North Carolina Community College EMS Program Directors OEMS Update

General Rules Please turn off (silence) your mobile devices If you must leave the room, please do so as discreetly as possible Please avoid side conversation Thank you for your cooperation!

Topics of discussion Rules Update Transition to National Education Standards New Education Guidelines Key Changes Level Specific Changes New Institution Application Current Concerns

Update on “NEW” rules

Update on “NEW” Rules Rules will be effective January 1, 2017 Will move to the following Credential Levels EMR EMT AEMT Paramedic All Education will be based on the National Education Standards EMS Education will be utilizing a competency based model

INITIAL CREDENTIALING REQUIREMENTS: EMR, EMT, AEMT and Paramedic Be at least 18 years of age An examination may be taken by someone 17 years of age Within 90 days of the course graded date, the student must complete their 1st written examination attempt If not, a letter of authorization from the Educational Institution’s program coordinator to qualify for an extension of the 90 day requirement will be required A maximum of three attempts within nine months shall be allowed If the student fails the third attempt, they may take a refresher course, complete another TSOP and be provided an additional three attempts within nine months A maximum of six attempts within an 18 month period will be allowed

RENEWAL REQUIREMENTS: EMR, EMT, AEMT and Paramedic NREMT National Continued Competency Requirements Based on a four year credential National Requirements (NCCR) 50% Local Requirement(LCCR) 25% Individual Requirements (ICCR) 25% Hours required to renew Emergency Medical Responder- 32 Emergency Medical Technician- 80 Advanced EMT- 100 Paramedic- 120

CREDENTIALING REQUIREMENTS FOR LEVEL I EMS INSTRUCTORS Changes: An individual seeking credentialing for Level I EMS Instructor may qualify for initial credentialing under the legal recognition option defined in G.S. 131E-159(c). Instructional methodology courses approved to qualify Level I EMS instructors shall conform with the "US DOT NHTSA 2002 National Guidelines for Educating EMS Instructors"

CREDENTIALING REQUIREMENTS FOR LEVEL II EMS INSTRUCTORS Changes: Have two years teaching experience as a Level I EMS Instructor at the level of application in an approved EMS educational program Complete the "EMS Education Administration Course" conducted by a North Carolina Community College or the National Association of EMS Educators Level II Instructor Course;

RENEWAL REQUIREMENTS FOR LEVEL I & II EMS INSTRUCTORS Changes: 24 hours of educational professional development as defined by the educational institution that provides for: (A) enrichment of knowledge; (B) development or change of attitude; or (C) acquisition or improvement of skills; Within one year prior to renewal application, attend an OEMS Instructor workshop sponsored by the OEMS.

EXPIRED CREDENTIAL AND REFRESHER COURSES These rules were added Expired Credential Outlines the options to reinstate an expired EMS Credential Refresher Course Allows the institution to develop refresher course Same was not included in National Education Standards Hours will run consistent with the CE hours

INSTITUTION Types Continuing Education Institutions Basic/Advanced Education Institution Accredited Institution

BASIC and advanced INSTITUTION REQUIREMENTS Written educational policies and procedures that includes the written educational policies and procedures set forth in Rule .0601(b)(4) of this Section; Delivery of cognitive and psychomotor examinations in a manner that will protect and limit the potential for exploitation of such content and material; Exam item validation process utilized for the development of validated cognitive examinations; Completion of an annual evaluation of the program to identify any correctable deficiencies

BASIC and advanced INSTITUTION REQUIREMENTS Written educational policies and procedures that includes the written educational policies and procedures set forth in Rule .0601(b)(4) of this Section; Selection and monitoring of all in-state and out-of-state clinical education and field internship sites; Selection and monitoring of all educational institutionally approved clinical education and field internship preceptors; Utilization of EMS preceptors providing feedback to the student and EMS program; Evaluation of preceptors by their students, including the frequency of evaluations; Evaluation of the clinical education and field internship sites by their students, including the frequency of evaluations;

ACCREDITED EMS EDUCATIONAL INSTITUTION REQUIREMENTS EMS Educational Institutions who already possess accreditation by the CAAHEP may be credentialed by the OEMS by presenting: An application for credentialing; Evidence to the OEMS of current CAAHEP accreditation; A copy of the self study; A copy of the executive analysis; and Documentation reflecting compliance with Rule .0602(b) and (c) EMS Educational Institutions maintaining CAAHEP accreditation shall renew credentials no more than 12 months prior to expiration Institution credentials are valid for a period not to exceed five years.

