Webinar | EMS and COVID-19 Testing

EMS Focus webinar on Tuesday, May 12, at 3 p.m. ET/12 p.m. PT will feature local EMS medical directors and Federal officials discussing COVID-19 testing and implications for EMS organizations and clinicians

EMS and COVID-19 Testing

Tuesday, May 12, 2020
3:00 PM ET / 12:00 AM PT

As we continue to learn more about the novel coronavirus and COVID-19, we’re also learning more about COVID-19 testing: Who should get tested, and when? How accurate are the tests? In this webinar, hosted be NHTSA’s Office of EMS, you’ll learn:

  • The local experience of some of the first EMS systems to have personnel quarantined and test positive for COVID-19
  • The latest guidance on testing of first responders and other healthcare personnel
  • What the result of a COVID-19 test or antibody test really means for individuals and EMS organizations

Register Now

Three panelists deeply involved in the EMS and public health response to COVID-19 will share their expertise:

Jonathan Jui, MD, MPH, FACEP, is EMS medical director for Multnomah County, Oregon, including the City of Portland and the county 911 center. He is also a member of the Oregon 2 Disaster Medical Assistance Team and a professor of emergency medicine at Oregon Health & Science University. Dr. Jui is board certified in emergency medicine, internal medicine, EMS, and infectious disease.

Michael Sayre, MD, is medical director for the Seattle Fire Department and the Seattle Medic One program and an emergency physician at Harborview Medical Center. He is a professor of emergency medicine at the University of Washington, where he also serves as the medical director for the Michael K. Copass Paramedic Training Program and leads the EMS Medicine Fellowship program.

S. Michele Owen, PhD, is associate director for laboratory science at the US Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB prevention. She is also currently serving as Co-Lead for the COVID-19 Laboratory Task Force in the CDC Incident Management Structure.

The webinar will be moderated by Jon Krohmer, MD, FACEP, FAEMS, director of the NHTSA Office of EMS and co-chair of the EMS/Pre-hospital Team within the FEMA Healthcare Resilience Task, which is leading the development of a comprehensive strategy for the US healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19.

Note: This live webinar will be limited to the first 3000 people to login using the link provided. Attendees will be encouraged to submit questions during any point of the discussion. The webinar and Q&A will last approximately one hour. A recording of the webinar will be shared as soon as it is available.

Gowns | Merrow Forloh Reusable

AAA Professional Standards Committee Chair Bill Mergendahl has offered to coordinate a bulk order of Merrow Forloh reusable gowns.

Although each gown is pricey ($40/pp), they are made of extremely high-quality ripstop material and can be washed 100 times, making them comparable to a $0.40 disposable.  Additionally, they can be sprayed with standard outdoor gear water repellant and be good for another 100 washes.  One size fits all.

These gowns are American made in Fall River, Massachusetts, which avoids a number of the quality assurance problems many member organizations have experienced with imports.

The goal is to pull together a group order of 10,000 pieces for delivery in 3–4 weeks. Pro EMS will coordinate splitting the payments between providers.

Please see the attached brochure, then contact wmerg@proems.com if you would like to participate.

Webinar | Emergency Department: Patient Care and Clinical Operations

Our partners at HHS Office of the Assistant Secretary for Preparedness and Response are hosting a COVID-19 Clinical Rounds webinar this week. See below for more information and links to register. And be sure to access the latest COVID-19 information for EMS at the updated COVID-19 Resources for EMS.

Emergency Department: Patient Care and Clinical Operations

Thursday, May 7, 2020
12:00 PM EDT / 9:00 AM PDT

Webinar Agenda:

Welcome and Introductions
Richard C. Hunt, MD, FACEP, HHS/ASPR National Healthcare Preparedness Programs

Patient Care and Operations
James E. Black, MD, Medical Director for Emergency Services for Phoebe Putney Health Systems

Additional Speakers – TBD

Q & A and Discussion

Register Now

hippa

COVID-19 Literature and Research Resources for EMS

COVID-19 Literature and Research Resources for Emergency Medical Services (EMS)

Download PDF

This document provides an overview of information sources available to EMS personnel for peer-reviewed, scientific research articles, and other sources related to COVID-19.

