CMS Bolsters Payments for At-Home COVID-19 Vaccines

From CMS on June 9, 2021

Biden Administration Continues Efforts to Increase Vaccinations by Bolstering Payments for At-Home COVID-19 Vaccinations for Medicare Beneficiaries

As part of President Biden’s commitment to increasing access to vaccinations, CMS announced an additional payment amount for administering in-home COVID-19 vaccinations to Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach. This announcement further demonstrates continued efforts of the Biden-Harris Administration to meet people where they are and make it as easy as possible for all Americans to get vaccinated. There are approximately 1.6 million adults 65 or older who may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home.

While many Medicare beneficiaries can receive a COVID-19 vaccine at a retail pharmacy, their physician’s office, or a mass vaccination site, some beneficiaries have great difficulty leaving their homes or face a taxing effort getting around their communities easily to access vaccination in these settings. To better serve this group, Medicare is incentivizing providers and will pay an additional $35 per dose for COVID-19 vaccine administration in a beneficiary’s home, increasing the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose. For a two-dose vaccine, this results in a total payment of approximately $150 for the administration of both doses, or approximately $70 more than the current rate.

“CMS is committed to meeting the unique needs of Medicare consumers and their communities – particularly those who are home bound or who have trouble getting to a vaccination site. That’s why we’re acting today to expand the availability of the COVID-19 vaccine to people with Medicare at home,” said CMS Administrator Chiquita Brooks-Lasure. “We’re committed to taking action wherever barriers exist and bringing the fight against the COVID-19 pandemic to the door of older adults and other individuals covered by Medicare who still need protection.”

Delivering COVID-19 vaccination to access-challenged and hard-to-reach individuals poses some unique challenges, such as ensuring appropriate vaccine storage temperatures, handling, and administration. The CDC has outlined guidance to assist vaccinators in overcoming these challenges. This announcement now helps to address the financial burden associated with accommodating these complications.

The additional payment amount also accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The payment rate for administering each dose of a COVID-19 vaccine, as well as the additional in-home payment amount, will be geographically adjusted based on where the service is furnished.

How to Find a COVID-19 Vaccine:

As this action demonstrates, a person’s ability to leave their home should not be an obstacle to getting the COVID-19 vaccine. As states and the federal government continue to break down barriers – like where vaccines can be administered – resources for connecting communities to vaccination options remain key. Unvaccinated individuals and those looking to assist friends and family can:

  • Visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby
  • Text GETVAX (438829) for English or VACUNA (822862) for Spanish for near-instant access to details on three vaccine sites in the local area
  • Call the National COVID-19 Vaccination Assistance Hotline at 1-800-232-0233 (TTY: 1-888-720-7489) for assistance in English and Spanish

Coverage of COVID-19 Vaccines:

The federal government is providing the COVID-19 vaccine free of charge or with no cost-sharing for all people living in the United States. As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers cannot charge patients any amount for administering the vaccine.

Because no patient can be billed for COVID-19 vaccinations, CMS and its partners have provided a variety of information online for providers vaccinating all Americans regardless of their insurance status:

