R426.  Health, Family Health and Preparedness, Emergency Medical Services.
R426-5.  Emergency Medical Services Training, Endorsement, Certification, and Licensing Standards.
R426-5-100.  Authority and Purpose.
	(1)  This rule is established under to provide uniform minimum standards to be met by those providing emergency medical services in the State of Utah; and for the training, certification, and licensing of individuals who provide emergency medical service and for those providing instructions and training to pre-hospital emergency medical care providers.

R426-5-200.  Scope of Practice.
	(1)  The Department may license an individual as an EMR, EMT, AEMT, EMT-IA Paramedic, or EMD who meets the requirements in this rule.
	(2)  The Committee adopts as the standard for EMR, EMT, AEMT, EMT-IA, or Paramedic training and competency in the state, the United States Department of Transportation's National Emergency Medical Services Education Standards.
	(3)  An EMR, EMT, AEMT, or Paramedic may perform the skills as described in the EMS National Education Standards, to their level of licensure, as adopted in this section.

R426-5-300.  EMS Individual Licensure for EMR, EMT, AEMT, EMT-IA, and Paramedic.
	(1)  The Department may license an EMR, EMT, EMT-IA, AEMT, or Paramedic for a two-year period.
	(2)  An individual who wishes to become licensed as a EMR, EMT, AEMT, EMT-IA, or Paramedic shall:
	(a)  successfully complete a Department-approved EMR, EMT, AEMT, EMT-IA, or Paramedic course as described in this rule;
	(b)  be able to perform the functions listed in the National EMS Education Standards adopted in this rule as verified by personal attestation and successful accomplishment by certified EMS Instructors during the course;
	(c)  achieve a favorable recommendation from the course coordinator and course medical director stating technical competence during field and clinical training and successful completion of all training requirements for an EMR, EMT, AEMT, EMT-IA, or Paramedic certification;
	(d)  submit the applicable fees and a completed application, including social security number, to the Department;
	(e)  submit to and pass a background investigation, including an FBI background investigation;
	(f)  retain documentation of having completed a Department approved CPR course within the prior two years that is consistent with the most current American Heart Association Guidelines for the level of Healthcare Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) Basic Life Support (BLS); and
	(g)  retain TB test results.
	(3)  Age requirements:
	(a)  EMR may certify at 16 years of age or older; and
	(b)  EMT, AEMT, EMT-IA and Paramedic may certify at 18 years of age or older.
	(4)  Within two years after the official course end date the applicant shall successfully complete the Department's approved National Registry of Emergency Medical Technician's written and practical EMR, EMT, AEMT, EMT-IA, or Paramedic examinations, or reexaminations, if necessary.
	(5)  Licensed personnel shall retain and submit upon request by the Department any documentation required for licensure.
	(6)  An individual who wishes to enroll in an AEMT, EMT-IA, or Paramedic course shall have as a minimum a Utah EMT license.  This license or other equivalent state license or certification approved by the Department shall remain current until new license level is obtained.
	(7)  The Department may extend time limits for an individual who has unusual circumstances or hardships.

R426-5-310.  Emergency Medical Dispatcher (EMD) Individual Licensure.
	(1)  The Department may license an EMD for a two-year period.
	(2)  An individual who wishes to become licensed as an EMD shall:
	(a)  successfully complete and become certified in a Department approved EMD protocol system by the system vendor no later than July 1, 2020;
	(b)  submit to and pass a criminal background investigation and screening clearance;
	(c)  retain documentation of having completed a Department approved CPR course within the prior two years.  CPR training shall be kept current during licensure.
	(3)  An EMD may be licensed at 18 years of age or older.

R426-5-400.  Licensure at a Lower Level.
	(1)  An individual who has taken a Paramedic course, but has not been recommended for licensure, may request to become licensed at the AEMT levels if:
	(a)  the paramedic course coordinator submits to the Department a favorable letter of recommendation stating that the individual has successfully obtained the knowledge and skills of the AEMT level as required by this rule; and
	(b)  the individual successfully completes all other application and testing requirements for an AEMT.

R426-5-500.  License Challenges.
	(1)  The Department may license an individual as an EMT or AEMT, in consecutive order; individuals with military medical training, a registered nurse licensed in Utah, a nurse practitioner licensed in Utah, a physician assistant licensed in Utah, or a physician licensed in Utah who:
	(a)  is able to demonstrate knowledge, proficiency and competency to perform all the functions listed in the National EMS Education Standards as verified by personal attestation and successful demonstration to a currently certified course coordinator and an off-line medical director;
	(b)  has a knowledge of:
	(i)  medical control protocols;
	(ii)  state and local protocols; and
	(iii)  the role and responsibilities of an EMT or AEMT respectively;
	(c)  maintain and submit documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for adult and Pediatric Healthcare Professional CPR and ECC BLS; and
	(d)  is 18 years of age or older.
	(2)  To become licensed, the applicant shall:
	(a)  submit the applicable fees and a completed application, including social security number, signature, and, proof of current Utah license as a Registered Nurse, a Physician Assistant, or a Medical Doctor, or military transcripts for training;
	(b)  successfully complete the Department approved written and practical EMT or AEMT examinations, or reexaminations, if necessary; and
	(c)  submit to and pass a background screening clearance as per R426-5-3200.

