Part of any successful recruitment and retention strategy is having a competitive compensation and benefits package. This is achieved most successfully by providing employees with a Total Compensation Statement.
A Total Compensation Statement communicates and provides an employee with a picture of the value of an employee’s compensation package, including wages and other costs which are typically shown in an employee’s paystub. However, a Total Compensation Statement shows the hidden costs, many paid by the employer on behalf of the employee, such as employer-paid healthcare, retirement, payroll taxes, and other supplements that employers provide. The purpose is to provide employees with the full picture of compensation and arm them with information about how your organization stacks up against your competitors.
Attached are two samples of Total Compensation Forms that can be used by AAA member companies. The forms offer the ability for our members to personalize by inserting their company logo. These are typically issued on a quarterly, bi-annual, or yearly basis.
Total Compensation and Benefits Statement
The Total Compensation and Benefits Statement is a fillable PDF form that performs the calculations as you enter the different compensation-related items. The costs are shown in two columns, one for the employee wages and other costs, and the other for the often-hidden cost paid by the employer on the employee’s behalf.
Total Compensation Calculation Spreadsheet
The Total Compensation Calculation Spreadsheet is also a fillable PDF form that performs the calculations as you enter the different compensation-related items. There is a column that allows the employer to provide a Description of the benefit item listed. The costs are shown in two columns, one for the employee wages and other costs, and the other for the often-hidden cost paid by the employer on the employee’s behalf.
About the AAA Workforce Committee
The AAA Workforce Committee was formed by the AAA Board of Directors with the committee charge to evaluate and assist AAA member companies with the factors that impact the recruitment and retention of qualified EMS employees. If there are compensation or benefit items that we failed to include that you believe should be part of these documents, please let us know!
Send your feedback to firstname.lastname@example.org.
Please share this email and survey link with EMS education providers in your area! If your ambulance service operates its own training program, please also complete the survey on its behalf. Thank you for helping us gather this critically important data!
Dear Education Partner/Collaborator,
As a leader in Emergency Medical Services and a member of the American Ambulance Association, the Association leadership is trying to better understand the current challenges regarding the new and current workforce. One of our goals this year is to better understand the impact that Covid-19 has placed on education institutions offering programs in emergency medical services.
Therefore, I am requesting your help in completing a short survey and answer five short questions through the link below to help gather data and try to determine the short- and long-term effects we might expect because of any potential disruption in the graduation or completion of future students entering the field of EMS?
We appreciate your time and effort towards helping us better understand the future of our EMS workforce and begin building more solutions to try and recruit and retain our workforce for long term sustainability. If you have any questions, please feel free to reach out to me directly or contact the American Ambulance Association’s CEO, Maria Bianchi at email@example.com.
Thanks for considering.
EMS Service Name
At a time when emergency responders are under immense stress, innovative health tech organization develops YOU | ResponderStrong wellness tool to support comprehensive well-being for at-risk group
DENVER, Aug. 27, 2020 /PRNewswire/ — Grit Digital Health LLC, a tech startup at the intersection of behavioral health, well-being and technology, has partnered with The Anschutz Foundation, Global Medical Response (GMR) and All Clear Foundation to create YOU | ResponderStrong — the world’s first personalized wellness platform for emergency responders. Emergency responders face well-being challenges (e.g. shift work, consistent exposure to trauma, and working in high risk environments) that put them at higher risk for mental health issues and suicide, yet barriers make it difficult to seek out available resources and discuss concerns, leaving many to struggle with these challenges alone.
For emergency responders, rescuing others is second nature, but the mental and physical impacts can be debilitating if left unaddressed. Studies show that first responders are more likely to die by suicide than in the line of duty, 20 to 25 percent of all first responders experience post-traumatic stress and the life expectancy of a first responder is 20 years less than average.
