Part III. EMS Education and Certification

Regulation

Compliance Statement

PART III.
EMS EDUCATION AND CERTIFICATION.

12 VAC 5-31-1300. Applicability.
This part applies to initial, refresher or bridge certification courses and EMS continuing education (CE) programs.

Policies and procedures for application of these regulations for EMS training programs are further described in the "Training Programs Administration Manual" available from the Office. Each section of the "Training Programs Administration Manual" is cross referenced to the applicable section(s) of these regulations.

12 VAC 5-31-1310. BLS certification programs.
A. BLS certification programs authorized for issuance of certification in Virginia are:

1. EMS First Responder;

2. EMS First Responder Bridge [to EMT]; and

3. Emergency Medical Technician (EMT).

EMS Certification at these training levels are referred to as Basic Life Support Programs. No other BLS certification levels are recognized in Virginia.

B. A course coordinator for a BLS certification program must be an EMT instructor.

Only certified EMT-Instructors may coordinate BLS certification programs or BLS CE programs except those CE programs approved by the Office as having a nationally recognized parent organization and certifying body.

C. A course coordinator for a BLS certification program must use the following curriculum:

1. The Virginia standard curriculum for the EMS first responder for an EMS First Responder certification program.

2. The U.S. Department of Transportation National Standard Curriculum for the EMT-Basic for an EMS First Responder Bridge certification program or an EMT certification program.

The Office approves the specific edition of these curricula and all certification testing will be based upon the approved edition then in use.

12 VAC 5-31-1320. ALS certification programs.
A. ALS certification programs authorized for issuance of certification in Virginia are:

1. EMT-Enhanced;

2. EMT-Enhanced to EMT Intermediate Bridge;

3. EMT-Intermediate;

4. EMT-Intermediate to EMT-Paramedic Bridge;

5. Registered Nurse to Paramedic Bridge; and

6. EMT-Paramedic.

EMS Certification at these training levels are referred to as Advanced Life Support Programs. No other ALS certification levels will be recognized in Virginia after December 31, 2008.

B. Transitional ALS certification programs that are authorized for issuance of certification in Virginia for six years from January 1, 2003 are:

1. EMT-Shock Trauma to EMT-Enhanced.

EMT-Shock Trauma certification courses must begin by December 31, 2003 and must be completed by June 30, 2004. Students in these programs must begin testing by December 31, 2004 and all testing at this level will end on December 31, 2005.

2. EMT-Cardiac to EMT-Intermediate.

a. After recertifying once at his current certification level, an EMS provider with EMT-Shock Trauma or EMT-Cardiac certification shall complete the designated "transition" program to certify at the corresponding replacement certification level listed in this subsection.

b. An EMS provider in an initial or bridge EMT-Shock Trauma or EMT-Cardiac certification program who completes the program and attains certification shall complete the designated "transition" program to certify at the corresponding replacement certification level listed in this subsection.

c. An EMS provider with EMT-Shock Trauma or EMT-Cardiac certification shall complete the requirements for the designated "transition" certification level by January 1, 2009.

EMT-Cardiac certification courses must begin by December 31, 2003 and must be completed by June 30, 2004. Students in these programs must begin testing by December 31, 2004 and all testing at this level will end on December 31, 2005. Transition programs to achieve certification at the EMT-Enhanced and EMT-Intermediate levels must be completed by December 31, 2008.

C. A course coordinator for an ALS certification program shall be an ALS coordinator who is certified or licensed at or above the certification level of the course to be announced.

Only Endorsed ALS Coordinators may coordinate ALS certification programs or ALS CE programs except those CE programs approved by the Office as having a nationally recognized parent organization and certifying body.

D. A course coordinator for an ALS certification program shall use the following curriculum:

1. The Virginia Standard Curriculum for the EMT-Enhanced or an equivalent approved by the Office of EMS for an EMT-Enhanced certification program.

2. The U.S. Department of Transportation National Standard Curriculum for the EMT-Intermediate or a bridge certification program approved by the Office of EMS for an EMT Enhanced to EMT-Intermediate Bridge or an EMT-Intermediate certification program.

3. The U.S. Department of Transportation National Standard Curriculum for the EMT-Paramedic or a bridge certification program approved by the Office of EMS for an EMT-Intermediate to EMT-Paramedic Bridge, a Registered Nurse to EMT-Paramedic Bridge or EMT-Paramedic certification program.

The Office approves the specific edition of these curricula and all certification testing will be based upon the approved edition then in use.

12 VAC 5-31-1330. EMT Instructor certification program.
The EMS Instructor certification program authorized for issuance of certification in Virginia is EMT-Instructor.

EMT-Instructor certification is granted to those individuals who complete the requirements for successful completion of the EMT Instructor Institute.

12 VAC 5-31-1340. Program site accreditation.

A. Program site accreditation. Training programs that lead to eligibility for initial certification at the EMT- Intermediate and EMT-Paramedic level shall hold a valid "Program Site Accreditation" issued by the Office of EMS. (“Program Site Accreditation” is not required when conducting continuing education programs for recertification purposes.)

An application for "Program Site Accreditation" may be obtained by contacting the Office of EMS.

B. All certification programs seeking accreditation in Virginia must comply with these regulations and the standards for an Accredited Educational Program for the Emergency Medical Technician-Paramedic established by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) as initially adopted in 1978, and revised in 1989 and 1999, by the American Academy of Pediatrics, American College of Cardiology, American College of Emergency Physicians, American College of Surgeons, American Society of Anesthesiologists, Commission on Accreditation of Allied Health Education Programs, National Association of Emergency Medical Technicians, and National Registry of Emergency Medical Technicians.

The standards published by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) are hereby adopted as having regulatory authority in Virginia except for those sections specifically exempted or modified  in these regulations.