R426-5-600.  License Renewal Requirements for EMR, EMT, AEMT, EMT-IA, and Paramedic.
	(1)  The Department may renew an individual license for a two-year period or for a shorter period as modified by the Department to standardize renewal cycles.
	(2)  An individual seeking recertification shall:
	(a)  submit the applicable fees and a completed application, including social security number to the Department;
	(b)  submit to and pass a background screening clearance as per R426-5-3200;
	(c)  retain documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for the level of Adult and Pediatric Healthcare Professional CPR and ECC BLS.  CPR shall be kept current during licensure; and
	(d)  provide documentation of completion of Department-approved CME requirements.
	(3)  The EMR, EMT, AEMT, EMT-IA and Paramedic shall complete the required CME hours, as outlined in the Department's Renewal Protocol for EMS Personnel Manual.  The hours shall be completed throughout the prior two years.
	(4)  The EMR, EMT, AEMT, EMT-IA, or Paramedic shall complete and provide documentation upon request of demonstrating the psychomotor skills listed in the current National EMS Education Standards at their level of licensure.
	(5)  An EMR, EMT, AEMT, EMT-IA, or Paramedic who is affiliated with a licensed or designated EMS provider shall have the licensed or designated EMS provider's training officer submit a letter verifying the completion of the renewal requirements.  An EMR, EMT, AEMT, EMT-IA, or Paramedic who is not affiliated with a licensed or designated EMS provider shall provide upon the request of the Department verification of all renewal requirements directly to the Department.
	(6)  An AEMT, EMT-IA or Paramedic shall obtain verification from a certified off-line medical director recommending the individual for renewal verifying the individual has demonstrated proficiency in the psychomotor skills listed in the current National EMS Education Standards at their license level.
	(7)  Individuals are responsible to complete and submit all required renewal material to the Department at one time, no later than 30 days and no earlier than six months prior to the individual's current license expiration date.  Renewal material submitted less than 30 days may result in a license expiration.  The Department processes renewal material in the order received.
	(8)  A Department approved entity who provides CME may compile and submit renewal materials on behalf of an EMR, EMT, AEMT, EMT-IA, or Paramedic; however, the individual EMR, EMT, AEMT, EMT-IA, or Paramedic is responsible for a timely and complete submission.
	(9)  The Department may not lengthen an individual's license period to more than the two-years, unless the individual is a member of the National Guard or reserve component of the armed forces and is on active duty when the license expired.

R426-5-700.  License Renewal Requirements for EMD.
	(1)  The Department may renew an individual license for a two-year period or for a shorter period as modified by the Department to standardize renewal cycles.
	(2)  An individual seeking renewal shall:
	(a)  submit the applicable fees and a completed application, including social security number to the Department;
	(b)  submit to and pass a background screening clearance as per R426-5-3100;
	(c)  retain documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for the level of Adult and Pediatric Healthcare Professional CPR and ECC BLS.  CPR shall be kept current during licensure;
	(d)  a minimum of a two-hour course in critical incident stress management (CISM);
	(e)  successfully complete certification in a Department approved EMD protocol system; and
	(3)  An EMD applying for renewal shall have the communications center supervisor or Department endorsed training officer of the designated medical dispatch center submit a letter verifying the completion of renewal requirements.
	(4)  Individuals are responsible to complete and submit all required renewal material to the Department at one time, no later than 30 days and no earlier than one year prior to the individual's current license expiration date.  Renewal material submitted less than 30 days may result in license expiration.  The Department processes renewal material in the order received.
	(5)  The Department may shorten an individual's license period.
	(6)  The Department may not lengthen an individual's license period to more than two years unless the individual is a member of the National Guard or reserve component of the armed forces and was on active duty when their license expired.

R426-5-800.  Reciprocity for EMR, EMT, AEMT, and Paramedic.
	(1)  The Department may license an individual as an EMR, EMT, AEMT, or Paramedic who is licensed or certified by another state or certifying body if the applicant can demonstrate the applicant's out-of-state training and experience requirements are equivalent to or greater than what is required in Utah.
	(2)  An individual seeking reciprocity for licensure in Utah based on out-of-state training and experience shall:
	(a)  Submit the applicable fees and a completed application, including social security number to the Department and complete all of the following within two years of submitting the application;
	(b)  submit to and pass a background screening clearance as per R426-5-3200;
	(c)  retain documentation of having completed a CPR course within the prior two years that is consistent with the most current version of the American Heart Association Guidelines for the level of Healthcare Professional CPR and ECC and BLS.  A Paramedic candidate shall also retain documentation of successful completion of ACLS or equivalent.  All AMET, EMT-IA, and Paramedic licensed personnel shall retain documentation of PEPP, PALS, or equivalent courses within the prior two years;
	(d)  successfully complete the National Registry of Emergency Medical Technician's written and practical EMR, EMT, AEMT, or Paramedic examinations, or reexaminations, if necessary; and
	(e)  submit a current certification or license from one of the states of the United States or its possessions, or current registration and the name of the training institution if registered with the National Registry of EMTs.

R426-5-900.  Lapsed Licenses.
	(1)  An individual whose EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD license has expired for less than one year may, within one year after expiration, complete all renewal requirements, pay a late licensure fee.  Individuals applying for EMR, EMT, AEMT, or Paramedic licensure also may be required to successfully pass the Department's approved written examination to become licensed.  The individual's new expiration date will be two years from the previous expiration date.
	(2)  An individual whose license for EMR, EMT, AEMT, EMT-IA, or Paramedic has expired for more than one year shall:
	(a)  submit a letter of recommendation including results of an oral examination, from a certified off-line medical director, verifying proficiency in patient care skills at the licensure level;
	(b)  successfully complete the applicable Department's approved written examination;
	(c)  complete all renewal requirements; and
	(d)  the individual's new expiration date will be two years from the completion of all renewal materials.
	(3)  An individual whose certification has lapsed, is not authorized to provide care as an EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD until the individual completes the renewal process.

R426-5-1000.  Emergency Medical Care During Clinical Training.
	A student enrolled in a Department-approved training program may, under the direct supervision of the course coordinator, an instructor in the course, or a preceptor for the course, perform activities delineated within the training curriculum that otherwise requires licensure to perform.

