On-Demand | EMS ESOP Webinar

How to Use an ESOP in These Turbulent Times
June 16 | 14:00 ET | Free Webinar

Watch On-Demand

The COVID-19 pandemic will likely have a financial impact on ambulance services for 2020, 2021, and perhaps for several years beyond. During this era, many private for-profit mobile healthcare providers will be looking for ways to minimize corporate taxes and maximize cash preservation, while also maintaining competitive employee benefits. Other companies will be looking for ways to create liquidity for shareholders who wish to retire or reduce their ownership stake.

This session will cover the basics of Employee Stock Ownership Plans, but more importantly how new ESOPs can be structured and used to increase private ambulance service cash flow and motivate employees in times of uncertainty and stressed balance sheets.

ABOUT PHILIP E. DeDOMINICIS
Phillip DeDominicis, MBA has served as the East Coast Partner of Menke & Associates for the last 16 years. Previously, he served as director of mergers and acquisitions for Salomon Smith Barney. He is a seasoned public speaker and serves on numerous boards.

ABOUT MENKE & ASSOCIATES
Menke & Associates, Inc. was founded in 1974 by John Menke who co-authored the landmark ESOP legislation which subsequently spawned the industry. Today, the firm is one of the leading firms in the United States in structuring Employee Stock Ownership Plan transactions.
Since its founding, Menke has structured more than 3500 ESOPs, the most of any single organization. Menke serves organizations of all sizes, from 10 employees to 30,000+, from its 10 regional offices throughout the U.S.

Watch On-Demand

WEBINAR: EMS: Patient Care and Operations | Monday, June 1

Our partners at the HHS Office of the Assistant Secretary for Preparedness and Response are hosting a COVID-19 Clinical Rounds webinar next week. See below for more information and links to register. And be sure to access the latest COVID-19 information for EMS at the updated COVID-19 Resources for EMS.

EMS: Patient Care and Operations

Monday, June 1, 2020
12:00 PM EDT / 9:00 AM PDT

Register Here

Webinar Agenda
Welcome and Introductions

Jon R. Krohmer, MD, FACEP, FAEMS, Director, Office of EMS, National Highway Traffic Safety Administration

Patient Care and Operations

Lekshmi Kumar, MD, MPH, FACEP, Associate Professor, Section of Prehospital and Disaster Medicine, Department of Emergency Medicine, Emory University School of Medicine; Medical Director, Grady EMS

Bill Salmeron, Chief, New Orleans EMS

Q & A and Discussion

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

EPIC Webinar 5/27: Hurricanes & COVID-19

2020 Hurricane Season During COVID-19

Are you prepared for the 2020 hurricane season while the world is also responding to COVID-19? CDC’s National Center for Environmental Health is joining the CDC EPIC Team Wednesday, May 27, at 1 p.m. EST. CDC experts will discuss possible health risks that could come from hurricanes combined with COVID-19; planning for the 2020 hurricane season while adhering to guidance on social distancing; and how community leaders, nonprofit organizations, and public health professionals can effectively communicate messages. Closed captioning will be available. Click here to learn more about this webinar, including continuing education options.

More information on this webinar, previous EPIC webinars, and continuing education can be found on the EPIC Webinar website.

Webinar Information

When: May 27, 2020 at 1 p.m. ET

 

Please click the link below to join the webinar:
https://www.zoomgov.com/j/1614675517

Or iPhone one-tap:
US: +16692545252,1614675517# or +16468287666,1614675517#
Or Telephone:
Dial (for higher quality, dial a number based on your current location):
US: +1 669 254 5252 or +1 646 828 7666

Webinar ID: 161 467 5517

International numbers available: https://www.zoomgov.com/u/aedA7dyLM2

 

 

CISA Guidance on Essential Critical Infrastructure Workers

ADVISORY MEMORANDUM ON IDENTIFICATION OF ESSENTIAL CRITICAL
INFRASTRUCTURE WORKERS DURING COVID-19 RESPONSE

As the Nation comes together to slow the spread of COVID-19, on March 16th the President issued updated Coronavirus Guidance for America that highlighted the importance of the critical infrastructure workforce.

The Cybersecurity and Infrastructure Security Agency (CISA) executes the Secretary of Homeland Security’s authorities to secure critical infrastructure. Consistent with these authorities, CISA has developed, in collaboration with other federal agencies, State and local governments, and the private sector, an “Essential Critical Infrastructure Workforce” advisory list. This list is intended to help State, local, tribal and territorial officials as they work to protect their communities, while ensuring continuity of functions critical to public health and safety, as well as economic and national security. Decisions informed by this list should also take into consideration additional public health considerations based on the specific COVID-19-related concerns of particular jurisdictions.

This list is advisory in nature. It is not, nor should it be considered, a federal directive or standard. Additionally, this advisory list is not intended to be the exclusive list of critical infrastructure sectors, workers, and functions that should continue during the COVID-19 response across all jurisdictions. Individual jurisdictions should add or subtract essential workforce categories based on their own requirements and
discretion. The advisory list identifies workers who conduct a range of operations and services that are typically essential to continued critical infrastructure viability, including staffing operations centers, maintaining and repairing critical infrastructure, operating call centers,
working construction, and performing operational functions, among others. It also includes workers who support crucial supply chains and enable functions for critical infrastructure. The industries they support represent, but are not limited to, medical and
healthcare, telecommunications, information technology systems, defense, food and agriculture, transportation and logistics, energy, water and wastewater, law enforcement,  and public works.

