Policy Administration Manual

Section 1 – Specific Policies

Payment Policies

Effective January 1, 2020:

Online application and recertification are the most efficient method of recertifying with the Registry. All payments must be made in full prior to release of certification documents or testing.

After submission of application fees to the Registry, refunds less an administrative fee are offered within 90 days of payment for the following situations: Completion of incorrect application or Candidate no longer wishes to seek Certification.

No refunds are provided for recertification or other applications.

No refunds of any kind will be issued after 90 days.

Payment may be made only with bank card, credit card, or via agency payment.

Complaints Policy

It is the policy of the Registry to respond to complaints in a constructive and timely manner. The Registry responds to all inquiries and concerns brought to our attention. Complaints can be submitted by email to [hidden email]

The Registry will confirm receipt by email and provide status updates. Most notifications and initial responses are sent within 10 days. A candidate or registrant who wishes to submit a complaint to the Registry must submit notice of complaint to the office of the Registry within thirty (30) days of the action(s) resulting in complaint. The notice of complaint must contain the individual’s personal statement and any supporting documentation and all contact information. The Registry will treat any person who invokes this complaint procedure with professionalism and due respect. The Registry will handle all complaints as quickly as possible and confidentially to the extent possible, considering the need to take appropriate corrective action. Most complaints are investigated and resolved within 30 days, and updates will be provided if delays are encountered. Documentation and information submitted as part of a complaint will be subject to the Registry Privacy Policy.

Designated Authorizing Agency

The Governmental Designated Authorizing Agency must show valid documentation they are following a regulatory construct that includes a standardized initial and renewal process for healthcare providers in order to be considered for this designation.

Government Director Equivalent is the assigned agent, responsible for overall system.

Authorizing Agency Training Coordinator/Credentialing Equivalent Agent is responsible for approval of education programs, has oversight and experience in approving education programs to validate they meet or exceed education standards and validates recertification education for certified providers, approves the system of agents that sign recertification applications

Medical Director Equivalent has medical oversight, assures providers are educated to the minimal competency levels of care outlined in the Scope of Practice Model, oversees medical quality assurance and reports disciplinary actions taken against providers to the certification agency.

Disciplinary Policy is the method in which incompetent acts or criminal convictions that result in removal of the ability to practice are reported to the certification agency.

Patient Safety Program utilizes patient care reports to document care.

All requests for recognition as Authorizing Agency will be provided to currently known government licensing agencies prior to Registry recognition

Privacy

The Registry has adopted the following Privacy Policy applicable to personal information that we may receive related to certification, licensure, and research.

We provide certification services as a service to licensing and regulatory agencies. These agencies issue licenses to practice healthcare within their respective jurisdiction. We collect and receive personal information during the certification process. We use this information in order to evaluate candidate's ability, to collect payment services, to provide information about individual's certification status to licensing agencies, and to conduct research.

Providing personal data is voluntary, but necessary if you wish to receive certification and/or licensure. We will handle and treat all personal information collected and received by us in connection with application, examination administration, and certification in the manner outlined in this Privacy Policy.

The personal data that we collect or receive in registering a candidate ("you") for certification services will include your: name, address, email address, phone/fax numbers, government identification number, credit/debit card information, date of birth, employment information, previous examination history, education information, and disciplinary actions (including, but not limited to, revocations and suspensions). For candidate verification and identification purposes, we may collect all or part of the information on a government-issued identification number.

When a certification examination is administered to you, we may collect and score your exam responses and then derive a score and generate a report about your professional certification examination results and will report that information to licensing agencies. Depending upon where your examination takes place and the level of exam that you are taking, we may collect your signature, photographic image, and fingerprint when you arrive at an examination center and you may be audio and/or video recorded while taking the exam.

We may statistically aggregate in non-person-specific form exam performance and other information collected during the certification. Such aggregated non-person-specific information may be used for quality control/improvement, operations management, security and marketing purposes and to enhance, develop or improve the certification processes, testing services, examinations and related products and services. By applying for certification through us, you give your consent for us to use this non-person-specific aggregated data as outlined above.

We may use your email and/or postal address to send you information about your certification status and other information that may be of interest to you professionally. We may also contact you regarding participation in research projects that are deemed to be of value to the professional community. You may opt out of receiving information from the Registry at any time by notifying us in writing or following the opt-out instructions in your electronic profile; but be forwarded this may prevent us from providing you certification in the future.

By applying for certification through us, you give your consent for your personal information (with the exception of your debit/credit card information) to be transmitted by the Global Emergency Medical Registry (GEMR) to licensing agencies. Licensing agencies require this personal data so that they may issue licenses to practice. For further information about how the licensing agencies may use your personal information, please contact the specific regulatory authority.

By applying for certification through the Registry, you give your consent for your personal information (with the exception of your debit/credit card information) to be transmitted by the Registry to your educational institution and/or educational program accreditation agency. Such information may be used for quality control/improvement, operations management, security and marketing purposes and to enhance, develop or improve the educational processes.

By applying for certification through the Registry, you give your consent for your personal information (with the exception of your debit/credit card information) to be transmitted by the Registry to any Healthcare Agency you request or maintain affiliation with. Such information may be used for quality control/improvement, operations management, security and marketing purposes and to enhance, develop or improve the educational processes.

In addition to the above circumstances, we may disclose personally identifiable information about you in the following situations: (a) in response to a subpoena, court order or legal process, to the extent permitted and required by law; (b) to protect your security or the security of other persons, consistent with applicable law; (c) for investigation of possible misconduct; or (d) legitimate research purposes.

By applying for Certification, you give your consent for your personal information to be transmitted in the situations outlined above.

Since Certification is part of a health care credentialing process, and the public has the right to verify the qualifications of the individuals providing care, the Registry considers your name, certification level, certification status, expiration date, certification number, and country of residence to be public information.

The Registry certification examinations are administered through Registry representatives and/or independent testing centers. These independent testing centers may provide unrelated services and may collect and use personal data for other purposes under different terms and policies. If you have any questions or concerns about an independent testing center’s collection or use of any of your personal information, please contact the independent testing center directly. If you have unaddressed concerns about an independent testing center relating to certification, please contact The Registry.

To access and correct the personal information that we have collected under this policy, please contact us in writing. To protect your privacy and security, we will take reasonable steps to verify your identity before granting access or making alterations.

Data collected or analyzed for research purposes will be handled according to the protocol approved by the Institutional Review Board of the principal investigator for that project. Depending on the project, this may differ from this Privacy Policy.

We use reasonable precautions to protect personal information from unauthorized use, access, disclosure, alteration or destruction. These precautions include appropriate physical, electronic and managerial procedures. We provide a secured transmission method for the electronic transmission of credit/debit card information.

If you have questions or concerns about this Privacy Policy or how the Registry has handled personal data, please contact us at [hidden email]

If we are unable to satisfactorily address your concerns, you should contact the Data Protection Authority, or other relevant organization, in your area.

This web site and our certification services are not directed to children or anyone under the age of sixteen (16). The Registry will not, through this web site or through its professional certification examination and administration process, knowingly collect, maintain or use any personally identifiable information about anyone under the age of sixteen (16).

This web site receives information that is automatically generated by a user’s Internet Service Provider (ISP). This information may include the IP address (a number automatically assigned to a computer by the ISP), the associated URLs, domain types, the browser type used to access our site, the country, state and telephone area code, the location of the ISP’s servers, the pages of our site that the user views during the visit, any search terms entered on this site, and the user’s web site address and email address. This information may be collected for system administration purposes, to gather broad demographic information and to monitor the level of activity on the site. The Registry does not link IP addresses to personally identifiable information; however, we reserve the right to link IP addresses and other information supplied by the ISP to personally identifiable information in order to protect the integrity of our system and for security purposes.

Cookies are small text files that a web site transfers to your computer’s browser. We use cookies to measure traffic patterns, personalize content and control security. The cookies we use supply non-personally identifiable information, but they may identify your computer, browser and Internet specifications.

The Internet is a global environment. By using this site and sending information to us electronically, you consent to trans-border and international transmission of any data that you may choose to supply us. Information transmissions to this site and emails sent to us may not be secure. Given the inherent operation and nature of the Internet, all Internet transmissions are done at the user’s own risk.

This site may contain links to other web sites on the Internet. The information practices of those web sites are not covered by this Privacy Policy, but by their own terms and policies, which you should read carefully. These other sites may send their cookies to users, collect data or solicit personal information. This Privacy Policy applies only to information collected or received in connection with certification and license testing. This Privacy Policy is not intended to apply to other web sites, or other types of information which may be subject to different privacy policies.

We reserve the right to change the terms of this Privacy Policy from time to time by posting an updated Privacy Policy. We encourage you to review this Privacy Policy periodically for any changes or updates.

