An Act To Improve the Efficiency of the Maine Emergency Medical Services System
Maine Legislature, Session 123, LD 1841
Committee: Criminal Justice and Public Safety
Sponsors: SYKES, NASS, GERZOFSKY, TUTTLE, SNOWE-MELLO
Amends: 32 MRSA §81-A, 32 MRSA §83, 32 MRSA §84, 32 MRSA §8, 32 MRSA §85, 32 MRSA §88, 32 MRSA §90-A

Legislative Document 
No. 1841 
H.P. 1283 
House of Representatives, April 6, 2007 
An Act To Improve the Efficiency of the Maine Emergency Medical 
Services System 
Submitted by the Department of Public Safety pursuant to Joint Rule 204. 
Reference to the Committee on Criminal Justice and Public Safety suggested and ordered 
printed. 
Presented by Representative SYKES of Harrison. 
Cosponsored by Senator NASS of York and 
~~ 
/J7.11/d£~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: GERZOFSKY of Brunswick, TUTTLE of Sanford, Senator: SNOWE-
MELLO of Androscoggin. 
Printet.l pn rel,;yd~J ra~r 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 32 MRSA §81-A, 2nd~, as amended by PL 1993, c. 311, §2, is further 
amended to read: 
It is the intent of the Legislature to designate that a central agency be responsible for 
the coordination and integration of all state activities concerning emergency medical 
services and the overall planning, evaluation, coordination, facilitation and regulation of 
emergency medical services systems. Further, the Legislature finds that the provision of 
prompt, efficient and effective emergency medical dispatch and emergency medical care, 
a well-coordinated trauma care system, effective communication between prehospital 
care providers and hospitals and the safe handling and transportation of the sick and 
injured are key elements of an emergency medical services system. This chapter is 
intended to promote the public health, safety and welfare by providing for the creation of 
a statewide emergency medical services system with standards for all providers of 
emergency medical services. 
Sec. 2. 32 MRS A §82, sub-§l, as amended by PL 2005, c. 683, Pt. C, §9, is 
further amended to read: 
1. 
Licenses required. 
An ambulance service, ambulance, nontransporting 
emergency medical service ef.1 emergency medical services person, emergency medical 
dispatch center or emergency medical dispatcher may not operate or practice unless duly 
licensed by the Emergency Medical Services' Board pursuant to this chapter, except as 
stated in subsection 2. 
Sec. 3. 32 MRS A §82, sub-§3, as enacted by PL 2005, c. 683, Pt. C, §10, is 
amended to read: 
3. 
Violation. 
lill ambulanee, ambulanee serviee, nentransperting emergeney 
medieal sePliee er emergeney medieal serviees A person that fails te eetain lieensure 
under sueseetien 1 who violates this section commits a Class E crime, unless ether 
penalties are speeified. 
Sec. 4. 32 MRSA §83, sub-§6, as enacted by PL 1981, c. 661, §2, is amended to 
read: 
6. Basic emergency medical services person. "Basic emergency medical serviees' 
services person" means a person licensed to perform basic emergency medical treatment. 
Licensed first responders, ambulance attendants and basic emergency medical technicians 
are basic emergency medical serviees' services persons. 
Sec. 5. 32 MRSA §83, sub-§17-A is enacted to read: 
17-A. 
Online medical control. 
"Online medical control" means the online 
physician, physician assistant or nurse practitioner, licensed by the State, authorized ~ 
hospital to supervise and direct the actions of emergency medical services persons. 
Page I - 123LR0494(Ol)-1 
Sec. 6. 32 MRSA §83, sub-§19, as amended by PL 1999, c. 182, §7, is further 
amended to read: 
19. Protocol or Maine Emergency Medical Services protocol. "Protocol" or 
"Maine Emergency Medical Services protocol" means the written statement, aflflrOyea 
developed by the Medical Direction and Practices Board and filed with the board, 
specifying the conditions under which some form of emergency medical care is to be 
given by emergency medical services persons. 
