Tenn. Comp. R. & Regs. 1200-12-01-.04

Current through April 28, 2024

Section 1200-12-01-.04 - EMERGENCY MEDICAL SERVICES (EMS) PERSONNEL CERTIFICATION AND LICENSURE

(1) Scope of Practice for Emergency Medical Services Personnel.

(a) Definitions. Terms used in this rule shall be defined as follows:

1. "Advanced Emergency Medical Technician (AEMT)" means a person who has successfully completed the Advanced Emergency Medical Technician training course, has qualified by examinations to perform pre-hospital emergency patient care, and provides basic and limited advanced emergency medical care, under medical direction, pre-hospital and during transportation for critical, emergent, and non-emergent patients who access the emergency medical system.

2. "Board" means the Tennessee Emergency Medical Services Board.

3. "Department" means the Tennessee Department of Health.

4. "Division" means the Division of Emergency Medical Services.

5. "Emergency Medical Responder (EMR)" means a person who has successfully completed the Emergency Medical Responder training course and has qualified by examinations to perform lifesaving interventions while awaiting additional EMS response and to assist higher level personnel at the scene and during transport, under medical direction.

6. "Emergency Medical Technician (EMT)" means a person who has successfully completed the Emergency Medical Technician training course, has qualified by examinations to perform pre-hospital emergency patient care, and provides basic emergency medical care, under medical direction, pre-hospital and during transportation for critical, emergent and non-emergent patients who access the emergency medical system.

7. "Medical Direction" means the supervision by a physician licensed to practice in the state of Tennessee of all medical aspects of patient care within Emergency Medical Services.

8. "Paramedic" means a person who has successfully completed an accredited Paramedic Program at the certificate or associate degree level, has qualified by examinations to perform pre-hospital emergency patient care, and provides basic and advanced emergency medical care, under medical direction, pre-hospital and during transportation for critical, emergent and non-emergent patients who access the emergency medical system.

9. "Protocols" mean a ranking or formal listing of procedures approved by an EMS service's medical director that may be utilized for patient care after physician or medical facility communications have been established.

10. "Standing Orders" mean orders based on an agreement established by an EMS service's medical director, delegating authority to agents within their control to commence treatment and authorizing procedures for patient care that may be utilized until the patient is presented for continuing medical care.

(b) Scope of Practice for Certified Emergency Medical Responder (EMR).

1. An EMR will perform lifesaving interventions while awaiting additional EMS response and will assist higher level personnel at the scene and during transport.

2. An EMR functions as part of a comprehensive EMS response, under medical direction.

3. A certified EMR shall possess, at a minimum, skills as defined by the current National EMS Scope of Practice Model and National EMS Education Standards.

4. An EMR's scope of practice may be extended to include skills the Board authorizes and approves.

(c) Scope of Practice for a Licensed Emergency Medical Technician (EMT).

1. An EMT will provide basic emergency medical care for critical, emergent and non-emergent patients who access the emergency medical system.

2. An EMT functions as part of a comprehensive EMS response, under medical direction.

3. The EMT's scope of practice includes, at a minimum, the skills listed within the EMR scope of practice as well as the "Minimum Psychomotor" skills set as identified in the current National EMS Scope of Practice Model and National EMS Education Standards for EMTs, including but not limited to, non-invasive interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies for patients of all ages.

4. An EMT's scope of practice may be extended to include skills the Board authorizes and approves.

(d) Scope of Practice for a Licensed Advanced Emergency Medical Technician (AEMT).

1. An AEMT will provide basic and limited advanced skills that are effective and can be performed safely in an out-of-hospital setting with medical direction and limited training and focused on the acute management and transportation of critical, emergent, and non-emergent patients.

2. An AEMT functions as part of a comprehensive EMS response, under medical direction.

3. The AEMT's scope of practice includes, at a minimum, the skills listed within the EMT scope of practice as well as the "Minimum Psychomotor" skills set identified in the current National EMS Scope of Practice Model and National EMS Education Standards for the AEMT, including but not limited to, basic non-invasive and limited advanced invasive interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies for patients of all ages.

