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i guess what i wanted to say is it looks like the testing or not to test for

recertification will always be a issue. i quite frankly dont like the idea

of having to retest. my reasoning is that i have never done good on written

tests, through out my schoolings weither it was in high school, or college.

ive always been better with hands on things or being able to tell you what i

have learned verbally verses through written exams. this doesnt mean that i

can not document things, by all means i do a very good job with my

paperwork. its just the testing situations that i have problems with. i do

also have to content with learning disablities and adhd. i have always

managed to do the very best that i can, even though i struggle with it

sometimes. i guess the bottom line is what ever is finally decided whether

i like or not. i will back and comply with it 150%. this is just my opinion

to this matter. i just wanted someone to know that yeah i may not always be

able to pass written tests all the time or the first time, but if asked the

same things through verbal testing and hands on testing. i will rank right

up there with them all. now that is a thought. why cant there be oral

testing for those who need some assistance? i know that you can take other

types of exams orally. they cover the same material but instead of the test

being written it is in an oral format. please dont feel that im crazy for

thinking this. feel free to privately email me on this if you want to.

randy,emtp

emt@...

TDH Rule Changes

> If you are interested in the TDH Rule Change issues, please read the

> following. These are updates and thoughts I have put together since the

> March 8 Stakeholders' Meeting in Austin. Please feel free to respond.

>

> Thank you,

> Leon Charpentier

> Director of Emergency Services

> 401 Indian Trail

> Harker Heights, TX 76548

> (office)

> (fax)

> hhfd@...

>

> ________________________________________________________________________

> ______________________

> March 10, 2000

> *****RESULTS FROM STAKEHOLDERS MEETING, MARCH 8, 2000, AUSTIN, TX*****

>

> RULE 157.32

> After an hour's discussion on Rule 157.32 (which pertains to Paramedic

> curriculum), the Stakeholders Committee agreed to forward exactly what the

> Texas Fire Chiefs Association was proposing to be passed to the Advisory

> Council. This means that the D.O.T. Paramedic curriculum was adopted with

> a 700-hour minimum course and left all curriculum proposals in writing to

> Texas Department of Health (TDH) and not Higher Education.

>

> I do not foresee any more opposition in this. I believe the Rule will

make

> it all the way through to the Board of Health without any problems. To

> make sure, I will be watching it all the way.

>

>

> RULE 157.33

> On the other hand, the discussion f Rule 157.33 (which pertains to how to

> recertify) was a bloody battle. The consensus of the Committee members

was

> to do away with the test being that a written exam does not prove

> competency of a Paramedic or an EMT-B. However, the doctors representing

> the Texas Emergency Physicians, the Texas Medical Directors and the Texas

> Medical Association were adamantly against dropping the State exam. TDH

> appeared to be for dropping the exam for recertification. I reminded them

> (on several occasions) that if the testing was kept, they would need to

> validate three (3) different types of exams; one exam for the seasoned

> Paramedic of today, one for the new curriculum, and one for persons

> completing the new curriculum course, whether it be a certification course

> or a licensing course.

>

> Of the 12 representatives on the panel, 9 organizations were in favor of

> dropping the exams and recertifying by CE hours only. Three organizations

> were against this: Texas Medical Association, Texas Emergency Physician's

> Association, and Texas Medical Directors Association. The medical

doctors,

> again, were very adamant about wanting to keep the exam.

>

> After a lengthy discussion, a possible solution was formed. This solution

> would probably work, but it is not feasible to implement. The solution

was

> a possible two-tier recertification system. Each EMS provder would choose

> their own option. These options are as follows:

>

> OPTION 1: The Department's EMS providers would recertify by CE hours

> only. With an approved QA/QI system in place, CE hours would probably go

> back to 160 CE hours for four years recertification. This is for

> Paramedcs. EMTs and ECAs have different requirements. However, the no

> test proposal is for all levels.

>

> OPTION 2: A Department that does not wish to complete the extra CE

> hours or does not wish to put together an approved QA/QI program, would

> need to send their personnel to TDH for testing.

>

>

> I really cannot tell you where this is going. It appears to be a conflict

> once again. I believe we should stand our ground and request no testing

> for recertifcation, even if they want to add a good QA/QI program. I

think

> that the two-tier program would be a logistic nightmare and that written

> exams do not prove competency.

>

> Be aware that this will be discussed at the next workshop on March 23. I

> will be there to speak on our behalf if this is what you wish. I will

> solicit all questions, comments, and support.

> ________________________________________________________________________

> ______________________

> March 16, 2000

>

> As all the Fire Chiefs know, the EMS Advisory Council is meeting in Austin

> for a Workshop on March 23 and a meeting on March 24.

>

> Through the response I have received over the last week, I believe there

is

> only one thing we can do to help the problem of eliminating the written

> test for recertification. This is to contact all of the EMS Advisory

> Council members with our opinion on the testing. By the way, no need to

> contact our representative Holloway. He is definitely in-tune

with

> what is going on.

>

> To recap what happened and the issue on hand is that on March 8, 2000, the

> Stakeholders' Committee all agreed to go forward to the Advisory Council

> making the new criteria for Texas a minimum of 700 hours and keeping all

of

> the curriculum criteria writing to Texas Department of Health and not

> Higher Education. The problem at hand is what to do with Rule 157.33.

>

> Nine (9) of the twelve (12) Stakeholders agreed that recertification

should

> be done by continuing education, not a written test. Three (3) doctors

> representing their respective medical organizations disagreed and wanted

> testing to remain.

