1. (a) Emergency Medical Responder education programs.

   1. (1) The Department of Health shall approve all EMR courses prior to the beginning of any period of instruction.

   2. (2)

      1. (A) EMR training may only be sponsored by a Department of Health-approved EMS education program.
      2. (B) Any Arkansas-licensed ambulance service applying for accreditation and approval by the Department of Health must be a licensed EMT service or hold a Department of Higher Education Private Career Education license.
   3. (3) Primary lead EMR instructors must be Arkansas-licensed EMSP — Instructors.
   4. (4) Only those students from a Department of Health-approved EMS education program that have successfully completed all course requirements as documented by the instructor will be allowed to challenge the NREMT certification exam.

2. (b) Emergency Medical Technician education programs.

   1. (1) The Department of Health shall approve all EMT courses and training sites prior to the beginning of any period of instruction.

   2. (2)

      1. (A) EMT training may be sponsored only by a Department of Health-approved EMS education program.
      2. (B) Any Arkansas-licensed ambulance service applying for accreditation and approval by the Department of Health for an EMS education program must:

3. (i) Be a licensed EMT service; and

   1. (ii) Hold a Department of Higher Education Private Career Education license.
   2. (3) Primary EMT instructors must be either Arkansas-licensed physicians or Arkansas-licensed EMSP instructors at the EMT level or higher.
   3. (4) EMT educational programs must follow the current National Highway Traffic Safety Administration’s National EMS Education Standards.
   4. (5) Only those students from a Department of Health-accredited EMS educational facility that have successfully completed all course requirements as documented by the instructor and medical director will be allowed to challenge the NREMT certification examination.

   5. (6) Clinical and field training.

      1. (A) Clinical and field training hours must meet or exceed the current National Highway Traffic Safety Administration’s National EMS Education Standards.
      2. (B) Clinical phases of training are recommended and should be conducted within a medical facility with hospital concurrence following the Department of Health’s Emergency Medical Services Accreditation Manual.
      3. (C) During clinicals, EMT students will be trained within the hospital or medical facility by qualified personnel under guidelines and requirements stated in the curriculum and approved by the facility’s governing body during clinical phases of training.

      4. (D)

         1. (i) If using a medical facility for clinicals, there shall be an academic as well as a clinical atmosphere.
         2. (ii) Trainees must be in uniform with a standard means of identification when engaged in the patient care and clinical portions of the program.
      5. (E) Field training must be completed with an Arkansas-licensed ambulance service approved by the Department of Health with which there is an affiliation agreement allowing students to actively participate in patient care.

      6. (F) The student must be in the patient compartment during transport.

         1. (c) Advanced EMT education programs.

   6. (1) AEMT curriculum, evaluations, and clinical and field internships will:

      1. (A) Be developed and approved by the Department of Health’s Emergency Medical Services Accreditation Manual for initial training sites; and
      2. (B) Follow AEMT policies set forth by the Department of Health.

   7. (2) All training sites must:

      1. (A) Complete the Department of Health-required self-study; and
      2. (B) Pass a training site inspection at their level.
   8. (3) The Department of Health shall approve all AEMT courses and training sites prior to the beginning of any periods of instruction.

   9. (4)

      1. (A) AEMT training shall be sponsored only by a Department of Health-approved EMS program.

      2. (B) Any Arkansas-licensed ambulance service applying for accreditation and approval for an AEMT education program by the Department of Health must:

         1. (i) Be an Arkansas-licensed AEMT or paramedic service; and
         2. (ii) Hold a current Department of Higher Education Private Career Education License.
      3. (C) The training site will follow all Department of Health requirements for new training sites according to the Department of Health’s Emergency Medical Services Accreditation Manual.
   10. (5) Primary AEMT instructors must be either Arkansas-licensed physicians or Arkansas-licensed EMSP instructors at the AEMT level or higher.
   11. (6) AEMT courses must follow the current National Highway Traffic Safety Administration’s National EMS Education Standards.
   12. (7) There shall be an academic as well as a clinical atmosphere.
   13. (8) Only those students from a Department of Health-accredited EMS educational facility that have successfully completed all course requirements as documented by their instructor and medical director will be allowed to challenge the NREMT certification examination.
   14. (9) All AEMT students must be an Arkansas-licensed EMT prior to any clinical or field training that involves patient care.

   15. (10) Medical facility training.

