Bigfork, Montana, May 17 – Binder Lift, a supplier of patient handling equipment and training for emergency care providers, recently became PHASE (Patient Handling and Safety Experts) in response to the ongoing workforce shortage in the emergency care industry. “Patient handling causes far more injuries to emergency care providers than any other job function,” said PHASE CEO Rick Binder. “Though we can’t help agencies find new personnel, we can help them retain employees by providing them with the equipment and training necessary to avoid injuries where they happen most.”
Recognizing a problem they could help solve, the company expanded its resources to protect emergency care providers from the most common cause of injury. It added new solutions to its product line and helped produce an accredited training program on patient handling safety that will be available without cost. “Suddenly, we weren’t only helping providers avoid lifting injuries by supplying a single product; we were helping customers safely move patients from the bathtub in the patient’s home all the way to the hospital bed,” Binder said. “Becoming PHASE was a natural progression.”
The company’s first product, Binder Lift, was born in 2012 out of a friendly argument between Binder’s mother and father. Julie Binder, an EMT-I at the time, told Dan Binder there was nothing available to help her and her partner safely lift a large patient from the floor to a standing position. Dan didn’t believe her. “After a long web search to prove her wrong, he found nothing,” Binder said. “So he got to work making his own solution.”
The result was the company’s flagship product. Since then, more than 3,000 emergency care departments have invested in the Binder Lift to keep their personnel safe when lifting patients. The device has also won multiple industry awards, including EMS Innovation of the Year.
Binder believes adding new products and resources to its offerings is the best way the company could serve the emergency care providers it works to protect. “These are remarkable people,” he said. “They work tough hours for modest pay in order to help others. They shouldn’t have to worry about being injured simply by doing their job.”
Continuing its commitment to their health and safety, PHASE is offering free product trials to first responders through its new website, www.phaseintl.com.
The new website also includes a comprehensive resource center where users can watch instructional videos, get product information, and read case studies. The site will also feature free access to an accredited training program created in partnership with other industry stakeholders in the coming months.
“We’ve grown a lot over the last decade since first bringing the Binder Lift to market,” Binder said. “But we’re still the same family-owned and operated business that values our relationships with our customers and industry partners.”
About PHASE (Patient Handling and Safety Experts)
We’re on a mission to empower emergency care providers to have longer and healthier careers by providing the equipment and training necessary to safely move patients of any size with ease. All our products and services are science-backed solutions that help emergency care providers avoid injuries where they happen most. PHASE is a family-owned business that brings our family values to the workplace. When you do business with us, you’re more than a customer. You’re family. So, let’s connect. We look forward to helping you. To learn more, visit www.phaseintl.com
This appointment demonstrates its commitment to serving those in emergency services with the wellness resources they need, when they need them, free of charge
Denver, Colorado, USA – All Clear Foundation (ACF), a national 501c3 nonprofit dedicated to improving the wellbeing and longevity of Emergency Responders, including Healthcare Workers, and their families, has appointed Mike Taigman Chairman of the Board.
“My life’s purpose–for my entire life–has been to recognize suffering in all its forms and do something about it. All Clear Foundation’s mission is in complete alignment with that passion,” says Taigman. “I am humbled and excited by this opportunity.”
Taigman brings a wealth of experience to this role. He spent decades on the streets of Denver as a paramedic, honing his “people first” approach. The author of more than 600 articles in professional journals, Taigman is a recognized expert in the areas of quality improvement, data science, leadership, and EMS. He serves as adjunct faculty at University of Maryland, Baltimore County and UCSF, and he is the Improvement Guide at FirstWatch, a data analytics firm dedicated to quality improvement in public safety.
“We are thrilled to have Mike on board,” says Rhonda Kelly, the foundation’s Executive Director. “His passion for improving quality of life among Emergency Responders is sincere and his track record is unparalleled. We appreciate his focus on the full spectrum of wellness supports from proactive education to crisis intervention. And we are very excited about his commitment to utilizing evidence-based practices to drive improvement.”
ACF relies upon the power of strategic partnerships to affect change and appreciates Taigman’s extensive experience building and growing partnerships in the Responder wellness world. In addition to facilitating development of EMS Agenda 2050, a vision EMS 20 years into the future, he is the author of Super-Charge Your Stress Management in the Age of COVID and is regular faculty at the Institute for Healthcare Improvement.
