Statement for House Ways & Means Hearing on America’s Mental Health Crisis

Written by Shawn Baird on . Posted in Employee Wellness, Executive, Government Affairs, Legislative, Operations, Professional Standards, Regulatory.

Committee on Ways and Means

U.S. House of Representatives Hearing on “America’s Mental Health Crisis”

Statement of Shawn Baird, President, American Ambulance Association

February 2, 2022

Chairman Neal, Ranking Member Brady, and members of the Committee, on behalf of the members of the American Ambulance Association (AAA), I greatly appreciate the opportunity to provide you with a written statement on America’s Mental Health Crisis. Simply put, America’s hometown heroes who provide emergency medical services and transitional care need the Congress to recognize the significant stress and trauma paramedics and emergency medical technicians (EMTs) have experienced as a result of this pandemic. The AAA urges members of Congress not to forget these heroes and to expressly include all ground ambulance service personnel in efforts to address America’s Mental Health Crisis.

Emergency medical services (EMS) professionals are ready at a moment’s notice to provide life-saving and life-sustaining treatment and medical transportation for conditions ranging from heart attack, stroke, and trauma to childbirth and overdose. These first responders proudly serve their communities with on-demand mobile healthcare around the clock. Ground ambulance service professionals have been at the forefront of our country’s response to the mental health crisis in their local communities. Often, emergency calls related to mental health services are triaged to the local ground ambulance service to address.

While paramedics and EMTs provide important emergency health care services to those individuals suffering from a mental or behavioral health crisis, these front-line workers have been struggling to access the federal assistance they need to address the mental health strain that providing 24-hour care, especially during a COVID-19 pandemic, has placed on them. We need to ensure that there is equal access to mental health funding for all EMS agencies, regardless of their form of corporate ownership so that all first responders can receive the help and support they need.

EMS’s Enhanced Role in the Pandemic

As if traditional ambulance service responsibilities were not enough, paramedics and EMTs have taken on an even greater role on the very front lines of the COVID-19 pandemic. In many areas, EMS professionals lead Coronavirus vaccination, testing, and patient navigation. As part of the federal disaster response subcontract, EMS personnel even deploy to other areas around the country to pandemic hotspots and natural disasters to bolster local healthcare resources in the face of extraordinarily challenging circumstances.

Mental & Behavioral Health Challenges Drive Staffing Shortages on the Front Line

Myriad studies show that first responders face much higher-than-average rates of post- traumatic stress disorder[1], burnout[2], and suicidal ideation[3]. These selfless professionals work in the field every day at great risk to their personal health and safety—and under extreme stress.

Ambulance service agencies and fire departments do not keep bankers’ hours. By their very nature, EMS operations do not close during pandemic lockdowns or during extreme weather emergencies. “Working from home” is not an option for paramedics and EMTs who serve at the intersection of public health and public safety. Many communities face a greater than 25% annual turnover[4] of EMS staff because of these factors. In fact, across the nation EMS agencies face a 20% staffing shortage compounded by near 20% of employees on sick leave from COVID-19. This crisis-level staffing is unsustainable and threatens the public safety net of our cities and towns.

Sadly, to date, too few resources have been allocated to support the mental and behavioral health of our hometown heroes. I write today to ask for Congressional assistance to help the helpers as they face the challenges of 2022 and beyond.

Equity for All Provider Types

Due to the inherently local nature of EMS, each American community chooses the ambulance service provider model that represents the best fit for its specific population, geography, and budget. From for-profit entities to municipally-funded fire departments to volunteer rescue squads, EMS professionals share the same duties and responsibilities regardless of their organizational tax structure. They face the same mental health challenges and should have equal access to available behavioral health programs and services.

Many current federal first responder grant programs and resources exclude the tens of thousands of paramedics and EMTs employed by for-profit entities from access. These individuals respond to the same 911 calls and provide the same interfacility mobile healthcare as their governmental brethren without receiving the same behavioral health support from

Federal agencies. To remedy this and ensure equitable mental healthcare access for all first responders, we recommend that:

  • During the current public health emergency and for at least two years thereafter, eligibility for first responder training and staffing grant programs administered by the U.S. Department of Health and Human Services (such as SAMHSA Rural EMS Training Grants and HHS Occupational Safety and Health Training Project Grants) should be expanded to include for-profit entities. Spending on training and services for mental health should also be included as eligible program
  • Congress should authorize the establishment of a new HHS grant program open to public and private nonprofit and for-profit ambulance service providers to fund paramedic and EMT recruitment and training, including employee education and peer-support programming to reduce and prevent suicide, burnout, mental health conditions and substance use
  • Any initiatives to fund hero pay or death benefits for first responders should be inclusive of all provider models—for-profit, non-profit, and

The rationale for the above requests is twofold. First, ensuring the mental health and wellness of all EMS professionals—regardless of their employer’s tax status—is the right thing to do.