4. An AEMT's scope of practice may be extended to include skills the Board authorizes and approves.

(e) Scope of Practice for a Licensed Paramedic.

1. A Paramedic will provide basic and advanced skills that are effective and can be performed safely in an out-of-hospital setting with medical direction and advanced training and focused on the acute management and transportation of critical, emergent, and non-emergent patients.

2. Paramedics function as part of a comprehensive EMS response, under medical direction, to perform interventions with the basic and advanced equipment typically found on an ambulance.

3. The Paramedic scope of practice includes, at a minimum, all basic knowledge and skills of an AEMT as well as the "Minimum Psychomotor" skills set identified in the current National EMS Scope of Practice Model and National EMS Education Standards for a Paramedic, including but not limited to, advanced invasive and non-invasive interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies for patients of all ages.

4. A Paramedic's scope of practice may be extended to include skills the Board authorizes and approves.

(2) Emergency Medical Responder Initial Certification, Renewal, and Reinstatement Requirements.

(a) Initial Certification as an EMR. To be eligible for initial certification as an EMR by the Division, an applicant shall meet the following requirements:

1. Be at least seventeen (17) years of age;

2. Be able to read, write and speak the English language;

3. Have no documented history within the past three (3) years of habitual intoxication or personal misuse of any drugs or intoxicating liquors, in such a manner as to adversely affect the applicant's ability to practice as an EMR;

4. Hold a signed current Basic Cardiopulmonary Resuscitation Healthcare Provider card or equivalent;

5. Successfully complete all aspects of a Board approved Emergency Medical Responder course, including but not limited to, attendance requirements;

6. Achieve an established passing score on a Board approved examination within two (2) years of completion of an EMR training course;

(i) Applicants who fail to pass the examination shall be eligible to reapply for examination.

7. Applicants must successfully complete all requirements for certification within two (2) years of completion of training.

8. Submit the completed Division-provided application from, along with all required supporting documents and the appropriate certification and application fees in accordance with Rule 1200-12-01-.06.

9. If an applicant does not complete all requirements for certification within two (2) years of date of initial application, the application shall be considered abandoned and the Division shall destroy it.

10. Validity of initial EMR certification shall not exceed thirty-six (36) months.

(b) Post Initial Certification Requirements for an EMR.

1. An EMR shall receive training and show competency under EMS service authorized medical direction to be permitted to perform Board approved extended skills and/or procedures.

2. The EMS service medical director shall monitor performance through a quality assurance program.

(c) Renewal Requirements for Emergency Medical Responder Certification. To be eligible for renewal of certification as an EMR by the Division, an applicant shall meet the following requirements:

1. File the Division provided renewal application and submission of renewal fees, in accordance with Rule 1200-12-01-.06.

2. Submit a copy of a signed current Basic Cardiopulmonary Resuscitation Healthcare Provider card or equivalent;

3. Submit verification of one of the following:

(i) Successful completion of Board approved refresher training course; or

(ii) Satisfactory completion of the examination as established in part (2)(a)6; or

(iii) Completion of ten (10) Continuing Education Contact Hours, or one (1) college credit hour in EMR related studies, as approved by the Division. A minimum of two (2) hours must be in pediatric related topics.

(I) Documentation of skills competency must also be submitted to the Division administrative office with documentation of continuing education.

(iv) The due date for completion of the required continuing education is the expiration date of the EMR's certification renewal.

(v) All EMR's must retain independent documentation of completion of all continuing education hours. This documentation must be retained for a period of four (4) years from the end of the renewal period in which the continuing education was acquired. This documentation must be produced for inspection and verification, if requested by the Division during its verification process. Certificates verifying the individual's completion of the continuing education program(s) shall consist of one or more of the following:

(I) Continuing education program's sponsor, date, length in hours awarded, program title, certified individual's name, and certificate number; or

(II) An original letter on official stationary from the continuing education program's sponsor indicating date, length in hours awarded, program title, certified individual's name, and certificate number.