“Responders shouldn’t pay for their service with their lives, either in longevity or quality,” said Rhonda Kelly, founder of ResponderStrong and director of health, wellness and resilience for GMR. “Especially now when the stressors are so extreme and prolonged, burnout is on a meteoric rise. The result of our failing to meet our basic human needs, burnout is one of our biggest enemies. This tool is a tremendous aid in supporting our self-care, building our resiliency, and improving our quality of life.”
Using a human-centered research and design process, the founding partners of you.responderstrong.org brought together national leaders across various emergency responder verticals (law enforcement, EMS, fire service, dispatch and healthcare workers, etc.) to uncover the needs, motivations and challenges of these populations with respect to their mental health and well-being. The insights gathered during this process highlighted the increased pressure and new risks currently facing emergency responders across the country.
“One challenge that has been clear for first responders is figuring out the balance between being able to perform their jobs and also act in the other roles they fill as parents and spouses,” said Caleb Demers, LCSW, who works directly with emergency responders as a clinical social worker and member of the LEADER program at McLean Hospital. “Many patients we work with use a lot of energy attempting to not ‘bring the work home,’ but now that is a tangible fear with more immediate consequences. We see first responders work very hard to maintain confidence and competence in their roles, but when their supports are not as accessible, it affects their mental health.”
The solution is a digital platform, available 24/7, with hundreds of evidence-based resources and tools to support emergency responders with their personal and professional well-being. The first platform of its kind, YOU | ResponderStrong uses a tailored profile and proprietary health assessments to personalize the experience for each emergency responder that creates an account. The platform delivers customized online resources and tools across three areas of well-being: Succeed (financial and career success), Thrive (mental and physical health) and Matter (purpose and connections). The foundations of this comprehensive approach lie in Grit Digital Health’s proprietary well-being model.
“High stress work environments invariably lead to stress that carries into one’s personal life,” said Nathaan Demers, Psy.D., VP and director of clinical programs at Grit Digital Health. “It’s essential that we support the comprehensive well-being of emergency responders by decreasing the stigma and providing educational resources regarding how to support peers, as well as oneself. This is especially important in times of heightened stress, as we see now in light of COVID-19.”
The platform is built on a research-backed tool called YOU, a personalized well-being software created for college campuses and later expanded to serve rural veterans, community mental health centers, workplace wellness and now emergency responders. The platform provides an experience aligned with key research insights gathered from emergency responders: maintaining confidentiality, keeping data secure, including crisis information and providing 24/7 access to support any need any time. Data provided to tap into the platform’s personalization algorithm is completely anonymous, an essential aspect in building trust with emergency responders using the platform.
“Emergency Responders sacrifice more than most and shoulder unfathomable burdens to keep us all safe,” said Janell Farr, president of All Clear Foundation. “They are so focused on helping others that they often don’t take time to help themselves. And if they would like to, options have previously been limited. With YOU | ResponderStrong, responders can now easily assess their overall well-being and immediately access content to enhance their health, well-being and everything in-between.”
The platform is currently undergoing further testing and iteration efforts. Grit Digital Health will collaborate with the founding partner organizations to roll out a second version of the ResponderStrong wellness tool in fall 2020. The release will include learnings from testing with emergency responders and analysis of impact/engagement data. See the tool in action by visiting you.responderstrong.org.
About Grit Digital Health
Grit Digital Health develops behavioral health and well-being solutions through design and technology that envision a new way to approach mental health and well-being. The company solves complex health problems through innovation and creativity, including products that address veteran transitions to civilian life, student loneliness and well-being, employee satisfaction and the mental health of working-age men. For more information, visit www.gritdigitalhealth.com.
About All Clear Foundation
All Clear Foundation is a nonpartisan, nonprofit 501(c)3 supporting First Responders by creating, convening, amplifying and funding innovative programs to improve their life expectancy and wellbeing – as well as the wellbeing of their families. In addition to YOU | ResponderStrong, the foundation has curated a First Responder Resource Database with thousands of resources for responders and their families, and recently launched ResponderRel8, a peer-to-peer chat app that enables First Responders to connect, celebrate and commiserate with peers without fear or stigma getting in the way, and anonymously if they choose. To learn more about All Clear Foundation’s programs or to join the cause, visit AllClearFoundation.org.
