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DEPARTMENT OF HEALTH
NOTICE OF FINAL RULEMAKING
The Director of the Department of Health (“Department”), pursuant to the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1201.01 et seq. (2012 Repl.)), as amended by the Trauma Technologists Licensure Amendment Act of 2013, effective January 25, 2014 (D.C. Law 20-64, 60 DCR 16533 (December 6, 2013)), and Mayor’s Order 98-140, dated August 20, 1998, hereby gives notice of the adoption of new Chapter 106 to Title 17 (Business, Occupations, and Professionals) of the District of Columbia Municipal Regulations (DCMR), entitled “Trauma Technologists,” and the adoption of an amendment to Section 3500 (Fees) of Chapter 35 (Licensing Fees) of Title 17 DCMR.
Adoption of Chapter 106 is necessary to establish rules specific to trauma technologists practicing in the District, including licensure, scope of practice, supervision, and continuing education, as well as to provide the duties of the advisory board of trauma technologists to the District of Columbia Board of Medicine.
This rulemaking was published in the D.C. Register as emergency and proposed rulemaking on December 25, 2015 at 62 DCR 16344. No comments were received. The Department adopts the final rulemaking with no changes to the emergency and proposed rulemaking.
Title 17 DCMR, BUSINESS, OCCUPATIONS, AND PROFESSIONALS, is amended by adding a new Chapter 106, entitled TRAUMA TECHNOLOGISTS, to read as follows:
CHAPTER 106 TRAUMA TECHNOLOGISTS
10600 General Provisions
10601 Term of License
10602 Renewal of License
10603 Licensure Requirements
10604 Transition to Licensure
10605 [Reserved]
10606 [Reserved]
10607 [Reserved]
10608 Continuing Education Requirements
10609 Approved Continuing Education Programs and Activities
10610 [Reserved]
10611 [Reserved]
10612 [Reserved]
10613 SCOPE OF PRACTICE
10614 Supervising Physician
10615 Title Protection
10616 Duties of Advisory Committee of Trauma Technologists
10699 Definitions
10600 GENERAL PROVISIONS
10600.1 This chapter shall apply to applicants for a license to practice as a trauma technologist.
10600.2 Chapters 40 (Health Occupations: General Rules) and 41 (Health Occupations: Administrative Procedures) shall supplement this chapter.
10601 TERM OF LICENSE
10601.1 Subject to § 10601.2, a license issued pursuant to this chapter shall expire at 12:00 midnight of December 31st of each even-numbered year.
10601.2 If the Director changes the renewal system pursuant to § 4006.3 of Chapter 40 of this title, a license issued pursuant to this chapter shall expire at 12:00 midnight of the last day of the month of the birthdate of the holder of the license or other date established by the Director.
10602 RENEWAL OF LICENSE
10602.1 The holder of a license to practice as a trauma technologist shall renew his or her license by submitting a completed application on the forms prescribed by the Board and paying the required fees prior to the expiration of the license.
10602.2 A licensed holder applying for renewal of a license to practice as a trauma technologist shall submit documentary evidence that, in addition to meeting the requirements of § 3-1205.04(r), he or she has successfully completed fifty (50) hours of Board-approved continuing medical education within two (2) years before the date the license expires. Continuing medical education may consist of critiques, didactic session, practical drills, workshops, seminars, or other Board-approved means.
10603 LICENSURE REQUIREMENTS
10603.1 An applicant shall furnish proof satisfactory to the Board in accordance with D.C. Official Code § 3-1205.04 (2012 Repl.) that the applicant has met the following requirements:
(a) Successfully completed courses and training in anatomy and physiology, respiratory and cardiac care, wound treatment and closure, treatment of musculoskeletal injuries and burns, and other clinical aspects of emergency medical care from a trauma technology training program approved by the Board;
(b) Successfully completed the written and practical examinations for trauma technologists within twelve (12) months after completing the trauma technology training program; and
(c)
(1) Successfully completed and provided evidence of course completion of a life support training course, which includes all adult, child, and infant cardiopulmonary resuscitation and airway obstruction skills, from an agency approved by the Board, which teaches these skills in accordance with the current American Heart Association Guidelines for Basic Life Support at the health care provider level;
(2) Successfully completed and provided evidence of completion of a dedicated training program for trauma technologists in the armed forces and has been performing the functions of trauma technologists for at least five (5) years before the date of application for licensure; or
(3) Demonstrated to the satisfaction of the Board the completion of full-time work experience performed in the United States or Canada under the direct supervision of an emergency room physician licensed in the United States or Canada and consisting of at least one thousand three hundred (1,300) hours of performance as a trauma technologist in a Level 1 trauma facility as designated by the Director of the Department of Health pursuant to Chapters 27 and 28 of Subtitle B of Title 22 of the District of Columbia Municipal Regulations (22-B DCMR §§ 2700 et seq. and §§ 2800 et seq.), within the three (3) years preceding the date of application for licensure.