Among his top priorities, Taigman looks forward to ensuring the sustainability of All Clear’s mission. “My hope is to support the ongoing mission and build sustainable support and funding for the foundation so we can continue this important work,” says Taigman. “There’s so much evidence that being involved in emergency services and healthcare takes a toll on the folks doing the job.”
“All Clear Foundation has pulled together an ecosystem of resources that is unmatched and provides them free of charge to Emergency Responders, their agencies, and their families. Securing reliable support for these efforts is essential and ongoing.”
The need is there. One study found Emergency Responders suffer from depression and PTSD at five times the rate of the general population. Among the many challenges inherent in the work are frequent trauma exposure, rotating shift schedules, limited agency support, amplified stress on the family and other relationships, and physical injury.
“Too many Emergency Responders have paid for their service with their lives, either in quality or longevity,” says Director Kelly. “The barriers of shame, stigma, lack of local resources, and lack of finances have kept many from accessing the supports they deserve and need. This is where All Clear Foundation steps in. Built by Responders, for Responders, we are here to help across the domains of wellness: mental, emotional, physical, social, and spiritual.”
All Clear Foundation provides an array of easily accessible and navigable wellness solutions at no cost to agencies or participants. ResponderStrong, its mental health initiative, has had a significant impact nationally and continues to grow with hybrid-format educational content and digital tools. Partners organizations include Global Medical Response, FirstNet-Built with AT&T, Abbott Nutrition, The Center for Relationship Education, IndyCar, IPSDI, Sigma Tactical Wellness, and NERPSC.
“The work All Clear and its partner organizations provide is saving lives,” says Taigman. “But, beyond that, it’s making Emergency Responders happier, healthier, and more resilient. This is good news for all of us.”
Since 1998, FirstWatch has been helping EMS agencies monitor real-time situational awareness, operational performance, clinical quality and performance improvement measures, as well as health surveillance, bioterrorism or other potentially concerning incidents. FirstWatch is designed to aggregate data from your agency’s CAD, ePCR, ProQA, RMS, Hospital ED, Billing and Phone system into a single, automated real-time view. For more information, visit www.firstwatch.net.
ABOUT ALL CLEAR FOUNDATION
Through assessing community wellness needs, priorities, and barriers, All Clear Foundation, a 501c3 public charity, leverages the power of strategic partnerships to create easily accessible and navigable systems of wellness solutions, improving the wellbeing and longevity of those who serve our communities. In 2019, ACF was founded by Global Medical Response as an autonomous public charity designed to serve and benefit the national Emergency Responder community. As one of the largest employers of Public Safety personnel in the U.S., GMR believes it has a duty to support the overall wellness of all Responders nationally. All Clear Foundation’s mission is to improve the overall wellbeing and longevity of those who serve our communities in times of need. We believe that healthy emergency responders contribute to healthier communities. For more information, visit www.allclearfoundation.org.
For more information, please contact Crawford Coates at email@example.com.
The American Ambulance Association is partnering with Newton 360, an ambulance industry partner and Human Resource support firm, to conduct our fifth annual industry turnover study. Our intent is to comprehensively collect and analyze ambulance industry employee turnover data to produce a report that provides useful and actionable data. We are inviting EMS organizations to participate in the study. The study will be conducted and managed by Dennis Doverspike, PhD, and Rosanna Miguel, PhD, who are associated with the Center for Applied Talent Analytics at John Carroll University. Each individual or organizational response will be strictly confidential.
The purpose of the study is to better quantify and understand the reasons for turnover at nearly every organizational level within the EMS Industry. Thank you very much for your time and support.
Laying the Groundwork for Reducing Employee Turnover
Why participate in the survey?
Before You Start
It is recommended you gather information about your employees and about turnover before completing the questionnaire.
In this survey, we will be asking about headcount (filled and open positions), the number of employees leaving the organization, and reasons for employees leaving. We will be asking these questions for each of the following job categories: supervisor, dispatch, EMT, part-time EMT, paramedic, and part-time paramedic. Headcount refers to the number of filled and open positions for each job category at the end of 2022. Filled positions refer to the number of employees in each job category that were on payroll at the end of 2022. For each job category, the number of filled positions should be added to the number of open positions at the end of 2022 to determine the total headcount.
The survey will open on April 17th, 2023, and close at end of the day, on April 30th, 2023. The survey can be accessed by following the link below. If the hyperlink does not work when clicked, please copy the hyperlink and paste it into your browser.
