Treatment In Place in Senate Draft

Ambulance Treatment in Place Bill Included in Senate Draft Budget Reconciliation Package

The draft bill by Senate Democrats on a Budget Reconciliation package includes the language of S. 149 which would waive the transport requirement under Medicare for certain 9-1-1 ground ambulance services during the public health emergency. The Senate is expected to consider the package as soon as tomorrow.

Senators Catherine Cortez Masto (D-NV) and Bill Cassidy, M.D. (R-LA) introduced S. 149 on February 3 which is supported by the AAA, International Association of Fire Chiefs, International Association of Firefighters, National Volunteer Fire Council and National Association of EMTs.

Under S. 149, the Centers for Medicare and Medicaid Services (CMS) would have the authority to waive the requirement that a patient must be transported to a medical facility in order for a ground ambulance service organization responding to a 9-1-1 emergency call to be reimbursed by Medicare when there is a community-wide EMS protocol restricting the transport of the patient.  Ground ambulance service organizations whose paramedics and EMTs are on the frontlines of this pandemic are struggling financially due to the reduction in ambulance transports and higher costs such associated with responding to medical emergencies that cannot be reimbursed because of the transportation requirement. S. 149would greatly help address part of that problem and recognizes the critical role that ground ambulance service organizations are playing in controlling hospital surges and reducing the spread of COVID-19 .”

The House has already passed their version of Budget Reconciliation and would still need to pass a Senate version before sending to the President. S. 149 would provide CMS with the authority and, if passed, the AAA would advocate for the agency to exercise that authority and follow through with the waiver starting at the beginning of the public health emergency.

EMS.gov | Rural EMS training and recruiting grants

From NHTSA’s Office of EMS

DEADLINE REMINDER: Apply now for rural EMS training and recruiting grants
Eligible applicants from rural EMS agencies are encouraged to submit applications before March 18, 2021

EMS organizations planning on applying for a Rural EMS Training Grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment must submit applications by March 18. SAMHSA plans on awarding up to $5.5 million in awards to help eligible agencies recruit and train personnel. More information is available on SAMHSA’s website.

In recognition of the great need for emergency services in rural areas and the critical role EMS personnel serve across the country, SAMHSA plans on funding up to 27 projects, with a maximum of $200,000 per grant awardee. Eligible applicants include rural EMS agencies operated by a local or tribal government (fire-based and non-fire based) and non-profit EMS agencies.

Learn More or Apply Now

JAMA | Ontario | Economic Analysis of MIH Delivered by EMS

From JAMA on February 24, 2021

Economic Analysis of Mobile Integrated Health Care Delivered by Emergency Medical Services Paramedic Teams

Question  Is mobile integrated health care (MIH) delivered by emergency medical services more efficient than regular ambulance responses in addressing the needs of urgent care in the community?

Findings  This economic evaluation compared 1740 calls serviced by MIH in 2018 to 2019 with propensity score–matched ambulance calls for the same period and 2 years prior and found that MIH was associated with a decrease in the proportion of patients transported to the emergency department and saved health care costs compared with regular ambulance responses.

Meaning  These findings suggest that MIH is a promising and viable solution to meeting urgent health care needs while improving the efficiency in using emergency care resources.

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Updated CDC Guidance for Fully Vaccinated Individuals

This past week, the Centers for Disease Control (CDC) updated their guidance related to the COVID-19 vaccination. The guidance modifies the quarantine restrictions for fully vaccinated individuals who were exposed to COVID-19. The guidance is a small sign of progress for many EMS organizations who have been on the frontlines of the pandemic.

Under the most recent guidance, those individuals who are fully vaccinated (defined as those who are two weeks following the second dose administration), are within three months following the last dose in the series and have remained asymptomatic since the current COVID-19 exposure, are not required to quarantine. Individuals who do not meet all three criteria, must follow the current quarantine guidance. The guidance recommends that individuals who meet all three criteria should continue to monitor for COVID-19 related symptoms for two weeks following the exposure. If symptoms develop, individuals should be tested.

