 546; eff. 2-1-2022.
202 KAR 3:030 Retailers {#sec-202-kar-3-030 omnilex-key=us-ky-regs-official--title-202--202 KAR 3:030}
Section 1. Definitions.
(1) "Applicant" means the individual or entity applying for a license to sell lottery products.
(2) "Board" means the Board of Directors of the KLC as established by KRS 154A.030(1).
(3) "Cashing agent" means a retailer who has signed a "Retailer License Agreement Addendum for Cashing Agents" and who is authorized and required to cash lottery products of a value authorized by the KLC, up to and including $25,000, during KLC's business hours (8:00 a.m. EST to 5:00 p.m. EST).
(4) "Draw-based product" means:
(a) Any KLC ticket or product in which the player may determine if the player has won or lost after the drawing in which the prize was won; or
(b) Any other KLC ticket or product generated by the retailer terminal.
(5) "Draw-based retailer" means a retailer that sells one (1) or more draw-based products.
(6) "Instant product" means any KLC ticket or product in which the player may determine instantly if the player has won or lost.
(7) "KLC" means the Kentucky Lottery Corporation.
(8) "Licensing documents" means the:
(a) Application for Retailer License;
(b) Retailer License Agreement;
(c) Retailer License Agreement Addendum for Cashing Agents; and
(d) Retailer License Certificate.
(9) "Lottery equipment and supplies" means all lottery devices and materials provided to retailers by the KLC or its vendors: terminals, monitors, ticket checkers, communication devices, advertising materials, play slips, play centers, vending machines, ticket stock, and ticket dispensers.
(10) "Lottery product" means any KLC draw-based product, instant product, or a coupon issued by the KLC for a draw-based or instant product sold or distributed at a retail outlet or directly by the KLC.
(11) "Owner" means:
(a) An individual or sole proprietor;
(b) A partner;
(c) A member of a limited liability company;
(d) An officer;
(e) A director; or
(f) A shareholder of a corporation, except that, in the case of owners of equity securities of a publicly-traded corporation, only the names and addresses of those known to the corporation to own beneficially five (5) percent or more of the securities.
(12) "Retailer" is defined by KRS 154A.010(7) and includes the following:
(a) An individual or sole proprietorship;
(b) A limited or general partnership, including a registered limited partnership;
(c) A limited liability company;
(d) A corporation;
(e) A trust;
(f) Other entity, business, or enterprise; or
(g) The owner of a retailer.
(13) "Retailer handbook" means the handbook made available to retailers by the KLC, which describes KLC's billing, ticket validation and ordering procedures, payments to retailers, lottery products, and the operation and maintenance of lottery equipment and supplies.
(14) "Retailer License" means the ability to sell lottery products to the public and is identified through the issuance of a Retailer License Certificate.
(15) "Retailer License Agreement" means the agreement executed by the retailer and the KLC, setting forth the terms and conditions under which the Retailer License is issued.
Section 2. Conditions of Licensing. As a condition to be licensed to sell lottery products and to act as a retailer, each applicant shall be deemed to have agreed to the following conditions:
(1) Compliance with law. To fully comply with applicable laws, rules and regulations of the United States, including the Americans with Disabilities Act (ADA) (42 U.S.C. 12101 et seq.), the Commonwealth of Kentucky and its political subdivisions, including KRS Chapter 154A and 202 KAR Chapter 3, and with all policies, procedures, rules, directives, and instructions of the KLC, including applicable licensing documents and the Retailer Handbook, all as may be amended.
(2) Sale and cashing of lottery products.
(a) To offer for sale in a manner convenient and accessible to the public, and to actively promote the sale of, in a manner consistent with the directives of the KLC (including the display of KLC point-of-sale materials, signs or other displays,) all lottery products the retailer is authorized to sell, and to abide by all promotional guidelines promulgated by the KLC;
(b) To only use ticket stock issued to the specific retail outlet, unless otherwise authorized by the KLC;
(c) To cash valid winning lottery products sold or issued by retailer or by another retailer up to the limit set for the retailer by Sections 3(3) and 7 of this administrative regulation, or in an amount as otherwise authorized by the KLC in a manner consistent with the directives of the KLC throughout the retailer's business hours, by making a cash payment, or by issuing a check or money order;
(d) To neither charge nor ask for a fee, tip, tax, or anything of value for cashing a lottery product or for cashing a check or money order issued by retailer's retail outlet for payment of a prize;
(e) Upon request by a lottery player and when the lottery product is validated, to provide a lottery player with a copy of the validation slip for the lottery product presented; and
(f) To accept all valid coupons issued by the KLC and give the bearer of the coupons lottery products or merchandise in accordance with the terms of the lottery coupons.
(3) Training of retailer personnel. To require its employees to attend all training sessions and review training materials offered by the KLC or its vendors, as needed, to effectively perform its responsibilities as a KLC retailer.
(4) Accounting records. To maintain for the prior and current fiscal year (July 1 through June 30) current, accurate, and detailed accounting records of every operation and transaction relating to the sale, cashing, or maintenance of lottery products in conformance with the directives of the KLC, and as otherwise required by law. The records shall be made available to KLC representatives or agents, the Commonwealth of Kentucky's Auditor of Public Accounts, and to any other person as otherwise required by law.
Section 3. Licensing.
(1) In general.
(a) An applicant for a Retailer License shall complete, sign, and submit:
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An application for Retailer License, including an acknowledgement that the KLC may conduct the criminal, financial, and other background investigations required by Section 5 of this administrative regulation at any time during any term of the Retailer License Agreement with or without notice to the retailer;
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A Retailer License Agreement; and
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If a cashing agent, a Retailer License Agreement Addendum for Cashing Agents.
(b) Upon submission of an application for Retailer License, an applicant shall tender a $250 fee, which shall be nonrefundable, except as provided in Section 5(5)(a)2 and (b)3 of this administrative regulation.
(c) There shall be a $100 fee per new retail outlet for an existing chain retailer.
(d) Criminal, financial, and other background investigations shall be conducted in accordance with Section 5 of this administrative regulation for the applicant and each owner of the applicant. If the KLC determines that the applicant or an owner of the applicant does not meet the criteria established in KRS Chapter 154A and in this administrative regulation for the issuance of a Retailer License, the applicant shall be notified in writing, and the Retailer License shall be denied.
(e) Upon satisfactory completion of the criminal, financial, and other background investigations pursuant to paragraph (d) of this subsection, the KLC may:
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Sign a Retailer License Agreement with the successful applicant; and
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Issue a Retailer License Certificate for the successful applicant.
(f) Unless earlier terminated by the terms of the Retailer License Agreement in accordance with KRS Chapter 154A or Section 9 of this administrative regulation, the Retailer License Agreement shall be in effect for an initial one (1) year term from the date it is signed by the KLC. At the end of the initial one (1) year term, the Retailer License Agreement shall automatically renew for additional successive one (1) year terms, not to exceed four (4) years from the date the Retailer License Agreement was signed by the KLC. At the expiration of the four (4) years, unless the Retailer License Agreement was earlier terminated, the retailer shall seek relicensing pursuant to subsection (4) of this section.
(2) Special rules relating to chain retailers. More than one (1) retail outlet with identical owners may be treated as one (1) chain retailer. Each retail outlet shall be issued a separate retailer number and a Retailer License. The KLC may issue one (1) billing statement for all retail outlets or separate billing statements for each retail outlet. If the chain retailer wishes to add a new retail outlet, the chain retailer shall not be required to undergo a new background investigation.
(3) Special rules relating to cashing agents.
(a) The KLC may designate one (1) or more retailers as cashing agents. A cashing agent shall sign a Retailer License Agreement Addendum for Cashing Agents for cashing lottery products of a value up to an amount authorized by the KLC, not to exceed $25,000. If internet is available and if the KLC determines internet is necessary and in the best interest of the KLC to complete the claim process, the retailer may be required to maintain internet access during KLC's business hours.
(b) All cashing agents shall:
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During the KLC's business hours, cash validated winning lottery products by making a cash payment, or by issuing a check or money order;
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Follow all KLC practices and procedures; and
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Take all reasonable steps necessary to protect a player's private information, including address, telephone number, Social Security number, and birth date from public disclosure or any disclosure beyond that which is necessary for awarding the prize to the player. If any private information is disclosed, the KLC shall be immediately notified.
(c) The KLC may terminate a retailer's status as a cashing agent with or without revocation of the retailer's Retailer License.
(4) Relicensing.
(a) At least ninety (90) days prior to the expiration of the Retailer License Agreement as established in subsection (1)(f) of this section, each retailer shall seek relicensing by completing the application process in subsection (1) of this section, except the retailer shall not be required to tender the fees required by subsection (1)(b) and (c) of this section. If the retailer is a cashing agent, the retailer shall also complete the process in subsection (3) of this section.
(b) If a retailer continues to sell lottery products beyond the term of the Retailer License Agreement, the retailer shall continue to be liable to the KLC for all products sold.
(5) Change in Information. A retailer shall promptly notify the KLC of a change in information previously given to the KLC. For a complete or partial change in ownership, the retailer shall comply with Section 4 of this administrative regulation.
Section 4. Rules for Change in Ownership.
(1) Special rules relating to transfer of ownership of existing retailers.
(a) A Retailer License shall not be sold, transferred, assigned, pledged, or otherwise conveyed.
(b) A retailer shall give thirty (30) days prior written notice to the KLC of its intent to vacate or convey its retail outlet or business, change its location, or change the form of the business of the retailer. Retailer acknowledges that a complete change in ownership shall be accomplished by tendering to the KLC:
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An application for Retailer License;
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A Retailer License Agreement;
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If a cashing agent, a Retailer License Agreement Addendum for Cashing Agents;
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The fees required by Section 3(1)(b) and (c) of this administrative regulation; and
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Proof of conveyance documentation acceptable to the KLC.
(c) The KLC may, for a period not to exceed sixty (60) days, temporarily license an owner or applicant who has acquired the retail outlet or business of an existing retailer, so that the sale of lottery products will not be interrupted during the application process. The temporary licensing of an owner or applicant to sell lottery products shall not limit the KLC's right to exercise its discretion regarding issuance of a Retailer License to the owner or applicant. If the retail outlet or business of a retailer is conveyed and the sale of lottery products continues without issuance of a temporary or new Retailer License to the acquiring owner, the conveying retailer and the acquiring owner shall be jointly and severally liable for all debts and other obligations incurred to the KLC prior to and after the conveyance, and shall remain liable for all debts and other obligations until paid.
(d) In addition to other grounds for denial of a Retailer License or termination of a Retailer License Agreement, the KLC may deny issuance of a Retailer License to an owner or applicant acquiring or seeking to acquire the retail outlet or business of a retailer, until all debts and other obligations of the conveying retailer to the KLC are paid in full.
(2) Special rules relating to a partial change in ownership of a retailer.
(a) To the extent possible, retailers shall provide the KLC with thirty (30) days prior written notice of any partial change in owners, and in any event, shall provide the KLC with written notice within fifteen (15) days after any partial change in owners. Failure to do so may result in termination of the retailer's Retailer License. Written notice of a partial change shall be accomplished by tendering to the KLC a new application for Retailer License and a fee in the amount of fifty (50) dollars.
(b) The KLC shall conduct background and financial investigations of and make inquiries of the Kentucky Revenue Cabinet regarding a new owner of retailers in accordance with Section 5 of this administrative regulation.
Section 5. Requirements and selection criteria for applicants, retailers, and owners.
(1) Criminal and other background investigations. The KLC may investigate, at any time and during any license term, the criminal and other background history of, and existence of any statutory or regulatory violations by, an applicant, an owner, a retailer seeking relicensing, a retailer seeking licensing due to a complete change in ownership, or a retailer reporting a partial change in ownership.
(a) The KLC may, unless required by statute, deny the application of an applicant, and suspend or revoke the license of an existing retailer:
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For any reason established in KRS 154A.400 for denying the issuance of a Retailer License;
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For any reason established in KRS 154A.410(1) for terminating an existing Retailer License Agreement;
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If the applicant, owner, or retailer has been convicted of any offense that relates to or may adversely impact the security or integrity of, or public confidence in, the KLC or its retailers. The KLC shall consider:
a. The physical and fiscal security of the KLC and its retailers and the integrity of the KLC's games;
b. Public perception of and public confidence in the KLC and its retailers; and
c. Other relevant factors;
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If an applicant, owner, or retailer has been found by the Chief Financial Officer or his designee to have made a statement of material fact to the KLC while the person was serving as a previous owner or related entity, and the person knew or should have known that the statement was false or untrue in any respect, unless at least ten (10) years have passed since the statement was made;
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If an applicant, owner, or retailer has been found by the Chief Financial Officer or his designee to have provided false or misleading information, or failed to provide material information the failure of which to provide is false or misleading, to the KLC or to a law enforcement agency with respect to obtaining or retaining a Retailer License;
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If an applicant, owner, or retailer provides products, services, or entertainment that may have an adverse effect upon the credibility, integrity, and reputation of the KLC;
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If an applicant, owner, or retailer sells products, services, or entertainment that constitutes products or services deceptively similar to or in competition with the KLC's products or services; or
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If an applicant, owner, or retailer does not demonstrate the ability to sell and continue to sell an acceptable level of lottery products.
(b) The KLC may permit the applicant or retailer a period of time, not to exceed thirty (30) days, to remove the person as owner or to correct the situation resulting in an unsatisfactory criminal, financial, or other background check.
(c) If an existing retailer is requesting a relicensing, seeking to open a new retail outlet, or is an entity related to an existing retailer, or who shares one (1) or more owners with an existing retailer, and facts are disclosed that would cause the KLC to deny an application for licensing or a relicensing if tendered by the existing retailer, the KLC may:
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Immediately revoke or suspend all existing Retailer Licenses of the retailer in accordance with KRS Chapter 154A; or
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Notify all the retailers that their licenses will be revoked within thirty (30) days if the conditions justifying revocation are not corrected.
(2) Financial investigations.
(a) The KLC shall conduct a financial investigation of each applicant applying for a Retailer License, and of each retailer under consideration for licensing due to a change of ownership. In addition to information available from other sources, the KLC shall maintain, and shall review during each financial investigation, a database regarding existing, suspended, and canceled retailers and their owners. The KLC may consider in its determination regarding the financial responsibility of an applicant or retailer undergoing relicensing, the connection of the owner or related entity with any retailer whose Retailer License was suspended or canceled due to a default in its obligations to the KLC.
(b) If, as a result of financial investigation of the applicant or retailer and its owners, the KLC determines that a prospective or existing retailer poses a financial risk, the KLC may:
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Deny the application or revoke the Retailer License in accordance with KRS 154A.410(2); or
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License an applicant or permit an existing retailer to retain its Retailer License upon receipt of the letters of credit, bonds, personal guaranty agreements, or other security or assurances of payment as the KLC may deem satisfactory, in an amount based upon actual or potential sales.
(3) Kentucky Department of Revenue inquiries.
(a) Except as provided in Section 4(1)(c) of this administrative regulation, a Retailer License shall not be issued to an applicant which is not, or has an owner which is not, and a retailer shall not be permitted to retain a Retailer License which is not, or has an owner which is not, current in the payment of taxes, interest and penalties owed to, and current in filing of applicable tax returns with, the Commonwealth of Kentucky.
(b) A Retailer License shall not be issued to an applicant which has not previously been issued a federal employment tax identification number, or if the applicant is an individual, a Social Security number, and, if applicable, a Kentucky sales tax license number. The KLC shall confirm with the Kentucky Department of Revenue that an applicant for a Retailer License, and an existing retailer seeking relicensing, complies with this paragraph. The KLC shall rely upon information received from the Kentucky Department of Revenue. The KLC may permit an existing retailer a period of time not to exceed thirty (30) days within which to meet or cause the owner in question to meet its obligations with the Kentucky Department of Revenue prior to revocation of the retailer's Retailer License or prior to final denial of issuance of a relicensing of the Retailer License.
(4) Kentucky Secretary of State Inquiries. An applicant shall be registered and in good standing with the Kentucky Secretary of State if the applicant is a corporation or limited liability company.
(5) Selection criteria.
(a) In order to sell draw-based products, an applicant shall meet the following criteria:
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Whether, based on historic traffic patterns in the geographic area of the proposed retail outlet, the applicant is likely to have sales equal to or in excess of $100 per week in draw-based product; and
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If the KLC determines that the applicant is not likely to have the expected draw-based product sales, the KLC may deny the applicant's application for a Retailer License and refund any license fee previously paid by the applicant.
(b) In order to sell instant products, an applicant shall meet the following criteria:
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Whether, based on historic traffic patterns in the geographic area of the proposed retail outlet, the applicant is likely to have sales equal to or in excess of $300 per week in draw-based and instant products;
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Whether the applicant will agree to and has the physical space to carry a minimum of six (6) unique instant products at its retail outlet at all times; and
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If the KLC determines that the applicant is not likely to have the expected draw-based and instant product sales, the KLC may deny the applicant's application for a Retailer License and refund any license fee previously paid by the applicant.
(c) Retailers shall sell both draw-based products and instant products unless specifically authorized by the KLC to sell one (1) or more draw-based products only based on the retailer's type of business.
(6) Storage of unsold products. A retailer shall store unsold lottery products and ticket stock in a safe and secure place to minimize the risk of loss, theft, damage, or destruction. The KLC may inspect, and require alteration or relocation of, the storage place.
(7) Reasonable access to lottery products, equipment, and supplies. A retailer shall provide the KLC with reasonable access to lottery products, equipment, and supplies upon reasonable notice.
(8) Game end dates. A retailer shall adhere to the KLC's directives and policies on game end dates and return dates for lottery products. A retailer shall adhere to the KLC's directives on return of unsold lottery products upon the announcement of game end dates.
(9) Loss, destruction, or theft of lottery products, equipment, or supplies.
(a) A retailer shall promptly report to the Security Division of the KLC and to the appropriate local law enforcement agency, a loss, destruction, or theft of lottery products, equipment, or supplies and cooperate, and cause its employees to cooperate, fully with the investigations of the KLC's Security Division and law enforcement officials.
(b) The retailer shall be liable to the KLC for payment in full for all lottery products allegedly lost, destroyed, or stolen after activation of the relevant pack of products.
(c) Retailers shall receive reimbursement for activated products stolen during a robbery or burglary, if the Security Division and law enforcement each receive accurate game, pack, and ticket number ranges in a timely manner, followed-up by a copy of the police offense report submitted to the Security Division within ten (10) business days.
(10) Security Inspection and Investigations. The KLC Security Division may inspect the retail outlet to ensure that lottery products, equipment, and supplies are maintained in an environment that will minimize the risk of loss, theft, damage, or destruction. The KLC may require alteration of the environment or relocation of lottery products, equipment, or supplies if a security risk is evident. The retailer shall cooperate, and cause it employees to cooperate, fully with all investigations of the KLC's Security Division and law enforcement officials.
Section 6. Lottery equipment and supplies.
(1) Criteria for allocation of lottery equipment and supplies.
(a) Installation and retention of lottery equipment and supplies at a retail outlet shall be determined by the KLC, based upon the following criteria, as appropriate:
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The probable future or actual historic sales at the retail outlet relative to the installation costs of any lottery equipment and supplies and ongoing communications charges associated with any lottery equipment and supplies;
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The retailer's and the retailer's owners' and related entities' history with the KLC;
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The number of games carried by the retailer; and
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The retailer's retail outlet, including business, location, size, and hours.
(b) In calculating the probable future or actual historic sales, the KLC shall consider:
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Actual historic sales of the lottery products sought to be sold by similarly situated retailers; and
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Total actual historic sales by the retailer in question.
(c) The KLC may establish initial fees and periodic charges with respect to installation or maintenance of lottery equipment and supplies.
(2) Title, placement, and removal of lottery equipment and supplies.
(a) Lottery equipment and supplies provided to retailers are and shall remain the property of the KLC or its vendors, and shall not be or become property of a retailer or person claiming an interest in lottery equipment and supplies through a retailer including, without limitation, the holder of any lien.
(b) Before placement of lottery equipment and supplies within a retailer's retail outlet, the retailer shall obtain KLC approval of the proposed location for the lottery equipment and supplies. The retailer shall not move, modify, or alter the equipment or supplies.
(c) The KLC shall have the right to enter a then-present or former retail outlet, during normal business hours, or at any other time with the consent of the holder of any interest in the real property on which the retail outlet is situated, to remove lottery products, equipment, and supplies.
Section 7. Prize Payments.
(1) Prize payments up to and including $600. During its business hours, a retailer shall pay the nonminor holder of a validated winning lottery product the amount of the prize to which the winner is entitled, up to and including the sum of $600, by making a cash payment, or by issuing a check or money order.
(2) Prize payments up to $25,000. The KLC may establish a network of cashing agents. During the KLC's business hours, authorized cashing agents shall pay the nonminor holder of a validated winning lottery product the amount of the prize to which the winner is entitled, up to and including any sum that the KLC has authorized the cashing agent to pay, not to exceed the sum of $25,000, by making a cash payment, or by issuing a check or money order.
Section 8. Retailer Accounting.
(1) Lottery product purchases, billings, and payment. The KLC shall make available to all retailers detailed accounting procedures regarding purchases of and billings for lottery products, which procedures shall be deemed to be a part of the Retailer License Agreement. The KLC may establish payment terms with individual retailers to address situations unique to those retailers. All proceeds from the sale of lottery products shall be deposited not later than the close of the next banking day after the date of their collection by the retailer and shall be held in an account designated, in writing, by the retailer to the KLC in the application for Retailer License. The account shall be in an institution insured by the Federal Deposit Insurance Corporation or Federal Savings and Loan Insurance Corporation, or their successors. All proceeds of the sale of lottery products, net of credits for compensation due to retailers and for prizes paid by retailers, are the property of the KLC and shall be held by retailers in trust and in a fiduciary capacity for the benefit of the KLC.
(2) Credits. Retailers' accounts with the KLC shall be credited by the KLC in accordance with its retailer compensation policies, as established by the KLC pursuant to KRS 154A.050(1)(d)8.
(3) Delinquent accounts. In addition to all other rights and remedies available to the KLC at law or in equity, including the rights and remedies provided in KRS Chapter 154A, the KLC shall have the following rights and remedies:
(a) The right to set off against and recoup from sums due by the KLC to a delinquent retailer or owner any sums due the KLC by the delinquent retailer or owner, or by any other retailer in which the delinquent retailer or owner is an owner;
(b) The right to request the Commonwealth of Kentucky to set off against and recoup from sums due any delinquent retailer, owner, or other retailer which is in part owned by an owner of the delinquent retailer by the Kentucky Department of Revenue, any sums due to the KLC by the delinquent retailer;
(c) The right to require payment of all sums due the KLC by a retailer prior to issuance of a Retailer License to a new retailer at the same retail outlet; and
(d) The right to write off a retailer's obligations to the KLC, without releasing any retailer from its obligations for repayment of sums owed the KLC, and reimburse its operating accounts in the amount of the write-off from a segregated account that may be established from all licensing fees received by the KLC, including any additional sums authorized for that purpose by the board. The board may increase or reduce the amount held in the segregated account.
Section 9. Termination or Suspension.
(1) Termination for cause. Unless required by statute, the KLC may terminate or suspend a retailer's Retailer License and Retailer License Agreement at any time, for good cause, upon a finding that:
(a) The retailer or an owner has committed any act or omission established in KRS 154A.410(1) for termination of a Retailer License Agreement;
(b) The retailer or an owner has committed any act or omission that would prevent the issuance of a Retailer License for any reason in this administrative regulation;
(c) The retailer or an owner has committed a material breach of any provision of its Retailer License Agreement with the KLC;
(d) The retailer or an owner has provided false or misleading information in obtaining or attempting to obtain a Retailer License and Retailer License Agreement;
(e) The retailer or an owner been convicted of, or has entered a plea of guilty or nolo contendere, regardless of adjudication, to an offense punishable as a felony, or to any gambling-related offense, unless the time established in KRS 154A.400(1)(b)(3) has expired;
(f) The retailer or an owner has outstanding tax delinquencies owed to the federal government or any taxing authority within the Commonwealth of Kentucky;
(g) The retailer or an owner has jeopardized the integrity, security or efficient operation of the KLC;
(h) The ownership or location of the business has changed without providing prior notice to the KLC as provided in this administrative regulation;
(i) The retailer has failed to accurately account for lottery tickets, revenues, or prizes as required by the KLC;
(j) The retailer has failed to remit or is delinquent in remitting money owed to the KLC;
(k) The retailer or owner has committed any fraud, deceit, or misrepresentation to the KLC or to any individual purchasing a lottery ticket or tickets from retailer;
(l) The retailer has sold a lottery ticket or paid a prize to any person under eighteen (18) years of age;
(m) The retailer has sold a lottery ticket at any place other than the place authorized in its Retailer License;
(n) If required by statute, the retailer has not prominently displayed its Retailer License Certificate at the approved sales location;
(o) The retailer has not prominently displayed and maintained ticket displays/dispensers and points-of sale materials provided by the Lottery;
(p) The retailer has not made point-of-sale information for lottery products accessible to the public;
(q) The retailer has sold tickets at a price other than established by the KLC;
(r) The retailer or an owner has committed a material violation of any rule or administrative regulation promulgated by the KLC;
(s) The retailer has violated any directive or instruction issued by the KLC;
(t) The retailer or an owner has committed a material violation of KRS Chapter 154A;
(u) The retailer's reputation is no longer consistent with the protection of the public interest;
(v) The retailer has materially changed any factor considered by the KLC in selecting the retailer;
(w) The retailer or an owner has engaged in conduct prejudicial to public confidence in the lottery;
(x) The retailer has charged a fee or tip to redeem a lottery ticket or has required a customer to purchase another item in order to purchase a lottery ticket;
(y) The retailer has paid a prize valued greater than the retailer is authorized to cash by the KLC, or the retailer has refused to cash a winning lottery prize, properly validated, up to the amount authorized by the KLC; or
(z) The retailer has insufficient sales of lottery products.
(2) Termination without cause. The KLC may terminate a retailer's Retailer License and Retailer License Agreement without cause, upon thirty (30) days prior written notice.
(3) Termination by retailer. A retailer may terminate its Retailer License and Retailer License Agreement upon thirty (30) days prior written notice. The KLC may, at its option, elect to terminate the retailer's Retailer License and Retailer License Agreement prior to the end of the thirty (30) day period.
(4) Effect of termination or suspension. If a retailer possesses multiple retail outlets, suspension or termination of one (1) outlet is grounds for suspension or termination of the others. Every obligation of a retailer to the KLC shall survive termination or suspension of the Retailer License and Retailer License Agreement. Upon termination or suspension of a Retailer License and Retailer License Agreement, the retailer shall immediately pay to the KLC all sums owed to the KLC and shall surrender to the KLC the retailer's Retailer License Certificate and all lottery products, equipment and supplies.
(5) Other remedies. In addition to the remedies of termination or suspension, the KLC may avail itself of any other remedies available to it at law or in equity, including, without limitation, injunctive relief.
Section 10. Retailer Remedies.
(1) Right to protest. An applicant for a Retailer License or a retailer aggrieved in connection with an action taken by the KLC pursuant to KRS Chapter 154A or this administrative regulation may protest, in writing, to the president of the KLC. The protest shall be submitted within thirty (30) calendar days after the aggrieved applicant or retailer knows or should have known of the facts giving rise to the protest. An applicant or retailer shall be deemed to have knowledge of the facts giving rise to the protest within thirty (30) days of the KLC's issuance of a written notification to the retailer or applicant for a Retailer License regarding the action or decision of the KLC.
(2) Effect of protest. If a timely protest is filed under this section and the action protested is the termination of a Retailer License, the Retailer License shall be temporarily suspended rather than terminated until all administrative and judicial remedies have been exhausted. In all other circumstances, the KLC's action or decision shall stand unless and until reversed or revised as a result of the protest.
(3) Action by President and Right to Appeal. The decision of the president shall be promptly issued in writing and shall be immediately furnished to the protesting person by hand-delivery, telecopier (with a hard copy sent by certified mail, return receipt requested,) certified mail (return receipt requested), or by appropriate electronic means. A notice shall be deemed received on the date hand-delivered or sent by telecopier, three (3) business days after deposit of the notice in the United States Mail, postage prepaid, if sent by certified mail, return receipt requested and upon receipt, if sent electronically. The decision shall recite the grounds relied upon by the president in reaching the decision and shall inform the protesting party of its further appellate rights under subsections (4) and (5) of this section. The president's decision shall be final and conclusive, unless within ten (10) calendar days from the date of receipt of the decision, the protesting party delivers a written appeal to the board, by hand, by telecopier (with a hard copy sent by certified mail, return receipt requested) or by certified mail, return receipt requested, all pursuant to KRS Chapter 154. The address is: Board of Directors, Kentucky Lottery Corporation, 1011 West Main Street, Louisville, Kentucky 40202, Telecopier No. (502) 560-1532.
(4) Board appeal.
(a) After receipt of an appeal, the board shall schedule a hearing for the protesting party which shall be scheduled as soon as practicable; and
-
The hearing shall be conducted in accordance with KRS Chapter 13B; or
-
The chairman of the board may determine that the hearing will be conducted by a hearing officer. The chairman shall determine whether the hearing officer will conduct the hearing in the presence of a quorum of the board, who renders a decision without the recommended order of the hearing officer, or whether the hearing officer will conduct the hearing outside of the presence of the board and will complete and submit to the board a written recommended order, which shall include findings of fact, conclusions of law, and recommended disposition, as provided in KRS 13B.110. The decision of the board shall be made by a majority of the board members present at the meeting in which the appeal is decided.
(b) The decision of the board shall be final unless the decision is appealed as provided by subsection (5) of this section and other applicable law.
(5) Access to state courts. A person aggrieved by a decision of the board under this section may appeal the decision, within thirty (30) calendar days of its date of issuance, to a court of competent jurisdiction, in accordance with KRS Chapter 154A.
Section 11. Sales of Lottery Products by KLC. Nothing in 202 KAR Chapter 3, licensing documents, or any other document shall limit the right of the KLC to sell lottery products directly to the public, in person, electronically, by mail, by subscription, or otherwise.
Section 12. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Application for Retailer License", 12/8/17;
(b) "Retailer License Agreement", 12/8/17;
(c) "Retailer License Agreement Addendum for Cashing Agents", 12/8/17; and
(d) "Retailer License Certificate", 12/8/17.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Lottery Corporation, 1011 West Main Street, Louisville, Kentucky 40202-2623, Monday through Friday, 8:00 a.m. through 5:00 p.m. EST.
History
- RELATES TO: KRS Chapter 154A
- STATUTORY AUTHORITY: KRS 154A.050(1)(d), 154A.400(1)(b)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 154A.400(1) requires the Kentucky Lottery Corporation to develop and maintain a statewide network of lottery retailers that will serve the public convenience to promote the sale of lottery products, while insuring the integrity of the lottery. To govern the selection of lottery retailers, KRS 154A.400(1)(b) requires the Board of Directors of the Kentucky Lottery Corporation to develop a list of objective criteria upon which the selection of lottery retailers shall be based. This administrative regulation lists the objective criteria upon which the selection of lottery retailers shall be based.
- History: 25 Ky.R. 584; 834; eff. 10-12-1998; 28 Ky.R. 1682; 2195; eff. 4-15-2002; 44 Ky.R. 1728; 1976; eff. 4-6-2018; Crt to Am, filing deadline 10-1-2026.
202 KAR 3:040 Internal audit {#sec-202-kar-3-040 omnilex-key=us-ky-regs-official--title-202--202 KAR 3:040}
Section 1. Definitions.
(1) "Board" means the Board of Directors of the corporation established by KRS 154A.030.
(2) "Internal audit department" means the department head of internal audit, together with other employees of the corporation who are designated by the president of the corporation and approved by the audit committee.
Section 2. Audit Committee.
(1) The audit committee shall consist of:
(a) No less than two (2), nor more than three (3), members of the board; and
(b) The chairman of the board, who shall serve as an ex-officio member.
(2) Members of the audit committee shall be appointed by the chairman of the board and serve until the earliest of:
(a) Their resignation or removal from the board;
(b) The expiration of their terms as members of the board; or
(c) Their resignation or removal from the audit committee by majority vote of the board.
(3) In appointing members to the audit committee, the chairman of the board shall give preference to members of the board who:
(a) Are certified public accountants or certified internal auditors; or
(b) Otherwise possess expert knowledge in auditing, accounting, business, or commerce.
(4) The members of the audit committee shall select a chairman from its members.
(5)
(a) Except as provided by paragraph (b) of this subsection, the chairman of the audit committee shall determine the date, time, and place of a meeting of the audit committee.
(b) More than two (2) regular meetings of the board shall not have occurred between meetings of the audit committee.
(6) At least one (1) member of the Internal Audit Department shall be present at a meeting of the audit committee.
(7) If requested by the audit committee, a member of the corporation management shall be present at all or a part of the meeting of the audit committee.
Section 3. Duties and Authority of the Audit Committee.
(1) The audit committee shall review the operations and financial reporting procedures of the corporation and shall report and make recommendations to the board. It shall:
(a) Review the adequacy of the corporation's system of internal control through review of audit reports and presentations at Audit Committee meetings;
(b) Review at least annually the corporation's system of risk identification, assessment, and management;
(c) Review the organizational structure of the Internal Audit Department of the corporation and the activities and qualifications of its staff;
(d) Review the findings made by the Internal Audit Department;
(e) Request a department head or other corporation personnel to discuss audit findings or issues with the audit committee, as may be necessary;
(f) Assist the president in the hiring, evaluation, promotion, and removal of the Chief Audit Executive;
(g) Review legal matters that could have a significant impact on the corporation's financial statements with the corporation's:
-
Legal counsel;
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If deemed appropriate, outside counsel; and
-
Other personnel or entities as necessary;
(h) Review the findings of an examination of the corporation or its operations by a regulatory (or any other outside) agency;
(i) Review audits conducted by the Auditor of Public Accounts or an independent auditor selected by the Auditor of Public Accounts; and
(j) Perform other oversight functions at the request of the board.
(2)
(a) A member of the audit committee may meet with:
-
Corporation employees;
-
The Auditor of Public Accounts, and designees; and
-
Independent auditors.
(b) An employee of the corporation may request to meet with the chairman of the audit committee.
(c) The audit committee may hold a closed meeting pursuant to KRS 154A.030(7).
(3) The audit committee shall:
(a) Inform the board of its meetings and actions; and
(b) Discuss its reviews, reports, and recommendations with the board.
(4)
(a) The audit committee may institute a special investigation.
(b) In the conduct of a special investigation, the audit committee may:
-
Hire special outside counsel or experts; or
-
Utilize the services of corporation employees, officers, or directors.
(c) The audit committee shall submit a report of its findings and recommendations to the board for its action.
Section 4. Internal Audit Department.
(1) In order to assist the president, the audit committee and the management of the corporation, the internal audit department shall furnish objective analyses, appraisals, recommendations, and information concerning the operations of the corporation, through use of an annual audit plan, as follows:
(a) Review the operations of the corporation to assure compliance with the systems, and policies and procedures established to ensure conformity with the applicable statutes and administrative regulations of the Commonwealth and other applicable governmental entities;
(b) Review the operations of the corporation to assure compliance with the systems, and policies and procedures established by the corporation;
(c) Review the reliability and integrity of financial and operating information;
(d) Review and evaluate the means of safeguarding the assets of the corporation and, as appropriate, verify the existence and ownership of the assets by the corporation;
(e) Appraise the economy and efficiency of the corporation in the use of resources;
(f) Advise the management of the corporation and the board on the accounting, financial, and operational policies, procedures, and systems;
(g) Coordinate, supplement, and evaluate examinations of the corporation's activities by outside auditors, accountants, and other review teams; and
(h) Perform other oversight functions as requested by the audit committee or by the board.
(2) The internal audit department shall report to the president for administrative purposes but shall report the results of its work directly to the audit committee.
Section 5. The internal audit department shall use a risk-based method of developing an annual audit plan in the following manner:
(1) Prior to the end of each fiscal year, the department head of internal audit shall submit a proposed detailed internal audit plan for the next fiscal year for:
(a) Review by the president; and
(b) Review and approval by the audit committee.
(2) The audit committee shall forward its recommendations to the board.
(3) The department head shall initiate audits pursuant to the approved plan, as may be revised with the approval of the the audit committee.
(4) Internal audit work shall be performed in accordance with standards established by the Institute of Internal Auditors and shall include:
(a) Planning the audit;
(b) Identifying, analyzing, evaluating, and documenting the information;
(c) Communicating results; and
(d) Monitoring progress.
Section 6. Communicating Results. The internal audit department shall report on all its activities to the Audit Committee through written audit reports, periodic activity reports, and regular Audit Committee meetings.
(1) Written audit reports shall be completed at the end of each audit engagement and shall be distributed to the Audit Committee members. All applicable internal parties shall receive a copy.
(2) Written reports shall include any deficiencies noted during the engagement and shall include a description of the associated risk.
Section 7. Procedure on Loss of Assets.
(1) The internal audit department shall be notified if assets of the corporation have been, or are thought to have been, lost through defalcation or other breaches in the security, financial, or operating systems.
(2) Immediately upon receipt of a notification, the department head of internal audit shall:
(a) Request that the department head of security notify the proper authorities of the potential loss; and
(b) Consult with the Corporation's Security Department to coordinate an investigation.
(3) If the investigation reveals a loss, the internal audit department shall:
(a) Identify the weakness in financial or operating procedures that enabled the loss to occur; and
(b) Recommend to the president, the audit committee, and the board improvements to the procedures to correct the weakness.
Section 8. Internal Audit Department Authority and Limitations.
(1) The internal audit department shall have unrestricted access to all activities, records, properties, and personnel applicable to any area of the corporation under review.
(2) The department head of internal audit shall develop a policy to assure the confidentiality of all matters reviewed, unless disclosure is required by law or internal audit procedures established by this administrative regulation.
(3)
(a) The internal audit department and its members shall not have direct authority over, or responsibility for, any of the activities reviewed by it.
(b) The internal audit department and its members shall not develop or install procedures, prepare records, or engage in any other activity that could be reasonably construed to compromise its independence.
(c) If the internal audit department participates in an activity that might be construed as compromising its independence, the activity shall be reviewed by an independent external auditor, if deemed necessary by the board, or recommended by the audit committee and approved by the board.
(4) The internal audit department shall coordinate its efforts with those of the Auditor of Public Accounts and other external auditors who may be employed to achieve comprehensive, cost-effective audit coverage.
Section 9. Continuing Education.
(1) An auditor in the internal audit department shall annually obtain the same continuing education credits required by the Institute of Internal Auditors for certified internal auditors or any other acceptable certifying body including the American Institute of Certified Public Accountants (AICPA), or the Information Systems Audit and Control Association (ISACA).
(2) The head of the Internal Audit Department shall monitor compliance with the continuing education requirements established by this section.
History
- RELATES TO: KRS 154A.020(1), 154A.030, 154A.050(2)(b), 154A.060(2)(a), (c)
- STATUTORY AUTHORITY: KRS 154A.050(1)(d), 154A.060(2)(c)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 154A.020(1) requires the Kentucky Lottery Corporation to be accountable to the Governor, the General Assembly, and the people of the Commonwealth through a system of audits, reports, and thorough financial disclosure. As a part of that system of accountability, KRS 154A.060(2)(c) requires the corporation to promulgate by administrative regulation a system of continuous internal audits. This administrative regulation establishes the system of continuous internal audits for the Kentucky Lottery Corporation.
- History: 22 Ky.R. 1395; Am. 1825; eff. 4-5-1996; 45 Ky.R. 2757; eff. 5-31-2019; Crt eff. 5-20-2026.
Chapter 6 911 Services Board
202 KAR 6:010 Definitions for 202 KAR Chapter 6 {#sec-202-kar-6-010 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:010}
Section 1. Definitions.
(1) "Alternate routing" means sending 9-1-1 calls to a designated alternate location if all 9-1-1 trunks to the normal PSAP are busy or out of service. Alternate routing may be activated automatically, if an equipment failure is detected, or upon request.
(2) "Call transfer function" means the ability to redirect a call to another party.
(3) "Contracted wireline E9-1-1 service provider" means the company providing by signed agreement the E9-1-1 features, functions, and network connections to the PSAP.
(4) "Cost recovery plan" means a detailed description of how a CMRS carrier intends to comply with the wireless E9-1-1 requirements established in the FCC order.
(5) "Default routing" means the ability of the 9-1-1 network to automatically send 9-1-1 calls to a predetermined alternate PSAP if a call cannot be selectively routed due to an ANI failure or other cause.
(6) "E9-1-1" means the features and functions available in an enhanced 9-1-1 capable PSAP as defined by the FCC order.
(7) "FCC" means the Federal Communications Commission.
(8) "Next Generation 911" is defined by KRS 65.7621(17).
(9) "Nondisclosure agreement" means a signed statement whereby a person swears to maintain the confidentiality of designated information provided to them.
(10) "NRC" means nonrecurring cost.
(11) "P-ANI" means pseudo automatic number identification as defined by KRS 65.7621(21).
(12) "Phase I" means the interim step in implementing the wireless E9-1-1 network to include the provision of a caller's mobile phone number and P-ANI, and as further defined by the FCC.
(13) "Phase II" means the second step in implementing the wireless E9-1-1 network to include the functions of Phase I, and as further defined by the FCC.
(14) "RC" means recurring cost.
(15) "Sworn paid invoice" means a notarized statement submitted with invoices for reimbursement that:
(a) Lists the included invoices or other approved documentation;
(b) Attests that the invoices are accurate and reflect true costs for the carrier's implementation of wireless E9-1-1; and
(c) Is signed and dated by a person designated by a carrier.
(16) "Sworn statement" means a notarized letter signed and dated by a person designated by a PSAP, which may be given in lieu of documentation.
History
- RELATES TO: KRS 65.7621-65.7643, 9 U.S.C. 1-16, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7633(1)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7633(1) requires the Kentucky 911 Services Board to implement the provisions of KRS 65.7621 to 65.7643 through the promulgation of administrative regulations. This administrative regulation establishes definitions for terms used in 202 KAR Chapter 6.
- History: 26 Ky.R. 2104; eff. 12-7-2000; 46 Ky.R. 131, 894; eff. 9-10-2019.
202 KAR 6:020 CMRS provider cost recovery {#sec-202-kar-6-020 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:020}
Section 1. A provider shall file a cost recovery plan with the Kentucky 911 Services Board in order to receive reimbursement for NRCs and RCs.
Section 2. Cost Recovery Plan Submission.
(1) Upon receipt of a written request for wireless E911 service from a PSAP (public safety answering point) that has been certified by the board in accordance with KRS 65.7631(6)(a), the CMRS carrier shall:
(a) Acknowledge receipt of the request back to the PSAP within thirty (30) days; and
(b) Develop a comprehensive detailed plan for implementation of E911 service for:
-
The requesting PSAP; or
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The appropriate service area if the CMRS carrier's switch serves more than one (1) PSAP.
(2) A CMRS provider shall provide the technical aspects of the plan to the requesting certified PSAP. The CMRS provider shall submit the plan and the associated cost structure to the board, including a completed "Kentucky CMRS Provider Data Sheet". The board shall request from the provider, if necessary to reach a decision:
(a) Additional information; or
(b) A presentation.
(3) Only carrier costs directly attributable to wireless E911 call completion shall be considered for recovery, in accordance with Section 8 of this administrative regulation.
Section 3. Cost Recovery Plan Requirements. A plan submitted to the board shall contain the following information:
(1) The provider's good faith estimate of its total cost recovery reimbursement claim for providing wireless E911 service in the area served by the requesting PSAP or the appropriate service area for the carrier's switch;
(2) Specific detail for each NRC and RC the carrier expects to recover:
(a) An RC shall be described as subscriber-based or nonsubscriber-based; and
(b) An RC shall be based on a calendar month unless a provider chooses a different period on which to base its RCs. If a different period is chosen, the provider shall state the period used and the reasons for using that period;
(3) A description of the technology solution the CMRS provider has elected to implement and the projected implementation dates;
(4) A map or other detailed description of the coverage area affected by the plan;
(5) A list of the PSAPs affected by the provider; and
(6) The name and office of any individual who is authorized by the carrier to submit sworn paid invoices to the board for reimbursement.
Section 4. Cost Recovery Plan Approval.
(1) A cost recovery plan submitted to the Kentucky 911 Services Board shall be stamped "Confidential" and proprietary information received shall be filed and maintained so as to preserve its confidentiality in accordance with KRS 65.7639.
(2) A cost recovery plan submitted to the board shall be evaluated for conformity with the requirements established in Sections 2 and 3 of this administrative regulation, and shall be approved or disapproved within ninety (90) days of its receipt by a simple majority vote of the board.
(3) Within ten (10) business days of its approval or disapproval, notice of the decision shall be sent to the provider and affected PSAPs, in writing, by certified mail, return receipt requested.
Section 5. Rejection of a Cost Recovery Plan.
(1) If a plan is rejected, the board shall include with the decision specific reasons for its rejection.
(2) The carrier may submit a revised plan to the board.
(3) The provider may appeal the board's rejection in accordance with KRS Chapter 13B.
Section 6. Implementation of Additional Service Using an Approved Plan.
(1) After initial approval of a CMRS provider plan by the board, if the provider wishes to implement service to an additional area in the state using the existing approved plan, the carrier:
(a) Shall send a letter to the board, by certified mail, return receipt requested, proposing the provider's intention to use an approved plan for the implementation of additional service;
(b) Shall include with the letter to the board a map of the area to be served by the planned additional implementation; and
(c) Need not make an additional presentation to the committee if the board agrees that the provider's intention fits within the existing approved plan.
(2) The board shall:
(a) Decide within ninety (90) days of its receipt of the provider's letter if it agrees that the provider's intention to use an approved plan is appropriate for the additional service implementation;
(b) Within ten (10) business days of its decision, notify the provider, in writing, by certified mail, return receipt requested; and
(c) Accept the cost recovery outlined in the approved plan as sufficient to submit a claim for reimbursement.
(3) If the board concludes that the inclusion of the additional service implementation is not appropriate under the approved plan, the board shall:
(a) Within ten (10) business days of its decision, notify the provider, in writing, by certified mail, return receipt requested, identifying its specific concerns; and
(b) Schedule the earliest possible date to meet with the carrier and discuss the identified concerns.
(4) If the board concludes that the inclusion of the additional service implementation is not appropriate under the approved plan, the provider may appeal the board's decision in accordance with KRS Chapter 13B.
Section 7. Revision of an Approved Plan.
(1) In addition to the process established in Section 6 of this administrative regulation, after a cost recovery plan is approved, a subsequent change may be requested by either the CMRS provider or the board.
(2) The board may review an existing plan and request re-substantiation, new documentation, and reapproval of an existing cost recovery plan, or may revoke approval of a plan as necessary, to maintain the integrity of:
(a) The wireless E911 system as new technologies are deployed; and
(b) The CMRS fund.
(3) A provider may submit a revised plan or a change in reimbursement rate as business needs and new technologies dictate.
(4) The party requesting revision of a plan shall send written notice of the requested changes to the other party by certified mail, return receipt requested.
(5) An existing approved plan shall remain in effect until a review and decision regarding a requested change is made.
(6) Except as stated in subsection (7) of this section, if the board revokes approval of a plan, reimbursements from the CMRS fund shall cease immediately, except for RCs and NRCs for which the carrier is obligated by a previously signed contract.
(7) Failure of a carrier to respond in writing to a board request within the time frame indicated in the request, may be considered cause for the board to revoke approval of a previously approved plan and to cease reimbursement payments to the carrier.
Section 8. Appropriate Costs for Recovery.
(1) For the purpose of differentiating between CMRS carrier costs and PSAP costs, the point of demarcation shall be the selective router of the contracted wireline E9-1-1 service provider, or similarly placed functional equipment within the E9-1-1 call completion hierarchy. The board shall determine, based upon industry standards, what equipment is to be considered "similarly placed functional equipment".
(2) Recoverable RCs and NRCs shall include:
(a) Trunking;
(b) Connection fees between carrier switches or other interface equipment to a selective router;
(c) Facilities: T-1's, selective router ports;
(d) Routing charges;
(e) Operations;
(f) Engineering;
(g) Switch upgrades;
(h) Network design;
(i) Test plan development;
(j) P-ANI administration;
(k) Database management;
(l) Reporting requirements;
(m) Software required for the operation of wireless E-911;
(n) Call counting;
(o) Amortization and carrying costs;
(p) Costs of complying with CMRS audit; and
(q) Other costs attributed to wireless E911 call completion and approved by the board. The CMRS provider shall provide full rationale for other costs submitted.
(3) Submission of costs for activities that occurred more than twenty-four (24) months prior to submission of an invoice by the carrier to the Kentucky 911 Services Board shall not be reimbursed.
Section 9. Use of Reimbursed Funds. A CMRS carrier shall use money received from the CMRS fund only for those expenditures and purposes authorized in KRS 65.7631(3), listed in invoices accepted by the board and as previously authorized in an approved cost recovery plan.
Section 10. Claims for Reimbursement.
(1) After a cost recovery plan is approved, a CMRS provider may file a claim for reimbursement of NRCs and RCs defined in the plan by submitting an invoice or other documentation, as defined in the plan.
(2) An invoice submitted by a CMRS provider that is consistent with the then-current approved plan shall be paid by the board.
(3) A carrier may appeal a rejected invoice in accordance with KRS Chapter 13B.
(4) The board shall suspend payment of a claim, including a claim previously approved but unpaid by the board, from a carrier who fails to comply with the requirements for remittance as specified by KRS 65.7635, until the carrier complies.
Section 11. Amount of Reimbursement.
(1) The amount of payments by the board to a carrier shall be determined by one (1) of the following methods, as set out in the approved cost recovery plan:
(a) By submission of NRCs necessary for the realization of the carrier's approved plan and actually incurred by the carrier;
(b) By submission of the predefined calendar period's nonsubscriber-based RCs;
(c) By submission of the predefined calendar period's subscriber-based RCs; or
(d) By a combination of methods in paragraphs (a), (b), and (c) of this subsection, as previously approved by the board.
(2) To document costs requested to be reimbursed, a carrier shall submit:
(a) A sworn paid invoice for actual costs or purchases from other vendors or suppliers; and approved documentation for internal costs (e.g., time slips for actual work performed by the carrier's employees) sufficient to establish the internal costs as reasonable and necessary; or
(b) other appropriate documentation approved by the board as part of the cost recovery plan.
(3) The subscriber count reported monthly by a carrier with the CMRS fund remittance and reporting process shall be used to determine the total for subscriber-based RCs. The subscriber count shall be subject to audit by the board, in accordance with KRS 65.7629(13).
Section 12. Payment Frequency. At least once per calendar quarter, the Kentucky 911 Services Board shall approve and pay claims submitted by carriers for reimbursement that are consistent with approved cost recovery plans.
Section 13. Prorated Payments. If the board determines that the total amount of invoices submitted by CMRS carriers and approved by the board exceeds the amount of revenue in the fund in a month or other payment period, the board shall pay a prorated share of the available funds to carriers who have submitted board-approved invoices for the relevant period. The priority of payment shall be as follows:
(1) The balance of approved unpaid invoices, including additional carrying charges at a rate established in the approved plan, shall be paid first; and
(2) Current invoices approved by the board shall then be paid.
Section 14. Amortization of Costs.
(1) Nonrecurring costs may be amortized over a period not longer than twenty-four (24) months, until the amounts claimed for NRCs are fully recouped by the CMRS carrier.
(2) The board may reject a cost recovery plan or revised cost recovery plan if the amortization period of NRCs selected by the carrier is not long enough to ensure adequate monthly surcharge revenues with which to meet the carrier's monthly reimbursement demands.
(3) The interest rate for carrying unreimbursed NRCs shall be established and fully documented in the carrier's cost recovery plan.
(4) The actual cost of borrowing to fund NRCs shall be a legitimate recoverable RC.
(5) Only NRCs shall be amortized.
Section 15. Sunset of 202 KAR 6:020. Pursuant to KRS 65.7631(3)(b), enforcement of this administrative regulation shall sunset upon final payment of all outstanding carrier cost recovery obligations incurred by tier III CMRS providers from June 30, 2011, to January 1, 2016.
Section 16. Incorporation by Reference.
(1) "Kentucky CMRS Provider Data Sheet" (07/09/2007) is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky 911 ServicesBoard, 200 Mero Street, Frankfort, Kentucky 40622, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 65.7621-65.7643, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7633(1)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7631(3) requires the Kentucky 911 Services Board to distribute a portion of the revenues deposited into the CMRS fund to CMRS providers (carriers) licensed to do business in the Commonwealth, solely for the purpose of reimbursing the actual expenses incurred by the CMRS providers in complying with the wireless E911 service requirements established by the FCC order and any rules and regulations which are or may be adopted by the Federal Communications Commission in carrying out the FCC order. KRS 65.7633(1) requires the Kentucky 911 Services Board to promulgate administrative regulations to implement KRS 65.7621 to 65.7643. This administrative regulation establishes the process by which CMRS carriers may obtain cost recovery for those expenses.
- History: 26 Ky.R. 2105; Am. 27 Ky.R. 68; 1770; eff. 12-7-2000; 29 Ky.R. 1010; 1524; eff. 12-18-2002; 33 Ky.R. 4214; 34 Ky.R. 233; eff. 8-31-2007; 46 Ky.R. 133, 895; eff. 9-10-2019.
202 KAR 6:030 Confidential and proprietary information {#sec-202-kar-6-030 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:030}
Section 1. Identification of Confidential or Proprietary Information.
(1) Information identifying subscribers shall be held confidential, as proprietary information belonging to the disclosing CMRS provider, by the board and each of its employees. Identifying information shall include a subscriber's:
(a) Name;
(b) Telephone number; and
(c) Billing address.
(2) A CMRS provider, PSAP, board-contracted entity, or local exchange carrier (LEC) shall explicitly and clearly mark as confidential, prior to submission, information supplied and regarded by the provider, PSAP, board-contracted entity, or LEC as proprietary.
(3) The board shall not regard as confidential or proprietary the identification of a provider or LEC or a subsidiary of either.
Section 2. Allowable Uses of Confidential and Proprietary Information. The use of confidential or proprietary information shall be strictly limited to:
(1) Disburse funds as provided in KRS 65.7631(1), (2), (3), (4), and (5);
(2) Discharge the duties of the board and its agents as provided in KRS 65.7629(1), (3), (8), (12), (13)(a), and (16);
(3) Process revenues remitted to the board by CMRS providers; and
(4) Manage calls by PSAPs in accordance with KRS 65.7639.
Section 3. Management of Confidential and Proprietary Information in the Possession of the Board.
(1) The board shall instruct, in writing, all board personnel, agents of the board, and PSAPs as to the proper management and uses of confidential and proprietary information.
(2) A nondisclosure agreement shall be signed by each board member, employee, and agent of the board who may handle or possess information deemed confidential or proprietary.
(3) Material deemed confidential or proprietary shall be specifically and clearly identified by the board.
(4) Only persons specifically authorized by the board shall open board correspondence. Correspondence received by postal mail, electronic mail, or facsimile and opened by an unauthorized person shall:
(a) Not be copied;
(b) Be immediately returned to its container; and
(c) Immediately forwarded to the board.
(5) Proprietary and confidential information in the possession of the board, a member, agent, or any other person or entity shall be stored in a secure room, vault, or container. The room, vault, or container shall be kept locked when unattended or outside of normal business hours. Electronic files containing confidential or proprietary information shall be secured utilizing established mainframe protocols, stand alone servers, secured sockets, or password protected desktop applications, as appropriate.
(6) Access to confidential and proprietary information shall be limited to persons specifically authorized by KRS 65.7639.
(7) Each copy of confidential or proprietary information may be distributed as necessary for the efficient discharge of board duties and responsibilities.
(a) Copies shall be explicitly and clearly marked as confidential.
(b) A person possessing copies of documents containing confidential or proprietary information shall be responsible for document security.
