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TITLE 836 INDIANA EMERGENCY MEDICAL SERVICES COMMISSION

Proposed Rule
LSA Document #06-10

DIGEST

Amends 836 IAC 1-1-1 to add definitions relating to emergency medical dispatch. Adds 836 IAC 5 to establish requirements and provisions applicable to the certification and regulation of emergency medical dispatch agencies and emergency medical dispatchers to implement IC 16-31-3.5. Effective 30 days after filing with the Publisher.




SECTION 1. 836 IAC 1-1-1 IS AMENDED TO READ AS FOLLOWS:

836 IAC 1-1-1 Definitions

Authority: IC 16-31-2-7


Sec. 1. The following definitions apply throughout this title unless the context clearly denotes otherwise:
(1) "14 CFR 135 and 14 CFR 119" means air carriers with reference to F.A.R. 135 and 119, and holding a current F.A.A. air carrier certificate, with approved air ambulance operations-helicopter or air ambulance operation-airplane operations specifications.
(2) "Advanced life support", for purposes of IC 16-31, means the following:
(A) Care given:
(i) at the scene of an:
(AA) accident;
(BB) act of terrorism (as defined in IC 35-41-1-26.5), if the governor has declared a disaster emergency under IC 10-14-3-12 in response to the act of terrorism; or
(CC) illness;
(ii) during transport; or
(iii) at a hospital;
by a paramedic, emergency medical technician-intermediate, and that is more advanced than the care usually provided by an emergency medical technician or an emergency medical technician-basic advanced.
(B) The term may include any of the following:
(i) Defibrillation.
(ii) Endotracheal intubation.
(iii) Parenteral injection of appropriate medications.
(iv) Electrocardiogram interpretation.
(v) Emergency management of trauma and illness.
(3) "Advanced life support fixed-wing ambulance service provider organization" means a service provider that utilizes fixed-wing aircraft to provide airport to airport transports where the patients involved:
(A) require a stretcher or cot; and
(B) are being transported to or from a definite care medical setting.
(4) "Advanced life support nontransport vehicle" means a motor vehicle other than an ambulance, owned or leased by a certified emergency medical service provider organization, that provides advanced life support but does not supply patient transport from the scene of the emergency. The term does not include an employer-owned or employer-operated vehicle used for first aid purposes within or upon the employer's premises.
(5) "Advanced life support rotorcraft ambulance service provider organization" means a service provider that utilizes rotorcraft aircraft to respond directly to the scene of a medical emergency either as an initial first responder or as a secondary responder and are utilized to airlift critically ill or injured patients:
(A) directly to or between definitive care facilities; or
(B) to a point of transfer with another more appropriate form of transportation.
(6) "Agency" means the state emergency management agency emergency medical services division. department of homeland security.
(7) "Air-medical director" means a physician:
(A) with an unlimited license to practice medicine in Indiana; and
(B) who has an active role in the delivery of emergency care.
The licensed physician shall be ultimately responsible for patient care during each transport. The air-medical director is responsible for directly overseeing and assuring that appropriate aircraft, air-medical personnel, and equipment are provided for each patient transported by the air ambulances within the air-medical services as well as the performance of air-medical personnel.
(8) "Air-medical personnel" means a person who is:
(A) certified by the commission as a paramedic; or is
(B) a registered nurse or physician.
(9) "Ambulance" means any conveyance on land, sea, or air that is used, or is intended to be used, for the purpose of:
(A) responding to emergency life-threatening situations; and
(B) providing transportation of an emergency patient.
(10) "Ambulance service provider organization" means any person certified by the commission who engages in or seeks to:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain;
(E) advertise; or
(F) otherwise engage in;
services for the transportation and care of emergency patients as a part of a regular course of doing business, either paid or voluntary.
(11) "Auto-injector" means a spring-loaded needle and syringe that:
(A) contains a single dose of medication; and
(B) automatically releases and injects the medication.
(12) "Basic life support" means the following:
(A) Assessment of emergency patients.
(B) Administration of oxygen.
(C) Use of mechanical breathing devices.
(D) Application of antishock trousers.
(E) Performance of cardiopulmonary resuscitation.
(F) Application of dressings and bandage materials.
(G) Application of splinting and immobilization devices.
(H) Use of lifting and moving devices to ensure safe transport.
(I) Use of an automatic or a semiautomatic defibrillator if the defibrillator is used in accordance with training procedures established by the commission.
(J) Administration by an emergency medical technician or emergency medical technician-basic advanced of epinephrine through an auto-injector.
(K) For an emergency medical technician-basic advanced, the following:
(i) Electrocardiogram interpretation.
(ii) Manual external defibrillation.
(iii) Intravenous fluid therapy.
(L) Other procedures authorized by the commission, including procedures contained in the revised national emergency medical technician-basic training curriculum guide.
(M) Except as provided by:
