| HISTORY: FIRST RESPONDER AND EMT PROGRAM |
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HISTORY OF THE FIRST RESPONDER AND EMT PROGRAM UNDER THE OREGON MEDICAL BOARD.
The EMT I, II, III, and IV program came into existence in July 1975 with House Bill 2107. The EMT II, III, and IV certification levels became the responsibility of the Oregon Medical Board, while the EMT I certification level was under the Health Division. The statutory language set forth the EMT II, III, and IV certification levels, as well as the composition of an advisory committee that advised the Board on educational requirements and scope of practice for advanced EMTs. There were eight members of the advisory committee: two were physicians, who treated emergencies, such as trauma and cardiovascular injuries, five were Oregon certified EMTs II, III, and IV, and one lay person. Each Congressional district was to be represented by at least one member who resided in the district at the time of his appointment.
Between 1975 and 1979 the committee worked on drafting guidelines to grandfather in existing EMTs, determining their certification level and the examination(s) they were required to pass in order to be certified, developing curricula and educational standards for the EMT II, III and IV courses, writing the examinations for these certification levels, and developing continuing education requirements. In 1978 rules were adopted that specified that an EMT could not function as an EMT without a Board approved “controlling physician.” This was later changed to “supervising physician,” and rules were written to specify the requirements to be an EMT supervising physician or agent, and their duties in supervising, providing continuing education, and ride-along time.
Legislation was introduced in 1979 to move the EMT I program from the Health Division to the Board, which would have merged all the certification programs together. This bill did not pass, as there were funding and staffing issues.
In 1983 a scope of practice for the EMTs II, III, and IV was written as an administrative rule. Once the scope of practice was defined, the Committee held annual scope of practice meetings. Because the scope of practice was still evolving, these meetings were often large and lively. During this same year the Committee drafted administrative rules that defined the qualifications of an EMT supervising physician and his/her duties.
In 1985 the Committee developed the EMT II-D (defibrillation) certification level, its scope of practice and examination.
Between July 1975 and 1989, the Board was responsible for EMT II, III, and IV certification, including the course curricula, the examinations, the exam retake policies, qualifications for instructors/coordinators of EMT courses, accreditation of EMT IV courses, the requirement of a Board approved EMT “controlling” or “supervising” physician, research projects, developing scope of practice, investigations and discipline, registration renewal and continuing education.
When the EMT II, III, and IV certification program moved to the Health Division in 1989, the Board retained responsibility for scope of practice, and the qualifications needed to be an EMT supervising physician. The actual administration of the application and approval process for EMT supervising physicians was transferred to the Health Division a year or so after the program transfer. The statutory language regarding the EMT certification program, including the EMT committee, was deleted from the Medical Practice Act (ORS Chapter 677) in 1989.
Shortly after the transfer of the EMT program to the Health Division, the Board determined that there was still a need for an advisory committee on EMT scope of practice and EMT supervising physicians. A committee was created to provide recommendations to the Board on issues pertaining to scope of practice, the development by the Health Division of three new levels of EMT certification, curricula development and the drafting of administrative rules. The Board discusses and votes on the recommendations of this advisory committee. The EMT Advisory Committee is currently composed of five members: two physicians who are EM/trauma physicians and EMT supervising physicians, and three EMT-Ps, two of whom practice as paramedics, and one who is an instructor/coordinator of the EMT paramedic program at OHSU/OIT, and is also member of the State EMS Committee.
In 1995 legislation added the responsibility of developing and maintaining a scope of practice for First Responders, and a scope of practice was developed and added to the administrative rules.
Since 1989, the Committee and Board has continued to be responsible for the First Responder and EMT scope of practice, the qualifications and duties of physician supervisors, and the nomination of the physician members of the State EMS Committee. The present Committee has concentrated on issues affecting scope of practice, including the addition of non-emergency care, and rewriting the scope to change the certification levels from the EMT 2, 2-D, 3, and 4 to the EMT-Basic, Intermediate, and Paramedic.
If you have any questions concerning the First Responder and EMT Scope of Practice, please contact the Oregon Medical Board at (971) 673-2700, or through e-mail at omb.info@state.or.us.
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