>

> If they prevail, things we all need to remember:

>

> 1. The State of Texas must write and validate three (3) separate Paramedic

> exams. In the past, Texas has always used the same test meeting the

> objectives of the Paramedic course for original examination upon

completion

> of a Paramedic school and the same test is given to Paramedics to

recertify

> no matter how many years they have been in service. This will no longer

> work. Testing all Paramedics who are already certified on the objectives

> of the new curriculum could not possibly be fair. How many would fail?

> This means we would need one validated test to recertify Paramedics

> trained under the old curriculum. We need a second validated test to test

> Paramedics graduating from Paramedic school based on the new objectives.

> We would need a third exam to test the Paramedics who need to recertify

> under the new currculum. The cost of this would be astronomical, probably

> in the millions of dollars.

>

> 2. Texas has already set a precedence in the licensing rule stating that

if

> you have a Paramedic license, you no longer have to recertify by testing.

> There is no difference in the licensed Paramedic of today and a certified

> Paramedic of today except for they have to prove 60 hours of college

> credit.

>

> 3. Forty states in the U.S. currently are recertifying their Paramedics

> with continuing education only. We do not see these states with long

lines

> of dead bodies because Paramedics are incompetent or long lines at the

> lawyer's offices because of malpractice.

>

> 4. For the past few years, Texas has been recertifying Paramedics whether

> they pass or fail the exam. Again, no long lines.

>

> 5. We all need to remember that a written test does not show competency.

> We all know Paramedics who can pass every test but cannot adequately

treat

> a live patient. Continuing education, quality assurance, and quality

> improvement will train or weed out the medics, and the administration and

> Medical Directors can make the decision whether they want them treating

> patients or not.

>

> We need to get on the band wagon and convince the Advisory Council of

these

> problems and testing for recertification should be eliminated. Remember

> the Workshop on March 23 at 1:30 in Austin and the Advisory Council

meeting

> at 9:00 a.m. on March 24. You may need to be there to help voice your

> opinion on this issue. I will be there and I will speak on this issue.

> Again, if you have any questions or comments, please feel free to contact

> me.

>

> Leon Charpentier

> Director of Emergency Services

> 401 Indian Trail

> Harker Heights, TX 76548

> (office)

> (fax)

> hhfd@...

>

>

> ------------------------------------------------------------------------

> Special Offer-Earn 300 Points from MyPoints.com for trying @Backup

> Get automatic protection and access to your important computer files.

> Install today:

> http://click./1/2344/3/_/4981/_/953237175/

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> -- /docvault//?m=1

>

>

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Guest guest

If you are interested in the TDH Rule Change issues, please read the

following. These are updates and thoughts I have put together since the

March 8 Stakeholders' Meeting in Austin. Please feel free to respond.

Thank you,

Leon Charpentier

Director of Emergency Services

401 Indian Trail

Harker Heights, TX 76548

(office)

(fax)

hhfd@...

________________________________________________________________________

______________________

March 10, 2000

*****RESULTS FROM STAKEHOLDERS MEETING, MARCH 8, 2000, AUSTIN, TX*****

RULE 157.32

After an hour's discussion on Rule 157.32 (which pertains to Paramedic

curriculum), the Stakeholders Committee agreed to forward exactly what the

Texas Fire Chiefs Association was proposing to be passed to the Advisory

Council. This means that the D.O.T. Paramedic curriculum was adopted with

a 700-hour minimum course and left all curriculum proposals in writing to

Texas Department of Health (TDH) and not Higher Education.

I do not foresee any more opposition in this. I believe the Rule will make

it all the way through to the Board of Health without any problems. To

make sure, I will be watching it all the way.

RULE 157.33

On the other hand, the discussion f Rule 157.33 (which pertains to how to

recertify) was a bloody battle. The consensus of the Committee members was

to do away with the test being that a written exam does not prove

competency of a Paramedic or an EMT-B. However, the doctors representing

the Texas Emergency Physicians, the Texas Medical Directors and the Texas

Medical Association were adamantly against dropping the State exam. TDH

appeared to be for dropping the exam for recertification. I reminded them

(on several occasions) that if the testing was kept, they would need to

validate three (3) different types of exams; one exam for the seasoned

Paramedic of today, one for the new curriculum, and one for persons

completing the new curriculum course, whether it be a certification course

or a licensing course.

Of the 12 representatives on the panel, 9 organizations were in favor of

dropping the exams and recertifying by CE hours only. Three organizations

were against this: Texas Medical Association, Texas Emergency Physician's

Association, and Texas Medical Directors Association. The medical doctors,

again, were very adamant about wanting to keep the exam.

After a lengthy discussion, a possible solution was formed. This solution

would probably work, but it is not feasible to implement. The solution was

a possible two-tier recertification system. Each EMS provder would choose

their own option. These options are as follows:

OPTION 1: The Department's EMS providers would recertify by CE hours

only. With an approved QA/QI system in place, CE hours would probably go

back to 160 CE hours for four years recertification. This is for

Paramedcs. EMTs and ECAs have different requirements. However, the no

test proposal is for all levels.

OPTION 2: A Department that does not wish to complete the extra CE

hours or does not wish to put together an approved QA/QI program, would

need to send their personnel to TDH for testing.

I really cannot tell you where this is going. It appears to be a conflict

once again. I believe we should stand our ground and request no testing

for recertifcation, even if they want to add a good QA/QI program. I think

that the two-tier program would be a logistic nightmare and that written

exams do not prove competency.