Scott Moore, Esq.
Workforce Dynamics, Inc.
(781) 236-4411 office
(781) 771-9914 mobile
The American Ambulance Association has submitted comments to the Senate Committee on Health, Education, Labor, and Pensions (HELP) in response to their request for input on crafting legislation to address the health care workforce shortage.
Ground ambulance service organizations are facing a severe shortage of paramedics and EMTs which is placing a significant strain on an emergency medical system already in financial distress. We greatly appreciate the opportunity to provide our legislative solutions to the committee to help address the ongoing workforce crisis.
Please see the document linked below, which was sent to the HELP Committee Chairman, Senator Bernie Sanders, and the Ranking Member, Senator Bill Cassidy.
3-17-2023 HELP Workforce Comments
In October 2022, The National EMS Museum Board of Directors made a progressive and far-reaching decision to re-image the function and direction of the Museum and its Board of Directors. At that time, the Board decided to announce an initiative to reach out to more communities to recruit a diverse and interested group of leaders that could aggressively move the Museum forward through new strategic initiatives. After an extensive search and interview process conducted by an independent review panel, The National EMS Museum is pleased to announce the new members of The National EMS Museum Board of Directors with skills in EMS, museum management, fundraising and sponsorship development:
Larry J. Appel, M.B.A., EMT joins the NEMSM Board of Directors with 45 years of experience in EMS as an EMT. His experiences include non-profit director, business owner, manager of several Maryland-based commercial ambulance services, paid 911 EMS provider, V.P. of Ambulance Sales for FR Conversions, and currently the EMS Business Development Manager for Bioquell (An Ecolab Solution).
Fred Claridge is retired and living in North Carolina after a 41-year career in EMS and emergency management. He served as a field provider, EMS instructor, and administrator, including directing one of the largest EMS systems in the country, as well as service as an emergency planner. Additionally, Fred has served as the inaugural editor of the EMS Historian: The Journal of The National EMS Museum.
Fred is serving at the National EMS Museum Vice President, 2023-2025
Elyssa Gonzales is a Master of Arts candidate at Johns Hopkins University for Museum Studies and Nonprofit Management with an additional focus on understanding museum operations and the continuing value to their communities. Her interests lay in supporting the building and/or restructuring museums from the ground up and to help museums find their unique way of supporting their communities.
J. Sam Hurley, MPH, EMPS, NRP currently serves as the Director of Maine’s Bureau of Emergency Medical Services. Sam began his career in EMS in North Carolina at a small rural volunteer fire department and subsequently continued his involvement with EMS throughout his undergraduate studies at the University of North Carolina at Chapel Hill and graduate school at Emory University, where he worked for Grady Health System in downtown Atlanta.
Cindy Kessler holds a Bachelors of Science in Design and has worked in various positions with museums, aquariums, and nonprofit organizations for the better part of three decades. Outside of her nonprofit work, Cindy is an avid singer, having performed at Carnegie Hall and The Kennedy Center. She is also a writer and artist, and enjoys directing youth theater performances in her spare time.
Cindy is serving at the National EMS Museum Secretary, 2023
Christopher Montera has more than 34 years of experience in Paramedic Services, Public Health, and the Fire Service. He is the Director of State and Federal Programs for ESO and the former Chief Executive Officer at Eagle County Health Service District and holds a Master’s in Health Leadership.
Chris is serving at the National EMS Museum Treasurer, 2023
Gary M. Schindele has been an EMT for 47 years and is a leading subject matter expert in the field of emergency preparedness design and implementation and serves as a member of the Central Florida Disaster Medical Coalition. Gary also volunteers as the Public Affairs Officer for the United States Naval Sea Cadet Corps youth program. Gary is also the President and Owner of Paladin Healthcare LLC which manufactures the original Fairfield Equipment Rail, once the standard for Equipment Management in most ambulances back in the late 70’s and 80’s.
Dave Zaiman has been in and around EMS for over 30 years. He spent 15 years working in the field as an EMT, EMD, and Paramedic. Dave finished his career at Hennepin County Medical Center in Minneapolis MN. Since then, Dave has held several leadership roles in the healthcare technology industry. Dave currently serves as Pulsara’s VP Sales – Midwest.