(c) A copy no longer required shall be:
-
Returned to the board immediately; or
-
Destroyed immediately in such a manner as to prevent its reconstruction.
(8) An original record or file no longer needed for processing shall be:
(a) Sealed securely, retaining the notice of confidentiality, and transferred:
-
To a facility accessible only to the board administrator; or
-
With board approval, to the state archival and record storage center;
(b) With board approval, destroyed; or
(c) Returned to the proprietor.
Section 4. Breaches of Security.
(1) The board shall take immediate action to determine the cause, impact, and persons involved in a security violation of the confidential information entrusted to the board.
(2) Unauthorized access to confidential or proprietary information shall be promptly reported to the board in writing.
(3) A report of a security breach shall include a description of the incident, specific identification of the information disclosed, identification of each person who accessed the records, and the purposes for which access was obtained.
(4) The board shall notify an affected party immediately, providing a copy of the written report detailing the incident.
(5) A board member, agent, or employee who willfully or negligently disregards a provision of this administrative regulation shall be dismissed or requested to resign.
(6) If a PSAP or its employee willfully or negligently disregards a provision of this administrative regulation, the board shall decertify the PSAP.
(7) A board member, agent, or employee who has been dismissed or asked to resign for willful or negligent disregard of the provisions of this administrative regulation may appeal the dismissal in accordance with KRS Chapter 13B.
(8) A PSAP that has been decertified for willful or negligent disregard of the provisions of this administrative regulation may appeal the decertification in accordance with KRS Chapter 13B.
History
- RELATES TO: KRS 65.7621-65.7643, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7633(1), 65.7639
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7633(1) requires the Kentucky 911 Services Board to implement the provisions of KRS 65.7621 to 65.7643 through the promulgation of administrative regulations. In order to comply with KRS 65.7629, 65.7639, and administrative regulations promulgated by the Kentucky 911 Services Board, it is necessary that the board and PSAPs (public safety answering points) certified by the board obtain proprietary information. KRS 65.7639 protects such information and governs the form and manner of its release to others. This administrative regulation establishes the procedures by which the board shall ensure the security of confidential or proprietary information.
- History: 26 Ky.R. 2108; Am. 27 Ky.R. 70; 1771; eff. 12-7-2000; 33 Ky.R. 4217; 34 Ky.R. 235; eff. 8-31-2007; 46 Ky.R. 136; eff. 9-10-2019.
202 KAR 6:050 PSAP certification {#sec-202-kar-6-050 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:050}
Section 1. Phase I Certification.
(1) Certification of a PSAP by the board implies that the board has examined the operation and infrastructure of the requesting PSAP and determined that it is capable of complying with the requirements for handling wireless E9-1-1 calls.
(2) The board shall:
(a) Provide for increasing integrity in E9-1-1 systems statewide; and
(b) Coordinate and assist in the implementation of new technology in the operation of emergency telecommunications in the state.
(3) A PSAP seeking certification shall send to the board the following:
(a) A completed "Kentucky 911 Services Board PSAP Certification Application";
(b) A copy of:
-
Documentation which establishes the PSAPs authority to establish 9-1-1 service in accordance with KRS 65.760;
-
A list of the public safety agencies served by the requesting PSAP and a copy of any agreement between the PSAP and the designated agencies;
-
Any agreement between the requesting PSAP and the contracted wireline E9-1-1 service provider; and
-
A printed map detailing the PSAP service boundary.
(c) A description of:
- The mapping and addressing applications including:
a. The location of each database;
b. How each database is maintained; and
c. Who maintains each database.
-
The network and its characteristics currently or proposed to be in use by the PSAP; and
-
Call transfer functions in the PSAP.
(d) Documentation of:
-
Sworn statements that telecommunicators and PSAP management have signed nondisclosure agreements regarding confidential information accessible by them;
-
The disaster recovery application used by the PSAP including:
a. Default routing and alternate routing of call applications or other contingency applications for rerouting calls in the event of system failure;
b. Type of backup power equipment installed; and
c. Evacuation and relocation applications.
-
Seven (7) digit service for administrative non-emergency service;
-
Telecommunications devices for the deaf and hard of hearing in the PSAP;
-
A certificate or sworn statement that telecommunicators employed by the PSAP that handles wireless E9-1-1 calls meet the training requirements as required by law; and
-
The PSAP's standard operating procedures for the handling of wireless E9-1-1.
(e) A description of:
-
The PSAP's ability or anticipated ability to handle the data elements associated with wireless E9-1-1 calls; and
-
The anticipated use of the CMRS funds, in accordance with KRS 65.7631.
(4) Subsection (3)(b)1. of this section shall not prohibit the Kentucky State Police from establishing a public safety answering point as otherwise permitted by law.
(5) After its initial review, the board shall:
(a) Require submission of other necessary documentation; and
(b) Schedule an on-site inspection by a member or members of the board or advisory council.
Section 2. Application for Certification.
(1) An application for certification shall be stamped "Confidential." Proprietary information received by the board shall be filed and maintained so as to maintain its confidentiality in accordance with KRS 65.7639 and 202 KAR 6:030.
(2) The board shall evaluate an application for adherence and compliance with all requirements, standards, and guidelines listed in the Kentucky 911 Services Board PSAP Certification Application within ninety (90) days of receipt. Board action on the application shall be determined by a simple majority vote.
(3) Within ten (10) business days of its decision, written notice of the board's approval or disapproval of an application shall be sent to the PSAP.
(4) If an application for PSAP certification is disapproved:
(a) The board shall:
-
State in its written notice of decision the specific reason for rejection; and
-
Schedule a meeting with the PSAP applicant to resolve identified problems.
(b) The PSAP may:
-
Submit a revised application to the board for its review and approval or disapproval, following the procedure set out in Sections 1 and 2 of this administrative regulation; or
-
Appeal the board's rejection in accordance with KRS Chapter 13B.
Section 3. Revision of an Approved Application.
(1) After an application is approved, subsequent changes may be requested by either the PSAP or the board.
(2) The board may review an existing certification and request re-substantiation and re-approval of an application if necessary:
(a) To maintain the integrity of the wireless E9-1-1 system;
(b) To implement Phase II as specified by the FCC; or
(c) If the board becomes aware of changes or deficiencies that have occurred at a PSAP.
(3) New or revised requirements specified by the board shall be applied to all PSAPs, upon written notice, within a reasonable period, not to exceed ninety (90) days.
(4) A party requesting revision of an application shall send written notice of the requested changes to the other party.
(5) An existing and approved application shall remain in effect until the board has notified the PSAP of its decision on the proposed changes.
(6) The board shall review a request for revision under the procedure designated in Sections 1 and 2 of this administrative regulation.
(7) The board shall decertify a previously approved application and shall discontinue payments to a PSAP, if the PSAP fails, without good cause, to respond in writing to a board request within the time period specified in the request.
Section 4. Phase II Certification. If the evolving technology necessary to implement Phase II requires additional enhancements to a PSAP's operation, the board shall:
(1) Seek additional documentation and substantiation of a PSAP's continuing ability to handle E9-1-1 calls; or
(2) Impose more stringent requirements to receive or maintain certification.
Section 5. Decertification of a PSAP.
(1) The board shall decertify a PSAP if the PSAP:
(a) Has used funds for purposes other than as prescribed by KRS 65.7631 and 202 KAR Chapter 6; or
(b) Has not maintained or purchased the necessary technology or infrastructure to comply with evolving requirements.
(2) A PSAP that has been decertified may appeal the decertification in accordance with KRS Chapter 13B.
Section 6. Incorporation by Reference.
(1) "Kentucky 911 Services Board PSAP Certification Application", 04/01/2019, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky 911 Services Board, 200 Mero Street, Frankfort, Kentucky 40622, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 65.760, 65.7621-65.7643, 9 U.S.C. 1-16, 42 U.S.C. 12101, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7631(6)(a), 65.7633(1)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7631(6)(a) states that no PSAP shall be eligible to request or receive a disbursement from the CMRS fund unless and until the PSAP is expressly certified as a PSAP by the Kentucky 911 Services Board, upon written application to the Kentucky 911 Services Board. KRS 65.7633(1) requires the Kentucky 911 Services Board to implement the provisions of KRS 65.7621 to 65.7643 through the promulgation of administrative regulations. This administrative regulation establishes the process by which a PSAP shall establish and maintain eligibility for disbursement from the CMRS fund.
- History: 26 Ky.R. 2109; Am. 27 Ky.R. 70; 1772; eff. 12-7-2000; TAm eff. 8-31-2007; 46 Ky.R. 138, 897; eff. 9-10-2019.
202 KAR 6:060 PSAP pro rata fund disbursement {#sec-202-kar-6-060 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:060}
Section 1. Revenues Collected by the Kentucky 911 Services Board.
(1) Monthly revenues remitted to the CMRS Board after March 31, 2000 shall be disbursed to PSAPs (public safety answering points) in quarterly payments.
(2) Any PSAP that is certified by the end of a calendar quarter shall be eligible to receive a pro rata share of funds collected during that quarter. Payments shall be made within forty-five (45) days of the end of each calendar quarter.
History
- RELATES TO: KRS 65.7621-65.7643, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7633(2)(c)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7633(2)(c) requires the Kentucky 911 Services Board to establish procedures and guidelines for reviewing, evaluating, and approving or disapproving disbursements under KRS 65.7631(3), (4), and (5) from the CMRS fund and requests for disbursements. This administrative regulation establishes the pro rata fund disbursement process.
- History: 26 Ky.R. 2112; Am. 27 Ky.R. 72; 1773; eff. 12-7-2000; 33 Ky.R. 4218; 34 Ky.R. 236; eff. 8-31-2007; 46 Ky.R. 140, 898; eff. 9-10-2019.
202 KAR 6:070 PSAP workload fund disbursement {#sec-202-kar-6-070 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:070}
Section 1. Revenues Collected by the Kentucky 911 Services Board.
(1) Wireless workload revenues remitted to the CMRS Board during a calendar quarter shall be disbursed in one (1) payment to PSAPs (public safety answering points) within 120 days of the end of that same calendar quarter.
(2) Each PSAP certified by the end of a calendar quarter shall be eligible for a disbursement of funds received during that same calendar quarter.
Section 2. Determination of the Zip Codes or Portions thereof in a PSAP's Jurisdiction.
(1) Upon initial certification, the board shall submit to each PSAP a list of zip codes within the PSAP's jurisdiction. A zip code with at least three (3) percent of its total area in a jurisdiction shall be included in the list. Percentage allocation shall be determined by the Commonwealth Office for Technology, Division of Geographic Information, and communicated to the board.
(2) If three (3) percent or more of a zip code's geographic area is in more than one (1) PSAP's jurisdiction, the Kentucky 911 Services Board shall adjust the allocation determined by the Commonwealth Office for Technology so that the percentage of zip code area allocated to the PSAP shall be equivalent to the percentage of CMRS connections within the zip code area.
(3) Within forty-five (45) days of receipt of the zip code list from the Kentucky 911 Services Board, each PSAP shall acknowledge, in writing to the Kentucky 911 Services Board whether the list of zip codes in the PSAP's jurisdiction is correct and complete.
(4) Within forty-five (45) days of receipt of the zip code list from the Kentucky 911 Services Board, a PSAP may dispute zip code or percentage allocations by notifying the board and any other PSAP affected by the dispute, in writing, of the disputed zip code.
(a) Within five (5) working days of receipt of a notice of dispute, the board shall notify each PSAP affected by the dispute. The affected PSAPs shall:
-
Negotiate a mutually agreeable resolution to the identified problem; and
-
Notify the Kentucky 911 Services Board of the result.
(b) If within the following thirty (30) days the Kentucky 911 Services Board is not notified of a mutually-agreeable resolution between the affected PSAPs, the board shall determine the percentage of the identified zip code to be allocated to each PSAP.
(5) A PSAP may request a change to a previously-approved zip code allocation by submitting a written request to the Kentucky 911 Services Board and the other affected PSAPs no later than thirty (30) days after the end of a calendar quarter.
(a) Within five (5) working days of receipt of a request, the board shall notify each affected PSAP. The affected PSAPs shall:
-
Negotiate a mutually-agreeable resolution to the requested change; and
-
Notify the Kentucky 911 Services Board of the result.
(b) If, within the following thirty (30) days, the board is not notified of a mutually-agreeable resolution between the affected PSAPs, the board shall determine the percentage of the zip code to be allocated to each PSAP.
(6) A PSAP may appeal the final allocation of a zip code assignment in accordance with KRS Chapter 13B.
Section 3. Calculation of Individual PSAP Disbursements Under the PSAP Wireless Workload Formula.
(1) Within ninety (90) days after the end of calendar quarter, the board shall determine a value for each CMRS connection by dividing the total amount of funds remitted to the board during the collection period established for this disbursement by the total number of CMRS connections, as submitted in a quarterly report by CMRS providers.
(2) The board shall multiply the value for each connection by the number of connections in each zip code, as reported in the quarterly reports by the CMRS providers.
(3) The Kentucky 911 Services Board shall divide the disbursement for a zip code that crosses a PSAP jurisdictional boundary according to the percentages established in Section 2 of this administrative regulation.
(4) A PSAP's workload disbursement shall consist of the total amounts for all zip codes or percentage of zip codes whose areas are served by a PSAP, as determined by subsections (2) and (3) of this section.
(5) Disbursement amounts attributed to zip codes whose allocation of CMRS connections is disputed by a PSAP shall be reserved by the board in the PSAP volume account until an allocation for that zip code is determined.
(a) Disputed funds shall remain in the CMRS fund accounts until disbursed.
(b) Interest accrued by disputed funds shall be deposited in the CMRS Fund and thereafter distributed in accordance with KRS 65.7631.
(c) Upon resolution of a dispute, the reserved funds shall be disbursed to the PSAPs with the next regular workload fund disbursement. .
History
- RELATES TO: KRS 65.7621, 65.7627, 65.7629(5)-(8), 65.7631(5), 65.7643, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7633(2)(c)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7633(2)(c) requires the Kentucky 911 Services Board to establish procedures and guidelines for reviewing, evaluating, and approving or disapproving disbursement from the CMRS Fund and requests for disbursements under KRS 65.7631(3), (4), and (5). This administrative regulation establishes the wireless workload fund disbursement process.
- History: 28 Ky.R. 1269; Am. 1613; eff. 1-14-2002; 33 Ky.R. 4220; 34 Ky.R. 236; eff. 8-31-2007; 46 Ky.R. 141, 898; eff. 9-10-2019.
202 KAR 6:080 CMRS surcharge remittance and reporting {#sec-202-kar-6-080 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:080}
Section 1. Remittance of postpaid and Lifeline CMRS Surcharge.
(1) A CMRS provider shall remit to the Kentucky 911 Services Board the CMRS surcharge for postpaid and Lifeline subscribers on form "Provider Remittance Report", incorporated by reference, and also available on the web page at https://911board.ky.gov.
(2) At least ninety (90) calendar days before implementation of a change in remittance procedure, the board shall notify each provider of the change. Notice shall include copies of required forms and instructions for their completion.
(3) The board shall:
(a) Upon request of a provider, provide copies of required forms and instructions for their completion; and
(b) Maintain on the Web site https://911board.ky.gov, a copy of the form and instructions in current use.
Section 2. Remittance of prepaid CMRS Surcharge. The prepaid service charge imposed by KRS 65.7634 shall be collected by the retailer from the purchaser at the time of purchase and remitted to the Department of Revenue as provided in KRS 142.100 to 142.135.
Section 3. Quarterly Report of CMRS Connections in a Zip Code.
(1) Each provider or reseller shall submit to the Kentucky 911 Services Board a quarterly report of the number of postpaid, prepaid, and Lifeline CMRS connections served by them for the previous three (3) months of the reporting periods ending March 31, June 30, September 30, and December 31.
(2) Each quarterly report shall list for each zip code served by the provider and located at least partially in Kentucky, the number of CMRS postpaid, prepaid, and Lifeline connections billed by them in each month of the reporting period.
(3) The Provider Remittance Report shall be sorted by zip code and submitted in a format as designated by the Kentucky 911 Services Board. The board shall maintain on the Web site https://911board.ky.gov, a copy of the form and instructions in current use.
(4) A reseller shall include:
(a) A list of the CMRS providers on whose network they resell service; and
(b) The number of CMRS connections on each network.
(5) The report shall be due at the Kentucky 911 Services Board office no later than sixty (60) days following the end of the reporting month.
Section 4. Required Reports Regarding Resellers of CMRS Service.
(1) A provider who contracts with a reseller of wireless service shall submit to the CMRS Board a quarterly report listing each vendor reselling wireless service on the provider's network.
(2) The quarterly report shall:
(a) Be submitted to the board no later than sixty (60) days after the end of the calendar months of March, June, September, and December;
(b) Include the reseller's:
-
Business name;
-
Business address;
-
Contact person;
-
Telephone numbers; and
-
E-mail address; and
(c) Include the number of CMRS connections receiving service on the provider's network and billed by the listed reseller.
Section 5. Provider Failure to Comply with Reporting and Remittance Requirements.
(1) A provider's failure to comply with the requirements of this administrative regulation shall constitute cause for the board to suspend cost recovery payments to the provider.
(2) A cost recovery payment shall be suspended only if authorized by a majority vote of the Kentucky 911 Services Board.
(3) The board shall not consider suspension of payment to a provider unless the provider has been:
(a) Notified in writing of the failure to comply with a stated provision of this administrative regulation; and
(b) Allowed ten (10) days from receipt of notice in which to respond.
(4) The provider may appeal the board's suspension of cost recovery payments, in accordance with KRS Chapter 13B.
Section 6. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Provider Remittance Report", 3/20/2019; and
(b) "Bank Routing and Account", 6/2001.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky 911 Services Board, 200 Mero Street, Frankfort, Kentucky 40622, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 65.7621, 65.7627, 65.7629(3)-(9), (13), 65.7631, 65.7634, 65.7635, 65.7636, 65.7639, 65.7643, 142.100-142.135, 9 U.S.C. 1-16, 47 U.S.C. 153(27), 332(d), FCC Order Docket #94-102, 1996
- STATUTORY AUTHORITY: KRS 65.7633(1)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7631(5) requires the Kentucky 911 Services Board to collect surcharges from every prepaid, postpaid and Lifeline CMRS connection in the Commonwealth and to distribute a portion of the revenues deposited into the CMRS fund to Board-certified PSAPs, based in part on their workload in complying with the wireless E911 service requirements established by the FCC order. KRS 65.7633(1) requires the Kentucky 911 Services Board to promulgate administrative regulations to implement the provisions of KRS 65.7621 to 65.7643.This administrative regulation establishes the process by which point of sale retailers of prepaid wireless communication services, and CMRS providers and their resellers of prepaid, postpaid and Lifeline CMRS connections remit surcharges and report the information necessary to collect the remittances and to calculate the required disbursements.
- History: 28 Ky.R. 1271; Am. 1614; eff. 1-14-2002; TAm eff. 8-31-2007; 45 Ky.R. 143, 899; eff. 9-10-2019.
202 KAR 6:090 Allowable expenditures by public safety answering points (PSAPs) using the commercial mobile radio service emergency telecommunications (CMRS) fund {#sec-202-kar-6-090 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:090}
Section 1. Definitions.
(1) "AVL" means automatic vehicle location systems used to track emergency responder vehicles.
(2) "CAD" means computer aided dispatch systems used by 911 personnel to allocate and track emergency responder resources during a 911 call.
(3) "ECC" means an emergency call center.
(4) "EMS" means emergency medical system, which includes paramedics, emergency medical technicians, and other personnel and equipment used to respond to medical emergencies.
(5) "GIS" means Geographic Information Systems used to create, maintain, and manage graphic location data for use by PSAPs or services routing emergency calls to PSAPs.
(6) "LINK/NCIC" means the Law Enforcement Information Network of Kentucky and the National Crime Information Center, two (2) systems commonly used by law enforcement and emergency communications personnel for short messaging between agencies and to request vehicle, driver, and criminal history checks.
(7) "MSAG" means Master Street Address Guide, the database used by 911 centers to determine an emergency call's initial location.
(8) "Paging" means a hardware or software service originating in the PSAP that:
(a) Notifies first responders in the field; and
(b) Reflects hardware, software, or interface that connects with the CAD to notify first responders in the field.
(9) "PSAP" is defined by KRS 65.7621(23).
(10) "VoIP" means voice over internet protocol.
Section 2. Allowed 911 Center Operational Expenditures.
(1) Personnel costs. Costs related to employees as established in paragraphs (a) and (b) of this subsection, to the extent the employees' duties are directly attributable to delivery of 911 service, shall be allowed.
(a) Positions allowed shall include:
-
Director;
-
Supervisor;
-
Dispatcher;
-
Call-taker;
-
Technical staff;
-
Support staff; and
-
Other staff involved in the provision of 911 service.
(b) Associated costs allowed shall include:
-
Salaries;
-
Fringe benefits;
-
MSAG coordination;
-
Uniforms; and
-
Addressing or database development and management.
(2) Facility costs. Facility costs for the following expenses, to the extent expenses are directly attributable to delivery of 911 service, shall be allowed:
(a) Capital improvements for construction, remodeling, or expansion;
(b) Lease or rental payments;
(c) Utilities;
(d) Heating and air conditioning;
(e) Fire suppression systems;
(f) Security systems;
(g) Cleaning and maintenance;
(h) Emergency power and uninterruptible power equipment;
(i) Insurance;
(j) Office supplies;
(k) Printing and copying services; and
(l) Furniture.
(3) Training and memberships. Training and memberships in professional associations shall be allowed to the extent the training and memberships are directly attributable to the enhancement of knowledge, skills, and abilities of 911 personnel in the provision of 911 service, including:
(a) Vendor provided training;
(b) Conferences;
(c) Necessary travel and lodging;
(d) On-the-job training; and
(e) Memberships in 911 related associations, such as the Association of Public Communications Officials, or the National Emergency Number Association.
(4) Hardware, software, and peripheral equipment. Costs for the following equipment shall be allowed to the extent the equipment's function is directly attributable to the provision of 911 service, whether on the premises or remotely located:
(a) 911 controllers, telephone equipment, or software;
(b) 911 trunks or administrative lines for the PSAP;
(c) Remote 911 hardware or modems;
(d) Automatic call distribution (ACD) systems or other call management facilities and software;
(e) Call-time stamping or other clock functions;
(f) Computer workstations;
(g) Telephone device for the deaf equipment;
(h) Voice and data recording systems;
(i) Radio systems, including consoles;
(j) CAD; GIS or mapping software, equipment, and services; paging; paging peripherals; and field communication equipment between first responders allowing connectivity to CAD to provide emergency communication to first responders in the field, or LINK/NCIC;
(k) Associated databases;
(l) Network connectivity;
(m) Software licenses;
(n) Maintenance or service agreements for equipment or software listed in paragraphs (a) through (p) of this subsection;
(o) Text or video to and from a PSAP/ECC; and
(p) VoIP.
(5) Vehicle costs. Vehicle costs for the following, either as reimbursement to an employee for the use of a private vehicle or direct costs for a vehicle assigned to the agency, shall be allowed to the extent the vehicle use is directly attributable to the provision of 911 service:
(a) MSAG and address development and maintenance;
(b) GIS verification and testing; and
(c) Public education.
(6) Professional services. Costs for the following professional services shall be allowed to the extent the services are directly attributable to the provision of 911 related service:
(a) Legal;
(b) Architectural;
(c) Auditing;
(d) Consultation; and
(e) GIS.
(7) Public education. Costs for public education regarding the proper use of 911 shall be allowed.
Section 3. Not Allowed 911 Center Operational Expenses.
(1) Personnel costs. Personnel costs for the following personnel shall not be allowed, except if directly functioning as 911 center staff:
(a) Law enforcement;
(b) EMS personnel;
(c) Fire personnel;
(d) Emergency management staff; and
(e) Shared support or technical staff.
(2) Facility costs. Facility costs for the following purposes and facilities shall not be allowed, except for that portion used for 911 operations:
(a) Capital and furnishing costs for facilities whose primary purpose is other than 911 operations;
(b) Facilities primarily intended for use by police, fire, EMS, or other emergency management personnel; and
(c) Facilities providing general offices for county or municipal government operations.
(3) Training and memberships.
(a) Costs for training for staff not directly involved in the delivery of 911 services or courses with content not intended to increase of the knowledge, skills, and abilities of 911 personnel in regard to delivery of 911 service shall not be allowed.
(b) Costs for memberships in organizations or associations with the primary purpose being other than public safety communications or 911 issues shall not be allowed.
(4) Hardware, software, and peripheral equipment. The following hardware, software, or peripheral equipment costs, unless directly attributable to the delivery of 911 service, shall not be allowed:
(a) Law enforcement, fire, EMS, or jail record management systems;
(b) Word processing, databases, and other general computer applications;
(c) GIS applications providing data layers not needed for the location of emergency calls, or other general mapping and location services for government operations;
(d) Court information systems;
(e) Field equipment used outside of the 911 center by emergency responders or other government personnel for radio, paging, mobile data, LINK/NCIC, CAD, or AVL systems;
(f) Connectivity for an application listed in paragraphs (a) through (e) of this subsection;
(g) A maintenance or service agreement for an application listed in paragraphs (a) through (e) of this subsection; and
(h) Software license for an application listed in paragraphs (a) through (e) of this subsection.
(5) Vehicle costs. The cost of an emergency response or other government vehicle not directly attributable to the delivery of 911 service shall not be allowed.
(6) Professional services. Costs for professional services not directly attributable to the delivery of 911 service shall not be allowed.
(7) Public education. Costs for public education not directly attributable to the delivery of 911 service shall not be allowed.
(8) Radio infrastructure costs shall not be allowed.
History
- RELATES TO: KRS 65.7621, 65.7627, 65.7629(3) - (9), (13), 65.7631, 65.7635, 65.7639, 65.7643, 47 C.F.R. 1, 9, 12, 20, 22, 25, 64, 9 U.S.C. 1 - 16, 47 U.S.C. 153(27), 332(d), FCC Order Docket #94-102, 1996
- STATUTORY AUTHORITY: KRS 65.7633(2)(c)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7633(2)(c) requires the Kentucky 911 Services Board to promulgate administrative regulations to establish guidelines to be followed by the board in reviewing, evaluating, and approving or disapproving disbursements from the CMRS fund and requests for disbursements under KRS 65.7631(3) through (5). KRS 65.7631(5) requires that disbursed funds shall be used solely for the purposes of answering, routing, and properly disposing of CMRS 911 calls, training PSAP staff, public education, and complying with the wireless E911 service requirements established by the FCC. This administrative regulation establishes requirements to be followed by the board in its review and evaluation of CMRS fund disbursement requests by local 911 centers.
- History: 29 Ky.R. 1160; Am. 1524; eff. 12-18-02; TAm eff. 8-31-2007; 46 Ky.R. 145, 900; eff. 9-10-2019; 50 Ky.R. 2098; 51 Ky.R. 266; eff. 11-5-2024.
202 KAR 6:100 PSAP Phase II certification {#sec-202-kar-6-100 omnilex-key=us-ky-regs-official--title-202--202 KAR 6:100}
Section 1. PSAPs not currently certified by the Kentucky 911 Services Board in accordance with 202 KAR 6:050 shall not be eligible for disbursement from the CMRS fund as provided in KRS 65.7631(6) until they successfully complete both the requirements established in 202 KAR 6:050 and Sections 5 through 7 of this administrative regulation.
Section 2. PSAPs Already Certified by the Kentucky 911 Services Board.
(1) In order to maintain continued eligibility for CMRS funds, PSAPs that are currently certified by the Kentucky 911 Services Board in accordance with 202 KAR 6:050 shall no later than September 1, annually submit:
(a) An updated PSAP Annual Survey, including any changes to the documentation supplied in their original Phase I Application; and
(b) Based on an actual tabulation of call traffic for at least the first week in each calendar quarter:
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A count of wireless 911 calls received by the PSAP for the previous fiscal year;
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A count of non-wireless 911 calls received by the PSAP for the previous fiscal year; and
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An accounting of the receipt and disbursement of funds used to operate the PSAP as provided in KRS 65.7630(3).
(2) Certified PSAPs shall:
(a) Make operational the hardware, software, and database necessary to receive and utilize the data elements associated with Phase II wireless E911 service;
(b) Notify the board, in writing, of their readiness to receive and utilize the data elements associated with Phase II wireless E911 service; and
(c) Supply to the board the following documentation:
-
An electronic copy of the digital maps of the PSAP's response area boundary and emergency service boundaries for law, fire, and emergency medical response, in accordance with subsection (3) of this section;
-
An electronic copy of the digital street centerlines that meets the mapping criteria in Section 3(1)(c) and Section 3(2) of this administrative regulation;
-
Beginning July 1, 2021, an electronic copy of the digital data set of all address site and structure points that meets the mapping criteria as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide;
-
Updated digital mapping data set layers monthly or at least quarterly, as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide;
a. Copies of return receipts and letters sent certified mail requesting Phase II service from all wireless carriers licensed to operate in the PSAP's jurisdiction response area; or
b. Documentation from a wireless carrier licensed to operate within the PSAP response area that Phase II service is operational or has been requested by the PSAP;
-
Evidence from the LEC, 911 service provider, and any contracted third party database services that all network elements necessary to the provision of Phase II wireless E911 service are operational; and
-
Evidence from hardware and software vendors that all hardware and software necessary to utilize Phase II calls is now operational.
(3) Digital maps of the PSAP's response area boundary and emergency service boundaries.
(a) The digital maps required by subsection (2)(c)1. of this section shall comply with the mapping criteria as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide.
(b) Updated electronic response boundary and emergency response boundaries shall be updated or validated at least quarterly.
(c)
-
If a PSAP's submitted jurisdictional or an emergency service boundary or boundaries conflicts with the jurisdictional or emergency service boundary or boundaries of another PSAP, the board shall notify all PSAPs affected by the dispute within five (5) working days.
-
The affected PSAPs shall:
a. Negotiate a mutually agreeable resolution to the identified problem; and
b. Notify the Kentucky 911 Services Board of the result.
-
If within the following thirty (30) days the Kentucky 911 Services Board is not notified of a mutually-agreeable resolution between the affected PSAPs, the board shall establish an arbitration panel that includes no fewer than three (3) members and includes GIS professionals and representatives of PSAPs certified for CMRS funding to determine the proper jurisdictional or emergency service boundary or boundaries.
-
A PSAP may appeal the final determination of a boundary in accordance with KRS Chapter 13B.
Section 3. Mapping Criteria. Regardless of the source of its data, a PSAP certified for CMRS funding shall be responsible for the accuracy of the geographic data and supporting databases used by the PSAP and those supplied to the Kentucky 911 Services Board.
(1) Maps in use by PSAPs shall include the following:
(a) PSAP response boundaries as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide;
(b) Emergency response boundaries for law, emergency medical service (EMS), and fire agencies within the PSAP response boundary as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide;
(c) Road centerlines that have been prepared and attributed with only items as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide;
(d) Beginning July 1, 2021, site and structure points as established in the Kentucky 911 Services Board Kentucky NG911 Mapping Guide; and
(e) Address data that is ninety (90) percent accurate upon audit as established in Section 4 of this administrative regulation.
(2) The geospatial positional accuracy of all geographic elements submitted shall be within thirty-three (33) feet of its true location, plus the accuracy of the device used to conduct the test, for ninety (90) percent of all tested sites.
Section 4. Geospatial Audit Requirements and Methodology.
(1) The Kentucky 911 Services Board shall audit the use and quality of geospatial data supplied by certified PSAPs. The PSAP is not responsible for the accuracy of data provided by wireless carriers.
(2) Audits shall be conducted:
(a) Utilizing equipment and methodology as approved and supplied by the Kentucky 911 Services Board or its designee and calibrated according to manufacturer's specifications; and
(b) Using testsapproved by the board which includes GIS professionals and representatives of PSAPs certified for CMRS funding.
(3) Audits shall verify that upon receipt of a wireless 911 call the PSAP's mapping component shall:
(a) Display the X, Y coordinates on digital base maps used by the PSAP;
(b) Identify the incoming 911 call on the map display; and
(c) Identify the closest assigned address to the X, Y coordinates provided.
(4) Each PSAP's mapping shall be tested for the accuracy of the GIS software and hardware used within the PSAP. A minimum of twenty (20) randomly-selected address points shall be tested in each PSAP response area. If a PSAP response area encompasses multiple counties, a sampling of a minimum of twenty (20) randomly-selected address points per county shall be tested. Tested locations shall:
(a) Be distributed across the PSAP response area to yield a valid cross section of urban and rural environments;
(b) Plot on the correct side of the street as shown on the base map data supplied by the PSAP;
(c) Plot within the correct cross streets as shown on the base map data supplied by the PSAP; and
(d) Plot within one-tenth (1/10) of a mile of their location on PSAP supplied base maps.
Section 5. Audit Results.
(1) The Kentucky 911 Services Board shall notify PSAPs, in writing, within ten (10) business days of audit results.
(2) If a PSAP fails to meet the audit requirements, the Kentucky 911 Services Board shall allow the PSAP ninety (90) days from receipt of the audit notification to remedy the identified problems.
(3) After receipt of the PSAP response, the board may schedule a reaudit.
(4) A PSAP shall be decertified for CMRS funding if it:
(a) Fails to remedy the problems identified by the board; or
(b) Fails a reaudit.
(5) The board shall notify the PSAP Director, in writing, return receipt requested, of its decision to decertify the PSAP.
Section 6. Appeals of Decertification.
(1) A PSAP may request a review of its decertification by submitting a request in writing, within thirty (30) days of receipt of a decertification notice.
(a) The decertification shall be suspended pending the review by the board.
(b) The board shall schedule the requested review at a regularly scheduled board meeting, no later than ninety (90) days after receipt of the PSAP request.
(c) The board shall notify the PSAP of the scheduled review date, in writing, at least thirty (30) days prior to the meeting.
(d) After the board's review, the board shall notify, in writing, the PSAP of its decision within ten (10) business days.
(2) A PSAP that has been decertified may further appeal its decertification in accordance with KRS Chapter 13B.
Section 7. Status of PSAP Funds During an Appeal.
(1) During a PSAP's appeal of its decertification, the PSAP's pro rata and workload payments shall be held in reserve in the appropriate CMRS fund account until resolution of all appeals by the PSAP.
(a) If the PSAP's appeal is successful, the reserved funds shall be disbursed to the PSAP with the next regular disbursement of each account.
(b) If the PSAP's appeal is unsuccessful, the reserved funds shall be disbursed to the remaining certified PSAPs with the next regular payments from each account in accordance with KRS 65.7631(5).
(2) All interest accrued by reserved funds shall be distributed among the normal CMRS accounts in accordance with KRS 65.7631.
Section 8. Incorporation by Reference.
(1) The Kentucky 911 Services Board "Kentucky NG911 Mapping Guide", 06/01/2019, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky 911 Services Board, 200 Mero Street, Frankfort, Kentucky 40622, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 65.7621-65.7643, 47 U.S.C. 153(27), 332(d)
- STATUTORY AUTHORITY: KRS 65.7631(6)(a), 65.7633(1)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 65.7631 (6)(a) states that no PSAP shall be eligible to request or receive a disbursement from the CMRS fund unless and until the PSAP demonstrates that the PSAP has made the investment which is necessary to allow the PSAP to receive and utilize the data elements associated with wireless E911 service. KRS 65.7633(1) requires the Kentucky 911 Services Board to implement the provisions of KRS 65.7621 to 65.7643 through the promulgation of administrative regulations. This administrative regulation establishes the process by which a PSAP shall demonstrate its ability to receive and utilize the data elements associated with wireless E911 and Next Generation 911 (NG911) service.
- History: 30 Ky.R. 513; Am. 907; 1208; eff. 12-5-2003; 33 Ky.R. 4221; 34 Ky.R. 238; eff. 8-31-2007; 46 Ky.R. 147, 902; eff. 9-10-2019.
Chapter 7 Kentucky Board of Emergency Medical Services
202 KAR 7:010 Definitions for 202 KAR Chapter 7 {#sec-202-kar-7-010 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:010}
Section 1. Definitions.
(1) "Abandonment" means:
(a) Leaving the physical presence of a patient, once care is initiated, without assuring the presence of appropriately qualified personnel who is certified at or above the level of the original caregiver who continues or maintains care;
(b) Failure to physically transfer documents or other information relating to the condition or care of a patient to ambulance services, medical facilities or appropriately qualified personnel assuming care for a patient;
(c) Failure to communicate to ambulance services, medical facilities or appropriately-qualified personnel assuming care for a patient, information pertinent to the physical findings or care of a patient while in the care of a first responder, EMT, or paramedic; or
(d) Other act that fails to maintain the continuity of care for a patient that is or has been in the care of a first responder, EMT, or paramedic.
(2) "ACLS" means holding a certificate of completion in advanced cardiac life support.
(3) "Adjunct faculty" means a person, who is determined by an EMS-TEI to be uniquely qualified by experience or training in a field that relates to a prehospital discipline.
(4) "AHA" means American Heart Association.
(5) "Airline transport pilot" or "ATP" means a pilot that has received a certificate from the FAA that denotes the highest level of achievement that a pilot may attain.
(6) "Air medical communications specialist" or "ACS" means a person trained in the air medical communications environment that is appropriate to the mission of the air ambulance service.
(7) "ALS" means advanced life support.
(8) "ALS patient contact" means interaction with a patient, where an advanced level patient assessment is conducted that utilizes skills or techniques that are beyond the scope of practice for an EMT.
(9) "ASHI" means American Safety and Health Institute.
(10) "ATLS" means holding a certificate of completion in advanced trauma life support.
(11) "Base station" means the primary physical location of the ambulance service.
(12) "BLS" means basic life support.
(13) "BTLS" means holding a certificate of completion in basic trauma life support.
(14) "CCEMTP" means the Critical Care Emergency Transport Program conducted by or under the control of the University of Maryland, Baltimore Campus.
(15) "Certificate" means the certificate issued by the board to an individual qualified to perform the duties of a first responder, EMT or EMS instructor.
(16) "Contact hour" means a period of sixty (60) minutes during which a minimum of fifty (50) minutes is utilized for active instructional purposes.
(17) "CPR" means cardiopulmonary resuscitation.
(18) "Critical care interfacility transport" means medical care provided during transport between hospitals utilizing sophisticated medical equipment and supplies and licensed paramedics with critical care endorsements or licensed physicians or RNs in conjunction with licensed paramedics operating under approved medical protocols which exceed the scope of practice of a licensed paramedic not holding a critical care endorsement.
(19) "Deficiency" means a violation of a statutory or regulatory requirement as identified by a KBEMS office representative during an inspection or investigation.
(20) "Dispatch center" means the location where incoming calls are initially received requesting an ambulance and where contact is made with the ambulance service base station or vehicles for direction to the patient scene.
(21) "Emergency" means services provided after the sudden onset of a medical condition or injury manifesting itself by acute symptoms of such severity (including severe pain) that the absence of immediate medical attention could reasonably be expected to result in placing the patient's health in serious jeopardy, serious impairment to bodily functions or serious dysfunction of any bodily organ or part.
(22) "EMS" means emergency medical services.
(23) "EMS-I" means an individual that is certified by the board as an emergency medical services instructor.
(24) "EMS-TA" means Emergency Medical Services Testing Agency.
(25) "EMS-TEI" means Emergency Medical Services Training and Educational Institution.
(26) "FAA" means the Federal Aviation Administration.
(27) "FAR" means federal aviation regulations.
(28) "FCC" means Federal Communications Commission.
(29) "Flight nurse" means a registered nurse licensed by the Kentucky Board of Nursing acting in the air medical environment with training and education appropriate to the mission of the individual air ambulance service that at a minimum addresses:
(a) Altitude physiology;
(b) Aircraft safety;
(c) Survival techniques; and
(d) Flight operations.
(30) "Flight paramedic" means a paramedic licensed by the board acting in the air medical environment with training and education appropriate to the mission of the individual air ambulance service that at a minimum addresses:
(a) Altitude physiology;
(b) Aircraft safety;
(c) Survival techniques; and
(d) Flight operations.
(31) "GPA" means grade point average.
(32) "Helipad" means a designated area, usually with a prepared surface, on a heliport, airport, landing or take-off area, apron or ramp, or movement area used for take off, landing, or parking helicopters.
(33) "IFR" means instrument flight rules.
(34) "Interfacility" means a situation in which a licensed ambulance is utilized to transport a person from a licensed health care facility or a physician's office to another licensed health care facility.
(35) "Interfacility care" means BLS or ALS emergency or nonemergency medical care provided to a patient during ambulance transportation between two (2) health care facilities.
(36) "KBEMS" means the Kentucky Board of Emergency Medical Services.
(37) "KBEMS Office" means the office and its staff established by KBEMS and headed by the executive director.
(38) "KBML" means the Kentucky Board of Medical Licensure.
(39) "KBN" means the Kentucky Board of Nursing.
(40) "KKK-1822" means the General Services Administration's standards for ground ambulance vehicles.
(41) "Landing zone" means a prepared on unprepared area where a helicopter will be landing that:
(a) Is large enough to accommodate the aircraft being used;
(b) Is free of dangerous obstacles;
(c) Has adequate approach and departure path as determined by the PIC; and
(d) If landing at night, has light sources to mark the boundaries of the area.
(42) "Lead instructor" means an individual that provides a significant portion of the instruction in a first responder or EMT training program and assumes responsibilities for classroom administrative functions as outlined in 202 KAR 7:601.
(43) "Medical director" means an EMS medical director that meets the provisions of 202 KAR 7:801.
(44) "Mutual aid agreement" means a formal written agreement with another appropriate entity as identified in 202 KAR 7:501, Section 6, for back up or assistance if a situation exists where the provider cannot respond to an emergency request for assistance or the situation exceeds the response capabilities of the provider.
(45) "The National Registry of Emergency Medical Technicians" or "NREMT" means the national professional organization that specializes in practical skills and written examination materials used in evaluation of prehospital personnel.
(46) "NREMT-B" means a student that has successfully completed the registration requirements for an EMT-Basic with the NREMT.
(47) "NREMT-FR" means a student that has successfully completed the registration requirements for a first responder with the NREMT.
(48) "NREMT-P means a student that has successfully completed the registration requirements for a paramedic with the NREMT.
(49) "PEPP" means provider level certification in pediatric emergency prehospital provider.
(50) "PHTLS" mean provider level certification in prehospital trauma life support.
(51) "Physician" means an individual holding an unrestricted license issued by the KBML to practice medicine in the Commonwealth of Kentucky.
(52) "PIC" means pilot in command.
(53) "Pilot program" means a program approved by the board to permit an authorized entity to educate, train, and authorize selected students or employees to utilize a specialized procedure, for a specified time period, that has not been previously approved by administrative regulation.
(54) "Preestablished I.V." means an intravenous solution that has been established on a person prior to the arrival of emergency medical service personnel at the scene or facility.
(55) "Primary response vehicle" means a vehicle utilized by a licensed Class I ambulance service for the purpose of responding certified licensed personnel or equipment to an emergency incident scene.
(56) "Program coordinator" means an individual that serves to coordinate or administer an EMS training program.
(57) "Provider" means an ambulance provider as defined in KRS 311A.010 or individual or entity licensed by the board to provide ambulance service, medical first response, or air ambulance services pursuant to the appropriate administrative regulation.
(58) "RN" means a registered nurse licensed by the KBN.
(59) "Satellite location" means a physical location with a street address where an ambulance is based from on a twenty-four (24) hour basis.
(60) "Sharps" means a portion, or the whole unit, of medical supplies used in treatment procedures that may puncture the skin, including needles and glass ampules.
(61) "SIC" means second in command.
(62) "VFR" means visual flight rules.
History
- RELATES TO: KRS 311A.010
- STATUTORY AUTHORITY: KRS 311A.020, 311A.030
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.030 requires the board to promulgate administrative regulations relating to emergency medical services. This administrative regulation establishes the definitions used in 202 KAR Chapter 7.
- History: 202 KAR 007:010. 28 Ky.R. 1724; 2016; eff. 3-14-2002; 30 Ky.R. 89; 909; 1209; 1474; eff. 11-19-2003; Crt eff. 2-19-2019; Crt to Am 2-17-2026, filing deadline 8-17-2027.
202 KAR 7:020 Board organization {#sec-202-kar-7-020 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:020}
Section 1. Appointment of Committee Members and Committee Chairpersons.
(1) The chairpersons and members of a standing committee of the board, subcommittee of the board, and any task force shall be appointed by the board chairperson.
(2) A standing committee shall be comprised of seven (7) members, excluding the EMS-C Advisory Committee, which shall be established consistent with the EMS for Children Performance Measures: Implementation Manual for State Partnership Grantees.
(3) The executive director shall serve as an ex officio member to each standing committee. The chairperson may also appoint other KBEMS office staff members to serve as ex officio members to a standing committee.
(4) Standing committee members shall have a term that expires November 30 of each calendar year. Reappointments for subsequent terms may be made by the chairperson of the board any time after November 1 and before November 30. All appointments shall be made by November 30.
(5) Only a standing committee or task force chairperson or vice-chairperson in the absence of the chairperson may bring reports or recommendations before the board for action. All reports to the board shall be submitted in written format. The chairperson or vice-chairperson shall disclose to the board through written report any committee, subcommittee, or task force member who has resigned his or her position by virtue of missing three (3) or more meetings consistent with Section 2(10) of this administrative regulation.
(6) A task force shall be comprised of no more than five (5) members, excluding the chairperson.
(7) A task force may be created:
(a) At the request of the chairperson of a standing committee;
(b) At the request of the executive director; or
(c) At the determination of the board chairperson.
(8) A task force shall cease to exist at the close of its work. A member of a task force shall not serve for a period of more than one (1) year without reappointment. A task force shall serve at the pleasure of the board. The board chairperson may dissolve a task force at any time including prior to the completion of an assigned task, subject to a majority vote of board members.
(9) When a task force is created, the board chairperson shall give a specific written charge to the task force with guidelines, as appropriate. The board chairperson may establish a reporting deadline for the completion of the specific written charge.
(10) Task Force members shall serve without compensation.
Section 2. Standing Committees of the Board.
(1) Executive committee. The executive committee shall address legislative issues and proposals and review administrative regulations for submission to the board including:
(a) Recommending to the board promulgation of administrative regulations, amendment of administrative regulations, or repeal of administrative regulations relating to:
-
All levels of personnel licensed or certified by the board, and ambulance services licensed or certified by the board;
-
Rules and operating procedures for the board and each of its standing committees, subcommittees, and task forces;
-
EMS Grant Program; and
-
EMS for Children Program;
(b) Serving as a resource for board staff:
-
In reviewing applications regarding requests for funding under programs administered by or overseen by the board;
-
With the development of funding programs or applications, including state and federal grants pertaining to EMS and monitoring and reviewing the grants once received by the board;
-
With creating and recommending to the board a biennial budget for the board prior to submission to appropriate state agencies;
-
With identifying, developing, and recommending to the board sources of funding for its programs; and
-
In developing reimbursement programs and providing consult for emergency medical service providers.
(c) Making recommendations to the board regarding fees to be charged by the board.
(2) A majority of executive committee appointees shall be members of the board.
(3) The vice-chairperson of the board shall be the ex-officio chairperson of the executive committee with full voting rights.
(4) Medical oversight committee. The medical oversight committee shall address issues pertaining to quality assurance, medical control, scope of practice, medical standards of curricula, or other related issues as may be assigned by the board.
(5) EMS for children committee. The EMS for children committee shall assist the coordinator and executive director of the board in achieving the mission of the program.
(6) Data management committee. The data management committee shall be responsible for the following:
(a) The development of a statewide plan for data collection and compliance;
(b) Identification of information initiatives for EMS in Kentucky;
(c) Identification and research of funding sources tied to EMS data collection;
(d) Assistance to ambulance providers with questions or other needs associated with this administrative regulation, KRS Chapter 311A, and other issues associated with the board's statutory authority to require data collection and submission; and
(e) Matters identified by board members, the chairperson, or the executive director that involve data collection, data submission, or information use.
(7) Education committee. The purpose and charge of the education committee shall be to:
(a) Assist the board in developing a strategic plan for EMS education in the Commonwealth of Kentucky;
(b) Act as a resource for EMS educators and EMS-TEIs in the Commonwealth; and
(c) Assume the lead role in formulating, drafting, and sending to the board for approval and subsequent promulgation of all administrative regulations that set the standards and requirements for EMS education in Kentucky.
(8) The membership of each standing committee shall include one (1) member of the board or more, except as established in Section 1(2) of this administrative regulation.
(9) Standing committees shall schedule on an annual basis at least six (6) regular meetings.
(10) A member of a standing committee, subcommittee, or task force who is absent for three (3) or more regular meetings in a term of one (1) year shall be found to have resigned from his or her appointed position and his or her position shall be determined as vacant.
Section 3. Agendas.
(1) A person desiring a matter to be placed on the agenda for a regular board meeting shall, not less than twenty (20) working days prior to the board meeting, submit a written request to the executive director.
(2) The request shall contain the following information:
(a) The matter requested to be placed before the board;
(b) The action desired on the matter;
(c) Documentation in support of the request;
(d) The name, address, telephone number, and other contact methods as may be necessary to contact the person or organization submitting the request; and
(e) The name, address, telephone number, and other contact methods as may be necessary to contact each person requesting to speak on behalf of the request at the board meeting.
(3) Not less than seven (7) working days prior to the board meeting, the chairperson of the board shall set the agenda and cause its publication on the KBEMS Web site at https://kbems.kctcs.edu/ and in writing.
(4) The submission of a request for a matter to be placed on the agenda at a regular board meeting shall not guarantee that the matter will be placed on the agenda, or the sequential order of a matter approved for the agenda on the agenda.
(5) The board shall adhere to the published agenda at a regular board meeting, unless the board takes action to amend the agenda.
(6) Each agenda for a regular or special meeting shall include an item to allow public comments. The chairperson may limit the time each person comments.
(7) Nothing in the section shall prohibit or constrain any board member from requesting that an item be added to the agenda of a regular meeting. A request may be made from the floor of the meeting. This provision shall not apply to special or emergency meetings.
Section 4. Quorum.
(1) A simple majority of sitting board members shall constitute a quorum.
(2) A vacant position on the board shall not be counted toward the number of sitting members of the board.
(3) A quorum shall be present in order for the board to take action, other than adjourn, or adjourn to a time certain.
(4) The board shall transact business so long as it has convened with a quorum present. A quorum shall be presumed present until a question of "no quorum" is raised, or the absence of a quorum is disclosed by vote of the members present.
(5) A simple majority of appointed members shall constitute a quorum for standing committee, subcommittee, and task force meetings.
Section 5. Voting.
(1) Voting shall be accomplished by one (1) of the following methods:
(a) Voice vote;
(b) A show of hands; or
(c) A roll call vote.
(2) A roll call vote shall be conducted at the call of any member of the board.
(3) In order for the board to take action on the following matters, a majority of board members present shall have agreed to the action:
(a) Promulgate, amend, or repeal an administrative regulation;
(b) Appoint, directly, or by personal service contract, the executive director, general counsel, or medical advisor;
(c) Initiate a legal action on behalf of the board;
(d) Adopt a budget or proposed budget for the board;
(e) Authorize the expenditure of more than $7,500, unless the amount is a routine budgeted expenditure;
(f) Take action on an item added to the agenda of the board at the same meeting at which the item is added to the agenda of the board; or
(g) Take an action at an emergency meeting of the board.
(4) In order for the board to take action on the following matters, two-thirds (2/3) of the members of the board that are present shall have agreed to the action:
(a) Discipline or negative action regarding statutory employees; or
(b) Hire outside legal counsel to defend the board in a legal action against the board, a member of the board, or an employee of the board, or for other specified purpose.
Section 6. Attendance of Board Staff and Employees at a Board Meeting.
(1) The following staff of the board shall attend each board meeting, unless excused in writing by the chairperson of the board or excused from the meeting by action of the board:
(a) Executive director;
(b) Deputy executive director;
(c) General counsel; and
(d) State medical advisor.
(2) An employee of the board, other than one (1) specified in subsection (1) of this section, shall attend a meeting of the board if requested to do so by a member of the board or the executive director. Board member requests for an employee to attend shall be communicated through the executive director or the deputy executive director.
(3) An employee of the board, other than one specified in subsection (1) of this section, may attend a meeting of the board as part of their state duty time with the permission of the chairperson of the board, the executive director, or deputy executive director.
Section 7. A person aggrieved by an action of a standing committee or task force may appeal to the board by serving written notice to the board within ten (10) working days prior to a regularly scheduled board meeting.
Section 8. Incorporation by Reference.
(1) "EMS for Children Performance Measures: Implementation Manual for State Partnership Grantees", March 2017, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 118 James Court, Lexington, Kentucky 40505, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) These materials may also be obtained online on the Emergency Medical Services for Children, Innovation and Improvement Center's Web site at https://emscimprovement.center/programs/partnerships/performance-measures/.
History
- RELATES TO: KRS Chapter 13A, 311A.015, 311A.020, 311A.145
- STATUTORY AUTHORITY: KRS 311A.020, 311A.030
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020(1)(h) requires the board to establish procedures and processes for committees and subcommittees. KRS 311A.030 requires the board to promulgate administrative regulations in accordance with KRS Chapter 13A to carry out the functions of KRS Chapter 311A. This administrative regulation establishes the organization and committee structure of the board.
- History: 30 Ky.R. 144; 912; 1211; eff. 11-19-2003; Crt eff. 2-19-2019; 46 Ky.R. 1291, 2036; eff. 02-27-2020; TAm eff. 3-24-2021.
202 KAR 7:030 Fees of the board {#sec-202-kar-7-030 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:030}
Section 1. Definitions.
(1) "Critical violation" means an inspection deficiency listed in the current Agency License & Vehicle Inspection Critical Violation List.
(2) "Non-critical violation" means any inspection deficiency that is not a critical violation as defined by subsection (1) of this section.
Section 2. EMS-TEI.
(1) EMS-TEI Initial Application fee shall be $500.
(2) EMS-TEI Renewal licensing of all levels shall be $250.
(3) In addition to the licensing fee, an EMS-TEI shall remit an additional fee for each course taught which has the potential to lead to state or national certification or licensure as follows:
(a) Emergency Medical Responder - $100;
(b) Emergency Medical Technician - $150;
(c) Advanced Emergency Medical Technician - $200; or
(d) Paramedic - $300.
Section 3. Certification and License Renewal.
(1) EMR certification renewal fee shall be fifteen (15) dollars.
(2) EMT certification renewal fee shall be twenty-five (25) dollars.
(3) AEMT certification renewal fee shall be forty (40) dollars.
(4) Paramedic license renewal fee shall be fifty (50) dollars. A paramedic shall not be required to pay the fee established in subsection (2) of this section.
(5) Advanced practice paramedic certification renewal fee shall be ten (10) dollars for each specialty certification.
(6) EMS Educator certification renewal fee shall be sixty (60) dollars. An EMS Educator shall not be required to pay the fees established in subsections (1) through (4) of this section.
Section 4. Certification and License Reciprocity and Reinstatement.
(1) The fee for a reciprocal certification or license shall be $100. A paramedic seeking reciprocity as an Advanced Practice Paramedic shall only be required to pay the $100 fee for a reciprocal paramedic license. A reciprocity fee for an Advanced Practice Paramedic license or certification shall not be required.
(2) The fee to reinstate a certification or license shall be $100.
Section 5. Ground Ambulance Service Licensing and License Renewal.
(1) Initial prelicense fee, to establish compliance with 202 KAR 7:501, shall be $3,000.
(2) Transfer of license fee shall be $3,000.
(3) License renewal fee shall be $500.
(4) Inspection fee shall be fifty (50) dollars for each ambulance.
(5) Each cited deficiency shall be a fee of $100 per non-critical violation and $500 per critical violation.
(6) Inspection of additional or replacement ambulances for an existing license shall be a fee of $150 per ambulance.
Section 6. Administrative Fees.
(1) Late fee shall be $100 for any certification or license renewal applicant or any official document required to be received by the KBEMS office, which is postmarked after the due date or expiration date.