Be aware that this will be discussed at the next workshop on March 23. I

will be there to speak on our behalf if this is what you wish. I will

solicit all questions, comments, and support.

________________________________________________________________________

______________________

March 16, 2000

As all the Fire Chiefs know, the EMS Advisory Council is meeting in Austin

for a Workshop on March 23 and a meeting on March 24.

Through the response I have received over the last week, I believe there is

only one thing we can do to help the problem of eliminating the written

test for recertification. This is to contact all of the EMS Advisory

Council members with our opinion on the testing. By the way, no need to

contact our representative Holloway. He is definitely in-tune with

what is going on.

To recap what happened and the issue on hand is that on March 8, 2000, the

Stakeholders' Committee all agreed to go forward to the Advisory Council

making the new criteria for Texas a minimum of 700 hours and keeping all of

the curriculum criteria writing to Texas Department of Health and not

Higher Education. The problem at hand is what to do with Rule 157.33.

Nine (9) of the twelve (12) Stakeholders agreed that recertification should

be done by continuing education, not a written test. Three (3) doctors

representing their respective medical organizations disagreed and wanted

testing to remain.

If they prevail, things we all need to remember:

1. The State of Texas must write and validate three (3) separate Paramedic

exams. In the past, Texas has always used the same test meeting the

objectives of the Paramedic course for original examination upon completion

of a Paramedic school and the same test is given to Paramedics to recertify

no matter how many years they have been in service. This will no longer

work. Testing all Paramedics who are already certified on the objectives

of the new curriculum could not possibly be fair. How many would fail?

This means we would need one validated test to recertify Paramedics

trained under the old curriculum. We need a second validated test to test

Paramedics graduating from Paramedic school based on the new objectives.

We would need a third exam to test the Paramedics who need to recertify

under the new currculum. The cost of this would be astronomical, probably

in the millions of dollars.

2. Texas has already set a precedence in the licensing rule stating that if

you have a Paramedic license, you no longer have to recertify by testing.

There is no difference in the licensed Paramedic of today and a certified

Paramedic of today except for they have to prove 60 hours of college

credit.

3. Forty states in the U.S. currently are recertifying their Paramedics

with continuing education only. We do not see these states with long lines

of dead bodies because Paramedics are incompetent or long lines at the

lawyer's offices because of malpractice.

4. For the past few years, Texas has been recertifying Paramedics whether

they pass or fail the exam. Again, no long lines.

5. We all need to remember that a written test does not show competency.

We all know Paramedics who can pass every test but cannot adequately treat

a live patient. Continuing education, quality assurance, and quality

improvement will train or weed out the medics, and the administration and

Medical Directors can make the decision whether they want them treating

patients or not.

We need to get on the band wagon and convince the Advisory Council of these

problems and testing for recertification should be eliminated. Remember

the Workshop on March 23 at 1:30 in Austin and the Advisory Council meeting

at 9:00 a.m. on March 24. You may need to be there to help voice your

opinion on this issue. I will be there and I will speak on this issue.

Again, if you have any questions or comments, please feel free to contact

me.

Leon Charpentier

Director of Emergency Services

401 Indian Trail

Harker Heights, TX 76548

(office)

(fax)

hhfd@...

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Guest guest

I cant remember? Whats wrong with the current re-certification process.

Whether you get a passing score or not, it is up to the medical director and

administration to make the final determination of competency by evaluating

the emt with their QA program. The failing score does put up a flag for

that employee for review, but does not automatically de-certify them. After

the Med. Dir. evaluates that persons CE contact(Was it all off the

internet/or did the emt participate in ACLS, BTLS, etc. and got actual hands

on and didactical instruction), the Med. Dir. will make the call. If the

emt fails miserably, then thats a bigger flag, but as it is now, its not the

only criteria to re-certify and de-certify.

If I'm off base, then let me know and tag me out!!

Jessie

>

>Reply-To: egroups

>To: <egroups>

>Subject: Re: TDH Rule Changes

>Date: Thu, 16 Mar 2000 15:53:25 -0600

>

>i guess what i wanted to say is it looks like the testing or not to test

>for

>recertification will always be a issue. i quite frankly dont like the idea

>of having to retest. my reasoning is that i have never done good on

>written

>tests, through out my schoolings weither it was in high school, or

>college.

>ive always been better with hands on things or being able to tell you what

>i

>have learned verbally verses through written exams. this doesnt mean that

>i

>can not document things, by all means i do a very good job with my

>paperwork. its just the testing situations that i have problems with. i

>do

>also have to content with learning disablities and adhd. i have always

>managed to do the very best that i can, even though i struggle with it

>sometimes. i guess the bottom line is what ever is finally decided whether

>i like or not. i will back and comply with it 150%. this is just my

>opinion

>to this matter. i just wanted someone to know that yeah i may not always

>be

>able to pass written tests all the time or the first time, but if asked the

>same things through verbal testing and hands on testing. i will rank right

>up there with them all. now that is a thought. why cant there be oral

>testing for those who need some assistance? i know that you can take other

>types of exams orally. they cover the same material but instead of the

>test

>being written it is in an oral format. please dont feel that im crazy for

>thinking this. feel free to privately email me on this if you want to.

>

>randy,emtp

>emt@...

> TDH Rule Changes

>

>

> > If you are interested in the TDH Rule Change issues, please read the

> > following. These are updates and thoughts I have put together since the

> > March 8 Stakeholders' Meeting in Austin. Please feel free to respond.