  • Original Medicare and Medicare Advantage: Beneficiaries with Medicare pay nothing for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance or deductible.
  • Medicaid and the Children’s Health Insurance Program (CHIP):State Medicaid and CHIP agencies must cover COVID-19 vaccine administration with no cost sharing for nearly all beneficiaries during the COVID-19 Public Health Emergency (PHE) and for over a year after it ends. For the very limited number of Medicaid beneficiaries who are not eligible for this coverage (and do not receive it through other coverage they might have), providers may submit claims for reimbursement for administering the COVID-19 vaccine to underinsured individuals through the COVID-19 Coverage Assistance Fund, administered by the Health Resources and Services Administration (HRSA), as discussed below. Under the American Rescue Plan Act of 2021 (ARP), signed by President Biden on March 11, 2021, the federal matching percentage for state Medicaid and CHIP expenditures on COVID-19 vaccine administration is currently 100% (as of April 1, 2021), and will remain 100% for more than a year after the COVID-19 PHE ends. The ARP also expands coverage of COVID-19 vaccine administration under Medicaid and CHIP to additional eligibility groups. CMS recently updated the Medicaid vaccine toolkit to reflect the enactment of the ARP at https://www.medicaid.gov/state-resource-center/downloads/covid-19-vaccine-toolkit.pdf.
  • Private Plans: The vaccine is free for people enrolled in private health plans and issuers COVID-19 vaccine and its administration is covered without cost sharing for most enrollees, and such coverage must be provided both in-network and out-of-network during the PHE. Current regulations provide that out-of-network rates must be reasonable as compared to prevailing market rates, and the rules reference using the Medicare payment rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect health insurance issuers and group health plans to continue to ensure their rates are reasonable when compared to prevailing market rates. Under the conditions of participation in the CDC COVID-19 Vaccination Program, providers cannot charge plan enrollees any administration fee or cost sharing, regardless of whether the COVID-19 vaccine is administered in-network or out-of-network.

The Biden-Harris Administration is providing free access to COVID-19 vaccines for every adult living in the United States. For individuals who are underinsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine through the COVID-19 Coverage Assistance Fund administered by HRSA after the claim to the individual’s health plan for payment has been denied or only partially paid. Information is available at https://www.hrsa.gov/covid19-coverage-assistance.

For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by HRSA. Information on the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program is available at https://www.hrsa.gov/CovidUninsuredClaim.

More information on Medicare payment for COVID-19 vaccine administration – including a list of billing codes, payment allowances and effective dates – is available at https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment.

More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html.

JEMS | Quality of Handoffs from EMS to ED

Quality of Handoffs from Emergency Medical Services to Emergency Department Providers

Literature and study team experience indicate emergency medical services (EMS) to emergency department provider handoffs could be an opportunity for improvement in emergency medical care. To date, no study has been published to specifically determine the perceived quality of handoffs between EMS and emergency department providers in the state of Minnesota. This exploratory project could help provide insight toward improving handoffs and guide future research and quality improvement projects.

Read at JEMS

Webinar 7/7 | Lights & Sirens Responses


Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!

Free Webinar July 7 | 14:00–15:15 ET

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
Team Lead, COVID-19 EMS/Prehospital Team
Director, Office of EMS
National Highway Traffic Safety Administration

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

Register Now (Free)

ABC | Global microchip shortage impacting ambulance supply

May 21, 2021 | By Mina Kaji and Amanda Maile | Read Full Story

“Without those chassis, the production of ambulances essentially slows down dramatically,” American Ambulance Association Spokesman Mark Van Arnam said. “So that becomes a public safety issue.”

Chassis inventories were already at “historically low levels” due to coronavirus shutting down manufacturing plants, Van Arnam explained.

In order to make an ambulance, manufacturers need to first construct a chassis, or frame, to build it on.

“An ambulance chassis contains dozens and dozens of microchips — more microchips than the average F-150,” Van Arnam said.

Read Full Story

CMS | Medicare COVID-19 Data Snapshot

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 4.1 million COVID-19 cases among the Medicare population and over 1.1 million COVID-19 hospitalizations.

The updated snapshot covers the period from January 1, 2020 to March 20, 2021. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by April 16, 2021.

View the Updated Snapshot

Microchip Shortage to Affect Ambulance Supply

From the American Ambulance Association & The Commission on Accreditation of Ambulance Services (CAAS) Ground Vehicle Standards

By Mark Van Arnam, Administrator, CAAS GVS

A global semiconductor shortage is crippling the production of motor vehicles both in the US and worldwide.  Ford Motor Company, which supplies approximately 70% of the ambulance chassis used in the US, shut down production at various plants that produce the E series, T series, and F series ambulance chassis in mid-April.  These scheduled shutdowns continue and are already approaching the 6 to 7-week mark.  The end is not yet in sight, with the shortage of the critical microchips predicted to run into 2022. Ford currently predicts an overall production loss of over 1.1 million units in 2021.