Second, because keeping paramedics and EMTs employed by private ambulance agencies who are on the frontlines of providing vital medical care and vaccinations during this pandemic is the smart thing to do.

Thank you for considering this request to support ALL of our nation’s frontline heroes. They are ready to answer your call for help, 24/7—two years into this devastating pandemic, will Congress answer theirs?

Please do not hesitate to contact American Ambulance Association Senior Vice President of Government Affairs, Tristan North, at tnorth@ambulance.org or 202-486-4888 should you have any questions.

  • Prevalence of PTSD and common mental disorders amongst ambulance personnel: A systematic review and meta-analysis. Soc Psychiatry Psychiatr 2018;53(9):897-909.
  • ALmutairi MN, El Mahalli AA. Burnout and Coping Methods among Emergency Medical Services Professionals. J Multidiscip Healthc. 2020;13:271-279. Published 2020 Mar 16. doi:10.2147/JMDH.S244303
  • Stanley, I. H., Hom, M. A., & Joiner, T. E. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and Clinical Psychology Review, 44, 25–44. https://doi.org/10.1016/j. cpr.2015.12.002
  • Doverspike D, Moore S. 2021 Ambulance Industry Employee Turnover Study. 3rd Washington, DC: American Ambulance Association; 2021.

CAAS Releases GVS V3.0 Draft for Public Comment

Written by Mark Van Arnam on . Posted in Operations, Professional Standards.

The Commission on Accreditation of Ambulance Services (CAAS) formed a Ground Vehicle Standard Revision Committee to develop V3.0 of the GVS document. Based on industry feedback, this Committee has developed a list of proposed changes to V2.0.

To ensure that anyone with an interest in the medical transportation industry has a voice in the Standard revision process, CAAS has now posted the proposed changes for public comment. These proposed changes will be posted for 60 days, commencing January 7, 2022. Interested parties who care to comment on the changes should complete the online feedback form and submit their input during this public comment period.

The GVS Committee will review all submissions received during the period and will consider each of the comments received. Following this first round review, a second 60-day public comment period will be held to give further opportunity to comment on any items that may have been changed from the first draft as part of the process. The CAAS GVS V3.0 document has a scheduled effective date of July 1, 2022.

Download CAAS GVS v2

Download Proposed Changes

Submit Public Comment

If you have any questions, please contact Mark Van Arnam, Administrator, CAAS GVS.

Colorado | What it’s like in the day of a Denver Health paramedic

Written by AAA Staff on . Posted in Digest State News, News, Operations, Patient Care, Press.

From KDVR on January 3, 2022

DENVER (KDVR) — Denver Health paramedics are often first on the scene of an emergency. And when seconds matter, they make life or death decisions.

FOX31 joined them on a ride-along to see how they do their jobs and how they are holding up during the pandemic.

If you need help, Denver Health paramedics are just minutes away.

Continue Reading on KDVR

Jan 5 | EMS360: Fatigue Risk Management in EMS Webtool Demo

Written by AAA Staff on . Posted in Employee Wellness, Operations.

Fatigue Risk Management in EMS: Project Summary and Webtool Demo

Wed, Jan 5, 2022 11:00 AM – 12:15 PM EST
Show in My Time Zone
Five years after its launch, the Fatigue in EMS Project made available through funding support from the National Highway Traffic Safety Administration is reaching its conclusion with the launch of a biomathematical model/fatigue risk analyzer for EMS personnel. We will summarize the project and provide a live demonstration of the new webtool!

HRSA Federal Office of Rural Health Policy Updates

Written by AAA Staff on . Posted in Operations, Patient Care, Regulatory.

From HRSA’s Federal Office of Rural Health Policy

What’s New

HRSA Rural Public Health Workforce Training Network Program – applications due March 18.  HRSA anticipates awards for more than 30 community-based organizations that will join an effort to train and place public health professionals in rural and tribal areas.  Eligible applicants include minority-serving institutions of higher education, Critical Access Hospitals, community health centers, nursing homes, Rural Health Clinics, substance use providers, and state or local workforce development boards.  Each grantee will receive approximately $1.5 million for a three-year project.  FORHP will hold a webinar for applicants on Wednesday, January 5 at 1:00 pm ET.  For those unable to view online, see the Events section below for dial-in information.

HRSA Rural Residency Planning and Development (RRPD) Program  – deadline extended until January 11. The Health Resources and Services Administration (HRSA) revised the program sustainability requirements and extended the deadline for RRPD grant applications. Applicants should review the changes and can resubmit their applications if needed. HRSA will only review your last submitted application. This program aims to increase opportunities for physicians to train in rural residencies. A total of $10.5 million will develop 14 new rural residency programs accredited by the Accreditation Council on Graduate Medical Education (ACGME). Eligible applicants include rural hospitals, GME consortiums, and tribal organizations. For questions, email RuralResidency@hrsa.gov.

