Course Funding - Course Sponsors and EMS Agencies

Bureau of EMS Policy Statement
Policy Statement # 09-06
Date May 29, 2009
Subject Re: Course Funding - Course Sponsors and EMS Agencies
Supercedes/Updates 95-02, 95-05, 98-07, 99-05, 00-05 and 02-10

PURPOSE

This policy statement addresses emergency medical services (EMS) educational reimbursement for course sponsors and EMS agencies. This policy replaces policies 95-02, 95-05, 98-07, 99-05, 00-05 and 02-10.

STUDENT ELIGIBILITY

  1. Basic Life Support (BLS) Course reimbursement may only be requested and received for the tuition costs of eligible students. Course sponsors may receive reimbursement for those students that are members or employees of a volunteer agency, employees of a municipal emergency medical service, commercial service, hospital-based service or a Basic Life Support (BLS) First Response Service, which is recognized by DOH as providing EMS on a routine and on going basis and have an assigned EMS agency code. Employees of Fire Department of New York (FDNY) who obtain their education through the FDNY course sponsorship are eligible for course reimbursement at a reduced rate.
  2. Any student who is eligible for reimbursement from DOH BEMS and is enrolled in a course through a DOH approved course sponsor, must complete form DOH - 3312, Verification of Membership in an EMS Agency. It is the responsibility of the course sponsor to assure students return this completed document and it is placed within the student's file. The definition of a "member" of an agency may be different at each agency. However, BEMS requires that the student be on the agencies member list supplied to BEMS, be actively participating in EMS for the agency, have a complete personnel file at the agency, and documented on a Prehospital Care Report as being apart of a responding EMS crew.
  3. Advanced Life Support (ALS) course reimbursement may be available for eligible students who are members or employees of ALS volunteer ambulances or ALS First Response Services, municipal services, or commercial and hospital-based services. Employees of FDNY who obtain their education through the FDNY course sponsorship are eligible for course reimbursement at a reduced rate.
  4. Students who are members of a private/corporate/industrial EMS service that does not routinely provide EMS in the public sector as a primary response (i.e., corporate property response teams and specialty teams and brigades that do not have municipal recognition and a primary EMS role) are ineligible for state tuition reimbursement.
  5. Students who are members of a state or federal agency EMS system are ineligible for state tuition reimbursement.
  6. Reimbursement will be provided for candidates who achieve certification from a DOH approved course sponsor through an approved course or approved Continuing Medical Education (CME) refresher program.
  7. Faculty teaching in an EMS course in which they are enrolled, and are being paid to teach in the course they are enrolled, are ineligible for reimbursement. These instructors must check the box "On Faculty" on the student application, DOH-65 form.

SPECIAL CONSIDERATION

  1. CME Recertification: Students who are members of agencies participating in the CME Recertification program and obtain their training through an approved course sponsor, will be eligible for reimbursement of the mandatory core content hours at the CME refresher rate. Course sponsors may NOT seek reimbursement for the practical skill examinations for these students.

    Agencies who are submitting vouchers for students enrolled in the CME recertification program may submit their vouchers once the student has been recertified and received their new EMT certification card.

    Course sponsors who are submitting vouchers for students enrolled in the CME recertification program and have a memorandum of understanding with the student and/or agency, may submit their voucher once the student has completed the "core" portion of the CME recertification process.

  2. Rapid Recertification Courses: Course sponsors who conduct rapid recertification courses will receive a reimbursement rate of $50.00 per student in addition to the practical skill examination rate.

COURSE SPONSOR REQUIREMENTS

  1. To be eligible for state tuition reimbursement, a sponsor must be approved by the DOH and have a current sponsorship agreement on file.
  2. New York State requires that organizations receiving state funds have a Federal Employer Identification Number (FEIN).
  3. State funding is "last dollar" funding. Funding received from other sources, including grants, employer tuition payments (such as a volunteer's employer paying all or part of the cost of training), and municipal payments to ambulance services for this purpose, etc. must be deducted prior to requesting DOH reimbursement. The sponsor must certify that no other claim is being made for funds, which could be obtained elsewhere. Municipalities who are course sponsors may claim reimbursement directly, as long as no other state or local funds have been used to support the course. Sponsors who receive other funds toward the courses must submit vouchers that clearly indicate partial payment is being requested.
  4. Students who are charged tuition may be enrolled in the same course as students for whom the sponsor is seeking state reimbursement. However, it is the responsibility of the sponsor to differentiate the students for whom DOH funding is being requested on the Standard State Voucher. Accompanying documentation listing the names of the students for whom funding is being sought must be included with the voucher submitted to BEMS.
  5. Sponsors are responsible for maintaining documentation on all courses per 10 NYCRR Part 800, the Course Sponsor's Administrative Manual and BEMS Policies.
  6. For the purpose of audit, sponsors are responsible for maintaining documentation of all financial aspects of the course. This includes, but is not limited to:
    • The number of students enrolled
    • The level of certification of students enrolled in each course; and
    • Financial expenditure reports and audit trails of all student fees and NYS BEMS reimbursement dollars.
    • Records of all funds requested and received from the state to support EMS courses;
    • Financial records documenting use of the state reimbursement funds. Please refer to the section entitled Reimbursement Policies for details on what is considered acceptable uses of state reimbursement funds;
    • Individual student records which document eligibility for course reimbursement; and
    • Records documenting other funding sources received to support the course.

