(a)

1. (1) The Department of Health shall license or certify individuals for the provision of emergency medical services.
2. (2) EMSPs may not provide patient care without a current Arkansas EMSP license.

3. (3) The Department of Health shall issue the following types of licenses:

   1. (A) Emergency Medical Responder;
   2. (B) Emergency Medical Technician;
   3. (C) Advanced Emergency Medical Technician (AEMT);
   4. (D) Paramedic;
   5. (E) Community Paramedic; and
   6. (F) EMSP — Instructor.
4. (4) The Department of Health shall issue the following types of certifications, Emergency Vehicle Operator.

5. (5) Applicable fees.

   1. (A)

(b) (b) Accompanied by the fee set forth by Arkansas Code § 20-13-211.

1. (ii) An application for the community paramedic licensure shall be submitted to the Department of Health with the application fee waived.

   1. (B)

      1. (i) Pursuant to Acts 2021, No. 725, an applicant may receive a waiver of the initial licensure fee, if eligible.
      2. (ii) Eligible applicants are applicants who:

(a) (a) Are receiving assistance through the:

1. (1) (1) Arkansas, or current state of residence equivalent, Medicaid Program;
2. (2) (2) Supplemental Nutrition Assistance Program (SNAP);
3. (3) (3) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC);
4. (4) (4) Temporary Assistance for Needy Families Program (TEA); or
5. (5) (5) Lifeline Assistance Program (LAP);

(b) (b) Were approved for unemployment within the last twelve (12) months; or

1. (c) (c) Have an income that does not exceed two hundred percent (200%) of the federal poverty income guidelines.

   1. (C) Applicants shall provide documentation showing their receipt of benefits from the appropriate state agency:

      1. (i) For Medicaid, SNAP, WIC, TEA, or LAP, documentation from the Department of Human Services or current state of residence equivalent agency;
      2. (ii) For unemployment benefits approval in the last twelve (12) months, the Division of Workforce Services or current state of residence equivalent agency; or
      3. (iii) For proof of income, copies of all Internal Revenue Service forms indicating the applicant’s total personal income for the most recent tax year, for example, W-2, 1099, etc.
   2. (D) Applicants shall attest that the documentation provided under subdivision (a)(5)(C) of this section is a true and correct copy, and fraudulent or fraudulently obtained documentation shall be grounds for denial or revocation of license.

2. (6) Proof of certification and licensure cards.

   1. (A) Each EMSP shall have:

      1. (i) Proof of Arkansas EMSP licensure or certification, issued by the Department of Health, on their person while on duty; or
      2. (ii) The ability to contact their EMS service for licensure or certification verification.

   2. (B)

      1. (i) All licensure levels shall maintain a Department of Health-approved cardiopulmonary resuscitation (CPR) certification.
      2. (ii) Paramedics are also required to maintain a Department of Health-approved advanced cardiovascular life support (ACLS) certification during their license period.

   3. (C) The Department of Health-approved CPR and ACLS certifications must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.
   4. (D) Each service shall have a copy of all current licensure and certification cards readily available for all employees.
3. (7) Criminal history form. Any applicant applying for initial licensure or EVO certification shall complete state, federal, or both criminal history checks, depending on residency status.

4. (8) Licensure level requirements — Emergency medical responder.

   1. (A) Successful completion of a Department of Health-accredited EMR program.
   2. (B) Successful completion of the NREMT certification process.

   3. (C) Department of Health-approved CPR certification must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.

5. (9) Emergency Medical Technician.

   1. (A) Successful completion of a Department of Health-accredited EMT program, including all didactic, clinical, and field internship requirements.
   2. (B) Successful completion of both the Arkansas practical skills examination, or documented verification of skills proficiency, and the NREMT certification process.

   3. (C) Department of Health-approved CPR certification must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.

6. (10) Advanced Emergency Medical Technician.

   1. (A) Successful completion of a Department of Health-accredited AEMT program, including all didactic, clinical, and field internship requirements.
   2. (B) Successful completion of the NREMT certification process.

   3. (C) Department of Health-approved CPR certification must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.

7. (11) Paramedic.

   1. (A) Successful completion of a Department of Health and Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) and Committee on Allied Health Education and Accreditation (CAHEA) accredited paramedic program, including all didactic, clinical, and field internship requirements.
   2. (B) Successful completion of the NREMT certification process.

