(a) Regulatory administration.

1. (1) Any authorized representative of the Department of Health shall have the right to enter the premises of any ambulance service, permitted ambulance, or EMS education program at any time in order to make whatever inspection necessary in accordance with the minimum standards prescribed herein.

2. (2) Each service shall maintain and make available during normal business hours to the department for inspection records including, but not limited to:

   1. (A) Patient records;
   2. (B) Equipment checks;
   3. (C) EMSP certifications, continuing education, and credentialing;
   4. (D) Policies and procedures; and
   5. (E) Any document related to service licensure or EMS education program.

(b) Penalty.

1. (1) The department may impose one (1) or more penalties for any offense committed hereunder including revocation, suspension, or probation of a license or any other discipline that is appropriate under the circumstances, including but not limited to requiring completion of education requirements or fines.

2. (2)

   1. (A) As to ambulance service licenses, pursuant to Arkansas Code § 20-13-1005, three (3) formal citations during the license term for failure to comply with Arkansas Code § 20-13-1001, et seq., and any rules promulgated by the department and the State Board of Health regarding ambulance services shall result in revocation of the ambulance service license.
   2. (B) However, the board and department are not limited in disciplinary action up to and including revocation of licensure in the event of fewer than three (3) formal citations.

3. (3)

   1. (A) Any nonlicensed person found violating this part may be prohibited from obtaining Arkansas state licensure for one (1) year.
   2. (B) If such person does obtain Arkansas state licensure after one (1) year, they will be placed on probation for their first two-year licensure period.

(c) Offenses.

1. (1) Conviction or pleading guilty or nolo contendere to any criminal offense listed in Arkansas Code § 20-13-1106.
2. (2) Demonstration of incompetence, knowingly or willfully violating this part, or other inability to provide adequate service.
3. (3) Violation of any local, state, or federal law or rules affecting the practice of EMS.
4. (4) Any conduct that is in violation of any criminal, civil, or administrative code or statute.
5. (5) Falsifying, destroying, failing to make accurate, complete, or clearly written or oral patient care reports documenting a patient’s condition upon arrival at the scene, the prehospital care provided, and the patient’s status during transport, including signs, symptoms, and responses during duration of transport per EMSP’s approved protocol.
6. (6) Disclosing confidential information or knowledge concerning a patient by any means of communication, except where required or allowed by law.
7. (7) Causing or permitting physical or emotional abuse, injury to a patient or the public, or failing to report such abuse or injury to the EMSP’s employer, the department, and appropriate legal authority within twenty-four (24) hours after the event occurs, or the next business day within twenty-four (24) hours after the event, if earlier disclosure is not possible.
8. (8) Failure to follow their medical director’s protocol, performing advanced-level or invasive treatment without medical direction or supervision, or practicing beyond the scope of certification or licensure while on duty or off-duty.
9. (9) Failure to respond to a call while on duty or leaving duty assignment without proper authority.
10. (10) Abandoning a patient.

11. (11) Failing to comply with the terms of a department-approved:

    1. (A) Consent agreement;
    2. (B) Ordered probation; or
    3. (C) Suspension.
12. (12) Misrepresenting the level of any certification or licensure.

13. (13) Misappropriating, or failure to take precautions to prevent misappropriation of, medications, supplies, equipment, personal items, or money belonging to:

    1. (A) The patient;
    2. (B) The employer; or
    3. (C) Any other person or entity.
14. (14) Falsifying or altering, or assisting another in falsifying or altering, any department application or EMS certificate or license, or using or possessing any such falsified or altered certificate or license.
15. (15) Cheating or assisting another to cheat on any examination, written or psychomotor, by any EMSP licensed by the department or any institution or entity conducting EMS education or training or providing an EMS examination leading to obtaining licensure or renewing licensure.

