Pelham is across the border in Indiana. It's fairly expensive in my opinion.
I've worked with a few EMTs that went through their course and didn't have any issues with them. I've seen Paramedic students in clinicals, but I've never spoken to any of them, or seen them with patients.
The federal rule making process.
It's why most conservatives hate the ATF. It gives Federal agencies the autonomy to change rules or interpretation of rules at the whim of the President.
This covers OSHA, the medicare/medicaid rule is likely going to piggyback off existing rules.