The Federal Healthcare Resilience Task Force (HRTF) is leading the development of a comprehensive strategy for the U.S. healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19. The Task Force’s EMS/Pre-Hospital Team is comprised of public and private-sector EMS and 911 experts from a wide variety of agencies and focuses on responding to the needs of the pre-hospital community. This Team is composed of subject matter experts from the National Highway Traffic Safety Administration (NHTSA) Office of Emergency Medical Services (OEMS), National 911 Program, Center for Disease Control (CDC), Federal Emergency Management Agency (FEMA), U.S. Fire Administration (USFA), U.S. Army, U.S. Coast Guard (USCG), Department of Homeland Security (DHS) Cybersecurity and Infrastructure Security Agency (CISA) and non-federal partners representing stakeholder groups and areas of expertise. Through collaboration with experts in related fields, the team develops practical resources for field providers, supervisors, administrators, medical directors, and associations to better respond to the COVID-19 pandemic.

Federal Government Resources:
1.  LITCOVID: US National Library of Medicine

  • Available at https://www.ncbi.nlm.nih.gov/research/coronavirus
  • “LitCovid is a curated literature hub for tracking up-to-date scientific information about the
    2019 novel Coronavirus. It is the most comprehensive resource on the subject, providing central access to 5645 (and growing) relevant articles in PubMed. The articles are updated daily and are further categorized by different research topics and geographic locations for improved access.”

2. The Centers for Disease Control and Prevention (CDC)

  •  Morbidity and Mortality Weekly Report (MMWR): Novel Coronavirus Reports
  • Available at: https://www.cdc.gov/mmwr/Novel_Coronavirus_Reports.html
  • Coronavirus Disease 2019 (COVID-19) Peer-Reviewed Publications
  • Available at: https://www.cdc.gov/coronavirus/2019- ncov/communication/publications.html

3. Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR)

  • TRACIE Healthcare Emergency Preparedness Gateway: Novel Coronavirus Resources
  • Available at: https://asprtracie.hhs.gov/COVID-19

Other Resources:

4. COVID-19 Literature Surveillance

  •  Available at: https://www.covid19lst.org*
  •  “…affiliated group of medical students, PhDs, and physicians keeping up with the latest research on SARS-CoV-2 / COVID-19. We find the newest articles, read them, grade their level of evidence, and bring you the bottom line.”*

5. The Lancet: COVID-19 Resource Centre

  • Available at https://www.thelancet.com/coronavirus*
  • “To assist health workers and researchers working under challenging conditions to bring this outbreak to a close, The Lancet has created a Coronavirus Resource Centre. This resource brings together new 2019 novel coronavirus disease (COVID-19) content from across The Lancet journals as it is published. All of our COVID-19 content is free to access.”*

6. The New England Journal of Medicine: Coronavirus (Covid-19) Collection

  •  Available at https://www.nejm.org/coronavirus*
  • “A collection of articles and other resources on the Coronavirus (Covid-19) outbreak, including clinical reports, management guidelines, and commentary.”*

7. The Journal of the American Medical Association (JAMA) Network COVID-19 Collection

  • Available at https://jamanetwork.com/journals/jama/pages/coronavirus- alert*
  • “Browse the JAMA Network COVID-19 collection below, including Q&A’s with NIAID’s Anthony Fauci, an interactive map of the outbreak courtesy of The Johns Hopkins Center for Systems Science and Engineering, and past publications on vaccine development, infection control, and public health preparedness.”*

8. The Science journal network: Coronavirus: Research, Commentary, and News

  • Available at https://www.sciencemag.org/collections/coronavirus*
  • “The Science journals are striving to provide the best and most timely research, analysis, and news coverage of COVID-19 and the coronavirus that causes it. All content is free to access.”*

9. The World Health Organization (WHO): Global research on coronavirus disease (COVID-19)

  • Available at https://www.who.int/emergencies/diseases/novel- coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov*