Sec. 7. 32 MRS A §83, sub-§20, as amended by PL 1985, c. 730, §§8 and 16, is 
further amended to read: 
20. Regional council. "Regional s01:lHsils council" means those gr01:lflS a business 
entity recognized by the board whish rej3reseHt the vario1:ls regioHs that represents a 
geographical area of the State, as designated by the board, with respect to matters subject 
to this chapter. 
Sec. 8. 32 MRS A §84, sub-§l, ~C, as amended by PL 1991, c. 588, §8, is further 
amended to read: 
C. The board shall appoint a licensed physician as statewide emergency medical 
services medical director. The physician shall advise Maine Emergency Medical 
Services and shall carry out the duties assigned to the medical director pursuant to 
this chapter, or as specified by contract. A person appointed and serving as the 
statewide emergency medical services medical director is immune from any civil 
liability, as are employees of governmental entities under the Maine Tort Claims Act, 
for acts performed within the scope of the medical director's duties. 
Sec. 9. 32 MRS A §84, sub-§l,~, as amended byPL 1991, c. 588, §9, is further 
amended to read: 
D. 
Rules adopted pursuant to this chapter must include, but are not limited to, the 
following: 
(1) The composition of regional councils and the process by which they come to 
be recognized as reflreseHtiHg their regioHs; 
(2) 
The manner in which regional councils must report their activities and 
finances, and the manner in which those activities must be carried out under this 
chapter; 
(3) The designation of regions within the State; 
(4) The requirements for licensure for all vehicles, persons and services subject 
to this chapter, including training and testing of personnel; and 
(5) Fees to be charged for licenses under this section. 
In aaofltiHg aHY mle 1:lHaer S1:l9flaragraflh (4) that re~1:lires servises that aeliyer 
aayaHSea sare to meet a sflesifiea flerseHtage leyel of flerfeFffiaHee, the reg1:llatioH 
may Hot take efrest 1:lnless the level is sflesifiea after st1:lay, iH eoofleratioH with 
regioHal s01:lflsils aHalosal sen'ise 1:lHits. 
Sec. 10. 32 MRSA §84, sub-§2, as amended by PL 1991, c. 588, §11, is further 
amended to read: 
2. Goals. The board shall establish and pursue its goals as follows. 
A. 
The board shall monitor the provision of emergency medical services within the 
State. The board shall establish, by rule, its goals in monitoring the provision of 
services and in isffi:Hisg ensuring that these services are appropriately delivered. 
These goals must be in the nature of objectives and do not constitute absolute 
requirements. In establishing these goals, the board shall seek the input of 
individuals, agencies, services and organizations interested in emergency medical 
services. The board shall also take iAto cossideratios the goals established by the 
regiosal cO\H1cils pursuaRt to sectios 89. 
B. 
In each year, and in conjunction with the preparation of the emergency medical 
services report, the director under the direction of the board shall prepare a list of 
those among the goals that most need to be pursued in the succeeding year. This list 
must be made a'.<ailable to the regioool couscils so that the regiosal cOURcils may 
propose projects to further particular goals withis their own regions. 
C. 
In pursuing these goals, the board may make grants to the regiosal councils for 
projects the regional cO\H1cils have proposed, asd that the board has determined are 
cossisteRt with the requiremests and goals of this chapter; contract for services with 
regional councils; cooperate with other departments or agencies; accept and disburse 
granted funds; or act in other lawful ways as may best serve the public good. 
Sec. 11. 32 MRS A §85, sub-§1, as amended by PL 1985, c. 730, §§ 11 and 16, is 
further amended to read: 
1. Basic and advanced skills. With advice from and in consultation with eooh 
regiosal cOURcil asd its medical control cofl'lfRittee asd 'Nith the statevlide emergency 
medical seryices' medical director the Medical Direction and Practices Board, the board 
may provide, by rule, which skills, techniques and judgments constitute a basic 
emergency medical treatment. 