C. The CoAEMSP standards are adopted by reference with the following provisions:

The standards published by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) are hereby adopted as having regulatory authority in Virginia except for those sections specifically exempted or modified  in these regulations.

1. In any instance where the CoAEMSP standards conflict with these regulations, these regulations will prevail.

Requirements, exemptions or modifications listed in these regulations override any conflicting CoAEMSP standards.

2. The CoAEMSP standards, as adopted by reference, will apply equally to all training programs required to hold accreditation by these regulations with these exclusions:

The CoAEMSP standards for Accredited Educational Program for the Emergency Medical Technician-Paramedic apply for both EMT-Paramedic and EMT-Intermediate programs in Virginia except as noted in these regulations.

a. The following are optional components of the Virginia Paramedic Accreditation Standards:

1. Section 1: General Requirements, A. Sponsorship, 1. Institutional Accreditation

2. Section 1: General Requirements, A. Sponsorship, 2. Institutional Authority

3. Section 1: General Requirements, A. Sponsorship, 4. Eligible Sponsors

4. Section 1: General Requirements, A. Sponsorship, 6. Institutional Commitment

5. Section 1: General Requirements, B. Resources, 1 Personnel, a. Administrative Personnel, (1) Program Director/Direction, (c) Qualifications or Equivalents, 1).

6. Section 1: General Requirements, B. Resources, 1 Personnel, c. Support Staff

7. Section 1: General Requirements, B. Resources, 1 Personnel, d. Professional Development

8. Section 1: General Requirements, D. Operation Policies, 1. Fair Practices, j.

Refer to the CoAEMSP standards for specific items exempted by these regulations for EMT-Paramedic programs in Virginia.

b. The following are optional components of the Virginia Intermediate Accreditation Standards:

1. Section 1: General Requirements, A. Sponsorship, 1. Institutional Accreditation

2. Section 1: General Requirements, A. Sponsorship, 2. Institutional Authority

3. Section 1: General Requirements, A. Sponsorship, 4. Eligible Sponsors

4. Section 1: General Requirements, A. Sponsorship, 6. Institutional Commitment

5. Section 1: General Requirements, B. Resources, 1 Personnel, a. Administrative Personnel, (1) Program Director/Direction, (c) Qualifications or Equivalents, 1).

6. Section 1: General Requirements, B. Resources, 1 Personnel, c. Support Staff

7. Section 1: General Requirements, B. Resources, 1 Personnel, d. Professional Development

8. Section 1: General Requirements, D. Operation Policies, 1. Fair Practices, j.

Refer to the CoAEMSP standards for specific items exempted by these regulations for EMT-Intermediate programs in Virginia.

c. Training programs that hold current “Program Site Accreditation” to conduct EMT-Paramedic programs may also conduct EMT-Intermediate programs.

A separate "Program Site Accreditation" is not required for approved EMT-Paramedic programs to also conduct EMT-Intermediate programs.

3. The program director for an EMT-Intermediate program is not required to hold a bachelor's degree as specified in subsection B 1 a (1) (c) 1) of the CoAEMSP standards.

The Course Coordinator for EMT-Intermediate training programs is not required to hold a college degree.

4. The medical director required by subsection B 1 a (2) of the CoAEMSP standards shall also meet the requirements for a physician course director (PCD) as required by these regulations.

All training program Physician Course Directors for EMT-Paramedic and EMT-Intermediate programs must hold Virginia endorsement as an EMS Physician.

5. The guidelines accompanying the CoAEMSP standards and printed in that document in italics typeface provide examples intended to assist in interpreting the CoAEMSP standards. These guidelines are not regulations as defined by the Code of Virginia.

Some information contained in the CoAEMSP standards is provided for clarification purposes only and are not considered as requirements under these regulations.

12 VAC 5-31-1350. Training site accreditation process.

A. The accreditation process will begin upon the receipt by the Office of EMS of a written request for accreditation.

The accreditation process will begin when the office receives an applicant's self study with a cover letter requesting accreditation.

B. The Office of EMS will forward the request to a site reviewer who will conduct the accreditation analysis. Independent site reviewers utilized by the Office of EMS shall be persons who are not affiliated with the applicant training program or another similar program located in the same geographical region.

All applications for "Program Site Accreditation" will be reviewed by a Site Reviewer who is not located in the same geographic region to reduce the possibility of preexisting conflicts  or competitive interests.

C. The applicable regional EMS council or local EMS resource shall submit to the site reviewer an evaluation indicating its position toward the applicant program's accreditation request.

The regional EMS council or local EMS resource for the geographic region where a "Program Site Accreditation" will be based will be consulted on the applicant's qualifications for the accreditation request.

D. The Office of EMS will determine the suitability of the training site for program site accreditation upon review of the accreditation analysis submitted to the Office of EMS by the site reviewer. The Office of EMS may either accept or deny the application for accreditation.

The Office of EMS will make the final decision on approval of any application for "Program Site Accreditation".

1. If the accreditation analysis determines that the training program is in full compliance with the requirements for accreditation, the Office of EMS will issue full accreditation for a period of five years.

Programs with no deficiencies noted may receive a five-year "Program Site Accreditation".

2. The Office of EMS will issue conditional accreditation for a period of less than five years if the accreditation analysis identifies deficiencies that are determined to be of concern but do not justify prohibiting the program from starting and completing an initial training program. Before starting any additional certification courses, the program site must receive full accreditation by correcting the identified deficiencies.

Programs with noted minor deficiencies may be allowed to conduct an initial training program while correcting the deficiencies. However, no additional training programs may be conducted until full "Program Site Accreditation" is achieved.

3. The Office of EMS will deny an application for accreditation if the accreditation analysis identifies deficiencies that are determined to be sufficient to prohibit the program from starting an initial training program.

Programs with significant deficiencies will not be allowed to conduct any training program until it has completed correcting the deficiencies.

