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This report outlines specified services and payment rates for these services to be performed by community paramedics. The contents of this report are the result of extensive research and consultation with a workgroup conveined by the DHS consisting of representatives of emergency medical service providers, physicians, public health nurses, community health workers, and local public health agencies.

1. “A series of factors – demographic changes, economic development, global travel and commerce, and conflict – ‘have heightened the risk of disease outbreaks,’ ranging from emerging infectious diseases such as HIV/AIDS and drug resistant tuberculosis to food borne pathogens and bioterrorist attacks.”

2. “Although there is a great sense of urgency to address contemporary biosecurity problems— and while impressive resources have been mobilized to do so — there is no consensus about how to conceptualize these threats, nor about what the most appropriate measures are to deal with them.”

3. “There is no such thing as being “too secure.” Living with risk, by contrast, acknowledges a more complex calculus. It requires new forms of political and ethical reasoning that take into account questions that are often only implicit in discussions of biosecurity interventions.”