10. Association of American Medical Colleges (AAMC): Coronavirus (COVID19)

  • Clinical Guidance Repository
  • Available at https://www.aamc.org/coronavirus-covid-19-clinical-guidance-repository*

 

 

 

 

 

 

 

 

 

 

Innovative 9-1-1 Call Handling for COVID-19

REDIRECTING 911 CALLS FOR INFORMATION & LOW
ACUITY MEDICAL COMPLAINTS

Download as a PDF

Federal Healthcare Resilience Task Force EMS/Prehospital Team: As the COVID 19 pandemic continues to evolve, Public Safety Answering Points (PSAPs)/Emergency  Communications Centers (ECC) may need to revise procedures and redirect resources for handling  incoming calls for COVID-19 Information and Low Acuity Medical Complaints. These revisions may  require administrative, technical and operational protocols, policies and procedures to be  modified. This document provides guidance and considerations for these modifications and examples of how a sample of a few individual PSAPs/ECCs have handled/redirected these calls in response to the COVID-19 pandemic.

Developed By
The Federal Healthcare Resilience Task Force (HRTF) is leading the development of a comprehensive strategy for the U.S. healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19. The Task Force’s EMS/Pre-Hospital Team is comprised of public and private-sector Emergency Medical Service (EMS) and 911 experts from a wide variety of agencies and focuses on responding to the needs of the pre-hospital community. This Team is composed of subject matter experts from NHTSA OEMS, National 911 Program, CISA, CDC, FEMA, USFA, US Army, USCG, and non-federal partners representing stakeholder groups and areas of expertise. Through collaboration with experts in related fields, the team develops practical resources for field providers, supervisors, administrators, medical directors, and associations to better respond to the COVID-19 pandemic.

How to use this document: The general guidance and examples included in this document can be used to assist PSAP/ECC directors with the implementation and/or modification in Standard Operating Procedures (SOPs) and Emergency Medical Dispatch (EMD) protocols, for receiving and responding to two types of calls:
1. Calls for COVID-19 Information.
2. Calls for patients with Low Acuity Medical Complaints.

It is very important that PSAP/ECC directors refer to local medical direction, health department and other local COVID initiatives to ensure that the PSAP/ECC does not sustain any liability for the redirection of calls. This document was completed by representatives from the Association for Public Safety Communications Officials (APCO), the APCO Institute, the International Academies of Emergency Dispatch (IAED), the National Association of State 911 Administrators (NASNA), the National Emergency Number Association (NENA), and Power Phone; as well as their members and some of their clients.

I. Calls for COVID Information
  • Purpose/Goal: To provide guidance for the redirection of callers requesting COVID-19
    information to local and state health departments, COVID-19 hotlines, websites, links, and
    non-emergency lines such as 311, 211, 411 or other 10-digit lines.

    • General Considerations:
      • Administrative
        • Coordinate messaging to be provided with the Medical Director, health care facilities, and health departments to ensure appropriate changes are consistent as the COVID-19 pandemic evolves.
        • Identify appropriate local health departments and/or other local agencies’ resources (e.g., those that administer non-emergent support lines, e.g. 211/311/411), to understand what links, websites, hotlines, three-digit lines, and 10-digit lines are available/operational.
        • Ensure relationships are established and supported and conduct information sharing sessions by all mission partners to be effective and provide continuous communications.
        • Frequently update local PSAPs/ECCs, emergency medical services (EMS) agencies, fire departments, public health (PH) agencies, emergency management agencies (EMA) and emergency operations centers (EOC), to ensure consistent messaging and evolving needs are met.
        • Establish an ongoing mechanism for updating/changing information as the COVID-19 pandemic evolves.
        • Identify any agreements/contracts/policies/ SOPs that need to be established. Agreements among emergency services organizations for 211, 311, and 411 should be consistent.
        • Review employee contracts/ collective bargaining agreements, to understand possible impacts due to changes in protocols, policies, and/or SOPs.
      • Technical
        • Implement a mechanism for collecting and aggregating data (such as number of calls by incident type, EMD codes, etc.) for program evaluation and decision. Establish a mechanism for collecting/reporting data on calls received exclusively seeking information. Utilize that data to develop public service announcements and post the response to FAQs on appropriate websites.
        • Toll-free numbers typically receive Automatic Number Information (ANI). If the PSAP/ECC transfers a 911 call to a toll free number via their selective router, the entity receiving the call may be able to call back the PSAP/ECC, using the ANI received upon call transfer. Work with service providers and receiving agencies, if possible, to ensure this function.
      • Operational
        • Promote the use of Public Safety Telecommunicator (PST) “Just-in-time” education, training and awareness of the technological tools available and changes in procedures.
        • Public education, training, and awareness may be key for public acceptance of alternate call handling. Examples of available resources include:

        • CDC self-checker, or other decision tree approved by a locally designated authority for the general public, on when to call 911 versus nurse/primary care provider/health dept./info line.
        • CDC Phone Advice Line Tool for possible COVID-19 patients
          • PSAP/ECC, who dispatch EMS, should know the status of all hospitals i.e., COVID only hospitals, which hospitals have no hospital beds or ICU units.
          • Utilize COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns
          Hopkins University* to understand COVID case locations
          • Consider HIPAA constraints (if the PSAP/ECC/EOC and/or their personnel fall under the category of “health care providers who transmit any health information electronically in connection with certain transactions”), seek/coordinate with legal counsel. Please see the COVID-19 and HIPAA:
          Disclosures to law enforcement, paramedics, other first responders and public health authorities.
II. Low Acuity Medical Complaints Requests

Purpose/Goal: To provide guidance for the redirection of low acuity medical complaints to alternate medical resources (e.g., Nurse Triage/Call Line, Telemedicine, Paramedic Triage) due to increase in call volume and/or decline in hospital, EMS and other resources as a result of the
COVID-19 pandemic.

  •  General Considerations:
    • Administrative
      • Work with local Medical Director to determine specific criteria for referral.
      • Work with current EMD personnel and local Medical Director to identify questions to be asked and the specific criteria the caller must meet to be transferred to alternate medical resources such as Nurse Call Line or Telemedicine Triage Line.
  •  Confirm local Medical Director approval for changes to the medical call handling process,
    and/or response changes, including changes in EMD questions and referrals to alternate medical resources.
  • Identify and execute any agreements/contracts that need to be established.
  • Revise current policies and procedures and/or implement temporary procedures for PSTs.
  • Consider additional security requirements if the alternate medical resource will be located in the PSAP/ECC (e.g. Criminal Justice Information Systems (CJIS), National Crime Information Center (NCIC), etc.)
  • For Triage/Call Lines not already established: ensure notification of completion of training for nurse triage and PSAP staff —to understand how referral process will work; and how processes may change due to evolving circumstances. (Example: as COVID expands within a specific jurisdiction, is the behavioral hotline still active for referral?)
  • Ensure agreements and arrangements with the alternate care resource to ensure they are ready to take calls.
  • Facilitate consistent interaction among local PSAPs/ECCs, EMS, PHs, EMAs and EOCs is essential, to ensure evolving needs are met.
  • If the medical resource line is not a 24 hours/7 days a week call line, develop a working schedule, and communicate often between the call line side and the PSAP/ECC side.
  • Consider Syndromic Surveillance1 processes where available.

 

  • Technical
    • Work with 911 service providers to ensure call transfer can be made
      while keeping the caller’s call-back number.
    • Ensure call transfer works both ways in the event that the call needs to be transferred back to the PSAP/ECC.
    • Implement one-button transfers of calls, if feasible.
    • Work with information technology (IT) services to accommodate any necessary changes to computer-aided dispatch (CAD) systems
  • Operational
    • Develop and execute 911 Public Safety Telecommunicator (PST) training on all new processes and procedures.
    • Update pandemic guide cards/protocols with COVID-19 related questions and transfer instructions—modifiable at agency level and approved by the local Medical Director.
    • Anticipate frequent changes as the pandemic progresses, which may include modified response criteria for EMS due to the depletion of personnel and other resources.
Examples of Low Acuity Call Redirection Protocols: The following are examples of PSAPs/ECCsthat have implemented protocols to redirect low acuity calls alternate medical resources:

