EMS Agencies

The IGEMS Agency Administrator User Guide offers step-by-step instructions for updating the personnel roster, adding a new vehicle, inactivating an existing vehicle, uploading a new policy or procedure, and making updates or additions to station information.

For other questions not addressed in the guide, refer to Help University.

EMS Agency Licensing Requirements and Waivers

For coverage area and personnel complexities, the two waivers below could be considered. For comprehensive information on the waiver application requirements and process, please refer to the EMS Agency Standards Manual.

Waiver of Personnel Requirements for Agency Licensure

• Personnel Requirement Waiver for Abandonment of Higher Service Level.
  • If granted, this waiver allows an agency to offer the same level of clinical services to their community on a part-time basis while maintaining the existing level of licensure and required equipment even though personnel licensed to provide care at the agency’s license level are not available 24 hours a day, 7 days per week, or 365 days per year. Only 911 Response Transport or 911 Response Non-transport services are eligible for this waiver.
• Personnel Requirement Waiver for Improving Access to a Higher Service Level.
  • If granted, this waiver allows an agency to offer services at a higher clinical level than currently licensed, but on a part-time basis because personnel licensed at the higher clinical level are not available 24 hours a day, 7 days per week, or 365 days per year.

Waiver of 24/7 Response Requirement

Each EMS agency must respond to calls 24 hours a day within the agency's declared geographic coverage area unless a waiver exists.

• A non-transport service may petition for the following:
  • Not Populated on a 24-Hour or Daily Basis
  • Undue Hardship or Abandonment of Service
• An ambulance service or air medical service may petition for the following:
  • Undue Hardship or Abandonment of Service

Renewal of Waivers

The controlling authority of a non-transport agency desiring to renew a waiver of the 24-hour response requirement must declare the request for renewal of the waiver on the annual renewal application for agency licensure to the Bureau.

Equipment List Modifications

An EMS agency’s minimum equipment list may be modified with a request for an exception or exemption. This will require approval by the Bureau. For more information and details on equipment modification requests, please contact a field coordinator (208)-334-4000.

• Exceptions: Under specific conditions, an agency can request to replace a required piece of equipment with an alternate.
• Exemptions: Under specific conditions, an agency can request to remove a required piece of equipment.

IDAPA 16.01.03 Section 500.03.a EMS Agency-General Equipment Requirements and Modifications.

When an agency changes medical directors, there are several tasks that need to be reviewed and completed:

• Verify the new medical director is an Idaho-licensed physician (Medical Doctor/Doctor of Osteopathy).
• Add the medical director to the IGEMS roster and assign Medical Director permissions.
• Upload the new Medical Director Agreement, Medical Supervision Plan, and Protocols in IGEMS.
• If the agency uses optional modules (OM), the medical director must submit a new OM Addendum and create a new internal OM Matrix for credentialing.

There are additional resources and trainings for first time EMS medical directors on the EMS Physician Commission page.

What is an OM?

OMs are skills identified by the EMS Physician Commission (EMSPC) that exceed the floor level scope of practice for EMS personnel and may be adopted by the agency medical director. To view what skills are identified as OMs, refer to the Standards Manual and the current scope of practice on the EMS Physician Commission page.

Adopting an OM

Submit an OM Addendum

The agency administrator must identify which OM’s the agency will utilize per their medical director. The Optional Modules Addendum form is completed in your agency’s IGEMS account under Agency Applications.

Training

The EMS medical director must ensure licensed EMS personnel receive appropriate initial training and verify competency in these skills and interventions.

• The training must provide for all didactic, psychomotor, lab, and clinical learning over the knowledge and skills as described in the National Education EMS Standards and Idaho EMS curriculum.
• The student must be trained and evaluated to the depth and breadth of competency for the level of training where the skill exists as a floor skill.

Testing and Credentialing

Before EMS personnel can perform OM skills that do not require testing, the agency must maintain a record of:

• Full names and license numbers of all personnel.
• The date of their completed training.
• Sign off from the medical director credentialing personnel to perform the OM skills in the field.
• The OM credentialing records must be regularly updated and available upon request by the Bureau.