> >

> > Thank you,

> > Leon Charpentier

> > Director of Emergency Services

> > 401 Indian Trail

> > Harker Heights, TX 76548

> > (office)

> > (fax)

> > hhfd@...

> >

> > ________________________________________________________________________

> > ______________________

> > March 10, 2000

> > *****RESULTS FROM STAKEHOLDERS MEETING, MARCH 8, 2000, AUSTIN, TX*****

> >

> > RULE 157.32

> > After an hour's discussion on Rule 157.32 (which pertains to Paramedic

> > curriculum), the Stakeholders Committee agreed to forward exactly what

>the

> > Texas Fire Chiefs Association was proposing to be passed to the Advisory

> > Council. This means that the D.O.T. Paramedic curriculum was adopted

>with

> > a 700-hour minimum course and left all curriculum proposals in writing

>to

> > Texas Department of Health (TDH) and not Higher Education.

> >

> > I do not foresee any more opposition in this. I believe the Rule will

>make

> > it all the way through to the Board of Health without any problems. To

> > make sure, I will be watching it all the way.

> >

> >

> > RULE 157.33

> > On the other hand, the discussion f Rule 157.33 (which pertains to how

>to

> > recertify) was a bloody battle. The consensus of the Committee members

>was

> > to do away with the test being that a written exam does not prove

> > competency of a Paramedic or an EMT-B. However, the doctors

>representing

> > the Texas Emergency Physicians, the Texas Medical Directors and the

>Texas

> > Medical Association were adamantly against dropping the State exam. TDH

> > appeared to be for dropping the exam for recertification. I reminded

>them

> > (on several occasions) that if the testing was kept, they would need to

> > validate three (3) different types of exams; one exam for the seasoned

> > Paramedic of today, one for the new curriculum, and one for persons

> > completing the new curriculum course, whether it be a certification

>course

> > or a licensing course.

> >

> > Of the 12 representatives on the panel, 9 organizations were in favor of

> > dropping the exams and recertifying by CE hours only. Three

>organizations

> > were against this: Texas Medical Association, Texas Emergency

>Physician's

> > Association, and Texas Medical Directors Association. The medical

>doctors,

> > again, were very adamant about wanting to keep the exam.

> >

> > After a lengthy discussion, a possible solution was formed. This

>solution

> > would probably work, but it is not feasible to implement. The solution

>was

> > a possible two-tier recertification system. Each EMS provder would

>choose

> > their own option. These options are as follows:

> >

> > OPTION 1: The Department's EMS providers would recertify by CE hours

> > only. With an approved QA/QI system in place, CE hours would probably

>go

> > back to 160 CE hours for four years recertification. This is for

> > Paramedcs. EMTs and ECAs have different requirements. However, the no

> > test proposal is for all levels.

> >

> > OPTION 2: A Department that does not wish to complete the extra CE

> > hours or does not wish to put together an approved QA/QI program, would

> > need to send their personnel to TDH for testing.

> >

> >

> > I really cannot tell you where this is going. It appears to be a

>conflict

> > once again. I believe we should stand our ground and request no testing

> > for recertifcation, even if they want to add a good QA/QI program. I

>think

> > that the two-tier program would be a logistic nightmare and that written

> > exams do not prove competency.

> >

> > Be aware that this will be discussed at the next workshop on March 23.

>I

> > will be there to speak on our behalf if this is what you wish. I will

> > solicit all questions, comments, and support.

> > ________________________________________________________________________

> > ______________________

> > March 16, 2000

> >

> > As all the Fire Chiefs know, the EMS Advisory Council is meeting in

>Austin

> > for a Workshop on March 23 and a meeting on March 24.

> >

> > Through the response I have received over the last week, I believe there

>is

> > only one thing we can do to help the problem of eliminating the written

> > test for recertification. This is to contact all of the EMS Advisory

> > Council members with our opinion on the testing. By the way, no need to

> > contact our representative Holloway. He is definitely in-tune

>with

> > what is going on.

> >

> > To recap what happened and the issue on hand is that on March 8, 2000,

>the

> > Stakeholders' Committee all agreed to go forward to the Advisory Council

> > making the new criteria for Texas a minimum of 700 hours and keeping all

>of

> > the curriculum criteria writing to Texas Department of Health and not

> > Higher Education. The problem at hand is what to do with Rule 157.33.

> >

> > Nine (9) of the twelve (12) Stakeholders agreed that recertification

>should

> > be done by continuing education, not a written test. Three (3) doctors

> > representing their respective medical organizations disagreed and wanted

> > testing to remain.

> >

> > If they prevail, things we all need to remember:

> >

> > 1. The State of Texas must write and validate three (3) separate

>Paramedic

> > exams. In the past, Texas has always used the same test meeting the

> > objectives of the Paramedic course for original examination upon

>completion

> > of a Paramedic school and the same test is given to Paramedics to

>recertify

> > no matter how many years they have been in service. This will no longer

> > work. Testing all Paramedics who are already certified on the

>objectives

> > of the new curriculum could not possibly be fair. How many would fail?

> > This means we would need one validated test to recertify Paramedics

> > trained under the old curriculum. We need a second validated test to

>test

> > Paramedics graduating from Paramedic school based on the new objectives.

> > We would need a third exam to test the Paramedics who need to recertify

> > under the new currculum. The cost of this would be astronomical,

>probably

> > in the millions of dollars.