Dave is serving at the National EMS Museum President, 2023-2025
Alan DeYoung is the current Executive Director of the Wisconsin EMS Association with a passion for strategic development and business marketing. Alan will serve as an Ex-Officio member of the Board of Directors as the Immediate Past President, 2023-2025.
The Board of Directors will continue to be supported by Kristy Van Hoven (Museum Director), Tom Scott (Accounting), and the incredible volunteers of this organization. We invite anyone interested in volunteering to reach out to the Board of Directors at board@emsmuseum. org or Kristy at director@emsmuseum. org.
The National EMS Museum is a volunteer-led organization that collects, preserves, and shares the history of emergency medical response in the United States to celebrate the contributions of providers across the country and inspire future professionals to take up the call. To learn more about The National EMS Museum, please visit emsmuseum.org.
Rocco V. Morando, the Founder and first Executive Director of the National Registry of Emergency Medical Technicians passed away peacefully and surrounded by family on the morning of February 21, 2023 after a prolonged illness. He was 95.
“It is with a heavy heart and deep sadness that I inform you of the passing of our organization’s founder,” Bill Seifarth, the current executive director of the organization announced to his staff and board this afternoon. “Rocco Morando was a luminary in the EMS profession and was instrumental in helping shape the lifesaving system we know today. His legacy will continue to provide inspiration for years to come, and we are grateful for his contributions.”
On June 4, 1970, the National Registry of Emergency Medical Technicians was established following the recommendation of a task force assembled under President Lyndon B. Johnson’s Committee on Highway Traffic Safety. Morando was selected as the National Registry’s founding executive director in 1971 and held that position for nearly two decades.
During his career at the National Registry, Morando oversaw a number of accomplishments, including: the first basic NREMT-A examination administered simultaneously to 1,520 ambulance personnel at 51 test sites throughout the United States (1971); the first recertification of Nationally Registered EMTs based on re-evaluation of skills (1973); the development of the first national paramedic curriculum in conjunction with leading EMS agencies and the University of Pittsburgh (1976-77); and the first NREMT-Paramedic examination (1978); the development of the first NREMT-Intermediate curriculum and examination (1980).
Upon his retirement on December 31, 1988, Morando was honored with a celebration attended by hundreds of friends and representatives from national EMS organizations. The National Registry’s headquarters in Columbus, Ohio was renamed the Rocco V. Morando Building that same year.
The Rocco V. Morando Lifetime Achievement Award, named in his honor, recognizes a lifetime of commitment, contributions and leadership to Emergency Medical Services (EMS). The award is presented by the National Association of EMTs and is sponsored by the National Registry.
Current and former employees, along with those throughout the EMS community, send their thoughts and condolences to Rocco’s family and friends.
Funeral arrangements are still being made at this time. More information will be available on the funeral home’s website.
CONFIDENTIALITY NOTE: This e-mail is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this e-mail message is not the intended recipient, or the employee or agent responsible for delivery of the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is prohibited. If you have received this e-mail in error, please notify us immediately by telephone at (614) 888-4484 and also indicate the sender’s name. Thank you, National Registry of EMTs.
Copyright © 2023 National Registry of Emergency Medical Technicians (NREMT), All rights reserved.
Want to change how you receive these emails?
You can update your preferences or unsubscribe from this list.
View this email in your browser
|For Immediate Release|
GLENVIEW, ILLINOIS – February 2, 2023 – The Commission on Accreditation of Ambulance Services (CAAS) is pleased to announce that Mark Postma has accepted the position of Interim Administrator for CAAS’s Ground Vehicle Standard. Mark Postma succeeds Mark Van Arnam, who held the Administrator position from the inception of the Ground Vehicle Standard in 2014. Van Arnam leaves CAAS to take on the role of President of the REV Ambulance Group.
CAAS Chair Dale Berry said “CAAS wishes to extend its deep-felt appreciation for the tremendous contributions that Mark Van Arnam has provided over the last 7 years. Tapping into his significant industry expertise and passion for creating standards that improve ground vehicle safety, Mark Van Arnam was instrumental in establishing the CAAS Ground Vehicle Standard as the emergency transportation’s preferred standard. Our industry is safer because of Mark Van Arnam’s commitment and passion.”
