(a) Recertification requirements.
  (1) Not later than the 30th day before the date a person's certificate is scheduled to expire, the Department of State Health Services (department) may send to the person a notice of expiration at the address shown in the current records of the department.
  (2) If a certificant has not received a notice of expiration from the department 30 days prior to the expiration, it is the duty of the certificant to notify the department and to request an application for recertification or download an application from the Internet.
  (3) To maintain certification status without a lapse, an applicant shall submit a completed application for recertification and shall meet all requirements for renewal of the current certification prior to the expiration date of the current certificate, but no earlier than one year prior to the expiration date.
  (4) The certificant shall submit the following non-refundable fees as applicable:
    (A) $60 for Emergency Care Attendant (ECA) or Emergency Medical Technician (EMT);
    (B) $90 for Advanced EMT (AEMT), EMT-Intermediate (EMT-I), or EMT-Paramedic (EMT-P); and
    (C) EMS volunteer--no fee. However, if such an individual receives compensation during the certification period, the exemption ceases and the individual shall pay a prorated fee to the department based on the number of years remaining in the certification period when employment begins. The non-refundable fee for ECA or EMT certification shall be $15 per each year remaining in the certification. The non-refundable fee for AEMT or EMT-P shall be $22.50 per each year remaining in the certification. Any portion of a year will count as a full year.
  (5) Recertification by voluntary downgrade. An individual who holds a Texas EMS certification or paramedic license may renew at a lower level by meeting the requirements of this subsection. The applicant must meet the requirements for the lower level of certification requested as described in subsection (b) or (f) or (g) of this section. On the date the downgrade is final, the previous higher level of certification becomes invalid. To regain the original higher level of certification, the candidate shall meet the late recertification requirements outlined in subsection (g) of this section, within one year after the expiration date.
  (6) A certificate is not transferable.
  (7) Military personnel. A person certified by the department who is deployed in support of military, security, or other action by the United Nations Security Council, a national emergency declared by the President of the United States, or a declaration of war by the United States Congress is eligible for recertification under timely recertification requirements from the person's date of demobilization until one calendar year after the date of demobilization but will not be certified during that period.
    (A) In addition to requirements described in this subsection, the candidate shall submit a copy of deployment and demobilization orders.
    (B) The four-year certification will commence on issue date of the certificate.
(b) Recertification options. Upon submission of a completed application for recertification, the applicant shall commit to, and recertify through one of the options described in paragraphs (1) - (5) of this subsection.
  (1) Option 1--Written Examination Recertification Process.
    (A) The applicant shall pass the National Registry assessment exam. An overall score of 70 is considered to be passing.
    (B) If the applicant fails the examination for recertification, the applicant may attempt two retests of the examination after:
      (i) submitting a retest application for each attempt at any eligible level; and
      (ii) submitting a non-refundable retest fee of $30 for each attempt.
    (C) For each subsequent retest attempt, an applicant may apply for and retest at a lower level by complying with paragraph (1)(B) of this subsection, if applicable.
    (D) An applicant who selects option 1 and attempts the exam but does not pass the National Registry assessment examination may not gain recertification by any other option and shall not qualify for inactive certification addressed in §157.33(h) of this title (relating to Certification) or subsection (f) or (g) of this section.
    (E) An applicant who does not pass the third attempt at the National Registry assessment examination:
      (i) shall successfully complete a Formal Recertification Course as described in paragraph (4) of this subsection; and
      (ii) shall submit a course completion certificate of the Formal recertification course, reflecting that the course was completed after the 2nd retest failure; and
      (iii) shall pass the National Registry assessment examination in accordance with the provisions in subparagraphs (A) - (D) of this paragraph.
      (iv) shall not qualify for more than a total of six attempts at the exam, in any combination of levels attempted.
    (F) The certification status of an applicant who does not successfully complete the examination recertification process as described in paragraph (1)(A) - (E) of this subsection shall expire on the date of the current certificate.
    (G) The applicant has completed a state approved jurisprudence examination to determine the knowledge on state EMS laws, rules, and policies.
  (2) Option 2--Continuing Education Recertification Process.
    (A) The certificant shall attest to accrual of department approved EMS continuing education as specified in §157.38 of this title (relating to Continuing Education); and
    (B) the applicant has completed a state approved jurisprudence examination to determine the knowledge on state EMS laws, rules, and policies.
  (3) Option 3--National Registry Recertification Process.
    (A) The applicant shall attest to and hold current National Registry certification at the time of applying for recertification; and
    (B) the applicant has completed a state approved jurisprudence examination to determine the knowledge on state EMS laws, rules, and policies.
  (4) Option 4--Formal Course Recertification Process. The applicant shall attest to successful completion of a department approved recertification course.
    (A) The recertification course shall be a formal structured interactive training course as approved by the department and conducted within the four-year certification period.
    (B) The minimum contact hours required for recertification courses are:
Attached Graphic
    (C) The applicant has completed a state approved jurisprudence examination to determine the knowledge on state EMS laws, rules, and policies.
  (5) Option 5--CCMP Recertification Process. An applicant affiliated with an EMS provider that has a department-approved Comprehensive Clinical Management Program (CCMP) may be recertified if:
    (A) the applicant is currently credentialed in the provider's CCMP;
    (B) the applicant has been enrolled in the provider's CCMP for at least six continuous months;
    (C) the applicant submits to the department a signed written statement by the CCMP's medical director, attesting to the applicant's successful participation in and completion of the provider's CCMP; and
    (D) The applicant has completed a state approved jurisprudence examination to determine the knowledge that the applicant has on state EMS laws, rules, and policies.
