Tag: EMS

DEA Final Rule Takes Effect for EMS Controlled Substances

Member News

A new Drug Enforcement Administration (DEA) final rule took effect March 9, codifying regulations enacted in 2017 within the Controlled Substances Act (CSA) related to the handling of controlled substances by Emergency Medical Services (EMS) agencies.

While many provisions reiterate existing statutory requirements, the rule creates a process allowing EMS agencies to register with the DEA. It remains unclear whether EMS agencies must register with the DEA or if the rule creates an alternative to operating under a hospital’s existing DEA registration (the current process in Michigan).

If the rule requires EMS agencies to register with the DEA, it would conflict with the state’s current statutory framework, which does not allow EMS agencies to obtain their own controlled substance licenses.

Michigan’s Current Framework

Three key aspects of Michigan law include:

  • Hospital pharmacies own and maintain inventory of all EMS medications; EMS agencies serve only as custodians.
  • EMS agencies are ineligible for a state-controlled substance license under the current statute.
  • Existing MDHHS licensure and Medical Control Authority protocols authorize EMS agencies to administer controlled substances but not to purchase, own or independently store them.

MHA Actions

The MHA has engaged key stakeholders, including Michigan Department of Health and Human Services (MDHHS), the Michigan Department of Licensing and Regulatory Affairs, the Michigan Pharmacists Association, the Michigan Board of Pharmacy and the Michigan Association of Ambulance Services — as well as the Michigan DEA Field Office to provide guidance. DEA staff have informally recommended a “business as usual” approach and the MHA is working to obtain a more formal written statement.

MDHHS Bureau of Emergency Preparedness, EMS and Systems of Care released a memo on March 6 outlining that Michigan’s existing custodial framework and EMS licensure protocols remain sufficient to comply with the new rule and reaffirm the DEA position of “business as usual.”

The MHA believes this clarification will allow Michigan hospitals and EMS agencies to continue operating under current processes without disruption and will share further direction from the DEA when available.

Members with questions should contact Kelsey Ostergren at the MHA.

MDHHS Seeks Volunteers to Support Development of New EMS Credentialing Exams

Member News

The Michigan Department of Health and Human Services (MDHHS) is developing a Paramedic Exam and an Instructor Coordinator Exam and is seeking volunteers to support the process. Individuals across the Emergency Medical Services (EMS) and healthcare community are encouraged to participate in shaping exam content and ensuring the testing process aligns with best practices.

MDHHS will convene several committees to support this work, including groups focused on test question and scenario development, practice analysis and a broad advisory committee. Volunteers do not need to be paramedics to participate on the advisory committee. MDHHS aims to assemble a professionally diverse group to help maintain exam integrity and support a positive experience for future test takers. Professionals who may consider participating include field supervisors, educators, nurses, dispatch staff, clinicians, students or emergency preparedness coordinators.

Frequently Asked Questions

When will committee work begin?

MDHHS anticipates that work will begin in December, with time commitments varying by committee. Participants can expect no more than two meetings per month. Please note that dates and times may change based on the progress of each committee.

  • Practice Analysis Panels for EMS and Instructor Coordinators require a total commitment of about 13 hours, with virtual meetings scheduled for January and June 2026.
  • Practical Exam committees require a total commitment of about 16 hours.
  • Test Question Panels will meet during July and August 2026, and each participant will write a minimum of 20 questions.

Will meetings be in person?

Most meetings will be held virtually. Some in-person meetings may be scheduled.

Are early-career professionals encouraged to apply?

Yes. MDHHS encourages young professionals to apply. Recent educational experiences offer valuable insight that can help create exams that are relevant, equitable and reflective of today’s workforce.

Members are encouraged to apply by Nov. 26, 2025. To apply, please complete the application form.

Members with questions may contact Amanda Kinney with MDHHS at (517) 582-5816.

Collaborating to Address EMS Challenges

Member News, MHA Rounds

Following National EMS Week, it’s important to recognize how we can continue to support the dedicated teams providing lifesaving care every day to Michigan patients and communities.

In my role as director of health policy initiatives at the MHA, it’s a priority to identify the challenges facing our EMS workforce so we can bridge solutions with our member hospitals. We continue to be engaged with the state’s EMS Coordination Committee (EMSCC) with extensive discussions around the barriers that have a direct impact on our EMS workforce, hospitals and patients. I’ve outlined a few of these challenges below, along with how teams are responding.

Challenge: EMS teams are limited in where they transport patients for care. Because hospital emergency departments (EDs) are a common and reimbursable destination for the ambulance provider, it leads to a growing number of behavioral health patients presenting to hospital EDs rather than a specialty behavioral health facility.

Response: While hospitals are equipped to stabilize and triage patients, the ED is not the most appropriate care setting for an individual in need of mental or behavioral healthcare. Given the establishment of Crisis Stabilization Units (CSUs) in Michigan, which are designed to provide 24/7 care for emergent behavioral health needs, the MHA wants to ensure that EMS providers are reimbursed for the transport of patients to this care setting. We are working to add CSUs as an approved destination for patient drop-off to ensure timely and appropriate services can be rendered to patients experiencing a behavioral health emergency.

Challenge: Responding to physical and behavioral health emergencies are especially challenging for EMS and ambulatory agencies due to continued staffing shortages.

Response: The MHA is working to identify alternative, appropriate and reimbursable mechanisms to transport patients with behavioral health needs who do not require the medical interventions provided in an ambulance. We also launched an ongoing public awareness campaign to expand interest in healthcare careers in Michigan, targeting messages to high school and college students as well as working professionals.

Challenge: Regulation and reimbursement mechanisms vary between EMS and hospitals, which can lead to conflict when challenges occur on either side.

Response: The MHA convened a group of executive leaders from behavioral health hospitals and EMS services to share some of the challenges each side experiences interacting with the other. One immediate action item from this discussion was the recognition that not all behavioral health hospitals have the same protocols for accepting new admissions, which can be a challenge for EMS providers. In response to this, the MHA deployed a survey that is currently in the field to identify how each hospital accepts patients, what mode of transportation is authorized and whether their admission status (voluntary/involuntary) plays a role. This information will help the MHA and the EMSCC better understand and identify opportunities to standardize the process and ensure a more seamless handoff between EMS and behavioral health hospitals.

The role EMS plays in our world cannot be understated – the MHA is heavily engaged in responding to concerns raised by this group and aligning priorities to continue offering support and collaborating on solutions. We must work together to overcome these challenges.

Members with questions may contact the MHA advocacy team.