(i) clause (J) and the training and certifications standards established under IC 16-31-2-9(4); IC 16-31-2-9(3);
(ii) clause (K)(iii); and
(iii) the training standards established under IC 16-31-2-9(5); IC 16-31-2-9(4);
the term does not include invasive medical care techniques or advanced life support.
(13) "Basic life support nontransport provider organization" means an organization, certified by the commission, that provides first response patient care at an emergency that includes defibrillation but does not supply patient transport from the scene of the emergency.
(14) "Call routing" means the reception of emergency calls where the purpose is to determine only the course of direction of the routing (such as police, fire, medical) resulting in rapid transfer of medical callers to the emergency medical dispatch agency or emergency medical dispatcher for emergency medical dispatching services.
(14) (15) "Certificate" or "certification" means authorization in written form issued by the commission to a person to:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain;
(E) advertise; or
(F) otherwise engage in providing;
emergency medical services as a part of a regular course of doing business, either paid or voluntary.
(15) (16) "Commission" means the Indiana emergency medical services commission.
(16) (17) "Director" means the executive director of the state emergency management agency. department of homeland security established by IC 10-19.
(18) "Dispatch agency" means an emergency medical dispatch agency.
(19) "Dispatch life support" means the knowledge, procedures, and skills used by trained emergency medical dispatchers in providing care and advice through prearrival instructions and postdispatch instructions to callers requesting emergency medical assistance.
(17) (20) "Emergency ambulance services" means the:
(A) transportation of emergency patients by ambulance; and the
(B) administration of basic life support to emergency patients before or during such transportation.
(18) (21) "Emergency management of trauma and illness" means the following:
(A) For a paramedic, those procedures for which the paramedic has been specifically trained and:
(i) that are a part of the curriculum prescribed by the commission; or
(ii) are a part of the continuing education program and approved by the supervising hospital and the paramedic provider organization's medical director.
(B) For an emergency medical technician-intermediate, those procedures for which the emergency medical technician-intermediate has been specifically trained:
(i) in the Indiana basic emergency medical technician and Indiana emergency medical technician-intermediate curriculums; and
(ii) that have been approved by the:
(AA) administrative and medical staff of the supervising hospital; the
(BB) emergency medical technician-intermediate provider organization medical director; and the
(CC) commission;
as being within the scope and responsibility of the emergency medical technician-intermediate.
(22) "Emergency medical dispatch agency" means any person that provides emergency medical dispatching for emergency medical assistance that is certified under 836 IAC 5.
(23) "Emergency medical dispatcher" means a person who is:
(A) trained to provide emergency medical dispatch services; and
(B) certified under 836 IAC 5.
(24) "Emergency medical dispatching" means the reception, evaluation, processing, and provision of dispatch life support, management of requests for emergency medical assistance, and participation in ongoing evaluation and improvement of the emergency medical dispatch process. This process includes:
(A) identifying the nature of the request;
(B) prioritizing the severity of the request;
(C) dispatching the necessary resources;
(D) providing medical aid and safety instructions to the callers; and
(E) coordinating the responding resources as needed;
but does not include call routing itself.
(25) "Emergency medical dispatch medical direction" means the management and accountability for the medical care aspects of an emergency medical dispatch agency including the following:
(A) Responsibility for the medical decision and care advice rendered by the emergency medical dispatcher and emergency medical dispatch agency.
(B) Approval and medical control of the operational emergency medical dispatch program.
(C) Evaluation of the medical care and prearrival instructions rendered by the emergency medical dispatch personnel.
(D) Direct participation in the emergency medical dispatch system evaluation and continuous quality improvement process.
(E) The medical oversight of the training of the emergency medical dispatch personnel.
(26) "Emergency medical dispatch medical director" means a physician who:
(A) has an unlimited license to practice medicine in Indiana;
(B) has an active role in the delivery of emergency care;
(C) provides emergency medical dispatch medical direction to an emergency medical dispatch agency; and
(D) works with the local emergency medical services provider medical director, if not the same person.
(27) "Emergency medical dispatch program" or "dispatch program" means a system that includes the protocol used by an emergency medical dispatcher in an emergency medical dispatch agency to dispatch aid to medical emergencies that includes:
(A) systematized caller interrogation questions; and
(B) systematized dispatch life support instructions and systematized coding protocols that match the dispatcher's evaluation of the injury or illness severity with the vehicle response mode and vehicle response configuration.