About The Anschutz Foundation
Founded in 1984, The Anschutz Foundation was created by Philip F. Anschutz as a private charitable foundation. Over three decades, the foundation has given substantially to hundreds of nonprofit organizations primarily concentrated in Colorado. The Anschutz Foundation currently makes more than 500 grants annually. In 2016, The Anschutz Foundation received the Outstanding Foundation award from National Philanthropy Day in Colorado. This annual event celebrates exceptional philanthropic and volunteer contributions in Colorado. For more information, visit theanschutzfoundation.org.
With more than 38,000 employees, Global Medical Response teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services in the United States, the District of Columbia and around the world. GMR was formed by combining the industry leaders in air, ground, managed medical transportation, and community, industrial/specialty and wildland fire services. Each of our companies have long histories of proudly serving the communities where we live: American Medical Response (AMR), Rural Metro Fire, Air Evac Lifeteam, REACH Air Medical Services, Med-Trans Corporation, AirMed International and Guardian Flight. Combined, we completed 4.9 million patient transports last year utilizing 7,000 ground vehicles, 111 fire vehicles, 306 rotor-wing aircraft and 106 fixed-wing aircraft. We are the largest medical transport company in the world, focusing on intimate and high-service solutions at a local level. For more information, visit globalmedicalresponse.com.
SOURCE Grit Digital Health LLC
AAA understands that EMS staff often experience significant challenges securing quality, reliable childcare, and that these challenges have been exacerbated by school and daycare closures caused by COVID-19. We are here to help!
The American Ambulance Association is proud to share that we have partnered with Kindercare to offer EMS providers priority childcare placement as well as a 10% discount on tuition. Please share this information with your staff! Visit www.kindercare.com/aaa for full details.
AAA member employee families receive priority placement at all 1600 Kindercare centers.
AAA member employees save 10% on full-time, part-time, and drop-in tuition for children ages six weeks to 12 years at any KinderCare Learning Center or Champions before- and after-school sites nationwide.
This offer is available to new families as well as those already enrolled in a participating center.
American Ambulance Association mental and behavioral health partner the Firefighter Behavioral Health Alliance is offering two sessions of their “Saving Those Who Save Others” virtual workshop.
This Zoom seminar, typically $25, is free to AAA members! Please enter “AAA member” in the comment section of the registration page and you will not be charged for your attendance.
FBHA understands the stress COVID 19 has brought to fire and EMS organizations in regard to educating your members on behavioral health, PTSD and suicide awareness. To date, FBHA has cancelled over 80 workshops across the US this year. Since we are not able to travel and businesses are still on lockdown, we are offering another option.
We are excited to offer needed training virtually! We are offering our “Saving Those Who Save Others” workshop on the Zoom platform. During the workshop, we will discuss PTSD within the fire and EMS services as well as suicide awareness, plus recommendations to help yourself and your department.
Two classes will be offered on December 17, 2020. The afternoon class is at 1300 hours (CST) and the evening class is at 1900 hours (CST). The 2 hour class is $25.00.
The Centers for Medicare & Medicaid Services (CMS) has released the Physician Fee Schedule Proposed Rule for Calendar Year (CY) 2021 which has traditionally included proposed changes to the Ambulance Fee Schedule for the same year. The American Ambulance Association (AAA) has confirmed with CMS that the reason there are no references to the Ambulance Fee Schedule in the Proposed Rule is because the temporary add-ons were built into the regulations themselves. Thus, the governing regulations already indicate that the temporary add-on payments for ground ambulance transports are effective for services furnished through December 31, 2022. The regulations are at 42 CFR §414.610 (c)(1)(ii) and 42 CFR §414.610 (c)(5)(ii).
The Proposed Rule also seeks to extend or make permanent several of the telehealth waivers CMS has implemented during the public health emergency. Because CMS does not believe it has the authority to reimburse ambulance providers or suppliers for services provided without transportation also occurring, these waivers have not applied to ground ambulance. However, we will review these provisions of the rule closely to identify potential opportunities to include ground ambulance providers and suppliers in these policies.