> >

> > 2. Texas has already set a precedence in the licensing rule stating that

>if

> > you have a Paramedic license, you no longer have to recertify by

>testing.

> > There is no difference in the licensed Paramedic of today and a

>certified

> > Paramedic of today except for they have to prove 60 hours of college

> > credit.

> >

> > 3. Forty states in the U.S. currently are recertifying their Paramedics

> > with continuing education only. We do not see these states with long

>lines

> > of dead bodies because Paramedics are incompetent or long lines at the

> > lawyer's offices because of malpractice.

> >

> > 4. For the past few years, Texas has been recertifying Paramedics

>whether

> > they pass or fail the exam. Again, no long lines.

> >

> > 5. We all need to remember that a written test does not show competency.

> > We all know Paramedics who can pass every test but cannot adequately

>treat

> > a live patient. Continuing education, quality assurance, and quality

> > improvement will train or weed out the medics, and the administration

>and

> > Medical Directors can make the decision whether they want them treating

> > patients or not.

> >

> > We need to get on the band wagon and convince the Advisory Council of

>these

> > problems and testing for recertification should be eliminated. Remember

> > the Workshop on March 23 at 1:30 in Austin and the Advisory Council

>meeting

> > at 9:00 a.m. on March 24. You may need to be there to help voice your

> > opinion on this issue. I will be there and I will speak on this issue.

> > Again, if you have any questions or comments, please feel free to

>contact

> > me.

> >

> > Leon Charpentier

> > Director of Emergency Services

> > 401 Indian Trail

> > Harker Heights, TX 76548

> > (office)

> > (fax)

> > hhfd@...

> >

> >

> > ------------------------------------------------------------------------

> > Special Offer-Earn 300 Points from MyPoints.com for trying @Backup

> > Get automatic protection and access to your important computer files.

> > Install today:

> > http://click./1/2344/3/_/4981/_/953237175/

> >

> > -- 20 megs of disk space in your group's Document Vault

> > -- /docvault//?m=1

> >

> >

>

>

>------------------------------------------------------------------------

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Guest guest

I'm stumped!?

jessie

>

>Reply-To: egroups

>To: egroups

>Subject: Re: TDH Rule Changes

>Date: Sat, 18 Mar 2000 06:53:50 -0800

>

>,

>

>The answer to this is easy and two fold:

>

>#1 Licensed Paramedics want sooooo bad to be different than certified

>paramedics, and this will do it because the slightly different patch, tiny

>pay raise if any and slightly different CE hours did not accomplish it.

>

>#2 TDH has to change something every couple of years to make it look like

>they actually need the large staff and budget they have.

>

>

>Here is a challenge to the group

>Can anyone tell me what good can come from a paramedic not testing

>proficiency every four years?

>

>

> >

> >To: egroups

> >Date: Sat, 18 Mar 2000 06:36:43 PST

> >Reply-To: egroups

> >Subject: Re: TDH Rule Changes

> >

> >

> ><< msg1.html >>

>

>

>

>

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Guest guest

And did you know that niether do physicians or nurses or lab techs or

physical therapists or respiratory therapists ect. Nurses are required to

accumulate ceu's every two years,which is a must-do for all health

professionals, but my personal opinion is that once you've proved you know

the basics, you shouldn't have to do it again every four years. Thanks.

Re: TDH Rule Changes

Did you know that school teachers do not have to re-test their competency

every 4 years. Every time the subject comes up they start squealing like

stuck pigs!

Now with that thought, can you tell me that you are satisfied with the

quality of students we are allowing to graduate?

If you hold a certificate or a license in any professional area you should

be tested periodically for competency.

A license should not be an achievement award, it should be maintained. And

the only way to accomplish that is by continuing education, testing skills

and knowledge.

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Guest guest

Bob,

Although your point regarding the quality of students being churned out by

the public school system is well taken, requiring public school teachers to

continually re-take an entrance exam will do nothing to stem the problem.

The ability to pass an entrance exam proves minimum competency. I would hope

that both public school teachers and paramedics alike would progress beyond

bare minimum competency over the course of time.

Required continuing education should be the norm for both paramedics and

public school teachers. True continuing education too, not simple re-hashing

of old material. Just as we should want our teachers to stay abreast of new

technology and new materials in the field of education, we should also

insist that our seasoned paramedics stay abreast of new knowledge in the

field of pre-hospital medicine.

Regards,

Donn

-----------------------------------------------

D.E. (Donn) , REMT-P

Safety & Training Coordinator

R & B Falcon Deepwater Drilling

Houston, Texas

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donn@...

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http://www.rbfalcon.com/

Re: TDH Rule Changes

| Did you know that school teachers do not have to re-test their competency

every 4 years. Every time the subject comes up they start squealing like

stuck pigs!

|

| Now with that thought, can you tell me that you are satisfied with the

quality of students we are allowing to graduate?

|

| If you hold a certificate or a license in any professional area you should

be tested periodically for competency.

|

| A license should not be an achievement award, it should be maintained. And

the only way to accomplish that is by continuing education, testing skills

and knowledge.

|

|

|

|

| ------------------------------------------------------------

| Super-Meta Search Engine! GoHip! http://www.gohip.com

|

| ------------------------------------------------------------------------

| Make history and take part in the first online majority survey.

| Voice your opinions on american politics and the next president.

| Have your say at

| http://click./1/1873/4/_/4981/_/953350446/

|

| -- 20 megs of disk space in your group's Document Vault

| -- /docvault//?m=1

|

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Guest guest

,

The answer to this is easy and two fold:

#1 Licensed Paramedics want sooooo bad to be different than certified

paramedics, and this will do it because the slightly different patch, tiny pay

raise if any and slightly different CE hours did not accomplish it.

