CAAHEP Accreditation Facts and What this Means to EMS

Accreditation Overview [pdf 20 slides]

Question:   Why do we need Paramedic program accreditation?

Answer: The National EMS community asked for accreditation as part of the EMS Education Agenda for the Future: A System’s Approach (2000). The Institute of Medicine’s (IOM) EMS At the Crossroads (2006) also recommended a single national EMS accrediting agency for the country as part of a process of standardization in EMS education. Additionally, several current research articles published in peer-review academic journals indicate an increased success rate on national certification exams from graduates of nationally accredited Paramedic programs.

The CAAHEP accreditation process is designed to support continual program improvement. The peer review process is one essential element to the improvement of the EMS profession. 

Accreditation in all areas of education and in particular, medical education is unique throughout the world.  At the present time, EMS is one of the few, if not the only, allied health care profession that does not require its educational programs to be accredited.  If the EMS professions are to ever enjoy the stability, respect, and benefits of being considered an allied health care profession, we must strive to meet nationally established standards of adult medical education.

Question:   Who is CAAHEP?

Answer: The Commission on Accreditation of Allied Health Education Programs (CAAHEP) is the parent organization of the Committee on Accreditation of Educational Programs for the EMS Professions (CoAEMSP).   CAAHEP is a non-profit, non-governmental agency, who reviews and accredits over 2000 educational programs in twenty (20) health science occupations.

CAAHEP issues accreditation to Paramedic education programs, based on the review and recommendation of the CoAEMSP.

Question:   Is the CoAEMSP the only nationally accrediting agency for EMS?

Answer: YES. Although CAAHEP is the actual accrediting agency, the CoAEMSP represents the EMS profession and has for over the past 30 years when the Paramedic was recognized as an allied health occupation by the American Medical Association in 1975. Currently, the CoAEMSP Board of Directors is sponsored by the following organizations:

            American Academy of Pediatrics (AAP)
            American Ambulance Association (AAA)
            American College of Cardiology (ACC)
            American College of Emergency Physicians (ACEP)
            American College of Osteopathic Emergency Physicians (ACOEP)
            American College of Surgeons (ACS)
            American Society of Anesthesiologists (ASA)
            International Assocition of Fire Chiefs (IAFC)
            National Association of EMS Educators (NAEMSE)
            National Association of EMS Physicians (NAEMSP)
            National Association of EMT’s (NAEMT)
            National Association of State EMS Officials (NASEMSO)
            National Registry of EMT’s (NREMT)

These Sponsors represent the specialties and organizations of the EMS profession and are all committed to the accreditation process. The members of each sponsoring organization serve on the Board of Directors and perform duties as program Reviewers and Site Visitors, in addition to their many other duties and commitments.  Currently, the International Association of Fire Chiefs (IAFC), EMS Section is petitioning to become an additional sponsor.

Question:   I thought state EMS offices were responsible for authorizing training programs in my state.  Does the CAAHEP accreditation process supersede our state EMS office?

Answer:  NO.  Individual state laws, rules and requirements remain the central authority for who is authorized to provide EMS education in each state.  The accreditation process is designed to supplement and support state EMS offices in providing clear guidelines and standards for education. 

The CAAHEP process is not designed to be punitive and is not an enforcement tool.  The CAAHEP standards are relatively broad since they apply to all programs throughout the United States.  Individual states may have more specific requirements, or implement standards related to issues in their locale.  Ultimately, the state EMS office remains the point authority in terms of allowing programs to function.  However, state EMS offices are informed of the accreditation process of programs in their jurisdiction.  This information includes notification of applications, scheduling of site visits, and other routine public matters throughout the accreditation process.  Through the CoAEMSP structure, input from state EMS directors and state EMS training coordinators is solicited in the development of the CAAHEP standards.

Question:   What does it cost to accredit our program?

Answer: There are actually three components of the costs of accreditation.   

There is an Annual Fee of $1,200.00 per year to maintain the program’s on-going accreditation and support the various services provided to programs by CoAEMSP.  CAAHEP also has an Institutional Fee ($450.00) that is due annually for the program. If your institution has more than one CAAHEP program this single fee is spread over all of the programs. Once every five (5) years, a site visit by two CoAEMSP reviewers is conducted.  The program is responsible for paying the actual costs (travel, accommodations and meals) of the site visit.  Depending on specific travel arrangements, these costs can vary.  In most cases, the average cost of a site visit by two reviewers is approximately $2,500.00.  Another cost associated with the 5 year review is a fee of $500.00 for the executive review of the program’s self study.