12 VAC 5-31-1360. Renewal of program site accreditation.
A. A training program site shall apply for renewal not less than 90 days before expiration of its current accreditation period. Reaccredidation will require review by a site reviewer of the program's performance and a recommendation to the Office of EMS for approval. However, programs conducting training courses leading to certification at the EMT-Paramedic level may be renewed only through compliance with the requirements of 12 VAC 5-31-1390. Renewal of a "Program Site Accreditation" will be valid for an additional five-year period.

Programs holding "Program Site Accreditation" must apply for renewal at least 90 days before expiration of the  "Program Site Accreditation" certificate.  EMT-Paramedic programs may not renew their "Program Site Accreditation" except after meeting the requirements of Section 12 VAC 5-31-1390.

B. If the site reviewer does not recommend renewal of a program site's accreditation, the Office of EMS will review all supporting documentation and make a determination of suitability for "Program Site Accreditation" renewal.

The Office of EMS will make the final decision on approval of any application for "Program Site Accreditation" renewal.

12 VAC 5-31-1370. Appeal of site accreditation application results.
Appeals by a program concerning the denial of initial or renewal accreditation, or the issuance of conditional accreditation by the Office of EMS will be reviewed by a committee of the State EMS Advisory Board and follow the Administrative Process Act.

If a "Program Site Accreditation" application or renewal application is denied, the applicant may request an initial review of the application denial by the state EMS Advisory Board. Any further appeal of a denial must follow the formal Administrative Process Act hearing process.

12 VAC 5-31-1380. Program site accreditation administration.

A. State accreditation will be administered through the process established in the "Training Program Administration Manual" for the certification levels of the training programs conducted by the program site.

Refer to the "Training Program Administration Manual" for specific forms, policies, etc. that apply to  training programs conducted at a site holding "Program Site Accreditation".

B. Any program that has achieved accreditation issued by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) or an equivalent organization approved by the Office of EMS will be considered in compliance with this Section. State "Program Site Accreditation" will be issued for a period concurrent with that issued by the CoAEMSP or other approved organization up to a maximum of five years.

Upon presentation of an application for "Program Site Accreditation" along with current documentation of  accreditation issued by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) or an equivalent organization approved by the Office of EMS the  "Program Site Accreditation" may be granted without further review by the Office.

1. As a condition for equivalent accreditation, a representative from the Office of EMS must be included with each visit by the CoAEMSP or any other approved accreditation organization.

If an applicant for "Program Site Accreditation" is first seeking accreditation from the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) or an equivalent organization approved by the Office of EMS , the Office must be notified of the application and allowed to participate in the CoAEMSP site review visits.

2. The program must notify the Office of EMS immediately upon receiving the dates for any visits and include:

a. Dates;

b. Times; and

c. The schedule of events.

(See above)

3. Accreditation issued by CoAEMSP or other organization approved by the Office of EMS must remain current during any certification training program that requires accreditation by the Office of EMS. Revocation, removal or expiration of accreditation issued by CoAEMSP or other another organization approved by the Office of EMS will invalidate the corresponding state accreditation of the training program.

If accreditation issued by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) or an equivalent organization approved by the Office of EMS expires or is denied renewal, the corresponding Virginia "Program Site Accreditation" will be voided.

C. Each program must meet all other requirements as outlined in these regulations and the state-approved curriculum and course guide.

Refer to the "Training Program Administration Manual" for specific forms, policies, etc. that apply to  training programs conducted at a site holding "Program Site Accreditation".

12 VAC 5-31-1390. Program site accreditation of EMT-Paramedic programs.

A. A training program that leads to eligibility for certification at the EMT-Paramedic level must be an accredited program before the course begins.

All EMT-Paramedic programs must be conducted at sites holding "Program Site Accreditation".

B. Initial accreditation can be issued by the Office of EMS pursuant to 12 VAC 5-31-1340 or by acceptance of accreditation issued by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) or another approved equivalent accreditation organization.

An applicant for "Program Site Accreditation" for an EMT-Paramedic program may initially seek either state or national accreditation to fulfill the requirements of these regulations.

C. Following an initial five-year state accreditation period, renewal of accreditation at the EMT-Paramedic level will be issued only upon verification of accreditation issued by the CoAEMSP or another approved equivalent accreditation organization per 12 VAC 5-31-1380.

Program Site Accreditation for an EMT-Paramedic program may only be renewed by presenting documentation of accreditation issued by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) or an equivalent organization approved by the Office of EMS.

12 VAC 5-31-1400. Course approval request.

A. A course coordinator shall submit to the Office of EMS a complete course approval request form 30 days before the beginning date of a certification or continuing education course that includes the following:

1. The signature of the course coordinator.

2. The signature of the physician course director if requesting a BLS or ALS certification program or "Required (Category 1)" CE hours.

All EMS training programs seeking to conduct certification or continuing education training in Virginia must be announced on a Course Approval Request form at least 30 days prior to the start of the program.

B. The course coordinator shall use the course number assigned by the Office of EMS to identify the certification or CE program.

Each training program is assigned a unique Course Number that identified the individual program for state record purposes.

C. The course coordinator shall only use those CE topic and subtopic numbers assigned for the specific course approved by the Office of EMS when submitting a CE record/scan card.

Use of any other CE topic or sub-topic codes will result in rejection of the CE attendance record(s) submitted.

D. In addition, training programs leading to certification at an initial or higher certification level shall also comply with the requirements for "Program Site Accreditation" listed in 12 VAC 5-31-1340 through 12 VAC 5-31-1390, if an accreditation process for the involved certification level has been adopted by the Office of EMS.

All EMT-Paramedic and EMT-Intermediate certification programs must be conducted at sites holding "Program Site Accreditation".

12 VAC 5-31-1410. Physician course director involvement.
A course coordinator must inform the physician course director of the program schedule, progress of individual student performance, student or instructor complaints and the status of other program activities.