Sec. 12. 32 MRSA §8S, sub-§3, ~, as amended by PL 1995, c. 161, §6, is 
repealed. 
Sec. 13. 32 MRSA §85, sub-§3, ~C, as enacted by PL 1981, c. 661, §2, is 
amended to read: 
C. 
The person must have successfully completed a state written and practical test 
for basic emergency medical treatment and a board-approved practical evaluation of 
emergency medical treatment skills. 
Sec. 14. 32 MRSA §85, sub-§4, ~, as enacted by PL 1991, c. 742, §3, is 
amended to read: 
B. 
The person must have satisfactorily demonstrated competence in the skills 
required for the license level. Skill competence may be satisfied by a combination of 
run report reviews and continuing education training programs conducted in 
accordance with the rules or by satisfactorily completing the state written ana 
practical tests test and a board-approved practical evaluation of emergency medical 
treatment skills. 
Sec. 15. 32 MRS A §86, sub-§2-A, as amended by PL 1999, c. 182, §11, IS 
further amended to read: 
2-A. 
Treatment. 
When an ambulance service or nontransporting emergency 
medical service is present at an accident or other situation in which a person or persons 
require emergency medical treatment, the medical treatment of the patients must be 
carried out in accordance with any rules adopted under this chapter, any protocols as 
defined in section 83, subsection 19 and any ¥eFbal orders given under the system of 
delegation established by the regional medical director by online medical control; except 
that: 
A. When a patient is already under the supervision of a personal physician or a 
physician's assistant or nurse practitioner supervised by that physician and the 
physician, physician's assistant or nurse practitioner assumes the care of the patient, 
then for as long as the physician, physician's assistant or nurse practitioner remains 
with the patient, the patient must be cared for as the physician, physician's assistant or 
nurse practitioner directs. The emergency medical services persons shall assist to the 
extent that their licenses and protocol allow; and 
B. A patient is not required to accept treatment to which the patient does not consent. 
Sec. 16. 32 MRS A §87-A, sub-§I, as enacted by PL 1993, c. 311, §4, is amended 
to read: 
1. Trauma care system development. Maine Emergency Medical Services shall 
develop a statewide trauma care system plan with the advice of the State Trauma 
Prevention and Control Advisory Committee and the regional emergency medical 
s6fVices councils. 
Sec. 17. 32 MRS A §87-A, sub-§2, ~, as enacted by PL 1993, c. 311, §4, is 
repealed and the following enacted in its place: 
H. 
A representative of the regional councils; 
Sec. 18. 32 MRS A §88, sub-§I, ~A, as amended by PL 2001, c. 7l3, §1, is 
further amended to read: 
A. 
The board has one member representing each regional council, region and 11 
persons in addition. Of the additional persons, one is an emergency physician, one aH 
attorney, tv,'o a representative of emergency medical dispatch providers, 2 
representatives of the public, one a representative of for-profit ambulance services, 
one an emergency professional nurse, one a representative of nontransporting 
emergency medical services, one a representative of hospitals, one a representative of 
a statewide association of fire chiefs, one a ffi:e municipal emergency medical 
services provider and one a representative of not-for-profit ambulance services. The 
members that represent for-profit ambulance services, nontransporting emergency 
medical services and not-for-profit ambulance services must be licensed emergency 
medical services persons. One of the nonpublic members must be a volunteer 
emergency medical services provider. Appointments are for 3-year terms. Members 
are appointed by the Governor. The state medical director is an ex officio nonvoting 
member of the board. 
Sec. 19. 32 MRSA §88, sub-§I, ~, as amended by PL 1991, c. 588, §16, is 
further amended to read: 
D. 
A majority of the members appointed and currently serving constitutes a quorum 
for all purposes and no decision of the board may be made without a quorum present. 
