16 DEPARTMENT OF PUBLIC SAFETY

163 BUREAU OF EMERGENCY MEDICAL SERVICES (MAINE EMS)

CHAPTER 5: PERSONNEL LICENSES

1. Personnel licenses are issued for the following levels of care, in ascending order:
2. Emergency Medical Responder (EMR)
3. Emergency Medical Technician (EMT)
4. Advanced Emergency Medical Technician (AEMT)
5. Paramedic
6. Scope of Practice

The scopes of practice for Emergency Medical Responders, Emergency Medical Technicians, Advanced Emergency Medical Technicians, and Paramedics are defined by the U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA) document, "National EMS Scope of Practice Model 2019.” (Report No. DOT HS 812-666). Accordingly, the following document is incorporated by reference: National Association of State EMS Officials. National EMS Scope of Practice Model 2019 (Report No. DOT HS 812-666). Washington, DC: National Highway Traffic Safety Administration. Copies of this document are available at Maine EMS.

1. Licensees may perform the following treatments:
2. Basic Emergency Medical Treatment: All licensed personnel may perform basic emergency medical treatment within the scope of their practice as defined below, as permitted by protocol and in accordance with this chapter of the Rules.
   1. Emergency Medical Responder: NHTSA’s National EMS Scope of Practice Model, 2019 edition, defines the scope of practice for a person licensed at the Emergency Medical Responder level. An Emergency Medical Responder’s clinical practice is defined by Maine EMS protocol. A person licensed at the Emergency Medical Responder level may operate without the supervision of another Maine EMS licensee at the scene of a medical emergency until such time that a person licensed above the Emergency Medical Responder level arrives at the scene. Once on the scene, personnel licensed above the Emergency Medical Responder level are responsible for supervising Emergency Medical Responder licensed personnel, who may not operate without such supervision.

1. Patient immobilization for transport, patient loading, and patient care during transport must be directly supervised by personnel licensed above the Emergency Medical Responder level. Any basic emergency medical treatments not described in the scope of practice for an Emergency Medical Responder in NHTSA’s National EMS Scope of Practice Model 2019 , may only be performed while assisting, and in the presence of personnel licensed above the Emergency Medical Responder level.
   1. One EMS provider licensed at or above the EMT level must accompany the patient in the patient compartment of the ambulance during transport.

1. 1. Emergency Medical Technician: NHTSA’s National EMS Scope of Practice Model 2019, defines the scope of practice for a person licensed at the Emergency Medical Technician level. An Emergency Medical Technician’s clinical practice is defined by Maine EMS protocol.

1. Additions for Emergency Medical Technicians with Certification As "Wilderness EMT"
   1. Any licensee certified as a Wilderness Emergency Medical Technician (WEMT), consistent with Chapter 2 of these Rules, may apply WEMT emergency medical care as allowed by the Maine EMS protocol.

1. Advanced Emergency Medical Treatment: Advanced emergency medical treatments may be provided only by those licensed at, or above, the levels indicated, within the scope their practice as defined below, as permitted by protocol and in accordance with this section of the Rules:
   1. Advanced Emergency Medical Technician (AEMT): NHTSA’s National EMS Scope of Practice Model 2019, defines the scope of practice for a person licensed at the Advanced Emergency Medical Technician level. An Advanced Emergency Medical Technician’s clinical practice is defined by Maine EMS protocol.

1. 1. Paramedic: NHTSA’s National EMS Scope of Practice Model 2019, defines the scope of practice for a person licensed at the Paramedic level. A Paramedic’s clinical practice is defined by Maine EMS protocol.
   2. Paramedic Inter-Facility Transfer (PIFT) - In order to practice as a PIFT provider, a Maine licensed Paramedic must:

1. Complete a Maine EMS approved PIFT provider course; and,
2. Be affiliated with a Maine EMS licensed service that is approved by the Board to provide PIFT services.
3. A licensee may perform emergency medical treatment when:
   1. The licensee practices in accordance with Maine EMS protocol, and
   2. The licensee acts with the approval of the ambulance crew member in charge of the call.
   3. The licensee has completed the most recent Maine EMS pre-hospital protocol update, including necessary skills expansion.

