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Home > Topics > EMS Management

New community paramedicine law signed in Maine

Maine Emergency Medical Services Board will be reviewing proposals for pilot sites and where they will be approved

By Jen Lynds
Bangor Daily News

PRESQUE ISLE, Maine — An Aroostook County legislator has successfully shepherded a bill through the Legislature that he believes will reduce MaineCare costs, cut down on expensive emergency room visits and better assist those who receive care at home.

State Rep. Mike Willette, R-Presque Isle, sponsored LD 1837, An Act To Authorize the Establishment of Pilot Projects for Community Paramedicine.

Full story: New community paramedicine law signed in Maine

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Richard C Nix Richard C Nix Friday, April 06, 2012 4:28:12 PM This is crap. We need to be able to tell people "no, you don't need to go to the ER for a toothache" but the law prevents us from doing this. EMS units will be sucked dry and the community will quickly realize the error and unintended consequence of proving nanny care for the indigent with ambulances. But it will come very late and at a high cost. Provide these services during downtime? You realize the majority of EMS workers are on a 24 hour shift? Now you've eliminated any chance of getting rest because very shortly these calls will be scheduled and they will take priority over other calls. Mark my words. EMS workers should fight this tooth and nail. Community education is needed. Elimnation of the "safety net" will make people responsible for their own actions and health care. This "community paramedicine" BS was one of hillaryCare's planks for socialized medicine. Now it's Obamacare. Dumping grey area patients on EMS. what a stupid idea.
Steve Jacobi Steve Jacobi Friday, April 06, 2012 5:27:55 PM This is just another cert without any advancement in education to muddy the waters again. It looks like every crap mill is getting on the band wagon to cash in churning out as many CPs they possibly can. Many Paramedics are willing to pay a hefty price for a mere 200 hour cert which could have gone toward a real eduation to support the profession. Yet, they will whine and whine about getting a real education to raise the bar a little on entry into the profession.
Dani Koile Dani Koile Friday, April 06, 2012 6:25:19 PM Oh, I see LOTS of problems with this. Are we now taking the place of the PA and NP?
Edward Knudsen Edward Knudsen Saturday, April 07, 2012 11:32:14 PM Awesome.
Yvonne Schulte Simpson Yvonne Schulte Simpson Saturday, April 07, 2012 11:39:58 PM I know many persons on state medical who will call the ambulace for a sprained ankle or even less, because they won't have as long a wait as the person with 102 temp, and having trouble breathing, in the waiting room. The patients failure to have respect for the system, it's purpose, or even the poor sick guy in the waiting room is becoming overwhelming. Often times the doctors office will tell you to go to emergency if the patient is feeling anxious about his condition. There need to be some respectable boundries set up, from doctors office to EMS units to emergency room physicians....changes do have to be made for the uncoming increase in senior care emergencies which will effect all emergency services.
Jimi Clary Jimi Clary Sunday, April 08, 2012 1:10:26 AM hope they have malpractice insurance.
Diana York Diana York Sunday, April 08, 2012 4:14:01 AM Are you not able to take your non-urgent patients to the waiting room so they are in same triage system as if they had driven themselves? We do that where i work and explain to these patients that the ambulance ride is NOT giving them preference over other patients.
Pascal Hay Pascal Hay Sunday, April 08, 2012 4:16:14 AM If you bring your sprained ankle into my ED they will get triaged as you come in the door and put into a wheel chair then placed into the waiting room as a level 5 to await the next bed. Only if there are no patients in the ED will they get put into a room and even then we would probably send them to the front to be checked in first.
Pascal Hay Pascal Hay Sunday, April 08, 2012 4:23:02 AM All EMS services have malpractice insurance. The rider will be updated to cover any additional protocols and effects of such protocols. Most areas that are doing this are seeing the patient population that home health does not want due to their being indigent. If done properly it improves health care and reduces the overhead burden of ED overcrowding. It also catches the patients who do need to be treated and gets them the help they need. It is a plan for the section of society that rarely gets home health or any other care except for EMS and the ED.
Pascal Hay Pascal Hay Sunday, April 08, 2012 4:31:53 AM Dani Koile It is not a replacement of the PA or NP. If set up properly it is a program to help take some of the burden off of the ED and the EMS system. It should not be provided by front line EMS units with the exception that an initial 911 call brought that front line unit to the scene. Once recognized that this is a candidate for the program the patient is plugged into the system and the advanced care paramedic or community paramedic will begin to follow up the patient. All front line EMS units should be involved in community education as well as patient education. All health care providers should be educators as well as practitioners.
Roger Cole Roger Cole Sunday, April 08, 2012 5:13:02 AM All this done during "Downtime"? What exactly is that? I can assure you Paramedics in my Dept. ( Dekalb County FD, Ga. ) have none of that during a 24 hour shift.
