1.1.................... moves to amend H.F. No. 262, the first engrossment, as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2010, section 144E.001, is amended by adding a
1.4subdivision to read:
1.5    Subd. 5f. Emergency medical technician-community paramedic or EMT-CP.
1.6"Emergency medical technician-community paramedic," "EMT-CP," or "community
1.7paramedic" means a person who is certified as an EMT-P and who meets the requirements
1.8for additional certification as an EMT-CP as specified in section 144E.28, subdivision 9.
1.9EFFECTIVE DATE.This section is effective July 1, 2011.

1.10    Sec. 2. Minnesota Statutes 2010, section 144E.28, is amended by adding a subdivision
1.11to read:
1.12    Subd. 9. Community paramedics. (a) To be eligible for certification by the board
1.13as an EMT-CP, an individual shall:
1.14(1) be currently certified as an EMT-P, and have two years of full-time service
1.15as an EMT-P, or its part-time equivalent;
1.16(2) successfully complete a community paramedic training program from a college
1.17or university that has been approved by the board or accredited by a board-approved
1.18national accreditation organization. The training program must include clinical experience
1.19that is provided under the supervision of an ambulance medical director, advanced practice
1.20registered nurse, physician assistant, or public health nurse operating under the direct
1.21authority of a local unit of government; and
1.22(3) complete a board-approved application form.
1.23(b) A community paramedic must practice in accordance with protocols and
1.24supervisory standards established by an ambulance service medical director in accordance
1.25with section 144E.265. A community paramedic may provide services as directed by a
2.1patient care plan if the plan has been developed by the patient's primary physician or by
2.2an advanced practice registered nurse or a physician assistant, in conjunction with the
2.3ambulance service medical director and relevant local health care providers. The care
2.4plan must ensure that the services provided by the community paramedic are consistent
2.5with the services offered by the patient's health care home, if one exists, that the patient
2.6receives the necessary services, and that there is no duplication of services to the patient.
2.7(c) A community paramedic is subject to all certification, disciplinary, complaint,
2.8and other regulatory requirements that apply to EMT-Ps under this chapter.
2.9EFFECTIVE DATE.This section is effective July 1, 2011.

2.12(a) The commissioner of human services, in consultation with representatives of
2.13emergency medical service providers, physicians, and local public health agencies, shall
2.14determine specified services and payment rates for these services to be performed by
2.15community paramedics certified under Minnesota Statutes, section 144E.28, subdivision
2.169, to be covered by medical assistance under Minnesota Statutes, section 256B.0625.
2.17Services may include, but are not limited to, initial health assessments, diagnosis-related
2.18patient education services, the performance of minor medical procedures, and the
2.19monitoring of chronic disease management directives intended to prevent avoidable
2.20ambulance transportation or hospital emergency department use.
2.21(b) Payment for services provided by a community paramedic must be ordered by an
2.22ambulance medical director, must be part of a patient care plan that has been developed in
2.23coordination with the patient's primary physician and relevant local health care providers,
2.24and must be billed by an eligible medical assistance enrolled provider that employs or
2.25contracts with the community paramedic. In determining the community paramedic
2.26services to include under medical assistance coverage, the commissioner shall consider
2.27the potential of hospital admittance and emergency room utilization reductions as well
2.28as increased access to quality care in rural communities.
2.29(c) The commissioner shall submit the list of services to be covered by medical
2.30assistance to the chairs and ranking minority members of the senate Health and Human
2.31Services Budget and Policy Committee and the house of representatives Health and
2.32Human Services Finance Committee by January 15, 2012. These services shall not be
2.33covered by medical assistance until further legislative action is taken.

3.1The commissioner of human services shall evaluate the effect of medical assistance
3.2and MinnesotaCare coverage of community paramedic services on the cost and quality
3.3of care under those programs and the coordination of these services with the health care
3.4home services. The commissioner shall present findings to the chairs and ranking minority
3.5members of the senate and house of representatives committees with jurisdiction over
3.6health and human services by December 1, 2014. The commissioner shall require medical
3.7assistance and MinnesotaCare enrolled providers that employ or contract with community
3.8paramedics to provide to the commissioner, in the form and manner specified by the
3.9commissioner, the utilization, cost, and quality data necessary to conduct this evaluation."
3.10Amend the title accordingly