(28) "Emergency Medical Dispatch Protocol Reference System" means a system that provides information to the emergency medical dispatcher to:
(A) identify situations that might require prearrival instructions; and
(B) obtain information regarding scene safety for the:
(i) patient;
(ii) bystanders; and
(iii) responding personnel.
Such system includes a standard set of questions that allows the dispatcher to consistently identify what is happening medically and give medical instruction to the caller.
(19) (29) "Emergency medical services" means the provision of emergency ambulance services or other services, including extrication and rescue services, utilized in serving an individual's need for immediate medical care in order to prevent loss of life or aggravation of physiological or psychological illness or injury.
(20) (30) "Emergency medical services driver" means an individual who has a certificate of completion of a commission-approved driver training course.
(21) (31) "Emergency medical services provider organization" means any person certified by the commission who engages in or seeks to:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain;
(E) advertise; or
(F) otherwise engage in;
services for the care of emergency patients as part of a regular course of doing business, either paid or voluntary.
(22) (32) "Emergency medical services vehicle" means the following:
(A) An ambulance.
(B) An emergency medical service nontransport vehicle.
(23) (33) "Emergency medical technician" means an individual who is certified under this article to provide basic life support:
(A) at the scene of an accident or an illness; or
(B) during transport.
(24) (34) "Emergency medical technician-basic advanced" means an individual who:
(A) is certified under IC 16-31 to provide basic life support:
(i) at the scene of an accident or an illness; or
(ii) during transport; and
(B) has been certified to perform:
(i) manual or automated defibrillation;
(ii) rhythm interpretation; and
(iii) intravenous line placement.
(25) (35) "Emergency medical technician-basic advanced provider organization" means an ambulance service provider or other provider organization certified by the commission to provide basic life support services administered by emergency medical technicians-basic advanced and has been certified to perform:
(A) manual or automated defibrillation;
(B) rhythm interpretation; and
(C) intravenous line placement;
in conjunction with a supervising hospital.
(26) (36) "Emergency medical technician-intermediate" means an individual who can perform at least one (1) but not all of the procedures of a paramedic and who:
(A) has completed a prescribed course in advanced life support;
(B) has been certified by the commission;
(C) is associated with a single supervising hospital; and
(D) is affiliated with a provider organization.
(27) (37) "Emergency medical technician-intermediate provider organization" means an ambulance service provider organization or other provider organization certified by the commission to provide advanced life support services administered by emergency medical technician-intermediates in conjunction with a supervising hospital.
(28) (38) "Emergency patient" means an individual who:
(A) is acutely ill, injured, or otherwise incapacitated or helpless; and who
(B) requires emergency care.
The term includes an individual who requires transportation on a litter or cot or is transported in a vehicle certified as an ambulance under IC 16-31-3.
(29) (39) "Extrication service" means any actions that disentangle and frees free from entrapment.
(30) (40) "F.A.A." means the Federal Aviation Administration.
(31) (41) "F.A.R." means the federal aviation regulations, including, but not limited to, 14 CFR.
(32) (42) "First responder" means an individual who: is:
(A) is certified under IC 16-31; and who
(B) meets the commission's standards for first responder certification; and
(B) (C) is the first individual to respond to an incident requiring emergency medical services.
(33) (43) "Fixed-wing ambulance" means a propeller or jet airplane.
(34) (44) "Flight physiology" means the physiological stress of flight encountered during air-medical operations to include, but not be limited to:
(A) temperature;
(B) pressure;
(C) stresses of barometric pressure changes;
(D) hypoxia;
(E) thermal and humidity changes;
(F) gravitational forces;
(G) noise;
(H) vibration;
(I) fatigue; and
(J) volume and mass of gases.
(35) (45) "Medical director" means a physician:
(A) with an unlimited license to practice medicine in Indiana; and
(B) who has an active role in the delivery of emergency care.
(36) "Medical director designee" means a physician:
(A) with an unlimited license to practice medicine in Indiana;
(B) who has an active role in the delivery of emergency care; and
(C) who has been designated in writing by the medical director as the medical director designee.
(36) (46) "Nontransporting emergency medical services vehicle" or "emergency medical service nontransport vehicle" means a motor vehicle, other than an ambulance, used for emergency medical services. The term does not include an employer-owned or employer-operated vehicle used for first aid purposes within or upon the employer's premises.
(37) (47) "Paramedic" means an individual who:
(A) is:
(i) affiliated with a certified paramedic provider organization; or
(ii) employed by a:
(AA) sponsoring hospital approved by the commission; or
(iii) employed by a (BB) supervising hospital with a contract for inservice education with a sponsoring hospital approved by the commission;
(B) has completed a prescribed course in advanced life support; and
