Share With Your Team: Substance Abuse Resources

Find out how AAA’s LifeWorks Employee Assistance Program, automatically covers all member organizations’ employees, can help your staff that is struggling with addiction.

Download our Substance Abuse PDF, then share electronically with employees. Articles covered include:

  • If You Suspect an Employee Has a Substance Abuse Problem
  • Recognizing a Substance Abuse Problem and What to Do
  • Drug and Alcohol Abuse: Warning Signs
  • Prescription Drug Abuse
  • Quick Facts About Alcohol Abuse
  • Support Groups for Family and Friends of Substance Abusers
  • What to Do If You Suspect a Co-Worker Has a Substance Abuse Problem
  • What is Reasonable Suspicion?
  • How to Help Someone Getting Past Resistance to Drug and Alcohol Treatment
  • Treating Addiction
  • How to Use the Employee Assistance Program
  • and many more!

Download Substance Abuse PDF

As always, you and your team can call our dedicated hotline, 1-800-929-0068, 24/7 to set appointments for FREE IN-PERSON COUNSELING in your area. Learn more on our AAA Employee Assistance Program page (membership required.)

FDA Issues First Responder Drug Dispenser Guidance

In accordance with the Drug Supply Chain Security Act of 2013, the FDA issued regulations last year to require drug dispensaries to build an electronic system to identify and track the distribution of drugs. Many small dispensaries do not have the ability currently to electronically trace small quantities of drugs. The AAA became concerned that hospital and other small dispensers would no longer provide first responders with critical drugs in fear of not being compliant with the new regulations. The AAA joined a coalition of dispensaries, pharmacists and others that also had concerns with the new regulations.

As a result of the efforts of the coalition and the AAA, we were able to delay enforcement of the requirements until today, March 1. The AAA then worked directly with the FDA to educate them about the unique nature that small dispensaries sometimes play in restocking certain ambulance service providers. Upon learning of these transactions, the FDA shared our concerns and worked quickly to release the guidance.

The guidance states that the FDA will not take action against drug dispensaries in providing drugs to first responders if the dispensary follows certain basic recording keeping policies. The agency will also not take any action against the first responder. The guidance is entitled “Requirements for Transactions with First Responders under Section 582 of the Federal Food, Drug, and Cosmetic Act — Compliance Policy Guidance for Industry“.

Performance Reviews, Feedback from the Court

One of the hottest debates in Human Resources is the efficacy or usefulness performing Annual Performance Evaluations on employees. For the most part, many employees feel that the process is not a true reflection of their performance. At many companies Performance Evaluations are months behind and when they are finally done, little effort is committed to the process to make it worthwhile. Despite this, almost every ambulance company has some form of performance evaluation process. However, a recent decision from the US Court of Appeals for the 1st Circuit has elevated the importance Performance Evaluations and should serve as an alert to employers to pay more attention to the process.

John Ray III was an eight year associate with the law firm Ropes & Gray in Boston in 2008 when the firm informed him that he would not be considered for partner and was given six months to find a new job. Ray filed charges with the Equal Employment Opportunity Commission alleging racial discrimination for not advancing him to partner. This past August the court found that Ropes & Gray had not illegally discriminated against Ray and that he had not been promoted to partner because of a clearly defined and consistently practiced process for advancing attorneys within the firm. One of the deciding pieces of evidence were his performance evaluations which were “predominantly negative” during the majority of his time with Ropes and Gray. These evaluations literally saved the employer hundreds of thousands of dollars.

[quote_right]For supervisory staff, it is very challenging to provide honest meaningful feedback for employees as they generally don’t actually see the employee working or multiple supervisors are responsible for a particular employee over the course of the week.[/quote_right]This decision places employers on notice that performance review documents will be examined and can be key in the sustainability of a discrimination case. In our industry, the Performance Review or Evaluation process is generally more challenging due to the nomadic nature of our employees. Our employees are constantly on the move and generally work very independently, making it difficult to observe actual performance. For supervisory staff, it is very challenging to provide honest meaningful feedback for employees as they generally don’t actually see the employee working or multiple supervisors are responsible for a particular employee over the course of the week. As a result, those tasked with completing the Performance Evaluation Forms will often make their best guess and do not seek feedback from all stakeholders. With another list of reviews coming every month, shortcuts are often taken.