HRSA Small Health Care Provider Quality Improvement Program Funding Opportunity – applications due March 21. HRSA will be making approximately 40 awards of up to $200,000 each to support the planning and implementation of quality improvement activities in rural communities. Applicants must be rural domestic public or private nonprofit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations in a HRSA-designated rural area. FORHP will hold a technical assistance webinar for applicants via Zoom on Wednesday, January 26, 2022 from 2-3 p.m. ET. A recording will be available for those who cannot attend.

Share Your Experiences on Rural Emergency Preparedness and Response. The Rural Health Information Hub (RHIhub)  wants to hear about how rural communities, health care facilities, public health departments, first responders, tribes, rural serving organizations, and others have had to adapt, collaborate, and innovate in the face of disasters and public health emergencies. They are looking for examples of lessons learned, successes, challenges, or other helpful information to highlight related to emergency preparedness, response, and recovery for a variety of disasters. Examples will be shared in an emergency preparedness toolkit on the RHIhub website.

Spread the Word About Vaccine Boosters. The U.S. Department of Health & Human Services released new resources – posters, flyers, videos, and talking points – to help promote the extra protection from COVID-19 boosters.  All vaccinated adults aged 18+ are eligible for a booster.  Search by zip code to find nearby locations providing adult and pediatric vaccines and boosters for COVID-19 and the flu at vaccines.gov.

Ongoing: HRSA Payment Program for RHC Buprenorphine-Trained Providers.  In June 2021, HRSA launched an effort to improve access to substance use disorder treatment by paying for providers who are waivered to prescribe buprenorphine, a medication used to treat opioid use disorder.  Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.  Approximately $1.5 million in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted.  Send questions to DATA2000WaiverPayments@hrsa.gov. There is ongoing availability of a free online course for waiver eligibility training from the American Osteopathic Academy of Addiction Medicine and the Providers Clinical Support System.

COVID-19 Resources

NARHC Assistance with Federal Programs for COVID-19 Testing, Vaccine Distribution, and Provider Relief Fund. The National Association of Rural Health Clinics (NARHC) has background information and guidelines in its collection of technical assistance webinars for all COVID-related programs designated for Rural Health Clinics.

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

Rural Health Clinic Vaccine Distribution (RHCVD) Program.  Under the program, Medicare-certified RHCs will receive direct COVID-19 vaccines in addition to their normal jurisdictions’ weekly allocation.  Contact RHCVaxDistribution@hrsa.gov for more information.

Community Toolkit for Addressing Health Misinformation. The new resource asks for participation from individuals, teachers, school administrators, librarians, faith leaders, and health care professionals to understand, identify, and stop the spread of misinformation.  The toolkit includes common types of misinformation and a checklist to help evaluate the accuracy of health-related content.

Online Resource for Licensure of Health Professionals.  As telehealth usage increased during the pandemic, FORHP funded new work with the Association of State and Provincial Psychology Boards to reduce the burden of multi-state licensure.  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.

HRSA COVID-19 Coverage Assistance Fund.  HRSA will provide claims reimbursement at the national Medicare rate for eligible health care providers administering vaccines to underinsured individuals.

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.

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, COVID-19 Vaccination Trainings for new and experienced providers, and Tips for Talking with Patients about COVID-19 Vaccination.

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 telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians, and email to learn more and sign up.

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 Grant 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.

New: Reaching Farm Communities for Vaccine Confidence.  The AgriSafe Network is a nonprofit organization that provides information and training on injury and disease related to agriculture.  Their health professionals and educators created a social media toolkit that aims to provide clear messages about COVID-19 vaccination for agriculture, forestry, and fishing workers.

Funding and Opportunities

SAMHSA Grants for Rural Emergency Medical Services Training – February 14.  The Substance Abuse and Mental Health Services Administration (SAMHSA) will make 27 awards of up to $200,000 each to recruit and train emergency medical services (EMS) personnel with a focus on mental and substance use disorders.  Eligible applicants are rural EMS agencies operated by a local or tribal government and non-profit EMS agencies.

Policy Updates

Send questions to ruralpolicy@hrsa.gov.

Medicare Rule Adds 1,000 Physician Residency Slots and Other GME Policies.  Last week, the Centers for Medicare & Medicaid Services (CMS) finalized several graduate medical education (GME) proposals that will enhance the health care workforce and fund additional medical residency positions in hospitals serving rural and underserved communities.  This Fiscal Year 2022 Medicare Inpatient Hospital Payment Final Rule adds 1,000 new Medicare-funded residency positions prioritizing hospitals that serve areas with the greatest needs. It also allows new opportunities for rural teaching hospitals participating in an accredited rural training track to increase their full time equivalent (FTE) caps.  The rule also allows hospitals beginning a new medical residency training program to reset their FTE caps and per-resident amounts under qualifying circumstances.  Rural hospitals seeking a cap reset must start new residency training programs by December 2025.  Finally, CMS seeks comments on alternative methods to prioritize additional FTE resident cap slots and the review process to determine eligibility for per resident amounts or FTE cap resets in specified situations.

