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Scope of practice waiver requests

EMS medical directors may submit a request to expand the scope of practice for the agencies they oversee. Initial, renewal, and transfer applications for existing approved waiver types are submitted via the medical director's OATH account. The EMS medical director must be registered and affiliated with each EMS agency and create separate applications for each waiver at each agency. The agency must have an up-to-date organizational profile, comply with data reporting requirements, complete the most recent waiver data entry training, and meet the guidelines for the applicable waiver type. To get started, find guidance for the different application types below. 

For waiver requests that are not in the existing approved waiver types folder, see the novel waiver section on this page. The Emergency Medical Practice Advisory Committee reviews novel waiver applications quarterly. Novel waiver applications must be submitted on the first Friday of January, April, July and October.

Application types

Initial waiver applications are reviewed monthly by the department.

Application prerequisites

  • The agency has a current organizational profile in OATH.
  • Your medical director registration is current and lists each agency you oversee.
  • At least one person at the agency has completed the online waiver data entry training.
  • The agency meets the approved guidelines for the requested waiver type.
    • If the agency is on a plan of correction, ensure the agency is compliant with the department-approved plan.
  • The agency is able to submit ePCR data to the state repository.

Application steps

  1. Log in to your OATH account.
  2. Click Applications and then start on the left-side menu.
  3. Click the "View All Services Applications" button under the agency name for which you're applying for a waiver.
    • If you are affiliated with multiple agencies, use the "Filter by Services" drop-down to select the appropriate agency.
  4. Click the "Apply Now" button next to the 'Scope of Practice Waiver - Agency application'.
  5. Select "Initial" and complete the rest of the application.
  6. Submit the completed application for review by the department.

Renewal applications are reviewed monthly by the department. Renewal applications can be submitted at any time prior to the waiver expiration date. If a renewal waiver application is not submitted prior to a waiver’s expiration date, you must submit an initial waiver application.

Application prerequisites

  • The agency has a current organizational profile in OATH.
  • Your medical director registration is current and lists each agency you oversee.
  • At least one person at the agency has completed the online waiver data entry training.
  • The agency meets the approved guidelines for the requested waiver type.
    • If the agency is on a plan of correction, ensure the agency is compliant with the department-approved plan.
  • The agency is able to submit ePCR data to the state repository.
  • The agency is up-to-date with the submission of quarterly waiver data verification forms (and any cardiac arrest supplemental forms as needed) in HIDs.

Application steps

  1. Log in to your OATH account.
  2. Click Applications and then start on the left-side menu.
  3. Click the "View All Services Applications" button under the agency name for which you're applying for a waiver.
    • If you are affiliated with multiple agencies, use the "Filter by Services" drop-down to select the appropriate agency.
  4. Click the "Apply Now" button next to the 'Scope of Practice Waiver - Agency application'.
  5. Select "Renewal" and complete the rest of the application.
  6. Submit the completed application for review by the department.

A transfer application must be submitted to transfer waivers from the current medical director to an incoming medical director. The incoming medical director must submit a transfer application before the existing medical director ceases medical direction at the agency. Exigent transfer requests are reviewed on an ongoing basis by the department. The department reviews transfer applications monthly. 

Application prerequisites

  • The agency has a current organizational profile in OATH.
  • Your medical director registration is current and lists each agency you oversee.
  • At least one person at the agency has completed the online waiver data entry training.
  • The agency meets the approved guidelines for the requested waiver type.
    • If the agency is on a plan of correction, ensure the agency is compliant with the department-approved plan.
  • The agency is able to submit ePCR data to the state repository.
  • The agency is up-to-date with the submission of quarterly waiver data verification forms (and any cardiac arrest supplemental forms as needed) in HIDs.

Application steps

  1. Log in to your OATH account.
  2. Click Applications and then start on the left-side menu.
  3. Click the "View All Services Applications" button under the agency name for which you're applying for a waiver.
    • If you are affiliated with multiple agencies, use the "Filter by Services" drop-down to select the appropriate agency.
  4. Click the "Apply Now" button next to the 'Scope of Practice Waiver - Agency application'.
  5. Select "Transfer" and complete the rest of the application.
  6. Submit the completed application for review by the department.

Novel waivers

Novel waiver applications are reviewed quarterly by the department and the Emergency Medical Practice Advisory Committee. Novel waivers are requested to propose guidelines for any waiver type for which guidelines don't already exist. 

  1. Follow the initial waiver application steps.
  2. After starting the application, select "Novel" for the application type.
    1. Novel waiver requests only need to be submitted once per medical director. If you oversee multiple agencies, you do not need to submit duplicative novel waiver requests for separate agencies.
    2. Novel waiver requests must include the following documentation:
      • How will this novel waiver improve, advance, or contribute to EMS care in the state of Colorado
      • Additional processes and/or infrastructure that should be in place to ensure patient safety while using this waiver
      • Specific clinical scenario in which the waiver would be used
      • Statewide guideline information, including:
        • Proposed protocols/guidelines
        • EMS provider level
        • Care setting (911, Interfacility Transfer)
        • Level of intervention (Monitor, Maintain, Initiate)
        • Authorization (Verbal Order, Written Order, Standing Order)
        • Supervision (Supervised, Independent)
        • Proposed education and training requirements
        • Proposed quality management requirements
        • Literature review/citations
        • Justification of need
  3. After submission, the department will de-identify the application and refer it to the EMPAC for review and recommendation at its next quarterly meeting. Upon recommendation, the department will make an approval decision.
  4. If approved, a Colorado EMS waiver guideline for the waivered act will be published online and added to the 'Scope of Practice Waiver - Agency' application in OATH. The novel waiver application you submitted will be processed as an initial application.

After approval

  • Follow the steps to apply for an initial, renewal or transfer waiver above for the newly approved waivered act for any additional agencies for which you oversee.

  • Register in HIDS and begin reviewing your quarterly waiver data. 

  • Submit waiver data verification forms for each waiver in HIDS quarterly.

  • Reach out to cdphe.emtsdata@state.co.us if you have any questions regarding your waiver data.