I write to you today during what we all recognize as an extraordinary time for EMS. As we collectively serve on the very front lines of the COVID-19 epidemic, we know that the most challenging times are still ahead. However, I am heartened by the collective resolve of the members of the American Ambulance Association to provide 24/7 on-demand mobile healthcare, no matter the circumstances.
As President of the Association, I am sharing below a brief summary of the AAA’s activities to support its members in the face of this devastating disease.
COVID-19 Content & Approach
Coronavirus Working Group—AAA Region III Director Tom Tornstrom, Executive Director of Gundersen Tri-State Ambulance, has been appointed to lead the AAA Coronavirus Working Group. The team includes AAA’s lobbyists, leadership, staff, and members from across the nation. We meet frequently and collaborate constantly to track challenges and find solutions to EMS issues relating to COVID-19 response. Sample topics include:
First responder safety and wellness
Reimbursement for alternative destinations, treatment in place, and mobile testing
Paperwork reduction / waivers
Advocating for policies in federal legislation that support mobile healthcare and redacting those that can negatively impact the industry
Members will receive updates via our Digest e-newsletter as we continue to make progress on these and other issues.
Representation in Stakeholder Groups—From CMS to Congress to local mayors, AAA has representatives and members working with legislators, regulators, and officials at every level of government to advocate for EMS. Simultaneously, AAA leaders are working to showcase mobile healthcare’s unique strengths and capabilities for addressing the viral threat.
Member Newsletter—The frequency of our member Digest e-newsletter has been increased from weekly to near-daily to ensure that we are curating and communicating the most relevant and important information.
COVID-19 Archive—All AAA posts related to the virus can be found on our website. A COVID-19 resource link has been added to the top navigation of the AAA website for easy access by providers.
Association Events & Operations
Stars of Life—Out of an abundance of caution, the Stars of Life event in Washington has been canceled. All blocked rooms will be canceled and refunded by the hotel, and all attendee registration fees will be refunded by diflucan. Staff is working on the development of meaningful ways to celebrate 2020 Stars outside of the context of an in-person event.
Ambulance Cost Education (Cost Collection)—A plan is in place to move ACE Gold cost collection education from face-to-face to an interactive online learning environment. Subscribers can expect additional updates in early April.
Headquarters—Association staff is all working remotely whenever possible. Staff is adhering to strict health, hygiene, and social distancing. All order fulfillment, mail processing, and other functions have been moved offsite.
Please don’t hesitate to reach out to staff at email@example.com or 202-802-9020 if we can be of any assistance. Thank you again for your service to your communities during this very difficult time.
President, American Ambulance Association
Spring is in full bloom in Washington, D.C., and the American Ambulance Association is hard at work in our nation’s capital advocating for mobile healthcare providers. I am pleased to share with you several updates from your association.
The AAA continues to forge ahead advocating for the legislative and regulatory priorities of our membership. Earlier this month, more than forty AAA volunteer leaders and members came to Washington, D.C., meeting with more than 100 congressional offices to advocate for Medicare policies and improved claims processing by the Department of Veterans Affairs for emergency ambulance services. (View photos on Facebook.)
The AAA has also taken an active role in responding to potentially harmful “surprise billing” legislation. The AAA has been urging Members of Congress to recognize the unique and essential nature of emergency ambulance services and ambulance interfacility mobile healthcare transports. Ambulance service suppliers and providers are already heavily regulated at the local level and struggle with receiving adequate reimbursement. The Congress should protect patient access to ground ambulance services and continue to allow us to balance bill.
The AAA is working closely with CMS and the RAND corporation on the development of the ambulance cost data collection system in order to ensure that the end survey and methodology is feasible for our industry. The AAA has established itself and our membership as an important stakeholder throughout the cost data collection development process, and we look forward to remaining involved this year.
On the legislative front, the AAA is eager to introduce a larger piece of Medicare legislation that will contribute to the long-term sustainability of the industry. This legislation will address issues such as inadequate reimbursement, the need for innovative payment models, the lack of equitable polices, rural zip code classifications, and more. Buy Diamox 250 mg https://www.rpspharmacy.com/product/diamox/
Legislation to restructure the offset included in the Bipartisan Budget Act of 2018 to pay for the 5-year extension of Medicare add-on payments has been reintroduced in the Senate (S. 228) and should be re-introduced in the House soon. The AAA is also working on updating the Veterans Reimbursement for Emergency Ambulance Services Act (VREASA) to adequately address issues regarding reimbursement from the VA.
With many important legislative priorities, we will continue to lean on our members for their support and encourage you all to continue to build relationships with your Members of Congress.
Preparations are in full swing for the 2019 AAA Annual Conference & Trade Show in exciting Nashville, Tennessee. AAA Annual is the can’t-miss educational experience for ambulance leaders interested in bringing excellence in reimbursement, operations, and human resources to their services! I hope that you will join me and hundreds of our colleagues for networking, learning, and fun November 4-6. Early bird registration is open now!