(2) A request for license or certification verification or other request for documentation to be forwarded to an out-of-state regulatory entity shall be twenty-five (25) dollars for each entity to which the verification or documentation is to be sent.
Section 7. Non-Transport Providers.
(1) Initial license fee to establish compliance with 202 KAR 7:501 shall be $3,000.
(2) Transfer of license fee shall be $3,000.
(3) License renewal fee shall be $400.
(4) Inspection fee shall be $100 for each set of equipment.
(5) Each cited deficiency shall be a fee of $100 per non-critical violation and $500 per critical violation.
Section 8. Air Ambulance Service Licensing and License Renewal.
(1) Initial prelicensing fee, to establish compliance with 202 KAR 7:510, shall be $5,000.
(2) Transfer of license fee shall be $4,000.
(3) License renewal fee shall be $1,000.
(4) Inspection fee shall be $400 dollars per air ambulance.
(5) Each cited deficiency shall be a fee of $100 per non-critical violation and $500 per critical violation.
Section 9. Incorporation by Reference.
(1) "Agency License & Vehicle Inspection Critical Violation List", KBEMS OPS-11-1, available at kbems.ky.gov, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m. This material is also available on the board's Web site at: kbems.ky.gov.
History
- RELATES TO: KRS 311A.145
- STATUTORY AUTHORITY: KRS 311A.145
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.145 authorizes the board to promulgate administrative regulations establishing a reasonable schedule of fees for examinations, licensure, certification, inspections, applications, and other provided services and materials. This administrative regulation establishes those fees.
- History: 27 Ky.R. 3394; 28 Ky.R. 563; eff. 9-10-2001; 30 Ky.R. 91; 914; 1213; eff. 11-19-2003; 35 Ky.R. 326; 850; 1447; eff. 1-5-2009; Crt eff. 2-19-2019; 50 Ky.R. 1180; eff. 2-16-2024.
202 KAR 7:055 Advisory opinions {#sec-202-kar-7-055 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:055}
Section 1. Form of Request.
(1) The request shall be signed by one (1) or more persons, with each signer's mailing address and telephone number, and if available, telefax number and email address, clearly indicated. If a person signs on behalf of a corporation or association, the name of the entity, the address, telephone number and telefax number of the entity shall be included. The signer shall date the request.
(2) The request shall contain:
(a) A clear and concise statement of all relevant facts on which the ruling is requested;
(b) A citation and the relevant language of the specific statutes, administrative regulations, decisions, orders, or other written statements of law or policy, where applicability is questioned; and any other relevant law;
(c) Each question the requester wants answered, stated in clear and concise language;
(d) The requester's proposed response to each question presented and a summary of the rationale supporting each proposed response;
(e) Any supportive documentation or research; and
(f) A statement indicating whether the requester currently is a party to another proceeding involving the questions at issue and whether, to the requester's knowledge or belief, each question has been decided by, is pending determination by, or is under investigation by any governmental entity or other entity with authority over a person or entity which the board governs or regulates.
Section 2. Consideration.
(1) The chairperson of the board, or designee in writing, may schedule an informal meeting between the requester, any interested persons, and a representative of the board, to present information and discuss questions raised. A final decision shall not be made at an informal meeting.
(2) In rendering an advisory opinion, the board shall:
(a) Consider all materials submitted with the request;
(b) Consider any relevant document, data, or other material; and
(c) Consider comments from the board's staff.
(3) The board may:
(a) Consult experts or other individuals as it deems necessary; or
(b) Require argument of the question or permit the introduction of evidence.
Section 3. Issuance of Opinion or Refusal to Issue an Opinion. The board shall issue an advisory opinion in response to the request, unless one (1) of the following apply:
(1) The board does not have jurisdiction over the questions presented in the request;
(2) The questions presented are pending in a disciplinary matter, or other board or judicial proceeding that may definitively decide the issues;
(3) The questions presented by the request would be more properly resolved in a different type of proceeding;
(4) The facts or questions presented in the request are unclear, overbroad, insufficient, or otherwise inappropriate as a basis upon which to issue an opinion;
(5) There is no need to issue an opinion because the questions raised in the request have been settled due to a change in circumstances;
(6) The requester is asking the board to determine whether a statute is unconstitutional; or
(7) The board concludes an opinion would not be in the public interest.
Section 4. Publication of Advisory Opinions.
(1) All advisory opinions shall be published and maintained by the KBEMS office. Publication shall be made by hard copy and by placing the entire opinion on the board-managed website.
(2) All names or references that may allow for the identification of parties shall be redacted from the formal, published advisory opinion.
(3) An index of all final, published advisory opinions shall be maintained by the KBEMS office. The index shall include the subject of each opinion, its publication date and any prospective changes that are effectuated by the published advisory opinions.
Section 5. Reconsideration and Appeals.
(1) Any person may request the board to reconsider a published advisory opinion within ten (10) working days of the publication of the opinion.
(2) Requests for reconsideration shall meet the requirements of Section 1(2) of this administrative regulation.
(3) Requests for reconsideration shall contain:
(a) A clear and concise statement of the grounds for the reconsideration;
(b) The proposed conclusion with a summary of the rationale supporting the proposed conclusion;
(c) Any supportive statute, administrative regulation, document, order or other statements of law or policy, with an explanation of the relevance of the material offered; and
(d) A statement of adverse impact, if any, resulting from the published advisory opinion.
(4) Any notice of appeal to the Franklin Circuit Court filed pursuant to KRS 311A.055 shall be served upon the chairperson of the board, the executive director and the general counsel for the board.
History
- RELATES TO: KRS 311A.040
- STATUTORY AUTHORITY: KRS 311A.020, 311A.030, 311A.040
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.040 authorizes the board to issue advisory opinions. KRS 311A.040 requires the board to promulgate an administrative regulation for submission, consideration, and disposition of a request for an advisory opinion. This administrative regulation establishes those procedures.
- History: 202 KAR 007:055. 30 Ky.R. 146; 1213; eff. 11-19-2003; Crt eff. 2-19-2019; TAm eff. 2-1-2021; Crt to Am, 2-17-2026, filing deadline 8-17-2027.
202 KAR 7:201 Emergency medical responders {#sec-202-kar-7-201 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:201}
Section 1. Emergency Medical Responder Student Eligibility. An individual shall be eligible to enroll as a student in an Emergency Medical Responder training program if the applicant:
(1) Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and
(2) Meets all additional requirements established by the EMS Training and Educational Institution (TEI).
Section 2. Certification Requirements. Individuals desiring initial certification as an Emergency Medical Responder shall:
(1) Successfully complete a board approved training program that conforms to the United States Department of Transportation, National Highway Traffic Safety Administration, National Emergency Medical Services Education Standards-Emergency Medical Responder Instructional Guidelines, except that the education curriculum shall not be satisfied by the completion of refresher or transition courses alone;
(2) Meet all educational standards established in 202 KAR 7:601;
(3) Obtain certification as a NREMT-Emergency Medical Responder;
(4) Submit a completed EMR Initial Certification Application in KEMSIS;
(5) Pay the fee required for certification pursuant to 202 KAR 7:030;
(6) Undergo a background check pursuant to KRS 311A.050 and 311A.100, which shall be:
(a) National in scope for an applicant not currently certified at any level in Kentucky;
(b) Statewide in scope for an applicant with current certification in Kentucky;
(c) Less than six (6) months old when the applicant submits to the board all requirements for certification;
(d) Provided by a vendor that has been contracted through the board; and
(e) Submitted to the board by the company that conducts the background check; and
(7) Be a citizen of the United States, a permanent resident of the United States, or otherwise lawfully present in the United States, as evidenced by submission to the board of:
(a) A Social Security card;
(b) Birth certificate;
(c) A United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card); or
(d) Other legal authorization to live and work in the United States.
Section 3. Renewal of Certification and Continuing Education Requirements.
(1) An Emergency Medical Responder shall be eligible for certification renewal if:
(a) The applicant submits a completed EMR Certification Renewal Application in KEMSIS;
(b) The applicant maintains written evidence of:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma training required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120;
(c) The applicant pays the fee pursuant to 202 KAR 7:030; and
(d) The applicant maintains evidence of:
-
Current certification by the NREMT as an Emergency Medical Responder, except that if this option is used, the board may request, though a continuing education audit, proof of continuing education to verify compliance with the requirements of this section; or
-
Successful completion of the NREMT Emergency Medical Responder National Component of the Continued Competency Program for Continuing Education, which shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(2) An application for certification renewal shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the applicable requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.
(3) A certified Emergency Medical Responder, in good standing, who is a member of a National Guard or military reserve unit called to active duty by presidential order pursuant to 10 U.S.C. §§ 121 and 12304, shall be renewed according to KRS 12.355 upon submission of the Military Extension Application.
(4) The board office may audit an Emergency Medical Responder's continuing education and continuing education records. The Emergency Medical Responder shall submit the documentation requested within ten (10) business days of receipt of the board's request.
(5) The Emergency Medical Responder shall maintain documentation of all continuing education for three (3) years from the date of completion.
(6) If documentation of continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the Emergency Medical Responder certification for the individual shall be summarily revoked and the individual shall reapply for certification through Reinstatement, if eligible.
(7) The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.
Section 4. Reinstatement of Certification.
(1) An Emergency Medical Responder whose certification has lapsed may reinstate his or her certificate by submitting to the board:
(a) A completed EMR Reinstatement Certification Application in KEMSIS;
(b) Evidence of previous certification as an Emergency Medical Responder in the Commonwealth of Kentucky;
(c) Proof of current training in:
-
Pediatric Abusive Head Trauma as required by KRS 311A.120;
-
Awareness of Sexual Violence Training required by KRS 311A.120; and
-
HIV/AIDS training required by KRS 311A.120; and
(d) Evidence of successful completion of the NREMT Emergency Medical Responder National Component of the Continued Competency Program for Continuing Education within twelve (12) months preceding his or her application for reinstatement of Emergency Medical Responder.
(2) The applicant shall pay the fee required for reinstatement pursuant to 202 KAR 7:030.
(3) The applicant shall undergo a national background check provided by a vendor that has been contracted through the board. The applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(4) Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of reinstatement of certification.
(5) The applicant for reinstatement of certification shall bear the burden of proof of previous certification in Kentucky if the previous certification is in issue or dispute.
(6) An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.
Section 5. Emergency Medical Responder Reciprocity.
(1) An individual who is certified in another state as an Emergency Medical Responder or by the NREMT as a NREMT-Emergency Medical Responder or any member of the United States Armed Forces, or veteran who has transitioned within the past six (6) years from the United States Armed Forces, and has been registered by the National Registry as a NREMT-Emergency Medical Responder or EMT shall be eligible for reciprocity for Kentucky certification as an Emergency Medical Responder if the applicant submits:
(a) A completed EMR Reciprocity Certification Application in KEMSIS;
(b) Proof of the applicant's current unrestricted certification as a NREMT-Emergency Medical Responder or current Emergency Medical Responder certification in another state, or proof of completing a board-approved United States Armed Forces medical training course which included NREMT-Emergency Medical Technician certification; and
(c) Proof of current training in:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma as required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120.
(2) An applicant shall pay the fee required for reciprocity pursuant to 202 KAR 7:030.
(3) An applicant for Emergency Medical Responder reciprocity shall undergo a national background check provided by a vendor that has been contracted through the board.
(a) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(b) Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of certification through reciprocity.
(4) An applicant shall not have been convicted of offenses described in KRS 311A.050.
(5) An applicant shall not have been subjected to discipline that would prevent reciprocity at the time of application.
(6) An Emergency Medical Responder certified pursuant to this administrative regulation shall not perform any procedures or skill on which the Emergency Medical Responder has not been trained. An Emergency Medical Responder who performs a skill for which the Emergency Medical Responder does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.050.
(7) An Emergency Medical Responder certified pursuant to this section shall complete the Kentucky supplemental Emergency Medical Responder curricula for the procedures listed in 202 KAR 7:701 prior to beginning work for a licensed agency in Kentucky.
(a) Kentucky supplemental Emergency Medical Responder curricula consistent with 202 KAR 7:701 shall be provided during employee orientation, or by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(b) Verification of competency on the supplemental curricula procedures in 202 KAR 7:701 shall be maintained by the Emergency Medical Responder for a minimum of three (3) years. Failure to submit the EMR Supplemental Curriculum Training Verification Report upon request shall result in revocation of the Emergency Medical Responder certification.
(c) If an Emergency Medical Responder certified pursuant to this section fails to supply verification of competency as required by subsection (7) of this section, the Emergency Medical Responder shall be ineligible to apply for and receive Emergency Medical Responder reciprocity certification until the applicant has submitted the EMR Supplemental Curriculum Training Verification Report as required by 202 KAR 7:701, and shall reapply for Reciprocity through the process listed in this section.
Section 6. Scope of Practice. An Emergency Medical Responder shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model and 202 KAR 7:701.
Section 7. Expiration of Certification.
(1) Certification periods and expiration dates shall be pursuant to KRS 311A.095.
(2) If an Emergency Medical Responder's certification lapses or expires, the Emergency Medical Responder shall cease provision of emergency medical services.
(3) An Emergency Medical Responder who has allowed his or her certification to lapse or expire shall reinstate certification pursuant to Section 4 of this administrative regulation.
Section 8. Surrender of Certification.
(1) An Emergency Medical Responder surrendering certification shall:
(a) Submit a completed Voluntary Surrender of EMR Certification Application in KEMSIS; and
(b) Pay the fee pursuant to 202 KAR 7:030.
(2) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon surrendering his or her certification.
Section 9. Reporting Requirements.
(1) An Emergency Medical Responder shall maintain current demographic information in KEMSIS including:
(a) Legal name;
-
Any changes to an Emergency Medical Responder's legal name shall be submitted using the Name Change Application in KEMSIS; and
-
One (1) of the following documents as verification of name change:
a. Social Security card;
b. Driver's license; or
c. Passport;
(b) Mailing address;
(c) Email address; and
(d) Phone number.
(2) An Emergency Medical Responder who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
Section 10. Exemptions from Emergency Medical Responder Administrative Regulations. Certification requirements for an Emergency Medical Responder shall not apply to:
(1) United States military personnel or state National Guard or employees of the United States government while providing services on a United States government-owned or operated facility, or while engaged in the performance of their official duties under federal law, or while providing assistance in a mass casualty or disaster type situation; or
(2) An Emergency Medical Responder certified in another state or territory of the United States who:
(a) Comes into Kentucky to transport a patient from another state into Kentucky; or
(b) Is transporting a patient through the state of Kentucky to an out-of-Kentucky location.
Section 11. Public Notice of Negative Action. The board office shall cause to be published on the board website the name of an Emergency Medical Responder who:
(1) Is fined;
(2) Is placed on probationary status;
(3) Is placed on restricted status;
(4) Is suspended; or
(5) Has had his or her certification revoked.
Section 12. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "National Emergency Medical Services Education Standards-Emergency Medical Responder Instructional Guidelines", The United States Department of Transportation, National Highway Traffic Safety Administration, DOT HS 811 077B, January 2009;
(b) "EMR Initial Certification Application" in KEMSIS, July 2019;
(c) "EMR Certification Renewal Application" in KEMSIS, July 2019;
(d) "EMR Reciprocity Certification Application" in KEMSIS, July 2019;
(e) "EMR Reinstatement Certification Application" in KEMSIS, July 2019;
(f) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;
(g) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;
(h) "EMR Supplemental Curriculum Training Verification Report", July 2019;
(i) "Voluntary Surrender of EMR Certification Application" in KEMSIS, July 2019;
(j) "National Registry of Emergency Medical Technicians National Continued Competency Program EMR", October 2016;
(k) "Name Change Application" in KEMSIS, July 2019;
(l) "Military Extension Application" in KEMSIS, July 2019; and
(m) "United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card)", July 2019.
(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board's Web site at: kyems.com.
History
- RELATES TO: KRS 12.355, 311A.010, 311A.025, 311A.030, 311A.050-311A.090, 311A.095, 311A.100, 311A.120, 311A.140, 311A.145, 311A.160, 10 U.S.C. 121, 12304
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.160
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020 requires the board to promulgate administrative regulations relating to emergency medical responders. KRS 311A.025 and 311A.160 require the board to establish standards relating to emergency medical responders. This administrative regulation establishes the standards relating to emergency medical responders.
- History: 30 Ky.R. 147; 915; 1214; 1476; eff. 11-19-2003; Cert eff. 2-19-2019; 47 Ky.R. 2428, 48 Ky.R. 390; eff. 9-22-2021; 49 Ky.R.1484, 1911; eff. 6-21-2023; 51 Ky.R. 748; eff. 2-5-2025.
202 KAR 7:301 Emergency medical technician {#sec-202-kar-7-301 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:301}
Section 1. Emergency Medical Technician Student Eligibility. An individual shall be eligible to enroll as a student in an Emergency Medical Technician education and training program if the applicant:
(1) Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and
(2) Meets all additional requirements established by the EMS Training and Educational Institution (EMS-TEI).
Section 2. Certification Requirements. Individuals desiring initial certification as an Emergency Medical Technician shall:
(1) Successfully complete a board approved education and training program that conforms to the curriculum of the United States Department of Transportation, National Highway Traffic Safety Administration National Emergency Medical Services Education Standards-Emergency Medical Technician Instructional Guidelines, except that the educational curriculum shall not be satisfied by the completion of refresher or transition courses alone;
(2) Meet all educational standards established by 202 KAR 7:601;
(3) Obtain certification as a NREMT-Emergency Medical Technician;
(4) Submit a completed EMT Initial Certification Application in KEMSIS;
(5) Pay the fee required for certification pursuant to 202 KAR 7:030;
(6) Undergo a background check pursuant to KRS 311A.050 and 311A.100, which shall be:
(a) National in scope for an applicant not currently certified at any level in Kentucky;
(b) Statewide in scope for an applicant with current certification in Kentucky;
(c) Less than six (6) months old when the applicant submits to the board all requirements for certification;
(d) Provided by a vendor that has been contracted through the board; and
(e) Submitted to the board by the company that conducts the background check; and
(7) Be a citizen of the United States, a permanent resident of the United States, or otherwise lawfully present in the United States, as evidenced by submission to the board of:
(a) A Social Security card;
(b) Birth certificate;
(c) A United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card); or
(d) Other legal authorization to live and work in the United States.
Section 3. Renewal of Certification and Continuing Education Requirements.
(1) An Emergency Medical Technician shall be eligible for certification renewal if:
(a) The applicant submits a completed EMT Certification Renewal Application in KEMSIS;
(b) The applicant maintains written evidence of:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120;
(c) The applicant pays the fee required for renewal pursuant to 202 KAR 7:030; and
(d) The applicant maintains evidence of:
-
Current certification by the NREMT as an Emergency Medical Technician, except that if this option is used, the board may request, through a continuing education audit, proof of continuing education to verify compliance with the requirements of this section; or
-
Successful completion of the NREMT Emergency Medical Technician National Component of the Continued Competency Program for Continuing Education, which shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(2) An application for certification renewal shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the applicable requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.
(3) A certified Emergency Medical Technician, in good standing, who is a member of a National Guard or a military reserve unit called to active duty by presidential order pursuant to 10 U.S.C. §§ 121 and 12304, shall be renewed according to KRS 12.355 upon submission of the Military Extension Application.
(4) The board office may audit an Emergency Medical Technician's continuing education and continuing education records. The Emergency Medical Technician shall submit the documentation requested within ten (10) business days of receipt of the board's request.
(5) If documentation of continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the Emergency Medical Technician certification for the individual shall be summarily revoked and the individual shall reapply for certification through reinstatement if eligible.
(6) The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.
(7) The Emergency Medical Technician shall maintain documentation of all continuing education for three (3) years from the date of completion.
Section 4. Reinstatement of Certification.
(1) An Emergency Medical Technician whose certification has lapsed may reinstate his or her certificate by submitting to the board:
(a) A completed EMT Reinstatement Certification Application in KEMSIS;
(b) Evidence of previous certification as an Emergency Medical Technician in the Commonwealth of Kentucky;
(c) Proof of current training in:
-
Pediatric Abusive Head Trauma as required by KRS 311A.120;
-
Awareness of Sexual Violence Training required by KRS 311A.120; and
-
HIV/AIDS training required by KRS 311A.120; and
(d) Payment of the fee pursuant to 202 KAR 7:030.
(2) The applicant for reinstatement of certification shall undergo a national background check provided by a vendor that has been contracted through the board.
(a) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(b) Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of reinstatement of certification.
(3) An applicant for reinstatement of certification shall submit to the board evidence of successful completion of the NREMT Emergency Medical Technician National Component of the Continued Competency Program for Continuing Education within twelve (12) months preceding his or her application for reinstatement of the Emergency Medical Technician.
(4) The applicant for reinstatement of certification shall bear the burden of proof of previous certification in Kentucky if the previous certification is in issue or dispute.
(5) An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.
Section 5. Emergency Medical Technician Reciprocity.
(1) An individual who is certified in another state or by the NREMT as an Emergency Medical Technician or any member of the United States Armed Forces, or veteran who has transitioned within the past six (6) years from the United States Armed Forces, and has been registered by the National Registry as a NREMT-Emergency Medical Technician shall be eligible for reciprocity for Kentucky certification as an Emergency Medical Technician if the applicant submits:
(a) A completed EMT Reciprocity Certification Application in KEMSIS;
(b) Proof of the applicant's current unrestricted certification as a NREMT-Emergency Medical Technician or current Emergency Medical Technician certification in another state, or proof of completing a board-approved United States Armed Forces medical training course which included NREMT-Emergency Medical Technician certification; and
(c) Proof of current training in:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma as required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120.
(2) An applicant shall pay the fee required for certification through reciprocity pursuant to 202 KAR 7:030.
(3) An applicant for Emergency Medical Technician reciprocity shall undergo a national background check provided by a vendor that has been contracted through the board.
(a) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(b) Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of certification through reciprocity.
(4) An applicant shall not have been convicted of offenses described in KRS 311A.050.
(5) An applicant shall not have been subjected to discipline that would prevent reciprocity at the time of application.
(6) An Emergency Medical Technician certified pursuant to this administrative regulation shall not perform any procedures or skill on which the Emergency Medical Technician has not been trained. An Emergency Medical Technician who performs a skill for which the Emergency Medical Technician does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.050.
(7) An Emergency Medical Technician certified pursuant to this section shall complete the Kentucky supplemental Emergency Medical Technician curricula for the procedures listed in 202 KAR 7:701 prior to beginning work for a licensed agency in Kentucky.
(a) Kentucky supplemental Emergency Medical Technician curricula consistent with 202 KAR 7:701 shall be provided during employee orientation, or by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(b) Verification of competency on the supplemental curricula procedures in 202 KAR 7:701 shall be maintained by the Emergency Medical Technician for a minimum of three (3) years. Failure to submit the EMT Supplemental Curriculum Training Verification Report upon request shall result in revocation of the Emergency Medical Technician certification.
(c) If an Emergency Medical Technician certified pursuant to this section fails to supply verification of competency as required by subsection (7) of this section, the Emergency Medical Technician shall be ineligible to apply for and receive Emergency Medical Technician reciprocity certification until the applicant has submitted the EMT Supplemental Curriculum Training Verification Report as required by 202 KAR 7:701, and shall reapply for reciprocity through the process listed in this section.
Section 6. Scope of Practice. An Emergency Medical Technician shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model and 202 KAR 7:701.
Section 7. Expiration of Certification.
(1) Certification periods and expiration dates shall be pursuant to KRS 311A.095.
(2) If an Emergency Medical Technician's certification lapses or expires, the Emergency Medical Technician shall cease provision of emergency medical services.
(3) An Emergency Medical Technician who has allowed his or her certification to lapse or expire shall be required to reinstate certification pursuant to Section 4 of this administrative regulation.
Section 8. Downgrading Certification.
(1) An Emergency Medical Technician currently certified as an Emergency Medical Technician by the board shall be eligible for certification downgrade if:
(a) The certification is in good standing with no pending disciplinary action;
(b) The applicant submits a completed EMT Certification Downgrade Application in KEMSIS; and
(c) The applicant pays the fee pursuant to 202 KAR 7:030.
(2) An Emergency Medical Technician shall only be eligible to downgrade his or her certification to an Emergency Medical Responder certification.
(3) Certification periods and expiration dates shall be pursuant to KRS 311A.095.
(4) An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:
(a) Statewide in scope for an applicant with current certification in Kentucky;
(b) Less than six (6) months old when the applicant submits to the board all requirements for certification; and
(c) Provided by a vendor that has been contracted through the board.
(5) Downgrade shall be denied if the applicant has not met the requirements of this section or has been subject to disciplinary action that prevents certification at the time of application.
(6) The applicant shall be responsible for meeting the renewal requirements of the downgraded certification level issued prior to expiration of that certification.
(7) To reinstate the certification or license that was previously held, the applicant shall meet the regulatory requirements for that level of certification or licensure.
(8) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon downgrading his or her certification.
(9) Once the applicant has downgraded his or her certification or license, the applicant shall no longer be permitted to provide emergency medical services at the previous certification or license level held.
(10) An applicant applying for downgrade who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
(11) All endorsements, certifications, or licenses held at the previous certification or license level shall be void at the completion of the downgrade.
Section 9. Surrender of Certification.
(1) An Emergency Medical Technician surrendering certification shall:
(a) Submit a completed EMT Certification Surrender Application in KEMSIS; and
(b) Pay the fee pursuant to 202 KAR 7:030.
(2) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon surrendering his or her certification.
Section 10. Reporting Requirements.
(1) An Emergency Medical Technician shall maintain current demographic information in KEMSIS including:
(a) Legal name;
-
Any changes to an Emergency Medical Technician's legal name shall be submitted using the Name Change Application in KEMSIS; and
-
One (1) of the following documents as verification of name change:
a. Social Security card;
b. Driver's license; or
c. Passport;
(b) Mailing address;
(c) Email address; and
(d) Phone number.
(2) An Emergency Medical Technician who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
Section 11. Exemptions from Emergency Medical Technician Administrative Regulations. Certification requirements for an Emergency Medical Technician shall not apply to:
(1) United States military personnel or state National Guard or employees of the United States government while providing services on a United States government owned or operated facility, or while engaged in the performance of their official duties under federal law, or while providing assistance in a mass casualty or disaster type situation; or
(2) An Emergency Medical Technician certified in another state or territory of the United States who:
(a) Comes into Kentucky to transport a patient from another state into Kentucky; or
(b) Is transporting a patient through the state of Kentucky to an out-of-Kentucky location.
Section 12. Public Notice of Negative Action. The board office shall cause to be published on the board Web site the name of an Emergency Medical Technician who:
(1) Is fined;
(2) Is placed on probationary status;
(3) Is placed on restricted status;
(4) Is suspended; or
(5) Has had his or her certification revoked.
Section 13. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "National Emergency Medical Services Education Standards-Emergency Medical Technician Instructional Guidelines", The United States Department of Transportation, National Highway Traffic Safety Administration, DOT HS 811 077C, January 2009;
(b) "EMT Initial Certification Application" in KEMSIS, July 2019;
(c) "EMT Certification Renewal Application" in KEMSIS, July 2019;
(d) "EMT Reciprocity Certification Application" in KEMSIS July 2019;
(e) "EMT Reinstatement Certification Application" in KEMSIS, July 2019;
(f) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;
(g) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;
(h) "EMT Supplemental Curriculum Training Verification Report", July 2019;
(i) "EMT Certification Downgrade Application" in KEMSIS, July 2019;
(j) "EMT Certification Surrender Application" in KEMSIS, July 2019;
(k) "National Registry of Emergency Medical Technicians National Continued Competency Program EMT", October 2016;
(l) "Name Change Application" in KEMSIS, July 2019;
(m) "Military Extension Application" in KEMSIS, July 2019; and
(n) "United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card)", July 2019.
(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board's Web site at: kyems.com.
History
- RELATES TO: KRS 12.355, 311A.010, 311A.025, 311A.050-311A.090, 311A.095, 311A.100, 311A.120, 311A.130, 311A.140, 311A.145, 311A.165, 10 U.S.C. 121, 12304
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.140, 311A.165
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.025 requires the board to promulgate administrative regulations relating to Emergency Medical Technicians. This administrative regulation establishes requirements for Emergency Medical Technicians.
- History: 30 Ky.R. 149; 917; 1216; 1478; eff. 11-19-2003; Cert eff. 2-19-2019; 47 Ky.R. 2433, 48 Ky.R. 394; eff. 9-22-2021; 49 Ky.R. 1488, 1913; eff. 6-21-2023; 51 Ky.R. 752; eff. 2-5-2025.
202 KAR 7:330 Advanced emergency medical technician {#sec-202-kar-7-330 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:330}
Section 1. Advanced Emergency Medical Technician Student Eligibility. An individual shall be eligible to enroll as a student in an Advanced Emergency Medical Technician education and training program if the applicant:
(1) Is currently certified at a minimum of an Emergency Medical Technician by the board or the NREMT;
(2) Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification; and
(3) Meets all additional requirements established by the EMS Training and Educational Institution (EMS-TEI).
Section 2. Certification Requirements.
(1) Individuals desiring initial certification as an Advanced Emergency Medical Technician shall:
(a) Successfully complete a board approved education and training program that conforms to the curriculum of the United States Department of Transportation, National Highway Traffic Safety Administration National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines, except that the educational curriculum shall not be satisfied by the completion of refresher or transition courses alone;
(b) Meet all educational standards established in 202 KAR 7:601;
(c) Obtain certification as a NREMT-Advanced Emergency Medical Technician;
(d) Be a citizen of the United States, a permanent resident of the United States, or otherwise lawfully present in the United States, as evidenced by submission to the board of:
-
A Social Security card;
-
Birth certificate;
-
A United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card); or
-
Other legal authorization to live and work in the United States.
(e) Submit a completed AEMT Initial Certification Application in KEMSIS; and
(f) Pay the fee pursuant to 202 KAR 7:030 for certification as an Advanced Emergency Medical Technician.
(2) An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:
(a) National in scope for an applicant not currently certified at any level in Kentucky;
(b) Statewide in scope for an applicant with current certification in Kentucky;
(c) Less than six (6) months old when the applicant submits to the board all requirements for certification; and
(d) Provided by a vendor that has been contracted through the board.
(3) An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check.
Section 3. Renewal of Certification and Continuing Education Requirements.
(1) An Advanced Emergency Medical Technician shall be eligible for certification renewal if:
(a) The applicant submits a completed AEMT Certification Renewal Application in KEMSIS;
(b) The applicant maintains written evidence of:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma as required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120;
(c) The applicant pays the fee required for renewal pursuant to 202 KAR 7:030; and
(2) The applicant maintains evidence of:
(a) Current certification by the National Registry of Emergency Medical Technicians as an Advanced Emergency Medical Technician, except that if this option is used, the board may request, through a continuing education audit, proof of continuing education to verify compliance with the continuing education requirements of this section; or
(b) Successful completion of the NREMT Advanced Emergency Medical Technician National Component of the Continued Competency Program, for Continuing Education which shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(3) An application for certification renewal shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the applicable requirements of this section;
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application; or
(c) The applicant is delinquent on fines or fees owed to the board pursuant to KRS 311A.055, 311A.060, or 202 KAR 7:030.
(4) A certified Advanced Emergency Medical Technician, in good standing, who is a member of a branch of the United States National Guard or a military reserve unit called to active duty by presidential order pursuant to 10 U.S.C. §§ 121 and 12304, shall be renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.
(5) The board office may audit an Advanced Emergency Medical Technician's continuing education and continuing education records.
(6) The Advanced Emergency Medical Technician shall submit the documentation requested within ten (10) business days of receipt of the board's request. If documentation of continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the Advanced Emergency Medical Technician certification for the individual shall be summarily revoked and the individual shall reapply for certification through Reinstatement if eligible.
(7) The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.
(8) The Advanced Emergency Medical Technician shall maintain documentation of all continuing education for three (3) years from the date of completion.
Section 4. Reinstatement of Certification.
(1) An Advanced Emergency Medical Technician whose Kentucky certification has lapsed shall be eligible for reinstatement of certification if the applicant submits:
(a) A completed AEMT Reinstatement Certification Application in KEMSIS; and
(b) Evidence of:
-
Previous certification as an Advanced Emergency Medical Technician in the Commonwealth of Kentucky;
-
Proof of current training in:
a. Pediatric Abusive Head Trauma as required by KRS 311A.120;
b. Awareness of Sexual Violence Training required by KRS 311A.120; and
c. HIV/AIDS training required by KRS 311A.120.
(2) The applicant shall pay the fee pursuant to 202 KAR 7:030.
(3) The applicant for reinstatement of certification shall undergo a national background check provided by a vendor that has been contracted through the board.
(a) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(b) Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of reinstatement of certification.
(4) The applicant for reinstatement of certification shall bear the burden of proof of previous certification in Kentucky if the previous certification is in issue or dispute.
(5) An applicant for reinstatement of an Advanced Emergency Medical Technician certification shall submit to the board evidence of successful completion of the NREMT Advanced Emergency Medical Technician National Component of the Continued Competency Program for Continuing Education within the twelve (12) months preceding application for reinstatement of the Advanced Emergency Medical Technician.
(6) An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.
Section 5. Advanced Emergency Medical Technician Reciprocity.
(1) An individual who is certified in another state or by the NREMT as an Advanced Emergency Medical Technician or any member of the United States Armed Forces, or veteran who has transitioned within the past six (6) years from the United States Armed Forces, and has been registered by the National Registry as an Advanced Emergency Medical Technician or EMT and has successfully completed a board-approved United States Armed Forces medical training course shall be eligible for reciprocity for certification as an Advanced Emergency Medical Technician in Kentucky if the applicant submits:
(a) A completed AEMT Reciprocity Certification Application in KEMSIS;
(b) Proof of the applicant's current unrestricted NREMT certification as an Advanced Emergency Medical Technician or current Advanced Emergency Medical Technician certification in another state or proof of completing a board-approved United States Armed Forces medical training course which included NREMT-Emergency Medical Technician certification; and
(c) Proof of current training in:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma training required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120.
(2) An applicant shall pay the fee required for certification through reciprocity pursuant to 202 KAR 7:030.
(3) An applicant for Advanced Emergency Medical Technician reciprocity shall undergo a national background check provided by a vendor that has been contracted through the board. An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check. Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of certification through reciprocity.
(4) An applicant shall not have been convicted of offenses described in KRS 311A.050.
(5) An applicant shall not have been subjected to discipline that would prevent reciprocity at the time of application.
(6) An Advanced Emergency Medical Technician certified pursuant to Section 2 of this administrative regulation shall not perform any procedures or skill on which the Advanced Emergency Medical Technician has not been trained. An Advanced Emergency Medical Technician who performs a skill for which the Advanced Emergency Medical Technician does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.050.
(7) An Advanced Emergency Medical Technician certified pursuant to this section shall complete the Kentucky supplemental Advanced Emergency Medical Technician curricula for the procedures listed in 202 KAR 7:701 prior to beginning work for a licensed agency in Kentucky.
(8) Kentucky supplemental Advanced Emergency Medical Technician curricula consistent with 202 KAR 7:701 shall be provided during employee orientation, or by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(9) Verification of competency on the supplemental curricula procedures in 202 KAR 7:701 shall be maintained by the Advanced Emergency Medical Technician for a minimum of three (3) years. Failure to submit the AEMT Supplemental Curriculum Training Verification Report shall result in revocation of Advanced Emergency Medical Technician certification.
(10) If an Advanced Emergency Medical Technician certified pursuant to this section fails to supply verification of competency as required by subsection (7) of this section the Advanced Emergency Medical Technician shall be ineligible to apply for and receive Advanced Emergency Medical Technician reciprocity certification until the applicant has submitted the AEMT Supplemental Curriculum Training Verification Report as required pursuant to 202 KAR 7:701, and shall reapply for Reciprocity through the process set forth in this section.
Section 6. Scope of Practice. An Advanced Emergency Medical Technician shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model and 202 KAR 7:701.
Section 7. Expiration of Certification.
(1) Certification periods and expiration dates shall be pursuant to KRS 311A.095.
(2) If an Advanced Emergency Medical Technician's certification lapses or expires, the Advanced Emergency Medical Technician shall cease provision of emergency medical services.
(3) An Advanced Emergency Medical Technician who has allowed his or her certification to lapse or expire shall be required to reinstate certification pursuant to Section 4 of this administrative regulation.
Section 8. Downgrading Certification.
(1) An Advanced Emergency Medical Technician currently certified as an Advanced Emergency Medical Technician by the board shall be eligible for certification downgrade if:
(a) The certification is in good standing with no pending disciplinary action;
(b) The applicant submits a completed AEMT Certification Downgrade Application in KEMSIS; and
(c) The applicant pays the fee established in 202 KAR 7:030.
(2) An Advanced Emergency Medical Technician is only eligible to downgrade his or her certification to an Emergency Medical Technician or Emergency Medical Responder certification.
(3) Certification periods and expiration dates shall be pursuant to KRS 311A.095.
(4) An applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:
(a) Statewide in scope for an applicant with current certification in Kentucky;
(b) Less than six (6) months old when the applicant submits to the board all requirements for certification; and
(c) Provided by a vendor that has been contracted through the board.
(5) Downgrade shall be denied if the applicant has not met the requirements of this section or has been subject to disciplinary action that prevents certification at the time of application.
(6) The applicant shall be responsible for meeting the renewal requirements of the downgraded certification level issued prior to expiration of that certification.
(7) To reinstate the certification or license that was previously held, the applicant shall meet the regulatory requirements for that level of certification or licensure.
(8) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon downgrading his or her certification.
(9) Once the applicant has downgraded his or her certification or license, the applicant is no longer permitted to provide emergency medical services at the previous certification or license level held.
(10) An applicant applying for downgrade who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
(11) All endorsements, certifications, or licenses held at the previous certification or license level shall be void at the completion of the downgrade.
Section 9. Surrender of Certification.
(1) An Advanced Emergency Medical Technician surrendering certification shall:
(a) Submit a completed AEMT Certification Surrender Application in KEMSIS; and
(b) Pay the fee established in 202 KAR 7:030.
(2) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon surrendering his or her certification.
Section 10. Reporting Requirements.
(1) An Advanced Emergency Medical Technician shall maintain current demographic information in KEMSIS including:
(a) Legal name;
-
Any changes to an AMET's legal name shall be submitted using the Name Change Application in KEMSIS; and
-
One (1) of the following documents as verification of name change:
a. Social Security card;
b. Driver's license; or
c. Passport;
(b) Mailing address;
(c) Email address; and
(d) Phone number.
(2) An Advanced Emergency Medical Technician who does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
Section 11. Exemptions from Advanced Emergency Medical Technician Administrative Regulations. Certification requirements for an Advanced Emergency Medical Technician shall not apply to:
(1) United States military members, state National Guard personnel, or employees of the United States government if the individual provides emergency medical services:
(a) On land owned by the United States government;
(b) In facilities owned by the United States government;
(c) In the performance of official duties under federal law; or
(d) As part of assistance for a mass casualty or disaster incident pursuant to federal law or official state assistance request; or
(2) An Advanced Emergency Medical Technician certified in another state or territory of the United States who:
(a) Enters Kentucky with a patient being transported to a medical facility or other final destination in Kentucky; or
(b) Travels through Kentucky during the course of a patient transport from an out-of-state location to a destination outside of Kentucky.
Section 12. Public Notice of Negative Action. The board office shall cause to be published on the board Web site the name of an Advanced Emergency Medical Technician who:
(1) Is fined;
(2) Is placed on probationary status;
(3) Is placed on restricted status;
(4) Is suspended; or
(5) Has had his or her certification revoked.
Section 13. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines", The United States Department of Transportation, National Highway Traffic Safety Administration, DOT HS 811 077D, January 2009;
(b) "AEMT Initial Certification Application" in KEMSIS, July 2019;
(c) "AEMT Certification Renewal Application" in KEMSIS, July 2019;
(d) "AEMT Reciprocity Certification Application" in KEMSIS, July 2019;
(e) "AEMT Reinstatement Certification Application" in KEMSIS, July 2019;
(f) "AEMT Supplemental Curriculum Training Verification Report", July 2019;
(g) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;
(h) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;
(i) "AEMT Certification Downgrade Application" in KEMSIS, July 2019;
(j) "AEMT Certification Surrender Application" in KEMSIS, July 2019;
(k) "National Registry of Emergency Medical Technicians National Continued Competency Program AEMT", October 2016;
(l) "Name Change Application" in KEMSIS, July 2019;
(m) "Military Extension Application" in KEMSIS, July 2019; and
(n) "United States Citizenship and Immigration Services (U.S.C.I.S.) Permanent Resident Card (form I-551/Green Card)", July 2019.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board's Web site at: kyems.com.
History
- RELATES TO: KRS 12.355, 38.030, Chapter 39, 39A.050, 311A.010, 311A.020, 311A.025, 311A.050-311A.090, 311A.095, 311A.100, 311A.120, 311A.140, 311A.145, 311A.150, 311A.195, 10 U.S.C. 121, 12304
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.025(2) requires the board to promulgate administrative regulations relating to the standards for training, education, examination, certification, practice, and recertification of the Advanced Emergency Medical Technician (AEMT). This administrative regulation establishes requirements for Advanced Emergency Medical Technician.
- History: 35 Ky.R. 467, 1153, eff. 12-5-2008; 39 Ky.R.2050; 40 Ky.R. 25; 273; eff. 8-21-2013; Cert eff. 2-12-2020; 47 Ky.R. 2439, 48 Ky.R. 400; eff. 9-22-2021; 49 Ky.R.1492, 1916; eff. 6-21-2023; 51 Ky.R. 756; eff. 2-5-2025.
202 KAR 7:401 Paramedics {#sec-202-kar-7-401 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:401}
Section 1. Paramedic Student Eligibility. Individuals shall be eligible to enroll as a student in a paramedic education and training program if the applicant:
(1) Holds current unrestricted certification as an Emergency Medical Technician or Advanced Emergency Medical Technician in Kentucky or holds current unrestricted certification with the National Registry of Emergency Medical Technicians (NREMT) as an Emergency Medical Technician or Advanced Emergency Medical Technician;
(2) Is not currently subject to disciplinary action pursuant to KRS Chapter 311A that would prevent licensure; and
(3) Meets all additional requirements established by the EMS Training and Educational Institution (EMS-TEI).
Section 2. Licensure Requirements.Individuals desiring initial licensure as a paramedic shall:
(1) Successfully complete a board approved education and training program that conforms to the curriculum of the United States Department of Transportation, National Highway Traffic Safety Administration, National Emergency Medical Services Education Standards- Paramedic Instructional Guidelines;
(2) Successfully complete all EMS-Training and Educational Institute (EMS-TEI) requirements for the education or training program that:
(a) Meet or exceed the National Emergency Medical Services Educational Standards- Paramedic Instructional Guidelines, which shall not be satisfied by the completion of refresher or transition courses alone; and
(b) Meet all educational standards established in 202 KAR 7:601;
(3) Obtain certification as a paramedic by the National Registry of Emergency Medical Technicians;
(4) Submit a completed Paramedic Initial Licensure Application in the Kentucky Emergency Medical Services Information System (KEMSIS);
(5) Pay the fee pursuant to 202 KAR 7:030;
(6) Undergo a background check pursuant to KRS 311A.050 and 311A.100.
(a) The background check shall be:
-
National in scope for an applicant not currently certified at any level in Kentucky;
-
Statewide in scope for an applicant with current certification in Kentucky;
-
Less than six (6) months old when the applicant submits to the board all requirements for licensure; and
-
Provided by a vendor that has been contracted through the board; and
(b) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check; and
(7) Be a citizen of the United States, a permanent resident of the United States, or otherwise lawfully present in the United States, as evidenced by submission to the board of:
(a) A Social Security card;
(b) Birth certificate;
(c) A United States Citizenship and Immigration Services (US.C.I.S.) Permanent Resident Card (form I-551/Green Card); or
(d) Other legal authorization to live and work in the United States.
Section 3. Renewal of Licensure and Continuing Education Requirements.
(1) A paramedic shall be eligible for license renewal if:
(a) The applicant submits a completed Paramedic License Renewal Application in KEMSIS;
(b) The applicant maintains written evidence of:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma as required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120;
(c) The applicant pays the fee pursuant to 202 KAR 7:030; and
(d) The applicant maintains evidence of:
-
Current certification by the NREMT as a paramedic, and if this option is used the board may request, through a continuing education audit, proof of continuing education to verify compliance with the continuing education requirements of this section; or
-
NREMT Paramedic National Component of the Continued Competency Program Paramedic for Continuing Education.
(2) All continuing education shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(3) An application for renewal of licensure shall be denied if:
(a) Prior to the licensure expiration date, the paramedic applicant has not met the applicable requirements of this administrative regulation; or
(b) The applicant has been subjected to disciplinary action that prevents relicensure at the time of application.
(4) A licensed paramedic, in good standing, who is a member of a National Guard or a military reserve unit called to active duty by presidential order pursuant to 10 U.S.C. 121 and 12304 shall be renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.
(5) The board office may audit a paramedic's continuing education and continuing education records. The paramedic shall submit the documentation requested within ten (10) business days of receipt of the board's request.
(6) If documentation of continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the paramedic license for the individual shall be summarily revoked and the individual shall reapply for licensure through reinstatement if eligible.
(7) The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.
(8) The paramedic shall maintain documentation of all continuing education for three (3) years from the date of completion.
Section 4. Reinstatement of License.
(1) A paramedic whose Kentucky license has lapsed may reinstate their license if the applicant submits:
(a) A completed Paramedic Reinstatement License Application in KEMSIS;
(b) Evidence of previous licensure as a paramedic in the Commonwealth of Kentucky;
(c) Evidence of current training in:
-
Pediatric Abusive Head Trauma as required by KRS 311A.120;
-
Awareness of Sexual Violence Training required by KRS 311A.120; and
-
HIV/AIDs training required by KRS 311A.120; and
(d) Payment of the fee pursuant to 202 KAR 7:030.
(2)
(a) The applicant for reinstatement of license shall undergo a national background check provided by a vendor that has been contracted through the board.
(b) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(c) Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of reinstatement of license.
(3) The applicant for reinstatement of licensure shall bear the burden of proof of previous licensure in Kentucky if the previous paramedic license is in issue or dispute.
(4) An applicant shall provide evidence of successful completion of the NREMT-Paramedic national component of the continued competency program for continuing education within the twelve (12) months preceding application for reinstatement of the paramedic license.
(5) An applicant ineligible for licensure pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.
Section 5. Paramedic Reciprocity.
(1) An individual who is certified or licensed in another state or by the NREMT as a paramedic or any member of the United States Armed Forces, or veteran who has transitioned within the past six (6) years from the United States Armed Forces, and has been registered by the National Registry as a paramedic or has obtained National Registry as a paramedic by successfully completing a board-approved United States Armed Forces medical training course that meets the National Emergency Medical Services Education Standards for Paramedic, shall be eligible for reciprocity for Kentucky licensure as a paramedic if the applicant submits:
(a) A completed Paramedic Reciprocity Licensure Application in KEMSIS;
(b) Proof of the applicant's current unrestricted certification as a NREMT-Paramedic, or current paramedic license in another state, or proof of completing a board-approved United States Armed Forces medical training course which included NREMT-Emergency Medical Technician certification and completion of a board-approved bridge course; and
(c) Completion of current training in:
-
HIV/AIDS training required by KRS 311A.120;
-
Pediatric Abusive Head Trauma training required by KRS 311A.120; and
-
Awareness of Sexual Violence Training required by KRS 311A.120.
(2) An applicant shall pay the fee required for licensure through reciprocity pursuant to 202 KAR 7:030.
(3) An applicant for paramedic reciprocity shall undergo a national background check provided by a vendor that has been contracted through the board. An applicant shall not directly submit a background check. The background check shall be submitted to the board by the company that conducts the background check. Background checks that are older than six (6) months shall not be considered current, and the applicant shall undergo another national background check prior to approval of licensure through reciprocity.
(4) An applicant shall not have been convicted of offenses described in KRS 311A.050.
(5) An applicant shall not have been subjected to discipline that would prevent reciprocity at the time of application.
(6) A paramedic licensed pursuant to this section shall not perform any procedures or skill on which the paramedic has not been trained. A paramedic who performs a skill for which the paramedic does not have documented training shall have exceeded the scope of practice and shall be in violation of KRS 311A.050.
Section 6. Scope of Practice. A paramedic shall provide emergency medical services consistent with the skills and procedures in the National EMS Scope of Practice Model and 202 KAR 7:701.
Section 7. Expiration of Licensure.
(1) Licensure periods and expiration dates shall be pursuant to KRS 311A.095.
(2) If a paramedic license lapses or expires, the paramedic shall cease provision of emergency medical services.
(3) A paramedic who has allowed his or her license to lapse or expire shall be required to reinstate his or her licensure pursuant to Section 4 of this administrative regulation.
Section 8. Downgrading Licensure.
(1) A paramedic currently licensed as a paramedic by the board shall be eligible for licensure downgrade if:
(a) The license is in good standing with no pending disciplinary action;
(b) The applicant submits a completed Paramedic License Downgrade Application in KEMSIS; and
(c) The applicant pays the fee pursuant to 202 KAR 7:030;
(2) A paramedic shall only be eligible to downgrade his or her license to an Advanced Emergency Medical Technician, Emergency Medical Technician, or Emergency Medical Responder certification.
(3) Certification periods and expiration dates shall be pursuant to KRS 311A.095.
(4) The applicant shall undergo a background check pursuant to KRS 311A.050 and 311A.100. The background check shall be:
(a) Statewide in scope for an applicant with current certification in Kentucky;
(b) Less than six (6) months old when the applicant submits to the board all requirements for certification; and
(c) Provided by a vendor that has been contracted through the board.
(5) Downgrade shall be denied if the applicant has not met the requirements of this section or has been subject to disciplinary action that prevents certification at the time of application.
(6) The applicant shall be responsible for meeting the renewal requirements of the downgraded certification level issued prior to expiration of that certification.
(7) To reinstate the certification or license that was previously held, the applicant shall meet the regulatory requirements for that level of certification or licensure.
(8) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon downgrading his or her license.
(9) Once the applicant has downgraded his or her certification or license, the applicant shall not provide emergency medical services at the previous certification or license level held.
(10) An applicant applying for downgrade that does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
(11) All endorsements, certifications, or licenses held at the previous certification or license level shall be void at the completion of the downgrade.
Section 9. Surrender of License.
(1) A paramedic surrendering licensure shall:
(a) Submit a completed Paramedic License Surrender Application in KEMSIS; and
(b) Pay the fee pursuant to 202 KAR 7:030.
(2) The applicant shall notify the board's licensed service director with whom the applicant is affiliated immediately upon surrendering his or her license.
Section 10. Reporting Requirements.
(1) A paramedic shall maintain current demographic information in KEMSIS including:
(a) Legal name;
-
Any changes to the paramedic's legal name shall be submitted using the Name Change application in KEMSIS; and
-
One (1) of the following documents as verification of name change:
a. Social Security card;
b. Driver's license; or
c. Passport;
(b) Mailing address;
(c) Email address; and
(d) Phone number.
(2) A paramedic that does not comply with this section shall be subject to disciplinary action pursuant to KRS Chapter 311A.
Section 11. Discontinuance of Resuscitative Efforts.A paramedic shall discontinue resuscitation efforts if presented with a properly executed Kentucky Emergency Medical Services Do Not Resuscitate (DNR) Order, or properly executed Kentucky Medical Orders for Scope of Treatment (MOST) form.
Section 12. Critical Care Endorsement.
(1) A paramedic licensed by the board may be granted a critical care endorsement upon completion of the Application for Paramedic Critical Care Endorsement, payment of the fee pursuant to 202 KAR 7:030, and completion of a board-approved training program that minimally meets the objectives of the University of Maryland Baltimore Campus CCEMTP Program.
(2) The critical care endorsement shall be valid if the paramedic maintains current licensure as a paramedic by the board.
(3) A paramedic with a critical care endorsement may perform the skills and procedures included in the paramedic's education and training subject to authorization by the medical director through established protocols.
(4) Notwithstanding subsection (1) of this section, applications for critical care endorsements shall no longer be accepted after June 30, 2025.
(5) Notwithstanding subsections (1) through (3) of this section, on and after January 1, 2027, critical care endorsements shall not be valid. Paramedics wishing to provide critical care on and after January 1, 2027, shall obtain an advanced practice paramedic license and certification as a critical care paramedic in accordance with 202 KAR 7:410.
Section 13. Exemptions from Paramedic Administrative Regulations. The Kentucky licensure requirements for a paramedic shall not apply to:
(1) United States military members, National Guard personnel, or employees of the United States government if the individual provides emergency medical services:
(a) On land owned by the United States government;
(b) In facilities owned by the United States government;
(c) In the performance of official duties under federal law; or
(d) As part of assistance for a mass casualty or disaster incident pursuant to federal law or official state assistance request; or
(2) A paramedic licensed in another state or territory of the United States who:
(a) Enters Kentucky with a patient being transported to a medical facility or other final destination in Kentucky; or
(b) Travels through Kentucky during the course of a patient transport from an out-of-state location to a destination outside of Kentucky.
Section 14. Public Notice of Negative Action. The board office shall cause to be published on the board website the name of a paramedic that:
(1) Is fined;
(2) Is placed on probationary status;
(3) Is placed on restricted status;
(4) Is suspended; or
(5) Has had his or her certification revoked.
Section 15. The paramedic shall document all items required by Sections 11 and 12 of this administrative regulation on the Patient Care Report required by KRS 311A.190.
Section 16. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "National Emergency Medical Services Education Standards-Paramedic Instructional Guidelines", The United States Department of Transportation, National Highway Traffic Safety Administration, DOT HS 811 077E, January 2009;
(b) "Paramedic Initial Licensure Application" in KEMSIS, April 2021;
(c) "Paramedic License Renewal Application" in KEMSIS, April 2021;
(d) "Paramedic Reciprocity Licensure Application" in KEMSIS, April 2021;
(e) "Paramedic Reinstatement License Application" in KEMSIS, April 2021;
(f) "Kentucky Emergency Medical Services Do Not Resuscitate (DNR) Order", April 2021;
(g) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;
(h) "National EMS Scope of Practice Model", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;
(i) "Kentucky Medical Orders for Scope of Treatment (MOST) Form", April 2021;
(j) "Application for Paramedic Critical Care Endorsement" in KEMSIS, April 2021;
(k) "Paramedic License Downgrade Application" in KEMSIS, April 2021;
(l) "Paramedic License Surrender Application", in KEMSIS April 2021;
(m) "National Registry of Emergency Medical Technicians National Continued Competency Program Paramedic", October 2016;
(n) "National Registry of Emergency Medical Technicians Advanced Level Examination Coordinator Manual", November 1, 2016;
(o) "Name Change Application" in KEMSIS, April 2021;
(p) "Military Extension Application" in KEMSIS, April 2021; and
(q) "United States Citizenship and Immigration Services (U.S.C.IS) Permanent Resident Card (form I-551/Green Card)", April 2021.
(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board's Web site at: kyems.com.
History
- RELATES TO: KRS 12.355, 72.020, 311A.025, 311A.030, 311A.050-311A.100, 311A.120, 311A.135, 311A.142, 311A.170, 311A.190, 446.400
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.120, 311A.125, 311A.135, 311A.170
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.025 requires the board to promulgate administrative regulations relating to requirements and procedures for licensure, relicensure, and reciprocity for paramedics. This administrative regulation establishes those requirements and procedures.
- History: 30 Ky.R. 152; 920; 1218; 1480; eff. 11-19-2003; Cert eff. 2-19-2019; 47 Ky.R. 2445, 48 Ky.R. 406; eff. 9-22-2021; 49 Ky.R. 1497; eff. 6-21-2023; 51 Ky.R. 760, 1433; eff. 2-13-2025.