CMS Suspends Enforcement of Vaccine Mandate While Court Ordered Injunctions Remain in Effect (pdf). This month, CMS issued a memo to State Survey Agency Directors indicating that the agency will not enforce the new rule stipulating vaccination for health care workers in certified Medicare/Medicaid providers and suppliers (including nursing facilities, hospitals, dialysis facilities and all other provider types covered by the rule). Health care facilities may voluntarily choose to comply with the Interim Final Rule at this time.

Learning Events and Technical Assistance

Assistance for Rural Public Health Workforce Funding Applications – Wednesday, January 5 at 1:00 pm ET.  FORHP will hold a one-hour webinar via Zoom for those applying for the Rural Public Health Workforce Training Network Program.  Applications are due March 18th for the grant that will invest $48 million to place newly trained public health professionals in rural areas.  To dial in:  1-833-568-8864; Participant Code: 86083981. Contact RPHWTNP@hrsa.gov for more information or a recording of the webinar.

Resource of the Week

Federally Qualified Health Centers and the Health Center Program. This recently updated topic guide at the Rural Health Information Hub includes new FAQs on Medicare reimbursement for telehealth services, insight on financial and operational performances of health centers, and the differences between a Federally Qualified Health Center and a Rural Health Clinic.

Approaching Deadlines

Last Day for RHCs to Spend COVID-19 Testing Funds – December 31

Department of Labor Stand Down Grants for Veterans Services – December 31

USDA Guaranteed Loans for Rural Rental Housing – December 31

COVID-19 Extension for Medicare Graduate Medical Education (GME) Affiliation Agreement  – January 1

Treasury Department New Markets Tax Credit Program – January 3

CDC Grants for New Investigators/Research for Interpersonal Violence Impacting Children/Youth – January 4

HRSA Family-to-Family Health Information Centers (F2F HICs)  – January 5

NIHB/CDC Building Capacity for Tribal Infection Control – January 7

Nominations Sought for Indigenous Health Equity Committee – extended to January 7

NIH Research for AI/AN End-of-Life Care – January 8

Burroughs Wellcome Fund Seed Grants for Climate Change and Health – January 10

USDA Farm to School Grants – January 10

HHS Grants for Family Planning Services – January 11

HRSA Rural Residency Planning and Development (RRPD) Program – extended to January 11

HRSA Nurse Corps Loan Repayment Program – January 13

HRSA Nurse Faculty Loan Program – January 13

HRSA Rural Communities Opioid Response Program – Implementation – January 13

SAMHSA Grants for Rural Emergency Medical Services Training – February 14

CDC Research on Telehealth Strategies for PrEP and ART – January 18

Comments Requested: DEA Regulation of Telepharmacy Practice – January 18

NIH Researching Behavioral Risk Factors for Cancer in Rural Populations – January 18

Department of Labor YouthBuild Program – January 21

CDC Centers for Agricultural Safety and Health – January 24

ACL Empowering Communities for Chronic Disease Self-Management – January 25

ACL Empowering Communities to Deliver and Sustain Falls Prevention Programs – January 25

CDC Seeking Public Input on Work-Related Stress for Health Workers – Extended to January 25

HRSA Delta Region Rural Health Workforce Training Program – January 25

CDC Cancer Prevention and Control for State, Territorial, and Tribal Organizations – January 26

HRSA Access to HIV Services for Women and Children – January 28

HRSA Rural Health Network Development Planning Program – January 28

HHS COVID-19 and Health Equity Impact Fellowship – extended to January 31

HHS Technology Challenge for Racial Equity in Postpartum Care – January 31

HRSA Centers of Excellence for Training Minorities in Health Professions – January 31

SAMHSA-American Psychiatric Association Diversity Leadership Fellowship – January 31

HRSA Leadership Education in Adolescent Health – February 1

Indian Health Service Forensic Healthcare Services for Domestic Violence Prevention – February 2

Indian Health Service Substance Abuse and Suicide Prevention Program – February 2

Indian Health Service Zero Suicide Initiative – February 2

National Health Service Corps Loan Repayment Programs – Extended to February 3

CDC Research to Prevent Firearm-Related Violence and Injuries – February 4

RWJF Summer Health Professions Education Program for Underrepresented Minorities – February 5

HRSA Predoctoral Training in Public Health Dentistry and Dental Hygiene – February 7

SAMHSA Harm Reduction Program – February 7

VA Supportive Services for Veteran Families – February 7

USDA Farm and Food Worker Relief Grants – February 8

IHS Tribal Self-Governance Negotiation – February 10

IHS Tribal Self-Governance Planning – February 10

CDC Strengthening Infection Prevention – February 11

CDC Evaluating Substance Use Prevention Incorporating ACEs Prevention – February 22

HRSA Mobile Health Training – Nurse Education, Practice, Quality and Retention – February 22

USDA Rural eConnectivity Broadband Loan and Grant Program – February 22

Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance (RCORP-BHCTA) – March 9