4. Continuing education contact hours shall be obtained through a Division approved agency or institution or program.

5. Validity of renewed EMR certification shall not exceed twenty-four (24) months.

(d) Reinstatement Requirements for Emergency Medical Responder Certification.

1. Those persons who fail to timely renew certification are eligible to apply for reinstatement of their certification as an EMR by the Division, if the applicant completes the following requirements:

(i) Submits an approved reinstatement application;

(ii) Submits payment of the reinstatement fee in accordance with Rule 1200-12-01-.06;

(iii) Submits a copy of a signed current Basic Cardiopulmonary Resuscitation Healthcare Provider card or equivalent.

(iv) Those persons applying for reinstatement of their certification less than sixty (60) days after expiration of previous certification shall present documentation of successful completion of one of the following:

(I) Required continuing education requirements and documentation of skills competency; or

(II) The Board approved refresher training course, as established in part (2)(a)5; or

(III) The examination, as established in part (2)(a)6.

(e) Those persons applying for reinstatement of their certification sixty (60) days or more after expiration of previous certification shall present documentation of successful completion of both the Board approved refresher training course and the examination as required in parts (2)(a)5 and 6.

(3) Initial Licensure Procedure for Emergency Medical Services Personnel.

(a) All applicants for licensure pursuant to T.C.A. Title 68, Chapter 140 shall comply with the following requirements to be eligible for licensure:

1. Be at least eighteen (18) years of age;

2. Be able to read, write, and speak the English language;

3. Possess a minimum of an academic high school diploma or a general equivalency diploma (G.E.D.);

4. Have no documented history within the past three (3) years of habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, in such a manner as to adversely affect the person's ability to practice emergency medical services.

5. Present evidence to the Division of Emergency Medical Services of a medical examination certifying physical health sufficient to conduct activities associated with patient care, including, but not limited to, visual acuity, speech and hearing, use of all extremities, absence of musculoskeletal deformities, absence of communicable diseases, and suitable emotional fitness to provide for the care and lifting of the ill or injured. This information shall be provided on a form approved by the Board and shall be consistent with the provisions of the Americans with Disabilities Act.

6. Successfully complete Board approved Tennessee training for the level at which licensure is being requested.

7. Qualify by examination to perform pre-hospital care.

(i) Each applicant shall successfully complete both a Board approved written and practical examination, for the level at which licensure is being requested.

(ii) Applicants who fail to pass the examination shall be eligible to reapply for examination.

(iii) Applicants must successfully complete all requirements for licensure within two (2) years of completion of training.

8. Submit a completed application for licensure form as provided by the Division with all necessary documents, attachments and appropriate fees.

9. An applicant shall disclose the circumstances surrounding any of the following:

(i) Conviction of any criminal law violation of any country, state or municipality, except minor traffic violations.

(ii) The denial of professional licensure/certification application by any other state or the discipline of licensure/certification in any state.

(iii) Loss or restriction of licensure or certification.

10. If an applicant does not complete all requirements for licensure within two (2) years of date of completion of initial training and/or application, the application shall be considered abandoned and the Division shall destroy it.

11. Remit the appropriate licensure and application fees in accordance with Rule 1200-12-01-.06; and

12. Cause the result of a criminal background check to be submitted to the administrative office of the Division, directly from the vendor identified in the Division's licensure application materials. Criminal background check shall be valid for one (1) year from the date it is obtained for filing with the Division.

(b) Initial Licensure for an EMT. To be eligible for licensure as an EMT, an applicant shall complete all licensure requirements listed in subparagraph (3)(a).

1. EMTs who have shown competency in basic knowledge and skills through completion of Board approved written and practical examination and wish to progress to AEMT training without obtaining an EMT license shall:

(i) Submit evidence of good moral character. Such evidence shall be two recent (within the preceding 12 months) original letters from medical professionals attesting to the applicant's personal character.