State, local, tribal, and territorial governments are responsible for implementing and executing response activities, including decisions about access and reentry, in their communities, while the Federal Government is in a supporting role. Officials should use their own judgment in issuing implementation directives and guidance. Similarly, while adhering to relevant public health guidance, critical infrastructure owners and operators are expected to use their own judgement on issues of the prioritization of business processes and workforce allocation to best ensure continuity of the essential goods and
services they support. All decisions should appropriately balance public safety, the health and safety of the workforce, and the continued delivery of essential critical infrastructure services and functions. While this advisory list is meant to help public officials and employers identify essential work functions, it allows for the reality that some workers engaged in activity determined to be essential may be unable to perform those functions
because of health-related concerns.

CISA will continue to work with our partners in the critical infrastructure community to
update this advisory list if necessary as the Nation’s response to COVID-19 evolves.
Should you have questions about this list, please contact CISA at CISA.CAT@cisa.dhs.gov.

Download as a PDF

AAA Membership Town Hall with Senator Bill Cassidy

Members-Only Exclusive Town Hall
Thursday, May 21, 2020 | 9:30am EST

Join U.S. Senator Bill Cassidy, MD (R-LA) for an exclusive members-only Virtual Town Hall Meeting on health care and COVID-19. Senator Cassidy will provide his perspective on the critical role of health care providers during the response to COVID-19. He will also offer insight into the direction the Senate is heading with regard to provider relief.

Senator Bill Cassidy, MD (R-LA)

Dr. Bill Cassidy is the senior United States Senator for Louisiana.

Bill grew up in Baton Rouge, Louisiana, and attended Louisiana State University (LSU) for undergraduate and medical school. In 1990, Bill joined LSU Medical School teaching medical students and residents at Earl K. Long Hospital, a hospital for the uninsured.
During this time, he co-founded the Greater Baton Rouge Community Clinic, a clinic providing free dental and health care to the working uninsured. Bill also created a private-public partnership to vaccinate 36,000 greater Baton Rouge area children against Hepatitis B at no cost to the schools or parents. In the wake of Hurricane Katrina, Bill led a group of health care volunteers to convert an abandoned K-Mart building into an emergency health care facility, providing basic health care to hurricane evacuees.
In 2006, Bill was elected to the Louisiana State Senate.
In 2008, he was elected to the United States House of Representatives to represent Louisiana’s Sixth Congressional District.
In 2014, he was elected to the U.S. Senate. He serves on the Finance Committee, the Health, Education, Labor, & Pensions Committee, the Energy and Natural Resources Committee, and the Veterans Affairs committees.
Bill is married to Dr. Laura Cassidy and they have three children. Laura is a retired general surgeon specializing in breast cancer. She helped found a public charter school to teach children with dyslexia. Bill, Laura, and their family attend church at the Chapel on the Campus.

Presidential Proclamation on EMS Week 2020

President Donald J. Trump released the  Proclamation below honoring mobile healthcare during EMS Week, May 17–23, 2020.

During Emergency Medical Services Week, we honor all of the Emergency Medical Services (EMS) providers who play such a critical role in our Nation’s health and safety.  These incredible professionals respond to daily calls for urgent assistance and work tirelessly to serve their communities.  Most recently, they have made significant contributions and immeasurable sacrifices during our Nation’s response to the coronavirus pandemic, one of the most daunting and demanding challenges the country has ever faced.  This week, we recognize these heroic men and women for their efforts to deliver life‑saving care and compassion to their fellow Americans, and we acknowledge that our country is a safer and healthier place because of their work.

EMS providers — many of whom are volunteers — make up a coordinated and comprehensive network of highly trained workers.  They are prepared to respond immediately to any crisis with pre‑hospital assessment, trauma care, and medical transport, and they also share valuable data with their public health partners.  They do all of this under incredible pressure that can take an emotional and physical toll on even the most seasoned professionals.  At a moment’s notice, these dedicated men and women rush to employ their specialized knowledge, experience, and leadership to reduce the severity of injuries and save lives, often in very high-risk situations.  Every day, EMS personnel stand ready to help those in peril, responding faithfully to the needs of their fellow citizens when lives are on the line and every second matters.

The far-reaching and devastating scope of the coronavirus pandemic has increased the demands on our Nation’s EMS professionals, including those from our military service branches.  These heroes have courageously risen to the challenge.  They remain undeterred in their efforts to deliver critical assistance to their fellow Americans.  EMS personnel are often the first point of contact with patients who are experiencing coronavirus symptoms.  Acting quickly and decisively, they evaluate and triage patients, transport them to hospitals or treatment facilities, and clearly and compassionately communicate with family members who are anxious about their loved ones.  During this unprecedented time in our Nation’s history, we are ceaselessly inspired by the sense of duty, selfless service, and sacrifice that epitomize EMS personnel.

This week, we honor all who provide emergency medical services across our country for their tenacity and life‑saving skills.  Thanks to their incredible efforts, our communities and our Nation are stronger, safer, and more resilient.  Especially in these trying times, we are immensely proud of these brave Americans.

NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 17 through May 23, 2020, as Emergency Medical Services Week.  I encourage all Americans to observe this occasion by showing their support for local EMS professionals through appropriate programs, ceremonies, and activities.

IN WITNESS WHEREOF, I have hereunto set my hand this fifteenth day of May, in the year of our Lord two thousand twenty, and of the Independence of the United States of America the two hundred and forty-fourth.