In announcing Postma’s new interim role within CAAS, Dale Berry, said; “CAAS is extremely fortunate to have someone with Mark Postma’s experience and leadership abilities to continue the very successful launch and ongoing development of the Ground Vehicle Standard. Mark Postma has been the CAAS GVS Committee Co-Chair since 2016 and has a depth of knowledge that ensures a seamless transition. Mark Postma started as a paramedic over 40 years ago and continues as an esteemed leader in the EMS field.”
About the CAAS Ground Vehicle Standard (GVS)
Starting in 2014, CAAS established a Vehicle Standard Committee to develop consensus-based ground ambulance vehicle standards called GVS. Thanks to the hard work of this broad-based committee, the third significant update to the standard, GVS 3.0, was released in July 2022.
The new ambulance vehicle section of GVS V3.0 contains updates and edits from the prior version, and includes the latest safety, quality, and compliance requirements for new production ambulances. In addition, GVS V3.0 contains a comprehensive Remount Standard. The GVS Remount Standard provides minimum requirements for both Remounters and Remounted Ambulances, including specific requirements for vehicle production processes and quality control.
About the Commission on Accreditation of Ambulance Services (CAAS)
The Commission on Accreditation of Ambulance Services (CAAS) was established in 1993 to encourage and promote quality patient care in America’s medical transportation system. CAAS is an independent Commission that established a comprehensive series of standards for the ambulance service industry.
CAAS accreditation signifies that an ambulance service has met the “gold standard” determined by the ambulance industry to be essential in a modern emergency medical services provider. These standards often exceed those established by state or local regulation. The CAAS standards are designed to increase operational efficiency and clinical quality, while decreasing risk and liability to the organization.
|Commission on Accreditation of Ambulance Services (CAAS)
BROOKFIELD, WI – January 31, 2023 – The long-time ambulance manufacturing team of
Mark Van Arnam and Randy Hanson have been selected to lead the REV Ambulance Group.
Mark will serve as President for the Group and Randy will function as Chief Operating Officer.
“Mark and Randy have worked together in our company’s ambulance operations for over 35
years” stated Paul Bamatter, Chairman of REV Group’s Board of Directors. “They are well
known as the leading ambulance team in the business.”
The REV Ambulance Group is the largest ambulance manufacturing corporation in the industry,
and consists of legendary brands AEV, Horton, Leader, Road Rescue and Wheeled Coach.
“Our main objective is to provide our customers and dealers the high-quality vehicles that they
need and that we are known for,” Bamatter added. “We believe this new leadership team will
take our ambulance group to the next level.”
About REV Group, Inc.
REV Group companies are leading designers and manufacturers of specialty vehicles and
related aftermarket parts and services, which serve a diversified customer base, primarily in the
United States, through three segments: Fire & Emergency, Commercial, and Recreation. They
provide customized vehicle solutions for applications, including essential needs for public
services (ambulances, fire apparatus, school buses, and transit buses), commercial
infrastructure (terminal trucks and industrial sweepers), and consumer leisure (recreational
vehicles). REV Group's diverse portfolio is made up of well-established principal vehicle brands,
including many of the most recognizable names within their industry. Several of REV Group's
brands pioneered their specialty vehicle product categories and date back more than 50 years.
REV Group trades on the NYSE under the symbol REVG.
Director of PR & Social Media
Recently, members have asked numerous questions about the COVID-19-related Employee Retention Tax Credit (ERTC). HR/Operations Consultant Scott Moore, Esq., addresses common areas of confusion and shares information about the ERTC program in this Quick Take.
As we start the new year, US Ambulances for Ukraine continues to actively seek donated used ambulances from across the United States to send to Ukraine. Since the full-scale invasion of Ukraine by Russia on February 24, 2022, US Ambulances for Ukraine, in collaboration with the Ukrainian Consulate in Chicago has successfully delivered 18 American ambulances to Ukraine, many coming from members of the American Ambulance Association. In addition, another 10 ambulances and one fire engine are sailing across the Atlantic Ocean and will soon be delivered to Ukraine. Efforts are currently underway to make the next shipment of donated American ambulances the largest to date. The goal is to secure 22 ambulances to be shipped in late January or early February, which would bring the total number of donated ambulances from the United States to 50. If you have an ambulance that is mechanically sound that you are considering retiring or have one that isn’t needed anymore and would like to participate in this effort US Ambulances for Ukraine would love to hear from you. This group has a proven track record of successfully delivering ambulances to hospitals, military units, NGOs, fire departments and other entities operating in Ukraine. The group also continuously updates donors during the process and provides photographic updates of the ambulances once they have been delivered. Every donor knows exactly where their ambulance will be donated before it even leaves the United States.