R426-5-1100.  Instructor Requirements.
	(1)  The Department may endorse an individual as an EMS Instructor an individual who:
	(a)  meets the initial licensure requirements in R426-5-1200; and
	(b)  is currently in Utah as an EMR, EMT, AEMT,EMT-IA, or Paramedic.
	(2)  The Department adopts the United States Department of Transportation's "EMS Instructor Training Program as the standard for EMS Instructor training and competency in the state, which is adopted and incorporated by reference.
	(3)  An EMS instructor may only teach up to the license level to which the instructor is licensed.
	(4)  An EMS instructor shall comply with the teaching standards and procedures in the EMS Instructor Manual.
	(5)  An EMS instructor shall maintain the EMS license for the level the instructor is endorsed to teach.  If an individual's EMS license lapses, the instructor endorsement is invalid until EMS license is renewed.
	(6)  The Department may waive a particular instructor endorsement requirement if the applicant can demonstrate the applicant's training and experience requirements are equivalent or greater to what are required in Utah.

R426-5-1200.  Instructor Endorsement.
	(1)  The Department may endorse a license an individual who is an EMR, EMT, AEMT, EMT-IA, or Paramedic as an EMS Instructor for a two-year period.
	(2)  An individual who wishes to become endorsed as an EMS Instructor shall:
	(a)  submit an application and pay all applicable fees;
	(b)  submit three letters of recommendation regarding EMS skills and teaching abilities;
	(c)  submit documentation of 15 hours of teaching experience;
	(d)  successfully complete all required examinations; and
	(e)  successfully complete the Department-sponsored initial EMS instructor training course, or equivalent.
	(3)  An individual who wishes to become endorsed as an EMS Instructor to teach EMR, EMT, AEMT, or Paramedic courses shall provide documentation of 30 hours of patient care within the prior year.
	(4)  The Department may waive portions of the initial EMS instructor training courses for previously completed Department-approved instructor programs.
	(5)  An individual shall submit every two years a completed and signed "instructor contract" to the Department agreeing to abide by the standards and procedures in the current Instructor Manual.

R426-5-1300.  Instructor Endorsement Renewal.
	(1)  An EMS instructor who wishes to renew an endorsement as an instructor shall:
	(a)  maintain current EMS licensure;
	(b)  attend the required Department-approved instructor seminar at least once in the two year endorsement renewal cycle; and
	(c)  submit an application and pay all applicable fees.

R426-5-1400.  Instructor Lapsed Endorsement.
	(1)  An EMS instructor whose instructor endorsement has expired for less than two years may again become endorsed by completing the endorsement requirements.
	(2)  An EMS instructor whose instructor endorsement has expired for more than two years shall complete all initial instructor endorsement requirements and reapply as if there were no prior endorsement, however the Department may waive portions of the initial EMS instructor training courses if the individual is able to demonstrate competency to the Department.

R426-5-1500.  Training Officer Endorsement.
	(1)  The Department may endorse a licensed of an individual who is an endorsed EMS instructor as a training officer for a two-year period.
	(2)  An individual who wishes to become endorsed as an EMS Training officer shall:
	(a)  Be currently endorsed as an EMS instructor;
	(b)  successfully complete the Department's course for new training officers;
	(c)  submit an application and pay all applicable fees; and
	(d)  submit biennially a completed and signed "Training Officer Contract" to the Department agreeing to abide by the standards and procedures in the then current Training Officer Manual.
	(3)  A training officer shall maintain EMS instructor endorsement to retain training officer endorsement.
	(4)  An EMS training officer shall abide by the terms of the Training Officer Contract, and comply with the standards and procedures in the Training Officer Manual as incorporated into the respective Training Officer Contract.

R426-5-1600.  Training Officer Endorsement Renewal.
	(1)  A training officer who wishes to renew an endorsement as a training officer shall:
	(a)  Attend a training officer seminar at least once in the two year endorsement renewal cycle;
	(b)  maintain current EMS instructor and EMS license;
	(c)  submit an application and pay all applicable fees;
	(d)  successfully complete any Department-examination requirements; and
	(e)  submit a completed and signed new "Training Officer Contract" to the Department agreeing to abide by the standards and procedures in the current training officer manual.

R426-5-1700.  Training Officer Lapsed Endorsement.
	(1)  An individual whose training officer endorsement has expired for less than two years may again become endorsed by completing the endorsement renewal requirements.  The individual's new expiration date will be two years from the old expiration date.
	(2)  An individual whose training officer endorsement has expired for more than two year shall complete all initial training officer endorsement requirements and reapply as if there were no prior endorsement.

R426-5-1800.  Course Coordinator Endorsement.
	(1)  The Department may endorse an individual as an EMS course coordinator for a two-year period.
	(2)  An individual who wishes to become endorsed as a course coordinator shall:
	(a)  Be endorsed as an EMS instructor;
	(b)  be a co-coordinator of record for one Department-approved course with a endorsed course coordinator;
	(c)  submit a written evaluation and recommendation from the course coordinator in the co-coordinated course;
	(d)  complete endorsement requirements within one year of completion of the Department's course for new course coordinators;
	(e)  submit an application and pay all applicable fees;
	(f)  complete the Department's course for new course coordinators;
	(g)  sign and submit the "Course Coordinator Contract" to the Department agreeing to abide to the standards and procedures in the then current Course Coordinator Manual; and
	(h)  maintain EMS instructor endorsement.
	(3)  A Course Coordinator may only coordinate courses up to the licensure level to which the course coordinator is licensed.
	(4)  A course coordinator shall abide by the terms of the "Course Coordinator Contract" and comply with the standards and procedures in the Course Coordinator Manual as incorporated into the "Course Coordinator Contract."
	(5)  A Course Coordinator shall maintain an EMS Instructor endorsement and the EMS license for the level that the course coordinator is endorsed to coordinate.  If an individual's EMS license lapses, the Course Coordinator endorsement is invalid until EMS license is renewed.

R426-5-1900.  Course Coordinator Endorsement Renewal.
	(1)  A course coordinator who wishes to renew an endorsement as a course coordinator shall:
	(a)  Maintain current EMS instructor and EMR, EMT, AEMT, EMT-IA, or Paramedic license;
	(b)  coordinate or co-coordinate at least one Department-approved course every two years;
	(c)  attend a course coordinator seminar at least once in the two year endorsement renewal cycle;
	(d)  submit an application and pay all applicable fees; and
	(e)  sign and submit a Course Coordinator Contract to the Department agreeing to abide by the policies and procedures in the then current Course Coordinator Manual.