DONALD J. TRUMP

2020 National EMS Moment of Silence Announcement

The National EMS Memorial Bike Ride (NEMSMBR), the National EMS Memorial Foundation (NEMSMF), and the National EMS Memorial Service (NEMSMS) announce the 2020 National EMS Moment of Silence and ask for broad participation.

The National EMS Moment of Silence will be observed on Saturday, May 16, 2020. It will begin at 1800 (6:00 PM) Eastern Daylight Time with a live-streamed reading of the names of the 24 Honorees originally planned for the 2020 Service, followed by an acknowledgement of those continuing to serve today and will culminate in a national moment of silence in a salute to all.

Read more►

Webinar | EMS and COVID-19 Testing

EMS Focus webinar on Tuesday, May 12, at 3 p.m. ET/12 p.m. PT will feature local EMS medical directors and Federal officials discussing COVID-19 testing and implications for EMS organizations and clinicians

EMS and COVID-19 Testing

Tuesday, May 12, 2020
3:00 PM ET / 12:00 AM PT

As we continue to learn more about the novel coronavirus and COVID-19, we’re also learning more about COVID-19 testing: Who should get tested, and when? How accurate are the tests? In this webinar, hosted be NHTSA’s Office of EMS, you’ll learn:

  • The local experience of some of the first EMS systems to have personnel quarantined and test positive for COVID-19
  • The latest guidance on testing of first responders and other healthcare personnel
  • What the result of a COVID-19 test or antibody test really means for individuals and EMS organizations

Register Now

Three panelists deeply involved in the EMS and public health response to COVID-19 will share their expertise:

Jonathan Jui, MD, MPH, FACEP, is EMS medical director for Multnomah County, Oregon, including the City of Portland and the county 911 center. He is also a member of the Oregon 2 Disaster Medical Assistance Team and a professor of emergency medicine at Oregon Health & Science University. Dr. Jui is board certified in emergency medicine, internal medicine, EMS, and infectious disease.

Michael Sayre, MD, is medical director for the Seattle Fire Department and the Seattle Medic One program and an emergency physician at Harborview Medical Center. He is a professor of emergency medicine at the University of Washington, where he also serves as the medical director for the Michael K. Copass Paramedic Training Program and leads the EMS Medicine Fellowship program.

S. Michele Owen, PhD, is associate director for laboratory science at the US Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB prevention. She is also currently serving as Co-Lead for the COVID-19 Laboratory Task Force in the CDC Incident Management Structure.

The webinar will be moderated by Jon Krohmer, MD, FACEP, FAEMS, director of the NHTSA Office of EMS and co-chair of the EMS/Pre-hospital Team within the FEMA Healthcare Resilience Task, which is leading the development of a comprehensive strategy for the US healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19.

Note: This live webinar will be limited to the first 3000 people to login using the link provided. Attendees will be encouraged to submit questions during any point of the discussion. The webinar and Q&A will last approximately one hour. A recording of the webinar will be shared as soon as it is available.

Webinar | Emergency Department: Patient Care and Clinical Operations

Our partners at HHS Office of the Assistant Secretary for Preparedness and Response are hosting a COVID-19 Clinical Rounds webinar this week. See below for more information and links to register. And be sure to access the latest COVID-19 information for EMS at the updated COVID-19 Resources for EMS.

Emergency Department: Patient Care and Clinical Operations

Thursday, May 7, 2020
12:00 PM EDT / 9:00 AM PDT

Webinar Agenda:

Welcome and Introductions
Richard C. Hunt, MD, FACEP, HHS/ASPR National Healthcare Preparedness Programs

Patient Care and Operations
James E. Black, MD, Medical Director for Emergency Services for Phoebe Putney Health Systems

Additional Speakers – TBD

Q & A and Discussion

Register Now

Webinar Today | COVID-19 Financial Resources for Governmental Providers Webinar

COVID-19 Financial Resources for Governmental Providers
Monday, May 4, 2020 | 2:00pm EST
FREE for AAA-Members | $150 for Non-Members

Ambulance districts, PUMs, fire departments, and other governmental provider types are invited to join Brian Werfel, Esq and Scott Moore, Esq for an overview of FEMA and Stimulus funding opportunities specific to them!

WEBINAR: EMS Patient Care and Operations | Monday, May 4

NHTSA Office of EMS Director Jon Krohmer, MD, will be moderating the next COVID-19 Clinical Rounds: EMS webinar, co-hosted by our partners at the HHS Office of the Assistant Secretary for Preparedness and Response. See below for more information and links to register. And be sure to access the latest COVID-19 information for EMS at the updated COVID-19 Resources for EMS.

EMS: Patient Care and Clinical Operations

Monday, May 4, 2020
12:00 PM EDT / 9:00 AM PDT

Webinar Agenda

Welcome and Introductions
Jon R. Krohmer, MD, FACEP, FAEMS, Director, Office of EMS, National Highway Traffic Safety Administration

Patient Care and Operations
David Gerstner, EMT-P, Regional MMRS Coordinator, West Central Ohio, Dayton Fire Department & Wright State University Boonshoft School of Medicine

Carol A. Cunningham, MD, FAAEM, FAEMS, State Medical Director, Ohio Department of Public Safety, Division of EMS

Q & A and Discussion

Register Now

EMS Education Pipeline

Read as a PDF
National Highway Traffic Safety Administration (NHTSA) staff prepared this summary document on the
status of the Emergency Medical Services (EMS) education pipeline during a series of recent conference
calls with EMS stakeholder organizations. Included is a list of national, state, and local considerations
for EMS stakeholders. These considerations do not necessarily reflect official policy positions of the
organizations that participated during the conference calls. This document is intended to serve as an
informational resource for EMS stakeholders. This summary does not establish legal requirements or
obligations, and its content does not necessarily reflect agency recommendations or policy.

Contributors to its content included representatives from the National Registry of Emergency Medical
Technicians (NREMT), the National Association of EMS Educators (NAEMSE), the Committee on
Accreditation for the EMS Professions (CoAEMSP), the Commission on Accreditation for Pre-Hospital
Continuing Education, the National Association of State EMS Officials, the International Association of
Fire Chiefs, the American Ambulance Association, the National Association of Emergency Medical
Technicians, the American College of Surgeons, and the Interstate Commission for EMS Personnel
Practice.

Challenges Facing EMS Education
Nationwide social distancing measures have led to closures, delays, and other impacts on the national
EMS education system. National, State, and local EMS organizations are collaborating to address these
challenges, but prolonged delays are likely in the education, certification, and licensing of tens of
thousands of entry-level EMS clinicians.

EMS Education Programs Closed
Community colleges, universities, fire academies, and other programs that provide EMS education
throughout the country closed in response to social distancing measures. Many of these institutions
created distance learning programs to help current students complete their didactic education.
However, not every EMS education program has the resources to support online or distance learning
alternatives.

To assist EMS education programs, NAEMSE has led a webinar series on transitioning to the online
classroom2 and is collaborating with NREMT to develop best practices for distance education.
EMS students must also complete in-hospital and pre-hospital clinical rotations to graduate.
Unfortunately, most clinical and field internship sites remain closed to students based on a combination
of factors, such as government restrictions and recommendations on traveling and social distancing, lack
of personal protective equipment (PPE) for students, or the decision of the clinical site to restrict
student access.

CoAEMSP acknowledged the need for its 706 accredited paramedic education programs to modify
current graduation requirements.

On April 5th, 2020, the CoAEMSP Board of Directors issued a
statement regarding Coronavirus Disease 2019 (COVID-19) to clarify that Paramedic educational programs may employ a broad array of approaches, including simulation, in determining competency in
didactic, laboratory, clinical, field experience, and capstone field internship.
Another option suggested by stakeholders for increasing the number of competent, entry-level EMS
clinicians to enter the workforce with advanced life support (ALS) skills may be allowing paramedic
students to graduate early and be tested as Advanced EMTs (AEMTs).

Testing and Certification Delayed
NREMT is the national certification agency for EMS clinicians. NREMT testing and certification (after
completion of approved education) is a requirement for EMS clinician licensure in most States. NREMT’s
cognitive (computer-based written) exam is administered by Pearson VUE. On March 17, 2020, Pearson
VUE closed most of its nearly 700 testing centers nationwide. Over the subsequent weeks,
approximately 450 of Pearson VUE’s testing centers have re-opened at reduced capacity, with more
projected to open in the future. Many testing sites remain closed under State government orders that
closed State colleges and universities. Allowing sites to remain open for the sole purpose of testing EMS
and other healthcare professionals would help alleviate the lack of testing capacity. Open testing centers
are operating at approximately 50% capacity due to social distancing measures.

NREMT is temporarily not requiring the psychomotor (hands-on skills) examination due to social
distancing guidelines. It is offering a provisional certification that requires only the successful completion of
the EMS education course and the cognitive exam. NREMT has accelerated plans for remote proctoring
of the cognitive exam, which will be available for the AEMT examination and the EMT examination in
May 2020. These emergency measures will help to continue certifying new EMS professionals.

Historically, the NREMT tests over 60,000 EMS clinicians in the spring season. NREMT projects that a
significantly lower number of EMS clinicians will be tested this year due to the cancellation of EMS
education courses. Consequently, local EMS agencies will face a severe workforce supply shortage
within the next three months.

Recertification Deadlines Extended
NREMT has approved a 90-day extension on EMS certifications that were due to expire on March 31,
2020, and waived continuing education requirements for face-to-face instruction. States are beginning
to modify relicensing requirements in line with NREMT’s actions.

Specialty certification courses (such as Cardio Pulmonary Resuscitation, Pediatric Advanced Life Support,
Pre-Hospital Trauma Life Support, Advanced Cardiac Life Support, etc.) are often required as part of EMS
education, certification, licensure, or affiliation. Many specialty certification course providers have
created online courses for didactic materials, and either waived hands-on skills requirements or
provided guidance on safely facilitating in-person instruction. Most have also extended or waived
current expiration dates.

Licensure Modifications Underway
State EMS offices license EMS clinicians, regulate local EMS agencies, and support EMS system
development. Many State EMS staff are currently deployed to state operations centers supporting the
COVID-19 response, including guiding statewide efforts to support crisis standards of care (CSC) planning
for EMS. Multiple States have temporarily waived or modified licensure policies to streamline licensure.

Emergency Medical Service (EMS) Education Pipeline
Twenty States are accepting NREMT provisional certification as a condition of licensure; however, some
States4 have reported that their laws and rules prohibit issuing licenses to holders of the NREMT
provisional certification.

A few states require fingerprinting and a criminal background check as a condition for licensure;
however, social distancing measures and public building closures have made fingerprinting services
largely unavailable. Some States5 are offering provisional licensure that defers a criminal background
check until the public health emergency ends. Employers cannot assume a provisional licensee had a
background check and may now need to do this as part of their hiring process. States are also
reactivating expired licenses within specified time frames.

Twenty States are members of the Interstate EMS Licensure Compact (Compact), which was formally
activated in response to COVID-19. The Compact will enable interstate recognition of EMS clinician
licensure between member States. However, the Compact does not address practice by EMS clinicians in
non-traditional settings, such as hospitals. Many States6 grant physicians authority to delegate certain
aspects of medical practice, which may give hospitals flexibility to use EMS personnel in an expanded
clinical role.

Service Impact
In the United States, more than 18,200 EMS agencies, staffed by a total licensed workforce of more than
1.03 million EMS clinicians, provide ubiquitous 24/7 coverage of the entire Nation. In 2019, these EMS
agencies responded to more than 28.5 million 911 dispatches.

Stakeholders have reported an average 30 percent decline in EMS transports in areas not yet severely
impacted by the public health emergency, which they attribute to less public willingness to be
transported to hospitals. This decline in EMS transports has led to a decline in insurance reimbursement
revenue9 accompanied by an anticipated decline in State and local tax revenue. As a result, EMS
stakeholders have reported widespread hiring freezes and potential future furloughs and layoffs.
Despite the need for 24/7 service, stakeholders anticipate that the inability to hire, coupled with
workforce supply shortages (attributed to the shutdown of EMS education programs), will lead to
prolonged EMS staffing shortfalls. In some cases, these staffing shortfalls may take effect as COVID-19
peaks locally resulting in potentially insufficient staffing to respond to an expected surge of EMS calls.
As components of the workforce pipeline partially resume operations, employers will face additional
challenges, such as delays in fingerprint-based background checks and remedial education and testing
for provisionally certified and licensed EMS personnel.

The long-term impact of system accommodations (e.g., deferred background checks, proctored exams,
provisional certification and licensing) is unknown. In addition, there is also growing concern that the
pandemic may increase EMS workforce turnover.
State and Local Considerations for EMS Stakeholders
Based on the issues and challenges discussed above, stakeholders may consider the following
measures at the State and local levels:
1. Enable EMS clinicians with a NREMT provisional certification to pursue provisional State
licensure.
2. Enable EMS clinicians with expired licenses to pursue provisional State licensure.
3. Prioritize the reopening of EMS clinical skills labs when reopening educational institutions.
4. Encourage EMS education programs to provide distance learning resources to all students. Front-load didactic education for EMS students until clinical skills labs, clinical internships, and field
internships can resume.
5. Enable States, colleges, and educational programs to allow modified approaches to clinical skills
labs, clinical internships, and field internships, when they can be conducted safely.
6. Encourage the sharing of best practices by State and local authorities.
7. Encourage collaboration between educational programs to develop online education
capabilities.
8. Permit public and private education testing centers to administer the NREMT examination
within local jurisdictions, while following strict social distancing protocols.
9. Explore the ability to verify course completion and/or testing paramedic students at the AEMTlevel,
provided the state has approved an AEMT course.

National Considerations for EMS Stakeholders
In addition, stakeholders may consider the following measures at the national level to the extent
permitted by applicable law:
1. Permit fingerprinting centers to open to support criminal background checks for EMS clinicians
as a condition of licensure or employment. Explore other innovative solutions for conducting
criminal background checks.
2. Continue convening national EMS organizations to facilitate collaborative and innovative
problem-solving. Engage additional stakeholders, such as the Accreditation Council for Graduate
Medical Education, to coordinate healthcare education efforts.
3. Consider, as essential critical infrastructure workers, those workers involved in the certification,
licensing, and credentialing of EMS personnel and other healthcare workers.
4. Consider, as essential critical infrastructure workers, those workers supporting public and
private education testing centers for EMS personnel and other healthcare workers.
5. Share EMS educational best practices nationally.
6. Support technology for EMS education programs to conduct remote training, high-fidelity
simulation and other tools for effective training while also supporting social distancing.

Watch now: HHS Funding For EMS

HHS Funding For EMS: What You Need to Know & How to Calculate Net Patient Revenue

Join Asbel Montes, Brian Werfel, Steve Wirth as they discuss how to register, apply, and calculate net patient revenue correctly to maximize the amount of revenue you can receive from the second allocation of general funds. Panelists will also review the process of submitting claims for uninsured patients which begins on May 6th.

Hear straight from the experts on the dos and don’ts of revenue calculation, reporting periods, definition of terms and strategies to overcome the challenge of providing data from 2018 in a way that meets the criteria of CMS.

This webinar is a must for all ambulance service providers as they navigate the sometimes complex, oftentimes confusing avenues of relief offered through the Cares Act. Download the slides for the presentation HERE

EMS Week Featured Service Application

EMS Week will take place from May 17–23, 2020.  To celebrate the extraordinary contributions of ambulance services to the communities they serve, we will be featuring specific services throughout EMS week on AAA’s website and social media.

If you would like to apply to have your service featured, please complete and submit all fields below by May 7. Thank you for your service to your community!

 

 

 

2020 Medicare Reference Manual & Medicare Update Webinar

The 2020 Medicare Reference Manual and the 2020 Medicare Update Webinar are both available for purchase. Please see details below!