Many EMS organizations have inquired if the administration of the COVID-19 vaccination to their workforce modifies the state-level mask mandates or other bloodborne/airborne pathogen protection practices or procedures that are currently in place at EMS organizations or other healthcare facilities.  While the roll-out of the vaccination is a step in the direction of returning to a “new normal”, employers should know that this does not modify any existing COVID-19 related restrictions or requirements.  Employees should continue to wear masks, socially distance, and follow all other COVID-19 recommended safety precautions.

We will keep you informed of updates to the guidance by the CDC and other regulatory agencies.  Be sure to visit the CDC’s website for more information on the current CDC guidance for COVID-19 or the COVID-19 vaccination.  As always, if you have questions or need assistance, contact the AAA at hello@ambulance.org.

Senators Wyden & Cortez Masto Propose Mobile Crisis Response Teams

From Chairman Ron Wyden on February 18

FOR IMMEDIATE RELEASE

Contact: Taylor Harvey   

February 18, 2021

 

WYDEN, CORTEZ MASTO, SENATORS PROPOSE FUNDING TO IMPROVE PUBLIC SAFETY WITH MOBILE CRISIS RESPONSE TEAMS

After Down Payment on the Policy Included in Reconciliation Relief Legislation, CAHOOTS Act Builds on Proven Models to Help Americans with Mental Illness and Enhances Medicaid Funding to States

Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., Senator Catherine Cortez Masto, D-Nev., and six senators today proposed a bill to help states adopt mobile crisis response teams that can be dispatched when a person is experiencing a mental health or substance use disorder (SUD) crisis instead of immediately involving law enforcement. The funding is provided through an enhanced federal match rate for state Medicaid programs.

“I’m proud there is a down payment on CAHOOTS in the emergency relief package moving through Congress now,” Wyden said. “Every day there are stories across the country of Americans in mental distress getting killed or mistreated because they did not receive the emergency mental health services they needed. White Bird Clinic in Eugene, Oregon has been a pioneer for years in this area, and it’s high time the CAHOOTS model is made available to states and local governments across the country. I am eager to get the down payment signed into law and continue working to get further investments in mobile crisis services made under the bill across the finish line.”  

“Individuals experiencing a behavioral health crisis deserve to be treated with compassion and care by health care and social workers,” Cortez Masto said. “These professionals are extensively trained in deescalating situations and addressing mental health crises, and this legislation would help more states across the country fund mobile crisis teams. I’m hopeful that these investments in community-based crisis intervention services will be included in the final version of the current coronavirus relief package, and I’ll continue to advocate for effective, trauma-informed care for those in need.” 

Earlier this month, the House Energy and Commerce Committee included provision in its budget reconciliation language for COVID-19 relief that makes an investment in these services by funding state Medicaid programs at an enhanced 85 percent federal match if they choose to provide qualifying community-based crisis intervention services and funding state planning grants to apply for the option. The pandemic has taken a serious toll on the mental health and wellbeing of Americans with studies showing a four-fold increase in the rates of anxiety and depressive disorders since the beginning of the pandemic.

The bill, the Crisis Assistance Helping Out On The Streets (CAHOOTS) Act, grants states further enhanced federal Medicaid funding for three years to provide community-based mobile crisis services to individuals experiencing a mental health or SUD crisis. It also provides $25 million for planning grants to states and evaluations to help establish or build out mobile crisis programs and evaluate them.

Senators Jeff Merkley, D-Ore., Bob Casey, D-Pa., Tina Smith, D-Minn., Dianne Feinstein, D-Calif., Sheldon Whitehouse, D-R.I., and Bernie Sanders, D-Vt., are co-sponsors of the CAHOOTS Act.

A one page summary of the bill can be found here. Legislative text can be found here.