The Physician Course Director must be kept informed of the progress and any changes in an approved training program.

12 VAC 5-31-1420. Course coordinator and instructor accountability.

A. A course coordinator or instructor who violates these regulations is subject to enforcement action by the Office of EMS. The Office of EMS may suspend the instruction of an ongoing course or withhold issuance of certification until an investigation is concluded.

The Office of EMS may stop the instruction of any program or withhold student certification(s) if these regulations are violated.

B. A course coordinator or instructor found to be in violation of these regulations following an investigation may be subject to the following:

1. Termination of the certification program.

2. Invalidation of certificates or CE hours issued to students.

3. Suspension or revocation of any or all certifications of the course coordinator.

4. Suspension or revocation of any or all certifications of an instructor.

12 VAC 5-31-1430. Certification examination.
A Test Site Coordinator shall comply with the requirements for certification examinations. The Office of EMS will publish the "Virginia EMS Certification Examination Manual," a document that describes and provides guidance to a test site coordinator on how to comply with these regulations.

All Test Site Coordinators are contractually obligated to meet the requirements of the "Virginia EMS Certification Examination Manual" in order to be paid or allowed to conduct future test sites.

12 VAC 5-31-1440. Certification course enrollment.

A. For all courses leading to certification at a new or higher level, the course coordinator shall have each student complete a "Virginia EMS Training Program Enrollment" form. These forms shall be reviewed by the course coordinator and submitted to the Office of EMS no later than 15 days following instruction of the third lesson of the training program and no later than 15 days prior to the course's end date. (Earlier submission is allowed and encouraged.)

"Virginia EMS Training Program Enrollment" forms must be received by the Office prior to the end of a certification course and before any student from the course may take a certification exam.

B. Only students listed as enrolled in the designated training program will be allowed to test for certification using the assigned course number for the specified training program.

Students who are not properly enrolled in a certification course will not be tested or certified by the Office.

All students attending a certification course for recertification must submit the necessary CE record/scan form for award of CE credits and issuance of a "Recertification Eligibility Notice" from the Office of EMS.

Students seeking recertification or re-entry must participate in the automated state continuing education system and may not test using a signed "Virginia EMS Certification Application" from a course coordinator or PCD.

12 VAC 5-31-1450. BLS student enrollment requirements.
The enrolled student, certification candidate or EMS provider must comply with the following:

1. Be proficient in reading, writing and speaking the English language in order to clearly communicate with a patient, family or bystander to determine a chief complaint, nature of illness, mechanism of injury or to assess signs and symptoms.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

2. Be a minimum of 16 years of age at the beginning date of the certification program. If less than 18 years of age, he shall provide the course coordinator with a completed parental permission form with the signature of a parent or guardian verifying approval for enrollment in the course.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

3. Have no physical or mental impairment that would render him unable to perform all practical skills required for that level of certification including the ability to function and communicate independently and perform appropriate patient care, physical assessments and treatments without the need for an assistant.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

4. Hold current certification in an approved course in cardio-pulmonary resuscitation (CPR) at the beginning date of the certification program. This certification shall also be current at the time of state testing.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

5. May not have been convicted or found guilty of any crime, offense or regulatory violation, or participated in any other prohibited conduct identified in these regulations.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

6. If in a bridge certification program, he shall hold current Virginia certification at the EMS first responder level.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

7. Meet other requirements for course enrollment as set by the regional EMS council or local EMS resource, the PCD or the course coordinator, approved by the Office of EMS.

Additional local or program specific course completion requirements must have prior approval from the Office. However, this requirement excludes routine requirements for minimum passing scores, reading or tasks assignments, etc.

12 VAC 5-31-1460. ALS student enrollment requirements.
An enrolled student in an ALS certification program (EMT-Enhanced, EMT-Intermediate or EMT-Paramedic) must comply with the following:

"Virginia EMS Training Program Enrollment" forms must be received by the Office prior to the end of a certification course and before any student from the course may take a certification exam.

1. Be proficient in reading, writing and speaking the English language in order to clearly communicate with a patient, family or bystander to determine a chief complaint, nature of illness, mechanism of injury or to assess signs and symptoms.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

2. Be a minimum of 18 years of age at the beginning date of the certification program.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

3. Hold current certification as an EMT or higher EMS certification level.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

4. Hold, at a minimum, a high school or general equivalency diploma.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

5. Have no physical or mental impairment that would render him unable to perform all practical skills required for that level of training. Physical performance skills must include the ability of the student to function and communicate independently, to perform appropriate patient care, physical assessments and treatments without the need for an assistant.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

6. Not have been convicted or found guilty of any crime, offense or regulatory violation, or participated in any other prohibited conduct identified in these regulations.

(This requirement must be met to enroll, maintain enrollment or take a certification exam.)

7. Meet requirements for course enrollment as set by the regional EMS council or local EMS resource, the PCD or the course coordinator, approved by the Office of EMS.

Additional local or program specific course completion requirements must have prior approval from the Office. However, this requirement excludes routine requirements for minimum passing scores, reading or tasks assignments, etc.

8. If in an ALS bridge certification program between certification levels, have completed the eligibility requirements for certification at the prerequisite lower ALS level at the beginning date of the ALS bridge certification program. He shall also become certified at the lower ALS certification level before certification testing for the higher level of the ALS bridge certification program.

A student may start a "Bridge" course to a higher ALS certification level if they have met all requirements for the lower ALS certification course and are eligible to test at the lower level or are awaiting test results. All retesting required must be completed and certification at the lower ALS level received before the student may test at the higher certification level.

12 VAC 5-31-1470. Course coordinator responsibility for certification candidate eligibility.
A course coordinator shall provide the successful certification candidate the following documentation of eligibility for testing:

1. A "Virginia EMS Certification Application" with required signature attesting to the eligibility for certification testing.

a. If a BLS certification program, the course coordinator shall by his signature attest to the eligibility of the certification candidate for certification testing.

b. If an ALS certification program, the physician course director shall by his signature attest to the eligibility of the certification candidate for certification testing.