A majority vote of those present and voting is required for board action, except that 
for purposes of either granting a waiver of any of its rules or deciding to pursue the 
suspension or revocation of a license, the board may take action only if the proposed 
waiver, suspension or revocation receives a favorable vote from at least 2/3 of the 
members present and voting and from no less than a majority of the appointed and 
currently serving members. When the board is reE:tuired to take emergensy astion and 
sonvening a meeting of the board in a timely fflanner is not possible, the board may 
take any astion authorized by telephonis sonferense or by any other means 
authorized by rule. The board may use video conferencing and other technologies to 
conduct its business but is not exempt from Title 1, chapter 13, subchapter l. 
Members of the board, its subcommittees or its staff may participate in a meeting of 
the board, subcommittees or staff via video conferencing, conference telephone or 
similar communications equipment by means of which all persons participating in the 
meeting can hear each other, and participation in a meeting pursuant to this 
subsection constitutes presence in person at such meeting. 
Sec. 20. 32 MRSA §88, sub-§2, ~E, as amended by PL 1989, c. 857, §70, is 
further amended to read: 
E. 
The board shall keep records and minutes of its activities and meetings. These 
records and minutes must be made easily accessible to the public and be provided 
expeditiously upon request. The board shall distribute to all licensed emergency 
medical services persons a publication listing training and testing opportunities, 
meeting schedules of the board and regional souRsils, proposed rule changes and 
other information judged by the board to have merit in improving emergency medical 
patient care in the State. The board shall create, print and distribute this publication 
in the most cost-efficient manner possible. 
Any paid advertising utilized to 
accomplish this purpose may not be solicited by board members or staff and must be 
included in such a way that endorsement of a product or service by the board can not 
reasonably be inferred. The board may prepare, publish and disseminate educational 
and other materials to improve emergency medical patient care. 
Sec. 21. 32 MRS A §89, as amended by PL 1999, c. 182, §15, is further amended 
to read: 
§89. Regions and regional councils 
1. Regions to be established; regional councils. The board shall delineate regions 
within the State to carry out the purposes of this chapter. The board shall set out 
conditions under which an organization in each region may be recognized by the board as 
the regional council for that region. A regional council shall, at a minimum, provide 
adequate representation for ambulance and rescue services, emergency room physicians 
and nurses, each hosJ3ital hospitals and the general public. A regional council must be 
structured to adequately represent each major geographical part of its region. Only one 
regional council may be recognized in any region. 
2. Duties of regional councils. The regional councils shall function as the J3rimary 
J3lan:1ing and oJ3erationall:Hlits of the state'Nide emergency medical services system. Each 
regional council shall carry out an annual program, approved by the board, to further the 
goals specified in section 84, subsection 2. 
Specific responsibilities of the councils 
include, but are not limited to, the following: 
A. 
Establishing a regional medical control committee; 
B. 
Appointing, subject to approval by the board, a regional medical director, who 
must be a licensed physician qualified by training and experience and shall sep.,'e who 
serves as an agent of Maine Emergency Medical Services. The regional medical 
director may delegate in writing to other licensed physicians, who shall similarly 
sep.,'e as agents of Maine Emergency Medical SePt'ices, the responsibilities of this 
position; 
C. 
Advising the board on the licensing of new ambulance, nontransJ3orting 
emergency medical and air ambulance sep.,rices within each region; 
D. 
Assisting Maine Emergency Medical Sep.,rices in carrying on a J3rogram of 
testing emergenc;' medical services J3ersons within each region, subject to availability 
of financial resources for the testing; 
E. 
Assisting the board in de .. 'eloJ3ing and iR'lJ3lementing a statevlide certification and 
decertification J3fOcess for emergency medical sep.,rices J3ersons; 
F. 
Nominating 2 or more candidates from each council region for a position on the 
Emergency Medical Services' Board, from whom the Governor may select a member; 
and 
G. 
Establishing regional goals to carry out the provisions of this chapter. 
