ALS Provider Credentialing and Authorization Procedures
Suffolk County EMS System
Entry Requirements for Regional Emergency Medical Advisory Committee (REMAC)
ALS Provider Credentialing and Authorization
The Suffolk County Department of Health Services, Division of Emergency Medical Services (EMS), is the region’s designated Program Agency, and serves as the Suffolk County EMS System Administrator. Clinical care is provided under the general supervision of the Regional EMS System Medical Director. Among its administrative responsibilities is managing the Regional Emergency Medical Advisory Committee (REMAC) credentialing and re-credentialing process for Advanced Life Support (ALS) providers upon initial entry into the regional EMS System, and on an as needed basis to maintain credentialing and authorization, as policies and protocols are modified.
In order for a New York State certified Emergency Medical Technician (EMT)-Critical Care or EMT-Paramedic to perform ALS in Suffolk County, he/she must be NY State DOH-CERTIFIED as well as regionally CREDENTIALED AND AUTHORIZED.
There are two (2) issues to address. The first is achieving entry into the ALS System through separate CREDENTIALING and AUTHORIZATION processes, typically used for currently certified individuals from another region seeking membership or employment in a Suffolk County-approved agency, or providers in a Suffolk County-approved agency that attain certification as an EMT-Critical Care or EMT-Paramedic through a NY State-approved Course Sponsorship. The second is maintaining ALS System authorization to function as an ALS Provider through periodic re-credentialing processes.
CREDENTIALED is defined as meeting minimum standard pre-requisite eligibility criteria for ALS authorization, successfully completing an online protocol in-service session, and passing a qualifying protocol exam. Pre-requisite eligibility criteria are:
- Current NY State EMT-Critical Care or EMT-Paramedic Certification;
- Current AHA Advanced Cardiac Life Support Certification (required for EMT-Paramedic Certified Providers only);
- Successful completion of a Suffolk County EMS-sponsored CPAP course: and
- Obtain and become thoroughly familiar with the current edition of the Suffolk County EMS ALS Policies and Procedures Manual (V4. March, 2019).
Once the pre-requisite eligibility criteria requirements are satisfied, the candidate must then:
- Click HERE to register for the online credentialing course.
- Once you submit the registration you will receive a confirmation email immediately.
- You will then receive an email from the Suffolk EMS Division confirming your registration and providing links to two (2) online courses (policies and protocols) within five (5) business days.
- Please allow yourself at least two (2) hours to complete each course and when you have completed each course you must print out the completion certificates.
- Once the online courses are successfully completed, candidates may contact James MacDonell at James.MacDonell@suffolkcountyny.gov to register for a proctored Suffolk County ALS Protocol Exam.
- Sit for the Suffolk County ALS Protocol Exam, at the appropriate certification level. Exams are held at the Suffolk County EMS Division, 360 Yaphank Avenue, Suite 1B, Yaphank, NY 11980, and will be administered by a member of the Division staff.
- Candidates must bring to the exam a copy of both the policies and protocols completion certificates from the online course as well as a copy of their current NY State EMT-Critical Care or EMT-Paramedic certification card.
- Minimum (50) question exam based on current ALS Protocols and Suffolk County EMS System Standard Operating Procedures contained in the ALS Policies and Procedures Manual (V3. March, 2018).
- A minimum score of 80% is required to pass the proctored exam.
- For initial system entry, the candidate shall not use any resources during the Suffolk County ALS Protocol Exam.
- Anyone who does not achieve a grade of 80% or higher on the written exam will be offered a remediation session with one of the EMS Division Staff members to ensure appropriate knowledge of the subject material, as well as an alternate exam. The alternate exam(s) must be scheduled at least a week apart and you must achieve a grade of 84% or higher.
- The Suffolk County EMS Division offers proctored ALS Protocol Exams Monday through Friday from 10:00 AM – 9:00 PM as well as Saturday and Sunday from 8:00 AM – 1:00 PM.
Once the candidate successfully completes the proctored exam, they are considered CREDENTIALED.