These production shutdowns by Ford and other chassis manufacturers have created a major supply chain interruption of chassis needed to produce ambulances in North America. Many Final Stage Ambulance Manufacturers (FSAMs) and Remounters are reporting chassis shortages that are worse than those experienced in the 2020 pandemic period when those OEM truck plants shut down for COVID reasons.

Both Ford and GM report that the duration and extent of the semiconductor shortage and resulting production shutdowns are not yet known and “the situation changes daily”.  As of mid-May, many FSAMs are reporting significant ambulance production slowdowns due to chassis shortages, with complete shutdowns of some ambulance assembly lines highly likely in the near future.

Study | EMS Super-Utilizers

The Penn State College of Medicine is conducting a national study of social needs in EMS patients, particularly in regards to potential interventions for EMS super-utilizers (frequent flyers). The study consists of an approximately 7 minute online survey with questions about provider (911-EMT, Paramedic, EMS Physician) knowledge of social needs, recognition of patient needs, perceptions of possible interventions, and background information. Those who participate will have the option to enter into a drawing for a $50 gift card.

With the implementation of programs such as ET3, we are hoping to hear from as many EMS providers as possible to give them a voice in how to best to address social needs and EMS super-utilizers. As such, we are hoping you consider sharing our study flyerstudy overview from JEMS, or the study link with your employees and/or social media.

2019 National EMS Scope of Practice Model, Change Notices

Download Change Notice

Date:               March 29, 2021

To:                  State EMS Directors

From:              Jon R. Krohmer, M.D., FACEP, Director, Office of Emergency Medical Services

RE:                  2019 National EMS Scope of Practice Model, Change Notices

The National EMS Scope of Practice Model (model) was first published in February 2007 by the National Highway Traffic Safety Administration’s (NHTSA’s) Office of Emergency Medical Services (EMS). The most recent version of the model was published by NHTSA in February 2019. The model was developed by the National Association of State EMS Officials (NASEMSO) with funding provided by NHTSA and the Health Resources and Services Administration (HRSA). Over the past 14 years, the model has provided guidance for States in developing their EMS Scope of Practice legislation, rules, and regulation. While the model provides national guidance, each State maintains the authority to regulate EMS within its border, and determine the scope of practice of State-licensed EMS clinicians.

Recognizing that the model may impact States’ ability to urgently update their Scope of Practice rules, in 2016 the National EMS Advisory Council (NEMSAC) recommended that NHTSA develop a standardized urgent update process for the model. The Rapid Process for Emergent Changes to the National EMS Scope of Practice Model (rapid process) was developed by NASEMSO and published by NHTSA in September 2018.

Using the rapid process, in March 2021 NHTSA convened a subject matter expert panel (panel) to respond to the following questions: 1) Should immunizations via the intramuscular (IM) route be added to the emergency medical responder (EMR) and emergency medical technician (EMT) scope of practice levels?; 2) Should monoclonal antibody (MCA) infusion be added to the advanced EMT (AEMT) and paramedic scope of practice levels?; and 3) Should specimen collection via nasal swabbing be added to the EMR, EMT, AEMT, and paramedic scope of practice levels?

The panel considered the ability of EMRs and EMTs to perform the psychomotor skill of medication administration via the IM route and recommended that IM medication administration be added only to the EMT scope of practice as part of their common daily practice.

The panel considered the ability of EMRs and EMTs to administer medical director approved immunizations and recommended that immunizations during a public health emergency be added only to the EMT scope of practice.

The panel considered the ability of EMRs, EMTs, AEMTs, and Paramedics to perform the psychomotor skill of specimen collection via nasal swab and recommended that specimen collection via nasal swab be added only to the EMT, AEMT, and Paramedic scopes of practice as part of their common daily practice.

