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At the Region - EMS - 6 - FEMA Region VI - Arkansas, Louisiana, New Mexico, Oklahoma, Texas

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At the Region is an ongoing feature that discusses the state-by-state training, certification and employment requirements of first responder departments across the nation. This section looks at the history and development of first responder standards, and spotlights the way that small departments integrate local specialties into national regulations. This month we look at EMS requirements for certification or licensure in Region VI.

FEMA Region VI

Arkansas

Arkansas
The Arkansas Department of Health, section of Emergency Services, manages the licensure and licenses of EMS Providers in the state. Currently, Arkansas recognizes EMT-B, AEMT, and Paramedic. All EMS candidates must pass a criminal background check mandated by the State of Arkansas legislature.

Rules and Regulations for EMS were updated and adopted March 1, 2014.

All EMT students in Arkansas must meet the minimum requirements:

   •   Be high school graduates
   •   Be 18 years old
   •   Have current immunizations, including tuberculosis
   •   Submit letters of recommendation
   •   Have a clear criminal background
   •   At this time (October 2015) 23 schools in Arkansas offer EMS Training

The Arkansas Department of Health, Section of Emergency Services, Publishes a Scope of Practice for all Licensed EMS levels in the state.

Reciprocity

Application for Reciprocity Licensure can be completed online here.

The following items are required for reciprocity candidates of every level, and must be sent in via mail or email within 60 days of completion of the online application.

1. A completed Verification of EMT Status Form (Page 9).

2. An application fee in the form of a money order or check made payable to the Arkansas Department of Health. (all fees can be paid online as part of the application process). Note: licensure fees are not refundable.

3. Copy of a current signed Healthcare Provider CPR card (must follow current American Heart Association Guidelines and require hands on skills component).

4. Copies of all current State and National Registry certification cards.

5. Arkansas requires a criminal background check (which includes a State and FBI check) for all EMSP reciprocity candidates. The Arkansas Criminal History form can be found on our website and must be completed and notarized before submitted to the section. If you do no reside in the state of Arkansas, or your permanent address has not been in the state of Arkansas for the past 5 years or longer you must obtain a FBI criminal history fingerprint card from your local police station. The FBI fingerprint card must be completed with candidate information and fingerprints and submitted to the Section of EMS for processing.

*Note: If you are a licensed RN/EMSP or LPN/EMSP, within the Nurse Licensure Compact (NLC) State agreement, complete the appropriate background check forms. Submit a copy of your nursing license. No fee is required. Contact the Section if you need further clarification.

All requirements must be met prior to applying online. Once requirements are fulfilled, candidate can apply online. Additional requirements (e.g. military and RN) can be found in manual or online. Mandatory requirements include current:

   •   State card
   •   NREMT
   •   CPR
   •   ACLS (Paramedics)

The Reciprocity Manual is available here. If you need additional information or have questions, please contact the Section of Emergency Medical Services at 501-661-2262.

Louisiana

Louisiana
In Louisiana, individuals desiring to obtain an EMS License are required to complete an educational program approved by the Louisiana Bureau of EMS. Louisiana is a National Registry State, in that Certification in the National Registry is the requirement for first licensure in Louisiana. The National EMS Education Standards define the minimal entry-level educational competencies for each level of EMS personnel as identified in the National EMS Scope of Practice Model. For initial LA licensing information visit here.

The Bureau of EMS currently approves initial training programs at the following levels:

   •   Emergency Medical Responder
   •   Emergency Medical Technician
   •   Advanced EMT
   •   Paramedic

Louisiana Department of Health and Hospitals publishes a skills list for all levels of EMS.

Minimum Requirements:

   •   EMT candidates in Louisiana should not be less than 18 years of age.
   •   A state-approved EMT training program should be completed by the candidate.
   •   CPR (Cardiopulmonary Resuscitation) certification is a must.
   •   He/she should have passed a NREMT examination.
   •   The candidate must provide a proof of his/her citizenship in the United States.
   •   It is significant for the aspirant to possess good stamina and strong mental fitness to cope up with the hardships in the job.
   •   He/she must be able to communicate well in English.
   •   A criminal background check is compulsory for the candidate in Louisiana.