202 KAR 7:410 Advanced Practice Paramedics {#sec-202-kar-7-410 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:410}
Section 1. Licensure of Advanced Practice Paramedics. In accordance with this administrative regulation, the board office shall issue an advanced practice paramedic license to an individual certified as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic.
Section 2. Certification of Community Paramedics.
(1) Individuals desiring initial board certification as a community paramedic shall:
(a) Hold a current unrestricted license as a paramedic in Kentucky;
(b) Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;
(c) Submit a course completion certification from an education and training program that minimally meets the International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline topic areas;
(d) Submit proof of current certification as a community paramedic (CP-C) by the International Board of Specialty Certification (IBSC);
(e) Submit a completed Initial Advanced Practice Paramedic License Application in KEMSIS; and
(f) Pay the fee required by 202 KAR 7:030.
(2) To be eligible for renewal of a community paramedic certification, a community paramedic shall:
(a) Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;
(b) Submit a completed EMS Clinician Renewal in KEMSIS;
(c) Pay the renewal fee required by 202 KAR 7:030, Section 3; and
(d) Maintain written evidence of:
-
Current certification by the International Board of Specialty Certification (IBSC) as a community paramedic (CP-C); or
-
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Community Paramedic Content Outline topic areas.
(3) An application for renewal of community paramedic certification shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.
Section 3. Certification of Wilderness Paramedics.
(1) Individuals desiring initial board certification as a wilderness paramedic shall:
(a) Hold a current unrestricted license as a paramedic in Kentucky;
(b) Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;
(c) Submit a course completion certificate from an education and training program that minimally meets the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas;
(d) Submit proof of current certification as a wilderness paramedic (WP-C) from the International Board of Specialty Certification (IBSC);
(e) Submit a completed Initial Advanced Practice Paramedic License Application in KEMSIS; and
(f) Pay the fee required by 202 KAR 7:030.
(2) To be eligible for renewal of a wilderness paramedic certification, a wilderness paramedic shall:
(a) Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;
(b) Submit a completed EMS Clinician Renewal in KEMSIS;
(c) Pay the renewal fee required by 202 KAR 7:030, Section 3; and
(d) Maintain written evidence of:
-
Current certification by the International Board of Specialty Certification (IBSC) as a wilderness paramedic (WP-C); or
-
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline topic areas.
(3) An application for renewal of a wilderness paramedic certification shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.
Section 4. Certification of Critical Care Paramedics.
(1) Individuals desiring initial board certification as a critical care paramedic shall:
(a) Hold a current unrestricted license as a paramedic in Kentucky;
(b) Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;
(c) Submit a course completion certificate from an education and training program that minimally meets the International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline topic areas;
(d) Submit proof of current certification as a critical care paramedic (CCP-C) from the International Board of Specialty Certification (IBSC);
(e) Submit a completed Initial Advanced Practice Paramedic License Application in KEMSIS; and
(f) Pay the fee required by 202 KAR 7:030.
(2) To be eligible for renewal of a critical care paramedic certification, a critical care paramedic shall:
(a) Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;
(b) Submit a completed EMS Clinician Renewal in KEMSIS;
(c) Pay the renewal fee required by 202 KAR 7:030, Section 3; and
(d) Maintain written evidence of:
-
Current certification by the International Board of Specialty Certification (IBSC) as a critical care paramedic (CCP-C); or
-
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline topic areas.
(3) An application for renewal of a critical care paramedic certification shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification at the time of application.
Section 5. Certification of Flight Paramedics.
(1) Individuals desiring initial board certification as a flight paramedic shall:
(a) Hold a current unrestricted license as a paramedic in Kentucky;
(b) Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;
(c) Submit a course completion certificate from an education and training program that minimally meets the International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline topic areas;
(d) Submit proof of current certification as a flight paramedic (FP-C) from the International Board of Specialty Certification (IBSC);
(e) Submit a completed Initial Advanced Practice Paramedic License Application in KEMSIS; and
(f) Pay the fee required by 202 KAR 7:030.
(2) To be eligible for renewal of a flight paramedic certification, a flight paramedic shall:
(a) Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;
(b) Submit a completed EMS Clinician Renewal in KEMSIS;
(c) Pay the renewal fee required by 202 KAR 7:030, Section 3; and
(d) Maintain written evidence of:
-
Current certification by the International Board of Specialty Certification (IBSC) as a flight paramedic (FP-C); or
-
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline topic areas.
(3) An applicant for renewal of a flight paramedic certification shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.
Section 6. Certification of Tactical Paramedics.
(1) Individuals desiring initial board certification as a tactical paramedic shall:
(a) Hold a current unrestricted license as a paramedic in Kentucky;
(b) Not currently be subject to disciplinary action pursuant to KRS Chapter 311A that would prevent certification;
(c) Submit a course completion certificate from an education and training program that minimally meets the International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline topic areas;
(d) Submit proof of current certification as a tactical paramedic (TP-C) from the International Board of Specialty Certification (IBSC);
(e) Submit a completed Initial Advanced Practice Paramedic License Application in KEMSIS; and
(f) Pay the fee pursuant to 202 KAR 7:030.
(2) To be eligible for renewal of a tactical paramedic certification, a tactical paramedic shall:
(a) Meet the requirements for paramedic licensure renewal in accordance with 202 KAR 7:401;
(b) Submit a completed EMS Clinician Renewal in KEMSIS;
(c) Pay the renewal fee pursuant to 202 KAR 7:030; and
(d) Maintain written evidence of:
-
Current certification by the International Board of Specialty Certification (IBSC) as a tactical paramedic (TP-C); or
-
At least fifty (50) hours of continuing education in the International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline topic areas.
(3) An application for renewal of a tactical paramedic certification shall be denied if:
(a) Prior to the certification expiration date, the applicant has not met the requirements of this section; or
(b) The applicant has been subjected to disciplinary action that prevents certification renewal at the time of application.
Section 7. Transition for Currently Certified Providers.
(1) Proof of a successful course completion certification shall not be required for initial licensure and certification if:
(a) At the time of application, the applicant is certified as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic by the International Board of Specialty Certification (IBSC); and
(b) The application is submitted on or before September 30, 2026.
(2) Proof of current certification as a community paramedic (CP-C) by the International Board of Specialty Certification (IBSC) shall not be required for initial licensure and certification as a community paramedic if:
(a) At the time of application, the applicant is operating under a board-approved community paramedic pilot program; and
(b) The application is submitted on or before September 30, 2026.
(3) Proof of current certification as a critical care paramedic (CCP-C) from the International Board of Specialty Certification (IBSC) shall not be required for initial licensure and certification as a critical care paramedic if:
(a) At the time of application, the applicant has a board-issued critical care paramedic endorsement; and
(b) The application is submitted on or before September 30, 2026.
Section 8. Advanced Practice Paramedic License and Certification Renewal for Active-Duty Members of the Armed Forces. A licensed advanced practice paramedic in good standing, who is a member of the Armed Forces of the United States and called to active duty by presidential order pursuant to 10 U.S.C. 121 and 12304, shall have his or her advanced practice paramedic license and certification renewed in accordance with KRS 12.355 upon submission of the Military Extension Application.
Section 9. Certification and Continuing Education Validation and Audits.
(1) All continuing education for advanced practice paramedics shall be validated by entities authorized to conduct continuing education pursuant to 202 KAR 7:601.
(2) The board office may audit an advanced practice paramedic's continuing education record and IBSC certification. Upon request, the advanced practice paramedic shall submit the requested documentation within ten (10) business days of receipt of the board office's request.
(3) If documentation of IBSC certification or continuing education hours required by this administrative regulation are not received using the board-approved submission process within ten (10) business days of receipt of the board's request, the advanced practice paramedic license and certification shall be deemed to have lapsed and the individual shall reapply for licensure and certification through reinstatement, if eligible.
(4) The ten (10) business days for submission shall not apply to investigations conducted pursuant to KRS Chapter 311A.
(5) Each advanced practice paramedic shall maintain documentation of all IBSC certifications and all continuing education for three (3) years from the date of completion.
Section 10. Expiration of Advanced Practice Paramedic License and Certification.
(1) A board-issued advanced practice paramedic license and a board-issued certification as a community paramedic,wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic shall lapse or expire upon lapse or expiration of the individual's board-issued paramedic license pursuant to KRS 311A.095.
(2) An individual whose board-issued advanced practice paramedic license and board-issued certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic has lapsed or expired shall cease providing the specialty care authorized by the lapsed or expired license and certification.
Section 11. Scope of Practice.
(1) An advanced practice paramedic may perform care consistent with the skills, procedures, and techniques established in the current board-approved EMS Advanced Practice Paramedic Scope of Practice document.
(2) Assessment of techniques, skills, and procedures of an advanced practice paramedic shall be subject to the board-approved agency medical protocols adopted by the advance practice paramedic's agency.
(3) Each agency that adopts skills, procedures, and techniques established in the current board-approved EMS Advanced Practice Paramedic Scope of Practice document shall implement and maintain a policy requiring annual clinical competency assessments for employees licensed as advanced practice paramedics.
Section 12. Exemptions to this Administrative Regulation. The advanced practice paramedic licensure and certification requirements established by this administrative regulation shall not apply to United States military members, National Guard personnel, or employees of the United States government if the individual provides services:
(1) On land owned by the United States government;
(2) In facilities owned by the United States government;
(3) In the performance of official duties under federal law; or
(4) As part of assistance for a mass casualty or disaster incident pursuant to federal law or an official state assistance request.
Section 13. Public Notice of Negative Action. The board office shall cause to be published on the board's Web site the name of an advanced practice paramedic who:
(1) Is fined;
(2) Is placed on probationary status;
(3) Is placed on restricted status;
(4) Is suspended; or
(5) Has had their license or certification revoked.
Section 14. Surrender of Advanced Practice Paramedic License and Certification.
(1) An advanced practice paramedic surrendering his or her license as an advanced practice paramedic and certification as a community paramedic,wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic shall:
(a) Submit a completed License/Certification Surrender in KEMSIS; and
(b) Pay the fee pursuant to 202 KAR 7:030.
(2) Upon surrendering an advanced practice paramedic license and applicable certification, the surrendering individual shall immediately give notice to his or her agency's chief operations or service director.
Section 15. Reinstatement of Advanced Practice Paramedic License and Certification.
(1) An advanced practice paramedic whose license and certification has lapsed or expired may reinstate his or her advanced practice paramedic license and certification by submitting to the board:
(a) A completed Reinstatement Certification/License Application in KEMSIS;
(b) The reinstatement fee pursuant to 202 KAR 7:030, Section 4;
(c) Proof of current unrestricted license as a paramedic in Kentucky;
(d) Proof of previous licensure as an advanced practice paramedic in Kentucky; and
(e) Proof of current IBSC certification as a community paramedic, wilderness paramedic, critical care paramedic, flight paramedic, or tactical paramedic.
(2) The applicant for reinstatement shall undergo a background check pursuant to KRS 311A.100, which shall be:
(a) Statewide in scope for an applicant with a current license or certification in Kentucky;
(b) Less than six (6) months old when the applicant submits to the board all requirements for certification; and
(c) Provided by a vendor approved by the board.
(3) The applicant for reinstatement shall bear the burden of proof of previous licensure and certification in Kentucky if previous certification or licensure is in dispute.
(4) An applicant who is ineligible for certification pursuant to KRS 311A.050 through 311A.090 shall be ineligible for reinstatement.
Section 16. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Initial Advanced Practice Paramedic License Application", (12/2024);
(b) "Reinstatement Certification/License Application", (12/2024);
(c) "License/Certification Surrender", (12/2024);
(d) "EMS Clinician Renewal", (04/2025);
(e) "EMS Advanced Practice Paramedic Scope of Practice", document, (10/2024);
(f) "International Board of Specialty Certification (IBSC) Community Paramedicine Content Outline", (2019);
(g) "International Board of Specialty Certification (IBSC) Critical Care Paramedic Content Outline", (2016);
(h) "International Board of Specialty Certification (IBSC) Flight Paramedic Content Outline", (2020);
(i) "International Board of Specialty Certification (IBSC) Tactical Paramedic Content Outline", (2016);
(j) "International Board of Specialty Certification (IBSC) Wilderness Paramedic Content Outline", (2022).
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m. This material is also available on the agency's Web site at http://kbems.ky.gov or in KEMSIS at http://kemsis.ky.gov.
History
- RELATES TO: KRS 12.355, 311A.050-311A.100, 311A.170
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.120, 311A.125, 311A.135, 311A.170(3)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.170(3) requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations establishing the educational requirements, testing requirements, credentialing, and licensure requirements of advanced practice paramedics. This administrative regulation establishes those requirements.
- History: 202 KAR 007:410. 50 Ky.R. 1213, 1684; eff. 2-16-2024; 51 Ky.R. 1524, 1847; eff. 7-30-2025.
202 KAR 7:501 Ambulance agency licensure {#sec-202-kar-7-501 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:501}
Section 1. Applying for Licensure.
(1) An applicant shall submit:
(a) A completed Initial Ground Agency License Application, accessed at kemsis.ky.gov;
(b) An application fee as established in 202 KAR 7:030; and
(c) A written description of the ambulance agency's geographic service area within the Commonwealth, which shall identify with specificity the complete boundary of the area served by the provider upon applying for initial licensure or if the service area has changed since the last written description was provided to the KBEMS office. The written description shall accurately reflect the service area as identified by the provider's Certificate of Need, if appropriate.
(2) The board shall conduct a physical inspection of an agency's premises prior to granting a license or license renewal.
(3) A license to operate shall be issued only for the person, service area, and premises, including the number of ambulances, named in the application, and shall not be transferable.
(4) An agency shall display its license in a prominent public area at the service base station and at any fixed satellite location.
(5) The following information shall be included on the license issued by the office of the board:
(a) Operating name of the provider;
(b) Physical location of the base station;
(c) The number and physical location of satellite stations, if any, operated by the licensee;
(d) The license classification;
(e) The level of service provided; and
(f) The specific geographic area to be served by the licensee.
(6) A license shall expire on December 31 following the original date of issue and shall subsequently expire annually on December 31 of each year.
Section 2. License Renewal. To renew a license, the holder shall:
(1) Submit a completed Renewal Application for Class I, II, III, and IV Agencies, accessed at kemsis.ky.gov;
(2) Pass inspection conducted by the board of the agency's premises, equipment, supplies, vehicles, and records; and
(3) Submit a fee in the amount established in 202 KAR 7:030.
Section 3. Agency Changes.
(1) A new application shall be filed if a change of ownership occurs. A change of ownership for licenses shall be deemed to occur if more than fifty (50) percent of the assets, capital stock, or voting rights of a corporation or agency is purchased, transferred, leased, or acquired by comparable arrangement by one (1) person or entity from another.
(2) A new license application filed due to a change of ownership shall be filed, at minimum, ten (10) days prior to the change of ownership. The new license shall be issued for the remainder of the previous licensure period.
(3) There shall be full disclosure to the board of the changes, such as name and address, of:
(a) Each person having direct or indirect ownership interest of ten (10) percent or more in the agency;
(b) Officers and directors of the corporation, if an agency is organized as a corporation; or
(c) Partners, if an agency is organized as a partnership.
Section 4. Inspections.
(1) Compliance with licensing pursuant to this administrative regulation shall be validated through on-site inspections of the agency by representatives or employees of the KBEMS Office. The inspection shall include a:
(a) Safety and maintenance check of all vehicles in operation;
(b) Review of all equipment and supplies stocked on vehicles; and
(c) Review of personnel records, policy manuals, and other reports required to be maintained pursuant to 202 KAR Chapter 7.
(2) Each representative or employee of the KBEMS Office shall have access to the service during hours that the agency operates.
(3) A regulatory violation identified during an inspection shall be transmitted in writing to the agency by the KBEMS office.
(4) Within ten (10) business days of receipt of the statement of violation, the agency shall submit a written plan for the elimination or correction of a regulatory violation to the KBEMS office.
(5) The plan shall specify the date by which the violations shall be corrected.
(6) Within ten (10) business days following receipt of the plan, the KBEMS office shall notify the agency in writing whether or not the plan is accepted as providing for the elimination or correction of the violation.
(7) The KBEMS office may conduct a follow-up visit to verify compliance with the plan.
(8) If a portion or all of the plan is unacceptable:
(a) The KBEMS office shall specify why the plan cannot be accepted; and
(b) The provider shall modify or amend the plan and resubmit it to the KBEMS office within ten (10) business days after receipt of notice that the plan is unacceptable.
(9) Unannounced inspections may be conducted for a:
(a) Complaint allegation;
(b) Follow-up visit;
(c) Relicensing inspection; or
(d) Random compliance audit.
Section 5. Unethical Conduct.
(1) The following acts shall be considered unethical conduct in the practice of providing emergency medical services and may be subject to the sanctions established in KRS 311A.060:
(a) Failure to submit, amend, or modify a plan of correction in order to eliminate or correct regulatory violations;
(b) Failure to eliminate or correct regulatory violations;
(c) Falsifying an application for licensing;
(d) Changing a license issued by the board;
(e) Attempting to obtain or obtaining a license by:
-
Fraud;
-
Forgery;
-
Deception;
-
Misrepresentation; or
-
Subterfuge;
(f) Providing false or misleading advertising;
(g) Falsifying, or causing to be falsified reports regarding patient care or other reports provided to the KBEMS office;
(h) Providing an unauthorized level of service;
(i) Failing to provide the board or its representative with information upon request, or obstructing an investigation regarding alleged or confirmed violations of KRS Chapter 311A or 202 KAR Chapter 7;
(j) Issuing a payment on an invalid account or an account with insufficient funds to pay established fees, fines, or charges;
(k) Submitting fraudulent or misleading claims for reimbursement; or
(l) Failure to comply with local ordinances, federal statutes, KRS Chapter 311A, or 202 KAR Chapter 7.
(2) Unless the agency receives prior approval from the board, an agency whose license is currently under disciplinary review shall not be eligible to sell the license to another entity until all fines or fees owed to the board are satisfied and any associated legal action has been fully resolved.
(3) A licensed agency shall not be disciplined for responding to calls outside of its geographic service area if the agency is providing:
(a) Mutual aid at the request of and under an existing agreement with another licensed agency whose geographic service area includes the area in which the emergency or non-emergency call originates;
(b) Disaster assistance;
(c) Interfacility medical transfer from damaged or closed health facilities;
(d) Interfacility medical transfer to residents of its service area, who are patients in facilities outside of its service area, for the purpose of returning the patients to their home service area or transporting them to another health facility;
(e) A response authorized by 202 KAR 7:555; or
(f) Scheduled and non-scheduled medically necessary ambulance transportation within another service area if the licensed agency or agencies within the service area have denied response.
Section 6. Exemptions from Administrative Regulations.
(1) The following situations shall be exempt from the provisions of this administrative regulation:
(a) First aid or transportation provided in accordance with KRS 216B.020(2)(f);
(b) A vehicle serving as an ambulance during a disaster or major catastrophe; or
(c) A vehicle operated by the U.S. government on property owned by the U.S. government.
(2) Out-of-state agencies licensed by and in good standing with another state shall be exempt from the provisions of this administrative regulation unless the agency:
(a) Transports a patient from a Kentucky location to another Kentucky location; or
(b) Transports a Kentucky resident from Kentucky to another state more than six (6) times during a calendar year.
(3) In addition to the exemption established in subsection (2) of this section, out-of-state agencies licensed by and in good standing with a state contiguous to Kentucky shall be exempt from the provisions of this administrative regulation when the agency is responding to a mutual aid request from a Kentucky licensed provider for emergency assistance if the out-of-state agency is the closest service appropriately capable of responding to the request or if Kentucky licensed providers:
(a) Are unavailable;
(b) Have already responded; or
(c) Are physically unable to reach the incident.
Section 7. Public Notice of Negative Action. The board office shall publish, on the KBEMS website or similar publication of the board, or otherwise disseminate, the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
Section 8. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Initial Ground Agency License Application", (5/2025); and
(b) "Renewal Application for Class I, II, III, and IV Agencies", (5/2025).
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor, 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board's website at: kbems.ky.gov.
History
- RELATES TO: KRS 216B.020(2)(f), 311A.030, 311A.060
- STATUTORY AUTHORITY: KRS 311A.020(1), 311A.025, 311A.030(1)
- CERTIFICATION STATEMENT: This is to certify that this administrative regulation complies with the requirements of 2025 RS HB 6, Section 8.
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020(1) requires the Board of Emergency Medical Services to exercise all administrative functions in the regulation of the EMS system and the licensing of ambulance services and medical first response agencies, except those regulated by the Board of Medical Licensure or the Cabinet for Health and Family Services. KRS 311A.030(1) requires the board to promulgate administrative regulations for the licensing, inspection, and regulation of ambulance providers and medical first response agencies. This administrative regulation establishes minimum ambulance agency licensing requirements.
- History: 202 KAR 007:501. 30 Ky.R. 155; 923; 1221; 1483; eff. 11-19-2003; 44 Ky.R. 1637, 2187; eff. 5-4-2018; 52 Ky.R. 87, 557; eff. 10-22-2025.
202 KAR 7:510 Air ambulance services {#sec-202-kar-7-510 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:510}
Section 1. Provider Licensing Requirements.
(1) A person or entity shall not provide, advertise, or profess to engage in the provision of air ambulance service originating in Kentucky without having first obtained a license from the board pursuant to this administrative regulation.
(2) A provider shall comply with local ordinances, state and federal statutes and administrative regulations.
(3) A provider shall display its license in a prominent public area at the service base station and all satellite locations. The following information shall be included on the license:
(a) Operating name of the provider;
(b) Physical location of the base station;
(c) The number and physical location of satellite stations, if any, operated by the licensee;
(d) The license classification;
(e) The level of service provided;
(f) The number of rotor and fixed-wing aircraft operated by the provider; and
(g) The specific geographic area to be served by the licensee.
(4) Providers shall provide the KBEMS Office with an accurate map and a written description of its geographic service area within the commonwealth, which shall identify with specificity the complete boundary of the area served by the provider when applying for initial licensure or if the service area has changed since the last map was provided to the KBEMS Office.
(5) A licensed provider may respond to emergency calls outside of its geographic service area only if the provider is providing:
(a) Mutual aid under an existing agreement with another licensed provider whose geographic service area includes the area in which the emergency call is made;
(b) Disaster assistance; or
(c) Nonemergency transfers from damaged or closed health facilities.
Section 2. Licensing, Inspection and Change of Ownership.
(1) To obtain a license, an air ambulance provider shall file a "Kentucky Application for Ambulance Service Licensing", Form EMS-1 (6/96), with the KBEMS Office.
(2) An applicant for a license or a licensee shall, as a condition precedent to licensing or relicensing, be in compliance with all applicable sections of this administrative regulation as determined through means including a physical inspection process, subject to subsection (4)(b) of this section.
(3) A license shall expire on December 31 following the original date of issue and shall subsequently expire annually on December 31 of each year.
(4) A license may be renewed upon:
(a) Payment of the prescribed fee; and
(b) Action by the board, based upon recommendation of staff following the physical inspection of the provider.
(5) A license to operate shall be issued only for the person or entity, service area, and premises, including the number of aircraft, named in the application, and shall not be transferable.
(6) A new application shall be filed if a change of ownership of an air ambulance service occurs. A change of ownership for licenses shall be deemed to occur if more than fifty (50) percent of the assets, capital stock, or voting rights of a corporation or provider operating an air ambulance is purchased, transferred, leased, or acquired by comparable arrangement by one (1) person or entity from another.
(7) If a new application for a license is filed due to change of ownership, the new license shall be issued for the remainder of the current licensure period.
(8) There shall be full disclosure to the board of the changes in ownership, including the name and address, of:
(a) Each person having direct or indirect ownership interest of ten (10) percent or more in the service;
(b) Officers and directors of the corporation, if a service is organized as a corporation; or
(c) Partners, if a provider is organized as a partnership.
(9) Representatives of the board shall have access to the service during hours that the service operates.
(10) A regulatory violation identified during an inspection shall be transmitted in writing by the board and given to the provider.
(11) The provider shall submit a written plan for the elimination or correction of a regulatory violation to the KBEMS Office within ten (10) working days after receipt of the statement of violation and shall include the specific date by which the violation may be corrected.
(12) Within ten (10) working days following a review of the plan, the KBEMS Office shall notify the provider in writing whether or not the plan is accepted as providing for the elimination or correction of the violation.
(13) The KBEMS Office may conduct a follow-up visit to verify compliance with the plan.
(14) If a portion or all of the plan is insufficient:
(a) The KBEMS Office shall specify the reasons why the plan cannot be accepted; and
(b) The provider shall modify or amend the plan and resubmit it to the KBEMS Office within ten (10) days after receipt of notice that the plan is insufficient.
(15) Unannounced inspections may be conducted at the discretion of the board or its representative.
(16) Any licensed provider may be recommended for discipline based upon:
(a) Failure to submit, amend, or modify a plan of correction to eliminate or correct regulatory violations;
(b) Failure to eliminate or correct regulatory violations;
(c) Falsifying an application for licensing;
(d) Changing a license issued by the board;
(e) Attempting to obtain or obtaining a license by:
-
Fraud;
-
Forgery;
-
Deception;
-
Misrepresentation; or
-
Subterfuge;
(f) Providing false or misleading advertising;
(g) Falsifying, or causing to be falsified a:
-
Patient record;
-
Service run report; or
-
Other reports provided to the KBEMS Office;
(h) Providing an unauthorized level of service;
(i) Demonstrating a history of staff violations that have resulted in disciplinary action;
(j) Failing to provide the board or its representative with information upon request, or obstructing an investigation regarding alleged or confirmed violations of statutes or administrative regulations;
(k) Issuing a check for a license on an invalid account or an account with insufficient funds to pay fees to KBEMS;
(l) Submitting fraudulent or misleading claims for reimbursement to:
-
An individual;
-
A private insurance company;
-
A governmental agency; or
(m) Any violation of KRS Chapter 311A or 202 KAR Chapter 7.
Section 3. Utilization of Aircraft by Licensed Providers.
(1) At the time of initial inspection, each provider shall inform the KBEMS Office of the make, model, year, serial number, and FAA identification number for each aircraft it uses.
(2) Except as provided by this administrative regulation, an aircraft shall not be placed into operation until after the board has been notified and has verified through a physical inspection that the aircraft meets the requirements of this administrative regulation.
(3) Each provider shall notify the KBEMS Office via U.S. mail, email, or fax, no later than the next board business day, of the permanent removal of any licensed aircraft from service by the license holder.
(4) A licensed provider may use a replacement aircraft on a temporary basis if an approved aircraft is out of service, if:
(a) The KBEMS Office receives notice within twenty-four (24) hours or on the next business day by fax or email of the need for the provider to place an aircraft into service on a temporary basis; and
(b) Within five (5) business days, the provider provides the board written notice identifying:
-
The make, model, year, serial number, and FAA identification number for the aircraft being removed from service and for the aircraft being placed into temporary service; and
-
The temporary replacement aircraft meets the requirements of this administrative regulation.
(5) A temporary replacement aircraft shall not be used for more than sixty (60) days, unless the KBEMS Office has verified through a physical inspection that it meets the requirements of this administrative regulation.
(6) The KBEMS Office shall be notified by email or fax within twenty-four (24) hours or on the next business day when a temporary aircraft is removed from service and the original licensed aircraft is returned to service.
(7) A provider that fails to meet the reporting requirements for use of a temporary aircraft may be required to immediately cease use of the replacement aircraft until the reporting requirements are met.
(8) A provider that fails to remove a temporary aircraft from service upon written order may be fined an amount not to exceed $1,000 per day for each day or partial day the aircraft is in service and the reporting requirements are not met.
(9) This administrative regulation shall not prevent a provider from utilizing other means of transporting patients in:
(a) Disasters;
(b) Mass casualty incidents; or
(c) Extraordinary scene conditions that may impair the safety of the patient or personnel operating at the scene.
Section 4. Provider Management Requirements.
(1) All providers shall:
(a) Maintain an organizational chart that establishes lines of authority, including the designation of:
-
An administrator responsible for assuring compliance with this administrative regulation during the daily operation of the service; and
-
A designee who shall serve in the absence of the administrator;
(b) Maintain records and reports at the ambulance service base station or at a location where the records can be made readily available to KBEMS staff including an original, microfilm, electronic equivalent, or copy of all run reports whether reported on:
-
The EMS-8A and EMS-8B "Kentucky Emergency Medical Ambulance Run Report" (9/98), with all nonshaded portions of the run report completed as appropriate for each patient and each run; or
-
A paper or electronic run form developed by the provider that contains all of the data components of the nonshaded areas of the EMS-8A and EMS-8B (9/98);
(c) Maintain a copy of all completed run report forms, maintained to ensure confidentiality and safekeeping, for a minimum of five (5) years from the date on which the service was rendered, or in the case of a minor, until five (5) years after the minor reaches eighteen (18) years of age. Copies of run reports shall be accessible so as to be immediately available to the board, KBEMS Office, or representatives upon request;
(d) Maintain personnel files for each employee or volunteer who staffs an aircraft. Personnel files shall be maintained for a minimum of five (5) years following separation from employment. As a minimum, personnel files shall contain:
-
Current certification or licensure with corresponding numbers and expiration dates for the position that the individual fulfills on the aircraft;
-
Proof that the provider has conducted a pre-employment criminal background check; and
-
Health records, maintained in accordance with state and federal laws and administrative regulations, in a separate secure file, that include:
a. A post-offer of employment health assessment;
b. Annual tuberculin skin testing or other method of evaluation;
c. Hepatitis-B vaccinations and seroconversion testing unless exempted by the employees' physician, or an employee signed waiver; and
d. A record of all work-related illnesses or injuries;
(e) Maintain a plan and records for the provision of continuing education for staff and volunteers including a written plan for the method of assessment of staff continuing education needs and a coordinated plan to meet those needs including:
-
Training or continuing education rosters that include the printed name, signature, and certification or license number of those in attendance;
-
A curriculum vitae for the instructor; and
-
A brief outline of the presentation including the educational objective for the offering and the method of presentation used for the presentation;
(f) Maintain an infection control plan in accordance with KyOSHA guidelines;
(g) Maintain a written plan for training or educating personnel for responding to hazardous materials, criminal, and potential terrorist incidents, including plans for the protection and decontamination of patients, aircraft, equipment, and staff;
(h) Maintain a written plan for the quality assessment of patient care and provider quality improvement including a periodic review of ambulance run report forms, and evaluation of staff performance related to patient care. This plan shall address as a minimum:
-
Aircraft maintenance as it impacts the clinical aspects of patient care delivery, employee health and safety;
-
Compliance with protocols and operating procedures;
-
Transport response and transport limitations;
-
Assessment of dispatch procedures;
-
Aircraft operations and safety;
-
Equipment preventive maintenance programs; and
-
A process for the resolution of customer complaints;
(i) Maintain a written plan for training personnel and responding to mass casualty incidents and disasters, which shall include an internal incident command structure and how it will integrate into a community response plan;
(j) Maintain an orientation program for all personnel related to:
-
Aircraft, scene, ground, and base safety;
-
Communication equipment at the base station and on each aircraft;
-
The location and use of fire extinguishers;
-
Transport response and transport limitation standards;
-
Map reading and geographic orientation;
-
Mutual aid agreements;
-
Cleaning of equipment including aircraft;
-
Stretcher operations and use;
-
Completion of run reports; and
-
Other standard operating procedures that have been established by the provider;
(k) Maintain proof of professional liability malpractice insurance;
(l) Maintain proof of aircraft liability insurance;
(m) Provide a copy of the current FAA Air Carrier Certificate; and
(n) Maintain a written policy regarding patient criteria for interfacility transfers including a written statement of medical necessity signed by a physician for each patient transferred.
(2) Each provider shall, in the county in which their base station or a substation is located:
(a) Document evidence of participation in county emergency management disaster exercises, if conducted;
(b) Coordinate with the county emergency management director plans for the possible utilization of a provider's personnel for use in the emergency operations center in a disaster; and
(c) Maintain a copy of the county and state emergency management agency's emergency operations plan at the ambulance base station.
Section 5. Operating Requirements.
(1) All air ambulance providers shall provide service twenty-four (24) hours a day, seven (7) days a week, subject to safety issues and weather conditions established in Part 135 of the FAR. These provisions may be met through a call system or through mutual aid agreements.
(2) A provider shall have a written plan, developed in consultation with the air ambulance provider's medical director, that requires:
(a) Utilization of the air medical intake flow chart;
(b) Dispatch of requests for emergency service within two (2) minutes of the call taker's determination of the correct address or location of the emergency incident site and completion of a weather check;
(c) Disclosure of the accurate availability of provider's aircraft, including the estimated time of arrival to the requesting agency. If the provider's closest aircraft is not available, and so requested by the requesting agency, the provider shall attempt to contact the closest known aircraft to the scene; and
(d) The air ambulance provider to share current aircraft position data, through computer interface with other air ambulance providers, if the air ambulance provider utilizes a satellite tracking position mechanism.
(3) A provider may enter into mutual aid agreements with other Kentucky licensed air ambulance services operating within the same geographic area.
(4) A provider may accept a request to provide service outside of its service area except it shall require documentation from the requesting facility or provider that a good faith effort was made to utilize a provider licensed for the area.
(5) A preventive maintenance program shall be maintained that complies with Part 135 FAR or Part 92 FAR.
(6) Minimally, documentation of annual inspections or annual preventative maintenance records in addition to any records of maintenance performed shall be maintained by the provider to support evidence of periodic inspections or calibrations required for maintenance and operation of medical equipment utilized on the aircraft.
(7) Each aircraft and its equipment shall be checked after each use to ensure that it is in a clean and sanitary condition, unless precluded by emergency conditions. Minimally, documentation shall be maintained by the provider to support the evidence of a daily medical equipment checklist.
(8) A communications system shall be developed, coordinated, and maintained by each ambulance provider. The communication system shall meet the following requirements:
(a) Radio equipment used in emergency medical services aircraft shall be appropriately licensed through the FCC. Copies of the current FCC licenses shall be on file in the provider's office;
(b) Aircraft shall be equipped with two (2) way radio communication equipment capable, under normal conditions, of contacting dispatch centers and hospitals;
(c) Aircraft shall have air-to-air, ground-to-air, and air-to-ground communication capabilities and shall be capable of communicating with ground personnel to properly coordinate the landing and primary medical responders on the ground who may be caring for the patient;
(d) Aircraft shall have a minimum of two (2) portable communication devices capable of operating on the provider frequency that shall be provided for personnel when away from the aircraft; and
(e) All aircraft when approaching and departing a landing zone in uncontrolled airspace shall announce their intentions to other aircraft via 123.025 MHz.
(9) Air ambulance providers shall comply with FAR specifications for flight following and position plotting by a provider based or maintained communication center. The communication center shall be equipped with communications equipment and staffed by a properly trained ACS to receive and coordinate all calls as provided for by FAR. If providing fixed-wing service, this requirement may be met by filing an FAA flight plan.
(10) An ACS shall have documented training appropriate to the transport of the provider that shall as a minimum address the following areas:
(a) FAA and FCC regulations pertinent to air ambulance operations;
(b) Air medical radio communications;
(c) Medical terminology;
(d) Flight coordination and utilization;
(e) Navigation and weather interpretation;
(f) Flight following; and
(g) Emergency procedures.
(11) An air ambulance provider shall provide proof that it:
(a) Complies with FAR pertaining to maintenance inspections, flight, and duty time;
(b) Complies with FAA and FAR required maintenance activities; and
(c) Holds FAR required air ambulance operations specifications.
Section 6. Aircraft Requirements.
(1) Fixed and rotor-wing air ambulance aircraft shall:
(a) Have an entry that allows patient loading and unloading without tilting the patient greater than thirty (30) degrees from the horizontal axis;
(b) Be climate controlled and maintain a temperature of not less than sixty-five (65) degrees nor more than eighty-five (85) degrees Fahrenheit in the patient compartment during patient transport or demonstrate a procedure for maintaining patient temperature sufficient to prevent hypothermia and hyperthermia;
(c) Keep all pharmaceuticals within the recommended temperature range as established by the manufacturer or as otherwise established by FDA standards;
(d) Utilize an alternate aircraft or alternate mode of transportation, if the environment within the aircraft is such that it would be detrimental to the staff's physical welfare or the patient's condition, until those conditions are alleviated;
(e) Be configured in such a way that air medical personnel shall have access to the patient to begin and maintain both basic and advanced life support;
(f) Have interior lighting adequate to ensure complete observation of the patient;
(g) Have a procedure in place to limit light in the cockpit area during night operation;
(h) Have an electric inverter, with two (2) outlets, to convert direct current (DC) to alternating current (AC) for operation of specialized equipment, such as an isolette or intra-aortic balloon pump;
(i) Have equipment, stretchers, and seating:
-
Arranged so as not to block rapid egress by air ambulance personnel or patients; and
-
Affixed or secured in FAA approved racks, compartments, or strap restraints which meet FAR "G" loading requirements;
(j) Have a patient stretcher or litter which:
-
Has the capability to raise the head of the patient; and
-
Has appropriate devices to secure the patient to the stretcher;
(k) Provide proof of an FAR Part 135 certificate with an FAR required air ambulance specification; and
(l) Not transport more patients, personnel, and other persons than can be safely secured by means of seat safety belts or similar devices in the aircraft during flight.
(2) Fixed-wing aircraft shall be pressurized if patient flights are to exceed 6000 feet mean sea level.
Section 7. Air Ambulance Medical Personnel.
(1) A rotor-wing air ambulance service operating an ALS aircraft shall assure that it is minimally staffed by:
(a) A pilot as required by this administrative regulation; and
(b) Two (2) attendants that meet one (1) of the following staffing configurations:
-
A Kentucky licensed paramedic and RN authorized to practice in the state of Kentucky pursuant to KRS Chapter 314;
-
A RN and RN both of which are authorized to practice in the state of Kentucky pursuant to KRS Chapter 314; or
-
A physician authorized to practice in the state of Kentucky pursuant to KRS Chapter 311 and RN authorized to practice in the state of Kentucky pursuant to KRS Chapter 314.
(2) Each attendant required by subsection (1)(b) of this section shall additionally maintain documentation of current certification or the equivalent thereof as approved by the board of the following:
(a) ACLS;
(b) BLS;
(c) PALS;
(d)
-
PHTLS;
-
ITLS; or
-
TNATC; and
(e) NRP.
(3) BLS fixed-wing patient transports shall be minimally staffed by:
(a) A pilot as required by this administrative regulation; and
(b) Two (2) attendants whom shall be minimally certified as EMT's by the board.
(4) ALS fixed-wing patient transports shall be minimally staffed by:
(a) A pilot as required by this administrative regulation; and
(b) Two (2) attendants of which:
- The first patient attendant shall be:
a. A flight nurse; or
b. A RN authorized to practice in the state of Kentucky pursuant to KRS Chapter 314, qualified by specific patient population, experience, and current competencies in emergency and critical care; and
- The second patient attendant shall be:
a. A RN authorized to practice in the state of Kentucky pursuant to KRS Chapter 314, qualified by specific patient population, experience, and current competency in emergency and critical care;
b. A licensed paramedic;
c. A certified or registered respiratory therapist qualified by specific patient population, experience, and current competency in mission-specific patient care; or
d. A physician authorized to practice in the state of Kentucky pursuant to KRS Chapter 311 and qualified by relevant training, experience, and current competency in mission-specific patient care.
(5) A staffing variance on an ALS fixed-wing patient mission necessitated by staffing or patient care requirements shall not be permitted unless prior approval is granted by the medical director or designee.
(6) ALS specialty care patient transports by rotor or fixed wing air ambulance shall be minimally staffed by:
(a) A pilot meeting the requirements of this administrative regulation; and
(b) Two (2) attendants with relevant training, experience, and current competency in transport-specific patient care as authorized by the medical director or designee of which:
- The first patient attendant shall be:
a. A RN authorized to practice in the state of Kentucky pursuant to KRS Chapter 314;
b. A nurse practitioner; or
c. A physician authorized to practice in the state of Kentucky pursuant to KRS Chapter 311; and
- The second patient attendant shall be:
a. A RN authorized to practice in the state of Kentucky pursuant to KRS Chapter 314;
b. A Kentucky licensed paramedic;
c. A certified or registered respiratory therapist;
d. A nurse practitioner; or
e. A physician authorized to practice in the state of Kentucky pursuant to KRS Chapter 311.
(7) All regular and specialty care air ambulance patient attendants shall attend and document flight orientation training. Flight orientation training shall include:
(a) Altitude physiology;
(b) Aircraft-specific operations and in-flight safety;
(c) Emergency egress and survival training;
(d) Crew resource management; and
(e) Communication equipment utilization and emergency procedures.
(8) All regular air ambulance patient attendants shall complete and document additional flight orientation training to include:
(a) Scene safety;
(b) Use of extrication equipment;
(c) Scene triage;
(d) Kentucky EMS statutes and administrative regulations;
(e) Advanced airway management;
(f) Anatomy, physiology, and assessment of adult, pediatric, and neonatal patients as outlined within the program's scope of care;
(g) Cardiac emergencies and advanced critical car;
(h) Burns;
(i) Environmental emergencies;
(j) High risk OB;
(k) Multitrauma emergencies;
(l) Toxicology;
(m) Hazardous materials awareness level training;
(n) Hemodynamic monitoring;
(o) Mechanical ventilation and respiratory physiology; and
(p) Pharmacology;
(9) All regular air ambulance patient attendants shall complete and document annual continuing education which shall include a review of:
(a) Infection control;
(b) Kentucky EMS administrative regulations regarding ground and air transport;
(c) Crew resource management;
(d) Stressors of flight if not included in crew resource management;
(e) Survival training; and
(f) Skill maintenance program or competency program for invasive, high risk, or low volume procedures as outlined in the program's scope of care.
(10) An attendant shall remain with the patient, in the patient compartment, at all times during transport.
(11) All aircraft responding to flights originating in Kentucky shall be licensed by the board.
(12) Aircraft that are licensed in Kentucky may use the staffing requirements of the state in which they are located if they are licensed in that state and the staffing requirements for that state, at a minimum, for scene flights shall be:
(a) Paramedic and RN;
(b) RN and RN; or
(c) Physician and RN.
(13) This administrative regulation shall not prevent a provider from utilizing staff other than that required by this administrative regulation in:
(a) Disasters;
(b) Mass casualty incidents; or
(c) Extraordinary scene conditions that may impair the safety of the patient or personnel operating at the scene.
(14)
(a) Staffing configurations as outlined in this administrative regulation may supplement or replace the patient care attendants on a ground ambulance licensed in Kentucky for the purpose of facilitating the care and the transport of a patient if:
-
The aircraft was unable to complete a patient flight due to deteriorating weather conditions or other unplanned events; or
-
For the purpose of providing a continuum of care from the scene to the aircraft or from the aircraft to the patient destination.
(b) Air ambulance personnel shall assure the availability of necessary equipment to care for the patient during transport.
Section 8. Provider Requirements for Air Ambulance Pilots. The air ambulance provider shall assure that prior to performing emergency medical service transports the PIC complies with all requirements as set forth in 14 FAR Part 135.4. All documentation of having met this requirement shall be provided upon request.
Section 9. Basic Life Support Equipment and Supplies.
(1) All rotor air ambulance providers shall carry and maintain, in full operational order, the following minimum BLS equipment and supplies:
(a) Suction equipment, which shall include:
-
Two (2) sources of suction apparatus, one (1) of which shall be fixed, and one (1) of which shall be portable;
-
Rigid catheters;
-
Flexible catheters in adult, pediatric, and infant sizes;
-
Bulb syringe or meconium aspiration device for infant and neonate suction;
(b) Oxygen and airway supplies and equipment, including:
-
An installed oxygen system with a capacity of at least 2,000 liters of oxygen for each aircraft;
-
Portable oxygen system supplying at least 300 liters;
-
A backup source of oxygen, which may be the required portable tank if it is carried in the patient care area during flight in the event the main system fails. The backup source shall be delivered via a nongravity dependent delivery device;
-
Pressure gauge and flow rate regulator for fixed and portable units with a range of zero to fifteen (15) liters per minute;
-
Oxygen supply tubing;
-
Transparent nonrebreather oxygen masks for adults and pediatrics;
-
Nasal cannulas for adults and pediatrics;
-
Disposable adult, pediatric, and infant bag-valve-mask ventilation units with oxygen reservoir, oxygen tubing, and masks;
-
Nasopharyngeal and oropharyngeal airway kits in sizes for adult and children with water soluble lubricant; and
-
Bite stick;
(c) Trauma equipment and supplies including:
-
Two (2) sterile universal dressings at least 10 in. x 30 in., compactly folded and packaged;
-
Four (4) by four (4) gauze pads;
-
Soft roller self-adhering bandages, various sizes;
-
Four (4) rolls of adhesive tape, minimum of two (2) sizes;
-
Two (2) sterile burn sheets;
-
Two (2) eye protector pads and shields or an approved substitute;
-
Two (2) occlusive dressings;
-
Shears for bandages;
-
Splints, including:
a. Lower extremity mechanical traction splint in adult and pediatric sizes; and
b. Splints for arm, full leg and foot using semi-rigid immobilization devices; and
- Immobilization devices, including:
a. Lower adult and pediatric long spine boards or other full body immobilization device with straps and cervical immobilization accessories;
b. Five (5) rigid, still cervical collars in four (4) different sizes including pediatric sizes; and
c. Towel rolls or other bulk dressings to be used for cervical immobilization for infants;
(d) Patient assessment and management equipment and supplies, including:
-
Adult, obese adult, pediatric, and infant sphygmomanometer cuffs with stethoscope. A permanently mounted sphygmomanometer shall not satisfy this requirement;
-
One (1) penlight;
-
An AED with a minimum of two (2) complete sets of pads for all non-ALS air ambulances;
-
A device for monitoring pulse oximetry; and
-
Thermometer;
(e) Personal protective equipment, which shall be available to each staff member responding on the aircraft, including:
-
One (1) clean scrub gown or substitute, such as disposable coveralls;
-
Simple disposable face mask;
-
Clear protective goggles or safety glasses;
-
Disposable gloves;
-
One (1) particulate filter mask rated at N95 or better without an exhaust port for patient use;
-
One (1) particulate filter mask rated at N95 or better with or without an exhaust port for protection of crew members; and
-
A means of cleansing the hands, such as disposable towelettes or other solutions;
(f) Patient comfort items including:
-
Two (2) clean blankets and sheets; and
-
An emesis container or similar substitute; and
(g) Miscellaneous supplies, including:
-
Hand held flashlight capable of providing adequate lighting to assess a scene or a patient away from the aircraft;
-
One (1) sterile obstetrical kit;
-
Instant glucose; and
-
One (1) multipurpose fire extinguisher which meets FAA requirements for each specific aircraft and configuration.
(2) All aircraft shall have a stretcher or litter with:
(a) Head-raising capabilities;
(b) An FAA approved aircraft-specific mechanism for securing the stretcher or litter in the aircraft during transit; and
(c) An FAA approved aircraft-specific patient to stretcher securing mechanism.
(3) Cleaning materials shall be available, including:
(a) Hospital type disinfectants;
(b) Glass or multisurface cleaner;
(c) Trash bags for disposal of nonbiohazard waste materials;
(d) Biohazard bags for the disposable of biohazard waste; and
(e) Environment, terrain, and mission-specific rescue and survival supplies
(4) Current expiration dates shall be required for any item that carries an expiration date.
Section 10. Advanced Life Support Equipment and Supplies.
(1) All ALS providers shall maintain evidence in the form of a letter that medical protocols have been reviewed and approved by the board.
(2) In addition to the BLS equipment required in Section 9 of this administrative regulation, an ALS provider shall carry on each aircraft, and maintain in fully-operational order, supplies and equipment required by the providers protocols, including as a minimum:
(a) Endotracheal intubation equipment consisting of:
-
Laryngoscope handle;
-
Various laryngoscope blades in adult, pediatric, and infant sizes;
-
Extra batteries and bulbs for handles or blades;
-
A minimum of seven (7) different sizes of endotracheal tubes for oral and nasal placement in adult, pediatric, and infant sizes;
-
Equipment necessary to perform emergency cricothyrotomy;
-
Alternative airway device to include at least one (1) of the following:
a. LMA;
b. Combitube;
c. King Airway; or
d. Additional alternative airway device as approved by the service medical director;
- End tidal carbon dioxide detection devices, including:
a. A Capnography device that provides continuous waveform and digital readout of end tidal CO2; and
b. A disposable colormetric device;
-
Stylettes in adult and pediatric sizes;
-
Magill forceps in adult and pediatric sizes;
-
One-half (1/2) inch wide twill tape or equivalent for securing endotracheal tubes; and
-
Water soluble lubricant for lubrication of endotracheal and nasotracheal tubes;
(b) A portable monitor defibrillator that:
-
Is capable of displaying a visual display of cardiac electrical activity;
-
Is capable of providing a hard copy of cardiac electrical activity measure;
-
Is capable of delivering direct current energy over a variable range, which is suitable for pediatric and adult usage;
-
Is capable of providing external cardiac pacing;
-
Has adult and pediatric external paddle electrodes or pads, capable of utilization for immediate monitoring of heart activity and delivery of counter shock in both the adult and pediatric patient;
-
Is capable of being operated from internal rechargeable batteries;
-
Has synchronized counter-shock capability for cardioversion; and
-
Has a patient monitoring cable with:
a. Electrode paste or gel or equivalent;
b. Electrode pads or equivalent for use with the patient monitoring cable; and
c. One (1) additional roll of paper for hard copy printout;
(c) Pulse oximeter;
(d) Mechanical ventilation device;
(e) Sterile, disposable needles in types and sizes sufficient for personnel to administer medications and perform procedures allowed by the providers' patient treatment protocols;
(f) Disposable syringes in types and sizes sufficient for personnel to administer medications and perform procedures allowed by the providers' patient treatment protocols;
(g) Restriction band appropriate for use with venipuncture procedure;
(h) Dextrostix or equivalent for the measure of blood glucose levels;
(i) Disposable, individually-packaged antiseptic wipes;
(j) Intravenous fluids as required by the provider's protocol, with macrodrip and microdrip fluid sets, extension sets and accessory items including over-the-needle catheter devices in sizes fourteen (14) to twenty-four (24) gauge;
(k) Intraosseous needles; and
(l) Pediatric drug dosage tape or equivalent that provides easy reference for pediatric and infant treatment and drug dosages.
(3) An ALS provider shall stock and maintain drugs and medications as required by the master drug list contained in protocols established in accordance with this section.
(4) Controlled drugs shall be stored in a locked storage box in a locked compartment on the aircraft. A provider that stores and utilizes controlled substances shall show proof of having submitted the provider's protocols to the Cabinet for Health Services' Drug Control Branch.
(5) A provider may maintain other supplies or equipment that are required to carry out its protocols as approved by the board.
(6) Current expiration dates shall be required for any item that carries an expiration date.
(7) Drugs and fluids maintained on the aircraft shall be stored based on manufacturer's recommendations.
Section 11. Specialty Care Equipment. A provider may maintain other equipment specified by the medical director if needed for the transport of neonates or other special needs patients.
Section 12. Medical Directors.
(1) All providers of air ambulance services shall have a medical director.
(2) Medical directors shall meet the requirements as set forth in 202 KAR 7:801.
Section 13. Request for Waiver.
(1) A provider licensed or contemplating licensure under this administrative regulation may make a written request to the board for certain provisions of this administrative regulation to be waived.
(2) A request shall justify that a proposed waiver, if approved, shall not jeopardize the quality of patient care or public safety.
(3) The board may approve a request based on at least one (1) of the following:
(a) Circumstances where public health and safety is a factor;
(b) Extenuating or mitigating circumstances that warrant consideration to assure the delivery of adequate emergency medical services;
(c) Substitution of equipment authorized by this administrative regulation; or
(d) Testing of new procedures, techniques, or equipment in a pilot study authorized by the board.
(4) The board shall establish time limits and conditions on all waivers.
Section 14. Exemptions from Regulations.
(1) The following situations shall be exempt from the provisions of this administrative regulation:
(a) First aid or transportation provided in accordance with KRS 216B.020(2)(f);
(b) An aircraft serving as an ambulance during a disaster or major catastrophe; or
(c) An aircraft operated by the United States government on property owned by the United States government.
(2) In addition, the following out-of-state providers shall be exempt from the provisions of this administrative regulation:
(a) An aircraft licensed by another state that is transporting a patient from out of state to a Kentucky medical facility or other location in Kentucky;
(b) An aircraft licensed by another state that is transporting a patient from out of state through Kentucky to another location out of state; and
(c) An aircraft licensed in an adjoining state that responds to a mutual aid request from a Kentucky licensed provider for emergency assistance if the out-of-state service is the closest service appropriately capable of responding to the request or if Kentucky licensed providers:
-
Are unavailable;
-
Have already responded; or
-
Are physically unable to reach the incident.
Section 15. Public Notice of Negative Action. The board office shall cause to be published, in the KBEMS News or similar publication of the board, or otherwise disseminate, the name of an ambulance provider that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
Section 16. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) Form EMS-8A, "Kentucky Emergency Medical Services Ambulance Run Report", 9/98;
(b) Form EMS-8B, "Kentucky Emergency Medical Services Ambulance Run Report", 9/98;
(c) Form EMS-1, "Kentucky Application for Ambulance Service Licensing", 6/96; and
(d) "Air Medical Intake Flow Chart", 10/2008.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 311A.030, 311A.190, 14 C.F.R. Parts 91, 135
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.190
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020 requires the board to exercise all administrative functions in the regulation of the emergency medical services system and the practice of emergency medical services, except those functions regulated by the Board of Medical Licensure or the Cabinet for Health and Family Services. KRS 311A.030 requires the board to promulgate administrative regulations for the licensing, inspection, and regulation of air ambulance providers. This administrative regulation establishes minimum licensing requirements for air ambulance providers.
- History: 30 Ky.R. 162; 930; 1228; 1489; eff. 11-19-2003; 35 Ky.R. 328; 1156; eff. 12-5-2008; Cert eff. 2-19-2019; 49 Ky.R. 2355; 50 Ky.R. 644; eff. 9-27-2023.
202 KAR 7:520 Allocation of block grant funding assistance for emergency medical services {#sec-202-kar-7-520 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:520}
Section 1. Eligibility to Receive EMS Grant Funding.
(1) A county in the Commonwealth of Kentucky shall be eligible to apply for and may receive emergency medical services (EMS) grant funding if the applicant county meets the requirements in this administrative regulation.
(2) A merged government shall not lose eligibility pursuant to this administrative regulation and may apply for and receive EMS grant funding if the applicant meets all requirements of this administrative regulation.
(3) This administrative regulation shall not be construed to grant an agency licensed pursuant to 202 KAR Chapter 7 the authority to apply for or receive EMS grant funding independent of the county.
(4) A county or merged government that applies for EMS grant funding shall maintain, within its boundaries and for the benefit of its inhabitants, one (1) or more agencies that provide primary EMS 911 response and transport service.
(5) A county or merged government shall be considered to maintain EMS 911 level of service by:
(a) Holding the license for and operating a county-owned Class I ground ambulance service;
(b) Holding the license for a Class I ground ambulance service, but contracting with a licensed service to operate within the county;
(c) Allowing an agency or multiple agencies to operate within the county to provide EMS 911 level of service for the benefit of the inhabitants of that area; or
(d) Not holding the license for, but bearing the responsibility of, operating or allowing the operation of, an agency or multiple agencies within the county to provide EMS 911 level of service for the benefit of the inhabitants of that area.
(6) A county or merged government shall be eligible to receive EMS grant funding only for agencies licensed as Class I. Other classes of service shall not be eligible.
(7) A county or merged government shall not disperse funds to a licensed agency that cannot provide evidence of compliance with KBEMS' data collection requirements pursuant to KRS 311A.190 and 202 KAR 7:540.
(8) An agency that is not compliant with data collection requirements in KRS 311A.190 and 202 KAR 7:540 may submit a plan of correction for approval by the executive director. A plan shall include at least:
(a) A detailed outline of measures that shall be taken to achieve compliance;
(b) Proof of equipment and software necessary to achieve compliance; and
(c) A stipulation that an agreed percentage of awarded grant funds shall be used in taking measures that shall achieve compliance with data collection requirements in KRS 311A.190 and 202 KAR 7:540.