So what should ambulance providers do? Providers need to evaluate their current Performance Review process to determine if it is working. Is the supervisor/manager that is completing the Performance Review the individual best suited to evaluate the employee’s performance? Is the Performance Evaluation Form actually designed to measure performance for the essential functions of the position? Are there objective benchmarks that all supervisors are using when evaluating a particular job function?

As with most things in employment practices, consistency is key. Every ambulance provider should provide training to individuals who conduct Performance Evaluations and should refresh that training annually. We often promote field personnel into supervisory roles and then do not provide them with the necessary training to perform certain aspects of that job. Performance management is no different.

During the supervisory training period, individuals should be educated on the entire performance management process, including how to compile performance data, how to interpret the information for utilization of the grading system, even how they should interact with the employee during actual Performance Evaluation. Providing feedback to employees is the single most important thing a supervisor or manager can do. Do not expect those skills to be innate in your new or existing management personnel.

Frequently, we in Human Resources are approached by a supervisor or manager that tells you that a particular employee’s performance is historically terrible and that they need to be terminated immediately. Only to find when inspecting their personnel record that there are several years of glowing performance evaluations. Imagine the message that a glowing performance evaluation sends to this problem employee. More importantly, what message does it send to the coworkers who he/she will undoubtedly tell?

I strongly recommend that the there be a real quality assessment plan for the performance evaluation process. If the message to supervisors is to “get them done” and there is very little focus on providing meaningful feedback to employees, then the goal will be frustrated and the process becomes useless. I suggest that the process include having someone, a manager or director, review the evaluation when it is turned in. The manager should review the evaluation for:

  • Completeness
  • Validation of the assessment grading
  • Variation in grading from category to category
  • Comparison to prior period evaluations
  • Employee input/comments
  • Employee Signature
  • Supervisor Signature

[quote_left]If there are internal inconsistencies within the performance evaluation or drastic changes in ratings from year to year, you should follow up with both the supervisor and the employee to figure out why that inconsistency exists.[/quote_left]If there are internal inconsistencies within the performance evaluation or drastic changes in ratings from year to year, you should follow up with both the supervisor and the employee to figure out why that inconsistency exists. I also suggest a message to the employee via email or, better yet, a letter to the employee’s home informing them that you appreciated their participation in the Performance Evaluation process and that a copy is being placed in their file. The letter should encourage feedback regarding the process, preferably in questionnaire format. SurveyMonkey.com is a great free product that any employer can use to solicit feedback and synthesize that feedback data.

Lastly, I often see a great emphasis placed on ensuring that the field or office staff receive regular performance evaluations. However, frequently the manager or supervisor conducting the evaluation has not received any formal performance feedback in years. Supervisors and managers are employees too and deserve regular performance feedback. Giving the manager or supervisor a thorough and considerate evaluation of their performance will serve as reinforcement of the importance of the process.


Have a question for HR and operations legal eagle Scott Moore? Submit it today!

Audit Alert! USCIS Form I9

One of the most commonly misunderstood compliance issues for any employer is the US Citizenship and Immigration Services (USCIS) Form I9. Form I9 is the document all US employers are required to have completed when hiring a new employee to assure that they are legally eligible to work in the United States. While there has been a reduction in Form I9 Audits from USCIS in 2015, employers should be prepared as the five year trend is on the rise. In fact, I am aware of several ambulance providers currently dealing with audits.

The Law

The Immigration Reform and Control Act (IRCA) of 1986 requires employers to examine documentation from each newly hired employee to prove his or her identity and eligibility to work in the United States. The IRCA led to the Form I-9 Employment Eligibility Verification, which requires employees to attest to their work eligibility, and employers to certify that the individual presented documents to the employer that appeared to for the individual and genuine. The form has very specific rules regarding when the certain section of the form must be completed, which documents the employee can proffer as proof of eligibility, and how information must be present in the different sections of the Form I9.

I believe that most employers understand that they must obtain certain information from every newly hired employee. However, with the Form I9, there are very specific dates upon which the different sections of this form must be completed. This is where the greatest number of compliance issues arise when dealing with I9 Audits.

The Form’s Timing

Section 1 of Form I9 is the Employee Information and Attestation section and must be completed by the employee by the close of business on the employee’s first day of employment. This section consists several mandatory fields of the personal information of the new employee and two optional fields. It includes the employee’s full name, date of birth, address, and social security number, email address (optional), telephone number (optional). In addition, the employee must attest that they are a citizen of United States, a Non-Citizen National, a Lawful Permanent Resident, or an Alien Authorized to Work in the US. The employee must provide an Alien Registration Number or USCIS Number if they check that they are a lawful permanent resident. If they are an Alien Authorized to Work, they must provide the date their authorization expires and their Alien Registration Number. The employee must sign the document and date it. If there is a translator or preparer, they must complete the certification at the end of Section 1.