In New York, New York, from March 1 to May 31, 2020, 201 102 individuals were diagnosed with coronavirus disease 2019 (COVID-19), resulting in 51 085 hospitalizations and 16 834 deaths.1 The Fire Department of the City of New York (FDNY), the largest in the US, responds to nearly 1.5 million emergency medical calls per year in a city of more than 8.4 million people. Active paid FDNY responders include 4408 emergency medical service (EMS) responders and 11 230 firefighters. These FDNY responders are required to don personal protective equipment before patient contact per US Centers for Disease Control and Prevention guidelines.2 In this cohort study, we compared medical leave of FDNY responders during the pandemic with prior years.
Prezant DJ, Zeig-Owens R, Schwartz T, et al. Medical Leave Associated With COVID-19 Among Emergency Medical System Responders and Firefighters in New York City. JAMA Netw Open. 2020;3(7):e2016094. doi:10.1001/jamanetworkopen.2020.16094
This document provides a brief overview of COVID-19 testing to inform decision-making for first responders including emergency medical service (EMS), Fire & Rescue, Law Enforcement and 911 telecommunicators.
Overview of testing for SARS-CoV-2 (the virus that causes the disease COVID-19): The Food and Drug Administration (FDA) is the U.S. government entity responsible for regulating medical devices, including tests and devices like those being used to detect SARS-CoV-2. Because of the public health emergency caused by a novel coronavirus, the FDA has issued multiple Emergency Use Authorizations (EUA) for various types of medical devices, including tests. Final validation of these tests still needs to be completed through all of the normal FDA clearance processes and receive approval by the FDA under the traditional marketing pathways approval processes. A list of tests that have been issued EUAs is available at EUA Information: FDA.gov.
a. Specificity: Specificity is a measure of a test’s ability to correctly generate a negative result for people who don’t have the condition that’s being tested for (also known as the “true negative” rate). A high-specificity test will correctly rule out almost everyone who doesn’t have the disease when the test is negative and won’t generate a high percentage of false-positive results. (Example: a test with 90% specificity will correctly return a negative result for 90% of people who don’t have the disease but will return a positive result — a false-positive — for 10% of the people who don’t have the disease and should have tested negative.)
b. Sensitivity: Sensitivity is a measure of how often a test correctly generates a positive result for people who have the condition that’s being tested for (also known as the “true positive” rate). A test that’s highly sensitive will identify almost everyone who has the disease and not generate many false-negative results. (Example: a test with 90% sensitivity will correctly return a positive result for 90% of people who have the disease but will return a negative result — a false-negative — for 10% of the people who have the disease.)
c. There are currently a variety of tests which have not been reviewed by FDA but may be purchased to test for COVID-19. The concern with false negatives relates to the higher potential for future transmissions whereas the concern for a false positive relates to unnecessary diagnostic or medical procedures for the patent and wasted PPE use for the provider. A false negative result could lead to additional exposure to contacts of the patient, including first responders and EMS personnel.
a. Testing for first responders and EMS clinicians should be coordinated with the EMS Medical Director and other local/state public health agencies.
b. Check the FDA site (COVID-19 Testing EUA Recipients) to determine whether the test you are considering purchasing has received an EUA by the FDA.
c. Work with the EMS Medical Director to identify the test error rate to determine whether the results can be relied upon and if actions should be made based upon the data obtained.
d. Purchase tests only through verified suppliers to ensure authenticity. There have been reports of counterfeit tests being sold to unsuspecting clients.
e. Follow the test instructions exactly to avoid increasing the error rate and to achieve full test performance. Use Clinical Laboratory Improvement Amendments (CLIA)-certified labs for test processing, if required, based on the specific test.
