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East Baton Rouge EMS | 2021 EMS Week Featured Service

East Baton Rouge EMS
Baton Rouge, Lousiana
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About East Baton Rouge EMS

East Baton Rouge EMS is a municipal service that originated on August 6th, 1982. The Department is funded by a property tax and insurance billing. EBREMS is the primary ALS provider for the parish of East Baton Rouge, Louisiana. Unlike most systems, all 911 calls in the parish are first answered by EBREMS Medics. East Baton Rouge Parish is 456sq/mi and is comprised of the City of Baton Rouge and the towns of Zachary, Baker and Central. With a total population +440,000, East Baton Rouge is the Capitol of the State of Louisiana and is the home of two major Universities.

EBREMS operates 11 EMS stations with 24 ambulances, 20 sprint vehicles, 1 mass casualty unit and 3 ASAP carts. There are 138 Field Medics, 9 Shift supervisors, Division managers, and 32 communications officers. EBREMS responds to approximately 64,000 calls per year. In addition to responding to 911 calls, EBREMS also offers Telemedicine, Event coverage, HAZ-MAT, CISM, Bicycle, and Special Response Teams. A new Bariatric unit has just been purchased along with 16 new ambulances. The new fleet will go into operation in July.

Our COVID-19 Response

A response plan to COVID was discussed in March 2020. The first order was to acquire enough PPE for our medics in the field. PPE included P-100 masks, goggles, and isolation kits. Two ambulances were converted into “COVID units” by using plastic sheeting to block the walk-through access of the units and the ALS cabinet. The units were stocked with an abundance of disinfectant and PPE. 12 medics volunteered to work on these units and only respond to COVID-related calls. The intention was to isolate the cab of the truck from the patient compartment, and limit exposure to the rest of the field by only using the assigned medics for these types of calls. 911 Operators began asking COVID screening questions, and would relay the information to the responding unit. Every patient was provided a surgical mask and the use of nebulizers was banned due to the aerosolization.

The Mayor declared a local public health emergency on March 13th. Schools, restaurants, bars, and non-essential businesses were closed and a “stay at home order” was implemented. 911 Operators began to see a surge in calls from the public asking COVID-related questions. This overwhelming number of non-emergent calls led to a Public Service campaign to inform the public not to call 911 for COVID questions. A new 211 number was utilized for these types of calls. Several testing sites opened throughout the parish, including one at the EBREMS Headquarters. Despite a large number of tests given, the percentage of positive tests was only about 7%.

East Baton Rouge lifted the Emergency Declaration in May 2020. Schools remained closed for a while, but offered virtual learning. Restaurants, Bars, Churches and non-essential businesses opened with limited capacity and mandated face mask requirements. Today EBR parish is 100% open, and EMS operation is back to pre-COVID status with the exception of continued use of face masks on every response.

“It is my belief that Baton Rouge EMS has some of the finest medics in the country and you would be hard pressed to find a better group of people to work with. Their dedication and professionalism through this last year’s pandemic has been nothing short of impressive. They care for their patients and their fellow first responders and treat them like family. It is an honor to work with all the medics here in Baton Rouge, and they deserve recognitions for the hard job that they do.”
-Chad Guillot
EMS Director
East Baton Rouge Parish EMS

How We Celebrate EMS Week

Every year our Public Information Officers work hard to promote the Department by doing interviews on Morning News shows, Submitting stories to the newspaper, and posting on Social Media. Our Paramedic Association purchases EMS Week gifts for the employees and also funds the annual Award Ceremony that is always held during EMS Week. The Administration Department provides lunch to the crews on each shift, and local hospitals also provide snacks and food at their hospitals for the field medics.

“We are a family-oriented department, and we treat the community like our own”
-Hillary Duncan, Paramedic

“We strive to meet the goals of our mission statement and continually adapt to fulfill the needs of our community”
-Otha Henry, Training Officer

“As EMS providers we value our community”
-Kerri Avara, Unit Commander

Podcast | EMS One-Stop on Rural EMS Funding

In this episode of EMS One-Stop With Rob Lawrence, Rob is joined by Justin Grohs, general manager at Great Falls Emergency Services, Montana. Grohs also serves the American Ambulance Association as chair of the Rural Task Force.
Together, they discuss the realities, challenges, and funding of rural EMS, where staffing and financial stressors have been further exacerbated by the pandemic.

Allina Health EMS | EMS Week 2021 Featured Service

Allina Health EMS
St. Paul, Minnesota
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Founded in 1920, the 600+ employees of Allina Health EMS serves over one million citizens in the communities surrounding the Minneapolis/St. Paul vicinity with 911, Critical Care and Interfacility transports. In addition, we provide Community Paramedics, Tactical Paramedics, EMS Education and Special Event support to the communities we serve. Our Communications Center answers one in ten 911 calls throughout the state of Minnesota, not only providing dispatching services for Allina Health EMS, but other EMS services throughout the state.

Our staff rose (and continues to rise) to the challenges that COVID-19 presents to us. Some parted with facial hair! The collaboration was evident when staff helped to inform our processes and procedures for PPE and communication at the beginning of COVID-19. Each day we were learning something new, whether it was PPE procedures, hospital information such as entrance and transfer of patient care changes or services available to support our essential working employees. Our Communications Center began revising questions asked of our 911 callers to help determine potential risks prior to the arrival of our ambulance crew and to inform the level of PPE needed. Whether it was a 911 response or an interfacility transfer, we continued to improve our processes so our staff was protected and prepared when responding to our patients.
Our Education department tested and transitioned to online platforms for continued internal education and our external educators came into the bases to provide Just in Time Training (JITT) to our staff so the practical application of equipment and PPE changes were able to be understood and practiced prior to use. Our EMS maintenance and inventory technicians helped to implement changes to our ambulances to protect both patients and staff from the virus through protective devices and the task of keeping up with equipment and stocking changes.

Our Emergency Operations Center strived to provide timely updates and information, which we did in traditional written and email form. In addition, to support a mobile and 24/7 workforce, we used technology to provide information through videos and update posts via a closed social media group for our employees.

During the start of the pandemic, a significant event took place in our area. We supported our local EMS and Public Safety partners as we experienced civil unrest as a result of the death of George Floyd. This time was demanding physically pandemic, the unrest and the summer increased our responses and it was emotionally demanding as we saw the toll both of these events took on our staff and our communities.

While COVID became a part of our regular responses, we moved into 2021 and experienced a workplace shooting at one of our clinics that our EMS staff responds to on a regular basis. The response to this event, the level of teamwork and dedication of our staff to providing exceptional care, highlights what makes Allina Health EMS one of the leaders in Minnesota EMS.