Sec. 22. 32 MRSA §90-A, sub-§5, ~, as amended by PL 1993, c. 600, Pt. A, 
§36, is repealed. 
Sec. 23. 32 MRS A §90-A, sub-§5, ~-1 is enacted to read: 
B-1. The use of any drug, narcotic or substance that is illegal under state or federal 
law, or to the extent that the licensee's ability to provide emergency medical services 
or emergency medical dispatch services would be impaired; 
Sec. 24. 32 MRS A §90-A, sub-§5, ~-2 is enacted to read: 
B-2. 
A declaration of or claim pertaining to the licensee of legal incompetence that 
has not been legally terminated; 
Sec. 25. 32 MRS A §90-A, sub-§5, ~-3 is enacted to read: 
B-3. 
Any condition or impairment within the preceding 3 years, including, but not 
limited to, substance abuse, alcohol abuse or a mental, emotional or nervous disorder 
or condition, that in any way affects, or if untreated could impair, the licensee's 
ability to provide emergency medical services or emergency medical dispatch 
servIces; 
Sec. 26. 32 MRSA §90-A, sub-§5, ~C, as amended by PL 1991, c. 588, §19, is 
repealed. 
Sec. 27. 32 MRSA §90-A, sub-§5, ~G, as amended by PL 2003, c. 559, §2, is 
further amended to read: 
G. 
Subject to the limitations of Title 5, chapter 341, conviction of a crime that 
involves dishonesty or false statement, conviction of a crime that relates directly to 
the practice for which the licensee is licensed, conviction of a crime for which 
incarceration for one year or more may be imposed or conviction of a crime defined 
in Title 17-A, chapter 11.....ll or 45; 
Sec. 28. 32 MRS A §92-B is enacted to read: 
§92-B. Disclosure of confidential information to the board 
Notwithstanding any other provision of law, information that relates to a person 
. licensed or certified by the board who is alleged to have engaged in any unlawful activity 
or professional misconduct or in conduct in violation of laws or rules relating to the board 
must be disclosed to the board and may be used by the board only in accordance with this 
chapter. 
1. Purpose for which disclosure is made. Any confidential information provided to 
the board may be used only for investigative and other actions within the scope of the 
authority of the board and for determining whether the person licensed or certified by the 
board has engaged in unlawful activity, professional misconduct or an activity in 
violation of the laws or rules relating to the board. 
2. Designation of person to receive confidential information. The director shall 
designate a person to receive confidential information for investigative purposes. 
3. Limitations on disclosure. Disclosure is limited to information that is directly 
related to the matter at issue. The identity of reporters and other persons may not be 
disclosed except as necessary and relevant. Access to the information is limited to board 
investigators, parties to the matter at issue, parties' r<a>resentatives, counsel of record, 
hearing officers and board members who are directly involved in the adjudicatory 
process. The information may be used only for the purpose for which the release was 
intended. 
4. Confidentiality at conclusion of investigation. Notwithstanding section 92, 
information received pursuant to this section remains confidential at the conclusion of an 
investigation. 
Sec. 29. 32 MRS A §95 is enacted to read: 
§95. Authorize to participate 
Maine Emergency Medical Services is authorized to participate in and provide 
information to the National Emergency Medical Services Information System. 
SUMMARY 
This bill removes mandatory language regarding the role of the regional emergency 
medical services councils to allow for evolution of that role in accordance with 
recommendations resulting from a review of the Maine Emergency Medical Services 
system and, based on the needs of the State, provides that the state emergency medical 
services medical director is subject to the Maine Tort Claims Act, authorizes the 
Emergency Medical Services' Board to use certain technologies to conduct public 
meetings, improves the efficiency of the practical testing process, amends the basis for 
certain licensing actions, clarifies treatment of confidential information disclosed to the 
board for investigative and licensing purposes and authorizes Maine Emergency Medical 
Services to participate in and provide information to the National Emergency Medical 
Services Information System.