   3. (C) Department of Health-approved CPR and ACLS certifications must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.

8. (12) Community Paramedic.

   1. (A) Community paramedic licensure will run concurrent with the current Arkansas paramedic license expiration date.

   2. (B)

      1. (i) Successful completion of a Department of Health-approved community paramedic curriculum, including all didactic and clinical hour requirements.
      2. (ii) Education hours for initial licensure are valid for two (2) years from course completion.
   3. (C) Hold NREMT certification as a paramedic and be in good standing with the NREMT.
   4. (D) Must hold and maintain an Arkansas license as a paramedic and be in good standing with the Department of Health.

   5. (E)

      1. (i) Have two (2) years of full-time service as a paramedic and be actively employed by a licensed paramedic service.
      2. (ii) Potential licensees shall submit a letter from a licensed paramedic service:

(b) (b) Confirming that they are actively employed by that service.

1. (F) Department of Health-approved CPR and ACLS certifications must:

   1. (i) Follow American Heart Association guidelines; and

      1. (ii) Require a hands-on skills component designed specifically for healthcare providers.
   2. (G) May only practice as a community paramedic performing community paramedic skills through a licensed community paramedic service.

2. (13) EMSP — Instructor.

   1. (A) EMSP — Instructor licensure will run concurrent with Arkansas EMSP license expiration date.
   2. (B) Hold an Arkansas EMSP license and be in good standing with the Department of Health.
   3. (C) Licensed as an EMSP continuously at the level of instruction from any state, national status, or military for a minimum of two (2) years.
   4. (D) Successful completion of a Department of Health-approved forty-hour EMSP — Instructor course following National Association of EMS Educators (NAEMSE) standards.

   5. (E) EMSP instructors must maintain a Department of Health-approved CPR and/or ACLS instructor certification, must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed for healthcare providers.

3. (14) Emergency Vehicle Operator certification.

   1. (A) Successful completion of a nationally recognized first responder course of a minimum of forty (40) hours of training that includes an emergency vehicle operator driving skills component.

   2. (B) Department of Health-approved CPR certification, must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.

4. (15) Uniformed service members. As used in this part:

   1. (A) “Automatic licensure” means granting the occupational licensure without an individual having met occupational licensure requirements provided:

      1. (i) Under the Arkansas Code; or
      2. (ii) By other provisions in this part.

   2. (B) “Uniformed service member" means an:

      1. (i) Active or reserve component member of the:

(b) (b) United States Army;

1. (c) (c) United States Coast Guard;

   1. (d) (d) United States Marine Corps;

(g) (g) National Guard;

1. (ii) Active component member of the National Oceanic and Atmospheric Administration Commissioned Officer Corps; or

   1. (iii) Active or reserve component member of the United States Commissioned Corps of the Public Health Service.
   2. (C) “Uniformed service veteran" means a former member of the United States uniformed services discharged under conditions other than dishonorable.

   3. (D) Applicability applies to a:

      1. (i) Uniformed service member stationed in the State of Arkansas;
      2. (ii) Uniformed service veteran who resides in or establishes residency in the State of Arkansas; or
      3. (iii) The spouse of subdivision (a)(15)(D)(i) or (a)(15)(D)(ii) of this section, including a uniformed service member who is:

(b) (b) Killed or succumbs to his or her injuries or illness in the line of duty if the spouse establishes residency in Arkansas.

1. (16) Temporary and provisional license for uniformed service members.

   1. (A) The Department of Health shall issue a temporary and provisional license immediately upon receipt of the application, the required fee, and the documentation required under this section.
   2. (B) The temporary and provisional license shall be effective for at least ninety (90) days or until the Department of Health decides on the application unless the Department of Health determines that the applicant does not meet the requirements in this section, in which case the temporary and provisional license shall be immediately revoked.
   3. (C) An applicant may provide the rest of the documentation required above to receive a license, or the applicant may only provide the information necessary for the issuance of a temporary and provisional license.
   4. (D) The Department of Health shall require an applicant to hold a current NREMT certification if the applicant is licensed in another state that does not offer reciprocity to Arkansas residents that is like reciprocity to out-of-state applicants in Arkansas Code § 17-1-108.