“Allina Health EMS providers show up everyday to be ready to respond to the needs of their community, whether it is a multi-vehicle crash on the freeway, a cardiac arrest of a grandparent or a new mom who is just scared and needs reassurance that her baby is okay. Our providers go above and beyond each day to take exceptional care of their patients and their communities. We are proud of everyone who supports the care of our communities and are looking forward to celebrating EMS Week 2021 with the team.” Susan Long, Vice President of Operations

EMS is important on many levels, but being there during a critical time of someone’s life is the most important to me. Being there to providing that voice of comfort to those who really need it, is the most rewarding part of all.
Kymberly Markgraf, EMT

Courage is being scared to death, but jumping in anyway. or Success is knowing another has breathed easier because of your help.
Kelly Pischke, Paramedic

EMS Week Celebrations

Food and fellowship are the highlights of this year’s EMS Week at Allina Health EMS! Physical distancing guidelines prevented us from having our typical EMS gatherings last year and hampered our ability to celebrate our Centennial Year of Service. We are looking forward to recognizing our staff in everyday interaction but especially during their week with safety measures in place during meals and activities during the week

NHTSA EMS.gov | EMS Week Video

From NHTSA’s Office of EMS on May 17, 2021

This week, May 16-22, 2021, we once again recognize the people of EMS by celebrating National EMS Week. We hope you’ll take a minute to watch this special message from the entire team here at the National Highway Traffic Safety Administration Office of EMS.


This year’s EMS Week theme, “This is EMS: Caring for our Communities,” couldn’t be more appropriate. The past year has been a challenge, but it has also reminded people across the nation just how valuable emergency medical services systems—and most important, clinicians—are to our communities. This nation is in debt to all of the EMS clinicians and the people behind the scenes who show up every day with true professionalism and dedication.

From all of us here at the Office of EMS, NHTSA, and the Department of Transportation: Thank you.

St. Charles County Ambulance District | EMS Week 2021 Featured Service

St. Charles County Ambulance District
St. Peters, Missouri
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St. Charles County Ambulance District (SCCAD) began operations in 1975 with three ambulances covering a largely rural 592 square mile service area. Over the past 45 years, the community has grown considerably; today, the population eclipses 400,000 residents. SCCAD, which currently employs 195 full-time staff and 70 part-time employees, has kept pace with the growth, adding stations and ambulances in strategic locations to ensure that response times to 911 emergencies remain short. The District currently staffs 19 advanced life support units from 16 stations serving all municipalities and unincorporated areas of the county. In addition to 911 response, SCCAD offers non-emergency inter-facility transport, which is staffed separately from the 911 division. In 2019, the District implemented a successful critical care ground transport program to help high-acuity patients get from our county’s community hospitals to the larger healthcare centers in St. Louis city and county.

Over the past decade, SCCAD has developed and implemented a number of innovative initiatives to better meet the evolving healthcare needs of our community. These include a multi-faceted Mobile Integrated Health (community paramedic) program, which focuses on readmission avoidance in partnership with several hospitals in our area, and SCCAD high-utilization patients identified by our paramedics. In addition, the MIH team collaborates with commercial insurers to offer services to their patients in the county. Also developed in recent years was the American Ambulance Association AMBY award-winning Substance Use Recovery Response Team, which sees specially-trained paramedics helping facilitate overdose patients’ entry into treatment programs if they’re willing to seek help. In 2018, the District launched a successful behavioral health telemedicine program in partnership with Behavioral Health Response. Most recently, SCCAD was one of only three EMS organizations in the state of Missouri selected to pilot the Centers for Medicare & Medicaid Services Emergency Triage, Treat & Transport (ET3) program.

While COVID-19 most certainly presented operational challenges, it also offered EMS providers an opportunity to showcase our industry’s collective ability to adapt in the face of adverse conditions, and develop innovative, mission-driven solutions to meet the mobile health needs of the communities we serve.

From the onset, SCCAD embraced the challenge, working to develop strategies that would meet the needs of our employees, fellow first responders, and the community at large. To this end, our leadership team has worked in tandem with the St. Charles County Department of Public Health. Our Deputy Chiefs of Operations and Special Operations were added to the County’s incident command structure, and worked out of the County’s EOC to ensure a coordinated response. Meanwhile, our Deputy Chief Medical Officer worked tirelessly to develop aggressive contract tracing and quarantine procedures to ensure the safety of our team members, and worked to regularly push updated information out to crews. Under his direction, our training team spent time carefully reviewing donning/doffing and other safety protocols with team members.

In spring of last year, St. Charles County, like most other communities, struggled to scale up COVID-19 testing processes to meet demand. Residents experiencing symptoms were at times unable to get appointments for several days. Given the number of potential exposures that could result from a single infected paramedic, firefighter, or police officer, SCCAD’s MIH Team launched their first effort: a first responder testing program. The testing site enabled local police and fire agencies, along with SCCAD employees, to obtain a testing appointment in an expedited fashion. When local partners added more testing capacity toward autumn, we were able to scale down the testing effort.

Around the same time, Pfizer and Moderna began announcing initial success in clinical trials with their vaccines. With signs pointing toward emergency use authorization being granted by the FDA before year-end, the SCCAD team once again began strategizing on ways to make an impact. In conference with Public Health, it was determined that we would initially take point on first responder vaccinations, then move into other segments of the population while concurrently assisting with large-scale vaccination events being hosted by Public Health. Some of the vulnerable populations we’ve vaccinated have included elderly citizens residing at independent living senior apartments, homebound individuals, and those residing in rural areas of our county.

Though the past 14 months have been a stressful, challenging time, they’ve also shed a spotlight on the strength, determination, and character of many within our industry. In communities large and small across our state and nation, EMS is playing a critical role in getting things back to normal.

“Each and every day, our team of skilled professionals embody our values of dedication, compassion, accountability, integrity and respect. Through interactions on 911 calls, non-emergency transfers, and community safety programs, they are promoting best practices to integrated, community healthcare and enhancing the reputation not only of our organization, but also of the EMS industry.”
Kelly Cope, Chief

“Today’s healthcare landscape is constantly evolving, and paramedics are increasingly being relied upon to deliver the right treatment at the right place, time, and cost. Our team has risen to the occasion, developing and implementing several unique programs to address the unique needs of our community in recent years.”
Dave Lewis, Assistant Chief of Administration

“As is the case in many communities, our paramedics frequently find themselves serving not only a clinical role, but also one of counseling/social services. Our team has helped members of our community navigate everything from bed bug infestations to food instability. No matter the circumstances, patient advocacy is a critical role fulfilled by EMS.”
Kimberlyn Tihen, Mobile Integrated Health Division Captain

“EMS plays an important role in communities every day, but that role is heightened during significant and/or unique events. We’re relied upon to be part of the overall solution, projecting a sense of calm and reassurance. I’m grateful to work for an organization that invests heavily in training and equipment for these unique scenarios, giving me the tools I need to serve residents when the need arises.”
Rees Remington, Battalion Chief

To celebrate EMS Week, we’re patronizing a local small business in our community to show our appreciation to the paramedics and support staff of SCCAD. Prados, an upscale locally-owned Mexican cantina located within our community, will be preparing meal kits on May 17, 19 and 21 so each of our crews can enjoy a handcrafted lunch. Our leadership team will report to Prados at 11 a.m. on each of the aforementioned days, and will deliver the kits to our 16 stations across the county. Of course, our training, service center, maintenance, administration and other non-clinical team members are included.