  (6) If a candidate wishes to change options (other than option 1), another application form must be submitted. An additional fee is not required if the candidate completes all requirements within the same time period of the original submission.
(c) After verification by the department of the information submitted by the applicant, that the information is true, correct and complete with regard to the applicant meeting recertification requirements by the certification expiration date, the department shall recertify the applicant for four years, commencing on the day following the expiration date of the most recent certificate. A candidate must verify current certification before staffing an EMS vehicle. Certification may be verified by the applicant's receipt of the official department identification card, by using the department's certification website, or by contacting the department directly.
(d) Applicant immunization history.
  (1) If the applicant's immunization history is included in the immunization registry as defined by Health and Safety Code, §161.007, the department shall provide notice of the applicant's immunization history using information from the immunization registry.
Cont'd...
(2) If the applicant's immunization history is not included in the immunization registry, the department shall provide:
    (A) details about the program developed under Health and Safety Code §161.00707; and
    (B) the specific risks to emergency medical services personnel when responding rapidly to an emergency of exposure to and infection by a potentially serious or deadly communicable disease that an immunization may prevent.
(e) Late recertification.
  (1) The candidate whose certification has expired shall be considered late, non-certified and shall not function in the capacity of an EMS certificant or represent that he is EMS certified until recertification is issued.
  (2) A candidate whose certificate has been expired for 90 days or less may renew the certificate by submitting an application accompanied by a non-refundable renewal fee that is equal to 1-1/2 times the normally required application renewal fee for that level as listed in subsection (a)(4) of this section. Applicant shall meet one of the recertification options described in subsection (b)(1) - (5) of this section and submit verification of skills proficiency from an approved education program. If the applicant has already submitted an application and fee, but has not met all of the requirements prior to expiration, another application will not be required, but a total of 1-1/2 times the normally required application renewal fee shall be necessary. The applicant shall be recertified for a period of four years beginning on the date of issuance.
  (3) A candidate whose certificate has been expired for more than 90 days but less than one year may renew the certificate by submitting an application accompanied by a non-refundable renewal fee that is equal to two times the normally required application renewal fee as listed in subsection (a)(4) of this section. Applicant shall meet one of the recertification options described in subsection (b)(2) - (6) of this section and submit verification of skills proficiency from an approved education program. If the applicant has already submitted an application and fee, but has not met all of the requirements prior to the 90th day after expiration, another application will not be required, but a total of two times the fee shall be necessary.
  (4) The applicant shall be recertified for a period of four years beginning on the date of issuance.
  (5) A candidate whose certificate has been expired for one year or more may not renew the certificate. The candidate may become certified by complying with the requirements of §157.33(a) or (j) of this title.
  (6) A candidate who was certified in this state, moved to another state, and is currently certified or licensed and has been in practice in the other state for two years preceding the date of application may become certified without reexamination. The candidate may gain recertification by:
    (A) submitting to the department a non-refundable fee that is equal to two times the normally required renewal fee for certification as listed in subsection (a)(4) of this section; and
    (B) attesting to regular practice of emergency medical care in the other state for the two years preceding the date of application.
(f) Renewal of inactive certification.
  (1) To renew inactive certification, an applicant holding inactive certification shall submit an application and the non-refundable fee as described in §157.33(a)(4) of this title. The $30 inactive fee is not required for renewal when renewing inactive certification. A candidate who meets requirements for inactive renewal shall be awarded inactive certification for a period of four years beginning on the first day after the expiration of the previous inactive certification.
  (2) A candidate whose inactive certification has been expired for 90 days or less may renew the inactive certification during the 90 day period after expiration of the certification upon submitting a fee of 1-1/2 times the normally required renewal fee as described in subsection (a)(4) of this section. If the applicant has already submitted an application and fee, but has not met all of the requirements prior to expiration, another application will not be required, but a total of 1-1/2 times the fee shall be necessary. The applicant shall be recertified for a period of four years beginning on the date of issuance.
  (3) A candidate whose inactive certification has been expired more than 90 days but less than one year may renew the inactive certification upon submitting a fee of two times the normally required renewal fee as described in subsection (a)(4) of this section. If the applicant has already submitted an application and fee, but has not met all of the requirements prior to the 90th day after expiration, another application will not be required, but a total of two times the fee shall be necessary. The applicant shall be recertified for a period of four years beginning on the date of issuance.
  (4) A candidate whose inactive certificate has been expired more than one year must regain active certification before reapplying for inactive certification as described in subsection (g) of this section.
(g) Inactive to active certification.
  (1) An inactive certificant prior to the expiration of the first four-year inactive certification period may obtain active certification by submitting an application and the non-refundable fee to the department, as described in subsection (a)(4) of this section and by completing one of the following options:
    (A) Option 1--meet the normal four year continuing education requirement for certification renewal as listed in subsection (b)(2) of this section, submit verification of skills proficiency from an approved education program or recognized physician by the department, and pass the National Registry EMT cognitive assessment exam.
    (B) Option 2--complete a department approved recertification course, and pass the National Registry EMT psychomotor (practical) exam and cognitive assessment exam.
  (2) A certificant who has held inactive certification for more than four years may return to active certification only by completing requirements described in §157.33(a) or (j) of this title.
(h) For all applications and renewal applications, the department is authorized to collect subscription and convenience fees, in amounts determined by the Texas Online Authority, to recover costs associated with application and renewal application processing through Texas Online.

Source Note: The provisions of this §157.34 adopted to be effective August 31, 2006, 31 TexReg 6739; amended to be effective February 12, 2017, 42 TexReg 430; amended to be effective December 5, 2019, 44 TexReg 7396