HRSA Rural Public Health Workforce Training Network Program – March 18

HRSA Small Health Care Provider Quality Improvement Program – March 21

FCC/USAC Rural Health Care Connect Fund – April 1

FCC/USAC Telecommunications Program – April 1

USDA Local Food Purchase Assistance Program – April 5

Ongoing Opportunities

CFPB Rental Assistance Finder

HHS/DoD National Emergency Tele-Critical Care Network

Extended Public Comment Period for FCC’s COVID-19 Telehealth Program

FCC Emergency Broadband for Individuals and Households

FEMA COVID-19 Funeral Assistance

HRSA Payment Program for Buprenorphine-Trained Clinicians – Until Funds Run Out

AgriSafe Nurse Scholar Program – March 2022

AHRQ Health Services Research Demonstration and Dissemination Grants – September 2022

AHRQ Research to Improve Patient Transitions through HIT – December 2022

American Indian Public Health Resource Center Technical Assistance

ASA Rural Access to Anesthesia Care Scholarship

Burroughs Wellcome Fund Seed Grants for Climate Change and Health – Quarterly through August 2023

CDC Direct Assistance to State, Tribal, Local, and Territorial Health Agencies

CDC Training Pediatric Medical Providers to Recognize ACEs

Delta Region Community Health Systems Development Program

Department of Commerce American Rescue Plan Funding for Indigenous Communities – September 2022

Department of Commerce: Economic Development Assistance Programs

Department of Labor Dislocated Worker Grants

DRA Technical Assistance for Delta Region Community Health Systems Development

EPA Drinking Water State Revolving Fund

FEMA/SAMHSA Crisis Counseling Assistance and Training Program (CCP)

GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment

HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program

Housing Assistance Council: Housing Loans for Low-Income Rural Communities

HUD Hospital Mortgage Insurance Program

IHS Tribal Forensic Healthcare Training

IHS/DOD Medical Supplies and Equipment for Tribes (Project TRANSAM)

NARHC Certified Rural Health Clinic Professional Course

NIH Project Talk Initiative Host Site Applications

NIH Dissemination and Implementation Research in Health – May 2022

NIH Practice-Based Research for Primary Care Suicide Prevention – June 2022

NIH Research – Alcohol and Other Substance Use – Various Dates Through August 2022

NIH Research: Intervening with Cancer Caregivers to Improve Patient Outcomes – September 8, 2022

NIH Research on Minority Health/Health Disparities – September 8, 2022

NIH Research on Palliative Care in Home/Community Settings – September 8, 2022

NIH Intervention Research to Improve Native American Health – Various Dates Until September 2023

NIH Researching the Role of Work in Health Disparities – Various Dates Until September 2024

NIH Special Interest Research – Pandemic Impact on Vulnerable Children and Youth – May 2024

Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases

Nominations for National Advisory Committee on Migrant Health

Primary Care Development Corporation Community Investment Loans

Rural Graduate Medical Education Planning and Development

RWJF Investigator-Initiated Research to Build a Culture of Health

RWJF Pioneering Ideas Brief Proposals

SBA Guaranteed Loans for Small Business

Southeast Rural Community Assistance Loans

Tribal Grant Writing Training

USDA Community Facilities Program

USDA Community Food Projects Technical Assistance

USDA Drinking Water and Waste Disposal for Rural and Native Alaskan Villages

USDA Economic Impact Initiative Grants

USDA Emergency Community Water Assistance Grants

USDA Healthy Food Financing Initiative Technical Assistance

USDA Intermediary Relending Program

USDA Rural Business Development Grants

USDA Rural Business Investment Program

USDA Rural Energy Savings Program

USDA SEARCH – Special Evaluation Assistance for Rural Communities and Households (for Water/Waste Projects)

USDA Summer Food Program

USDA Technical Assistance for Healthy Food Financing Initiative

USDA Telecommunications Infrastructure Loans

USDA Funding for Rural Water and Waste Disposal Projects

USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S)

The Announcements from the Federal Office of Rural Health Policy are distributed weekly. To receive these updates, send an email with “Subscribe” in the subject line.

 

EMS360: Fatigue Risk Management in EMS Webtool Demo

Written by AAA Staff on . Posted in Employee Wellness, Operations.

Fatigue Risk Management in EMS: Project Summary and Webtool Demo

Wed, Jan 5, 2022 11:00 AM – 12:15 PM EST
Show in My Time Zone
Five years after its launch, the Fatigue in EMS Project made available through funding support from the National Highway Traffic Safety Administration is reaching its conclusion with the launch of a biomathematical model/fatigue risk analyzer for EMS personnel. We will summarize the project and provide a live demonstration of the new webtool!

HHS/ASPR Project ECHO COVID-19 Clinical Rounds

Written by AAA Staff on . Posted in Operations, Patient Care, Regulatory.

From HHS/ASPR – Project ECHO COVID Clinical Rounds

COVID-19 CLINICAL ROUNDS
A Peer-to-Peer Virtual Community of Practice

We Are Back!
Thank you for your support in the HHS/ASPR – Project ECHO COVID Clinical Rounds.To sign up for emails regarding upcoming HHS/ASPR COVID-19 sessions, please click here!
You will be redirected to a page that will allow you to opt into an email list serve that will keep you up to date with our weekly sessions. 

Resources from past sessions are below
*Regional Ebola and Other Special Pathogen Treatment Centers
Massachusetts General Hospital (Boston, Massachusetts)
New York City Health and Hospitals Corporation/HHC Bellevue Hospital Center (New York City, New York)
Johns Hopkins Hospital (Baltimore, Maryland)
Emory University Hospital and Children’s Healthcare of Atlanta/Egleston Children’s Hospital (Atlanta, Georgia)
University of Minnesota Medical Center (Minneapolis, Minnesota)
University of Texas Medical Branch at Galveston (Galveston, Texas)
Nebraska Medicine – Nebraska Medical Center (Omaha, Nebraska)
Denver Health Medical Center (Denver, Colorado)
Cedars-Sinai Medical Center (Los Angeles, California)
Providence Sacred Heart Medical Center and Children’s Hospital (Spokane, Washington)
Resources

AAMC COVID-19 Clinical Guidance Repository:
https://www.aamc.org/covid-19-clinical-guidance-repository

ASPR’s Technical Resources, Assistance Center, and Information Exchange (TRACIE) Novel Coronavirus Resources:
https://asprtracie.hhs.gov/covid-19

CDC COVID-19 Resources for Health Care Professionals:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html

NETEC, the National Emerging Special Pathogen Training and Education Center:
https://netec.org/

SCCM COVID-19 Guidelines:
https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/COVID-19

WHO COVID-19 Technical Guidance:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance

WHO COVID-19 Situation Reports:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Please be mindful of COVID-2019 infection prevention and control, try to limit numbers of people joining this learning session from one gathering place and practice social distancing.
WHO guidance on getting workplaces ready for COVID-2019

Special Sessions

Transitions of Care – August 4
Update on Remdesivir and Dexamethasone – Oct 1
Home Health, EMS, Emergency Department and Critical Care – Oct 29

Monoclonal Antibodies – Dec 3

Crisis Care Update – Dec 10

100th Session – Dec 15

For resources and recordings of earlier sessions, visit the Project ECHO website
COVID-19 Clinical Rounds: Critical Care Resources

Feb 2 – System Level Surge Staffing and Resilience Strategies

Jan 26 – System Level Surge Capacity: Crucial Strategies

For earlier presentations and recordings, please visit the Project ECHO COVID-19 Webpage
COVID-19 Clinical Rounds: Emergency Department Resources

Feb 4 – ED Update

Jan 28 – ED Nursing Update

For earlier presentations and recordings, please visit the Project ECHO COVID-19 Webpage
COVID-19 Clinical Rounds: EMS Resources

Feb 1 – EMS Involvement in Monoclonal Antibody Infusion Programs

Jan 25 – COVID-19 and Riots

For earlier presentations and recordings, please visit the Project ECHO COVID-19 Webpage
Please direct any additional questions or concerns to
C19echo@salud.unm.eduFor help with connecting, please call (505) 750-4897 or email echoit@salud.unm.edu
ECHO is a movement to demonopolize knowledge and amplify the capacity to provide best practice care for underserved people all over the world.

EMS.gov | Template Protocol for EMS Administration of Monoclonal Antibodies

Written by AAA Staff on . Posted in Operations, Patient Care.

From EMS.gov on August 27, 2021

Developed by the NHTSA Office of EMS and HHS Office of the Assistant Secretary for Preparedness and Response, the template is intended to assist state EMS officials and local EMS systems in developing their own protocols 
he U.S. Food and Drug Administration has issued an Emergency Use Authorization to permit the emergency use of REGEN-COV (casirivimab and imdevimab) co-formulated product, and REGEN-COV (casirivimab and imdevimab) supplied as individual vials to be administered together, for the treatment of mild to moderate COVID-19 in adult and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Monoclonal antibodies are used to neutralize the COVID-19 virus and intended to prevent progression of disease. The U.S. Government is currently supplying REGEN-COV (casirivimab and imdevimab) for the treatment and post-exposure prophylaxis of COVID-19. The dosing is the same for both indications (casirivimab 600mg and imdevimab 600mg). The medication can be administered either intravenously (IV) or by subcutaneous (SQ) injection.EMS agencies throughout the country have been asked or may be asked to assist in the administration of this product through either route of administration.

To assist EMS agencies in planning, the NHTSA Office of EMS and HHS Office of the Assistant Secretary for Preparedness and Response have developed a template protocol for state EMS offices and EMS Medical Directors to use to assist in these programs. Some states have created blanket state-level authorizations for EMS administration; some states will still require provider authorization prior to administration. Please follow local protocols and regulations. This template is only designed to facilitate the development of those local protocols as needed. Please contact the NHTSA Office of EMS with any questions.

EMS.gov | Information About COVID-19 for EMS Systems and Clinicians

Written by AAA Staff on . Posted in Emergency Preparedness, Employee Wellness, Operations, Patient Care.

From EMS.gov

Resources include guidance documents, links to the latest from the CDC, and information about vaccine safety and administration
With cases of COVID-19 surging again across the country, EMS clinicians and leaders may once again be responding to increased numbers of PUIs, have questions about handling exposures, and be looking for information about coronavirus vaccines.

The EMS.gov COVID-19 Resources for EMS page continues to provide a number of helpful tools, on topics ranging from crisis standards of care to first responder mental health. The source of each resource is clearly identified, including documents created by the Federal Healthcare Resilience Working Group EMS/Prehospital Team.

The NHTSA Office of EMS once again would like to thank EMS clinicians and our public safety and healthcare colleagues across the country for your dedicated service. What you do is vital to our communities and our nation. We urge you to take steps to ensure the health and safety of you, your patients and your families and protect yourself from COVID-19, stress, and other dangers.

Please contact nhtsa.ems@dot.gov with questions or comments.

Monkeypox & COVID-19 Resources for EMS Clinicians

Written by AAA Staff on . Posted in Operations, Patient Care.

From EMS.Gov

Monkeypox Resources for EMS Clinicians

The arrival of an individual in the United States who was diagnosed with monkeypox, as well as the uptick in COVID-19 cases, are reminders that EMS clinicians must remain vigilant and prepared. The CDC is conducting contact tracing of the monkeypox case and local public health departments have been notified, and it is unlikely that EMS clinicians will be exposed to the monkeypox virus is low. However, reviewing information about the disease may still be helpful.

Click here to access information compiled by the National Emerging Special Pathogen Training and Education Center to help inform EMS clinicians about monkeypox.

COVID-19 Resources for EMS

Low vaccination rates, the highly contagious delta variant, and increased social interaction has caused significant increases in rates of COVID-19 and related hospitalizations in many communities around the nation. The NHTSA Office of EMS continues to make resources available to help EMS clinicians, organizations and regulators safely maintain operations during the pandemic. Those resources are available on the EMS.gov COVID-19 Resources Page.

EICC Pediatric Emergency Champion Program

Written by AAA Staff on . Posted in Operations, Patient Care.

From the Emergency Medical Services for Children Innovation and Improvement Center

September 1, 2021 – June 30, 2022

Purpose

This collaborative will develop individuals who are interested in improving the quality of pediatric care at your EMS agency, ED/hospital, or within your region. We will provide resources, example practices and networking opportunities at no cost to help push forward any effort for pediatric improvement.

What is a PECC?

A Pediatric Emergency Care Coordinator (PECC)–sometimes referred to as a pediatric champion or pediatric liaison–is a term that the EMSC program uses to refer to any individual who has a particular interest in or responsibilities related to pediatric emergency care. Sometimes this individual is dedicated solely to this role. However, depending on the pediatric volume of the EMS agency or hospital, this person may take on the PECC duties in addition to other responsibilities (e.g., educator, trauma coordinator, etc.). Various roles and responsibilities are often given to a PECC but common responsibilities include ensuring the availability of pediatric equipment, supplies and medications, pediatric education/training and advocating for pediatric considerations to be included in protocol/policy development.

Who should participate

Anyone that is interested in improving pediatric readiness within your EMS agency, ED/hospital, or within your region, to include EMSC State Partnership Programs. You do NOT need to have any formal pediatric training, or a title related to pediatric care. You already have everything you need to participate…an interest in pediatric emergency care

Why join?

We know that the presence of an individual with an interest in pediatric emergency care is strongly correlated with improved outcomes for children. No effort to improve pediatric emergency care is too small to make an impact. This collaborative will have a broad scope. No matter where your starting point is, we will provide you with tools to improve. There is no cost to participate, and you will have the opportunity to earn continuing education or Maintenance of Certification Part 4 credit. Learn more…

How it works

The collaborative will occur in two parts. During the first half, we will explore seven pediatric readiness areas of focus, evaluate your agency or ED/hospital level of pediatric readiness, and identify areas for improvement. In the second half, we provide coaching and tools to help you develop an improvement project. Learn more…

Location

All collaborative activates will be conducted online and through virtual meetings.

Learn More

Study | Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation

Written by AAA Staff on . Posted in Operations, Patient Care.

Thank you to Dr. John Russell of Cape County Private Ambulance for sharing this resource.

