AJC | Ambulance companies hit hard by COVID costs

From the Atlanta Journal Constitution by Yamil Berard on  July 17, 2020

“We are gravely concerned that various factors related to this pandemic are pushing ambulance services to the breaking point,‘’ Georgia ambulance executive Pete Quinones wrote to a top official at the Georgia Department of Community Health.

One request by the Georgia Ambulance Providers Association has been to urge the Georgia Trauma Commission to release up to $29 million in block grants to support EMS staffing over the next six months.

“Without that, we don’t have the financial ability to keep a state of readiness,‘’ said Terence Ramotar, director of government affairs for the southeast region for American Medical Response, the exclusive 911 ambulance provider for DeKalb County.

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California’s 50 years of prehospital medicine

From EMS1 on July 14 by AAA Communications Chair Rob Lawrence

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

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

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

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CNN | Louisville mayor to be investigated for handling of protesters and EMT Breonna Taylor’s case

From CNN ‘s  “Louisville mayor to be investigated for handling of protesters and Breonna Taylor’s case” on July 16

The Government Oversight and Audit Committee (GOA) of the Louisville Metro Council filed an order Monday to officially launch an investigation “into the action and inaction of the Fischer Administration,” according to a press release from the city.
Though it has not happened yet and there is no timeline to finish the investigation, the GOA plans to subpoena former Louisville Metro Police Department Chief Steve Conrad and current Chief Robert Schroeder as part of their investigation, according to the release.
CNN has reached out to the mayor’s office for comment.
Taylor, a 26-year-old EMT, was shot eight times after police broke down the door to her apartment while executing a nighttime warrant in a narcotics investigation on March 13.

AAA’s Terence Ramotar on Morning Joe

Terence Ramotar, President of the Florida Ambulance Association and AAA Board member, discusses how the coronavirus crisis in Florida is impacting ambulance services on MSNBC’s Morning Joe!

This morning, AAA Alternate Director and Florida Ambulance Association President Terence Ramotar made a compelling case…

Posted by American Ambulance Association on Thursday, July 16, 2020

2020 Ambulance Ride-Along Toolkit

AAA ambulance emt member legislation

2020 Ride-Along Toolkit Now Available!

Educating your members of Congress about ambulance industry issues makes them more likely to support our policy efforts. An easy and effective way to educate them is to invite them to participate in a local Ambulance Ride-Along!

Congress is adjourned this week and will then again starting on August 7 for an entire month with members of Congress returning home to their districts and states. This is the perfect opportunity for you to educate your members of Congress about our issues, in particular the need for additional COVID-19 financial relief, reimbursement for Treatment in Place during the pandemic, access to FEMA Public Assistance grants and coverage for all paramedics and EMTs under the Public Safety Officers Benefit (PSOB) program.

The most effective way to deliver these key messages is to host your member of Congress or their staff on a tour of your operation and an ambulance ride-along. While COVID-19 has made a traditional ride-along difficult, you can still host them for a virtual site visit to show your operation and how you are handling the public health emergency. The AAA has made the process of arranging a ride-long or scheduling a meeting easy for you with our 2020 Congressional Ride-Along Toolkit.

Everything you need to arrange the ride-along or schedule a meeting during this time of social distancing and virtual participation is included in the Toolkit. Act now and invite your elected officials to join you on an Ambulance Ride-Along!

CNN | COVID-19 Data Will Be Sent to Trump Administration, Not CDC

From CNN’s “Coronavirus hospital data will now be sent to Trump administration instead of CDC” on July 15.

Hospital data on coronavirus patients will now be rerouted to the Trump administration instead of first being sent to the US Centers for Disease Control and Prevention, the Department of Health and Human Services confirmed to CNN on Tuesday.

The move could make data less transparent to the public at a time when the administration is downplaying the spread of the pandemic, and threatens to undermine public confidence that medical data is being presented free of political interference.

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For-profit providers have to pay taxes on COVID-19 relief grants

From Modern Healthcare on July 13, 2020

The IRS clarified that for-profit healthcare providers will have to pay taxes on the grants they received from the COVID-19 Provider Relief Fund.

The two laws that set aside $175 billion in grants to help providers cover lost revenue and coronavirus-related expenses didn’t explicitly state that the funds would be taxable. However, the IRS issued guidance stating that the grants are taxable income days before a tax filing deadline on July 15. The change means that grants to for-profit healthcare providers including hospitals and independent physician practices will be subject to the 21% corporate tax rate.

