c. National EMS associations should: i. Advocate for more inclusive, standardized training and credentialing processes that enhance the portability of EMS providers, both during routine work and during regional or national emergencies. 5. Relaxing Certificate of Need Policies a. Local EMS agencies / authorities should: i. Clearly define which services are provided by their EMS agencies. ii.Understand local health care and other community needs. iii. Be mindful of their overall capabilities, and provide accurate assessments of these capabilities to local, state, and regional EMS authorities as requested. b. State EMS authorities / associations should: i. Maintain an accurate accounting of EMS agency capabilities and service provision to facilitate consideration of modification of “certificate of need” policies. ii.Encourage local EMS agencies to meet unmet community EMS needs when identified through this accounting process. iii. Assist local EMS agencies, in an unbiased fashion, with managing resources to meet community needs without fragmentation or inappropriate redundancy. c. National EMS associations should:
b. Local EMS authorities should: i. Consider developing protocols that guide the transport of appropriate patients without emergency medical conditions to locations other than emergency departments. c. Hospitals should: i. Consider amending their bylaws to authorize EMS personnel in the field to perform or facilitate the necessary medical screening examination to comply with EMTALA and thereby enable alternative destination or treat and refer protocols. ii. Use their convening power to bring multiple EMS agencies together to support jurisdictional amendments to protocols. d. State EMS authorities / associations should: i. Consider developing statewide policies or protocols that authorize or direct the transport of patients without emergency medical conditions to locations other than emergency departments. ii.Facilitate knowledge transfer about best practices and EMTALA compliance. e. National EMS associations should: i. Encourage research to further the science around criteria for transport to alternate destinations. ii. Gather and disseminate best practices around protocol development and EMTALA compliance.
4.Enabling Portability of Licensure a. Local EMS agencies / authorities should:
i. Meet with other national stakeholder groups to provide resource typing guidelines that state EMS authorities and local EMS agencies can use when describing capabilities and services provided, while maintaining flexibility to include new capabilities and services not yet implemented or imagined.
i. Ensure that initial and continuing paramedic education is provided that meets the minimum standards established by national guidelines.
b. State EMS authorities / associations should: i. Evaluate the credentialing processes for
neighboring jurisdictions to establish expedited processes that will allow for rapid, safe reassignment of EMS providers across state lines during emergencies. ii. Evaluate the training and credentialing provided by military branches to expedite the entry of skilled military EMS personnel into civilian EMS agencies.
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CHAPTER 2
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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