Title of Regulation: 12VAC5-31. Virginia Emergency Medical Services Regulations (amending 12VAC5-31-2810, 12VAC5-31-2830, 12VAC5-31-2840, 12VAC5-31-2860, 12VAC5-31-2880, 12VAC5-31-2900, 12VAC5-31-2920, 12VAC5-31-2930).

Statutory Authority: §§ 32.1-12 and 32.1-111.3 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: December 16, 2015.

Effective Date: January 4, 2016.

Agency Contact: Michael Berg, Regulatory and Compliance Manager, Department of Health, 1041 Technology Park Drive, Glen Allen, VA 23059-4500, telephone (804) 888-9131, or email michael.berg@vdh.virginia.gov.

Basis: Sections 32.1-111.4 and 32.1-111.5 of the Code of Virginia authorize the State Board of Health, with the Emergency Medical Services (EMS) Advisory Board, to prescribe by regulation emergency services.

Purpose: The amendments are essential to protect the health, safety, and welfare of the citizens because they clarify the regulations by better defining the purpose, eligibility criteria, and approval process for certain grant applications. There are no substantive content changes being proposed. The changes have been reviewed by the Financial Assistance Review Committee and approved by the Rules and Regulations Committee of the Emergency Medical Services (EMS) Advisory Board.

Rationale for Using Fast-Track Process: The technical changes have been vetted through the standing committees of the EMS Advisory Board and are technical in nature only. There is no anticipated opposition to these changes as presented.

Substance: The amendments are technical in nature and intended to clarify existing language in the regulations without making any substantive changes. There is no new terminology or requirements to this section of the EMS regulations. Recommended changes include moving certain language to a more appropriate section of the regulations; improving the flow, understanding, and readability of the regulations; and better defining the purpose and approval process for the grant application.

Issues: The primary advantage to the public is a regulation that is easier to read and that provides a better understanding of the grant process. There are no disadvantages to the public. The primary advantage to the agency and the Commonwealth is a clearer, more understandable flow of the EMS regulations for the reviewer. There is no known disadvantage to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The State Board of Health (Board) proposes to: 1) require that the eligible designated regional Emergency Medical Services (EMS) council nominate three candidates to fill a vacancy on the Financial Assistance and Review Committee (FARC), 2) no longer require that length of nonrepresentation of geographic regions be explicitly considered for filling vacancies on FARC, 3) add to the regulation a requirement currently in the grant application and contract that a copy of the title for all EMS vehicles obtained through the grant be provided to the Virginia Office of EMS, and 4) make several language changes for clarity.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. FARC was created in 1978 by the EMS Advisory Council to carry out the responsibility of reviewing Rescue Squad Assistance Fund (RSAF) grant applications and recommend funding. In 1996, FARC was statutorily established by § 32.1-111.12:01 in the Code of Virginia for the purposes of administering the Virginia RSAF grant funds. FARC reviews the RSAF grant applications from eligible licensed EMS agencies and other eligible not for profits involved in emergency medical service, and then make its recommendations for grant awards to the Commissioner of Health.

The current regulation specifies that the eligible designated regional Emergency Medical EMS council nominate one to three candidates to fill a vacancy on FARC. The EMS Advisory Board makes appointments to FARC from the nominations submitted by the designated regional EMS council. The Board proposes to require that the eligible designated regional Emergency Medical EMS council nominate specifically three candidates rather than the current one to three. The current regulation specifies that in regard to FARC, "Consideration for filling vacancies shall include length of nonrepresentation on FARC in an effort to provide reasonable geographic distribution." The Board proposes to eliminate this sentence from the regulation. Both of these proposed amendments are designed to give the EMS Advisory Board a broader pool of potential nominees from which to find those most qualified. Neither proposed amendment will necessarily change who is ultimately appointed in the majority of cases.

RSAF grant application and contract forms specify that a copy of the title for all EMS vehicles obtained through the grant be provided to the Virginia Office of EMS.¹ The Board proposes to include this requirement in the regulation. Including the language in the regulation will have no impact beyond informing potential applicants of the requirement and adding clarity. The Board proposes several other clarifying amendments that do not change requirements in practice. These amendments will likely produce a net benefit in that they may reduce potential confusion over requirements without adding any cost.

Businesses and Entities Affected. The proposed amendments affect approximately 600 EMS agencies, approximately 500 nonprofit entities that participate in EMS activities and approximately 100 local governments that provide EMS services.²

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendments will not significantly affect employment.

Effects on the Use and Value of Private Property. The proposed amendments will not significantly affect the use and value of private property.

Real Estate Development Costs. The proposed amendments will not affect real estate development costs.

_____________________________

¹ Source: Virginia Department of Health,

² Data Source: Ibid

Agency's Response to Economic Impact Analysis: The Department of Health concurs with the Department of Planning and Budget's economic impact analysis.

