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. Among its administrative responsibilities is managing the Regional Emergency Medical Advisory Committee (REMAC) credentialing and re-credentialing process for Advanced Life Support (ALS) providers (Emergency Medical Technician-Critical Care (EMT-CC) and Emergency Medical Technician-Paramedic (EMT-P)) 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. Clinical care is provided under the general supervision of the Regional EMS System Medical Director.

In order for a New York State Department of Health (NYSDOH) certified EMT-CC or EMT-P to perform ALS in Suffolk County, they must be NYSDOH 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-P through a NYSDOH-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 program, and passing a qualifying online protocol exam.

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. They may only operate in the System when acting as an agent of their 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.

Prerequisite eligibility criteria to become credentialed are:

• Current NYSDOH EMT-CC or EMT-P certification (with physical provider card or passing score report from PSI testing center);
• Proof of affiliation with a Suffolk County EMS Agency in the 911 System, either as a volunteer or employee; and
• Thorough familiarization with the current edition of the Suffolk County EMS System Basic and Advanced Life Support Policy Manual (Version 23.1, February 15, 2023).

Once the prerequisite eligibility criteria requirements are satisfied, the candidate must then: 

• First, ensure that you have an updated account with the eLearning Site.  Please click on the link in red below.

         eLearning Site

• Click here to register for the online credentialing program.
• After you submit the registration form, you must email proof of affiliation with a Suffolk County EMS Agency in the 911 System to Suffolk County EMS Division Deputy Chief of Education and Training Christopher Nuccio. This can be a copy of an agency identification card or a letter from a Chief or Supervisor stating affiliation at the ALS level.
• Once you submit the registration form and submit proof of affiliation with a Suffolk County EMS Agency in the 911 System, the information will be verified and within five (5) business days you will receive a confirmation email from a staff member at the Suffolk County EMS Division with instructions and a link to the online credentialing program for your level of certification. You will not receive this email until proof of affiliation with a Suffolk County EMS Agency in the 911 System is submitted.
• Note: This email will also include a registration code that must be entered to access the online program. This code is unique to the individual registering, must not be shared with anyone else, and is only able to be redeemed one (1) time by the registrant. If the code is not redeemed within forty eight (48) hours, the provider must re-register for the online ALS credentialing program.
• Please allow yourself at least two (2) hours to complete the online ALS credentialing program. You may pause the program and resume where you left off at a later time. At the conclusion of the program, you must complete a timed fifty (50) question protocol examination with a minimum score of 80%. The examination is composed of questions based upon the NYS Collaborative Advanced Life Support Adult and Pediatric Patient Care Protocols (Version 2023.1, February 15, 2023), as well as the Suffolk County EMS System Basic and Advanced Life Support Policy Manual (November, 2022). Providers will have sixty (60) minutes to complete the protocol examination.
• If you do not attain a minimum score of 80% on the first attempt, you will have one (1) additional attempt to take the online protocol exam and attain a minimum score of 80%.
• If you do not attain a minimum score of 80% on the second attempt, you must contact Suffolk County EMS Division Deputy Chief of Education and Training Christopher Nuccio for further guidance.
• When you have completed the entire program you should save and print out the certificate of completion to retain a copy for your records. 

Upon submission of proof of affiliation with a Suffolk County EMS Agency in the 911 System, successful completion of the online credentialing program, and achieving a minimum score of 80% on the online protocol exam, the provider is considered CREDENTIALED and AUTHORIZED. The provider’s information will be forwarded 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 providers. The provider’s name will be added to the list of regionally credentialed and authorized providers for their certification level on the Suffolk REMSCO website, and they will be issued a picture identification card documenting regional authorization. They may begin providing ALS care at their level of certification in the Suffolk County Region.

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.

Credentialed and authorized EMT-CCs that upgrade to EMT-P are required to complete the Suffolk County ALS protocol examination at the EMT-P level, administered by the Suffolk County EMS Division. Upon successful completion of the EMT-P protocol examination, the provider will receive an updated regional authorization picture identification card, and their name will be moved from the list of regionally credentialed and authorized EMT-CCs on the Suffolk REMSCO website to the list of regionally credentialed and authorized EMT-Ps. This information will also be forwarded to Suffolk County Medical Control.

An EMT-CC or EMT-P that is NO LONGER a member or employee of a Suffolk County EMS Agency in the 911 System loses their 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 from the agency. The Division notifies Suffolk County Medical Control and the provider’s name is purged from the database. Should the provider seek membership or employment with a new Suffolk County EMS Agency in the 911 System, 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 or therapeutic modalities. In order to maintain operating privileges, an EMT-CC or EMT-P 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 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.