It is important to put these costs in context over a 5-year period, if your program serves 25 paramedic students per year X 5 years (125 students), the total costs for accreditation services would be:

Generally, CAAHEP accreditation costs approximately 8.4 cents for each student for each contact hour. Since the average Paramedic course is between 1000-1200 hours (1100 hour average)

$92.00 per student ÷1100 hours = 0.084 cents per student per contact hour, a minimal cost to the program for their accreditation investment.

Question:   What is the process to become accredited and how long will it take?

Answer: One size DOES NOT fit all. Every educational program is different and they will each have unique areas that require attention by CoAEMSP. There is no way to say for certain “how long” each school will take to gain accreditation through the CAAHEP process but clearly some are faster than others.

The process begins with the institutions submission of its self-study and fees to the CoAEMSP. The CoAEMSP Executive Director will read each Self-Study and complete an Executive Summary. The Summary will be sent to the Reviewer (a CoAEMSP Board member) and the Site Visitors, along with a copy of the Self-Study.  

The Site Visit will be scheduled with input from both the program and the site review team.  Once the site review takes place, the site review team completes their report and shares their findings with all the principal participants at an exit conference. The Site Report is returned to the Reviewer and Executive Director and the Reviewer will make a formal recommendation to the Board of Directors. Once approved, the recommendation will be sent to the CAAHEP Board, which meets every other month, for a final vote and approval. Accreditation certificates, recommendations and correspondence will be sent directly from CAAHEP once action is taken by the group. 

Each application for accreditation receives individual attention by the CoAEMSP, and time lines vary, the general experience is that CAAHEP accreditation is granted within 6 – 12 months of initial receipt of the self-study.

Question:   The whole process looks pretty intimidating. How do we get started?

Answer: JUST DO IT. As mentioned in the famous advertisement, getting started is the hardest thing to do.

As you prepare for accreditation it is be important that you take time to become familiar with the process and required materials.  The CoAEMSP website at www.coaemsp.org has many resources, including, Standards and Guidelines, an Initial Accreditation link that details all of the tabs you will fill in your accreditation notebook, as well as the Site Visitor Report (the actual document and questions asked by reviewers) and many other documents required for accreditation.

Contact the CoAEMSP office at 817.330.0080 for more details or to get your questions answered.

Question:   Is the Program Director required to possess a Bachelors degree?

Answer: Yes.  

The CAAHEP Standards and Guidelines require the Program Director hold a Bachelors degree to run the program.

Recognizing this may impact programs seeking accreditation, the CoAEMSP Board of Directors in February, 2008 stated that ANY NEW program that submits their self study report and fees to the CoAEMSP for evaluation prior to January 1, 2011, will allow the Program Director to demonstrate continual enrollment and progress (as defined by 15 semester hours per year) toward a Bachelors degree until successfully completed. This progress will be monitored by the CoAEMSP. Failure to meet the mandate will result in probation and loss of CAAHEP accreditation. There is NO mandate that requires PD’s to possess a Master’s degree, however it is recommended if they oversee a Paramedic educational program.

Question:   Is it mandatory that our program be affiliated with a college or university?

Answer: NO, however, the program MUST meet one of the sponsorship requirements outlined in the Standards and Guidelines.  

        Examples include:

a) a post-secondary academic institution accredited by an institutional accrediting agency or equivalent recognized by the U.S. Department of Education and authorized to provide a post-secondary program or to approve college credit which awards a minimum of certificate of completion for the program
(example - a college or university accredited by a regional institutional accreditor such as the Southern Association of Colleges and Schools)

b) foreign post-secondary academic institution approved by CAAHEP

c) a hospital, clinic, or medical center accredited by a healthcare accrediting agency or equivalent recognized by the U.S. Department of Health and Human Services, authorized to provide healthcare, which is affiliated with a post-secondary educational institution or equivalent, or an accredited graduate medical education program, which awards a certificate of completion for the program (example - an accredited residency program, accredited nursing school or accredited allied health school in a hospital and owned by a hospital)

d) a branch of the U.S. Armed Forces or other governmental educational or medical service which is affiliated with an accredited post-secondary educational institution or equivalent that is authorized under applicable law or other acceptable authority to provide a post-secondary educational program which awards a minimum of a certificate of completion of the program, or a national organization authorized under applicable law or other acceptable authority to approve college credit
(example - U.S. Public Health Service, U.S. Indian Health Service, or United States Army)

Question:   Our program does not meet any of the current sponsorship requirements. Are there any options available to continue our Paramedic education program?

Answer: Yes.

The Standards and Guidelines permit the development of a CONSORTIUM. The Consortium allows a minimum of two (2) or more members, with an interest in operating an educational program to work together to meet the needs of their community.

At least one (1) member MUST meet the requirements of Sponsorship as defined by the Standards and Guidelines. The CoAEMSP provides a template for the Consortium which defines the roles and responsibilities of each member including governance and lines of authority?