(9) An agency that is following an approved plan of correction for data collection compliance pursuant to KRS 311A.190 and 202 KAR 7:540 may be eligible to obtain block grant funds from an applicant county or merged government.
(10) An agency undergoing disciplinary action pursuant to KRS 311A.060 shall be eligible to receive funds if in compliance with board-recommended disciplinary action.
(11)
(a) All distributions of grant funding shall be conducted by direct deposit to a bank account of the applicant county or merged government.
(b) The applicant county or merged government shall ensure that an updated W-9 form is submitted to the office of the board upon a change in bank routing information.
Section 2. Application Requirements.
(1) An applicant for EMS grant funds shall complete all portions of the County Application, Kentucky Ambulance Grant, KBEMS G-1, and the Agency Application, Kentucky Ambulance Grant, KBEMS G-2. These applications shall be submitted in an electronic format prescribed by the office of the board.
(2) Each electronic application shall be received by January 31 of each year. An applicant shall not receive EMS grant funds if the application is not received by the office of the board on or before January 31.
(3) Each electronic application shall include an itemized list of items intended to be purchased with EMS grant funds, price and quantity of those items, and a narrative justification for the purchase of those items. An application that does not include the itemized list or the narrative justification shall be denied by the office of the board and shall not be approved if the applicant does not submit a revised application by the filing deadline established in subsection (2) of this section.
(4) If an applicant requests to maintain carry-over funds in accordance with KRS 311A.155(5), the applicant shall notate the years that shall be carried forward on the application mandated by this administrative regulation.
(5)
(a) If an applicant does not request to maintain carry-over funds on the initial application, but chooses to select this option at a later time during the fiscal award year, the applicant shall submit the electronic Ambulance Grant Substitute Item Form, KBEMS G-3, to remove the previously approved items and substitute the request to carry over funds to the next fiscal year.
(b) Carry-over funds that are requested on a KBEMS G-3 shall meet the submission deadlines as established for all KBEMS G-3 submissions in Section 6 of this administrative regulation for the award year.
(6) Each applicant shall identify on the application, which agency or agencies will receive the EMS grant funds sought in the application process.
(7) If the applicant intends for more than one (1) agency to receive funds, the applicant shall specifically identify each agency to which funds shall be dispersed and the monetary amount to be distributed to each.
(8) The ambulance service agency director or ambulance service board chair of an agency receiving funds from an applicant shall certify that the agency:
(a) Is a licensed Class I ground ambulance service in the state of Kentucky;
(b) Acknowledges, understands, and agrees to comply with the requirements and duties of KRS 311A.155 and this administrative regulation;
(c) Has not made a false statement or misrepresentation on the application and that falsely certifying shall subject the agency to reimbursement of funds to KBEMS and sanctions pursuant to KRS 311A.060;
(d) Shall not misuse funds and that doing so shall require the agency to reimburse those funds to KBEMS and shall subject the agency to sanctions pursuant to KRS 311A.060;
(e) Shall expend awarded funds for the fiscal year of award only after written approval of award;
(f) Shall expend all awarded grant funds, except any approved carry-over funds, by June 30 of the fiscal year of award; and
(g) Acknowledges that approved grant funds, except any approved carry-over funds, that are not expended by June 30 of the fiscal year of award shall be returned to the office of the board prior to the award of any future grant funds.
(9) An applicant county or merged government shall submit the County Application, Kentucky Ambulance Grant, KBEMS G-1, with the county Judge Executive's signature or an agent duly authorized by the applicant. A duly authorized agent may include, for example, a chief administrative officer for the applicant, but shall not include a person unable to legally bind the applicant. The KBEMS G-1 application shall be scanned with a certifying signature affixed and submitted electronically as a required portion of the Kentucky ambulance grant electronic application process.
(10) An applicant shall certify on the County Application, Kentucky Ambulance Grant, KBEMS G-1 that the county or merged government:
(a) Acknowledges, understands, and agrees to comply with the requirements and duties of KRS 311A.155 and this administrative regulation;
(b) Has not made a false statement or misrepresentation on the County Application, Kentucky Ambulance Grant, KBEMS G-1, and that falsely certifying shall subject the applicant to reimbursement of funds to KBEMS;
(c) Shall not misuse funds and that doing so shall subject the applicant to reimbursement of those funds to KBEMS;
(d) Shall be jointly responsible for ensuring that all purchases and expenditures of block grant funds are approved and allowable pursuant to KRS 311A.155 and this administrative regulation;
(e) Shall expend awarded funds for the fiscal year of award only after written approval of award;
(f) Shall expend all awarded grant funds, except any approved carry-over funds, by June 30 of the fiscal year of award; and
(g) Acknowledges that approved grant funds, except any approved carry-over funds, that are not expended by June 30 of the fiscal year of award shall be returned to KBEMS prior to the award of any future grant funds.
Section 3. Application for Change of Items.
(1) An applicant wishing to expend awarded funds on items not previously approved in the electronic Agency Application, Kentucky Ambulance Grant, KBEMS G-2, shall submit the electronic Ambulance Grant Substitute Item Form, KBEMS G-3, to remove the previously approved items and substitute alternative items for purchase.
(2) Approved purchase transactions shall occur by June 30 of the fiscal year of award. If applicable, the electronic Ambulance Grant Substitute Item Form, KBEMS G-3 shall be submitted and approved by the office of the board by May 31 of the fiscal year of award.
(3) A substitute item purchased without prior approval from the office of the board shall be considered misuse of grant funds and shall preclude the applicant from approval of all grant funds during the following application year.
(4)
(a) Authorization for substitute items shall not be approved retroactively.
(b) Approval for a substitute item shall only be authorized by the office of the board prior to the purchase date.
Section 4. Allowable Expenditures.
(1) Awarded funds shall only be expended on authorized purchases.
(2) Authorized purchases shall include:
(a) Ambulances, equipment, training services, or other items necessary for the agency or its personnel to meet the minimum requirements of 202 KAR 7:501;
(b) EMS-related educational tools;
(c) EMS-related continuing education registrations; and
(d) Items on the Department of Homeland Security Authorized Equipment List.
(3)
(a) If seeking reimbursement for attendance at continuing education courses, conferences, or seminars, only expenses directly related to courses or training shall be authorized.
(b) Block grant funds shall not be used for reimbursement of participants' travel, food, gas, lodging, or incidental expenses related to EMS continuing education courses, conferences, or seminars.
Section 5. Accountability.
(1) Each applicant that receives funds and each agency to which the applicants disperse funds shall be jointly accountable for use of all funds distributed.
(2) Each applicant and agency shall submit an electronically filed Grant Accountability of Funds, KBEMS G-4 that includes at a minimum:
(a) Itemization of any previously approved purchases;
(b) Attached receipts for all purchases; and
(c) Included packing slips or invoices.
(3) Each applicant shall submit an electronically filed Grant Accountability of Funds, KBEMS G-4 each year no later than the deadline established in Section 6 of this administrative regulation that accounts for funds that were distributed from the block grant fund for the application year that occurred two (2) years prior to the forthcoming application year.
(4) If an applicant or agency maintains approved carry-over funds in accordance with KRS 311A.155(5), the applicant or agency shall submit proof of the continued availability of those funds. Proof may include, for example, a bank statement, a letter from the designated county or government official, a budgetary line-item, or other evidence sufficient to account for the unused, carry-over funds.
(5) Failure to submit documents accounting for grant funds by the deadline established in Section 6 of this administrative regulation shall subject the applicant or agency to being ineligible for further award of block grant funds.
(6) The board may request documentation of purchases and expenditures during the grant cycle. Failure to comply with this request shall make an applicant or agency ineligible for further award of grant funds.
(7) An agency that fails to comply with subsections (5) or (6) of this section shall also be subject to discipline pursuant to KRS 311A.060.
Section 6. Time limits and Deadlines for Block Grant Funds Awards.
(1) The ambulance block grant funding cycle shall follow a fiscal year of July 1 to June 30 each award year.
(2)
(a) All grant funding shall be appropriately expended by the applicant and agency between July 1 and June 30 of the fiscal year of award.
(b) All purchases shall be expressly approved on the electronic Agency Application, Kentucky Ambulance Grant, KBEMS G-2 for the fiscal year of award.
(3) The office of the board shall ensure availability of electronic county and agency ambulance block grant applications no later than October 1 of the forthcoming application year.
(4) The office of the board shall provide a notification of the availability of applications on its Web site and by email to each Class I licensed agency eligible to submit an application no later than October 1 of the forthcoming application year.
(5) County and agency applications for block grant funds shall be received electronically by the office of the board no later than January 31 of each year.
(6) Each applicant and agency shall submit electronically a Grant Accountability of Funds, KBEMS G-4 no later than January 31 of each year which accounts for funds that were distributed from the block grant fund for the application year that occurred two (2) fiscal years prior to the forthcoming application year.
(7) The office of the board shall provide notification by email to the applicants and agencies of their grant award no later than July 1 of each fiscal year of award.
(8) The office of the board shall process payment of awarded grant funds to applicants no later than August 31 of each fiscal year of award.
(9) Submission and approval of an electronic Ambulance Grant Substitute Item Form, KBEMS G-3 shall be approved by the office of the board by May 31 of the current fiscal year of award.
(10) An electronic Ambulance Grant Substitute Item Form, KBEMS G-3 received after the deadline for alternative items not listed on the electronic Agency Application, Kentucky Ambulance Grant, KBEMS G-2 form for the current fiscal year of award shall be denied by the office of the board.
(11) An electronic Ambulance Grant Substitute Item Form, KBEMS G-3 received after the deadline for carry-over funds for the current fiscal year of award shall be denied by the office of the board.
Section 7. Review of Grant Applications.
(1) A grant application shall be subject to review by the office of the board and other entities relevant to the award process.
(2) Review of applications shall include:
(a) Level One Review, which shall determine completeness of the application.
-
An incomplete application shall be denied, and if still within the deadline for application, an amended application may be submitted.
-
If outside the application deadline, the amended application shall be denied; and
(b) Level Two Review, which shall determine regulatory compliance and appropriateness of expenditures.
(3) The executive director of the office of the board shall have approval authority for grant applications and purchase authorization.
(4) Release of ambulance grant funds shall require a majority vote of the board prior to distribution of funds.
Section 8. Grant Program Management.
(1) Implementation and management of the grant program may include employment of an individual with primary responsibility of managing the block grant fund program.
(2) Other responsibilities shall include:
(a) Research of and application for additional EMS grant sources and funding streams that benefit KBEMS' regulatory obligations to licensed agencies; and
(b) Assistance to licensed EMS agencies in their efforts to locate and obtain other EMS grants.
(3) Employment of the grant management employee shall be dependent upon the availability of budgetary funds.
Section 9. Statewide Initiatives.
(1) The board may reserve all or a portion of the block grant funds appropriated to it by the General Assembly if a unanimous vote of the board determines:
(a) That a statewide initiative is necessary to further one (1) or more of the statutory functions of the board in KRS 311A.035; or
(b) A portion of the funds shall be distributed to assist agencies in meeting a federal or state mandate relevant to EMS.
(2) KBEMS shall not reserve funds for statewide initiatives in consecutive years.
(3) Notification of reservation of funds shall be sent to all eligible applicants and agencies by October 1 of the calendar year prior to the grant cycle.
Section 10. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "County Application, Kentucky Ambulance Grant", KBEMS G-1, April 2019;
(b) "Agency Application, Kentucky Ambulance Grant", KBEMS G-2, April 2019;
(c) "Ambulance Grant Substitute Item Form", KBEMS G-3, April 2019; and
(d) "Grant Accountability of Funds", KBEMS G-4, April 2019.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 118 James Court, Suite 50, Lexington, Kentucky 40505, Monday through Friday, 8:30 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 311A.010, 311A.030(2), 311A.035, 311A.050, 311A.055, 311A.060, 311A.155, 311A.190, 2 C.F.R. 215-225
- STATUTORY AUTHORITY: KRS 311A.155(3)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.155(3) requires the Kentucky Board of Emergency Medical Services to administer the emergency medical services grant program, and authorizes the board to promulgate administrative regulations concerning the implementation and operation of the emergency medical services grant program. KRS 311A.155(1) requires the board to maintain a block grant fund program for the purpose of assisting units of local government in the provision of emergency medical services. This administrative regulation establishes standards and criteria governing the allocation of emergency medical services funding assistance to eligible applicants.
- History: 27 Ky.R. 3438; Am. 28 Ky.R. 594; eff. 9-10-2001; 29 Ky.R. 1311; 1763; eff. 1-15-2003; 39 Ky.R. 2056; 40 Ky.R. 278; eff. 8-21-2013; 45 Ky.R. 2760, 3405; eff. 7-5-2019; Crt eff. 6-30-2026.
202 KAR 7:540 Emergency Medical Services data collection, management, and compliance {#sec-202-kar-7-540 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:540}
Section 1. Data Collection and Statewide Compliance Plan.
(1) The board shall require each licensed ambulance service to collect and submit run report data that aids in identifying patient care needs in the Commonwealth of Kentucky.
(2) The board shall collect, maintain, and use data provided by licensed ground and air ambulance services to assist the board and other state and federal agencies relevant to emergency management or public health.
(3) The information and data collected shall be used at a minimum to determine demographic trends and other emerging situations involving the provision of EMS to and the medical transport of individuals within the state.
(4) The board shall collect and use the submitted data to develop and adopt a statewide plan for EMS Information and Analysis.
Section 2. Data Management Committee.
(1) A Data Management Committee shall be established by this section.
(2) The Data Management Committee shall consist of seven (7) members appointed by the board chair in the manner established in 202 KAR 7:020.
(3) Any office of the board staff member specifically employed through or designated by the Kentucky Community and Technical College System (KCTCS) for the purpose of EMS data collection and analysis shall serve as the staff liaison for the Data Management Committee.
(4) The Data Management Committee shall be responsible for the following:
(a) The development of a statewide plan for data collection and compliance;
(b) Identification of information initiatives for EMS in Kentucky;
(c) Identification and research of funding sources tied to EMS data collection;
(d) Assistance to licensed services with questions or other needs associated with this administrative regulation, KRS Chapter 311A, and other issues associated with the board's statutory authority to require data collection and submission; and
(e) Matters identified by board members, the chair, or the executive director that involve data collection, data submission, or information use.
(5) The Data Management Committee shall be conducted in accordance with 202 KAR 7:020 and the board bylaws.
(6) The Data Management Committee shall schedule on an annual basis at least six (6) regular meetings.
Section 3. Data Collection and Submission.
(1) Each licensed ground and air ambulance service shall collect data relevant to patient care in Kentucky.
(2) Each service shall collect data at a rate that allows the service to submit the required data elements to the board on a schedule established by Section 5 of this administrative regulation.
(3) Each service shall ensure data is collected and electronically entered only by the certified or licensed EMS professional involved in the delivery of care for the incident reported.
(4) Clinical data entry by individuals unaffiliated with the incident shall not be permitted and may subject the agency to discipline in accordance with KRS Chapter 311A.
Section 4.
(1) The most recent version of the National EMS Information System (NEMSIS) data dictionary, US Department of Transportation National Highway Traffic Safety Administration (NHTSA), Office of Emergency Medical Services, NEMSIS Data Dictionary, NHTSA v3.5.0, EMS Data Standard found at www.nemsis.org shall be Kentucky's standard for required data elements.
(2) The board may specify additional mandatory, required, recommended, or optional NEMSIS data elements be documented and submitted to the board as determined by the needs of the data program, EMS system, or research projects.
(3) The required data set shall be known as the Kentucky State Ambulance Reporting System (KSTARS) project.
(4) Modifications to the state required data elements may be received by the Data Management Committee continuously and evaluated not more than bi-annually or as determined by the Committee Chair at regularly scheduled or specially called meetings of the Committee.
(a) The Data Management Committee shall evaluate the requested state data standard modification and vote to recommend modification or to take no action on the request.
(b) Recommendations on modification to the state data standard from the Data Management Committee shall then be forwarded to the board for action.
(c) If approved by the board, the office of the board shall initiate coordination of system and process modifications with applicable software vendors within fourteen (14) days.
(d)
-
Licensed Kentucky EMS agencies shall coordinate with software vendors to implement modifications to applicable agency software within 120 days of notice.
-
Licensed Kentucky EMS agencies retain ultimate responsibility for data submission as required by this administrative regulation.
Section 5. Compliance; Manner and Rate of Submission.
(1) Each licensed service shall submit data electronically upon the full implementation of KSTARS.
(2) Data shall be provided electronically to the board no later than 120 hours after incident completion for ninety (90) percent of responses per calendar month.
(3) Failure to timely submit collected data at the rate required by subsection (2) of this section shall subject a service to disciplinary action pursuant to KRS Chapter 311A and late fees pursuant to 202 KAR 7:030.
Section 6. Quality of Data Determined by Completeness.
(1) The board shall determine a service's compliance with data collection requirements by the quality of data submitted.
(2) The quality of a service's data shall be determined by the completeness of the submitted data using incident validation scores.
(3) The board shall impose on a service a plan of correction pursuant to KRS 311A.060 and 202 KAR 7:501 if a service's rate of completeness falls below ninety (90) percent for three (3) consecutive months.
(4) Failure to comply with a plan of correction shall subject a service to disciplinary action pursuant to KRS 311A.060.
(5) The board staff shall report to the Data Management Committee a determination of incomplete data submission that results in a plan of correction.
Section 7. Run Reports.
(1) Each ambulance service shall provide a copy of the completed run report, or its electronic equivalent, to the receiving medical facility prior to departure.
(2) A service that cannot leave a copy of the completed run report, or its electronic equivalent, with the receiving medical facility prior to departure shall leave a continuation of care form that contains at least the following data elements for the patient:
(a) First name;
(b) Last Name;
(c) Date of birth;
(d) Complaint;
(e) Duration of complaint;
(f) Time units of duration of complaint;
(g) Provider's primary impression;
(h) Current medications;
(i) Medical and surgical history;
(j) Medication allergies;
(k) SBP (Systolic Blood Pressure);
(l) DBP (Diastolic Blood Pressure);
(m) Heart rate;
(n) Respiratory rate;
(o) Date and time medication administered;
(p) Medication given;
(q) Condition of patient at destination;
(r) Unit notified by dispatch date and time;
(s) EMS agency name; and
(t) EMS provider name.
(3) If a service provides the receiving hospital or other healthcare facility with a continuation of care form that meets the requirements of subsection (2) of this section, the service shall have twenty-four (24) hours to provide the full patient care report.
(4) The twenty-four (24) hour timeframe for delivery of the full patient care report shall not apply to situations involving mass disaster, mass casualty, or other documented emergency of similar scope.
Section 8. Data Use and Confidentiality.
(1) Unless otherwise required by law, the board shall not release information of a confidential or private nature or any information protected by local, state, or federal non-disclosure laws.
(2) The board may release information of a statistical nature that does not reveal or contain personal information.
(3) The board may share information with research, state, and other organizations that have a shared interest in the promotion of EMS or patient care.
(4) Unless otherwise required by law, the board shall not release information for purely commercial uses.
Section 9. Incorporation by Reference.
(1) "National Highway Traffic Safety Administration, Office of Emergency Medical Services, NEMSIS Data Dictionary, NHTSA v3.5.0, EMS Data Standard", 2019, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 2464 Fortune Drive, Suite 195, Lexington, Kentucky 40509. Monday through Friday, 8:30 a.m. to 4:30 p.m.
(3) This material may also be obtained at https://nemsis.org/media/nemsis_v3/release-3.5.0/DataDictionary/PDFHTML/EMSDEMSTATE/NEMSISDataDictionary.pdf.
History
- RELATES TO: KRS 311A.020, 311A.035, 311A.045, 311A.060, 311A.155, 311A.190, 23 U.S.C. 403(b)(1)(A)(iv), 405(c)(3)(C), 42 U.S.C. 300d-4(b)(1)
- STATUTORY AUTHORITY: KRS 311A.190
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.190 authorizes the Kentucky Board of Emergency Medical Services to promulgate administrative regulations concerning EMS information that ambulance services shall furnish to the board and authorizes the Kentucky Board of Emergency Medical Services to require collection and submission of EMS data that will allow for analysis of the state's needs for provision of EMS and that will allow the state to participate in the National Emergency Medical Services Information System (NEMSIS), a multi-partnered project that is funded by the National Highway Traffic Safety Administration, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the Federal Emergency Management Administration, and HRSA's Office of Rural Health Policy. This administrative regulation establishes standards and criteria for data collection, submission, and compliance.
- History: 39 Ky.R. 2092; 40 Ky.R. 30; 281; eff. 8-21-2013; Crt eff. 2-12-2020; 47 Ky.R. 2452, 414; eff. 9-22-2021.
202 KAR 7:545 License classifications {#sec-202-kar-7-545 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:545}
Section 1. Definitions.
(1)
(a) "911 scene response" means a response:
-
Resulting from a 911 call or other call to a dispatch center or public safety answering point for assistance;
-
Where an ambulance provider is dispatched to, responds to, provides an assessment to, provides care to, or transports a person reporting a medical condition or injury; and
-
Where transportation of the patient will terminate in an emergency room or other location for immediate assessment or treatment.
(b) "911 scene response" shall not include a response to a call in which a patient is receiving care at a hospital.
(2) "Agency" means an individual or private or public organization, except the United States government, seeking or holding a license from the board to provide emergency medical services pursuant to KRS Chapter 311A and 202 KAR Chapter 7.
(3) "ALS first response" means 911 scene response to provide ALS emergency care or treatment to an ill or injured person by emergency medical services personnel.
(4) "BLS first response" means 911 scene response to provide BLS emergency care or treatment to an ill or injured person by emergency medical services personnel.
(5) "Medical first response" means 911 scene response to provide ALS or BLS emergency care or treatment to an ill or injured person by emergency medical services personnel before the arrival of an ambulance.
(6) "Mobile integrated healthcare" or "MIH" is defined by KRS 311A.010(18).
(7) "Nonemergency" means any scheduled, non-scheduled, or interfacility medically necessary ambulance transportation that is not a 911 scene response.
Section 2. License Classifications.
(1) Beginning on January 1, 2026, license classifications for ambulance providers, mobile integrated healthcare programs, and medical first response agencies shall include:
(a) Class I ground ambulance providers, which shall be classified as:
-
Class Ia – (911 Services) – A ground ambulance provider operating at the ALS or BLS level, or both, that shall provide 911 scene response and may provide emergency, nonemergency, or interfacility care and transportation; or
-
Class Ib – (CON-Exempt City and County Services) – A ground ambulance provider operating pursuant to KRS 216B.020(8) at the ALS or BLS level, or both;
(b) Class II ground ambulance providers, which shall be classified as:
-
Class IIa – (Non-911 Services) – A ground ambulance provider operating at the ALS or BLS level, or both, to provide interfacility care and nonemergency care and transportation; or
-
Class IIb – (CON-Exempt Hospital Services) – A ground ambulance provider operating pursuant to KRS 216B.020(7) at the ALS or BLS level, or both;
(c) Class III ground ambulance providers, which, based on the provider's Certificate of Need and scope of care policy, shall be classified as one (1) or more of the following:
-
Class IIIa – (Adult Critical Care Services) – A ground ambulance provider operating at the ALS level as an adult critical care agency providing critical care interfacility transport services to patients ages twelve (12) and above;
-
Class IIIb – (Pediatric Specialty Care Services) – A ground ambulance provider operating at the ALS level as a pediatric specialty care agency providing critical care interfacility and specialty care transport services to patients under the age of twenty-one (21); or
-
Class IIIc – (Neonatal Specialty Care Services) – A ground ambulance provider operating at the ALS level as a neonatal specialty care agency providing critical care interfacility and specialty care transport services to patients less than twenty-nine (29) days of age;
(d) Class IV – (Restricted Location Services) – A ground ambulance provider operating at the ALS or BLS level to provide emergency and nonemergency care with or without transportation for restricted locations, such as industrial sites or other sites that do not provide services outside the designated geographic service area;
(e) Class V – (Mobile Integrated Health Care Programs) – A mobile integrated health care program operating at the ALS and BLS level;
(f) Class VI – (Medical First Response Agencies) – An agency providing medical first response without patient transport at the ALS or BLS level;
-
Each ALS first response agency shall be licensed separately as a Class VI ALS agency.
-
Each BLS first response agency shall be licensed separately as a Class VI BLS agency unless a memorandum of understanding is executed with a licensed Class I agency that provides services for the geographic service area.
-
A licensed Class I agency may execute a memorandum of understanding with multiple nonlicensed BLS first response agencies that serve the same geographic service area.
-
A memorandum of understanding shall automatically renew at the conclusion of a calendar year.
-
A nonlicensed BLS first response agency or a Class I agency may terminate a memorandum of understanding thirty (30) days after written notice is provided to the other party.
-
A memorandum of understanding between a Class I agency and a nonlicensed BLS first response agency serving the same geographic area shall be updated as changes to the agreement occur and shall include provisions for:
a. Medical direction;
b. BLS protocols consistent with the current scope of practice;
c. Response protocol;
d. Geographic service areas to be served;
e. Circumstances causing dispatch of the nonlicensed BLS first response agency;
f. Training;
g. Quality assurance processes; and
h. Liability insurance, if applicable.
-
A nonlicensed BLS first response agency shall not provide BLS care outside of its geographic service area unless responding through an executed mutual aid agreement.
-
A nonlicensed BLS first response agency unable to secure a written memorandum of understanding with a Class I agency within its geographic service area may operate within the jurisdiction as a nonlicensed BLS first response agency if:
a. The agency has written correspondence from at least one (1) Class I agency within its geographic service area denying the nonlicensed BLS first response agency's request to enter into a memorandum of understanding; and
b. The agency maintains:
(i) The correspondence denying the memorandum of understanding request on file at the agency;
(ii) Board-approved medical direction;
(iii) Board-approved BLS first response agency protocols; and
(iv) Written policies addressing each of the issues listed in subsection (1)(f)6.c. through h. of this section.
- A license to provide BLS care shall not be issued solely through the execution of a memorandum of understanding between a Class I agency and a nonlicensed BLS first response agency;
(g) Class VII – (Air Ambulance Services) – A rotor or fixed wing air ambulance service providing ALS and BLS 911 scene response or emergency, interfacility, or nonemergency care and air transportation;
(h) Class VIII – (Event Medicine Providers) – An agency utilizing emergency medical services personnel to provide ALS or BLS care at special events, sports events, concerts, or other large social gatherings;
-
A Class VIII agency shall be licensed separately as a Class VIII ALS or BLS agency.
-
A Class VIII agency shall not transport patients independently to a hospital.
-
If transport of a patient is required, a Class VIII agency shall contact 911 for transport by a Class I agency licensed for the geographic service area.
-
Upon request, a Class VIII agency shall make available to any Class I agency within its geographic service area its protocols, treatment capabilities, and updated contact information;
(i) Class IX – (State Special Response Agencies) – An agency providing emergency and nonemergency care as part of a state-sponsored specialty team, such as Kentucky Urban Search and Rescue or other state special response agency, that provides services and conducts trainings throughout the Commonwealth.
-
A Class IX agency shall be licensed separately as a Class IX ALS or BLS agency.
-
A Class IX agency shall not transport patients independently to a hospital.
-
If transport of a patient is required, a Class IX agencyshall contact 911 for transport by a Class I agency licensed for the geographic service area; and
(j) Class X – (Nonemergency Out-of-State Reciprocity License) – An out-of-state agency providing nonemergency response that is licensed by and in good standing with another state EMS regulatory body and holds a Certificate of Need to operate a Class III agency in Kentucky.
- An out-of-state agency shall be eligible for a reciprocal Kentucky license if the agency:
a. Provides only nonemergency response;
b. Is licensed by and in good standing with another state EMS regulatory body; and
c. Holds a Certificate of Need to operate a Class III agency in Kentucky.
-
An out-of-state agency may apply for a Class X license by submitting a valid agency license from another state to the KBEMS office.
-
A Class X agency shall be exempt from all administrative regulations promulgated by the board except 202 KAR 7:030, 202 KAR 7:501, and 202 KAR 7:540.
-
A Class X agency shall satisfy all requirements for maintaining its license issued by another state EMS regulatory body.
-
A Class X license shall not require an initial or annual inspection by the KBEMS office, but a Class X agency shall be subject to random inspections by the KBEMS office.
-
If a Class X agency fails to maintain its license issued by another state EMS regulatory body, the agency shall be deemed to have surrendered its Class X license.
-
If a Class X agency's license issued by another state EMS regulatory body is revoked, suspended, lapses, or placed on probationary status, the agency shall notify the KBEMS office within five (5) days of such action.
(2) The KBEMS office shall license agencies in accordance with subsection (1) of this section.
(3) An agency shall not hold more than one (1) license per level of classification in one (1) defined geographic service area unless each license was obtained prior to January 1, 2018.
Section 3. Public Notice of Negative Action. The board office shall publish on the KBEMS website or similar publication of the board, the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
History
- RELATES TO: KRS 216B.020, 311A.010, 311A.030, 311A.190
- STATUTORY AUTHORITY: KRS 311A.020(1), 311A.025, 311A.030(1), 311A.190
- CERTIFICATION STATEMENT: This is to certify that this administrative regulation complies with the requirements of 2025 RS HB 6, Section 8.
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020(1) requires the Board of Emergency Medical Services to exercise all administrative functions in the regulation of the emergency medical services system, except those functions regulated by the Board of Medical Licensure or the Cabinet for Health and Family Services. KRS 311A.030(1) requires the board to promulgate administrative regulations establishing the license classifications of ambulance services, mobile integrated healthcare programs, and medical first response providers. This administrative regulation establishes the classes of ambulance services, mobile integrated healthcare programs, and medical first response providers.
- History: 202 KAR 007:454. 44 Ky.R. 1734, 2041, 2195; eff. 5-4-2018; 48 Ky.R. 2851; eff. 8-25-2022; 52 Ky.R. 90, 558; eff. 10-22-2025.
202 KAR 7:550 Required equipment and vehicle standards {#sec-202-kar-7-550 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:550}
Section 1. Ground Ambulance Specifications.
(1) Ground ambulances utilized by Class I, II, III, and IV agencies shall:
(a) Have the name of the provider permanently affixed by paint, decal, or wrap on both sides of the exterior surface of the vehicle.
-
The name shall be the incorporated name or the name under which the provider does business and as it appears on the provider's license.
-
This requirement shall not preclude a provider from adding additional names from another entity on the vehicle due to a joint venture, if the name as licensed by the board is larger, and visible and legible by the public.
-
A vehicle operated by an agency shall not be marked with the words "advanced life support", "paramedic," or similar words that convey essentially the same meaning on the vehicle's exterior surface visible to the public unless the:
a. Vehicle is always staffed at an Advanced Life Support level; or
b. Agency was licensed by the board prior to January 1, 2018.
(b) Be maintained in good operating condition and in full repair without obvious apparent problems relating to tires, exhaust, body integrity, warning devices, or mechanical reliability, which would be recognized by the average lay person who is not an automotive mechanic.
(c) Be designed to provide for the medical care or transportation of patients.
(d) Stow all equipment weighing three (3) pounds or more in an enclosure, bracket, mount, or other appropriate securing device.
(e) Have tires that meet the manufacturer's standards for the gross vehicle weight of the vehicle.
-
A tire shall not display exposed tire cord or have tread depth less than 2/32 on back tires and 4/32 on front tires if measured in any two (2) adjacent grooves at three (3) locations spaced equally around the tire.
-
Retread tires shall not be used on ground vehicles.
-
Internal patches may be utilized for tire repairs if necessary.
-
More than two (2) patches shall not be used on any one (1) defective tire.
-
Plugs shall not be used for the repair of defective ambulance tires.
(2) All Class I, II, III, and IV ground ambulances shall meet or exceed the minimum physical characteristics established in paragraphs (a) through (d) of this subsection.
(a) An ambulance manufactured prior to January 1, 2019 shall meet or exceed the standards established in the U.S. General Services Administration Federal Specification for the Star-of-Life Ambulance (GSA KKK-A-1822) in effect on the original date of manufacture.
(b) For a unit in which the chassis of an ambulance is later replaced, the agency shall require the conversion company to supply a letter to verify that no modification exists that was contained in GSA KKK-A-1822 on the original date of module manufacture.
(c) A new production ground ambulance that is ordered after January 1, 2019 shall comply fully with the ambulance design criteria contained in the Commission on Accreditation of Ambulance Services Ground Vehicle Standard for Ambulances (GVS), 7/2022. A decal or letter of verification from the manufacturer certifying that the vehicle meets the GVS standard, if ordered after January 1, 2019, shall be made available upon inspection.
(d) For any GVS certified vehicle in which the chassis of an ambulance is later replaced, the agency shall require the conversion company to supply a letter to verify that no modification exists that was contained in the GVS standard on the original date of module manufacture.
(3) In addition to the GSA KKK-A-1822 or the GVS standards, additional requirements shall be met as established in paragraphs (a) through (d) of this subsection.
(a) The air-conditioning system shall minimally deliver a temperature of sixty-five (65) degrees Fahrenheit or less from the vent or vents in the driver and patient compartments in warm weather conditions as determined by a standard automotive testing thermometer.
(b) The heating system shall minimally deliver a temperature of eighty-five (85) degrees Fahrenheit or more from the vent or vents in the driver and patient compartments in cool weather conditions as determined by a standard automotive testing thermometer.
(c) There shall not be more patients, personnel, and other persons than can be safely secured by means of permanently installed safety belts in the vehicle while the vehicle is in motion.
(d) The patient care area lighting shall be fully functional.
(4) A preventive maintenance program shall be maintained for each vehicle and its equipment to keep them in optimum working order to protect the health and safety of the patient and ambulance personnel.
(5) Documentation shall be maintained by the agency to support evidence of periodic inspections as recommended by the manufacturer, including calibrations required for maintenance and operation of the vehicle and its equipment.
(6) Unless precluded by emergency conditions, each vehicle and its equipment shall be checked after each use to ensure that it is in a clean and sanitary condition.
(7)
(a) Except as established in paragraph (b) of this subsection, all linen used for patient care including sheets, blankets, pillowcases, pillows, towels, and washcloths shall be stowed in a separate cabinet and secured from body fluids.
(b) One (1) pillow, one (1) pillow-case, one (1) fitted sheet, two (2) flat sheets, one (1) towel, and two (2) blankets may be utilized on the stretcher that is in-service and shall not require stowing.
Section 2. Class I, II, and IV Basic Life Support Ambulance Equipment and Supplies.
(1) Each BLS agency shall maintain evidence in the form of a letter that adult and pediatric medical protocols have been reviewed and approved by the board pursuant to KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) Each Class I, II, and IV BLS agency shall carry and maintain, in full operational order, the following minimum basic life support equipment and supplies:
(a) Suction, ventilation, and blood pressure equipment, which shall include:
-
Two (2) sources of suction apparatus, one (1) of which shall be mechanically operated;
-
Rigid catheters;
-
Flexible catheters in adult, pediatric, and infant sizes;
-
Bulb syringe for infant and neonate suction;
-
Disposable adult and pediatric bag-valve-mask with a pediatric pop-off valve with oxygen reservoir, oxygen tubing, and adult, pediatric, infant, and neonate masks;
-
Nasopharyngeal airways (16F-34F; adult and child sizes) with water-soluble lubricant;
-
Oropharyngeal airways (sizes 0-5; adult, child, and infant sizes);
-
Blind-Insertion Airway Device (BIAD) (adult and pediatric); and
-
Manual pediatric and adult regular and large sphygmomanometer cuffs with stethoscope;
(b) Oxygen equipment, including:
-
A fixed oxygen system for each ambulance;
-
Two (2) portable, adequately filled, secured oxygen tanks that are minimally size D;
-
Pressure gauge and flow rate regulator for fixed and portable units with a range of zero to fifteen (15) liters per minute; and
-
Transparent non-rebreather oxygen masks and nasal cannulas for adults and pediatrics;
(c) Bandages, bandaging supplies, and tape, including:
-
Triangular bandages;
-
Dressings of the following types:
a. Sterile dressings, including gauze sponges of suitable size; and
b. Abdominal dressings;
-
Gauze rolls, various sizes;
-
Occlusive dressing, or equivalent;
-
Adhesive tape of various sizes (including one (1) inch and two (2) inch);
-
A minimum of four (4) arterial tourniquets; and
-
Shears for bandages;
(d) Miscellaneous supplies, including:
-
Handheld flashlight capable of providing adequate lighting to assess a scene or a patient away from the vehicle;
-
Penlight;
-
A copy or electronic equivalent of the most recent version of the U.S. Department of Transportation, Emergency Response Guidebook;
-
A minimum of ten (10) triage tags consistent with a commercial system of triage;
-
Obstetrical supplies that shall include at a minimum:
a. Sterile scalpels or scissors;
b. Sterile gloves;
c. Bulb suction;
d. Two (2) umbilical clamps; and
e. Thermal absorbent blanket and head cover, aluminum foil roll, or appropriate heat-reflective material sufficient to cover a newborn infant;
-
Sterile irrigation fluids;
-
Glucometer or blood glucose measuring device with reagent strips and lancets for obtaining a blood glucose sample;
-
Oral glucose;
-
Cold packs;
-
Heat packs;
-
An AED with a minimum of two (2) complete sets of pads suitable for adult and pediatric populations for all non-ALS vehicles;
-
Pulse oximeter with pediatric and adult probes;
-
Reference material or a guide that shall be assigned to the ambulance and may be in an electronic or physical format that provides appropriate guidance for pediatric drug dosing and equipment sizing based on age, length, or weight;
(e) Splints, including:
-
Lower extremity mechanical traction splint in adult and pediatric sizes; and
-
Upper and lower extremity rigid splint devices for adult and pediatric patients;
(f) Immobilization devices, including:
-
One (1) adult and one (1) pediatric impervious long spine board, scoop stretcher, or other full body device that provides spinal protection with a minimum of three (3) appropriate restraint cross-straps;
-
Cervical collars in the following sizes:
a.
(i) Cervical collars for pediatric patients ages two (2) years or older; and
(ii) Cervical collars for adults in small, medium, large, and other available sizes; or
b. Pediatric and adult adjustable cervical collars; and
- Towel rolls or other commercially available cervical immobilization devices for adults and pediatrics;
(g) Two (2) currently certified five (5) pound size or larger, secured, ABC multipurpose fire extinguishers, approved by Underwriters Laboratory, Coast Guard, or Factory Mutual. One (1) shall be accessible to the driver and the other to the attendant or attendants in the patient compartment in the ambulance;
(h) Multi-position stretcher with wheels and a minimum of three (3) cross-straps in addition to one (1) set of shoulder straps for securing the patient to the stretcher and a fixed mechanism to secure the stretcher while in transit;
(i) Until January 1, 2025, a pediatric transport device with a minimum weight range of ten (10) to forty (40) pounds;
(j) On and after January 1, 2025, a pediatric transport device with a minimum weight range of five (5) to ninety-nine (99) pounds; and
(k) A stair chair for the movement of patients in a seated position.
(3) Personal protective equipment shall be available to each staff member responding on the vehicle, including:
(a) One (1) clean scrub gown (or substitute, such as disposable coveralls);
(b) Simple disposable face mask;
(c) Clear protective goggles or safety glasses;
(d) Disposable gloves;
(e) One (1) particulate filter mask rated at N95 or better without an exhaust port for patient use;
(f) One (1) particulate filter mask rated at N95 or better with or without an exhaust port for protection of crew members; and
(g) A means of cleansing the hands, such disposable towelettes or other solutions.
(4) Cleaning materials shall be available including:
(a) Hospital grade disinfectants;
(b) Trash bags for disposal of nonbiohazard waste materials;
(c) Biohazard bags for the disposal of biohazard waste; and
(d) Puncture resistant containers for disposal of sharp objects that are secured to the vehicle.
(5) Patient comfort items shall be available including:
(a) Two (2) clean blankets, sheets, pillows, and pillowcases;
(b) A disposable urinal;
(c) A disposable bed pan; and
(d) An emesis container or similar substitute.
(6) All items with an expiration date shall not be expired.
Section 3. Class I ALS, Class III ACC, Class III PSC, and Class IV Advanced Life Support Ambulance Equipment and Supplies.
(1) Each ALS agency shall maintain evidence in the form of a letter that adult and pediatric medical protocols have been reviewed and approved by the board pursuant to KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) In addition to the BLS equipment required in Section 2 of this administrative regulation, each Class I ALS, Class III ACC, Class III PSC, and Class IV ALS vehicle shall maintain, in fully operational order, supplies and equipment required by the agency's protocols, including a minimum of:
(a) Endotracheal intubation equipment consisting of:
-
Laryngoscope handle with extra batteries, bulbs, or blades if applicable;
-
At least four (4) laryngoscope blades to allow intubation of patients in accordance with agency protocols, including a minimum of:
a. 0-4, straight Miller; or
b. 2-4, curved Macintosh;
- Endotracheal tubes in the following sizes:
a. 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, and 5.5 cuffed or uncuffed; or
b. If intubation is not included in the agency's protocols for pediatric patients, supraglottic airways in all available sizes per the manufacturer of the specific device chosen; and
c. 6.0, 6.5, 7.0, 7.5 and 8.0 cuffed;
-
Stylettes in adult and pediatric sizes;
-
10-mL syringes;
-
Magill forceps in adult and pediatric sizes;
-
Water-soluble lubricant for lubrication of endotracheal and nasotracheal tubes;
-
End-Tidal CO2 detection capability (adult and pediatric);
-
One-half (1/2) inch wide twill tape or equivalent for securing endotracheal tubes;
-
Equipment necessary to perform emergency percutaneous cricothyrotomy;
-
Disposable nebulizer; and
-
Continuous waveform capnography;
(b) A portable, battery-operated monitor defibrillator that:
-
Has a tape write-out or recorder, hands-free defibrillator pads, electrocardiogram monitoring leads, and electrodes for adults and pediatrics;
-
Is capable of delivering direct current energy over a variable range, which is suitable for pediatric and adult usage;
-
Has synchronized counter-shock capability for cardioversion;
-
Has a transcutaneous cardiac pacemaker, including adult and pediatric pads and cables; and
-
Has 12-Lead ECG capability if the vehicle is staffed to provide ALS services;
(c) Vascular Access supplies consisting of:
-
Isotonic crystalloid solutions;
-
Antiseptic solution (alcohol wipes and providone-iodine wipes);
-
Intravenous catheters, 14G-24G;
-
Long-large bore needles or angiocatheters (at least 3.25 inches in length for needle chest decompression in large patients);
-
Intraosseous needles or intraosseous devices appropriate for children and adults; and
-
Latex-free tourniquet;
(d) Needles of various sizes, including suitable sizes for intramuscular injections;
(e) Intravenous macrodrip and microdrip administrations sets; and
(f) Intravenous arm boards, adult and pediatric, or appropriate substitute.
(3) An ALS agency shall stock and maintain drugs and medications as required by the master drug list contained in protocols established in accordance with this section.
(4) Controlled drugs shall be stored in a locked storage box in a locked compartment on the vehicle that is immediately accessible to personnel.
(5) This administrative regulation shall not prevent an agency from maintaining other supplies or equipment that are required to carry out its protocols as approved by the board in accordance with KRS 311A.180.
(6) All items with expiration dates shall not be expired.
Section 4. Class III Adult Critical Care (ACC) Transport Equipment.
(1) Each Class III ACC agency shall maintain evidence in the form of a letter that medical protocols have been reviewed and approved by the board in accordance with KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) In addition to the BLS equipment required in Section 2 of this administrative regulation and the ALS equipment required in Section 3 of this administrative regulation, Class III Adult Critical Care agencies shall carry on each vehicle and maintain in fully operational order all supplies and equipment required by the agency's protocols, including at a minimum:
(a) A portable transport ventilator, the capabilities of which shall include:
-
Controlling rate;
-
Volume;
-
FiO2 up to 100 percent;
-
I:E ratio;
-
PEEP;
-
Volume control;
-
Pressure control;
-
SIMV mode;
-
NPPV mode; and
-
Low- and high-pressure warning alarms;
(b) Two (2) portable transport ventilator circuits appropriately sized for the patient being transported;
(c) Continuous Positive Airway Pressure (CPAP) ventilation portable equipment;
(d) Electronic waveform capnography, intubated patient, capable of waveform display;
(e) Difficult airway equipment in the form of a bougie gum elastic ET introducer;
(f) Sterile cricothyrotomy set, surgical or needle;
(g) Invasive pressure monitoring capability electronic waveform available on two (2) channels;
(h) An infusion pump or pumps capable of infusing three (3) separate medications simultaneously;
(i) Six (6) IV infusion pump tubing sets;
(j) Two (2) blood infusion sets; and
(k) A device to monitor core body temperature through rectal or esophageal probe.
Section 5. Class III Pediatric Specialty Care (IIIPSC) Transport Equipment.
(1) Each Class III Pediatric Specialty Care agency shall maintain evidence in the form of a letter that all medical protocols have been reviewed and approved by the board in accordance with KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) In addition to the BLS equipment required in Section 2 of this administrative regulation, the ALS equipment required in Section 3 of this administrative regulation, and the Critical Care equipment listed in Section 4 of this administrative regulation, each Class III Pediatric Specialty Care agency shall carry on each vehicle and maintain in fully operational order supplies and equipment required by the agency's protocols, including:
(a) Two (2) 250 ml bags of normal saline or lactated ringers;
(b) Twelve (12) syringes assorted from 1cc to 2cc;
(c) Four (4) three-way stopcocks;
(d) A needle cricothyrotomy kit for children from the ages of twenty-nine (29) days until twenty-one (21) years of age; and
(e) A blind-insertion airway device (BIAD) in appropriate sizes for children from the ages of twenty-nine (29) days until twenty-one (21) years of age.
Section 6. Class III Neonatal Specialty Care (III NSC) Transport Equipment.
(1) Each Class III Neonatal Specialty Care agency shall maintain evidence in the form of a letter that all medical protocols have been reviewed and approved by the board in accordance with KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) In addition to compliance with Section 1 of this administrative regulation, each Class III Neonatal Specialty Care agency shall carry on each vehicle and maintain in fully operational order all supplies and equipment required by the agency's protocols, including:
(a) Direct two-way communications with the designated neonatologist, attending physician, or receiving NICU;
(b) A standby or backup power source other than the one (1) contained in the isolette;
(c) A source of electrical power sufficient to operate the isolette and ancillary electrically powered equipment;
(d) A transport incubator with portable power supply, portable oxygen tanks, or liquid oxygen, and a source of compressed air, including appropriate valves, meters, and fittings. The transport incubator shall be secured in the vehicle using a manufacturer-approved vehicle-mounting device;
(e) One (1) portable heart rate monitor with visual or audible display and alarm system per patient;
(f) One (1) portable blood pressure monitor with an assortment of cuff sizes suitable for infants;
(g) Three (3) battery powered mechanical IV pumps capable of delivering as low as 1cc increments for IV fluids;
(h) A battery or self-powered oxygen sensor and transcutaneous oxygen monitor or oxygen saturation monitor;
(i) Oxygen delivery devices and tubing capable of administering high concentrations of oxygen;
(j) A temperature-monitoring device;
(k) A portable ventilator appropriate for neonatal patients;
(l) An anesthesia or self-inflating bag with an oxygen reservoir of less than 750 ml, a manometer pressure gauge, and premature newborn and infant size clear masks;
(m) A laryngoscope handle;
(n) Laryngoscope Blades in Miller sizes 00, 0, 1, 2, 3;
(o) Two (2) bulbs;
(p) Two (2) batteries;
(q) Endotracheal tubes in various sizes;
(r) Two (2) stylets;
(s) Two (2) meconium aspirators;
(t) Oral airways in various sizes;
(u) Suction equipment with low suction capabilities of less than eighty (80) mmHg;
(v) Two (2) suction catheters in sizes 5.0, 6, 6.5, 8, and 10 each;
(w) Syringes sizes 1 cc through 60 cc in various sizes;
(x) Two (2) medication access devices;
(y) 23-27 gauge vascular access devices in various sizes;
(z) Sterile gloves in various sizes and sufficient quantity for all crewmembers;
(aa) Medications as required by the master drug list contained in protocols established in accordance with this section;
(bb) IV extension tubing in sufficient length to administer IV fluids or medications;
(cc) IV securing devices in various sizes;
(dd) Two (2) IV filters;
(ee) Two (2) umbilical catheters, sizes 3.5 and 5;
(ff) Ten (10) antiseptic solution wipes;
(gg) One (1) blood glucose-monitoring device;
(hh) Five (5) lancets for obtaining a blood glucose sample;
(ii) One (1) neonatal stethoscope;
(jj) One (1) flashlight;
(kk) Gauze pads;
(ll) One (1) No. 5 and one (1) No. 8 French feeding tube;
(mm) One (1) high intensity light capable of transillumination;
(nn) A biomedical waste plastic bag or impervious container;
(oo) Puncture resistant containers for disposal of sharp objects that shall be secured to the vehicle;
(pp) Gloves made of nitrile or other suitable materials in sufficient quantity for all crewmembers;
(qq) Respiratory face masks in sufficient quantity for all crew members;
(rr) Special procedure trays or instruments capable of performing umbilical catheterization, venous cutdown, and thoracostomy in accordance with established protocol;
(ss) One (1) bulb syringe;
(tt) One (1) cord clamp;
(uu) One (1) age appropriate chest tube evacuation device; and
(vv) Needle aspiration device or chest tubes in appropriate sizes for a neonate patient.
Section 7. Class VI and Class VIII BLS Agency Equipment.
(1) Each Class VI and VIII BLS agency shall maintain evidence in the form of a letter that all medical protocols have been reviewed and approved by the board in accordance with KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) Each Class VI and VIII BLS agency shall be exempt from the ground ambulance requirements established in Sections 1 through 6 of this administrative regulation.
(3) Each Class VI and VIII BLS agency shall provide ready access to and maintain in fully operational order all supplies and equipment required by the agency's protocols.
(4)
(a) Each Class VIII BLS agency shall have ready access to and maintain in operational order, two (2) complete sets of equipment required by the agency's protocols and this administrative regulation.
(b) Each Class VI BLS agencies shall be required to maintain one (1) complete set of equipment.
(5) Each basic life support non-transport vehicle shall wrap, properly store, and handle all single-service implements to be inserted into the patient's nose or mouth.
(6) Each Class VI and VIII BLS agency shall properly store and keep multiuse items clean and sterile if indicated.
(7) Each Class VI and VIII BLS agency shall carry the following assembled and readily accessible equipment:
(a) Respiratory and resuscitation equipment, including:
- Portable suction apparatus, capable of a minimum vacuum of 300 millimeters mercury, equipped with two (2) each of the following:
a. Wide-bore tubing;
b. Rigid catheters;
c. Soft pharyngeal suction tips in child size; and
d. Soft pharyngeal suction tips in adult size;
- One (1) hand-operated bag-mask ventilation unit equipped with clear facemasks and oxygen reservoirs with oxygen tubing in each of the following sizes:
a. Adult;
b. Child;
c. Infant; and
d. Neonatal mask only;
- Two (2) oropharyngeal airways in each of the following sizes:
a. Adult;
b. Child; and
c. Infant;
-
Blind-Insertion Airway Devices (BIAD) in adult and pediatric sizes; and
-
Portable oxygen equipment of at least 300 liters capacity and D size cylinder with a regulator capable of delivering 25LPM;
(b) Oxygen delivery devices, including:
-
Two (2) non-rebreathing oxygen masks in both adult and pediatric sizes;
-
Two (2) nasal cannula in both adult and pediatric sizes;
-
Two (2) nasopharyngeal airways with water-soluble lubricant in each of the following sizes:
a. Adult;
b. Child; and
c. Infant;
(c) Wound care supplies, including:
-
Two (2) airtight dressings for open chest wounds;
-
Assorted bandaging supplies for the care of soft tissue injuries; and
-
Sterile water for irrigation;
(d) An AED with a minimum of two (2) complete sets of pads for all non-ALS providers and vehicles;
(e) Patient stabilization equipment, including:
-
Two (2) upper and two (2) lower extremity-splinting devices; and
-
Two (2) cervical collars in each of the following sizes or adjustable equivalents:
a. Pediatric;
b. Small;
c. Medium;
d. Large; and
e. No-Neck;
(f) Personal protection and body substance isolation equipment, including at least one (1) of each of the following for each EMS provider:
-
Gown;
-
Face mask and shield;
-
Gloves;
-
Biohazard bag;
-
Puncture resistant container for the disposal of sharp objects; and
-
Antimicrobial hand cleaner; and
(g) Miscellaneous items, including:
- Obstetrical supplies, including:
a. Sterile scalpels or scissors;
b. Sterile gloves;
c. Bulb suction; and
d. Two (2) umbilical clamps;
- One (1) blood pressure sphygmomanometer in each of the following cuff sizes:
a. Large adult;
b. Adult; and
c. Pediatric;
- One (1) stethoscope in each of the following sizes:
a. Adult; and
b. Pediatric; and
- A glucometer or blood glucose-measuring device with reagent strips and lancets for obtaining a blood glucose sample.
Section 8. Class VI and VIII ALS Agency Equipment.
(1) Each Class VI and VIII ALS agency shall maintain evidence in the form of a letter that medical protocols have been reviewed and approved by the board in accordance with KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each call.
(2) Each Class VI and VIII ALS agency shall be exempt from the ambulance requirements established in Sections 1 through 6 of this administrative regulation.
(3)
(a) Each Class VIII ALS agency shall have ready access to and maintain in operational order, two (2) complete sets of equipment required by the agency's protocols and this administrative regulation.
(b) Each Class VI ALS agency shall be required to maintain one (1) complete set of equipment.
(4) In addition to the BLS equipment required in Section 7 of this administrative regulation, each Class VI and VIII ALS agency shall provide ready access to and maintain in fully operational order, supplies and equipment required by the agency's protocols, including a minimum of:
(a) Endotracheal intubation equipment consisting of:
-
Laryngoscope handle;
-
Various laryngoscope blades in adult, pediatric, and infant sizes;
-
Extra batteries and bulbs for handles or blades;
-
A minimum of seven (7) different sizes of endotracheal tubes for oral and nasal placement in adult, pediatric, and infant sizes;
-
Equipment necessary to perform emergency cricothyrotomy;
-
An end tidal carbon dioxide detection device;
-
Stylettes in adult and pediatric sizes;
-
Magill forceps in adult and pediatric sizes;
-
One-half (1/2) inch wide twill tape or equivalent for securing endotracheal tubes; and
-
Water-soluble lubricant for lubrication of endotracheal and nasotracheal tubes;
(b) A portable monitor defibrillator that:
-
Is capable of displaying a visual display of cardiac electrical activity;
-
Is capable of providing a hard copy of cardiac electrical activity measure;
-
Is capable of delivering direct current energy over a variable range, which is suitable for pediatric and adult usage;
-
Is capable of providing external cardiac pacing;
-
Has adult and pediatric external pads, capable of utilization for immediate monitoring of heart activity and delivery of counter shock in both the adult and pediatric patient;
-
Is capable of being operated from internal rechargeable batteries;
-
Has synchronized counter shock capability for cardioversion; and
-
Has a patient monitoring cable with electrode pads or equivalent for use with the patient monitoring cable;
(c) Sterile, disposable needles, in types and sizes sufficient for personnel to administer medications and perform procedures allowed by the agency's patient treatment protocols;
(d) Disposable syringes in types and sizes sufficient for personnel to administer medications and perform procedures allowed by the agency's patient treatment protocols;
(e) Restriction band appropriate for use with venipuncture procedure;
(f) Disposable, individually packaged antiseptic wipes;
(g) Intravenous fluids as required by the agency's protocol, with macrodrip and microdrip fluid sets, and accessory items including over the needle catheter devices in sizes fourteen (14) to twenty-four (24) gauge;
(h) Intraosseous needles or intraosseous devices appropriate for children and adults; and
(i) Pediatric drug dosage tape or equivalent that provides easy reference for pediatric and infant treatment and drug dosages.