2020 Medicare Update Webinar

Thursday, April 30, 2020 | 2:00pm EST
Presenter: Brian Werfel, Esq.
$99 for AAA-Members | $198 for Non-Members

Join A.A.A. Medicare Consultant Brian S. Werfel, Esq. for an update on recent changes to Medicare’s coverage of ambulance services. This webinar coincides with the American Ambulance Association’s release of its 2020 Medicare Reference Manual. Brian will discuss recent changes in Medicare policy, including changes to the rules governing the enforcement of fraud and abuse, the appeals process, etc. We will also discuss Medicare’s proposed plan for the ET3 Program, the national expansion of the prior authorization model for scheduled non-emergency transports, and much more.

Of course, we will also discuss Medicare’s coverage of ambulance services during the current COVID-19 process. This will include a frank discussion of the issues related to medical necessity for the transportation of known or suspected COVID-19 patients, the coverage of transports to field hospitals and other alternative destinations, the current status of certain administrative rules like the Medicare patient signature requirement and the Notice of Privacy Practices, etc.

The session will include an extended Q&A period to address any and all questions from attendees. Purchase Webinar► 

*2020 Medicare Reference Manual Sold Separately* 

 

2020 Medicare Reference Manual 

$200 for AAA-Members | $400 for Non-Members
By David Werfel, Esq & Brian Werfel, Esq

The American Ambulance Association’s 2020 Medicare Reference Manual is a must-have for ambulance services that bill Medicare for transports.

Webinar | Living Room Leadership

Living Room Leadership – Addressing Telework, IT, Compliance and Security Issues in a Remote Office Environment

Wednesday, April 17, 2020 | 1:00 pm Eastern Time
Presented by:  Katie Arens, Scott Moore, Esq., and Frank Gresh

During the ongoing COVID-19 pandemic, EMS providers have been forced to adopt new strategies for working while social distancing, though this has raised new challenges. Join Director of Customer Accounts & Mobile Health Solutions at LIFE EMS Katie Arens, EMS workforce consultant Scott Moore, and Chief Technology Officer at EMSA Frank Gresh as they discuss the challenges and solutions to the new normal of working from home. Learn best practices for IT support and maintenance, compliance, cybersecurity, and other challenges facing the at-home workforce.

Webinar April 15 | Tax Day…Not! Tax Implications from the Stimulus Packages

Tax Day…Not! Tax Implications from the Stimulus Packages for your Personal and Business Tax Filings

Wednesday, April 15, 2020 | 1:00pm Eastern Time
Watch on Demand 
Presented by:  Peter K Scott, Esq.

Join former Deputy Chief Counsel to the IRS Commissioner, Peter Scott Esq. for an informative presentation on COVID 19 tax and business relief provisions. Learn from one of the leading experts in tax law the best ways to navigate the complex IRS codes and sometimes contradictory statutes. If you are trying to discern from a TAX perspective which of the loan and grant programs are best for tax purposes, you won’t want to miss this webinar from a true tax expert.

Watch On-Demand

Webinar April 10 | Navigating the COVID-19 Stimulus Loans and Grant Programs

Navigating the COVID-19 Stimulus Loans and Grant Programs

Friday, April 10, 2020 | 1:00pm Eastern Time
Watch On-Demand Below!
Presented by:  Scott Moore, Esq. and Asbel Montes

The last few weeks have pushed field providers and EMS organizations to their limits, testing their ability to prepare and respond to this unprecedented pandemic. In response, Congress has provided the first in many relief measures under the CARES Act in an effort to ensure that EMS agencies can continue to answer the calls for help. This webinar is intended to provide an overview of the financial relief that is available to EMS organizations, including loans and grant monies and will provide attendees with the advantages and disadvantages of each, as well as, the strategies and best practices for accessing funds under the FEMA or HHS grant programs. In addition, we will discuss how to best prepare your organization to apply for the various financial relief options, as well as, help you institute the appropriate cost tracking mechanisms to ensure that you are prepared for any subsequent financial relief compliance review from the granting authority.

Presenters

Asbel Montes
Senior Vice President of Strategic Initiatives and Innovation, Acadian Ambulance Service

 

Asbel has been a member of the American Ambulance Association (AAA) for eight years and has served on its Board of Directors; he currently is Chair of the Payment Reform Steering Committee. Asbel also sits on the board of the Louisiana Ambulance Alliance. He is a respected thought leader on reimbursement initiatives within the industry and is a requested speaker at many conferences. He has also been asked to testify as an expert witness before federal and state health committees regarding ambulance reimbursement.

Asbel began his employment with Acadian in May 2009. He oversees Acadian’s revenue cycle management, contract management, business office process improvements, and government relations for state and federal reimbursement policy initiatives.

In 1999, Asbel began working for an ambulance billing and consulting firm. After three years, he decided to work for a private, non‐emergency ambulance service. Since then, he has provided leadership in revenue cycle management to four ambulance agencies located throughout the Southeast.

Asbel pursued his education the non‐traditional way by attending college online while maintaining a fulltime job. He received an associate’s degree in accounting in 2007 and graduated in November 2010 with a bachelor’s degree in business management.

Asbel is married to Stephenie Haney‐Montes. He has one daughter and resides in Carencro, LA.

Scott Moore, Esq.
AAA Human Resource and Operations Consultant; Moore EMS Consulting, LLC

 

Scott A. Moore, Esq. has been in the emergency medical services field for more than 28 years. Scott has held various executive positions at several ambulance services in Massachusetts. Scott is a licensed attorney, specializing in Human Resource, employment and labor law, employee benefits, and corporate compliance matters. Scott has a certification as a Professional in Human Resources (PHR) and was the Co-Chair of the Education Committee for the American Ambulance Association (AAA) for several years.

