HB1321

We, as highly trained Paramedics, are trusted to administer IV fluids and medication in emergency situations, but not elective? Ridiculous. Remember who you all tagged to do all your Covid vaccine clinics!

Elective IV therapy was essential in my recovery from Lyme Disease. I was severely debilitated and unable to leave my home, and because I was able to have IV therapy brought into my home, my recovery was able to begin and jumpstart my journey back towards health. I oppose this bill and shame any goal that seeks to restrict the care and support that elective IV therapy provides.

I am opposing this bill for the fact that elective IV therapy was critical in the recovery phase for my husband who was suffering from Lyme disease. My husband was quite literally on the brink of the death, unable to leave our home for support services, and IV therapy brought into our home was one of the most essential components in his journey to healing and bringing him back from the brink. I significantly OPPOSE this bill in its mission to restrict care and services for those who truly need elective IV therapy treatment.

Do not approve this bill.

Paramedics and AEMTs in NH are already authorized to initiate IV access and administer medications in high-acuity, emergency environments under physician-approved standing orders. If they are trusted to perform these skills in a moving ambulance, they should not be prohibited from performing them in a controlled outpatient setting under physician oversight. This bill threatens: • Healthcare workforce stability • Patient access to care • Small healthcare businesses • Scope-of-practice consistency

I oppose HB1321. This is an infringement on the rights of the public to be able to have access to IV healthcare in the privacy of their own home. I have had this treatment and it was extremely helpful to me during a severe illness and I was too sick to leave my home.. It made a significant difference in my recovery. This is also infringement on small businesses who have ample qualifications to administer these treatments. New Hampshire is the live free or die state, stop trying to create more bureaucratic controls where they are not needed.

I have received treatment in clean private establishments for holistic care that I could not afford through traditional medical care due to entanglement between insurance providers and privatize and profiteering hospitals.. If this bill passes, I will no longer be able to afford treatment. I will lose autonomy over my own health.

Paramedics are allowed to administer IV's Some of these companies travel to your home, I have used one that is owned by a paramedic during Covid and other sickness they have been amazing Waste your time on bigger issues.. because we have them, stop shitting ok small business's

I oppose this bill. It lacks an understanding of science and common sense.

Invasive IV therapy should be allowed by paramedics to be done in any environment, due to their knowledge and education of their occupation.

Dear Members of the House Health, Human Services and Elderly Affairs committee: I am writing to provide medical justification for the provision of elective intravenous (IV) therapy services in an outpatient setting, with administration performed by licensed paramedics operating under direct physician supervision. I am requesting an amendment to the proposed HB 1321 to add paramedics as another class of medical professional who can administer elective IV therapy. If unable to amend, I am opposing the passage of this bill in hopes an amendment can be added to include paramedics in a future bill regarding this matter. Rationale based on clinical evidence: Paramedics are highly trained healthcare professionals with extensive experience in peripheral IV catheter insertion and IV fluid/medication administration. Studies demonstrate that paramedics achieve IV cannulation success rates of 80-92% across diverse patient populations and clinical settings. A population-based study of over 56,000 patients found that IV access established by EMS personnel was associated with favorable clinical outcomes, with no increased risk of adverse events. The safety profile of paramedic administered IV therapy is well-established. Both basic life support and advanced life support paramedics are trained in patient assessment, vital sign monitoring, and the administration of IV fluids, operating under medical directives and physician oversight. The American Heart Association recognizes peripheral IV access as a standard skill within paramedic scope of practice, with established protocols for vascular access and medication administration. Regulatory Framework and Oversight: Community paramedicine programs, in which paramedics provide care outside traditional emergency response roles, are recognized in numerous U.S. states with appropriate regulatory frameworks. These programs demonstrate that paramedics can safely practice with an expanded scope under physician supervision, improving patient access to care while maintaining safety standards in or outside a hospital or office setting. State policies generally recognize that the provision of IV therapy constitutes a practice of medicine requiring physician oversight, with administration performed by licensed professionals (including paramedics) with medication administration within their scope of practice. Proposed Model of Care (i.e. adding paramedics to who may administer IV therapy) The outpatient IV therapy services described herein will operate under the following safeguards: 1. Physician Supervision: All IV therapy will be prescribed by a licensed physician/PA/NP following individualized patient assessment. A supervising physician or PA or ARNP will be available or immediately accessible for consultation during all treatment sessions, while in an office or mobile setting. 2. Qualified Personnel: IV catheter insertion and infusion administration will be performed by licensed paramedics with current certifications and demonstrated competency in IV access procedures. 3. Standardized Protocols: Written protocols and standing orders will govern patient selection criteria, IV insertion techniques, infusion monitoring parameters, and management of potential complications. 4. Patient Monitoring: Patients will be monitored throughout the infusion for adverse reactions, with established protocols for emergency response if needed. 5. Documentation: Complete records will be maintained for each patient encounter, including indication for therapy, vital signs, infusion details, and any adverse events. Conclusion The evidence supports that IV therapy administered by paramedics under physician supervision is safe, effective, and consistent with established standards of care. This model of care delivery expands patient access to necessary treatments while maintaining appropriate medical oversight and quality standards. Please do not hesitate to contact me if you require additional information or clarification regarding this matter. Sincerely, Patrick Lee MD FACEP Medical Director, Hydropeutics LLC, Granvera LLC 50 S. Willow Street, unit 7 Manchester, NH 03103