In addition, we’ll be utilizing our social media feeds to highlight EMS Week and the work of our team.

Presidential Proclamation for EMS Week 2021

From Whitehouse.gov’s Briefing Room on Presidential Actions

A Proclamation on Emergency Medical Services Week, 2021

Every day, in communities across the country, Emergency Medical Service (EMS) providers put themselves on the line to save lives, safeguard dangerous situations, and deliver hope to families and communities in crisis.  With selflessness, professionalism, and grace under fire, they provide essential care — never more so than during our battle with COVID-19 over the past year.  This year’s Emergency Medical Services Week theme, “THIS IS EMS:  Caring for Our Communities,” honors our heroic frontline workers who provide vital emergency medical care and ease the burden of crisis for Americans in need of help.

Through service, compassion, and dedication, EMS providers represent the very best of the American spirit.  In the face of unprecedented challenges, their expertise, endurance, and hard work have been a literal lifeline for families in every community.  Whether responding to the enormous suffering caused by COVID-19, the devastation of extreme climate events, or daily medical emergencies, EMS providers — many of whom are volunteers — prepare, sacrifice, and put others ahead of themselves.  Not only do they assume the heightened risks associated with emergency care during a pandemic, but they also spend countless hours away from families and friends in order to serve their communities.

In the face of these challenges, EMS providers have not hesitated to take on new roles, including supporting COVID-19 testing, therapeutics, and vaccination sites.  To help support the women and men who do this vital work, my American Rescue Plan included $100 million to support the mental well-being — including the mental health — of our health care professionals, paraprofessionals, public safety officers, and EMS providers.  My Administration has also made it a priority to ensure that our State, local, Tribal, and territorial partners have the resources they need so that EMS providers are trained and equipped to respond to public health emergencies safely and effectively, now and in the future.

During Emergency Medical Services Week, we extend our deepest gratitude to all EMS providers.  Their courage, selflessness, and commitment are extraordinary examples of what it means to serve this great country.  We also extend our sincere condolences to the loved ones of EMS providers who have given their lives in the line of duty.  This week and every week, I urge all Americans to express their appreciation for our Nation’s EMS providers — and to bring greater safety to their lives, and to all of our lives, by getting vaccinated to help bring an end to the COVID-19 pandemic.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 16 through May 22, 2021, as Emergency Medical Services Week.  I call upon public officials, doctors, nurses, paramedics, Emergency Medical Service providers, and all the people of the United States to observe this week with appropriate programs, ceremonies, and activities.

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

 JOSEPH R. BIDEN JR.

 

 

National EMS Museum Jack Stout Archive Announced

FOR IMMEDIATE RELEASE: May 13, 2021

Media Contact:

Jenny Abercrombie
jabercrombie@firstwatch.net
951.440.6848

FirstWatch and the Academy of International Mobile Healthcare Integration (AIMHI) Partner to Fund the Jack Stout Archive at The National EMS Museum

Online Collection will Showcase the Late EMS Visionary’s Legacy

Carlsbad, Calif.—FirstWatch, a technology and quality improvement company serving public safety and healthcare organizations, has partnered with the Academy of International Mobile Healthcare Integration to preserve the written legacy of the late EMS visionary Jack Stout. The partnership will fund an online archive hosted by The National EMS Museum, making more than 100 of Stout’s articles and essays available to the public. Many of them appeared in JEMS, the Journal of Emergency Medical Services, beginning with his pivotal series introducing the concepts of high-performance EMS in the May 1980 edition.

As EMS Week approaches with the theme of, “This is EMS: Caring for our Communities,”

Keith Griffiths, the founding editor of JEMS and now a partner with the RedFlash Group, noted that

Stout is known for creating efficiency in EMS systems. However, his philosophy was very much about doing what was best for the patient and their community, according to their priorities and policies.  Griffiths worked with Stout on dozens of his articles and columns. “He was a brilliant communicator and storyteller,” he said, “taking abstract concepts and making them come alive with clear, down-to-earth prose that still resonates today.”

Known as the “Father of High-Performance EMS and System Status Management,” Stout developed his concepts in the 1970s to improve EMS systems by making them more efficient and focused on patient care. An economist by trade, he found that applying the science, concepts, and economics used in manufacturing provided the framework for standing up high-quality EMS systems that could afford to provide effective and reliable prehospital care.

Stout’s son, FirstWatch Founder and President, Todd Stout, has granted The National EMS Museum the rights to provide access to all of his father’s articles in a format that’s fully searchable. “Teaming up with AIMHI was the natural and obvious choice to enable The National EMS Museum to ensure my father’s work, which is still so timely today, is available for future generations to learn from,” he said. “We appreciate that JEMS provided a good home for his ideas for more than a decade.”

The National EMS Museum will digitally transcribe and catalog the documents as part of its digital library and research archives—part of the virtual museum program created and maintained by volunteers. Many of the articles are already available in the museum’s online Jack Stout Archive. Additional material will be added in future months.

“We’re delighted to preserve and share these historical and transformative articles,” said Kristy Van Hoven, the museum’s director.

“AIMHI is proud to partner with FirstWatch to contribute to the creation of the Jack Stout Archive,” said Chip Decker, president of AIMHI and CEO of the Richmond Ambulance Authority. “His legacy lives on as many of our member organizations were formed around the high-performance principles and practices of Jack’s work—which is increasingly valuable in today’s economically-challenged EMS landscape.”

The principles established by Stout led to the creation (by him, Jay Fitch, and others) of nationally recognized and award-winning high-performance EMS systems including the Three Rivers Ambulance Authority (TRAA) in Fort Wayne, Indiana; the Richmond Ambulance Authority (RAA) in Richmond, Virginia; Metropolitan EMS (MEMS) in Little Rock, Arkansas; the Regional EMS Authority (REMSA) in Reno, Nevada; the EMS Authority (EMSA) in Tulsa and Oklahoma City, Oklahoma; the Sunstar system in Pinellas County, Florida; and MEDIC in Charlotte, North Carolina.

