Author: AAA Staff

Study | EMS education research priorities during COVID-19

From the Journal of the American College of Emergency Physicians
Emergency medical services education research priorities during COVID-19: A modified Delphi study
Rebecca E. Cash PhD, MPH, William J. Leggio EdD, Jonathan R. Powell MPA, Kim D. McKenna PhD, Paul Rosenberger EdD, Elliot Carhart EdD, Adrienne Kramer PhD, Juan A. March MD, Ashish R. Panchal MD, PhD, for the Pandemic Educational Effects Task Force

Objective

Our objective was to identify research priorities to understand the impact of COVID-19 on initial emergency medical services (EMS) education.

Methods

We used a modified Delphi method with an expert panel (n = 15) of EMS stakeholders to develop consensus on the research priorities that are most important and feasible to understand the impact of the COVID-19 pandemic on initial EMS education. Data were collected from August 2020 to February 2021 over 5 rounds (3 electronic surveys and 2 live virtual meetings). In Round 1, participants submitted research priorities over 9 specific areas. Responses were thematically analyzed to develop a list of research priorities reviewed in Round 2. In Round 3, participants rated the priorities by importance and feasibility, with a weighted score (2/3*importance+1/3*feasibility) used for preliminary prioritization. In Round 4, participants ranked the priorities. In Round 5, participants provided their agreement or disagreement with the group’s consensus of the top 8 research priorities.

Results

During Rounds 1 and 2, 135 ideas were submitted by the panel, leading to a preliminary list of 27 research priorities after thematic analysis. The top 4 research priorities identified by the expert panel were prehospital internship access, impact of lack of field and clinical experience, student health and safety, and EMS education program availability and accessibility. Consensus was reached with 10/11 (91%) participants in Round 5 agreeing.

Conclusions

The identified research priorities are an important first step to begin evaluating the EMS educational infrastructure, processes, and outcomes that were affected or threatened through the pandemic.

EMS.gov | Template Protocol for EMS Administration of Monoclonal Antibodies

From EMS.gov on August 27, 2021

Developed by the NHTSA Office of EMS and HHS Office of the Assistant Secretary for Preparedness and Response, the template is intended to assist state EMS officials and local EMS systems in developing their own protocols 
he U.S. Food and Drug Administration has issued an Emergency Use Authorization to permit the emergency use of REGEN-COV (casirivimab and imdevimab) co-formulated product, and REGEN-COV (casirivimab and imdevimab) supplied as individual vials to be administered together, for the treatment of mild to moderate COVID-19 in adult and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Monoclonal antibodies are used to neutralize the COVID-19 virus and intended to prevent progression of disease. The U.S. Government is currently supplying REGEN-COV (casirivimab and imdevimab) for the treatment and post-exposure prophylaxis of COVID-19. The dosing is the same for both indications (casirivimab 600mg and imdevimab 600mg). The medication can be administered either intravenously (IV) or by subcutaneous (SQ) injection.EMS agencies throughout the country have been asked or may be asked to assist in the administration of this product through either route of administration.

To assist EMS agencies in planning, the NHTSA Office of EMS and HHS Office of the Assistant Secretary for Preparedness and Response have developed a template protocol for state EMS offices and EMS Medical Directors to use to assist in these programs. Some states have created blanket state-level authorizations for EMS administration; some states will still require provider authorization prior to administration. Please follow local protocols and regulations. This template is only designed to facilitate the development of those local protocols as needed. Please contact the NHTSA Office of EMS with any questions.

CMS Releases Medicare COVID-19 Vaccine Data Analysis and PUF

From CMS on August 25, 2021

Today, the Centers for Medicare & Medicaid Services (CMS) released two new resources with information on Medicare beneficiaries on whose behalf at least one fee-for-service (FFS) claim for the administration of the COVID-19 vaccine has been submitted to the Medicare program.

First, we released a paper titled Assessing the Completeness of Medicare Claims Data for Measuring COVID-19 Vaccine Administration. This paper presents preliminary findings on the count of individuals ages 65 and older with at least one COVID-19 vaccine administration claim in the Medicare data compared to the count of people 65+ with at least one COVID-19 vaccine dose in the data reported by the Centers for Disease Control and Prevention (CDC). Using data as of June 4th, 2021, we estimate that CMS received a claim for COVID-19 vaccine administration for roughly half of Medicare beneficiaries who have received at least one COVID-19 vaccine dose as compared to the estimated counts based on adjusted CDC figures (17.5 million out of 36.6 million). As a result, we recommend that the public apply significant caution when analyzing COVID-19 vaccine administration trends using Medicare claims data.

Second, we released the Medicare COVID-19 Vaccine Public Use File (PUF) which presents a high-level and preliminary overview of Medicare utilization and spending information from Medicare FFS claims for the administration of the COVID-19 vaccine. The PUF shows that between December 11, 2020 and June 30, 2021, Medicare payments for administration of the COVID-19 vaccine were over $1.1 billion.  The PUF is based on Medicare FFS claims CMS received by August 6, 2021.