(ii) Begin training no later than one hundred twenty (120) days after successful completion of EMT training.

(iii) AEMT training beginning more than one hundred and twenty (120) days after successful completion of a Board approved EMT training course or failure to successfully complete an AEMT training course shall require a current Tennessee EMT license prior to admission into an AEMT training program.

(c) Initial Licensure for an AEMT. In addition to meeting all licensure requirements listed in subparagraph (3)(a), to be eligible for an AEMT license an applicant shall:

1. Submit evidence of good moral character. Such evidence shall be two recent (within the preceding 12 months) original letters from medical professionals attesting to the applicant's personal character.

2. Hold a current license as a Tennessee EMT; or

3. Have begun AEMT training within one hundred and twenty (120) days of completion of a Board approved EMT training class.

(d) Initial Licensure for a Paramedic. In addition to meeting all licensure requirements listed in subparagraph (3)(a), to be eligible for licensure an applicant for a Paramedic license shall:

1. Demonstrate knowledge and competence in the basic knowledge and skills of an AEMT and possess the complex knowledge and skills necessary to provide patient care and transportation;

2. Submit evidence of good moral character. Such evidence shall be two recent (within the preceding 12 months) original letters from medical professionals attesting to the applicant's personal character; and

3. Hold a current Tennessee license as an AEMT.

(e) Post Initial Licensure Requirements for all licensed EMS personnel.

1. Licensed emergency medical services personnel shall receive training and show competency under EMS service authorized medical direction to be permitted to perform Board approved extended skills and/or procedures.

2. The EMS service medical director shall monitor performance through a quality assurance program.

(4) Licensure Renewal for all Emergency Medical Services Personnel.

(a) To be eligible for licensure renewal all EMS personnel must complete the following requirements prior to the expiration date of the license cycle:

1. Submit the renewal application and appropriate renewal fee in accordance with Rule 1200-12-01-.06;

2. Prior to license expiration date, successfully complete a Board approved renewal examination or the continuing education requirements for the licensure renewal. A renewal applicant using continuing education requirements shall produce proof of continuing education requirements upon a request for inspection.

(i) Certificates verifying the licensee's completion of the continuing education program(s) shall consist of one or more of the following:

(I) Continuing education program's sponsor, date, length in hours awarded, program title, licensee's name, and/or license number; or,

(II) An original letter on official stationary from the continuing education program's sponsor indicating date, length in hours awarded, program title, licensee's name, and/or license number.

(ii) Retention of independent documentation of completion of continuing education renewal requirements shall be maintained by all emergency medical services personnel as follows:

(I) Independent documentation of completion of continuing education renewal requirements must be retained for a period of four (4) years from the end of the renewal period in which the requirement was acquired; and,

(II) This documentation must be maintained in a form available for production for inspection and verification, if requested by the Division during its verification process.

(iii) The due date for completion of the required continuing education is the expiration date of the EMS personnel license renewal.

3. Submit a current copy of Cardiopulmonary Resuscitation Healthcare Provider card or equivalent.

4. EMT Licensure Renewal. In addition to meeting all licensure renewal requirements listed in subparts (4)(a)1 through 3, an applicant for an EMT licensure renewal shall complete EMT continuing education requirements as follows, to be eligible for licensure renewal:

(i) Maintain proof of successful completion of a Board approved license renewal examination; or

(ii) Complete twenty (20) Board approved continuing education contact hours (A minimum of five (5) must be in pediatric related topics); or

(iii) Complete a minimum of two (2) Division approved college credit hours in EMT-related studies.

5. AEMT Licensure Renewal. In addition to meeting all licensure renewal requirements listed in subparts (4)(a)1 through 3 an applicant for an AEMT licensure renewal shall complete AEMT continuing education requirements as follows, to be eligible for licensure renewal:

(i) Maintain proof of successful completion of a Board approved license renewal examination; or

(ii) Complete twenty-five (25) Board approved continuing education contact hours (A minimum of eight (8) must be in pediatric-related topics); or

(iii) Complete a minimum of two (2) Division approved college credit hours in AEMT-related studies.