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Play Is A Gripping Reminder Of What First Responders Are Going Through

From WBUR Boston on July  13, 2020

Ed, a paramedic, hates the word “hero.” Played by veteran actor Jamey Sheridan in the Public Theater’s virtual play, “The Line,” Ed tells us that hero is a word “we use in the face of fear that separates us.” He’s been working in the field for 26 years and his cut-to-the-chase approach to life is indicative of what he’s endured. Ed and his colleagues typically “thrive in chaos,” but COVID-19, they soon learn, is no ordinary monster. The tumult it creates leaves an indelible mark on him and everyone else.

“The Line,” a documentary theater piece written by Jessica Blank and Erik Jensen, is an enthralling collection of seven stories gleaned from interviews, via Skype or FaceTime, with a diverse group of New York city health-care workers that details the fear, frenzy and loss they’ve gone through during the pandemic.

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Cleveland EMS crews win PTSD coverage, $3.7M in back pay

From Cleveland 19 News on July 13, 2020

CLEVELAND, Ohio (WOIO) – A fight for Post Traumatic Stress Disorder coverage years in the making has ended with a win for Cleveland paramedics, EMTs and dispatchers.

A union contract for Cleveland EMS just passed, under an agreement out of court that still needs to be ratified by city council.

The agreement includes about $3.7 million in back pay for employees and mental health language, addressing PTSD.

CARE has been negotiating their contract since March of 2016.

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CNBC | Why Ambulance Rides Are So Expensive In The United States

Thank you to American Ambulance Association Payment Reform Chair Asbel Montes for eloquently representing the EMS perspective on surprise coverage in this video from CNBC:

It’s an open secret in America that calling for an ambulance can be a financial gamble because of surprise bills. There’s no way for patients to know how much an ambulance will cost before they get inside the vehicle, and the final bill can be thousands of dollars. Here’s why ambulances are so expensive in the United States and what can be done to change it.

Covid-19 Is Bankrupting American Companies at a Relentless Pace

From Bloomberg on July 9, 2020.

Retailers, airlines, restaurants. But also sports leagues, a cannabis company and an archdiocese plagued by sex-abuse allegations. These are some of the more than 110 companies that declared bankruptcy in the U.S. this year and blamed Covid-19 in part for their demise.

Many were in deep financial trouble even before governors ordered non-essential businesses shut to help contain the spread of the virus. Most will reorganize and emerge from court smaller and less-indebted. The hardest hit, however, are selling off assets and closing for good.

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JEMS | Armstrong Ambulance Tackles COVID-19 Together

From the Journal of Emergency Medical Services on July 8, 2020.

To cope with the unprecedented challenge that remains before them, Armstrong’s first responders have been finding the support they need in numerous ways, whether it be from a member of the team, those working in a similar industry, or members of the many communities they serve delivering food and messages of encouragement to local bases.

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CNN | Contact Tracing Not Possible in the South

From CNN Health’s Contact tracing is no longer possible across the US South due to rapid coronavirus surges, health expert says on July 7, 2020

“The cases are rising so rapidly, that we cannot even do contact tracing anymore. I don’t see how it’s possible to even do that,” Dr. Peter Hotez, dean of tropical medicine at Baylor College of Medicine, told CNN’s Anderson Cooper Monday.
The rapid rise in cases is considered a surge, not a second wave, because the infection numbers never lowered to where officials hoped they would, director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci said in a Facebook and Twitter livestream Monday.

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NYT | The Fullest Look Yet at the Racial Inequity of Coronavirus

From the New York Times on July 5, 2020 by By Richard A. Oppel Jr., Robert Gebeloff, K.K. Rebecca Lai, Will Wright and Mitch Smith

Early numbers had shown that Black and Latino people were being harmed by the virus at higher rates. But the new federal data — made available after The New York Times sued the Centers for Disease Control and Prevention — reveals a clearer and more complete picture: Black and Latino people have been disproportionately affected by the coronavirus in a widespread manner that spans the country, throughout hundreds of counties in urban, suburban and rural areas, and across all age groups.

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WSJ | TX, AZ and FL have been some of the worst-hit states in recent days

From the Wall Street Journal on July 5

Some Hospitals in Southern, Western U.S. States Near Capacity Amid Coronavirus Outbreaks

Top officials in southern and western U.S. cities and states with growing coronavirus cases sounded the alarm Sunday, saying hospitals were near capacity and that stricter social-distancing enforcement was needed to stem the growing outbreaks.

