NREMT Testing Voucher Program FAQs

Voucher Frequently Asked Questions

What EMS services qualify to apply for the Initial NREMT Testing Voucher Program?

An EMS service established by volunteer or municipal corporations or an association made up of two or more municipalities in a rural area may qualify for the Initial NREMT Testing Voucher Program. The Department of Health, Emergency Care System can help you determine if your EMS service qualifies. Contact us by email if you have questions.

How do I determine if my staffing model for my EMS service is considered volunteer?

Merriam-Webster defines a volunteer as "a person who freely offers to take part in an enterprise or undertake a task."

The National Highway Traffic Safety Association, National EMS Workforce Data Definition document defines volunteers as "licensed EMS workers who receive nominal or no compensation for their provision of EMS services at the agency."

The Washington State Fire Chiefs Association categorizes services as volunteer if one volunteer staff member is identified as being used by the service.

The following categories of personnel service level status will be used to identify EMS service staffing model:

  • Paid: All staff members are compensated.
  • Volunteer: All staff members are volunteer.
  • Combination: A combination of any of the following:
    • Some staff members are paid
    • Some staff members are volunteer and receive some form of *nominal compensation.
    • Some staff members are volunteer and receive no compensation.

*Nominal means 20 percent or less than what a public EMS service would otherwise pay to hire a full-time person for the same services.

What is an association made up of two or more municipalities?

An association is defined as “an organization of persons having a common interest.” (Merriam-Webster). For example, two towns who provide a joint ambulance service.

How do I determine if my staffing model for my EMS service is considered volunteer?

Merriam-Webster defines a volunteer as "a person who freely offers to take part in an enterprise or undertake a task."

The National Highway Traffic Safety Association, National EMS Workforce Data Definition document defines volunteers as "licensed EMS workers who receive nominal or no compensation for their provision of EMS services at the agency."

The Washington State Fire Chiefs Association categorizes services as volunteer if one volunteer staff member is identified as being used by the service.

The following categories of personnel service level status will be used to identify EMS service staffing model:

  • Paid: All staff members are compensated.
  • Volunteer: All staff members are volunteer.
  • Combination: A combination of any of the following:
    • Some staff members are paid
    • Some staff members are volunteer and receive some form of *nominal compensation.
    • Some staff members are volunteer and receive no compensation.

*Nominal means 20 percent or less than what a public EMS service would otherwise pay to hire a full-time person for the same services.

How do I determine if my EMS service is in a rural area?

Rural is defined in WAC 246-976-010 as "unincorporated or incorporated area with a total population of less than ten thousand people, or with a population density of less than one thousand people per square mile." The Department of Health, Emergency Care System section can help you determine if your EMS service is identified as rural within the census block identified in the rule. If you have questions, please contact us at 360-236-2809.

Do I need to fill out separate applications for different levels of EMS course vouchers?

Yes, at this time EMS services must fill out separate applications if they are applying for different levels of EMS vouchers.

What is advanced first aid (AFA)?

Advanced first aid is defined in WAC 246-976-010 as "means an advanced first-aid course prescribed by the American Red Cross or its equivalent."

What is a non-medically trained driver?

According to RCW 18.73.150, "With approval from the department, an ambulance service established by volunteer or municipal corporations in a rural area with insufficient personnel may use a driver without any medical or first aid training so long as the driver is at least eighteen years old, successfully passes a background check issued or approved by the department, possesses a valid driver's license with no restrictions, is accompanied by a non-driving emergency medical technician while operating the ambulance during a response or transport of a patient, and only provides medical care to patients to the level that they are trained."

Where can I find my EMS service's legacy number?

The legacy number is also known as the fire department identification number (FDID) assigned to that agency by the Washington Fire Chiefs Association. The legacy number is the same number as FDID, with just a different name for Washington State Department of Health.

What is the approval process?

EMS service or SEI will complete and submit the application for the initial NREMT testing voucher program to hsqa.ems@doh.wa.gov. EMS service or SEI should return the application no later than three weeks before the course end date.

Department of Health, Emergency Care System personnel will review applications for the initial NREMT testing voucher program.

The vouchers awarded to EMS services are distributed on a first-come, first-served basis. A standard point-based criteria will be used to identify EMS services that have demonstrated high need to decide the number of vouchers awarded.

Vouchers will be given to EMS services who have demonstrated high need, which includes services established in rural areas with an all-volunteer staffing model and services using advanced first aid (AFA) personnel or non-medically trained drivers.

Additionally, geographic distribution, number of requests per EMS service, and identified financial support for course and testing may be taken into consideration and could affect the number of vouchers awarded.

As a requirement of participation in the Initial NREMT Testing Voucher Program, requesting EMS service representative or SEI will be required to complete a follow-up survey. Instructions for this survey will be included in the approval email and must be submitted to the Department of Health.

When will my EMS service be notified if it is approved or denied for a voucher? How will my EMS service be notified?

The approval process is expected to take two to four weeks. The Department of Health, Emergency Care System will notify services via email if they have been awarded or denied vouchers.

Why wasn't my EMS service chosen for the number of vouchers applied for?

EMS services may be awarded fewer vouchers based on a needs assessment that was conducted during the approval process. The needs assessment gives priority to services that have demonstrated a higher need, which includes services established in rural areas and services with an all-volunteer staffing model, or using advanced first aid or non-medically trained drivers. Identified financial support and geographic distribution is also considered. If you have any questions regarding this process please contact Department of Health, Emergency Care System, at hsqa.ems@doh.wa.gov, for more information.

When do the vouchers expire?

The vouchers expire in one year from the time the Department of Health Emergency Care System purchases them, and will be identified in your award letter.

Who submits the completed application for the Initial NREMT Testing Voucher Program?

The application should be completed and submitted by the student's affiliated EMS service or the course senior EMS instructor (SEI).

If I pay for the exam out of pocket, can I be reimbursed?

No, the department doesn't have a way to reimburse people who paid for the exam out of pocket. The voucher must be used as the form of payment at the time of exam purchase.

What if my EMS service doesn't use a voucher after it is issued?

The EMS service may return the unredeemed voucher back to the program for reissuance to another EMS service. Please contact the Department of Health, Emergency Care System, 360-236-2838 or by email at hsqa.ems@doh.wa.gov, for more information.

What is required of my EMS service once awarded a voucher(s) for initial NREMT testing?

After receiving vouchers from the initial NREMT testing voucher program, EMS services will be required to complete a follow-up survey and to supply additional information.

How many vouchers are available?

The availability of vouchers varies depending on need and funding. Please contact EMS Education and Training 360-236-2842, or administrative support 360-236-2838, or by email, hsqa.ems@doh.wa.gov to check on availability.

Where does the money come from?

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H54RH00002, the Medicare Rural Hospital Flexibility Program.

How long can my EMS service depend on the initial NREMT testing voucher program?

Because of the nature of the FLEX grant, there is no guarantee in the future. The Department of Health must reapply for the grant annually with no promise of getting ongoing funding awarded.

Who may I contact for more information on the initial NREMT voucher program?

If you have any questions regarding the initial NREMT testing voucher program, please contact EMS Education and Training 360-236-2842, or administrative support, 360-236-2838, or via email at hsqa.ems@doh.wa.gov.