On June 24, FirstWatch will host a special edition of Conversations That Matter—a series of thought-provoking discussions in EMS—to answer the question, “Who Was Jack and Why Do His Ideas Still Resonate?” Facilitators Mike Taigman and Rob Lawrence will be joined by Kristy Van Hoven, Todd Stout, Keith Griffiths, and Jon Washko, a “Stoutian” disciple and highly respected consultant and EMS system expert, to explore why Stout’s ideas remain critically relevant for today’s EMS leader and key to the design of EMS systems of the future. Register for the session now here.

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About FirstWatch

FirstWatch helps public safety and healthcare professionals serve their communities through the use of technology and the science of quality improvement. Drawing on deep experience in emergency services, the FirstWatch team develops software and personalized solutions to help organizations continuously improve at what they do. Founded in 1998, and based in Carlsbad, Calif., FirstWatch has partnered with more than 500 communities across North America to improve outcomes, efficiency, safety, and operations. Learn more at: https://firstwatch.net.

About the Academy of International Mobile Healthcare Integration (AIMHI)

The Academy of International Mobile Healthcare Integration (AIMHI) represents high performance emergency medical and mobile healthcare providers in the U.S. and abroad. AIMHI, formerly known as the Coalition of Advanced Emergency Medical Services (CAEMS), changed its name in March 2015 to better reflect its members’ dedication to promoting high performance ambulance and mobile integrated healthcare systems working diligently to performance and technological advancements. Member organizations are high performance systems that employ business practices from both the public and private sectors. By combining industry innovation with close government oversight, AIMHI affiliates are able to offer unsurpassed service excellence and cost efficiency. Learn more at: http://aimhi.mobi/.

About The National EMS Museum

The National EMS Museum is dedicated to preserving and commemorating the history of EMS in the U.S. By collecting historic equipment, books, articles and tools of the trade, the museum showcases how EMS has developed over the last 150 years. Through the study of the past, the museum strives to inspire EMS practitioners and leaders of today to develop new tools and procedures to provide better and more effective emergency care to patients and communities. Learn more at: https://emsmuseum.org/.

HRSA | Federal Office of Rural Health Policy Update

HRSA | Federal Office of Rural Health Policy Update | May 13, 2021

What’s New

CDC and USDA Team Up for Vaccine Education Effort.  The Centers for Disease Control and Prevention (CDC) is providing $9.95 million in funding to the U.S. Department of Agriculture’s USDA) National Institute of Food and Agriculture (NIFA) to improve vaccine confidence in rural areas.  NIFA will work with local partners through the Land Grant University System and its Cooperative Extension System, a nationwide educational network that provides non-formal higher education and learning to farming communities.

HRSA COVID-19 Coverage Assistance Fund.  The Health Resources and Services Administration (HRSA) will provide claims reimbursement at the national Medicare rate for eligible health care providers administering vaccines to underinsured individuals. This may be particularly helpful in rural communities given higher rates of uninsured and underinsured.

HHS/DoD National Emergency Tele-Critical Care Network.  A joint program of the U.S. Department of Health & Human Services (HHS) and the U.S. Department of Defense (DoD) is available at no cost to hospitals caring for COVID-19 patients and struggling with access to enough critical care physicians, nurses, respiratory therapists and other specialized clinical experts. Teams of critical care clinicians are available to deliver virtual care through lightweight telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians and email to learn more and sign up.

HHS Coordinates New Effort to Vaccinate Migratory/Seasonal Workers in Agriculture.  The U.S. Department of Health & Human Services (HHS) is working with several divisions, including the Food and Drug Administration and the Health Resources and Services Administration to boost vaccination rates in a workforce often at heightened risk of COVID-19 infection.

RAND/RWJF Report:  COVID-19 and the Experiences of Populations at Greater Risk.  The RAND Corporation joined with the Robert Wood Johnson Foundation (RWJF) to examine the way people view health issues. Researchers asked people in the United States about their experiences related to the pandemic, and their views on issues such as freedom, racism, and the role of government.


COVID-19 Resources

New: FCC Emergency Broadband Benefit ProgramThe Federal Communications Commission (FCC) created this temporary program to help eligible individuals and households afford internet service during the pandemic. Eligible households can enroll through an approved broadband service provider or by visiting GetEmergencyBroadband.org.  The program will end when the fund runs out of money, or six months after the U.S. Department of Health and Human Services declares an end to the COVID-19 health emergency, whichever is sooner.

We Can Do This: COVID-19 Public Education Campaign.  The U.S. Department of Health & Human Services announced a national effort to help community partners promote COVID-19 vaccine confidence.  The campaign includes educational materials targeted to specific audiences and seeks volunteers for the COVID-19 Community CorpsNew: The Rural Communities Toolkit provides resources for building vaccine confidence.  

Volunteer to Administer COVID-19 Vaccines.  The U.S. Department of Health & Human Services has expanded its definition of persons authorized to give the vaccine.  These include, among others, current and retired traditional and non-traditional health care professionals, and students in health care programs.

HHS Facts About COVID Care for the Uninsured. The U.S. Department of Health & Human Services (HHS) helps uninsured individuals find no-cost COVID-19 testing, treatment and vaccines.  The HRSA Uninsured Program provides claims reimbursement to health care providers generally at Medicare rates for testing, treating, and administering vaccines to uninsured individuals, including undocumented immigrants.  There are at-a-glance fact sheets for providers and for patients in English and Spanish.

Federal Office of Rural Health Policy FAQs for COVID-19.  A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders.  NewResources for Rural Health Clinics.

COVID-19 FAQs and Funding for HRSA Programs. Find COVID-19-related funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).

CARES Act Provider Relief Fund Frequently Asked Questions.  Includes information on terms and conditions, attestation, reporting and auditing requirements, general and targeted distributions, and how to report capital equipment purchases.

CDC COVID-19 Updates.  The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care, a vaccine locator by state, and COVID-19 Vaccination Trainings for new and experienced providers.  NewUpdated Frequently Asked Questions about COVID-19 vaccination, including new guidance for use in adolescents 12 and older.

CMS Coronavirus Partner Resources.  The Centers for Medicare & Medicaid Services (CMS) provides information for providers, health plans, state Medicaid programs, and Children’s Health Insurance Programs and holds regular stakeholder calls to provide updates.

HHS Coronavirus Data Hub.  The U.S. Department of Health & Human Services (HHS) website includes estimated and reported hospital capacity by state, with numbers updated daily.

