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CMS End of PHE Roadmap

Written by Kathy Lester on . Posted in Emergency Preparedness, Medicaid, Medicare, Member Advisories, News.

CMS Prepares Providers and Suppliers for the End of the Public Health Emergency:

CMS Issues Updates on the End of Emergency Waivers and Flexibilities Issued during the PHE

By Kathy Lester, J.D., M.P.H.

 

Even though it appears that the Biden-Harris Administration will extend the COVID-19 Public Health Emergency (PHE) for at least another 90 days, CMS has begun the process of preparing for the termination of waivers and flexibilities that have been in effect during the pandemic.  During the PHE, the American Ambulance Association has worked closely with CMS and Congress to make sure that ground ambulance services were prioritized and provided with waivers and flexibilities to support their integral role as a front-line medical response during the pandemic.

 

CMS announced its roadmap for the end of the PHE on August 18.  The roadmap includes a summary of the policies that will terminate at the end of the PHE, but also notes that CMS intends to keep some policies in place even after the PHE ends. Examples of policies that will continue after the PHE is allowed to expire include certain morbidity and mortality reporting requirements on long-term care facilities and certain telehealth services expanded by Congress.

 

In its announcement, CMS indicated particular concern about patient safety.  “As mentioned by Lee A. Fleisher, M.D.; Michelle Schreiber, M.D.; Denise Cardo, M.D.; and Arjun Srinivasan, M.D., in February 17, 2022, New England Journal of Medicine Perspective, ‘Safety has also worsened for patients receiving post-acute care, according to data submitted to the Centers for Medicare and Medicaid Services (CMS) Quality Reporting Programs…’”

 

As part of this announcement, CMS released a fact sheet detailing the current status of the Medicare waivers and flexibilities for ambulance providers and suppliers.  Some of the policies highlighted in this fact sheet include:

 

  • Vaccine Reimbursement Rates: CMS will continue to pay approximately $40 per dose for administering COVID-19 vaccines in outpatient settings for Medicare beneficiaries through the end of the calendar year that the COVID-19 PHE ends.  Effective January 1 of the year following the year that the COVID-19 PHE ends, CMS will set the payment rate for administering COVID-19 vaccines to align with the payment rate for administering other Part B preventive vaccines.  CMS plans to continue to pay a total payment of approximately $75 per dose to administer COVID-19 vaccines in the home for certain Medicare patients through the end of the calendar year that the COVID-19 PHE ends.

 

  • Alternative Destination: CMS indicates that it will include this issue in future rulemaking.

 

  • Treat in Place: CMS indicates that the waiver will end with the end of the PHE.

 

  • Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization: CMS notes that it has already returned to the full model operations including post-payment reviews of claims submitted during the PHE.

 

  • Signature Requirements: Absent indications of potential fraud and abuse, CMS will not review claims for dates of service during the COVID-19 PHE for compliance with the signature requirements.

 

  • Appeal Flexibilities: CMS will allow some of the flexibilities related to the timing of appears to continue consistent with existing authority for appeals once the PHE ends.

 

The AAA will continue to monitor the PHE and any changes in the waivers and flexibilities specific to ground ambulance services.  We encourage members to reach out to our team if concerns or questions arise as CMS winds down the PHE.

EMS.Gov | Know the Signs of Monkeypox

Written by Amanda Riordan on . Posted in Emergency Preparedness, Operations, Patient Care.

EMS News

Recognize Monkeypox
In Prehospital Settings

EMS and healthcare clinicians should know the signs of Monkeypox
The National Emerging Special Pathogens Training and Education Center (NETEC) is providing updates about the recently evolving situation regarding the spread of Monkeypox, a rare but potentially serious viral disease. Monkeypox has emerged in countries in which it is not normally found, including the United States. To ensure early detection and isolation of the infected, EMS/prehospital and hospital clinicians should be on alert for signs of the disease.

Monkeypox can spread between humans via contact with skin lesions and infected respiratory droplets. It is important to recognize and report cases of the disease to the local public health department for surveillance purposes.

Visit the link above or review these EMS strategies for preventing the spread of monkeypox:

If you suspect a case of Monkeypox, contact your state health department for possible initiation of special pathogen transport protocols.

More Information

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HRSA eNews | Expanding Health Care Access and Resources in Underserved Populations,

Written by AAA Staff on . Posted in Emergency Preparedness, News, Press, Regulatory.

HRSA eNews March 3, 2022

March 3, 2022

Administrator Carole Johnson on HRSA’s Commitment to President Biden’s National Mental Health Strategy

douglas-emhoff-carole-johnson-nationwide-childrens-hospitalIn his State of the Union address, President Biden announced an ambitious strategy to address our national mental health crisis. At the Health Resources and Services Administration, we stand with the President in his call for unity in our national response and know that for the millions of Americans living with a mental health condition or caring for a loved one with a mental health condition, the time for action is now.

Yesterday, Administrator Johnson and HRSA Chief of Staff Jordan Grossman joined the Second Gentleman Mr. Emhoff and Assistant Secretary for Health Admiral Levine in Columbus, Ohio, to visit HRSA grantees addressing youth mental health care needs and providing mental health supports for the health care workforce.

Read Administrator Johnson’s full statement on the President’s National Mental Health Strategy.