The panel did not issue a recommendation on MCA infusion.

Based on the panel’s recommendations NHTSA used the rapid process to develop the two attached change notices on IM medication administration, vaccinations during a public health emergency, and specimen collection via nasal swab.

It should be noted that, although the recommendations address the psychomotor skills associated with these specific activities, the assumption of the panel in making the recommendations was that all associated educational activities, knowledge of indications and potential contraindications, other potential skills (e.g.: drawing the appropriate dose of medication up from an ampule or vial [single or multi-dose], supervised assessment of skill competency, and quality improvement activities) would be components of the entire program.

I hope you find these change notices useful to you in meeting the urgent needs of your patients and the practitioners you regulate. In the very near future we will publish a revised version of the model which incorporates these change notices. Please feel free to contact me should you have any questions.

Download Change Notice

EMS Mental Health Study

“Dynamic psychosocial risk and protective factors associated with mental health in Emergency Medical Service (EMS) personnel”

Published in the Journal of Affective Disorders

Highlighted Findings

  • Emergency medical service personnel have a heightened risk for PTSD and depression relative to other occupational populations.
  • Dynamic psychosocial factors contribute to this elevated risk.
  • Daily occupational stressors predicted elevated PTSD symptom severity.
  • Daily social conflicts predicted elevated depression symptom severity.
  • The meaning made from the day’s challenges and recovery activities predicted lower depression symptom severity.

Full Study

CAAS | Standards v4.0 First Draft Available for Public Comment

The Commission on Accreditation of Ambulance Services (CAAS) is pleased to announce the first public comment period on the first draft of the CAAS Accreditation Standards document version 4.0. All materially affected parties including members of the EMS community, EMS groups and associations, affiliated healthcare groups and associations, members of other public health and safety communities, and the general public are encouraged to review and comment on these proposed standards.

The revision of the CAAS Accreditation Standards was an extensive process conducted by the Standards Review Committee, a diverse and comprehensive team of EMS, Fire, and healthcare professionals that has dedicated over 250 work hours and engaged with subject matter experts and materially impacted stakeholders across EMS and healthcare to create this first draft of the v4.0 CAAS Accreditation Standards.

These standards were developed in accordance with the standard establishing policies set forth by the American National Standards Institute (ANSI.) CAAS is an ANSI Standards Developing Organization (SDO) committed to the development of Ambulance Accreditation Standards in a fair, balanced, accessible, and responsive manner.

This is the first public comment period, and we encourage you to review and provide your feedback to the CAAS Standards Review Committee using this online form. This public comment period will be open from March 26, 2021 until May 25, 2021.

CAAS v4.0 Accreditation Standards – First Draft and Public Comment Form

We ask that you submit one form for each standard comment you have – please do not comment on multiple standards in one form. We want to be able to review the feedback in an organized manner.

If you have any questions on the proposed standards or the standard-setting process, please contact us at caas-staff@tcag.com. We look forward to your feedback.

CMS COVID-19 Snapshot March 24

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 2.7 million COVID-19 cases among the Medicare population and nearly 700,000 COVID-19 hospitalizations.  This update includes new data on COVID-19 case and hospitalization rates by race/ethnicity.

The updated snapshot covers the period from January 1 to December 26, 2020. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by January 22, 2021.

View the Updated Snapshot

Texas A&M Study | Anonymous Survey for EMS

Dr. Joyce Hnatek, Timothy Fan, and Logan DuBose from the Texas A&M College of Medicine are conducting a research study to assess the awareness of an often overlooked patients’ right – the right to not be hospitalized/transported against one’s will. You were selected to receive this invitation because you may provide healthcare to patients with decreased ability to communicate.
We respectfully request that you complete this brief anonymous survey. It should take < 5 minutes to complete. Thank you in advance for your time and support. The informed consent is included in the survey link (https://tamu.qualtrics.com/jfe/form/SV_6LvpSzXslKzRz1z)
Sincerely,

Timothy (fan@tamu.edu) and Logan (logandubose960@tamu.edu)

JAMA | Ontario | Economic Analysis of MIH Delivered by EMS

From JAMA on February 24, 2021

Economic Analysis of Mobile Integrated Health Care Delivered by Emergency Medical Services Paramedic Teams

Question  Is mobile integrated health care (MIH) delivered by emergency medical services more efficient than regular ambulance responses in addressing the needs of urgent care in the community?