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The AAA Public Relations Campaign Continues

AAA has once again teamed up with Mercury Public Affairs to run a public affairs campaign to ensure that Emergency First Responders are not forgotten by Congress.

For this campaign, our key message is as follows:

America’s front-line first responders, including paramedics, EMTs, and critical care nurses, are the very first medical professionals seen by all citizens that access healthcare using the 9-1-1 system.

 Surpisingly, Washington has forgotten all about them as the virus spreads, and our emergency response providers are being infected with COVID-19. Ambulance services are the public health and safety net for our country, but they have only gotten one tenth of the relief they are owed. Some are even being forced to shut down operations in communities across our country.

 Ambulance services have also been treating more and more patients at home for ailments like diabetes and asthma because emergency rooms are full. They have not been reimbursed for these critical services.

To take action and participate in this campaign, please visit the American Ambulance Association Action page.

Public Affairs Campaign

We have worked with our government relations team to identify the following Senators as the focus of our campaign:

  • Leader Mitch McConnell (R-KY)
  • Chuck Grassley (R-IA)
  • Todd Young (R-IN)
  • Rob Portman (R-OH)
  • Catherine Cortez Masto (D-NV)
  • Sherrod Brown (D-OH)
  • Steve Daines (R-MT)
  • John Cornyn (R-TX)

News Coverage

In addition to the Wall Street Journal and Washington Post, this effort has yielded even more news coverage:

Fear of Hospitals Driving Changes for Ambulance Pay in Medicare

May 29, 2020 in   Bloomberg Government

“Sen. Bill Cassidy (R-La.) has been discussing with Senate Finance Committee Chairman Charles Grassley (R-Iowa) how Medicare can reimburse ambulance services for “treat in place” services, a Cassidy spokesman confirmed in an emailed response to a question.”

Ambulance services getting crushed by being roped into virus response

May 25, 2020 in the Washington Examiner

“In an effort to combat hospital overcrowding during the coronavirus pandemic, states have required ambulances to treat patients at home if possible. Yet Medicare only reimburses ambulances when they transport a patient to a hospital, and most private insurers follow Medicare’s lead. This Catch-22 has cut deeply into ambulance companies’ revenues during the pandemic.”

Yonkers ambulance company seeks Medicare payment for treat-at-home calls

June 16, 2020
By: Jonathan Lamantia and Jennifer Henderson in Crain’s Health Pulse New York

During the height of the Covid-19 pandemic, New York’s ambulance companies increasingly found themselves treating lower-acuity patients at their homes rather than bringing them to overcrowded hospitals.

Empress EMS, a Yonkers-based ambulance company that covers parts of New York City and the Hudson Valley, provided about 1,200 treat-in-place visits during one 30-day period at the height of the crisis, including helping more than 300 individuals who were in cardiac arrest, said Hanan Cohen, Empress’s director of corporate development, mobile integrated health care and community paramedicine.

But none of the visits were reimbursable by Medicare, which Cohen estimates cost Empress more than $700,000 during that 30-day span.

Medicare shouldn’t make ground ambulance services take a financial hit for providing at-home care

June 29, 2020 By: Hanan Cohen STAT

Hanan Cohen is a paramedic and director of corporate development at Empress EMS, a partner of PatientCare EMS Solutions, which operates in New York in the Bronx and Westchester County.

 Balance of Power: Gen. McChrystal, Rep. Hill

July 1, 2020

By: David Westin on Bloomberg Radio (Interview begins around 54:12)

Hanan Cohen interviewed by David Westin, one of the network’s most prominent anchors and the former president of ABC News.

The program is syndicated across 300 stations in the US, including leading news radio stations in major cities from coast to coast. In addition, it is heard nationally on Sirius XM.


Study | Nationwide EMS Calls Have Dropped 26%, Attended Deaths Doubled

From the University at Buffalo News Center

Since early March and the start of the COVID-19 pandemic in the U.S., 911 calls for emergency medical services have dropped by 26.1 % compared to the past two years, a new study led by a University at Buffalo researcher has found.

But the study also found that EMS-attended deaths have doubled, indicating that when EMS calls were made, they often involved a far more serious emergency.

Study Details

Effect of the Coronavirus Disease 2019 (COVID‐19) Pandemic on the United States Emergency Medical Services System: A Preliminary Report
E. Brooke Lerner PhD
Craig D. Newgard MD, MPH
N. Clay Mann PhD, MS, MBA