HRSA Works to Expand Health Care Access and Resources in Underserved Populations

physicianIn February, HRSA announced the winners of the Promoting Pediatric Primary Prevention Challenge, $66.5 million to support community-based vaccine outreach efforts, more than $560 million in pandemic relief payments to health care providers, funding to increase virtual care quality and access, and new funding to support primary care residency programs.

Read our announcements.

HHS Distributing $560 Million in Provider Relief Fund Payments to Health Care Providers Affected by the COVID-19 Pandemic

Clipart of health professionalsWith this funding, nearly $19 billion will have been distributed from the Provider Relief Fund and the American Rescue Plan Rural provider funding since November 2021 

February 24 – The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4,100 providers across the country this week.

“Provider Relief Funds have been living up to its name, providing much-needed relief to our nation’s health care providers,” said Health and Human Services Secretary Xavier Becerra. “From expanding life-saving services to tackling workforce challenges, these funds will continue to help weather the pandemic’s continued impact. The Biden-Harris Administration remain committed to ensuring our providers with the necessary support and tools to keep our families safer and healthier.”

Read the press release.

National Health Service Corps: 50 Years of Commitment, Compassion and Community

nhsc anniversary social media cardOur National Health Service Corps (NHSC) is gearing up to celebrate its 50th anniversary, and you’re invited to join in. Established with the Emergency Health Personnel Act of 1970, the NHSC placed its first clinicians – which included physicians, dentists and nurses – in 20 communities in 13 states. Learn how you can engage with, promote, and celebrate this historic milestone with our largest class of participants yet!

New Report on Children’s Mental Health Features Key Data from National Survey of Children’s Health

children lined upA new report featuring data from HRSA’s 2016-2019 National Survey of Children’s Health, shows that children’s mental health was a substantial public health concern even before the COVID-19 pandemic started.

This report is an update to one first published in 2013 in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. The 2013 report was the first ever cross-agency children’s mental health surveillance report, and includes input from HRSA, the Substance Abuse and Mental Health Services Administration and the National Institute of Mental Health. HRSA’s Reem Ghandour and Jesse Lichstein are co-authors.

The current report found that attention-deficit/hyperactivity disorder and anxiety among children of all ages, and symptoms related to depression among adolescents, are the most common concerns. It also features data on behavioral problems, autism, Tourette syndrome, as well as treatment received and signs that children are doing well. The report concludes that we need further research on positive indicators of mental health such as emotional well-being and resilience to provide the fullest picture of children’s mental health.

Climate Change and Health: The Risks to Community Health and Health Care Utilization

climate change Climate change influences human health and diseases in numerous ways. Underserved communities stand to bear the brunt of these climate-induced risks (e.g., extreme heat, poor air quality, flooding, extreme weather events). HRSA and CDC’s Climate and Health Program invite you to consider the impacts of climate change on the U.S. health care system. CDC will share its work to build resilience to these public health effects.

Webinar Date: Thursday, March 17, 1-2 p.m. ET. 

Register.

Patient Safety Awareness Week Event: Harnessing Individual Power to Effect Positive Change

webcast iconPatient Safety Awareness Week is March 13-19. We are hosting an event in partnership with the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), the Food and Drug Administration (FDA), the Indian Health Service (IHS), and the National Institutes of Health (NIH).

Amelia Brooks from Safe and Reliable Healthcare will provide strategies that health care organizations can implement immediately to improve the safety culture in their organizations. She will share:

  • How to focus on safety in the context of global health and staffing crises
  • How to reduce burdens on frontline providers
  • Implementing practical strategies to support staff

There will also be a virtual exhibit hall at the end of the session.

Webinar Date: Thursday, March 17, 2-3:30 p.m. ET. 

Register.

States Take Action to Address Children’s Mental Health in Schools

teens against locker in schoolChildren’s mental health continues to be a top priority for state leaders across both legislative and executive branches of state government. With COVID-19 exacerbating the challenges children are facing, there is much more work to be done.

This National Academy for State Health Policy (NASHP) blog post summarizes the actions many states have taken from March 2020 through December 2021 to support school mental health systems, while many more states continue to consider legislation during the 2022 session.

HRSA’s National Organizations of State and Local Officials Cooperative Agreement provided support for this blog post.

image of a calendar

March

  • National Colorectal Cancer Awareness Month
  • National Poison Prevention Week (20-26)
  • National Women and Girls HIV/AIDS Awareness Day (10)
  • National Native American HIV/AIDS Awareness Day (20)
  • National Drug and Alcohol Facts Week (21-27)

Funding Opportunities

 

Health Workforce

Dental Faculty Loan Repayment Program – apply by March 22

Teaching Health Center Graduate Medical Education (THCGME) Program – apply by March 31

Area Health Education Centers Program – apply by April 6

State Loan Repayment Program (SLRP) – apply by April 8

Health Workforce Research Center Cooperative Agreement Program – apply by April 14

HIV/AIDS Bureau

Ryan White HIV/AIDS Program Part F Dental Reimbursement Program – apply by March 11

Ryan White HIV/AIDS Program Part D Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth (WICY) Limited Existing Geographic Service Areas – apply by March 31

Telehealth Strategies to Maximize HIV Care – apply by April 8

Ryan White HIV/AIDS Program Part B States/Territories Supplemental Grant Program – apply by May 9

