1. (a) Application Requirements for paramedic licensure.

   1. (1) From the effective date of this section through August 31, 2002, a currently certified paramedic may apply for a paramedic license if the candidate has met at least one of the following requirements:

      1. (A) at least 60 hours of college credit from a regionally accredited college or university which includes the Academic Core Curricula as defined by the Texas Higher Education Coordinating Board;
      2. (B) an associate degree;
      3. (C) a baccalaureate degree; or
      4. (D) a post graduate degree from a regionally accredited college or university.
   2. (2) This section shall not be interpreted as limiting the authority of a regionally accredited college or university to grant academic credit for non-traditional educational experiences to persons who are able to demonstrate competence through examination or other methods consistent with institutional policy and procedure.

   3. (3) Beginning September 1, 2002, a currently certified paramedic may apply for a paramedic license if the candidate has at least one of the following requirements:

      1. (A) an associate degree in emergency medical services (EMS);
      2. (B) a baccalaureate degree; or
      3. (C) a post graduate degree from a regionally accredited college or university.

2. (b) Process for those applying for a paramedic license. A candidate for licensure under this section shall:

   1. (1) be at least 18 years of age;
   2. (2) submit an application and a nonrefundable fee, if applicable, of $100;
   3. (3) have completed a Texas Department of Health (department) approved paramedic course. If the candidate is not currently certified as an active paramedic, the candidate shall submit a paramedic course completion certificate;
   4. (4) have met the appropriate requirements in subsection (a) of this section;
   5. (5) submit a certified copy of a transcript from a regionally accredited college or university;
   6. (6) achieve a passing grade on the department's written examination or pass the National Registry examination, if the candidate is not currently certified as an paramedic; and

   7. (7) complete the department's examination within six months of the course completion date:

      1. (A) one retest may be taken within six months of the course completion date if the candidate fails to pass the written exam; and
      2. (B) a fee of $25 shall accompany the request for a retest.

3. (c) Examination scheduling. The department has final authority for scheduling all examination sessions.

   1. (1) Examinations shall be administered at regularly scheduled times in regional test centers.
   2. (2) The candidate shall make appropriate arrangements for the examination.
   3. (3) The department is not required to set special examination schedules for a single candidate or for a specific group of candidates.

4. (d) Verification of information. After verification by the department of the information submitted by the candidate, a candidate who meets the requirements shall be licensed for a period of four years from the effective date.

   1. (1) The license is not transferable. A wallet-size copy of the license shall be issued and carried by the licensee while on EMS duty.
   2. (2) Duplicate copies of the license and wallet-size copy may be issued to replace lost credentials for a fee of $5.00.
5. (e) A licensed paramedic may not hold a department EMS certificate except for that of EMS coordinator, EMS examiner or EMS instructor.

6. (f) Continuing education (CE) hours. During the four-year licensure period, each licensee shall complete at least the following minimum number of contact hours of approved CE to be eligible for renewal of a license. Licensees shall accrue at least one-half of the required number of hours in the first two years of the licensure period.

   1. (1) Licensed paramedics are required to complete 96 hours to be eligible for renewal of their license.
   2. (2) Employers and/or medical directors may require licensees under their supervision to complete additional requirements.
   3. (3) All CE shall meet the requirements of §157.38 of this title (relating to Continuing Education) except for §157.38(b) hour requirements and (c) content requirements.

7. (g) CE subject areas. CE hours shall be accrued within one or more of the following medical subject areas:

   1. (1) patient assessment and management;
   2. (2) cardiac disorders;
   3. (3) pulmonary disorders;
   4. (4) endocrine disorders;
   5. (5) neurological disorders;
   6. (6) other medical disorders;
   7. (7) behavioral disorders;
   8. (8) obstetrics/gynecology;
   9. (9) pediatrics;
   10. (10) geriatrics;
   11. (11) trauma; or
   12. (12) protocols.

8. (h) Renewal.

   1. (1) Prior to the expiration of a license, the department shall mail a notice of expiration by United States mail or electronic mail to the licensee at the address shown in current records of the Bureau of Emergency Management (bureau). It is the responsibility of the licensed paramedic to notify the bureau of any change of address.
   2. (2) If a licensed paramedic has not received notice of expiration from the department 45 days prior to the expiration of the license, it is the duty of the license holder to notify the department and request an application for renewal of the license. Failure to apply for renewal of the license shall result in expiration of the license.
   3. (3) An application for renewal of a license shall be submitted and all requirements for renewal of the license shall be completed no later than the expiration date of the current license.

   4. (4) A licensed paramedic shall meet the following requirements for renewal of the license:

      1. (A) complete within the previous four years the number of approved CE hours for the licensed paramedic as required in subsection (f)(1) of this section within one or more of the medical subject areas listed in subsection (g) of this section and submit a CE summary form listing the completed hours;
      2. (B) submit an application for renewal of the license to the department along with the appropriate nonrefundable fee as required in subsection (b)(2) of this section;

      3. (C) achieve a passing grade on the department's written examination or pass the National Registry examination; however,

         1. (i) the test shall be waived if the candidate submits authorization from the medical director; and
         2. (ii) documentation of an additional ten hours of CE per year for a four year total of 136 CE hours;

      4. (D) complete the examination before the current license expiration date:

         1. (i) one retest may be taken no later than the expiration date of the current license if the candidate fails the written exam;
         2. (ii) a fee of $25 shall accompany the request for a retest; and
         3. (iii) the National Registry examination may be taken in lieu of the department's retest.
      5. (E) completion of the process in this paragraph establishes eligibility for licensure renewal only. Other requirements may be levied by an employer and/or medical director as a condition of employment/volunteering.

