Paramedic

Paramedic Application

Note: Applications are required to be submitted 30 days prior to expiration of current accreditation. We cannot guarantee application will be processed by your renewal date if not submitted per Agency requirements. All documents must be submitted in a legible secure document format. Applications are subject to a late fee if your current accreditation has expired. Acceptable payment methods are Debit, Visa, or MasterCard. Personal checks are not accepted. All fees are non-refundable.

Initial Accreditation

If on probation with the California EMS Authority or local EMS Agency, submit a copy of the stipulation agreement with application.

If the applicant is applying for accreditation for the first time, the following must be submitted to our online portal:

1. Paramedic or Flight Paramedic Accreditation Application
2. Paramedic Initial Accreditation Fee
3. Proof of Affiliation with an approved SCEMSA ALS provider or Flight Program if applying for the Flight Paramedic. (Online Application Portal will submit this automatically to the affiliated provider.)
4. A copy of a valid California Paramedic License
5. A copy of a valid State or federal ID (front & back)
6. A copy of your current CPR card (front & back) for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another approved program
7. Enroll in and successfully pass the Paramedic Accreditation Orientation (PAO) course and Protocol test. (See application for registration requirements)
8. Upon completion and verification of all the above requirements, the applicant will be authorized to complete a supervised pre-accreditation field evaluation of at least five (5) but no more than ten (10) ALS contacts with an approved Stanislaus County EMS ALS provider agency. (If applying for the Flight Paramedic, this step will not be required.)

Reaccreditation

If on probation with the California EMS Authority or local EMS Agency, submit a copy of the stipulation agreement with application.

1. Paramedic Accreditation Application
2. Proof of Affiliation with an approved SCEMSA ALS Provider. (The online application portal will submit this automatically to the affiliated provider.)
3. A copy of a valid California Paramedic License
4. A copy of a valid State or federal ID (front & back)
5. A copy (front &back) of your current CPR card for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another program approved by the SCEMSA
6. If renewing your Flight Paramedic accreditation a copy of a valid Flight Paramedic Certification (FP-C) or Critical Care Paramedic Certification (CCP-C) will be required.

Expired accreditation less than 6 months:

1. Complete the necessary steps for Paramedic Reaccreditation
2. Paramedic Expired Reactivation Fee

Expired accreditation greater than 6 months but less than 12 months:

1. Complete the necessary steps for the Paramedic Reaccreditation
2. Paramedic Expired Reactivation Fee
3. Attend and successfully pass the Paramedic Accreditation Orientation (PAO) course and Protocol test. Enroll in the required SCEMSA PAO. (See application for registration requirements)

Expired accreditation greater than 12 months:

1. Complete the necessary steps for the Paramedic Reaccreditation
2. Paramedic Expired Reactivation Fee
3. Attend and successfully pass the Paramedic Accreditation Orientation (PAO) course and Protocol test. Enroll in the required SCEMSA PAO course. (See application for registration requirements)
4. After successful completion of the PAO, complete a supervised pre-accreditation field evaluation of at least five (5) but no more than ten (10) ALS calls with an approved Stanislaus County EMS ALS provider agency. (If applying for the Flight Paramedic, this step will not be required.)

 MICN

MICN Application

Note: Applications are required to be submitted 30 days prior to expiration of current authorization. We cannot guarantee application will be processed by your renewal date if not submitted per Agency requirements. All documents must be submitted in a legible secure document format. Applications are subject to a late fee if your current authorization has expired. Acceptable payment methods are Debit, Visa, or MasterCard. Personal checks are not accepted. All fees are non-refundable.

To be eligible for MICN authorization in Stanislaus County, the applicant must:

• Be currently licensed as a registered nurse, in good standing in California
• Have at least one year experience as a full-time RN in a critical care area in the past two (2) years. Prehospital liaison nurse (PLN) must verify experience by completing the verification section of the MICN application
• Successfully complete the Stanislaus County MICN course.

Initial Authorization

If the applicant is applying for authorization with our Agency for the first time, the following must be submitted to our online portal:

1. MICN Initial Application
2. MICN Initial Authorization Fee
3. A copy of current State of California Registered Nurse License BreEZe detailed verification printout from website
4. A copy of a valid state or federal ID (front & back)
5. A copy of current ACLS card (front & back)
6. Current Employer Affiliation (The online portal will submit this automatically to the affiliated provider.)
7. Enroll in and successfully pass the MICN certification class and Protocol test.(See application for registration requirements)
8. After attending the MICN Certification Class, you will be required to submit a completed MICN Accreditation packet which includes: satisfactorily completion of a Base Hospital evaluation that includes no less than 10 ALS radio calls supervised by a Mobile Intensive Care Nurse or Base Hospital Physician.