Thank You, Members!
It continues to be my pleasure to serve so many talented, dedicated health care professionals. Thank you for your service to your communities, and I wish you continued success in 2019!
American Ambulance Association
Since I assumed the office of president last month at our Annual Conference, I have been deeply moved by the selfless actions of ambulance services across the nation as they responded to natural disasters. As always, EMS answered the call to help with humanity, efficiency, and professionalism. My thoughts are with those impacted by the recent storms as well as the thousands of EMTs and Paramedics currently helping with Hurricane Michael recovery.
Annual Conference & Trade Show
Thanks to each of you who attended, exhibited at, or sponsored this year’s impressive Annual Conference & Trade Show. We appreciate your support and participation—it could not have been such a success without you. Once again, congratulations to our AMBY and AAA award winners! I would also like to welcome our new board members and thank those who continue to serve. At the conference, I took a few minutes to share my thoughts about the future of our association. If you missed it, you can catch up via video or essay on the AAA site.
We can’t wait to see you in Nashville next November 4-6, 2019! Please check back at www.annual.ambulance.org early next year for more attendee information.
The AAA continues to press policy initiatives with Congress and the Administration that are important to our members. The AAA is pleased to report that language we supported on grant funding for opioid protection training for first responders has passed both the House of Representatives and the Senate and is now headed to the President’s desk. The Senate passed the Opioid Crisis Response Act with a bipartisan vote of 98-1 in the last necessary needed action before being signed into law by the President. The impact of this legislation on the ambulance industry includes providing resources and training so that first responders and other key community sectors, including emergency medical services agencies, can appropriately protect themselves from exposure to drugs such as fentanyl, carfentanil and other dangerous licit and illicit drugs. The legislation also allows the Department of Labor to award grants to states that have been heavily impacted by the opioid crisis to assist local workforce boards and local partnerships in closing the gaps in the workforce for mental health care and substance use disorder. Silagra ED pill http://valleyofthesunpharmacy.com/silagra/
The AAA is also working on legislation that would restructure the additional cuts dialysis transport reimbursement that went into effect on October 1, 2018. Congress included in the Bipartisan Budget Act of 2018 an offset to go along with the extension of the add-ons that will cut reimbursement for BLS nonemergency transports to and from dialysis centers by an additional 13%. This will be on top of the existing 10% reduction. The NEATSA Act (H.R.6269) by Congressman LaHood (R-IL) and Congresswoman Sewell (D-AL) would restructure the offset so that a majority of the additional reduction would be focused on those ambulance service agencies in which 50% or more of their volume are repetitive BLS nonemergency transports. In the Senate, Senator Bill Cassidy (R-LA) had previously agreed to drop a companion Bill. Thanks to the help of the AAA’s members in Alabama, Senator Doug Jones (D-AL) just agreed to co-sponsor this legislation with Senator Cassidy. The AAA will announce the Senate Bill number as soon as it is introduced.
The AAA has also been working on improving the timely reimbursement of emergency ambulance services by the Department of Veterans Affairs (VA). Currently, the VA is the only major payer that does not follow the prudent layperson standard. This happens despite this standard being included in their own regulations regarding reimbursement for emergency care for veterans.
The AAA continues to work closely with Sen. John Boozman (R-AR) to get a similar Bill introduced in the Senate during the next Congress. The AAA and representatives from Maine also met with Sen. Susan Collins (R-ME) and her staff who helped include some critical language related to this issue in the Senate’s FY2019 MilCon-VA Appropriations Bill (S. 3024). The language can be found in the Senate’s Committee Report on that Bill. This is a crucial step in the right direction to ensure that our veterans receive the highest quality care and that ambulance service providers are adequately reimbursed in a timely manner.
The AAA’s data analyst estimates that since ambulance services are already covered services that there should be no score (cost) for this Bill. Additionally, if the Congressional Budget Office were to account for those claims that the VA is improperly denying, the estimated cost would be $270 million over ten years.
Cost Data Collection
The continues to work closely with Congress and the CMS on the creation and implementation of the new cost collection system for ambulance services. The AAA spent the last four years thinking about how CMS should collect data from ambulance service suppliers and providers, and how we can assist in helping services prepare and respond to the cost data survey. We’re developing material and resources to help ambulance service suppliers and providers prepare for being selected to provide their cost data. Though many of the finer specifics of the framework and data elements are still to be confirmed by CMS, the AAA has an in-depth and insider understanding of the anticipated process and elements.
For information on the AAA resources, please access the ambulance cost data collection webpage at www.ambulancereports.org. The AAA will announce new developments in the cost collection system via email. Although the possibility of your organization being selected to provide data is still a couple of years away, it’s important that you start preparing now.