AUTHORIZATION is defined as the ability to provide ALS care under the delegated practice of the Regional EMS System Medical Director, and as an agent of an ALS agency. In order to receive authorization to perform ALS, the provider must be a member or employee of an agency that has an agreement with the Suffolk County Department of Health Services to provide 911 emergency response. He/she may only operate in the system when acting as an agent of his/her agency or when specifically requested to assist another agency that has an agreement with the Suffolk County Department of Health Services in accordance with the Suffolk County Inter-agency Utilization of ALS Personnel Policy.
NOTE THAT commercial and hospital-based ambulance services operating in the Suffolk Region providing routine inter-facility transportation, or specialty care transportation, are responsible for developing their own agency-specific credentialing and authorization requirements and are outside the scope of the Suffolk County EMS System.
Generally speaking, CREDENTIALING and AUTHORIZATION occur simultaneously, but may occur independently. From time to time, providers seek to become credentialed prior to admission into an agency in the Suffolk County EMS System. This is acceptable, and the candidate may complete the credentialing process. Authorization will occur after documentation of membership or employment in a Suffolk County-approved agency is provided. Once both credentialing and authorization are complete, the Suffolk County EMS Division issues a picture identification card documenting regional authorization. The Division passes this information along to Suffolk County Medical Control, who maintains the credentialed and authorized technician database and ensures Medical Control orders are forwarded to properly identified, credentialed and authorized ALS providers.
Credentialed and authorized EMT-Critical Care technicians that upgrade to EMT-Paramedic are required to complete the Suffolk County ALS Protocol Exam at the EMT-Paramedic level, administered by the Suffolk County EMS Division, in accordance with the testing and remediation practices previously described. The candidate will receive an updated regional authorization identification card upon return of the previously issued card.
An EMT-Critical Care or EMT-Paramedic that is NO LONGER a member or employee of a recognized agency loses his/her AUTHORIZATION and MAY NOT continue to function as an advanced level provider in the system. The provider is responsible for returning the regional authorization picture identification card to the Suffolk County EMS Division upon separation of service. The Division notifies Suffolk County Medical Control and the provider’s name is purged from the database. Should the provider seek reinstatement by way of membership or employment with a new Suffolk County-approved agency, the Suffolk County EMS Division will determine the pathway to re-authorization based on length of absence, quality improvement reviews, and other factors deemed necessary by the Division and the Regional EMS System Medical Director.
RE-CREDENTIALING/RE-AUTHORIZATION is defined as the periodic refreshing of a provider’s ALS status. Generally speaking, re-credentialing/re-authorization is required whenever there are substantive changes to medical protocol, introduction of new medications and/or introduction of new practical skills/therapeutic modalities. In order to maintain operating privileges, an EMT-Critical Care or EMT-Paramedic must complete all EMS System protocol or policy updates in the prescribed format and time frame established by the Regional EMS System Medical Director, which is based on the relative complexities of the changes being introduced.
The Suffolk County EMS System does not recognize the NY State EMT-Intermediate level of ALS care as a sole ALS provider and does not maintain EMT-Intermediate protocols. An individual that is certified to the EMT-Intermediate level, upon successful completion of the credentialing and authorization procedures previously described, commensurate with this level of certification, must pass a practical skills review administered by the Suffolk County EMS Division. Upon successful completion, the EMT-Intermediate may perform advanced airway maneuvers, initiate IV therapy, and communicate with Medical Control ONLY IN THE PRESENCE OF AN EMT-CRITICAL CARE OR EMT-PARAMEDIC in any applicable ALS protocol.
The Regional EMS System Medical Director has the responsibility of ensuring appropriate pre-hospital medical care, and with the Suffolk County EMS Division and Suffolk County Medical Control, manages a comprehensive countywide Quality Improvement Program. EMS System authorization may be restricted, suspended pending successful remediation, or revoked, per the progressive remedial and disciplinary actions documented in the Quality Improvement Plan.
For further information please contact the Suffolk County EMS Division Office at 631-852-5080.