Section 2 is the Employer or Authorized Representative Review and Verification section and must be completed by the close of business on the third day of employment. This section is where many make a very simple error. First, there is a place at the top of this section where the employer must list the employee’s full name. This frequently gets left blank. Next, the employer must identify the document(s) that the employee is presenting as proof of identity and employment authorization. In Column A, there is a list of acceptable documents, typically a Passport, Permanent Resident Card, or Employment Authorization Document. One or more of these documents can be sufficient. Alternatively, the employee can present one document from each List B and C. These are typically a driver’s license and a birth certificate. These documents don’t have to be copied, but if they are, they must be kept with the Form I9.

It is critical that the employer complete the Certification section of Section 2. This is another area where employers frequently make mistakes. In the Certification, there is a section to mark the date of the employee’s first day of employment. I often find this section blank or find that the employer mistakenly enters the date that they viewed the employee’s documents. The employer needs to complete the Certification section and date it, entering the employer’s business name and address. Failure to complete any of these sections can lead to a Substantive or Technical Violation and fines.

Section 3 of the Form I9 is completed by the employer when re-verifying that an employee is authorized to work or when rehiring an employee within three years of the date on the original Form I9. It is important that employer develop a mechanism for identifying and ensuring any expiring document(s) that requires re-verification. Of course, an employer can always complete a new Form I9 for a returning employee.

Penalties

Title 8 of the Code of Federal Regulations Section 27a.10 established a fine range from $110 to $1,100 per violation. Fines can be for either a Technical violation, one where an employer fails to ensure that the employee provided all of the personal information, name, DOB, address, etc. or a Substantive violation, where the employer fails to review and verify the required documents or when someone is working without authorization. These fines can be issued for each individual violation and can be substantial.

Other common errors that carry fines include not documenting the title of the document that the employee presented as proof (example, US Passport, State Driver’s License and Social Security Card). Not initialing corrections made to the form when corrections are necessary. Not re-verifying those work authorization documents that require re-verification.

Solution

All of the fines are avoidable by ensuring that you clean up the Form I9 process within your organization. First, services should ensure that only individuals trained and knowledgeable in completing the Form I9 are involved in this process.  The USCIS provides great Form I9 training for free on their website. In addition, USCIS has great instructions that accompany the Form I9 and provide for video instruction on their website. Following these instructions carefully will be the best guarantee that you will complete the form correctly.

In addition, every ambulance service should conduct an audit of their Form I9 processes within their organization. I would have one individual, who is knowledgeable about the rules, conduct a review of all Form I9s for current employees and for any employees who were terminated within the last five years. Employers can purge any Form I9 documents for employees who are terminated after one year from termination or three years after the date of hire, whichever date is later. However, employers should have Form I9 documents on all employees who are currently on your payroll.

For purposes of record keeping, it is best to keep all Form I9s in one location so that they can be easily provided in the event of an audit. Employers are not required to make copies of the documents an employee provides to the employer as proof of authorization. However, if the employer does copy the documents, they should be kept with the Form I9. I recommend employers make copies of those documents, store them with the Form I9, and be kept in a secure location. If those documents are stored electronically, it is critical that there are sufficient systems in place to ensure the integrity and security of the documents including an electronic audit trail.

Many employers utilize e-Verify, the online system hosted by the USCIS in partnership with Social Security Administration (SSA) that allows employers to search the linked federal databases to ensure that employees are eligible to work in the US and verifies the employee’s Social Security Number. e-Verify is free to employers and is voluntary throughout the country. However, you should check you state law as many states have passed legislation requiring the use of e-Verify. It is easy to enroll and is a necessary part of any I9 compliance plan.

I can tell you that all of the providers that I have questioned about this issue assured me that they have adequate processes in place to ensure compliance. However, after we discussed the timing and information required for the different sections of the Form I9 that were identified in many of the audits I am aware of, it quickly became apparent that most did not really have safeguards in place.

VIDEO: AAA Experts in Reimbursement, Regulations, Human Resources, Operations

Did you know that your AAA membership includes access to some of the top minds in the ambulance industry today? As the healthcare landscape becomes ever more complex, it’s nice to know you have experts on your side.