If you have any questions or concerns about this Privacy Policy, please contact us at [hidden email]

Terms of Use

By using this Web site, (hereinafter, this "Web site"), you signify your understanding and agreement to these terms of use. If you do not agree to these terms of use, please do not use this Web site. The Registry may at any time make modifications, improvements and/or changes to these terms of use, the information, names, images, pictures, logos and icons described in this Web site, or the products and services referred to within, with or without notice. Your continued use of this Web site following the posting of any changes to these terms of use will mean you accept such changes.

This Web site contains copyrighted material, trademarks and other proprietary information (collectively, "Intellectual Property") including text, software, photos and graphics. You may not modify, publish, transmit, display, participate in the transfer or sale, create derivative works, or in any way commercially exploit the content of this Web Site without the express prior written permission of The Registry and/or the copyright owner or except as otherwise expressly permitted under copyright law. You acknowledge that you do not acquire any ownership rights by downloading any content from this Web Site.

This Web site may include publications with technical inaccuracies or typographical errors that may be corrected as they are discovered, at our sole discretion. Additionally, changes are periodically added to the information contained herein. These corrections and changes may be incorporated into this Web site at any time at our sole discretion.

This Web site may contain links to other Web sites, resources and advertisers. The Registry is not responsible for the availability of these external web sites nor does it endorse, nor is it responsible for the contents, advertising, products or other materials made available on or through such web sites. Under no circumstances shall The Registry be held responsible or liable, directly or indirectly, for any loss or damage caused or alleged to have been caused to a user in connection with such web sites. You hereby grant to The Registry a worldwide, royalty-free, perpetual, irrevocable, non-exclusive right and license to use, reproduce, modify, adapt, publish, translate, create derivative works from, distribute, perform and display any message you post on this Web site and/or any e-mail sent by you to The Registry (in whole or in part) and/or to incorporate either in other works in any form, media or technology now known or later developed.

The Registry prohibits the use of the Registry logo as a "hot" link to this Web site unless the establishment of such a link is approved in writing by The Registry. You may establish a hypertext link to this Web site from your Web site provided that:

  • the link must be a text-only link clearly marked "The Global Emergency Medical Registry"
  • the link must be to https://www.gemr.org/
  • the appearance, position and other aspects of the link may not be such as to damage or dilute the goodwill associated with The Registry's name and service/trademarks
  • the appearance, position and other aspects of the link may not create the false appearance that you or any other entity is associated with or sponsored by The Registry
  • the link, when activated by a user, must display this Web site full-screen and not within a "frame" on the linked Web site and
  • The Registry reserves the right to revoke its consent to the link at any time in its sole discretion.

THIS WEB SITE AND THE INFORMATION, NAMES, IMAGES, PICTURES, LOGOS AND ICONS REGARDING OR RELATING TO PRODUCTS AND SERVICES IS PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS WITHOUT ANY REPRESENTATION OR ENDORSEMENT MADE AND WITHOUT WARRANTY OF ANY KIND, WHETHER EXPRESSED OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT. ANY MATERIAL DOWNLOADED OR OTHERWISE OBTAINED THROUGH THE USE OF THIS WEB SITE IS DONE AT YOUR OWN RISK AND DISCRETION AND YOU WILL BE SOLELY RESPONSIBLE FOR ANY DAMAGE TO YOUR COMPUTER SYSTEM OR LOSS OF DATA THAT RESULTS FROM THE DOWNLOADING OR USE OF ANY SUCH MATERIAL. YOU EXPRESSLY UNDERSTAND AND AGREE THAT IN NO EVENT SHALL NREMT, ITS AFFILIATES, CONTRACTORS OR THEIR RESPECTIVE EMPLOYEES OR AGENTS, BE LIABLE FOR ANY DAMAGES WHATSOEVER, WHETHER IN AN ACTION OF CONTRACT, NEGLIGENCE (TORT) OR ANY OTHER CAUSE OF ACTION OR THEORY OF RECOVERY WHATSOEVER, ARISING OUT OF OR IN CONNECTION WITH THE USE OR PERFORMANCE OF THIS WEB SITE, INCLUDING WITHOUT LIMITATION, LIABILITY FOR ANY SPECIAL, INDIRECT OR CONSEQUENTIAL DAMAGES RESULTING FROM LOSS OF USE, DATA OR PROFITS OR OTHERWISE, EVEN IF THE REGISTRY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

Section 2 - Certification Eligibility, Discipline and Appeals

The Purpose of Certification and the Registry

The Registry Certification is utilized in the licensure process in legal jurisdictions approving of the Registry standards and practices. The Registry Certification also serves to identify individuals who have attained a standard internationally recognized level of education and competency.

The Registry conducts its activities in accordance with its mission to certify and register Healthcare Professionals throughout their careers by a valid and uniform process which assesses the knowledge and skills for competent practice and by maintaining a database of registrants. Registry policies are established to assure the public, licensing or authorizing agencies, employers and other healthcare providers that certified persons have demonstrated the required knowledge and skills to practice safely and effectively.

The Role of the Registry

In its role as the certification agency, the Registry:

  1. Establishes eligibility requirements for applicants for certification
  2. Develops examination requirements (cognitive and psychomotor)
  3. Establishes re-certification requirements
  4. Reviews applicants’ self-disclosed criminal convictions and actions taken against their healthcare related professional licenses
  5. Monitors certification status of registrants and takes appropriate action against the certification when apprised of adverse licensure actions and criminal convictions
  6. Provides to licensing or authorizing agencies obtained adverse licensure action and criminal conviction information regarding registered EMS professionals
  7. Provides a structure for educational institutions accreditation.

The Registry does not:

  1. Establish or approve education programs
  2. Assess job performance
  3. Assess fitness for all aspects of job performance (physical, mental, criminal background clearance)
  4. Investigate complaints regarding medical practice
  5. Establish local standards of care
  6. Establish job-related standards of professional behavior

The Differences Between Certification and Licensure

Certification

Government entities in many countries, including the United States, defined “certification” as the process by which a non-governmental organization grants recognition to an individual who has met predetermined qualifications specified by that organization (U.S. Department of Health, Education, and Welfare, Report on Licensure and Related Health Personnel Credentialing (Washington, D.C.: June, 1971 p. 7). Similarly, the United States National Commission for Certifying Agencies defines certification as “a process, often voluntary, by which individuals who have demonstrated the level of knowledge and skill required in the profession, occupation, role, or skill are identified to the public and other stakeholders.”

Accordingly, there are three hallmarks of certification (as functionally defined).

Certification is:

  1. voluntary process;
  2. by a private organization;
  3. for the purpose of providing the public information on those individuals who have successfully completed the certification process (usually entailing successful completion of educational and testing requirements) and demonstrated their ability to perform their profession competently.

Nearly every profession certifies its members in some way, but a prime example is medicine is the use of private certifying boards to certify physician specialists. Although certification may assist a physician in obtaining hospital privileges, or participating as a preferred provider within a health insurer’s network, it does not affect his or her legal authority to practice medicine. For instance, a surgeon can practice medicine in any jurisdiction in which he or she is licensed regardless of whether or not he or she is certified by the American Board of Surgery.

Licensure

Licensure is the government’s grant of legal authority, pursuant to the government’s police powers, to practice a profession within a designated scope of practice. Under the licensure system, governments define, by statute, the tasks and function (or scope of practice) of a profession and provide that these tasks may be legally performed only by those who are licensed. As such, licensure prohibits anyone from practicing the profession who is not licensed, regardless of whether or not the individual has been certified by a private organization.

Confusion between the terms “certification” and “licensure” arises because many governments call their licensure processes “certification,” particularly when they incorporate the standards and requirements of private certifying bodies in their licensing laws or regulations and require that an individual be certified in order to have government authorization to practice. The use of a certification issued by the Registry by some governments as a basis for granting individuals the right to practice and calling the authorization granted “certification” is an example of this practice. Nevertheless, certification by the Registry, by itself, does not give an individual the right to practice.

Regardless of what descriptive title is used by a government agency, if an occupation has a statutorily or regulatorily defined scope of practice and only individuals authorized by the government can perform those functions and activities, the authorized individuals are licensed. It does not matter if the authorization is called something other than a license; the authorization has the legal effect of a license.

The Global Emergency Medical Registry (GEMR) is a private, third party, certifying organization. The various government agencies serve as the government licensing agencies. Certification by the Registry is a distinct process from licensure; and it serves the important independent purpose of identifying for the public, government licensure agencies and employers, those individuals who have successfully completed the Registry’s educational requirements and demonstrated their skills and abilities in the mandated examinations. Furthermore, the Registry’s tracking of adverse licensure actions and criminal convictions provides an important source of information which protects the public and aids in the mobility of healthcare providers.