16. (16) Obtaining or attempting to obtain, or assisting another in obtaining or attempting to obtain, any advantage, benefit, favor, or gain by:

    1. (A) Fraud;
    2. (B) Forgery;
    3. (C) Deception;
    4. (D) Misrepresentation;
    5. (E) Untruth; or
    6. (F) Subterfuge.
17. (17) Illegally possessing, dispensing, administering, distributing, or attempting to illegally dispense, administer, or distribute controlled substances as defined by federal or state laws or rules, including but not limited to the Controlled Substances List promulgated by the board.
18. (18) Receiving disciplinary action relating to any healthcare provider certification or licensure issued in Arkansas or another state or territory.
19. (19) Failure or refusal to give the department full and complete information requested by the department in a timely manner.
20. (20) Failure to notify the department of being convicted or pleading guilty or nolo contendere to a criminal offense within ten (10) business days of the conviction or plea, other than any Class C misdemeanor not related to EMS.
21. (21) Failure to notify the department within five (5) business days of his or her being arrested, charged, or indicted for any criminal offense other than any Class C misdemeanor not directly related to EMS.
22. (22) Engagement in any conduct that jeopardizes or has the potential to jeopardize the health or safety of any person.
23. (23) Failure of any drug screening test administered during an EMS work or volunteer shift, or within twelve (12) hours of the beginning or end of any such shift.
24. (24) Resigning employment or refusing by the employee of an employer drug screening test right before, after, or during an assigned EMS work or volunteer shift.
25. (25) Failure to maintain the requisite skill, knowledge, and/or academic acuity to timely and/or accurately perform the duties or meet the responsibilities required of a licensed EMSP at appropriate licensure level that endangers the safety or welfare of patients and/or EMSPs.
26. (26) Delegation of medical functions to other personnel without approval from the medical director per approved protocols.

27. (27) Disruptive behavior or exhibition of unprofessional conduct toward:

    1. (A) Other EMS personnel;
    2. (B) Law enforcement officers;
    3. (C) Firefighters;
    4. (D) Hospital personnel;
    5. (E) Other medical personnel;
    6. (F) Patients;
    7. (G) Family members; or
    8. (H) Others on the scene.
28. (28) Falsification or alteration of clinical or internship documents for EMS students.
29. (29) Falsification or failure to complete daily readiness checks on EMS vehicles, medical supplies, or equipment as required by EMS employers.
30. (30) Engagement in acts of dishonesty that relate to the EMS profession.

31. (31)

    1. (A) Behavior that exploits the EMSP patient relationship in a sexual way.
    2. (B) This behavior is nondiagnostic or nontherapeutic, may be verbal or physical, and may include expressions or gestures that have sexual connotations or that a reasonable person would construe as such.
32. (32) Falsification of, or making any false statements in, any information provided to or by the department, to include misrepresentation, fraud, or concealment including but not limited to applications for licensure, certification, or renewal of licensure or certification and continuing education requirements.
33. (33) Acting negligently, neglectfully, or with intent to cause harm toward a patient or other person.
34. (34) Reporting to duty or rendering patient care while under the influence of alcohol according to current Arkansas Code, illegal drugs, or illegally obtained drugs concurrent with state law.
35. (35) Use of alcohol or any intoxicating substance while on duty.
36. (36) Providing false information to regulatory officials or willfully concealing known deficiencies during an inspection.
37. (37) Conviction of driving under the influence of alcohol or any intoxicating substance while on duty, on emergency response, or during patient transport.
38. (38) Failure to report substance abuse of an on duty EMSP to the department.
39. (39) Failure to follow accepted standards of care in the management of a patient or in response to a medical emergency.
40. (40) Use of equipment or performance of procedures beyond the EMSP’s licensure level, scope of practice, or the level of licensure of the ambulance service.
41. (41) Unauthorized release or divulgence of confidential information to an unauthorized person or use of confidential patient information by any means of communication for personal or financial benefit.
42. (42) Providing care as an Arkansas EMSP, independently or with a licensed EMS service, while having a lapsed or expired Arkansas EMSP license.
43. (43) Failure to accept or respond to official departmental correspondence sent by certified mail.
44. (44) Misappropriation, theft, stealing, or embezzlement of EMS grants or equipment purchased under such grants.
45. (45) Falsification of records related to ambulance service operations.
46. (46) Failure to provide patient information to a hospital or other healthcare facility in response to an authorized request.
47. (47) Failure to report to the department actions regarding incompetent, unethical, or illegal practice by any EMSP.
48. (48) Enactment of a requirement or coercion of EMSPs to violate any of this part or Arkansas law related to EMS.
49. (49) Engagement in the delivery of emergency medical services on a revoked, suspended, expired, or inactive Arkansas EMS license.
50. (50) Alteration or transfer of a vehicle permit from one vehicle to another.