#2 TDH has to change something every couple of years to make it look like they

actually need the large staff and budget they have.

Here is a challenge to the group

Can anyone tell me what good can come from a paramedic not testing proficiency

every four years?

>

>To: egroups

>Date: Sat, 18 Mar 2000 06:36:43 PST

>Reply-To: egroups

>Subject: Re: TDH Rule Changes

>

>

><< msg1.html >>

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Guest guest

Howdy Bob,

Let me reverse your question if I may. Tell me what harm will be done by

dropping a re-certification written exam that only tests minimum competency.

Re: TDH Rule Changes

|

| Here is a challenge to the group

| Can anyone tell me what good can come from a paramedic not testing

proficiency every four years?

|

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Guest guest

Bob:

There is much in what you say. However, one issue that must be borne in mind

is the way TDH formerly approached the issue of retesting. TDH, for whatever

reason, chose to use the same test to reevaluate experienced medics as was

used to test new paramedic candidates fresh out of school. Many of the

" facts " those newbies were expected to regurgitate on that exam ran counter

to the way things were done in the field. The whole approach to medical

problemsolving that an experienced medic uses is different than that used by

a rookie. Much of the extraneous information that is seldom used by

paramedics in the field on a regular basis is not as close to the surface

for the experienced medic. For all these reasons, to say nothing of the test

anxiety phenomenon, the experienced medic is at a serious and unfair

disadvantage when he or she is required to take a test designed for new

paramedic candidates in order to recertify. That is, unless he or she spends

many hours cramming and unlearning things it has taken four years to master

(admittedly, unlearning some bad habits in the process, most likely). TDH

has been quoted repeatedly as stating they do not have the resources to

devise one type of exam for initial certificants and another for

recertification (which statement sounds pretty lame when you think about

it). Granted, there are some who object to the idea of recertification

testing because it is inconvenient, or because they don't want to be called

to any account for the quality of their growth as a medic over the last

certification period. Contrawise, some medical directors favor a return to

the old system because they don't want to accept responsibility for making

sure their medics are competent. It's too much work. The arguements of both

these groups probably deserve to be discounted. Many however, including

myself, object to the concept of pass-fail testing for recertification, as

that process has previously been applied, because it does not in any way

accurately indicate or measure the continuing competency of an

already-in-practice EMT or paramedic. Because I have serious doubts about

the continuing competency of a certain percentage of our paramedics in this

state, I'd like to see some type of evaluation process that really works

come into being, but re-adopting something that never worked in the past and

won't work any better now, is worse than leaving the no pass - no fail

system in place for the time being. At least everyone knows it is flawed and

that medical directors have to take the responsibility for making sure their

medics are up to snuff, but it keeps otherwise good medics from being

victimized by an invalid testing procedure. I think it best that we leave

things as they are for now, with the requirement that a new and effective

system be researched, described, analyzed for effectiveness, and put in

place at the earliest possible time.

Dave

Re: TDH Rule Changes

> Did you know that school teachers do not have to re-test their competency

every 4 years. Every time the subject comes up they start squealing like

stuck pigs!

>

> Now with that thought, can you tell me that you are satisfied with the

quality of students we are allowing to graduate?

>

> If you hold a certificate or a license in any professional area you should

be tested periodically for competency.

>

> A license should not be an achievement award, it should be maintained. And

the only way to accomplish that is by continuing education, testing skills

and knowledge.

>

>

>

>

> ------------------------------------------------------------

> Super-Meta Search Engine! GoHip! http://www.gohip.com

>

> ------------------------------------------------------------------------

> Make history and take part in the first online majority survey.

> Voice your opinions on american politics and the next president.

> Have your say at

> http://click./1/1873/4/_/4981/_/953350446/

>

> -- 20 megs of disk space in your group's Document Vault

> -- /docvault//?m=1

>

>

>

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Guest guest

Jessie:

One big problem with this that makes many medical directors want the ball to

be out of their court is the fact that, when the medical directors for some

EMS services try to revoke the practice privileges of a medic who has failed

the current CE evaluation exam, the EMS service director or the fire chief

(interested only in continuing to have a warm body with a patch on the

ambulance) threatens to replace the medical director with another doctor who

goes along with the program. Granted some docs aren't paid for medical

direction and this isn't much of a threat, but many others, particularly

those working for municipal services, are paid. For some, it represents a

fair amount of money. That is one of the fundamental flaws with our system

in Texas. Medical directors are officially responsible for the paramedics in

their system, but have very limited power in practical terms, to enforce

their view of who should be practicing and under what conditions. Ask any

TDH rep about the currency of medical director lists and they will tell you

that the lists change more often than some of our colleagues change their

socks. Part of this is because some services go doc-shopping when they don't

get their way and TDH rules allow that. Maybe a TDH-designated regional

medical director, with each local medical director and EMS service answering

to him or her, would be a way to put a stop to that.

Dave

TDH Rule Changes

> >

> >

> > > If you are interested in the TDH Rule Change issues, please read the

> > > following. These are updates and thoughts I have put together since

the

> > > March 8 Stakeholders' Meeting in Austin. Please feel free to respond.

