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Rev. 8/8/2018 - 2 - <br />9. Agency Quality Assurance Plan <br />10. Agency Equipment Attestation <br />11. Agency Infection Control Plan/Policy <br />12. Agency Medical Treatment Agreement <br />Required Document Description <br />1. Agency CONTINUUM Roster Attestation: Completed Attestation (Attachment 2) <br />that the Agency is maintaining an active and up to date roster in the North Carolina <br />Office of EMS Credentialing Information System. <br />a. CONTINUUM - "Credentialing Information System" is a database of all <br />credentialed providers in the North Carolina EMS system. It is a <br />mechanism for agencies to verify an individual's credential and date of <br />expiration. <br />b. All EMS Response Agencies in Orange County are currently listed in the <br />CONTINUUM. <br />c. As a credentialed provider joins or leaves an Agency, Agencies will update <br />their CONTINUUM roster. <br />d. The North Carolina Office of EMS will update provider’s credentials as they <br />change including expiration dates. The EMS system administrator, training <br />Coordinator, and Agency representative receive notification of all expired <br />credentials automatically through the CONTINUUM system. <br />e. Providers receive email notification at thirty days prior to expiration and new <br />credentials are mailed through CONTINUUM to the provider’s listed <br />address; therefore it is critical that providers ensure their contact information <br />is current in CONTINUUM. <br />2. Agency Service Description: Orange County Emergency Services requires a full <br />description of the type and level of EMS service to be provided by the applying <br />Agency, including the location(s) from which it is intended to operate. <br />a. Agencies should define the type and level of service to be provided (e.g. <br />Emergency Medical Technician, Advanced EMT, Paramedic). <br />b. Agencies applying for Advanced EMT or Paramedic Level upgrade to <br />service must obtain Provider License with the North Carolina State Office of <br />EMS as defined in 10A NCAC 13P .0204. Applications to State OEMS <br />must occur at least 30 days prior to projected implementation date. <br />c. Agencies should provide their defined service area and any mutual aid <br />areas for EMS response. <br />d. Agencies should describe the vehicles routinely used for responding to <br />medical calls with the vehicle’s staging location. (i.e. If an Agency utilizes a <br />1st Responder Vehicle for all calls.) <br />DocuSign Envelope ID: 79C5D167-B6CA-4E59-B4AC-AA38CC1B20BD