10604 TRANSITION TO LICENSURE
10604.1 All references to trauma technologists shall be deemed to refer to persons meeting the requirements for licensure in the District, regardless of whether they are licensed in fact, until January 25, 2016.
10605 [RESERVED]
10606 [RESERVED]
10607 [RESERVED]
10608 CONTINUING EDUCATION REQUIREMENTS
10608.1 This section shall apply to applicants for the renewal, reactivation, or reinstatement of a license for a term expiring December 31, 2016, and for subsequent terms.
10608.2 An applicant for renewal of a license to practice as a trauma technologist shall submit proof pursuant to § 10608.5 of having completed during the two-year (2) period preceding the date the license expires approved continuing education units (CEUs) constituting fifty (50) hours of CEU credit as specified in § 10609.2.
10608.3 A continuing education credit may be granted only for a program or activity approved by the Board in accordance with § 10609.
10608.4 An applicant for reactivation of an inactive license or reinstatement of a license to practice as a trauma technologist shall submit proof pursuant to § 10608.5 of having completed during the two-year (2) period immediately preceding the date of application approved CEUs.
10608.5 An applicant under this section shall furnish proof of having completed required continuing education units by submitting with the application the following information:
(a) The name of the program and its approval number;
(b) The dates on which the applicant attended the program or performed the activity;
(c) The hours of credit claimed; and
(d) Verification that the applicant has completed the required continuing education program.
10609 APPROVED CONTINUING EDUCATION PROGRAMS AND ACTIVITIES
10609.1 The Board, in its discretion, may approve continuing education programs and activities that contribute to the knowledge, skills, and professional performance and relationships that a trauma technologist uses to provide services to patients, the public or the profession and that meet the other requirements of this section.
10609.2 The Board may approve continuing education programs and activities for credit that are:
(a) Designated for AMA Category 1 credit approved by the American Medical Association;
(b) Sponsored, co-sponsored, or accredited by a state medical board; or
(c) Specifically approved by the Board.
10609.3 An applicant shall have the burden of verifying whether a program or activity is approved by the Board pursuant to this section prior to attending the program or engaging in the activity.
10610 [RESERVED]
10611 [RESERVED]
10612 [RESERVED]
10613 SCOPE OF PRACTICE
10613.1 An individual shall be licensed by the Board of Medicine before practicing as a trauma technologist in the District of Columbia.
10613.2 An individual licensed to practice as a trauma technologist shall have the authority to:
(a) Identify respiratory emergencies and perform critical interventions with oxygen therapy equipment, including bag valve masks;
(b) Identify circulatory emergencies and perform critical interventions, including cardiopulmonary resuscitation;
(c) Identify, assess, and treat, as required, various eye injuries, soft tissue injuries, ligament and tendon injuries, musculoskeletal injuries, environmental emergencies, and exposure and reactions to poisons;
(d) Provide topical application of a local anesthetic,
(e) Apply tourniquets, casts, immobilizers, and surgical dressings;
(f) Perform phlebotomy and insert intravenous catheters; and
(g) Suture lacerations and provide wound care.
10613.3 A trauma technologist shall not:
(a) Perform any surgical procedure independently;
(b) Have prescriptive authority; or
(c) Write any progress notes or orders on hospitalized patients.
10613.4 Telecommunication by a physician licensed to practice in the District of Columbia may suffice as a means for directing delegated acts for a trauma technologist who is under the indirect supervision of that physician.
