Back Me Up: Actual Certification Needed for Private Hire?

[Mountain Res-Q]

So, this is gonna seem like a REALLY stupid question... because it is. I am 99.9% sure I know the answer. However, I could be wrong and even if I am right, what I really need are references to back up my stand on this subject.

Basically, I got into a discussion with a fellow Manager over the hiring of EMTs and/or MFRs for work at a Private Recreational Facility. My position has been and always will be that any EMTs or MFRs that are hired must present valid copies of their certifications to me (so that I can have them on file FOREVER) before they can work in a medical capacity under my supervision. By certifications, I of course mean a locally recognized EMT or MFR Certification issued by the local EMSA, as well as a CPR/AED cert. However, this Manager (also an EMT) made the claim that according to the regulations (not sure which or where these regs are located) EMTs and MFRs only have to possess a valid cert from the local EMSA if they are working for the County or other local government agency (even those contracted by the county, such as private ambulance companies). If hired by a private business with no mandated public emergency response, all that is required is proof that a legit EMT/MFR class was completed (i.e. a Course Completion Record). Included in this category would be Ski Resorts, Casinos, Theme Parks, etc...

I, of course, believe this to be pure B.S. for many reasons. As I have always understood it, you have to have an actual certification from the local EMSA to be able to call yourself an EMT and work as one. Just because I pass a class whose standards might be questionable doesn’t mean that I can get a job as an EMT (for Ski Patrol or at a Casino) for an undisclosed period of time; I am still identifying myself as an EMT and am acting in such a capacity so I need an official cert, right? Certification testing, background checks prior to certification, the CE requirements, and the need for annual recertification are procedures in place to provide a standard (however minimal) for EMTs and MFRs. I have a 9 year old course completion record for my EMT in my records, but I could never take that piece of paper and use it to prove that I am an EMT as there is no authority associated with it past the school that I took the course with. I want and NEED actual certification from anyone I would allow to "play" EMT so that I know that they have passed an authorizing agencies DOT-approved minimal standards.

Am I crazy? Does this other person’s claim have any validity? Does anyone know where I can find official information to refute this claim associated with EMTs at Private (non public response) Recreational Facilities?

The reason this came up is that a current employee got their MFR after last season and has asked to be used in a Medical Staff capacity in addition to his previous job. However, while he passed the class, he has yet to produce an EMSA certification and another Manager (using this argument) is pushing for him to be used medically, relying purely on the course completion record to “prove” that he is trained to the MFR level and can legally act as a MFR. I, on the other hand, have a feeling that this employee might not pass a background check needed for certification and that alone is reason to say “HELL NO!” Why would I allow anyone who has a criminal background and cannot get a MFR cert (or whose charecter I would out right question) to touch a patient that is ultimately under my supervision? Is this not the craziest thing you have ever heard?

 

[JPINFV]

First off, my understanding of California's system is that it just have to be a LEMSA certification issued by any LEMSA, not just your local LEMSA. An Imperial County EMT-B cert is valid as an EMT-B cert anywhere in California. Now a county can require an additional local accreditation cert (examples: LA and now OC both require an additional course and local accreditation cert).

Second, if you're requiring that an employee has a specific certification, you should maintain records that the employee has met the requirements. I'm not sure what your park's legal requirements are, but I was told in essentially no uncertain terms (in fact, it's part of how I got the job) that an EMT-B had to be on duty at all times that the water park I used to work at was open.

 

[Lifeguards For Life]

hope this helps Mo?



Although the general public continues to use the terms interchangeably, there are important functional distinctions between the two concepts.

The federal government has defined “certification” as the process by which a non-governmental organization grants recognition to an individual who has met predetermined qualifications specified by that organization.1 Similarly, the National Commission for Certifying Agencies has recently defined certification as “a process, often voluntary, by which individuals who have demonstrated the level of knowledge and skill required in the profession, occupation, role, or skill are identified to the public and other stakeholders.”2

Accordingly, there are three hallmarks of certification (as functionally defined).

Certification is:

1.

voluntary process;
2.

by a private organization;
3.

for the purpose of providing the public information on those individuals who have successfully completed the certification process (usually entailing successful completion of educational and testing requirements) and demonstrated their ability to perform their profession competently.

Nearly every profession certifies its members in some way, but a prime example is medicine. Private certifying boards certify physician specialists. Although certification may assist a physician in obtaining hospital privileges, or participating as a preferred provider within a health insurer’s network, it does not affect his legal authority to practice medicine. For instance, a surgeon can practice medicine in any state in which he is licensed regardless of whether or not he is certified by the American Board of Surgery.

Licensure, on the other hand, is the state’s grant of legal authority, pursuant to the state’s police powers, to practice a profession within a designated scope of practice. Under the licensure system, states define, by statute, the tasks and function or scope of practice of a profession and provide that these tasks may be legally performed only by those who are licensed. As such, licensure prohibits anyone from practicing the profession who is not licensed, regardless of whether or not the individual has been certified by a private organization.