Findings  This economic evaluation compared 1740 calls serviced by MIH in 2018 to 2019 with propensity score–matched ambulance calls for the same period and 2 years prior and found that MIH was associated with a decrease in the proportion of patients transported to the emergency department and saved health care costs compared with regular ambulance responses.

Meaning  These findings suggest that MIH is a promising and viable solution to meeting urgent health care needs while improving the efficiency in using emergency care resources.

Continue Reading

EMS.gov | Response to Incidents w Electric / Hybrid Vehicles

From NHTSA’s EMS.gov on February 11

New Report Highlights Potential Risks While Responding to Incidents Involving Electric or Hybrid Vehicles

Responders urged to review NHTSA guidance for vehicles equipped with high-voltage batteries

A new National Transportation Safety Board report offers safety recommendations for emergency response involving electric vehicles (EV) and hybrid-electric vehicles (HEV) equipped with high-voltage batteries.

NTSB investigations into four electric vehicle fires identified two major safety issues:

  • The inadequacy of vehicle manufacturers’ emergency response guides.
  • The gaps in safety standards and research related to high-voltage lithium-ion batteries involved in high-speed, high-severity crashes.

EMS, fire and law enforcement personnel are encouraged to review the report to stay up to date on the latest safety advisories for responding to vehicle crashes of this nature. In addition, NHTSA’s guidance for responding to emergency incidents involving these types of vehicles provides important information for all first responders and can be accessed on NHTSA.gov.

To access the full report, read the official NTSB announcement.

EMS.gov | Training Resources for Vaccination Programs Using EMTs

From EMS.gov on February 10

These resources can serve as just in time training for vaccination programs utilizing emergency medical technicians:

Training video on COVID-19 intramuscular vaccine administration
This video created by the Maryland Institute of Emergency Medical Services Systems (MIEMSS) can be used to provide EMTs with didactic knowledge to administer IM injections. With the exception of the MIEMSS link referenced in the video, it can be used by EMTs in any state or territory. It should be accompanied by a skills assessment, which is discussed below.

Intramuscular Injection Skill Checklist
A clinical skills assessment checklist for EMTs preparing to administer IM injections.

SARS-CoV-2 Vaccine Training for EMTs
A written description of the skills required of EMTs to administer the vaccine.

Moderna and Pfizer Vaccine Comparison
A simple side-by-side comparison of the Pfizer and Moderna SARS-CoV-2 vaccines

Vaccine Update Video
In this presentation from late January 2021, Florida State EMS Medical Director Kenneth Scheppke, MD, provides an overview of the latest science related to COVID vaccines.

COVID-19 Vaccination Training Programs and Reference Materials for Healthcare Professionals
CDC recommended resources to prepare healthcare workers to administer COVID-19 vaccines.

EMS Vaccine Administration Program Manual
This guide from the State of Indiana can serve as a resource to help state and local officials and EMS organizations with the creation and implementation of EMS vaccination programs.

CDC | National Forum on COVID-19 Vaccine

Download CDC Fact Sheet

In support of the Biden-Harris administration’s National Strategy for the COVID-19 Response and Pandemic Preparedness, the Centers for Disease Control and Prevention is organizing a virtual National Forum on COVID-19 Vaccine that will bring together practitioners from national, state, tribal, local, and territorial levels who are engaged in vaccinating communities across the nation.