NIH Community Engagement Alliance Against  COVID-19 Disparities.  The National Institutes of Health (NIH) created a collection of online resources with information for communities hit hardest by the pandemic, such as African Americans, Hispanics/Latinos, and American Indian/Alaska Natives.

COVID-19 Data from the U.S. Census Bureau. The site provides access to demographic and economic data, including state and local data on at-risk populations, poverty, health insurance coverage, and employment.

ATTC Network COVID-19 Resources for Addictions Treatment. The Addiction Technology Transfer Center (ATTC) Network was established in 1993 by the Substance Abuse and Mental Health Services Administration.  The online catalog of COVID-related resources includes regularly-updated guidance and trainings for professionals in the field.

GHPC’s Collection of Rural Health Strategies for COVID-19.  The FORHP-supported Georgia Health Policy Center (GHPC) provides reports, guidance, and innovative strategies gleaned from their technical assistance and peer learning sessions with FORHP grantees.  New: The Impact of Rural Residence on COVID-19 Disparities.

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties.  The RUPRI Center for Rural Health Policy Analysis provides up-to-date data on rural and urban confirmed cases throughout the United States.  An animated map shows the progression of cases beginning March 26, 2020 to the present.

Rural Response to Coronavirus Disease 2019.  The Rural Health Information Hub has a compendium of rural-specific activities and guidelines, including Rural Healthcare Surge Readiness, a tool with resources for responding to a local surge in cases.

SAMHSA Training and Technical Assistance Related to COVID-19.  The Substance Abuse and Mental Health Services Administration (SAMHSA) created this list of resources, tools, and trainings for behavioral health and recovery providers.

Mobilizing Health Care Workforce via Telehealth.  ProviderBridge.org was created by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Program. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.

Online Resource for Licensure of Health Professionals.  Created by the Association of State and Provincial Psychology Boards, the site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical therapists assistants, and social workers. 


Funding and Opportunities

Nurse Corps Scholarship Program – extended to May 26. The Nurse Corps Scholarship Program provides financial support to students enrolled in nursing degree programs in exchange for a commitment to serve in high-need areas across the country. This year, Nurse Corps has additional funding for qualified nursing students that includes tuition, fees, other reasonable educational costs, and a monthly living stipend.

DOJ National Tribal Clearinghouse on Sexual Assault – June 3. The U.S. Department of Justice (DOJ) will make one award for $980,000 to an organization that can provide nationwide training and technical assistance for response to sexual assault crimes and services for victims in American Indian/Alaska Native communities.

DOJ Comprehensive Opioid, Stimulant, and Substance Abuse Site-Based Program – June 7. The U.S. Department of Justice (DOJ) will make 110 awards with total funding of $163 million to support state, local, tribal, and territorial response to use of illicit substances.  A subcategory of the program will award up to $600,000 each for projects in rural areas, small counties, and tribal areas with a population of fewer than 100,000 for a federally recognized tribe.

HRSA Rural Northern Border Region Planning Program – June 14. The Health Resources and Services Administration’s (HRSA) will make approximately four awards of up to $190,000 each to support health care needs in underserved rural communities of the Northern Border Regional Commission (NBRC) service area.

DOJ Second Chance Act Youth Offender Reentry Program – June 15.  The U.S. Department of Justice (DOJ) will make 13 awards of up to $750,000 each to support youth returning to their communities from correctional facilities.  The program encourages collaboration between state agencies, local government, and community- and faith-based organizations.  Separately, the DOJ will make approximately 15 awards of up to $750,000 each for the Juvenile Drug Treatment Court Program – June 15.

USDA Local Food Promotion Program – June 21.  The U.S. Department of Agriculture (USDA) will make grants of up to $200,000 each for planning grants, and up to $750,000 for implementation grants.  Grant recipients will create or expand projects that increase the availability of locally produced food.

DOJ Strategies to Support Children Exposed to Violence – June 22.  The U.S. Department of Justice (DOJ) estimates eight awards with total investment of $7 million to support community-level strategies for children exposed to violence.  Priority consideration will be given to applications promoting civil rights, building trust between law enforcement and the community, and that are intended to benefit high poverty areas.

HUD Housing Opportunities for Persons with AIDS – July 6.  The U.S. Department of Housing and Urban Development (HUD) will make 18 awards of up to $2.25 million each for community projects that provide housing for people with HIV/AIDS in underserved areas. Rural populations are among those of interest for ensuring health equity. Also known as Housing as an Intervention to Fight AIDS, the program aims to create housing and service models that can be replicated in other similar localities.


Rural Health Research

Research in this section is provided by the HRSA/FORHP-supported Rural Health Research Gateway.  Sign up to receive alerts when new publications become available. 

Medicare-Paid Naloxone: Trends in Nonmetropolitan and Metropolitan Areas.  Previous research has found that Medicare paid for an increasing share of naloxone prescriptions from 2016 to 2018 and pays for 1/3 of all naloxone dispensed from retail pharmacies as of 2018.  This brief from the Rural and Underserved Health Research Center examines trends in Medicare-paid naloxone dispensing rates in nonmetropolitan versus metropolitan areas from 2014 to 2018.


Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov.

Request for Information on Advancing Equity and Support for Underserved Communities – Comments due July 6.  The Office of Management and Budget (OMB) seeks input from a broad array of stakeholders in the public, private, advocacy, not-for-profit, and philanthropic sectors, including State, local, Tribal, and territorial areas, on available methods, approaches, and tools that the Government can use to promote equity and support underserved communities.

Increased Medicare payment for COVID-19 monoclonal antibody infusions.  The Centers and Medicare & Medicaid Service (CMS) announced last week an increase in the national average payment rate for administering monoclonal antibody treatments for COVID-19 from $310 to $450 for most health care settings.  Additionally, they have established a higher national payment rate of $750 for monoclonal antibody treatments administered in a beneficiary’s home, including the beneficiary’s permanent residence or temporary lodging.  CMS is updating its COVID-19 toolkits for providers, states, and insurers to reflect this change.

Medicare Guidance on Interoperability Rule Requirements for Hospitals.   This interpretive guidance from the Centers for Medicare & Medicaid Services (CMS) outlines the Conditions of Participation (CoPs) requiring hospitals, psychiatric hospitals, and Critical Access Hospitals (CAHs) to send electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner, which are effective as of May 1, 2021.  These CoPs were finalized in the May 2020 Interoperability and Patient Access Final Rule and are addressed in the recently released Interoperability Final Rule FAQs.

Medicare Waiver for Ambulance Treatment in Place.  This Fact Sheet describes the circumstances in which ground ambulance services may be reimbursed by Medicare for treatment provided in place because a patient was not able to be transported to a destination permitted under Medicare regulations due to community-wide emergency medical service (EMS) protocols due to the COVID-19 PHE.  This waiver is retroactively effective to March 1, 2020.