CMS Ambulance Open Door Forum Feb 25

From CMS on February 18, 2021

February 25 Open Door Forum

Thursday, February 25, 2021 | 14:00 ET

Dial: 1-888-455-1397 & Reference Conference Passcode: 8604468

The next CMS Ambulance Open Door Forum is scheduled for:

Date:  Thursday, February 25, 2021

Start Time:  2:00pm-3:00pm PM Eastern Time (ET);

Please dial-in at least 15 minutes before call start time.

Conference Leaders: Jill Darling, Susanne Seagrave

Agenda

**This Agenda is Subject to Change**

  1. Opening Remarks

Acting Chair- Susanne Seagrave, Acting Director, Division of Data Analysis and Market-Based Pricing (Center for Medicare)

Moderator – Jill Darling (Office of Communications)

  1. Announcements & Updates

III. Open Q&A

**DATE IS SUBJECT TO CHANGE**

Next Ambulance Open Door Forum: TBA

ODF email: AMBULANCEODF@cms.hhs.gov

———————————————————————

This Open Door Forum is open to everyone, but if you are a member of the Press, you may listen in but please refrain from asking questions during the Q & A portion of the call. If you have inquiries, please contact CMS at Press@cms.hhs.gov. Thank you.

Open Door Participation Instructions:

This call will be Conference Call Only.

To participate by phone:

Dial: 1-888-455-1397 & Reference Conference Passcode: 8604468

Persons participating by phone do not need to RSVP. TTY Communications Relay Services are available for the Hearing Impaired.  For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

Instant Replay: 1-866-372-3811; Conference Passcode: No Passcode needed

Instant Replay is an audio recording of this call that can be accessed by dialing 1-866-372-3811 and entering the Conference Passcode beginning 1 hours after the call has ended. The recording is available until February 27, 2021, 11:59PM ET.

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

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

CMS provides free auxiliary aids and services including information in accessible formats. Click here for more information. This will point partners to our CMS.gov version of the “Accessibility & Nondiscrimination notice” page. Thank you.

Senators Cortez Masto and Cassidy Introduce Bill on Ambulance Treatment in Place

Yesterday, Senators Catherine Cortez Masto (D- NV) and Bill Cassidy, MD (R-LA) introduced legislation (S. 149) to allow for Medicare reimbursement under certain circumstances of treatment in place by ground ambulance service organizations during the COVID-19 public health emergency. The AAA applauds the efforts of Senators Cortez Masto and Bill Cassidy as well as the Senate Finance Committee and Leadership.

S. 149 would provide the Centers for Medicare and Medicaid Services (CMS) with the authority to waive the requirement that a patient be transported to a medical facility in order for the ground ambulance service provider or supplier to receive Medicare reimbursement. The waiver would apply to 9-1-1 emergency ambulance services in which the transport did not occur as a result of “community-wide EMS protocols” due to the public health emergency. While the bill would not apply to situations in which a patient declines transport due to COVID-19 exposure concerns as advocated by the AAA, S. 149 is a significant step in the right direction to recognize ground ambulance services not being reimbursed during the pandemic.

The American Ambulance Association (AAA) along with the International Association of Fire Chiefs (IAFC), International Association of Firefighters (IAFF) and National Association of Emergency Medical Technicians (NAEMT) have spearheaded efforts for the Congress to provide CMS with waiver authority for treatment in place. We will be pushing to include the language of S. 149 in the COVID-19 stimulus package currently being negotiated between the White House and the Congress.

For the official statement of the AAA on the introduction of S. 149, please click here.

S.149 Treatment In Place

The American Ambulance Association Urges Immediate Passage of  S. 149 to Allow CMS to Support Local Ground Ambulance Service Responses to the Public Health Emergency

Treatment in Place Supports Patients and Sustains 9-1-1 EMS Providers During the COVID-19 Pandemic

Washington, DC, February 2, 2021 – The American Ambulance Association (AAA), our nation’s voice for ground ambulance service organizations commends Senators Catherine Cortez Masto (D-NV) and Bill Cassidy, M.D. (R-LA) for the introduction of S. 149 and urges its immediate passage. This legislation would remove a statutory barrier that has stopped ground ambulance service organizations from being reimbursed for health care services they provide consistent with local emergency medical service (EMS) protocols.

