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Rulemaking Activity

EMS and Trauma Systems Rulemaking Activity

Information relating to rulemaking actions by the EMS and Trauma Systems program can be accessed below and includes information on current Rule Advisory Committees (RACs) in progress as well as how a person or community affected by EMS regulatory functions may apply to serve on a Rule Advisory Committee (RAC). RACs are an important process that allow members of the public and communities to provide input and suggestions during the development of new rules or amending current rules. 

The following rules have been recently adopted or amended:

EMS Initial Education Standards

The EMS and Trauma Systems program has adopted new administrative rules under OAR chapter 333, division 264 and amended and repealed rules under OAR chapter 333, division 265 relating to EMS initial education standards. These rules go into effective November 1, 2024. Administrative rules have been amended due to changes to the certification examination policies and practices of the National Registry of Emergency Medical Technicians, the 2019 National EMS Scope of Practice Model, and the 2021 National EMS Education Standards. More information about these changes can be found in the factsheet: 

Revised Trauma Hospital Categorization and Resource Standards (Exhibit 4)

The EMS and Trauma Systems program has revised OAR chapter 333, division 200 and division 205​ and corresponding Exhibit 1 and Exhibit 4.  Rules go into effect November 1, 2024. A trauma system hospital must comply with the revised Exhibit 4 standards on or before October 1, 2025. A trauma system must continue to meet the Exhibit 4 standards dated September 25, 2018 until the revised standards are implemented.  

Revised Field Triage Guidelines (Exhibit 2) and Trauma Team Activation Criteria (Exhibit 3) 

The EMS and Trauma Systems program has revised OAR chapter 333, division 200 and corresponding Exhibit 2 to align with the revised 2021 National Guideline for Field Triage of Injured Patients. Exhibit 3 has been amended based on the changes to the field triage criteria and the American College of Surgeons, Resources for Optimal Care of the Injured Patient (2022 Standards.) These amendments are effective October 15, 2024 at which time ambulance service agencies and trauma hospitals must comply with the revised standards. The current rules remain in effect until that date. 

Transitional Paramedic License and Military Service Member/Spouse or Domestic Partner Provisions​

The EMS & Trauma Systems program has made the following amendments to administrative rules: 
  • ​Modified the associate degree requirement for a person seeking Paramedic licensure, replacing the Provisional Paramedic license with a Transitional Paramedic license;
  • Revised the work experience necessary for an out-of-state licensee to be eligible for reciprocity; 
  • Adopted rules allowing the program to issue a license to a military servicemember or the spouse or domestic partner of a servicemember that is stationed in Oregon and who has a license to practice as an EMS provider in another state. 

​There are no temporary rules in place at this time.

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Notice of Proposed Permanent Rulemaking: OAR chapter 333, divisions 250 and 255 – "Ambulance Service and Ambulance Vehicle Licensing Requirements"​

The Oregon Health Authority (OHA), Public Health Division, Health Care Regulation and Quality Improvement section is proposing to permanently adopt and amend administrative rules relating to the licensing requirements for ambulance service agencies and ambulance vehicles including the license application process, qualifications for licensure, operations, policies and procedures, personnel, EMS medical direction, required notifications, ambulance vehicle construction requirements, ambulance vehicle equipment requirements, infection control practices, and violations. 

Administrative rules are being adopted and amended to improve the accuracy, structure and clarity of the rules; align language with current processes including simplifying procedures; clarify licensing requirements; address concerns regarding ambulance service agencies responding to calls in accordance with an ambulance service plan; address enforcement issues for violation of ambulance service vehicle regulations; address confusion around ambulance vehicle construction requirements; and ensure that ambulance vehicles are properly cleaned and decontaminated or disinfected to ensure compliance with federal standards.

For more details, including a description of each rule's proposed changes, please see the following Notice of Proposed Rulemaking including the Statement of Need and Fiscal and Racial Equity Impacts, and the full text of the proposed rules:
You are invited to review and comment on the proposed rules. There are two (2) options to provide comments:

 1. You may provide oral (spoken) testimony during a public hearing scheduled on Monday, July 21, 2025, at 10:00 A.M. Pacific Time via video/phone conference using Microsoft Teams. ​To provide oral testimony during this hearing: 
  • Join using this Meeting URL. You can also find the join link for the meeting in the Notice of Proposed Rulemaking under "Remote Meeting Details" using the "Meeting URL."
  • You may also contact the Public Health Division Rules Coordinator at publichealth.rules@odhsoha.oregon.gov to sign-up to give oral testimony and receive the link for the Microsoft Teams video conference via calendar appointment.
  • To join the hearing via phone (audio/listen only), you may dial 971-277-2343, phone conference ID 838 257 872#. 
 2. Written comments may be submitted before 5:00 P.M. Pacific Time on July 22, 2025:
​​​​           OHA-Public Health Division
           Brittany Hall, Administrative Rules Coordinator 
           800 NE Oregon St. Suite 930
           Portland, OR 97232

​           * Comments sent by regular mail must be postmarked
              by 5:00 P.M. Pacific Time on July 22, 2025. 