Ready for Children Part II: Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting

Hilary A. Hewes, Andrea L. Genovesi, Rachel Codden, Michael Ely, Lorah Ludwig, Charles G. Macias, Patricia Schmuhl & Lenora M. Olson (2021) Ready for Children Part II: Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting, Prehospital Emergency Care, DOI: 10.1080/10903127.2021.1942340

Abstract

Objectives: Treating pediatric patients often invokes discomfort and anxiety among emergency medical service (EMS) personnel. As part of the process to improve pediatric care in the prehospital system, the Health Resources and Services Administration (HRSA) Emergency Services for Children (EMSC) Program implemented two prehospital performance measures -access to a designated pediatric care coordinator (PECC) and skill evaluation using pediatric equipment-along with a multi-year plan to aid states in achieving the measures. Baseline data from a survey conducted in 2017 showed that less than 25% of EMS agencies had access to PECC and 47% performed skills evaluation using pediatric equipment at least twice a year. To evaluate change over time, the survey was again conducted in 2020, and agencies that participated in both years are compared.

Methods: A web-based survey was sent to EMS agency administrators in 58 states and territories from January to March 2020. Descriptive statistics, odds ratios, and 95% confidence intervals were conducted.

Results: The response rate was 56%. A total of 5,221 agencies participated in both survey periods representing over 250,000 providers. The percentage of agencies reporting the presence of a PECC increased from 24% to 34% (p= <0.001). However, some agencies reported that they no longer had a PECC, while others reported having a PECC for the first time. Fifty percent (50%) of agencies conduct pediatric psychomotor skills evaluation at least twice/year, a 2% increase over time (p = 0.041); however, a third (34%) evaluate skills using pediatric equipment less than once a year. The presence of a PECC continues to be the variable associated with the highest odds (AOR 2.15, 95% CI 1.91–2.43) of conducting at least semiannual skills evaluation.

Conclusions: There is an increase in the presence of pediatric care coordination and the frequency of pediatric psychomotor skills evaluation among national EMS agencies over time. Continued efforts to increase and sustain PECC presence should be an ongoing focus to improve pediatric readiness in the prehospital system.

Access Full Study

EMS.gov | New Resources Help EMS Clinicians and Agencies Navigate HIPAA

Written by AAA Staff on . Posted in Operations, Patient Care, Regulatory.

Nationwide, EMS agencies regularly report that hospitals and other healthcare workers refuse to share patient information with them, citing Health Insurance Portability and Accountability Act (HIPAA) concerns. Misconceptions about HIPAA can create artificial barriers to the legitimate, approved exchange of data between EMS and other providers, resulting in missed opportunities to improve patient outcomes and advance evidence-based practices in prehospital care.

To address this issue, the NEMSIS Technical Assistance Center collaborated with the law firm Page, Wolfberg & Wirth to provide helpful resources explaining the sharing of patient information between EMS and other healthcare professionals:

While obstacles may remain for the appropriate sharing of patient information, HIPAA is not one of them. Sharing patient information benefits EMS agencies and improves prehospital patient care by revealing evidence-based practices that make a difference for patients in the field.

On-Demand | Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!

Written by AAA Staff on . Posted in Employee Wellness, Operations, Webinars.

Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!
Recorded July 7, 2021 | 14:00–15:15 pm ET | FREE Webinar

Download Slide Deck | Watch on YouTube

HOT (red light and siren) responses put EMS providers and the public at significant risk. Studies have demonstrated that the time saved during this mode of vehicle operation and that reducing HOT responses enhances safety of personnel, with little to no impact on patient outcomes. Some agencies have ‘dabbled’ with responding COLD (without lights and sirens) to some calls, but perhaps none as dramatic as Niagara Region EMS in Ontario, Canada – who successfully flipped their HOT responses to a mere 10% of their 911 calls! Why did they do it? How did they do it? What has been the community response? What has been the response from their workforce? Has there been any difference in patient outcomes? Join Niagara Region EMS to learn the answers to these questions and more. Panelists from co-hosting associations will participate to share their perspectives on this important EMS safety issue!

Speakers

Kevin Smith, BAppB:ES, CMM III, ACP, CEMC
Chief
Niagara Emergency Medical Services

Jon R. Krohmer, MD, FACEP, FAEMS
 Director, Office of EMS
National Highway Traffic Safety Administration
Team Lead, COVID-19 EMS/Prehospital Team

Douglas F. Kupas, MD, EMT-P, FAEMS, FACEP
 Medical Director, NAEMT
Medical Director, Geisinger EMS

Matt Zavadsky, MS-HSA, NREMT
 Chief Strategic Integration Officer
MedStar Mobile Integrated Healthcare

Bryan R. Wilson, MD, NRP, FAAEM
 Assistant Professor of Emergency Medicine
St. Luke’s University Health Network
Medical Director, City of Bethlehem EMS

Robert McClintock
 Director of Fire & EMS Operations
Technical Assistance and Information Resources
International Association of Fire Fighters

Mike McEvoy, PhD, NRP, RN, CCRN
 Chair – EMS Section Board – International Association of Fire Chiefs
EMS Coordinator – Saratoga County, New York
Chief Medical Officer – West Crescent Fire Department
Professional Development Coordinator – Clifton Park & Halfmoon EMS
Cardiovascular ICU Nurse Clinician – Albany Medical Center

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