(5) All items with expiration dates shall not be expired.
(6) An ALS agency shall stock and maintain drugs and medications as required by the master drug list contained in protocols established in accordance with this section.
(7) Controlled drugs shall be stored in a locked storage box in a locked compartment that is immediately accessible to personnel.
(8) This administrative regulation shall not prevent an agency from maintaining other supplies or equipment that are required to carry out its protocols as approved by the board in accordance with KRS 311A.180.
Section 9. Safety Equipment.
(1) Each ground agency licensed to respond to emergency pre-hospital responses shall provide and maintain in full operational order the following minimum light access and extrication equipment on the ambulance for each staff member:
(a) Eye protection goggles or safety glasses;
(b) Heavy work gloves;
(c) Hard hats that meet ANSI standards, as stated in 29 C.F.R. 1910.135;
(d) Reflective safety wear for each crew member that meet current ANSI standard ANSI 107-2010 or ANSI 207-2011; and
(e) Three (3) reflective triangles or strobes, or equivalent warning devices.
(2) A ground ambulance agency subject to emergency pre-hospital response not equipped to provide extrication and rescue services shall execute an agreement with an agency capable of providing extrication and rescue services to the primary geographic service area.
(3) Each Class II, III ACC, III PSC, III NSC, and VIII agency shall be exempt from the requirements of this section unless emergency pre-hospital response is included in the agency's scope of care.
Section 10. Equipment or Medication Waiver.
(1) The board for good cause shall grant a waiver of any section of this administrative regulation upon request. An applicant for waiver shall submit:
(a) An "EMS Equipment or Staff Waiver Request"; and
(b) A nonrefundable application fee of $500 per waiver request.
(2) The application request shall include:
(a) Evidence of prior good faith efforts to comply with each section for which a waiver is requested;
(b) A written explanation of the agency's inability to comply with each section for which a waiver is requested, including any financial or other significant hardship resulting from the agency's efforts to comply;
(c) A written plan for providing adequate care to patients;
(d) The length of time for which the waiver is requested; and
(e) A plan for compliance with each section of this administrative regulation for which a waiver has been requested.
(3) Requests for waivers shall be submitted to the executive director of the board.
(4) The administrator and medical director of the agency requesting a waiver shall appear before the board's executive committee and the full board at a regularly scheduled meeting to present evidence of hardship that compliance with this administrative regulation may cause.
(5) Waivers shall not be issued for minimum staffing requirements.
(6) Any waiver issued by the board shall expire on December 31 of the year of issue.
(7) Within twenty (20) days of the board's decision, the executive director shall notify the applicant of the decision in writing.
(8) A waiver approved by the board upon a finding of good cause shall be considered a fulfillment of the licensing requirements established in the waiver through December 31 of the year of issue.
(9) The board shall deny the waiver request if, after reviewing the application, it is determined that if the waiver is granted the:
(a) Agency is no longer able to meet the needs of the agency's patients or geographic service area; or
(b) Health or safety of the agency's patients or geographic service area may be jeopardized.
(10) An applicant whose request for waiver is denied may file a written request for a hearing before the board within thirty (30) days of the written notice of denial.
(11) A hearing shall be conducted in accordance with KRS Chapter 13B.
Section 11. Public Notice of Negative Action. The board office shall cause to be published, on the KBEMS Web site or similar publication of the board, or otherwise disseminate, the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
Section 12. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "EMS Equipment or Staff Waiver Request", (12/2017), http://kemsis.ky.gov/;
(b) "U.S. Department of Transportation, Emergency Response Guidebook", (2020), www.phmsa.dot.gov/sites/phmsa.dot.gov/files/2021-01/ERG2020-WEB.pdf;
(c) "Commission on Accreditation of Ambulance Services Ground Vehicle Standard for Ambulances (GVS)", (7/2022), www.groundvehiclestandard.org/wp-content/uploads/2022/06/CAAS_GVS_V3_Final_07_01_2022_2.pdf; and
(d) "U.S. General Services Administration Federal Specification for the Star-of-Life Ambulance (GSA KKK-A-1822F)", (8/2007), www.ehsf.org/sites/default/files/2017-07/Federal%20Specification%20for%20the%20Star-of-Life%20Ambulance.pdf.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor, 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 13B, 311A.030, 311A.180, 311A.190, 29 C.F.R. 1910.135
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.190
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020 requires the Board of Emergency Medical Services to exercise all administrative functions in the regulation of the emergency medical services system and the licensing of ambulance services and medical first response agencies, except those regulated by the Board of Medical Licensure or the Cabinet for Health and Family Services. KRS 311A.030 requires the board to promulgate administrative regulations for the licensing, inspection, and regulation of ambulance providers and medical first response agencies. This administrative regulation establishes the required equipment to operate an ambulance service.
- History: 44 Ky.R. 1736, 2042, 2196; eff. 5-4-2018; 50 Ky.R. 426, 1251; eff. 12-13-2023.
202 KAR 7:555 Ground agencies {#sec-202-kar-7-555 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:555}
Section 1. Utilization of Ground Vehicles by Class I, II, III, and IV Licensed Agencies.
(1) At the time of initial inspection, each agency shall inform the Kentucky Board of Emergency Medical Services (KBEMS) office of the make, model, year, vehicle identification number or serial number, and license tag number for each vehicle the agency plans to use for medical care and transportation.
(2) Each agency shall complete a Vehicle Add application in the Kentucky Emergency Medical Services Information System (KEMSIS) no later than five (5) business days before any unlicensed vehicle is placed into operation.
(3) Unless exigent circumstances exist and the agency receives written approval from the executive director of the board to place an unlicensed vehicle into operation, a vehicle shall not be placed into operation until the board has conducted a physical inspection of the vehicle and determined it meets the requirements of 202 KAR Chapter 7.
(4) Each agency shall complete a Vehicle Delete application in KEMSIS no later than the next business day after the permanent removal of any licensed vehicle from service by the license holder.
(5)
(a) A licensed agency may use a replacement vehicle that meets all of the requirements of 202 KAR Chapter 7 on a temporary basis while a permitted vehicle is out of service. The agency shall complete an Add TEMPORARY Vehicle/Aircraft Part 1 application in KEMSIS within twenty-four (24) hours of the replacement.
(b) A temporary replacement vehicle shall not be used for more than thirty (30) days annually unless the KBEMS office has verified, through a physical inspection, that it meets the requirements of 202 KAR Chapter 7.
(6) The KBEMS office shall be notified by a completed Add TEMPORARY Vehicle/Aircraft Part 2 application in KEMSIS within twenty-four (24) hours or on the next business day if a temporary vehicle is removed from service and the original licensed vehicle is returned to service.
(7)
(a) An agency that fails to report using a temporary vehicle shall be required to immediately cease use of the replacement vehicle until the reporting requirements are met.
(b) An agency that fails to remove a temporary vehicle from service after thirty (30) days shall be fined $500 for each day or partial day the vehicle is in service and not reported.
(8) This administrative regulation shall not prevent a licensed agency from utilizing other means of transporting patients in:
(a) Disasters;
(b) Mass casualty incidents; or
(c) Extraordinary scene conditions that would impair access to the safety or care of the patient or personnel operating at the scene.
Section 2. Provider Management Requirements.
(1) All licensed agencies shall maintain:
(a) An organizational chart that establishes lines of authority, including the designation of:
-
An administrator responsible for assuring compliance with KRS Chapter 311A and 202 KAR Chapter 7 during the daily operation of the service; and
-
A designee who shall serve in the absence of the administrator;
(b) Records and reports at the ambulance agency base station including:
-
An original, electronic equivalent, or copy of all patient care records consistent with the U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA) National Emergency Medical Services Information System (NEMSIS) data dictionary found at www.nemsis.org/technical-resources/version-3;
-
An electronic copy of all completed patient care reports, which shall be maintained to ensure confidentiality and safekeeping for at least seven (7) years from the date on which the service was rendered, or in the case of a minor, at least three (3) years after the minor reaches the age of majority; and
-
Copies of Patient Care Reports for the preceding twelve (12) months, which shall be accessible and be immediately available to the board, KBEMS office, or representatives upon request;
(c) Personnel files for each employee or volunteer who staffs a vehicle of a licensed agency. Personnel files shall be maintained for at least one (1) year following separation from employment. At a minimum, all personnel files shall contain:
- Pre-employment and biennial criminal background checks, which shall be national in scope and administered by a vendor approved by the board.
a. All criminal background checks shall include searches of:
(i) County criminal records;
(ii) Nationwide crime database;
(iii) Federal criminal records;
(iv) Nationwide sexual offender registry;
(v) Healthcare fraud and abuse scan; and
(vi) Address history;
b. A new employee or volunteer shall not staff any licensed vehicle until the agency has requested an initial employment background check from a vendor approved by the board;
c. If a new employee or volunteer is currently employed by another agency licensed by the board and a national criminal background check for that employee or volunteer has been completed within the last six (6) months, the hiring agency may, with the employee's or volunteer's written consent and with approval from the other licensed agency, obtain the completed background check from the other licensed agency, and such background check shall constitute the employee's or volunteer's initial employment background check;
-
A copy of the employee's valid KBEMS certification or licensure card;
-
A Federal Emergency Management Agency (FEMA) transcript or copy of each employee's completion of the National Incident Management System (NIMS) Incident Command System (ICS) 100, 200, 700, and 800 courses;
-
A valid copy of the employee's driver's license and documentation of the employee's completion of driver's training, if the employee operates any agency vehicle; and
-
Annual fitness for duty statements, which shall be consistent with the agency's pre-employment and annual health assessment policy and signed by an authorized representative of the agency;
(d) A policy for the provision of a pre-employment and annual health assessment of employees of the agency, which shall include reporting mechanisms for work-related illness or injury;
(e) A written plan for providers to consult with online adult and pediatric medical direction. This plan shall address at a minimum:
-
The availability of medical direction twenty-four (24) hours a day, seven (7) days a week;
-
The availability of medical direction during an emergency event;
-
The provision of medical direction by a physician, physician assistant (PA), or nurse practitioner (NP); and
-
Recommended actions if:
a. There is an equipment failure, a communication barrier, or other unusual circumstance; and
b. It is not possible to contact online medical direction;
(f) A plan and records for the provision of continuing education for staff and volunteers, including:
-
A written plan for the method of assessment of staff continuing education needs; and
-
A coordinated plan to meet those needs, including a provision that all continuing education shall be provided either by a licensed TEI or in accordance with 202 KAR 7:601;
(g) An infection control plan in accordance with 29 C.F.R. 1910.1030;
(h) A written plan for training or educating personnel for responding to hazardous materials, criminal, and potential terrorist incidents;
(i) Written policies for the protection and decontamination of patients, ambulances, equipment, and staff. If an agency carries firefighter structural personal protective equipment, the written policies shall include provisions for bagging or containing the equipment to minimize off-gassing and prevent cross-contamination within the patient compartment when storing the equipment in an external compartment is not possible;
(j) A written policy regarding the appropriate destination of a patient who expires during transport if a valid Kentucky EMS Do Not Resuscitate (DNR) or Medical Orders for Scope of Treatment (MOST) form is present;
(k) A written plan for the quality assessment of patient care and provider quality improvement, including a monthly review of patient care reports and evaluation of staff performance related to patient care. This plan shall address as a minimum:
-
Employee health and safety;
-
Compliance with protocols and operating procedures;
-
Assessment of dispatch protocols;
-
Vehicle operations and vehicle safety;
-
Additional training necessary for the patient care provider or providers;
-
Equipment preventive maintenance programs; and
-
A process for the resolution of customer complaints;
(l) A written plan for training personnel and responding to mass casualty incidents and disasters;
(m) A written orientation program for all personnel, including at a minimum:
-
Validation of certification or license with KBEMS;
-
Validation of the National Incident Management System (NIMS) Incident Command System (ICS) 100, 200, 700, and 800 courses within sixty (60) days of employment for any employee who staffs a licensed vehicle;
-
Completion of driver's training in accordance with 202 KAR 7:560 prior to operating a board licensed vehicle during an emergency response or when actively transporting a patient, if applicable;
-
A review of all agency policies, procedures, and protocols;
-
Communication equipment at the base station and on each vehicle;
-
Operational aspects of the agency fleet and equipment;
-
Inspection and routine maintenance of agency fleet, facilities, and equipment;
-
Appropriate processes for disinfection of agency fleet, facilities, and equipment;
-
Local navigation and geographic orientation; and
-
Completion of Patient Care Reports and other documentation as established by the agency;
(n) Proof of professional liability malpractice insurance of a minimum of $1,000,000; and
(o) Proof of vehicular liability insurance.
(2)
(a) Each agency shall maintain professional liability malpractice insurance and vehicular liability insurance.
(b) An agency that fails to maintain professional liability malpractice insurance and vehicular liability insurance shall notify the board immediately and cease operations until all insurance coverage has been restored.
(3) Each agency shall verify that all staff certifications and licenses are valid as of the first day of the calendar year.
(4) If an agency is ceasing to operate, the agency shall provide the board with the physical or electronic digital storage location of all Patient Care Reports within five (5) business days of closure. These reports shall be maintained by the owner of the licensed agency, or a contracted third party to meet the timeline established in subsection (1)(b) of this section.
(5) Each agency that allows an employed emergency responder to provide medical services while off duty in accordance with 202 KAR 7:701 shall maintain and implement a policy regarding which employees are approved to provide medical services off duty by the agency's medical director and the manner in which worker's compensation and general liability insurance covers employees off duty.
(a) The policy shall be signed by both the agency's administrator and medical director and shall be reviewed annually.
(b) Off duty emergency medical personnel shall not provide off duty care that would require an agency license, such as a Class VIII license.
(6) Each Class I, II, and VI agency shall, in the county in which the agency's base station or a satellite is located:
(a) Document evidence of participation in a local, county, facility, regional, or state disaster or preparedness exercise within the preceding twelve (12) months;
(b) Coordinate with the county or facility emergency management director plans for the possible use of agency personnel for use in the emergency operations center in a disaster;
(c) Maintain a hard copy or electronic equivalent of the most current adopted facility, city, county, or urban county government emergency management agency's emergency operations plan at the ambulance base station; and
(d) Document evidence of use and operation of Kentucky Ready Ops patient tracking during a disaster or preparedness exercise.
Section 3. Operating Requirements.
(1) Each licensed agency, except Class IV, VIII, and IX, shall provide service twenty-four (24) hours a day, seven (7) days a week. Class IV, VIII, and IX agencies shall operate during the hours of operation for their geographical service area or designated events.
(2) Each licensed agency shall retain staffing schedules for at least the previous twelve (12) months.
(3) A licensed agency shall have a written scope of care policy to include the types of services performed, limitations of response, and the types of medical teams provided.
(4) Unless utilizing a medical dispatch prioritizing system, any agency licensed and located within the geographical service area that determines it is unable to have a vehicle responding within ten (10) minutes from the initial time a 911 scene response call is received shall request that the next closest appropriate licensed agency respond.
(5) If an agency licensed for a specific geographical service area is unable to respond to a scheduled or non-scheduled medically necessary ambulance transportation call within two (2) hours from the initial time the call is received, the requesting healthcare facility may contact any appropriately-licensed agency and request that the agency conduct the transport.
(6) Each Class I agency shall attempt to enter into a mutual aid agreement with another licensed Class I agency operating within the same or contiguous counties. These agreements shall be in writing and address:
(a) The type of mutual aid assistance to be provided, including advanced life support (ALS) or basic life support (BLS) medical care and transport and ALS or BLS medical first response;
(b) Response personnel, including levels of training or education and provisions for joint in-service training or education if appropriate;
(c) Response vehicles, including unit identifiers and the station or location from which the vehicles shall be operated;
(d) A plan of action for the mutual aid agreement, including dispatch and notification procedures;
(e) Radio and other communications procedures between the ambulance agency and other response agencies with which the agency has mutual aid agreements;
(f) On-scene coordination and scene control including medical direction if several agencies respond to the same incident;
(g) Exchange of patient information, records, and reports as allowed by law; and
(h) The effective dates and process for amendment or termination.
(7) A Class I agency shall send a written request for a mutual aid agreement to at least two (2) contiguous counties and retain a copy of each request and each county's response.
(8) Each Class I and VI agency shall maintain a policy or affiliation agreement with the primary call-taking center that provides dispatch services for all or part of the service area of the ground agency. The agreement or policy shall state at a minimum that:
(a) Unless utilizing a medical dispatch prioritizing system, requests for 911 scene response shall be dispatched or notified within two (2) minutes from determining that the caller is requesting an ambulance response;
(b) If the closest licensed agency for that geographic service area is unable to have an ambulance responding to an emergency 911 scene response call within ten (10) minutes from the time the call is dispatched, the agency shall notify the next closest appropriate licensed agency to respond; and
(c) The agreement shall specify which patient information shall be collected by the call-taking center during a call for service.
(9) Each Class II and III agency shall maintain a policy or affiliation agreement with the primary call-taking center that provides dispatch services for all or part of the service area of the ground agency. The agreement or policy shall state, at a minimum, which patient information shall be collected by the call-taking center during a call for service.
(10) If a ground agency is unable to secure a written affiliation agreement with the dispatch center, the ground agency shall retain all written correspondence to the dispatch center requesting an affiliation agreement and the dispatch center's denial of the agency's request.
(11) An agency shall not respond to requests for emergency service outside of its licensed geographic service area without first receiving authorization from the licensed agency in the geographic service area in which the request originates.
(12) A licensed Class I ground agency that is located in a geographical service area containing multiple destination hospitals, with regard to the furnishing of 911 scene response and transportation, shall not engage in:
(a) Exclusive or coercive practices regarding transportation decisions with regard to any affiliated hospital or hospital emergency department;
(b) Preferential transportation to any affiliated hospital emergency department if the transports are not justified by time, place, patient convenience, or other objective factors affecting a patient;
(c) Noncompetitive transportation to any affiliated hospital emergency department; or
(d) Transports to any affiliated hospital emergency department if that hospital is not the closest to the patient location or most appropriate based on the availability of particular services or patient preference.
(13) Each licensed Class I and II agency shall schedule a minimum of one (1) staffed ambulance to be staged in the agency's geographic service area.
(14) An agency that cannot meet the timelines established in subsection (8) of this section shall contact another licensed agency and receive an estimated time of arrival to the request for service. If the mutual aid agency can arrive at the location where the request originated more quickly than the agency licensed for the geographic service area, the agency licensed for the geographic service area shall request mutual aid from its neighboring agency to respond to the call.
(15) Class I, IV, and VI agencies shall not refuse a request for an emergency site or 911 scene response if a unit is available in its geographic service area.
(16) A Class I agency shall not exhaust its resources by responding to a scheduled or non-scheduled medically necessary call or by responding to a mutual aid request.
(17) This administrative regulation shall not be construed to prevent a licensed agency from providing medical first response emergency or nonemergency pre-hospital care at or below the level for which the agency is licensed through the use of designated agency-owned response vehicles.
(18) A communications system shall be developed, coordinated, and maintained by each licensed agency. The communication system shall comply with paragraphs (a) through (f) of this subsection.
(a) Radio equipment used in emergency medical services vehicles shall be appropriately licensed through the Federal Communications Commission (FCC). Copies of the current FCC licenses shall be on file in the agency office.
(b) Each ambulance shall have an operational push-to-talk two-way radio programmed with all very high frequency (VHF) Kentucky State Mutual Aid Frequencies in accordance with the Commonwealth of Kentucky Field Operations Guide (KY-FOG).
(c) Each Class I ambulance shall be equipped with a minimum of one (1) mobile two-way radio located in the driver's compartment.
(d) Each Class I ambulance shall have a minimum of two (2) portable push-to-talk two-way radios capable, under normal conditions, of operating on the agency, dispatch center, mutual aid, and hospital frequencies.
(e) Each ambulance shall be equipped with mobile two-way radio communication equipment with the ability to communicate from the driver's compartment and patient care compartment.
(f) One (1) alternative method of two-way communication may be substituted for one (1) portable two-way radio.
Section 4. Ceasing Continuous Service.
(1) A licensed Class I, II, III, VI, or VII agency that ceases to provide continuous service on a twenty-four (24) hour basis shall surrender its license to the board office within twenty-four (24) hours of the agency ceasing to provide continuous service.
(2) The agency's chief operations or service director shall immediately contact the executive director of the board upon determining that his or her Class I, II, III, VI, or VII agency will cease providing continuous service, and shall provide the approximate date and time that the agency will cease continuous service.
(3) The agency's chief operations or service director shall immediately contact the executive director of the board upon determining that his or her Class I, II, III, VI, or VII agency has ceased providing continuous service, and shall provide the date and time that the agency ceased continuous service.
(4) Notwithstanding subsection (1) of this section and Section 3(1) of this administrative regulation, a Class I, II, III, VI, or VII agency shall resume continuous service no later than seventy-two (72) hours after ceasing continuous service if the executive director of the board determines, in writing, that:
(a) Circumstances beyond the agency's control exist that justify the agency's temporary lapse in continuous service; and
(b) Public health, safety, and welfare will be better served by allowing the agency to resume continuous service within seventy-two (72) hours after ceasing continuous service.
(5) A licensed Class I, II, III, VI, or VII agency that ceases continuous service shall be deemed to pose a threat to the public and the agency's license shall be temporarily suspended in accordance with KRS 311A.075 if:
(a) The agency fails to surrender its license in accordance with subsection (1) of this section; and
(b) The executive director of the board does not make the determinations set forth in subsection (4)(a) and (b) of this section; or
(c) The executive director of the board makes the determinations set forth in subsection (4)(a) and (b) of this section, but the agency fails to resume continuous service within seventy-two (72) hours after ceasing continuous service and fails to surrender its license to the board office within seventy-two (72) hours after ceasing continuous service.
(6)
(a) Unless the agency surrenders its license to the board within two (2) hours after ceasing continuous service, a Class I, II, III, VI, or VII agency that ceases continuous service shall be assessed $200 per hour for non-operations after the second hour of failure to provide continuous service.
(b) Assessments for non-operations shall not be imposed for any period of non-operations after an agency surrenders its license, after an agency's license is suspended, or, if the executive director of the board makes the determinations established in subsection 4(a) and (b) of this section, after the written determinations are made.
Section 5. Issuance of Temporary Class I Hardship Licenses to Counties.
(1) The board office shall issue a temporary Class I hardship license to the county or counties listed as the geographic service area on a Class I license thatis the only Class I license for the geographic service area and:
(a) Is surrendered in accordance with Section 4(1) of this administrative regulation; or
(b) Is temporarily suspended in accordance with Section 4 of this administrative regulation and KRS 311A.075.
(2) The board office may issue a temporary Class I hardship license to a county or counties subject to emergent conditions that pose a threat to public health, safety, and welfare.
(3) A temporary hardship license shall not be transferrable.
(4) A county issued a temporary hardship license may contract with a licensed Class I agency to provide service to the geographic service area listed on the temporary hardship license.
(5) Notwithstanding Sections 3(1) and 4(1) of this administrative regulation, a county issued a temporary hardship license shall begin providing continuous service no later than 120 days after the license is issued.
(6) Notwithstanding any other administrative regulation promulgated by the board, for up to and not exceeding 120 days after a temporary hardship license is issued to a county under this section, the county may request that any licensed Class I agency respond to a call for service in the geographic service area listed on the temporary hardship license.
(7) A temporary hardship license issued pursuant to subsection (1) of this section shall expire one (1) year after the license is issued, after a new Class I license for the geographic service area is issued, or, if the Class I license for the geographic service area was temporarily suspended in accordance with Section 4 of this administrative regulation, after that license is reinstated, whichever occurs first.
(8) A temporary hardship license issued pursuant to subsection (2) of this section shall expire one (1) year after the license is issued, unless extended by approval of the board for up to one (1) additional year.
Section 6. Medical Directors.
(1) Each licensed agency shall have a medical director who meets the requirements established in 202 KAR 7:801.
(2) A licensed agency shall notify KBEMS within twenty-four (24) hours of a decision to discontinue a medical director agreement by either the agency or the medical director.
(3)
(a) If an agency is found to be operating without a medical director, the agency shall be provided emergency medical direction by the KBEMS Medical Advisor for a fee of $100 per day for the first thirty (30) calendar days the agency is without a medical director.
(b) The fee shall increase to $500 per day after thirty (30) calendar days.
Section 7. Public Notice of Negative Action. The board office shall cause to be published, on the KBEMS web site or similar publication of the board, the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
Section 8. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Commonwealth of Kentucky Field Operations Guide (KY-FOG)", (6/2012) found at https://kwiec.ky.gov/SiteCollectionDocuments/KYFOG.pdf.;
(b) "NHTSA NEMSIS Data Dictionary", (v3.40) U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA) National Emergency Medical Services Information System (NEMSIS) data dictionary found at https://www.nemsis.org/media/nemsis_v3/3.4.0.150302/DataDictionary/PDFHTML/DEMEMS/NEMSISDataDictionary.pdf;
(c) "Vehicle Add application in KEMSIS", (12/2025);
(d) "Vehicle Delete application in KEMSIS", (12/2019);
(e) "Add TEMPORARY Vehicle/Aircraft application Part 1 in KEMSIS", (12/2019); and
(f) "Add TEMPORARY Vehicle/Aircraft application Part 2 in KEMSIS", (12/2019).
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board's Web site at: kyems.com.
History
- RELATES TO: KRS 311A.030, 311A.075, 311A.190, 29 C.F.R. 1910.1030
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.190
- CERTIFICATION STATEMENT: This is to certify that this administrative regulation complies with the requirements of 2025 RS HB 6, Section 8.
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020 requires the Board of Emergency Medical Services to exercise all administrative functions in the regulation of the EMS system and the licensing of ambulance services and medical first response agencies, except those regulated by the Board of Medical Licensure or the Cabinet for Health and Family Services. KRS 311A.030 requires the board to promulgate administrative regulations for the licensing, inspection, and regulation of ambulance providers and medical first response agencies. This administrative regulation establishes minimum licensing requirements.
- History: 202 KAR 007:555. 44 Ky.R. 1742; 2049; 2201; eff. 5-4-2018; 46 Ky.R. 2311, 2109, 2621; eff. 7-29-2020; 50 Ky.R. 135, 816; eff. 10-25-2023; 52 Ky.R. 94, 560; eff. 1-22-2026.
202 KAR 7:560 Ground vehicle staff {#sec-202-kar-7-560 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:560}
Section 1. Staffing Requirements.
(1) Each Class I agency BLS ambulance shall at minimum, be staffed by:
(a) A driver certified as an emergency medical responder (EMR); and
(b) An attendant certified as an emergency medical technician (EMT).
(2) Each Class I agency ALS ambulance shall at minimum be staffed by:
(a) A driver certified as an emergency medical responder (EMR); and
(b) An attendant certified as an Advanced EMT or licensed as a paramedic.
-
Each Class I ALS agency shall ensure that it has at least one (1) paramedic on-duty at all times.
-
To ensure compliance, each agency shall maintain its work schedules from the previous twelve (12) months until reviewed by board staff during its annual inspection.
(3) Each Class I agency operating an ALS ambulance providing a BLS level of care shall at minimum be staffed by:
(a) A driver certified as an emergency medical responder (EMR); and
(b) An attendant certified as an emergency medical technician (EMT).
(4) Each Class II agency shall at minimum be staffed by:
(a) A driver certified as an emergency medical responder (EMR); and
(b) An attendant certified as an emergency medical technician (EMT).
(5) A Class III Adult Critical Care ambulance agency shall at minimum be staffed by:
(a) A driver certified as an emergency medical responder (EMR);
(b) An attendant licensed as a paramedic; and
(c) One (1) licensed:
-
Registered nurse;
-
Advanced practice registered nurse;
-
Respiratory therapist;
-
Physician assistant;
-
Physician; or
-
Additional paramedic.
(6)
(a) Each Class III Pediatric Specialty Care Ambulance Agency shall at minimum be staffed by:
-
A driver certified as an emergency medical responder (EMR);
-
A primary attendant licensed as a registered nurse; and
-
One (1) additional attendant licensed as a:
a. Registered nurse;
b. Advanced practice registered nurse;
c. Respiratory therapist;
d. Physician assistant;
e. Physician; or
f. Paramedic.
(b) Any attendant hired after January 1, 2020 shall acquire and maintain within one (1) year of hire, a specialty certification in Pediatric Critical Care or Neonatal Critical Care acquired through successful completion of a validated examination administered by an independent entity not associated with a specific course or program of education.
(7)
(a) Each Class III Neonatal Specialty Care Ambulance Agency shall at minimum be staffed by:
-
A driver certified as an emergency medical responder (EMR);
-
A primary attendant licensed as a registered nurse; and
-
One (1) additional attendant licensed as:
a. An advanced practice registered nurse;
b. A respiratory therapist;
c. A physician assistant;
d. A physician;
e. A registered nurse; or
f. Paramedic.
(b) Any attendant hired after January 1, 2020 shall acquire and maintain within one (1) year of hire, a specialty certification in Pediatric Critical Care or Neonatal Critical Care acquired through successful completion of a validated examination administered by an independent entity not associated with a specific course or program of education.
(8) Each Class IV agency operating a BLS ambulance shall at minimum be staffed by:
(a) A driver certified as an emergency medical responder (EMR); and
(b) An attendant certified as an emergency medical technician (EMT).
(9)
(a) Each Class IV service operating an ALS ambulance shall at minimum be staffed by:
-
A driver certified as an emergency medical technician (EMT); and
-
An attendant certified as an Advanced EMT or licensed as a paramedic.
(b) Each Class IV ALS agency shall have at least one (1) licensed paramedic on duty at all times. To ensure compliance, each agency shall maintain its work schedules from the previous twelve (12) months until reviewed by board staff during its annual inspection.
(10) Each Class VI BLS medical first response agency shall at minimum be staffed by a certified:
(a) Emergency medical responder (EMR); or
(b) Emergency medical technician (EMT).
(11) Each Class VI ALS medical first response agency shall at minimum be staffed by:
(a) A certified Advanced EMT; or
(b) A licensed paramedic.
(12) Each Class VIII BLS agency shall be minimally staffed by a certified:
(a) Emergency medical responder (EMR); or
(b) Emergency medical technician (EMT).
(13) Each Class VIII ALS agency shall be minimally staffed by:
(a) A certified Advanced EMT; or
(b) A licensed paramedic.
(14) At all times, the attendant shall monitor the patient and remain with the patient in the patient compartment.
(15) This administrative regulation shall not prevent an agency from utilizing staff other than those required by this administrative regulation in:
(a) Disasters;
(b) Mass casualty incidents; or
(c) Extraordinary scene conditions that would impair the safety of the patient or personnel operating at the scene.
(16) Alternative staff shall not operate a licensed vehicle unless the:
(a) Agency administrator so directs; and
(b) Vehicle is out of service and not subject to an emergency response.
Section 2. Temporary Waiver of Paramedic Staffing Requirement.
(1) Notwithstanding Section 1(2)(b)1. of this administrative regulation or 202 KAR 7:550, Section 10(5), if the board grants a temporary waiver to a Class I ALS agency pursuant to this section, the agency shall ensure that it has at least one (1) AEMT or one (1) paramedic on duty at all times.
(2) A Class I ALS agency may request a temporary waiver by submitting to the office of the board a sworn and notarized affidavit from the agency's chief operations or service director. In the affidavit, the chief operations or service director shall:
(a) Explain why the agency is unable to have at least one (1) paramedic on duty at all times;
(b) Explain the steps the agency has taken to have at least one (1) paramedic on duty at all times;
(c) Identify the number of paramedics the agency has on staff;
(d) Identify the compensation the agency pays paramedics;
(e) Identify the additional steps the agency will take to hire paramedics;
(f) Identify the number of ambulances the agency has staffed each day; and
(g) Certify that the chief local elected official of the agency's geographic service area has been notified, in writing, that the agency is requesting a temporary waiver pursuant to this section.
(3) The chief operations or service director shall attach to the affidavit any documentation supporting the statements made in the affidavit.
(4) In addition to the affidavit and any supporting documentation submitted pursuant to subsections (2) and (3) of this section, the board may consider any other relevant information in determining whether to grant a temporary waiver.
(5) The board shall grant a request for a temporary waiver if it determines that the agency has made a good faith effort to have at least one (1) paramedic on duty at all times but has been unable to do so.
(6) If the board has probable cause to believe that the agency has not made a good faith effort to have at least one (1) paramedic on duty at all times, the board shall refer the matter for a hearing in accordance with KRS Chapter 13B to determine whether a temporary waiver should be granted to the agency.
(7) An agency granted a temporary waiver pursuant to this section shall submit a report to the office of the board on January 1, April 1, July 1, and October 1 of each year. Each report shall include:
(a) The additional steps the agency has taken to hire paramedics since the last report deadline or, if no report deadline has passed, since the temporary waiver was granted;
(b) The number of paramedics on staff;
(c) The number of days that the agency was without at least one (1) paramedic on duty at all times since the last report deadline or, if no report deadline has passed, since the temporary waiver was granted;
(d) The number of paramedic employment applications received by the agency since the last report deadline or, if no report deadline has passed, since the temporary waiver was granted; and
(e) For each paramedic who applied for employment with the agency since the last report deadline or, if no report deadline has passed, since the temporary waiver was granted, but was not hired by the agency, the reasons why the paramedic was not hired.
(8) An agency granted a temporary waiver in the month preceding a report deadline shall not be required to submit the next month's report. (For example, if the temporary waiver is granted in March 2025, the agency is not required to submit the April 1, 2025 report.)
(9) All temporary waivers granted pursuant to this section shall expire on December 31, 2026.
(10) Notwithstanding subsection (9) of this section, if an agency fails to submit a report required by subsection (7) of this section, the agency's temporary waiver shall expire seven (7) days after the report deadline if the report still has not been received by the office of the board by that date.
(11) The board shall publish on its Web site all agencies that have been granted a temporary waiver pursuant to this section.
Section 3. Motor Vehicle Operator Requirements.
(1) Each person operating a vehicle shall:
(a) Be at least eighteen (18) years of age;
(b) Hold a valid driver's license in any state or territory of the United States; and
(c) Complete at least four (4) hours of driver training and education every two (2) years.
(2) The driver training and education shall consist of a:
(a) Review of driving a vehicle under emergency conditions;
(b) Review of KRS 189.910 through 189.950 regarding operation of emergency vehicles;
(c) Demonstration by the student of forward and back-up driving maneuvers in a controlled situation, such as in an obstacle course designed specifically for this purpose; and
(d) Review of defensive driving techniques and procedures with hands-on experience or exposure by visual aids or planned demonstrations.
Section 4. Public Notice of Negative Action. The board office shall cause to be published, on the KBEMS Web site or similar publication of the board, or otherwise disseminate, the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
History
- RELATES TO: KRS 189.910-189.950, 311A.030, 311A.190
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.190
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020 requires the Board of Emergency Medical Services to exercise all administrative functions in the regulation of the emergency medical services system and the licensing of ambulance services and medical first response agencies, except those regulated by the Board of Emergency Medical Services or the Cabinet for Health and Family Services. KRS 311A.030 requires the board to promulgate administrative regulations for the licensing, inspection, and regulation of ambulance providers and medical first response agencies. This administrative regulation establishes the minimum staffing requirements for ground vehicles.
- History: 44 Ky.R. 1745, 2042, 2204; eff. 5-4-2018; 45 Ky.R. 3489, 46 Ky.R. 428; eff. 8-19-2019; 48 Ky.R. 3036; eff. 9-28-2022; 51 Ky.R. 768, 1277; eff. 2-5-2025.
202 KAR 7:565 Clinical pilot programs {#sec-202-kar-7-565 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:565}
Section 1.
(1) A clinical pilot program shall allow for the use of assessment techniques or clinical procedures beyond the regular scope of practice of emergency medical responders established in 202 KAR 7:701.
(2)
(a) A licensed agency seeking authorization for a clinical pilot program shall submit a Clinical Pilot Program Application that includes a:
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Letter of intent;
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Description of the type of pilot project;
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General project description;
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Patient Interaction Plan;
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Staffing Plan;
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Training and Education Plan;
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Medical Direction and Quality of Improvement Plan;
-
Data Collection and Quantitative Reporting;
-
Written confirmation of research approval from an Institutional Review Board (IRB) within the Commonwealth, if applicable; and
-
Nonrefundable application fee of $500.
(b) The applicant agency's administrator and medical director shall appear before the Medical Oversight Committee and subsequent meeting of the board to present the applicant agency's proposed pilot program for review or additional information.
(c) The Medical Oversight Committee shall review the applicant's proposal and assess on its individual merits if the project or program to be developed or implemented by the applicant is likely to benefit patients and providers of emergency medical services. The Medical Oversight Committee shall present its recommendation of approval or denial to the board at the next regularly scheduled board meeting.
(d) Upon approval of a clinical pilot program, the board shall develop quarterly report deadlines and data points for quarterly review by the Medical Oversight Committee.
-
The data points shall relate to the specific methods and goals identified in the applicant's proposal.
-
The reporting deadlines and data points shall be incorporated into a Memorandum of Understanding between the board and the applicant.
(3) An individual certified or licensed by the board who successfully completes an approved educational pilot program in accordance with 202 KAR 7:601 shall perform the procedures relevant to the training and education received in the pilot program subject to protocols established by the medical director and approved by the board in accordance with KRS 311A.180.
(4) The board may limit:
(a) The geographic area or service location where the procedure is performed; and
(b) The performance of the procedure subject to a:
-
Specific and defined event;
-
Disaster; or
-
Designated directive.
(5) The board shall authorize the use of physicians or other medical professionals to supervise and monitor the training and education of providers involved in a pilot program.
(6) The board may restrict actions that involve the performance of an invasive procedure or the administration of medication subject to:
(a) Physician or medical director oversight; or
(b) The use of protocols that have been submitted to the board for review and approved by the state medical advisor and the board in accordance with KRS 311A.180.
(7) The office of the board shall retract the approval of any Clinical Pilot Program immediately if:
(a) The agency is in violation of any provisions approved by the board, including data submission requirements; or
(b) There is evidence the assessment technique or procedure has caused physical or psychological harm to a patient.
(8) Violation of any provision of a Clinical Pilot Program shall be grounds for discipline in accordance with KRS Chapter 311A.060.
Section 2. Public Notice of Negative Action. The board office shall publish on the KBEMS web site or similar publication of the board the name of any licensed agency that is fined, placed on probationary status, placed on restricted status, suspended, or had a license revoked.
Section 3. Incorporation by Reference.
(1) "Clinical Pilot Program Application", (5/2025), is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor, 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available on the board website at: kbems.ky.gov.
History
- RELATES TO: KRS 311A.060, 311A.180, 311A.190
- STATUTORY AUTHORITY: KRS 311A.020(1), 311A.035
- CERTIFICATION STATEMENT: This is to certify that this administrative regulation complies with the requirements of 2025 RS HB 6, Section 8.
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.020(1) requires the board to exercise all administrative functions in the regulation of the EMS system and the licensing of ambulance services and medical first response agencies, except those regulated by the Board of Medical Licensure or Cabinet for Health and Family Services. KRS 311A.035 authorizes the board to develop, monitor, and encourage other projects and programs that may be of benefit to emergency medical services in the Commonwealth. This administrative regulation establishes the process for agencies to submit clinical pilot programs and the standards for approval by the board.
- History: 202 KAR 007:565. 44 Ky.R. 1747; eff. 5-4-2018; 52 Ky.R. 94, 560; eff. 10-22-2025.
202 KAR 7:575 Fee schedules of licensed ambulance providers {#sec-202-kar-7-575 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:575}
Section 1. Fee Schedule Disclosure.
(1) Licensed Ground and Air Ambulance Services, and Medical First Response agencies shall provide a comprehensive fee schedule consistent with KRS 311A.032.
(2) The fee schedule shall be consistent with the Healthcare Common Procedure Coding System (HCPCS). Itemized charges shall be reflected for each of the following:
(a) A0428- Ambulance service, BLS, non-emergency transport;
(b) A0429- Ambulance service, BLS, emergency transport;
(c) A0426- Ambulance service, ALS1, non-emergency transport;
(d) A0427- Ambulance service, ALS1, emergency transport;
(e) A0430- Ambulance service, conventional air services, transport, one way (fixed wing);
(f) A0431- Ambulance service, conventional air services, transport, one way (rotary wing);
(g) A0433- Advanced life support, level 2 (ALS2);
(h) A0434- Specialty Care Transport (SCT);
(i) A0425- Ground mileage, per statute mile;
(j) A0436- Rotary Wing Air Mileage, per statute mile;
(k) A0435- Fixed Wing Air Mileage, per statute mile; and
(l) Other charges.
Section 2. Posting Requirements. Licensed Ground and Air Ambulance Services, and Medical First Response agencies shall post fee schedules as established in KRS 311A.032(1)(a).
Section 3. Reporting Requirements.
(1) Licensed Ground and Air Ambulance Services, and Medical First Response agencies shall submit:
(a) An initial fee schedule to the Kentucky Board of Emergency Medical Services through an electronic Application for Initial Fee Schedule in the agency KEMSIS account; and
(b) An annual fee schedule to the Kentucky Board of Emergency Medical Services at the time of agency licensure renewal with the electronic Renewal and Inspection Application for Class I, II, III, IV, VII, and VIII Agencies, and the Renewal and Inspection Application for Class VI Agencies.
(2) Fee schedules that are modified shall be updated and posted as established in KRS 311A.032, and an electronic Application for Ambulance Fee Schedule Modification shall be submitted to the Kentucky Board of Emergency Medical Services within fifteen (15) days of fee schedule modification.
Section 4. Accountability and Oversight.
(1) Posting provisions as required by KRS 311A.032(1)(a) shall be evaluated by staff of the Kentucky Board of Emergency Medical Services at least annually as part of the agency annual inspection.
(2) Unannounced inspections may be conducted for a:
(a) Verification of posting requirements;
(b) Complaint allegation;
(c) Follow-up visit; or
(d) Relicensing inspection.
(3) The Kentucky Board of Emergency Medical Services shall:
(a) Assess a licensed ambulance agency a monetary penalty of $150 as required by KRS 311A.032(2)(a) and Sections 2 and 3 of this administrative regulation; and
(b) Issue a statement of violation consistent with 202 KAR 7:501.
Section 5. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Application for Initial Fee Schedule", April 2019;
(b) "Application for Ambulance Fee Schedule Modification", April 2019;
(c) "Renewal and Inspection Application for Class I, II, III, IV, and VII Agencies", April 2019; and
(d) "Renewal and Inspection Application for Class VI Agencies", April 2019.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 118 James Court, Suite 50, Lexington, Kentucky 40505, Monday through Friday, 8:30 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 311A.010, 311A.032, 61.870-61.884
- STATUTORY AUTHORITY: KRS 311A.032
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.032 requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations concerning the posting of fee schedules of licensed ambulance providers. This administrative regulation establishes standards and criteria governing the mandatory posting of fees, modification of fee schedules, reporting requirements, public posting requirements, and penalties for non-conformity.
- History: 45 Ky.R. 2805, 3408; eff. 7-5-2019; Crt eff. 6-30-2026.
202 KAR 7:596 Mobile integrated healthcare licensure {#sec-202-kar-7-596 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:596}
Section 1. Definitions.
(1) "Discharge planner" means a person coordinating the transition of the patient from the care facility to another location and who ensures that the services and care that the patient needs are coordinated.
(2) "Home health agency" means an appropriately licensed organization that provides skilled nursing care and therapy services in eligible patients' homes in accordance with applicable federal, state, and local requirements.
(3) "Mobile integrated healthcare" or "MIH" is defined by KRS 311A.010(18).
(4) "Organization" means any business entity created under the laws of the Commonwealth of Kentucky.
(5) "Patient care planning" means written documents that help empower patients with complex conditions to better manage their own care. These plans are meant to be written collaboratively with the patient and family and incorporate the patient's and family's goals, preferences for care, and action plans for exacerbations of conditions.
(6) "Primary care provider" means a physician (Doctor of Medicine or Doctor of Osteopathy), nurse practitioner, or physician assistant licensed or certified under Kentucky law, who provides, coordinates, or helps a patient access a range of healthcare services.
Section 2. Applying for a Mobile Integrated Healthcare Program License. An individual or organization applying for an MIH program license shall submit to the KBEMS office:
(1) A completed Mobile Integrated Healthcare Program License Application;
(2) The application fee as established in 202 KAR 7:030, Section 7(1);
(3) A current map or the ZIP codes of the MIH program's intended service area;
(4) A written description of the:
(a) Program;
(b) Service area; and
(c) Specific services to be provided.
Section 3. Mobile Integrated Healthcare Program Licensure.
(1) The KBEMS office shall issue a Class V mobile integrated healthcare program license to an individual or organization that satisfies the requirements of this section and Section 2 of this administrative regulation.
(2) A Class V MIH program license shall be issued only to the individual or organization named in the Mobile Integrated Healthcare Program License Application.
(3) A Class V MIH program license shall not be transferable.
(4) A Class V MIH program shall conspicuously display its license in a prominent public area at the program's primary administrative office of operation.
(5) The following information shall be included on the license issued by the KBEMS office:
(a) Operating name of the MIH program;
(b) Physical location of the MIH program's primary administrative office of operation;
(c) The number and physical location of satellite locations, if any, operated by the MIH program;
(d) The license classification;
(e) The level of service provided;
(f) The number of equipment sets operated by the MIH program; and
(g) The specific geographic area to be served by the MIH program.
(6) A MIH program license shall expire annually on December 31.
Section 4. Renewal of a Mobile Integrated Healthcare Program License. To renew a Class V MIH program license, the license holder shall:
(1) Submit to the KBEMS office a completed Mobile Integrated Healthcare Program Renewal Application;
(2) Pass an inspection conducted by the KBEMS office of the MIH program's premises, equipment, supplies, and records; and
(3) Submit to the KBEMS office the fee established in 202 KAR 7:030.
Section 5. Inspections.
(1) Compliance with licensing pursuant to this administrative regulation shall be validated through on-site inspections of the MIH program by representatives or employees of the KBEMS office. The inspection shall include a:
(a) Review of all equipment and supplies stocked; and
(b) Review of personnel records, policy manuals, and other reports required to be maintained pursuant to 202 KAR Chapter 7.
(2) Each representative or employee of the KBEMS office shall have access to the MIH program's premises, records, and equipment during the hours that the MIH program operates.
(3) Notice of a regulatory violation identified during an inspection shall be transmitted in writing to the MIH program by the KBEMS office.
(4) Within ten (10) business days of receipt of notice of a regulatory violation, the MIH program shall submit a written plan for the elimination or correction of the regulatory violation to the KBEMS office.
(5) The plan shall specify the date by which the violations will be corrected.
(6) Within ten (10) business days following receipt of the plan, the KBEMS office shall notify the MIH program, in writing, whether the plan is accepted as providing for the elimination or correction of the violation.
(7) The KBEMS office may conduct follow-up visits to verify compliance with the plan.
(8) If a portion or all of the plan is unacceptable:
(a) The KBEMS office shall specify, in writing, why the plan is unacceptable; and
(b) The provider shall modify or amend the plan and resubmit it to the KBEMS office within ten (10) business days after receipt of notice that the plan is unacceptable.
(9) Unannounced inspections of an MIH program may be conducted for a:
(a) Complaint allegation;
(b) Follow-up visit; or
(c) Relicensing inspection.
Section 6. Unethical Conduct. The following acts shall be considered unethical conduct in the practice of providing MIH, and an MIH program or its EMS personnel shall be subject to disciplinary action and sanctions in accordance with KRS Chapters 311A and 13B:
(1) Failing to submit, amend, or modify a plan of correction to eliminate or correct a regulatory violation;
(2) Failing to eliminate or correct a regulatory violation;
(3) Falsifying an application for licensure;
(4) Changing a license issued by the board without board approval; or
(5) Attempting to obtain or obtaining a license by:
(a) Fraud;
(b) Forgery;
(c) Deception;
(d) Misrepresentation;
(e) Subterfuge;
(f) Providing false or misleading advertising;
(g) Falsifying, or causing to be falsified, reports regarding patient care or other reports provided to the KBEMS office;
(h) Providing an unauthorized level of service;
(i) Failing to provide the board or its representative with information upon request, or obstructing an investigation regarding alleged or confirmed violations of KRS Chapter 311A or 202 KAR Chapter 7;
(j) Issuing a payment on an invalid account or an account with insufficient funds to pay established fees, fines, or charges;
(k) Submitting fraudulent or misleading claims for reimbursement; or
(l) Failing to comply with local ordinances, federal statutes, KRS Chapter 311A, or 202 KAR Chapter 7.
Section 7. Public Notice of Negative Action. The KBEMS office shall publish on the KBEMS web site, or shall otherwise disseminate, the name of any MIH program that is fined, placed on probationary status, placed on restricted status, suspended, or that has had its license revoked.
Section 8. Management Requirements for Mobile Integrated Healthcare Programs.
(1) All MIH programs shall maintain:
(a) An organizational chart that establishes lines of authority, including the designation of:
-
An administrator responsible for ensuring compliance with KRS Chapter 311A and 202 KAR Chapter 7 during the daily operation of the MIH program; and
-
A designee who shall serve in the absence of the administrator;
(b) Records and reports at the MIH program's primary administrative office, including:
-
An original, electronic equivalent, or copy of all patient care records;
-
An electronic copy of all completed patient care reports, which shall be maintained to ensure confidentiality and safekeeping for at least seven (7) years from the date on which the service was rendered or, in the case of a minor, at least three (3) years after the minor reaches the age of majority;
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Copies of patient care reports for the preceding twelve (12) months, which shall be accessible and be immediately available to the board, KBEMS office, or their representatives upon request; and
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Referrals for service received or made by the MIH program, which shall be maintained to ensure confidentiality and safekeeping for at least seven (7) years from the date on which the service was rendered or, in the case of a minor, at least three (3) years after the minor reaches the age of majority;
(c) Personnel files for each employee or volunteer who performs MIH activities on behalf of a MIH program. Personnel files shall be maintained for at least one (1) year following separation from employment. At a minimum, all personnel files shall contain:
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A pre-employment and annual criminal background check administered by the Kentucky Administrative Office of the Courts; and
-
A copy of the employee's valid KBEMS certification or licensure card, if any;
(d) A written plan for providers to consult with online medical control for the patient population they are treating. This plan shall address at a minimum:
-
The availability of medical direction during hours of operation;
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The availability of medical direction during an emergency event;
-
The provision of medical direction by a medical professional with a higher level of training or expertise; and
-
Recommended actions if:
a. There is an equipment failure, a communication barrier, or other unusual circumstance; and
b. It is not possible to contact online medical direction;
(e) A plan and records for the provision of continuing education for staff and volunteers, including:
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A written plan for the method of assessing the continuing education needs of the MIH program's staff; and
-
A coordinated plan to meet those needs, including a provision that all continuing education shall be provided either by a licensed EMS-TEI or in accordance with 202 KAR 7:601;
(f) An infection control plan in accordance with 29 C.F.R. 1910.1030;
(g) Policies and procedures that address the assessment, planning, and care coordination services while providing MIH services. At a minimum, the policies shall address:
-
Securing consent to obtain or release patient medical records to other healthcare providers;
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Coordination of care and reporting to discharge planners, home health agencies, primary care providers, and other organizations;
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Referral process to other outpatient care providers appropriate to address the needs identified in the patient care planning;
-
Identification of patients eligible for services;
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Discontinuation of care and completion of care goals;
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Documentation requirements for each visit; and
-
Patient communication and contact with the MIH program and its staff;
(h) A written plan for the quality assessment of patient care and provider quality improvement, including a monthly review of patient care reports and evaluation of staff performance related to patient care. This plan shall address at a minimum:
-
Employee health and safety;
-
Compliance with protocols and operating procedures;
-
Additional training necessary for the patient care provider or providers;
-
Equipment preventive maintenance programs; and
-
A process for the resolution of customer complaints;
(i) A written orientation program for all personnel, including at a minimum:
-
Validation of certification or license with KBEMS;
-
A review of all agency policies, procedures, and protocols;
-
Operational aspects of the equipment;
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Inspection and routine maintenance of equipment;
-
Appropriate processes for disinfection of equipment;
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Local navigation and geographic orientation; and
-
Completion of patient care reports and other documentation as established by the MIH program; and
(j) Proof of professional liability malpractice insurance of a minimum of $1,000,000.
(2) Each agency shall notify the board at least twenty-four (24) hours prior to the transfer of coverage, cancellation, lapse, or other cessation or change in professional liability malpractice insurance.
(3) Each MIH program shall verify valid staff certification or licensure as of the first day of the calendar year.
(4) If ceasing to operate, a MIH program shall provide the KBEMS office with the physical storage location of all patient care reports within five (5) business days of closure. The reports shall be maintained by the owner of the MIH program or a contracted third party to meet the retention requirements established in subsection (1)(b) of this section.
Section 9. Operating Requirements for Mobile Integrated Healthcare Programs.
(1) Each MIH program shall establish and publish its hours of operation for its geographic service area.
(2) Each MIH program shall retain staffing schedules for at least the previous twelve (12) months.
(3) A MIH program shall have a written scope of care policy which includes the types of services performed, limitations of response, and the types of medical teams provided.
(4) A MIH program shall promptly submit any changes to its written scope of care policy to the KBEMS office.
(5) Each MIH program shall post fee schedules in accordance with KRS 311A.032(1)(a) and 202 KAR 7:575.
Section 10. Staffing Requirement for Mobile Integrated Healthcare Programs. Each MIH program shall, at a minimum, be staffed by one (1) advanced practice paramedic licensed by the board and certified by the board as a community paramedic.
Section 11. Medical Directors of Mobile Integrated Healthcare Programs.
(1) Each MIH program shall have a medical director who meets the requirements established in 202 KAR 7:801.
(2) A MIH program shall notify the KBEMS office within twenty-four (24) hours of a decision to discontinue a medical director agreement by either MIH program or the medical director.
(3) If a MIH program is found to be operating without a medical director, the MIH program shall be provided emergency medical direction by the KBEMS medical advisor for a fee of $100 per day for the first thirty (30) calendar days that the MIH program is without a medical director, and for a fee of $500 per day thereafter.
Section 12. Equipment Requirements for Mobile Integrated Healthcare Programs.
(1) Each MIH program shall maintain evidence in the form of a letter that its medical protocols have been reviewed and approved by the board in accordance with KRS 311A.180. A hard copy or electronic equivalent of approved protocols shall be accessible to each provider throughout each patient encounter.
(2) A MIH program shall stock and maintain drugs and medications as required by the master drug list contained in protocols established in accordance with this section.
(3) Controlled drugs shall be stored in a locked storage box in a locked compartment that is accessible to emergency medical services personnel.
(4) A MIH program may maintain other supplies or equipment that are required to carry out its protocols as approved by the board in accordance with KRS 311A.180.
(5) All items with expiration dates that are maintained by a MIH program shall not be expired.
(6) A MIH program shall establish a master equipment and medication list by policy. All equipment and medication required by MIH program policy shall be fully operational and available for each patient encounter.
Section 13. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Mobile Integrated Healthcare Program License Application", July 2024; and
(b) "Mobile Integrated Healthcare Program Renewal Application", December 2024.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material may also be obtained at kbems.ky.gov.
History
- RELATES TO: KRS 311A.010, 311A.020, 311A.025, 311A.032, 311A.170, 311A.180, 311A.190, 29 C.F.R. 1910.1030
- STATUTORY AUTHORITY: KRS 311A.030
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.030 requires the Kentucky Board of Emergency Medical Services to promulgate administrative regulations establishing requirements for licensing, inspecting, and regulating mobile integrated healthcare programs. This administrative regulation establishes the requirements for mobile integrated healthcare program licensure.
- History: 51 Ky.R. 828, 1278; eff. 2-5-2025.
202 KAR 7:601 Training, education, and continuing education {#sec-202-kar-7-601 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:601}
Section 1. Education Committee.
(1) The board shall create and recognize a standing committee on EMS Education.