1. A license is valid for three years from the month of issuance unless otherwise specified in these Rules. A license issued on or after November 1, 2022, will be valid for a period of two years from the month of issuance unless otherwise specified in these Rules.
2. An application will not be accepted as complete unless it includes all materials required to be evaluated for licensure. To obtain a new or renewed license, an applicant must:
3. Provide proof of parental consent if the applicant is less than 18 years of age. No application for licensure by a person under 18 years of age will be approved unless the service(s) with which the applicant will be practicing emergency medical care submits and maintains a Maine EMS-approved plan for supervision. No one under the age of 16 may be licensed.
   1. An applicant must be at least 18 years of age in order to be eligible for licensure above the EMT level.
4. Not have received a three-year Maine EMS license at the same level within the past year. Effective November 1, 2022 – Not have received a two-year Maine EMS license at the same level within the past year.
5. Submit the following to Maine EMS:
   1. A completed Maine EMS application signed by the applicant.
   2. Certification of Board-approved training or training judged by Maine EMS to be equivalent. If the training was completed more than a year prior to application, a license may be issued that is valid for three years (two years after November 1, 2022) from the month of the training completion date (or from the month of the required test if that preceded training completion). Board approved training includes a Board approved initial course at the appropriate level, or a course judged by Maine EMS to be equivalent.
   3. Certification of Board-approved continuing education hours (CEH) at the appropriate level, or continuing education hours judged by Maine EMS to be equivalent, in the case of an applicant whose Maine license is current or not expired by more than two years, or who submits a history of training which Maine EMS accepts as qualifying him/her to use continuing education hours for licensure.
      1. 1. CEH must be of the type and amount appropriate to the level, and may be used to fulfill training requirements provided that:
6. The applicant's Maine license is current or not expired by more than two years; and
7. Certificates of continuing education hours have not been used for a previous license renewal and have been earned within the current license renewal cycle or the past two years; whichever is greater. "Training completion date" for the purpose of setting a license expiration date will be the date of the most recently completed continuing education program, which is submitted for licensure.
8. Continuing education hours appropriate to each level are as follows:
9. Emergency Medical Responder - 32 total hours consisting of: 2 hours in Preparatory and Operations; 8 hours in Airway, Breathing and Cardiac; 2 hours in Patient Assessment; 4 hours in Medical; 4 hours in Trauma; 4 hours in Obstetrics and Pediatrics; and 8 hours in BLS Psychomotor Skills.
10. EMT - 52 total hours consisting of: 2 hours in Preparatory and Operations; 8 hours in Airway, Breathing and Cardiac; 4 hours in Patient Assessment; 8 hours in Medical; 6 hours in Trauma; 8 hours in Obstetrics and Pediatrics; 8 hours in BLS Psychomotor Skills; and 8 hours in Further Continuing Education.
11. Advanced Emergency Medical Technician (AEMT) - 56 total hours consisting of: 2 hours in Preparatory and Operations; 12 hours in Airway, Breathing and Cardiac; 4 hours in Patient Assessment; 8 hours in Medical; 6 hours in Trauma; 8 hours in Obstetrics and Pediatrics; 4 hours in BLS Psychomotor Skills; 4 hours in ALS Psychomotor Skills; and 8 hours in Further Continuing Education.
12. Paramedic - 72 total hours consisting of: 2 hours in Preparatory and Operations; 16 hours in Airway, Breathing and Cardiac; 4 hours in Patient Assessment; 12 hours in Medical; 8 hours in Trauma; 8 hours in Obstetrics and Pediatrics; 4 hours in BLS Psychomotor Skills; 8 hours in ALS Psychomotor Skills; and 10 hours in Further Continuing Education.
13. For license renewals on or after November 1, 2023, continuing education requirements will be based upon a two-year licensing cycle and shall be in accordance with the National Registry of Emergency Medical Technicians’ 2016 National Continued Competency Program Hour Requirements listed below. This rule incorporates by reference the National Registry of Emergency Medical Technicians’ Recertification Guide (Updated July 15, 2019) . Copies of this standard are available from the National Registry of Emergency Medical Technicians at their website (http://www.nremt.org) or Maine EMS, Department of Public Safety, 45 Commerce Drive, Suite 1, 152 State House Station, Augusta, ME 04333-0152.
14. Emergency Medical Responder (EMR) - 16 Total Hours consisting of 8 hours in National Continued Competency Requirements (NCCR), 4 hours in Maine-EMS-approved Local Continued Competency Requirements (LCCR), and 4 hours in Individual Continued Competency Requirements.
15. Emergency Medical Technician (EMT) - 40 Total Hours consisting of 20 hours in National Continued Competency Requirements (NCCR), 10 hours in Maine-EMS-approved Local Continued Competency Requirements (LCCR), and 10 hours in Individual Continued Competency Requirements.
16. Advanced Emergency Medical Technician (AEMT) - 50 Total Hours consisting of 25 hours in National Continued Competency Requirements (NCCR), 12.5 hours in Maine-EMS-approved Local Continued Competency Requirements (LCCR), and 12.5 hours in Individual Continued Competency Requirements.
17. Paramedic - 60 Total Hours consisting of 30 hours in National Continued Competency Requirements (NCCR), 15 hours in Maine-EMS-approved Local Continued Competency Requirements (LCCR), and 15 hours in Individual Continued Competency Requirements.
18. Further Continuing Education as identified in the aforementioned CEH requirements is not a category but represents additional training in categories 1-5. Category 7 CEH (Instructor Coordinator Continuing Education Hours) is not considered Further Continuing Education for purposes of this Chapter.
19. Nationally standardized training programs may be awarded continuing education hours when that applicant provides proof of current certification at the time of application. Current certification is determined by definition of the national sponsor of the training program.