(C) has been certified by the commission.
(38) (48) "Paramedic provider organization" means an ambulance service provider organization or other provider organization certified by the commission to provide advanced life support services administered by paramedics or physicians with an unlimited license to practice medicine in Indiana in conjunction with supervising hospitals.
(39) (49) "Person" means any:
(A) natural person or persons;
(B) partnership;
(C) corporation;
(D) association;
(E) joint stock association; or
(F) governmental entity other than an agency or instrumentality of the United States. "Agency or instrumentality of the United States" does not include a person operating under a contract with the government of the United States.
(40) (50) "Physician" means an individual who currently holds a valid unlimited license to practice medicine in Indiana under IC 25-22.5-1-1.1.
(51) "Postdispatch instructions" means case-specific advice, warnings, and treatments given by trained emergency medical dispatchers after dispatching emergency medical services personnel and vehicles.
(52) "Prearrival instructions" means the current, scripted medical instructions given in life-threatening situations whenever possible and appropriate, where correct evaluation, verification, and advice given by emergency medical dispatchers are essential to provide necessary assistance and control of the situation prior to arrival of emergency medical services personnel. These protocols are:
(A) part of an emergency medical dispatch program; and
(B) used as close to word-for-word as possible.
(53) "Prescheduled emergency medical transports" means a transport that goes to and from a long term medical facility and hospital.
(41) (54) "Program director" means a person employed by a certified training institution to coordinate the emergency medical services training programs.
(42) (55) "Provider organization" means an ambulance service or other emergency care organization certified by the commission to provide emergency medical services.
(43) (56) "Provider organization operating area" means the geographic area in which an emergency medical technician-basic advanced, affiliated with a specific emergency medical technician-basic advanced provider organization, is able to maintain two-way voice communication with the provider organization's supervising hospitals.
(57) "Quality assurance and improvement program" means a program approved by the medical director and administered by the emergency medical dispatch agency for the purpose of ensuring safe, efficient, and effective performance of emergency medical dispatchers in regard to their use of the emergency medical dispatch program and patient care advice provided. This program shall include, at a minimum, the random case review evaluating the following:
(A) Emergency medical dispatcher performance.
(B) Feedback of emergency medical dispatch program compliance levels to emergency medical dispatchers.
(C) Related continuing education retraining and remediation.
(D) Submission of compliance data to the medical director and the agency.
(44) (58) "Registered nurse" means a person licensed under IC 25-23-1-1.1.
(45) (59) "Rescue services" means the provision of basic life support, except it the term does not include the following:
(A) Administration of oxygen.
(B) Use of mechanical breathing devices.
(C) Application of antishock trousers.
(D) Application of splinting devices.
(E) Use of an automatic or a semiautomatic defibrillator.
(F) Electrocardiogram interpretation.
(G) Manual external defibrillation.
(H) Intravenous fluid therapy.
(I) Invasive medical care techniques.
(46) (60) "Rescue squad organization" means an organization that holds a voluntary certification to provide extrication, rescue, or emergency medical services.
(61) "Response protocol" means a procedure that will identify the level of medical need to ensure the appropriate response by the emergency medical services provider, as well as information to be relayed to the responding crew or crews to help them address the situation upon arrival.
(47) (62) "Supervising hospital" means a hospital licensed under IC 16-21-2 or under the licensing laws of another state that has been certified by the commission to supervise:
(A) paramedics;
(B) emergency medical technicians-intermediate;
(C) emergency medical technician-basic advanced; and
(D) provider organizations;
in providing emergency medical care.
(48) (63) "Training institution" means an institution certified by the commission to administer emergency medical services training programs.
(64) "Vehicle response configuration" means the specific vehicle or vehicles of varied types, capabilities, and numbers responding to render assistance as:
(A) assigned by the emergency medical dispatch agency; and
(B) approved by the emergency medical dispatch medical director.
(65) "Vehicle response mode" means the use of emergency driving techniques, such as warning lights-and-siren or routine driving response as:
(A) assigned by the emergency medical dispatch agency; and
(B) approved by the emergency medical dispatch medical director.
(Indiana Emergency Medical Services Commission; Emergency Medical Services Preliminary; filed Jun 5, 1975, 11:57 a.m.: Rules and Regs. 1976, p. 84; filed Nov 3, 1980, 3:55 p.m.: 3 IR 2191; filed Dec 13, 1985, 9:13 a.m.: 9 IR 1035; filed Aug 18, 1986, 1:00 p.m.: 10 IR 23; filed May 15, 1998, 10:25 a.m.: 21 IR 3865; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2718; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2333; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3507)


