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Recertification abuses prompt EMT scrutiny

Thorough review pledged

By Donovan Slack
Globe Staff / May 28, 2010

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State public health officials are reviewing EMT certification procedures after discovering that more than 200 emergency medical responders in a dozen communities, including Boston, had obtained recertification without attending medical training.

As state health officials continued to investigate new tips yesterday, they said the state’s process for biannual recertification training is more lax than for initial licensing and may need to be revamped.

“One outcome of the investigation is a thorough review of the procedure for refresher courses,’’ Public Health Commissioner John Auerbach said.

In order to teach the more intensive initial training courses, instructors are closely vetted and are subjected to annual written evaluations. By contrast, anyone with a valid EMT or paramedic li cense and a teaching certificate can conduct recertification training and operate with little supervision. State health officials, who say recertification trainers authorized credentials for people who did not attend their classes, now wonder whether stricter vetting and supervision would have averted the problem.

In Boston, Mayor Thomas M. Menino said he was disturbed by the state’s findings that 18 city firefighters are among those who obtained EMT recertifications without attending training, in some cases collecting overtime pay without going to class and meeting in bars and restaurants to get their recertification cards.

“How long has this been going on? That’s the question somebody has to answer,’’ Menino said. “They’ve defrauded the system.’’

He said the city’s fire commissioner is conducting a swift and thorough investigation to get to the bottom of what happened in Boston and mete out whatever discipline is warranted.

Among the 18 are a district chief and several lieutenants and captains, according to two public officials who spoke on condition of anonymity because they do not have permission to speak publicly.

The state has been investigating the recertification abuse for several weeks, and officials expect it will expand to include first responders in more cities and towns. State officials have demanded that improperly certified technicians and paramedics undergo new training, but they have remained silent on whether any of the cases will be referred to the attorney general for criminal prosecution. It is illegal to falsify emergency medical training records in Massachusetts.

“This has been and continues to be an in-depth investigation,’’ Auerbach said.

One Northern Massachusetts ambulance company named in the investigation said yesterday that about 30 EMTs were found to have obtained recertification without attending the required training through an employee who operated an outside training business. Christopher Dick of Haverhill-based Trinity Emergency Medical Services said the employee has now been let go and that he did not sign off on recertifications as part of his work at Trinity.

Dick said the company discovered the recertification scheme on its own and reported it to state officials a few weeks ago, then suspended affected employees until they had completed proper recertification courses.

“We had them all trained the following week,’’ Dick said.

Trinity ambulances serve a dozen cities and towns in Massachusetts and New Hampshire.

There are 22,878 certified emergency medics in Massachusetts, from basic EMT level to advanced paramedic level. All must complete recertification training of between 24 and 36 hours every two years to reinforce basics and learn about new medications, techniques, and equipment.

“While it isn’t possible to evaluate the specific impact on care that may result from failing to attend a recertification training, these refresher courses are an important way of optimizing the skills of the EMTs,’’ Auerbach said.

Under state law, both the trainers and the EMTs who awarded or received fake credentials could be held accountable. In a letter sent to emergency medical providers last week, officials said it is unlawful for any person or entity to knowingly omit a material fact or make a false statement in any written document in the EMT certification process. The state can suspend or revoke licenses of individuals found in violation and can refer cases to prosecutors for criminal sanctions.

Auerbach said the state has not taken such actions yet because the investigation is still underway.

“We cannot suspend or terminate EMT licenses without going through due process,’’ he said. “After the completion of the investigation in the next few weeks, we will take action.’’

Auerbach gave more details yesterday about how the state determined that public health has not been jeopardized by the recertification scandal. He said investigators from his agency asked each affected ambulance company or municipality to sift through medical records and patient complaints during the past two years to find any evidence that medical care was compromised by the improperly certified medics. None reported problems.

“We were relieved that there was no such evidence,’’ Auerbach said. “From the start of this investigation, our primary concern has been whether there had been a threat to the health and safety of the public.’’

Donovan Slack can be reached at dslack@globe.com.

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