Maternal and Child Health

Enhancing Systems of Care for Children with Medical Complexity (Coordinating Center) – apply by March 7

Enhancing Systems of Care for Children with Medical Complexity (Demonstration Projects) – apply by March 7

Maternal and Child Environmental Health Network (MCEHN) – apply by March 28

MCH Adolescent and Young Adult Health Research Network (AYAH-RN) – apply by March 29

Children and Youth with Special Health Care Needs Research Network – apply by April 4

Autism Single Investigator Innovation Program (Autism-SIIP) – Autism Transitions Research Project (ATRP) – apply by April 4

Autism Single Investigator Innovation Program (Autism-SIIP) – Autism Longitudinal Data Project (ALDP) – apply by April 4

American Rescue Plan Act – Pediatric Mental Health Care Access – New Area Expansion – apply by April 5

Home Visiting Collaborative Improvement and Innovation Network 3.0 (HV CoIIN 3.0) – apply by April 6

Autism CARES Act National Interdisciplinary Training Resource Center – apply by April 7

Catalyst for Infant Health Equity – apply by April 19

Infant-Toddler Court Program – National Resource Center – apply by May 4

Infant-Toddler Court Program – State Awards – apply by May 4

Early Childhood Developmental Health Systems: Evidence to Impact – apply by May 10

Federal Office of Rural Health Policy

Medicare Rural Hospital Flexibility Program- Emergency Medical Services Competing Supplement – apply by March 4

Rural Health and Economic Development Analysis – apply by March 8

Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance – apply by March 9

Rural Public Health Workforce Training Network Program – apply by March 18

Small Health Care Provider Quality Improvement Program – apply by March 21

Rural Maternity and Obstetrics Management Strategies Program – apply by April 5

Rural Communities Opioid Response Program – Behavioral Health Care Support – apply by April 19

View All Funding Opportunities
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NAEMT | Quick Survey on EMS Utilization of COVID-19 Waivers

Written by AAA Staff on . Posted in Emergency Preparedness.

EMS Utilization of COVID-19 Waiver Survey

TAKE SURVEY
Please help our industry understand how EMS has utilized the current COVID-19 waivers. The results of this survey will be used to educate federal regulators and elected officials on EMS reimbursement reform. The survey will take no longer than five (5) minutes to complete and will ask how your ambulance agency has utilized the waivers throughout the COVID-19 pandemic.

 

During the ongoing Public Health Emergency (PHE), CMS issued four waivers to assist ambulance agencies. Separate from the CMS ET3 project, these waivers allowed for reimbursement for transporting to alternate destination of care, treatment in lieu of transport, hospital at home utilizing community paramedics, and telehealth facilitation.

 

We kindly ask that ONE leader from your agency take the survey before March 14. No identifiable information will be shared or distributed. NAEMT will share the results of the survey with its members and participants.

Thank you for taking time to participate in this survey to advance EMS!
TAKE SURVEY

CMS Releases Medicare COVID-19 Vaccine Data Analysis and PUF

Written by AAA Staff on . Posted in Emergency Preparedness, Executive, Patient Care, Regulatory.

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

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

Written by AAA Staff on . Posted in Emergency Preparedness, Employee Wellness, Operations, Patient Care.

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.

Letter to Senate HELP Committee Leadership on Provider-Type Equity

Written by AAA Staff on . Posted in Emergency Preparedness, Legislative.

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 Increases Medicare Payment for COVID-19 Vaccinations

Written by Brian Werfel on . Posted in Drugs & Pharma, Emergency Preparedness, Medicare, Reimbursement.

CMS Increases Medicare Payment for COVID-19 Vaccinations

 

                                                                        By Brian S. Werfel, Esq.

On March 15, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that it would be increasing the Medicare payment amount for administrations of the COVID-19 vaccines.

The original Medicare reimbursement rate depended, in part, on whether the vaccine being administered required a two-dose regimen (as is the case for the Pfizer-Biontech and Moderna vaccines), or a single dose (Johnson & Johnson vaccine).  For vaccinations that require a two-dose regime, CMS initially paid: (1) $16.04 for the administration of the first dose and (2) $28.39 for the administration of the second dose.  For vaccines that require only a single dose, Medicare paid $28.39 for the administration of that single dose.

Effective for vaccinations administered on or after March 15, 2021, CMS has increased these payments to $40 per administration.  Thus, the total reimbursement for a vaccine requiring a single dose will be $40, while the total reimbursement for a vaccine requiring a two-dose regimen will be $80.

Grants and Tax Credits Toolkit

Written by Akin Gump on . Posted in Emergency Preparedness, Legislative, Medicare, Regulatory.

Grants and Tax Credits Toolkit

Download materials from Akin Gump including aid summaries and how-to guides on qualifying for tax credits and deferments and applying for financial assistance.

 

 

COVID-19 Update II for EMS

Written by Rob Lawrence on . Posted in Emergency Preparedness, Patient Care, Regulatory.