SECTION 2. 836 IAC 5 IS ADDED TO READ AS FOLLOWS:

ARTICLE 5. EMERGENCY MEDICAL DISPATCH


Rule 1. Emergency Medical Dispatch


836 IAC 5-1-1 General provisions

Authority: IC 16-31-3.5-7


Sec. 1. (a) After December 31, 2006, an individual may not:
(1) furnish;
(2) operate;
(3) conduct;
(4) maintain; or
(5) advertise;
services as an emergency medical dispatcher or otherwise be engaged as an emergency medical dispatcher unless that individual is certified by the commission as an emergency medical dispatcher.

(b) After December 31, 2006, a person may not:
(1) furnish;
(2) operate;
(3) conduct;
(4) maintain; or
(5) advertise;
services as an emergency medical dispatcher or otherwise be engaged as an emergency medical dispatch agency unless certified by the commission as an emergency medical dispatch agency.
(Indiana Emergency Medical Services Commission; 836 IAC 5-1-1)


836 IAC 5-1-2 Exemptions

Authority: IC 16-31-3.5-7


Sec. 2. (a) A person that solely dispatches prescheduled emergency medical transports is not required to be certified under this article.

(b) A person that solely performs call routing is not required to be certified under this article.

(c) A person is not required to be certified under this article if the person solely receives calls from either of the following:
(1) An acute care facility licensed under IC 16-21-2.
(2) A health facility licensed under IC 16-28.
(Indiana Emergency Medical Services Commission; 836 IAC 5-1-2)


Rule 2. Emergency Medical Dispatch Agencies


836 IAC 5-2-1 Emergency medical dispatch program

Authority: IC 16-31-3.5-7


Sec. 1. An emergency medical dispatch program used by an emergency medical dispatch agency must meet or exceed the standards established by the National Highway Traffic Safety Administration (NHTSA) in the Emergency Medical Dispatch Program Implementation and Administration Managers Guide.
(Indiana Emergency Medical Services Commission; 836 IAC 5-2-1)


836 IAC 5-2-2 Application for certification; renewal

Authority: IC 16-31-3.5-7


Sec. 2. (a) An application for certification as an emergency medical dispatch agency shall be made on forms provided by the agency and shall include the fee required by 836 IAC 5-4. Both an application for original certification and an application for a renewal certification shall include the following:
(1) Organizational structure, including name, address, phone number, and e-mail address for the following:
(A) The legal name of the applicant for certification and a list of all "doing business as" ("DBAs") or assumed names that the applicant intends on using.
(B) The dispatch agency.
(C) The director of the dispatch agency.
(D) The emergency medical dispatch medical director.
(2) A complete listing of affiliated emergency medical dispatch personnel to be utilized as emergency medical dispatchers, including the full name and emergency medical dispatcher certification number of each person.
(3) The following information:
(A) A description of the quality assurance and improvement program.
(B) The location of the dispatch agency's records.
(C) The hours of operation.
(D) A list of emergency medical service provider organizations dispatched by the dispatch agency.
(E) Continuing education requirements.
(F) The location of all remote dispatch centers, if applicable.
(4) Current Federal Communications Commission license or letter of authorization.
(5) Name and version of the emergency medical dispatch program proposed to be used. If the version of the dispatch program that is proposed to be used has already been reviewed and approved by the agency, then the applicant must submit sufficient information to demonstrate that the proposed emergency medical dispatch program has been approved for use by the agency. If the agency has not already determined that the proposed dispatch program meets or exceeds the NHTSA standards, then a copy of the emergency medical dispatch program proposed to be used must be submitted as part of the application.
(6) The signature of both the:
(A) emergency medical dispatch medical director; and
(B) director of the dispatch agency;
each affirming to the best of their knowledge, under penalty of perjury, that the information contained in the application is accurate and complete.
(7) Other information as required by the agency.

(b) For an original certification, applicants shall provide a completed application to the agency at least sixty (60) days prior to the preferred effective date of the certification.

(c) An emergency medical dispatch agency certificate expires on the expiration date established when it is issued, which must be at least two (2) years after the date of its issuance.

(d) An application for renewal of an emergency medical dispatch agency certification shall be provided to the agency at least sixty (60) days prior to the expiration date of the current certificate. If the application for renewal is received by the agency after the expiration date of the certification, it shall include the late fee established in 836 IAC 5-4.

(e) An emergency medical dispatch agency shall provide the agency written notification within thirty (30) days of a change in any of the information provided in an application for original or renewal certification. This written notification shall include the signature of both the:
(1) emergency medical dispatch medical director; and
(2) director of the dispatch agency;
each affirming to the best of their knowledge, under penalty of perjury, that the information contained in the application is accurate and complete.