10614 SUPERVISING PHYSICIAN
10614.1 To be authorized to supervise a trauma technologist, a physician must be currently licensed as a physician in the District. The license must be unrestricted and active.
10614.2 A supervising physician shall perform the critical portions of any procedure. Supervision shall be continuous, and shall require that the supervising physician be immediately available in the emergency room suite for delegated acts that the trauma technologist performs and to respond to any emergency until the patient is released from the emergency room suite and care has been transferred to another physician, or until the trauma technologist has completed his or her tasks and has been excused by the supervising physician.
10614.3 It is the responsibility of the supervising physician(s) and the trauma technologist(s) to ensure that:
(a) The trauma technologist's scope of practice is clearly defined;
(b) Delegation of medical tasks is appropriate to the trauma technologist's level of competence;
(c) The relationship between the members of the team is defined;
(d) That the relationship of, and access to, the supervising physician is clearly defined and understood by both the supervising physician and the trauma technologist; and
(e) A process for evaluating the trauma technologist's performance is established.
10615 TITLE PROTECTION
10615.1 Unless authorized to practice as a trauma technologist, a person shall not use or imply the use of the words or terms "trauma technologist" or any similar title or description of services with the intent to represent that the person practices as a trauma technologist.
10616 DUTIES OF ADVISORY COMMITTEE ON TRAUMA TECHNOLOGISTS
10616.1 The Advisory Committee on Trauma Technologists shall consist of three (3) members appointed by the Mayor. Of the members of the Advisory Committee on Trauma Technologists, two (2) shall be emergency room physicians licensed in the District with experience working with trauma technologists, and one shall be a trauma technologist who shall be deemed to be and shall become licensed in the District in accordance with this chapter. The Committee shall advise the Board on all matters pertaining to this chapter and shall meet at least annually to review the guidelines for the licensing and regulation of trauma technologists and shall make necessary revisions for submission to the Board.
10616.2 Upon request of the Board, the Committee shall review applications for a license to practice as a trauma technologist and make recommendations to the Board.
10616.3 Upon request of the Board, the Committee shall review complaints regarding trauma technologists referred by the Board and make recommendations to the Board regarding what action should be taken.
10699 DEFINITIONS
10699.1 As used in this chapter the following terms have the meanings ascribed:
Board - the Board of Medicine, established by § 203(a) of the Act, D.C. Official Code § 3-1202.03(a) (1) (2012 Repl.).
Committee - the Advisory Committee on Trauma Technologists, established by § 203 (a) of the Act. D.C. Official Code § 3-1202.03(a) (2012 Repl.).
Immediately available - physically present in the emergency room suite and capable of responding to the trauma technologist and the patient as medically appropriate.
Practice by trauma technologists - means the provision of emergency medical care to trauma patients in a Level 1 trauma facility as designated by the Director of the Department of Health pursuant to Chapters 27 and 28 of Subtitle B of Title 22 of the District of Columbia Municipal Regulations (22-B DCMR §§ 2700 et seq. and §§ 2800 et seq.), under either the direct or indirect supervision of a physician licensed to practice medicine in the District of Columbia.
Trauma technologist - a person licensed to practice as a trauma technologist under the Act, or meeting the requirements for licensure in the District, regardless of whether he or she are licensed in fact, until January 25, 2016.
Emergency room suite - includes the emergency room of any hospital or Level 1 trauma facility, as well as contiguous examination rooms, surgical suites and recovery rooms.
Supervising physician - a physician licensed by the Board who may delegate specified duties to a licensed trauma technologist, and oversees and accepts responsibility for the trauma technologist.
10699.2 The definitions in § 4099 of Chapter 40 of this title and the Act are incorporated by reference into and are applicable to this chapter.
Chapter 35, LICENSING FEES, of Title 17 DCMR, BUSINESS, OCCUPATIONS, AND PROFESSIONALS, is amended as follows:
Section 3500, FEES, Subsection 3500.1, is amended by adding a new paragraph to read as follows:
TRAUMA TECHNOLOGISTS:
Application Fee $85.00
License Fee $145.00
Paid Inactive Status $145.00
Renewal Fee $145.00
Late Renewal Fee $85.00
Document Duplication Fee $34.00
Verification of Records $34.00
Reinstatement Fee $229.00
Criminal Background Check $50.00