R426-5-2000.  Course Coordinator Lapsed Endorsement.
	(1)  An individual whose course coordinator endorsement has expired for less than two year may again become endorsed by completing the renewal requirements.  The individual's new expiration date will be two years from the renewal date.
	(2)  An individual whose course coordinator endorsement has expired for more than two year shall complete all initial course coordinator endorsement requirements and reapply as if there were no prior endorsement.  The Department may waive portions of the initial course coordinator requirements such as the co-coordinator requirements if the candidate has coordinated or co-coordinated a course within the past three years.

R426-5-2100.  Critical Care Paramedic Endorsement.
	(1)  The Department may endorse an individual as a critical care paramedic for up to a four-year period.
	(2)  An individual who wishes to become endorsed as a critical care paramedic shall:
	(a)  Be a licensed paramedic in the State of Utah;
	(b)  be certified by the International Board of Specialty Certification as a:
	(i)  Certified Critical Care Paramedic (CCP-C) or
	(ii)  Certified Flight Paramedic (FP-C)
	(c)  submit an application for critical care paramedic certification and pay all applicable fees;
	(d)  submit proof of certification from the International Board of Specialty Certification; and
	(e)  maintain paramedic license
	(3)  Education cannot be used in lieu of a valid and current IBSC Critical Care or Flight Paramedic Certification to maintain the critical care endorsement.

R426-5-2200.  Critical Care Paramedic Endorsement Renewal.
	(1)  A Critical Care Paramedic who wishes to renew shall:
	(a)  Maintain a paramedic license;
	(b)  submit an application for critical care paramedic;
	(c)  pay all applicable fees; and
	(d)  submit proof of certification from the International Board of Specialty Certification.

R426-5-2300.  Course Approvals.
	(1)  A course coordinator offering EMS training to individuals who wish to become licensed as an EMR, EMT, AEMT, EMT-IA, or Paramedic shall obtain Department approval prior to initiating an EMS training course.  The Department shall approve a course if:
	(a)  The applicant submits the course application and fees no earlier than 90 days and no later than 30 days prior to commencing the course;
	(b)  the applicant has sufficient equipment available for the training or if the equipment is available for rental from the Department;
	(c)  the Department finds the course meets all the Department rules and contracts governing training;
	(d)  the course coordinators and instructors hold current respective course coordinator and EMS instructor endorsements; and
	(e)  the Department has the capacity to offer the applicable examinations in a timely manner after the conclusion of the course.

R426-5-2400.  Paramedic Training Institutions Standards Compliance.
	(1)  A person shall be authorized by the Department to provide training leading to the licensure of a Paramedic.
	(2)  To become authorized and maintain authorization to provide Paramedic training, a person shall:
	(a)  Enter into the Department's standard Paramedic training contract; and
	(b)  adhere to the terms of the contract, including the requirement to provide training in compliance with the Course Coordinator Manual and the Utah Paramedic Training Program Accreditation Standards Manual.

R426-5-2500.  Off-line Medical Director Requirements.
	(1)  The Department may certify an off-line medical director for a four-year period.
	(2)  An off-line medical director shall be:
	(a)  a physician actively engaged in the provision of emergency medical care or meets this requirement at the discretion of the State EMS Medical Director;
	(b)  familiar with the Utah EMS Systems Act, Title 26, Chapter 8a, and applicable state rules; and
	(c)  familiar with medical equipment and medications required.

R426-5-2600.  Off-line Medical Director Certification.
	(1)  An individual who wishes to certify as an off-line medical director shall:
	(a)  have completed an American College of Emergency Physicians or National Association of Emergency Medical Services Physicians medical director training course or the Department's medical director training course within twelve months of becoming a medical director;
	(b)  submit an application and;
	(c)  pay all applicable fees.
	(2)  An individual who wishes to recertify as an off-line medical director shall:
	(a)  attend the medical directors annual workshop at least once every four years;
	(b)  submit an application; and
	(c)  pay all applicable fees.

R426-5-2700.  Epinephrine Auto-Injector Use.
	(1)  Any qualified entities or qualified adults as defined in 26-41-102 in accordance with 26-41-107 shall receive training approved by the Department.  The training shall include:
	(a)  recognition of life threatening symptoms of anaphylaxis;
	(b)  appropriate administration of an epinephrine auto-injector;
	(c)  proper storage of an epinephrine auto-injector;
	(d)  disposal of an epinephrine auto-injector; and
	(e)  an initial and annual refresher course.
	(2)  The annual refresher course requirement may be waived if:
	(a)  the qualified entities or qualified adults are currently licensed at the EMR or higher level by the State of Utah, or
	(b)  the approved trainings are the Red Cross and American Heart Association epinephrine auto-injector modules.
	(3)  Training in the school setting shall be based on approved Department trainings found on http://www.choosehealth.utah.gov/prek-12/school-nurses.php and provided in accordance with 26-41-104.
	(4)  All epinephrine auto injectors shall be stored and disposed of following the manufacturer's specifications.

R426-5-2800.  Law Enforcement Blood Draws Authorized Individual Qualifications.
	(1)  Individuals who are not authorized to draw blood pursuant to Utah Code Title 41-6a-523(1)(b), or individuals who are not licensed by the Department such as AEMTs, EMT-IAs, or Paramedics shall meet one of the following requirements as a prerequisite for authorization to withdraw blood for the purpose of determining its alcohol or drug content when requested to do so by a peace officer:
	(a)  training in blood withdrawal procedures obtained as a defined part of a successfully completed college or university course taken for credit, or
	(b)  training in blood withdrawal procedures obtained as a defined part of a successfully completed training course which prepares individuals to function in routine clinical or emergency medical situations, or
	(c)  training of no less than three weeks duration in blood withdrawal procedures under the guidance of a licensed physician.