(f) An emergency medical dispatch agency may operate multiple remote dispatch centers under one (1) certificate if:
(1) all dispatch centers operated under the certificate are part of a single legal entity;
(2) emergency medical dispatch medical direction is provided by a single emergency medical dispatch medical director; and
(3) supervision of emergency medical dispatch operations is provided by a single emergency medical dispatch agency director.
(Indiana Emergency Medical Services Commission; 836 IAC 5-2-2)


836 IAC 5-2-3 Personnel change notification requirements

Authority: IC 16-31-3.5-7


Sec. 3. For an individual certified by the commission and employed (either paid or volunteer) by an emergency medical dispatch agency, the emergency medical dispatch agency shall notify the agency within thirty (30) days of any of the following:
(1) An action taken by the emergency medical dispatch agency or the emergency medical dispatch medical director to:
(A) restrict, suspend, or revoke the individual's authorization to perform emergency medical dispatch for the emergency medical dispatch agency; or
(B) suspend or terminate the individual's employment or affiliation with the emergency medical dispatch agency.
(2) The individual is no longer:
(A) employed; or
(B) affiliated;
with the emergency medical dispatch agency either voluntarily or involuntarily.
(3) This notification shall include the following:
(A) The name of the individual.
(B) The emergency medical dispatcher certification number.
(C) The date the action was taken.
(D) A description of the action taken, including:
(i) the length of the action if the action was temporary; and
(ii) any conditions and terms associated with the action.
(E) The reason the action was taken.
(Indiana Emergency Medical Services Commission; 836 IAC 5-2-3)


836 IAC 5-2-4 Operating procedures

Authority: IC 16-31-3.5-7


Sec. 4. (a) An emergency medical dispatch agency shall be operated in a safe, efficient, and effective manner and in compliance with all provisions of the agency-approved emergency medical dispatch program, including the following:
(1) All personnel providing emergency medical dispatch services for the emergency medical dispatch agency must be certified under this article as emergency medical dispatchers before functioning alone in an on-line capacity.
(2) The agency-approved emergency medical dispatch program shall be used on every request for medical assistance.
(3) The emergency medical dispatcher interrogating the caller must be the same emergency medical dispatcher that provides the prearrival instructions and postdispatch instructions to the caller.
(4) Under the written approval and supervision of the emergency medical dispatch medical director, the emergency medical dispatch agency shall establish the following:
(A) A quality assurance and improvement program.
(B) A continuing education program.
(C) Emergency medical dispatch guidelines and operating procedures to implement the emergency medical dispatch program.
(D) A response protocol to ensure the appropriate responding units are dispatched.
(E) An Emergency Medical Dispatch Protocol Reference System.

(b) Each dispatch agency shall do the following:
(1) Have an emergency medical dispatch medical director to provide supervision and oversight over the medical aspects of the operation of the emergency medical dispatch agency. The medical director shall do the following:
(A) Review and approve the emergency medical dispatch guidelines and operating procedures.
(B) Participate in the quality assurance and improvement program.
(C) Review and approve the emergency medical dispatch agency's education program.
(2) Comply with Federal Communications Commission regulations.
(3) Maintain a current license on all frequencies utilized for emergency medical services dispatch.
(4) Report to the agency whenever an action occurs that may justify the revocation or suspension of a certificate issued by the agency.
(5) Retain its records relating to the emergency medical dispatch program as follows:
(A) All audio recordings shall be retained for a minimum of six (6) months.
(B) All other records relating to the emergency medical dispatch program shall be retained for a minimum of seven (7) years, including the following types of records:
(i) Training records of emergency medical dispatchers.
(ii) Records of audit and review.

(c) As part of the quality assurance and improvement program, the emergency medical dispatch agency shall conduct an audit and review at least quarterly to assess, monitor, and evaluate the quality and efficiency of the dispatch system as follows:
(1) The audit shall evaluate the following:
(A) Dispatcher performance.
(B) The effectiveness of the dispatch program.
(2) The results of the audit shall be reviewed with the emergency medical dispatcher.
(3) Documentation for the audit and review shall include the following:
(A) The criteria used to select audited emergency medical dispatch event.
(B) Problem identification and resolution.
(C) The date of the review.
(D) Attendance at the review.
(E) A summary of the discussion at the review.
(4) The audit and review shall be conducted under the direction of one (1) of the following:
(A) The emergency medical dispatch agency director and medical director.
(B) The emergency medical dispatch agency committee that is designated and supervised by the dispatch agency director and medical director.
(Indiana Emergency Medical Services Commission; 836 IAC 5-2-4)


