• Describes what interventions a licensed individual legally can and cannot do.
• Idaho’s SoP is established by the EMS Physician Commission (EMSPC).

Learn More: EMSPC Standards Manual

• Four separate but related activities:

-    Education (trained to do)

-    Certification (certified as competent)

-    Licensure (state licensed to practice)

-    Credentialing (agency medical director)

• The skills and interventions that all personnel of a certain license level can perform. 
• The fundamental skills at each level that define the minimum standard of service.
• Floor skills are marked with an “X” in the SoP grid.

• Optional skills that can be authorized by an agency’s medical director.
• Optional modules are marked with an “OM” in the SoP grid.

• The agency medical director chooses to incorporate OMs.
• Agency must: report patient care, submit addendum to medical supervision plan MSP) indicating which OMs will be implemented, and submit verification of OM credentialing to the EMS Bureau.

Learn More: EMSPC Standards Manual > pg 14       
                 Idaho EMS Webpage > Education > Optional Modules

• OMs are independent of the scope transition. 
• Transitioning does not automatically give an agency authority to implement OMs.
• Even if currently authorized to use OMs, providers will still have to transition before practicing the new SoP.
• There are some select OMs that will become floor skills in the new scope (see below).

• EMR-2011: Tourniquet

• EMT-2011: Pulse Oximetry, Asprin, Epi Auto Injector

• AEMT-2011: Pulse Oximetry, Intraosseous-Adult, IM medication admin, Subcutaneous medication admin, Aspirin, Epi Auto Injector, Glucagon

• Paramedic: BiPAP, CPAP, PEEP-Therapeutic, Blood Chemistry Analysis, Maintenance of Blood Admin

• Yes, for EMR, EMT and Paramedic providers.
• Optional, for AEMT providers.

• Complete your transition education
• Competency assessment (for AEMT-2011 this includes NREMT exams)  This is determined by the assigned course physician.  At the BLS level (EMR/EMT) the course physician can delegate a designee to assess competency.
• State Licensing
• Submit a Transition Application and receive a new, updated license. New licenses will identify providers that have transitioned.
• Credentialing from your agency medical director

• The Idaho EMS Bureau keeps a list of transition courses on the EMS webpage

• This can vary depending on the educational medium you choose.

-    Many agencies are doing transition courses during their monthly training meetings.  This would keep costs at a minimum.

-    Other providers are choosing to go through educational institutions and pay for their course.  This is a more costly approach.

• Transition Courses count as CE.  The EMS Bureau provides a tracking tool on the website to monitor CE hours during a transition course.
• If 75% or more of your required CE hours in a single license cycle are spent in a transition course, venue requirements no longer apply.  Note: This only applies if you intend to transition.
• CE requirements do not change with the new scope:  EMR-24hr, EMT-48hr, AEMT-54hr, Paramedic-72hr

• EMT: No, there is new knowledge and skills at both the EMR and EMT levels.
• AEMT: Yes, you can revert to an EMR-2011.  You cannot revert to an EMT-2011 without an EMT transition course.
• Paramedic: Yes, you can revert to an EMR-2011, EMT-2011 or AEMT-2011 without any transition course.

• EMR, EMT, and Paramedic transition courses do not have a required exam associated with them.  If the course physician uses an exam to determine competency, then they determine who gets access to that exam.
• AEMTs must complete a Transition or Initial IEC course to get access to the NREMT written and practical exams.

• The 2011 Idaho EMS Curriculum (IEC) is competency based, so there is no minimum or maximum classroom hours required.
• Course will be successfully completed when student can demonstrate competency to the course physician in the new information and skills.

• EMR/EMT: May begin practicing at the new SoP after July 1, 2012 upon completion of:
                            -    Transition education
                            -    Competency assessment
                            -    Licensing at the 2011 level
                            -    Medical director credentialing 

• AEMT/Paramedic: May begin practicing at the new SoP after January 1, 2013 upon completion of:
                            -    Transition education
                            -    Competency assessment (NREMT exams for AEMT)
                            -    Licensing at the 2011 level
                            -    Medical director credentialing  

Emergency Medical Responders (EMR) and Emergency Medical Technicians (EMT)

Paramedics & Advanced EMTs (if the AEMT chooses to transition)

• If you transition early, your new license will have same expiration date, but new effective date.