   5. (E) Reciprocity in another state will be considered like reciprocity under Arkansas Code § 17-1-108 if the reciprocity provisions in the other state:

      1. (i) Provide the least restrictive path to licensure for Arkansas applicants;
      2. (ii) Do not require Arkansas applicants to participate in the apprenticeship, education, or training required as a prerequisite to licensure of a new professional in that state, except that the state may require Arkansas applicants to participate in continuing education or training that is required for all professionals in that state to maintain licensure; and
      3. (iii) Do not require Arkansas applicants to take a state-specified education unless required under the same conditions described in Arkansas Code § 17-1-108.

   6. (F) Automatic licensure shall be granted to persons listed in subdivision (a)(15)(D) of this section if the person:

      1. (i) Is a holder in good standing of occupational licensure with similar scope of practice issued by another state, territory, or district of the United States;
      2. (ii) Holds an NREMT certification; and
      3. (iii) Pays the criminal history background fees.
   7. (G) Credit toward initial licensure. Relevant and applicable uniformed service education, training, or service-issued credential shall be accepted toward initial licensure for a uniformed service member or a uniformed service veteran who makes an application within one (1) year of his or her discharge from uniformed service.

   8. (H) Expiration dates and continuing education.

      1. (i) A license expiration date shall be extended for a deployed uniformed service member or spouse for one hundred eighty (180) days following the date of the uniformed service member's return from deployment.
      2. (ii) A uniformed service member or spouse shall be exempt from continuing education requirements in subsection (d) of this section for one hundred eighty (180) days following the date of the uniformed service member's return from deployment.
      3. (iii) Any uniformed service member or spouse exercising the exemption shall provide evidence of completion of continuing education before renewal or grant of a subsequent license.

(b) General licensure renewal standards.

1. (1) One (1) continuing education unit (CEU) is defined as every fifty (50) minutes of approved classroom or skills laboratory activities.
2. (2) Continuing education courses or activities shall not be approved or accepted for less than one-half (1/2) hour unit of credit.

3. (3) CEUs shall not be awarded until:

   1. (A) All requirements have been met; and
   2. (B) The EMSP attended the complete training.
4. (4) Hour-for-hour credit can be applied for nationally standardized courses, including but not limited to ABLS, ACLS, AMLS, EMPACT, EPC, ITLS, PHTLS, PALS, PEPP, etc.

5. (5) The following cannot be applied towards the National Continued Competency Program (NCCP):

   1. (A) Performance of duty or volunteer time with agencies;
   2. (B) Clinical rotations;
   3. (C) Instructor methodology courses;
   4. (D) Management/leadership courses;
   5. (E) Preceptor hours; and

   6. (F) Disciplinary or remediation hours ordered by the Department of Health.

      1. (c) Recertification audits.

6. (1)

   1. (A) Renewal applications may be randomly selected for audit.
   2. (B) If a licensed EMSP’s application is randomly selected, the EMSP must provide documentation for all hours submitted for their renewal within fifteen (15) business days from notification.

7. (2) Documentation may consist of course completion certificates, written verification from the training officer, or other proof as approved by the Department of Health.

   1. (d) Renewal standards.

8. (1) All individuals applying for renewal of a license or emergency vehicle operator certification shall submit the following to the Department of Health:

   1. (A) Completed renewal application;

   2. (B)

      1. (i) Payment of application fee set forth by current EMS statute payable to the Department of Health.
      2. (ii) An application fee is not applicable for community paramedic licensure;

   3. (C) Department of Health-approved CPR certification, must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers;

   4. (D) Paramedics must have a Department of Health-approved ACLS certification:

      1. (i) Following current American Heart Association guidelines; and
      2. (ii) Requiring a hands-on skills component specifically designed for healthcare providers;

   5. (E)

      1. (i) Document completion of all education requirements for your level of licensure or certification.
      2. (ii) It is the responsibility of the EMSP to maintain copies of all rosters, certificates, proof of attendance, or both, to all continuing education used for renewal.
      3. (iii) These documents will be required should the EMSP be audited; and
   6. (F) If employed by a licensed service, the EMSP must be verified by the service and medical directors.

9. (2) Specific renewal requirements by EMS license and certification level.

   1. (A) Emergency Medical Responder.