CDC Serology Testing: https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html
Emergency Use Authorizations: https://www.fda.gov/medical-devices/emergency-use-authorizations-medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices
FAQs on Diagnostic Testing for SARS-CoV-2: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2
FDA Contact Information on Testing:
• Toll-free line 24 hours a day: 1-888-INFO-FDA option *;
• Email to report shortages: firstname.lastname@example.org;
Email applicable diagnostic tests: COVID19DX@FDA.HHS.GOV
FDA Statement Regarding COVID-19 Antigen Testing: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-antigen-test-help-rapid-detection-virus-causes
Serology Test FAQs: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2#serology
CDC recommendations for the Testing of COVID 19: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html
Infectious Disease Society of America (IDSA) primer on serological testing : https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody-testing-primer.pdf*
Please join the American Ambulance Association in honoring those who have fallen serving their communities in the COVID-19 pandemic.
What does it mean to be a hero? Paramedics, EMTs, nurses, and firefighters risk their lives every day to serve on the…
#EMS providers risk their lives every day to serve on the front lines of #COVID19. Tragically, this means that some don’t make it home to their families. It is our responsibility to honor their memories and support their loved ones. #SupportEMS #PSOB #NotJustaRide #alwaysopen pic.twitter.com/vv7XF7mCH6
— AmericanAmbulanceAsc (@amerambassoc) June 30, 2020
Use of personal protective equipment (PPE) during the COVID-19 pandemic response is at unprecedented levels. In order to slow usage rates and maintain supply chain stability, the U.S. Food and Drug Administration (FDA) has authorized an Emergency Use Authorization (EUA) for the emergency use of an N95 respirator decontamination system. This is one of several EUAs for decontamination technologies granted by the FDA. This document is intended to provide basic information on the Critical Care Decontamination System (CCDS) for pre-hospital use.
MANUFACTURER SYSTEM REQUIREMENTS
The CCDS location for your area can be found by contacting your state or local EMS agency/public health agency / Emergency Operations Center (EOC).
NOTE: If there is not one in your area, a request can be submitted through your local EOC to
Further information can be found on the CCDS Site
Days after announcing plans for Stay at Home 2.0, New Hampshire Gov. Chris Sununu announced the allocation of $40 million in aid for communities across the state dealing with the COVID-19 pandemic…
Also using the CARES Act funding, a stipend for hazard pay is being made available to police officers, firefighters, EMS personnel and correctional officers. Full-time workers will receive $300 a week, while part-time workers receive $150 a week.
Federal Healthcare Resilience Task Force EMS/Prehospital Team: As the COVID 19 pandemic continues to evolve, Public Safety Answering Points (PSAPs)/Emergency Communications Centers (ECC) may need to revise procedures and redirect resources for handling incoming calls for COVID-19 Information and Low Acuity Medical Complaints. These revisions may require administrative, technical and operational protocols, policies and procedures to be modified. This document provides guidance and considerations for these modifications and examples of how a sample of a few individual PSAPs/ECCs have handled/redirected these calls in response to the COVID-19 pandemic.
The Federal Healthcare Resilience Task Force (HRTF) is leading the development of a comprehensive strategy for the U.S. healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19. The Task Force’s EMS/Pre-Hospital Team is comprised of public and private-sector Emergency Medical Service (EMS) and 911 experts from a wide variety of agencies and focuses on responding to the needs of the pre-hospital community. This Team is composed of subject matter experts from NHTSA OEMS, National 911 Program, CISA, CDC, FEMA, USFA, US Army, USCG, and non-federal partners representing stakeholder groups and areas of expertise. Through collaboration with experts in related fields, the team develops practical resources for field providers, supervisors, administrators, medical directors, and associations to better respond to the COVID-19 pandemic.