Rule 3. Emergency Medical Dispatchers


836 IAC 5-3-1 General certification provisions

Authority: IC 16-31-3.5-7


Sec. 1. (a) As follows, for an applicant to be eligible to apply for original certification, an applicant must:
(1) Be at least eighteen (18) years of age.
(2) Have a high school diploma or general education equivalent.
(3) Have a current certification in cardiopulmonary resuscitation.
(4) Have successfully completed an education and training program that the agency determines meets or exceeds the standards established by the National Highway Traffic Safety Administration (NHTSA) in the Emergency Medical Dispatch: National Standard Curriculum-Instructor Guide. This education and training program must either have been completed not more than two (2) years before the date the application is received by the agency, or the following conditions must be met:
(A) The application must be received by the agency by not later than one (1) year after the effective date of this rule.
(B) The applicant must have at least twenty-four (24) hours of continuing emergency medical dispatch education in each two (2) year period since completion of the education and training program.
(5) Have successfully completed a written competency examination approved by the commission. This written competency examination must either have been completed not more than two (2) years before the date the application is received by the agency, or the following conditions must be met:
(A) The application must be received by the agency by not later than one (1) year after the effective date of this rule.
(B) The applicant must have at least twenty-four (24) hours of continuing emergency medical dispatch education in each two (2) year period since completion of the written competency examination.

(b) That certain document entitled, "Emergency Medical Dispatch: National Standard Curriculum- Instructor Guide" dated August 31, 1995, and published by the National Highway Traffic Safety Administration, 400 Seventh Street, SW, Washington, D.C. 20590, be and the same is hereby adopted by reference as if fully set out in this section.

(c) To be eligible to renew a certification, an emergency medical dispatcher shall meet the following continuing emergency medical dispatch education requirements during the two (2) year certification period:
(1) Participate in a minimum of twelve (12) hours of each of the following:
(A) Emergency medical dispatch audit and review.
(B) Any combination of:
(i) lectures;
(ii) critiques;
(iii) continuing education course; or
(iv) teaching sessions;
that review subject matter presented in the emergency medical dispatch agency's program.
(2) Have a current certification in cardiopulmonary resuscitation.

(d) An emergency medical dispatcher shall do the following:
(1) Not:
(A) furnish;
(B) operate;
(C) conduct;
(D) maintain; or
(E) advertise;
services as an emergency medical dispatcher or otherwise be engaged as an emergency medical dispatcher except for an emergency medical dispatch agency.
(2) Comply with the:
(A) protocols;
(B) procedures;
(C) standards;
(D) rules; and
(E) policies;
established by the agency and the commission.
(3) Comply with the:
(A) emergency medical dispatch program; and
(B) written policies and procedures adopted by the emergency medical dispatch:
(i) agency; or
(ii) medical director.
(4) Not act negligently, recklessly, or in such a manner that endangers the health or safety of:
(A) emergency patients; or
(B) members of the general public.
(5) Comply with the state and federal laws governing the confidentiality of patient medical information.
(6) Not delegate to a less qualified individual any skill that requires an emergency medical dispatcher.
(7) Report to the agency whenever an action has taken place that may justify the revocation or suspension of a certificate issued by the commission.
(8) Inform the agency:
(A) of each emergency medical dispatch agency with which the dispatcher is affiliated; and
(B) within thirty (30) days of a change in this information.
(Indiana Emergency Medical Services Commission; 836 IAC 5-3-1)


836 IAC 5-3-2 Application for original certification or certification renewal

Authority: IC 16-31-3.5-7


Sec. 2. (a) An application for certification as an emergency medical dispatcher shall be made on forms provided by the agency and shall include the fee required by 836 IAC 5-4. The application shall include the following:
(1) The:
(A) name;
(B) address;
(C) phone number; and
(D) e-mail address;
of the applicant.
(2) Date of birth.
(3) Documentation proving the following:
(A) That the applicant has a high school diploma or general education equivalent.
(B) That the applicant has a current certification of cardiopulmonary resuscitation.
(C) The applicant has met the education and training requirements established by 836 IAC 5-3-1(a)(4), which shall include the following:
(i) The name of the participant.
(ii) The name of the completed emergency medical dispatch program.
(iii) The emergency medical dispatch program name and address.
(iv) The course title.
(v) The date of the course.
(vi) Signatures of the instructor or course director.
(vii) The number of medical dispatch continuing education hours completed.
(viii) If the education and training was provided by an entity that provides certification or some other written proof of completion, then provide a copy of this written proof of completion. If this entity has established continuing education requirements or other requirements to maintain a current certification with that entity, provide proof of current certification with program.
(D) The applicant has completed the written competency examination required by 836 IAC 5-3-1(a)(5), which shall include the following:
(i) The name of the participant.
(ii) The name of the completed emergency medical dispatch program.
(iii) The emergency medical dispatch program name and address.
(iv) The exam title.
(v) The date of the exam.
(vi) Signatures of the instructor or course director.
(4) The name of all emergency medical dispatch agencies with which the applicant is affiliated.
(5) A question asking the applicant if the applicant has ever been charged or convicted of a crime other than a minor traffic violation. If the answer to this question is "yes", then the applicant will be asked to submit additional information to allow the agency to evaluate the applicant's criminal history.
(6) Other information required by the agency.
(7) Signature of the applicant, affirming under penalties of perjury that all information submitted with the application is accurate and complete.