Louisiana EMT-Intermediate to Advanced EMT Transition

   •   Transition from an EMT-Intermediate to an Advanced-EMT, must successfully complete a Bureau of EMS approved transition course. Applicants for the AEMT Bridge course must meet the course entrance requirements, as outlined by the Training Institution sponsoring the course, including pre-course assessments, if required.
   •   EMT TO AEMT EMTs desiring to become licensed as an Advanced EMT, must meet the course entry requirements, as outlined by the Training Institution sponsoring the course, including pre-course assessments and/or testing, as required by sponsoring Training Institution.

To enroll in an EMTA course, students must be currently licensed by the Louisiana Bureau of EMS as an EMT. Notes: Non-resident students with a valid NREMT certification at the EMT level, must apply for a Louisiana EMT License prior to starting clinical rotations and/or field internships. To take the NREMT Advanced-EMT exam, students must have a current NREMT EMT certification.

Reciprocity information has not been found in the statutes. Contact DHH for information.
Mailing Address: Department of Health & Hospitals | P. O. Box 629 | Baton Rouge, LA 70821-0629
Physical Address: 628 N. 4th Street | Baton Rouge, LA 70802 |
Phone: 225.342.9500

New Mexico

New Mexico
New Mexico requires all levels of EMS Providers to have National Registry Certification at the level of licensure. The licensing rules can be found here.

All EMT students must complete:

   •   Criminal Background Check (beginning July 1, 2015)
   •   Immunizations
   •   Drug Screen and Health Exam
   •   Generally, the age of 18 is considered to obtain EMT license, but in New Mexico, a candidate with an age of 16 can also apply for certification under parental permission.
   •   The EMT prospects have to complete a training coursework.
   •   Applicants are ought to finish a CPR training.
   •   The applicants should have completed minimum education, i.e., a high school diploma or GED.
   •   An applicant must have ability to carry 120 pounds.
Reciprocity

New Mexico has a provision to grant a temporary license while transferring an existing EMS NREMT Certification to licensure in the state.

A. Individuals who are currently licensed or certified in another state or certified with the National Registry of EMT’s at any EMS licensure level, may apply for New Mexico EMS licensure as provided in this section. The individual shall:

(1) Submit an application for the appropriate licensure level along with a copy of a current out-of state certification or licensure card, or national registry certification card;
(2) provide a copy of a current bureau approved CPR certification card;
(3) If applying for the EMT-P level, provide a copy of current bureau approved training which meets or exceeds the current national standard for advanced cardiac life support (ACLS) on emergency cardiac care (ECC);
(4) Pay the appropriate out-of-state reciprocity fee as required by these rules; there will be no refund of fees, except in unusual circumstances; as determined by the bureau;
(5) If applying for the EMSFR, EMT-B and EMT-I level, successfully complete a bureau approved transition course for out-of-state applicants, as determined by the EMS bureau;
(6) successfully complete the New Mexico transition written examination at the appropriate licensure level within three attempts and if, requested by the EMS bureau, successfully demonstrate appropriate practical skills proficiency; the initial state transition examination shall be completed within nine months from the date the application was received at the EMS bureau; successful completion of the examination process that results in the issuance of a NM EMS license shall be complete within 12 months from the date the application was received at the EMS bureau;
(7) Meet all other licensing requirements found in 7.27.2.8 NMAC of these rules.

B. Additional provisions:

(1) Frequency: an out-of-state reciprocity application for an individual will only be accepted once in a 12 month time period;
Temporary licensure: a reciprocity applicant may be granted a temporary license to practice at the appropriate licensure level for a period of up to six months or until failure of any part of the transition examination, whichever occurs first.

