 Accreditation standards are periodically revised to reflect the dynamic, changing environment of medical transport, with considerable input from all disciplines of the medical profession.Other U.S. states require either CAMTS accreditation "or" a demonstrated equivalent, such as Rhode Island, and Texas, which has adopted CAMTS' Accreditation Standards (Sixth Edition, October 2004) as its own.In Texas, an operator not wishing to become CAMTS accredited must submit to an equivalent survey by state auditors who are CAMTS-trained.