Appeals Policy

The intent of this policy is to define the appeals process for candidates in cases of Adverse Decisions. The policy applies to all Adverse Decisions, excluding decisions with respect to the timeliness of applications, scoring, or reporting of the examinations.

Definitions:

Adverse Decision An unfavorable ruling regarding an individual's application for certification or recertification, request for an accommodation in the administration of an examination, cancellation or revocation of examination results, or any disciplinary action, including, but not limited to, revocation or suspension of certification.

Policy: Notice of Adverse Decision

When the Registry makes an Adverse Decision, the Audit Committee or designee shall send the individual a statement that includes:

  1. The action taken.
  2. The reason(s) for the action or ineligibility.
  3. If applicable, a statement explaining the alleged violation of any of the Registry’s rules, policies, or standards.
  4. The time period in which the individual may appeal.
  5. Any additional information deemed appropriate.

Appeal Process

An applicant or registrant who is subject to an Adverse Decision may appeal the decision by mailing a Notice of Appeal to the Registry within forty-five (45) days of the date that such decision was mailed (based on postmark electronic equivalent). The Notice of Appeal must contain the individual’s statement of the basis of the appeal, as well as any documents in support of the appeal.

The procedure for the Appeal is as follows:

  1. Upon the Registry’s receipt of a Notice of Appeal, the Audit Committee or designee shall consider any additional information submitted by the individual in support of the appeal and conduct any further investigation as appropriate.
  2. If the Audit Committee or designee grants the appeal, the individual shall be notified in writing.
  3. If the Audit Committee or designee denies the appeal, the affected individual shall be notified in writing and informed that:
    1. they have forty-five (45) days from the date the denial was mailed (based on postmark electronic equivalent) to appeal the denial to the Appeals Panel and
    2. that they must provide any supporting statement or documentation for the appeal.
  4. Upon receipt of a notice of appeal, the Appeals Panel (composed of an oversight board member, auditor, and a medical director) shall consider any additional information submitted by the individual in support of his or her appeal and make such further investigation it deems appropriate.
  5. If the Appeals Panel grants the appeal, the Audit Committee or designee shall notify the
  6. individual in writing.
  7. If the Appeals Panel denies the appeal, the Audit Committee or designee shall notify the individual (by email, return receipt requested), and inform the individual that:
    1. The individual has forty-five (45) days from the date the decision was mailed (based on postmark electronic equivalent) to appeal the decision and provide any supporting statement or documentation for the appeal.
    2. The request for appeal must have postmark electronic equivalent within 45 days of the postmark of the decision.
  8. If an appeal is made, a hearing will be held before a Hearing Panel.
    1. The individual may appear at the hearing in person (at his or her own expense) and produce evidence on their behalf, including submission of written supporting statement and/or documents. Remote participation by electronic means is not allowed.
    2. The individual may be represented by legal counsel at his or her own expense.

Hearing Process

If there is an appeal for a hearing, the Chairman of the Board of Directors shall designate a Hearing Panel consisting of three (3) members of the Board of Directors who are not on the Appeals Panel. The Chairman of the Board of Directors shall designate one of the members of the Hearing Panel to chair the hearing.

  1. The Hearing Panel shall convene at a site designated by the Registry.
  2. The Audit Committee shall send the individual by email, return receipt requested, a Notice of Hearing.
  3. The Notice of Hearing shall include a statement of the time and place of the hearing.
  4. The individual making the appeal must confirm in writing his or her attendance at the hearing no later than seven (7) days before the date and time of the scheduled hearing.
  5. The Hearing Panel shall determine all matters relating to the hearing by majority vote.
  6. A written record shall be made of the proceedings and shall be available to the individual at a cost of $250 usd following the hearing.

Evidence

  1. Formal rules of evidence shall not apply.
  2. All information related to the allegations shall be admissible at the hearing, notwithstanding the admissibility of the evidence in a court of law.
  3. The purpose of the hearing is to assemble as much information as practical regarding all material aspects of the situation, and the Hearing Panel shall be entitled to consider any information of the type normally relied upon by reasonable individuals in the conduct of important personal matters.
  4. Disputed questions shall be determined by majority vote of the Hearing Panel.

Decision

The decision of the Hearing Panel shall be made by a majority vote and rendered in writing following the hearing. The decision shall contain the basis for the determination to uphold, modify, or overrule the decision of the Appeals Panel. It shall be transmitted to the individual by certified mail, return receipt requested. The decision of the Hearing Panel shall be final and binding.

Release of Information

The appeals policy authorizes the Registry and its agents to communicate all information relating to Registry application, registration and review, including outcome of disciplinary proceedings, to appropriate government authorities.

Certification Status Pending Appeal

Excepting cases of summary suspensions as provided in the Disciplinary Policy, a registrant’s designation as certified by the Registry shall not be changed pending the opportunity for the registrant to appeal to the Appeals Panel a decision of the Audit Committee to suspend or revoke his or her certification. Upon the denial by the Appeals Panel of an appeal of the Audit Committee’s decision to suspend or revoke a registrant’s certification, the registrant’s certification shall be designated in the Registry’s database as suspended. A registrant shall not be removed from Registry’s database as a registrant until the exhaustion of all appeals or the expiration of the time in which to appeal a decision denying recertification or revoking certification.

Rationale

A fair and expeditious appeals process is an essential part of due process requirements to protect registrants from arbitrary decisions.

Disciplinary Actions Policy

This policy specifies the situations which may lead to action against a certification. This policy specifies potential causes of disciplinary action but does not cover the procedures used in disciplinary action.

Policy

The Registry may, in its sole discretion, deny an individual’s eligibility for initial certification or

recertification, deny, suspend or revoke an individual's certification or take any other appropriate

disciplinary action with respect to an individual’s application, certification and/or recertification or deny authorization to use the Registry website for any and all purposes, including submitting applicant training information in the case of:

  1. Ineligibility for Registry certification.

  2. Failure to comply with any policy or rule of the Registry, including, but not limited to, Registry website Terms of Use Policy.

  3. Irregular behavior in connection with any Registry examination.

  4. The intentional and material misrepresentation, withholding of any material information or the failure to provide Registry updated information on any application for certification or recertification or in any other representation or communication to the Registry.

  5. The intentional misrepresentation by a trainer of any applicant’s satisfaction of the training requirements for certification.

  6. Misrepresentation of the individual's status as a registrant of the Registry.

  7. The conviction of, plea of guilty or plea of nolo contendre to, a felony or any criminal offense which is directly related to public health or the provision of emergency medical service in accordance with the Registry Criminal Conviction Policy.

  8. Limitation, suspension, revocation or other disciplinary action by a licensing or authorizing agency relating to practice, or the ability to practice safely and effectively, as a healthcare professional or the voluntary surrender of a licensee in connection with or in lieu of any such disciplinary action. The Registry reserves the right summarily to suspend an individual’s certification, prior to the exhaustion of any right of appeal, upon the revocation or summary or emergency suspension of the individual’s license by a licensing or authorizing agency based on the agency’s finding that the individual poses an imminent threat to the public and/or cannot practice safely and effectively.

  9. Copying, reproducing, disclosing, disseminating or removing of examination-related materials from the test site, attempting to do same or solicit the same.

Rationale

Healthcare professionals, under the authority of their licensure, have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to a patient’s personal property. These patients may be unable to defend or protect themselves, voice objections to particular actions, or provide accurate accounts of events at a later time. healthcare professionals, therefore, are placed in a position of the highest public trust. The public, in need of healthcare services, relies on licensure and certification to assure that those healthcare professionals who respond to their calls for aid qualify for this extraordinary trust.

Reconsideration of Eligibility

The intent of this policy is to specify the circumstances under which reconsideration of eligibility or reinstatement of certification is allowed. This policy specifies circumstances in which reconsideration may be made but does not cover the procedures used in disciplinary action.

Policy

An individual’s certification may be reconsidered for eligibility after revocation upon submission

of a new application for certification only on the following basis:

  1. The individual satisfies all eligibility requirements for certification in effect as of the request for reinstatement.
  2. In the event of a felony conviction or conviction for a crime directly related to public health or the provision of emergency medical service, no earlier than one (1) year from the exhaustion of appeals, release from confinement or reinstatement of license, whichever is later.
  3. In any other event, no earlier than one (1) year from the final decision of ineligibility for or revocation of certification.
  4. In addition to other information required for application, an individual seeking reinstatement must fully set forth the circumstances of the decision denying eligibility or revoking certification as well as all facts and circumstances relevant to the application occurring after the decision.
  5. Where eligibility is denied because of felony conviction, the individual bears the burden of demonstrating by clear and convincing evidence that the individual has been rehabilitated and does not pose a danger to others.

