Which EMS Leadership Credential is Best?

As a firefighter, my leadership development path would include obtaining an Executive Fire Officer credential after four on-campus courses and a capstone research deliverable at the National Fire Academy, submitting a portfolio for a peer review to get a Chief Fire Officer designation from the Center for Public Safety Excellence, and becoming a Fellow (FIFireE) with the Institution of Fire Engineers, a United Kingdom based professional credential process. As a paramedic, my path is less clear.

For this article, we will divide United States Emergency Medical Services into three universes.

• Private services include national commercial agencies like Falck and American Medical Response, regional agencies like Acadian, hospital-based services, local “Mom and Pop” services, and community volunteer rescue squads
• Non-fire municipal services like Boston, Cleveland, Wake County (North Carolina), Indianapolis, Pittsburgh, as well as the High-Performance Public Utility Models
• Fire-based EMS represents the largest universe and employs both firefighters and single-role employees as EMS caregivers.

Updating a Legacy EHS Master’s Degree

I submitted a proposal to the Emergency Health Services (EHS) department chair at the University of Maryland Baltimore County (UMBC) in 2019 to increase industry awareness of UMBC EHS’s role in EMS leadership development. The legacy master’s degree in Emergency Health Services needed an update for the 2020s. This was part of my public policy doctoral adventure as an adjunct EHS faculty member – following a tradition of adjunct faculty updating the EHS curriculum while working on their Ph.D.

Creating and maintaining EHS 640: High Performance EMS

EHS 640: High-Performance EMS was a core course in the brand-new 1999 EHS master’s degree. Stephen Dean developed and delivered the original course while working on his Ph.D. at UMBC. In 2010, Kurt Kruperman, while a visiting EHS professor and Ph.D. student, significantly updated 640, adding a digital version of the American Ambulance Association’s EMS Structured for Quality: Best Practices in Designing, Managing and Contracting for Emergency Ambulance Service reference. Jon Washko assisted with providing deployment and revenue exercises. In 2022, I revised and updated 640, covering the same knowledge areas but in a format more accessible to the international, preventative medicine/epidemiology, physician, and cybersecurity students enrolling in the program.

“Who Will Pay For It?”

One question was, “Who would pay for it?” in terms of employers. Would they preferentially hire a candidate with this EHS degree over another candidate? Would they send their rising leaders to get this degree or credential?

Most EMS employers surveyed in 2019 that responded to the survey wanted leadership candidates with a pre-existing master’s in Health Administration, Quality Management, or Business Administration. Private and non-fire employers would not send their rising leaders to get a master’s degree on the agency’s time or dime. Some fire-based employers used undergraduate formal education as part of a career-development promotional path, but not at the graduate-school level. In some fire departments, a master’s degree would be a preferred requirement for a fire chief candidate.

This was one factor that led UMBC to replace the EHS master’s degree with an Emergency and Disaster Health Systems master’s degree in 2026. There was a disconnect between who EHS thought would enroll and who actually enrolled. Most of the students enrolling in the EHS master’s program in the 2020s were not paramedics seeking upward mobility.

Graduate programs are subsidized by funded research. Pre-DOGE, there was scant research or grants for non-clinical EMS research. Available research grant money goes to disaster research and emergency management. Other universities with similar graduate disaster/emergency management programs had higher enrollments than UMBC EHS.

Let’s see what is available for the upwardly bound EMS caregiver.

Portfolio-based Professional Development

There are two portfolio-based assessments. Candidates provide information on formal education, clinical credentials, work experience, community involvement, and professional development.

Center for Public Safety Excellence

The Commission on Professional Credentialing recognizes 4,542 professional designations held by fire and emergency service leaders committed to continuous improvement, professional development, and excellence in service. This includes 310 Chief EMS Officers as of July 2026.

Candidates must have at least 10 years of EMS experience as an EMT, Paramedic, RN, Advanced Registered Nurse Practitioner, or Physician. The evaluation process is based on a points system:

• Education points range from 25 to 150 points and can include an academic certificate
• Experience points range from 5 to 60 and may be influenced by the length of time in the position

Once submitted, there is a peer review process that evaluates the candidate’s resume, professional development, employment information, professional contributions/recognition, community involvement, and professional memberships/affiliations. The credential needs to be renewed every three years.

The American College of Paramedic Executives

The American College of Paramedic Executives was developed by the National EMS Management Association (NEMSMA) and follows the process used to credential health care executives. Candidates present a portfolio of education, letters of recommendation, and a description of professional and community service.

There is a written exam based on the NEMSMA National EMS Officer Competencies. For the managing and executive (fellow) levels, an interview. The fellow level (FACPE) requires a presentation, publication, or research paper. The credential must be renewed every five years. I was in the first cohort to be credentialed as Fellows, and I renewed the credential in 2023.

As of August 2026, there are 309 credentialed officers:

• 113 Fellows of the American College of Paramedic Executives (FACPE)
• 100 Managing Paramedic Officers (MPO)
• 96 Supervising Paramedic Officers (SPO)

Potential ProBoard or State Credential: NPFA 1020 EMS Officer I, II, III

After 15 years of requests to the committee, the 2025 edition of NFPA 1020 Standard for Fire and Emergency Instructor, Fire Officer, and Emergency Medical Services Officer Professional Qualifications includes Job Performance Requirements (JPR) for EMS Officer I, EMS Officer II, and EMS Officer III. Most of the JPRs are similar or identical to the Fire Officer JPRs.