The American Ambulance Association has followed the Twitter feed of US Ambulances for Ukraine @AmbulancesU and encourages you to do so as well. There you can see the latest updates on their efforts and several images of donated American ambulances in action. If you are interested in donating an ambulance or would like more information you can reach out to the founder of US Ambulances for Ukraine, Chris Manson, Vice President of Government Relations for OSF HealthCare at Christopher.M.Manson@osfhealthcare.org.
Every day, federal, state, and local law enforcement officers engage in exceptional acts of bravery while in the line of duty. Often, such acts place the officers involved at personal risk of injury or result in their sustaining a physical injury. To honor these acts of bravery, Congress passed the Law Enforcement Congressional Badge of Bravery Act of 2008 (Public Law 110-298), creating the Federal Law Enforcement Congressional Badge of Bravery and the State and Local Law Enforcement Congressional Badge of Bravery. The act establishes an award to honor exceptional acts of bravery in the line of duty by federal, state, and local law enforcement officers. The medals are awarded annually by the U.S. Attorney General and are presented by the recipients’ Congressional representatives.
To meet the definition of an act of bravery, nominees for the Congressional Badge of Bravery must have either:
The submitting of nominations is by/at the direction of law enforcement agency heads to the Department of Justice, Office of Justice Programs, Bureau of Justice Assistance. Nominations are considered by either the Federal Law Enforcement Congressional Badge of Bravery Board or the State and Local Law Enforcement Congressional Badge of Bravery Board, which submit their recommendations to the U.S. Attorney General.
The opening date for nominations is on or about December 15 of each year. When the nomination period is open, all nominations must be submitted through the online Congressional Badge of Bravery Nomination System.
PLEASE NOTE: The background of Congressional Badge of Bravery nominees may be reviewed as part of the selection process. Agency heads must submit nominations through the online Congressional Badge of Bravery Nomination System.
The AAA has sent a letter to VA Secretary Denis McDonough asking him to delay the implementation of a final rule that would allow the Department of Veterans Affairs (VA) to reimburse at the lower of billable charges or Medicare rates for certain non-contracted ambulance services. The proposed rule was issued back in 2020 but we understand that the VA could now issue the final rule in January 2023. GMR has been advocating on Capitol Hill for a delay in air and ground ambulance services. The AAA will be issuing later today a request for AAA members to reach out to the VA to also request the delay.
December 12, 2022
The Honorable Denis McDonough
Secretary of Veterans Affairs
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420
Dear Secretary McDonough,
The American Ambulance Association (AAA) respectfully requests that the Department delay release and implementation of the final rule on the “Change in Rates VA Pays for Special Modes of Transportation (RIN 2900-AP89).” Reimbursing for services to veterans at Medicare rates would have dire consequences for the ability of ground ambulance service organizations to provide lifesaving 9-1-1 emergency and also interfacility ambulance services not only to veterans but entire communities. We ask that the Department delay the rule until after Congress has had an opportunity to act on the results from the Medicare ambulance data collection system which is currently underway.
As documented by the Government Accountability Office (GAO) in 2007 and 2012, the Medicare program reimburses ground ambulance service organizations below the cost of providing their services when temporary add-ons are not considered. Since 2012, the disparity between the cost of providing ambulance services and reimbursement by Medicare has only increased through sequestration cuts, a reduction in inflation updates, and other Medicare payment policy changes. Ground ambulance service organizations are already facing difficult financial straits and cannot
sustain a reduction in reimbursement from another federal payor.
Ground ambulance service organizations serve as the foundation for emergency medical response for veterans and communities throughout the country. Our members are a vital component of our local and national health care and 9-1-1 emergency response systems and serve as lifelines of medical care for many rural and underserved communities. However, our ability to continue to serve communities is already at risk due to inadequate reimbursement and access to care for veterans would be further jeopardized if the Department were to reimburse at lower levels for ground ambulance services.
The AAA is the primary association for ground ambulance service organizations, including governmental entities, volunteer services, private for-profit, private not-for-profit, and hospital-based ambulance services. Our members provide emergency and non-emergency medical transportation services to more than 75 percent of the U.S. population. AAA members serve
patients in all 50 states and provide services in urban, rural, and super-rural areas.
