Since the early years of EMS advanced life support, the Tidewater region has progressed beyond what the state classified as “minimum requirements” in advanced life support programs. In areas of knowledge content, skills and medications, the region has typically exceeded what many other places in Virginia, and nationwide, have required of its advanced life support providers. The ALS provider sanctioning process helps ensure high quality patient care through verification that ALS providers possess the knowledge and skills necessary to fully perform with all EMS agencies within the Tidewater region.

The ALS provider sanctioning process applies to EMT-Intermediate and EMT-Paramedic whether they are trained in the region or outside the region and then relocate to Tidewater. The process was established by the region’s operational medical directors (OMD) and includes a written test, practical skills verification and an oral interview.

For providers trained within the region, in a regional OMD committee approved “regional training program,” the written and practical skills verification are incorporated into the curricula of training program.  The oral interview is scheduled by the provider’s EMS agency after all educational and field internship requirements are met.

For those trained outside the region, or for those trained within the region in a program not approved by the OMD committee as a “regional training program”, the written exam and practical skills verification are scheduled by the provider’s EMS agency when all agency affiliation and field internship requirements are met and after the local OMD has agreed to move the provider through the sanctioning process. National Registry paramedics are exempt from the practical test portion of the sanctioning process.

The written test consists of 100 multiple choice and short answer questions (150 questions for paramedics). An 80% score is necessary to successfully pass the test. Retests are allowed. The practical skills verification occurs at the provider's EMS agency and is consistent with the National Registry practical exam for the level tested. The oral interview takes place with at least one OMD, one EMS peer and a staff member and uses a set of standardized and discretionary questions and scenarios that help verify the provider’s ability to function at their level of certification.

The advantage of the regional ALS provider sanctioning process is that once approved, the ALS provider is recognized by all EMS agencies within the region to function at their current level of state certification. Many providers affiliate with, or move among, multiple EMS agencies so separate agency-level verification of knowledge and skills is avoided.  Even if affiliated with only one EMS agency, the agency, its operational medical director and fellow providers can be assured that each provider has verified their knowledge and skill proficiency through a process of peer and medical director review. In addition, almost all EMS agencies in the region transport to multiple hospitals and the need for knowledge and skill consistency and standardization is essential. Overall, the process helps to ensure a consistent high level of quality patient care throughout the region.

For more information about the Tidewater EMS region ALS provider sanctioning process, please review the Regional ALS Sanctioning Policies and Procedures, speak with your agency’s training officer or medical director, or contact the regional EMS Education Coordinator at the Tidewater EMS Council.