1. Location: Seattle/King County Washington

  • Description: Referral Program
    For COVID-19, the Seattle Fire Department’s Mobile Integrated Health program stood up a referral program to address the secondary impacts of the COVID-19 pandemic. This included generally concerned 9-1-1 callers as well as individuals who have been cut off from social services,
    healthcare, caregivers, substance abuse resources, critical supplies, or other services due to quarantine/isolation/shelter-in-place, or ill family members. The city has a team of two firefighters and four case managers who are fielding these referrals and reach out to callers by phone or in person. It is believed that non-emergent 9-1- 1 calls will likely continue throughout the duration shelter-in-place lengthens.

Seattle is in the early stages of exploring how to use nurse triage (either on-site in the 911 center or remotely) to further handle non-emergent calls, however, such a program has not been operationalized.

  • Point of Contact:
    Jon Ehrenfeld
    Mobile Integrated Health Program Manager Seattle Fire Department
    O: 206-233-7109 | M: 206-771-0269
    Jon.Ehrenfeld@seattle.gov

2. Location: Washington, DC; Office of Unified Communications (OUC)

  • Description: DC Nurse Triage Line
    Since 2018, DC’s Office of Unified Communications currently transfers a portion of their basic life support (BLS) calls to a nurse triage line (NTL), with the goal of keeping people out of the emergency department and treating people at home. While the nurses are housed within the 911 call center, this is a program under DC’s Fire and EMS Department. Other relevant points about this
    program:

    • Additional goal: Savings relate to not mobilizing EMS
    • Program has resulted in both a financial and human resources savings.
    • Office of Unified Communications (OUC) has incrementally increased the types of calls redirected to NTL. Now transferring 60-90 calls per day (approximately 6-10% of medical calls)
    • Public Service Ads – important to explain to the public the advantages of EMS tiered medical response that an RN answers NTL in advance of implementation to avoid caller resistance to call transfer.
    • Both OUC and EMS field units can call the NTL and initiate the process
    • Nurses answer calls from work stations within the OUC, and if needed, can access backup nurse triage personnel in TX and FL. Part of their protocol includes asking for insurance information, so patients can be coupled with appropriate clinics, MDs). Nurses also are able to schedule appointments for callers.
    • Targeting calls that were responded to, but not transported.
    • Now looking at how to anticipate changes in call volume relevant to COVID- 19 and how to change current protocols
    • A strong relationship with Fire & EMS and Medical Director is essential
    • Not a failure if NTL screens and determines that the patient needs a response. This is the safety net.
  • Point of Contact:
    Cleo Subido, Chief
    Office of Professional Standards and Development Office of Unified Communications
    2720 Martin Luther King Jr. Ave. SE Washington DC, 20032
    O: 202-340-7916
    Cleo.subido1@dc.gov

3. Location: Orleans Parish Communication District (New Orleans 9-1-1)

  • Description:
    All Orleans Parish Communication District (OPCD) Operations Staff are certified Emergency Medical
    Dispatchers (EMD) using protocols from the International Academies of Emergency Dispatch (IAED)*.
    Within those protocols are both a pandemic surveillance tool and a response protocol referred to as
    Protocol 36*.

Two directives and one guidance document enable the video medical triage process:
1. Emergency Directive 20-01 – Advising staffing to start using the surveillance tool.
(Issued 2/5/20)
2. Emergency Directive 20-02- Formally activating Protocol 36 (Issued 3/9/20)
3. Special Guidance advising elevating the pandemic level to Level 1

The pandemic protocol identifies calls that are low acuity for which an emergency department is not the best option. At that time, a paramedic initiates a video call with the patient and reviews their symptoms. In the current situation, in most cases, they are being advised to self-quarantine
and not go to an emergency
department. The process then places that person on a “self-quarantine registry” and someone from the staff calls the person daily to check on them. If their conditions get worse, the person is triaged again as a new patient and they may then get transported if needed.