Learning Events and Technical Assistance

ONDCP Workshop for SUD: Rural Faith-Based Leaders – Thursday, May 13 at 1:00 pm ET.  The Office of National Drug Control Policy (ONDCP) will hold a second session (90 minutes) in its series for faith leaders in rural areas.  The workshops are meant to increase understanding of substance use disorder (SUD) and provide guidance on connecting faith to prevention, treatment, and recovery.  If you would like to attend, please RSVP to Betty-Ann Bryce, Special Advisor for Rural Affairs at MBX.ONDCP.RuralAffairs@ondcp.eop.gov with your name, title, organization, state/county, and contact information/email address. The Rural Health Information Hub has a recording of the first workshop for faith leaders in its Community Toolbox for SUD.

MATRC: Answering Questions About Telehealth and Telemental Health – Friday, May 14 at 12:00 pm ET.  The Mid-Atlantic Telehealth Resource Center (MATRC) holds a live, two-hour event to answer questions about the basics.  The MATRC is one of 14 FORHP-Supported Telehealth Resource Centers.  This is a recurring session taking place every other Friday from 12:00 to 2:00 pm ET.

HRSA Telehealth Series: Learn About Licensure Compacts – Monday, May 17 at 12:30 pm ET.  Experts from the National Center for Interstate Compacts will discuss agreements for doctors, nurses, psychologists and other clinicians to see patients across state lines via telehealth.

SBIRT for SUD Native American Communities – Tuesday, May 18 at 11:00 am ET.  Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a process to quickly assess substance use disorder (SUD) in a person and move them toward more extensive treatment.  This hour-long session is hosted by the National American Indian & Alaska Native Prevention Technology Transfer Center.

AgriSafe: Zoonotic Disease and Pregnancy – Wednesday, May 19 at 1:00 pm ET.  The AgriSafe Network will hold a one-hour session to explain the risk that diseases transmitted between farm animals and humans pose to pregnant women.

Overcoming Mental Health Stigma in Rural Communities – Wednesday, May 19 at 2:00 pm ET.  The Mental Health Technology Transfer Center Network will host a one-hour workshop to discuss what influences negative attitudes toward mental health and techniques to overcome various forms of stigma.

Assessment of Opioid Misuse Risk Among Farmers in the Clinical Setting – Friday, May 21 at 1:00 pm ET. The AgriSafe Network will host an hour-long webinar to provide insight on misuse risk factors and warning signs among farmers.

SAMHSA Connecting Prevention Specialists to Native Communities – Friday, May 21 at 1:00 pm ET.  The Tribal Training and Technical Assistance Center at the Substance Abuse and Mental Health Services Administration (SAMHSA) holds virtual trainings to cover topics such as crisis response, youth engagement, and sexual assault awareness.  Trainings will take place on the third Friday of each month.


Resource of the Week

Successful COVID-19 Messaging in Rural CommunitiesIn this 30-minute video, the state leadership in West Virginia present insight from their research and vaccine outreach campaign.


Approaching Deadlines

CDC Childhood Lead Poisoning Prevention and Surveillance – extended to May 14 (from April 25)

Park and Recreation Mentorship Grants for Rural Youth Impacted by Opioids – May 15

ARC Investments Supporting Partnerships/Recovery Ecosystems – Letters of Intent May 17

CDC Drug Free Communities – extended to May 17 (from May 10)

Cross-Jurisdictional Sharing in Public Health: Small Grants Program – May 17

EPA Technical Assistance for Wastewater Treatment – May 17

SAMHSA Overdose Treatment for Use by First Responders – May 17

HRSA Expanding Community-Based Workforce for COVID-19 Vaccine Outreach – May 18

Comments Requested:  Proposed Changes to the Census Bureau Definition of Urban – May 20

CMS Primary Care First Model Cohort 2 – extended to May 21 (from April 30)

CDC Community Health Workers for COVID Response – May 24

New Sites for National Health Service Corps (NHSC) – May 25

Native American Agriculture Fund Grants for Youth – May 25

Nurse Corps Scholarship Program – extended to May 26

EMS Week Featured Service Application

EMS Week will take place from May 16–22, 2021.  To celebrate the extraordinary contributions of ambulance services to the communities they serve, we will be featuring specific services throughout EMS week on AAA’s website and social media.

If you would like to apply to have your service featured, please complete and submit all fields below by May 12. Thank you for your service to your community!

 

 

 

Congress Recognizes Ambulance Services as Health Care Services in “The American Rescue Plan Act of 2021”

Also Adds Dollars to the Provider Relief Fund to Support Rural Providers and Suppliers

March 10, 2021

Moments ago, the House of Representatives joined the Senate in passing “The American Rescue Plan.” Among the many provisions, this legislation includes waiver authority to allow the Medicare program to reimburse for ground ambulance services provided during the COVID-19 public health emergency when the beneficiary has not been transported under certain circumstances. It also increases the Provider Relief Fund by $8.5 billion, targeting the money to rural providers and suppliers, including ground ambulance services.

The American Ambulance Association (AAA) worked diligently with Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) to reimburse ground ambulance services when they provide health care services to a beneficiary, but because of the pandemic the beneficiary was not transported. CMS concluded and communicated in a Frequently Asked Question (FAQ) that the Social Security Act requires the beneficiary to be transported in order for Medicare to reimburse the ground ambulance provider or supplier for the care provided.

To address this problem during the pandemic, Sens. Catherine Cortez Masto (D-NV) and Bill Cassidy (R-LA) introduced S. 149 that would allow CMS to waive the statutory provision creating the barrier to reimbursement during the pandemic. More specifically, it would allow CMS to reimburse ground ambulance services responding to a 9-1-1 or equivalent emergency call even when the beneficiary is not transported when a community-wide EMS protocol prohibiting the transport is in place. Reps. Cindy Axne (D-IA), John Larson (D-CT), and Bruce Westerman (R-AR) introduced the companion bill, H.R. 1609, in the House.

The Senate included S. 149 in “The American Rescue Plan Act of 2021,” which passed the Senate 50-49 on March 6. This amended version passed the House along party lines earlier today and the President is expected to sign the bill into law before March 14.

CMS must exercise its authority under the waiver for the provision to be implemented. The AAA has already begun working with CMS to urge it to act as quickly as possible and we are coordinating this effort with the International Association of Fire Chiefs, International Association of Fire Fighters, National Association of EMTs, National Volunteer Fire Council and the Congressional Fire Services Institute.

