Several proposed regulations regarding Maine ambulance services are being discussed in Augusta.

The proposed rules include requiring more frequent training and putting more control over record-keeping in the hands of services, but the strain these rules will place on ambulance services is going to be quite challenging, according to Boothbay Region Ambulance Service Director of Operations Scott Lash.

“It's a huge challenge to emergency medical services, especially small ones,” Lash said. “The license period is going from every three years to every two years, and in that two years each EMT needs 60 hours of training.”

The training isn't general either, it's specific. Each EMT must be trained in specific categories, usually taught at college-level courses that would require BRAS to pay for training and a great deal of time to be spent away from Boothbay, which means they can't respond to emergency calls.

“I am not opposed to being proficient,” Lash said. “It is necessary, but it is a hardship to pay. Looking at our roster and these new regulations means in two years there would be over 2,000 hours of training.”

Another proposed change is how licensing is handled.

Previously, EMTs sent in their certificates to Augusta where they would be reviewed to make sure all requirements were met; then the licenses would be sent back.

Now that burden will be shifted to the services themselves, which will require a great deal more paperwork and training.

“There are hundreds and hundreds of classes to keep track of, and if we mess up, it's a double violation — both on the EMT and the service,” Lash said. “While we agree this is a great goal, and that EMTs should be the best at what they do, the system cannot handle that demand.”

Another new requirement is that every ambulance must be fully equipped to handle emergencies with full equipment, including a $30,000 defibrillator. While this is also a good idea in theory, it doesn't work well in practical situations, Lash said.

“Previously we could equip one (ambulance) at a basic level of life support, and that ambulance could respond to routine transfers and non life-threatening situations,” Lash said. “With no more tiered response, we lose a lot of flexibility.”

These changes are some of the reasons why services can no longer run on a volunteer basis, according to Lash.

“It's a career now. People can't do it causally as a community service,” Lash said. “It's a high-intensity job, with a huge time commitment and it creates wear-and-tear on a family. You never know when the call will come in.”

“Five years ago people could do this on a quasi-volunteer level. Now with these demands, it's not possible. Ambulance services can't take the risk of people not panning out after over $10,000 of training.”

While BRAS continues to recover from the loss of St. Andrews, and works to increase fundraising efforts to shift the burden of costs away from the town and taxpayers, new regulations such as these place further strain on the system, Lash said.

“It's not a 'brace yourself' kind of situation,” Lash said. “The regulations won’t be in effect until 2019. But it's important that the public learns about what is going on and driving things, including why our costs are up.”

Those wishing to give input can write to Maine Emergency Medical Services, Department of Public Safety, 45 Commerce Drive Suite 1, 152 State House Station, Augusta, ME 04333-0152 or email maine.ems@maine.gov.