The Forum will facilitate information exchange on the most effective strategies to:

  • Build trust and confidence in COVID-19 vaccines
  • Use data to drive vaccine implementation
  • Provide practical information for optimizing and maximizing equitable vaccine access

Practitioners include representatives of organizations focused on vaccine implementation in communities from:

  • State, tribal, local, and territorial public health departments
  • Healthcare system providers and administrators and their national affiliate organizations
  • Pharmacies
  • Medical and public health academic institutions
  • Community-based health service organizations

Dates and Deadlines:

  • February 9: Registration opens: www.cdc.gov/covidvaccineforum
  • February 16: Last day to register
  • February 22: Building Trust and Vaccine Confidence
  • February 23: Data to Drive Vaccine Implementation
  • February 24: Optimize and Maximize Equitable Access

Download CDC Fact Sheet

AHA Pre-Hospital News & Resources

From the American Heart Association on February 10

Dear Pre-hospital Emergency Colleagues,

The American Heart Association®’s Quality, Outcomes Research and Analytics team is excited to launch the Pre-hospital News and Resources newsletter for prehospital emergency care providers. In this issue you will find information on 2021 Mission: Lifeline Recognition information, conferences and webinars, prehospital resources, American Heart Association guidelines and statement, prehospital articles, and 2020 Mission: Lifeline recognized agencies.

2021 MISSION: LIFELINE® EMS RECOGNITION

The 2021 Mission: Lifeline EMS recognition updates are now available. The Mission: Lifeline EMS recognition is a program designed to showcase emergency prehospital care organizations across the nation for excellent care based on American Heart Association guidelines.

Process

For agencies that applied for 2020 recognition. An email fromAHASurveys@surveys.heart.org was sent on December 17, 2020 to the primary contacts from last year that will include a recognition application link, unique to the applicant agency. ACTION: If you applied last year and have not received your application link, please let your regional quality director know immediately.

For new applicants or agencies that did not apply in 2020.  ACTION: Please complete the 2021 New Mission: Lifeline EMS Application Request form. Upon completion of this form an application link will be sent via email within 2-business days.

Recognition Measures

For the 2021 recognition year (based on 2020 calendar year data) the required achievement measures will remain the same as those required for 2020 recognition, below.

Due to COVID-19, updates to the required achievement measures to include the two new stroke measures is being delayed until 2022.  On a related note, the National EMS Quality Alliance approved 11 measures in August 2019 including  “Stroke-01 Suspected Stroke Receiving Prehospital Stroke Assessment” which is one of the Mission: Lifeline EMS stroke recognition measures planned for 2022.

Data Submission

The data submission portal is open and will remain open and accessible through the application deadline, April 30, 2021.

Recognition Resources

To assist agencies, there are resources on the website including; Application Overview VideoRecognition CriteriaRecognition FAQApplication Category, and Webinars

Recognition Questions or Assistances

If you have questions or need assistance, please reach out to your regional Mission: Lifeline EMS contact below.

Eastern region (CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VA, VT, WV)
Rob Horton – rob.horton@heart.org
Midwest region (IA, IN, IL, KS, KY, MI, MN, MO, ND, NE, OH, SD, WI)
Alex Kuhn – alexander.kuhn@heart.org
Southeast region (AL, FL, GA, LA, MS, NC, PR, SC, TN)
Lori Hollowell – lori.hollowell@heart.org
Southwest region (AR, CO, NM, OK, TX, WY)
Loni Denne – loni.denne@heart.org
Western region (AK, AZ, CA, HI, ID, MT, NV, OR, UT, WA)
Paula Hudson – paula.hudson@heart.org

CONFERENCES AND WEBINARS

February 11, 2021 from 11am – 12pm CST
Resuscitation Education in the Real World: How the Columbus Fire Department transformed the way they practice High-Quality CPRFebruary 18, 2021 from 9am – 12pm CST
Innov8te NRP:  Introduction to the Neonatal Resuscitation Program, 8th Education

February 23, 2021 from 12pm-1pm CST
Getting to the Heart of the Issue: Rural Stroke and Cardiac System of Care Trends, Inequities and Opportunities

March 11, 2021 from 1pm-2pm CST 
Pre-Hospital Quality Roundtable Webinar

March 17-19, 2021
International Stroke ConferenceMarch 31, 2021 9am-4pm CST 
Strive to Revive Resuscitation Virtual Conference 
Agenda and registration coming soon. 

