Legal Opinion - Certification v. Licensure
August 21, 2002
Mr. William E. Brown, Jr.
The National Registry of Emergency Medical Technicians
Rocco V. Morando Building
6610 Busch Blvd.
P.O. Box 29233
Columbus, OH 43229-1233
Re: Update of Legal Differences Between "Certification" and
You have asked that we update our October 22, 1993 letter delineating the
differences between “licensure” and “certification.” Although the general
public continues to use the terms interchangeably, there are important
functional distinctions between the two concepts.
The federal government has defined “certification” as the process by which
a non-governmental organization grants recognition to an individual who has
met predetermined qualifications specified by that organization.1 Similarly, the National Commission
for Certifying Agencies has recently defined certification as “a process,
often voluntary, by which individuals who have demonstrated the level of
knowledge and skill required in the profession, occupation, role, or skill
are identified to the public and other stakeholders.”2
Accordingly, there are three hallmarks of certification (as functionally
defined). Certification is a:
(a) voluntary process;
(b) by a private organization;
(c) for the purpose of providing the public information on those
individuals who have successfully completed the certification process
(usually entailing successful completion of educational and testing
requirements) and demonstrated their ability to perform their profession
Nearly every profession certifies its members in some way, but a prime
example is medicine. Private certifying boards certify physician
specialists. Although certification may assist a physician in obtaining
hospital privileges, or participating as a preferred provider within a health
insurer’s network, it does not affect his legal authority to practice
medicine. For instance, a surgeon can practice medicine in any state in
which he is licensed regardless of whether or not he is certified by the
American Board of Surgery.
Licensure, on the other hand, is the state’s grant of legal authority,
pursuant to the state’s police powers, to practice a profession within a
designated scope of practice. Under the licensure system, states define, by
statute, the tasks and function or scope of practice of a profession and
provide that these tasks may be legally performed only by those who are
licensed. As such, licensure prohibits anyone from practicing the
profession who is not licensed, regardless of whether or not the individual
has been certified by a private organization.
Confusion between the terms “certification” and “licensure” arises because
many states call their licensure processes “certification,” particularly
when they incorporate the standards and requirements of private certifying
bodies in their licensing statutes and require that an individual be
certified in order to have state authorization to practice. The use of
certification by the National Registry by some states as a basis for
granting individuals the right to practice as EMTs and calling the
authorization granted “certification” is an example of this practice.
Nevertheless, certification by the National Registry, by itself, does not
give an individual the right to practice.
Regardless of what descriptive title is used by a state agency, if an
occupation has a statutorily or regulatorily defined scope of practice and
only individuals authorized by the state can perform those functions and
activities, the authorized individuals are licensed. It does not matter if
the authorization is called something other than a license; the
authorization has the legal effect of a license.
In sum, the National Registry is a private certifying organization. The
various state offices of EMS or like agencies serve as the state licensing
agencies. Certification by the National Registry is a distinct process from
licensure; and it serves the important independent purpose of identifying
for the public, state licensure agencies and employers, those individuals
who have successfully completed the Registry’s educational requirements and
demonstrated their skills and abilities in the mandated examinations.
Furthermore, the National Registry’s tracking of adverse licensure actions
and criminal convictions provides an important source of information which protects
the public and aids in the mobility of EMT providers.
I hope this letter is responsive to your request. Please feel free to
contact me if you have further questions.
Very truly yours,
Thomas G. Abram
1 U.S. Department of Health, Education, and Welfare, Report on
Licensure and Related Health Personnel Credentialing (Washington, D.C.:
June, 1971 p. 7).
2 NCCA Standards for the Accreditation of Certification Programs,
approved by the member organizations of the National Commission for
Certifying Agencies in February, 2002 (effective January, 2003).
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