First Case of 2019 Novel Coronavirus in the United States

The New England Journal of Medicine has rapidly published a peer-reviewed paper on the Snohomish County WA ‘Patient 1’. This was the first reported case of COVID 19 in the US. This seminal document, which given the magnitude of the case and its initial findings is released in full here

The work by Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, et al for the Washington State 2019-nCoV Case Investigation Team was turned round in just over 5 weeks and below is an ‘Executive summary’ ( as extracted from the paper) but the full paper and range of results should be read in full.

Patient Presentation

On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and subjective fever. On checking into the clinic, the patient put on a mask in the waiting room. After waiting approximately 20 minutes, he was taken into an examination room and underwent evaluation by a provider. He disclosed that he had returned to Washington State on January 15 after traveling to visit family in Wuhan, China. The patient stated that he had seen a health alert from the U.S. Centers for Disease Control and Prevention (CDC) about the novel coronavirus outbreak in China and, because of his symptoms and recent travel, decided to see a health care provider.

On admission, the patient reported persistent dry cough and a 2-day history of nausea and vomiting; he reported that he had no shortness of breath or chest pain. Vital signs were within normal ranges. On physical examination, the patient was found to have dry mucous membranes. The remainder of the examination was generally unremarkable. After admission, the patient received supportive care, including 2 liters of normal saline and ondansetron for nausea.

Viral Presence

Both upper respiratory specimens obtained on illness day 7 remained positive for 2019-nCoV, including persistent high levels in a nasopharyngeal swab specimen (Ct values, 23 to 24).

Stool obtained on illness day 7 was also positive for 2019-nCoV (Ct values, 36 to 38).

Nasopharyngeal and oropharyngeal specimens obtained on illness days 11 and 12 showed a trend toward decreasing levels of virus

Day 8: Condition Improves

On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity.

History Taking

This case report highlights the importance of clinicians eliciting a recent history of travel or exposure to sick contacts in any patient presenting for medical care with acute illness symptoms, in order to ensure appropriate identification and prompt isolation of patients who may be at risk for 2019-nCoV infection and to help reduce further transmission. Finally, this report highlights the need to determine the full spectrum and natural history of clinical disease, pathogenesis, and duration of viral shedding associated with 2019-nCoV infection to inform clinical management and public health decision making.

Conclusion

There is little doubt that this paper is about to become a globally sited document as we continue to deal with COVID 19. As far as EMS and our first response to it goes, the paper reinforces the key actions currently being taken

 

Sample COVID-19 Policies for Mobile Healthcare Providers

Thank you to the following organizations for sharing their policies as examples.
Global Medical Response maintains a COVID-19 page to provide information to all members of the GMR community—clinicians and non-clinicians.

Updates from GMR Chief Medical Officer, Dr. Ed Racht

GMR Procedures

General Information for Caregivers

Compliance

HIPAA Reminder

FirstWatch Solutions

The intention of the COVID-19 Process/Policy Template is to provide agencies, medical directors, or others who want to utilize it, an outline/template on which to build an agency-specific policy/protocol to address COVID-19. This includes suggestions for development and/or oversight committees, outside partners and stakeholders, as well as preparation and process for EMS workers who provide best practice care for patients as well as providing for the protection of pre-hospital providers and medical director(s). Its application is totally up to the user.

This document is meant to be a living document that can be revised as circumstances or guidance changes. It can also be a discussion piece for those who choose to develop a different type of policy but may want to use some of the components of the document as a starting point.

Agency Guidance
CDC Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States
NEW March 6, 2020: CMS COVID-19 FAQs for Healthcare Providers (PDF Download)

March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs.  https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

March 4, 2020: CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare. https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus

February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19.  https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test

February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt

February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19.  https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov

4 Tips: Add Empathy to EMS Care

Written by Scott McConnell on . Posted in Community, Emergency Preparedness, Patient Care.

Empathy is about trying to understand, as best we can, someone else’s situation or experience. The question is, do we in EMS truly understand the word? Are we empathetical to ourselves and to the people we work with?

While some say that empathy comes from proper upbringing, today’s decline in civility means we see less and less of it displayed. A major contributing factor is the “tough” exterior we favor in each other: how often have you heard comments like “come on, just suck it up buttercup,” “you need to be tougher than that to be a medic,” or “we’re EMS, we eat our young.” Why are we like this, and why can’t we reinforce the empathy that naturally resides in all of us?

Empathy is a big part of our jobs, and we need to teach it to our students, our employees and each other. People need to feel that it’s OK to be empathetic and that it’s a natural part of the whole EMS picture.

One of the best techniques to foster empathy is active listening — not only to our patients but also to staff and co-workers. When you actively listen, you H.E.A.R. …

 Halt: Stop whatever else you are doing, end your internal dialogue on other thoughts, and free your mind to give the speaker your attention.

 Engage: Focus on the speaker. We suggest a physical component, such as turning your head slightly so that your right ear is toward the speaker as a reminder to be engaged solely in listening.

Anticipate: By looking forward to what the speaker has to say, you are acknowledging that you will likely learn something new and interesting, which will enhance your motivation to listen.

Replay: Think about what the speaker is saying. Analyze and paraphrase it in your mind or in discussion with the speaker and other classmates. Replaying and dialoguing the information you have heard will aid in understanding what the speaker is attempting to convey.”1

So always look at the other’s point of view and try to understand what he or she is facing. It just might change your attitude and make you a better provider.