R426-5-2900.  Permits for Blood Draws.
	(1)  The Department may issue permits to withdraw blood for the purpose of determining the alcohol or drug content therein, when requested by a peace officer, to qualified applicants, as determined by the Department.  Individuals described in R426-5-2800 are exempt from permit requirements.
	(2)  Application to obtain a permit shall be made to the BEMSP on forms provided by the Department.
	(3)  When the permit holder is requested to withdraw blood for the above stated purpose at a location other than the facility indicated above, they shall possess a valid permit card.
	(4)  Permits shall be valid for a three year period.  The date the permit expires shall appear on the permit.
	(5)  Application to renew permits shall be made to the Department within three months prior to the expiration date to ensure that it will not lapse.  Such application shall be made on forms provided by the Department.  The permit holder shall either verify that he has been engaged in performing blood withdrawal procedures during the current permit period or submit verification signed by a physician attesting to their competence to perform blood withdrawal procedures.
	(6)  Permit holders shall notify the Department within 15 days of a change in name or mailing address.

R426-5-3000.  Cause for Blood Draw Permit Termination or Revocation.
	(1)  Permits shall be subject to termination or revocation under any one of the following:
	(a)  the permit holder has made any misrepresentation of a material fact in his application, or any other communication to the Department or its representatives, which misrepresentation was material to the eligibility of the permit holder;
	(b)  the permit holder is not qualified to hold a permit;
	(c)  the permit holder after having received a permit has been convicted of a felony or of a misdemeanor which misdemeanor involves moral turpitude; or
	(d)  the permit holder does not comply with the possession requirements.

R426-5-3100.  Published List of Individuals Permitted to Draw Blood.
	(1)  The Department will make available to the public a list of individuals permitted to withdraw blood for determination of its alcohol or drug content.
	(2)  The Department may publish amended lists when deemed necessary.

R426-5-3200.  Background Screening Clearance for EMS Licensure.
	(1)  The Department shall conduct a background screening on each individual who seeks licensure or renewal as an EMR, EMT, AEMT, EMT-IA, Paramedic, or EMD.  The Department shall approve EMS licensure upon successful completion of a background screening.  Background clearance indicates the individual does not pose an unacceptable risk to public health and safety.
	(2)  The individual seeking licensure or renewal shall submit the completed applications, including fees, prior to submission of finger prints.
	(3)  The Department may review relevant information obtained from the following sources:
	(a)  Department of Public Safety arrest, conviction, and disposition records described in Title 53, Chapter 10, Criminal Investigations and Technical Services Act, including information in state, regional, and national records files;
	(b)  juvenile court arrest, adjudication, and disposition records, as allowed under Section 78A-6- 209;
	(c)  federal criminal background databases available to the state;
	(d)  the Department of Human Services' Division of Child and Family Services Licensing Information System described in Section 62A-4a-1006;
	(e)  child abuse or neglect findings described in Section 78A-6-323;
	(f)  the Department of Human Services' Division of Aging and Adult Services vulnerable adult abuse, neglect, or exploitation database described in Section 62A-3-311.1; and
	(g)  licensing and certification records of individuals licensed or certified by the Division of Occupational and Professional Licensing under Title 58, Occupations and Professions.
	(4)  If the Department determines an individual is not eligible for licensure based upon the criminal background screening and the individual disagrees with the information provided by the Criminal Investigations and Technical Services Division or court record, the individual may challenge the information as provided in Utah Code Annotated Sections 77-18a.
	(5)  If the Department determines an individual is not eligible for licensure based upon the non-criminal background screening and the individual disagrees with the information provided, the individual may challenge the information through the appropriate agency.