(a) while under a temporary license, those applicants seeking full New Mexico licensure at the EMSFR, EMT-B, or EMT-I level shall complete a bureau approved out-of-state transition course and complete the New Mexico transition examination; applicants applying at the EMT-P level shall complete the New Mexico paramedic transition examination;
(b) applicants holding a temporary license shall be fully licensed when they have successfully completed New Mexico EMS transition examination at the appropriate licensure level and remit payments of required fees, all applicants are required to keep their out-of-state license or certification current until the New Mexico reciprocity process is successfully completed;
(c) Temporary licenses issued to out-of-state reciprocity candidates shall only be issued once during a 12 month period;
(d) Temporary licensure commences on the issue date of the temporary license from the bureau
(e) A temporary license may be issued only upon application and payment of required fees;
(f) the temporary license may also be used to facilitate licensure of an out-of-state seasonal EMS caregiver; temporary licenses issued to applicants for a seasonal license shall be issued once in a 12 month period, unless otherwise determined by the bureau for good cause; the temporary license is valid for six months from the date of issue; applicants for a seasonal temporary license must show proof of New Mexico medical direction provided by a medical director in accordance with 7.27.3 NMAC, as well as agree to provide care that does not exceed the New Mexico scope of practice for their level and that is approved by their medical director; the applicant must submit a completed application with appropriate fees.

Oklahoma
Oklahoma

The EMS division is created by statute in OS 63 1-2501 et seq., titled the Emergency Response Systems Development Act (formerly the Emergency Medical Services Act.) The Act requires the health department to develop Rules for administering emergency response systems in the state. These are codified in the Oklahoma Administrative Code (OAC) in Chapter 310Emergency Medical Services, within the State Department of Health, which is tasked with inspecting and auditing EMS agencies throughout the State of Oklahoma.

As of 2010, All EMS Providers in the State of Oklahoma must be Nationally Registered. There is a provision for license renewal if the EMS licensee obtained the license prior to 2010: “all new EMS personnel licensed in Oklahoma after April 1, 2010 must maintain their National Registry Certification (O.A.C. 310:641-5-13 (a).”

EMS Personnel without National Registration:

Applicants who are currently not registered with National EMT Registry may continue to renew their Oklahoma EMS Personnel license if:
1. They have been licensed in Oklahoma before April 1, 2010.
2. They have maintained their Oklahoma EMS license since April 1, 2010.

Oklahoma also publishes an Authorized Procedure List by level of Certification.

Reciprocity

As of the publishing of this article, the reciprocity requirements and eligibility information are not available. For more information, please contact:
Oklahoma State Department of Health
1000 NE 10th
Oklahoma City, OK 73117
Local: (405) 271-5600 Toll Free: (800) 522-0203

Texas

Texas
Texas has five levels of certification. The highest is Licensed Paramedic, followed by EMT-Paramedic, EMT-Intermediate, EMT-Basic and Emergency Care Attendant (ECA).

EMS degree programs are available, though many courses are offered through technical programs and others are approved through programs outside college settings. In Texas, EMS training programs are approved and monitored by staff in field offices located throughout the state.

   •   You must be at least 18 years old
   •   Have a high school diploma or GED certificate
   •   Successfully complete a DSHS approved EMS training course
   •   Submit a completed EMS Personnel Certification application and fee
   •   Pass the National Registry exam
   •   Submit fingerprints for Texas/FBI criminal history check.
Paramedic licensure applicants are required to follow the steps above and submit proof of either a two-year EMS degree or a four-year degree in any field.

Reciprocity

According to Policy P2001-A, effective 7/20/2011, reciprocity applicants must hold a valid and current EMS personnel certification issued by another state or U.S. Territory.

An out-of-state certified emergency medical services (EMS) person may apply for Texas certification by reciprocity. Persons with Emergency Care Attendant (ECA); First Responder (FR) or Emergency Medical Responder (EMR) are not eligible for Texas Reciprocity.