Watch the video below to learn more about the attorney-consultants that AAA retains in order to ensure our member organizations are ahead of the curve on human resource, reimbursement, legislative, and regulatory issues.

Attention, AAA Members!
Have a question? Submit it to our experts today!
Ask a reimbursement or Medicare question.
Ask a human resources or operations question.

Not yet a member? Join today to gain access to AAA experts, plus a wealth of other powerful member benefits.

Savvik 10 Minute, 10 Item, 10% Savings Challenge

Savvik Buying Group, formerly North Central EMS Cooperative, is offering AAA members the opportunity to save even more on their first orders for Henry Schein medical supplies. Read below to learn more!

10 ITEM – 10 MINUTE – 10% CHALLENGE!

Give Savvik 10 items and 10 minutes of your time, and we will help you save money!
Pick the 10 med supply items that you use the most and we will share with you our Savvik national contract price. We will do all of the comparison work! We will even give you an extra 10% discount* on top of our already low contract price on your first order with our medical supplies provider Henry Schein. No minimum purchase requirement, no long term commitment, no freight charges orders of $150.00 or more.

Start the new year saving money!

Email Savvik Your Top 10 Items!

Good for new Henry Schein customers only thru January 31st 2016. *10% discount offer on first orders not to exceed an order total of $10,000.

10 Safety Topics that Will Move EMS Forward in 2016

What are your ambulance services’s safety priorities for 2016? AAA member The Center for Patient Safety has just released 10 Safety Topics that Will Move EMS Forward in 2016, a free download covering:

  • Airway Management
  • Behavior Health Encounters
  • Crashes: Ambulance and Helicopter
  • Device Failures
  • Medication Errors
  • Mobile Integrated Healthcare
  • Pediatric Patients
  • Safety Culture
  • Second Victim Intervention
  • Transition of Care

Get your copy today to learn how to ensure safety for your employees and patients.

Download Now

Savvik: Save on Vehicles, Supplies, and More!

Did you know that your service may be overpaying for everything from new ambulances to computers to staplers?
If you are not already purchasing necessities through the American Ambulance Association’s partnership with Savvik Buying Group, you’re missing out on deeply discounted group purchasing savings.

Watch our video below to learn more from Savvik President and AAA Treasurer Aarron Reinert.

 

[styled_box title=”Get Started With Savvik” footer=”” icon=”” class=”panel-default”]AAA members, start saving now!

Not yet a member of the AAA? Join today and start saving tomorrow.[/styled_box]

Win for Employers with H.R. 2029, Consolidated Appropriations Act, 2016

On December 18, 2015 President Obama signed into law H.R. 2029, The Consolidated Appropriations Act, 2016, which is a nearly $2 trillion budget deal covering government funding and taxes.  This law provides some relief to employers who offer employer-sponsored health plans from two key provisions of Affordable Care Act (ACA).  The ACA has been one of the most contentious political issues during the Obama administration as its impact on employers is significant.

The first key change effect the “Cadillac Tax”.  The Cadillac Tax is a non-deductible 40% excise tax that applies to the cost of employer-sponsored health coverage whose value exceeds the prescribed thresholds of $10,200 for individual coverage and $27,500 for family coverage.  These thresholds which were established in 2010 were supposed to be implemented starting in 2018.  The purpose of this tax was threefold:

This tax was expected to raise $1.7 billion in 2018.

One of the major criticisms of the Cadillac Tax is that it is indexed to inflation.  Health care expenditures increase at a higher rate than inflation.  As a result, this will cause more employer plans to be subject to the tax over time.  It is predicted that this tax will cause more employers to decrease benefits under their plan in an effort to avoid being subject to the tax.  In turn, this will cause employees to shoulder more of the burden of healthcare costs through increased deductibles and copays, as more employer sponsored plans become consumer-driven health plans.

Under the law signed by President Obama on December 18, 2015, the implementation of the Cadillac Tax has been delayed until 2020.  Also, the 40% tax that was initially not tax-deductible has been changed to tax-deductible permanently.  An additional change under this law will require the commission of a study by the Comptroller of the United States, in consultation with the National Association of Insurance Commissioners.  This study will determine the suitability of the current use of the premium cost of Federal Blue Cross/Blue Shield standard benefit as a benchmark for the age and gender adjustments of the applicable dollar limit with respect to the tax on high cost plans under the Internal Revenue Code. This is an adjustment to the upper dollars limits for the employer’s plan that can be made if a specific employer’s workforce differs from the characteristics of the national workforce.  This study may lead to other possible changes to the thresholds for the Cadillac Tax in the future.