In addition, Scott is a Site Reviewer for the Commission on the Accreditation of Ambulance Services (CAAS). Scott earned his Bachelor’s Degree in Psychology from Salem State College and his Juris Doctor from Suffolk University Law School. Scott maintains his EMT and still works actively in the field as a call-firefighter/EMT in his hometown. Scott is a member of the American Bar Association, the Massachusetts Bar Association, the Society for Human Resource Management, and the Northeast Human Resource Association.

Webinar Materials & FAQ: Claims Guidance for COVID-19

Webinar: How to Best Document and Track Claims Related to COVID-19

Recorded: Thursday, March 26th | 12:00pm Eastern
View On-Demand Recording
View PPT Slides

FAQ of unanswered webinar questions:

  1. Is the idea that the ET3 model will be pushed to all ambulance companies or only previously selected participants?

The request into CMS and leadership during the declared public health emergency is to allow all ambulance providers and suppliers to transport patients or treat in place based upon the concepts outlined in the Emergency Triage, Treatment and Transport model as defined by CMMI’s release last year.

  1. While we wait for finalization of the ET3 protocols, will billing be allowed retroactively?

If CMS follows other waiver provisions that they have been approving, then we would expect the waiver to be retroactive. However, that will be clearly identified when and if the final waiver is approved.

  1. Asbel spoke about Telehealth medical necessity, which we assume applies to the QHP.  Neither CMS nor the MAC has provided any guidance regarding MN guidance for the ambulance that is facilitating the telehealth.  CMS ET3 FAQ provides a non-answer. Can you advise?

You will need to understand the nuances around telehealth and what Medicare requires as a covered benefit for telehealth. Please see attached resources below

  1. Do we need to file an application for TIP?

That is unclear at this time. The AAA has been advocating for national policy that would not include an application process during this public health emergency. If CMS accepts our proposal, then we do not expect an application process.

  1. Will Medicare pay for signs and symptoms such as a cough that is not on our LCD list?

The Centers for Disease Control and Prevention (CDC) has established new codes related to COVID-19.  They are available in this link:  https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

  1. How can we bill for lift assists and basically public assist? For example, we are seeing increased med alarm pulls because in some of the senior assisted living or independent with aide service, the aide staff is not showing up or is late.  We are getting 911 calls for help getting dressed, move me from my chair to bed at night, etc. (We have one building with many PACE participants, so many Medicare primary)

Yes, you can bill for any response. I am assuming you are looking to understand who the payer source will be for those responses. Currently, Medicare does not pay for an ambulance response without a subsequent medically necessary transport to a covered destination.

The lift assist and public assist responses may be billed to whoever the caller source is if there is no state or local law that prohibits this practice.

Suggestion: You could work with your state legislature or local governing body to codify in statute or local ordinance the responsibility for these false alarms, or public assists are the responsibility of the requestor and invoke penalties if not paid. There are many local jurisdictions that codify this in law with prescribed penalties to try and deter this abuse.

  1. How does this impact the patients who typically are transported by sedan cars or gurney vans to dialysis, but now are confirmed COVID-19 or suspected and still need to be transported to Dialysis? Gurney Van or Sedan cars don’t have the isolation precautions to transfer those patients. Can those patients now be transported by BLS Non-Emergency ambulance?

Medicare has not changed its requirements for transporting beneficiaries to/from dialysis facilities.  We understand that some MACs recognize as a primary reason for ambulance transport patients who have a communicable disease or hazardous material exposure and must be isolated from the public or whose medical condition must be protected from public exposure.  Some MACs do not view this condition as a primary reason to transport a patient, however.  The AAA is seeking clarification from CMS to try to align MACs around the view that patients who require isolation because of a communicable disease or hazardous material exposure can be transported by ground ambulances.

  1. There is already an “I” origin/destination modifier for the site of transfer between modes of ambulances. Wouldn’t this new “I” confuse things?

Great question. Yes. We will wait and see final direction from CMS if they approved transport to a COVID-19 testing site.

  1. Does the use of the “I” modifier include a site such as a shelter that might be set up for COVID-19 patients? Specifically I am referring to a site that maybe the state or local authority has set up and is not directly tied to a hospital.

Yes, that is the waiver that we are seeking from CMS. They could recommend a different modifier. It should be noted that States do have the authority to request a waiver to allow for this, as well. You do not have to wait on the CMS.

  1. The ICD 10 codes related to COVID19 are not effective until April 1st. Once effective, can they be used on a run that occurred before that date?

On February 20, 2020, the Centers for Disease Control and Prevention issued guidance on the ICD-10 codes that should be used. You can find this guidance at the following site:

https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

  1. Is there anything on the end user if ambulance personnel need to document differently for billing purposes?

Best practices would be to provide instruction or edits within your PCR that identifies the following: (1) COVID-19 suspected or positive patient; (2) PPE equipment used (not just a general statement); and (3) any other pertinent information related to the inability to sign any forms due to local or state mandates.

Due to circumstances surrounding this national emergency that we have not experienced before, things are constantly changing. Documentation will be the CRITICAL in helping to obtain additional federal, state and local waivers. Accurate and reliable documentation will be key in building the case retrospectively.