• CEs will continue to count toward renewal requirements.

• EMRs and EMTs have 3 years from the day they start their transition education to finish. 
• AEMTs and Paramedics have 2 years from the day they start their transition education to finish. 
• It is OK if the education carries over into another license cycle.

• Students trained in the old scope ISC curricula must be successfully tested and licensed by certain deadlines:

-    EMR/EMT by Dec. 31, 2011

-    AEMT/Paramedic by Dec. 31, 2012

• Students trained in the new scope IEC curricula must successfully pass state designated exams based on new scope standards to be licensed.

• It is competency based, so the course is complete when competency is demonstrated to the course physician or designee (BLS level).
• No minimum/maximum number of hours.

• No, for EMR, EMT and Paramedic providers.
• Yes, for AEMT providers transitioning to AEMT-2011.  They will take the NREMT written exam and 10 station practical exam.

• Yes, though it will still require competency assessment by the course physician or designee (BLS level).
• Educators may consider managing initial and transition courses concurrently.

• ICS-100 - Course available at: http://training.fema.gov/emiweb/is/is100b.asp

• NIMS-700 - Course available at: http://training.fema.gov/EMIWeb/is/is700.asp

• HazMat - Course available at: http://www.saferesponse.com/sub_page/hazmat_main.htm

• Extrication Awareness - Course available at: www.IdahoEMS.org > Education Page > Scope of Practice Transition, Transition Education Materials > Extrication Awareness

• No, there are components of an EMR transition course that will not be included in the EMT Transition Course.

• Transition courses do not require approved Idaho EMS instructors.  Rather, any health care provider or educator with qualifying credentials, education or experience can teach portions of a transition course.
  
  • Example: Paramedics, Nurses, MD/Physicians, FNP, PA, RT, etc.
•  All transition instructors must be approved by the course sponsoring physician. Instructors teaching at their same license level must be transitioned prior to teaching a transition course.
  
  • Example: An EMT instructor must take their transition education before teaching any other new scope EMT courses.

• If required, obtain necessary education (transition course for your license level)
• Update your instructor status at the new license level with the EMS Bureau.
• Stay current with Instructor Orientation (required every two years)

• EMR/EMT: After 12/31/2011
• AEMT/Paramedic: After 12/31/2012

***Remember to leave your students enough time to complete their exams and apply for licensure before those dates if currently teaching ISC courses.

• Maintain and renew your AEMT-85 license indefinitely.
• Complete an AEMT-2011 transition course, NREMT exams (written & practical), and license as an AEMT-2011.
• Complete an EMT-2011 transition course for supplemental knowledge and skills but maintain and renew your AEMT-85 license.
• Complete an EMT-2011 transition course and revert to EMT-2011.
• Revert to EMR-2011 (no transition required).

• ATV- non-intubated, Pulse Oximetry, Aspirin, Epi Auto-Injector, Atropine Sulfate auto injector

• No, you would be required to transition or revert to reinstate your license.

• Currently licensed AEMT-85s can maintain their license at that level until they retire.
• New graduates will only be licensed at that level until December 31, 2012

• After Jan 1, 2013 you may apply for the new license if you hold either a current National Registry I-99 card or state licensure at the I-99 level.

• This is determined by each individual MD/Course Physician.
• Examples of methods to verify competency:

-    Observation

-    Exams (written, practical, oral, etc)

-    Field Internship/Clinical Hours

-    Consider current licensure or certifications for skills evaluated

• Transition Courses: All license levels now require a designated course physician for Transition courses.
• EMR and EMT Initial IEC Courses: They require a designated course physician, but the physician can identify designees that are authorized to determine competency in their stead.
• AEMT and Paramedic Initial IEC Courses: They require a designated course physician.

a.       www.IdahoEMS.org

b.      Scope of Practice Transition Webpage

a.      www.emspc.dhw.idaho.gov

b.      EMSPC Standards Manual

c.      Scope of Practice Grid (Appendix A of EMSPC Standards Manual)