       1. (A) Clinical phases of training will be conducted within a medical facility with hospital concurrence with signed affiliation agreements.
       2. (B) AEMT students will be trained within the hospital or medical facility by qualified personnel under guidelines and requirements stated in the curriculum and approved by the medical staff and the facility’s governing body during clinical phases of training with appropriate oversight and written affiliation agreement.
       3. (C) Students must be in uniform with a standard means of identification when engaged in the patient care and clinical portions of the program.

   16. (11) Field internship.

       1. (A) Internship must be completed with an Arkansas-licensed paramedic or AEMT-licensed ambulance service approved by the Department of Health with which there is an affiliation agreement allowing students to actively participate in patient care.

       2. (B) The student must:

          1. (i) Be in the patient compartment during transport; and
          2. (ii) Always have direct supervision by a licensed AEMT or paramedic.
          3. (d) Paramedic education programs.

   17. (1) All current Arkansas paramedic and community paramedic education programs must complete one (1) of the following prior to starting a paramedic or community paramedic education program:

       1. (A) Achieved accreditation by the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) and have submitted all Department of Health-required paperwork, including the self-study; or
       2. (B) Have submitted all Department of Health-required paperwork, including the self-study, and be awaiting the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) site visit or hold a CoAEMSP official letter of review.

   18. (2) Any potential qualifying institution wishing to apply to be a paramedic or community paramedic education program must:

       1. (A) Meet Arkansas requirements as listed in the Department of Health’s Emergency Medical Services Accreditation Manual for initial Arkansas EMSP courses;
       2. (B) Submit their application and site review to the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP); and
       3. (C) Be scheduled for the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) site visit.
   19. (3) Full accreditation by the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP) and the Committee on Allied Health Education and Accreditation (CAHEA) shall be attained as documented by a letter from CoAEMSP prior to Department of Health approval.

4. (e) Paramedic training.

   1. (1) Medical facility training.

      1. (A) Clinical phases of training will be conducted within a medical facility as approved by the educational program’s medical director.
      2. (B) Paramedic students will be educated within the hospital or medical facility by qualified personnel under guidelines and requirements stated in the curriculum and approved by the medical facility’s governing body during clinical phases of training with appropriate oversight and written affiliation agreement.

   2. (2) Field internship.

      1. (A) Internship must be completed with an Arkansas-licensed paramedic ambulance service approved by the Department of Health.
      2. (B) There shall be a written agreement allowing students to actively participate in patient care.

      3. (C) The student must:

         1. (i) Be in the patient compartment during transport; and
         2. (ii) Always have direct supervision by a licensed paramedic.

   3. (3) Only those students from CoAEMSP-accredited Department of Health-approved programs who are recommended by their instructor and medical director will be allowed to:

      1. (A) Challenge the NREMT certification examination; and
      2. (B) Obtain an Arkansas paramedic license.

5. (f) Community paramedic.

   1. (1)

      1. (A) Community paramedic evaluations and clinical and field internships will:

         1. (i) Follow the Department of Health-approved community paramedic curriculum; and
         2. (ii) Consist of a minimum of one hundred sixty (160) hours of didactic clinical education hours.
      2. (B) Twenty percent (20%) of the patient contacts in each subtopic outlined below may be made within a Department of Health-licensed community paramedic service.

      3. (C) The curriculum shall include the following minimum patient contacts:

         1. (i) Public Health and Collaboration (public health clinic).

6. (a) (a) Must observe six (6) immunizations in the following age categories:

   1. (1) (1) Adult; and
   2. (2) (2) Pediatrics.

7. (b) (b) Must observe reporting of communicable diseases;

   1. (ii) Public Health and Collaboration (home health).
8. (a) (a) All experiences within the home health setting must be completed with a home health registered nurse or other designated provider as outlined below.

9. (b) (b) Six (6) home safety evaluations and inspections, must observe and participate.

   1. (c) (c) Twenty (20) patient contacts, to include:
   2. (1) (1) Home health patient assessments, observe and participate;
   3. (2) (2) Patient documentation/charting at home visits; and

   4. (3) (3) Medication reconciliation with patient, observe and participate.

      1. (d) (d) Ten (10) contacts with patients in each of the following categories:
   5. (1) (1) CHF assessment and management plan, observe and participate;
   6. (2) (2) COPD assessment and management plan, observe and participate;
   7. (3) (3) Diabetic-related illness issues, participate;
   8. (4) (4) Neurological conditions (CVA, TBI, MS, etc.), observe and participate; and

   9. (5) (5) Wound care;

      1. (iii) Social determinants;

         1. (iv) Hospice.