Again, we request that you delay the release and implementation of the final rule on the “Change in Rates VA Pays for Special Modes of Transportation”.
If you have any questions regarding our request, please do not hesitate to have a member of your staff contact AAA Senior Vice President of Government Affairs Tristan North. Tristan can be reached by phone at (202) 802-9025 or email at firstname.lastname@example.org.
Thank you in advance for your consideration.
On November 23, 2022, CMS posted the 2023 Ambulance Fee Schedule Public Use Files. These files contain the amounts that will be allowed by Medicare in the calendar year 2023 for the various levels of ambulance service and mileage. These allowable reflect an 8.7% inflation adjustment over the calendar 2022 rates. The 2023 Ambulance Fee Schedule Public Use File can be downloaded from the CMS website by clicking here.
Please note that these files reflect the Medicare allowable based on current federal law. Accordingly, the 2023 Public Use Files do not include the current add-ons (i.e., 2% for urban, 3% for rural, and the super-rural bonus), as these add-ons are currently scheduled to expire on December 31, 2022.
The AAA is actively working with congressional offices to not only extend but hopefully increase, the Medicare ambulance add-ons by the end of the year. If you have not already written to your members of Congress about extending the add-ons at increased levels, please do so today by using the AAA online advocacy tool by clicking here.
Unfortunately, in recent years, CMS has elected to release its Public Use Files without state and payment locality headings. As a result, in order to look up the rates in your service area, you would need to know the CMS contract number assigned to your state. This is not something the typical ambulance service would necessarily have on hand. For this reason, the AAA will be publishing a reformatted version of the CMS Medicare Ambulance Fee Schedule that includes the state and payment locality headings. The reformatted fee schedule will be available on the AAA website in the coming days.
The AAA will also be publishing an updated version of its Medicare Rate Calculator, which we expect to have available on our website once we have a better sense of the timing of the extension of the add-ons.
Member Advisory: CMS Issues CY 2023 Final Ambulance Fee Schedule Rule Updated Data Ground Ambulance Data Collection System
by Kathy Lester, JD, MPH
CMS has released the “CY 2023 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicare and Medicaid Provider Enrollment Policies, Including for Skilled Nursing Facilities; Conditions of Payment for Suppliers of Durable Medicaid Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS); and Implementing Requirements for Manufacturers of Certain Single-dose Container or Single-use Package Drugs to Provide Refunds with Respect to Discarded Amounts” (Final Rule). The Final Rule includes proposals affecting ground ambulance services in terms of medical necessity requirements and documentation requirements, as well as to the ground ambulance cost collecting tool.
I. Medical Necessity and Documentation Requirements for Nonemergency, Scheduled, Repetitive Ambulance Services
CMS finalizes the modifications to the documentation requirements codified in regulation pertaining to the medical necessity and documentation requirements for nonemergency, scheduled, repetitive ambulance services, such as those to/from dialysis facilities. The Final Rule clarifies that the Physician Certification Statement (PCS), and additional documentation from the beneficiary’s medical record, may be used to support a claim that transportation by ground ambulance is medically necessary. It also notes that the PCS and additional documentation must provide detailed explanations that: (1) are consistent with the beneficiary’s current medical condition; and (2) explain the beneficiary’s need for transport by an ambulance. Coverage includes observation or other services rendered by qualified ambulance personnel. It maintains the following requirements:
CMS declines to “confine this regulatory clarification to the RSNAT prior authorization program, as there may be non-emergent, scheduled, repetitive ambulance transport services outside of that program that would be affected.” (Display Copy 1756) CMS also does not provide further clarification about what it means by the term “additional documentation” because it believes that “the data elements needed will vary depending upon the beneficiary’s specific conditions and needs.” (Id.) CMS also states that “[t]his proposal does not establish new obligations for documentation; rather, it merely clarifies existing requirements.” (Id. at 1757). In response to a comment, CMS also writes, “In addition, our pre-proposal language and proposed regulatory language both reflect that the presence of a PCS alone is not sufficient to demonstrate medical necessity, and, therefore, must be supported by medical documentation.” (Id.) CMS also declined to extend authorization to nurse practitioners and physicians’ assistants, stating that to do so would be outside of the scope of the rule.
II. Ground Ambulance Data Collection Instrument
CMS finalizes the proposed changes to the ground ambulance data collection instrument and instructions with a few additional modifications in response to comments. They fall within four areas: (1) editorial changes for clarity and consistency; (2) updates to reflect the web-based system; (3) clarifications responding to feedback from questions from interested parties and testing; and (4) typos and technical corrections. The updated instrument that includes all of the CY 2023 proposed changes to review and provide comments on is posted on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AmbulanceFeeSchedule/Downloads/Medicare-Ground-Ambulance-Data-Collection-System-Instrument.pdf.
One of these modification is to Section 5, Question 3c, which now reads: Does your organization respond to calls with another non- transporting agency such as a local fire department that is not part of your organization? After the question, the following instructions will be provided: This includes joint responses with other ground ambulance organizations as well as cases where a fire, police, or other public safety department responses to calls for service with your organization. Only consider cases where your ground ambulance does or would have transported the patient, if necessary.
The Final Rule notes that the system already includes an “autosave” feature that saves responses as they are entered. The system also allows the same user to enter information at different times, and/or multiple users to enter information at different times. The system also already includes many validation and error checking steps that are automatically applied as respondents enter information. CMS also noted that it has no plans to adopt additional import functionality prior to the launch of the system, but that it will continue to explore the option of an API. CMS also indicates that the final written tool and web-based platform will align before the system goes live. A print function will also be available for the online submissions.
CMS indicates that the data from the collection system will be made available to the public through posting on the CMS website at least every 2 years. Summary results will be posted by the last quarter. The data collected under the ground ambulance data collection system will be publicly available beginning in 2024.
CMS also indicates that it will not require a ground ambulance organization to fill the data entry submitter and data certifier roles with different individuals.
CMS has also provided additional guidance, including FAQs available at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/AmbulanceFeeSchedule/Downloads/Medicare-Ground-Ambulance-FAQs.pdf.
CMS also finalizes its proposal for an automated process for submitting a hardship exemption request and informal review request.
III. Origin and Destination Requirements Under the Ambulance Fee Schedule
In the Final Rule, CMS also responds to comments it received on the Interim Final Rule that expanded the origin and destination requirements. It finalizes the interim final policy that the expanded list of covered destinations for ground ambulance transports including, but are not limited to, any location that is an alternative site determined to be part of a hospital, CAH or SNF, community mental health centers, FQHCs, RHCs, physician offices, urgent care facilities, ASCs, any location furnishing dialysis services outside of an ESRD facility when an ESRD facility is not available, and the beneficiary’s home. The policy will be In effect for the duration of the PHE for the COVID-19 only.
OSHA Publishes Resources to Assist Employers with Mental Health & Wellness
The United States Department of Labor Occupational Safety & Health Administration has posted numerous resources and tools for employers to utilize to combat workplace stress. OSHA has published these resources following a survey conducted by the American Psychological Association in 2021 that reported burnout and stress at an all-time high across all professions and that “actions from their employers would help their mental health.”
The resources published by OSHA include:
Employers are starting to recognize the impacts that worker mental health has in the workplace. Statistics cited by OSHA reveal that workplace stress has been reported to cause 120,000 deaths in the U.S. each year. Nearly 83% of workers suffer from work-related stress and more than half of those report that workplace stress impacts their home life. Importantly, for every $1.00 spent on ordinary mental health concerns, employers see a $4.00 return in productivity gains.
The American Psychological Association encourages employers to develop mental health and wellness programs in the workplace. They recommend that employers go beyond simply offering an Employee Assistance Program (EAP). They recommend a cross-departmental review of your company’s EAP offerings to assess if they are meeting your workforce needs. Also, ensure that your program includes mental health professionals from diverse backgrounds and specialties. Additionally, they encourage launching a communications campaign about the things that your EAP professionals can cover, including stress, mental health, and financial guidance. Most importantly, ensure that your frontline leaders are informed and able to communicate the EAP availability and offerings to your team.
Under the Mental Health Parity and Addiction Equity Act (MHPAEA), all employers sponsored health plans are required to offer the same level of health coverage for mental health-related concerns as for any other medical concerns. Most short- and long-term disability insurance plans offer a limited number of free Employee Assistance Plan visits as part of the included benefits. Lastly, American Ambulance Association members get free access to the Counselor Match Program, which provides access to mental health counselors with extensive experience in working with EMS and public safety professionals.
If you need assistance with this, or any other workplace challenges, please contact the AAA at email@example.com.