Rationale

Healthcare professionals, under the authority of their licensure, have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to a patient’s personal property. These patients may be unable to defend or protect themselves, voice objections to particular actions, or provide accurate accounts of events at a later time. Healthcare professionals, therefore, are placed in a position of the highest public trust. The public, in need of medical services, relies on licensure and certification to assure that those healthcare professionals who respond to their calls for aid qualify for this extraordinary trust.

Reporting of Possible Misconduct

The intent of this policy is to clearly articulate the importance of reporting misconduct information to the Registry and to outline the process for reporting. This policy encourages reporting of possible misconduct. It does not address complaints or reports of disciplinary action by licensing agencies.

Policy

Persons with information regarding a possible misconduct should submit this specific information in writing addressed to the Audit Committee. This information should identify the person(s) alleged to be involved and the facts concerning the alleged conduct in as much detail and specificity as possible, supplying all available supporting documentation. The statement should identify by name, address, and telephone number the person making the information known to the Registry and others who may have knowledge of the facts and circumstances concerning the alleged conduct. Supplemental information may be requested. The Registry may forward reported information to the designated authorized agency. The Registry will not accept an anonymous letter or take action based upon an anonymous claim.

Rationale

Healthcare professionals, under the authority of their licensure, have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to a patient’s personal property. These patients may be unable to defend or protect themselves, voice objections to particular actions, or provide accurate accounts of events at a later time. Healthcare professionals, therefore, are placed in a position of the highest public trust. The public, in need of medical services, relies on licensure and certification to assure that those healthcare professionals who respond to their calls for aid qualify for this extraordinary trust. Reporting of possible misconduct helps to ensure the validity of certification processes and ultimately the protection of the public.

Terms of Certification

This policy establishes requirements for eligibility for certification and recertification. In its role as the certifying agency, the Registry:

  1. Establishes eligibility requirements for applicants for certification

  2. Develops examination requirements (cognitive and psychomotor)

  3. Establishes re-certification requirements

  4. Reviews applicants’ self-disclosed criminal convictions and actions taken against their healthcare related professional licenses

  5. Monitors certification status of registrants and takes appropriate action against the certification when apprised of adverse licensure actions and criminal convictions

  6. Provides to licensing or authorizing agencies obtained adverse licensure action and criminal conviction information regarding registered professionals

  7. Provides a structure for educational providers to obtain accreditation

The Registry does not:

  1. Establish or approve education programs for certification or recertification

  2. Assess job performance

  3. Assess fitness for all aspects of job performance (physical, mental, criminal background clearance)

  4. Investigate complaints regarding medical practice

  5. Establish local standards of care

  6. Establish job-related standards of professional behavior

  7. Issue a license or authorization to practice

  8. Warrant job performance of healthcare professionals

Policy: Eligibility for Certification and Recertification

  1. To be eligible to apply for certification or recertification, an individual must at all times be eligible for or hold a full and unrestricted license to practice as a healthcare professional under the laws of the licensing or authorizing agency of the jurisdiction(s) in which he or she practices. The Registry may deny an individual eligibility for certification or recertification because of the limitation, suspension or revocation of any of the individual’s licenses to practice as a healthcare professional by any licensing or authorizing agency or the surrender of such a license while under investigation and/or in lieu of disciplinary action against his or her license.
    1. An individual is not rendered ineligible for certification if the individual is denied licensure solely by reason of seeking licensure in a jurisdiction which does not recognize Registry certification as a basis for licensure as a healthcare professional.
    2. An individual is not rendered ineligible because of entry into and successful participation in a non-disciplinary rehabilitation or diversionary program for chemical dependency authorized by the applicable licensing or authorizing agency.
    3. An individual may not be rendered ineligible solely on the basis of a limitation, suspension, termination or surrender of a license in any jurisdiction where the applicant does not practice and/or where the action of such jurisdiction is based upon and derivative of a prior disciplinary action taken by another jurisdiction where the applicant has a full and unrestricted license in the jurisdiction in which he or she practices, and provided further that the jurisdiction, in granting such licensure, was aware of the applicant’s outstanding disciplinary actions in other jurisdiction(s).
  2. An individual must comply with all initial certification and recertification requirements, deadlines, rules and standards of the Registry as set out in the Entry Requirements and Application Process provisions for the applicable level of EMS professional posted on the Registry website and described in the Requirement Requirements. The individual bears the burden of demonstrating and maintaining compliance at all times. The Registry considers the individual to be solely responsible for his or her certification.
  3. An individual must truthfully complete and submit an application in the form provided by the Registry and shall provide all additional information as requested.
  4. An individual must submit a complete recertification application on or before the expiration date (post-marked) for consideration of recertification.
  5. An individual convicted of a felony or any other crime directly related to public health or the provision of medical service will be reviewed for eligibility for certification and recertification under policies outlined in the Registry Criminal Conviction Policy.
  6. The Registry reserves the right to withhold or revoke certification or recertification in the event an applicant fails to make payment in full of all applicable fees. An applicant may not take a Registry examination if the application fee has been stopped, cancelled or otherwise revoked, either by the applicant or a financial institution. An applicant will not be issued an authorization to take a Registry examination until payment of the application fee in full has been made for all previous Registry examinations for which such fee is due. Registry also reserves the right to hold, cancel or revoke an applicant’s results on a Registry examination for which payment in full has not been made.
  7. The Registry also may require an applicant to retake a certification examination if presented with sufficient evidence that the security or integrity of the examination has been compromised, notwithstanding the absence of any evidence of an applicant’s personal involvement in the security compromise.

Review of Applications

  1. The Registry requires submission of accurate and valid information demonstrating an applicant's fulfillment of Registry requirements for certification and recertification. The Registry has developed a secure web site to facilitate communication between a variety of individuals who are responsible for providing the necessary documentation to be submitted by applicants and healthcare professionals.
  2. Individuals using the Registry web site are subject to and must comply with the web site Terms of Use Policy.

Terms of Certification

In applying for certification or recertification, and as a condition for the maintenance of certification, an applicant or registrant agrees that:

  1. The Registry examinations, certificates, cards, logos, emblems, the name "Global Emergency Medical Registry", “GEMR”, and abbreviations relating thereto are all exclusive property of the Registry and are protected by trademarks and copyrights. They may not be used for any purpose, other than accurately identifying an individual as a registrant or referencing the Registry and its examinations, without express written consent.
  2. The individual will immediately relinquish and refrain from using any Registry certificate, card, logo, emblem, and the Registry name and related abbreviations in case of expiration, suspension, limitation, revocation or voluntary surrender of the individual's certification or as otherwise requested by the Registry.
  3. If the individual misappropriates any Registry property or refuses immediately to relinquish, refrain from using and correct at their expense any misuse or misleading use of any of the above identified Registry intellectual property when requested, the Registry shall be entitled to obtain injunctive relief, damages, costs and attorney's fees incurred in obtaining any such or other relief.
  4. The individual will notify the Registry within ten (10) days of the occurrence of any and all of the following: any change in address, e-mail address, telephone number, location of employment and licensure and any other facts bearing on eligibility or certification, including, but not limited to, the initiation of any disciplinary action by any government which has resulted in the suspension, revocation or restriction placed on the individual’s license, or right to practice or voluntary surrender of license while under investigation (or in lieu of disciplinary action) and any felony conviction.
  5. The individual authorizes the Registry and its agents to communicate all information relating to application, certification and review thereof, including the misrepresentation of material information on an application or of certification status and/or the outcome of disciplinary proceedings, to government authorities.

Rationale

The Registry Certification is utilized in the licensure process in countries and jurisdictions accepting the Registry Standards. The Registry conducts its activities in accordance with its mission to certify and register Healthcare Professionals throughout their careers by a valid and uniform process which assesses the knowledge and skills for competent practice and by maintaining a database of registrants. Registry policies are established to assure the public, licensing or authorizing agencies, employers and other healthcare providers that certified professionals have demonstrated the required knowledge and skills to practice safely and effectively.

Code of Conduct

The Code of Conduct specifies that, as a condition for certification and recertification by the Registry, you will:

  1. Comply with all policies and rules of the Registry, including, but not limited to, the Registry’s website Terms of Use Policy.
  2. Provide full, truthful and updated information on any application for certification or recertification or in any other representation or communication to the Registry.
  3. Provide accurate documentation of the training requirements for certification
  4. Accurately represent to the public your certification status with the Registry.
  5. Adhere to the highest standards of professionalism and ethics as a certified professional.
  6. At all times be eligible for or hold a full and unrestricted license to practice as a professional under the laws of the licensing or authorizing agency of the jurisdiction(s) in which you practice.
  7. Protect the security and integrity of the Registry certification and examination process and you will not copy, reproduce, disclose, disseminate or remove any examination related materials from the test site or attempt to do so.