Transition Over the past few years, States and EMS Systems have moved from the National Standard Curriculum which included Medical Responder, EMT-Basic, EMT-Intermediate and EMT-Paramedic to the National EMS Education Standards and National Scope of Practice Model.   As EMS progresses into the future, EMS Education and the ability to care for and treat our customers based on validated research and a standard of care will continue to evolve.

Transition Timeframe Beginning January 1, 2017, The North Carolina Office of EMS will be requiring Credentialed EMS personnel to transition their EMS credential to the National Education Standards by December 31, 2018 Institutions and Instructors must meet outlined requirements by December 31, 2017 For more information regarding the transition to the National Education Standards, please visit https://ncems.org/transition/

Who needs to transition? EMS Professionals that received their initial North Carolina EMS Credential prior to 1/1/14. This does not include EMD. EMD will utilize their Proprietary Credentials to Legal Rec OEMS will no longer offer/support EMD exams Essentially, those individuals that were taught under the National Standard Curriculum for Medical Responder, EMT-Basic, EMT-Intermediate and EMT-Paramedic If an EMS Professionals Initial Credentialing course was taught utilizing the National EMS Education Standards, then they are considered to have obtained the information throughout the course

What must one do to transition? Complete one (1) of the four (4) acceptable options for transitioning Refer to the transition website for the acceptable options If your Initial Credentialing course was taught utilizing the National EMS Education Standards, and was prior to 1/1/14, the NCOEMS Approved Educational Institution will need to verify this with the North Carolina Office of EMS

What happens someone does not transition? If you do not transition prior to 12/31/18: Your Credential can’t be renewed at the end of your current Credential Cycle You will need to complete an NCOEMS Approved Refresher Course prior to your date of expiration to prevent a lapse in your Credential

What happens if someone expires and did not transition? To regain your Credential you would have to go through the expired Credential process: EMR’s and EMT’s Will have 24 months from the date of expiration to: Complete a NCOEMS approved Refresher course and take the (Level Specific) State Credentialing Exam AEMT’s and Paramedics Will have 48 months from the date of expiration to:

I am an Instructor, what do I have to do? Currently Credentialed Instructors will be required to attend an NCOEMS Instructor Workshop by 12/31/2017: Instructors not attending an NCOEMS Instructor Workshop by 12/31/2017 will not be allowed to serve as the Lead Instructor for any course   Will the North Carolina OEMS provide us with a North Carolina specific curriculum? No, the National Education Standards replaces the previous curricula You will not have a “curriculum” to follow National Education Standards National Instructor Guidelines North Carolina specific documents to use All of these documents will be available on our web site.

How long will Institutions have to transition? All Institutions must become compliant as soon as possible: The National EMS Education Standards National Scope of Practice Model Most up to date NCOEMS Educational Guidelines Effective 1/1/17, courses submitted to the NCOEMS for approval shall follow the “New” NCOEMS Educational Guidelines Courses beginning prior to and ending after 1/1/17 must contain the required transition content

What happens if my Institution does not transition? Institutions that do not become compliant with the “New” Educational Guidelines will not be allowed to offer any EMS Courses until they are compliant with 10A NCAC 13P

Educational Guideline Changes

Key Changes All levels have moved to Pre-Requisites Only A&P for Paramedic remains a Co-Requisite Recommended hours has been changed to minimum required in all levels Preceptor Ratio is noted as recommended Competency based Clinical/Field Minimum required skills Minimum required hours

Emergency Medical Responder- EMR Pre-Requisites: 17 years of age on or before the official end date of the course. Possession of a high school diploma, high school equivalency or successful completion of an exam assessing basic reading comprehension skills at a minimum at the tenth-grade level.

Emergency Medical Responder- EMR Educational Program Summary- Required minimum of 60 hours Didactic, skills practice/evaluation, written exams, scope of practice 60 hours Clinical Hours: Not Required Field Internship Hours: Not Required

Emergency Medical Technician- EMT Pre-Requisites: 17 years of age on or before the official end date of the course. Possession of a high school diploma, high school equivalency or successful completion of an exam assessing basic reading comprehension skills at a minimum at the eleventh- grade level.