51. (51) Operation of an ambulance or EMS vehicle that is not:

    1. (A) Licensed;
    2. (B) Permitted; or
    3. (C) Insured.
52. (52) Failure to follow all requirements concerning drugs and pharmaceuticals.
53. (53) Carrying or using equipment not approved by the department for licensure level by a licensed ambulance service or EMSP.
54. (54) Use of an EMSP who has a lapsed Arkansas license or is not Arkansas-licensed to meet ambulance staffing requirements.
55. (55) Failure to have all necessary equipment and nonexpired supplies in licensed ambulances at the level of licensure.
56. (56) Failure to follow the manufacturer’s recommendations for the use of medical equipment in a manner that causes harm to the patient.
57. (57) Conviction of a violation of Federal Communications Commission concurrent with federal laws.
58. (58) Falsification by the instructor of facts on student paperwork or applications.
59. (59) Teaching an EMS-related course that requires preapproval from the department without having that approval.
60. (60) Abandonment of an approved EMSP course.
61. (61) Failure to complete and submit required documentation for all EMS students.
62. (62) Failure to teach courses by the current National Highway Traffic Safety Administration’s National EMS Education Standards curriculum.
63. (63) Failure to observe recognized professional teaching standards.
64. (64) Falsification of continuing education documentation.
65. (65) Falsification by the training site of records related to courses or training.
66. (66) Conduct or actions by the training site that result in harm to the health and safety of the student.
67. (67) Failure to meet and maintain the criteria for EMS program approval as set by the department or accrediting body.
68. (68) Failure to allow the department to inspect, observe, or evaluate EMS programs, including program personnel, facilities, classes, and clinical practice sessions.
69. (69) Use of training personnel not competent for the type of training offered.
70. (70) Failure to observe recognized professional standards in the course content and operation of the training program.
71. (71) Failure to keep accurate and adequate records of the names and addresses and type of training completed by all attendees and graduates for a minimum of two (2) years.
72. (72) Allowing an AEMT or paramedic student to participate in medical facility or field internship without being an Arkansas-licensed EMT.
73. (73) Failure to offer training consistent with the approved EMS education or ambulance service application.

(d) Criteria for denial of EMSP licensure. An EMSP certification/license may be denied for the following reasons:

1. (1) Failure to meet any requirements set forth in this part or other applicable law.

2. (2) Previous conduct of the applicant during the performance of duties that are like those required of EMSPs, whether performed as a volunteer or for compensation, that is contrary to:

   1. (A) Acceptable standards of care or conduct for an EMSP; or
   2. (B) Accepted standards of conduct as described or required in this part.
3. (3) Submission of false information, failure to disclose material facts, or failure to disclose disciplinary action against any certification or license or in conjunction with any Arkansas initial or renewal application for certification or licensure.
4. (4) Staffing a licensed EMS vehicle with an EMSP holding an expired, suspended, or revoked license or certification.
5. (5) Any other fact, condition, or circumstance which in the judgment of the department renders the applicant or renewal applicant unfit to practice as an EMSP.

(e) Department of Health hearing and procedures.

1. (1) It shall be the department’s policy to use its discretionary right to consider all available information that is relevant and material.