  • Point of Contact:
    Tyrell T. Morris, MBA CPE Executive Director
    Orleans Parish Communication District (New Orleans 9-1-1) 118 City Park Ave.
    New Orleans, LA 70119 O: 504-671-3615
    tmorris@911nola.org www.opcdla.gov*

 

4. Location: Orange County Virginia Fire and EMS Department

  • Description: Area hospitals color code their status availability.
    • Code Green: Open
    • Code Yellow: Busy, not accepting trauma patients, running out of beds
    • Code Red: Very busy, only accepting life critical illness/injury
    • Code Black: Hospital lock down (i.e. pandemic), cannot accept more patients

PSAP/ECC receive fax updates of hospital status. PSTs page out the status of the hospital to the responders. Life or death situations can still go to the closest hospital and override the color codes except in Code Black situations.

  • Contact:
    Chief Nathan Mort
    Orange County Virginia Fire and EMS Department Cell: 540-406-1484
    nmort@orangecountva.gov

5. Location: New York City – Northwell Health

  • Description: The Northwell Health Center for EMS, Clinical Call Center, Centralized Transfer
    Center, Telehealth Center and Health Solutions provide NYC 311 and FDNY EMS 911 with an emergent stand up of call center operations in order to provide telemedicine-based services to callers seeking medical advice, clinical navigation of clinical care on the COVID-19 virus as well as work
    with the FDNY to take New York City-based low and medium acuity groups of 911 callers, as possible, and cleared with Medical Director. This system of care includes a comprehensive integrated system of 911 Emergency Medical Dispatcher (AEMD) Triage, Nurse based telephonic triage, care navigation and advice, Qualified Healthcare Provider (QHP – MD, NP, PA, LCSW telephonic/telemedicine services, QHP based telemedicine services, Community Paramedicine services, traditional EMS services and home-based Primary Care services.
  • At the Clinical Call Center, 12 RNs manage a steady flow of calls from patients and employees seeking clinical advice and navigation services including recently discharged patients whose multiple, chronic health issues make them a high risk for hospital readmission and patients seeking care during off hours from our physician practices. Using Emergency protocols, The International Academies of Emergency Dispatch’s (IAED) certified Emergency Communication Nurse System (ECNS), the nurses telephonically screen patients for priority symptoms and determine the level of care that
    the caller needs, weighing additional factors such as medication use and allergies. Once the type of care is determined, the Nurse can provide care instructions or arrange the appropriate level of care based on the patient’s clinical needs.
    Northwell 911 Telemedicine Resources*
  • Point of Contact:
    Jonathan Washko
    Assistant Vice President of the Center for EMS at Northwell Health
    Jwashko@northwell.edu

Crisis Mode – Building Resilience in Healthcare Workers

Employee Infographics

These infographics contain simple and practical suggestions that people can use to cope while in crisis mode.

Ariadne Labs recognizes that leaders play an important role during this stressful time. Ariadne Labs has created a supplement to this infographic with strategies for leaders and managers. This offers suggestions for leaders to facilitate the actionable steps included in the infographic.

This is a resource to help others and you can post it to your website, social media, or distribute it within your organization.

Resilience for Health Care Workers

      Resilience for Managers     

WEBINAR: EMS Patient Care and Operations | Monday, May 4

NHTSA Office of EMS Director Jon Krohmer, MD, will be moderating the next COVID-19 Clinical Rounds: EMS webinar, co-hosted by our partners at the HHS Office of the Assistant Secretary for Preparedness and Response. See below for more information and links to register. And be sure to access the latest COVID-19 information for EMS at the updated COVID-19 Resources for EMS.

EMS: Patient Care and Clinical Operations

Monday, May 4, 2020
12:00 PM EDT / 9:00 AM PDT

Webinar Agenda

Welcome and Introductions
Jon R. Krohmer, MD, FACEP, FAEMS, Director, Office of EMS, National Highway Traffic Safety Administration

Patient Care and Operations
David Gerstner, EMT-P, Regional MMRS Coordinator, West Central Ohio, Dayton Fire Department & