CISA: Emergency Services Sector Active Shooter Guide

The FBI designated 28 shootings in 2019 as active shooter incidents. The 28 incidents resulted in 247 casualties, 97 people killed, and 150 people wounded, excluding the shooters. No community appears immune from these potential incidents; therefore, it is important for every community to develop an Active Shooter Program. The purpose of this guide is to provide emergency services personnel with the basic building blocks for developing an Active Shooter Program with communities. This guide highlights resources and planning considerations, which will enhance emergency services organizations’ ability to develop or improve community planning and preparedness for active shooter incidents. For more information, email the Emergency Services Sector-Specific Agency at essteam@cisa.dhs.gov....

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Coronavirus (COVID-19) Impacts on the EMS Workplace

There has been a great deal activity and press coverage over the past few weeks relative to the Coronavirus (COVID-19). This activity has generated several questions from EMS organizations regarding how to handle the impact on the workplace. Healthcare workers have been identified by the Occupational Safety and Health Administration (OSHA) as a group of workers who are at an increased risk of exposure to COVID-19. There are many steps EMS organizations can take to best prepare their workplace and protect their personnel. EMS agencies are already required to follow and maintain OSHA’s Infection Control Standards for Bloodborne and Airborne Pathogens (29 CFR 1910.1030). If EMS organizations and their employees are diligent in maintaining these standards, they will already be doing nearly everything that is being recommended for employers to combat the spread of COVID-19. The Centers for Disease Control (CDC) released their Interim Guidance for Businesses and Employers, which includes additional practical recommendations for employers to utilize to further combat the spread of COVID-19, including: Actively encouraging sick employees to stay home; Separating sick employees from the rest of the workforce; Encouraging workers to stay home when sick, respiratory etiquette, and hand hygiene by all employees; Performing routine environmental (more…)

HHS Releases Communication Checklist to Aid First Responders

HHS Releases Checklist to Aid First Responders in Communicating Effectively with Patients The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) has released a plain language checklist that is intended to aid First Responders during emergencies that involve individuals with Limited English Proficiency (LEP) and communications related disabilities. The AAA issued numerous articles to its members in 2016 about the newly published requirements for all healthcare providers, including EMS agencies, under the nondiscrimination provisions of the Affordable Care Act (ACA) Section 1557. The requirements are intended to prevent discrimination in the provision of healthcare and ensure that all individuals can meaningfully participate in their healthcare treatment, including those patients with LEP and other communications related disabilities. The announcement yesterday is intended to provide additional resources for healthcare providers to ensure compliance with the ACA Section 1557. The checklist includes numerous recommendations and action steps that EMS agencies can utilize to ensure that they are serving all members of a community in a meaningful way. These recommendations include conducting research about the communities by accessing U.S. Census Bureau data, engaging Centers for Independent Living and local assistance groups, and by preparing emergency messaging that can be...

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EEOC Sexual Harassment Update Fall 2018

The Equal Employment Opportunity Commission (EEOC) released a Press Release yesterday encouraging employers to take “concrete steps to change their workplace cultures to prevent harassment”.  The EEOC held a meeting yesterday at their headquarters in Washington D.C. as it has been 12 months since the #MeToo movement first exploded in the media in October 2016.  Long before the #MeToo movement gained momentum, the EEOC assembled a Select Task Force on the Study of Harassment in the Workplace to try to ascertain the progress made in the last 30 years of anti-harassment efforts.  This Special Task Force released a report in June 2016 in which they state that sexual harassment in the workplace is still a significant problem and that many of the employer awareness and educational efforts have done little to reduce or prevent it. The EEOC released the final 2018 fiscal year data regarding its efforts to fight or prevent workplace harassment.  The report included data that showed a 13.6% increase in sexual harassment charges and nearly 50% increase in harassment lawsuits.  EEOC Acting Chair Victoria A. Lipnic and Select Task Force Co-Chair Chai R. Feldblum, stated that there needs to be a holistic approach to fighting and preventing (more…)

Recovering Loss of Revenue from “not at fault” Accidents

When your units get hit by a third party and the vehicle is out of service, are you getting Loss of Revenue for the downtime while the unit is being repaired? Whether you answered yes or no to that question, reading this article will be the one of the most lucrative uses of your time this year. A call comes in and your dispatcher does a perfect job of answering and scheduling the run. The EMT’s jump into the clean, fueled, and well stocked ambulance responding to the call. Then from out of nowhere, a car turns directly into the ambulance’s path rolling through a stop sign. Now what? You have two paramedics stranded on the side of the road who will be spending the next few hours on paperwork and drug testing. In addition, all the drugs and small equipment need to be removed or secured. Hopefully you have another unit to dispatch or your competitor may have already been called. What happens next is key to getting maximum recovery for your losses caused by the accident. Key items that help maximize your recovery from accidents: Educate and equip fleet drivers with the tools necessary to collect key accident...

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Family Liaisons Following EMS Line of Duty Deaths

I was just a kid when I started in EMS. 23 years old, hungry for adventure, and ready for everything the world of EMS was prepared to give me. Car accidents, gunshot wounds, stabbings, intoxicated shenanigans, elderly falls, fist fights, medical emergencies, strokes, and cardiac arrest were all on my list of expected possibilities. One of the scenarios I had not thought of, and nobody presented to me throughout school and orientation, was the possibility of clocking in for shift and not going home. I do not recall line of duty deaths being a discussion point in the paramedic curriculum, job interview, or orientation process. I had experienced the unexpected loss of a younger sibling due to a motor vehicle crash before I started my journey in EMS, but the fact that life is short and unpredictable did not connect with the fact that I was knowingly and willingly walking myself into unknown and potentially dangerous situations with each response. Even after the UW Med Flight crash happened early in my career, and in my service area, we simply did not talk about our own potential for death as a direct result of our profession. Years later, after many more...

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OSHA Updates & Reminders 2018

It is important that employers remember that they must post a copy of their OSHA Form 300A which is a summary of workplace injuries starting February 1, 2018 through April 30, 2018.  The OSHA Form 300A is a summary of all job-related injuries and illnesses that occurred in an employer’s workplace during 2017.  If a company recorded no injuries or illnesses in 2018, the employer must enter “zero” on the total line. The form must be signed and certified by a company executive. The OSHA Form 300A Injury Summary must be displayed in a common area where notices to employees are usually posted.  In addition to posting these reports in the workplace, covered employers will have to electronically report their injury data on the Injury Tracking Application (ITA) by July 1, 2018. Also, a reminder to employers who are subject to OSHA or to those who operate in a state with an OSHA approved state level plan, the penalty amounts for OSHA violations are increasing effective January 2, 2018.  In accordance with the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015, the Department of Labor is required to adjust penalties for inflation each year. New penalties for willful...

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OSHA Electronic Injury Reporting Deadline Is Dec 15

Several months ago, we alerted AAA members that the Occupational Safety and Health Administration (OSHA) had announced that it would further delay the deadline for employers to electronically file injury data until December 1, 2017.  With that deadline quickly approaching, we wanted to make sure that our members were prepared and reporting the data correctly. OSHA announced in July that it will be launching the new electronic Injury Tracking Application (ITA) on August 1, 2017.  The new rules are an effort to “nudge” employers to improve safety in the workplace by publishing employee injury data, as reported by employers.  Electronic data reporting would give job candidates and employees the ability to compare potential employers and their safety records.  Currently, most employers are required to record injuries that occur in the workplace, but this data is not easily available to candidates or OSHA itself.  It is anticipated that employers can expect greater investigative and enforcement actions after electronic injury reporting begins. Under the Old & New Rules Every year, ambulance services with 10 or more employees are required to record all workplace injuries that involve medical treatment beyond first aid, days away from work, restricted/transfer of duties, or loss of consciousness. ...

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Time to handle 911 call demands with Paramedics

When discussing this new and growing field of pre-hospital care, there seems to be two unique paths that services are following. The first is the hospital-owned or contracted service, where community providers seek ways to decrease readmission rates for CHF, COPD, Pneumonia, Sepsis, MI and other chronic illnesses. When a patient discharged with one of these targeted conditions is readmitted within a 30 day window, “hospitals face penalties of up to 3 percent of Medicare payments in 2018” (Gluck, 2017, para. 10). That is a lot of money. Consider, “Lee Health, Southwest Florida’s largest hospital operator, which is expected to lose $3.4 million in payments” (Gluck, 2017, para. 2). This model represents the if, or, and type of service, meaning if we can do it for less and there are providers willing to do this type of medicine, then we can save the expensive penalties from CMC. The other model of community paramedicine is 911 abuse reduction. For years EMS has conditioned the public to call 911 for any emergency. But today, what we consider an emergency is far from the public’s perception of an emergency. “EMS has experienced a 37% increase in 911 calls since 2008.” (White, 2016, para. (more…)

Protecting EMS and What That Means

I have been seeing a lot of chatter on social media and reading quite a bit about ambulance services issuing ballistic vests and providers being allowed to arm themselves. Looking at the available data, consider the following: 67% (95% CI = 63.7%–69.5%) of respondents reported that either they or their partner had been cursed at or threatened by a patient; 45% (95% CI = 42.4%–48.3%) had been punched, slapped, or scratched and 41% (95% CI = 37.9%–43.7%) were spat upon; Four percent (95% CI = 2.8%–5.0%) of the respondents reported that they or their partner had even been stabbed or involved in an attempted stabbing; and 4% (95% CI = 2.5%–4.8%) reported being shot or involved in a shooting attempt by a patient.” (Oliver & Levine, 2014, para. 22). When looking at the survey results, specifically the low percentages of violent activities, it would appear that such protections are not needed. However, I cannot support the notion that a provider feels that where they work this protection is essential to them. I think a closer, more current look with a larger sample will create a better perspective. This study is relatively small and would be better served if the questions (more…)

OSHA to Launch Electronic Injury Reporting on August 1, 2017

A few weeks ago, we alerted AAA members that the Occupational Safety and Health Administration (OSHA) had announced that it would further delay the deadline for employers to electronically file injury data.  The new rules, which require electronic injury data reporting were originally to take effect on July 1, 2017.  These rules were delayed until this December 1, 2017.  It was believed the requirements, an Obama administration initiative, might never see the light of day under the new administration.  However, OSHA announced Friday that all employers (ambulance providers) who employ twenty or more employees will be able to begin submitting electronic report injury data starting August 1, 2017. OSHA announced Friday that it will be launching the new electronic Injury Tracking Application (ITA) on August 1, 2017.  The new rules are an effort to “nudge” employers to improve safety in the workplace by publishing employee injury data, as reported by employers.  Electronic data reporting would give job candidates and employees the ability to compare potential employers and their safety records.  Currently, most employers are required to record injuries that occur in the workplace, but this data is not easily available to candidates or OSHA itself.  It is anticipated that employers...

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The Cost of a Bad Hire

Our industry has been struggling with a staffing crisis for several years. We are all looking for ways to attract and hire qualified individuals to staff our ambulances and work in our dispatch and billing offices. This shortage has often resulted in ambulance providers hiring many people who meet the basic qualifications for the position even if they might not be the best fit for the company. There is a strong focus on reducing overtime hours to keep cost in line with shrinking reimbursement dollars. However, when a new person is introduced to the company community and culture, there are impacts that are not always recognized. Our industry has also struggled with the concept of collecting and reporting cost data because there are many dynamics that drive cost for ambulance providers throughout the country. Difficulties with identifying and isolating recruitment and retention costs are no exception to this struggle. An article published by the HR Daily Advisor discusses a recently published survey that studied the financial impacts a bad hire has on an organization. Not only does the organization lose the money associated with onboarding the wrong candidate (interview time, screening costs, orientation costs, uniforms, third ride time, etc.) but (more…)

Maintaining Compliance Within an EMS Service

Maintaining compliance within an EMS service can be a daunting task, especially given the number of regulations that we must follow. One way to look at EMS is if a trucking company married a hospital. There are rules and regulations to abide by for an entire fleet of vehicles, from safe operation guidelines all the way down to the use and color of lights. Then there are requirements for a group of healthcare providers, which include necessary certifications such as CPR and knowledge of pertinent life-saving skills. Not only does maintaining compliance keep vehicles and equipment running smoothly, but it can offer employees valuable peace of mind and keep everyone focused on the same goals of providing the best care possible. I like to consider compliance an investment in common sense. Employees know what is expected of them at all times, and they know what type of support their employer will provide to keep their skills sharp. In turn, an EMS service gains from being in good standing with regulators and from an engaged, confident workforce. The benefits of a strong culture of compliance are immense. An organization that lives and breathes compliance can help ensure a smooth-running operation that...

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HR Wrap-Up: A Look Back at 2016

As we wind up 2016 I thought it would be a good idea to review the year’s human resource and legal developments to ensure that our members are compliant and prepared for what faces them in 2017.  We knew that this was going to be an interesting year as we experienced the most unusual Presidential Election in our history.  It overshadowed everything else that occurred in 2016.  As the Obama administration comes to its final days, employers and ambulance providers saw some of the most sweeping regulatory changes. Fair Labor Standards Act (FLSA) The biggest change facing employers in 2016 was the Fair Labor Standards Act (FLSA) overtime changes.  The Department of Labor (DOL) issued updated regulations which were to become effective December 1, 2016, raising the minimum salary thresholds for the so called “white collar” exemptions.  Under the new regulations, the minimum salary would increase from $455 to $970 per week.  For those employees earning under the new amount, employers would need to decide if they are going to raise the salary level or pay the employee overtime for hours worked over 40 in one week.  The changes have not gone into effect yet as a 5th Circuit Judge...

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 Video: Managing Former Peers—Tips for New Supervisors

A must-watch for your new managers and supervisors! One of the trickiest transitions in am emergency medical services career is moving from peer to supervisor. The American Ambulance Association’s HR & Operations Consultant, Scott Moore, Esq. shares some tips on redefining relationships with the EMTs and Paramedics you now supervise. Have a question for Scott? AAA members, submit your requests today via our HR & Operations Consultation form!

HR Series Webinar – 25% Off During Cyber Week!

I Really Can’t Stay… Managing Employee Leave December 8 at 2:00 PM ET $99 for Members – $75 DURING CYBER WEEK SALE  $198 for non-Members – $150 DURING CYBER WEEK SALE  This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP   Speaker: Scott Moore, Esq., EMS Resource Advisors Managing employee leaves can be a complex and challenging task which can expose employers to significant risk. Nearly 52% of employers believe that employees are fraudulently using FMLA leave. This webinar will provide employers with a solid understanding of an employee’s right to protected leave and best practices for preventing abuse, and managing and tracking leave. This session will cover some of the challenges with managing intermittent leave, the impact of built in overtime in FMLA time calculation, importance of the Medical Certification, pay during leave, and the interaction with the ADA. Register Now►

OSHA Reporting Requirement Changes Delayed Until November 2016

This past May, the AAA published an Advisory to members to alert them of new OSHA injury reporting requirements for employers starting this August 10, 2016. The Department of Labor announced today that it will be delaying the implementation of these new requirements until November 1, 2016. In the press release, the DOL stated that it is “delaying enforcement of the anti-retaliation provisions of the new rule to allow time for additional outreach and education.” The DOL states that the intent of the new rules are an effort to collect data for the purposes of improving safety to reduce injuries and illnesses in the workplace. The Occupational Safety Health Administration (OSHA) has issued its final rule regarding new Federal Reporting requirements for certain employers. The new rule will require those employers who are already required to record injuries to report those injuries to OSHA electronically. All ambulance providers with ten or more employees are required to keep a record of injuries that occur in the workplace. To ensure that employees are encouraged to report work related injuries, the new rule has provisions that require employers to have reasonable procedures for reporting work related injuries and that they be able to...

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OSHA Reporting Requirement Changes Coming August 2016

In an effort to collect data for the purposes of improving safety to reduce injuries and illnesses in the workplace, The Occupational Safety Health Administration (OSHA) has issued its final rule regarding new Federal Reporting requirements for certain employers.  The new rule, that takes effect on August 10, 2016, will require those employers who are already required to record injuries to report those injuries to OSHA electronically.  All ambulance providers with ten or more employees are required to keep a record of injuries that occur in the workplace. Every year, employers are required to record all workplace injuries that involve medical treatment beyond first aid, days away from work, restricted/transfer of duties, or loss of consciousness on the Form 300.  There are certain injuries that must be reported immediately to OSHA if they occur, workplace fatalities, hospitalization, loss of an eye, or an amputation.  The injury logs must be compiled and kept for five years.  Each year, employers are required to post a summary of all workplace injuries in the workplace for from February 1 through April 30. Currently, OSHA collects workplace injury information primarily through onsite inspections, mandated reports of specific serious injuries, and through data collection from limited...

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EEOC Sounds Off On Transgender Issues

A few days ago the Equal Employment Opportunity Commission released Fact Sheet: Bathroom Access Rights for Transgender Employees Under Title VII of the Civil Rights Act of 1964.  This was in direct response to the passing of North Carolina’s HB2 in March that restricts multi-use bathrooms and changing facilities to be utilized only by those individuals based upon their sex noted at birth.  The North Carolina “Bathroom Rule” is directly aimed at transgender individuals and would force transgender individuals to use the restroom that is opposite of how they physically present.  In other words, a transgender male who has a beard and other characteristics typically associated with being male, would be forced to use a women’s restroom. In response to the new law, the Department of Justice (DOJ) had notified North Carolina that HB2 violates not only Title VII of the Civil Rights Act but also Title IX Education Amendments of 1972, and the Violence Against Women Reauthorization Act of 2013.  The DOJ sent a letter to the Governor and State legislature on May 4th informing them that they had until May 9th to notify the Department of their intent not to implement or enforce the new law or risk (more…)