The second change doesn’t directly impact employers, but does indirectly effect employer plan costs.  The new law eliminates the Health Insurer Fee for 2017.  The Health Insurer Fee, which began in 2014, is a fee charged to health insurance carriers based on the insurance premiums they collect on from their share of the market.  This fee in 2014 was approximately $8 billion, and was projected to increase to $13.9 billion in 2017.  While not directed at employers, it is believed that this fee is being passed down to the purchasers of health insurance through increased premiums.  While this fee is being eliminated for 2017, that is temporary and is currently set to return the following year unless other measures are passed.

These changes will shift the impacts of these two provisions until after the next Presidential election in November 2016.  Dependent upon what occurs in the next election, there will likely be other changes to the ACA for employers and employees to contend with.  As always, the American Ambulance Association will continue to monitor the political atmosphere to ensure that you are informed and prepared.

 

ACA Filing Deadline Extension

In Fall 2015, we alerted you to a deadline for a new employer filings under the Affordable Care Act.  On December 28, 2015 the IRS extended the deadline to furnish and file the required forms for all required filers. The new deadlines are:

  • March 31, 2016, to deliver the 2015 Forms 1095-C to affected employees;
  • May 31, 2016, to manually file the 2015 Forms 1094-C and 1095-C with the IRS — for employers who’re eligible for paper filing; and
  • June 30, 2016, to electronically file the 2015 Forms 1094-C and 1095-C with the IRS.

According to the IRS this is a one-time filing extension and will not be further extended.   This will give employers and payroll companies additional time to prepare for this new requirement.  If you fail to make the required filings by these extended deadlines, you will be subject to penalties.  If you have not yet determined how you will prepare for this deadline, you should be contacting your payroll service or benefits broker for assistance.

As always, the American Ambulance Association can assist you with any ACA questions.

Active Shooter/Violence Resources for EMS

Updated December 22, 2015

In the sad wake of many recent mass shooting incidents, the AAA wants to ensure you and your team have all of the best information possible about handling these scenarios.

Are there other resources you use with your team to prepare for active shooters? Please share with us in the comments and we will augment this list. Thank you, and stay safe!

Preventing and Surviving Violence

Recovering from Active Shooter Incidents

Articles

Special thanks to Scott Moore of EMS Resource Advisors, Steve Delahousey of AMR, Aarron Reinert of Lakes Region EMS, John Peterson of Sunstar Paramedics, and Christopher Eisenhardt of Pinellas County Sheriff’s Office SWAT Team for their assistance.

Spotlight: Randy Strozyk

Randy Strozyk
Tukwila, WA, USA
Senior Vice President of Operations, American Medical Response (AMR)
Secretary, AAA Board of Directors
Randy’s LinkedIn Profile

Tell us a little about yourself, please.

My life-long automobile obsession continues, but that’s old news. Something people may not know about me is that I’m a relatively new and incredibly proud grandfather. My grandson, Samuel, was born in April 2014. Samuel’s parents are brilliant—our son, Terrell, is an attorney and the deputy director of the Oregon insurance commission; Sophie, our daughter-in-law, is Taiwanese and took her final exam for her MBA just a few days before Samuel was born (despite being dilated and having some minor contractions, she aced the test)—so we assume Samuel will develop a cure for cancer, broker peace in the Middle East or do something else to change the world. Samuel is learning English and Taiwanese, which means that when he goes through his awful adolescence period, he’ll be able to hurl insults at me in a language I don’t understand.

My wife, Karma, and I are excited to meet our second grandchild—Samuel’s cousin, and the first child of our other son, Todd, and his lovely wife, Julie—in November. I don’t expect my granddaughter to be speaking a language I don’t understand before she’s potty-trained, but stranger things have happened. What I do know is that this baby is going to have Grandpa wrapped around her little finger in no time.

Our youngest child, Erin, just got married to a great guy, Keith, this summer. No kids in that household, but they have four-legged babies and a shared passion for helping the underprivileged by expanding access to affordable, reliable solar energy.

Our children are unique, interesting and, with six degrees between the three of them, highly learned individuals. I couldn’t be prouder of my family.