2. If a certification candidate is less than 18 years of age on the beginning date of the program, the parental permission form that was completed and signed at the beginning of the program.

Students between 16 and 18 years of age must have parental permission to enroll or attend any certification program. Underage students may not "audit" any training program without parental permission.

3. A completed individual skill performance, clinical training or field internship record, or a combination of these, as applicable for the EMS certification program.

12 VAC 5-31-1480. Eligibility for certification examination.

A. A certification candidate shall take the initial EMS certification examination within 180 days of the end date of the EMS certification program by presenting the following at a state certification examination:

A student must begin certification testing within 180 days of the course END date.

1. A completed "Virginia EMS Certification Application" form signed by the course coordinator for BLS programs or the physician course director for ALS programs.

2. A parental permission form if the certification candidate was less than 18 years of age on the beginning date of a BLS program.

3. A completed individual skill performance, clinical training or field internship record, or a combination of these, as applicable for the EMS certification program.

4. For BLS certification courses, a current CPR card or a valid copy of the course roster from a CPR course approved by the Office of EMS unless an individual skill performance record verifies this information.

5. Positive identification in the form of a government issued picture identification card.

B. A certification candidate in recertification, reentry, equivalency challenge or legal recognition status shall present the following at a state certification examination:

1. A "Recertification Eligibility Notice" or test authorization letter from the Office of EMS.

2. Positive identification in the form of a government-issued picture identification card.

12 VAC 5-31-1490. Recertification Eligibility Notice.
A.  An EMS provider who has satisfied the CE hours specified for his certification level may be issued a "Recertification Eligibility Notice."

A "Recertification Eligibility Notice" is sent automatically upon receipt by the Office of the final CE record fulfilling the recertification requirements for the level requested.

B. A "Recertification Eligibility Notice" remains valid until the expiration of the current certification period or the two-year "reentry" period for the level indicated unless the requirements for recertification are changed by the Office of EMS.

Once issued a "Recertification Eligibility Notice" may be used for recertification purposes at any time while the person is still allowed to test by these regulations.

12 VAC 5-31-1500. Eligibility for EMT-Instructor certification program.

A. An EMS provider must comply with the following in order to be eligible to take the EMT Instructor written examination:

1. Be a minimum of 21 years of age.

2. Hold current certification as an EMT or higher EMS certification level, and have been certified as an EMT for a minimum of two years.

3. Be a high school graduate or equivalent.

4. Have completed any other prerequisite training required by the Office of EMS.

5. Obtain a minimum score of 85% on a written pretest examination.

a. Instructor pretest results are valid for a period of two years from the date of the written examination.

 b. An EMS provider failing a written pretest examination is not eligible to repeat the examination for a period of 90 days from the date of the examination.

B. An EMT instructor candidate shall demonstrate competency during a formal practical pretest examination. An EMT instructor candidate shall provide the Office of EMS the following to be eligible for the practical examination:

1. An EMT instructor candidate affiliated with an EMS agency shall be recommended by the EMS physician serving as the agency's OMD.

2. An EMT instructor candidate who is not affiliated with an EMS agency shall provide both a recommendation from an EMS physician and a statement from his employer or perspective employer attesting to the need for instructor certification to meet the EMS training needs of the organization.

B. Eligibility to take the EMT Instructor practical examination requires prior approval from the Office of EMS.  Eligibility approval requires the following pre-requisites: a) passing the written instructor examination.  Completed on forms supplied by the Office of EMS the following:

1. Endorsement by the applicants agency's OMD or

2. A statement from their employer or perspective employer attesting to the need for instructor certification to fulfill the EMS Training needs of the organizations. Employer includes any public or private organization that has a substantial legal or operational need to conduct on-going EMS related training programs such as industrial facilities, school systems, community colleges, etc.

C. An EMT instructor candidate shall receive an invitation from the Office of EMS to attend an instructor institute.

1. An EMT instructor candidate shall successfully complete an EMT-instructor institute conducted by the Office of EMS. Attendance of some portions of the EMT-instructor institute may be waived for qualified candidates who present documentation of completion of equivalent programs in adult education approved by the Office of EMS.

Only applicants who have successfully completed the written and practical exam are eligible to
receive an invitation from the OEMS to attend an Instructor Institute.

2. An EMT instructor candidate shall demonstrate application of the knowledge and skills required of an Instructor during a teaching presentation made at the Instructor Institute.

a. An EMT instructor candidate who performs to an acceptable level may be certified.

b. An EMT instructor candidate who performs at an unacceptable level will be deemed to have failed the instructor institute. The candidate will be required to repeat the entire EMT Instructor certification process to apply for EMT-instructor certification.

c. An EMT instructor candidate who performs at a marginal level may be granted "Conditional Instructor Status."

12 VAC 5-31-1510. EMS certification written examination.

A certification candidate shall pass the written certification examination with a minimum score of:

1. 70% on a BLS certification examination.

2. 80% on an ALS certification examination.

3. 85% on an EMT-Instructor pretest examination.

4. 80% on an EMT-Instructor recertification examination.

Note that initial certification as an Intermediate or Paramedic requires possession of current
National Registry of EMTs I-99 or Paramedic certification and must apply through Reciprocity for
Va. Intermediate or Paramedic certification.  The provider is not required to maintain the National
Registry of EMTs Certification once certification is issued.

12 VAC 5-31-1520. EMS certification practical examination.
A. A certification candidate shall pass all practical stations required for the certification level being tested.
B. A grade of UNSATISFACTORY on a critical criteria within a practical station will result in failure of that station.
C. A grade of UNSATISFACTORY on a practical station that uses numeric scoring will include failure to obtain the minimum required points.