[Note: The Medicare FFS program is paying for COVID-19 vaccine administration on behalf of MA beneficiaries as well as for FFS beneficiaries receiving COVID-19 vaccinations in 2020 and 2021.]

Read Now

CMS Webinar | Cost Collection Instrument Walk-Through

From CMS

Medicare Ground Ambulance Data Collection System Webinar: Instrument Walkthrough

Thursday, August 26, 2021 from 2:00 PM-3:30 PM ET.

To register for this webinar: https://cms.zoomgov.com/webinar/register/WN_S0aGs_TWTpWRBWF5hDAf3Q.

After registering, you will receive a confirmation email containing information about joining the webinar.

The slide presentation is available here. (PDF)

During this call, CMS will walk through the Medicare Ground Ambulance Data Collection Instrument section-by-section, focusing on select instructions, data collection guidelines, and common questions and answers. The webinar will also highlight proposed changes to the instrument in the CY 2022 Physician Fee Schedule (PFS) Proposed Rule: https://www.govinfo.gov/content/pkg/FR-2021-07-23/pdf/2021-14973.pdf.

A question-and-answer session will follow this presentation. You may send questions in advance to AmbulanceDataCollection@cms.hhs.gov with “August 26 Instrument Webinar” in the subject line. We will answer your questions that you submitted in advance during the call or participants may also submit live questions in the “chat” box.

For more information, including ground ambulance organizations that must report, see the Ambulances Services Center webpage, CY 2020 Physician Fee Schedule final rule, and Bipartisan Budget Act of 2018.

Due 9/13 | AAA Board Candidates, Ethics Committee, & Honorary Members

Nominations Due 9/13 for
Board Candidates, Ethics Committee, and Honorary Members

Board Nominations

In accordance with the Bylaws of the American Ambulance Association, it is time to call for members in good standing that wish to serve the association in one of the following positions:

  • Region I Director
    (CT, MA, ME, NH, NJ, NY, RI & VT)
  • Region II Director
    (AL, DE, DC, FL, GA, MD, MS, NC, PA, SC, VA, WV)
  • Region III Director 
    (IL, IN, KY, MI, OH, TN, WI)
  • Region IV Director
    (AR, IA, KS, LA, MN, MO, OK, ND, NE, SD, TX)
  • Region V Director
    (AK, AZ, CA, CO, HI, ID, MT, NM, NV, OR, UT, WA, WY)
  • Ethics Committee Member 
    (Open to all regions)

Due to recent bylaws changes, this year’s election will result in ten new Region Directors, two in each region. The candidate with the most votes in each region will serve a one-time, three-year term and the candidate with the second most votes in each region will serve a one-time, two-year term.

AAA Regional Director Qualifications

Individuals who wish to be considered for an elected position as Regional Director must:

  • Be the designated representative of an Active Member of the AAA, in good standing;
  • Be ready to devote time and effort to matters which concern the Board of Directors and to actively participate in all Board activities;
  • Be prepared to assist other AAA members with concerns and problems which relate to the ambulance industry and the workings of the AAA; and,
  • Understand that these positions provide no compensation for time or reimbursement for expenses. All travel-related expenses, including transportation, lodging, and food are the responsibility of the individual and/or the sponsoring organization.
  • Be willing to comply with all governance policies of the association including, Conflict of Interest, Standards of Conduct, and Board Confidentiality, Public Comment and Lobbying Agreement (PDF).

Regional Director Nomination Process

Step 1: Nomination Form
Step 2: Candidate Questionnaire

Both forms must be completed by the September 13 deadline!

All those who wish to stand for election and believe they are qualified are requested to complete a Nomination Form as well as answer the Candidate Questionnaire, which describes both their qualifications and reasons for wanting to participate in the leadership of the AAA.

(Please note that the Nomination Form may be completed by any designated contact for an AAA Active member for him or herself, or on behalf of another designated contact at a fellow AAA active member service. The Candidate Questionnaire must be completed by the nominee.)

Candidates’ statements and pictures, as well as the position(s) for which they are running, will be listed on the AAA website.

2021 Election Timeline

8/19 | Nominations Open
9/13 | Nominations Close
9/21  | Approval of Candidates by AAA Board of Directors
10/6 | Voting Opens. Election will be paperless. Ballots will be delivered to AAA Active Member primary contacts via email.
10/21 | Voting Closes 11:59pm
11/1 | Election results announced at the AAA membership meeting at the Annual Conference.

About Honorary Membership

AAA accepts written nominations for worthy individuals who have significantly contributed to the accomplishments of the AAA and should therefore be recognized through the granting of Honorary Membership.
Nominate►

About the Ethics Committee

It is the mission of the Ethics Committee to define and distribute guidelines that promote self-imposed high ethical standards for providers of ambulance services. The committee is responsible for hearing complaints and making appropriate recommendations regarding violations of the AAA Code of Ethics and Standards of Conduct. Apply to join►

Nominate a Board Candidate

Nominate an Honorary Member

Join the Ethics Committee

Please contact hello@ambulance.org with any questions. 

EMS.gov | Information About COVID-19 for EMS Systems and Clinicians

From EMS.gov

Resources include guidance documents, links to the latest from the CDC, and information about vaccine safety and administration

With cases of COVID-19 surging again across the country, EMS clinicians and leaders may once again be responding to increased numbers of PUIs, have questions about handling exposures, and be looking for information about coronavirus vaccines.

The EMS.gov COVID-19 Resources for EMS page continues to provide a number of helpful tools, on topics ranging from crisis standards of care to first responder mental health. The source of each resource is clearly identified, including documents created by the Federal Healthcare Resilience Working Group EMS/Prehospital Team.

The NHTSA Office of EMS once again would like to thank EMS clinicians and our public safety and healthcare colleagues across the country for your dedicated service. What you do is vital to our communities and our nation. We urge you to take steps to ensure the health and safety of you, your patients and your families and protect yourself from COVID-19, stress, and other dangers.

Please contact nhtsa.ems@dot.gov with questions or comments.

Into the Unknown Documentary to Tell Paramedics’ Stories

FOR IMMEDIATE RELEASE: August 11, 2021

Media Contact:

Tonya Mantooth
Executive Producer
tonya@intotheunknown.com
858-945-8912

Documentary to Tell Paramedics’ Stories

“Into the Unknown: The Paramedics’ Journey,” Produced by “Emergency!” Stars Randy Mantooth and Kevin Tighe, in Pre-Production

LOS ANGELES—The 1970s TV show Emergency! introduced the concept of paramedics to millions of viewers and inspired thousands to become EMS practitioners themselves. Some historians say it launched modern EMS in the U.S.

Now the two stars of the show are coproducing a documentary to tell the story of today’s paramedic—following a pandemic that strained our healthcare system and revealed the critical role paramedics play in caring for their communities.

“My life was saved by two firefighter paramedics,” said Randy Mantooth, who played Johnny Gage in the Emergency! series. “My sister’s life was saved by a paramedic and a flight nurse. They literally gave us our lives back, and yet I don’t even know their names.”

“Overworked, sometimes overlooked, and nearly always taken for granted, paramedics are real-world heroes,” Mantooth said. “My hope is that Into the Unknown will provide the public with an understanding of and appreciation for the critical role these individuals play.”

“Paramedics have to deal with unending fatigue and stress,” said Kevin Tighe, who played Roy Desoto in the series. “This is a topic we have to explore not only on the job but also at home. We have to face it and also show how it can be successfully overcome.”

FirstNet, Built with AT&T* is the principal sponsor of the project, which will realistically depict the lives and jobs of half a dozen paramedic crews around the nation. Additional sponsors supporting the documentary’s production include Masimo and ZOLL Medical Corporation.

EMS World is a media partner of the project.

“This project brings awareness of the vital role EMS plays and highlights the very real impacts to the personal health and wellness of these individuals,” said Lynnée Hopson, assistant vice president, FirstNet Marketing at AT&T. AT&T holds the federal contract to build and maintain FirstNet.

“Stories like these are why we’re committed to supporting FirstNet. And it’s one of the reasons we launched the FirstNet Health and Wellness Program. Paramedics—and all the first responders they represent—need our support as they face daunting challenges in delivering care in every situation imaginable.”

The project has an advisory board made up of 18 key industry leaders and is endorsed by 20 of the major national EMS organizations, representing almost 2 million members. Baxter Larmon, PhD, a nationally recognized EMS educator/researcher and professor of emergency medicine at UCLA’s David Geffen School of Medicine, serves on the executive committee for Into the Unknown.

“Throughout my four-decade career and in my travel and interactions with every type of stakeholder in the EMS profession, I’ve found they all have one thing in common,” Larmon said. “They believe the U.S. public doesn’t understand what EMS is about and what paramedics do day to day, one patient at a time, to make sure they are cared for, safe, and end up where they belong.

“Whether it’s a senior who has fallen, a teenager who has overdosed, a middle-age woman in cardiac arrest, or the victim of a severe car crash,” he continued, “these are people often facing the worst days of their lives—we’re there to help. This documentary will go a long way in ensuring that the public understands who we are, what we do, and why we matter.”

In additional to Larmon, the executive team includes executive producer Tonya Mantooth, sister to Randy Mantooth, a 10-time Regional Emmy award winner, and Steve Martin, assistant fire chief (retired), Los Angeles County Fire Department.

Find out more about the documentary, the advisory committee, and the organizations supporting it at intotheunknowndoc.com. You can also sign up to get regular updates on the progress of the documentary and behind-the-scenes stories and footage.

ITU Doc LLC is dedicated to telling the stories of today’s paramedics through documentary film. It has an advisory board made up of 18 key industry leaders and has been endorsed by 20 major national EMS organizations, representing almost 2 million members nationwide. Learn more about the project at intotheunknowndoc.com.

CMS Open Door Forum | Medicare Ground Ambulance Data Collection System

August 12, 2021 Ambulance Open Door Forum

August 12, 2021 | 14:00–15:30 ET

Slide presentation on the Overview of the Medicare Ground Ambulance Data Collection System (PDF) is now available.

The next CMS Ambulance Open Door Forum scheduled for:
Date: Thursday, August 12, 2021
Start Time: 2:00pm-3:30pm PM Eastern Time (ET);
Please dial-in at least 15 minutes before call start time.
Conference Leaders: Jill Darling, Maria Durham

Agenda

**This Agenda is Subject to Change**

I. Opening Remarks
Chair- Maria Durham, Director, Division of Data Analysis and Market-based Pricing
Moderator – Jill Darling (Office of Communications)

II. Announcements & Updates

  • Emergency Triage, Treat, and Transport (ET3) Model Update
    • ET3 Model Website: https://innovation.cms.gov/innovation-models/et3
      • ET3Model@cms.hhs.gov for inquiries
      • ET3 Model Listserv for Model updates: https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_12521

 

Overview of the Medicare Ground Ambulance Data Collection
System
 A copy of the presentation will be available on the
Ambulances Services Center website under
Spotlights: https://www.cms.gov/Center/ProviderType/Ambulances-Services-Center
III. Open Q&A

**DATE IS SUBJECT TO CHANGE**
Next Ambulance Open Door Forum: TBA
ODF email: AMBULANCEODF@cms.hhs.gov
———————————————————————
This Open Door Forum is open to everyone, but if you are a member of the Press, you may listen in but please refrain from asking questions during the Q & A portion of the call. If you have inquiries, please contact CMS at Press@cms.hhs.gov. Thank you.

Open Door Participation Instructions

This call will be Conference Call Only.

To participate by phone:
August 12, 2021 | 14:00–15:30 ET | Dial: 1-888-455-1397 & Reference Conference Passcode: 8604468
Persons participating by phone do not need to RSVP. TTY Communications Relay
Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

Instant Replay

1-866-470-7051; Conference Passcode: No Passcode needed
Instant Replay is an audio recording of this call that can be accessed by dialing 1-
866-470-7051 and entering the Conference Passcode beginning 1 hours after the
call has ended. The recording is available until August 14, 2021, 11:59PM ET.

For ODF schedule updates and E-Mailing List registration, visit our website at
http://www.cms.gov/OpenDoorForums/.

Were you unable to attend the recent Ambulance ODF call? We encourage you to visit our CMS Podcasts and Transcript webpage where you can listen and view the most recent Ambulance ODF call. Please allow up to three weeks to get both the
audio and transcript posted to: https://www.cms.gov/Outreach-andEducation/Outreach/OpenDoorForums/PodcastAndTranscripts.html.

 

Rest in Peace, Jacob Dindinger

From Global Medical Response

It is with a heavy heart that we inform you that Jacob’s family made the decision to remove him from life support. This decision did not come easy; it came after many tests and conversations and much consideration to his condition. Jacob fought hard, but unfortunately the injuries he sustained were so damaging, he was not able to survive them.

Jacob made such a big impact in our community with each interaction he had. He was dedicated and driven to succeed and continually looking for his next accomplishment. To Jacob, failure was a setback, but it didn’t stop him from working harder to succeed. His family meant everything to him, and the smiles we have seen in recent photos show the love he had for his family and friends. He made an even bigger impact on our family here at AMR and we feel like we are all better people after being touched by Jacob and his family.

These past two weeks have been difficult for the entire GMR family. We appreciate all the support you have given to our local teams as well as the family. CISM teams have been working in Arizona to help our teams there, and GMR Life teams have been offering support across all our operations. I encourage you to reach out to them and to our HR teams, and to use EAP resources.

When final arrangements have been made, we will notify our local teams.

If you would like to help the family, a Go Fund Me account has been established.

Thank you,

Glenn Kasprzyk, Southwest Region President
Jackie Evans, Regional Director
Global Medical Response

Monkeypox & COVID-19 Resources for EMS Clinicians

From EMS.Gov

Monkeypox Resources for EMS Clinicians

The arrival of an individual in the United States who was diagnosed with monkeypox, as well as the uptick in COVID-19 cases, are reminders that EMS clinicians must remain vigilant and prepared. The CDC is conducting contact tracing of the monkeypox case and local public health departments have been notified, and it is unlikely that EMS clinicians will be exposed to the monkeypox virus is low. However, reviewing information about the disease may still be helpful.

Click here to access information compiled by the National Emerging Special Pathogen Training and Education Center to help inform EMS clinicians about monkeypox.

COVID-19 Resources for EMS

Low vaccination rates, the highly contagious delta variant, and increased social interaction has caused significant increases in rates of COVID-19 and related hospitalizations in many communities around the nation. The NHTSA Office of EMS continues to make resources available to help EMS clinicians, organizations and regulators safely maintain operations during the pandemic. Those resources are available on the EMS.gov COVID-19 Resources Page.

NHTSA | Office of EMS Director Jon Krohmer, MD, to Retire

NHTSA Office of EMS Director Jon Krohmer, MD, to Retire Later this Year

After 15 years of federal service, including the last five leading the National Highway Traffic Safety Administration Office of EMS, Jon Krohmer, MD, will be retiring in November.

During his tenure as director, Dr. Krohmer and the NHTSA Office of EMS team oversaw a number of milestones for the profession, including the creation of EMS Agenda 2050; major revisions to the National EMS Scope of Practice Model and the National EMS Education Standards; and improvements in the collection and use of EMS data through the expansion of the National EMS Information System. Soon after the onset of the coronavirus pandemic, Dr. Krohmer was tapped to lead the prehospital/911 team as part of the Federal Healthcare Resilience Task Force.

“Dr. Krohmer’s tenure at NHTSA—especially over the last year and a half as EMS clinicians have faced one of the greatest public health challenges in generations—has been marked by real advances for the profession, thanks in no small part to his leadership,” said Nanda Srinivasan, NHTSA’s associate administrator for research and program development. “He was a true advocate at the federal level for state, tribal and local EMS systems, EMS clinicians, and patients.”

Prior to joining NHTSA, Dr. Krohmer had decades of experience as a local EMS medical director, initially in his home state of Michigan. His EMS career began as an EMT with a volunteer rescue squad. Like many EMS professionals, he was inspired by the television show Emergency! and by the emergence of the relatively new field of emergency medicine. He entered medical school at the University of Michigan knowing he wanted to make EMS his career. After becoming involved in EMS at the state and national level, he also served as president of the National Association of EMS Physicians from 1998 to 2000. In 2006, he came to Washington to serve as the first deputy chief medical officer for the Department of Homeland Security Office of Health Affairs and served in several other DHS roles before joining NHTSA in 2016.

“Working alongside EMS clinicians and the people who support them at local, state and national levels has been a privilege and a heck of a lot of fun,” said Dr. Krohmer. “The decision to leave NHTSA was difficult, but it’s made easier knowing that the team in the Office of EMS, our colleagues throughout the federal government, and leaders of EMS at state and local levels are committed to improving the lives of people in their communities and will continue to advance EMS systems everywhere.”

NHTSA will launch a national search for a new director for the Office of EMS.

“The example set by Dr. Krohmer will serve as a great model for the next director,” said Associate Administrator Srinivasan, “and the team of dedicated public servants at the Office of EMS has the experience and expertise to ensure a smooth transition.”

EICC Pediatric Emergency Champion Program

From the Emergency Medical Services for Children Innovation and Improvement Center

September 1, 2021 – June 30, 2022

Purpose

This collaborative will develop individuals who are interested in improving the quality of pediatric care at your EMS agency, ED/hospital, or within your region. We will provide resources, example practices and networking opportunities at no cost to help push forward any effort for pediatric improvement.


What is a PECC?

A Pediatric Emergency Care Coordinator (PECC)–sometimes referred to as a pediatric champion or pediatric liaison–is a term that the EMSC program uses to refer to any individual who has a particular interest in or responsibilities related to pediatric emergency care. Sometimes this individual is dedicated solely to this role. However, depending on the pediatric volume of the EMS agency or hospital, this person may take on the PECC duties in addition to other responsibilities (e.g., educator, trauma coordinator, etc.). Various roles and responsibilities are often given to a PECC but common responsibilities include ensuring the availability of pediatric equipment, supplies and medications, pediatric education/training and advocating for pediatric considerations to be included in protocol/policy development.


Who should participate

Anyone that is interested in improving pediatric readiness within your EMS agency, ED/hospital, or within your region, to include EMSC State Partnership Programs. You do NOT need to have any formal pediatric training, or a title related to pediatric care. You already have everything you need to participate…an interest in pediatric emergency care


Why join?

We know that the presence of an individual with an interest in pediatric emergency care is strongly correlated with improved outcomes for children. No effort to improve pediatric emergency care is too small to make an impact. This collaborative will have a broad scope. No matter where your starting point is, we will provide you with tools to improve. There is no cost to participate, and you will have the opportunity to earn continuing education or Maintenance of Certification Part 4 credit. Learn more…


How it works

The collaborative will occur in two parts. During the first half, we will explore seven pediatric readiness areas of focus, evaluate your agency or ED/hospital level of pediatric readiness, and identify areas for improvement. In the second half, we provide coaching and tools to help you develop an improvement project. Learn more…


Location

All collaborative activates will be conducted online and through virtual meetings.

Learn More

Study | Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation

Thank you to Dr. John Russell of Cape County Private Ambulance for sharing this resource.

Ready for Children Part II: Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting

Hilary A. Hewes, Andrea L. Genovesi, Rachel Codden, Michael Ely, Lorah Ludwig, Charles G. Macias, Patricia Schmuhl & Lenora M. Olson (2021) Ready for Children Part II: Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting, Prehospital Emergency Care, DOI: 10.1080/10903127.2021.1942340

Abstract

Objectives: Treating pediatric patients often invokes discomfort and anxiety among emergency medical service (EMS) personnel. As part of the process to improve pediatric care in the prehospital system, the Health Resources and Services Administration (HRSA) Emergency Services for Children (EMSC) Program implemented two prehospital performance measures -access to a designated pediatric care coordinator (PECC) and skill evaluation using pediatric equipment-along with a multi-year plan to aid states in achieving the measures. Baseline data from a survey conducted in 2017 showed that less than 25% of EMS agencies had access to PECC and 47% performed skills evaluation using pediatric equipment at least twice a year. To evaluate change over time, the survey was again conducted in 2020, and agencies that participated in both years are compared.

Methods: A web-based survey was sent to EMS agency administrators in 58 states and territories from January to March 2020. Descriptive statistics, odds ratios, and 95% confidence intervals were conducted.

Results: The response rate was 56%. A total of 5,221 agencies participated in both survey periods representing over 250,000 providers. The percentage of agencies reporting the presence of a PECC increased from 24% to 34% (p= <0.001). However, some agencies reported that they no longer had a PECC, while others reported having a PECC for the first time. Fifty percent (50%) of agencies conduct pediatric psychomotor skills evaluation at least twice/year, a 2% increase over time (p = 0.041); however, a third (34%) evaluate skills using pediatric equipment less than once a year. The presence of a PECC continues to be the variable associated with the highest odds (AOR 2.15, 95% CI 1.91–2.43) of conducting at least semiannual skills evaluation.

Conclusions: There is an increase in the presence of pediatric care coordination and the frequency of pediatric psychomotor skills evaluation among national EMS agencies over time. Continued efforts to increase and sustain PECC presence should be an ongoing focus to improve pediatric readiness in the prehospital system.

Access Full Study

HHS | $103mm for Healthcare Workforce Resiliency and to Address Burnout

FOR IMMEDIATE RELEASE
Contact: HHS Press Office
202-690-6343
media@hhs.gov

HHS Announces $103 Million from American Rescue Plan to Strengthen Resiliency and Address Burnout in the Health Workforce

Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of an estimated $103 million in American Rescue Plan funding over a three-year period to reduce burnout and promote mental health among the health workforce. These investments, which take into particular consideration the needs of rural and medically underserved communities, will help health care organizations establish a culture of wellness  among the health and public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers.

“The Biden-Harris Administration is committed to ensuring our frontline health care workers have access to the services they need to limit and prevent burnout, fatigue and stress during the COVID-19 pandemic and beyond,” said HHS Secretary Xavier Becerra. “It is essential that we provide behavioral health resources for our health care providers – from paraprofessionals to public safety officers – so that they can continue to deliver quality care to our most vulnerable communities.”

Health care providers face many challenges and stresses due to high patient volumes, long work hours and workplace demands. These challenges were amplified by the COVID-19 pandemic, and have had a disproportionate impact on communities of color and in rural communities. The programs announced today will support the implementation of evidence-informed strategies to help organizations and providers respond to stressful situations, endure hardships, avoid burnout and foster healthy workplace environments that promote mental health and resiliency.

“This funding will help advance HRSA’s mission of developing a health care workforce capable of meeting the critical needs of underserved populations,” said Acting HRSA Administrator Diana Espinosa. “These programs will help to combat occupational stress and depression among our health care workers as they continue their heroic work to defeat the pandemic.”

There are three funding opportunities that are now accepting applications:

  • Promoting Resilience and Mental Health Among Health Professional Workforce – Approximately 10 awards will be made totaling approximately $29 million over three years to health care organizations to support members of their workforce. This includes establishing, enhancing, or expanding evidence-informed programs or protocols to adopt, promote and implement an organizational culture of wellness that includes resilience and mental health among their employees.
  • Health and Public Safety Workforce Resiliency Training Program – Approximately 30 awards will be made totaling  approximately $68 million over three years for educational institutions and other appropriate state, local, Tribal, public or private nonprofit entities training those early in their health careers. This includes providing evidence-informed planning, development and training in health profession activities in order to reduce burnout, suicide and promote resiliency among the workforce.
  • Health and Public Safety Workforce Resiliency Technical Assistance Center – One award will be made for approximately $6 million over three years to provide tailored training and technical assistance to HRSA’s workforce resiliency programs.

To apply for the Provider Resiliency Workforce Training Notice of Funding Opportunities, visit Grants.gov. Applications are due August 30, 2021.

Learn more about HRSA’s funding opportunities.

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Note: All HHS press releases, fact sheets and other news materials are available at https://www.hhs.gov/news.
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Last revised: 

Letter to Senate HELP Committee Leadership on Provider-Type Equity

The Honorable Patty Murray
Chair, United States Senate Committee on Health, Education, Labor and Pensions

The Honorable Richard Burr
Ranking Member
United States Senate Committee on Health, Education, Labor and Pensions

Dear Chairwoman Murray and Ranking Member Burr:

The American Ambulance Association (AAA) appreciates the opportunity to provide suggestions for bipartisan legislation to improve medical preparedness and response programs. The AAA is the primary association for ground ambulance service suppliers/providers, including governmental entities, volunteer services, private for-profit, private not-for-profit, and hospital-based ambulance services. Our members provide emergency and non-emergency medical transportation services to more than 75 percent of the U.S. population. AAA members serve patients in all 50 states and provide services in urban, rural, and super-rural areas. As the National Highway Transportation Safety Administration identified in its 2013 report on emergency services, EMS-only systems – such as our members – provide the vast majority of emergency ambulance services throughout America.

Our members are often the first health care teams to encounter patients who are sick and/or suspect they might have COVID-19. In addition to responding to 911 emergencies and transporting patients to appropriate destinations, they are also being asked to provide health care services within their existing State-defined scope of practice without transporting patients to help reduce hospital surge, as well as to protect high-risk patients from potential exposure to COVID-19. State and Local governments and public health authorities are also enlisting ground ambulance organizations to assist with testing suspected COVID-19 patients. In addition, ground ambulances provide important medical transitional care for patients moving between facilities in both emergency and non-emergency situations.

During this pandemic, our members have experienced first-hand the gaps in the public health infrastructure and the medical preparedness and response systems and programs. One of the most frustrating aspects of the current system has been the lack of recognition and support for communities that contract with non-governmental ground ambulance providers/suppliers in everything from federal grant programs to the distribution of personal protective equipment for EMTs and paramedics.

Many of the federal grant programs triggered during the pandemic have fallen short of their promise because the statutes and regulations governing them do not recognize non-governmental ground ambulance providers/suppliers as eligible entities. This distinction remains confusing because in other areas of health care, federal grant programs are accessible by private, for-profit health care providers and suppliers.

Outdated statutes and regulations often assume that first responders are governmental or not-for-profit entities and ignore the decisions of State and Local governments to contract with private ground ambulance providers/suppliers to provide 911 or equivalent services. As others have recognized, “State and Local officials know what works best in their communities – what works best in New York City may be much different than what works in rural Tennessee.”1 The federal government should respect these local decisions and support all first responders.

An example of this problem arose early during the COVID-19 pandemic. The FEMA public assistance grant program reimburses first responders for PPE and other expenses related to the response to COVID-19. When public and private non-profit emergency ambulance providers/suppliers sought direct reimbursement under the program, they were turned away. Private emergency ambulance providers/suppliers were required to have a State or Local government agency apply on their behalf. As State and Local governments responded to the public health emergency, it was understandably difficult for them to allocate resources to work through the application process on behalf of their contractors.

This differential treatment impacts communities across the United States, including those in Arkansas, California, Colorado, Florida, Georgia, Indiana, Louisiana, Massachusetts, Mississippi, Nevada, New York, Oregon, Texas, and Wisconsin, among others.

In contrast to statutes like the one government FEMA allocations, the Homeland Security Act of 2002 (6 U.S.C. § 101) includes language that recognizes the decision of State and Local governments to contract with private not-for-profit and for-profit ground ambulance providers/suppliers within the definition of “emergency response providers.”

The AAA urges the Congress to adopt the Homeland Security Act definition of “emergency response providers” throughout the U.S. Code as applicable. Such language will help to make sure that when funding is available to help State and Local governments prepare and respond, the allocation mechanisms governing the funding permit all types of first responders, including non-governmental ground ambulance providers/suppliers, to access the dollars quickly and with minimal burden.

Recommendation

The Committee should carefully review federal public health programs and revise them as necessary to ensure that the funds may be used to support both non-governmental and governmental ground ambulance providers/suppliers to ensure that all communities, regardless of their individual decisions related to the entities operating their EMS systems, have federal funds to support their response efforts during public health emergencies.

On behalf of the AAA, I want to thank you for your ongoing support of EMS and ground ambulance providers/suppliers, as well as the leadership demonstrated by your work to prepare for the next pandemic. Over the years, the Congress has consistently recognized the vital and unique role that ground ambulance providers/suppliers play in protecting their communities and providing mobile health care services. In light of the lessons learned during this pandemic, we encourage you and your colleagues to revise antiquated language that no longer represents the innovations and progress that have led to State and Local governments to rely upon ground ambulance providers/suppliers, including non-governmental organizations.

The AAA and its volunteer leaders would welcome the chance to discuss this recommendation. We would also be pleased to participate in any fact-finding discussion or hearing that the Congress plans to host to better understand how the problems experienced during the current pandemic can be avoided in the future. Please do not hesitate to reach out to Tristan North at (202) 486-4888 or tnorth@ambulance.org, or Kathy Lester at (202) 534-1773 or klester@lesterhealthlaw.com to schedule a time for further discussion.

Sincerely,

Shawn Baird
President, American Ambulance Association
Vice President of Rural Services, Metro West Ambulance

1The Honorable Lamar Alexander, “Preparing for the Next Pandemic” White Paper” 4 (June 9, 2020).

