MaineStateHouse

The Maine Ambulance Association is actively involved in public policy decisions that impact emergency medical services in Maine. Our advocacy goals are:

  • Educate legislators about emergency medical services in Maine
  • Maintain and Improve services, especially in rural areas
  • Provide sufficient compensation to maintain financial stability
  • Maintain high standards of qualifications for licensure
  • Provide efficient and effective service throughout Maine

Legislative Priorities for the 128th Maine Legislative Session

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End of Session Legislative Summary

On Friday, April 29, 2016, the Maine House and Senate finished the 2nd Regular Session of the 127th Legislature. This session, 425 bills were submitted, but only 195 passed into law. The Governor vetoed 59 bills, of which 38 were overridden by the House and Senate.

Below is the summary of the bills the Maine Ambulance Association tracked this year. The effective date for nonemergency laws passed during this past session is Friday, July 29, 2016. Emergency legislation became effective immediately.

If there is other legislation you are interested in, please visit the Maine Office of Policy and Legal Analysis to view their list of bill summaries.

LD 1465, “Resolve, To Require the Department of Health and Human Services To Conduct a Study of Ambulance Services”
Resolve, Chapter 87

The Department of Health and Human Services is required to contract with a 3rd-party consultant to conduct a rate study on ambulance services. The rate study must include the feasibility of developing community paramedicine reimbursement rates. DHHS must submit a report on developing a reimbursement rate for community paramedicine programs to the Health and Human Services Committee no later than January 1, 2017.

LD 1521, “An Act To Create Equity among Essential Nonprofit Health Care Providers in Relation to the Sales Tax and the Service Provider Tax”
Public Law, Chapter 510

The exemption from the sales and use tax currently provided for sales made to incorporated nonprofit rural community health centers extends to all incorporated nonprofit federally qualified health centers. The same change is made in the exemption for incorporated nonprofit rural community health centers under the service provider tax to maintain consistency in the exemptions under those two taxes.

LD 1547, “An Act To Facilitate Access to Naloxone Hydrochloride”
Public Law, Chapter 508

The Maine Board of Pharmacy is directed to establish, by rule, procedures and standards for authorizing pharmacists to dispense naloxone hydrochloride. The rules must establish adequate training requirements and protocols for dispensing naloxone hydrochloride by prescription drug order or standing order or pursuant to a collaborative practice agreement.

Current law is clarified to allow municipal law enforcement and fire departments to obtain the naloxone hydrochloride that they are authorized to administer.

Criminal, civil and professional disciplinary immunities are established for health care professionals and persons who, acting in good faith and with reasonable care, possess, store, prescribe, dispense or administer naloxone hydrochloride in accordance with the governing law.

LD 1683, “An Act To Increase Penalties for the Use of Violence against Firefighters”
Public Law, Chapter 471

The current crime of assault on an emergency medical care provider does not apply to a firefighter. This law creates a new crime of assault on a firefighter as a Class C crime.

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Legislative Priorities for the 127th Maine Legislative Session, Second Session

 

MAINECARE FUNDING

MAA worked with Rep. Michel Lajoie of Lewiston to craft LD 1465, An Act To Require the State To Adequately Pay for Emergency Medical Services. This legislation will increase MaineCare reimbursement for ambulance services to the Medicare allowable rate.

The cost of preparedness for Maine EMS providers is higher than national averages.

Maine Law requires EMS providers to respond to emergency calls and transport patients without regard for their ability to pay. As a rural State, Maine EMS providers have very long distances to travel for these responses and transport to hospitals, especially when transporting patients to the tertiary care hospitals in Bangor, Lewiston and Portland.

The GAO has studied EMS costs around the nation, and found that rural EMS providers have higher costs. This is especially true for Maine, where the small population is spread over a large area.

Maine EMS providers are struggling to maintain the emergency network in Maine.