A. Practical examinations are required for all levels for initial certification at any level.  The
Intermediate and Paramedic Practical will be conducted by the National Registry.  First Responders,  EMTs, and EMT Enhanced all have practicals examinations.  Failure of a critical results in a failure of that station.  Failure to obtain minimum points when required also results in a failure of the station. 

12 VAC 5-31-1530. Certification examination retest.

A. A certification candidate may have up to two series of state certification examinations before being required to repeat an entire BLS or ALS certification program.

Test for the Intermediate and Paramedic follows the National Registry of EMTs testing policy.  This section only applies to providers taking the Virginia certification examination.  A Test Series is comprised of test and a retest.  Two complete test series allows up to four attempts at testing.

B. A certification candidate failing the written or practical certification examination of an exam series shall retest within 90 days from the date of the original examination.

Any eligible retests must be taken within 90 days of the original examination or the retest for that
test series is lost. 

C. A certification candidate failing a practical examination but passing the written examination of an exam series shall only repeat the practical examination of an exam series. A certification candidate failing the written examination but passing the practical examination shall only repeat the written examination for the exam series.

Only the station of the failed examination must be taken during a retest.

D. A certification candidate who has failed the retest of the initial examination series or has not taken the retest within the 90 day series retest period, shall satisfy the following before an additional certification test may be attempted:

1. Completion of the recertification CE hour requirements for the level to be tested.

2. Receipt of a "Second Certification Testing Eligibility Notice" from the Office of EMS.

Failure of the first series retest or not retesting within the 90 day retest period will require the candidate to meet the following criteria prior to attempting the second series of tests:

i. Complete the recertification CE hour requirements for the level to be tested.  This CE must be submitted to the OEMS using CE cards just like any other CE. 

ii. The candidate must present to the test site administrator a letter from OEMS indicating eligibility to start the second series of tests. 

E. A certification candidate who has received a "Second Certification Testing Eligibility Notice" must pass both the written and practical certification examinations for the certification level.

Any station of the first test series that was passed can not be used toward the second test series. 

F. A certification candidate who fails a retest during the second certification examination series must complete an initial certification program or applicable bridge course in order to be eligible for further certification examination.

Failure of the second test series requires the candidate to complete the entire training program prior to testing at that level again.

G. A certification candidate shall complete all certification examination series within 12 months from the date of the first certification examination attempt. This 12-month maximum testing period may shorten the time available for retesting specified in subsection B of this section.

Both test series must be completed within one year of the initial test.  A 90 day retest period
does not extend the one year test period.  If on a second test series, the first test of the second test series is taken at 11 months and failed, the candidate must retest in 30 days which is when the year testing period expires; not the 90 days allowed for retest. 

12 VAC 5-31-1540. Prohibition of oral examination administration.
A certification candidate may not use another person or any electronic or mechanical means to translate certification examination material into an audible or tactile format.

12 VAC 5-31-1550. Certification examination security.
A person found to have given or obtained information or aid before, during or following a certification examination may be subject to disqualification of eligibility for certification examination and to further enforcement action. Unauthorized giving or obtaining of information will include but not be limited to:

Don’t copy or distribute information in any manner about the certification examination.  Cheating during an examination is forbidden and may result in loss of certification and / or other penalties.

1. Unauthorized access to a certification examination question;

2. Copying, reproducing or obtaining all or any portion of material from a certification examination;

3. Divulging any material from a certification examination;

4. Altering in any manner the response of a certification candidate, except by the Office of EMS;

5. Providing false certification or identification on any certification examination form;

6. Taking a certification examination on behalf of another person; or

7. Participating in, directing, aiding, or assisting in any of the acts prohibited by this section.

12 VAC 5-31-1560. BLS course coordinator reimbursement.

A. The BLS course coordinator for approved first responder and emergency medical technician certification courses and Category 1 "Required" CE programs is eligible to request reimbursement. Reimbursement is designed to cover estimated costs for instruction and coordination of approved programs.

B. A BLS course coordinator is eligible for reimbursement if he is not receiving payment or reimbursement from any source other than a rescue squad or other emergency medical services organization that operates on a nonprofit basis exclusively for the benefit of the general public for instruction of the same course.

1. Fees not exceeding actual cost may be charged to students for textbooks, handouts, disposable medical supplies, and other course materials and payment of assisting instructors actually utilized in the course. Upon request, a schedule of fees charged shall be provided to the Office of EMS.

2. Tuition enrollment or institutional fees charged students for taking the course may be reason for denial of reimbursement payment.

 3. The sponsoring rescue squad or other emergency medical services organization may make payment to the Course Coordinator in an amount up to the hourly reimbursement rate established by the Office for BLS programs.

C. Requirements for Reimbursement Approval. A BLS course coordinator requesting reimbursement shall complete and sign the "Independent Contractor" agreement section of the Course Approval Request form.

1. A BLS course coordinator requesting reimbursement is an "Independent Contractor" and is not an employee of the Office of EMS or any agency of the Commonwealth of Virginia while fulfilling this independent contractor agreement.

2. The training program shall be "open" to any qualified student up to the maximum of 30 allowed in a single program. No requirement for specific agency or employment affiliation may be imposed to limit or exclude enrollment by any individual in reimbursed courses.

3. There shall be a minimum enrollment of 13 students at the start of the program to qualify for full reimbursement, unless the Office of EMS has granted specific prior approval.

a. Programs with enrollments of less than 13 students at the time of instruction of the third lesson of the course curriculum shall submit a "Small Course Special Approval Request" form to the Office of EMS. This form requires justification of the need for continued instruction of this program for reimbursement.

b. Programs approved for reimbursement with enrollments of less than 13 will be reimbursed at a lower rate than larger programs.

