Commonly needed policies and other good stuff
EMS
The Emergency Medical Services (EMS) system in Massachusetts is a coordinated network of resources regulated by the Massachusetts Department of Public Health (DPH) Office of Emergency Medical Services (OEMS). Its goal is to reduce death and disability from acute illness or injury by ensuring prompt, high-quality pre-hospital care and transport to appropriate healthcare facilities.
Key Components
Oversight and Regulation: OEMS is the primary regulatory body, responsible for:
Certifying EMS personnel (EMTs at all levels).
Licensing ambulance services (Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care).
Enforcing the statewide EMS regulations (105 CMR 170.000).
Coordinating local and regional EMS resources.
Regional EMS Councils: The state is divided into five geographical EMS regions, each with a designated regional council. These councils coordinate EMS activities, oversee quality patient care, and provide continuing education opportunities within their specific areas.
EMS Personnel Levels: Massachusetts has four recognized levels of function and training for EMS personnel:
Emergency First Responder (EFR)
EMT-Basic
Advanced EMT
Paramedic
All certified EMTs must also be authorized to practice by an affiliate hospital medical director.
Affiliate Hospital Medical Directors (AHMDs): AHMDs provide medical oversight and are responsible for authorizing EMS personnel to practice under their ambulance service's affiliation agreement. They ensure care is delivered according to statewide treatment protocols.
Response and Transport: When 911 is called for a medical emergency, the system dispatches qualified pre-hospital clinicians (EMTs and paramedics) who provide on-scene care and safe transport to the most appropriate healthcare facility, such as a DPH-approved acute care hospital emergency department or trauma center.
Emerging Programs: The system also includes newer initiatives like Mobile Integrated Health Care (MIH) and Community EMS programs, which use mobile resources and community paramedics to deliver care and services in out-of-hospital environments, often to support patients' needs within their communities and avoid unnecessary emergency department visits.
EMS Certification Levels in Massachusetts
EFR- Emergency First Responder – a trained individual, often a public safety professional like an EMT, firefighter, or police officer, who provides immediate assistance at the scene of an emergency before more advanced medical help arrives. This includes assessing the situation, administering basic first aid, and ensuring the scene is safe. Roles can also include other trained personnel, such as lifeguards or community emergency response team members, who provide first response care. This level of certification is not directly over seen by MA OEMS.
EMT-Basic – a certified first responder who provides basic emergency medical care, such as CPR, bleeding control, and stabilization, to patients before they reach a hospital.
EMT-Advanced (AEMT)- provides basic and limited advanced emergency medical care, building upon standard EMT skills to include interventions like IV access and medication administration. To become an AEMT, one must first be a licensed EMT and then complete a specialized, longer Advanced EMT program.
Paramedic (EMT-P)- A paramedic provides emergency medical care to patients, responds to 911 calls, and transports sick or injured individuals to medical facilities. They are trained to perform advanced life support, which includes administering medications, starting IVs, and advanced airway management. To become a paramedic, one must first be a licensed EMT and then complete a specialized, longer paramedic program.
What paramedics do?
· Respond to emergency calls and provide medical care at the scene and enroute to the hospital.
· Perform advanced life support procedures like giving medications, starting IVs, and using defibrillators.
· Provide advanced airway management, including performing emergency tracheotomies.
· Use equipment like defibrillators and interpret medical tests.
· Communicate with patients, their families, and other healthcare professionals.
· Transport patients safely to hospitals or other medical facilities.
· Provide care for a wide range of medical and traumatic emergencies, including assisting with childbirth.
Skills and qualifications
· Education: Must complete a paramedic program after becoming a licensed EMT.
· Certifications: Need to be licensed in the state of employment, which may include national certification exams like those offered by the National Registry of Emergency Medical Technicians (NREMT).
· Skills: Requires both technical and soft skills, such as medical knowledge, ability to work under pressure, and strong communication abilities.
· Physical demands: Must be able to meet the physical demands of the job, which can include lifting, carrying, and working in stressful environments.
Critical Care Paramedic- The scope of practice for a critical care paramedic (CCP) varies depending on the jurisdiction and state regulations. However, some common elements of the CCP scope of practice include:
Advanced Airway Management: Intubation (endotracheal and nasotracheal), Extubation, Cricothyrotomy, and Mechanical ventilation.
Advanced Medication Administration:
Intravenous medications (e.g., sedatives, analgesics, vasoactive agents)
Blood products
Glycoprotein IIb/IIIa inhibitors
Thrombolytic agents
Hemodynamic Monitoring: Arterial and central venous pressure monitoring, Cardiac output measurement, and Ultrasound-guided fluid management.
Trauma Care: Advanced trauma life support (ATLS) procedures, Pelvic stabilization, and Chest decompression.