(2) The Education Committee shall consist of seven (7) voting members representative of EMS Educators in the Commonwealth of Kentucky. The Education Committee shall consist of:
(a) One (1) voting member of the board;
(b) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI 4;
(c) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI 3;
(d) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI 2;
(e) One (1) director, coordinator, or lead instructor affiliated with a board-certified EMS-TEI CE; and
(f) Two (2) EMS educators at large affiliated with a board-certified EMS-TEI.
(3) The Education Committee shall schedule on an annual basis at least six (6) regular meetings of the committee.
(4) The purpose and charge of the Education Committee shall be to:
(a) Assist the board in developing a strategic plan for EMS education in the Commonwealth of Kentucky;
(b) Act as a resource for EMS educators and EMS-TEIs in the Commonwealth of Kentucky; and
(c) Assume the lead role in formulating, drafting, and sending to the board for approval and subsequent promulgation of all administrative regulations that set the standards and requirements for EMS education and EMS provider certification in the Commonwealth of Kentucky.
Section 2. EMS-TEI Certification.
(1) Only an entity certified by the board as an EMS-TEI may conduct training and education programs in the Commonwealth of Kentucky that lead to certification or licensure by the board. Training shall include:
(a) In person, online, or hybrid; and
(b) Laboratory, clinical, or field internship if required by this administrative regulation.
(2) An applicant for certification as an EMS-TEI in the Commonwealth of Kentucky may be certified at the following levels:
(a) EMS-TEI 1, which includes EMR and continuing education;
(b) EMS-TEI 2, which includes EMR, EMT, and continuing education;
(c) EMS-TEI 3, which includes EMR, EMT, AEMT, and continuing education;
(d) EMS-TEI 4, which includes EMR, EMT, AEMT, Paramedic, and continuing education; or
(e) EMS-TEI CE, which includes continuing education only.
(3) An applicant may seek one (1) level of certification during the two (2) year certification term. A single applicant shall not hold more than one (1) identical TEI certification simultaneously.
(4) An applicant for a level of EMS-TEI certification shall meet all requirements for that level.
(5) An applicant for certification as an EMS-TEI shall electronically submit a completed Training and Educational Institution (TEI) Application, the appropriate EMS-TEI pre-inspection worksheet (Level 1-4 or CE Only), and upload all required documentation listed in the EMS-TEI pre-inspection worksheet to the EMS-TEI KEMSIS account.
(6) An applicant shall submit a nonrefundable fee pursuant to 202 KAR 7:030 with the Training and Education Institution (TEI) Application.
(7) An applicant applying for an EMS-TEI certification shall meet all requirements for that level within sixty (60) days of submitting the Training and Education Institution (TEI) Application for certification. An applicant that exceeds the sixty (60) day requirement shall reapply and resubmit all required fees.
(8) An Emergency Medical Services (EMS) training and educational entity not residing in the Commonwealth of Kentucky, but seeking to do business in Kentucky as an EMS-TEI, shall obtain EMS-TEI certification with the board before teaching any EMS courses that lead to certification or licensure by the board.
(a) These courses include:
-
Initial EMS certification or licensure courses; and
-
EMS continuing education courses.
(b) This does not include continuing education courses covered in Section 13(1) of this administrative regulation.
(9) An EMS-TEI that had its certification revoked shall be eligible to apply for certification as an EMS-TEI two (2) years after the date of revocation. This shall be enforced by name of entity holding the EMS-TEI certification and name of owner or operator listed on the TEI Application and official business license or licenses filed by the entity, owner or operator with local, county and state officials.
(10) An EMS-TEI may surrender its certification prior to the end of a certification period by notifying the board in writing of the intent to do so thirty (30) days prior to the intended effective date of the surrender.
(a) An EMS-TEI surrendering its certification while classes are underway shall notify the students impacted by the closure in writing at least thirty (30) days prior to the intended effective date of closure.
(b) An EMS-TEI surrendering its certification while courses are underway shall complete the courses underway before surrendering its EMS-TEI certification or fully refund all tuition and fees paid by the students in the courses underway that are impacted by the EMS-TEI closure.
(11) An EMS-TEI that does not comply with subsection (10) of this section shall not be eligible to reapply for EMS-TEI certification for a period of five (5) years from the date of closure. This administrative regulation shall not preclude civil action against the TEI Owner, Director, or business.
Section 3. Certification Requirements for EMS-TEIs.
(1) If an applicant is required to file as a business entity with Kentucky's Secretary of State, the applicant for EMS-TEI certification shall provide proof of registration with the Kentucky Secretary of State to the board that the EMS-TEI is legally able to conduct business in the Commonwealth of Kentucky. The applicant shall provide documentation of exemption status if not registered with the Kentucky Secretary of State and proof of registration with local, county, or state officials as an individual operator or a Doing Business As (DBA).
(2) If an applicant is required to notify, obtain permission, or obtain a license from another regulatory entity in the Commonwealth of Kentucky to operate as an educational entity, it shall be the responsibility of the applicant to make the appropriate notifications, obtain permission, or obtain license to legally operate in the Commonwealth of Kentucky. An EMS-TEI that fails to comply with subsection (1) of this section or this subsection shall be subject to disciplinary action by the board pursuant to KRS Chapter 311A.
(3) Facilities. Facilities where EMS-TEI courses are conducted shall be:
(a) Maintained and operated in compliance with the safety and health requirements pursuant to local, city, and county ordinances and federal and state laws;
(b) Sponsored or approved by a sponsoring agency;
(c) Offered with an enrollment that shall not exceed the design characteristics of the facilities;
(d) Offered in a controlled environment, including:
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Temperature;
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Humidity; and
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Lighting; and
(e) Offered with instruction in classrooms and laboratories that shall:
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Provide appropriate space for students to participate in classroom activities, kinematic learning, and practice activities;
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Provide appropriate space for instructor preparation; and
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Provide adequate and secure storage for instructional materials.
(4) An applicant shall provide the board with an organizational chart indicating, at a minimum:
(a) The names, contact information, and addresses of the owner, operator, chief administrative officer, and other personnel necessary for operation of the entity as an EMS-TEI;
(b) The name and contact information of the EMS-TEI's director;
(c) The name and contact information of the EMS-TEIs medical director;
(d) Proof that the medical director is qualified pursuant to 202 KAR 7:801;
(e) A Memorandum of understanding or contract executed between the owner of the EMS-TEI and the medical director outlining the relationship, duties, and requirements of a medical director for an EMS-TEI. The memorandum of understanding or contract shall include at a minimum that:
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The medical director shall be responsible for medical oversight of the program;
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The medical director shall review and approve the educational content of the program curriculum;
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The medical director shall review and approve the instruments and processes used to evaluate students in didactic, laboratory, clinical, and field internship;
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The medical director shall review the progress of each student throughout the program, and assist in the determination of appropriate corrective measures, if necessary;
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The medical director shall engage in cooperative involvement with the program director; and
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The medical director's interaction shall be in a variety of settings, such as lecture, laboratory, clinical, field internship. Interaction may be by synchronous electronic methods.
(f) The name and contact information of the EMS-TEI's program coordinator; and
(g) The names and contact information of all EMS-TEI Instructors.
(5) EMS training courses that require accreditation shall conform to the requirements of the National Registry of EMT's (NREMT). An EMS-TEI shall submit accreditation documentation to the board upon request.
(a) For programs that require national accreditation, an accreditation letter of review is acceptable in the interim for newly formed EMS-TEIs that are required by CAAHEP to obtain accreditation.
(b) Continuous accreditation status shall be maintained by the EMS-TEI as required by this administrative regulation. Failure to maintain continuous accreditation status by the TEI shall be grounds for summary revocation of the TEI certification.
(6) EMS-TEIs shall obtain and maintain professional liability malpractice insurance of a minimum of $1 million. The EMS-TEI shall provide proof of professional liability malpractice insurance upon initial certification, certification renewal, and upon application for certification upgrade.
Section 4. Certification Periods and Inspections.
(1) An EMS-TEI shall display the current certificate issued through the board:
(a) In a prominent place in the EMS-TEI's business;
(b) In the classroom if classes are being conducted away from the primary business location; and
(c) Provided electronically to the student if the classes are being conducted online.
(2) Certification of an EMS-TEI shall be valid for a period of two (2) years unless limited by disciplinary action.
(3) Prior to expiration of the two (2) years certification period, an EMS-TEI may apply for recertification for a subsequent two (2) year period.
(4) Upon application for recertification, an applicant shall electronically submit:
(a) A Training and Educational Institution (TEI), Certification Renewal Application through the EMS-TEI KEMSIS account with the board;
(b) The appropriate EMS-TEI pre-inspection worksheet (Level 1-4 or CE Only); and
(c) Upload all required documentation listed in the EMS-TEI pre-inspection worksheet (Level 1-4 or CE Only) to the EMS-TEI KEMSIS account.
(5) An EMS-TEI seeking certification renewal shall pay all applicable nonrefundable fees upon application. Failure to pay fees or subsequent rejection of a payment method shall result in denial of the Training and Educational Institution (TEI) Application.
(6) An applicant for EMS-TEI renewal shall meet all renewal requirements prior to the expiration date of the TEI certification.
(a) A TEI that does not comply with all renewal requirements prior to the certification expiration date shall expire.
(b) A TEI that allows the TEI certification to expire shall be required to apply as an initial EMS TEI.
(7) An EMS-TEI applying for initial or certification upgrade shall undergo an inspection prior to offering classes. The type of inspection, on-site or virtual, shall be determined by the office of the board and the EMS-TEI shall be responsible for establishing the virtual connection at their facility if necessary.
(8) Each inspection shall ensure that the EMS-TEI has met all applicable requirements of this administrative regulation. If the board's inspection finds that the EMS-TEI has failed to meet a requirement, the EMS-TEI shall correct all deficiencies prior to offering a class and receiving subsequent certification as an EMS-TEI.
(9) The board may conduct inspections of EMS-TEIs for initial, renewal, certification upgrade, or to monitor compliance with statutory and regulatory requirements for TEIs. Inspections may be scheduled or unscheduled.
(10) The office of the board shall conduct an application review of required documentation and inspection of the EMS-TEI applicant no later than sixty (60) days following the submission of the Training and Educational Institution (TEI) Application by the EMS-TEI applicant for initial certification and upgrades.
(11) Approval of notice of intent to upgrade shall not extend the two (2) year EMS-TEI certification period.
(12) An EMS-TEI requesting a name change or change in ownership shall notify the board in KEMSIS no later than thirty (30) days prior to the name change or change in ownership by completing:
(a) A new Training and Educational Institution (TEI) Application electronically through the EMS-TEI KEMSIS account;
(b) Legal documentation reflecting the legal name or ownership change, or registration with the Kentucky Secretary of State Office reflecting the change which shall be uploaded with the TEI application in KEMSIS; and
(c) Payment of the application fee pursuant to 202 KAR 7:030 in KEMSIS.
Section 5. EMS-TEI Operating Requirements.
(1) Each EMS-TEI shall maintain files for a period of three (3) years beyond the end date of each EMS Course program that contains the following documentation:
(a) For courses requiring accreditation, all documents necessary for the EMS-TEI to have met the accrediting agency's standards, policies, and guidelines;
(b) A copy of the last accreditation self-study and letter of accreditation;
(c) The student attendance sign-in sheets for each course taught, including:
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Lectures;
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Practical skills lessons; and
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Clinical and field rotations;
(d) A master copy of each set of examinations administered and answer keys for the exams;
(e) A master copy of practical skills examination forms;
(f) A master copy of each course syllabus;
(g) Current, written affiliation agreements executed between hospitals or EMS agencies and the EMS-TEI;
(h) Health records for students as may be required by the EMS-TEI or as expressly required in written affiliation agreements and determined necessary for students to complete clinical assignments, field-internships, or summative field evaluations;
(i) Records of all disciplinary actions taken against a student, if applicable. Records shall include notification to students of the complaint; responses, if applicable, made by or on behalf of the student; and actions taken as a result of a complaint or other documented incident, grievance, or deficiency;
(j) For students requiring remediation, documentation of specific activities or procedures requiring remediation and actions taken in response to deficiencies, including how the specific remediation was accomplished and the success or failure of remediation;
(k) A master file of the objectives and competencies to be achieved by students during each educational program; and
(l) Documentation of other requirements that the EMS-TEI has established as part of the offered courses.
(2) Failure of an EMS-TEI to maintain records required by the board shall result in disciplinary action against an EMS-TEI.
(3) The board shall require an EMS-TEI to submit a copy of the EMS-TEI's annual accreditation report electronically through the EMS-TEI's KEMSIS account if accreditation is necessary for licensure or certification of the students taking the EMS-TEI's offered course.
(4) EMS-TEIs shall conduct an annual review and revision of all courses and programs to ensure the EMS-TEI has complied with necessary updates to courses, programs, and accepted educational standards. The participants involved with the annual review shall include:
(a) The program director;
(b) Course coordinator;
(c) Medical director;
(d) An instructor or a faculty member that was actively involved in teaching courses during the preceding twelve (12) months of the annual review; and
(e) A student that successfully completed a course offered through the EMS-TEI during the preceding twelve (12) months of the annual review.
(5) An EMS-TEI shall document in writing the required annual review and updates resulting from the annual assessment.
(6) Documentation of the annual review shall be in writing, signed by the program director, program coordinator, and medical director. The annual review shall be maintained in the course or TEI program files and submitted to the board electronically with the TEI renewal application.
(7) An EMS-TEI shall assure that all physical resources required by the curriculum, including classrooms, skill practice areas, notices of where to purchase or access textbooks, instructional aides, equipment, and supplies shall be:
(a) Available at each class session where skills are taught or practiced;
(b) Adequate in number to allow for practice by students enrolled; and
(c) In good working order and well-maintained.
(8) An EMS-TEI shall maintain and protect the privacy of all records pertaining to the health and safety of patients, students, and faculty members that are obtained or developed through or as a result of participation in training and educational activities with the EMS-TEIs.
(9) The EMS-TEI shall be responsible for knowing and following all federal and state laws relevant to safeguarding privacy of records, including educational and health records.
(10) The EMS-TEI shall develop and make available to all prospective students a clearly defined admissions policy.
(11) An EMS-TEI's admission policy shall include specific requirements for students to gain admission, maintain enrollment, and all academic requirements necessary to successfully complete the offered course or program. The admission policy shall be provided to the student at the start of the course and a verified receipt by signature shall be kept in the student's file including any changes to the admission policy while the student is enrolled in the course. Admissions policies shall include at a minimum:
(a) Tuition rates and fees associated with the training and education program;
(b) Fees and other costs associated with remediation;
(c) The availability of any bridge programs or advanced placement;
(d) Any credit for previous educational, experimental learning, certifications, or transfer hours;
(e) A descriptive synopsis of the curriculum for each type of course taught;
(f) Course educational objectives;
(g) Classroom lecture and skills practice schedules;
(h) Clinical or field rotation locations with beginning and ending dates;
(i) Participation requirements for each clinical or field rotation site;
(j) Continued course competency and course completion requirements; and
(k) Citations to and language of prohibited actions pursuant to KRS 311A.050 that provide grounds for sanctions against or denial of individuals making application for certification or licensure by the board.
(12) EMS-TEIs shall establish written policies that provide for:
(a) The creation and use of course or program advertising that accurately portrays the course or program content as offered by the EMS-TEI;
(b) A uniform process for filing, investigating, and resolving complaints or grievances by applicants, students, preceptor sites, patients, members of the general public, or faculty members;
(c) A procedure for a student to withdraw from a course and a clear statement of refund policies and the steps necessary for a student to obtain a refund of tuition or fees already paid;
(d) Faculty to acquire or develop examinations for each course offered;
(e) The establishment of and adherence to examination procedures and policies;
(f) The requirements for a student to take and pass examinations in courses the EMS-TEI offers including requirements that shall be met during the course for the student to be eligible to take the National Registry of EMTs certification exam; and
(g) Public disclosure, using Web-based materials, concerning the EMS-TEI student cumulative pass rate on the NREMT certification exam for the calendar year. The disclosure shall be updated by January 31 of each year and shall include at a minimum:
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All provider levels tested;
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Date range for which the report was calculated;
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EMS-TEI name, number, and physical address;
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Number of students that took the exam; and
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Cumulative pass rate calculated by percentage.
(13) An EMS-TEI shall assure that each student, while participating in a clinical or field rotation, is clearly identified as a student. Identification shall be accomplished by use of:
(a) Nameplate;
(b) A uniform; or
(c) Other publicly apparent means.
(14) A student or a faculty member shall maintain proper personal and professional conduct during classroom, clinical, and field internship activities.
(15) EMS-TEIs shall have a program director who shall be responsible for:
(a) All aspects of the program, including administration, organization, and supervision of the educational program;
(b) Assuring the quality and credentials of the program coordinator, EMS educators, EMS educator adjuncts, and students accepted into the EMS-TEI's programs or courses;
(c) Assuring the security of examination results and materials;
(d) Monitoring the activities of the EMS-TEI's faculty and students;
(e) Maintaining records and documents and submit reports;
(f) Continuously reviewing the quality and improvement of the educational program;
(g) Long range planning and ongoing development of the program;
(h) The orientation, training, and supervision of clinical and field internship preceptors; and
(i) The effectiveness and quality of fulfillment of responsibilities delegated to another qualified individual.
(16) EMS-TEIs shall include faculty and instructional staff who shall be responsible for:
(a) Didactic, clinical instruction, or supervised practice in each location where students are assigned; and
(b) Coordination, supervision, and frequent assessment of the students' progress in achieving acceptable program requirements.
(17) A certified EMS-TEI shall maintain an ongoing level of competence, evidenced by a minimum pass rate for each level of instruction of sixty (60) percent calculated upon a cumulative pass rate of students who have taken the National Registry of EMTs and other board-approved exam(s) within the twenty-four (24) months immediately preceding the EMS-TEI's renewal date.
(a) The minimum pass rate shall be calculated, and compliance determined by, the office of the board.
(b) An EMS-TEI that fails to maintain a sixty (60) percent pass rate for each level of instruction as required by this subsection shall notify all students enrolled in courses offered by the EMS-TEI that the EMS-TEI is not in compliance with testing standards.
(18) If an EMS-TEI fails to meet an ongoing level of competence determined according to this administrative regulation and demonstrated by compliance with KRS Chapter 311A and 202 KAR Chapter 7, the EMS-TEI shall be subject to a plan of correction mediated through the office of the board. An EMS-TEI that cannot maintain an ongoing level of competence may be subject to discipline pursuant to KRS Chapter 311A.
(19) If requested by the office of the board, the EMS-TEI shall submit graduate data to the Kentucky Center for Education and Workforce Statistics including:
(a) Student's name;
(b) Date of birth;
(c) Social Security number;
(d) Gender;
(e) Ethnicity;
(f) Residency at point of graduation; and
(g) The Classification of Instructional Programs (CIP) code, if applicable.
(20) The EMS-TEI director shall keep the EMS-TEI KEMSIS account information updated, including:
(a) The EMS-TEI demographics;
(b) The EMS-TEI personnel roster; and
(c) The EMS-TEI policy and procedures required by this administrative regulation.
(21)
(a) The program director of EMS-TEIs offering initial certification courses shall create and maintain, with current information, a National Registry of EMTs educational program account.
(b) The EMS education program name, director name, address, and contact information listed with NREMT shall match the EMS-TEI program information listed in KEMSIS.
Section 6. Disciplinary Action.
(1) As certified entities under the board's jurisdiction, all EMS-TEIs shall be subject to the disciplinary procedures and sanctions established in KRS Chapter 311A.
(2) Discipline of an EMS-TEI as a certified entity shall not prevent the board from taking disciplinary action against a certified or licensed individual associated with the EMS-TEI at any level of certification or licensure applicable.
Section 7. Reporting Requirements for EMS-TEI.
(1) An EMS-TEI shall submit electronically to the board the documents as required by this section for all EMS courses or psychomotor skill verification that lead to certification by The National Registry of EMTs or certification or licensure by the board.
(2) An EMS-TEI shall submit the following documents to the board office:
(a) Course Notification Application submitted no less than fourteen (14) days prior to the course start date;
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An EMS-TEI shall notify the board within fourteen (14) days of any changes to a board approved class start and end date using Course Change Notification Application.
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All EMR courses shall utilize the EMR Portfolio Skills Form for evaluation of psychomotor skills in the initial courses.
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All EMT courses shall utilize the EMT Portfolio Skills Form for evaluation of psychomotor skills in the initial courses.
(b) A Final Educational Course Roster within thirty (30) days of course completion date listed on the Course Notification Application.
(3) Upon submission of all documents required by this section for courses that lead to certification by The National Registry of EMTs and licensure or certification by the board, the TEI shall be assigned a course number or other identifier.
(4) An EMS-TEI that fails to provide documents as required by subsection (2) of this section shall be subject to disciplinary action pursuant to KRS Chapter 311A up to and including revocation of the TEI.
(5) A course shall not commence until the EMS-TEI has obtained an identification code and notified the board as required in this section.
(6) A course that does not meet all requirements of this administrative regulation may not lead to certification or licensure for the EMS students enrolled in the course.
(7) An EMS-TEI shall notify the board within seven (7) days of any changes to the lead instructor of an initial course that leads to certification or licensure by the board.
(8)
(a) An EMS-TEI shall notify the board within seven (7) days of cancelation of an initial certification or licensure course.
(b) An EMS-TEI that cancels an initial certification or licensure course that is underway or planned shall fully refund all tuition and fees paid by the students in the course that are impacted by the course cancellation.
Section 8. Requirements for All Training and Education Courses.
(1) All EMS educational programs in Kentucky that lead to EMS Provider certification by The National Registry of Emergency Medical Technicians (NREMT) and certification or licensure by the board shall:
(a) Comply with this administrative regulation;
(b) Not begin until the EMS-TEI has filed all documents required pursuant to Section 7 of this administrative regulation;
(c) Not begin until the EMS-TEI has paid all fees required pursuant to 202 KAR 7:030;
(d) Use the National Emergency Medical Services Education Standards that are appropriate for the level of EMS provider course being offered;
(e) Teach students the Kentucky and National EMS Scope of Practice Models;
(f) Meet the course administrative and faculty requirements in this administrative regulation, if applicable, as established by the NREMT approved accrediting agency; and
(g) Use educators certified by the board as EMS educators who are minimally certified or licensed at the level of the offered course.
(h)
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An EMS-TEI shall ensure that all student course work including lectures, practical skills lessons, and clinical or field rotations for courses that lead to certification by the National Registry of EMTs and certification and licensure by the board be completed within sixty (60) days of the course completion date listed on the Course Notification Application.
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The board shall not accept any changes made to course completion documents listed in Section 7 of this administrative regulation if submitted more than sixty (60) days after the course completion date as listed on the Course Notification Application.
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In exceptional circumstances, as determined by the board in instances such as if there is an emergent medical condition or a death in the immediate family, the EMS-TEI may submit a Final Course Roster of students approved by the EMS-TEI program director and medical director for course work extension required in Section 5 of this administrative regulation.
(i) The EMS-TEI director shall approve all students to test with the National Registry of EMTs within seven (7) days of successful completion of an initial certification course and completion of all necessary documents and applications by the student.
(2) The EMS-TEI may use an assistant instructor who is not a board-certified educator to instruct no more than forty (40) percent of the classroom education time for initial certification or licensure courses.
(3) The EMS-TEI shall maintain an instructor to student ratio of no more than 1:20 for classroom sessions where skills are practiced. These sessions shall not proceed without the presence of:
(a) A certified educator for the first twenty (20) students; and
(b) An additional educator or adjunct faculty for each one (1) to twenty (20)additional students. Additional adjunct faculty used shall:
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Not be required to be certified as an EMS educator, but shall be certified by the board as an EMS provider at or above the level for the course being taught; or
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Be a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA); and
(4) The EMS-TEI program director and medical director shall approve any assistant instructor or adjunct faculty before the individual may assist in instruction.
(5) The EMS-TEI shall have a medical director qualified pursuant to 202 KAR 7:801, who shall:
(a) Be employed by or under memorandum of understanding or a written contract with the EMS-TEI to serve as the medical director of the program;
(b) Be routinely available to the EMS-TEI to provide consultation regarding issues related to the training and education program;
(c) Participate in the approval of the didactic clinical and evaluation material and student progress review;
(d) Meets the applicable accrediting agency standards, policies, and guidelines;
(e) Provide medical consultation and guidance to the course faculty; and
(f) Certify the skills of all EMS-TEI students who are enrolled in courses leading to EMS Provider certification by The National Registry of Emergency Medical Technicians (NREMT) or certification or licensure by the board.
(6) An EMS-TEI shall maintain a written contractual affiliation agreement or memorandum of understanding with each clinical rotation site that outlines, at a minimum, the responsibilities of each entity and reporting requirements for students involved in clinical and field training and education.
(7) An EMS-TEI shall provide faculty from the EMS-TEI training and education program, clinical coordinators, or designees under contract with the EMS-TEI to oversee student activity while in the clinical or field internship setting.
(8) The EMS-TEI shall provide clinical or field preceptor training to all clinical or field preceptors overseeing students during clinical or field internship rotations.
Section 9. Emergency Medical Responder Training and Education Course Requirements.
(1) Each Emergency Medical Responder (EMR) training and education course shall:
(a) Include all training and education requirements established in KRS Chapter 311A, 202 KAR 7:201, and 202 KAR 7:701;
(b) Use the National Emergency Medical Services Education Standards – Emergency Medical Responder Instructional Guidelines for the duration of course including individual class segments; and
(c) Ensure student competency throughout the course by an EMS-TEI validated examination measuring process.
(2) To be eligible for certification as an EMR, a student shall also receive instruction covering the National and Kentucky EMS Scope of Practice for an EMR.
(3) EMR candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:201.
Section 10. Emergency Medical Technician Training and Education Course Requirements.
(1) Each Emergency Medical Technician (EMT) training and education course shall:
(a) Include all training and education requirements established in KRS Chapter 311A, 202 KAR 7:301, and 202 KAR 7:701;
(b) Use the National Emergency Medical Services Education Standards – Emergency Medical Technician Instructional Guidelines for duration of course and individual class segments; and
(c) Ensure student competency throughout the course by an EMS-TEI validated examination measuring process.
(2) To be eligible for certification as an EMT, a student shall receive instruction covering the National and Kentucky EMS Scope of Practice for an EMT.
(3) Each student shall complete clinical and field rotation that meets the requirements for EMT education as determined by this administrative regulation, including the National and Kentucky EMS Scope of Practice for an EMT student as approved by the applicable accrediting agency's minimum requirements.
(4) Clinical or field rotations for EMTs shall be conducted at a licensed ambulance service or other licensed health care facility selected by the EMS-TEI director and medical director that, if applicable, meets nationally accepted accreditation standards or EMS-TEI requirements to verify EMT course competency.
(5) If a student fails to achieve the goals established by the EMS-TEI for the EMT education program, the EMS-TEI program director and medical director shall require the student to repeat the failed portion of the EMT education program.
(6) If a student is required to repeat a portion of the EMT education program, the program director and medical director shall have a written procedure for remediation that ensures the student shall be provided with adequate due process protections that include at a minimum:
(a) Notification of allegations or academic issues;
(b) A right for the student to be heard on the subject of the allegations or academic issues;
(c) A right for the student to appeal the decision of the EMS-TEI to the director and medical director about the allegations or academic issues; and
(d) The notification to the student shall be in writing and signed by:
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The student;
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The TEI Administrator;
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The Medical Director; and
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The Course Coordinator.
(7) EMT candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:301.
(8) EMT students shall meet health and immunization standards as required through established TEI policy, or policies established by contracted TEI clinical sites.
Section 11. Advanced-Emergency Medical Technician Training and Education Programs.
(1) Advanced-Emergency Medical Technician (AEMT) training and education course requirements. Each AEMT training and education course shall:
(a) Include all training and education pursuant to KRS Chapter 311A, 202 KAR 7:330, and 202 KAR 7:701;
(b) Use the National Emergency Medical Services Education Standards – Advanced Emergency Medical Technician Instructional Guidelines for duration of course and individual class segments; and
(c) Ensure student competency throughout the course by an EMS-TEI validated examination measuring process.
(2) To be eligible for certification as an AEMT, a student shall complete a clinical and field rotation that meets the requirements for AEMT education as determined by this administrative regulation including the National and Kentucky EMS Scope of Practice for an AEMT student as approved by the applicable accrediting agency's minimum requirements.
(3) Clinicals or field rotations for AEMTs shall be conducted at a licensed ambulance service or other licensed health care facility selected by the EMS-TEI director and medical director that, if applicable, meets nationally accepted accreditation standards or EMS-TEI requirements to verify AEMT course competency.
(4) If a student fails to achieve the goals established by the EMS-TEI for the AEMT education program, the EMS-TEI program director and medical director shall require the student to repeat the failed portion of the AEMT education program.
(5) If a student is required to repeat a portion of the AEMT education program, the program director and medical director shall have a written procedure for remediation that ensures the student shall be provided with adequate due process protections that include at a minimum:
(a) Notification of allegations or academic issues;
(b) A right for the student to be heard on the subject of the allegations or academic issues;
(c) A right for the student to appeal the decision of the EMS-TEI to the director and medical director about the allegations or academic issues; and
(d) The notification to the student shall be in writing and signed and dated by the:
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Student;
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TEI Administrator;
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Medical Director; and
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Course Coordinator.
(6) AEMT candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:330.
(7) AEMT students shall meet health and immunization standards as required through established TEI policy, or policies established by contracted TEI clinical sites.
Section 12. Paramedic Training and Education Programs. Paramedic training and education course requirements.
(1) Each Paramedic training and education course shall:
(a) Include all training and education as required by this administrative regulation, KRS Chapter 311A, 202 KAR 7:401, 202 KAR 7:701, and any other Kentucky statutes or administrative regulations that place mandates upon paramedic students;
(b) Use the National Emergency Medical Services Education Standards – Paramedic Instructional Guidelines for duration of course and individual class segments; and
(c) Ensure student competency throughout the course by an EMS-TEI validated examination measuring process.
(2) To be eligible for licensure as a paramedic, a student shall complete a clinical or field rotation that meets the requirements for paramedic education as determined by this administrative regulation including the National and Kentucky EMS Scope of Practice for a Paramedic student as approved by the applicable accrediting agency's minimum requirements.
(3) The minimum requirements of clinical or field rotations for paramedics shall include:
(a) Clinicals or field rotations conducted at a licensed ambulance service or other licensed health care facility selected by the EMS-TEI director and medical director that, if applicable, meets nationally accepted accreditation standards or EMS-TEI requirements to verify paramedic course competency; and
(b) A record of patient history and assessment on a care report form for each of the patients required in this section.
(4) If a student fails to achieve the goals established by the EMS-TEI for the EMS education program, the EMS-TEI program director and medical director shall require the student to repeat the failed portion of the paramedic education program.
(5) If a student is required to repeat a portion of the paramedic education program, the program director and medical director shall have a written procedure for remediation that ensures the student shall be provided with adequate due process protections that include at a minimum:
(a) Notification of allegations or academic issues;
(b) A right for the student to be heard on the subject of the allegations or academic issues;
(c) A right for the student to appeal the decision of the EMS-TEI to the director and medical director about the allegations or academic issues; and
(d) The notification to the student shall be in writing and signed and dated by the:
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Student;
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TEI Administrator;
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Medical Director; and
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Course Coordinator.
(6) Paramedic candidates shall meet all student eligibility requirements pursuant to 202 KAR 7:401.
(7) Paramedic students shall meet health and immunization standards as required through established TEI policy, or policies established by contracted TEI clinical sites.
Section 13. Continuing Education.
(1) Training and education courses provided to individuals that fulfill the continuing education requirements necessary to receive a certification or licensure from the board shall be provided by:
(a) An entity certified by the board as an EMS-TEI;
(b) An agency or department having contractual agreements with a board certified EMS-TEI that is in good standing and not subject to disciplinary action;
(c) A board approved symposia, state, national, or international school;
(d) A board approved or nationally accredited online or distance education provider with up to 100 percent of the total continuing education hours to fulfill the continuing education requirements for renewal pursuant to KRS Chapter 311A or 202 KAR Chapter 7; or
(e) One (1) or more of the approved continuing education entities listed below:
-
The Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE);
-
Kentucky Board of Nursing;
-
Kentucky Board of Medical Licensure;
-
Kentucky Board of Respiratory Care;
-
Department of Homeland Security and all department components;
-
U.S. Fire Administration and all department components;
-
Kentucky Department of Criminal Justice (DOCJT);
-
Kentucky Cabinet for Health and Family Services; or
-
Courses approved by any State EMS Office that are offered and or completed outside the Commonwealth of Kentucky.
(2) Continuing education courses shall:
(a) Contain material relevant to the job specifications and professional development of EMS personnel; and
(b) Be conducted at an EMS level appropriate for the discipline of the participants.
(3) EMS-TEIs that provide continuing education shall provide course completion documentation by hardcopy or electronically to all participants that successfully complete the continuing education course. The course completion documentation shall contain at a minimum the following items:
(a) Official name of the EMS-TEI as listed in the EMS-TEI KEMSIS account and certification number of the EMS-TEI issued by the board;
(b) Name of primary instructor and state EMS office EMS provider number;
(c) Name of course;
(d) Breakdown of completed hours and subject categories instructed that meet the continuing education requirements established by 202 KAR 7:201, 202 KAR 7:301, 202 KAR 7:330, and 202 KAR 7:401; and
(e) Signature of one (1) of the following EMS-TEI representatives:
-
Director;
-
Course coordinator; or
-
Course instructor.
Section 14. Continuing Education Instructor Requirements.
(1) The following persons shall be qualified to conduct continuing education courses for persons certified or licensed by the board:
(a) An EMS provider licensed or certified by the board that holds a CE, EMR, EMT, AEMT, or Paramedic Educator credential;
(b) A physician (DO or MD) or Physician Assistant (PA) licensed in Kentucky or another state, who has specific expertise in an area of a prehospital discipline;
(c) A registered nurse (RN) or Advanced Practice Registered Nurse (APRN) licensed in Kentucky or another state, who has specific expertise in an area of a prehospital discipline; or
(d) An individual who is at least one (1) of the following and who shall be limited to teaching the specific subject approved by the EMS-TEI director and medical director:
-
Certified by a state or federal agency to teach or perform subject matter relevant to the National Emergency Medical Services Education Standards and National and Kentucky EMS Scope of Practice for a prehospital discipline;
-
Certified by a nationally recognized entity to provide EMS related training and education;
-
A presenter at a National or State Symposium accredited by an agency or other board approved entity; or
-
A presenter approved by an EMS medical director who has specific expertise in an area of a prehospital discipline.
(2) The EMS-TEI or other approved contractual department or agency providing continuing education shall be required to:
(a) Maintain a roster, objectives, and outline for every continuing education course taught on file for a period of three (3) years beyond the end date of each EMS course;
(b) Maintain all documentation to have met the applicable accreditation agency standards, policies, and guidelines established in this administrative regulation; and
(c) Meet the requirements of this administrative regulation.
(3) If requested by the board, the EMS-TEI shall submit to the board the required documents for EMS continuing education courses taught within the preceding three (3) years that lead to re-certification or re-licensure by the board, including:
(a) Contractual agreements;
(b) The continuing education instructor curriculum vitae or resume that includes at a minimum the educator's name, address, phone number, email address, education history, and employment history documenting the qualifications listed in subsection (1) of this section have been met;
(c) A completed Continuing Education Course Student Roster. The course roster shall include the participants name, signature or digital equivalent, participant KEMSIS number, and board EMS credential held. If rosters are created or stored electronically, there shall be a verification of attendance component that may be verified by the board if requested; and
(d) Objectives, syllabi, outline, and a list of instructor resources used for each continuing education course.
Section 15. Pilot Programs.
(1) A board certified TEI that is in good standing may apply for an Educational Pilot Program.
(2) A pilot program shall involve specialized training and education, as well as associated procedures not otherwise provided for in 202 KAR Chapter 7.
(3) Educational Pilot Programs shall be subject to the provisions of 202 KAR 7:565.
Section 16. EMS Educators.
(1) An EMS Educator may be certified at the following levels:
(a) EMR Educator, which certifies the individual to teach EMR initial certification and continuing education courses;
(b) EMT Educator, which certifies the individual to teach EMR and EMT initial certification and continuing education courses;
(c) AEMT Educator, which certifies the individual to teach EMR, EMT, and AEMT initial certification and continuing education courses;
(d) Paramedic Educator, which certifies the individual to teach EMR, EMT, AEMT, and Paramedic initial certification and continuing education courses; or
(e) CE Educator, which certifies the individual to teach continuing education courses at or below the level of EMS provider certification or license issued by the board.
(2) Depending on the level of certification sought, an applicant for certification as a Kentucky EMS educator shall:
(a) Already hold a certificate or license in Kentucky as an Emergency Medical Responder (EMR), an Emergency Medical Technician (EMT), an Advanced Emergency Medical Technician (AEMT), or a paramedic; or
(b)
-
Hold a license in Kentucky or another state as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA);
-
A Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA) shall be considered an advanced EMS provider at the paramedic level only for the purpose of credentialing the individual as an EMS educator;
(c) Not be issued a certificate as an EMS educator for a level of instruction higher than his or her EMS provider certification or license;
(d) Have successfully completed:
-
A board-approved EMS educator course that meets the objectives of the National Highway Traffic Safety Administration National Guidelines for Educating EMS Instructors and the National Emergency Medical Services Education Standards which is designed to represent a common core for teaching knowledge and skills to assist in the education of adult learners; or
-
Holds an unrestricted and current license or certification as a teacher or educator through a state board of education in the United States;
(e) Submit a completed:
-
CE Educator Initial Application;
-
EMR Educator Initial Application;
-
EMT Educator Initial Application;
-
AEMT Educator Initial Application; or
-
Paramedic Educator Initial Application;
(f) Pay all fees pursuant to 202 KAR 7:030; and
(g) Undergo a background check pursuant to KRS 311A.050 and 311A.100.
- The background check shall be:
a. National in scope for an applicant not currently certified or licensed at any level in Kentucky;
b. Statewide in scope for an applicant with current certification or licensure in Kentucky;
c. Less than six (6) months old when the applicant submits to the board all requirements for Educator certification; and
d. Provided by a vendor that has been contracted through the board.
- An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
(3) Applicants applying for CE Educator shall present documented proof of completing a board approved nationally recognized or EMS-TEI instructor course.
(4) The expiration date of an EMS educator certification shall correspond to those established in KRS Chapter 311A and 202 KAR Chapter 7.
Section 17. Renewal of EMS Educator Certification.
(1) An EMS educator shall be eligible to renew the EMS educator certification if the applicant for renewal:
(a) Has maintained state certification or licensure as an EMS provider or as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA) at a level equal to or greater than the level at which they are certified as an EMS educator;
(b) Retains evidence of completing all training and education pursuant to KRS Chapter 311A;
(c) Is not subject to discipline pursuant to KRS Chapter 311A;
(d) Has paid fees pursuant to 202 KAR 7:030; and
(e) Has submitted to the board a completed Educator Renewal Application.
(2) The EMS educator shall maintain all training and education documentation outlined in this administrative regulation for three (3) years from the date of completion.
(3) The board office may audit an EMS educator's continuing education and EMS provider continuing education records.
Section 18. EMS Educator reinstatement. An EMS Educator whose certification has lapsed may reinstate. To reinstate a certificate, the EMS educator shall:
(1) Submit a completed:
(a) Application for CE Educator Reinstatement;
(b) Application for EMR Educator Reinstatement;
(c) Application for EMT Educator Reinstatement;
(d) Application for AEMT Educator Reinstatement; or
(e) Application for Paramedic Educator Reinstatement;
(2) Pay the reinstatement fee pursuant to 202 KAR 7:030;
(3) Submit evidence of previous certification as an EMS Educator in Kentucky; and
(4) Undergo a background check pursuant to KRS 311A.050 and 311A.100.
(a) The background check shall be:
-
National in scope for an applicant not currently certified or licensed at any level in Kentucky;
-
Statewide in scope for an applicant with current certification or licensure in Kentucky;
-
Less than six (6) months old when the applicant submits to the board all requirements for Educator certification; and
-
Provided by a vendor that has been contracted through the board.
(b) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
Section 19. Transition for Currently Certified Educators. An educator certified prior to the effective date of this administrative regulation shall be transitioned as follows:
(1) Level I Educator shall be certified as an EMR Educator;
(2) Level II Educator shall be certified as an EMT Educator or AEMT Educator;
(3) Level III Educator shall be certified as a Paramedic Educator; and
(4) Level IIIR Educator shall be certified as a Paramedic Educator.
Section 20. EMS Educator Reciprocity. A person certified as an EMS Educator or board approved equivalent in another state or United States territory shall be eligible for Kentucky EMS Educator certification upon:
(1) Submission of a completed:
(a) Application for CE Educator Reciprocity;
(b) Application for EMR Educator Reciprocity;
(c) Application for EMT Educator Reciprocity;
(d) Application for AEMT Educator Reciprocity; or
(e) Application for Paramedic Educator Reciprocity;
(2) Payment of the educator fee pursuant to 202 KAR 7:030;
(3)
(a) Submission of proof that the applicant is certified as an EMS Educator or board approved equivalent or certified as a teacher or educator through a state board of education in another state or United States territory;
(b) The applicant may only apply for educator certification at the same level of Educator certification currently held in another state or United States territory;
(4) Submission of certification or license by the board as an EMS provider or license as a Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), Physician (DO or MD), or Physician Assistant (PA); and
(5) Submission to a background check pursuant to KRS 311A.050 and 311A.100.
(a) The background check shall be:
-
National in scope for an applicant not currently certified or licensed at any level in Kentucky;
-
Statewide in scope for an applicant with current certification or licensure in Kentucky;
-
Less than six (6) months old when the applicant submits to the board all requirements for Educator certification; and
-
Provided by a vendor that has been contracted through the board.
(b) An applicant shall not directly submit a background check to meet the requirements of this section. The background check shall be submitted to the board by the company that conducts the background check.
Section 21. Educator Oversight. The board may conduct unscheduled visits to an EMS educator's classroom or to an EMS psychomotor examination site to verify compliance with KRS Chapter 311A and 202 KAR Chapter 7, instructional quality, and evaluative standards required by this administrative regulation.
Section 22. Incorporation by reference.
(1) The following material is incorporated by reference:
(a) "Training and Educational Institution (TEI) Application in KEMSIS", 2019 July;
(b) "Course Notification Application in KEMSIS", July 2019;
(c) "Initial Educational Course Roster", September 2012;
(d) "National Emergency Medical Services Education Standards", National Highway Traffic Safety Administration, DOT HS 811 077A, January 2009;
-
"National Emergency Medical Services Education Standards-Emergency Medical Responder Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077B, January 2009;
-
"National Emergency Medical Services Education Standards-Emergency Medical Technician Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077C, January 2009;
-
"National Emergency Medical Services Education Standards-Advanced Emergency Medical Technician Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077D, January 2009;
-
"National Emergency Medical Services Education Standards-Paramedic Instructional Guidelines", National Highway Traffic Safety Administration, DOT HS 811 077E, January 2009.
(e) "National EMS Scope of Practice Model 2007", National Highway Traffic Safety Administration, DOT HS 810 657, February 2007;
(f) "National EMS Scope of Practice Model 2019", National Highway Traffic Safety Administration, DOT HS 812 666, February 2019;
(g) "2002 National Guidelines for Educating EMS Instructors", National Highway Traffic Safety Administration, August 2002;
(h) CoAEMSP Interpretations of the CAAHEP 2015 Standards and Guidelines for the Accreditation of Educational Programs in the EMS Professions", February 2019;
(i) "Final Educational Course Roster", September 2012;
(j) "Continuing Education Course Student Roster", September 2012;
(k) "Course Change Notification Application" in KEMSIS, July 2019;
(l) "Psychomotor Exam Application" in KEMSIS, July 2019;
(m) "Comprehensive Skill Evaluation Report", July 2019;
(n) "CE Educator Initial Application" in KEMSIS, February 2013;
(o) "EMR Educator Initial Application" in KEMSIS, July 2019;
(p) "EMT Educator Initial Application" in KEMSIS, July 2019;
(q) "AEMT Educator Initial Application" in KEMSIS, July 2019;
(r) "Paramedic Educator Initial Application" in KEMSIS, July 2019;
(s) "Application for CE Educator Reciprocity" in KEMSIS, July 2019;
(t) "Application for EMR Educator Reciprocity" in KEMSIS, July 2019;
(u) "Application for EMT Educator Reciprocity" in KEMSIS, July 2019;
(v) "Application for AEMT Educator Reciprocity" in KEMSIS, July 2019;
(w) "Application for Paramedic Educator Reciprocity" in KEMSIS, July 2019;
(x) "Application for CE Educator Reinstatement" in KEMSIS, July 2019;
(y) "Application for EMR Educator Reinstatement" in KEMSIS, July 2019;
(z) "Application for EMT Educator Reinstatement" in KEMSIS, July 2019;
(aa) "Application for AEMT Educator Reinstatement" in KEMSIS, July 2019;
(bb) "Application for Paramedic Educator Reinstatement" in KEMSIS, July 2019;
(cc) "Application for Educator Renewal" in KEMSIS, July 2019;
(dd) "EMR Portfolio Skills Form", December 2022; and
(ee) "EMT Portfolio Skills Form", December 2022.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office for the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8:00 a.m. to 4:30 p.m.
(3) This material is also available on the board's Web site at: kyems.com.
History
- RELATES TO: KRS 311A.050, 311A.120, 311A.130, Chapter 362, Chapter 365
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.060, 311A.120, 311A.125, 311A.130
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.120 and 311A.125 require the board to promulgate administrative regulations establishing standards related to the training and education of emergency medical services personnel. KRS 311A.130 requires proper in-service and in-house in-service training and education. KRS 311A.025 requires the board to establish levels of certification. This administrative regulation establishes requirements for an organization to be approved by the board as an Emergency Medical Service Training and Education Institute (EMS-TEI) and also establishes standards for the certification and recertification of emergency medical services educators and providers.
- History: 30 Ky.R. 167; 935; 1233; 1495; eff. 11-19-2003; 38 Ky.R. 1770; 39 Ky.R. 40; 754; 952; 1981; eff. 10-17-2012; Cert eff. 2-19-2019; 47 Ky.R. 2455, 48 Ky.R. 416; eff. 9-22-2021; 49 Ky.R. 1506; eff. 6-21-2023.
202 KAR 7:701 Scope of practice matters {#sec-202-kar-7-701 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:701}
Section 1. Emergency Medical Responder.
(1) In addition to the skills and procedures established in the current National Highway Traffic Safety Administration National EMS Scope of Practice Model, emergency medical responders certified by the board shall be eligible to perform the supplemental procedures:
(a) Cervical spine and spinal immobilization; and
(b) Administration of Naloxone via Nasal Atomization Devices.
(2) To be eligible to perform a supplemental procedure established in subsection (1) of this section, an emergency medical responder shall have been trained and educated utilizing:
(a) Kentucky Required Mandatory Supplemental Curriculum: EMR Spinal Immobilization (KBEMS-E-34); and
(b) Kentucky Required Mandatory Supplemental Curriculum for the EMR in the Administration of Naloxone using a Nasal Atomization Device (KBEMS-E-33).
(3) An out-of-state emergency medical responder may perform any skill or procedure that the emergency medical responder may use in the state in which the emergency medical responder is certified subject to the emergency medical responder being called upon to assist in providing medical and related care during a disaster or emergency pursuant to KRS 39A.050, the Emergency Management Assistance Compact, or an agreement made pursuant to KRS Chapter 39A.
(4)
(a) An emergency medical responder shall adhere to the protocols established by KRS Chapter 311A and 202 KAR Chapter 7. Deviation from these protocols shall only occur if:
-
The emergency medical responder's medical director or designated on-line medical direction orders otherwise;
-
Compliance with approved protocols is not in the patient's medical best interest; or
-
The emergency medical responder does not have the equipment or medication to adhere to the protocol.
(b) Any deviation from an approved protocol shall be documented in the Patient Care Report (PCR) established in 202 KAR 7:540.
Section 2. Emergency Medical Technician (EMT).
(1) In addition to the skills and procedures established in the current National Highway Traffic Safety Administration National EMS Scope of Practice Model, an EMT certified by the board shall be eligible to perform the supplemental procedures:
(a) Identification of correct placement of an endotracheal tube (ETT) placed by a licensed paramedic;
(b) Securing of an endotracheal tube that has been inserted by appropriately licensed personnel;
(c) The use of Blind Insertion Airway Devices (BIADs);
(d) Utilizing a cardiac monitor and troubleshooting potential problems;
(e) Selecting and applying cardiac electrodes;
(f) Non-interpretive acquisition and transmission of a 12-Lead Electrocardiogram (ECG);
(g) Appropriate utilization of equipment and sampling of blood glucose using a glucometer;
(h) Care for a saline lock site where a catheter has been dislodged;
(i) Administration of Epinephrine for anaphylaxis;
(j) Administration of Naloxone using a Nasal Atomization Device;
(k) Administration of Albuterol using a Nebulizer; and
(l) Quantitative and qualitative capnography and capnometry.
(2) To be eligible to perform each of the supplemental procedures, an EMT shall have been trained and educated utilizing:
(a) Kentucky Required Mandatory Supplemental Curriculum for the EMT in Advanced Airway Management: Monitoring & Securing an ETT (KBEMS-E-38);
(b) Kentucky Required Mandatory Supplemental Curriculum for the Emergency Medical Technician (EMT) Using a Noninvasive Monitoring Device - Application of Electrocardiogram Electrodes, Use of a Cardiac Monitor, and Acquisition and Transmission of a 12-Lead ECG (KBEMS-E-35);
(c) Kentucky Required Mandatory Supplemental Curriculum for the Emergency Medical Technician (EMT): Training in the Monitoring, Maintaining, and Discontinuing of Pre-established Patient Intravenous Infusions in Prehospital, Interfacility, and Facility-to-Home Encounters (KBEMS-E-40);
(d) Kentucky Required Mandatory Supplemental Curriculum for the Emergency Medical Technician (EMT) Using a Noninvasive Monitoring Device - Application of End-tidal Carbon Dioxide Monitoring (KBEMS-E-39);
(e) Kentucky Required Mandatory Supplemental Curriculum for the EMT in the Administration of Naloxone Using a Nasal Atomization Device (KBEMS-E-36);
(f) Kentucky Required Mandatory Supplemental Curriculum for the EMT in Advanced Airway Management: Blindly Inserted Airway Devices (BIADs) (KBEMS-E-37);
(g) Kentucky Required Mandatory Supplemental Curriculum for the EMT: Sampling of Blood Glucose Using a Glucometer (KBEMS-E-41);
(h) Kentucky Required Mandatory Supplemental Curriculum: Administration of Epinephrine (KBEMS-E-42); and
(i) Kentucky Required Mandatory Supplemental Curriculum: Administration of Albuterol using a Nebulizer (KBEMS-E-43).
(3) An EMT shall adhere to the protocols established by KRS Chapter 311A and 202 KAR Chapter 7. Deviation from these protocols shall only occur if:
(a) The medical director or designated on-line medical direction orders otherwise;
(b) Compliance is not in the medical best interest of the patient; or
(c) The EMT does not have the equipment or medication to adhere to the protocol.
(4) Any deviation from an approved protocol shall be documented in the Patient Care Report (PCR) established in 202 KAR 7:540.
(5) An out-of-state EMT may perform any skill or procedure that the EMT may use in the state in which the EMT is certified subject to the EMT being called upon to assist in providing medical and related care during a disaster or emergency pursuant to KRS 39A.050, the Emergency Management Assistance Compact, or an agreement made pursuant to KRS Chapter 39A.
Section 3. EMT Students.
(1) During the didactic, laboratory, and clinical portions of an EMT course, an EMT student may perform any skill or procedure, or administer any medication within the scope of practice for an EMT as established by this administrative regulation, if the student:
(a) Has been trained and educated to perform the skill or procedure, or to administer the medication; and
(b) Is permitted to perform the skill or procedure in writing or by direct order of the medical director of the EMT course.
(2) During a field internship, an EMT student may perform any skill or procedure, or administer any medication within the scope of practice for an EMT as established by this administrative regulation, if:
(a) The student has written authorization by the medical director of the EMT course to perform the skill or procedure;
(b) Authorization to perform the skill or procedure is filed with the coordinator of the EMT course; and
(c) The medical director of the EMT course and the director of the agency for whom the skill or procedure is performed each give written permission to the EMT student to participate in a field internship with the agency.
(3) This administrative regulation shall not be construed to allow an emergency medical responder student or EMT student to perform any skill or procedure without direct supervision by a physician, registered nurse, paramedic, AEMT, or EMT, any of whom shall be licensed or certified in the Commonwealth of Kentucky, except for out-of-state clinical or field rotations specifically approved by the board.
Section 4. Advanced Emergency Medical Technician (AEMT).
(1) An AEMT shall provide emergency medical services consistent with the current National Highway Traffic Safety Administration National EMS Scope of Practice Model.
(2) In addition to the skills and procedures in the National EMS Scope of Practice Model, the scope of practice of a Kentucky AEMT shall include the supplemental procedures:
(a) Quantitative and qualitative capnography and capnometry;
(b) Bi-level Positive Airway Pressure and Continuous Positive Airway Pressure (BiPAP/CPAP) devices; and
(c) Establishing and maintaining an adult intraosseous infusion.
(3) To be eligible to perform each of the supplemental procedures, an AEMT shall have been trained and educated utilizing:
(a) Kentucky Required Mandatory Supplemental Curriculum for the AEMT Using a Noninvasive Monitoring Device - Application and Interpretation of Quantitative Capnography and End Tidal Carbon Dioxide Monitoring (KBEMS-E30);
(b) Kentucky Required Mandatory Supplemental Curriculum for the AEMT - Intraosseous Infusion in the Adult (KBEMS-E-31); and
(c) Kentucky Required Mandatory Supplemental Curriculum for the AEMT Using Bi-level Positive Airway Pressure and Continuous Positive Airway Pressure Devices (KBEMS-E-32).
(4)
(a) An AEMT shall adhere to the protocols established by KRS Chapter 311A and 202 KAR Chapter 7. Deviation from these protocols shall only occur if:
-
The AEMT's medical director or designated on-line medical direction orders otherwise;
-
Compliance with approved protocols is not in the patient's medical best interest; or
-
The AEMT does not have the equipment or medication to adhere to the protocol.
(b) Any deviation from an approved protocol shall be documented in the Patient Care Report (PCR) established in 202 KAR 7:540.
(5) If providing emergency medical services during a disaster or emergency that qualifies as part of the Emergency Management Assistance Compact pursuant to KRS 39A.050, or if acting pursuant to another agreement made pursuant to KRS Chapter 39, an AEMT certified in another state may perform the skills and procedures approved by the certifying state.
Section 5. AEMT Students.
(1) During the didactic, laboratory, and clinical portions of an AEMT course, an AEMT student may perform any skill or procedure, or administer any medication within the scope of practice for an AEMT, as defined by this administrative regulation, if the student:
(a) Has been trained and educated to perform the skill or procedure, or to administer the medication; and
(b) Is permitted to perform the skill or procedure in writing or by direct order of the medical director of the AEMT course.
(2) During a field internship, an AEMT student may perform any skill or procedure, or administer any medication within the scope of practice for an AEMT, as established by this administrative regulation, if:
(a) The student has written authorization by the medical director of the AEMT course to perform the skill or procedure;
(b) Authorization to perform the skill or procedure is filed with the coordinator of the AEMT course; and
(c) The medical director of the AEMT course and the director of the agency for whom the skill or procedure is performed each give written permission to the AEMT student to participate in a field internship with the agency.
(3) This administrative regulation shall not be construed to allow an AEMT student to perform any skill or procedure without direct supervision by a physician, registered nurse, paramedic, or AEMT, any of whom shall be licensed or certified in the Commonwealth of Kentucky, except for out-of-state clinical or field rotations specifically approved by the board.