Confusion between the terms “certification” and “licensure” arises because many states call their licensure processes “certification,” particularly when they incorporate the standards and requirements of private certifying bodies in their licensing statutes and require that an individual be certified in order to have state authorization to practice. The use of certification by the National Registry by some states as a basis for granting individuals the right to practice as EMTs and calling the authorization granted “certification” is an example of this practice. Nevertheless, certification by the National Registry, by itself, does not give an individual the right to practice.

Regardless of what descriptive title is used by a state agency, if an occupation has a statutorily or regulatorily defined scope of practice and only individuals authorized by the state can perform those functions and activities, the authorized individuals are licensed. It does not matter if the authorization is called something other than a license; the authorization has the legal effect of a license.

In sum, the National Registry is a private certifying organization. The various state offices of EMS or like agencies serve as the state licensing agencies. Certification by the National Registry is a distinct process from licensure; and it serves the important independent purpose of identifying for the public, state licensure agencies and employers, those individuals who have successfully completed the Registry’s educational requirements and demonstrated their skills and abilities in the mandated examinations. Furthermore, the National Registry’s tracking of adverse licensure actions and criminal convictions provides an important source of information which protects the public and aids in the mobility of EMT providers.

1 U.S. Department of Health, Education, and Welfare, Report on Licensure and Related Health Personnel Credentialing (Washington, D.C.: June, 1971 p. 7).
2 NCCA Standards for the Accreditation of Certification Programs, approved by the member organizations of the National Commission for Certifying Agencies in February, 2002 (effective January, 2003).

 

[JPINFV]

It should also be noted that some state laws use the term interchangable. For example, in California's Business and Professions code section dealing with medicine, section 2040 reads

2040. The terms "license" and "certificate" as used in this chapter
are deemed to be synonomous.

.


However, EMS is not regulated in the business and profession code of California like dentists, physicians, RNs, RTs, PAs, NDs, DVMs, PharmD, and hearing aid dispensers.

 

[Mountain Res-Q]

First off, my understanding of California's system is that it just have to be a LEMSA certification issued by any LEMSA, not just your local LEMSA. An Imperial County EMT-B cert is valid as an EMT-B cert anywhere in California. Now a county can require an additional local accreditation cert (examples: LA and now OC both require an additional course and local accreditation cert).

Correct. However, while a cert issued by a local emsa is generally valid statewide, in my experience, each local emsa will require that you also apply for their cert if you will work within that county. It is my belief that this is also done to verify that the holder of the cert will comply with local protocols that my differ greatly from the county they held a previous cert.

Second, if you're requiring that an employee has a specific certification, you should maintain records that the employee has met the requirements. I'm not sure what your park's legal requirements are, but I was told in essentially no uncertain terms (in fact, it's part of how I got the job) that an EMT-B had to be on duty at all times that the water park I used to work at was open.

Although not mandated, insurance costs are kept at a moderate level by having at least EMTs on staff during all operating hours. We back up the small number of EMTs we can usually get with MFRs. However, the question is "what constitutes an EMT or MFR? Do they need an actually local emsa issued certification or will proof of completion of a course LEGALLY be adequate (although ill advised) when it comes to NON-GOVERNMENT and NON-MANDATED EMERGENCY RESPONSE (911) Private Recreational Facilities?"

Life... this mostly has to do with the NREMT, which is a private certifying agency and the difference between a cert and lisence. The local EMSA is never helpful in answering these questions and the state emsa is also proving to be of little help so far. However, in my mind, the point is moot... I WANT AN ACTUAL CERT so that I know 100% that you have met the minimal standards set forth by DOT, relayed through the state EMSA, and enforced by the local EMSA. Passing a class means nothing to any Ambulance or Fire agnecy you apply to... and it means little to me. They, and I, want an actually cert from a government agency that says "this person is what they say they are after jumping through all of our official government hoops".

 

[Lifeguards For Life]

Life... this mostly has to do with the NREMT, which is a private certifying agency and the difference between a cert and lisence. The local EMSA is never helpful in answering these questions and the state emsa is also proving to be of little help so far. However, in my mind, the point is moot... I WANT AN ACTUAL CERT so that I know 100% that you have met the minimal standards set forth by DOT, relayed through the state EMSA, and enforced by the local EMSA. Passing a class means nothing to any Ambulance or Fire agnecy you apply to... and it means little to me. They, and I, want an actually cert from a government agency that says "this person is what they say they are after jumping through all of our official government hoops".

right. i just remembered reading it before, and wasn't sure if it's discussion of cert vs. licensure would help you out

 

[R.O.P.]

Hey Life- that was a good post up there. Thanks

 

[redcrossemt]

The answer is it depends on what services you are offering... If you are only providing first aid, even advanced first aid (O2, airways, backboarding) then a license is not required.

If you are providing emergency medical services, you would need to be licensed with your local medical control authority and obviously they would require licensure/local cert/whatever.

Unless you are operating as part of the local EMSA and with a physician's orders, you really aren't operating as an EMT or other EMS provider.