Emergency Medical Technician- EMT Educational Program Summary- Required minimum of 190 hours Didactic, skills labs, written exams, scope of practice to equal a minimum of 166 hours Clinical, Field or Standardized Patient Lab Hours: Not to exceed 24 hours unless there is documentation that shows the student needs improvement Active participation in the clinical, field or standardized patient lab educational component is required The educational institution should ensure enough patient contact time for the student to successfully perform ten (Live) patient assessments without assistance

Advanced Emergency Medical Technician- AEMT Pre-Requisites: Successful completion of all EMT educational requirements, before participating in the clinical education and field internship components Possession of a high school diploma, high school equivalency Successful completion of an entrance exam assessing basic reading comprehension and English language writing skills on a post-secondary level Demonstration of mathematical skills at a minimum at the post-secondary grade level

Advanced Emergency Medical Technician- AEMT Educational Program Summary- Required minimum of 256 hours Didactic, skills labs, written exams, scope of practice to equal a minimum of 160 hours Required minimum clinical 48 hours with a minimum of 24 hours in an ER Deemed competent prior to completion, then the remainder can be omitted Deemed as needs improvement, then upon the completion of the minimum hours, then the educational medical advisor/director, program lead instructor and program director are responsible for ensuring that the student is provided an outline for remediation. Additional clinical hours to ensure the student can satisfactorily meet all competencies required for successful completion of the educational program Documentation must be maintained in the students file to show that the educational medical advisor/director, program lead instructor and program director were in complete agreement with the final determination

Advanced Emergency Medical Technician- AEMT Required minimum field 48 hours in the third person (Student) role Deemed competent prior to completion, then the remainder can be omitted Deemed as needs improvement, then upon the completion of the minimum hours, then the educational medical advisor/director, program lead instructor and program director are responsible for ensuring that the student is provided an outline for remediation. Additional clinical hours to ensure the student can satisfactorily meet all competencies required for successful completion of the educational program Documentation must be maintained in the students file to show that the educational medical advisor/director, program lead instructor and program director were in complete agreement with the final determination

PARAMEDIC Pre-Requisites: Co/Pre-Requisite A&P Successful completion of all EMT educational requirements, before participating in the clinical education and field internship components Possession of a high school diploma, high school equivalency Successful completion of an entrance exam assessing basic reading comprehension and English language writing skills on a post-secondary level Demonstration of mathematical skills at a minimum at the post-secondary grade level Co/Pre-Requisite A&P EMS 3000 BIO 163 BIO 165 & 166 BIO 168 & 169

PARAMEDIC Educational Program Summary Didactic component, including cognitive examinations should meet or exceed a minimum of 460 classroom hours Laboratory time, skills practice and documented skills evaluations, including the scope of practice evaluations should consist of a minimum of 200 hours The field internship must provide the student with an opportunity to serve as team leader in a variety of pre-hospital advanced life support emergency medical situations.  The student’s achievement of the competencies is required for graduation and must be assessed by a summative and/or comprehensive final evaluation.  A summative program evaluation is a capstone event that occurs when the field internship is nearing completion.

PARAMEDIC Required minimum clinical Clinical- 100 hours with a minimum of 48 hours in an ER Deemed competent prior to completion, then the remainder can be omitted Deemed as needs improvement, then upon the completion of the minimum hours, then the educational medical advisor/director, program lead instructor and program director are responsible for ensuring that the student is provided an outline for remediation. Additional clinical hours to ensure the student can satisfactorily meet all competencies required for successful completion of the educational program Documentation must be maintained in the students file to show that the educational medical advisor/director, program lead instructor and program director were in complete agreement with the final determination

PARAMEDIC Required minimum field- Field- Minimum of 240 hours in the third person (Student) role Deemed competent prior to completion, then the remainder can be omitted Deemed as needs improvement, then upon the completion of the minimum hours, then the educational medical advisor/director, program lead instructor and program director are responsible for ensuring that the student is provided an outline for remediation. Additional clinical hours to ensure the student can satisfactorily meet all competencies required for successful completion of the educational program Documentation must be maintained in the students file to show that the educational medical advisor/director, program lead instructor and program director were in complete agreement with the final determination

“New” Institution Application

Current

Current Concerns Educational Institutions not following their Education Plan Institution Administration Overriding the Educational Plan Educational Institutions without a medical advisor or program Director Educational Institutions not maintaining adequate records

OEMS Regional Testing 2017 Exam Schedule Was developed based on data from the previous three years Attempted to eliminate multiple exams on the same weekend Increased the number of participants per exam Cutoff dates for exam will range from 7-15 days

Potential Changes- Future Computer Based Testing It’s coming Can’t give you an exact date Could be as soon as Q3 or Q4 of 2017 Credentials Consideration to move to electronic credentials

Q & A