“S. 149 will empower ground ambulance service organizations to better meet the emergency medical needs of their communities, which are struggling during the pandemic,” stated AAA President Shawn Baird. “I applaud Senators Cortez Masto and Cassidy for their leadership on introducing this vital piece of legislation, as well as the Senate Finance Committee and Leadership for their support of these efforts.”

Under S. 149, the Centers for Medicare and Medicaid Services (CMS) would have the authority to waive the requirement that a patient must be transported to a medical facility in order for a ground ambulance service organization responding to a 9-1-1 emergency call to be reimbursed by Medicare when there is a community-wide EMS protocol restricting the transport of the patient.  “Ground ambulance service organizations whose paramedics and EMTs are on the frontlines of this pandemic are struggling financially due to the reduction in ambulance transports and higher costs such associated with responding to medical emergencies that cannot be reimbursed because of this transportation requirement,” said Baird. “This bill would greatly help address part of that problem and recognizes the critical role that ground ambulance service organizations are playing in controlling hospital surges and reducing the spread of COVID-19 .”

The legislation would benefit patients by reducing their risk of exposure to the virus, which is often the focus of the local protocols requiring them to remain at home. It would also help hospitals experiencing surges during the pandemic by allowing hospital beds to be reserved for higher acuity patients.

The AAA will help push for swift passage of the bill. President Baird called on the Congress to address the legislation as part of negotiations on a new COVID-19 economic relief package. “The American Ambulance Association fully endorses S. 149 and we ask for all members of Congress to help their ground ambulance service organizations, their patients, and the communities they serve by supporting passage of this bill.”

About the American Ambulance Association

The American Ambulance Association safeguards the future of mobile healthcare through advocacy, thought leadership, and education. AAA advances sustainable EMS policy, empowering our members to serve their communities with high-quality on-demand healthcare. For more than 40 years, we have proudly represented those who care for people first. For more information about the AAA visit our website at www.ambulance.org.

E&C Health Subcommittee Announces Hearing on COVID-19

E&C Health Subcommittee Announces Hearing on COVID-19 Vaccines, Testing, and the Medical Supply Chain

Washington, D.C. – Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ) and Health Subcommittee Chairwoman Anna G. Eshoo (D-CA) announced that the Health Subcommittee will hold a fully remote hearing on Wednesday, February 3, at 11 a.m. (EST) on federal COVID-19 response efforts related to vaccines, testing, and medical supply chain. The hearing is entitled, “Road to Recovery: Ramping Up COVID-19 Vaccines, Testing, and Medical Supply Chain.”

“Congress took bipartisan action last year to combat the coronavirus, but it was a down payment on the substantial aid and assistance necessary to crush the pandemic and rebuild our economy,” Pallone and Eshoo said. “The health and well-being of the American people depend on us coming together to execute a comprehensive federal strategy and expand access to vaccines, tests, and critical medical supplies. Next week, we will hear from public health experts about what led to ongoing supply, distribution, and access concerns, what actions are being taken to successfully address those issues, and what more needs to be done as we chart a unified path out of this public health crisis.”

This hearing will be conducted remotely via Cisco Webex video conferencing. Members of the public may view the hearing via live webcast accessible on the Energy and Commerce Committee’s website. Please note the webcast will not be available until the hearing begins.

Information for this hearing, including the Committee Memorandum, witness list, testimony and a live webcast will be posted here as they become available.

US Department of Labor issues stronger workplace guidance on coronavirus

U.S. Department of Labor | January 29, 2021

US Department of Labor issues stronger workplace guidance on coronavirus
New OSHA guidance seeks to mitigate, prevent viral spread in the workplace

WASHINGTON, DC – The U.S. Department of Labor announced today that its Occupational Safety and Health Administration has issued stronger worker safety guidance to help employers and workers implement a coronavirus protection program and better identify risks which could lead to exposure and contraction. Last week, President Biden directed OSHA to release clear guidance for employers to help keep workers safe from COVID-19 exposure.

“Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace” provides updated guidance and recommendations, and outlines existing safety and health standards. OSHA is providing the recommendations to assist employers in providing a safe and healthful workplace.

“More than 400,000 Americans have died from COVID-19 and millions of people are out of work as a result of this crisis. Employers and workers can help our nation fight and overcome this deadly pandemic by committing themselves to making their workplaces as safe as possible,” said Senior Counselor to the Secretary of Labor M. Patricia Smith. “The recommendations in OSHA’s updated guidance will help us defeat the virus, strengthen our economy and bring an end to the staggering human and economic toll that the coronavirus has taken on our nation.”

Implementing a coronavirus protection program is the most effective way to reduce the spread of the virus. The guidance announced today recommends several essential elements in a prevention program:

  • Conduct a hazard assessment.
  • Identify control measures to limit the spread of the virus.
  • Adopt policies for employee absences that don’t punish workers as a way to encourage potentially infected workers to remain home.
  • Ensure that coronavirus policies and procedures are communicated to both English and non-English speaking workers.
  • Implement protections from retaliation for workers who raise coronavirus-related concerns.

“OSHA is updating its guidance to reduce the risk of transmission of the coronavirus and improve worker protections so businesses can operate safely and employees can stay safe and working,” said Principal Deputy Assistant Secretary for Occupational Safety and Health Jim Frederick.

The guidance details key measures for limiting coronavirus’s spread, including ensuring infected or potentially infected people are not in the workplace, implementing and following physical distancing protocols and using surgical masks or cloth face coverings. It also provides guidance on use of personal protective equipment, improving ventilation, good hygiene and routine cleaning.

OSHA will update today’s guidance as developments in science, best practices and standards warrant.

This guidance is not a standard or regulation, and it creates no new legal obligations. It contains recommendations as well as descriptions of existing mandatory safety and health standards. The recommendations are advisory in nature, informational in content and are intended to assist employers in recognizing and abating hazards likely to cause death or serious physical harm as part of their obligation to provide a safe and healthful workplace.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance.

Biden Administration Executive Orders Related to COVID-19

As the Biden Administration unveils their plans for the nation’s response to the COVID-19 pandemic we will continue to update this post with any documents that may be of interest to our membership and industry.

January 28, 2021 | Week 2

U.S. House and Senate Notification

Centers for Medicare & Medicaid Services
Re: HHS Announces Marketplace Special Enrollment Period for COVID-19 Public Health Emergency

 In accordance with the Executive Order issued today by President Biden, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced a Special Enrollment Period (SEP) for individuals and families for Marketplace coverage in response to the COVID-19 Public Health Emergency. This SEP will allow individuals and families in states with Marketplaces served by the HealthCare.gov platform to enroll in 2021 health insurance coverage.

Beginning February 15, 2021 and through May 15, 2021, these Marketplaces will operationalize functionality to make this SEP available to all Marketplace-eligible consumers who are submitting a new application or updating an existing application. State-based Marketplaces (SBMs) operating their own platform have the opportunity to take similar action within their states.  Starting February 15, consumers seeking to take advantage of the new SEP can find out if they are eligible by visiting HealthCare.gov. Consumers can find local help at Localhelp.healthcare.gov or by calling the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325.

To view a press release about this announcement, visit:  https://www.hhs.gov/about/news/2021/01/28/hhs-announces-marketplace-special-enrollment-period-for-covid-19-public-health-emergency.html

To view a fact sheet about this announcement, visit: https://www.cms.gov/newsroom/fact-sheets/2021-special-enrollment-period-response-covid-19-emergency

Memo from AAA lobbyist, Kathy Lester, on why these executive orders are important to AAA members. 