Eligibility for a full four-year Texas EMS certificate is contingent upon:

Verification of a current EMS certification from another state or US territory
   •   Submit an Out of State Verification Form A, completed by EACH state you currently hold or have ever held certification in.
   •   Out of State Verification Form A
   •   Applicants seeking reciprocity at the EMT-I level must have training (verifiable by the certifying state agency) that includes alternative airway intubation devices, and IV initiation as required for EMT-I certification in Texas.

Age
   •   You must be at least 18 years old

Completion of an EMS Personnel Reciprocity Certification Application and fee
   •   Apply Online
   •   Submit completed reciprocity application and nonrefundable administrative fee to: EMS Certification & Licensing Group, Department of State Health Services, Cash Receipts Branch, MC 2003, P.O. Box 149347, Austin, Texas 78714-9347.

Criminal history background verification
   •   All applicants will be required to undergo an FBI fingerprint criminal history check using L-1 Identity Solutions.
   •   Submit fingerprints through the Fingerprint Applicant Services of Texas (FAST) form.
   •   Schedule fingerprinting through L-1 Identity Solutions Locations
   •   The FAST Pass form includes instructions for scheduling an appointment with L-1 Identity Solutions, or you may visit their website. Any fees associated with this process will be your responsibility.
   •   If you are unable to go to the L-1 solution site please contact EMS Compliance and Quality Assurance at: 512/834-6700, to receive a hard copy fingerprint card. Please note this will delay our agency receiving your results up to several weeks and requires a law enforcement agency to process your prints.

Current National Registry certification or passing the National Registry assessment exam
   •   Applicants without a current National Registry (NR) certification must contact the NR to take their Assessment exam for the State of Texas. Applicants will not be approved to take the NR Assessment exam until the department has received a reciprocity application, fees, and verified you have a current EMS certification from another state or US territory.

Paramedic licensure applicants

A person currently certified or licensed as a paramedic in another state or US territory, who meets the department’s academic requirements may apply for paramedic licensure through reciprocity. If you do not meet the academic requirements for licensure, you may be eligible for paramedic certification by reciprocity.

Eligibility for a full four-year Texas EMS certificate is contingent upon:
   •   Verification of a current Paramedic certification from another state or US territory
   •   Submit an Out of State Verification Form A, completed by EACH state you currently hold or have ever held certification in.
   •   Out of State Verification Form A

Age
   •   You must be at least 18 years old

Completion of an EMS Personnel Reciprocity Certification Application and fee
   •   Apply Online
   •   Submit completed reciprocity application and nonrefundable administrative fee to: EMS Certification & Licensing Group, Department of State Health Services, Cash Receipts Branch, MC 2003, P.O. Box 149347, Austin, Texas 78714-9347.

College transcript or a copy of diploma that documents the academic requirements

You must possess the following academic requirements:
   •   an associate degree in EMS
   •   a baccalaureate degree; or
   •   a post graduate degree
   •   The degree must be from a school that is accredited by an agency recognized by the U.S. Department of Education as an approved accrediting authority.

Criminal history background verification
   •   All applicants will be required to undergo an FBI fingerprint criminal history check using L-1 Identity Solutions.
   •   Submit fingerprints through the Fingerprint Applicant Services of Texas (FAST) form.
   •   Schedule fingerprinting through L-1 Identity Solutions Locations
   •   The FAST Pass form includes instructions for scheduling an appointment with L-1 Identity Solutions, or you may visit their website. Any fees associated with this process will be your responsibility.
   •   If you are unable to go to the L-1 solution site please contact EMS Compliance and Quality Assurance at: 512/834-6700, to receive a hard copy fingerprint card.
**Please note this will delay our agency receiving your results up to several weeks and requires a law enforcement agency to process your prints. ***

Current National Registry certification or passing the National Registry assessment exam
   •   Applicants without a current National Registry (NR) certification must contact the NR to take their Assessment exam for the State of Texas. Applicants will not be approved to take the NR Assessment exam until the department has received an EMS personnel out-of state application, fees, and verified you have a current EMS certification from another state or US territory.





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