Councilman Mark Conway opened a public hearing on Council Bill 25-0014, which would authorize Baltimore emergency medical services personnel to administer buprenorphine to patients after opioid overdoses under defined circumstances.

Conway framed the proposal as a life‑saving policy and criticized procedural barriers after the administration and the Law Department raised legal objections. He warned that if the Law Department's memo operates as a veto, “then the laws of the city will no longer be written by its elected representatives.”

Several health-care and harm-reduction witnesses urged adoption. Lauren Rech, program director and founder of MAT Clinics, described buprenorphine as “a life‑saving medication” with a long half‑life that can blunt withdrawal after naloxone reversal and create an opportunity to link patients to ongoing treatment. Jay Unick, vice president of the Behavioral Health Leadership Institute, and Dr. Drew Fuller, an addiction‑medicine and emergency‑medicine physician, said evidence shows rapid initiation of buprenorphine after nonfatal overdose reduces mortality and helps engage patients in care.

Chief Robert Phillips, legislative chair for the Maryland State Firefighters Association, said the association supported the state bill and noted funding for training was authorized at the state level. Baltimore City Fire Department leaders said the department has trained a small population‑health unit and has phased plans to expand paramedic administration. Chief EMS James Madsen reported the department has roughly 200 paramedics on staff; initial population‑health training covered about eight members, expansion to specialized units brings that to roughly 24 trained providers in the near term, and a broader rollout could reach roughly 50 trained paramedics over several months.

Michelle Toth of the Law Department told the committee the department’s bill report concluded state law and regulation have “occupied the field” of emergency medical services — covering licensure, medical protocols and training — and that local legislation affecting EMS is therefore preempted. Mayor’s Office and other agencies reiterated that the Maryland Institute for Emergency Medical Services Systems (MIMS) issues protocols, including an optional supplemental protocol that jurisdictions may adopt. The administration said it does not oppose local use of buprenorphine where state protocols allow, but emphasized that implementation requires compliance with state process and regional approval.

Committee members pressed for clarity on implementation, warm handoffs to continuing care and patient‑data issues. Health Department staff described existing collaborations, including a mobile buprenorphine clinic (“Spot Healthcare on the Spot”) that coordinates referrals with the fire department’s population health team. Members asked the Law Department to research whether the mayor has authority to require the Fire Department to adopt the optional MIMS protocol, because if so that could be an administration route to enact practice without a local ordinance that the Law Department says would be preempted.

No formal vote was taken on Bill 25‑0014. The committee requested legal research and further interagency coordination to clarify implementation options and pathways to expand EMS‑initiated buprenorphine while complying with state regulation.