EMS services must maintain equipment and trained personnel to meet state licensing standards. Maine law also requires the EMS network to be able to respond to emergency calls within 20 minutes. With limited resources, EMS services around the State are cutting costs that affect preparedness. An example of these cuts are deferred maintenance and borrowing to maintain vehicles.

Unlike other healthcare services, consolidation of EMS services to reduce costs is not an option for EMS providers because the same equipment and personnel infrastructure must be located around the state in order to meet the 20 minute response time requirement.

Mainecare funding is not sufficient to pay for EMS costs for its members.

Maine EMS providers are reimbursed for only about 50% of the costs to provide services to MaineCare members. This rate is 35% below the Medicare rate, which is also below the cost of service. With rising costs of personnel and equipment, many services are struggling financially. Private, volunteer services are at risk and municipalities are being pressured to raise property taxes to make up for the lack of state funding.

The Legislative Process

The Health and Human Services Committee held a public hearing on LD 1465 on Wednesday, January 13, 2016. Tim Beals spoke on behalf of the Association. You can read his testimony by clicking here.

The Committee also held a work session on January 20th and will hold a second one on February 3rd at 10:30 AM in Room 209 of the Cross Office Building. For anyone who wishes to listen in to this work session, visit the Health and Human Services Committee website and click on the “Start” button.

In the News

The Maine Municipal Association wrote an interesting article on LD 1465 in their Legislative Bulletin from January 15, 2016, summarizing the issue and the public hearing. Click on the link below to read the article:

MaineCare Ambulance Rates: The Big Short

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Legislation for the 127th Maine Legislative Session – Passed Into Law

 

TAXATION – AMBULANCE FUEL TAX

During the first half of the 127th session, we tracked LD 315, An Act To Provide a Refund of Fuel Taxes to Maine Ambulance Companies, which would have provided a fuel tax exemption to all ambulance service companies and associations in Maine, including those that have a contract with a political subdivision and those that do not.

This legislation was not passed in the Taxation Committee, but remains a topic of interest for the Association. You can read Tim Beals testimony before the committee by clicking here: MAA Testimony

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COMMUNITY PARAMEDICINE PILOT PROJECTS

The Legislature did pass LD 629, An Act Regarding Community Paramedicine Pilot Projects, allowing the Emergency Medical Services’ Board establish an unlimited number of pilot projects for the purpose of developing and evaluating a community paramedicine program. There is also no time limitation on these projects.

This emergency legislation went into effect on May 19, 2015, as Public Law, Chapter 92.

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REGULATION

LD 818, An Act To Amend the Maine Emergency Medical Services Act of 1982 passed into law during the first session, making changes to align the Maine Emergency Medical Services Act of 1982 law with the Emergency Medical Services rules and the national scope of practice levels by changing the term “first responder” to “emergency medical responder.”

It also:

  • Removed a requirement that the Emergency Medical Services’ Board or its staff must request the Attorney General to file a complaint in District Court to commence either full or emergency proceedings to suspend a license for more than a year or to revoke a license when the board or its staff concludes to so suspend or revoke the license is in order;
  • Required applicants and licensees to notify the Emergency Medical Services’ Board regarding name and address changes, criminal convictions, actions taken by another regulatory agency against any of their occupational and professional licenses and material changes to their conditions and qualifications set forth in their original applications for licensure;
  • Gave the Emergency Medical Services’ Board has the power and duty to appoint or approve the members of the Medical Direction and Practices Board; and
  • Data collected by Maine Emergency Medical Services that allows identification of persons receiving emergency medical treatment may be released for purposes of research, public health surveillance and linkage with patient electronic medical records if the release is approved by the board, the Medical Direction and Practices Board and the director. Information that specifically identifies individuals must be removed from the information disclosed pursuant to this paragraph, unless the board, the Medical Direction and Practices Board and the director determine that the release of such information is necessary for the purposes of the research, public health surveillance or linkage with patient electronic medical records.