      1. (i) Continuing education hours needed to meet the renewal requirements are outlined below:

(b) (b) Four (4) hours to include the following Arkansas-specific topic areas:

1. (1) (1) Arkansas Trauma System, two (2) hours; and

2. (2) (2) Ethics and professionalism, two (2) hours; and

   1. (c) (c) Four (4) hours for individual required continuing education in any EMS-related topic areas.

      1. (ii) Renewal of NREMT certification is required.

   2. (B) Emergency Medical Technician.

      1. (i) Continuing education hours needed to meet the renewal requirements are outlined below:

(b) (b) Ten (10) hours in the following Arkansas-specific topic areas:

1. (1) (1) Arkansas Trauma System, two (2) hours;
2. (2) (2) Pediatrics, two (2) hours;
3. (3) (3) Stroke, two (2) hours;
4. (4) (4) Cardiology, two (2) hours;
5. (5) (5) Documentation, one (1) hour; and

6. (6) (6) Ethics and professionalism, one (1) hour; and

   1. (c) (c) Ten (10) hours for individual required continuing education in any EMS-related topic areas.

      1. (ii)

(b) (b) EMTs who have never held national certification shall document completion of all education requirements prior to their state license expiration date to renew their state EMT license.

1. (C) Advanced Emergency Medical Technician.

   1. (i) Continuing education hours needed to meet the renewal requirements are outlined below:

(b) (b) Twelve and one-half (12 1/2) hours in the following Arkansas-specific topic areas:

1. (1) (1) Arkansas Trauma System, two (2) hours;
2. (2) (2) Pediatrics, two and one-half (2 1/2) hours;
3. (3) (3) Stroke, two (2) hours;
4. (4) (4) Cardiology, two (2) hours;
5. (5) (5) Documentation, two (2) hours; and

6. (6) (6) Ethics and professionalism, two (2) hours; and

   1. (c) (c) Twelve and one-half (12 1/2) hours for individual required continuing education in any EMS-related topic areas.

      1. (ii)

(b) (b) AEMTs who have never held national certification shall document completion of all education requirements prior to their state license expiration date to renew their state AEMT license.

1. (D) Paramedic.

   1. (i) Continuing education hours needed to meet the renewal requirements are outlined below:

(b) (b) Fifteen (15) hours in the following Arkansas-specific topic areas:

1. (1) (1) Arkansas Trauma System, two (2) hours;
2. (2) (2) Pediatric, three (3) hours;
3. (3) (3) Stroke, four (4) hours;
4. (4) (4) Cardiology, two (2) hours;
5. (5) (5) Documentation, two (2) hours; and

6. (6) (6) Ethics and professionalism, two (2) hours; and

   1. (c) (c) Fifteen (15) hours for individual required continuing education in any EMS-related topic areas.

      1. (ii)

(b) (b) Paramedics who have never held national certification shall document completion of all education requirements prior to their state license expiration date to renew state paramedic license.

1. (E) Community Paramedic.

   1. (i) Community Paramedic licensure is for a two-year period to run concurrently with the primary paramedic licensure.

      1. (ii)

(b) (b) No license shall be issued until NREMT certification is verified.

1. (iii) Complete an additional fifteen (15) hours of community paramedic practice-focused training beyond the renewal requirements.

   1. (F) EMSP — Instructor.

      1. (i) EMSP — Instructor is for a two-year period to run concurrently with the EMSP’s primary license.
      2. (ii) The following must be completed and submitted for all instructors:

(b) (b) Department of Health-approved CPR instructor certification:

1. (1) (1) Following current American Heart Association guidelines; and

2. (2) (2) Requiring a hands-on skills component designed specifically for healthcare providers;

   1. (c) (c) Paramedic EMSP instructors shall maintain a Department of Health-approved ACLS instructor certification:
3. (1) (1) Following current American Heart Association guidelines; and

4. (2) (2) Requiring a hands-on skills component designed specifically for healthcare providers;

   1. (d)
5. (1) (d)(1) Complete twelve (12) hours of continuing education at the EMSP — Instructor level.
6. (2) (2) This education must include professional development or instructor-specific education; and

(e) (e) Submit a signed affiliation letter of good standing from a Department of Health-approved EMS training site, to include documentation courses taught during the renewal cycle.