	(6)  Exclusion from licensure.
	(a)  Criminal Convictions or Pending Charges:
	(i)  If an individual has been convicted, has pleaded no contest, is subject to a plea in abeyance, or a diversion agreement, for the following offenses within the past 15 years, they shall not be approved for licensure:
	(A)  any felony or class A under Title 76, Chapter 5 Offenses Against the Person, Utah Criminal Code;
	(B)  any felony or class A under Title 76, Chapter 9, Offenses Against Public Order and Decency, Utah Criminal Code excluding sections 103 and 108;
	(C)  any felony or class A or B under the following Utah Criminal Codes:
	(I)  76-9-301.8, Bestiality;
	(II)  76-9-702.1, Sexual Battery; and
	(III)  76-9-702.5, Lewdness Involving Child.
	(ii)  If an individual has been convicted or has pleaded no contest for the following offenses, 15 years have passed since the last conviction and the offense cannot be expunged they shall be considered for licensure:
	(A)  any felony or class A under Title 76, Chapter 5 Offenses Against the Person, Utah Criminal Code;
	(B)  any felony or class A under Title 76, Chapter 9, Offenses Against Public Order and Decency, Utah Criminal Code excluding sections 103 and 108;
	(C)  any felony or class A or B under the following Utah Criminal Codes:
	(I)  76-9-301.8, Bestiality;
	(II)  76-9-702.1, Sexual Battery; and
	(III)  76-9-702.5, Lewdness Involving Child.
	(iii)  If an individual has been convicted, has pleaded no contest, is subject to a plea in abeyance, or a diversion agreement, for the following offenses, they shall be considered for licensure:
	(A)  any felony or class A under Utah Criminal Code not listed in R426-5-3200(6)(a)(i).
	(B)  any class B or C under Title 76, Chapter 5 Offenses Against the Person, Utah Criminal Code;
	(C)  any felony, class A under Title 76, Chapter 6, Offenses Against Property, Utah Criminal Code;
	(D)  any felony or class A under Title 76, Chapter 6a, Pyramid Schemes, Utah Criminal Code;
	(E)  any felony or class A under Title 76, Chapter 8, Offenses Against the Administration of Government, Utah Criminal Code;
	(F)  any felony, class A under Title 76, Chapter 10, Offenses Against Public Health, Welfare, Safety and Morals, Utah Criminal Code;
	(G)  any felony, class A, B or C under the following Utah Criminal Codes:
	(I)  76-10-1201 to 1229.5, Pornographic and Harmful Materials and Performances; and
	(II)  76-10-1301 to 1314, Prostitution;
	(III)  any felony or class A under Utah Criminal Code 76-10-2301, Contributing to the Delinquency of a Minor;
	(H)  any felony or class A or B under Utah Motor Vehicles Traffic Code 41-6a-502, 502.5, and 517.
	(I)  any felony or class A or B under Utah Occupations and Professions Utah Controlled Substances Act 58-37.
	(J)  any felony or class A or B under Alcoholic Beverage Control Act 32B-4-409.
	(K)  any criminal conviction or pattern of convictions that may represent an unacceptable risk to public health and safety.
	(iv)  An individual seeking licensure who has been convicted or has pleaded no contest, is subject to a plea in abeyance, a diversion agreement, a warrant for arrest, arrested or charged for any of the identified offenses in R426-5-3200(6)(a)(iii), shall be considered for licensure.
	(v)  A licensed EMS individual who is subject to a warrant of arrest, arrested or charged for any of the identified offenses in R426-5-3200(6)(a)(iii), and after an investigation and Peer Review Board process as established in R426-5-3400, the Department may issue license, or suspend or revoke a license, or place a license on probation.
	(vi)  A licensed EMS individual who is subject to a warrant of arrest, arrested or charged for any of the identified offenses in R426-5-3200(6)(a)(i), shall immediately have the individuals EMS license placed on restriction pending the outcome of a Department investigation as per the process established in R426-5-3300.
	(b)  Juvenile Records.
	(i)  As required by Utah Code Subsection 26-8a-310(5)(b), juvenile court records shall be reviewed if an individual is:
	(A)  under the age of 28; or
	(B)  over the age of 28 and has convictions or pending charges identified in R426-5-3200(6)(a).
	(ii)  Adjudications by a juvenile court may exclude the individual from licensure if the adjudications refer to an act that, if committed by an adult, would be a felony or a misdemeanor any of the identified offenses in R426-5-3200(6)(a).
	(c)  Non-Criminal Records.
	(i)  The Department may deny licensure based on a supported finding from:
	(A)  the Department of Human Services' Division of Child and Family Services Licensing Information System described in Section 62A-4a-1006;
	(B)  child abuse or neglect findings described in Section 78A-6-323;
	(C)  the Department of Human Services' Division of Aging and Adult Services vulnerable adult abuse, neglect, or exploitation database described in Section 62A-3-311.1;
	(ii)  The Department may deny licensure based on a finding from licensing records of individuals licensed by the Division of Occupational and Professional Licensing under Title 58, Occupations and Professions.
	(d)  Review of Relevant Information.
	(i)  Results of background screening review, as listed above in R426-5-3200(6)(a)(ii)-(iii), (b) or (c) may be reviewed to determine under what circumstance, if any, the individual may be granted licensure.  The following factors may be considered:
	(A)  types and number;
	(B)  passage of time;
	(C)  surrounding circumstances;
	(D)  intervening circumstances; and
	(E)  steps taken to correct or improve.
	(ii)  The Department shall rely on relevant information identified in R426-5-3200(2) as conclusive evidence and may deny licensure based on that information.
	(e)  Appeal of Department licensure decision.
	(i)  A licensed EMS individual may appeal a Department licensure decision as listed in R426-5-3200(6)(d)(i)to the Department as per the process established in R426-5-3400.
	(7)  A licensed EMS individual who has been arrested, charged, or convicted shall notify the Department and all employers or affiliated entities who utilize the EMS individual's license within 7 business days.  The licensed EMS individual shall also notify the Department of all entities they work for or are affiliated with.
	(8)  All licensed or designated EMS providers who are notified or become aware of a licensed EMS individual arrest, charge or conviction shall notify the Department within 7 business days.