   5. (5) A licensed paramedic with an EMS degree shall meet the following requirements to extend the license for two more years:

      1. (A) complete within the previous four years the number of approved CE hours for the licensed paramedic as required in subsection (f)(1) of this section within one or more of the medical subject areas listed in subsection (g) of this section; and

         1. (i) submit a CE summary form listing the completed hours plus an additional 10 hours of CE per year for a four year total of 136 CE hours;
         2. (ii) submit an application for extension of the license to the department along with a fee of $50; and
         3. (iii) submit authorization from the medical director to waive the exam at the four-year mark.
      2. (B) completion of the process in this paragraph establishes eligibility for licensure extension only. Other requirements may be levied by an employer and/or medical director as a condition of employment/volunteering.

   6. (6) A licensed paramedic with an EMS degree who has received a two year extension, shall meet the following requirements for renewal of the license:

      1. (A) complete 68 hours of CE within the previous two years, for a total of 204 hours for six years, within one or more of the medical subject areas listed in subsection (g) of this section and submit a CE summary form listing the completed hours;
      2. (B) submit an application for renewal of the license to the department along with the a nonrefundable fee of $100;
      3. (C) achieve a passing grade on the department's written examination or pass the National Registry examination; however, the test shall be waived if the candidate submits authorization from the medical director; and

      4. (D) complete the examination before the extended license expiration date:

         1. (i) one retest may be taken no later than the current extended license expiration date if the candidate fails the written exam;
         2. (ii) a fee of $25 shall accompany the request for a retest; and
         3. (iii) the National Registry examination may be taken in lieu of the department's retest.
      5. (E) completion of the process in this paragraph establishes eligibility for licensure renewal only. Other requirements may be levied by an employer and/or medical director as a condition of employment/volunteering.
   7. (7) After verification by the department of the information submitted, the license will be renewed or inactive status will be initiated, whichever is appropriate, for four years beginning on the day following the expiration date of the license. A new wallet-size card signed by department officials shall be issued.

9. (i) Late renewal of a license. An application for renewal of a license shall be considered late if requirements for renewal are received after the most recent license has expired.

   1. (1) Late applications shall be accompanied by a late fee of $25 in addition to the regular fee.
   2. (2) Persons who do not complete the relicensure process by their expiration date are not licensed.

10. (j) Inactive status. A licensed paramedic may make application to the department for inactive status at any time during or within three years after the license expiration date, if the license can be verified by the department.

    1. (1) If the request is made to change a current license to an inactive status, there is no fee.
    2. (2) The initial inactive status period shall remain in effect until the end of the current license period for those candidates who are currently licensed and shall be renewable every four years thereafter. The candidate shall submit an application and the full fee as stated in subsection (b)(2) of this section.
    3. (3) The initial inactive status period shall remain in effect for four years from the date of issuance for those candidates not currently licensed.
    4. (4) While on inactive status a person shall not provide patient care as that of certified or licensed personnel and may only act as a bystander. Failure to comply shall be cause for revocation of the inactive status license and may cause denial of future applications for licensure.

11. (k) Reentry. Reentry is the process for regaining EMS licensure after a period of inactive or expired status, or when an application for renewal is postmarked and/or the requirements for relicensure are met more than three months after the expiration of the most recent license.

    1. (1) To reenter from inactive status the candidate shall:

       1. (A) complete a department-approved formal paramedic refresher course;
       2. (B) submit an application and nonrefundable fee as required in subsection (b)(2) of this section, in addition to a late fee as in subsection (i)(1) of this section;
       3. (C) pass the department's written examination or pass the National Registry examination; and
       4. (D) all reentry requirements shall be completed within six months after the application date.

    2. (2) To reenter after a license has expired, the candidate shall:

       1. (A) apply within the department's record retention requirements for the prior license, which is no later than three years past the license expiration;
       2. (B) have completed, within the previous four years, the number of approved CE hours for the licensed paramedic as required in subsection (f)(1) of this section within one or more of the subject areas listed in subsection (g) of this section and submit a CE summary form listing the completed hours;
       3. (C) submit an application for relicensure and the nonrefundable fee as required in subsection (b)(2) of this section; in addition to the late fee as in subsection (i)(1) of this section; and
       4. (D) pass the department's written examination or pass the National Registry examination, within six months after the application date.
12. (l) Reciprocity. A person currently certified by the National Registry and/or certified or licensed as a paramedic in another state and who meets all the requirements of this section may apply for licensure by submitting an application and a fee of $100. After the department evaluates the application, verifies the licensure and assures that the requirements in subsection (b) of this section have been met, the candidate will be licensed in Texas for four years from the issuance date of the current Texas licensure.

13. (m) Equivalency. A candidate from outside the United States applying for a paramedic license shall:

    1. (1) submit a personnel application and a nonrefundable fee of $150;
    2. (2) submit a copy of the curriculum for the course completed, after having it translated and evaluated (course-by-course) by a foreign credentials evaluation service at the applicant's expense;
    3. (3) submit evidence of successful course completion and licensure;
    4. (4) complete any deficiencies identified during the curriculum review or completion of a department-approved paramedic refresher course;
    5. (5) submit evidence that the requirements of this section have been met;
    6. (6) achieve a passing grade on the department's written examination or pass the National Registry examination; and

    7. (7) complete the examination within six months of the application date:

       1. (A) one retest may be taken within six months after the application date;
       2. (B) a fee of $25 shall accompany the request for a retest; and
       3. (C) the National Registry examination may be taken in lieu of the department's retest.
14. (n) Military personnel. A certificant who fails to renew a license within three months of the expiration date because of active duty in the United States military outside the State of Texas shall have one year from the date of discharge or the date of reassignment to Texas (whichever is first) to complete all requirements for relicensure.

Source Note:The provisions of this §157.40 adopted to be effective February 4, 1999, 24 TexReg 571.