1. In lieu of the license renewal continuing education hour requirements of this Chapter, an applicant may submit a current certification card at the license level being renewed from a national EMS certifying entity approved by the Board. Unless Maine EMS determines otherwise, a license renewal based upon a national EMS certifying entity certification shall carry an expiration that is concurrent with the applicant’s national EMS certifying entity certification’s expiration date.
2. At the time of renewal, each licensee must certify, on an application provided by Maine EMS, the number of continuing education hours completed for license renewal. The licensee shall retain documentation of continuing education hours for two license renewals, including the current renewal period. For purposes of this paragraph, “current renewal period” means the 24-month period prior to the application date. In calculating continuing education hours completed prior to the month of application, the last day of each month shall be considered the completion date for all continuing education completed within a given month.
3. Applicants for license renewal will be selected by Maine EMS on a random basis for an audit of continuing education compliance. In addition, an individual licensee may be selected for an audit as part of an investigation or if there is reasonable cause to believe the licensee has provided a false certification concerning the completion of continuing education requirements. An audit will review the continuing education hour certifications submitted by the licensee for the past two license renewals, including the current renewal period.
4. Licensees selected for audit will be notified to submit documentation of the continuing education hours that were certified by the licensee at the time of renewal if they are not already available to Maine EMS. Licensees will have ten (10) business days from the date of notification to submit all requested documentation. Continuing education hours that cannot be verified in accordance with the documentation requirements determined by the Board or that do not satisfy the requirements for continuing education contained in these Rules will be disallowed.
5. Applicants for license renewal must present proof of satisfactory completion of continuing education in accordance with these Rules. Failure to comply with the continuing education rules may, at Maine EMS’s discretion, result – in accordance with 32 M.R. Chapter 2-B and the Maine EMS Rules - in disciplinary action to deny license renewal or may result in a decision to enter into a consent agreement and probation setting forth terms and conditions to correct the licensee's failure to complete continuing education or may result in any other disciplinary action available to the Board. Terms and conditions of a consent agreement may include requiring completion of increased hours of continuing education, civil penalties, suspension and other terms as the Board, the licensee and the Department of the Attorney General determine appropriate.
   1. Board-approved testing certification:
      1. 1. An applicant must demonstrate successful completion of a Board approved cognitive exam and practical skills evaluation - at the license level being sought - within two years of the application date.
         2. For applicants whose initial course completion date is on or after March 1, 2016 - an applicant for an initial license at any provider level must successfully complete the Maine-EMS-Board-approved cognitive test and practical skills evaluation – for the license level being sought - within two (2) years of the course completion date of the initial course.
         3. Notwithstanding paragraphs 1 and 2 above, an applicant is not required to submit testing certification as part of the license application process if:

1. An applicant, whose Maine EMS license has expired within two years prior to the application date is applying for a new or renewed license at the license level held within the aforementioned two-year period.
2. An applicant possesses a current certification or license from another state or territory; or,
3. An applicant is determined by Maine EMS to be eligible to license based upon current certification from a national EMS certifying entity.
   1. 1. 1. For purposes of paragraph 1, above, if the test is more than a year old, a license may be issued that is valid for the licensing period as calculated from the month of the test (or from the month of the required training course if that precedes the test). When practical and written portions of the test are completed in different months, the test date will be the month the first test was completed.
   1. A complete history of criminal convictions as well as civil infractions for alcohol or drugs. Maine EMS will consider this to the extent allowed by Maine Law.
   2. A complete history of any action taken against any emergency medical services certification or license or professional certification or license that the applicant currently holds or has ever held.
4. License Expiration and Renewal
   1. An application will not be accepted as complete unless it includes all materials required to be evaluated for licensure.
   2. A person may apply for a renewal license for up to ninety (90) days after the date of expiration. The ninety-day period does not postpone the expiration date of the license. Licensees whose licenses have lapsed as of the expiration date cannot provide emergency medical treatment until a renewed license has been issued.
   3. An application submitted more than 90 days after the license expiration date shall be considered an application for a new license and subject to all requirements governing new applications
5. Duty to Report
6. A licensee or an applicant for licensure under this chapter shall notify the Board in writing within 10 days of a:

1. Change of name or address, including personal email address
2. Criminal conviction
3. Revocation, suspension, or other disciplinary action taken in this or any other jurisdiction against any occupational or professional license held by the applicant or licensee or,
4. Material change in the conditions or qualifications set forth in the original application for licensure submitted to the Board.

STATUTORY AUTHORITY:

1. 32 M.R.S., Chapter 2-B.

EFFECTIVE DATE:

July 3, 1978 (EMERGENCY)

AMENDED:

April 1, 1982

December 25, 1982 - Sec. 2.31, 3131, 6.311, 6.63 and 6.73

January 1, 1984 - Sec. 1, 2, 3, 5, 6, 8.32, 10.2, 10.3, 11.1066 and 11.1067

April 30, 1985 - Sec. 1, 2.846.222, 6.332, 9.313, 8.3216 and 9.11

January 1, 1986 - Sec. 1, 6. 8.15, 8.2, 8.3, 8.4 and 11.103

September 1, 1986

August 25, 1987 - Sec. 5, 6.011 and 12 (added)

July 1, 1988

March 4, 1992

September 1, 1996

December 24, 2022 – filing 2022-244

EFFECTIVE DATE (ELECTRONIC CONVERSION):

July 1, 2000

REPEALED AND REPLACED:

July 1, 2000

July 1, 2003

October 1, 2009

May 1, 2013

January 10, 2021

APAO WORD VERSION CONVERSION (IF NEEDED) AND ACCESSIBILITY CHECK: July 18, 2025