(1) Within 60 days of taking on the responsibilities of providing medical oversight as a medical director to an individual or group of ECPs, a physician or physician assistant shall:

(a) notify the board they are providing medical direction to ECPs on a form provided by the board; and

(b) provide proof of completion of a board-approved medical director training program or a board-approved exemption from the training on a form provided by the board.

(2) The medical director shall be responsible for the overall medical care provided by the ECPs for whom the director agrees to provide medical oversight.

(3) The medical director overseeing an ECP may grant or restrict the ECP's practice or utilization of any endorsement.

(4) The medical director must maintain and have access to records of all ECPs for whom the director provides medical oversight. These records must document:

(a) the name, address, and current Montana licensure of the ECP, including any endorsements;

(b) date when medical oversight began and at what level the ECP is authorized to practice; and

(c) any changes to limit or approve the ECP's authorization to function at the ECP's current licensure level including endorsement(s).

(5) The medical director must develop a process to continuously meet the applicable standard of medical practice and patient care. This process may include regular review of patient care reports (PCR), direct observation of care, skills demonstrations, and ongoing involvement in ECP education. Documentation of these activities must be maintained by the medical director.

(6) The medical director is responsible for assessing competency of skills required for endorsements held by ECPs under the medical director's supervision and shall sign an affidavit stating such competence as required under ARM 24.156.2718.

(7) A medical director may assign duties where appropriate, but retains the responsibility for all assigned duties. This includes delegation of:

(a) local offline medical direction responsibilities to another unrestricted Montana licensed physician or physician assistant; and

(b) maintenance of records required under (4).

(8) The medical director will approve and review the offering of online medical control which must be provided by any unrestricted Montana licensed physician or physician assistant who has been contacted for this purpose.

(9) A medical director shall provide written notice to the ECP and the board upon discontinuing medical oversight.

(10) The medical director shall be responsible for and approve a system to assure the inventory, storage, and security of all the medications utilized by the ECPs to whom the medical director provides medical oversight. The medical director may delegate the day-to-day duties where appropriate but retains overall responsibility.

(11) A medical director may not unilaterally alter a patient care plan developed by a physician, PA, or APRN for care provided by an ECP with a CIHC endorsement.