The majority of OM skills do not require testing, but the following EMR and EMT skills do:

• EMR
  • Cervical Stabilization - Cervical Collar
  • Extremity Splinting
  • Long Spine Board
  • Seated Spinal Motion Restriction (SMR)
• EMT
  • Advanced Airways Devices Not Intended to be Inserted into Trachea, End Tidal CO2 Capnography (King LTs, LMAs, iGels, etc.)
  • Intraosseous - Pediatric/Adult
  • IV Peripheral - Initiation (Includes External Jugular)
  • IV Fluid Infusion - Non-Medicated

For tested skills, an agency may conduct the psychomotor exam using the Bureau approved BLS OM Exam Administration Guidelines and submit the OM Exam Record in IGEMS.

IDAPA 16.01.03 Section 981. CHANGES TO A CURRENT LICENSE.

An agency’s officials must submit an agency update to the Bureau within sixty (60) days of any of the following:

• Changes Requiring Update. An agency’s officials must submit an agency update to the Bureau within sixty (60) days of any of the following:
  • Changes made to the geographic coverage area by agency annexation;
  • Licensed personnel added or removed from the agency affiliation roster. If licensed personnel are removed for cause, a description of the cause must be included;
  • Vehicles or equipment added or removed from the agency;
  • Changes to the agency communication plan or equipment;
  • Changes to the agency dispatch agreement; or
  • Changes to the agency Medical Supervision Plan.
• Changes Requiring Initial Licensure Application. When an agency decides to make any of the following changes, it must submit an initial agency application to the Bureau and follow the initial application process described in Section 900 of these rules:
  • Clinical level of licensed personnel it utilizes;
  • Geographic coverage area changes, except by agency annexation;
  • A non-transport agency that intends to provide patient transport or an ambulance agency that intends to discontinue patient transport and become a non-transport agency; or
  • An agency that intends to add a 911 Response to an Ambulance Service license or Non-Transport Service license.

To establish an EMS agency in Idaho, begin by reviewing IDAPA 16.01.03 EMS Agency Licensing Requirements. The required documentation for the application depends on the type of service chosen for the license. Refer to IDAPA to determine the necessary documents.

Prior to contacting the Bureau and starting the application process:

• Secure an Idaho-Licensed Medical Director for agency over-site and Medical Direction.
  • Have them create an IGEMS account.
• Purchase required equipment per Minimum Equipment Standard List.
  • List can be found under the Agency Administration Quick Links section above.
• Non-Profit agencies must file with the Idaho Tax Commission and For-Profit agencies must register with the Idaho Secretary of State.
• Verify that the EMS agency name you would like to utilize is not already in use by an existing Idaho EMS Agency.
  • Refer to the EMS Agency Contact List under EMS Agency Information at the top of the page.

For a detailed guide on applying for an initial agency license, follow the link here.

An EMS agency must renew its Idaho EMS agency license each year. The renewal process is completed in the IGEMS automated license management system. If a license renewal application is not submitted prior to the expiration date of the existing license, the license is no longer valid. If your license expires, the agency must complete the initial license application process and be granted a new license before returning to service.

Annual Renewal Requirements

• Confirm your Agency Roster is current, and each licensed provider has been credentialed.
  • Application in IGEMS: Agency Roster: Personnel Updates
• Confirm all current vehicles are listed and indicate mileage.
  • Application in IGEMS: Update Vehicle Information
• Confirm all station locations are current.
  • Application in IGEMS: Add/Update Station Information
• Confirm all documents are up-to-date in IGEMS.
  • Current Medical Director Agreement (IDAPA 16.02.02)
  • Current Medical Supervision Plan (IDAPA 16.02.02)
  • Current Agency Protocols (IDAPA 16.02.02)

Renewal Application

• Complete the EMS agency renewal application in IGEMS 30 Days prior to expiration.
• Agency administrator privileges in IGEMS are required to initiate the renewal application.
• Use the Agency Renewal Step-by-Step Instructions for completing EMS agency renewal applications.

Account Set Up

Account setup in IGEMS PCR (Elite) is performed by a sync from IGEMS Licensure upon agency creation.

• Billing accounts are for agencies that use billing services. Contact the Bureau if you would like to create a billing account 208-334-4000.