Billy Green Billy Green Sunday, April 08, 2012 5:50:35 AM Sounds like a really BAD idea! No way this can be handled by "On Duty" crews! Our rescues are already over taxed with people who dial 911 non urgent calls, plus the real emergencies that we run! Wow! 6 more years to retirement!
Noreen Staples Noreen Staples Sunday, April 08, 2012 6:38:06 AM Thinking out of the box, with an overloaded and overburdened system. Might need to be tweaked. Need to start some where.
Dani Koile Dani Koile Sunday, April 08, 2012 8:02:24 AM Pascal, this was tried with PHX FD and failed. The ED at the hospital I work with has a "Fast Track"which takes care of broken bones,ear aches, sore throats, etc. It has helped greatly with the pt w/o an MD, too.
Steve Jacobi Steve Jacobi Sunday, April 08, 2012 10:40:44 AM When does the education start for Paramedics? Other professions have a solid base education and experience in many areas required for home and long term chronic. None of the Paramedic education addresses that nor is there even a requirement for some of the basic sciences and a broader pharmacology course. The suggested 200 extra hours of training is barely enough to cover one subject even as an overview especially without a solid foundation established in A&P and pharmacology. Even the Advanced Paramedic in Wake county is not required to have these foundation courses. Their extra education consists of RSI, intubation and choosing the right facility. They found the agency was unable to train all Paramedics and keep their intubation and pharmacology skills current enough to effectively work a code so they focus on a few and give them a glorified title rather than demoting the others to EMTs. Also, some systems are spending much of the money they are getting to start these pilots on fire trucks and tricked out SUVs costing some serious dollars. If in the city they should have look at the little electric vehicles like the Home Health nurses and RTs use. But, that wouldn't be as cool for a Paramedic to ride around in. I really have to agree with the opponents of this bill that it just takes away from those who are trying to provide services in the home settings and more clinics are at risk of closing as funds are diverted. This just amplifies the problem even more. Anyone who has ever had a loved one with chronic needs should understand how complex these patients are and it is a joke to believe a Paramedic cert and a mere 200 hours of training is going to solve anything. I would say this is just a plot to get money for some pork EMS projects which will be of no benefit to the communities they serve. I also agree the full story is not being told with the agencies that claim success and a full audit should be done.
Sarah Kiefer Bomberger Sarah Kiefer Bomberger Sunday, April 08, 2012 4:19:17 PM Great Info Edward Knudsen, thanks for sharing!
Pascal Hay Pascal Hay Monday, April 09, 2012 3:12:08 AM We have a fast track in one of our ED's. The one I work at the most dosen't have one but we sort of set one up in four of our rooms. Our biggest problem is staffing on the floors. We hold patients in the ED that are admitted and that causes a large problem. The program in South Carolina that is being done seems to be well thought out and has the backing of all of the medical community. It is interesting to read how they have done theirs. I have been trying to get something like that here with us but the home health sees it as a threat to them. I feel once they realize that it would be a way of identifying new patiens and that we will only keep the ones who can't pay they may get on board. As with all new ideas and plans it will take time to sort it all out.
Thursday, April 12, 2012 6:17:35 AM I'm sorry folks but have you visited northern Maine lately? This is not coming from some bureaucrat, but from the folks in the field! I will agree that is will not work everywhere but it is a pilot program and intended for RURAL areas where there are not a lot of services. Good luck to all of those who participate!
Steve Jacobi Steve Jacobi Thursday, April 12, 2012 12:08:24 PM So what you are saying is people in rural areas don't need or deserve the same chance at qualified medical care? What if the hospitals lowered their standards for who they hired for staff? Cutting from other services or railroading legislation that was about to pass to allow for more services from better qualified personnel rather than something on the cheap is not always the answer. This pilot will line some pockets with the diverted funds but will still be just a bandaid. People of rural America deserve a voice and should not have to settle for a bandaid patch when they could have something much better.
Jeremy Derickson Jeremy Derickson Tuesday, January 22, 2013 6:49:19 PM I find this to be a good idea in rural systems where long transport times and overloaded, understaffed ERs put people in the waiting room for 4-6hrs before their condition is dealt with. If my ambulance (or paramedic car, as is proposed here) was allowed to suture simple lacerations, dole out acetaminophen/ibuprofen for fevers, and administer 1L IV NS then release the person, the ER wait times would definitely drop. In the face of a 50-60 minute transport time, a 15-20 minute on scene intervention-then-release time seems within reason.
Steve Jacobi Steve Jacobi Saturday, January 26, 2013 4:44:16 PM When it comes to funding and providing health care services to rural regions of the US, why should those living in these areas have to be given the cheapest and least trained providers. They should be entitled to NPs, PAs, RNs, PTs, SLPs and RTs just like others in metro areas. This is the same argument as the "EMT" will do in rural regions and no need for a Paramedic argument. Support the organizations who want equal medical care rather than fragmenting US health care even more with the economic divide.

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