The Maryland Institute for Emergency Medical Services Systems is an independent, executive-level agency responsible for the coordination of all emergency medical services.  MIEMSS is governed by an 11-member Governor-appointed State Emergency Medical Services Board.  By law, the Board must meet at least six times per year. The law gave the Board the authority to appoint an Executive Director of MIEMSS with the approval of the Governor.  The responsibilities of the Executive Director and the EMS Board are defined by law.

A 31-member Statewide Emergency Medical Services Advisory Council (SEMSAC) advises and assists the EMS Board.  SEMSAC is the principal advisory body to the Board and its membership is defined by statute.  Members are appointed by the EMS Board with the approval of the Governor.  The SEMSAC chairman is a member of the EMS Board, and many of the SEMSAC members serve on various subcommittees that deal with a range of EMS issues.

Dedicated funding for MIEMSS and the major state-level components of the EMS system is provided by the Maryland EMS Operations Fund (MEMSOF). MEMSOF is funded from a $14.50/year vehicle registration fee surcharge, a moving violation surcharge of $7.50 added to certain traffic cases, and interest earned on the MEMSOF. An additional $2.50/year is added to the vehicle registration fee charge to support Maryland’s trauma centers and trauma physicians through the Maryland Trauma Physician Services Fund. The MEMSOF is used to fund MIEMSS, as well as the Aviation Command of the Maryland State Police, the Maryland Fire and Rescue Institute, the R Adams Cowley Shock Trauma Center, and the Amoss Fire, Rescue and Ambulance Fund which provides aid to local jurisdictions. By statute, the EMS Board has “review and approve” authority over the budgets of all the MEMSOF-supported entities, except for the Amoss Fund.  This special funding source has provided a stable and reliable base of funding for the EMS System for more than a quarter of a century.

Several pieces of legislation have been enacted that strengthen the authority of the agency and the EMS Board to coordinate an effective EMS system.  From 1993 through 2001, section 13-515 was modified several times to define the Board’s and MIEMSS’ responsibilities for licensing and regulation of commercial ambulance services.  The most recent modification of the law authorizes licensing and regulation of commercial services providing aeromedical transport.  In 1998, section 13-516 established the EMS Board’s licensing and certification authority over all levels of Maryland EMS clinicians and strengthened the Board’s oversight responsibilities.  The law created an EMS Board-appointed 13-member Provider Review Panel to review patient care problems and allegations of EMS clinician misconduct and to recommend action to the EMS Board.  Within MIEMSS, an Office of Compliance was subsequently created and an Incident Review Committee established as part of this process. For further information see the compliance section.