FINANCIAL PENALTIES

  1. Late submission of required paperwork for examination scheduling (E.g. student applications, Course Memorandum, etc.) will result in a 50% reduction in a sponsor's total allowed reimbursement for the course number involved. Late submission may require the Department of Health to reschedule the requested examination date possibly impacting the students negatively. The financial penalty will be automatically imposed regardless of exam rescheduling. The value of the assessed penalty cannot be passed on to the student or included in tuition or administrative fees charged by the sponsor.
  2. Repeated failure to submit required examination paperwork described in number 1 above may result in loss of all requested reimbursement for the course and loss of course sponsorship approval with DOH.
  3. Failure to submit "end of course paperwork" 5 days or less after the examination date for a course may result in reduction or loss of requested reimbursement for the course.
  4. These penalties do not preclude additional enforcement action and/or fines imposed upon a sponsor who consistently fails to meet program objectives and deadlines.

REIMBURSEMENT POLICIES

  1. Reimbursement will only be provided for state-approved tuition costs at rates established by the state. Related expenses such as travel, textbooks, and other non-tuition items, will not be reimbursed.
  2. BEMS reimbursement will be paid only once per student per course. If a course sponsor receives reimbursement for a student the agency is not eligible to receive reimbursement. If the agency receives reimbursement for a student the course sponsor is not eligible to receive reimbursement.
  3. Sponsors must enroll refresher students in approved refresher courses. Refresher students may attend the same didactic and practical sessions as original students, but they must be enrolled in a refresher course. Refresher students may not be mixed in with original students under the same course number.
  4. Sponsors who claim state funding may charge fees for BLS CPR courses conducted by, or in accordance with, curricula of outside organizations.
  5. Students who successfully complete more than one EMS course per year:
    • The reimbursement policy limits reimbursement for student's tuition costs to no more than two courses within a 12-month period. No more than one of the two reimbursable courses can be an Advanced EMT original certification course.
    • EMS course sponsors must bill separately for each course successfully completed by an EMS student when the student independently completes two EMS courses in a 12-month period. An example of this situation is when a student successfully completes an EMT-B course and an advanced level course within the same 12-month period, and is not enrolled simultaneously in the two programs. Another example would be when a student must refresh at the EMT-B level in order to enroll in an ALS course.
  6. Requests for reimbursement will only be honored from approved course sponsors or EMS agencies that have paid the tuition for their members. Reimbursement is not made directly to students. In order for an EMS agency to be reimbursed for tuition paid; they must submit proof of the member's certification and the receipt for payment of the member's tuition for the course they completed.
  7. State vouchers for reimbursement must be submitted no later than fifteen (15) business days after receipt of examination results. Practical examination vouchers may be submitted at the same time. Requests for reimbursement received after 15 days may be denied. Vouchers received prior to receipt of examination results will be returned to course sponsors for re-submittal after examination results verify the number of students eligible for reimbursement.

    If an individual EMS agency is submitting a voucher for reimbursement of an approved course provided by a course sponsor, the voucher must be submitted within 15 days of the receipt of the student's certification card.

    All vouchers submitted must have an accompanying list of student names and identification numbers for whom reimbursement is being sought. This can be a copy of the written examination results with the students names highlighted for who you are seeking reimbursement or an internal form developed by the course sponsor. Also, if the voucher is seeking reimbursement for the Final PSE, a copy of the Final PSE Summary Sheet must accompany the voucher. Failure to supply the required documentation will result in the voucher being denied and returned to the sponsor.