CMS Addresses Substance Use, Mental Health Crisis Care for Those with Medicaid

CMS Addresses Substance Use, Mental Health Crisis Care for Those with Medicaid

$15 Million Funding Opportunity for State Planning Grants to Bolster Mobile Crisis Intervention Services

The Centers for Medicare & Medicaid Services (CMS) announced a funding opportunity made possible by the American Rescue Plan (ARP) to help states strengthen system capacity to provide community-based mobile crisis intervention services for those with Medicaid. The $15 million funding opportunity is available to state Medicaid agencies for planning grants to support developing these programs.

This funding opportunity provides financial resources for state Medicaid agencies to assess community needs and develop programs to bring crisis intervention services directly to individuals experiencing a mental health or substance use related crisis outside a hospital or facility setting. These services may include screening and assessment, stabilization and de-escalation, and coordination of referrals after the initial treatment.

“Investing in crisis intervention services ensures Americans experiencing a mental health or substance use disorder crisis get the care and treatment they need,” said Secretary Becerra. “These grants will help states build these critical services to help communities send a responder who is trained and ready to assist people in crisis.”

“It is vital that we can meet people where they are, especially when those individuals are in crisis,” said CMS Administrator Chiquita Brooks-LaSure. “This funding will help state Medicaid agencies plan innovative ways to provide and better mobilize these essential intervention services to their communities.”

The planning grants provide funding to develop, prepare for, and implement qualifying community-based mobile crisis intervention services under the Medicaid program. Grant funds can be used to support states’ assessments of their current services, strengthen capacity and information systems, ensure that services can be accessed 24 hours a day/365 days a year, provide behavioral health care training for multi-disciplinary teams, or to seek technical assistance to develop State Plan Amendment (SPAs), demonstration applications, and waiver program requests under the Medicaid program.

Letters of Intent to apply from states and territories are due July 23, 2021. Final applications must be submitted by August 13, 2021, 3:00 pm ET. The period of performance for this grant will be from September 30, 2021, through September 29, 2022. The Notice of Funding Opportunity (NOFO) provides additional details regarding eligibility and program requirements, as well as key deadline and application submission information.

To view the NOFO, visit Grants.gov and search for the announcement by CFDA# 93.639.

EMS.gov | New Resources Help EMS Clinicians and Agencies Navigate HIPAA

Nationwide, EMS agencies regularly report that hospitals and other healthcare workers refuse to share patient information with them, citing Health Insurance Portability and Accountability Act (HIPAA) concerns. Misconceptions about HIPAA can create artificial barriers to the legitimate, approved exchange of data between EMS and other providers, resulting in missed opportunities to improve patient outcomes and advance evidence-based practices in prehospital care.

To address this issue, the NEMSIS Technical Assistance Center collaborated with the law firm Page, Wolfberg & Wirth to provide helpful resources explaining the sharing of patient information between EMS and other healthcare professionals:

While obstacles may remain for the appropriate sharing of patient information, HIPAA is not one of them. Sharing patient information benefits EMS agencies and improves prehospital patient care by revealing evidence-based practices that make a difference for patients in the field.

On-Demand | Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!

Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!
Recorded July 7, 2021 | 14:00–15:15 pm ET | FREE Webinar

Download Slide Deck | Watch on YouTube

HOT (red light and siren) responses put EMS providers and the public at significant risk. Studies have demonstrated that the time saved during this mode of vehicle operation and that reducing HOT responses enhances safety of personnel, with little to no impact on patient outcomes. Some agencies have ‘dabbled’ with responding COLD (without lights and sirens) to some calls, but perhaps none as dramatic as Niagara Region EMS in Ontario, Canada – who successfully flipped their HOT responses to a mere 10% of their 911 calls! Why did they do it? How did they do it? What has been the community response? What has been the response from their workforce? Has there been any difference in patient outcomes? Join Niagara Region EMS to learn the answers to these questions and more. Panelists from co-hosting associations will participate to share their perspectives on this important EMS safety issue!

Speakers

Kevin Smith, BAppB:ES, CMM III, ACP, CEMC
Chief
Niagara Emergency Medical Services

Jon R. Krohmer, MD, FACEP, FAEMS
Director, Office of EMS
National Highway Traffic Safety Administration
Team Lead, COVID-19 EMS/Prehospital Team

Douglas F. Kupas, MD, EMT-P, FAEMS, FACEP
Medical Director, NAEMT
Medical Director, Geisinger EMS

Matt Zavadsky, MS-HSA, NREMT
Chief Strategic Integration Officer
MedStar Mobile Integrated Healthcare

Bryan R. Wilson, MD, NRP, FAAEM
Assistant Professor of Emergency Medicine
St. Luke’s University Health Network
Medical Director, City of Bethlehem EMS

Robert McClintock
Director of Fire & EMS Operations
Technical Assistance and Information Resources
International Association of Fire Fighters

Mike McEvoy, PhD, NRP, RN, CCRN
Chair – EMS Section Board – International Association of Fire Chiefs
EMS Coordinator – Saratoga County, New York
Chief Medical Officer – West Crescent Fire Department
Professional Development Coordinator – Clifton Park & Halfmoon EMS
Cardiovascular ICU Nurse Clinician – Albany Medical Center