Critical Care Transport:
Interfacility transport of critically ill patients
Management of complex medical emergencies during transport
Other Procedures: Cardiac defibrillation, Pediatric advanced life support (PALS), Neonatal resuscitation, and Obstetric emergency management.
Specific Requirements:
CCPs must have a valid paramedic license and complete additional training in critical care.
They may need to obtain specialized certification in certain areas, such as pediatric critical care or flight paramedicine.
Their scope of practice may be further defined by local protocols and medical director orders.
2024 EMS Salary Overview
In 2024, the average annual salary for an EMT in Massachusetts was approximately $46,350, with an hourly wage of about $22.28. The salary range for this role is broad, generally falling between $38,800 (25th percentile) and $51,300 (75th percentile) annually. The specific salary depends on factors like experience, location, and employer.
Salary breakdown
Average Annual Salary: $46,350
Average Hourly Wage: ~$22.28
25th Percentile (Lower End): $38,800
75th Percentile (Higher End): $51,300
Top Earners: Can exceed $58,974 annually
In 2024, the average annual salary for a paramedic in Massachusetts is approximately $59,883, with the 25th percentile earning about $48,100 and the 75th percentile earning around $66,600. This translates to an average hourly wage of about $29. Some companies may offer different rates, such as Pro EMS which lists a total pay range of $50K-$71K per year for a paramedic, including base salary and additional pay, says Glassdoor.
Salary breakdown
Average Annual Salary: $59,883
Average Hourly Wage: $29
25th Percentile (Lower earners): $48,100 annually / $23 per hour
75th Percentile (Higher earners): $66,600 annually / $32 per hour
Top Earners: Around $78,086 annually / $37 per hour
https://www.indeed.com/career/paramedic/salaries/MA
National Registry of Emergency Medical Technicians
https://www.nremt.org/EMR/Certification
The National Registry is a non-profit, non-governmental certification organization serving the emergency medical services (EMS) community. Through validating the knowledge, skills, and competency of EMS professionals and providing a uniform standard across states for emergency medical care. At its core, the National Registry is focused on public safety.
The National Registry certifies four (4) EMS levels—EMR, EMT, AEMT, and Paramedic—based on the National EMS Scope of Practice Model. National Subject Matter Experts (SMEs), including State Officials, educators, employers, and physicians, create and pilot test examination questions through a year-long process. The team calibrates each question to ensure entry-level competency while maintaining legal and psychometric standards.
Clarifying-Roles-in-EMS Oversight
The National Registry verifies competency — the knowledge, skills, and abilities needed to provide safe and effective patient care. It does NOT assess personality, character, or behavior.
Licensure and conduct oversight fall to state EMS offices, while employers make decisions about hiring or discipline. Each plays an important role in protecting the public and maintaining trust in the profession.
Massachusetts Office of Emergency Medical Services
https://www.mass.gov/orgs/office-of-emergency-medical-services
https://www.mass.gov/guides/apply-for-an-initial-emt-advanced-emt-or-paramedic-certification
EMS Education Programs – Region 1
EMT Academy
Springfield, MA
Approved Levels: EMT, AEMT, Paramedic (CAAHEP Accredited)
Region I
MA DPH accreditation expires 8/1/2028
Greenfield Community College
Greenfield, MA
Approved Levels: EMT, AEMT, Paramedic (CAAHEP Accredited)
Region I
MA DPH accreditation expires 5/1/2026
https://www.gcc.mass.edu/academics/programs/paramedic-certificate/
National EMS Institute
Carver, MA
Approved Levels: EMT
Regions I, II, III, IV and V
MA DPH accreditation expires 12/1/2025
NCTI-Springfield
Springfield, MA
Approved Levels: EMT, AEMT, Paramedic (CAAHEP Accredited)
Region I
MA DPH accreditation expires 1/1/2026
North Adams Ambulance Services, Inc.
North Adams, MA
Approved Levels: EMT
Region I MA
MA DPH accreditation expires 1/1/2027
https://northadamsambulance.com/
Southern Berkshire Volunteer Ambulance Squad, Inc.
Great Barrington, MA
Approved Levels: EMT
Region I
MA DPH accreditation expires 6/1/2028
Springfield College
Springfield, MA
Approved Levels: EMT
Region I
MA DPH accreditation expires 5/1/2027
Springfield Technical Community College
Springfield, MA
Approved Levels: EMT
Region I
MA DPH accreditation expires 4/1/2027
Westfield State University
Westfield, MA
Approved Levels: EMT, AEMT, Paramedic (CAAHEP Letter of Review)
Region I
MA DPH accreditation expires 6/1/2026
https://www.westfield.ma.edu/academics/non-credit-options/emergency-medical-services-training