Community Paramedics (CP)

Background

A 2012 Legislative Report from the Minnesota Department of Human Services describes how the concept of the CP grew from the traditional career ladder of Emergency Medical Technicians (EMTs). 

Most EMTs begin with a basic curriculum in emergency medicine and, over the course of a career, gain new skills and certifications through training. The typical progression of certification goes as follows:

1. Emergency Medical Responder (EMR)
2. Emergency Medical Technician (EMT)
3. Advanced Emergency Medical Technician (AEMT)
4. Paramedic

The Community Paramedic certification offers career paramedics another level of training and a new way to contribute their skills.

Definition

A Community Paramedic (CP) is an advanced paramedic that works to:

• increase access to primary and preventive care and
• decrease use of emergency departments, which in turn
• decreases health care costs. 

Among other things, CPs may play a key role in providing 

• follow–up services after a hospital discharge to prevent hospital readmission.
• CPs can provide health assessments,
• chronic disease monitoring and education,
• medication management,
• immunizations and vaccinations,
• laboratory specimen collection,
• hospital discharge follow–up care and
• minor medical procedures. 

CPs work under the direction of an Ambulance Medical Director.

Services provided

CP services include, but are not limited to the following: 

• Health assessments
• Chronic disease monitoring and education
• Medication compliance
• Immunizations and vaccinations
• Laboratory specimen collection
• Hospital discharge follow–up care
• Minor medical procedures approved by the Ambulance Medical Director

Education, training, and certification

Curriculum

The Community Paramedic Curriculum was developed by the North Central EMS Institute with input from many national and international instructors. Under The Office of Emergency Medical Services (OEMS), equivalent program offerings meet the requirements of the curriculum.

Curriculum Requirements 

• 14 credits
• 114 didactic hours and
• 196 clinical hours.

Schools offering approved Curriculum 

North Central EMS approved curriculum:

• Hennepin Technical College
• Inver Hills Community College

OEMS approved curriculum: 

• University of Wisconsin - Milwaukee

Certification Requirements

The Office of Emergency Medical Services (OEMS), formerly known as The Emergency Medical Services Regulatory Board (EMSRB), certifies Community Paramedics. 

In order to obtain Community Paramedic certification, an individual must:

• Be currently certified as a paramedic and have two years of full–time service as a paramedic or it’s part-time equivalent;
• Successfully complete a community paramedic education program through an accredited college or university; and
• Practice under the supervision of an ambulance services medical director.

Maintenance of Certification 

The Community Paramedic must complete 12 hours continuing education in clinical topics approved by the ambulance medical director.

Supervision

Community Paramedics work under the direct supervision of the Medical Director of an ambulance service. The Medical Director is responsible for coordinating CP services with the patient’s primary care provider.

Billing and reimbursement

According to Minnesota Statute 256B.0625, Subdivision 60, Medical Assistance covers services provided by community paramedics who are certified under section 144E.28, Subdivision 9, when the services are provided in accordance with this subdivision to an eligible recipient.

Key Requirements

Payment for services provided by a CP under this subdivision must be a part of a care plan ordered by a primary health care provider in consultation with the medial director of an ambulance service and must be billed by an eligible provider enrolled in medical assistance that employs or contracts with the community paramedic. The care plan must ensure that the services provided by a CP are coordinated with other community health providers and local public health agencies and that CP services do not duplicate services already provided to the patient, including home health and waiver services.

Services provided by a CP to an eligible recipient who is also receiving care coordination services must be in consultation with the providers of the recipient´s care coordination services.

Community Paramedic services have been covered by Minnesota´s Medicaid program since 2012, and Minnesota is the first state to cover this newly developed profession.

More Information

The Minnesota Department of Human Services Provider Manual includes information on enrollment and reimbursement for CPs serving Minnesota Health Care Program enrollees.

Questions regarding coverage, payment and reimbursement for clients enrolled in a managed care organization or commercial insurance carrier should be directed to those specific organizations.

Relevant Statutes and Rules:

• Minnesota Statute 256B.0625, Subdivision 60 (Community Paramedics)
• Minnesota Sec. 144E.28 MN Statutes, Subdivision 9

CP Toolkit

Background Research

Community Paramedic: Literature Review

• Community Paramedic Literature Review Introduction (PDF)
• Community Paramedic Literature Review Definitions (PDF)
• Community Paramedic: States with Legislation or Bills (PDF)
• Community Paramedic: Bibliography (Excel)
• Community Paramedic: State Legislation Update (Excel)
• Community Paramedic: State Community Paramedicine Statutes (Excel)

Environmental Scan

• Community Paramedics Environmental Scan, 2016 (PDF)
• Appendix: The Paramedic Foundation (TPF) Community Paramedic Survey, 2015 (PDF)

Review of Existing Toolkits

• Community Paramedics: Review of Existing Toolkits, 2015 (PDF)

Ambulance Agency Survey and Focus Groups

• Ambulance Service Survey and Focus Group Results, 2016 (PDF)
• Appendix: The Paramedic Foundation (TPF) Minnesota Ambulance Service Community Paramedicine Survey, 2016 (PDF)

Other Resources

Community Paramedic Projects in MN

• Scott County Health Care Collaborative – First MN program to use CPs, 2009
• North Memorial Medical Center, 2012
• Allina Health Emergency Medical Services
• HealthEast EMS Transportation, 2013 and July 2014 (Emerging Professions Integration Grant).
  • Note: HealthEast and Fairview have merged since.

Helpful tools

• Program Sustainability Assessment Tool and Framework, Center for Public Health Systems Science, 2013

Reports

• Community paramedic services. Minnesota Edocs: State Government Publications - Minnesota Legislative Reference Library
• Community Paramedic Services – Report to the Legislature, Minnesota Department of Human Services, January 2012 (PDF: 509 KB/19 pages)