Connecticut EMTs and Paramedics are expected to receive a little known benefit when the Connecticut Office of Emergency Medical Services (OEMS) adopts the National Registry’s standards for ongoing education in 2020. The Mark King Initiative, a program provided through the National Registry of Emergency Medical Technicians (NREMT), offers EMS professionals who have previously held a NREMT credential and continuous certification or licensure from their state, with reinstatement of NREMT certification.

The history behind NREMT certification

Since Connecticut adopted NREMT standards for initial EMT and Paramedic testing in 1998, EMS professionals were granted an initial two year certification from NREMT. After that initial period, EMS providers would need to complete continuing education every two years to maintain this certification.

Connecticut’s EMT renewal process required substantially less continuing education hours and also provided a third year of certification. Since employers typically only require state certification to work or volunteer, there was little incentive to complete the extra hours to maintain NREMT certification.

Paramedics licensed in Connecticut have not had to complete any continuing education hours to maintain their state license. An annual license renewal fee provides paramedics with an updated state credential. OEMS had left it up to employers and medical directors to set requirements, if any, for paramedics to complete continued training.

National Continued Competency Program

The NREMT was established to provide a national standard for EMS care and to advance professionalism in the EMS field. In 2016 the NREMT established the National Continued Competency Program (NCCP) which set education standards for nationally certified personnel for renewal of their certification. This program phased out the prior standard of having to complete a state approved EMT Refresher course plus additional continuing education hours.

As of 2019, all NREMT certified personnel must use the NCCP model to renew their certification. The NCCP model provides guidance as to the number of hours required per topic area to meet the competency standard.

Using the NCCP model provides some benefit beyond establishing a national standard of care. EMS Providers are encouraged to complete continuing education throughout the span of their two year certification rather than all at once during a refresher course.

This inherently keeps EMTs and Paramedics up to date on current trends and provides more frequent review of cases that they may seldom see. It is likely that this higher-frequency training has positive effects on patient care.

Unintended Consequence

By using the NREMT examination process for initial certification but not for renewals, Connecticut has created a legal gray area.

A state certified or licensed EMS provider who wanted to reinstate their lapsed NREMT certification would repeat the same examinations required for initial certification. Since this testing sets the standard of minimum competency for EMS providers, a state certified or licensed EMS provider who fails these exams would seemingly no longer meet the minimum competency for their care level. Theoretically, the state should revoke state certification or licensure until such time they are able to demonstrate minimum competency. However, Connecticut OEMS does not revoke state certification and licensure for EMS providers who fail to meet NREMT recertification standards since maintaining a NREMT certification is not required by the state.

Migrating to NREMT standards for both initial certification and renewal will close this loophole and help to validate competency for all state certified and licensed EMS professionals.

The Future of EMS in Connecticut

Connecticut OEMS plans to adopt the NCCP in January 2020. This model changes the renewal requirements for Connecticut EMS providers to maintain their licenses and certifications.

The NCCP model will migrate most Connecticut EMS providers to a 2 year certification period that matches the NREMT standard. Paramedics will still need to complete an annual license renewal plus the NREMT recertification process. All EMS providers will complete continuing education hours to maintain their certifications regardless of whether they hold a NREMT credential.

Adoption of NCCP will also eliminate the state’s written examination for EMR and EMT renewals.

Mark King Initiative

To ease the transition of using NREMT standards for renewal, the Mark King Initiative provides a pathway for EMTs and Paramedics to have their NREMT credential reinstated without having to repeat competency testing.

EMS providers who have previously held a NREMT credential and have held continuous state certification or licensure are eligible to pay a small fee and have their NREMT credential reinstated.

The window of opportunity to claim reinstatement through the Mark King Initiative will be set once the state adopts NCCP.

Code One’s Role

Code One is committed to providing quality EMS education that meets state and NREMT standards. We also strive to keep state EMS providers up to date on what is going on with changes in the certification process.

Code One’s EMS team is continuing to offer instructor-led EMT Refresher and EMR Refresher courses monthly in the East Hartford Training Center. This program meets the state’s current requirements for recertification. We will continue to offer this program until the NCCP standard is rolled out.

Earlier in 2019, Code One partnered with Prodigy, an online EMS training provider, to offer a hybrid EMT Refresher program that meets state EMT Refresher requirements. Participants in this program can complete additional Commission on Accreditation for Prehospital Continuing Education (CAPCE) approved content to renew NREMT certification at no additional cost.

Once Connecticut completes the transition to NCCP, Code One will roll out an updated instructor-led EMT and EMR Refresher program that will meet the revised NCCP standard.

Additionally, Connecticut EMS providers will begin to use Prodigy’s online-only NCCP Refresher program which features CAPCE approved content and virtual live instructor-led training. This course meets NREMT requirements for the EMT, AEMT, and Paramedic levels.

We recognize that this transition presents a significant change to Connecticut’s EMS education requirements so our expert team stands ready to assist EMS providers with questions that may arise.

More information about the Mark King Initiative can be found on the NREMT website: https://www.nremt.org/rwd/public/document/state-officials

Connecticut OEMS has also produced a FAQ regarding this proposal here: https://portal.ct.gov/DPH/Emergency-Medical-Services/EMS/NREMT-FAQ

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