Letter of Review (LoR)

The CoAEMSP has the Letter of Review (LoR) process, which is the official designation that a Paramedic program is in the “Becoming Accredited” process.

While a program that qualifies for a LoR must still complete the entire process to demonstrate substantial compliance with the Commission on Accreditation of Allied Health Education Programs (CAAHEP) accreditation Standards, and is not guaranteed an award of accreditation, holding a LoR does signify that the program is making satisfactory progress in the accreditation process. As such, after January 1, 2013, the NREMT recognizes graduates of CAAHEP accredited programs as well as graduates of programs holding a CoAEMSP LoR, as eligible for the National Registry of Emergency Medical Technicians (NREMT) certification examinations.

All new programs will follow the same pathway to enter the accreditation system:

Submit the LSSR-2015, along with the first CoAEMSP annual fee (prorated by month of submission of the LSSR), Self Study Report Evaluation fee plus the Technology fee. (see Fees page for LSSR Invoice Request Form.)

Once the LSSR is received, CoAEMSP will conduct an Executive Analysis (EA).If the core information is satisfactory, a LoR will be issued to the program.If the core information is not satisfactory, then CoAEMSP will communicate that and wait for re-submission by the program to address the deficiencies.

After a program receives the LoR, the program will complete the Initial Accreditation Self Study Report (ISSR). The ISSR is due no later than six (6) months after graduation of that class of students that was first enrolled after the date of issue of the LoR. The program will submit along with the ISSR the evaluation fee and the site visit flat fee (see Fees page. CoAEMSP will notify the program if there are exceptions to the flat site visit fee requiring additional payment). If the complete ISSR is not satisfactory, then the program will have thirty (30) days after receipt of the EA to provide additional information to address the deficiencies, otherwise the LoR may be revoked. The LoR may also be revoked if the six (6) month submission deadline is not met.

Once the ISSR is satisfactory, a site visit will be scheduled.The site visit, post-site visit Findings Letter, CoAEMSP action, and CAAHEP vote will follow the regular procedure.

Any student who graduates from a program that holds or held a LoR anytime during that student’s enrollment, will be considered eligible for the NREMT Paramedic Examinations. CoAEMSP and NREMT are in close communication to maintain the list of programs holding a LoR and the students enrolled during that time.

Documents for Programs Currently Holding the Letter of Review (LoR)


Letter of Review Programs – Preparing for the ISSR
Oct-2016 Download
Checklist for PD of CoAEMSP LoR Programs
Sep-2020 Download
Voluntary Withdrawal from LoR template for Adverse Action
May-2019 Download

Publishing the Letter of Review Status of a Program

Once a Letter of Review (LoR) has been granted, CoAEMSP Policy I.B.3 contains specific wording programs must use to publish its CoAEMSP Letter of Review (LoR) status. Prior to issuing the CoAEMSP LoR, no mention of the CoAEMSP LoR or the CAAHEP accreditation process may be made by or for the Paramedic program.

In addition to the policy above, the CoAEMSP Policies and Procedures Manual contains specific wording for LoR programs should the LoR be suspended (I.C.2) or revoked (I.C.3), as well as, once a program’s first site visit towards seeking Initial Accreditation has been scheduled (IV.A.2). The policies specifically referenced on this page (I.B., I.C., and IV.A.) can be viewed in their entirety within the CoAEMSP Policies and Procedures Manual located here. Please keep in mind, all CAAHEP accredited programs and those seeking CAAHEP accreditation should familiarize themselves with the CoAEMSP Policies and Procedures Manual.