Reauthorization

Note: If you are currently authorized as a Stanislaus County MICN, you will most likely already have an account setup in our Online Licensing Management System ImageTrend. Please do not create a new account, duplicate accounts will be deleted. Login with your User ID, which will be your First Initial Last Name, then click on Forgot Password to reset your password. If you are unable to reset your password online, please contact us.

1. MICN Reauthorization Application
2. MICN Reauthorization Fee
3. A copy of current State of California Registered Nurse License BreEZe detailed verification printout from website
4. A copy of a valid state or federal ID (front & back)
5. A copy of current ACLS card (front & back)
6. Current Employer Affiliation (The online portal will submit this automatically to the affiliated provider.)
7. Proof of successful completion of twelve (12) hours of approved EMS continuing education

Lapsed Authorization

• Additional CE documents required and possible MICN course and ALS calls required depending on number of years lapsed. Please refer to the MICN Authorization/Reauthorization Policy - Section VI. C. for requirements.
• Additional application Late Fee will be included for lapsed authorization

EMR

EMR Application

Note: Applications are required to be submitted 30 days prior to expiration of current certification. We cannot guarantee application will be processed by your renewal date if not submitted per Agency requirements. All documents must be submitted in a legible secure document format. Applications are subject to a late fee if your current certification has expired. Acceptable payment methods are Debit, Visa, or MasterCard. Personal checks are not accepted. All fees are non-refundable.

To be eligible as an Emergency Medical Responder (EMR) in Stanislaus County an applicant must:

• Successfully complete approved EMR course
• Submit the required documents to our online portal
• Be eighteen (18) years of age or older

Initial Certification

Applicants applying for certification in Stanislaus County for the first time must submit the following to our online portal:

1. EMR Certification Application
2. EMR Initial Certification Fee
3. A copy of your current CPR card (front & back) for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another program approved by the SCEMSA
4. A copy of a valid State or federal ID (front & back)
5. A copy of initial EMR Course Completion Record. Must have been completed by a SCEMSA approved program within the last two years.

Recertification

Applicants applying for recertification in Stanislaus County must submit the following to the SCEMSA online portal:

1. EMR Certification Application
2. EMR Initial Certification Fee
3. A copy of your current CPR card (front & back) for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another approved program
4. A copy of a valid state or federal ID (front & back)
5. Proof of Education: See requirements below

Recertification for current EMR, or those expired less than six months:

• Submit 16 hours of EMS Continuing Education (CEs)
• EMR Skills Verification Form
• Late Fee (If Applicable)

Expired more than six months but less than a year:

• Submit 22 hours of EMS Continuing Education (CEs)
• EMR Skills Verification Form
• Late Fee

Expired for more than a year but less than two years:

• Submit 32 hours of EMS Continuing Education (CEs)
• First Responder Exam
• EMR Skills Verification Form
• Late Fee

Expired two years or more:

• See steps for Initial Certification

 Paramedic Student Intern

Paramedic Student Intern Application

Note: All documents must be submitted in a legible secure document format. Acceptable payment methods are Debit, Visa, or MasterCard. Personal checks are not accepted. All fees are non-refundable.

Paramedic Student Intern Authorization

To be eligible for authorization as a Paramedic Student Intern, the applicant must:

1. Submit a completed Paramedic Student Intern Application
2. Submit a copy of a current valid California EMT certification card
3. A copy (front &back) of your current CPR card for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another program approved by the SCEMSA
4. Submit a copy of valid state identification card (i.e., driver's license) or valid federal identification (i.e., military identification)
5. Be enrolled and in good standing in an approved paramedic training program
6. Submit a letter from your paramedic training program approving your internship and providing the name of your Paramedic Preceptor. The letter must be signed and submitted in a secure document PDF format.

**The intern will be issued a paramedic student internship authorization card. The card shall be carried at all times while functioning as an intern.

Provider Applications

Special Event Applications

• ALS Special Event Application
• BLS Special Event Application

IFT Applications

• ALS Non-Emergency Interfacility Ambulance Application
• BLS Non-Emergency Interfacility Ambulance Application
• CCT Non-Emergency Interfacility Ambulance Application
• General Non-Emergency Interfacility Ambulance Application

Provider Applications

• CE Provider Application
• EMR Provider Application
• EMT Program Application