A BILL TO BE ENTITLED
AN ACT to require the national registry of emergency medical technicians examination for credentialing as various emergency medical services personnel.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 131E‑155 reads as rewritten:
"§ 131E‑155.  Definitions.
As used in this Article, unless otherwise specified:
…
(17)	"Practical examination" means a test that complies with National Registry of Emergency Medical Technicians examination standards where an applicant for credentialing as an emergency medical technician, emergency medical responder, advanced emergency medical technician, or paramedic demonstrates the ability to perform specified emergency medical care skills."
SECTION 2.  G.S. 131E‑159 reads as rewritten:
"§ 131E‑159.  Credentialing requirements.
(a)	Individuals seeking credentials as an emergency medical technician, advanced emergency medical technician, paramedic, emergency medical responder, emergency medical dispatcher, or emergency medical services instructor shall apply to the Department using forms prescribed by that agency. The Department's representatives shall examine the applicant by either written, practical, or written and practical examination. The Department shall issue appropriate credentials to the applicant who meets all the requirements set forth in this Article and the rules adopted for this Article and who successfully completes the examinations required for credentialing. Emergency medical technician, emergency medical responder, emergency medical dispatcher, advanced emergency medical technician, paramedic, and emergency medical services instructor credentials shall be valid for a period not to exceed four years and may be renewed if the holder meets the requirements set forth in the rules of the Commission. The Department is authorized to revoke or suspend these credentials at any time it determines that the holder no longer meets the qualifications prescribed.
(b)	Subject to subsections (c1) and (d1) of this section, the Commission shall adopt rules setting forth the qualifications required for credentialing of emergency medical responders, emergency medical technicians, advanced emergency medical technicians, paramedics, emergency medical dispatchers, and emergency medical services instructors.
(b1)	Beginning January 1, 2026, a person seeking credentialing or renewal of credentialing under subsection (b) of this section shall only qualify for credentials under this section if the person passes the National Registry of Emergency Medical Technicians examination for the level of certification desired. Any other examination shall not be recognized by the Commission. Persons that possess a State credential or other accepted credential that is not from the National Registry of Emergency Medical Technicians for their respective certification prior to January 1, 2026, shall be certified under the National Registry of Emergency Medical Technicians by January 1, 2030.
(c)	Individuals currently credentialed as an emergency medical technician, advanced emergency medical technician, paramedic, emergency medical responder, and emergency medical services instructor by the National Registry of Emergency Medical Technicians or by another state where the education/credentialing requirements have been approved for legal recognition by the Department of Health and Human Services, in accordance with rules promulgated by the Medical Care Commission, and who is either currently residing in North Carolina or affiliated with a permitted EMS provider offering service within North Carolina, may be eligible for credentialing as an emergency medical technician, advanced emergency medical technician, paramedic, emergency medical responder, and emergency medical services instructor without examination. This credentialing shall be valid for a period not to exceed the length of the applicant's original credentialing or four years, whichever is less.
(c1)	A person seeking credentialing under subsection (b) of this section is required to pass the National Registry of Emergency Medical Technicians examination for the level of certification desired and undergo a criminal history background check in accordance with subsection (g) of this section. The National Registry of Emergency Medical Technicians examination requirements shall include all sections of the examination as appropriate for each level, including (i) didactic, practical, and clinical requirements, (ii) cognitive and psychomotor skills examinations, and (iii) the receipt of the National Registry of Emergency Medical Technicians certification.
(d)	An individual currently credentialed as an emergency medical dispatcher by a national credentialing agency, or by another state where the education/credentialing requirements have been approved for legal recognition by the Department of Health and Human Services, in accordance with rules issued by the Medical Care Commission, and who is either currently residing in North Carolina or affiliated with an emergency medical dispatcher program approved by the Department of Health and Human Services offering service within North Carolina, may be eligible for credentialing as an emergency medical dispatcher without examination for up to one year. If a person is seeking credentialing in this State and holds a state‑level certificate as an emergency medical technician, advanced emergency medical technician, paramedic, emergency medical responder, emergency medical dispatcher, or emergency medical services instructor in another state, the person must obtain a credential from the National Registry of Emergency Medical Technicians within one year of the issuance of their credentialing in this State. After one year, the person cannot continue to be credentialed until passage of the National Registry of Emergency Medical Technicians examination for the level of certification desired.
(d1)	Any person seeking credentialing as a specialty certification, including a flight paramedic, critical care paramedic, community paramedic, tactical paramedic, wilderness paramedic, designated infection control officer, or a medical transportation safety professional, shall pass the appropriate examination from the International Board of Specialty Certification.
(e)	Duly authorized representatives of the Department may issue temporary credentials with or without examination upon finding that this action will be in the public interest. Temporary credentials shall be valid for a period not exceeding 90 days.
(f)	The Department may deny, suspend, amend, or revoke the credentials of an emergency medical responder, emergency medical technician, advanced emergency medical technician, paramedic, emergency medical dispatcher, or emergency medical services instructor in any case in which the Department finds that there has been a substantial failure to comply with the provisions of this Article or the rules issued under this Article. Prior to implementation of any of the above disciplinary actions, the Department shall consider the recommendations of the EMS Disciplinary Committee pursuant to G.S. 143‑519. The Department's decision to deny, suspend, amend, or revoke credentials may be appealed by the applicant or credentialed personnel pursuant to the provisions of Article 3 of Chapter 150B of the General Statutes, the Administrative Procedure Act.
(g)	An individual who applies for EMS credentials, seeks to renew EMS credentials, or holds EMS credentials is subject to a criminal background review by the Department. At the request of the Department, the Emergency Medical Services Disciplinary Committee, established by G.S. 143‑519, shall review criminal background information and make a recommendation regarding the eligibility of an individual to obtain initial EMS credentials, renew EMS credentials, or maintain EMS credentials. The Department and the Emergency Medical Services Disciplinary Committee shall keep all information obtained pursuant to this subsection confidential. The Medical Care Commission shall adopt rules to implement the provisions of this subsection, including rules to establish a reasonable fee to offset the actual costs of criminal history information obtained pursuant to G.S. 143B‑1209.33.
(g1)	A person who is credentialed under this Article shall be required to keep on their person a certification card that is up to date. In the event of a person losing their certification card, the person shall order a duplicate. The Commission shall publish on their website a method for contact to assist persons in ordering a replacement card.
(h)	A person who is required to register as a sex offender under Article 27A of Chapter 14 of the General Statutes, or who was convicted of an offense which would have required registration if committed at a time when such registration would have been required by law, shall not be granted EMS credentials. The Department shall not renew the credentials of any person who would be ineligible for EMS credentials under this subsection."
SECTION 3.  The Medical Care Commission shall adopt temporary rules to implement the provisions of this act. The temporary rules adopted shall remain in effect until permanent rules are adopted to replace the temporary rules.
SECTION 4.  This act becomes effective January 1, 2026.