Emergency Medical Services Personnel.  Emergency medical service (EMS) means medical treatment and care which may be rendered at the scene of any medical emergency or while transporting any patient in an ambulance to an appropriate medical facility, including ambulance transportation between medical facilities. EMS personnel are certified by the Department of Health (DOH).  There are four primary categories of EMS personnel:  paramedics; emergency medical technicians (EMTs); advanced emergency medical technicians (AEMTs); and emergency medical responders (EMRs), also known as first responders.  EMS personnel may only provide services within the scope of care established in the curriculum of the person's level of certification or any specialized training.
 
To obtain an initial EMS provider certification following the successful completion of approved training and association, a candidate must:

• be at least 18 years of age;
• obtain a high school diploma or GED—required for EMTs, AEMTs, and paramedics;
• complete a background check;
• provide proof of EMS agency association with a licensed aide or ambulance service; a law enforcement agency; a business with an organized safety team; or as instructors or coordinators with approved EMS training programs;
• receive recommendation of county medical program director; and
• meet EMS education and certification examination requirements.

A candidate must provide proof of successful EMS course completion from a department-approved EMS training program to meet the EMS education requirement. Paramedic applicants must have proof from a training program accredited by a department-approved national accrediting organization.

 An EMT is defined as a person who is authorized by the Secretary of Health to render emergency medical care or under the responsible supervision and direction of an approved medical director to participate in a community assistance referral and education services program.

A provisional certification for EMS providers is created. EMS providers who are currently licensed or certified in another state or hold a current EMS certification from a national certifying agency approved by DOH are eligible for a Washington provisional EMS provider certification.

To receive a Washington provisional certification for EMSproviders, an applicant must:

• be currently licensed or certified in another state and be in good standing with the EMS board of that state or hold a current EMS certification from a national certifying agency approved by DOH;
• be employed or have a valid employment offer from a Washington EMS agency; and
• be approved for a provisional status from the county medical program director for which the applicant is or will be employed.

If the employer or host agency has fewer than 25 employees holding a current EMT or paramedic certification or license, up to 20 percent of those employees, rounded to the next whole number, may practice under a provisional certification.

If the employer or host agency has twenty-five or more employees holding a current EMT or paramedic certification or license, up to 10 percent of those employees, rounded to the next whole number, may practice under a provisional certification. 

DOH has rule-making authority relating to the requirements for provisional certification procedures.

The committee recommended a different version of the bill than what was heard.  PRO:  In the current labor market, it has been very difficult to maintain an adequate number of paramedics and EMTs to fulfill the needs of the community.  As demands increase, the staffing challenges place a bottleneck on the whole system.  We need to streamline recruitment channels to meet this need and this bill gives us another tool and resource to assist in this multi-pronged approach.  The certification process can be delayed by months, which causes candidates to look elsewhere for employment.  The provisional certification can get people to work sooner.
 
OTHER:  There is support for the concept of creating a provisional certification which would help deploy EMS more rapidly as it is important when the broader healthcare system is stressed.  There are concerns with section 1 of the proposed substitute.