Recorded Webinars 

Outcomes of Targeted Temperature Management Webinar

RQI Pre-hospital and Public Safety Programs – RQI Telecommunicator Webinar

PREHOSPITAL RESOURCES 

Mission: Lifeline Stroke  is excited to announce the release of the Severity-based Stroke Triage Algorithm for EMS and a one-page document explaining the algorithm.

The AHA Lifelong Learning Pre-Hospital Stroke Rapid Response(on demand) course is designed to assist pre-hospital and hospital personnel in the education of EMS providers in their communities. Approved for 0.75 CAPCE Advanced CEHs.

Nominate a Heartsaver Hero.  The award is our way of saying thank you for performing the heroic act of CPR, a critical link in our chain of survival.

Check out the American Heart Association’s Don’t Die of Doubt campaign for useful information and tools to educate your community on the importance of calling 911 during an emergency.

The American Heart Association has teamed up with RapidSOS to create the world’s first emergency response data platform that securely links life-saving data from connected devices or profiles to 911 and first responders in an emergency.

AMERICAN HEART ASSOCIATION GUIDELINES AND STATEMENTS

Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association

2020 American Heart Association Guidelines for CPR and ECC (GuidelinesInstructor UpdatesDigital Content Highlights)

Telecommunicator Cardiopulmonary Resuscitation: A Policy Statement from the American Heart Association

PREHOSPITAL ARTICLES OF INTEREST

STEMI
Catheterization Laboratory Activation Time in Patients Transferred With ST-Segment-Elevation Myocardial Infarction: Insights From the Mission: Lifeline STEMI Accelerator-2 Project

Prehospital Activation of Hospital Resources (PreAct) ST‐Segment–Elevation Myocardial Infarction (STEMI): A Standardized Approach to Prehospital Activation and Direct to the Catheterization Laboratory for STEMI Recommendations From the American Heart Association’s Mission: Lifeline Program

Stroke
A Community-Engaged Stroke Preparedness Intervention in Chicago

Emergency Medical Services Utilization for Acute Stroke Care: Analysis of the Paul Coverdell National Acute Stroke Program, 2014-2019

Cardiac Arrest
Detailed post-resuscitation debrief reports: A novel example from a large EMS system

Delay to Initiation of Out-of-Hospital Cardiac Arrest EMS Treatments

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest

Outcomes for Out-of-Hospital Cardiac Arrest in the United States During the Coronavirus Disease 2019 Pandemic

Other articles of interests
Firefighting as an Independent Risk Factor for Atrial Fibrillation

PREHOSPITAL AGENCY MISSION: LIFELINE RECOGNITION

In 2020, more than 600 prehospital agencies were recognized for the quality of care provided for STEMI patients.