Section 6. Paramedic.
(1) A paramedic may perform any of the skills and procedures consistent with the current National Highway Traffic Safety Administration National EMS Scope of Practice Model.
(2) A paramedic shall adhere to the protocols established by KRS Chapter 311A and 202 KAR Chapter 7. Deviation from these protocols shall only occur if:
(a) The medical director or designated on-line medical direction orders otherwise;
(b) Compliance is not in the medical best interest of the patient; or
(c) The paramedic does not have the equipment or medication to adhere to the protocol.
(3) Any deviation from an approved protocol shall be documented in the Patient Care Report (PCR) established in 202 KAR 7:540.
(4)
(a) A paramedic functioning in a position of employment may perform any procedure or administer medications authorized by KRS 311A.170 or this administrative regulation, at any location within the Commonwealth subject to the written approval of, and limitations established by the paramedic's medical director and the paramedic's employer.
(b) A paramedic performing skills or procedures outside of the normal response area for the paramedic shall accompany and assist with or continue treatment for the patient until the patient is accepted by a receiving hospital, an ALS ground or licensed ALS air ambulance provider, or care is transferred to another licensed paramedic, receiving facility RN, advanced practice registered nurse (APRN), licensed physician's assistant, or physician.
(5)
(a)
-
An off-duty paramedic may perform any procedure or administer medications authorized by KRS 311A.170 or this administrative regulation, at any location within the Commonwealth subject to the written approval of, and limitations established by the paramedic's medical director and, if appropriate, the paramedic's employer; or
-
The paramedic may render care subject to the limitations of the paramedic's scope of practice at any location, if ordered to do so by a duly licensed physician.
(b) A paramedic performing skills or procedures outside of the normal response area for the paramedic shall accompany and assist with or continue treatment for the patient until the patient is accepted by a receiving hospital, an ALS ground or licensed ALS air ambulance provider, or care is transferred to another licensed paramedic, hospital emergency department, RN, advanced practice registered nurse (APRN), licensed physician's assistant, or physician.
(6) An out-of-state paramedic may perform any skill, procedure, or administer any medications that the paramedic may use in the state in which the paramedic is certified or licensed, subject to the control of the out-of-state paramedic's medical director or protocols and only in the following circumstances:
(a) An out-of-state paramedic is transporting a patient from out-of-state to a Kentucky medical facility or other location in Kentucky;
(b) An out-of-state paramedic is transporting a patient from out of state through Kentucky to another location out of state; or
(c) An out-of-state paramedic is called upon to assist in providing medical and related care during a disaster or emergency pursuant to KRS 39A.050, the Emergency Management Assistance Compact, or an agreement made pursuant to KRS Chapter 39A.
(7) A paramedic with a critical care endorsement shall be authorized to perform the skills and procedures included in the paramedic's education and training subject to authorization by the medical director through established protocols in accordance with KRS Chapter 311A and 202 KAR Chapter 7.
Section 7. Paramedic Hospital Scope of Practice.
(1) Paramedics functioning in the hospital environment shall perform within the scope of practice, as established in this administrative regulation.
(2) Employment of paramedics in hospital emergency department settings, exclusive of employment by air or ground transport components, or both, owned or operated by the hospital, shall be subject to demonstrating knowledge based and clinical competencies at a level satisfactory to the employing hospital and subject to KRS Chapter 311A and 202 KAR Chapter 7.
(3) An employer shall not require practice for a paramedic that exceeds the defined scope of practice established by KRS Chapter 311A and 202 KAR Chapter 7. The paramedic shall inform the employing institution or supervising staff of any inability or limitation to perform an ordered skill or procedure based upon:
(a) A lack of knowledge of or training or education in the procedure or skill; or
(b) The order or directive exceeding the paramedic's scope of practice.
(4) An employer may provide education or educational opportunities to expand the documented clinical practice of the paramedic but shall not do so with the intent of requiring the paramedic to perform skills or procedures exceeding the scope of practice established by KRS Chapter 311A and 202 KAR Chapter 7 while in the hospital's employ.
(5) A paramedic shall:
(a) Maintain strict patient confidentiality;
(b) Provide and assure continuity of care to patients;
(c) Be a patient advocate;
(d) Follow the hospital's chain of command;
(e) Be knowledgeable and function within the scope of practice of a paramedic;
(f) Be clearly identified as a licensed paramedic while functioning in the hospital's employ;
(g) Document on patient care records all interventions, treatments, and assessments performed by the paramedic;
(h) Perform patient assessment, which may include triage; and
(i) Institute appropriate therapy in the care of patients subject to the limitation of existing protocols.
Section 8. Paramedic Students.
(1) During the didactic, laboratory, and clinical portions of a paramedic course, a paramedic student may perform any skill or procedure, or administer any medication within the scope of practice for a paramedic as established by this administrative regulation, if the student:
(a) Has been trained and educated to perform the skill or procedure or administer the medication; and
(b) Is permitted to perform the skill or procedure in writing or by direct order of the medical director of the paramedic course.
(2) During the field internship, a paramedic student may perform any skill or procedure, or administer any medication within the scope of practice for a paramedic as established by this administrative regulation, if:
(a) The student has written authorization by the medical director of the paramedic course to perform the skill or procedure;
(b) The permission is filed with the paramedic course coordinator of the paramedic course; and
(c) The medical director and director of the ambulance service each give written permission to the paramedic student to participate in a field internship with the ambulance service.
(3) This administrative regulation shall not be construed to allow a paramedic student to perform any skill or procedure without direct supervision by a physician, registered nurse, or paramedic, any of whom shall be licensed or certified in the Commonwealth of Kentucky, except for out-of-state clinical or field rotations specifically approved by the board.
Section 9. Restriction of Practice. This administrative regulation shall not prohibit a medical director from restricting the scope of practice of any emergency medical responder, EMT, AEMT, or paramedic under the medical director's authority through established protocols.
Section 10. Exemptions. This administrative regulation shall not prohibit an emergency medical responder, emergency medical technician, advanced emergency medical technician, or paramedic certified or licensed in another state or registered with the NREMT from functioning in accordance with the scope of practice established in KRS Chapter 311A and 202 KAR Chapter 7 while assisting with mass casualties, weapons of mass destruction, or disaster incidents.
Section 11. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Kentucky Required Mandatory Supplemental Curriculum for the AEMT Using a Noninvasive Monitoring Device - Application and Interpretation of Quantitative Capnography and End Tidal Carbon Dioxide Monitoring", KBEMS-E-30, February 2007;
(b) "Kentucky Required Mandatory Supplemental Curriculum for the AEMT Intraosseous Infusion in the Adult", KBEMS-E-31, February 2007;
(c) "Kentucky Required Mandatory Supplemental Curriculum for the AEMT using Bi-level Positive Airway Pressure and Continuous Positive Airway Pressure Devices", KBEMS-E-32, February 2007;
(d) "Kentucky Required Mandatory Supplemental Curriculum for the EMR in the Administration of Naloxone Using a Nasal Atomization Device" KBEMS-E-33, February 2007;
(e) "Kentucky Required Mandatory Supplemental Curriculum: EMR Spinal Immobilization", KBEMS-E-34, February 2007;
(f) "Kentucky Required Mandatory Supplemental Curriculum for the Emergency Medical Technician (EMT) Using a Noninvasive Monitoring Device - Application of Electrocardiogram Electrodes, Use of a Cardiac Monitor, and Acquisition and Transmission of a 12-Lead ECG", KBEMS-E-35, February 2007;
(g) "Kentucky Required Mandatory Supplemental Curriculum for the EMT in the Administration of Naloxone Using a Nasal Atomization Device", KBEMS-E-36, February 2007;
(h) "Kentucky Required Mandatory Supplemental Curriculum for the EMT in Advanced Airway Management: Blindly Inserted Airway Devices (BIADs)", KBEMS-E-37, February 2007;
(i) "Kentucky Required Mandatory Supplemental Curriculum for the EMT in Advanced Airway Management: Monitoring & Securing an ETT", KBEMS-E-38, February 2007;
(j) "Kentucky Required Mandatory Supplemental Curriculum for the Emergency Medical Technician (EMT) Using a Noninvasive Monitoring Device - Application of End-Tidal Carbon Dioxide Monitoring", KBEMS-E-39, February 2007;
(k) "Kentucky Required Mandatory Supplemental Curriculum for Emergency Medical Technician (EMT): Training in the Monitoring, Maintaining, and Discontinuing of Pre-established Patient Intravenous Infusions in Prehospital, Interfacility, and Facility-to-Home Encounters", KBEMS-E-40, February 2007;
(l) "Kentucky Required Mandatory Supplemental Curriculum for the EMT: Sampling of Blood Glucose Using a Glucometer", KBEMS-E-41, February 2007;
(m) "Kentucky Required Mandatory Supplemental Curriculum: Administration of Epinephrine", KBEMS-E-42, February 2007;
(n) "Kentucky Required Mandatory Supplemental Curriculum: Administration of Albuterol Using a Nebulizer", KBEMS-E-43, February 2007; and
(o) "National Highway Traffic Safety Administration National EMS Scope of Practice Model", February 2007.
(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 2464 Fortune Drive, Suite 195, Lexington, Kentucky 40509, Monday through Friday, 8 a.m. to 4:30 p.m. This material is also available on the agency's Web site at https://kbems.kctcs.edu/about/forms.aspx.
History
- RELATES TO: KRS 39A.050, 311A.135, 311A.140, 311A.160, 311A.165, 311A.170, 311A.175
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.135, 311A.140, 311A.160, 311A.165, 311A.170
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.025, 311A.030, 311A.135, 311A.140, 311A.160, 311A.165, and 311A.170 require the board to promulgate administrative regulations relating to the scope of practice for individuals certified or licensed by the board. This administrative regulation establishes the scope of practice.
- History: 30 Ky.R. 174; Am. 942; 1240; 1501; eff. 11-19-2003; 41 Ky.R. 2313; 42 Ky.R. 17; eff. 7-15-2015; Cert. eff. 4-13-2022; 49 Ky.R. 425, 1059; eff. 11-15-2022.
202 KAR 7:801 Medical directors {#sec-202-kar-7-801 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:801}
Section 1. Existing Medical Directors Exempt from Initial Certification. A medical director who was approved by the board on or before October 1, 2026, shall be deemed to hold an initial medical director certification and shall not be required to apply for initial certification as an Agency Medical Director or EMS-TEI Primary Medical Director under Sections 2 or 7 of this administrative regulation.
Section 2. Agency Medical Director Certification Requirements.
(1) An individual desiring initial certification as an Agency Medical Director shall:
(a) Hold a current, unrestricted license to practice medicine in Kentucky as a physician;
(b) Satisfy one (1) of the following:
-
Be certified in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);
-
Be certified in emergency medicine by the ABEM or AOBEM and successfully complete the board-approved Kentucky EMS Medical Director Introductory Course; or
-
Be certified in any specialty by the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) and:
a. Successfully complete the board-approved Kentucky EMS Medical Director Full Course; and
b. Hold and maintain current provider certification in:
(i) Advanced Trauma Life Support (ATLS);
(ii) Advanced Cardiovascular Life Support (ACLS), through either American Heart Association or the American Safety and Health Institute (ASHI); and
(iii) Pediatric Advanced Life Support or Pediatric Education for Prehospital Professionals (PEPP);
(c) Submit a completed EMS Medical Director application in KEMSIS; and
(d) Pay the fee required for certification pursuant to 202 KAR 7:030.
(2) A physician applying to become an Agency Medical Directormay request a waiver for up to twelve (12) months to acquire the certifications under subsection (1)(b)3.b. of this section.
Section 3. Renewal of Agency Medical Director Certification and Continuing Education Requirements. An Agency Medical Director shall be eligible for certification renewal if the applicant:
(1) Submits a completed EMS Medical Director application in KEMSIS;
(2) Pays the renewal fee pursuant to 202 KAR 7:030;
(3) Submits evidence of current, unrestricted licensure to practice medicine in Kentucky as a physician;
(4) Maintains evidence of successful completion of at least sixteen (16) hours of continuing education consisting of the following:
(a) A board-approved medical director update;
(b) At least eight (8) hours of providing EMS education for agencies or providers; and
(c) At least four (4) hours of EMS continuing education or other equivalent American Medical Association Physician's Recognition Award program (AMA PRA Category 1) or Continuing Education Unit (CEU) in emergency medicine; and
(5) If certified pursuant to Section 2(1)(b)3. of this administrative regulation, submits evidence of current certification in:
(a) ATLS;
(b) ACLS, through either the AHA or the ASHI; and
(c) Pediatric ALS or PEPP; or
(6) If exempt from initial certification pursuant to Section 1 of this administrative regulation, submits evidence of:
(a) Current certification in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);
(b) Current certification in emergency medicine by the ABEM or AOBEM and successful completion of the board-approved Kentucky EMS Medical Director Introductory Course; or
(c) Current certification in:
-
ATLS;
-
ACLS, through either the AHA or the ASHI; and
-
Pediatric ALS or PEPP.
Section 4. Agency Medical Director Responsibilities. Agency Medical Directors shall function under terms of employment or a contractual agreement that specifically address the responsibilities of the medical director and the employer or the contractor responsibilities for the following topics:
(1) Establishing medical protocols and standing orders for communications and patient care personnel;
(2) Serving as a liaison with the local medical community;
(3) Interacting with regional, state, and local EMS authorities on issues relating to EMS standards, needs and requirements, and the optimization of resource utilization;
(4) Maintaining continuing education appropriate for the Agency Medical Director, administrative staff, communication and patient care personnel;
(5) Restricting or limiting patient care functions of staff;
(6) Establishing patient destination policies;
(7) Establishing initial qualification of personnel involved in patient care and dispatch;
(8) Developing, implementing, and maintaining a quality improvement program for continuous system and patient care improvement;
(9) Developing, implementing, and maintaining credentialing of personnel who provide patient care; and
(10) Developing on-line medical control policies.
Section 5. Associate Medical Director Certification.
(1) An individual desiring initial certification as an Associate Medical Director shall:
(a) Be a physician who meets the requirements of Section 1 of this administrative regulation or holds a current, unrestricted license to practice medicine in Kentucky as a nurse practitioner (NP) or physician assistant (PA);
(b) Successfully complete the board-approved Kentucky EMS Medical Director Introduction Course;
(c) Hold and maintain current provider certification in:
-
ATLS;
-
ACLS, through either AHA or the ASHI; and
-
Pediatric ALS or PEPP;
(d) Submit a completed EMS Medical Director application in KEMSIS; and
(e) Pay the fee required for certification pursuant to 202 KAR 7:030.
(2) Associate medical directors shall only function under the supervision and authority of the agency's board-certified Agency Medical Director.
(3) If approved by the Agency Medical Director, an associate medical director may serve as on-line medical control for an agency with which the associate medical director is affiliated.
Section 6. Renewal of Associate Medical Director Certification and Continuing Education Requirements. An associate medical director shall be eligible for certification renewal if the applicant:
(1) Submits a completed EMS Medical Director application in KEMSIS;
(2) Pays the fee required for certification renewal pursuant to 202 KAR 7:030;
(3) Submits evidence of current, unrestricted licensure to practice medicine in Kentucky as a nurse practitioner (NP) or physician assistant (PA); and
(4) Maintains evidence of successful completion of at least sixteen (16) hours of continuing education consisting of the following:
(a) A board-approved medical director update;
(b) At least eight (8) hours of providing EMS education for agencies or providers; and
(c) At least four (4) hours of EMS continuing education or other equivalent American Medical Association Physician's Recognition Award program (AMA PRA Category 1) or Continuing Education Unit (CEU) in emergency medicine.
Section 7. EMS-TEI Primary Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Primary Medical Director shall:
(1) Hold a current, unrestricted license to practice medicine in Kentucky as a physician;
(2) Satisfy one (1) of the following:
(a) Be a board-certified EMS Medical Director;
(b) Be certified in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);
(c) Be certified in emergency medicine by the American Board of Medical Specialties (ABMS), the American Association of Physician Specialists (AAPS), the ABEM, or the AOBEM; or
(d) Be certified in any specialty by the ABMS, the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) with evidence of training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;
(3) Successfully complete the board-approved EMS-TEI Medical Director Course;
(4) Submit a completed EMS Medical Director application in KEMSIS; and
(5) Pay the fee required for certification pursuant to 202 KAR 7:030.
Section 8. EMS-TEI Associate Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Associate Medical Director shall:
(1) Hold a current, unrestricted license to practice medicine in Kentucky as a physician;
(2) Successfully complete the board-approved EMS-TEI Medical Director Course;
(3) Have training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;
(4) Submit a completed EMS Medical Director application in KEMSIS; and
(5) Pay the fee required for certification pursuant to 202 KAR 7:030.
Section 9. EMS-TEI Assistant Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Assistant Medical Director shall:
(1) Hold a current, unrestricted license to practice medicine as a physician in the state where the EMS-TEI program's students are participating in clinical rotations, field experience, or a capstone field internship;
(2) Successfully complete the board-approved EMS-TEI Medical Director Course;
(3) Have training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;
(4) Submit a completed EMS Medical Director application in KEMSIS; and
(5) Pay the fee required for certification pursuant to 202 KAR 7:030.
Section 10. Renewal of EMS-TEI Primary Medical Director, EMS-TEI Associate Medical Director, and EMS-TEI Assistant Medical Director Certifications. An EMS-TEI Primary Medical Director, EMS-TEI Associate Medical Director, or EMS-TEI Assistant Medical Director shall be eligible for certification renewal if the applicant:
(1) Submits a completed EMS Medical Director application in KEMSIS;
(2) Pays the renewal fee pursuant to 202 KAR 7:030;
(3) If exempt from initial certification pursuant to Section 1 of this administrative regulation, maintains evidence of successful completion of the board-approved EMS-TEI Medical Director Course; and
(4) Submits evidence of current, unrestricted licensure to practice medicine as a physician in Kentucky; or
(5) If certified as an EMS-TEI Assistant Medical Director pursuant to Section 8 of this administrative regulation, submits evidence of current, unrestricted licensure to practice medicine in the state where the EMS-TEI program students are participating in clinical rotations, field experience, or a capstone field internship.
Section 11. Expiration of Certifications.
(1) All certifications issued pursuant to this administrative regulation shall:
(a) Be valid for a period of two (2) years upon renewal; and
(b) Expire on April 30 of the second year from its initial issuance.
(2) An initial certification issued to an existing medical director pursuant to Section 1 of this administrative regulation shall expire on April 30, 2028.
Section 12. Certification and Continuing Education Validation and Audits.
(1) The board office may audit a medical director's continuing education record and certifications. The medical director shall submit the documentation requested within ten (10) business days of receipt of the board office's request.
(2) If documentation of certifications or continuing education hours consistent with this administrative regulation are not received using the board-approved submission process within ten (10) business days upon receipt of the board's request, the medical director's certification shall be deemed to have lapsed and the individual shall reapply for certification, if eligible.
(3) The ten (10) business days for submission shall not apply to investigations pursuant to KRS Chapter 311A.
(4) Each medical director shall maintain documentation of all required certifications and all continuing education for three (3) years from the date of completion.
Section 13. Public Notice of Negative Action. The board office shall cause to be published on the board website the name of any person certified pursuant to this administrative regulation who:
(1) Is fined;
(2) Is placed on probationary status;
(3) Is placed on restricted status;
(4) Is suspended; or
(5) Has had his or her certification revoked.
Section 14. Incorporation by Reference.
(1) The following material is incorporated by reference: "EMS Medical Director" application in KEMSIS, August 2025.
(2) This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.
(3) This material is also available at kemsis.ky.gov.
History
- RELATES TO: KRS 311A.025, 311A.055, 311A.125, 311A.130, 311A.170, 311A.175, 311A.180
- STATUTORY AUTHORITY: KRS 311A.020, 311A.025, 311A.030, 311A.180
- CERTIFICATION STATEMENT: This is to certify that this administrative regulation complies with the requirements of 2025 RS HB 6, Section 8.
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 311A.025 requires the board to promulgate administrative regulations relating to EMS medical directors. This administrative regulation establishes requirements for EMS medical directors.
- History: 202 KAR 007:801. 30 Ky.R. 176; 945; eff. 11-19-2003; Crt eff. 2-19-2019; Crt to Am 2-17-2026, 52 Ky.R. 1761, 30; eff. 8-18-2026.
202 KAR 7:810 Survivor benefits for death of emergency medical services personnel {#sec-202-kar-7-810 omnilex-key=us-ky-regs-official--title-202--202 KAR 7:810}
Section 1. Definitions.
(1) "AEMT" means an advanced emergency medical technician certified by the board.
(2) "Board" means the Kentucky Board of Emergency Medical Services as defined by KRS 311A.010(3).
(3) "Child or children" means a:
(a) Biological child or children, including a child or children born after the EMS provider's death;
(b) Stepchild or stepchildren; and
(c) Legally adopted child or children.
(4) "Death in the line of duty" means death that occurs as a direct result of an act or acts in the "performance of duty" as defined by subsection (11) of this section and shall include death that results from a heart or circulatory malfunction that is treated within forty-eight (48) hours after participation in the performance of these duties, or as the result of illness, sickness, or injury caused by the performance of these duties that result in death within twelve (12) months of the activities if the death is not caused by suicide or self-inflicted injury.
(5) "Emergency medical services" means the services utilized in providing care for the perceived individual need for immediate medical care to protect against loss of life, or aggravation of physiological or psychological illness or injury.
(6) "EMR" means an emergency medical responder certified by the board.
(7) "EMS provider" means an emergency medical responder (EMR), emergency medical technician (EMT), advanced emergency medical technician (AEMT), or paramedic.
(8) "EMT" means an emergency medical technician certified by the board.
(9) "Heart or circulatory malfunction" means myocardial infarction, angina pectoris, coronary thrombosis, cardiac arrest, or a cerebral vascular accident, the symptoms of which are first medically treated within forty-eight (48) hours after participation in the performance of the duties of an EMS provider as described in subsection (11) of this section.
(10) "Paramedic" mean a paramedic licensed by the board.
(11) "Performance of duty":
(a) Means an EMS provider engaging in the following activities if the activities are performed at the direction or with the knowledge of an officer of a licensed ambulance service, or when immediate action is required at the scene of an emergency not involving an ambulance service or other emergency organization:
-
Provision of emergency medical care;
-
Participation in EMS-related education or training;
-
Rescue or emergency activities for which the ambulance service is licensed;
-
Reparation or other work about or in the ambulance or building and grounds of the licensed ambulance service;
-
Answering an emergency call;
-
Riding in the ambulance that is owned or used by the licensed ambulance service;
-
Performance of other duties of the licensed ambulance service as authorized by the jurisdiction that the licensed agency serves; and
-
Travel to or from and attendance at meetings related to emergency medical services: and
(b) Does not mean participation in any sports or athletic event or contest for any purpose if the EMS provider is representing an organization related to the field of emergency medical services.
Section 2. Requirements for Eligibility.
(1) Survivors. Benefits shall be paid to the surviving:
(a) Spouse;
(b) Child or children; or
(c) Spouse and child or children; or parents, as set forth in KRS 61.315(2).
(2) Heart or circulatory malfunction limitations. If an EMS provider becomes an active employee of a licensed ambulance service and has not been medically diagnosed or received any medication for a heart or circulatory malfunction within five (5) years prior to the date of employment, the EMS provider's eligible survivors shall receive the death benefits detailed in this administrative regulation if the EMS provider is killed in the line of duty.
(a) If an EMS provider has been medically diagnosed with or received medication for a heart or circulatory malfunction within five (5) years prior to becoming an active employee of a licensed ambulance service and presents a medical statement to the board from a licensed physician establishing that the individual has recovered or has been sufficiently medically rehabilitated to meet the physical demands of providing emergency medical services, the EMS provider's survivors shall be eligible to receive death benefits as outlined in this administrative regulation if the EMS provider dies in the line of duty.
(b) If an EMS provider employed by a licensed ambulance service is medically diagnosed with or is prescribed medication for a heart or circulatory malfunction and returns to active employment with a licensed ambulance service, the EMS provider's survivors shall not be eligible to receive death benefits as outlined in this administrative regulation if the EMS provider's death was caused by a heart or circulatory malfunction.
(3) If death occurs twelve (12) months or more after the performance of duty and is believed to be related to the provision of emergency medical services, the board may review the personnel's medical records to determine if the death qualifies as a death in the line of duty.
(4) Autopsy.
(a) The board shall reserve the right to request an autopsy of an EMS provider if sufficient cause is shown for this request.
(b) If an autopsy is performed for any reason, a copy of the report signed by the individual who performs the autopsy and a notary public shall be submitted to the board.
Section 3. Application.
(1)
(a) Upon the death in the line of duty of an EMS provider, the licensed ambulance service by which the EMS provider was employed at the time of death shall immediately notify the executive director of the board.
(b) Upon receipt of the notification, the executive director shall send Form KBEMS-01LDD to the notifying licensed ambulance service in care of the administrator and Form KBEMS-02LDD to the known survivors of the deceased EMS provider.
(2) Upon receipt of Forms KBEMS-01LDD and KBEMS-02LDD, the administrator of the licensed ambulance service and the EMS provider's survivors or their representative shall complete the forms and return them to the board in care of the executive director.
(3)
(a) Upon receipt by the executive director of the completed forms, a committee of the board appointed by its chairman shall review the forms for compliance with KRS 61.315 and this administrative regulation and make recommendations to the board for determination of eligibility for death benefits under this administrative regulation.
(b) The committee and the executive director may seek clarification of the forms' content with the EMS provider's survivors and licensed ambulance service. The board shall make the final determination of eligibility for death benefits pursuant to KRS 61.315 and this administrative regulation.
Section 4. Certification of Payment of Benefits. Upon certification of survivorship rights to the EMS provider's death benefit, the sum of $80,000 shall be paid by check by the state treasurer from the general expenditure fund of the state treasury, as required by KRS 61.315(2), and the treasurer shall transmit the check to the board for payment to the eligible survivor or survivors.
Section 5. Appeals.
(1) A decision of the board affecting the eligibility of a survivor to be a recipient of the fund shall not be final until the survivor shall have been afforded an opportunity to be heard on the matter.
(2) An appeal may be taken from a final decision of the board to withhold payment from the fund to any survivor.
Section 6. Incorporation by Reference.
(1) The following material is incorporated by reference:
(a) "Form KBEMS-01LDD, Report of the Death of Emergency Medical Personnel", November 2016; and
(b) "Form KBEMS-02LDD, Claim for Survivor Benefits", November 2016.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Emergency Medical Services, 118 James Court, Suite 50, Lexington, Kentucky 40505, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 61.315, 311A.010(3)
- STATUTORY AUTHORITY: KRS 61.315
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 61.315(6) requires the board to promulgate administrative regulations to authorize the payment of survivor benefits of $80,000 to the survivor of any paid or volunteer emergency medical services personnel who is employed directly by, or volunteering directly for, any county, city, fire protection district, or emergency ambulance service district created under KRS 108.080 to 108.180 to provide emergency medical services and who is killed in the line of duty after November 1, 2015. This administrative regulation establishes the procedures and criteria that shall be utilized to determine the eligibility of the emergency medical service personnel's survivor benefits.
- History: 43 Ky.R. 1118, 1551; eff. 3-31-2017; Cert. eff. 3-20-2024.
Chapter 8 Kentucky Military Heritage Commission
202 KAR 8:030 Procedure for Kentucky Military Heritage nomination, designation, and rescission {#sec-202-kar-8-030 omnilex-key=us-ky-regs-official--title-202--202 KAR 8:030}
Section 1. Definitions.
(1) "Articles of designation" means the writing by which any estate, interest, or right in a military heritage site is formally designated as provided in KRS 171.782 to 171.786.
(2) "Destroyed" means the physical act of demolishing or tearing down or razing character-defining features or historic landscape components of the designated military heritage site.
(3) "Military heritage" is defined by KRS 171.780(2).
(4) "Military heritage object" is defined by KRS 171.780(4).
(5) "Military heritage site" is defined by KRS 171.780(3).
(6) "Removed" means:
(a) The act of taking or removing the object from the site where it is located at the time of designation; or
(b) Removing character-defining features or historic landscape components from the designated military heritage site.
(7) "Significantly altered" means to be modified, changed, improved, reconstructed, defaced, vandalized, or damaged in any manner that is not considered ordinary repairs, maintenance, or renovations and is inconsistent with the U.S. Secretary of the Interior's Standards for the Treatment of Historic Properties, 36 C.F.R. 68.
(8) "Sold" means the transfer, sale, gift, donation, or exchange of ownership by agreement with or physical conveyance to a person or entity other than the owner at the time of designation.
(9) "Temporary loan" means the loan of a designated military heritage object to a person or entity other than the owner at the time of designation for a period not to exceed one (1) year.
Section 2. Nomination Process.
(1) A person or organization may nominate a geographic location for designation as a military heritage site or an object as a military heritage object by submitting a "Military Heritage Commission Historic Military Sites and Objects Application for Registration" form to the Historic Military Sites Preservation Coordinator at the Kentucky Heritage Council.
(2) The "Military Heritage Commission Historic Military Sites and Objects Application for Registration" form shall contain the following information:
(a) Name of property;
(b) Location;
(c) Ownership and category of site or object;
(d) Owner or location contact information;
(e) Information regarding site acreage and physical location;
(f) Brief description of site or object;
(g) Significance of historical site or object;
(h) Other documentation or recognition;
(i) Condition of site or object;
(j) Supporting documentation;
(k) Photograph log; and
(l) Owner consent.
(3) At least sixty (60) days prior to a biennial commission meeting, a completed registration application form shall be submitted to the Historic Military Sites Preservation Coordinator for staff review prior to submission to the full commission at the meeting. In determining qualification of the object or site for nomination, the commission shall consider the following characteristics:
(a) Whether the object or site:
-
Has a degree of connection to a military event or activity associated with military heritage;
-
Has relevance specifically to a military heritage event or activity as opposed to only an association with the lives of persons significant to the activity;
-
Possesses a distinctive feature of type, period, or method of construction germane to a military event or activity associated with military heritage;
-
Represents the work of a master or possessing high artistic values that memorializes a military event or activity of military heritage;
-
Is commemorative of a military event or activity associated with military heritage; and
-
Retains its integrity;
(b) The age of the object or site; and
(c) The authenticity of the object or site for consideration at one (1) of the regularly scheduled meetings.
(4) Prior to the biennial commission meeting, a staff reviewer shall:
(a) Review the application;
(b) Verify the accuracy and completeness of the application;
(c) Send copies of the application form to each commission member; and
(d) Make recommendations to the commission for approval or disapproval of the nominated site or object.
(5) The commission shall not consider incomplete applications. If an application is incomplete, review staff shall contact the applicant within five (5) working days of receipt of the application to request additional information or offer assistance in drafting the application so that it can be submitted to the commission for consideration.
(6) Within five (5) working days of receipt of the completed application, review staff shall determine whether a site or object is publicly or privately owned.
(7) If private property is nominated by someone other than the owner, review staff shall:
(a) Immediately notify the owner of the property or object of the receipt of the application by the commission; and
(b) Inform the owner that the application shall not be approved without the owner's written approval in accordance with KRS 171.784(3)(b).
(8) If public property if nominated by someone other than the owner, review staff shall:
(a) Immediately notify the owner of the property or object of the receipt of the application by the commission; and
(b) Inform the owner that he may submit a written agreement with, or objection to, the application.
(9) If the commission designates a site or object as a military heritage site or military heritage object, the Historic Military Sites Preservation Coordinator of the Kentucky Heritage Council shall, within thirty (30) days, forward official notification to the owner of record, outlining permitted and forbidden activities relating to designated military heritage sites and objects and which management activities require written permission of the commission, in accordance with KRS 171.786 and 171.788. At that time articles of designation shall be enacted and a certificate of listing to the Kentucky Military Heritage Sites and Objects Register shall be forwarded to the owner of record.
Section 3. Articles of Designation.
(1) Upon the determination by the commission that an area be designated a military heritage site, the military heritage site shall be so designated upon acceptance of articles of designation by the commission.
(2) Articles of designation shall be recorded in the:
(a) Office of the county clerk of the county in which the military heritage site is located;
(b) Office of the secretary of state; and
(c) Office of the commission.
(3) Articles of designation shall be used as the guideline for the management of each designated military heritage site. The management, use, development, and public access of each military heritage site shall be in accordance with 36 C.F.R. 68 and the provisions set forth in the articles of designation.
(4) Articles of designation may contain:
(a) Restrictions relating to:
-
Management;
-
Use;
-
Development;
-
Transfer; and
-
Public access; and
(b) Provisions necessary to further the purposes of the Military Heritage Act, KRS 171.780 to 171.788.
(5) Articles of designation may vary from one (1) military heritage site to another because of:
(a) Differences in the characteristics and conditions of the area involved; or
(b) Reasons found necessary by the:
-
Commission; and
-
Landowner, grantor, devisor, or donor.;
(6) Articles of designation may include:
(a) An agreement by the landowner to:
-
Give notice to the commission of any change in ownership; or
-
Allow limited public access; or
(b) Voluntary management agreements designed to protect the cultural and historic features of the military heritage site.
(7) Articles of designation may be amended by the commission upon a finding that the amendment will not permit an impairment, disturbance, use, or development of the military heritage site inconsistent with the purposes for which the site was designated or inconsistent with the Military Heritage Act, KRS 171.780 to 171.788.
Section 4. Recession Process.
(1) Any person or organization may apply to the Kentucky Military Heritage Commission to request the rescission of the designation of a site as a military heritage site or an object as a military heritage object.
(a) This request shall be made by contacting the Historic Military Sites Preservation Coordinator at the Kentucky Heritage Council, 300 Washington Street, Frankfort, Kentucky 40601, in writing and detailing why the continued designation of an individual site or object should no longer be in effect.
(b) An applicant shall clearly demonstrate:
-
That a site or object was erroneously listed; or
-
Other mitigating issues require the removal of the site or object from the Kentucky Military Heritage Sites and Objects Register.
(2)
(a) Within ten (10) days of receipt of the request, the Kentucky Military Heritage Commission staff shall confirm receipt of the request to the applicant and inform him of the approximate date, time and location of the meeting at which the commission is expected to consider the matter.
(b) Kentucky Military Heritage Commission staff:
-
May request further information from any parties, regarding the request, site or object in question, to assist the Commission in its deliberations; and
-
Staff shall notify the applicant and the owner of the property in writing at least fourteen (14) days prior to the meeting of the commission of the exact date, time and location of the meeting.
(c) The applicant, with the permission of the commission, may offer oral testimony in addition to the written request prior to the commission's vote on the matter.
(d) The commission may also hear testimony from other interested parties prior to making its decision.
(3)
(a) Letters requesting rescission of designation shall be presented to the commission for action during their next meeting.
(b) The commission shall review each request for rescission of designation as well as staff recommendations of that request and may request further information or investigation prior to the vote or may vote on the matter as presented.
(4)
(a) If the commission fails to rescind a designation in accordance with KRS 171.784(7), it may be brought before the commission again at a later meeting to consider new and material information regarding the request.
(b) A request for reconsideration shall require the applicant to submit a new written request for the rehearing.
(c) The commission may, consider the new and material information provided in the written request for a rehearing and staff review and may at the discretion of the chairman in consultation with the secretary, deny the request for a rehearing if they feel that the evidence is not new and material and therefore not substantially different from the information considered at the first hearing for rescission.
(5) Upon rescission of the designation of a site as a military heritage site or object by the commission:
(a) Notification shall be sent to the owner and applicant; and
(b) A notation of rescission shall be recorded in the Register Of Military Heritage Sites and Objects maintained by the Kentucky Heritage Council; and
(c) Articles of rescission of designation shall be recorded in the:
-
Office of the county clerk of the county in which the military heritage site is located;
-
Office of the secretary of state; and
-
Office of the commission.
Section 5. Incorporation by Reference.
(1) "Military Heritage Commission Historic Military Sites and Objects Application for Registration," KMHC Form #1, (2/12/03 edition), Kentucky Military Heritage Commission, is incorporated by reference.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Heritage Council, 300 Washington Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.
History
- RELATES TO: KRS 171.782(3), 171.784, 171.786
- STATUTORY AUTHORITY: KRS 171.782 (4); 171.784(4), 171.786(3).
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 171.782(4) requires the Kentucky Military Heritage Commission to promulgate administrative regulations necessary to carry out KRS 171.780 to 171.788 and to protect military heritage sites and objects. KRS 171.784(4) requires the commission to promulgate administrative regulations with regard to the process of designation of a military heritage site or object and the characteristics of qualifying sites or objects. KRS 171.786(3) requires the commission to promulgate administrative regulations regarding rescission of a designated military heritage site or object. This administrative regulation establishes the procedure for the nomination, designation, and rescission of military heritage sites and objects.
- History: 30 Ky.R. 1147; Am. 1503; eff. 1-5-2004; Crt eff. 2-28-2020.
Chapter 10 Kentucky Public Transportation Infrastructure Authority
202 KAR 10:010 Unsolicited proposals {#sec-202-kar-10-010 omnilex-key=us-ky-regs-official--title-202--202 KAR 10:010}
Section 1. Definitions.
(1) "Best interest of the commonwealth" means the unsolicited proposal meets goals of the state authority and the cabinet on safety, economic growth, enhancing the state transportation system, and technical and economic feasibility.
(2) "Cabinet" is defined by KRS 175B.010(3).
(3) "Project" is defined by KRS 175B.010(11).
(4) "Public-private partnership" is defined by KRS 175B.010(14).
(5) "State authority" is defined by KRS 175B.010(16).
(6) "Unsolicited proposal" means a proposal submitted pursuant to KRS 175B.020(5) to (9).
(7) "Unsolicited proposer" means a person, business, or entity submitting an unsolicited proposal.
Section 2. Submission of Unsolicited Proposals.
(1) To submit an unsolicited proposal, an unsolicited proposer shall file with the state authority three (3) hard copies in a sealed envelope marked "unsolicited proposal" and one (1) electronic copy to kyptia@ky.gov.
(2) The following information shall be included in the unsolicited proposal:
(a) The information required by KRS 175B.020(5);
(b) A cover letter for the executive summary with the following specifications:
-
The cover letter of the executive summary shall be marked "Executive Summary of Unsolicited Proposal for KPTIA" in twelve (12) point type;
-
The cover letter shall notify the state authority if exempt information is contained in the unsolicited proposal; and
-
If the unsolicited proposal contains a trade secret, a financial record, or other information that is exempt from public disclosure pursuant to KRS 61.878, the unsolicited proposer submitting the unsolicited proposal shall:
a. Mark all portions of the proposal that contain exempt information as "confidential" or "proprietary";
b. Submit a second copy of the unsolicited proposal from which the trade secret, financial record, or other information that is exempt from public disclosure pursuant to KRS 61.878 have been redacted; and
c. Indicate in the title of the electronically filed unsolicited proposal which version is a complete version and which version is the redacted version;
(c) A brief description and justification of the proposed project or concept;
(d) Details for the proposed project or concept regarding:
-
The revenue source;
-
The amount of revenue expected to be generated; and
-
The project costs;
(e) Information supporting the unsolicited proposer's position that the unsolicited proposal is in the best interest of the commonwealth; and
(f) Contact information for the unsolicited proposer, including name, address, telephone number, and e-mail address.
(3) The hard copies of the unsolicited proposal shall be sent via certified mail with return receipt requested or hand delivered to the head of the state authority.
Section 3. Unsolicited Proposal Fees.
(1) In accordance with KRS 175B.020(5)(c) and (8), an unsolicited proposer shall pay all costs incurred by the state authority and the cabinet for evaluating the unsolicited proposal, including any legal and investigative costs, and the costs of other necessary outside professionals and consultants.
(2)
(a) As an initial payment for these costs, the applicant shall submit, along with the executive summary, a cashier's check or certified check payable to the state authority in the amount of $400 for the initial filing fee.
(b) The initial filing fee shall be nonrefundable.
Section 4. Initial Decision by State Authority. After reviewing an unsolicited proposal, the state authority shall make a determination if continuing to review and evaluate the unsolicited proposal is in the best interest of the commonwealth and based on that decision shall:
(1) Approve the unsolicited proposal for further review; or
(2) Reject the unsolicited proposal.
Section 5. Notification to Unsolicited Proposer. After the state authority has made the determination to reject or approve the unsolicited proposal for further review, the state authority shall send a letter to the unsolicited proposer with the state authority's determination.
Section 6. Agreement between the State Authority and Unsolicited Proposer.
(1) If the state authority determines it is in the best interest of the commonwealth to continue reviewing and evaluating the concept set forth in the unsolicited proposal, the state authority and the unsolicited proposer shall negotiate the terms of the next phase of the review.
(2) If an agreement is reached between the state authority and the unsolicited proposer on the terms of the next phase, the agreement shall be memorialized and shall contain:
(a) A commitment by the unsolicited proposer to pay in full the costs to be incurred by the state authority and the cabinet in connection with the review and evaluation of the unsolicited proposal;
(b) An estimate of the amount of costs to be incurred in the review and evaluation process;
(c) The payment schedule for the costs;
(d) The agreement by the unsolicited proposer that the costs are nonrefundable even if the unsolicited proposal is rejected;
(e) Provisions for the state authority or the cabinet to pay an agreed amount in exchange for the use of any design, idea, or intellectual property contained in the proposal; and
(f) Other agreed to terms and conditions that may facilitate the evaluation and review process.
Section 7. Additional Information. The state authority and the cabinet may request additional information from an unsolicited proposer, ask for clarification of information, or ask questions, if the additional information may assist the state authority and the cabinet in deciding to approve or reject the unsolicited proposal.
Section 8. Competitive Procurement Process. If a determination has been made by the state authority and the cabinet that the unsolicited proposal is in the best interest of the commonwealth, the state authority, with the assistance of the cabinet, shall begin the competitive procurement process to implement some or all of the concepts contained in the unsolicited proposal. The procurement process established in 603 KAR Chapter 2 shall be utilized.
Section 9. Professional Assistance. The state authority and the cabinet shall retain any professional services necessary to enable an adequate review and evaluation of the unsolicited proposal, if the expertise to perform a review or evaluation within the state authority or the cabinet is inadequate or unavailable. Any procurement shall follow the processes established in KRS Chapter 45A.
Section 10. Public Inspection. Except for each portion of an unsolicited proposal that contains a trade secret, financial record, or other information that is exempt from public disclosure pursuant to KRS 61.878, each unsolicited proposal shall be available for public inspection after the latest of:
(1) The date of the written notification sent by the state authority that the state authority has rejected the unsolicited proposal;
(2) Sixty (60) days after the end of the notice period provided under KRS Chapter 175B; or
(3) The date a contract has been awarded, if the state authority elects to undertake an open, competitive procurement process pursuant to KRS Chapter 175B.
History
- RELATES TO: KRS Chapter 45A, 175B.005, 175B.010, 175B.015(12)(d), 175B.020(5)-(9), 175B.030, 175B.035, 175B.037, 175B.040, 175B.095
- STATUTORY AUTHORITY: KRS 175B.015(12)(d), 175B.020(5)-(9)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 175B.015(12)(d) authorizes the state authority to promulgate administrative regulations to fulfill any requirements of KRS Chapter 175B. KRS 175B.020(5) authorizes the state authority to receive unsolicited proposals if certain criteria are met. This administrative regulation establishes the process by which the state authority may receive, evaluate, approve, and reject unsolicited proposals.
- History: 43 Ky.R. 844, 1199; eff. 3-31-2017; Cert eff. 3-22-2024.
202 KAR 10:020 Public-private partnerships {#sec-202-kar-10-020 omnilex-key=us-ky-regs-official--title-202--202 KAR 10:020}
Section 1. Definitions.
(1) "Cabinet" is defined by KRS 175B.010(3).
(2) "Private partner" is defined by KRS 175B.010(10).
(3) "Project" is defined by KRS 175B.010(11).
(4) "Public-private partnership" is defined by KRS 175B.010(14).
(5) "State authority" is defined by KRS 175B.010(16).
Section 2. Use of a Public-Private Partnership.
(1) A public-private partnership may be used for construction or financing of a project or the procurement of services if the head of the state authority issues a written determination that due to the nature or circumstances of the project or services, a public-private partnership is the most advantageous method of awarding and administering a project.
(2) In determining if the use of a public-private partnership is the most advantageous method of awarding and administering a project, the head of the state authority, or a person authorized in writing as his or her designee, shall undertake an analysis of the proposed project using the criteria established in paragraphs (a) and (b) of this subsection.
(a) Qualitative considerations shall include:
-
The ability of the state authority to allocate and control risks, cost sharing, responsibilities, and rewards between the state authority and a private partner in a way that ultimately benefits the state authority, the cabinet, and the commonwealth;
-
The timeliness of completion, efficiency of delivery, and cost effectiveness of a project via a public-private partnership as compared with other project delivery methods;
-
A determination that the tangible and intangible benefits to be gained by using a public-private partnership equals or exceeds the cost of developing and maintaining a public-private partnership;
-
The ability and expertise of the state authority to measure and monitor performance and operational controls;
-
The ability of the state authority to capture and use incentives, efficiencies, and expertise derived from the involvement of a private partner;
-
If the project or other services are likely to be developed or entered into in the absence of private sector involvement;
-
If a means of financing or innovative approach is likely to be available that is not otherwise available with other project delivery methods;
-
If the project or other service promotes and encourages the use of local labor and resources, as well as disadvantaged, minority, or small business enterprises, consistent with 49 C.F.R. Part 26, KRS 154.1-750, 600 KAR 4:010, and other applicable law, including requiring a private partner who has been awarded a project for a public-private partnership to establish a local office within the Commonwealth of Kentucky;
-
If the public interest is best served through the use of a public-private partnership;
-
The impact of the development structure and financing plan on the long term level of project toll rates and the use of any excess toll revenue;
-
The urgency of need for the project or service by the state authority;
-
The allocation of risks and contingencies between the state authority and the private partner;
-
If a public-private partnership is likely to impact the ability to achieve investment grade credit ratings and successfully raise construction funding;
-
An analysis of the impact on procuring financing; and
-
If similar public-private partnership projects have been undertaken successfully.
(b) Quantitative criteria shall include:
- Net present value of the cost of the project over its entire useful life, including if applicable:
a. Financing, design, and construction costs;
b. Operation and management costs;
c. If the state authority is required to make payments to the private partner or receive payments from the private partner; and
d. Maintenance costs;
-
Operating cash flows expected to provide a return on investment to a private partner;
-
A detailed breakdown of all cash flow on all payments and expenditures, including interest cost associated with utilizing a public-private partnership; and
-
The anticipated value of the project deliverables at the end of the term of the agreement if any.
Section 3. Other Considerations. The state authority may ascribe relative weight to the criteria established in Section 2 of this administrative regulation, based on the size and nature of the project as well as the previous experience of the state authority, if any, in using public-private partnerships under similar circumstances.
History
- RELATES TO: KRS 45A.085, 154.1-750, 175B.005, 175B.010, 175B.020, 175B.030, 175B.035, 175B.037, 175B.040, 175B.095, 49 C.F.R. Part 26
- STATUTORY AUTHORITY: KRS 175B.015(12)(d), 175B.020(1)(c)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 175B.015(12)(d) authorizes the state authority to promulgate administrative regulations to fulfill any requirements of KRS Chapter 175B. KRS 175B.020(1)(c) authorizes the state authority to request the establishment of a public-private partnership as well as bi-state authorities and project authorities. This administrative regulation establishes the criteria by which the state authority shall determine if the public-private partnership procurement method is appropriate for a project.
- History: 43 Ky.R. 847, 1553; eff. 3-31-2017; Cert eff. 3-22-2024.
202 KAR 10:030 Tolling projects {#sec-202-kar-10-030 omnilex-key=us-ky-regs-official--title-202--202 KAR 10:030}
Section 1. Definitions.
(1) "Commercial motor vehicle" is defined by KRS 281A.010(8).
(2) "Development agreement" means a written agreement containing the information required by KRS 175B.035(8).
(3) "Interlocal agreement" means a written agreement as contemplated by KRS 65.245.
(4) "Out-of-service notice" means an affixed notice as contemplated by 601 KAR 1:005, Section 6.
(5) "Photo toll" means a charge associated with a particular vehicle that is identified by the vehicle's license plate if the vehicle's registered owner does not have a toll account.
(6) "Project" is defined by KRS 175B.010(11).
(7) "Project document" means the development agreement, public-private partnership agreement, or interlocal agreement for a project.
(8) "Protestant" means a person who protests the imposition of a toll, fine, or fee.
(9) "Protestant's vehicle" means the registered vehicle of a protestant used when the unpaid toll, fine, or fee was assessed or the toll account was debited.
(10) "Public-private partnership" is defined by KRS 175B.010(14).
(11) "Public private partnership agreement" means the agreement contemplated by KRS 175B.020(1)(c)(4).
(12) "State authority" is defined by KRS 175B.010(16).
(13) "Toll account" means a prepaid account that is linked to a transponder, license plate, or other means of identification of a vehicle in order to pay a toll by automatic debit.
(14) "Toll operator" means any entity designated by the state authority to implement and operate a toll system for a project.
(15) "Transponder" means a device used to identify and automatically debit a toll account for purposes of toll collection.
Section 2. Toll Rates and Fees.
(1) The state authority shall cause the identity of the toll operator, toll rates, escalation schedules, fees, and fines for each project on which tolls are implemented to be published yearly online at transportation.ky.gov/KPTIA/Pages/default.aspx and in at least two (2) statewide or regional newspapers. For projects between the commonwealth and another state, the state authority shall cause toll rates, escalation schedules, fee schedules, and fine schedules to be published in at least one (1) statewide or regional newspaper circular with distribution in that state.
(2) Toll rates, toll payment methods, escalation schedules, fine schedules, and fee schedules for a project shall be determined as established in the project document based on traffic and revenue studies, total project financial obligations, and community socioeconomic factors.
(a) Fees shall be assessed for account statements, late payment notices, collection efforts, inactivity, returned checks, or the purchase or lease of transponders as established in the project document.
(b) Fines shall be assessed for failure to pay tolls or fees as established in the project document.
(3) The state authority shall use all-electronic toll equipment or toll booths to charge and collect tolls.
(4) There shall be a rebuttable presumption that charged tolls, fees, and fines are correct and accurate.
Section 3. Administrative Hearings.
(1) If a protestant asserts that a toll, fine, or fee was assessed incorrectly or the protestant's account was debited incorrectly, the protestant shall file a written protest with the toll operator of the project that assessed the toll, fine, or fee within sixty (60) days of the toll operator mailing the disputed invoice or the debit being taken from the toll account.
(2) The written protest shall include:
(a) The grounds for the protest; and
(b) A copy of the disputed invoice or the account statement showing the disputed debit.
(3) The following shall be the exclusive grounds to protest a toll, fine, or fee:
(a) The license plate was misidentified;
(b) The protestant was incorrectly identified as the registered owner of the vehicle that was assessed the toll;
(c) The vehicle shown in the image associated with a toll assessed is not the vehicle to which the license plate shown in the image is assigned;
(d) The vehicle that used the tolled road or bridge had been sold, transferred, or stolen at the time of the use that resulted in the toll, fine, or fee; or
(e) The protestant's vehicle classification was incorrectly assigned.
(4) The toll operator may request additional information from the protestant.
(5) The toll operator shall notify the protestant by mail of the toll operator's determination on the protest and the protestant's right to a hearing pursuant to KRS Chapter 13B within thirty (30) days of receipt of the written protest.
(6) If the toll operator determines, pursuant to subsection (3)(a) through (e) of this section, that the protestant owes the toll, fee, or fine and the protestant agrees with the determination made by the toll operator, the protestant shall pay the toll, fine, or fee within ten (10) days of receipt of the determination from the toll operator.
(7) If the protestant does not agree with the determination made by the toll operator, the protestant shall request an administrative hearing pursuant to KRS Chapter 13B.
(a) A request for an administrative hearing shall be made to the state authority with a copy to the toll operator within thirty (30) days of the notice of determination from the toll operator.
(b) The state authority shall assign a hearing officer to conduct a hearing and provide a recommended order pursuant to KRS Chapter 13B. The hearing officer shall provide notice of the hearing to the protestant and any entity with a financial interest in the toll, fee, or fine in dispute.
(c) The toll operator shall submit the following to the state authority at least ten (10) days prior to the date of the administrative hearing:
-
The video or photographic images of the crossing in question, which shall include time, date, and location of the crossing; and
-
Evidence of the license plate look-up and registration records from the agency responsible for registration information in the state where the vehicle is registered.
(d) The hearing officer shall provide a recommended order to the chairman of the state authority. The chairman of the state authority shall make a final determination, pursuant to subsection (3)(a) through (e) of this section, regarding the validity and amount of the toll, fine, or fee assessed.
(e) During the time the administrative hearing process is pending, the unpaid toll, fine, or fee shall not be escalated and additional fees or fines associated with the disputed charge shall not be assessed.
(f) If the chairman of the state authority determines, pursuant to subsection (3)(a) through (e) of this section, that the protestant owes a toll, fee, or fine, the protestant shall pay the toll, fee, or fine within thirty (30) days of the date of the determination.
Section 4. Toll, Fine, and Fee Enforcement.
(1) A person shall be in violation of KRS 175B.040(4) if that person has not made a timely payment of a currently due and payable toll, fine, or fee as established in the project document. A toll operator for a project shall notify the Kentucky Transportation Cabinet Division of Motor Vehicle Licensing and the Kentucky Transportation Cabinet Division of Motor Carriers of people in violation of KRS 175B.040(4) and securely provide the following information to the Kentucky Transportation Cabinet Division of Motor Vehicle Licensing, the Kentucky Transportation Cabinet Division of Motor Carriers, and the Offices of the County Clerks:
(a) Identification of the vehicle used when the photo toll was assessed, evidence of the license plate look-up, and information showing to whom the vehicle was registered at the time the photo toll was assessed;
(b) Any photographic evidence showing the vehicle using the road or bridge when the toll, fine, or fee was assessed, along with the date, time, and location of the use;
(c) If an administrative hearing was requested, the determination of the chairman of the state authority;
(d) A copy of any invoice or violation notice related to the unpaid toll, fine, or fee, and any returned mail notice associated with those invoices and violations; and
(e) A record of any toll, fine, or fee currently due and payable, which shall be updated daily by the toll operator until payment in full is made.
(2) Upon receiving notice from the toll operator, the Kentucky Transportation Cabinet Division of Motor Vehicle Licensing shall place a hold on the protestant's vehicle registration.
(3) Upon receiving notice that a commercial motor vehicle is in violation of KRS 175B.040(4) and after verification that a notice of violation was sent to the owner of the commercial motor vehicle, an officer or inspector of the Division of Motor Vehicle Enforcement shall be authorized to affix to the commercial motor vehicle an out-of-service notice indicating the nature of the violation and requiring its correction before the commercial motor vehicle is further operated. A person shall not operate a commercial motor vehicle in violation of the out-of-service notice affixed to it.
History
- RELATES TO: KRS 65.245, 175B.010(11), (14), (16), 175B.015(12), 175B.035(8), 175B.040, 281A.010(8)
- STATUTORY AUTHORITY: KRS 175B.015(12), 175B.040(4)(b)
- NECESSITY, FUNCTION, AND CONFORMITY: KRS 175B.015(12)(c) authorizes the state authority to promulgate administrative regulations to collect and enforce tolls. KRS 175B.015(12)(a) authorizes the authority to establish the process for collection and enforcement procedures for fines, charges, assessments, and other enforcement mechanisms for the violation of KRS 175B.040(4), and for any violation of this administrative regulation. KRS 175B.015(12)(b) authorizes the state authority to establish an appeals process by which a person contesting a violation of this administrative regulation may obtain an administrative hearing to be conducted in accordance with KRS Chapter 13B. For the purpose of efficiently administrating the toll systems, this administrative regulation establishes the process by which the state authority shall collect and enforce tolls, establish enforcement mechanisms, and an appeals process.
- History: 43 Ky.R. 1120, 1553; eff. 3-31-2017; Cert eff. 3-22-2024.
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