R426-5-3300.  Review and Investigation of Complaints and Referrals.
	(1)  The Department shall review all complaints filed against an EMS provider and a licensed EMS individual.
	(2)  Designated or licensed provider complaints will be investigated by the Department.
	(a)  The Department may conduct interviews with the provider.
	(b)  The Department will allow the provider an opportunity to respond to the allegations and to provide supporting witnesses and documentation.
	(c)  Based on the investigation, the Department will make a recommendation to the Department's Bureau Director.
	(d)  If the Department's recommendation is that the provider is to be placed on probation or suspension, the Department's recommendation should include terms and conditions.
	(e)  The Department may take action against a designated or licensed provider's license or designation based on the investigative findings.
	(f)  The Department shall notify the provider in writing of the Department's decision within 30 days of completion of the investigation.
	(3)  Licensed EMS individual complaints will be investigated either by the Department or by the Primary Affiliated Provider (PAP).
	(a)  The Department shall investigate and may take action if the Department determines any of the following applies to a licensed EMS individual;
	(i)  the licensed EMS individual demonstrates a threat to him or herself or to a coworker,
	(ii)  the licensed EMS individual demonstrates a threat to the public health,
	(iii)  the licensed EMS individual demonstrates a threat to the safety or welfare of the public,
	(iv)  the licensed EMS individual potentially violated R426-5-3200(4), or
	(v)  the Department determines the risk cannot be reasonably mitigated.
	(vi)  The Department may place the licensed EMS individual on a restricted license while an investigation is pending until terms are reached for a provisional license using the process outlined in R426-5-3300(5)(e).
	(vii)  The Department may conduct interviews with all parties necessary.  The Department will gather information and evidence, which may include requiring the licensed EMS individual to submit to a drug or alcohol screening or any other appropriate evaluation.
	(viii)  The licensed EMS individual shall have an opportunity to respond to the allegations and to provide supporting witnesses and documentation.
	(ix)  Once the Department has completed its investigation it shall submit the report with all findings and recommendations to the Peer Review Board per R426-5-3400(4) for review.
	(b)  The PAP shall investigate a complaint against the licensed EMS individual who the Department refers to the PAP.
	(i)  The PAP investigation shall:
	(A)  be investigated by the licensed or designated EMS provider's EMS endorsed training officer or designee;
	(B)  be completed and findings submitted to the Department within 30 calendar days from receipt of complaint from the Department;
	(ii)  If the Department determines that the PAP actions are insufficient, the Department may initiate an investigation of the licensed EMS individual which follows the Department and the Peer Review Board process.
	(4)  The Department shall investigate an EMS individual's license or a provider's license or designation for any of the following:
	(a)  refusal to submit to a drug test requested by the EMS provider or the Department;
	(b)  failure to report by an individual or any affiliated provider pursuant to R426-5-3200(7)and(8);
	(c)  non-prescribed use of or addiction to narcotics or drugs;
	(d)  use of alcoholic beverages or being under the influence of alcoholic beverages at any level while on call or on duty as an EMS personnel or while driving any EMS vehicle;
	(e)  being under the influence of a prescribed or non-prescribed medication or drug(legal or illegal) while on call or on duty as a licensed EMS individual who affects the person's ability to operate or function safely.
	(f)  failure to comply with the training, licensing, or relicensing requirements for the license;
	(g)  failure to comply with a contractual agreement as an EMS instructor, a training officer, or a course coordinator.  Action taken by the Department on this item shall only be against the individual's ability to perform this particular function and would not affect their base EMS license;
	(h)  fraud or deceit in applying for or obtaining a license;
	(i)  fraud, deceit, lack of professional competency, patient abuse, or theft in the performance of the duties as a licensed EMS individual;
	(j)  false or misleading information or failure to disclose criminal background information during an investigation or an EMS Personnel Peer Review Board proceeding;
	(k)  unauthorized use or removal of narcotics, medications, supplies or equipment from a provider, emergency vehicle or health care facility;
	(l)  performing procedures or skills beyond the level of an individual's EMS licensure or provider's licensure;
	(m)  violation of laws pertaining to medical practice, drugs, or controlled substances;
	(n)  mental incompetence as determined by a court of competent jurisdiction;
	(o)  demonstrated inability and failure to perform adequate patient care;
	(p)  inability to provide emergency medical services with reasonable skill and safety because of illness, or as a result of any other mental or physical condition, when the individual's condition demonstrates a clear and unjustifiable threat or potential threat to oneself, coworkers, or the public health, safety, or welfare that cannot be reasonably mitigated;
	(q)  misrepresentation of an individual's level of licensure;
	(r)  failure of a licensed EMS individual to display a clearly identifiable level of EMS licensure during an EMS response;
	(s)  unsafe, unnecessary or improper operation of an emergency vehicle that would likely cause concern or create a danger to the general public; or
	(t)  improper or unnecessary use of emergency equipment.
	(5)  Background screening referrals may be submitted to the Department for review and investigation.
	(a)  The Department shall review any case referred under R426-5-3200.
	(b)  The Department may require the licensed EMS individual to provide the proper criminal background documentation.
	(c)  The licensed EMS individual shall notify the Department of all entities they work for or are affiliated with or that they may become affiliated with in connection to their EMS licensure.
	(d)  Failure to comply with any Department requirements may result in disciplinary action against the licensed EMS individual's licensure.
	(e)  The Department may negotiate with the licensed EMS individual and their PAP to determine terms and conditions of the EMS individual's provisional licensure.
	(i)  When the Department determines a licensed EMS individual's license will be restricted, the Department shall notify both the licensed EMS individual and all licensed or designated providers they are affiliated with.
	(ii)  The Department will attempt to contact and begin negotiations with the PAP and the licensed EMS individual.  All parties will attempt to determine reasonable terms and conditions to the licensed EMS individual's license .
	(iii)  If terms and conditions are agreed upon between the parties, the licensed EMS individual and all affiliated licensed or designated providers shall be notified immediately.  This notification will include information that the licensed EMS individual is under a provisional license with terms and conditions until the resolution of any criminal charge or the completion of an investigation.
	(iv)  If the licensed EMS individual is not employed or affiliated with a licensed or designated provider or if terms and conditions are not agreed upon, the Department may take action necessary to protect the public's best interest.
	(v)  The Department, the licensed EMS individual and the PAP, if applicable shall sign the terms of the provisional licensure agreement.  Any other affiliated licensed or designated EMS providers shall be notified of the provisional license and its terms and conditions.
	(vi)  Once the provisional license has been signed, all known EMS providers who the licensed EMS individual is affiliated with will be notified immediately by the Department.
	(vii)  If any affiliated licensed or designated EMS providers or the licensed EMS individual fail to abide by the terms and conditions of a provisional license, they may be subject to sanctions by the Department.
	(f)  The Department shall submit recommended background clearance actions for licensed EMS individuals to the Peer Review Board under R426-5-3400.
	(6)  Appeal process;
	(a)  If a licensed or designated EMS provider chooses to appeal an action by the Department, they may appeal to the EMS Committee or pursue a remedy under the Utah Administrative Procedures Act, Title 63G, Chapter 4, Administrative Procedures Act.
	(i)  If the Department action is appealed to the EMS Committee, then the recommendation shall be given to the Department Executive Director for a final decision.
	(b)  If a licensed EMS individual chooses to appeal an action by the Department, they may appeal to the Executive Director, or pursue a remedy under the Utah Administrative Procedures Act, Title 63G, Chapter 4, Administrative Procedures Act.

