REGULATORY ANALYSIS
For
Proposed Amendments to Rules Pertaining to Emergency Medical Services (6 CCR 1015-3),
Sections 1-6 – Provisional certification for Emergency Medical Technicians
Adopted by the State Board of Health on
November 18, 2009
1. A description of the classes of persons who will be affected by the proposed change, including classes that will bear the costs of the proposed rule and classes that will benefit from the rule.
The classes of persons who are affected by the rule changes implementing provisional certification for emergency medical technicians (EMTs) are applicants for initial and renewal EMT certification in Colorado, including residents and non-residents, as well as employers of EMTs, which include public and private ground and air ambulance services, hospitals, and other medical facilities in Colorado. The cost of compliance with these rules will be borne by the applicants for EMT certification. Those that benefit from the proposed changes include the entire emergency medical and trauma services community, including emergency medical technicians, ambulance services, air ambulance services, regional emergency medical and trauma advisory councils, hospitals, and ultimately the general public.
The proposed rule allowing the department to issue letters of admonition as a disciplinary sanction affects EMTs who have committed misconduct as defined in department rules. In appropriate circumstances, a letter of admonition may be used to discipline EMTs instead of more austere sanctions such as probation, suspension and revocation.
2. To the extent practicable, a description of the probable quantitative and qualitative impact of the proposed changes to the rule, economic or otherwise, upon affected class of persons.
HB 09-1275 was recommended by the Joint Select Committee on Job Creation and Economic Growth. The probable qualitative impacts of the proposed rule changes are that employers will be able to hire EMTs, and EMTs will be able to begin employment, sooner than they would under the existing rules. State law requires Colorado certification before an individual can practice as an EMT in Colorado. Applicants for EMT certification in Colorado are required to submit to a fingerprint-based criminal history record check when they initially apply for certification and if they move outside of the state during their certification period. Depending upon whether the applicant has lived in Colorado three years or less at the time of application, the applicant must undergo either a Colorado Bureau of Investigation or a Federal Bureau of Investigation criminal history record check. These checks can take from several weeks to several months. The proposed rules will allow an applicant to practice as an EMT with a provisional certification for up to 90 days while the department is awaiting the results of the applicant’s fingerprint-based criminal history record check. Consequently, employers of EMTs can fill job openings and EMTs can begin working or volunteering sooner than they are presently able.
Colorado does not charge a fee for initial or renewal EMT certification. A fee of $23.00 is specified in the proposed rules for this new certification option to process the provisional certification request. Applicants that request a provisional certification (or prospective employers of applicants) will pay this fee.
3. The probable costs to the agency and to any other agency of the implementation and enforcement of the proposed rule and any anticipated effect on state revenues.
Approximately 1200 applications for provisional certification may be received each year. Each application will require processing time, including accounting for the fee, reviewing a name-based criminal history report and issuing a provisional certification letter. Of these applications, 350 are expected to require additional review related to information on the name-based report. These activities require personal services of $18,979 and .4 FTE each year. No costs to any other agency are anticipated.
4. A comparison of the probable costs and benefits of the proposed rule to the probable costs and benefits of inaction.
Adoption of the proposed rules will benefit individuals seeking EMT certification in Colorado because it provides them with the ability to work or volunteer as EMTs up to several months earlier than they can under current rules. A provisional certification, with the corresponding $23.00 fee, is optional for applicants, depending upon whether they want to pay the fee and start working immediately or want to wait for their fingerprint-based criminal history report to be received by the department. If they choose the latter, no fee is charged for initial or renewal certification in Colorado. The rules also allow employers and volunteer emergency medical services providers to staff their ambulances with EMTs who can provide patient care immediately if approved for a provisional certification. Inaction will result in EMTs being delayed in starting employment or volunteering their services and in employers being unable to immediately fill job openings once qualified candidates are identified.
5. A determination of whether there are less costly methods or less intrusive methods for achieving the purpose of the proposed rule.
As these proposed rule changes are required by legislation enacted in the 2009 session, the department has determined that there are no other less costly or less intrusive methods for achieving the purpose of the rules at this time.
6. A description of any alternative methods for achieving the purpose of the proposed rule that were seriously considered by the agency and the reasons why they were rejected in favor of the proposed rule.
No other alternative for the proposed rules was considered due to the statutory requirements.
7. To the extent practicable, a quantification of the data used in the analysis; the analysis must take into account both short-term and long-term consequences.
Documents used in this analysis included: 1) State statute C.R.S. Section 25-3.5-203, and the existing rules on EMT certification. Input for modifications to the existing rules were obtained from stakeholders in the emergency medical and trauma services community, including the State Emergency Medical and Trauma Services Advisory Council (SEMTAC), regional emergency medical and trauma advisory councils (RETAC), and emergency medical services providers and providers of trauma care. Data used in this analysis included numbers from the EMT Registry database, information from the Federal Bureau of Investigation, Colorado Bureau of Investigation and state-level agencies on the availability of name-based criminal history checks, as well as data from third-party vendors that provide name-based record checks. The fee calculation was determined using general and specific fiscal impact assumptions.
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