1. (1) When applying for original approval or reapproval, every course sponsor shall file a completed application on a form provided by the department.
2. (2) Approval of a course sponsor shall be for no more than two years. Approvals shall expire on July 1st. One half the approvals of sponsors conducting courses on the effective date of this Part shall expire on the next succeeding July 1st and the other half shall expire on the second succeeding July 1st.
3. (3) Original and renewal sponsorship applications shall be reviewed by the appropriate regional emergency medical services council, which shall forward its recommendation to the department within 45 days of receiving the application. If the regional council is a course sponsor, it shall consider only the capability of the sponsor to meet the requirements of this Part. If the regional council is not a course sponsor, it may also consider the size of the potential student pool and the impact of an additional sponsor on the ability of existing sponsors to sustain a student body of adequate size. The department, when making a determination with regard to original and renewal sponsorship applications, shall consider the capability of the sponsor to meet the requirements of this Part, the size of the potential student pool and the impact of an additional sponsor on the ability of existing sponsors to sustain a student body of adequate size.

4. (4) The application for approval shall include the names of all certified instructor coordinators and certified lab instructors who will be providing instructional services.

   (b) Course planning.

   Each course sponsor shall on or before July 1st and January 1st of each year submit to the appropriate regional emergency medical services councils and the department a projected schedule of courses for the next six months, including the course type, tentative dates and locations, and proposed certified instructor coordinators.

5. (c) All course sponsors shall meet the following requirements:

   1. (1) Administration. Course sponsors shall comply with the following administrative requirements:

      1. (i) the course sponsor shall file applications for courses by the deadline included in a schedule supplied by the department;
      2. (ii) the course sponsor shall not admit students who do not meet the age requirements for certification in accordance with this Part, or who do not meet the requirements for entry into a refresher course (i.e., previous completion of an original course);
      3. (iii) the course sponsor shall submit student applications, in accordance with a schedule supplied by the department; and
      4. (iv) the course sponsor shall certify to the department those students who have met the requirements of the curriculum approved by the department and the State Emergency Medical Services Council.
   2. (2) Equipment and supplies. Supplies and equipment adequate for the provision of instruction shall be available consistent with the curriculum and sufficient for the number of students enrolled.
   3. (3) Instructional faculty. Every course except continuing education courses shall have a certified instructor coordinator. Each continuing education course shall be conducted by faculty who have completed an instructor training course, conducted by the department, for that specific course. The lab faculty of all courses except continuing education courses shall include one or more certified laboratory instructors.
   4. (4) Admission policies and procedures. Admission of students shall be made in accordance with clearly defined and published policies of the course sponsor, which shall be available to the department on request. Specific academic, health-related, and technical requirements for admission shall also be clearly defined and published. The standards and prerequisites for admission shall be made known to all individuals expressing an interest in enrollment.

   5. (5) Curricula. All emergency medical services training courses that result in State certification shall meet the following minimum standards regarding curricula for the specified certification level.

      1. (i) Any curriculum for each specified certification level must contain the following minimum course content areas:

         1. (a) Certified First Responder (CFR):

            1. (1) basic adult and pediatric patient assessment, including history taking, physical assessment, and determination of vital signs;
            2. (2) basic cardiopulmonary resuscitation (CPR);
            3. (3) basic airway management and oxygen therapy;
            4. (4) basic hemorrhage control;
            5. (5) manual stabilization of the spine;
            6. (6) spinal immobolization, including application of a rigid extrication collar; and
            7. (7) emergency childbirth.

         2. (b) Emergency Medical Technician-Defibrillation (EMT-D). In addition to the requirements of clause (a) of this subparagraph:

            1. (1) basic management of soft tissue injuries;
            2. (2) basic management of suspected fractures;
            3. (3) basic management of shock and use of medical anti-shock trousers;
            4. (4) basic management of medical and traumatic emergencies, adult and pediatric;
            5. (5) adult automated external defibrillation; and
            6. (6) basic management of behavioral emergencies.

         3. (c) Emergency Medical Technician-Intermediate (EMT-I). In addition to the requirements of clauses (a) and (b) of this subparagraph:

            1. (1) advanced airway management with endotracheal intubation and other definitive airways; and
            2. (2) peripheral intravascular therapy.

         4. (d) Emergency Medical Technician-Critical Care (EMT-CC). In addition to the requirements of clauses (a), (b) and (c) of this subparagraph:

            1. (1) medication administration;
            2. (2) fundamentals of electrocardiogram (EKG) rhythm interpretation and manual defibrillation;
            3. (3) advanced management of life-threatening cardiovascular emergencies;
            4. (4) synchronized cardioversion;
            5. (5) advanced management of respiratory emergencies;
            6. (6) advanced management of endocrine emergencies; and
            7. (7) advanced management of anaphylaxis, poisoning, drug abuse and overdose.