> > >

> > > Thank you,

> > > Leon Charpentier

> > > Director of Emergency Services

> > > 401 Indian Trail

> > > Harker Heights, TX 76548

> > > (office)

> > > (fax)

> > > hhfd@...

> > >

> > >

________________________________________________________________________

> > > ______________________

> > > March 10, 2000

> > > *****RESULTS FROM STAKEHOLDERS MEETING, MARCH 8, 2000, AUSTIN, TX*****

> > >

> > > RULE 157.32

> > > After an hour's discussion on Rule 157.32 (which pertains to Paramedic

> > > curriculum), the Stakeholders Committee agreed to forward exactly what

> >the

> > > Texas Fire Chiefs Association was proposing to be passed to the

Advisory

> > > Council. This means that the D.O.T. Paramedic curriculum was adopted

> >with

> > > a 700-hour minimum course and left all curriculum proposals in writing

> >to

> > > Texas Department of Health (TDH) and not Higher Education.

> > >

> > > I do not foresee any more opposition in this. I believe the Rule will

> >make

> > > it all the way through to the Board of Health without any problems.

To

> > > make sure, I will be watching it all the way.

> > >

> > >

> > > RULE 157.33

> > > On the other hand, the discussion f Rule 157.33 (which pertains to how

> >to

> > > recertify) was a bloody battle. The consensus of the Committee

members

> >was

> > > to do away with the test being that a written exam does not prove

> > > competency of a Paramedic or an EMT-B. However, the doctors

> >representing

> > > the Texas Emergency Physicians, the Texas Medical Directors and the

> >Texas

> > > Medical Association were adamantly against dropping the State exam.

TDH

> > > appeared to be for dropping the exam for recertification. I reminded

> >them

> > > (on several occasions) that if the testing was kept, they would need

to

> > > validate three (3) different types of exams; one exam for the seasoned

> > > Paramedic of today, one for the new curriculum, and one for persons

> > > completing the new curriculum course, whether it be a certification

> >course

> > > or a licensing course.

> > >

> > > Of the 12 representatives on the panel, 9 organizations were in favor

of

> > > dropping the exams and recertifying by CE hours only. Three

> >organizations

> > > were against this: Texas Medical Association, Texas Emergency

> >Physician's

> > > Association, and Texas Medical Directors Association. The medical

> >doctors,

> > > again, were very adamant about wanting to keep the exam.

> > >

> > > After a lengthy discussion, a possible solution was formed. This

> >solution

> > > would probably work, but it is not feasible to implement. The

solution

> >was

> > > a possible two-tier recertification system. Each EMS provder would

> >choose

> > > their own option. These options are as follows:

> > >

> > > OPTION 1: The Department's EMS providers would recertify by CE

hours

> > > only. With an approved QA/QI system in place, CE hours would probably

> >go

> > > back to 160 CE hours for four years recertification. This is for

> > > Paramedcs. EMTs and ECAs have different requirements. However, the

no

> > > test proposal is for all levels.

> > >

> > > OPTION 2: A Department that does not wish to complete the extra CE

> > > hours or does not wish to put together an approved QA/QI program,

would

> > > need to send their personnel to TDH for testing.

> > >

> > >

> > > I really cannot tell you where this is going. It appears to be a

> >conflict

> > > once again. I believe we should stand our ground and request no

testing

> > > for recertifcation, even if they want to add a good QA/QI program. I

> >think

> > > that the two-tier program would be a logistic nightmare and that

written

> > > exams do not prove competency.

> > >

> > > Be aware that this will be discussed at the next workshop on March 23.

> >I

> > > will be there to speak on our behalf if this is what you wish. I will

> > > solicit all questions, comments, and support.

> > >

________________________________________________________________________

> > > ______________________

> > > March 16, 2000

> > >

> > > As all the Fire Chiefs know, the EMS Advisory Council is meeting in

> >Austin

> > > for a Workshop on March 23 and a meeting on March 24.

> > >

> > > Through the response I have received over the last week, I believe

there

> >is

> > > only one thing we can do to help the problem of eliminating the

written

> > > test for recertification. This is to contact all of the EMS Advisory

> > > Council members with our opinion on the testing. By the way, no need

to

> > > contact our representative Holloway. He is definitely in-tune

> >with

> > > what is going on.

> > >

> > > To recap what happened and the issue on hand is that on March 8, 2000,

> >the

> > > Stakeholders' Committee all agreed to go forward to the Advisory

Council

> > > making the new criteria for Texas a minimum of 700 hours and keeping

all

> >of

> > > the curriculum criteria writing to Texas Department of Health and not

> > > Higher Education. The problem at hand is what to do with Rule 157.33.

> > >

> > > Nine (9) of the twelve (12) Stakeholders agreed that recertification

> >should

> > > be done by continuing education, not a written test. Three (3)

doctors

> > > representing their respective medical organizations disagreed and

wanted

> > > testing to remain.

> > >

> > > If they prevail, things we all need to remember:

> > >

> > > 1. The State of Texas must write and validate three (3) separate

> >Paramedic

> > > exams. In the past, Texas has always used the same test meeting the

> > > objectives of the Paramedic course for original examination upon

> >completion

> > > of a Paramedic school and the same test is given to Paramedics to

> >recertify

> > > no matter how many years they have been in service. This will no

longer

> > > work. Testing all Paramedics who are already certified on the

> >objectives

> > > of the new curriculum could not possibly be fair. How many would

fail?