January 20-27, 2021 | Week 1

 

 

CDC | Essential Workers Vaccine Communication Toolkit

CDC has designed a COVID-19 Vaccination Communication Toolkit for Essential Workers to help employers build confidence in this important new vaccine. The toolkit will help employers across various industries educate their workforce about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.

Access Toolkit

The toolkit contains a variety of resources including:

  • key messages,
  • an educational slide deck,
  • FAQs,
  • posters/flyers,
  • newsletter content,
  • a plain language vaccine factsheet (available in several different languages),
  • a template letter for employees,
  • social media content, and
  • vaccination sticker templates.

This toolkit will help your organization educate employees about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.
Access Toolkit

Fierce Healthcare | Agency veteran appointed as acting CMS administrator

From Fierce Healthcare on January 20

Agency veteran Liz Richter has been named the acting administrator of the Centers for Medicare & Medicaid Services (CMS).

The announcement Wednesday comes as President Joe Biden has yet to name a permanent administrator, who will require Senate confirmation.

Richter has served at CMS since 1990 and most recently served as the deputy center director for the Center for Medicare. She has also served as the director of the Hospital and Ambulatory Policy Group in the Center for Medicare Management.

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CMS | Updated Medicare COVID-19 Snapshot

From CMS on January 15

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 1.9 million COVID-19 cases among the Medicare population and over 493,000 COVID-19 hospitalizations.

The updated snapshot covers the period from January 1 to November 21, 2020. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by December 18, 2020.

Read on CMS.gov

CMS | Report Highlights Four Years of Accomplishments In Healthcare

From CMS on January 13

Today, the Centers for Medicare and Medicaid Services (CMS) released “Putting Patients First: The Centers for Medicare & Medicaid Services’ Record of Accomplishment from 2017-2020,” a report highlighting the agency’s transformation in ensuring all Americans have access to quality and affordable healthcare.

The report examines CMS’ accomplishments over the last four years, highlighting agency actions that responded to the coronavirus disease 2019 (COVID-19) pandemic and furthered CMS’s Four Core Goals identified in 2017: empowering patients and doctors, ushering in a new era of state flexibility and local leadership, developing innovative approaches, and improving the CMS customer service experience.

Accomplishments covered in the report include the response to the COVID-19 pandemic and efforts through 16 strategic initiatives that resulted in major regulatory actions, changes in guidance, and streamlined processes and procedures – including the reorganization of CMS. It also allows agency staff and leadership to better understand the impacts of policy decisions, while providing a resource to inform future CMS decisions. The report also covers how progress with respect to the Four Core Goals significantly contributed to the agency’s ability to respond to the unprecedented COVID-19 public health event.

Access “Putting Patients First: The Centers for Medicare & Medicaid Services’ Record of Accomplishment from 2017-2020.” 

Congratulations, Senator Schumer!

Congratulations to Senator Chuck Schumer, who will now serve as Majority Leader.

Congratulations to Senator Chuck Schumer of New York, who will now serve as Majority Leader. Senator Chuck Schumer D-NY'…

Posted by American Ambulance Association on Tuesday, January 12, 2021

OSHA | Submit Data to the Injury Tracking Application

The Occupational Safety and Health Administration (OSHA) announced that it has opened the electronic Injury Tracking Application (ITA), where all employers are required to submit 2020 Injury and Illness Data.  All EMS employers are required to report their yearly Form 300A Summary of Work-Related Injuries & Illnesses.  The Form 300A Summary of Work-Related Injuries & Illnesses is the document that must also be posted in all employer work locations from February 1st through April 30th each year.  For those who have not electronically reported your injury and illness data to OSHA through the Injury Tracking Application (ITA) previously, you will need to establish a user name for your organization in order to electronically report your data.  The deadline for electronically reporting your injury and illness data is March 2, 2021.

We know that this has been an unusually busy work-related illness year for many EMS agencies due to the COVID-19 pandemic.  If you have questions or require assistance to ensure that you accurately report your work-related injury and illness data to OSHA, be sure to contact the AAA and its consultants for assistance.