Hello, I guarantee big insurance, pharma, and our local monopolized health systems are behind this bill because independent qualified professionals are helping people while taking business away from them. Live free or die. I vehemently oppose this bill.

Good morning. I am speaking as a retired ER/Trauma nurse who op t ed to use the services of Hydropeutics. In the past couple of years. I chose not to go to an ER and sit hours to have to convince a doc I needed hydration due to illness . I chose this business as their staff is extremely trained &experienced as Paramedics with physician backup in my home. Their assessment of my need was thorough and their procedures were 5*. If they are considered qualified to provide IVs in emergency situations they should be allowed to do so in facilities and homes. As ERs are extremely busy , their services will save lives and keep ER care available for more severe cases. I speak as a EMT-P instructor so I know what is involved in their certification. Please do not allow this bill to pass.

There are licensed paramedics who can and do perform IV administration on a daily basis under standing orders. Their skills and training don't go out the window depending on whether it's an emergency or elective intravenous therapy.

This bill would prevent paramedics and advanced EMTs from performing a service that is within their scope of practice when acting under the standing orders of a licensed physician. Therefore, I urge you to vote Inexpedient to Legislate. This would create an unreasonable obstacle for small healthcare businesses and the people who currently rely on them for IV therapy. I'm a client of one such business, and I've received IV therapy in the comfort of my own home for dehydration following viral illness, as well as for nausea and pain relief during an excruciating passage of a kidney stone. This care was administered by a professionally trained paramedic. It was far safer for them to come to me than it would have been for me to leave my house to seek treatment. It also saved me hours I would have spent collapsed in a crowded waiting room, and hundreds of dollars I would have been charged, as I do not have health insurance. When it comes to healthcare, New Hampshire needs more access to care, not less. We do not need to make things more difficult for ourselves by imposing unnecessary restrictions on licensed professionals administering IV therapy.

I have suffered from migraines for 35+ years. Acute migraines can be very difficult to treat. In years past, I would go to the ER or urgent care. I was treated extremely poorly, often leaving feeling worse than when I arrived. One of the times, I was treated as a drug seeker when all I was looking for was an anti-inflammatory IV hydration, which had proved very effective in the past through my PCP‘s office. After that incident, my doctor wrote me a note to present to the ER or urgent care stating a treatment plan as mentioned above. This did not help. My alternative was to go home and suffer the extreme pain. Within the last five years, I have discovered private IV hydration clinics. There, I am treated with compassion and respect. I can receive IV hydration along with an anti-inflammatory and magnesium, which is very effective in reducing migraine symptoms. This has changed my quality of life immensely for the better. My physician is aware of this treatment and supportive because it has improved my quality of life. To be blunt, I would rather take the risk of a possible stroke, which can be easily confused with the symptoms of a migraine, then be treated with such terrible care at an ER or urgent care again. So to put it bluntly, risk my life than be treated as a drug addict or suffer through untreated pain. I am happy to share any further information.

Please keep this type of healthcare accessible as it is now,

I oppose this bill. this bill would take away our medical freedom of choice.

I absolutely oppose any effort to restrict Paramedic and AEMT personnel from administering intravenous fluids and vitamin supplements in a controlled environment. These professionals are already extensively trained and routinely carry out these procedures in high-pressure emergency situations without direct physician oversight. Additional restrictions are not needed and will limit care to those that truly need it. Our healthcare system is already a mess with issues with access to care in many areas. Don’t take away needed help.

Paramedics should be able to prescribe and give IV medication to patients requesting these services, without physician oversight.

I think paramedics should be able to give IVs in any environment needed. They went to school for this if they need to do it for a job they should be able to.

I oppose this bill because the elderly needs to be able to have services needed to make them feel better and safe. Shouldn’t take things away from elderly. They are people just as well is everyone else that’s younger. So I ask you to stop. I oppose this bill.

It is my belief that companies who offer therapuetic services And have met all requirements of start up and continuing that business should be allowed to do all treatments necessary that are within the scope of work. Many businesses operate under the direction of a doctor. All treaments and therapies must be approved by the medical director they work under. IV services are one of the baselines that allow these companies to operate. Without being able to do and offer this baseline service These companies will not be able to continue operating. This will stress other forms of services including hospitals, private ems companies and potentially 911 services.