BLS to ALS Conversion

If your agency is interested in converting their level of care from a Basic Life Support (BLS) to Advanced Life Support (ALS), there are a number of requirements that an agency must adhere to.

Medical Director

The first step in the process is to obtain a Medical Director that is familiar with ALS level Pre-Hospital Care.

The requirements for ALS Medical Directors are slightly different than those for Basic Life Support.

An ALS Medical Director must have the following:

  • Licensed to practice medicine in the Commonwealth of Kentucky
  • Has knowledge of EMS statutes and regulations in Kentucky

The Medical Director must then be EITHER:

  • Board Certified in Emergency Medicine


Maintain provider certifications in the following categories listed below:

  • Advanced Cardiac Life Support (ACLS)
  • Advanced Trauma Life Support (ATLS)
  • Pediatric Advanced Life Support (PALS) or Pediatric Education for Pre-Hospital Providers (PEPP)


The Medical Director needs to submit a signed copy of Protocols that they approve, which can be the approved Kentucky State Protocols . If the Medical Director chooses to alter the State Protocols in any way, they need to submit the changes to the protocols for approval to the State Medical Advisor.

If the Protocols are approved, you will receive notification from KBEMS.

Quality Assessment

According to 202 KAR 7:501 Section 5 (1) h, you must maintain a plan for Quality Assessment of patient care and provider Quality Improvement. In order to be certified as an ALS agency, your plan must include the QA/QI component for ALS licensed personnel.

Orientation Program

According to 202 KAR 7:501 Section 5 (1) j, an Orientation Program must be provided for all personnel. You will need to include ALS level updates to your Orientation Program.

Malpractice Insurance

According to 202 KAR 7:501 Section 5 (1) k, your agency must maintain professional liability malpractice insurance. Most insurance agencies will need to be notified that you are changing your level of care.

Mutual Aid Agreements

In order to maintain the highest level of care, your agency will need to enter into at least one Mutual Aid agreement with another ALS licensed agency. This will ensure that the level of care will be provided in case of a system breakdown or overload of your system.

Personnel Requirements

The personnel who are going to be staffing your ALS level units need to be licensed through the Kentucky Board of Emergency Medical Services. You will need to obtain and maintain records that show that your ALS personnel are licensed and current in the Commonwealth of Kentucky.

Equipment Requirements

Certain equipment is required to successfully operate ALS level providers. That equipment must be maintained in a safe and working order, and processes must be in place to ensure that.

202 KAR 7:501 Section 6 (11) states that Preventative Maintenance Programs for equipment must be in place for all ALS providers.

202 KAR 7:501 Section 6 (12) states that Documentation of periodic inspections or calibrations of equipment must be maintained by the provider.


Once you have set in motion all of the above requirements, you will need to contact the Kentucky Board of EMS and advise them that you are interested in converting from BLS to ALS. You will have to complete the Ambulance Service Application with your new level. There is no fee assessed, as long as you do not have any other changes on your license. You should mention a 'go-live' date that you are planning to convert to ALS level care.


Once you have completed all requirements, you will be contacted by the Field Operations Staff to schedule an inspection of your new ALS service. The Inspector will want to see all the items listed on this page, including inspection of your vehicles and equipment. The inspector will counsel you on any deficiencies, which must be corrected before an Advanced Life Support License is issued. If the inspector feels that everything is in order and that your service is compliant with regulations, they will approve your conversion to ALS.

Once the Inspector approves your inspection, KBEMS will issue you a new license with your new 'go-live' date as the effective date of service. You will need to return your previous license to KBEMS.

Your agency will then be responsible for 24-7 level ALS coverage and adhere to normal annual inspections.

The Kentucky Board of Emergency Medical Services is here to assist you through this process. Please do not hesitate to contact the Board if at any time you have questions about the process. We are here to help! or 859-256-3565