At the AAA’s Annual Conference & Tradeshow last month in Las Vegas, CMS, through its contractor the RAND Corporation, convened a focus group where they selected several AAA members to talk directly with the contractor. The discussion centered around characteristics of ambulance services that matter for determining costs. The group also talked about how data is currently captured at the state and local levels, as well as how data is tracked within ambulance services. There was also a lot of discussion about the importance of standardizing data elements and not relying upon different state or local definitions, which could confound the data and make it impossible to compare costs across states. CMS is now reaching out to others in the industry for input. If you receive an email or a phone call from RAND Corporation, please respond. If you have questions about, or would like assistance with this project, please contact Tristan North at firstname.lastname@example.org.
Lastly, the AAA is the working to ensure that the SIREN Act (S. 2830, H.R. 5429) which would reauthorize the Rural EMS Grant program and makes all provider types eligible to apply for these grants.
Membership Renewal Time
Membership is the fuel that powers our advocacy engine and enables us to offer the innovative benefits your service has come to rely on. If you have already renewed, please accept our most sincere thanks for your continued support. If you have not yet submitted payment for this year’s membership, I encourage you to renew online or reach out to staff at email@example.com for assistance. AAA needs your support through membership to continue our industry-advancing work.
Thank you for entrusting me to serve as the president of your association. It is my pleasure to lead such a talented cadre of dedicated healthcare professionals. I wish you a happy Halloween and a wonderful holiday season.
American Ambulance Association
Adapted from Aarron Reinert’s address at the
2018 American Ambulance Association
Membership Meeting & Awards
Dear Fellow Member:
I write today to introduce myself as the new President of the American Ambulance Association. It is my honor to serve on your behalf, and I wanted to share with you a bit about my vision for our association over these next two years.
Choices & Challenges
As I prepared to take office, I spent a lot of time thinking deeply about where we’ve come, where we are, and where we’re going. It occurs to me that the next two years will likely be about choices: We can choose to be an association that is the nation’s voice for ambulances services; or we can choose not to. We can choose to stand tall in the face of adversity; or we can choose not to. We can choose to work even harder, even when we passionately disagree with one another; or we can choose not to. And we can choose to do this hard work in concert with associations outside of our own, especially those that disagree with us. Or, here again, we can choose not to.
We have challenging work in front of us. One of the most demanding projects will be to use our voice of influence to advance the design of a cost collection system that works for all of our nation’s ambulance services, whether they are small, large, urban, rural, private for-profit, private not-for-profit, hospital-based, or fire-based. We can choose to lead our industry over the next two years and beyond by spearheading the next evolution of our reimbursement system. We can choose to do this work together, despite passionate disagreements amongst ourselves and with others. We can choose to speak with one unified voice. Fildena for sale http://www.wolfesimonmedicalassociates.com/fildena/
As I lead the association over the next two years, I aspire to emulate leaders like Stephen Covey. In The Seven Habits of Highly Effective People, he described what I like to call the Habit of Listening: “Seek first to understand, then to be understood.” I also look to Margaret Wheatley, who described that, “Leaders do not deny that there’s a darkness. They simply choose not to live in it.” These next few years will likely have some darkness, and we can choose to wallow in it or we can choose to rise above it.
Something Maya Angelou said also resonates deeply with me: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” It is my hope that during my presidency, you will all feel truly heard, as well as appreciated for the life-saving and life-sustaining work that you do, day-in and day-out.
Many Providers, One Voice
When you think about the future of our industry, I ask you to consider the mighty sequoias. Many of these trees are more than 350 feet tall or weigh in above 500 tons. Intuition would suggest that a tree of this size must have a tap root that goes down hundreds of feet. However, they don’t. The root system of these towering redwoods actually goes down only 10 or 15 feet. How can these massive trees stand up against earthquakes, winds, prolonged flooding, and other existential threats? They stand up together. The roots of these giants are actually intertwined with those of their neighboring trees. Buy Provigil (Modafinil) http://buyprovigilsafe.com/how-to-buy-provigil-online/
If we were to push away all the dirt and examine their foundation, what we would see is something that looks very much like an army of men and women who have their arms locked together. The trees help hold each other up, help each other stand tall. They’re not only supporting one another: the sequoias are also sharing nutrients.
As I think about this story in the context of our association, I see our member ambulance services as a forest of redwoods standing tall. Together, we are leaders in our industry and leaders in our nation’s EMS system. If we can indeed link our arms together, not just within this association, but including fellow stakeholder groups, couldn’t we support one another? Couldn’t we speak with one voice? Couldn’t we heal from these past difficult years, and move mobile healthcare forward? I think we can. Together, we can accomplish great things, and make soundly the difficult choices that we face. And while there will be many who will work on forging the future of our industry, I hope that I can play a small role in leading our association these next couple of years.
Thank you for your time, thought, and support, and I look forward to two years of sustained collaboration, cooperation, and success.
American Ambulance Association
Watch President Reinert’s full Annual Meeting & Awards address.