4. "Small Course Special Approval Request" forms will be reviewed by Office of EMS staff and returned to the course coordinator indicating approval or denial. Programs are initially approved for reimbursement based upon the information provided at the time of request. Failure to properly coordinate and instruct the program, or other violations of applicable sections of these regulations may be deemed as grounds to deny or modify reimbursement payments at course completion.

D. Final Payment. Upon course completion, and after all requirements of these regulations and the reimbursement contract have been satisfied, the course coordinator may request reimbursement.

1. To make application for payment, the Reimbursement Claim Form shall be submitted to the Office of EMS for review and final approval.

2. A course coordinator may request that payment be made out in his name or that of a sole proprietorship or partnership he operates as a principal party. Checks made to organizations require submission of the business' federal employers identification number (FEIN) in place of the course coordinator's social security number in these cases. Reimbursement may not be paid to anyone other than the course coordinator who announced and contracted for the involved course.

12 VAC 5-31-1570. EMS training grant program.
A reimbursement fund has been established to support certification and continuing education programs through the "Virginia Rescue Squad Assistance Fund" grant program. Reimbursement for coordination and instruction of approved programs will be administered through the separate regulations established for the "Virginia Rescue Squad Assistance Fund."

12 VAC 5-31-1580. Certification period.

An EMS certification may be issued for the following certification period unless suspended or revoked by the Office of EMS:

1. A BLS certification is valid for four years from the end of the month of issuance, except as noted below.

2. An ALS certification is valid for three years from the end of the month of issuance. An EMS provider with ALS certification may be simultaneously issued an EMT certification for an additional two years.

3. An EMT instructor certification is valid for two years from the end of the month of issuance. An EMS provider with EMT instructor certification may be simultaneously issued an EMT certification for an additional two years.

12 VAC 5-31-1590. Certification through reciprocity.
Upon demonstration of Virginia residency, Virginia EMS agency affiliation or a recognized need for Virginia EMS certification, a  person holding valid EMS certification from another state or a recognized EMS certifying body with which Virginia has a formal written agreement of reciprocity may be issued a certification.

12 VAC 5-31-1600. Certification through legal recognition.
Upon demonstration of Virginia residency, Virginia EMS agency affiliation or a recognized need for Virginia EMS certification, a person holding valid EMS certification from another state or a recognized EMS certifying body with which Virginia does not have a formal written agreement of reciprocity but who has completed a training program in compliance with the minimum training standards established by the National Standard Curriculum for the level requested, may be issued certification for a period of one year or the duration of their current certification, whichever is shorter. Legal Recognition is not available for any Virginia certification level if the Office has determined that no equivalent National Standard Curriculum exists at the level requested.

See also 12 VAC 5-31-1640 C1

12 VAC 5-31-1610. Certification through equivalency.
A Virginia licensed practical nurse, registered nurse (to include these recognized through the Nurse Licensure Compact § 54.1-3030 et. seq. of the Code of Virginia), physician assistant or military corpsman with current credentials may be issued EMT certification through equivalency after completing the requirements of 12 VAC 5-31-1640 B, including passing a written and practical certification examination.

12 VAC 5-31-1620. Certification through reentry.

A. An EMS provider whose EMS certification has expired within the previous two years may be issued certification after completing the requirements of 12 VAC 5-31-1640 B, including passing a written or practical certification examination, or both, as required by the Office of EMS. An EMS provider who fails to complete the reentry process by the end of the two-year period following expiration is required to complete an initial certification program.

B. An EMS provider who has resided outside of Virginia for a minimum of two years, has maintained certification through another state or the national registry of EMTs and whose eligibility to regain certification through reentry has expired, may be issued certification through 12 VAC 5-31-1590 or 12 VAC 5-31-1600 as applicable.

12 VAC 5-31-1630. Voluntary inactivation of certification.

Requests from individuals desiring to permanently surrender or downgrade their current certification on a voluntary basis will not be processed except upon verification of the individual's ineligibility for continued certification under these regulations (e.g., felony conviction, permanent disability, etc.).

1. Any individual holding a current EMS certification who is affiliated with a licensed EMS agency and no longer wishes to practice at their current level of certification; may request to have their certification placed in inactive status by the Office of EMS.

2. Requests for inactive status will require a minimum inactive period of 180 days during which time requests for reinstatement to active status will not be allowed.

12 VAC 5-31-1640. EMS recertification requirement.

A. An EMS provider must complete the requirements for recertification [and the Office must receive the required documentation] within the issued certification period to maintain a current certification.

Note, CE must be received prior to a providers certification expiration date to credit toward eligibility for examination waiver.  If a providers CE requirements are not received in the Office by the providers certification expiration, the provider will be in re-entry and exam waiver can not be used to re-certify.

B. An EMS provider requesting recertification must complete the CE hour requirements for the level to be recertified.

C. An EMS provider requesting recertification must pass the written state certification examination.

1. Except an EMS provider under legal recognition, 12 VAC 5-31-1600, must pass a written and practical EMS certification examination.

2. An EMS provider affiliated with an EMS agency may be granted an exam waiver from the state written certification examination by the OMD of the EMS agency, provided:

a. The EMS provider meets the recertification requirements including those established by the OMD; and

2. Examination waiver for re-certification requires that all CE be received by the OEMS no later than the close of business on the providers certification expiration date, the provider is a member of an EMS agency, and:
a. The provider complies with all agency and OMD requirements

b. The EMS provider must submit a completed "Virginia EMS Certification Application" with the exam waiver approval signed by the EMS agency OMD, which must be received by the Office of EMS within 30 days following the expiration of his certification.

i If the "Virginia EMS Certification Application" form is received by the Office of EMS after the EMS provider's certification expiration date, the EMS provider may not practice at the expired certification level until a valid certification is received from the Office of EMS.

ii. If the "Virginia EMS Certification Application" form is received by the Office of EMS more than 30 days after the EMS provider's certification expiration date, his certification will be in reentry and he will be required to test pursuant to 12 VAC 5-31-1620.