         5. (e) Emergency Medical Technician-Paramedic (EMT-P). In addition to the requirements of clauses (a), (b), (c) and (d) of this subparagraph:

            1. (1) advanced electrocardiogram (EKG) rhythm interpretation;
            2. (2) advanced management of cardiovascular emergencies;
            3. (3) chest decompression;
            4. (4) surgical airways;
            5. (5) transcutaneous pacing;
            6. (6) advanced management of central nervous system emergencies;
            7. (7) advanced management of acute abdomen, genitourinary and reproductive system emergencies;
            8. (8) advanced management of environmental emergencies;
            9. (9) advanced management of geriatric emergencies;
            10. (10) advanced management of pediatric emergencies;
            11. (11) advanced management of obstetrical and gynecological (OB/GYN) emergencies;
            12. (12) management of neonatal emergencies; and
            13. (13) management of behavioral emergencies including pharmacological interventions.
      2. (ii) The department shall maintain and provide for distribution of the approved model curriculum and any publication that directly relates to an approved emergency medical technician services training course curriculum. This material shall be available for public inspection and copying at the New York State Department of Health, Office of Regulatory Reform, Empire State Plaza, Corning Tower Building, Room 2415, Albany, NY 12237.
      3. (iii) Use by course sponsors of the model curriculum developed by the New York State Emergency Medical Services Council (SEMSC) and approved by the commissioner or her/his designee shall not require further review or approval. All other proposed curricula shall be reviewed by the SEMSC for compliance with the minimum standards described in this paragraph, and its recommendation shall be provided to the commissioner or her/his designee for approval.
   6. (6) Evaluation. Evaluation of students shall be conducted on a recurring basis and with sufficient frequency to provide the student, course medical director and certified instructor coordinator with valid and timely indicators of the student's progress toward and the achievement of the competencies and objectives stated in the curriculum. In order to ensure effectiveness of student evaluation, the test instruments and evaluation methods shall undergo at least annual review. When appropriate, reviews shall result in the update, revision, or formulation of more effective test instruments or evaluation methods. The reviewers shall include at least a certified instructor coordinator.
   7. (7) Identification. Students at clinical or internship sites shall be clearly identified by name and student status, using nameplate, uniform, or other apparent means to distinguish them from other personnel.

   8. (8) Fair operational practices. Announcements and advertising shall accurately reflect the program offered. Student and faculty recruitment, student admission, and faculty employment practices shall be nondiscriminatory with respect to race, color, creed, sex, age and national origin. The course sponsor shall have written policies which shall be approved by the department as being consistent with the curriculum, equitable in their treatment of students and in compliance with the requirements of this Part. Such policies shall be issued to all students at the first course session or earlier covering each of the following subjects:

      1. (i) course goals and objectives;
      2. (ii) interim testing requirements and pass/fail criteria;
      3. (iii) interim exam retesting;
      4. (iv) attendance requirements and make-up procedure;
      5. (v) requirements regarding personal conduct and ethics;
      6. (vi) emergency class cancellation procedure;
      7. (vii) course termination/expulsion and appeal procedure;
      8. (viii) textbooks required;
      9. (ix) tuition refund schedule; and
      10. (x) a student-course sponsor learning contract for all refresher courses.

   9. (9) Recordkeeping.

      1. (i) The course sponsor shall maintain for a period of at least five years, files which contain the following documentation on individual students. There shall be a system for accessing individual information:

         1. (a) individual attendance record;
         2. (b) signed student-course sponsor learning contract if applicable;
         3. (c) interim examination results;
         4. (d) practical skills examination sheets; and
         5. (e) clinical experience documentation and field internship experience documentation which show the student achieved the objectives of the clinical and field internship experiences and who evaluated the student's performance.

      2. (ii) The course sponsor shall maintain on file for a period of at least five years individual course files which shall contain the following documentation:

         1. (a) for State-funded courses, financial records showing all sources of funding and all expenditures for each course;
         2. (b) a list of the names of each faculty member;
         3. (c) the certification exam grades and other documentation received from the department pertaining to each individual course;
         4. (d) a copy of each interim examination administered, or a record of where it can be found; and
         5. (e) a copy of the course application, schedule and course approval from the department.
      3. (iii) The course sponsor shall maintain the names, last known addresses, business telephone numbers, and qualifications of all faculty. This information shall be maintained on file for the duration of the faculty member's working association with the sponsor plus five years.
   10. (10) Sponsor's medical director. Each course sponsor shall have a physician medical director, who shall be responsible for assuring the medical accuracy and medical appropriateness of the educational program and supervising all advanced life support course clinical and internship programs. The sponsor's medical director may delegate the medical direction of a specific course to another physician, provided that the department is notified in writing at least 30 days prior to the start of the course.
   11. (11) Practical skills examinations. The course sponsor shall follow the administrative procedures issued by the department for conducting the practical skills examination.

6. (d) The following requirements apply to advanced life support course sponsors and accredited paramedic course sponsors:

   1. (1) Clinical resources. Clinical affiliations shall be established and confirmed in written affiliation agreements with institutions and agencies that provide clinical experience under appropriate medical direction and clinical supervision. Students shall have access to patients who present common problems encountered in the delivery of advanced emergency care so that the students may meet the clinical objectives. Supervision in the clinical setting shall be provided by program instructors or hospital personnel, such as nurses or physicians, if they have been approved by the program to function in such roles. The ratio of instructors to students in the clinical facilities shall be no greater than 1:6.

   2. (2) Fair operational practices. Each sponsor shall have written policies which shall be approved by the department as being consistent with the curriculum, equitable in their treatment of students and in compliance with the requirements of this Part. Such policies shall be issued to all students at the first course session, or earlier, covering each of the following subjects:

      1. (i) clinical experience requirements and objectives; and
      2. (ii) field internship experience requirements and objectives.
   3. (3) Evaluation. The annual review of test instruments and evaluation methods shall be conducted by the sponsor's medical director and one or more certified instructor coordinators.

(a) Approval of course sponsors.