Criminal Conviction

The intent of this policy is to establish eligibility requirements for certification related to criminal convictions. This applies to eligibility requirements for initial and continuing certification by the Registry.

Definition: Conviction is an applicant’s plea of nolo contendre, a guilty plea, or plea agreement, as well as a conviction after trial.

Policy

  1. The Registry may deny an applicant eligibility to sit for a certification examination, deny certification, suspend or revoke an individual’s certification, or take other appropriate action with respect to the applicant’s certification or recertification based on an applicant’s felony criminal convictions and all other criminal convictions (whether felony or misdemeanor) relating to crimes involving physical assault, use of a dangerous weapon, sexual abuse or assault, abuse of children, the elderly or infirm and crimes against property, including robbery, burglary and felony theft.
  2. All applicants for certification or recertification must disclose any criminal conviction as required on an application.
  3. This policy applies to an applicant’s plea of nolo contendre, a guilty plea, or plea agreement, as well as a conviction after trial.
  4. Applicants are not required to disclose any criminal conviction that has been expunged from the public record or a deferred adjudication that did not result in the entry of a conviction judgment.
  5. Failure to disclose a covered criminal conviction or the withholding of any material information regarding such conviction shall be an independent basis for denial of eligibility to sit for a certification examination, revocation of a certification or denial of an application for recertification.
  6. Registry shall advise licensing authorities of the availability of information related to disclosure of convictions.
  7. Registry may deny an applicant eligibility to sit for the certification examination, or take other appropriate action, if the applicable licensing authority, in any area in which the applicant holds or seeks a license as a professional, denies the applicant’s eligibility to obtain, or suspends or revokes, authorization to practice, based on a criminal conviction.
  8. Notwithstanding the absence of any adverse action taken by an applicable licensing authority on the basis of an applicant’s criminal conviction, Registry may deny an applicant eligibility to sit for a certification examination or recertification if, in the Registry’s sole discretion, based on the following considerations, the Registry determines that certification may jeopardize public health and safety:
    1. The seriousness of the crime.
    2. Whether the crime relates to performance of the duties of a professional.
    3. How much time has elapsed since the crime was committed.
    4. Whether the crime involved violence to, or abuse of, another person.
    5. Whether the crime involved a minor or a person of diminished capacity.
    6. Whether the applicant's actions and conduct since the crime occurred are consistent with the holding of a position of public trust.
    7. Whether the applicant is a repeat offender.
    8. Whether the applicant has complied with all court orders and probationary requirements associated with the conviction.

Any applicant or registrant subject to an adverse decision by the Registry under this Policy may appeal that decision as outlined in the Registry Certification Eligibility, Discipline and Appeals

Rationale

The Registry has adopted a Criminal Conviction Policy to safeguard the public from individuals who, in practice as a professional, might pose a danger to the public. Healthcare professionals, under the authority of their government authorization to practice, have unsupervised, intimate, physical and emotional contact with patients at a time of maximum physical and emotional vulnerability, as well as unsupervised access to a patient’s personal property. These patients may be unable to defend or protect themselves, voice objections to particular actions, or provide accurate accounts of events at a later time. Healthcare professionals, therefore, are placed in a position of the highest public trust. The public in need of medical services relies on government authorization to practice and certification to assure that those professionals who respond to their calls for aid qualify for this extraordinary trust. For these reasons, the Registry has adopted this Criminal Conviction Policy to ensure that individuals, who have been convicted of certain crimes, are identified and appropriately evaluated as to whether they would pose a risk to public safety as a provider.

Lapsed Certification

This policy is to clarify the actions a registrant may take in the event of a lapsed certification.

Lapsed 0-24 Months

If the registrant did not meet all recertification requirements by the expiration date, their certification is considered to be lapsed. If the certification lapsed less than two years, or you are currently government licensed as a healthcare provider at the level of certification, you can regain certification by completing the cognitive and psychomotor examinations.

To obtain an authorization to test, lapsed registrants must demonstrate proof of education requirements. The following methods are acceptable:

  1. Complete an approved Refresher at the level of certification being attempted to regain.

Lapsed More Than 2 Years

Entry and/or re-entry into the Registry may be granted to a previously licensed or certified healthcare provider, assuming you:

  1. Officially document completion of a Training Program after January 1, 2009
  2. Show satisfactory evidence to the Registry of prior licensure at the Paramedic level.
  3. Have current AHA provider or instructor credential equivalent to the certification level sought:
    1. EMR and EMT = AHA BLS
    2. AEMT = AHA ACLS
    3. Paramedic = AHA ACLS and PALS
    4. APP = AHA ACLS EP and PALS
  4. Completed ATLS, PHTLS, ITLS, ATACC, or equivalent course as a provider or instructor within the past two (2) years.
  5. Have completed an approved refresher at the level of certification sought within the past two years.
  6. Successfully complete the Registry cognitive and psychomotor examinations.

Late Renewal

If the renewal application was not submitted prior to the deadline, the registrant may pay a $50 usd late application fee and submit the application within 30 days. However, all continuing education requirement must have been satisfied prior to their expiration deadline.

Inactive Status

When renewing Registry certification, registrants have the option of declaring their status as either "Active" or "In Active". Active status means the registrant is 'actively' working and providing patient care. To renew with an 'active status', registrants are required to be affiliated with a medical director.

An inactive status is designated for registrants who are currently not providing patient care at their certification level. For example, inactive status may be helpful for registrants who:

  1. Are not actively engaged in healthcare/patient care activity;
  2. Are not actively treating patients at their certification level but are involved solely as educators, administrators or regulators;
  3. Are unable to actively provide patient care for reasons such as, moving, illness, pursuit of education, family responsibilities, etc.

Registrants who wish to declare inactive status must continue to meet the Registry continuing education recertification requirements in subsequent cycles. Inactive status is not for those unable to obtain and meet the educational requirements or those who have had limitations or revocation of a health care license. Inactive registrants must complete all refresher, continuing education and skills requirements.

Returning to Active Status

Registrants may request return to active status at any time once they gain active affiliation with an EMS service. A request to return to active status must be completed through their registrant profile.

Audit Policy

The Registry reserves the right to investigate recertification materials at any time from the certified persons. In accordance with our accreditation requirements, the Registry randomly audits a percentage of all applications submitted. Audits are performed year-round. Registrants must retain verification of attendance of all education they acquire for at least three years. Failure to submit verification or documentation when audited will result in denial of eligibility to recertify or may result in a certification being revoked.

Transition Education Policy

The Registry Oversight Board is committed to implementation of the International Liaison Committee on Resuscitation (ILCOR) science guideline implementation. In addition, the Registry is committed to improving its scope of practice for levels certified on an ongoing basis.

Therefore, in order for healthcare professionals to maintain the pace of change, all certified professionals must meet the minimum requirements of knowledge and skills outlined in the Registry CME requirements. Due to the scope and impact of some ILCOR science changes, the Registry may, from time to time, mandate inclusion of specific transitional curriculum in approved refreshers in all courses for a specific period of time, on a global basis.

Education Program Accreditation

Education programs wishing accreditation through the Registry should contact the registry for specific procedures for accreditation and plan for adherence to the minimum curriculum objectives and practice scope for students in their educational processes.

Programs already accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), Canadian Medical Association, Health and Care Professions Council, or other government authorized process may utilize that accreditation as their basis for accreditation with the Registry, assuming accommodation can be met by the program to meet the adherence to current ILCOR guidelines and Registry objectives and scopes.

Section 3 – Cognitive Examination Processes

Late Arrival/No Show

Plan to arrive at the testing site at least 30 minutes before your exam. If you are more than 30 minutes late you may have to re-register and pay another exam fee. If you are not able to take your exam on the scheduled date or time, you must notify The Registry (online submission) at least 24 hours prior to your scheduled time. A "no show" will result in forfeiture of your exam payment.

If there are extenuating circumstances for missing your scheduled exam, you may elect to appeal the "No Show" designation. All appeals are considered, but those that fall outside the following list are typically not approved:

  • Medical emergencies for candidate or candidate's immediate family
  • Death of immediate family member
  • Called into work – EMERGENCY PERSONNEL ONLY
  • Jurisdictional or regional-wide weather/natural disaster emergency

Submit a signed personal statement to The Registry that contains:

  • First and last name
  • Mailing address
  • Telephone number
  • Registry candidate number
  • Date of scheduled exam
  • Location of exam
  • Explanation for missing scheduled exam

You must also submit supporting documentation that includes:

  • Medical provider's note with date of incident and/or medical records with date of incident
  • Obituary or other documentation of death
  • Work orders or documentation from supervisor on letterhead with supervisor's signature
  • Weather or regional report at time of scheduled exam.
  • Send your personal statement and supporting documentation to [hidden email]
  • You will be contacted by mail within 30 days with a decision

Retest Process

After successful completion of an approved education program, candidates are initially given three attempts to pass the cognitive examination (provided all other requirements for Certification are met). If a candidate is unsuccessful on an exam attempt, they may apply to retest 15 days after the last examination. After three unsuccessful examination attempts candidates must submit official documentation verifying the completion of a remedial training program.

