In Which States is a Paramedic Certified vs. Licensed?

Rick Tresnak

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I am just curious I live in Iowa and here we are considered certified. This makes some distinction for RNs who are licensed to think that because we are certified we are to always be working under their authority. It makes me curious if there are other States that are considered Licensed.
 

DesertMedic66

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In CA the paramedic is licensed where as EMTs and AEMTs are certified.
 

MrJones

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Kentucky licenses EMTs and Paramedics. Most states that I'm familiar with (other than Iowa, of course ;)) use the standard that Certified = qualified to perform and Licensed = authorized to perform, and you have to be certified in order to become licensed.
 

TransportJockey

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Texas has both for paramedic. Neither has any difference.in duties or scope. NM used the terms interchangeably
 

vcuemt

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I've heard the terms used interchangeably even though the difference is pretty important.

In VA both are certified.
 

MrJones

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Wow. There are more states that don't license their pre-hospital providers than I previously thought. I can't help but wonder if that's a symptom of the perceived or actual lack of respect for EMTs and Paramedics from within the wider medical profession.

Or, possibly, one of the causes....
 

gotbeerz001

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In CA the paramedic is licensed where as EMTs and AEMTs are certified.

To clarify, CA has 3 steps:

Your schooling and passing the NREMT certifies you.

Your certification allows you to apply for licensure through state EMSA.

While you are then a licensed paramedic, you still need to become accredited with your L(ocal)EMSA before you can begin working. The process of accreditation cannot begin until you have a sponsoring agency (employer).

(I know you know this DesertEMT)
 

Medic Tim

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Doesn't really matter what they call it. It functions as a license.
 

DesertMedic66

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To clarify, CA has 3 steps:

Your schooling and passing the NREMT certifies you.

Your certification allows you to apply for licensure through state EMSA.

While you are then a licensed paramedic, you still need to become accredited with your L(ocal)EMSA before you can begin working. The process of accreditation cannot begin until you have a sponsoring agency (employer).

(I know you know this DesertEMT)
Yep, but the OP was just asking if it was a cert or license for EMT and medics.
 

gotbeerz001

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https://www.nremt.org/nremt/about/Legal_Opinion.asp

This should help and should be universally recognized.

Furthermore, CA EMT "certification" is procedurally a licensure regardless of which term they choose to use.

Going back to the OPs original statement, while I don't believe that the licensure vs certification necessarily determines who works for whom, the fact that a nurse is a higher level of training often will.

If you are simply transferring care, there is only so much that you need to endure. However, if you are working in the same location for the same employer, the nurse will likely be higher on the org chart than you and therefore have some ability to dictate your actions. No?
 
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gotbeerz001

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Yep, but the OP was just asking if it was a cert or license for EMT and medics.
My point wasn't to correct you but to illustrate that CA always likes to add more steps than other places.

Here you can't just be licensed, you must also be accredited.
 

DesertMedic66

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My point wasn't to correct you but to illustrate that CA always likes to add more steps than other places.

Here you can't just be licensed, you must also be accredited.
Gotta get every dime out of us
 

Carlos Danger

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I am just curious I live in Iowa and here we are considered certified. This makes some distinction for RNs who are licensed to think that because we are certified we are to always be working under their authority. It makes me curious if there are other States that are considered Licensed.

I'm curious in what type of scenarios do RN's attempt to exert "authority" over a paramedic?

I've heard the terms used interchangeably even though the difference is pretty important.

Actually, there is no difference at all. The terms are often used interchangeably because, as they apply to EMS, they are interchangeable.

Here's how it was explained to me by an attorney years ago:

  • The term "certification" traditionally refers to a verification by an educational or credentialing body that one has completed an educational program or somehow proven a competency. That piece of paper that you get from your EMT or paramedic program that proves you successfully completed the program is a "certification"; so is the piece of paper you get when you pass the NREMT or FP-C exams. They certify that you successfully completed the program or passed the exam, but they don't authorize you to practice....you still have to apply to the state in order to gain authorization to practice.
  • A "license" is a legal authorization by a governmental authority to practice. Often, in order to apply for a license to practice (get your state EMT card, or your plumber's license or your medical license), you first have to obtain a certification - that piece of paper that says you completed EMT school or plumbing school or medical training.
  • Here's why the confusion arises: most states refer to the authorization that they grant EMTs and paramedics to practice as a certification, when traditionally that authorization would be referred to as a license. This is of course inconsistent with the way states typically refer to other occupational licenses (a plumber or hairdresser is "licensed" by the state, not "certified").
  • Here's why states use different terminology for EMS licensure: The states do this because early on, it was the opinion of some that the requirement to practice under the supervision of another professional (a physician) meant that one was not truly licensed to practice in the same way that other licensees are. This was based largely on the misconception that EMT's and paramedics would be legally shielded (by the physician) from the same types of legal responsibility and liability that other licensed professionals have.
  • Here's the bottom line: none of this matters all. Whether your state refers to your authorization or practice as a certification or a license is absolutely meaningless. Either way, your legal and professional responsibilities and liabilities are exactly the same. Either way, you have to be supervised by a physician to perform ALS interventions.
There is a misconception among many that if paramedics were just "licensed" rather than "certified", that it would have all sorts of important implications and would somehow make all sorts of positive difference in the way paramedics are viewed and in the things they are allowed to do. This is untrue, as is proven by the states where paramedics are "licensed" rather than "certified". In CA, for instance, paramedics are "licensed" yet have probably the most restrictions on their practice of all the states. In TX, paramedics can be either "licensed" or "certified", and there is zero difference between the two.
 
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Chewy20

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I do not know if all of Texas does this or just my department, but we have to be accredited as well as being certified or "licensed". There is no difference except the licensed guys have the same patch with gold "licensed paramedic".
 

STXmedic

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I do not know if all of Texas does this or just my department, but we have to be accredited as well as being certified or "licensed". There is no difference except the licensed guys have the same patch with gold "licensed paramedic".
The only thing that I've ever heard of needing to be accredited is the school. I've never heard it used in regards to individual providers.
 

TransportJockey

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I do not know if all of Texas does this or just my department, but we have to be accredited as well as being certified or "licensed". There is no difference except the licensed guys have the same patch with gold "licensed paramedic".
At my service to be fully able to do all skills (pericardiocentesis, chest tube, etc) we must be accredited at a CCT/CCP/FP-C level as well as our state cert/LP
 

TransportJockey

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The only thing that I've ever heard of needing to be accredited is the school. I've never heard it used in regards to individual providers.
There are a few services (AMR in CO Springs for example) that have a system so all medics can do some, but only some that are specially certified by the medical director can do others. Credentialing is the correct term for it.
 

STXmedic

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There are a few services (AMR in CO Springs for example) that have a system so all medics can do some, but only some that are specially certified by the medical director can do others. Credentialing is the correct term for it.
Ahh, we use the term "authorized" for that. Some are authorized for more than others.
 

Handsome Robb

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Nevada is a certification. Once you get a job you apply for an "Ambulance Attendant's License" at your appropriate level and cannot work on an ambulance, or volunteer for that matter, without an AAL.
 

Chewy20

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There are a few services (AMR in CO Springs for example) that have a system so all medics can do some, but only some that are specially certified by the medical director can do others. Credentialing is the correct term for it.

Yeah sorry our Medical Director credentials us so we can work on the truck
 
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