What is different includes:

EMS Officer I

• Deliver an educational topic that specifically covers EMS continuing education clinical and skill training
• Evaluate unmet requirements in a member’s continuing education training, given a training record, so that education gaps are identified and a plan is created to fufill the unmet requirements
• Deliver clinical or procedural training, given data from a quality review or direct observation, so that identified deficiencies are addressed
• Manage unit staffing assignments, given scheduled deployment, special conditions, and emerging situations, so that operational needs are met
• Respond to a public inquiry, given policies and procedures, so that the inquiry is answered accurately, courteously, and in accordance with applicable policies and procedures
• Collect patient care data, given the goals and mission of the organization, so that patient care data is complete, accurate, protected, and available for interpretation.
• Verify patient triage categories, given multiple triaged patients, an agency triage system and protocols, so that the patient priority is correctly determined.

EMS Officer II

• Conduct a climate survey, given a climate survey instrument, so that the survey reaches the intended audience and the privacy of the respondents is maintained.
• Evaluate clinical or procedural training needs, given data from a quality review report or direct observation that indicates a need for training, so that a training plan is developed and delivered, and the training need is addressed.
• Manage staffing assignments across multiple units or areas, given the need to adjust staffing and a list of personnel and their capabilities, so that the staffing needs of the organization are met
• Evaluate the community demographics, given community demographic data, so that the ability of the organization to provide EMS outreach programs to at-risk populations is determined and recommendations are made.
• Design an evaluation instrument, given EMS risk reduction program goals and objectives and an evaluation strategy, so that the evaluation instrument measures the program outcomes and program goals and objectives are demonstrated
• Recommend a change to a records management program, given EMS run reports, patient care records, report storage and retrieval methods, access to records, and a need for change, so that the change is assessed for compliance with all federal, tribal, territorial, state, provincial, or local laws
• Recommend changes to a risk management plan, given a specific risk to the organization, an EMS related risk, and a risk management plan, so that the risk is evaluated, risk management options are identified, and the recommended changes are presented to a supervisor.
• Recommend changes to an accident investigation program, given federal, tribal, territorial, state, provincial, or local laws and regulations, an accident investigation program, and a work-related accident, so that the recommended changes are presented to a supervisor
• Recommend changes to an injury prevention program, given relevant local and national data, an injury prevention program, and an EMS related injury, so that the recommendations are evaluated and the recommended changes are presented to a supervisor
• Recommend a change to a post-incident analysis policy, given a multi-unit EMS incident and the need for a change, so that all required critical elements for the change are identified, the change is communicated

EMS Officer III is a combination of Fire Officer III and IV and may be discussed in a later article.

Fire service credentialing is a state, professional group, or industry process. The National Board on Fire Service Professional Qualifications (“Pro Board“) has been the original fire service system for the accreditation of agencies that certify candidates to the various disciplines and levels identified in the NFPA Professional Qualification series of standards. The Pro Board did not include the NFPA 1020 (2025) chapters covering EMS Officer I, II, III in the January 7. 2025 “Agency Compliance Dates to NFPA Standards.” The Fire Instructor and Fire Officer chapters have an agency completion date of December 31, 2026.

EMS Officer Responsibilities Pushed Down the Fire Service Career Ladder

Some of the NFPA Job Performance Requirements (JPRs) for EMS Officers show significant differences in roles. The Fire Officer I is supervising a single fire company; the EMS Officer I is expected to “Manage unit staffing assignments, given scheduled deployment, special conditions, and emerging situations, so that operational needs are met.” That is a task performed by a manager (Captain or Battalion Chief) on the fire suppression side.

The EMS Officer II is expected to “Manage staffing assignments across multiple units or areas, given the need to adjust staffing and a list of personnel and their capabilities, so that the staffing needs of the organization are met.” That implies an agency-wide resource allocation, usually done by a manager/administrator (Battalion Chief or higher) on the suppression side.

Will Interest in NFPA 1020 EMS Officer Translate to State or Pro Board Credentialing?

At this date, no states have a stand-alone NFPA 1020 EMS Officer I or EMS Officer II credential. Maine, Alabama, Maryland, Virginia, Connecticut, Montana, Kentucky, Wisconsin, and North Carolina provide EMS leadership training, some based on the Fire Officer I and II professional qualifications, but there is no ProBoard-accredited or state NFPA 1020 credentialing exam.

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References

American College of Paramedic Executives (2020, August). Paramedic Certification Officer Handbook and Policy Manual. https://cdn.ymaws.com/www.nemsma.org/resource/resmgr/acpe/certification_manual_-_v4_fi.pdf

NEMSMA (2014). Seven Pillars of National EMS Officer Competencies. National EMS Management Association. https://cdn.ymaws.com/www.nemsma.org/resource/resmgr/pdfs/credentialing/nemsma_seven_pillars_of_nati.pdf

NFPA (2025). NFPA 1020 Standard for Fire and Emergency Instructor, Fire Officer, and Emergency Medical Services Officer Professional Qualifications. https://www.nfpa.org/codes-and-standards/nfpa-1020-standard-development/1020

Ward, M. J. (2019, April 8). Are you really a “pro”? A look at the growth of professions and what it means for firefighters and paramedics today. CompanyCommander.com. https://companycommander.com/2019/04/08/are-you-really-a-pro-a-historical-look-at-the-growth-of-professions-and-what-it-means-for-firefighters-and-paramedics-today/