Remedial training is designed to provide candidates additional education and to improve their performance on subsequent examination attempts. It is suggested that this education be over areas within the test plan where the candidate has been identified on their result letters to be near or below the passing standard. After a remedial training program is complete, the candidate is given additional attempts to pass the examination (provided all other requirements for Certification are met). Candidates who fail to pass the cognitive exam after a total of six attempts are required to complete an entire approved initial education program.

Remedial Education Requirements:

  • EMR: Not applicable. EMRs must repeat a full education program
  • EMT: 24 hour approved refresher completion.
  • AEMT: 36 hour approved refresher completion.
  • Paramedic: 60 hour approved refresher completion.
  • APP: 100 hour approved refresher completion.
  • POCUS: 12 hour approved refresher completion.

Authorizations to Test (ATT)

ATT Certification will be valid for up to 90 days from the date of issuance, provided all other requirements for Certification are met. Candidates who do not complete their cognitive examination prior to the expiration date will be required to complete a new application, including payment of the application fee. No refunds will be issued for expired Authorizations to Test.

Exam Review Process

Any candidate who questions the accuracy of the cognitive examination results may request that his/her examination be reviewed by the Registry. Requests must be made in writing within thirty (30) days of the notification of examination result and must be accompanied by a check or money order for the appropriate fee to cover the processing and handling of the review. The review fee is refunded in the unlikely event that an error is discovered. The review will take place within thirty (30) days of the payment being processed. You will receive a report after the requested review is completed.

The Registry offers candidates two types of review: An Exam Scoring Confirmation Report and an Item-by-Item Review.

Exam Scoring Confirmation Report:

The Exam Scoring Confirmation Report includes the following information about your exam:

  • Total time used for the exam
  • Minimum and maximum time on scored items
  • Total number of items delivered
  • Number of items correct
  • Number of items incorrect
  • Number of un-scored items (Includes Pilot Items, Non-Disclosure Statement, etc.)
  • A summary of the percent correct and incorrect by the time spent on items
  • Verification of the performance (above passing, near passing, and below passing)

The Exam Scoring Confirmation Report Processing and handling fee: $75.00 usd

Item-by-Item Review

Candidates may request a detailed review of each examination item delivered. An item-by-item review is recommended if a candidate believes that they received outdated content or duplicate items. Item-by-Item reviews include an analysis of every exam item by a qualified staff member of the Registry who is knowledgeable in the delivery of out-of-hospital care. When requesting an item-by-item review, you must specifically state the reason for the review. The review will include only those items relevant to your specific allegation. You will also receive an Exam Scoring Confirmation Report included in this review.

Item by Item Review Processing and handling fee: $500.00 usd

Acceptable Identification for Examination

The first and last names printed on your identification must match exactly the first and last names on your Authorization to Test (ATT).

When you arrive at the test site, you will be required to present two forms of valid, unexpired identification. One must be a government-issued ID that includes a signature and permanently affixed photo (visible signature not required for military IDs).

The second ID must include your name and signature.

If the ID does not meet these requirements, you will be turned away and required to reregister and pay another examination fee.

Acceptable Government issued identification includes:

  • Government Issued Driver's License
    • Temporary/paper IDs will not be accepted
  • Government Issued Identification Card
  • Military Identification Card
  • Passport

Exam Confidentiality

All Registry cognitive examination materials are copyrighted.

Candidates are not permitted to disclose or discuss with anyone, including instructors, information about the exam questions or answers seen in your examination. (This includes posting or discussing questions on the Internet and social media websites).

Reconstructing exam items using your memory of your exam or the memory of others is prohibited.

Candidates are not permitted to seek help from anyone in answering exam questions.

Candidates are not permitted to remove examination materials or notes about the examination from the testing center.

If you witness any of the above behavior, or any irregular behavior that may be in violation of the Registry Candidate Policies, report it to the Registry immediately by calling (800) .

Grounds for Dismissal or Cancellation of Results

A candidate who violates Registry policies, or the test site regulations or rules, or engages in irregular behavior, misconduct and/or does not follow the test administrator's warning to discontinue inappropriate behavior may be dismissed from the test center.

Exam fees for candidates dismissed from a test center will not be refunded. Additionally, your exam results may be withheld or canceled. The Registry may take other disciplinary action such as denial of Certification and/or disqualification from future Registry exams. Behaviors that are considered to constitute irregular behavior or misconduct include but are not limited to:

  • Giving or receiving assistance of any kind during an exam.
  • Using, accessing, or attempting to access any prohibited items. Prohibited items are any devices or materials that will be helpful in taking the Registry exam. Examples of aids that are prohibited include electronic devices (e.g. cell/mobile/smart phones, tablets, smart watches, etc.), hand-held calculators, conversion tables, dictionaries, etc.
  • Attempting to take the examination for someone else.
  • Accessing or attempting to access such study materials at any time after the start of the examination administration
  • Failing to follow testing regulations or the instructions of the test administrator.
  • Creating a disturbance of any kind.
  • Tampering with the operation of the computer or attempting to use it for any function other than taking the examination.

Section 4 – Psychomotor Examination Processes

All psychomotor exams are administered by Registry staff or Government Approved Personnel. The Registry Exam Coordinator Manuals and User Guides are provided as a reference to candidates and educational institutions.

Acceptable Identification for Examination

The first and last names printed on your identification must match exactly the first and last names on your Authorization to Test (ATT).

When you arrive at the test site, you will be required to present two forms of valid, unexpired identification. One must be a government-issued ID that includes a signature and permanently affixed photo (visible signature not required for military IDs).

The second ID must include your name and signature.

If the ID does not meet these requirements, you will be turned away and required to reregister and pay another examination fee.

Acceptable Government issued identification includes:

  • Government Issued Driver's License
    • Temporary/paper IDs will not be accepted
  • Government Issued Identification Card
  • Military Identification Card
  • Passport

Exam Confidentiality

All Registry cognitive examination materials are copyrighted.

Candidates are not permitted to disclose or discuss with anyone, including instructors, information about the exam questions or answers seen in your examination. (This includes posting or discussing questions on the Internet and social media websites).

Reconstructing exam items using your memory of your exam or the memory of others is prohibited.

Candidates are not permitted to seek help from anyone in answering exam questions.

Candidates are not permitted to remove examination materials or notes about the examination from the testing center.

If you witness any of the above behavior, or any irregular behavior that may be in violation of the Registry Candidate Policies, report it to the Registry immediately by calling ____________________.

Late Arrivals

Late arrivals to a psychomotor exam are generally not permitted.

Extenuating circumstances, such as inclement weather conditions, may be considered and the candidate may be granted permission to begin the psychomotor examination late. If admitted into the examination, candidates arriving late must be afforded the opportunity to complete the entire portion of the psychomotor examination he/she needs. No candidate may be permitted to complete only a portion of the psychomotor examination he/she needs. If the facility cannot ensure that the candidate will be able to complete all portions of the psychomotor, he/she needs, the candidate must be dismissed from the psychomotor examination and instructed to make alternate arrangements to complete the psychomotor examination at a later date. Late admission to a psychomotor exam is at the discretion of the Registry Exam Representative.

Grounds for Dismissal or Cancellation of Results

A candidate who violates Registry policies, or the test site regulations or rules, or engages in irregular behavior, misconduct and/or does not follow the test administrator's warning to discontinue inappropriate behavior may be dismissed from the test center.

Exam fees for candidates dismissed from a test center will not be refunded. Additionally, your exam results may be withheld or canceled. The Registry may take other disciplinary action such as denial of Certification and/or disqualification from future Registry exams. Behaviors that are considered to constitute irregular behavior or misconduct include but are not limited to:

  • Giving or receiving assistance of any kind during an exam.
  • Using, accessing, or attempting to access any prohibited items. Prohibited items are any devices or materials that will be helpful in taking the Registry exam. Examples of aids that are prohibited include electronic devices (e.g. cell/mobile/smart phones, tablets, smart watches, etc.), hand-held calculators, conversion tables, dictionaries, etc.
  • Attempting to take the examination for someone else.
  • Accessing or attempting to access such study materials at any time after the start of the examination administration
  • Failing to follow testing regulations or the instructions of the test administrator.
  • Creating a disturbance of any kind.
  • Tampering with the operation of the computer or attempting to use it for any function other than taking the examination.

Section 5 – Exam Accommodations Policy

The Registry complies with the Americans with Disabilities Act (ADA) in regards to requests for examination accommodations consistent with its mission and public protection.

