Administrative Policy Effective Expires April 1, 2015 Policy: MICN Challenge Applies To: MICN, EMS System 1210 March 31, 2016 Approval: REMSA Medical Director Daved van Stralen, MD Signed Approval: REMSA Director Bruce Barton, Paramedic Signed PURPOSE The purpose of this policy is to define the requirements for authorization by challenge as a mobile intensive care nurse (MICN) in Riverside County. AUTHORITY California Health and Safety Code - Division 2.5: Emergency Medical Services [1797. - 1799.207.] California Code of Regulations, Title 22. Social Security, Division 9. Prehospital Emergency Medical Services Mobile Intensive Care Nurse Challenge 1. In order to be eligible to challenge the Mobile Intensive Care Nurse (MICN) authorization process, an individual must: a. Be currently licensed by the State of California as a Registered Nurse (RN). b. Possess or have possessed a valid MICN authorization from a California EMS Agency OR possesses a MICN authorization within Riverside County which is over one year expired. c. Be currently employed in the Emergency Department (ED) at a Base Hospital within Riverside County AND have completed any length of employment requirements of that hospital. d. Have successfully completed an MICN orientation process to include a minimum of: i. Four hours of protocol review and successful completion of an approved MICN written examination. ii. 24 hours of precepted EMS radio time. iii. Eight hours of ride-along time and four hours of field care audits, with at least three of the audited cases being runs that the individual participated in as a MICN challenge candidate. iv. Eight hours of REMSA-approved Skills Labs on Performance Standards, to include all skills modules required by REMSA. 1. A REMSA-approved skills competency verification form must be submitted at the time of the challenge. v. Three months of probationary EMS radio experience. e. The MICN orientation process will be completed within a five month period. 2. MICN authorization will be valid for a period of two years from the month of completion of the probationary period or the expiration of the State Registered Nurse license, whichever comes first, provided Base Hospital ED employment is maintained. 3. Authorization expires on the final day of the final month of the authorization period. 4. An individual applying for MICN authorization by challenge will submit the following: a. A completed and signed application. b. A valid RN license from the State of California. c. Current legal photo I.D. (i.e., state driver license, state I.D. card, military I.D. or passport). Photo must clearly show the individual. d. Proof of "1.b." e. Submission of an original ALS Skills Competency Verification (SCV) form, completed by an approved verifier in accordance with the REMSA Policy for Skills Competency Verification. 1210 — MICN Challenge (3/31/15 - 18:40) 1 of 2 f. Original documentation of criteria fulfillment as specified in Section “1.c.” and “1.d.” Verification should be submitted (in letter form) by the PLN at the Base Hospital. g. The established non-refundable fee payable to Riverside County EMS Agency. 5. All applications must be done in person; appointments are strongly encouraged. As of June 15, 2015, appointments are mandatory. Call the EMS Agency at (951) 358 – 5029. a. If extenuating circumstances prohibit in-person submission, a notarized statement (using the appropriate EMS Agency form) validating identification may be submitted with photocopies (front and back) of items listed in Steps “4.b.” through “4.c.” and completion of all other steps. 6. Only complete applications (completed form and all supporting materials) will be accepted. Incomplete application packets will be returned with a written deficiency notice. Once the deficiencies are corrected, the complete application packet may then be resubmitted. a. Individuals required by the EMS Agency to submit information / documentation in addition to the standard elements will be permitted one month to submit those additional materials. 1210 — MICN Challenge (3/31/15 - 18:40) 2 of 2
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