Initial Application for PCCC, EDAP or SEDP

PCCC/EDAP Application

Below are links to each section of the PCCC/EDAP Application Packet that are located within the EMS Administrative Code, Section 515.4020.

• Application overview and application form
• PCCC/EDAP checklist
• PICU and pediatric inpatient requirements
• PCCC equipment requirements
• EDAP equipment requirements
• Hospital Pediatric Preparedness Checklist

EDAP or SEDP Application

Hospitals seeking designation as an EDAP or SEDP can click on each of the links below which provide access to sections of the application packet, which is available within the EMS Administrative Code, Sections 515.4000 and 515.4010. Also below are links to the EDAP and SEDP requirements. In addition, there are forms that need to be completed as part of the application. These forms are available below in the section titled Fillable Word documents.

EDAP/SEDP Facility Recognition Initial Application (PDF format contains the complete application packet)

• Application for EDAP or SEDP recognition
• Pediatric Plan Application Checklist
• EDAP requirements
• SEDP requirements
• EDAP/SEDP Equipment/Supply/Medication Requirements
• Interfacility Pediatric Trauma and Critical Care Consultation and/or Transfer Guideline
• Credentialing Forms
• Hospital Pediatric Preparedness Checklist

Fillable Word documents (these need to be completed and included in the renewal application)

• EDAP/SEDP Request for Recognition Form
• EDAP and SEDP Equipment/Supply/Medication Checklist
• Credentialing Forms (all)
  • Credentials of Emergency Department Physicians
  • Credentials of Fast Track/Urgent Care Physicians
  • Credentials of Emergency Department Nurse Practitioner, Clinical Nurse Specialist and Physician Assistant
  • Credentials of Emergency Department Nursing Staff
• Hospital Pediatric Preparedness Checklist