(b) An emergency medical dispatcher certificate expires on the expiration date established when it is issued, which must be at least two (2) years after the date of its issuance.

(c) An application for a renewal certification as an emergency medical dispatcher shall be made on forms provided by the agency and shall include the fee required in 836 IAC 5-4. The application shall include the following information:
(1) The:
(A) name;
(B) address;
(C) phone number; and
(D) e-mail address;
of the applicant.
(2) The name and address of all emergency medical dispatch agencies with which affiliation will be.
(3) Documentation proving that the applicant has a current certification of cardiopulmonary resuscitation.
(4) Proof of compliance with the requirements for renewing a certification as an emergency medical dispatcher established by 836 IAC 5-3-1(b).
(5) A question asking the applicant if the applicant has ever been charged or convicted of a crime other than a minor traffic violation. If the answer to this question is "yes", then the applicant will be asked to submit additional information, if the applicant has not previously submitted this information, to allow the agency to evaluate the applicant's criminal history.
(6) Other information required by the agency.
(7) Signature of the applicant, affirming under penalties of perjury that all information submitted with the application is accurate and complete.

(d) An emergency medical dispatcher shall provide the agency written notification within thirty (30) days of a change in any of the information provided in an application for original or renewal certification.

(e) An individual whose certification as an emergency medical dispatcher has expired may reacquire the certification by complying with the following:
(1) If the request to reacquire certification is received by the agency within six (6) months of the expiration date, the individual shall:
(A) comply with all of the requirements for a renewal application established in subsection (c); and
(B) pay the late fee established in 836 IAC 5-4.
(2) If the request to reacquire certification is received by the agency more than six (6) months after the expiration date, the individual shall comply with all of the requirements for obtaining an original certification established in subsection (a).

(f) A temporary emergency medical dispatcher certificate may be issued by the commission. To obtain a temporary certificate, an individual must do the following:
(1) Meet the standards established by the commission. The commission's standards must include a declaration by a certified emergency medical dispatch agency that the certified emergency medical dispatch agency is temporarily unable to secure a certified emergency medical dispatcher.
(2) Pay the fee established by the commission.

(g) A temporary emergency medical dispatcher certificate is valid:
(1) for sixty (60) days after the date of issuance; and
(2) only for emergency medical dispatching performed for the emergency medical dispatching agency that supported the temporary certification.

(h) A temporary emergency medical dispatcher certificate issued under this section may be renewed for one (1) subsequent sixty (60) day period. To renew the temporary certification, the certificate holder must submit the same information and fee required for the original temporary certification.
(Indiana Emergency Medical Services Commission; 836 IAC 5-3-2)


Rule 4. Emergency Medical Dispatch Fees


836 IAC 5-4-1 Application for original certification or certification renewal

Authority: IC 16-31-3.5-7


Sec. 1. (a) The following is the fee schedule for an emergency medical dispatch agency.
Type of fee  Amount 
Fee for original certification  $50 
Fee for renewal certification  $25 
Late fee, if renewal application is submitted late within six (6) months of the expiration date. This late fee is in addition to the fee for renewal.  $25 
Late fee, if renewal application is submitted more than six (6) months after the expiration date. This fee is in addition to the fee for renewal.  $100 
Payment of a late fee does not allow an emergency medical dispatch agency to operate when a certificate is expired.

(b) The following is the fee schedule for an emergency medical dispatcher:
Type of fee  Amount 
Fee for original certification  $25 
Fee for renewal certification  $15 
Late fee, if renewal application is submitted late within six (6) months of the expiration date. This late fee is in addition to the fee for renewal.  $20 
Payment of a late fee does not allow an emergency medical dispatcher to work as an emergency medical dispatcher when a certificate is expired.

(c) All payments shall be made payable to the Emergency Medical Services Fund.

(d) There will be an additional surcharge of thirty-five dollars ($35) for any returned check.

(e) All fees are nonrefundable.
(Indiana Emergency Medical Services Commission; 836 IAC 5-4-1)



Posted: 05/02/2007 by Legislative Services Agency

DIN: 20070502-IR-836060010PRA
Composed: May 02,2024 8:06:44AM EDT
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