6. Paramedic Licensure Renewal. In addition to meeting all licensure renewal requirements listed in subparts (4)(a)1 through 3, an applicant for a Paramedic licensure renewal shall complete Paramedic continuing education requirements as follows, to be eligible for licensure renewal:

(i) Maintain proof of successful completion of a Board approved license renewal examination; or

(ii) Complete thirty-two (32) Board approved continuing education contact hours (A minimum of eight (8) must be in pediatric-related topics); or

(iii) Complete a minimum of three (3) Division approved semester college credit hours in Paramedic-related studies.

(iv) Paramedic license renewal shall qualify for renewal of the EMT license.

(b) Violation of proscribed acts of the EMT, AEMT, and Paramedic as listed in T.C.A. § 68-140-311 shall be cause for revocation, suspension, or denial of license renewal.

(c) A licensee, permit or certificate holder may renew his or her license within sixty (60) days following the license expiration date upon payment of the renewal fee in addition to a late penalty established by the Board for each month or fraction of a month that payment for renewal is late; provided, that the late penalty shall not exceed twice the renewal fee. If a licensee fails to renew his or her license within sixty (60) days following the license expiration date, then the licensee shall reapply for reinstatement of licensure in accordance with the rules established by the Board.

(d) Licensure Reinstatement of a Lapsed License for All Emergency Medical Services Personnel.

1. Reinstatement of expired license within one (1) year of expiration for licensees showing "Good Cause." For the purpose of reinstatement renewal under the "Good Cause" provision of an emergency services personnel license which has expired, the following requirements shall be met by the applicant to be eligible for reinstatement:

(i) The Division must receive written notification and a request for reinstatement within one (1) year of expiration for "Good Cause" from the licensee. If no notification is initiated by the licensee, then "Good Cause" cannot be applied.

(I) "Good Cause" for delayed compliance with the regulations shall include:

I. Personal illness or hospitalization;

II. Extensive travel or relocation within the affected time period;

III. Conflicting professional or educational schedules (military);

IV. Immediate family illness or death; or

V. Extraordinary circumstances beyond the control of the licensee.

(II) The following reasons shall not constitute "Good Cause":

I. Failure to submit necessary forms or fees by the expiration date;

II. Willful defiance of rules.

(ii) The licensee must complete a continuing education or renewal examination within the prior license period and must pay the reinstatement fee as specified by Rule 1200-12-01-.06.

(iii) The Division must receive the completed renewal application and appropriate documentation and the reinstatement fee within one (1) year of the expiration date.

2. Reinstatement greater than sixty (60) days but less than one (1) year of expiration of the license for licensees not qualifying under the "Good Cause" provision. For the purpose of reinstatement of an emergency services personnel license which has expired, the following requirements shall be met by the licensee to be eligible for reinstatement:

(i) The licensee must successfully complete an EMS Board approved license renewal written examination for appropriate level of desired licensure;

(ii) The licensee must pay all applicable fees as specified by Rule 1200-12-01-.06; and,

(iii) The Division must receive the completed reinstatement application and appropriate documentation and the reinstatement fee as specified by rule within one (1) year after expiration of the license.

3. Reinstatement greater than one (1) year but less than two (2) years after expiration of the license. For the purpose of renewal of an emergency services personnel license which has expired, the following requirements shall be met by the licensee to be eligible for reinstatement:

(i) The licensee must successfully complete an EMS Board approved refresher course for the appropriate level of desired licensure;

(ii) The licensee must successfully complete an EMS Board license renewal written and practical examination for the appropriate level of desired licensure;

(iii) The licensee must pay all applicable fees as specified by Rule 1200-12-01-.06; and,

(iv) The Division must receive the completed reinstatement application and appropriate documentation and the reinstatement fee as specified by rule within two (2) years after expiration of the license.