How to use this document: The general guidance and examples included in this document can be used to assist PSAP/ECC directors with the implementation and/or modification in Standard Operating Procedures (SOPs) and Emergency Medical Dispatch (EMD) protocols, for receiving and responding to two types of calls:
1. Calls for COVID-19 Information.
2. Calls for patients with Low Acuity Medical Complaints.
It is very important that PSAP/ECC directors refer to local medical direction, health department and other local COVID initiatives to ensure that the PSAP/ECC does not sustain any liability for the redirection of calls. This document was completed by representatives from the Association for Public Safety Communications Officials (APCO), the APCO Institute, the International Academies of Emergency Dispatch (IAED), the National Association of State 911 Administrators (NASNA), the National Emergency Number Association (NENA), and Power Phone; as well as their members and some of their clients.
Purpose/Goal: To provide guidance for the redirection of low acuity medical complaints to alternate medical resources (e.g., Nurse Triage/Call Line, Telemedicine, Paramedic Triage) due to increase in call volume and/or decline in hospital, EMS and other resources as a result of the
1. Location: Seattle/King County Washington
Seattle is in the early stages of exploring how to use nurse triage (either on-site in the 911 center or remotely) to further handle non-emergent calls, however, such a program has not been operationalized.
2. Location: Washington, DC; Office of Unified Communications (OUC)
3. Location: Orleans Parish Communication District (New Orleans 9-1-1)
Two directives and one guidance document enable the video medical triage process:
1. Emergency Directive 20-01 – Advising staffing to start using the surveillance tool.
2. Emergency Directive 20-02- Formally activating Protocol 36 (Issued 3/9/20)
3. Special Guidance advising elevating the pandemic level to Level 1
The pandemic protocol identifies calls that are low acuity for which an emergency department is not the best option. At that time, a paramedic initiates a video call with the patient and reviews their symptoms. In the current situation, in most cases, they are being advised to self-quarantine
and not go to an emergency
department. The process then places that person on a “self-quarantine registry” and someone from the staff calls the person daily to check on them. If their conditions get worse, the person is triaged again as a new patient and they may then get transported if needed.
4. Location: Orange County Virginia Fire and EMS Department
PSAP/ECC receive fax updates of hospital status. PSTs page out the status of the hospital to the responders. Life or death situations can still go to the closest hospital and override the color codes except in Code Black situations.
5. Location: New York City – Northwell Health
Sustaining Mental Health during COVID-19
Thursday April 30th, 2020 – 11:00am-11:30am EDT
The NORA Public Safety Sector Council, is hosting an EMS Sustainability Update at 11:00 EDT on Thursday April 30, 2020 via Zoom. The topic is Sustaining Mental Health during COVID-19. The attachment includes the agenda for the meeting as well as available resources and tools outlined on page 2.
Registration is required using the link above. This is part of an ongoing series of updates to be hosted every other week. The registration link will register you for all occurrences and you can attend those you are interested in.
The Prehospital [911 and Emergency Medical Services (EMS)] Team of the Healthcare Resilience Task Force has released three more informational documents. The first contains guidance for emergency communications stakeholders on available funding in the CARES Act. The second is a summary document on the status of the Emergency Medical Services (EMS) education pipeline during a series of recent conference calls with EMS stakeholder organizations. The third is a corrected version of the COVID-19 Crisis Standards of Care.
These documents will also be posted on EMS.gov and/or 911.gov (as appropriate). Two portals for COVID Resources were created which we will continue to update three times a week, with new links and documents containing information on a variety of COVID-related topics. You will find COVID resources here on EMS.gov, and here on 911.gov.
The Cybersecurity and Infrastructure Security Agency (CISA), in partnership with SAFECOM and the National Council of Statewide Interoperability Coordinators (NCSWIC), prepared guidance for emergency communications stakeholders on available funding in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Stakeholders are encouraged to review this guidance and apply for funding, where applicable. CARES Act money is available to all 50 states, five territories, and the District of Columbia, with several fast-approaching application deadlines
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.
In response to the COVID-19 pandemic, emergency medical services (EMS) agencies (including fire service, third government service, hospital-based, private for-profit, and private non-profit services) may need to adjust operations and standards of care in order to preserve and effectively allocate limited EMS and healthcare system resources in the face of overwhelming demand due to the national pandemic response. This document provides an overview of general considerations, potential strategies, and existing resources that EMS agencies may use to inform changes to their operations and standards of care.
