Gathering Momentum: Recent Legislative Action on Community Paramedicine

Feb 3, 2016 by

Despite the best efforts of paramedics, physicians and other health workers, determined promotion of healthcare provision within the community is sometimes not enough to create and sustain successful Mobile Integrated Healthcare and Community Paramedicine programs. In many situations, implementation of MIH-CP could be better supported by specific legislation. While many states do not have laws supporting MIH-CP programs, emergency services are often not limited by laws that explicitly prohibit community paramedicine. Some providers have taken initiatives to provide paramedicine for their communities without specific legal boundaries, which can then lead to legislative measures and better recognition of mobile integrated healthcare.

In the past four years, legislation supporting MIH-CP has appeared in 10 states, reflecting on-the-ground moves toward MIH-CP and published reports detailing community paramedicine’s successes. Laws governing these programs vary between states, but generally address three central issues: codification of licensure or education for community paramedics, legal definition of MIH-CP terms, and the types of services that community paramedicine can provide. Below are some examples of the changes being made across the country.

Education and Licensure: In Arkansas and Minnesota, processes for EMT community paramedic certification were established in the past few years. Missouri paramedics are also now legally required to receive additional training and certification before working as community paramedics. In all three states, this educational background enables certified community paramedics to communicate directly with primary care physicians, in order to provide health services to patients outside the hospital setting.

Legal Definitions: Before Tennessee’s Senate Bill 2029 was passed in 2014, community paramedics were not allowed to provide non-emergency patient care, but the bill repealed this previous definition of EMS service. In 2015, Idaho health providers achieved legal recognition of “community health EMS”. In the same year, similar Ohio legislation was passed to redefine paramedicine, allowing paramedics and EMTs to help in non-emergency medical situations. The legal definition of the role of community EMS providers provides more protection for community paramedicine as a whole, while making MIH-CP provision more legitimate for patients and hospitals alike.

Types of Services: Under 2011 Senate Law Chapter 12, Minnesota community paramedics are now able to provide preventative care, evaluation, disease management and referrals, in addition to traditional emergency services. In Missouri, this expansion of community paramedicine is limited to populations with limited access to primary care services, and to the north, Maine paramedics can now work with chronically ill patients who are at risk for hospital readmission. The Nevada legislature ruled that EMS programs may include transportation to a health facility other than a hospital and the provision of healthcare services on a scheduled basis.

Though some of this legislation does put more constraints on the services that EMTs and paramedics are legally allowed to provide, it could be said that, in a sense, all of the abovementioned legal motions recognizing MIH-CP gives community paramedicine more widespread momentum in the world of healthcare. As evidenced by this report, the changes in MIH-CP laws are happening all over the country, from Massachussetts to Nevada, and we hope that they will spread further as the successes of paramedicine administered within the community become more visible.

The original article can be found below.

View the full report on state legislation from the Journal of Emergency Medical Services (JEMS) here and make sure to join NYMIHA for the latest news in mobile integrated healthcare.

Leave a Reply