(v) The licensee shall cause to be submitted to the Board's administrative office directly from the vendor identified in the Board's licensure application materials, the result of a criminal background check. Criminal background check shall be valid for one (1) year from the date it is obtained for filing with the Division.

4. Reinstatement greater than two (2) years after expiration of the license. When the license of an EMT or AEMT has lapsed for two (2) years or more, a licensee must complete the Board approved training course for appropriate level of licensure in its entirety and comply with initial license requirements in effect under subparagraph (3)(a).

5. Reinstatement of a Paramedic license greater than two (2) years after expiration of the license. When the license of a Paramedic has lapsed for two (2) years or more, the licensee must complete the following requirements:

(i) Officially document completion of a state approved EMT-Paramedic / Paramedic Training Program after January 1, 1977;

(ii) Show evidence of previous Tennessee licensure as a Paramedic;

(iii) Successfully complete Board approved written and practical examinations;

(iv) Hold a current Advanced Cardiac Life Support (ACLS) provider or instructor certification from the American Heart Association;

(v) Hold a current Pre-hospital Trauma Life Support (PHTLS) or International Trauma Life Support (ITLS) certification as a provider or instructor;

(vi) Hold a current Pediatric Advanced Life Support (PALS) certification as a provider or instructor;

(vii) Complete a state approved Paramedic Refresher Training Program or complete forty-eight (48) hours of Advanced Life Support training that overviews the topical content of the state approved Paramedic Refresher Training Program;

(viii) Pay all applicable fees as specified by Rule 1200-12-01-.06;

(ix) Send the completed reinstatement application and appropriate documentation and the reinstatement fee as specified by rule to the Division;

(x) Submit evidence of good moral character. Such evidence shall be two recent (within the preceding 12 months) original letters from medical professionals attesting to the applicant's personal character;

(xi) Cause to be submitted to the Board's administrative office directly from the vendor identified in the Board's licensure application materials, the result of a criminal background check. The criminal background check shall be valid for one (1) year from the date it is obtained for filing with the Division;

(xii) Submit a current copy of Cardiopulmonary Resuscitation Healthcare Provider card or equivalent; and

(xiii) Present evidence to the Division of Emergency Medical Services of a medical examination certifying physical health sufficient to conduct activities associated with patient care, including, but not limited to, visual acuity, speech and hearing, use of all extremities, absence of musculoskeletal deformities, absence of communicable diseases, and suitable emotional fitness to provide for the care and lifting of the ill or injured. This information shall be provided on a form approved by the Board and shall be consistent with the provisions of the Americans with Disabilities Act.

(5) Reciprocity Requirements for Emergency Medical Services Personnel for Certification or Licensure.

(a) Currently Certified or Licensed EMR, EMT, AEMT or Paramedic. Any EMR, EMT, AEMT or Paramedic who meets the following requirements is eligible to apply for reciprocity for certification or licensure:

1. Applicant holds current certification or licensure from another state, country, or was certified/licensed while employed by the federal government; or

2. Applicant was/is certified/licensed while employed by the federal government, but not certified or licensed currently by another state or country, holds current certification/licensure from the National Registry of Emergency Medical Technicians for the level

3. Applicant has successfully completed a course or curriculum based on the National Emergency Medical Services Education Standards for EMR, EMT, or Advanced EMT or Paramedic, or an equivalent course or curriculum; or

4. Applicant submits appropriate documentation of training conducted by an authorized federally approved training agency, if applicant was trained while employed by the federal government; and

5. Applicant conforms to all license/certification requirements for Tennessee certification or license, for level at which reciprocity is being requested;

6. Applicant demonstrates successful completion of all Board approved written and practical examinations, for level at which reciprocity is being requested; and

7. Applicant submits the appropriate application forms and fees, if applicable, to the Division.

8. Applicant shall cause to be submitted to the Board's administrative office directly from the vendor identified in the Board's licensure application materials, the result of a criminal background check. Criminal background check shall be valid for one (1) year from the date it is obtained for filing with the Division.