R426-5-3400.  EMS Personnel Peer Review Board.
	The EMS Personnel Peer Review Board is created under section 26-8a-105(4).
	(1)  Membership of the EMS Personnel Peer Review Board.  The EMS Personnel Peer Review Board shall be composed of the following 15 members appointed by the Executive Director of the Department of Health:
	(a)  One EMS administrative officer representing a licensed ambulance provider, a licensed paramedic provider, or a designated quick response unit provider from a county of the first or second class;
	(b)  One EMS administrative officer representing a licensed ambulance provider, a licensed paramedic provider, or a designated quick response unit provider from a county of the third through sixth class;
	(c)  One educational representative from an accredited EMS training program;
	(d)  One physician certified and practicing as an EMS Medical Director;
	(e)  One licensed EMD;
	(f)  Two representatives from professional employee groups, one fire based, and one non-fire based;
	(g)  Two endorsed EMS training officers;
	(h)  Two non-supervisory licensed EMT's;
	(i)  Two non-supervisory licensed AEMT's;
	(j)  Two non-supervisory licensed Paramedics;
	(2)  EMS Personnel Peer Review Board member terms of office:
	(a)  Except as provided in subsection (2)(b) members shall be appointed for a six year term beginning no later than October 1, 2015.
	(b)  The Department shall adjust the length of terms to ensure the terms of members of the board are staggered so approximately one third of the board is appointed every two years.
	(c)  No member shall serve consecutive full terms.
	(d)  When a vacancy occurs in the membership of the board for any reason, the Executive Director of the Department shall appoint the replacement for the balance of the unexpired term.  If the balance of the term is greater than 50% of the initial term, then the term shall be considered a full term.
	(e)  The EMS Personnel Peer Review Board shall organize and select one of its members as Chair and one of its members as Vice Chair to serve no more than two years in each position.
	(f)  If a board member becomes ineligible for the EMS Personnel Peer Review Board membership position through promotion, an increase in level of licensure or transfer out of the employment position which qualified them for the appointment, they shall be replaced at the next two year interval.
	(g)  An equitable mix of urban and rural members is preferred.
	(3)  EMS Personnel Peer Review Board Meetings.
	(a)  Regular meetings of the Peer Review Board shall be scheduled quarterly.
	(i)  Regular meetings shall be noticed and posted to employers and posted in accordance with the Utah Open and Public Meetings Act, Section 52-4-202.
	(ii)  Failure to attend three or more consecutive meetings by any member may be grounds for removal of that member and replacement in accordance with subsection (2)(d).
	(iii)  A member may not receive compensation or benefits from the Department for the member's service.  The member may receive per diem and travel expensed in accordance with Department rules and policies.
	(4)  Once a complaint or background screening finding against a licensed EMS individual is investigated, the Department shall refer the case and provide a report with all findings and recommendations to the EMS Personnel Peer Review Board.
	(5)  If the EMS Personnel Peer Review Board chooses to recommend any action that deviates from the Department recommendation, the Board shall provide written justification for that recommendation.
	(6)  The EMS Personnel Peer Review Board may make
	recommendations to the Department's Bureau Director, of:
	(a)  no Department action, or
	(b)  a letter of notice, or
	(c)  probation of the licensed EMS individual's license with specific terms and conditions for a period of time, or
	(d)  suspension of the licensed EMS individual's license for a defined period of time, or
	(e)  permanent revocation of the licensed EMS individual's license, or
	(d)  a combination of any of these actions.
	(7)  If the Department's Bureau Director modifies the recommended action of the EMS Personnel Peer Review Board, the Department's Bureau Director shall attach a written letter of dissent noting the reasoning for the decision.  The Department's Bureau Director shall then notify the EMS Personnel Peer Review Board of the dissent and action taken.
	(8)  The licensed EMS individual shall be notified by the Department of any action taken within 15 days of the decision by mail.
	(9)  An action to restrict, place on probation, suspend, or revoke the licensed EMS individual's license shall be done in accordance with Title 63G, Chapter 4, Administrative Procedures Act.

R426-5-3500.  EMS Rules Task Force.
	The EMS Rules Task Force is created under Title 26, Chapter 8a, EMS Act.
	(1)  The EMS Rules Task Force shall be composed of the following members appointed by the Executive Director of the Department of Health:
	(a)  a representative from the Utah Fire Chiefs' Association;
	(b)  a representative from the Utah Rural EMS Directors' Association;
	(c)  a EMS medical director;
	(d)  a privately owned EMS representative;
	(e)  a rural EMS medical dispatch representative;
	(f)  a paramedic licensed provider representative;
	(g)  an urban EMS medical dispatch representative;
	(h)  an Emergency Nurses Association representative;
	(i)  a course coordinator from an accredited EMS training program;
	(j)  an endorsed EMS training officer;
	(k)  a representative from the State EMS Committee;
	(l)  a designated trauma center representative;
	(m)  a designated patient receiving facility representative;
	(n)  a designated nonemergency secured behavioral patient transport representative.
	(2)  EMS Rules Task Force member terms of office:
	(a)  Except as provided in subsection (2)(b) members shall be appointed for a three year term.
	(b)  The Department shall adjust the length of terms to ensure the terms of members of the EMS Rules Task Force are staggered so approximately one third of the EMS Rules Task Force is appointed every two years.
	(c)  Members may serve two consecutive full terms.
	(d)  When a vacancy occurs in the membership for any reason, the Department shall solicit applications for replacement for the balance of the unexpired term.  If the balance of the term is greater than 50% of the initial term, then the term shall be considered a full term.
	(e)  The EMS Rules Task Force may organize and select one of its members as Chair and one of its members as Vice Chair to serve no more than two years in each position.
	(f)  If a EMS Rules Task Force member becomes ineligible for the EMS Rules Task Force membership position through promotion, an increase in level of license or transfer out of the employment position which qualified them for the appointment, they shall be replaced at the next two year interval.
	(g)  An equitable mix of urban and rural members is preferred.
	(3)  EMS Rules Task Force Meetings.
	(a)  Regular meetings of the EMS Rules Task Force shall be scheduled as determined by the membership and the Department.

KEY:  emergency medical services
Date of Enactment or Last Substantive Amendment:  October 30, 2019
Notice of Continuation:  December 6, 2016
Authorizing, and Implemented or Interpreted Law:  26-1-30; 26-8a-302