  8. As required in the Sponsor's Administrative Manual, all documents related to a course must be maintained for a minimum of five (5) years. Additionally, any funds received from NYS are subject to audit by representatives of NYS. Sponsors and agencies are required to cooperate with such audits.
  9. CHARGING TUITION:
    1. Students who are charged tuition may be enrolled in the same course as students for whom the sponsor is seeking state reimbursement (and not subject to tuition). However, sponsors may not charge additional tuition for CFR, EMT, EMT-I, or EMT-CC candidates for whom reimbursement is being sought from the state.
    2. Tuition may be charged to cover the cost of training an EMT-Paramedic student. The cost, when added to the state reimbursement may not be more than the tuition that would be charged to a student who is not eligible for reimbursement.
  10. NYS Reimbursement:
    1. Reimbursement dollars received by the sponsor from the state may only be used for direct costs of conducting the course and/or related to improvement of the sponsor's EMS educational program. These costs include but are not limited to: skills equipment (i.e., backboards, manikins), educational audio/video equipment and related software, instructor salaries, administrative costs, supplies and any other costs that are directly related to the educational programs delivered by the sponsor for NYS EMS certification courses.
    2. Reimbursement dollars received by an EMS agency for courses taught through a sponsor or for the CME recertification program can only be used for the sole purpose of training. The funds may be used to reimburse for training received that directly related to certification or for future training needs. These funds can be used to enhance educational programs (i.e. audio visual equipment, textbooks, educational computer programs and products, guest lecturers, reimburse students for pre-payments, etc.) at the agency for the purpose of recertification.
    3. All funds received from DOH must be placed in a separate line item or account within the organizations financial system. United States Generally Accepted Accounting Procedures (GAAP) must be strictly adhered to and audit trails must be obtainable for all NYS funds. These records are auditable by DOH and the NYS Office of the State Comptroller.
    4. Any items that are purchased with NYS funds must be so labeled and a separate inventory showing all items must be maintained and made available. In the event that a sponsor closes for what ever reason, all items purchased with NYS funds may be required to be returned to NYS.
  11. ALS tuition funds are available to volunteers of BLS services if that service is in the process of seeking ALS status (e.g., not yet certified as an ALS service) if the certification of providers as AEMT is the only criterion not yet met for ALS designation. So that tuition reimbursement is approved, letters from the Chair of the Regional EMS Council and Regional Emergency Medical Advisory Committee (REMAC) indicating the service has notified them of intent to apply for ALS authorization and is capable of providing this level of care must be submitted to the DOH. Confirmation from the Regional DOH office of the service's ability to provide ALS once training is complete must also be provided.
  12. If an eligible AEMT wishes to recertify at the EMT-B level and not the advanced level and has less than 18 months remaining on their certification, tuition reimbursement will be available to support the EMT-B recertification.

COURSE REIMBURSEMENT RATES

Effective for all courses beginning on or after August 1, 2009, the following reimbursement schedule shall apply:

Course Type Reimbursement Rate FDNY Rates Practical Skills Rates
CFR Original $220 $110 $40
CFR Refresher $100 $50 $45
EMT Original $700 $350 $75
EMT Refresher $335 $150 $90
EMT-I Original $530 $260 $75
EMT-I Refresher $400 $200 $90
EMT-CC Original $1,200 $600 $100
EMT-CC Refresher $700 $350 $125
EMT-P Original $1,500 $600 $150
EMT-P Refresher $700 $350 $180

CME Recertification Program

Course Type Reimbursement Rate FDNY Rates Practical Skills Rates
EMT Refresher $300 $150 NA
EMT-I Refresher $375 $187.50 NA
EMT-CC Refresher $400 $200 NA
EMT-P Refresher $500 $250 NA

Rapid Recertification Program

Course Type Reimbursement Rate FDNY Rates Practical Skills Rates
EMT-I Refresher $50 $25 $75
EMT-CC Refresher $50 $25 $100
EMT-P Refresher $50 $25 $150

‡ The Paramedic Sponsor may charge tuition in addition to NYS reimbursement. Per this Policy Statement, the sum of the tuition and NYS reimbursement may not exceed the amount charged for candidates for which the sponsor will not be receiving NYS reimbursement.

FUNDING ELIGIBILITY

Certification Level Member Type Agency Type Funding Eligility
CFR Unpaid/Paid Volunteer Yes
  Unpaid/Paid Municipal Yes
  Unpaid/Paid Hospital Yes
  Unpaid/Paid Commercial Yes
EMT Unpaid/Paid Volunteer Yes
  Unpaid/Paid Municipal Yes
  Unpaid/Paid Hospital Yes
  Unpaid/Paid Commercial Yes
AEMT Unpaid/Paid Volunteer Yes
  Unpaid/Paid Municipal Yes
  Unpaid/Paid Hospital Yes
  Unpaid/Paid Commercial Yes

Please direct your questions about this Policy Statement to:

NYS Department of Health
Andrew Johnson, Director EMS Certification and Education
Bureau of Emergency Medical Services
875 Central Avenue
Albany, New York 12206
518-402-0996

Issued and Authorized by:
Edward G. Wronski, Director
Bureau of Emergency Medical Services