(6) Name or Address Change Notification Requirements.

(a) Certified or Licensed EMS personnel shall notify the Division in writing or online through the Division's website of a change of name or address within thirty (30) days of such change.

(b) EMS Division notifications for any purpose, including but not limited to continuing education requirements, renewals or disciplinary actions, shall be posted to the address listed on file with the Division.

(c) Return by the post office of any Division notifications, which are posted to the address listed on file with the Division for the licensee, shall be interpreted as a willful violation for failure to retain a current address on file by the licensee.

(7) Retirement of an EMS Certification or License and Title Privilege

(a) Retirement of certification or license. A currently certified EMR or licensed EMT, AEMT or Paramedic may be eligible to retire his/her certificate or license upon submitting the following information to the Division:

1. A properly completed retirement affidavit form to be furnished by the Division; and,

2. A licensee or certificate holder with pending disciplinary action from this state or any other state shall not be eligible to retire the license or certificate until such time as the disciplinary action is concluded.

(b) EMS Title Privilege. Any EMS licensee who has filed the required information for permanent retirement of his/her license and received confirmation that the license will be retired, as requested, shall be permitted to use the following appropriate title for the licensee's level of licensure:

1. For emergency medical responder, EMR Retired or EMRR;

2. For emergency medical technicians, EMT Retired or EMTR;

3. For advanced emergency medical technician, AEMT- Retired, or AEMT-R; or,

4. For Paramedics, Paramedic - Retired or Paramedic - R.

(8) Reactivation of a Retired EMS Certificate or License.

(a) Reactivation request within two (2) or less years of retirement of certificate or license. A licensee whose certificate or license has been retired for two years or less may be eligible to reactivate his/her certificate or license by completing the requirements for reinstatement for the appropriate level of licensure.

(b) Reactivation request after two (2) or more years of retirement of certificate or license. If a licensee's certificate or license has been retired for more than two years, an applicant must complete the requirements for reinstatement of an expired license greater than two (2) years.

(9) Downgrade of a Current AEMT or Paramedic EMS License

(a) A currently licensed AEMT or Paramedic may be eligible to downgrade his/her license by submitting the following to the Division:

1. A properly completed downgrade affidavit form to be furnished by the Division; and

2. All necessary documentation, if applicable.

Tenn. Comp. R. & Regs. 1200-12-01-.04

Original rule filed March 20, 1974; effective April 19, 1974. Amendment filed February 4, 1976; effective March 5, 1976. Repeal and new rule filed February 8, 1983; effective May 16, 1983. Amendment filed November 30, 1984, effective February 12, 1985. Amendment filed August 22, 1985; effective September 21, 1985. Amendment filed February 21, 1986; effective May 13, 1986. Amendment filed September 18, 1986; effective December 29, 1986. Amendment filed April 8, 1987; effective May 23, 1987. Amendment filed June 30, 1987; effective August 14, 1987. Amendment filed October 22, 1987; effective December 6, 1987. Amendment filed January 17, 1989; effective March 3, 1989. Amendment filed September 24, 1990; effective November 8, 1990. Amendment filed October 21, 1993; effective January 4, 1994. Amendment filed April 13, 1994; effective June 27, 1994. Amendment filed August 5, 1996; effective October 19, 1995. Amendment filed August 29, 2003; effective November 12, 2003. Amendment filed December 16, 2005; effective March 1, 2006. Amendments filed April 13, 2006; effective June 27, 2006. Amendment filed September 21, 2007; effective December 5, 2007. Emergency rule filed October 27, 2009; effective through April 25, 2010. Emergency rule filed October 27, 2009, expired; On April 26, 2010, the rule reverted to its previous status. Repeal and new rule filed January 11. 2013; effective April 11, 2013.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 68-140-304, 68-140-308, 68-140-317, 68-140-504, 68-140-506, 68-140-508, 68-140-509, 68-140-511, 68-140-517, 68-140-518, 68-140-520, 68-140-525, and 42 USC §247d-6d.