10. (a) (a) Ten (10) home visits to include the following:

    1. (1) (1) Nursing services;
    2. (2) (2) Social services; and
    3. (3) (3) Chaplain services.

11. (b) (b) Ten (10) patient contacts addressing palliative care and/or pain management.

    1. (c) (c) Review three (3) hospice criteria for the patient referrals.

       1. (d) (d) Two (2) in-depth instructional trainings on in-home medication pump operations;

          1. (v) Clinic (any medical facility setting).
12. (a) (a) Five (5) urine specimen collections.

13. (b) (b) Five (5) wound, throat, nasal, sputum, or related cultures.

    1. (c) (c) Five (5) health promotion studies education, HAIC, cholesterol, colonoscopy, etc.

       1. (d) (d) Ten (10) otoscope, observe and use;

          1. (vi) Hospital. Twenty-four (24) hours of hospital case management to include but not limited to:
14. (a) (a) Discharge planning;

15. (b) (b) Utilization review; and

    1. (c) (c) Case management;

       1. (vii) Public health clinic. Individuals must observe a minimum of eight (8) hours in the public health setting; and

          1. (viii) General settings.

16. (a) (a) The following may take place in any care setting, to include but not limited to:

    1. (1) (1) An emergency department;
    2. (2) (2) Physical therapy;
    3. (3) (3) Home health; or
    4. (4) (4) Public health clinic.

17. (b) (b) Ten (10) patient contacts involving instruction and use of:

    1. (1) (1) Crutches;
    2. (2) (2) Wheelchairs;
    3. (3) (3) Walkers;
    4. (4) (4) Canes;
    5. (5) (5) Hospital beds;
    6. (6) (6) Hoyer lifts; and

    7. (7) (7) Slide boards.

       1. (c) (c) Ten (10) uses in the access of:
    8. (1) (1) Central lines;
    9. (2) (2) Ports;
    10. (3) (3) Ileostomies;
    11. (4) (4) Foley catheters;
    12. (5) (5) PEG tubes; and
    13. (6) (6) Wound management.
    14. (2) The Department of Health shall approve all community paramedic courses and EMS education program locations prior to the beginning of any period of instruction.
    15. (3) Community paramedic programs must obtain and maintain active paramedic training site accreditation by the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP).
    16. (4) Primary instructors must be either Arkansas-licensed physicians, registered nurses, or Arkansas-licensed paramedic/EMSP instructors.

    17. (5)

        1. (A) There shall be an academic as well as a clinical atmosphere.
        2. (B) Community paramedic students must have a standard means of identification when engaged in the patient care and clinical portions of the community paramedic program.

    18. (6) Community paramedic clinical internship.

        1. (A) Clinical experience shall be provided under the supervision of a community paramedic service medical director, advanced practice registered nurse, physician assistant, or home health nurse.
        2. (B) Community paramedics will be educated within the hospital or medical facility by qualified personnel under guidelines and requirements stated in the curriculum and approved by the medical facility’s governing body during clinical phases of training with appropriate oversight and written affiliation agreements.

        3. (C) Areas of clinical experience shall include at a minimum:

           1. (i) Social determinants;
           2. (ii) Home health services;
           3. (iii) Hospital case management; and
           4. (iv) Public health agencies services.

18. (g) EMSP — Instructor education program.

    1. (1) Requirements to conduct an EMS — Instructor course are as follows:

       1. (A) Must be a Department of Health-approved forty-hour course, National Association of EMS Educators, or International Fire Service Accreditation Congress course, sponsored by an Arkansas-approved EMS education program in affiliation with an educational program;
       2. (B) All courses must be approved by the Department of Health prior to the beginning of instruction;
       3. (C) All courses must follow the current National Highway Traffic Safety Administration’s National EMS Education Standards instructor guidelines for their level; and
       4. (D) An individual who holds a bachelor’s degree or higher must assist with the course.

    2. (2) EVO certification programs.

       1. (A) The Department of Health shall approve all EVO courses prior to the beginning of any periods of instruction.
       2. (B) EVO training must follow a nationally recognized first responder course with a minimum of forty (40) hours of training that includes an emergency vehicle operator driving skills component.
       3. (C) Primary EVO instructors must be Arkansas-licensed EMSP instructors.

Codification Notes: “CHF” means congestive heart failure. "COPD" means chronic obstructive pulmonary disease. "CVA" means cerebrovascular accident. "HAIC" means healthcare-associated infections — community interface activities. "MS" means multiple sclerosis. "PEG" means percutaneous endoscopic gastronomy. "TBI" means traumatic brain injury.