References:
1  Wilson, Donna & Conyers, Marcus, “4 Proven Strategies for Teaching Empathy”. Edutopia, January 4, 2017.

Your EMS Reputation Depends on Three Cs

Written by Scott McConnell on . Posted in Community, Emergency Preparedness, Patient Care.

Your EMS Reputation Depends on Three Cs—Credentials, Courtesy, Community

In EMS, your reputation is critical. Your character moves with you from provider to provider and from squad to squad; EMS is a small world where people know about you before you even step foot in the door.

People react to you based on judgments from not only real life, but also your digital life. With Facebook, Snapchat, Instagram and other social media networks so prevalent today, your social media profile serves as the basis of your reputation both professionally and privately.

Unfortunately, social media blunders abound among EMS providers, affecting their reputations and their future hiring ability. You can find hundreds of examples doing a quick online search; here are just two.

Three South Carolina responders fired for making statements like “idiots shutting down I-126. Better not be there when I get off work …” (Kaplan, 2016, para. 3)

A Brockton, Mass. dispatcher who said of a pregnant overdose patient, “She needs to be left to rot …” (Shephard, 2018, para. 5)

A better way to think of your reputation is the “Three Cs” — Credentials, Courtesy and Community.

  • Credentials may also be called Continuing Education, as it’s vital to keep learning throughout your career. Many of the best paramedics and EMTs are lifelong learners; in contrast there are others who take the NREMT exam and then never do more to see EMS from a wider perspective.
  • Courtesy means being courteous not only to your patients and coworkers but also to yourself. When others feel comfortable around you, it is easier to develop those close ties and professional relationships that boost your reputation.
  • Community refers to both where you live and the broader EMS community at large. The public and our industry look to us to build and improve a framework where we can all grow and thrive. Professional norms promote collaboration, knowledge sharing and a collective responsibility for improving ourselves and our treatments.

So, let’s follow the “Three Cs” to improve EMS as a community. Let’s have better, more convenient education that goes beyond the “same old, same old.” Let’s push our medical directors for improved, evidence-based treatments. Let’s pull each other up and be leaders at the healthcare table. Lastly, let’s stand out in the community with reputations that reflect the consummate professionals we truly are.

Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME, which recently launched a new learning platform. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings

References

(Kaplan, 2016, para. 3) “Three S.C. first responders fired for threatening comments about protesters” Retrieved from https://www.washingtonpost.com/news/post-nation/wp/2016/07/13/three-s-c-first-responders-fired-for-threatening-comments-about-protesters/ 

(Shephard, 2018, para. 5) “Dispatcher put on leave for harsh Facebook comments” Retrieved from https://www.ems1.com/ems-social-media/articles/378700048-Dispatcher-put-on-leave-for-harsh-Facebook-comments/

Make a Difference: EMS and Human Trafficking

Written by Scott McConnell on . Posted in Community, Emergency Preparedness, Patient Care, Uncategorized.

When we think of trafficking, we generally think of drugs or weapons, not human beings. Yet the problem exists in numerous communities where EMS responders deliver care.

Human trafficking is defined by the United Nations as “the recruitment, transportation, transfer, harboring, or receipt of persons by improper means for an improper purpose.” (End Slavery Now, 2018, para. 1) A more succinct definition comes from Kathryn Brinsfield, MD, MPH, Assistant Secretary for Health Affairs and Chief Medical Officer for the Department of Homeland Security: “Human trafficking is modern-day slavery.” (DHS, 2017, para. 3)

Why is this so important in today’s EMS field? We are the first on scene, we are the ones invited inside where others are not and we are the ones who see an injured person’s environment.  Our interactions with others can help us spot some of the tell-tale indicators.

Unfortunately, there are many reasons people are trafficked:

  • Domestic Slavery: People are brought into private homes to work as slave labor, with no options to leave.
  • Sex Trafficking: Children, men and women are forced into the commercial sex industry
  • Forced and Bonded Labor: People are forced to work under the threat of violence for no pay — often to repay a debt — without the ability to leave
  • Forced Marriage: Women and children are forced to marry another against their will and without their consent.

As an industry, there is much that EMS can do. We must keep our ears and eyes open, and report things that raise red flags in our minds. Some of the most common indicators we will see as emergency responders are:

  • Signs of abuse, wounds or bruising in various stages of healing or malnutrition
  • Scars or mutilations, including tattoos showing ownership
  • Language or cultural barriers preventing injured persons from communicating with you
  • Submissive or nervous appearances
  • Security measures like overly hardened doors or windows preventing movement of people

DHS has a great educational sheet with additional indicators to look for: click here for a printable copy. While a particular situation may turn out not to be what you suspect, report your suspicions regardless so trained law enforcement experts can evaluate the situation. Your hunch may save a life or multiple lives. Call Immigration and Customs Enforcement at 1-866-DHS-2-ICE (1-866-347-2423) or online here. You can also receive additional training here.

References

Slavery Today (2018). Retrieved from   http://www.endslaverynow.org/learn/slavery-today

EMS’s Role in the Effort to End Human Trafficking (2017). Retrieved from https://www.ems.gov/newsletter/marapr2016/end-human-trafficking.html

Changing the Face of EMS for the New Century

Written by Scott McConnell on . Posted in Community, Emergency Preparedness, Patient Care, Uncategorized.

EMS has always been the forefront of medicine, delivering care to the sick and injured in various roles dating as far back as the Civil War. It has come a long way from the days of horse and buggy. Yet, where are we going now?

One look at the trajectory of Nursing indicates where we are headed. When Nursing first started, the profession was comprised of caring women who were viewed and treated as indentured servants, subservient to the male dominated physicians. Nursing evolved when the “servant” became educated. What followed were thousands of women beginning to diagnose, conduct research and improve outcomes in the healthcare field. Soon thereafter, they broke free of the care assistant model they were in. I see EMS following the same path.

The ambulance industry started out as transporters, with a curriculum that was adopted and funded by the Department of Transportation (DOT). The industry has roots in DOT, Police Departments, Fire Departments and the military, but are truly physician extenders that should be firmly rooted in Health Departments. EMS is now developing a language, doing research, obtaining national accreditation for our schools, even supporting continuing education with CAPCE. But we need to do more.

Outreach will help accomplish what many have started.  We need to consider the picture the public has of EMS, especially when we have overlooked self-promotion for decades.

Let’s be the ones who show the public what EMS is and is capable of.  I look forward to EMS education mirroring, “The Georgia Trauma Commission,” which collaborated with the Georgia Society of the American College of Surgeons and the Georgia Committee on Trauma to create the “Stop the Bleed” campaign. This inspiring crusade is designed to train school teachers, nurses and staff across the state on how to render immediate and potentially life-saving medical aid to injured students and co-workers while waiting for professional responders to arrive.” (2018, para. 4)  This type of training gives us face time with the public so they can learn what we do and what we do not.

One of the other important outreach programs to help us in this endeavor is the Community Paramedic Program. We are seeing this education transform EMS into new and exciting roles in the community. “First responders frequently respond to calls for social services. So, the emergency responders may know of people who need some sort of services or resources,” (Todd) Babbitt, a former fire chief, said. “This team could help connect those people with the services they need. It’s about getting everybody to work together and communicate.” (2018, para. 4)

What we can do is start to get EMS in front of the public. Teach. And open our historically closed doors to the folks that make it easier to do our jobs. Educate others and learn together how our roles are changing modern day healthcare while embracing the change. Otherwise we risk being left in the dust by our progressive healthcare brethren.

References

(2018, Feb 1st, 2018). Ga. School Nurses Train to Stop the Bleed. The Brunswick News. Retrieved from https://www.emsworld.com/news/219782/ga-school-nurses-train-stop-bleed

(Ed.). (2018, January 30th, 2018). Conn. Fire Chiefs to Form Community Action Team. Norwich Bulletin. Retrieved from https://www.emsworld.com/news/219757/conn-fire-chiefs-form-community-action-team

Is Narcan the Answer?

Written by Scott McConnell on . Posted in Community, Drugs & Pharma, Emergency Preparedness, Patient Care, Uncategorized.

There has been a lot of talk recently in social media and the news about leaving Narcan behind after a reversal of an opioid overdose. A new voluntary program in Pittsburgh, PA allows the state to pay for Narcan atomizers that EMS can leave with friends and family of OD patients. The media buzz revolves around the idea that we are enabling this cycle of addiction; “There is some pushback that maybe you’re enabling the problem a little bit, but at least in the short term, reduce the chances that person is going to die and you create more opportunities to get them into treatment,” said Mark Pinchalk, patient care coordinator for Pittsburgh EMS.” (Media, 2018, para. 3) I agree with Mr. Pinchalk that as an EMS Provider we are not there to judge, we are there to render aid.

One of my early instructors said, “Scott, your purpose is to leave the patient better than the way you found them.” I have taken that long ago statement to heart ever since, trying to leave the patient better than the way I found them whether that is medically as in a Diabetic whose blood glucose I raise from 20mg/dl to 130mg/dl or the person who receives a ride to the hospital to be  checked out. EMS is about providing care. When we use our own judgements or opinions on our patients, it impedes or influences the care we provide.

These particular cases seem to bring out strong opinions surrounding a delicate issue. Thousands of people die every year from Opioid overdoses. A healthy percentage of them get their start on prescription pain killers. So where do we help? How do we not judge going to the same address three or four times a week to treat the same person in the same situation? These are just some of the tough questions providers and services face every day in America. Although we are trying to hold back the tide with a broom, it is up to us to provide the same level of care each and every time, regardless of the person or situation.

Will leaving Narcan at the scene save lives? Yes, I believe so. Will it encourage more drug use? I can’t be sure. Time will tell.

In comparison, studies show making birth control available to teens actually reduces sexual activity and reported pregnancies. Consider 2017 data that shows “Among adolescent females aged 15 to 19, 42 percent report having sex at least once. For males, that number was 44 percent. The numbers have gradually dropped since 1988, when 51 percent of female and 60 percent of male teens reported having had sex.” (Welch, 2017, para. 4)

So for now, I encourage the opportunity, as the law allows, to provide Narcan, knowing it doesn’t make the problem go away. And I look forward to EMS impacting this youthful epidemic. How? Community Paramedicine are the resource to embrace. Just like any other frequent patient, community paramedics will help those get the services they need including the much-needed follow up care.

