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February 6, 2020

Bill allowing EMTs to treat patients in hospital aims to fill rural workforce gap

Courtesy / SMCC EMT in training Cedrick Wa Bisembo practices treatment in a Southern Maine Community College class. If LD 2025 passes in the Legislature, licensed emergency services personnel would be allowed to practice in a hospital setting.

A bill that clarifies the role of emergency medical technicians in treating patients, designed to help address health care workforce shortages in rural Maine, has the support of several professional organizations.

The bill, LD 2025, allows a hospital to authorize EMTs and other emergency medical services personnel to provide patient treatment within the hospital setting, as long as the treatment is within the scope of their training and legally defined roles. The bill would replace language in the Maine Emergency Medical Services Act of 1982 so that those with EMS training can provide that treatment in the hospital. Currently they're not allowed to.

The bill unanimously passed the Legislature’s Health Coverage, Insurance and Financial Services Committee this week. It still must be approved by the full House and Senate. 

The bill was introduced by Senate President Troy Jackson, D-Allagash, on behalf of Cary Medical Center in Caribou, and during the committee process, it was supported with testimony by the Maine Ambulance Association, Maine EMS, the Maine Hospital Association, Maine Medical Association and Northern Light Health Care.

Hospitals in rural parts of the state are looking to hire EMTs and paramedics to fill some of their workforce gaps, according to a news release from Jackson's offices. Nurses, doctors and administrators at Cary Medical Center raised this issue in a meeting with Jackson last fall, according to the release.

“This bill is about supporting our rural hospitals and health care providers to ensure Mainers living in every corner of this state can get the care they need," Jackson said. "With our current workforce shortage in the health care industry, we need to take an aggressive and creative approach to fill these gaps. Recognizing the training and expertise of emergency medical technicians and their ability to work on hospital staff is a good start."

Support, concerns

At a Jan. 28 committee hearing on the bill, Jay Bradshaw, of the Maine Ambulance Association, said,“Making it clear that hospitals may employ EMS providers and utilize them in a manner defined by the hospital as directed by physicians is a win for EMS, hospitals and, most importantly, the patients."

Bangor-based Northern Light Health Care, which represents nine hospitals, as well as other medical centers, submitted testimony in support of the bill, but also said those designating EMS workers to help out in the hospital should be physicians or "mid-level providers," and not nurses.

But officials in towns and cities have some concerns, according to the Maine Municipal Association.

The MMA Legislative Policy Committee, which met for the first time this year after the hearing and hasn't yet established a position, said a straw poll of members indicates there are questions about municipal EMS staffing shortages, liability issues and more.

"Officials are concerned that fire/EMS personnel may be compelled to remain in the hospital as part of a patient transfer and be unavailable to return to the community should hospital staff ask them to assist with other patients," said the MMA's submitted testimony.

Municipal officials also questioned why the move is necessary, and "would prefer not to place these individuals in a space where they felt conflicted over their duty, could possibly be confused about their reporting structure, or expose the municipality to liability for behavior while acting as both a hospital and municipal employee simultaneously."  

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