Summary:

The amendments (i) require that the eligible designated regional Emergency Medical Services (EMS) council nominate three candidates to fill a vacancy on the Financial Assistance and Review Committee (FARC); (ii) remove the requirement that the length of nonrepresentation of geographic regions be explicitly considered for filling vacancies on FARC; (iii) add a requirement currently in the grant application and contract that a copy of the title for all EMS vehicles obtained through the grant be provided to the Virginia Office of EMS; and (iv) make several changes for clarity.

Part VIII
Financial Assistance For Emergency Medical Services

12VAC5-31-2810. The Financial Assistance and Review Committee (FARC).

A. Financial Assistance and Review Committee appointments.

1. Appointments shall be made for terms of three years or the unexpired portions thereof in a manner to preserve, insofar as possible, the representation of the emergency medical services councils. No member may serve more than two successive terms. The chairman shall be elected from the membership of the FARC for a term of one year and shall be eligible for reelection.

2. The EMS Advisory Board may revoke appointment for failure to adhere to the standards set forth in these regulations this chapter, and the State and Local Government Conflict of Interests Act (§ 2.2-3100 et seq. of the Code of Virginia).

3. Members serving on the FARC on January 1, 2008, shall complete their current terms of office.

4. Midterm vacancies shall be filled by nominations submitted from the affected designated regional EMS council.

B. Geographical representation.

1. Designated regional EMS councils shall be eligible to submit nominations to the EMS Advisory Board for representation on the FARC.

2. The eligible designated regional EMS council shall nominate one to three candidates to fill a vacancy on the FARC. The EMS Advisory Board shall make appointments from the nominations submitted by the designated regional EMS council. Consideration for filling vacancies shall include length of nonrepresentation on FARC in an effort to provide reasonable geographic distribution.

3. A designated regional EMS council whose representative has completed two successive terms on FARC shall not be eligible to submit a nomination for one full term (three years).

C. Meetings and attendance.

1. The FARC shall meet at least four times annually at the call of the chairman or the commissioner.

2. Attendance at FARC Grant Review meetings is mandatory for all members.

3. A quorum for a meeting of the FARC shall consist of not fewer than four members.

12VAC5-31-2830. Award of RSAF General Grants.

A. The requirements of this section shall apply to the disbursement of funds.

B. A nonprofit licensed EMS agency or other Virginia emergency medical service organization operating on a nonprofit basis exclusively for the benefit of the general public pursuant to § 32.1-111.12 of the Code of Virginia is eligible for an RSAF General Grant.

C. An applicant must be in compliance with these regulations this chapter.

C. D. Programs, services, and equipment funded by the RSAF must comply with the plans, policies, procedures, and guidelines adopted by the State EMS Advisory Board. Awards are based upon one or more of the following criteria Grants may be approved for the following:

1. Establishment of a new EMS agency, program, or service where needed to improve emergency medical services offered in an area;

2. Expansion or improvement of an existing EMS agency, program, or service;

3. Replacement of equipment or procurement of new equipment. EMS vehicles purchased with funding from the RSAF shall meet the current state and/or federal standards for the type of vehicle purchased; or

4. Establishment, expansion or improvement of EMS training programs.

12VAC5-31-2840. RSAF General Grant award cycle.

A. The grant period shall be for a period of 12 months from the date of award and there shall be two review cycles per year;

B. Deadline for submission of applications shall be March 15 and September 15 of each year. Applications must be received in the Office of EMS by 5 p.m. of the date of the deadline. In the event the deadline falls on a Saturday, Sunday, or state or federal holiday, the application must be received by 5 p.m. in the Office of EMS the next business day.

C. Applications shall be made to the Office of EMS on an approved application form.

C. D. Dates of award shall be July 1 and January 1 of each year.

D. E. Other dates in the award process shall be established by the Office of EMS.

12VAC5-31-2860. EMS System Initiative Awards.

EMS System Initiative Awards are based on priorities and needs identified by the EMS Advisory Board in concert consultation with the office Office of EMS to meet EMS system objectives as stipulated in § 32.1-111.3 of the Code of Virginia.

1. The Office of EMS or FARC, in consultation with EMS Advisory Board, may implement EMS System Initiative Awards at any time. Examples of such awards would include medically advanced equipment with broad application (automated external defibrillation) and information technology to enhance communications and data (computers).

2. Applications must be made to the Office of EMS on an approved application form. EMS System Initiative Award applications shall be submitted on the Office of EMS approved form, using approved pricing, application eligibility award criteria, and approved priorities.

3. The EMS System Initiative Award will be made or rejected by the Office of EMS within 30 business days after receiving an application on an approved form.