1. (G) Emergency Vehicle Operator certification. Continuing education hours needed to meet the renewal requirements are outlined below:

   1. (i) Six (6) hours of EMS-related education; and

      1. (ii) Four (4) hours in the following Arkansas-specific topic areas:

(b) (b) Ethics and professionalism, two (2) hours.

1. (3) EMSP late license renewal applications.

   1. (A) Late renewal will be allowed for those who submit their documentation after the expiration date, if:

      1. (i) All required educational hours, as outlined in subsection (d)(2) of this section, for their appropriate license level were completed prior to their current expiration date;
      2. (ii) Renewal application fees and all documentation is submitted no later than two (2) years after their current expiration date; and
      3. (iii) NREMT certification must be renewed before an Arkansas EMSP license renewal will be issued.
   2. (B) EMSPs submitting their renewal material after the expiration date, but who have completed all requirements prior to their current EMSP’s expiration date, will be relicensed to their previous expected expiration date matching the NREMT expiration date.

   3. (C) Request for extension to complete EMSP license renewal requirements:

      1. (i)

(b) (b) The letter must include the reason for the extension and supporting documentation; and

1. (ii) If the Department of Health receives the request, the EMSP’s documentation, or both after the expiration date or the extension request is denied, the EMSP will be considered lapsed.

(e) Lapsed Arkansas EMSPs.

1. (1) Individuals who do not complete their education and training requirements for renewal prior to their expiration date will:

   1. (A) Be considered lapsed; and
   2. (B) Have to complete the following requirements for their licensure level prior to renewing their Arkansas license.
2. (2) NREMT certification renewal is required before an Arkansas EMSP license may be issued.

3. (3) Lapsed two (2) years or less:

   1. (A) Documentation of the successful completion of required educational hours within your renewal cycle, as outlined in subsection (d)(2) of this section, for the appropriate license level; or
   2. (B) If educational requirements are not completed within the renewal cycle, then documentation of required hours; and

   3. (C) Additional documentation of continuing education hours as follows for their EMSP licensure level:

      1. (i) EMR, six (6) hours;
      2. (ii) EMT, twelve (12) hours;
      3. (iii) AEMT, eighteen (18) hours;
      4. (iv) Paramedic, twenty-four (24) hours;
      5. (v) Community paramedic, eight (8) hours;
      6. (vi) EMSP — Instructor, twenty-four (24) hours; and
      7. (vii) EVO, six (6) hours.
4. (4) All EMSP levels — Lapsed more than two (2) years. All expired EMSPs shall complete all initial licensure requirements as outlined in subsection (d)(2) of this section.

(f) Reciprocity.

1. (1)

   1. (A) An applicant applying for reciprocal licensure shall meet the following requirements:

      1. (i) The applicant shall hold a substantially similar EMSP license in another United States jurisdiction if the other state’s licensure qualifications require:

(b) (b) NREMT certification, CPR certification, and ACLS certification, if applicable;

1. (ii)

(b) (b) The Department of Health may verify this information online if the issuing jurisdiction provides primary source verification on its website, or by telephone call from another state’s licensing board; and

1. (iii) Provide proof of licensure for all states in which the applicant is currently licensed or has been previously licensed as an EMSP.

   1. (B) The applicant’s EMSP license shall be current and in good standing.

   2. (C) The applicant shall not have had a license revoked for:

      1. (i) An act of bad faith; or
      2. (ii) A violation of law, rule, or ethics.
   3. (D) The applicant’s license shall not be suspended, on probation, or revoked due to disciplinary action in a United States jurisdiction.

2. (2)

   1. (A) An applicant shall submit:

      1. (i) A completed application;
      2. (ii) The required fee; and
      3. (iii) An Arkansas criminal history background check and payment of the applicable fee, to include both state and federal checks.

   2. (B) All EMSPs shall have a Department of Health-approved CPR certification and must:

      1. (i) Follow current American Heart Association guidelines; and
      2. (ii) Require a hands-on skills component designed specifically for healthcare providers.

   3. (C) Paramedics must have a Department of Health-approved ACLS certification:

      1. (i) Following current American Heart Association guidelines; and
      2. (ii) Requiring a hands-on skills component designed specifically for healthcare providers.
3. (3) Provisional licenses are not eligible for reciprocity.
4. (4) The applicant shall hold a current NREMT certification.