(a) Purpose: Acquiring, issuing, and maintaining an EMS provider license.(b) EMS in Texas is a delegated practice, as written in Texas Occupations Code §157.003.(c) Application requirements for an EMS provider license.(1) An applicant for an initial EMS provider license must submit a completed application to the department on the required official forms, following the department's written process.(2) The nonrefundable application fee of $500 per provider plus $180 for each EMS vehicle to be operated under the license must accompany the application.(3) The department will process the EMS provider license application as per §157.3 of this chapter (relating to Processing EMS Provider Licenses and Applications for EMS Personnel Certification and Licensure).(4) An EMS provider holding a valid license or authorization from another state is exempt from holding a Texas EMS provider license if the provider:(A) serves an area that adjoins the State of Texas;(B) has a written mutual aid agreement with a licensed Texas EMS provider;(C) is requested to do so by a licensed Texas EMS provider;(D) responds into Texas for emergency mutual aid assistance; and(E) is obligated to perform to the same medical standards of care required by the home state.(5) A fixed-wing or rotor-wing air ambulance provider, appropriately licensed by the state governments of New Mexico, Oklahoma, Arkansas, Kansas, Colorado, or Louisiana, may apply for a reciprocal provider license. The application does not require staffing by Texas EMS certified or licensed personnel. A nonrefundable administrative fee of $500 per provider in addition to a nonrefundable fee of $180 for each EMS aircraft to be operated in Texas under the reciprocal license must accompany the application.(6) An applicant for an EMS provider license that provides emergency prehospital care is exempt from paying department licensing and authorization fees if the provider is staffed with at least 75 percent volunteer personnel, has no more than five full-time staff or equivalent, and is recognized as a §501(c)(3) nonprofit corporation by the Internal Revenue Service. An EMS provider who compensates a physician to provide medical supervision will be exempt from paying department licensing and authorization fees if all other requirements for fee exemption are met.(7) Required documents that must accompany a license application.(A) Document verifying volunteer status, if applicable.(B) Map and description of service area, a list of counties and cities in which applicant proposes to provide primary emergency service, and a list of all station locations with address and telephone and facsimile transmission numbers for each station.(C) Declaration of organization type and profit status.(D) Declaration of provider name.(i) The legal name of the EMS provider cannot include the name of the city, county, or regional advisory council (RAC) within or in part, unless written approval is given by the individual city, county, or RAC respectively.(ii) A proposed provider name is deemed to be the same name as an established licensed EMS provider if it meets the conditions listed in 1 Texas Administrative Code (TAC) §79.39 (relating to Same Defined) and therefore is not available if a comparison of the names reveals no differences.(E) Declaration of ownership.(F) Declaration of the address for the main location of the business, normal business hours, and proof of ownership or lease of the location.(i) The normal business hours must be posted for public viewing.(ii) A service area map must be provided.(iii) Only one EMS provider license will be issued to each fixed address.(iv) The applicant must attest no other licensed EMS provider is at the business location or address provided.(v) The EMS provider must remain in the same physical location for the period of licensure, unless the department approves a change in location.(G) A statement of an administrator of record under Texas Health and Safety Code §773.0571 or §773.05712.(H) The administrator of record statement must declare they:(i) are not employed or otherwise compensated by another private for-profit EMS provider;(ii) meet the qualifications required for an emergency medical technician certification or other health care professional license with a direct relationship to EMS and currently hold such certification or license issued by the State of Texas;(iii) have submitted to a criminal history record check at the applicant's expense as directed in §157.37 of this chapter (relating to Certification or Licensure of Persons With Criminal Backgrounds);(iv) have completed an initial education course approved by the department regarding state and federal laws and rules affecting EMS in the following areas:(I) Texas Health and Safety Code Chapter 773 and 25 TAC Chapter 157;(II) EMS dispatch processes;(III) EMS billing processes;(IV) Medical control accountability;(V) Quality improvement processes for EMS operations; and(v) have completed eight hours of continuing education related to the Texas and federal laws and rules related to EMS.(I) If the EMS provider held a license on September 1, 2013, and has an administrator of record with at least eight years of experience providing EMS, then the administrator of record statement is exempt from subparagraph(H)(ii) and (iii) of this paragraph.(J) EMS providers operated by a governmental entity are exempt from subparagraph (H) of this paragraph except for declaration of administrator of record.(K) Copies of Doing Business Under Assumed Name Certificates (DBA).(L) Completed EMS personnel form.(M) Staffing Plan describing how the EMS provider provides continuous coverage for the service area defined in documents submitted with the EMS provider application. The EMS provider must have a staffing plan that addresses coverage of the service area or must have a formal system to manage communication when not providing services after normal business hours.(N) Completed EMS vehicle form.(O) Declaration of an employed medical director and a copy of the signed contract or agreement with a physician currently licensed in the State of Texas, in good standing with the Texas Medical Board and in compliance with Texas Medical Board rules, 22 TAC Chapter 197, and Texas Occupations Code