Background Screening Policy - Form B4-A

Students must abide by the policies established by the health care (clinical) agencies with which the EMS Program contracts for clinical experiences. This may include a pre-clinical background screening. Fees for all background screening
must be paid by the student.

1. All students will receive notice of the background screening requirement prior to admission and will receive a copy of the policy upon admission to the program.
2. Background screening will be selected by the Regional Office.
3. Failure to pay appropriate fees or to consent to the background screening by the published deadline will prohibit the student from completing the clinical component of the required health program courses.
4. A student who is denied acceptance at a clinical facility due to a questionable/suspect background screen may be assigned to an alternative clinical facility for the required clinical experience. In the event that the alternative clinical facility denies acceptance due to the questionable/suspect background screen, the student will not be able to complete the course required to complete the program.

Procedure:

1. Students must pay the fee for the background screening to the Program clerk or as directed.
2. Students must sign appropriate consents prior to the screening. Consent will be kept on file in the office of the Director of the Program.
3. Background screening may include the following:
   Skip Trace: Checks for other names used, other states lived in or addresses used by the individual.
   Criminal History: Reveals felony and misdemeanor convictions, and pending cases usually include date, nature of offense, sentencing date, disposition and current status.
   Social Security Number Trace: Is verification that the number provided by the individual was issued by the Social Security Administration and is not listed in the files of the deceased.
   Office of Inspector General: Identifies those individuals who may no longer be capable of being provided with Medicare benefits.
4. The Program Director will notify the student of questionable/suspect findings prior to notification of the clinical facilities for a determination regarding student acceptance for clinical experience.
5. Questionable/suspect findings on the background screening will be reported to the Director of EMS or other designated person at the appropriate clinical facility. The clinical facility will determine if the student will be accepted for clinical experience. If a clinical facility denies a student’s placement then the Program Director will seek placement in a similar clinical facility for which the program has a contract using the same procedure of notification as described above. If all clinical facility options available to the program deny the student’s placement, then the student would not be able to complete the required clinical component of the course(s) and will not receive a  passing grade for the course(s).
6. Background screens which would render a student ineligible for placement include, but are not limited to, certain convictions or criminal charges which could jeopardize the health and safety of patients and sanctions or debarment.

Confidentiality:

1. The Program Director will receive all screening results which will be maintained in a locked file in the Director’s office. Confidentiality of test results will be maintained with only the Director and the student having access to the results with the exception of legal actions that require access to test results.
2. Students must sign consent prior to disclosure of the screening results to the Director of EMS or other designated person at the clinic facility.

 

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STUDENT BACKGROUND SCREEN POLICY PARTICIPATION

I understand that any student who enrolls in the EMS Program, and desires to participate in courses which have a clinical component, is required to have a pre-clinical background screen.

I acknowledge that I have received a copy of the EMS Program’s Background Screen Policy (Form B4-A), have read the policy, and understand the requirements of the policy.

I further understand that the information contained in these reports may be used to deny placement in clinical agencies. Questionable/suspect findings on the background screening will be reported to the EMR Program Director, Regional EMS Agency, and/or other designed person at the appropriate clinical facility. I understand that the EMT Program Director will notify me of questionable/suspect findings prior to notification of the clinical facilities for a determination regarding student acceptance for clinical experience.

I further understand that if I have a background screen that renders me ineligible; and I am denied access to clinical learning experiences at the clinical affiliate(s), that I will be dismissed from the program without eligibility for taking the National Registry examination.

By signing this document, I am indicating that I have read, understand, and voluntarily agree to the required background agents if deemed necessary. I understand that these results are confidential and will not be otherwise released without my authorization. I hereby release the EMS Program, ADPH OEMS&T, EMS Regional Office, and its affiliates from any and all liability, claims, and/or demands of whatever kind related to my completed background screen.