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STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-SIX
_____
S.P. 830 - L.D. 2133
An Act Regarding Licensing of Community Paramedicine Services and
Clinicians
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 22 MRSA §2147, sub-§15, as corrected by RR 2023, c. 2, Pt. A, §30, is
amended to read:
15. Emergency medical services community Community paramedicine services.
Ambulance services and nontransporting emergency medical Community paramedicine
services as defined in Title 32, section 83, subsection 9-C and licensed under Title 32,
chapter 2‑B, that are authorized by the Emergency Medical Services' Board to provide
community paramedicine services pursuant to Title 32, section 84, subsection 4. This
exemption applies for the express and exclusive purpose of delivering community
paramedicine services, as long as:
A. The care is episodic. For the purposes of this paragraph, "episodic" means an
encounter with a patient focused on presenting concerns and an identified medical
condition in which neither the community paramedic nor the patient has the expectation
of an ongoing general home care relationship; and
B. The Emergency Medical Services' Board adopts rules requiring authorized
community paramedicine services to:
(1) Comply with the Maine Background Check Center Act requirements as
described in chapter 1691;
(2) Conduct initial and ongoing training of all staff regarding their obligations as
mandatory reporters;
(3) Meet licensing standards consistent with those required by section 2145,
subsections 3 and 4; and
(4) Coordinate with home health agencies; and
Sec. 2. 24-A MRSA §4303-F, sub-§1, as amended by PL 2025, c. 34, §1 and
affected by §2, is further amended by amending the first blocked paragraph to read:
APPROVED
APRIL 3, 2026
BY GOVERNOR
CHAPTER
635
PUBLIC LAW
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Notwithstanding this subsection, a carrier is not required to reimburse an ambulance service
provider at the reimbursement rates required in this subsection for covered services
delivered through community paramedicine in accordance with Title 32, section 84,
subsection 4 85-D and a carrier may require an ambulance service provider to obtain prior
authorization before providing services through community paramedicine.
Sec. 3. 32 MRSA §82, sub-§1, as amended by PL 2021, c. 220, §1, is further
amended to read:
1. Licenses required. An ambulance service, ambulance, nontransporting emergency
medical service, emergency medical services person, community paramedicine clinician,
community paramedicine service, emergency medical services ambulance operator,
emergency medical dispatch center or emergency medical dispatcher may not operate or
practice unless duly licensed by the Emergency Medical Services' Board board pursuant to
this chapter, except as stated in subsection 2.
Sec. 4. 32 MRSA §83, sub-§9-A is enacted to read:
9-A. Community paramedicine. "Community paramedicine" means the practice by
an emergency medical services provider, primarily in an out-of-hospital setting, of
providing episodic patient evaluation, advice and treatment directed at preventing or
improving a particular medical condition.
Sec. 5. 32 MRSA §83, sub-§9-B is enacted to read:
9-B. Community paramedicine clinician. "Community paramedicine clinician"
means an emergency medical services person licensed under this chapter who has
completed specialized education and training to operate in an expanded role, providing
episodic, proactive and preventive health care services in nonemergency settings.
Sec. 6. 32 MRSA §83, sub-§9-C is enacted to read:
9-C. Community paramedicine service. "Community paramedicine service" means
an ambulance service or other nontransporting emergency medical service licensed to
provide community paramedicine.
Sec. 7. 32 MRSA §83, sub-§12-B is enacted to read:
12-B. Emergency medical services instructor. "Emergency medical services
instructor" means the lead instructor in a Maine Emergency Medical Services licensure
program.
Sec. 8. 32 MRSA §84, sub-§4, as repealed and replaced by PL 2023, c. 195, §4, is
repealed.
Sec. 9. 32 MRSA §85-C is enacted to read:
§85-C. Community paramedicine clinicians
1. License required. A community paramedicine clinician must be licensed by the
board in accordance with rules adopted by the board.
2. Minimum requirements for licensing. In adopting rules for the licensure of
community paramedicine clinicians, the board shall ensure that a person is not licensed to
provide community paramedicine unless that person's qualifications are at least those
specified in this subsection.
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A. The person has successfully completed training conducted by an emergency
medical services instructor as specified in rules adopted by the board pursuant to the
Maine Administrative Procedure Act.
B. The person has successfully demonstrated trustworthiness and competence to
engage in the practice of community paramedicine in such a manner as to safeguard
the interests of the public.
C. The person holds a separate license as an emergency medical services person.
Initial rules adopted pursuant to this section are major substantive rules and any
subsequent amendments to rules adopted pursuant to this section are routine technical rules
as defined in Title 5, chapter 375, subchapter 2-A.
Sec. 10. 32 MRSA §85-D is enacted to read:
§85-D. Community paramedicine services
1. License required. A community paramedicine service must be licensed and must
operate in accordance with rules and protocols adopted for services under this chapter.
2. Mandatory qualifications. The board shall adopt rules governing the
qualifications for and standards to be observed by community paramedicine services,
including:
A. The identification of a primary care medical director with whom the community
paramedicine service works;
B. The identification of an emergency medical services medical director;
C. The qualifications for a primary care medical director or emergency medical
services medical director identified under paragraph A or B, except that the board may
not restrict eligibility to only licensed physicians and shall permit eligibility for an
individual serving as a volunteer or serving in a dual capacity as a community
paramedicine service's primary care medical director and emergency medical services
medical director;
D. Compliance with the Maine Background Check Center Act requirements as
described in Title 22, chapter 1691;
E. Conducting initial and ongoing training of all staff regarding their obligations as
mandatory reporters; and
F. Meeting licensing standards that address the following areas:
(1) General requirements;
(2) Qualifications for professional personnel;
(3) Qualifications for paraprofessional personnel;
(4) Treatment and services and their coordination;
(5) Organizational structure, including lines of authority;
(6) Treatment records;
(7) Business records; and
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(8) Other aspects of community paramedicine that may be necessary to protect the
public.
Initial rules adopted pursuant to this section are major substantive rules and any
subsequent amendments to rules adopted pursuant to this section are routine technical rules
as defined in Title 5, chapter 375, subchapter 2-A.