2. (2) The department shall reserve the right to refrain from investigating complaints alleging violation until the complaint is received in writing and filed with the department stating the:

   1. (A) Nature of the alleged violation;
   2. (B) Date; and
   3. (C) Name of the person submitting the complaint.
3. (3) If the department’s investigation concludes that the charges brought against a licensed service or licensed EMSP are warranted, the matter shall be brought before the board following the current administrative rules process adopted by the State of Arkansas.

4. (4) In informal department hearings, a person may:

   1. (A) Appear in person and represent himself; or
   2. (B) Be represented by an attorney at law.

5. (5) Two types of hearings:

   1. (A) Informal. Those normally held for the purpose of obtaining necessary or useful information before the department; and
   2. (B) Formal. Those held for the purpose of adjudication of rights before the department.
6. (6) Where, in the opinion of the department, the public’s health, interest, or safety is jeopardized, or the failure to comply is willful, the department may temporarily suspend the license of a service or the licensure or certification of an EMSP until the matter is decided by the department.
7. (7) In all administrative enforcement and appeal procedures thereunder, it shall be in accordance with the Arkansas Administrative Procedure Act, Arkansas Code § 25-15-201 et seq., and amendments thereto.

8. (8) Probation. The department may place an EMSP license or certification on probation, and as a probationary condition may require the licensee to:

   1. (A) Report regularly to the department on matters that are the basis of the probation;
   2. (B) Limit practice to the areas prescribed by the department;
   3. (C) Continue or review professional education until the person attains a degree of skill satisfactory to the department in those areas that are the basis of the probation; and/or
   4. (D) Complete or continue to meet certain requirements or conditions related to the circumstances surrounding the certificant's or licensee's rule violations or background to ensure that he or she will continue to meet and maintain general EMS standards.

9. (9) Any person whose EMSP license has been revoked by the department and who later regains certification or license under this part shall be:

   1. (A) Placed on probation for one (1) year; and
   2. (B) Required to meet certain conditions to ensure that he or she will meet and maintain general EMS standards.

10. (10) Reapplication.

    1. (A)

(i) Two (2) years after denial of initial certification or license, revocation of a certification or license, or the voluntary surrender of a certification or license, an individual may petition the department in writing for reapplication for certification or licensure.

1. (ii) Expiration of a certificate or license during the suspension period shall not affect the two-year waiting period required before a petition can be submitted.

   1. (B) The petitioner bears the burden of proving fitness for certification or licensure.
   2. (C) The department may allow the petitioner to submit an application for certification or licensure to the board if there is proof that the health, safety, and confidence of the public will be protected.
   3. (D) The board may deny any petitioner if, in the judgment of the board or upon recommendation of the department, the reason for the original action continues to exist or if the petitioner has failed to offer sufficient proof that there is no longer a threat to public health, safety, and/or confidence.
2. (11) Notification of disposition. A copy of the order of final disposition of proposed disciplinary action shall be sent to the licensed EMSP, first responder organization, medical director, institution, or facility with which the certificant or licensee is known to be associated at the address shown in the current records of the department.

(f) Clinical investigations.

1. (1) Clinical investigations may be:

   1. (A) Recommended by the EMS Advisory Council; and
   2. (B) Approved by the department and the board.
2. (2) Test periods will be temporary in nature and will be determined on an individual basis for each procedure and technique tested.

3. (3) A written request to enroll in a clinical investigation must be:

   1. (A) Submitted to the EMS Advisory Council; and
   2. (B) Approved by the department.
4. (4) Clinical investigations beyond the scope of this part are to be evaluated in a carefully controlled study under appropriate medical control.
5. (5) At the completion of the evaluation period, the test results will be forwarded to the board for review.

6. (6) Permission for clinical investigations:

   1. (A) Will be granted only to determine if the procedure or technique should be added to this part; and
   2. (B) Must follow the clinical investigations guidelines recommended by the EMS Advisory Council and approved by the department.