Common Roles in IGEMS PCR (Elite)

• Agency Administrator
  • Only agency administrators will have Agency Administrator permissions. This permission group allows administrators to perform most of the functions within IGEMS PCR (Elite), such as adding or removing users from their roster, adding missing components from user accounts, or modifying permissions for users. Agency Administrators can assign others the Agency Administrator role at their discretion.
  • All personnel that need to appear on PCR run forms (including drivers and other EMS Support Staff) must appear on your agency roster in Licensure. They will need a role assigned such as ‘Credentialed Provider’ or ‘EMS Support Staff’ and have a license number assigned to them.
• EMS Support Staff
  • For questions on adding EMS Support Staff, refer to the IGEMS Agency Administrator User Guide.

PCR Run Forms

Run forms can be accessed from the ‘Incidents’ tab in their IGEMS PCR (Elite) account. The run forms are divided into sections and can be customized for ease of use.

• PCRs must be submitted to the State no later than the 15th of the following month.

PCR Vendor Rules

Agencies that choose to use a PCR software vendor for PCR reporting MUST ensure the export of PCRs from the vendor to our State Data Repository (IGEMS PCR Elite) is in place.

• Using a vendor and not exporting the records to our State Data Repository does not meet the rules and code outlining data submission requirements.

Why Filling Out PCRs in an Accurate and Timely Manner Matters

• Captures and stores patient documentation
• Maintains assessment and treatment records
• Ensures legal and billing compliance
• Facilitates data collection and reporting

Quick Links

• NEMSIS
• IDAPA 16.01.03
• Data Reporting Standards
• Help University
  • Help University is an all-encompassing guide, created by ImageTrend, for everything IGEMS LMS and IGEMS PCR (Elite).
• Billing 101
  • Billing 101 is a help guide for agency PCR billing.

Frequently Asked Questions

If I am dispatched to a lift assist, is a PCR still required?

• Yes, any call where responders were dispatched are required to fill out a PCR.

If my call was cancelled in route, is a PCR still required?

• Yes, there are fields to mark that the call was cancelled

Can we link a fire incident to an EMS incident?

• Yes. There is a button on the EMS run form that will link a NFIRS issue to the EMS incident.

Do I create a different account for Elite PCR?

• No, the account username and password are the same with IGEMS LMS and IGEMS PCR (Elite). Each platform has a different webpage.

Examples of the roles of CHEMS personnel include but are not limited to the following:

• Acting as healthcare navigators for patients
• Transitional care for patients after they are discharged from a hospital stay
• Vaccinations
• Medication inventories
• Resource coordination
• Basic medical therapeutics

In Idaho, CHEMS allows for all levels of EMS personnel and agencies to provide continued or follow-up care that can prevent unnecessary readmissions, or 911 calls from those patients within the community. As noted above, this extended care must be provided within their scope of practice.

The CHEMS operational declaration is available to an agency with a pre-hospital operational declaration that provides personnel and equipment for medical assessment and treatment at a non-emergency scene or at the direction of a physician or independent practitioner. There is currently not a standardized role for a CHEMS provider and this role must be determined by the agency; however, the Idaho Administrative Code 56-1012 provides guidance regarding a CHEMS operational declaration and Idaho code begins to define and provide structure to future standardizations. Through the efforts of the Bureau and additional partners, CHEMS education has been made available for the emergency medical technician and paramedic level providers.

Hennepin Community Paramedicine (BP/EP) Advanced Technical Certificate

• The Rural Community Paramedicine Toolkit
• Idaho Community Paramedic Toolkit - Appendices
• NAEMT MIH Toolkit
• NAEMT MIH Knowledge Center

Limited Request for Recognition (LRR) allows individuals with valid, unrestricted out-of-state EMS licenses to practice EMS under limited conditions in Idaho. The LRR is the incident documentation for reporting medical supervision and which non-Idaho licensed personnel are at the incident.

Licensed EMS personnel do not submit for LRR themselves. Licensed EMS personnel should report to the Medical Unit’s Medical Unit Leader (MEDL) to be added to the LRR form to be verified by the Bureau before providing EMS medical care in Idaho.

Instructions for MEDLs and Agency Administrators:

• Limited Request for Recognition & REPLICA Affiliation/Supervision Reporting

Other Wildland Fire Information and Resources

• National Association of State EMS Officials Wildland Fire Resolution 2007-02
• National Association of State EMS Officials Wildland Fire Resolution 2002-01
• Clinical Treatment Guidelines for Wildland Fire Medical Units 2012-7