Missouri § 190.098 - Community paramedic, certification requirements — scope of practice — written agreement — rulemaking authority.

§ 190.098. Community paramedic, certification requirements — scope of practice — written agreement — rulemaking authority.

1.  As used in this section, the term "community paramedic services" means services that are:

(1)  Provided by any entity that:

(a)  Employs licensed paramedics who are certified as community paramedics by the department; and

(b)  Has received an endorsement by the department as a community paramedic service entity;

(2)  Provided in a nonemergent setting, independent of a 911 system or emergency summons;

(3)  Consistent with the training and education, as well as within the scope of skill and practice, of the personnel and with the supervisory standard approved by the medical director; and

(4)  Reflected and documented in the entity's patient care plans or protocols approved by the medical director in accordance with section 190.142.

2.  In order for a person to be eligible for certification by the department as a community paramedic, an individual shall:

(1)  Be currently licensed as a paramedic;

(2)  Successfully complete or have successfully completed a community paramedic certification program from a college, university, or educational institution that has been approved by the department or accredited by a national accreditation organization approved by the department; and

(3)  Complete an application form approved by the department.

3.  A community paramedic shall practice in accordance with protocols and supervisory standards established by the medical director.  A community paramedic shall provide services of a health care plan if the plan has been developed by the patient's physician or by an advanced practice registered nurse through a collaborative practice arrangement with a physician or a physician assistant through a collaborative practice arrangement with a physician and there is no duplication of services to the patient from another provider.

4.  (1)  Any ambulance service shall enter into a written contract with another ambulance service provider to provide community paramedic services in their ambulance service area, as that term is defined in section 190.100.  The contract that is agreed upon may be for an indefinite period of time, as long as it includes at least a sixty-day cancellation notice by either ambulance service.

(2)  The department shall establish regulations for the purpose of recognizing community paramedic service entities that have met the standards necessary to provide community paramedic services, including physician medical oversight, training, patient recordkeeping, formal relationships with primary care services where necessary, and quality improvement policies.  The department shall issue an endorsement to any community paramedic service entity that meets such standards that allows the entity to provide community paramedic services for a period of five years.

5.  A community paramedic is subject to the provisions of sections 190.001 to 190.245 and rules promulgated under sections 190.001 to 190.245.

6.  No person shall hold himself or herself out as a community paramedic or provide the services of a community paramedic unless such person is certified by the department.

7.  The medical director shall approve the implementation of the community paramedic program.

8.  Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.  This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2013, shall be invalid and void.

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(L. 2013 H.B. 307 merged with H.B. 336, A.L. 2026 H.B. 2372)

---- end of effective  28 Aug 2026 ----

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