Scott F. McConnell is Vice President of EMS Education for OnCourse Learning and one of the Founders of Distance CME, which recently launched a new learning platform. Since its inception in 2010, more than 10,000 learners worldwide have relied on Distance CME to recertify their credentials. Scott is a true believer in sharing not only his perspectives and experiences but also those of other providers in educational settings.

References

Media, C. (Ed.). (2018, Jan, 26th, 2018). Local EMS starts program to leave Naloxone with OD victims. WPXI.com. Retrieved from http://www.wpxi.com/news/top-stories/local-ems-starts-program-to-leave-naloxone-with-od-victims/689842523

Welch, A. (2017, June 22nd, 2017). Are today’s teens more responsible about sex? CBS News. Retrieved from https://www.cbsnews.com/news/teen-sex-trends-birth-control-cdc-report/

Fentanyl Increasingly Dangerous to First Responders

Written by Matt Swift on . Posted in Community, Drugs & Pharma, Emergency Preparedness, Field Resources.

Fentanyl is a powerful drug that can be 50 times more potent than heroin. First responders are being warned to take precautions to avoid being exposed to the drug. Photo courtesy of the Drug Enforcement Administration.

The explosion of the opioid epidemic that is responsible for thousands of overdoses and deaths is a consistent problem that EMS and law enforcement encounter on an almost daily basis. Usually, the victims of these powerful drugs, such as heroin and fentanyl, are opioid users, who EMS personnel and law enforcement are regularly called to assist. However, first responders are also being warned about the increased risks they face of being exposed to these deadly drugs, specifically fentanyl—a popular synthetic opioid that is 40 to 50 times more powerful than heroin. To respond to these dangers, the Drug Enforcement Administration (DEA) released a field guide called “Fentanyl: A Brief Guide for First Responders” for EMS and police who find themselves responding to opioid-related calls.

“We need everybody in the United States to understand how dangerous this is,” Acting DEA Administrator Chuck Rosenberg warned. “Exposure to an amount equivalent to a few grains of sand can kill you.”

The warnings have become more urgent in recent months due to numerous cases of accidental overdoses and exposures involving EMS and police.

In May, Chris Green, a police officer with the East Liverpool Police Department, was accidentally exposed to fentanyl during a routine traffic stop after he inadvertently ingested the drug through his skin. Green needed four shots of Narcan, an emergency overdose medication, to be revived after collapsing from the effects of the drug. In another case, two Paramedics and a sheriff’s deputy in Hardford County, Maryland, were treated after showing signs of opioid exposure while treating an overdose victim.

“It is important to get the word out to everyone because it may be the first responder who needs to have Narcan administered,” said Baltimore City Health Commissioner Leana Wen.

The risks of accidental exposure are so high, in fact, that some emergency personnel have even begun carrying Narcan kits for drug-sniffing K-9s, just in case the dogs ingest the deadly drugs.

The DEA guide, along with a National Institute for Occupational Safety and Health manual on preventing fentanyl exposure, suggests certain precautions be taken to lower the risk of coming in direct contact with the substance. Personnel should be able to recognize the signs and symptoms of an overdose, be aware of the ways fentanyl can be ingested, and only allow trained professionals to handle substances that are suspect.

“Assume the worst,” Rosenberg said. “Don’t touch this stuff or the wrappings that it comes in without the proper personal protective equipment.”

The DEA video “Fentanyl: A Real Threat to Law Enforcement” offers advice on how police and EMS can protect themselves from the dangers of fentanyl.

Read more about fentanyl.

 

Ransomware: A Ticking Time Bomb for Health Care

Written by Cindy Elbert on . Posted in Emergency Preparedness, Operations.

By Cindy Elbert
President, Cindy Elbert Insurance Services, Inc

If you’re doing business online, you need cyber-insurance. This fact was never made truer than on May 12, 2017 when 50,000 businesses in at least 74 countries were hit by a ransomware attack code named “WannaCry”. Hackers demanded companies to pay a $300 ransom fee or their files would be published on the Internet. The data thieves targeted mostly hospitals and other medical facilities because their data not only included names, home addresses, addiction histories, financial information and religious affiliations but also disclosed patients’ mental health and medical diagnoses, HIV statuses and sexual assault and domestic violence reports. A gold mine of personal information for those with dark purposes.

Two days earlier, a data breach at the Bronx Lebanon Hospital Center in New York compromised the medical records of at least 7,000 people. According to NBC News, “Leaks from the Rsync servers, which transfer and synchronize files across systems, are common. How many more nude photos of patients or ultrasound images will be exposed because of misconfigured Rsync backups?”

On May 4, 2017, a group calling themselves TheDarkOverload uploaded almost 180,000 stolen patient/medical records from three companies onto the Internet because they refused to pay a ransom. The databases stolen were in the .csv format and contained health information about cardiac diagnoses and psychiatric conditions such as depression, along with date of birth and social security numbers.

Most ransomware attacks are led by organized criminal groups utilizing a network of computers infected with malware that then poisons other computers once a spam message is opened. An example of a spam malware would be emails falsely marked as being from a co-worker or friend asking a recipient to open an attached file. Or, an email might come from a trusted institution, like a bank or merchant, asking you to perform a specific task. In other instances, hackers will use scare tactics such as claiming that a victim’s computer has been used for illegal activities to bully victims. When the malware is executed, it encrypts files and demands a ransom to unlock them.