Candidates requesting examination accommodations should share this information with individuals responsible for rendering a diagnosis of the specific disability so that appropriate documentation can be assembled to support the request for accommodations.

It is the policy of the Registry to administer its certification examinations in a manner that does not discriminate against an otherwise qualified applicant. The Registry offers reasonable and appropriate accommodations for the written and psychomotor components of the registration examination for those persons with documented disabilities, as required by the Americans with Disabilities Act (ADA).

The Registry urges candidates requesting any accommodation to submit such requests as early as possible to provide adequate time to resolve any documentation issues that may arise. At a minimum, all requests for accommodations must be received by the Registry no less than thirty (30) days before the scheduled test date.

The Registry will review each request on an individual basis and make decisions relative to appropriate accommodations based on the following general guidelines:

To be considered for an accommodation under the ADA, an individual must present adequate documentation demonstrating that his/her condition substantially limits one or more major life activities.

Only individuals with disabilities who, with or without reasonable accommodations, meet the eligibility requirements for certification at the level of the requested examination are eligible for accommodations.

Requested accommodations must be reasonable and appropriate for the documented disability and must not fundamentally alter the examination’s ability to assess the essential functions of out-of-hospital care, which the test is designed to measure.

Professionals conducting assessments, rendering diagnoses of specific disabilities and/or making recommendations for appropriate accommodations must be qualified to do so The Registry realizes that each candidate’s circumstances are unique and uses a case by case approach to review the documentation is required.

All documentation submitted in support of a requested accommodation will be kept in confidence and will be disclosed to The Registry staff and consultants only to the extent necessary to evaluate the accommodation. No information concerning an accommodation request will be released to third parties without written permission from the candidate.

The Registry does not set policy for educational institutions regarding appropriate accommodations in the classroom. However, in the interests of public protection and appropriate counseling of prospective students, coordination of The Registry and educational accommodation policies is critical. Educators should seek guidance from the Disabilities support services connected with their educational institution. Independent education courses that are not sponsored by institutions with disability support should contact their regulatory office for advice. Furthermore, educators and Government offices should familiarize themselves with these guidelines for standard use:

No discussion or screening for disabilities, or other addressing of potential disabilities should be performed prior to a student’s admission to a training program. No inquiry may be made of a prospective student about any disability. Aptitude or diagnostic testing may only be required prior to admission if it is required of all students

The healthcare job description, which is included in curricula, should be provided for each student at the beginning of their training.

At the beginning of a course (but never before the course begins), instructors should inquire if there are students who may request accommodations for disabilities. If students request accommodations, the instructor should refer or advise the individual to contact the government regulatory office directly to assure a consistent approach to the application of appropriate accommodations in the classroom.

Educators should request documentation of the disability be sent to the school’s disability coordinator. Accommodations provided in the classroom setting should be approved in consultation with the disability coordinator and a disability expert (generally an educational psychologist).

Students who have stated they have a disability and are seeking an accommodation on the Registry examination should be directed to the Registry website and follow the instructions provided. The Registry recommends that all applicants complete an online profile and apply to take a Registry Certification examination 4-6 weeks prior to the desired date of examination.

Requesting an Accommodation

The Registry Certification has two components: a cognitive examination and a psychomotor examination, where candidates must perform competently some psychomotor aspects of the job of a healthcare provider.

Candidates requesting accommodations should print out and follow the “How to request an accommodation” step by step guide in the section below. Following these steps, including the timely submission of appropriate documentation, will facilitate the Registry’s review regarding appropriate accommodations.

Although each accommodation request is analyzed separately, some general principles guide Registry decisions. Documentation must be current and provided by a qualified professional. Documents will be reviewed by the Registry psychoeducational consultants and approval of accommodations must be obtained by the Registry.

The Registry administers examinations in English and Spanish only and does not provide accommodations for English or Spanish language learners or individuals with limited English proficiency as they are not considered disabled under the ADA.

The psychomotor examination evaluates necessary skills and simulations of skills required of a healthcare provider. Use of assistive devices on the psychomotor examination to assist disabled persons to demonstrate psychomotor competency may be permitted provided these same assistive devices can be used safely and effectively on the job. Prior approval of use of any of these devices on a Registry psychomotor examination must be obtained. Decisions cannot be made at the examination site. Documentation of a physical disability must be submitted in accordance with information found on the Registry website.

How to Request an Accommodation

If you are requesting an accommodation on any level of the Registry examination, you must complete the following steps:

  1. If you do not already have a Registry account with a username and password, create a New Account on the Registry homepage.
  2. Complete an application to take the examination. Do not pay the fee to take the test until you have received your Accommodations Letter.
  3. Email the following documents to [hidden email] at least 30 days prior to requesting a test date:
    1. Completed Accommodations Request
    2. A letter from an appropriately credentialed professional, such as an educational psychologist with (1) the diagnosis of your disability, (2) specific disability symptoms, and (3) recommendations for accommodations
    3. This information should be written on professional letterhead, dated, and signed
    4. Psychological evaluation, signed comprehensive assessment report, and accompanying standard scores
    5. Evidence of previously approved accommodations
    6. A personal statement written by you describing your disability and its impact on our daily life and educational functioning
    7. Please note: Some accommodations requests may require additional documentation
  4. The Registry will send you an email to confirm receipt of your documentation and follow up with an Accommodations Letter indicating whether your request has been granted.
  5. If you have not completed the training course but have already received an Accommodations Letter from the Registry approving your accommodation, you need to wait until your course has been completed and your Program Director validates your successful completion on the Registry website. The Program Director’s validation of your course completion will result in your receipt of an Authorization to Test (ATT) letter.
  6. If you have already completed your course and received an Authorization to Test (ATT) letter, wait to receive your Accommodations Letter before scheduling a test.
  7. Do not attempt to schedule your examination until you have received BOTH your Accommodations Letter AND Authorization to Test (ATT).
  8. When you receive the Accommodations Letter, it will include instructions on how to schedule your test. Do not schedule your test online. You will not receive your accommodations.
  9. Arrive on time at your scheduled examination appointment with appropriate identification and prepare to take an examination as outlined in your ATT letter and per the instructions regarding accommodations given to you by the Accommodations Coordinator.
  10. If you have any questions, contact the Registry via email or phone.

The Registry’s Role and Responsibility Regarding Disabilities

The Registry has worked with psychoeducational consultants, occupational rehabilitation specialists, reading specialists and legal counsel to develop its current accommodation policies. These disability and educational specialists reviewed job descriptions, functional job analysis, tasks within the Registry Scope of Practice, and observed providers during care.

The Registry is committed to the provision of reasonable accommodations which do not compromise the ability of its certification tests to evaluate a candidate’s ability to safely and effectively perform the critical tasks in the provision of healthcare. The Registry certification attests to a standard of care in the interest of public protection. Accordingly, this standard guides the accommodations that can be made for candidates taking the Registry examination. The Registry also recognizes that each disability is unique to the individual and all Registry decisions regarding reasonable accommodation are evaluated on a case-by-case basis.

The Registry is the certification agency and does not issue a license or permit to work. Not all aspects of a healthcare provider’s job are covered in the Registry cognitive or psychomotor examinations. Accordingly, the licensing agencies will continue to have the responsibility and authority to determine an applicant’s ability to safely and effectively provide healthcare services with respect to those physical and mental skills not tested on the Registry certification examinations.

Section 6 – Exam Irregular Behavior Policy

This policy specifies the situations which constitute irregular behavior during an examination, which may lead to action against a certification.

While the policy defines “irregular behavior,” it does not cover the reporting, investigation or response to irregular behavior.

Applicants should understand that engagement in any of the following activities may be sufficient cause to bar them from future examinations, to terminate their participation in an ongoing examination, to withhold, invalidate or revoke their results on an examination, to declare them ineligible for certification, to revoke their certifications or to take other appropriate action:

  1. The giving or receiving of aid in the examination as evidenced either by observation or by statistical analysis of answers of one or more participants in the examination, including:
  2. Any transfer of information or signals between examinees during the examination. This prohibition includes any transfer of information between an examinee and any other person at any time during the testing period, including bathroom breaks.
  3. Any appearance of looking at the answers of another examinee during the examination.
  4. Allowing another examinee to view one's answers or otherwise assisting another examinee in the examination.
  5. Taking or seeking to take an examination for another candidate or causing another individual to take or attempt to take an examination on the candidate’s behalf.
  6. The unauthorized possession or reference to, books, notes, or other study, test or preparation materials at any time at the testing site, including bathroom breaks. Prohibited material includes written or electronically stored information or information transferred by electronic, acoustical, or other means and devices, including cell phones.
  7. The making of threats to or engaging in unprofessional or abusive actions toward Registry staff or agents.
  8. The offering of any benefit to any agent of the Registry or the testing service and/or a testing site administrator in return for any aid or assistance in taking an examination.
  9. Creating a disturbance at the testing site, engaging in profane or abusive language directed at examinees or testing site administrators, tampering with the computer or otherwise not following the directions of a testing site administrator.
  10. The unauthorized possession, disclosure, reproduction, dissemination or use of any examination content or materials or the solicitation of same. All examination materials are the property of the Registry.

