At the last conference in Hot Springs, president Ben Blankenship asked me if I would work on legislation for licensing EMS providers. Considering the fact that I have had many wonderful discussions, arguments, altercations and knock down, drag out fights over the past six years on this very subject, I of course said “Of course sir. (OMG yes! Let me at it!) I’d be honored”. And so began our next phase in the journey of the profession we call EMS.
The first thing was to understand exactly what we wanted. Over the years, many possibilities have been proposed and sides could understandably be seen as polarized.
President Blankenship explained that the direction the AEMTA felt we should proceed was the direction laid out in the EMS Agenda for the Future: (HRSA & NHTSA).
In 1996, there were at least 44 levels of EMS certifications in the United States. Not a good way to build national quality and unity of purpose. The State of Arkansas currently has traditionally had 1) EMT-Basic 2) EMT-Ambulance 3) Intermediate 4)Paramedic and 4) EMT Instructor. The National Scope of Practice model advocates a standard of four levels of certification of EMS providers. 1) EMT 2) Advanced EMT 3) Paramedic and 4) EMS Instructor. These will be the adopted levels under the licensure act with the addition of EMS Instructor/Trainer.
The adoption of these levels will allow us to move positively toward national consistency. Why is this important? Because under a national scope of practice, all levels will have the same basic knowledge and skills whether the practitioner is from Florida or Washington state, Maine or New Mexico. Sound interesting? It certainly is if we want to consider reciprocity issues or assistance during times of national emergencies.
Does it lock us in to just these levels of practice? No. These are minimum skills which can be added to, if desired, by local medical control. In fact, by building on these skills and base of knowledge, we will be able to move forward with additional education and skills and still be part of an integrated national system.
Commendably, the state of Arkansas already meets or exceeds the minimum standards required by all levels of licensure. There will be minimal impact on our educational and skill levels with some additional allowed interventions. Oh and that required accreditation of EMS programs called for at the national level? We’re already there, 100%. [Insert applause for our (forward thinking) program directors here].
That established, we consulted with David Taylor, EMS Section Chief for his input, opinions and assistance. He was very supportive of our effort and worked hard to be sure we received all the information we needed to put together a bill to move the licensure forward. Lots of time reviewing and advising to be sure we met all the necessary requirements for presenting the bill. (Ask David about his New Years Eve reviewing the codes to try and get all the changes found).
The Governor’s Advisory Committee was also consulted for support and unanimously agreed that we should pursue the licensure. Letters of support were also received from many services, associations and individuals.
Finally, after many email and phone consults, we finally felt we had a bill that could be presented. Senator Broadway graciously agreed to sponsor the bill and filed it on January 26, 2009. We were off and running.
When the bill was to be presented to the Senate committee, we were ready. All the letters, people to testify, and prepped for the battle. Then the bill was presented. It was unanimous. The committee voted and a do pass was given. Amazing how good it felt to get that kind of support.
The next stop was the House committee and the same results.
The final results when presented to the Senate and House of Representatives?
- Approved by the senate on March 12, 2009 34 yeas, 0 nays,1 excused
- Approved by the house on March 23, 2009 96 yeas, 0 nays, 4 not voting
Not a negative vote in the bunch!
On March 27, 2009 Governor Mike Beebe signed into legislation…
After all the years of waiting, hours of work, concern over support and miles under the wheels, licensure was a reality.
Please let me be the first to congratulate all the hard working and deserving EMS professionals of the State of Arkansas on your licensure. (See the first sentence)
In closing, personal thanks to EMTA President Ben Blankenship for allowing me to be involved, EMS Section Chief, David Taylor for being involved and to the AEMTA and all the EMS family that make it all worth it.
Now the work begins.