Imagine the nightmare scenario of medical teams out on the field relying on electronic devices such as tablets, laptops, smartphones and PDAs to access patient care records suddenly discovering that their data has been locked, captured by malicious malware., held for ransom with lives in the balance.

Companies need the protection cyber liability insurance offers now more than ever.

Why Your Company Needs Cyber Liability Insurance

  • A single data breach could cost your company thousands of dollars, not to mention the hit to your reputation.
  • Hackers can be halfway across the world—or at the desk next to you.
  • An employee losing a company laptop or cell phone could result in a major security breach.
  • The more personal information your company collects opens your exposure to the likelihood of a data breach attack.
  • As of March 28, 2017, Internet providers can collect and sell your web browser history opening more opportunities for data to be stolen.
  • The average forensic investigation runs $25,000 per server.

Cyberthreats By the Numbers

  • Sixty percent of uninsured small businesses close their doors within six months following a cyber attack.
  • According to the 2016 NetDiligence Cyber Claims study, Healthcare data breaches made up 19% of all breach sectors.
  • The average cost for a breached healthcare company is $717,000.
  • According to the Identity Theft Resource Center’s 2017 Data Breach report, almost 2 million records have been stolen so far this year, making up 22 percent of all breaches – and this is before the “WannaCry” ransomware attack.
  • Forty-seven states mandate that your company take certain measures in the event of a security breach

Protect Your Company

Ransomware attacks and cyber theft will not be defeated any time soon. So now is the time to ask: How do you store sensitive information? How do you control access to sensitive information? Do you utilize a firewall and protection software? Do you allow employees and others remote access to your data bases? Do you have a written security policy? And, most importantly, do you have cyber liability insurance? Is it safe? If your company stores customer information, especially billing and medical data, then there is no question about it: You must protect yourself from the growing legion of cyber predators. You need cyber liability insurance.

About the Author

Cindy Elbert is President of Cindy Elbert Insurance Services, Inc. She is a licensed Property & Casualty Insurance broker/agent, and a proud member of the American Ambulance Association, California Ambulance Association, Arizona Ambulance Association, and The Independent Agents Association.

Cindy has been assisting ambulance providers with their insurance needs since 1982. She understands your questions and concerns and with her relationships with insurance underwriters she can provide you with coverage and service you deserve.
www.ambulanceinsurance.com
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Spotlight: SSM Health Cardinal Glennon Children’s Hospital STARS Program

Written by Aidan Camas on . Posted in Community, Emergency Preparedness, Patient Care, Spotlight.

The Special Needs Tracking & Awareness Response System (STARS), was founded just over two years ago at SSM Health Cardinal Glennon’s Children’s Hospital in St. Louis, Missouri. The team at Cardinal Glennon realized that they needed to do something to address the growing number of children in the U.S. with special health care needs, many of whom are at a higher risk for repeated ambulance transports.

As an EMT for over 18 years, Patricia Casey, the Missouri Coordinator of the STARS Program, knows how intimidating it can be for a first responder to walk into a home that in many ways may look like a hospital room. Children with special health care needs can require many different types of in home medical equipment that first responders are often not familiar with. The STARS Program aims to make the job of the first responders easier while making children with medical needs and their parents more comfortable with ambulances in case they need to be transported in one.

Cardinal Glennon works with local ambulance districts to enroll children with special medical needs in that district’s STAR Program. Once a child is registered in STARS, they are given a unique patient identification number and a home visit is scheduled with the patient and their family to compile pertinent medical history. Participating ambulance companies then create a book with all of the stars in their area so that their first responders have access to the medical information on the go. If a STAR needs to be transported, their caregiver can relay their STAR number to the dispatcher who will then let the first responders know. First responders can then look up crucial medical information about the STARS patient, so they can be better prepared when they arrive on scene.

Knowing that many medical devices in the homes of the STARS may be foreign to first responders, Cardinal Glennon’s staff provides free necessary trainings all around Missouri and now Illinois. Shelby Cox works as the Team Lead for EMS outreach, and Josh Dugal, RN, is the EMT-P STARS Coordinator for Illinois. Together with Casey, they help keep the program running smoothly. Each participating ambulance company appoints a STARS coordinator on their staff who will make biannual home visits and make sure the STARS medical information is up to date. Cardinal Glennon also sets up regular opportunities for STARS to visit their local first responders. Giving STARS the chance to get familiar with an ambulance and their local first responders prior to a medical emergency has been proven to help out both parties when an emergency occurs.

A paramedic who has responded to STARS calls explains that “the STARS system permitted me to have advanced medical knowledge before I walked through the door. There was no time lost backtracking to learn the patient’s history or baseline in the midst of a chaotic scene”. In addition to helping the first responders, the STARS program has been a huge reassurance to the parents of STARS whose children may often need medical assistance.

To learn more about Cardinal Glennon’s STARS program, visit their website or check them out on Facebook. Also check out Patricia Casey’s Article on the STARS Program which includes testimonials from both parents and first responders who have participated in the program.
Thanks to the entire team at Cardinal Glennon for your great work!

Do you know of other innovative programs being run by ambulance services? Share with the AAA so that we might feature those programs on the AAA Blog as well.

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