A special recognition goes out to the following 33 agencies that have been recognized every year.
Agency City State
Los Angeles County EMS Agency Santa Fe Springs CA
Oceanside Fire Department Oceanside CA
Ventura County EMS Oxnard CA
Western Connecticut Health Network Affiliates – EMS Danbury CT
Okaloosa County Department of Public Safety – EMS Division Niceville FL
MetroAtlanta Ambulance Service Marietta GA
Ada County Paramedics Boise ID
MidMichigan Health EMS Midland MI
Warren Fire Department Warren MI
Cabarrus EMS Concord NC
Rowan County Emergency Services – EMS Division Salisbury NC
NHRMC AirLink/VitaLink Critical Care Transport Wilmington NC
Mecklenburg EMS Agency Charlotte NC
Pender EMS & Fire Rocky Point NC
New Hanover Regional EMS Wilmington NC
Cumberland County EMS Fayetteville NC
F-M Ambulance Service Fargo ND
University Hospital EMS Newark NJ
Empress EMS Yonkers NY
Strongsville Fire Department Strongsville OH
EMSTAT Norman OK
Macungie Ambulance Corps Macungie PA
Riddle EMS Media PA
Western Berks Ambulance Association West Lawn PA
Lexington County EMS Lexington SC
Greenville County EMS Greenville SC
Charleston County EMS North Charleston SC
Grand Prairie Fire Department Grand Prairie TX
Williamson County EMS Georgetown TX
San Antonio Fire Department San Antonio TX
Garland Fire Department Garland TX
Austin Travis County EMS Austin TX
Alexandria Fire Department Alexandria VA

Rural Policy Research Institute EMS Study

From RUPRI in January 2021

Characteristics and Challenges of Rural Ambulance Agencies – A Brief Review and Policy Considerations

Rural ambulance agencies, a fundamental component of the rural emergency medical services (EMS) system, are challenged by the following issues:

  • long distances and challenging terrain that prolong emergency response and transport times,
  • insufficient payment by insurers to cover standby and fixed costs,
  • a changing workforce that has historically relied on volunteers but increasingly must include paid personnel,
  • a lack of regional EMS plans to coordinate services, and
  • insufficient State and Federal policy coordination across oversight agencies.

Specific public policies to address rural ambulance agency challenges could include the following:

  • Increase ambulance payment to adequately cover reasonable standby and fixed costs.
  • Consider EMS an essential service, the same as firefighting and law enforcement.
  • Collect rural ambulance agency workforce data to better understand workforce needs.
  • Expand the scope and authority of the Federal Interagency Committee on EMS to address rural ambulance agency payment and workforce challenges.

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CMS | COVID-19 Vaccine Resources

As COVID-19 vaccines begin rolling out across the country CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS.

With information coming from many different sources, CMS has compiled resources and materials to help you share important and relevant information on the COVID- 19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to promote vaccine safety and encourage our beneficiaries to get vaccinated when they have the opportunity.

If you are a healthcare provider:

Both the CDC and CMS have useful resources for your practice. Look to CDC for the latest science, vaccine administration information and patient-focused resources.

You can find additional resources on the CDC Resources for Health Care Providers Page.

CMS released aCOVID-19 Provider Toolkit to ensure health care providers have the necessary tools to respond to the COVID-19 public health emergency. The toolkit includes information on:

You can also review the set of COVID-19 FAQs, which has information specific to health care providers who bill Medicare for administering COVID-19 vaccines.

Here’s what else you should know:

  • Medicare covers the COVID-19 vaccine, so there will be no cost to your patients with Medicare.  Medicare will reimburse you for administering the vaccine.
  • State governments are handling the distribution of COVID-19 vaccines. Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups.
  • People without health insurance or whose insurance does not provide coverage of the vaccine can also get COVID-19 vaccine at no cost.  Providers administering the vaccine to people without health insurance or whose insurance does not provide coverage of the vaccine can request reimbursement for the administration of the COVID-19 vaccine through the Provider Relief Fund.
  • Most professional associations have pages devoted to COVID-19 vaccination.  Your association may have advice tailored to your discipline, specialty and/or location.

How can you help educate your patients?

  • You are a trusted source…encourage your patients to get the vaccine when it is available to them.
  • Let them know the vaccine is no cost and will help keep them from getting COVID-19. Learn more about the benefits of the vaccine.
  • Let them know the vaccine is safe and that safety is a top priority for COVID-19 vaccines.
  • Remind them to continue practicing the 3Ws (Wear a Mask, Watch your distance, Wash your hands).

Questions? Please e-mail us: Partnership@cms.hhs.gov