How did you come to work in the industry? How long have you been involved?

Becoming a paramedic and healthcare executive wasn’t my initial game plan, but I was bitten by the EMS bug. I had the chance to ride out with ambulance crews as a medical explorer scout in high school. I enjoyed the medicine and quick pace, so I earned my EMT certification while studying microbiology at Washington State University and worked on the ambulance during the summers before my junior and senior years. After earning my bachelor’s degree, I went to paramedic school. I planned to do it for only a short while. That was back when the Phillies were a championship baseball team and the only Madonna anyone had heard of wore a serene expression and hung out in mangers. Nearly 36 years later, I’m still here.

What do you enjoy most about your job?

Over the past 15 years at AMR, I’ve had the opportunity to work on many different projects. In the course of a single month, you might find me in Oklahoma at EMSA, in Denver at our National Resource Center and AMR-Air headquarters, in Washington on AAA business and in Hawaii with our air operation there. I love seeing how EMS functions across the country. I won’t say that I’ve “seen it all” just yet, but if there’s something I don’t know, there’s someone I know with an answer.

What is your biggest professional challenge?

Some people may think that the biggest challenges I’ve faced have to do with specific tough projects or some of the legendary personalities I’ve worked with or for over the past 36 years. But I’d say the biggest challenge for me—and probably for others—is more internalized. People with deep experience in one field have to work at remaining enthusiastic and engaged. We can’t become attenuated to our circumstances and accept “that’s how it’s always been” as acceptable answers. EMS is a dynamic industry. Many of the tools and techniques that were considered cutting-edge when I first started in the business have already gone the way of the dinosaurs; likewise, the next generation of paramedics are going to look at some of the things we’re doing now with utter disbelief. To remain relevant, leaders must stay informed and be open to new opportunities and alternative viewpoints.

What is your typical day like?

There is no “typical” day in my world. I might be in Oklahoma working with our operations team at EMSA, in Denver at our corporate headquarters or working with the AMR-Air folks, or in any number of other places. No two days are the same.

How has participation in AAA membership and advocacy helped your organization?

AMR has been a part of the American Ambulance Association since the beginning. Involvement—not just paying dues to have a name on the membership roll, but serving on committees, attending meetings and being part of the conversation—provides a platform for professional networking and shared learning. It gives us a chance to uncover about new solutions, hear different perspectives and see the big picture.

Spotlight: Reviving Responders Suicide Prevention

AAA caught up with Amy Young of CareFlite, group leader of an Ambulance Service Manager program team project on EMS suicide prevention. This project resulted in the creation of www.revivingresponders.com.

The Project Team

As part of the February 2015 Ambulance Service Manager (ASM) class, seven of us were randomly assigned to groups and asked to complete a project in ten weeks with team members spread across the United States. Our research we presented our data to the ASM class as part of the requirements for graduation.

All told, the seven members of our group have a combined total of 92 years of service in EMS. Many started as EMTs and worked up to Paramedic status, some began as volunteers, and the rest came to EMS as a second career. Nonetheless, we are all driven by ambitious personalities, our ability to make a difference, our desire to provide meaningful patient care, and the opportunity to work with other public service providers. The group consists of the following people:

Our group decided on a topic that was both personal and something we hoped could make a significant impact on the EMS culture. We chose to do a survey about the prevalence of critical stress amongst EMS and evaluate why suicide rates of EMS providers is on the rise.

The Shocking Survey Results

[quote_left]37% of providers across the nation who responded to our survey had contemplated suicide, and 6.6% of those respondents have actually attempted to take their own lives.[/quote_left]Our EMS specific-survey was open for 40 days, resulting in 4,022 responses from all 50 United States plus Guam, the District of Columbia, American Samoa, and Puerto Rico. When we closed the survey, we were hit with a hard reality: that EMS suicide numbers were skyrocketing and the programs available to help were not sufficient. Our data shows that 1,383 of the 4,022 (37%) providers across the nation who responded to our survey had contemplated suicide, and 6.6% of those respondents have actually attempted to take their own lives.

The survey data shows that respondents working in an EMS culture that does not support the mental wellness and does not encourage the use of formal support institutions like Employee Assistance Programs (EAPs) and Critical Incident Stress Management (CISM) are substantially more likely to contemplate and/or attempt suicide. Additionally, respondents that don’t come from an EMS culture of support and encouragement are much less likely to seek help when they need it, and are much less likely to engage in helpful support.