  • ​​​Send comments by fax to 971-673-1299
Final rules will be filed after consideration of all comments. 

If you have questions or would like a paper copy of the Notice of Proposed Rulemaking, please contact Mellony Bernal at mellony.c.bernal@oha.oregon.gov. 

Accessibility Statement: For individuals with disabilities or individuals who speak a language other than English, OHA can provide free help. Some examples are sign language and spoken language interpreters, real-time captioning, braille, large print, audio, and written materials in other languages. If you need help with these services, please contact the Public Health Administrative Rules Coordinator at 971-673-1222, 711 TTY or publichealth.rules@odhsoha.oregon.gov. All relay calls are accepted.


The following rule advisory committees (RACs) are in progress. RAC meetings are not subject to the public meetings law. Members of the public may attend in person or virtually to listen to the dialogue but may not participate or offer public comment during the meeting (see agenda for location & meeting link). Members of the public may submit comments or questions at the conclusion of the RAC meeting to mellony.c.bernal@oha.oregon.gov​ and information will be shared with appropriate staff. After the RAC process has concluded, information will be posted under "Proposed Rules Out for Public Comment" including time and location of public hearing and deadline for providing oral or written comments.  

OAR 333-250 & 255 - Ambulance Service and Ambulance Vehicle Licensing Requirements

The purpose of this RAC is to discuss licensing requirement updates for an ambulance service and an ambulance vehicle. RAC meetings will be held on the dates noted below from 9 a.m. to 11 a.m.  (RAC member recruitment is closed.) 

Meeting date(s), agendas and meeting notes



RECENTLY COMPLETED ​​​


OAR 333-200 and 205 - Oregon Trauma Hospital Resource Standards - (Exhibit 4) RAC

The purpose of this RAC is to consider replacing the current Exhibit 4 based on the American College of Surgeons, Resources for the Optimal Care of the Injured Patient (2014) with the updated version from 2022. The EMS and Trauma Systems program is currently seeking persons and communities affected by these rules to serve on a Rule Advisory Committee. RAC process is complete and permanent rules filed (see 'Recently Filed New and Amended Rules.')

Meeting date(s), agendas and meeting notes
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The following meetings will held from 2pm-4pm PDT.

OAR 333-264 and 265 - EMS Provider Initial Education RAC

The purpose of this RAC is to consider amendments to initial education requirements for persons seeking licensure as an EMS provider based on changes to the certification examination policies and practices of the National Registry of EMTs, 2019 Scope of Practice Model and the 2021 National EMS Education Standards. RAC process is complete and permanent rules filed (see 'Recently Filed New and Amended Rules.')​  

Meeting date(s), agendas and meeting notes


OAR 333-200-0080 - Guidelines for Field Triage of Injured Patients (Exhibit 2) and Trauma Team Activation (Exhibit 3) RAC

The purpose of this RAC is to review proposed amendments to OAR 333-265-0080 and Exhibit 2 and the adoption of the 2021, National Guideline for Field Triage of Injured Patients. This RAC will also consider amendments to the Trauma Team Activation Criteria in Exhibit 3 which includes changes to align with Exhibit 2 and the addition of findings-based criteria to activate a trauma team. (The RAC process is complete and final rules were filed on 4/5/2024. Final rules are available under 'Recently filed new and amended rules.')

Meeting date(s), agendas and meeting notes:

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The EMS and Trauma Systems Program is seeking persons and communities who would be affected by administrative rules relating to any of EMS and Trauma System's regulatory functions and who would be interested in serving on a RAC.

RACs are an important process​ that allow members of the public and communities to provide input and suggestions during the development of new administrative rules, amending or repealing existing rules, and identifying the potential fiscal impact on small business as well as the effect on racial equity in Oregon. Diverse opinions and viewpoints are an important part of the rulemaking process.

The following is a list of administrative rules pertaining to the regulatory and licensing functions of the EMS and Trauma System Program. Persons interested in serving on future RACs relating to any of these topics are encouraged to send the completed RAC Interest Application form to mellony.c.​bernal@oha.oregon.gov​ 

Applications will be saved and applicants contacted when future RACs are convened. 

Regulatory Functions

  • Ambulance Service Licensing (OAR 333-250)
  • Ambulance Vehicle Licensing (OAR 333-255)
  • County Ambulance Service Area Plans (OAR 333-260)
  • Emergency Medical Services and Systems/Trauma Hospital Designation (OAR 333-200)
  • Emergency Medical Services Providers (OAR 333-265)
  • Oregon POLST (Physician Orders for Life-Sustaining Treatment) Registry (OAR 333-270)
  • Training on Lifesaving Treatments (OAR 333-055)
  • Trauma System Hospital Designation in Trauma Area #1 (OAR 333-205)