Rationale

The Registry serves as the Certification organization. The Registry has always been centered on the protection of the public and advancing the professions, which includes adherence to the highest standards of professionalism and ethics. The Registry provides Certification, which is part of a validated and legally defensible attestation of competency through examination. When established standards of competency and expectation have been compromised, public protection and examination validity are at risk. The general public, employers, and government licensing authorities know that individuals who obtain a Certification have demonstrated competency. This standard of competency for an individual cannot be validated when irregular behavior occurs and may additionally jeopardize exam security, public protection, and the reputation of Registry Certification.

Section 7 - Glossary of Terms

Affiliation Your affiliation is the agency/organization you are associated with for clinical practice.

Agency Your agency is the organization that you work for.

AHJ Means the Agency Having Jurisdiction

AREMT Means the Australasia Registry of Emergency Medical Technicians, now the Global Emergency Medicine Registry (GEMR).

Assessment The Global Emergency Medical Registry provides an assessment examination process available for use by educational institutions or government regulatory agencies for practical and simulation skills assessment of candidates.

CAAHEP Commission on Accreditation of Allied Health Education Programs (CAAHEP)

CAT Computerized Adaptive Testing (CAT) is a type of Computer Based Testing (CBT) where an algorithm determines the difficulty level of a candidate's next test question, based on how the previous question was answered.

CBT Computer Based Testing (CBT).

CAPCE The Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE), formerly known as CECBEMS, is the leading accrediting body for EMS continuing education courses and course providers. For more information, visit the CAPCE website: www.capce.org.

Certification Certification means you have met the standards of the certifying body in credentialing. Certification is recognized by employers, government licensing agencies, and the public. It means you possess entry level competency. Certification is NOT a license to practice.

CoAEMSP Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP)

Course Director Means an individual with legal responsibility for the education process in a training program, and who has received instructor training from a recognized entity or has completed the initial educational sequence for an education major in an accredited AHJ or university recognized within the country of jurisdiction.

Critical Care Means the performance of acts or procedures when requested through pre-hospital or hospital duties in the observation, care and counsel of persons who are ill or injured with an Early Warning Score in excess of 4 or having been labeled as “unstable” by a licensed physician; in the administration of care, procedures, or medications as directed by a licensed physician medical director, insofar as any of these acts is based upon knowledge and application of the principles of biological, physical and social science as required by a completed course utilizing an approved curriculum in Advanced Practice Paramedic. However, “critical care” does not include prescriptive privileges for therapeutic or corrective measures.

Direction Refers to the standing order, written, or verbal direction provided to the emergency medical provider from the Medical Director or transferring licensed physician.

Distributive Education Distributive Education (DE) is a method of delivering education where the educator and student are not able to interact in real time. Examples include online courses, journal article reviews, and videos.

GEMR Global Emergency Medical Registry

Early Warning Score Or “EWS”, refers to a guide used by medical services to quickly determine the degree of illness of a patient. It is based on cardinal vital signs (respiratory rate, oxygen saturation, temperature, systolic blood pressure, pulse/heart rate, AVPU response).

Emergency Care Means the performance of acts or procedures when requested through pre-hospital or hospital duties in the observation, care and counsel of persons who are ill or injured or who have disabilities; in the administration of care or medications as directed by a medical director, insofar as any of these acts is based upon knowledge and application of the principles of biological, physical and social science as required by a completed course utilizing an approved curriculum in pre-hospital emergency care. However, “emergency care” does not include prescriptive privileges for therapeutic or corrective measures.

Emergency Medical Provider (EMP) Means a person licensed as an EMR, EMT, AEMT, Paramedic, or Advanced Practice Paramedic; only a licensed EMP may provide patient care in the prehospital environment, and must be under the direction of an approved Medical Director.

Inactive Status Inactive Status is for Certified persons who are currently not providing patient care at their certification level. Registrants who wish to declare inactive status must continue to meet the Registry continuing education recertification requirements. Inactive status is not for those who are unable to obtain and meet the educational requirements or those who have had limitations or revocation of a health care license.

In Good Standing Means a person who is currently licensed or certified, who does not have any restrictions placed on his/her license or certification, and who is not on probation with the licensing agency or the Registry for any reason.

Lapsed If you do not complete the recertification process by your expiration date, your Certification will lapse. If your certification has lapsed within a two year period or you are currently government licensed as an EMS provider, you can obtain Certification by completing an approved Refresher course and successfully completing the cognitive and psychomotor examinations. If your EMS certification expired more than two years ago, see the eligibility requirements for re-entry.

Letter of Review A Letter of Review (LOR) is issued by the Committee on Accreditation of Educational Programs to programs who are officially in the process of obtaining accreditation.

License A license from a government regulatory entity gives you the legal right to practice healthcare in a given jurisdiction. Certification is NOT a license to practice.

Licensed physician For the purpose of direction to an emergency medical provider, refers to a licensed specialist physician in emergency medicine, anesthesia, or critical care medicine who is providing direction for a specific patient incident beyond the standing orders provided by the Medical Director. An example of this would be a written order for a specific dose regime in a specific interfacility patient transport situation.

Medical Director Agencies who have healthcare providers are required to have a physician Medical Director affiliated electronically in the Registry system to achieve recognition. The physician Medical Director is responsible for verifying continued competence of skills for providers at the time they renew their Certification; as well as responsible for oversight of registrant’s medical care and scope.

Medical Program Director Means a person licensed as a specialist physician in Emergency Medicine or Critical Care Medicine, actively registered and in good standing with the Authority, who provides direction of, and is ultimately responsible for emergency and nonemergency care rendered by emergency medical providers as specified in these rules. The Medical Director is also ultimately responsible for the agent designated by the Medical Director to provide direction to the medical service agencies and the emergency medical provider as specified in these rules.

NCCP Is the United States National Continued Competency Program (NCCP) recertification model that allows flexibility at the local and individual levels. The NCCP is comprised of three components: national, local and individual.

Nonemergency care Means the performance of acts or procedures on a patient who is not expected to die, become permanently disabled or suffer permanent harm within the next 24 hours, including but not limited to observation, care and counsel of a patient and the administration of medications prescribed by a physician licensed in accordance with this section, insofar as any of these acts are based upon knowledge and application of the principles of biological, physical and social science and are performed in accordance with scope of practice rules adopted by the AHJ in the course of providing emergency care.

NREMT Means the National Registry of Emergency Medical Technicians of the United States.

Practice of Medicine without a license Means any person providing emergency or critical care, in the out of hospital setting, who is not a physician or EMP licensed by the AHJ; this is a violation of the law and the AHJ will refer every instance of this behavior to the government for prosecution.

Re-entry Re-entry into Certification may be granted to a previously government licensed or certified person(s) if they meet certain requirements outlined in the re-entry policy and passes the cognitive and psychomotor examinations.

Recertification Is the process by which certified persons renew their certification. Certified persons must renew their certification every two years.

Reciprocity Applying for license based on current certification may be possible in some jurisdiction. Please consult with the government regulatory office where you are seeking licensure for reciprocity requirements.

Reinstatement Certified persons who fail to submit their recertification applications by their expiration date, may seek re-instatement of their Certification within 30 days of their expiration date. Persons seeking reinstatement must complete the recertification application and pay the reinstatement fee. Please note that all educational requirements must have been met prior to your expiration date.

Scope of Practice Means the maximum level of emergency and nonemergency care that an emergency medical services provider may provide.

Self-Assessment Tool The Self-Assessment Tool is designed for certified persons to assess their knowledge and guide study in the next recertification cycle. The self-assessment tool is not a test and Individualized assessment tool results will not be released to any person other than the individual provider.

Standing Orders Means the written detailed procedures for medical or trauma emergencies and nonemergency care to be performed by an emergency medical services provider issued by the licensed physician Medical Director commensurate with the scope of practice and level of licensure of the emergency medical provider.

Training Officer A Training Officer is the individual responsible for managing the education requirements of an EMS agency. This person may be nationally certified, but this is not a requirement.

Transition In 2009, the USA National EMS Scope of Practice Model defined four (4) provider levels: EMR, EMT, AEMT and Paramedic. In accordance with the transition policy, historical levels have been transitioned to the National EMS levels: First Responder to Emergency Medical Responder (EMR); EMT-Basic to EMT; Intermediate-85 to AEMT; Intermediate-99 to Paramedic; EMT-Paramedic to Paramedic.