  1. Have there been any signature requirement changes due to COVID 19?

CMS has provided the following guidance:

“At this time, suppliers should do their best to obtain proof of delivery and should notate the file that the beneficiary declined to sign.  Where FedEx or similar delivery services have altered their delivery protocols (such as leaving packages at the home without signatures) due to the COVID-19 pandemic, CMS will consider the revised protocols if conducting review absent suspicion of deliberate gaming or attempted fraud.  Suppliers should continue providing the necessary supplies and document the proof of delivery to the best of their ability (such as a picture of the delivery and/or notation in the file). “

  1. Do any of the waivers apply to the patient signature requirement? Are there links or support for how to learn about 1135? How do we know what our state has done regarding 1135 waiver? How do we work with our state to expand services via 1135 waiver?

The link below is a great tutorial on how 1135 waivers work and tracking existing waivers.

https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/

The health agency in your state would be your POC to engage regarding ambulance requests for expanded services via the 1135 waiver.

  1. Is there a specific documentation on the HCFA form’s for using the 1135 waiver?

Each payer is issuing specific claims guidance on how to bill for waived services through the 1135. You will need to check with your state Department of Insurance or Medicaid Agency. They should have resources online to assist you with identifying what specific documentation is needed.

  1. Has there been any discussion in the delay of Data Collection?

No.  At this point the program remains underway.  The first set of services required to submit were notified at the end of 2019.  CMS continues to develop the tool it will use to collect the data, which we expect to see later this summer or early fall.  However, if the pandemic continues, we will engage with CMS to determine how they view data collection.

If you have an additional questions, please email the AAA at info@ambulance.org

Presenters:

Asbel Montes
Senior Vice President of Strategic Initiatives and Innovation, Acadian Ambulance Service

Asbel has been a member of the American Ambulance Association (AAA) for eight years and has served on its Board of Directors; he currently is Chair of the Payment Reform Steering Committee. Asbel also sits on the board of the Louisiana Ambulance Alliance. He is a respected thought leader on reimbursement initiatives within the industry and is a requested speaker at many conferences. He has also been asked to testify as an expert witness before federal and state health committees regarding ambulance reimbursement.

Asbel began his employment with Acadian in May 2009. He oversees Acadian’s revenue cycle management, contract management, business office process improvements, and government relations for state and federal reimbursement policy initiatives.

In 1999, Asbel began working for an ambulance billing and consulting firm. After three years, he decided to work for a private, non‐emergency ambulance service. Since then, he has provided leadership in revenue cycle management to four ambulance agencies located throughout the Southeast.

Asbel pursued his education the non‐traditional way by attending college online while maintaining a fulltime job. He received an associate’s degree in accounting in 2007 and graduated in November 2010 with a bachelor’s degree in business management.

Asbel is married to Stephenie Haney‐Montes. He has one daughter and resides in Carencro, LA.

Kathy Lester, Esq.
Principal, Lester Health Law

Kathleen Lester provides legal and strategic advice on legislative and regulatory matters involving Medicare and Medicaid coverage and reimbursement, quality measurement (including valuebased purchasing programs), federal health care funding, health information technology, and medical and Internet privacy — including the Health Insurance Portability and Accountability Act (HIPAA) regulations, other federal and state privacy laws.

Ms. Lester practices at the intersection of health care law and public policy. She focuses her practice on finding solutions to her clients’ problems by assisting them with compliance programs and by seeking legislative or regulatory modifications. She has worked with health care providers and suppliers to modernize their payment structures within the Medicare program. She also assists non-profit organizations navigate the complex maze of federal funding and the authorization process for public health programs. She has worked with manufacturers to ensure coverage and appropriate reimbursement. She helps clients identify and resolve issues that arise from creating, collecting, maintaining, using, and disclosing personal health information. She has been deeply involved in measure development, as well as the creation and implementation of value-based purchasing programs in the Medicare program.

Ms. Lester has served a wide variety of health care providers, including physicians, dialysis facilities, hospitals, long-term care providers, home respiratory suppliers, pharmaceutical manufacturers, device companies, and patient organizations. She also has assisted with the formation and growth of industry-wide coalitions. Ms. Lester has experience in all three branches of the federal government.

Ms. Lester served as a privacy consultant in the Office of General Counsel to the U.S. Department of Health and Human Services (HHS), where she finalized the HIPAA Privacy Rule. Ms. Lester also served as law clerk to the Honorable Michael S. Kanne, Circuit Judge, U.S. Court of Appeals for the 7th Circuit and worked for Senator Richard G. Lugar (R-IN). Prior to opening her own firm, Ms. Lester was a partner in the health care group at Patton Boggs LLP.

During her time at Johns Hopkins, Ms. Lester served on a number of research and review boards, including the Human Genome Project’s Ethical, Legal, and Social Issues Working Group. She has an undergraduate degree in biology with an emphasis on microbiology and genetic research.

Ms. Lester received her J.D. from Georgetown University (cum laude), her M.P.H. from The Johns Hopkins School of Hygiene and Public Health, and her B.A. from DePauw University (magna cum laude). She is a member of the District of Columbia, Indiana, and Maryland bars and is admitted to the U.S. Court of Appeals for the 7th Circuit.

CDC Conference Call: Optimization Strategies for Healthcare Personal Protective Equipment (PPE)

Crisis Standards of Care and COVID-19: What EMS Needs to Know
Webinar from EMS Focus
Wed, Mar 25, 2020, 2:00 PM EDT

Presenters from the Center for Disease Control will provide a COVID-19 update and discuss strategies for healthcare facilities to optimize personal protective equipment (PPE) supplies such as eye protection, isolation gowns, facemasks, and N95 respirators.

Webinar Link:
Click Here

Dial In:
US: +1 669 254 5252
or +1 646 828 7666

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