The Prehospital [911 and Emergency Medical Services (EMS)] Team of the Healthcare Resilience Task Force has released six (6) more documents (attached). They cover topics including crisis standards of care, PPE, and the behavioral health of 911 and EMS first responders.
These documents will also be posted on EMS.gov and/or 911.gov (as appropriate). Two portals for COVID Resources were created which we will continue to update three times a week, with new links and documents containing information on a variety of COVID-related topics. You will find COVID resources here on EMS.gov, and here on 911.gov.
CMS Relaxes Physician Certification Statement Signature Requirements During Public Health Emergency for COVID-19
By Kathy Lester, J.D., M.P.H.
The Centers for Medicare & Medicaid Services (CMS) has released guidance that recognizes the difficulty ambulance service providers and suppliers may have during the COVID-19 Public Health Emergency (PHE) in obtaining a physician certification statement (PCS) signed by a physician or other authorized professional. The question and answer below indicates that CMS (and its contractors by extension) will not deny claims during a future medical audit even if there is no signature for non-emergency ambulance transports, absent an indication of fraud or abuse. Ambulance service providers and suppliers should indicate in the documentation that a signature was not able to be obtained because of COVID-19. The AAA advises completing the PCS form and then indicating if a physician, or other appropriate personnel, has not signed it by writing “COVID-19 Public Health Emergency” on the signature line. CMS also reminds providers and suppliers that medical necessity still needs to be met.
The American Ambulance Association has been advocating for CMS to ease its restrictions on signature requirements during the COVID-19 PHE. The FAQ posted by CMS is consistent with our recommendations.
The specific Q&A is below:
Q. For ambulance services that require a physician, or, in lieu of that, certain non-physician personnel, to sign and certify that a non-emergency ambulance transport is medically necessary, are these signature requirements not required during the COVID-19 PHE?
A. We understand that in certain situations during the COVID-19 PHE it may not be feasible to obtain the practitioner signature. Therefore, for claims with dates of service during the COVID- 19 PHE (January 27, 2020 until expiration), CMS will not review for compliance with appropriate signature requirements for non-emergency ambulance transports during medical review, absent indication of fraud or abuse. Ambulance providers and suppliers should indicate in the documentation that a signature was not able to be obtained because of COVID-19. However, we note that Medicare Part B covers ambulance transport services only if they are furnished to a Medicare beneficiary whose medical condition is such that other means of transportation are contraindicated, and the beneficiary’s condition must require both the ambulance transportation itself and the level of service provided in order for the billed service to be considered medically necessary.
The full Q&A document can be accessed here.
Documents developed by the Prehospital [911 and Emergency Medical Services (EMS)] Team of the Healthcare Resilience Task Force.
Managing Patient and Family Distress Associated with COVID-19
Intended to provide care instructions for the psychological challenges associated with real or perceived exposure to COVID-19. This document includes practices for therapeutic communication between the EMS provider, their patient and the patient’s family to ensure that every aspect of the patient’s well-being is being managed by EMS.
NOTE: this document is based on the previously approved Managing Patient and Family Distress document for healthcare developed by the Behavioral Health Working Group and has been adapted for the EMS population.
Strategies to Mitigate EMS Clinician Absenteeism
This document provides strategies and techniques to maximize EMS capabilities and
service to the public and to hopefully minimize EMS Workforce Absenteeism. The
resilience of our Nation’s healthcare system depends on our healthcare workforce’s
ability to report for duty. Critical supplies, equipment, and surge capacity rely on
dedicated, trained EMS clinicians and support staff to enable care. Prepare now and
take actions, such as those listed below, to help your EMS agency protect your workers’
psychological health and well-being.
Personal Protective Equipment Supply for EMS
This document is intended to clarify for the EMS community the current Personal Protective Equipment (PPE) supply situation as well as the appropriate requisition process to address local shortages of available PPE supplies.