The also survey measured the effectiveness of formal support institutions like EAPs and CISM. The results startlingly showed that these support institutions were rated as being either “Very Helpful” or “Extremely Helpful” by the respondents that use them. After hearing so many stories about how inept an EAP counselor was or what a “waste of time” that CISM session turned out to be, we expected these numbers to be much, much lower.

In other words, we discovered a very significant prevalence of suicidal ideation in the EMS provider community. We discovered that EAPs and CISM have room for improvement, but do not fall as short of the mark as we originally perceived. It appears, however, that a very significant component to the prevalence and severity of stress in the EMS culture to include suicidal ideation and attempt is the EMS culture itself.

For us, these results brought a whole new meaning to the project. We named our team Reviving Responders, because we realized we need to revive ourselves if want to continue reviving others. A few group members had even experienced suicide by fellow associates in their organizations. [Team member] Monique Rose said, “I was exposed to this issue following a close call involving the resuscitation of the guys in my department. During this time our department struggled to process the tragedy, and I became aware of the flaws in the system while working through some of my own demons.”

CDC. (2012). www.cdc.gov. Retrieved from Centers for Disease Control and Prevention.

How You Can Help

First and foremost, recognition and acknowledgement. As leaders, we cannot afford to be timid about this. If we see one of our own in distress, we must step out of our comfort zone and have the difficult conversations. It will be hard. This is a very dominant and proud profession, and we may not have our staff lining up to say they are struggling. Leaders need tolearn to recognize the warning signs and say something before it’s too late. Really, it should be the responsibility of every single person in EMS to notice subtle changes in individual behavior or work ethics.

Second, employers must be supportive, and offer an environment that supports employee well-being and mental health.

Last, employers should help change the culture of EMS across the board by providing the appropriate resources and ensuring they are available all the time and for as long as the service is needed.

How the Ambulance Industry Can Help

[quote_right]There is no question that field providers are not inherently equipped to deal with the stressors of the profession.[/quote_right] The ambulance industry needs to own the fact that we do not have adequate culture of support for providers to deal with suicide. There is no question that field providers are not inherently equipped to deal with the stressors of the profession. Coping skills for these stressors need to be taught to providers, and providers need to realize that receiving assistance with those skills is acceptable. The irony of the matter here is that many cultures in the industry are in direct opposition to the idea of getting help to deal with the stressors in EMS. As industry leaders, we are responsible for the tone of our respective divisions, and as such have the ability to steer culture. Our data suggests that taking steps to move culture towards one of support for providers’ mental well-being will be far more effective than attempting to reform the current state of CISM and EAP.

With projects like Reviving Responders and ASM, the word is spreading quickly. If we shift the culture, we can reduce the stigma that surrounds this topic. Think about it this way—if we can’t take care of our providers, how do you expect them to take care of patients? As an industry, we must be serious and promote access to various types of resources as no single type will work for everyone.

Most importantly, we must expand our education curriculum to include acknowledgment, recognition, and coping mechanisms far beyond the current single chapter “well-being of the provider” in all our literature.

Final Thoughts

Please speak up so we can help. Reviving Responders is our group’s effort to continue working towards a solution. Right now we are partnering with multiple entities around the U.S. to compile a list of suitable resources tailored to EMS and public safety as a whole. We hope that by sharing our stories others will be encouraged to speak up.

One great resource is Safe Call Now, 206-459-3020, which provides a confidential 24-hour crisis referral service. Safe Call Now allows public safety employees to speak with mental health professionals that are familiar with our line of work , as well as  public safety professionals who understand and can relate. We have more resources available on our website, www.revivingresponders.com..

Credit-Card

Learn & Save: Your Guide to Credit Card Processing Agreements

AAA understands that ambulance services sometimes operate on razor-thin margins. One relatively painless way to reduce operating expenses is to ensure that you are getting the best possible deal on credit card processing. While card processing may seem like a commodity service, it’s not—taking a few moments to become educated on the basic elements of your processor contract may save your service thousands annually.

AAA Guide Tailored to Ambulance Services

AAA worked with industry expert and CardPaymentOptions.com CEO Phillip Parker to develop a card processing guide for ambulance services. We invite you to read it now in the AAA Member Center. Go Now►

New for 2015! Payline Data Partnership

AAA has teamed up with Payline Data, LLC to bring members ultra-low rates and overnight funding on card transactions. Learn more.

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