In addition to the waiver allowing for reimbursement for treatment in place, the final bill includes $8.5 billion additional dollars for the Provider Relief Fund directed to rural health care providers and suppliers. The funds can be used for health care related expenses and lost revenues that are attributable to COVID–19.  To be eligible for a payment, an eligible rural health care provider or supplier must be enrolled Medicare or Medicaid and submit to the Secretary an application that includes a justification statement, documentation of the expenses or losses, the tax identification number, assurance required by the Secretary, and any other information the Secretary requires.  The expenses and losses cannot have been reimbursed from another source or another source cannot already be obligated to reimburse.

“The American Rescue Act” marks an important step forward for ground ambulance organizations who have been on the front line of the pandemic and offers important relief recognizing the unique and essential role these organizations play in community response to the pandemic.

For more information on the provisions of the bill that impact ground ambulance services, please sign up for the webinar on “The American Rescue Plan and EMS” scheduled for this Friday, March 12, at 2:00 pm (eastern).

EMS1 | EMS advocacy and adaptability with Shawn Baird

EMS1 Interview of AAA President Shawn Baird by AAA Communications Chair Rob Lawrence

As we enter, hopefully, a happier new year, several of our national associations that have been at the forefront of collaborative advocacy efforts and the voices of the EMS profession have undergone planned changes in their leadership.

To welcome in 2021, I sat down, via Zoom, with Shawn Baird, incoming president of the American Ambulance Association and asked him about 2020 and his thoughts on the future of our industry. Shawn is the vice president for rural services with MetroWest Ambulance Family of Companies in Oregon. Shawn spent the last two years serving the AAA as president elect and has been at the center of AAA activity and advocacy.

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EMS1 | Inside EMS Podcast: Elephants In the Room

From EMS1 featuring AAA Communications Chair Rob Lawrence

What to do about the EMS elephants in the roomOur hosts discuss industry hot topics that will need to be addressed in the future, including the debate about responding with lights and sirensNov 6, 2020
This episode of Inside EMS is sponsored by ImageTrend, the creators of the free mobile app for first responders, CrewCare. It’s time to thrive.

In this episode, host Chris Cebollero speaks with guest host Rob Lawrence about his recent keynote address at the American Ambulance Association’s Annual Conference. Lawrence shares his thoughts on his EMS “elephants in the room.” Where should EMS stand on the issue of responding with lights and sirens? Do EMS practitioners need college degrees? Listen to the discussion and join the debate in the comments below.

Expanded Support for EMS Responding to Natural Disasters, COVID-19

Frontline Impact Project Expands Support for Frontline Heroes, Offers Companies a New Way to Give Amidst Historic Natural Disasters

COVID-19 response platform will now direct resources to first responders facing wildfires, hurricanes and other catastrophes   

September 15, 2020 – Frontline Impact Project is expanding its mission and will now also support heroes on the frontlines of major natural disasters including the Western wildfires and Hurricane Laura. The platform, which The KIND Foundation launched in partnership with dozens of companies in response to COVID-19, will activate its existing infrastructure to shepherd resources like meals, snacks, beverages and personal care items to first responders in need. The announcement comes after extraordinary displays of courage and sacrifice from the nation’s firefighters, paramedics and emergency volunteers.

“We started Frontline Impact Project to meet the needs of those on the frontlines of the COVID-19 pandemic. While this work will continue, we are cognizant of the many others risking their lives to keep us safe, particularly as peak wildfire and hurricane seasons approach,” says Michael Johnston, President of The KIND Foundation. “Thanks to the generosity of more than 60 companies, we’re set up to respond in real time and help take care of America’s heroes as they take care of us.”

As part of this expansion, Frontline Impact Project has initiated partnerships with two leading disaster response nonprofits, National Voluntary Organizations Active in Disaster (NVOAD) and Good360, to get donated items to workers across the Gulf Coast and Western United States.

“Non-profit staff and volunteers work tirelessly to serve survivors impacted by disaster. Frontline Impact Project’s commitment and efforts to supporting those serving on the frontlines of disasters across the country is a welcome addition to the disaster response community,” says Katherine Boatwright, Director of Operations, NVOAD.

Since April, Frontline Impact Project has matched more than 650 frontline institutions with companies that have products or services to donate. Available resources include food, beverages, personal care items, mental health services and virtual fitness classes. Together with its inaugural partner KIND, the project has donated nearly four million products to date.

“We were looking for a flexible and streamlined way to donate our products. Frontline Impact Project gives us the opportunity to scale our giving as the situation demands and reach a deserving audience whose needs are paramount but not always top of mind,” says Aaron Croutch, Executive Vice President, Lenny & Larry’s.

Kara Goldin, Founder and CEO of Hint, adds, “Now, more than ever, it’s critical that we support first responders and help keep them healthy and hydrated. Hint has donated water to hundreds of healthcare organizations and first responders across the country, and the Frontline Impact Project has made coordination with a number of those groups much easier.”

In addition to Lenny and Larry’s and Hint, a number of companies have signed on to support this effort, including Adrenaline Shoc Smart Energy; Belgian Boys; CLEAN Cause; Just the Cheese; Kabaki Tea; Kodiak Cakes; KIND; La Colombe; Neuro; Paunchy Elephant; RISE Brewing Co; ROWDY; Purely Elizabeth; and ZICO Coconut Water.

To submit a donation or make a request, visit www.frontlineimpact.org.

Department of Health and Human Services Extends Deadline to Apply for Provider Relief Funds

The Department of Health and Human Services (HHS) recently announced that it would be extending the deadline for health care providers to apply to receive general distribution funding from the HHS Provider Relief Fund.  The deadline to apply for these funds was previously June 3, 2020.

Relevant Background

On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).  As part of that Act, Congress allocated $100 billion to the creation of a “CARES Act Provider Relief Fund,” which will be used to support hospitals and other healthcare providers on the front lines of the nation’s coronavirus response.  An additional $75 billion was allocated as part of the Paycheck Protection Program and Health Care Enhancement Act, bringing the total “Provider Relief Fund” up to $175 billion.  This $175 billion will be distributed to health care providers and suppliers to fund healthcare-related expenses or to offset lost revenue attributable to COVID-10.

HHS ultimately elected to allocate these funds through a $50 billion “general allocation,” and multiple smaller “targeted allocations.”

Under its general allocation program, HHS intended to provide health care providers with funds roughly equal to 2% of the provider’s 2018 “net patient revenue,” i.e., the provider’s total revenues from patient care minus provisions for bad debt, contractual write-offs, and certain other adjustments.   This general allocation was made in two tranches, with the first tranche being distributed to all providers in mid-April.  This first tranche was made based on provider’s 2019 Medicare revenues.  As a result, any provider that received payments from the Medicare Fee-for-Service Program in 2019 automatically received an initial relief payment.  However, HHS required providers to submit an application to receive relief funding as part of the second tranche.  The deadline for applying for the second tranche of relief funding was June 3, 2020.

