Candace Byrnes

Mister Chair, Members of the Committee, thank you for the opportunity to testify. My name is Candace Byrnes. I am the owner of The DRIPBaR Portsmouth, a medically overseen IV therapy and wellness clinic, and founding member of the American IV Association. Our clinic operates under robust medical oversight. We participate in a national medical director program, and our protocols and menus are developed and reviewed by a multidisciplinary team that includes an oncologist, a doctor of pharmacy, an osteopathic physician, and nurse practitioners. All care is delivered under standing orders, evidence-based protocols, and strict safety standards. Regarding HB 1321 and the exclusion of paramedics and advanced emergency medical technicians from the list of licensed professionals permitted to administer intravenous therapy- In New Hampshire, paramedics and advanced EMTs are licensed by the New Hampshire Office of Emergency Medical Services under RSA 153-A and associated administrative rules. Their licensure requires formal education, supervised clinical training, successful completion of cognitive and psychomotor examinations, and ongoing continuing education to maintain certification. Critically, intravenous access and IV medication administration are mandatory competencies for licensure at the paramedic level and, where authorized, for advanced EMTs. These skills are not optional or employer-based add-ons — they are required, tested, and evaluated as part of the state and national certification process. Establishing IV access is central to the paramedic scope of practice in New Hampshire. Paramedics are trained to: • Initiate and manage IV access • Administer IV fluids and medications • Assess patients for contraindications and complications • Maintain sterile technique • Recognize and respond to adverse events They are entrusted to perform these skills in high-acuity, uncontrolled environments, including cardiac events, trauma, dehydration, allergic reactions, and other medical emergencies — often without the support structures found in hospitals or clinics. By contrast, IV insertion is not a universally required component of initial nursing education. While many nurses become highly skilled at IV initiation through post-licensure training, IV placement itself is learned after graduation, through employer orientation or continuing education, rather than as a condition of licensure. All of my Nurses are highly skilled at IV administration and part time/per diem with me, while also serving as ER, NICU, Labor and Delivery or ICU Nurses as well. From a patient safety perspective, it is inconsistent to allow paramedics to initiate IVs in emergencies in New Hampshire, but prohibit them from doing so in controlled, elective wellness based environments where medical oversight, protocols, and informed consent are already in place. I therefore oppose this bill. Thank you for your time and thoughtful consideration.