The examination waiver for recertification must be received by the Office no later than the close of
business 30 after the providers certification expiration date.  The provider should not be considered
currently certified unless he or she possesses a certification card with a current expiration date.

If the exam waiver is received in the OEMS more than 30 days after the providers certification
expiration date, the waiver is not valid and the provider must test to regain certification.

12 VAC 5-31-1650. EMT instructor recertification.
An EMT instructor requesting recertification must complete the following requirements within the two-year certification period to maintain current certification:

1. Instruct a minimum of 50 hours in BLS certification courses or other programs approved for BLS (Category 1) CE hours;

2. Attend one EMT-Instructor/ALS Coordinator Update Seminar;

3. Attend a minimum of 10 hours of approved continuing education. An instructor holding an ALS level certification is not required to attend these additional 10 hours of continuing education if his ALS certification is current at the time of EMT-Instructor recertification;

4. Pass the EMT-basic written certification examination with a minimum passing score of 80%. This examination may be attempted only after attending an EMT-Instructor/ALS Coordinator Update Seminar. If the EMT-instructor is affiliated with a licensed EMS agency, this examination may be waived by the EMS agency's OMD per 12 VAC 5-31-1580; and

5. Have no physical or mental impairment that would render the EMT Instructor unable to perform and evaluate all practical skills and tasks required of an EMT.

An EMT instructor's certification will revert back to his highest level of EMS certification remaining current upon expiration.

12 VAC 5-31-1660. EMT instructor reentry.

An EMS provider whose EMT instructor certification has expired may regain certification through completion of the reentry program within two years of the expiration date of his EMT Instructor certification:

1. If the EMT instructor had completed the teaching requirements of subdivision 1 of 12 VAC 5-31-1650, but was unable to fulfill one or more of the requirements of subdivisions 2-5 of 12 VAC 5-31-1650, the remaining requirements shall be completed within two years following the expiration date. If the EMT basic examination required under subdivision 4 of 12 VAC 5-31-1650 was not completed before expiration, this examination may not be waived by an EMS agency OMD.

2. If an EMT instructor does not complete the teaching requirements of 12 VAC 5-31-1650, the following requirements will be necessary for reentry:

a. Successful completion of the EMT-instructor written and practical pretest examinations as specified under 12 VAC 5-31-1480; and

b. Attendance of the administrative portions of an EMT-Instructor Institute.

12 VAC 5-31-1670. Continuing education categories.
A CE hour may be issued for one of the following categories:

1. "Required" (Category 1). CE hours may be issued provided the objectives listed in the applicable "Basic Life Support Category 1 Training Modules" or "Advanced Life Support Category 1 Training Modules" are followed, a qualified instructor is present and available to respond to students, requirements for specific contact hours are met and the course coordinator complies with these regulations.

2. "Approved" (Category 2). CE hours may be issued provided that a qualified instructor is present and available to respond to students, topics are approved and the course coordinator complies with these regulations.

3. "Multimedia" (Category 3). CE hours may be issued for contact with periodicals, videotapes, and other multimedia sources provided that specific contact hours for the certification level involved are met.

12 VAC 5-31-1680. Submission of continuing education.
A CE hour may be issued for attendance of a program approved by the Office of EMS provided:

1. A course coordinator must submit a CE record/scan card within 15 days of the course end date or the student's attendance of an individual lesson for an EMS provider attending a training program for recertification hours.

2. An EMS provider is responsible for the accuracy of all information submitted for CE hours.

12 VAC 5-31-1690. Recertification Eligibility Notice.
An EMS provider who has satisfied the CE hours specified for his certification level may be issued a "Recertification Eligibility Notice" that remains valid until the expiration of the current certification period for the level indicated or the two-year "reentry" period.

12 VAC 5-31-1700. ALS coordinator endorsement.

A. A person applying for endorsement as an ALS coordinator must:

1. Be a minimum of 21 years of age.

2. Hold ALS certification or licensure as one of the following:

a. Registered nurse;

b. Physician assistant; or

c. Physician.

3. Submit an "ALS Coordinator Application" form with the required recommendations and supporting documentation of qualifications to the Office of EMS including:

a. A recommendation for acceptance from an EMS physician knowledgeable of the applicant's qualifications. If the applicant is an EMS physician, the support of another EMS physician is not required on his "ALS Coordinator Application."

b. A recommendation for acceptance of the applicant's qualifications from the regional EMS council or local EMS resource.

B. A separate ALS Coordinator Application is required for each region in which the applicant intends to coordinate ALS certification or CE programs. An application submitted for approval to serve in additional regions will not alter the expiration date of the current ALS coordinator endorsement and all regional endorsements will be due for renewal on the current expiration date.

C. An ALS coordinator candidate meeting the requirements for endorsement shall attend an ALS Coordinator Seminar.

D. An ALS coordinator candidate that completes all requirements for ALS coordinator endorsement may be issued an endorsement that is valid for two years. An ALS coordinator endorsement does not provide concurrent provider credentials at any EMS certification level.

E. An ALS coordinator endorsement alone does not authorize the performance of any medical procedure.

12 VAC 5-31-1710. Renewal of ALS coordinator endorsement.
A. An ALS coordinator shall maintain current and unrestricted certification as an ALS provider, or licensure as a registered nurse, physician assistant or physician.

B. An ALS coordinator shall resubmit an ALS coordinator application before the expiration date of his ALS coordinator endorsement. A separate ALS coordinator application is required for each region in which the applicant desires to continue to coordinate an ALS certification or CE programs.

C. An ALS coordinator must attend one EMT Instructor/ALS Coordinator Update Seminar within his certification period.

D. An ALS coordinator attempting to regain endorsement through the reentry program shall, within two years of his expiration date, complete the ALS coordinator application and the requirements of subsections A, B and C of this section.