4. EMS System Initiative Awards shall be may be granted for the following purposes, based upon the demonstrated needs from the following criteria need:

a. Establishment of a new EMS agency, program, or service where needed to improve emergency medical services offered in an area;

b. Expansion or improvement of an existing EMS agency, program, or service;

c. Replacement of equipment or procurement of new equipment. EMS vehicles purchased with funding from the RSAF shall meet the current state and/or federal standards for the type of vehicle purchased; or

d. Establishment, expansion or improvement of EMS training programs.

12VAC5-31-2880. Application for award.

A. Applications must shall be made to the Office of EMS.

B. The Office of EMS will review applications for compliance with the EMS regulations and RSAF policies and procedures. The FARC reviews and grades applications and makes recommendations on general grant funding.

12VAC5-31-2900. Awards.

A. The Office of EMS shall make awards as approved by the commissioner.

B. Grantees will be notified of their award by mail.

C. Funds may be disbursed to the grantee at any time within the grant period. Agreement to the award and any attached conditions shall be secured prior to any disbursements.

12VAC5-31-2920. Use of funds.

A. Awards will shall be made in accordance with § 32.1-111.12 of the Code of Virginia.

B. Funds must shall be used only for the specific items, service, or programs for which they were awarded. This includes and in accordance with any conditions placed upon a grant award.

C. The grantee is required to shall sign an agreement form attesting that the award funds will shall be used as granted and the grantee meets all conditions placed upon the award.

D. Sale, trade, transfer, or disposal, within five years of vehicles or items specified by the Office of EMS in the notice of award purchased in whole or in part with the use of state moneys requires prior approval by the Office of EMS.

E. EMS vehicles purchased with funding from the RSAF shall meet the current state and federal standards for the type of vehicle purchased.

E. F. Funds must shall not be used for expenditures or commitments made before the date of the grant award or after the conclusion of the grant period.

F. G. Funds will shall not be approved or disbursed for:

1. Leased equipment or vehicle;

2. Equipment or vehicles secured by a lien;

3. Guarantees or warranties;

4. Used equipment or vehicles without prior approval; or

5. Fire suppression apparatus or law-enforcement equipment.

12VAC5-31-2930. Ownership.

The title for all All equipment, including EMS vehicles, shall be in the name of the organization to which the award has been made or in the name of the local jurisdiction or government entity in which the organization is located. This requirement shall apply to the ownership of equipment purchased in whole or in part with the use of these funds.

A copy of the title for each EMS vehicle shall be provided to the Office of EMS.

FORMS (12VAC5-31)

EMT Clinical Training Summary Record, EMS.TR.05 (rev. 8/2012)

Training Program Complaint Form, EMS.TR.30 (rev. 1/2011)

Course Approval Request, EMS.TR.01 (rev. 6/2011)

CTS Payment Request Form, EMS.TR.CTS.001 (rev. 6/2012)

EMS Variance/Exemption Application for Providers, EMS 6036 (rev. 6/2011)

EMS Variance/Exemption Application for Agencies, EMS 6037 (rev. 6/2011)

Course Summary Form, EMS.TR.03 (rev. 6/2011)

EMS Continuing Education (CE) Registration Card Scan Form, EM-156839:6543 (rev. 1/96).

Virginia EMS Training Program Enrollment Form, EM-234503-1:6543 (rev. 1/01).

Virginia EMS Certification Application, EM-210983-5:65432 (rev. 1/97).

EMS Certification Application, Form A (undated)

EMS Training Program Enrollment Form, Form E (undated)

EMS Continuing Education Registration Card (undated)

Application for EMS Agency License (rev. 8/2012)

Application for EMS Vehicle Permit and Instructions (rev. 8/2012)

Complaint Report Form (rev. 11/2010)

Operational Medical Director Agreement (rev. 8/2012)

ALS-Coordinator Application, EMS.TR.31 (rev. 11/2011)

Emergency Medical Services Medical Record (rev. 6/2010)

BLS Course Student Information Package, EMS.TR.09 (rev. 5/2012)

ALS Course Student Information Package, EMS.TR.10 (rev. 5/2012)

BLS Individual Age, Clinical and Skill Performance Verification, EMS.TR.33 (rev. 1/2011)

Student Permission Form For BLS Students Less Than 18 Years Old, EMS.TR.07 (rev. 7/2011)

Physician Assistant & Nurse Practitioner Paramedic Challenge Competency Summary, EMS.TR.37 (rev. 2/12)

Program Accreditation Application, Instructions and Self Study - Paramedic (rev, 7/2012)

Program Accreditation Application, Instructions and Self Study - Intermediate (rev. 7/2012)

Alternative Site Application for EMS Programs in Virginia (rev. 7/2012)

Rescue Squad Assistance Fund Grant Application, Office of Emergency Services (http://www.vdh.virginia.gov/OEMS/Agency/Grants/index.htm)

EMS System Initiative Award Application, Office of Emergency Services (http://www.vdh.virginia.gov/OEMS/Agency/Grants/index.htm)

OEMS Grant Program Memorandum of Agreement (rev. 1/2012)