Scope of New Extension

 HHS indicated that the new extension is limited to health care providers that missed the June 3, 2020 deadline to apply for the second tranche of relief funding.  The extension also applies to providers that were ineligible for the first tranche of relief funding due to a recent change of ownership.  The specific situations that HHS indicated would meet the requirements for the extension include:

  • Health care providers who were ineligible for the first tranche of relief funding because: (1) they underwent a change in ownership in calendar year 2019 or 2020 under Medicare Part A and (2) did not have Medicare Fee-for-Service revenues in calendar year 2019;
  • Health care providers who received a payment in the first tranche of funding but: (1) missed the June 3, 2020 deadline to submit revenue information or (2) did not receive funds in the first tranche that total approximately 2% of their net patient revenue; or
  • Health care providers who received a payment in the first tranche of funding, but who ultimately elected to refund that payment (e.g., because they did not believe they met the eligibility requirements), and who are now interested in reapplying.

Health care providers that meet one of the requirements listed above will have until August 28, 2020 to submit an application for additional relief funds.  This deadline aligns with the extended deadline for other eligible Phase 2 providers, such as Medicaid, Medicaid Managed Care, CHIP, and dental providers.

Applications should be submitted through the CARES Provider Relief Fund webpage, which can be found at: https://cares.linkhealth.com/#/.

California’s 50 years of prehospital medicine

From EMS1 on July 14 by AAA Communications Chair Rob Lawrence

The history of our history: 50 years of prehospital medicine: A transatlantic tale of former army doctors, paramedic development, cardiac arrest survival, and Johnny and Roy

Fifty years ago, on July 15, 1970, then California Governor Ronald Reagan signed into law the Wedworth-Townsend Paramedic Act. The law created the conditions for the establishment of the first accredited paramedic training program in the United States.

The story of American paramedicine did not begin in California or even in the U.S., but in Belfast, Northern Ireland. The inspiration for this program came from World War II era British Royal Army Medical Corps (RAMC) Medical Officer, Professor Frank Pantridge, MD.

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CMS Announces Resumption of Program Integrity Functions

On July 7, 2020, CMS updated its Coronavirus Disease 2019 (COVID-19) Provider Burden Relief Frequently Asked Questions (FAQs).  As part of this update, CMS indicated that it would resume several program integrity functions, starting on August 3, 2020.  This includes pre-payment and post-payment medical reviews by its Medicare Administrative Contractors (MACs), the Supplemental Medical Review Contractor (SMRC), and the Recovery Audit Contractors (RACs).  This also includes the resumption of the Prior Authorization Model for scheduled, repetitive non-emergency ambulance transports.  These programs had been suspended by CMS in March in response to the COVID-19 pandemic.

Resumption of Medicare Fee-For-Service Medical Reviews

 CMS suspended most Medicare FFS medical reviews on March 30, 2020.  This included pre-payment medical reviews conducted by its MACs under the Targeted Probe and Educate program, as well as post-payment reviews by its MACs, the SMRC, and the RACs.  CMS indicated that, given the importance of medical review activities to CMS’ program integrity efforts, it expects to discontinue its “enforcement discretion” beginning on August 3, 2020.

CMS indicated that providers selected for review should discuss any COVID-related hardships that might affect the provider’s ability to respond to the audit in a timely fashion with their contractor.

CMS further indicated that its contractors will be required to consider any waivers and flexibilities in place at the time of the dates of service of claims selected for future review.

Resumption of Prior Authorization Model

 Under the Repetitive, Scheduled, Non-Emergent Ambulance Transport Prior Authorization Model, ground ambulance providers in affected states are required to seek and obtain prior authorization for the transportation of repetitive patients beyond the third round-trip in a 30-day period.  The Prior Authorization Model is currently in place in Delaware, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina, Virginia, West Virginia, and the District of Columbia.

On March 29, 2020, CMS suspended certain claims processing requirements under the Prior Authorization Model.  During this “pause,” claims for repetitive, scheduled, non-emergency transports were not be stopped for pre-payment review to the extent prior authorization had not been requested prior to the fourth round trip in a 30-day period.  However, CMS continued to permit ambulance providers to submit prior authorization requests to their MACs.

CMS indicated that full model operations and pre-payment review would resume for repetitive, scheduled non-emergent ambulance transportation submitted in the model states on or after August 3, 2020.  CMS stated that the MACs will be required to conduct postpayment review on claims that were subject to the model, and which were submitted and paid during the pause.  CMS further indicated that it would work with the affected providers to develop a schedule for postpayment reviews that does not significantly increase the burden on providers.

CMS stated that claims that received a provision affirmation prior authorization review decision, and which were submitted with an affirmed Unique Tracking Number (UTN) will continue to be excluded from most future medical review.

IRS Guidance on Taxation of HHS Provider Relief Funds

On July 7, 2020, the Internal Revenue Service published a series of Frequently Asked Questions that address the taxation of payments to health care providers under the HHS Provider Relief Fund.

As part of the Coronavirus Aid, Relief and Economic Security Act (CARES Act), Congress appropriated $100 billion to reimburse eligible health care providers for health care-related expenses and/or lost revenue attributable to the COVID-19 pandemic.  The Paycheck Protection Program and Health Care Enhancement Act appropriated an additional $75 billion to the Provider Relief Fund.

The first FAQ addressed the issue of taxation for for-profit health care providers.  Specifically, the IRS was asked whether a for-profit health care provider is required to include HHS Provider Relief Fund payments in its calculation of “gross income” under Section 61 of the Internal Revenue Code (Code), or whether such payments were excluded from gross income as “qualified disaster relief payments” under Section 139 of the Code.

The IRS indicated that payment from the Provider Relief Fund do not qualify as qualified disaster relief payments under Section 139 of the Code.  As a result, these payments are includible in the gross income of the entity.  The IRS further indicated that this holds true even for businesses organized as sole proprietorships.

The second FAQ addressed the issue of taxation for tax-exempt organizations.  The IRS indicated that health care providers that are exempt from federal income taxation under Section 501(a) would normally not be subject to tax on payments from the Provider Relief Fund.  Notwithstanding this general rule, the IRS indicated that the payment may be subject to tax under Section 511 of the Code to the extent the payment is used to reimburse the provider for expenses or lost revenue attributable to an unrelated trade or business as defined in Section 513 of the Code.

The IRS FAQ can be viewed in its entirety by clicking here.  Members are advised to discuss the issue of potential taxation of any relief funding they received with their tax professionals.

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