> > > This means we would need one validated test to recertify Paramedics

> > > trained under the old curriculum. We need a second validated test to

> >test

> > > Paramedics graduating from Paramedic school based on the new

objectives.

> > > We would need a third exam to test the Paramedics who need to

recertify

> > > under the new currculum. The cost of this would be astronomical,

> >probably

> > > in the millions of dollars.

> > >

> > > 2. Texas has already set a precedence in the licensing rule stating

that

> >if

> > > you have a Paramedic license, you no longer have to recertify by

> >testing.

> > > There is no difference in the licensed Paramedic of today and a

> >certified

> > > Paramedic of today except for they have to prove 60 hours of college

> > > credit.

> > >

> > > 3. Forty states in the U.S. currently are recertifying their

Paramedics

> > > with continuing education only. We do not see these states with long

> >lines

> > > of dead bodies because Paramedics are incompetent or long lines at the

> > > lawyer's offices because of malpractice.

> > >

> > > 4. For the past few years, Texas has been recertifying Paramedics

> >whether

> > > they pass or fail the exam. Again, no long lines.

> > >

> > > 5. We all need to remember that a written test does not show

competency.

> > > We all know Paramedics who can pass every test but cannot adequately

> >treat

> > > a live patient. Continuing education, quality assurance, and quality

> > > improvement will train or weed out the medics, and the administration

> >and

> > > Medical Directors can make the decision whether they want them

treating

> > > patients or not.

> > >

> > > We need to get on the band wagon and convince the Advisory Council of

> >these

> > > problems and testing for recertification should be eliminated.

Remember

> > > the Workshop on March 23 at 1:30 in Austin and the Advisory Council

> >meeting

> > > at 9:00 a.m. on March 24. You may need to be there to help voice your

> > > opinion on this issue. I will be there and I will speak on this

issue.

> > > Again, if you have any questions or comments, please feel free to

> >contact

> > > me.

> > >

> > > Leon Charpentier

> > > Director of Emergency Services

> > > 401 Indian Trail

> > > Harker Heights, TX 76548

> > > (office)

> > > (fax)

> > > hhfd@...

> > >

> > >

> >

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Guest guest

Howdy Randy!

You bring up an interesting (and very important) point about the new

curriculum (and, for that matter, any curriculum). It really isn't about

hours. Unfortunately, in our environment an hour requirement is probably

necessary. If we had mandatory accreditation, then this wouldn't be an

issue. But we don't.

The really important point is that if we are saying that we adopt the

curriculum, we should really do it. The only real way to be sure that

programs are required to cover the full curriculum is to test the full

curriculum.

I feel that we need to include wording in the rule which requires the exam

to cover the full breadth and depth of the current national standard AND be

developed according to national industry practices. Without us adopting

accreditation, this is probably our best assurance that all programs really

are teaching the new curriculum.

Take care,

Jeff

Re: TDH Rule Changes

Let me start by stating my position up front. The Board should adopt the

proposed rule 173.32 as written. Proposed rule 173.33 should require

certified and licensed paramedics to follow the same standard for

recertification, that being CE hours only. Proposed rule 173.34 should

reflect the same. Place the responsibility for competence on the individual

and the agency, not on the rules or TDH.

Many have read of or heard of the National Standard Curriculum (NSC), but

have not seen it. If you have not read the National Standard Curriculum,

please take the time to download it and read it. It is available free from

the DOT NHTSA website. A link is listed at the TDH EMS website under file

libraries.

The Texas Fire Chiefs Association proposal sets a time frame for the length

of the program not consistant with the NSC. The Texas Fire Chiefs

Association proposal equates clock hours to demonstrating competency. The

NSC introduction has a section on course length. I believe the last

sentence speaks for itself.

" Competence of the graduate, not adherence to arbitrary time frames, is the

only measure of program quality. "

If we are going to adopt the NSC, why not use the entire document as it was

intendeded? The intent is to produce a competent paramedic, not to document

sitting in a classroom for X number of hours.

Randy E. FF/LP

P.S. Here is the entire section.

COURSE LENGTH

Basic academic skills play a very important role in course length and

attrition rate. Attrition rate is a function of the groups basic academic

skills and the length of the course. If course length remains constant, and

the basic skills of the applicants decreases, the attrition rate will rise.

Correspondingly, if a program seeks to decrease its attrition rate or

increase examination performance, it may do so by increasing the basic

academic skills of its students, increasing course length, or both. This

information should be taken into account in course planning.

The emphasis of paramedic education should be competence of the graduate,

not the amount of education that they receive. The time involved in

educating a paramedic to an acceptable level of competence depends on many

variables. Based on the experience in the pilot and field testing of this

curriculum, it is expected that the average program, with average students,

will achieve average results in approximately 1000-1200 hours of

instruction. The length of this course will vary according to a number of

factors, including, but not limited to:

-student’s basic academic skills competence

-faculty to student ratio

-student motivation

-the student’s prior emergency/health care experience

-prior academic achievements

-clinical and academic resources available

-quality of the overall educational program

Appendix D is a summary of the time that each of the eight field test sites

needed to cover a draft of the curriculum. These times are meant only as a

guide to help in program planing. Training institutes MUST adjust these

times based on their individual needs, goals and objectives. These times

are only recommendations, and should NOT be interpreted as minimums or

maximums. Those agencies responsible for program oversight are cautioned

against using these hours as a measure of program quality or having

satisfied minimum standards. Competence of the graduate, not adherence to

arbitrary time frames, is the only measure of program quality.

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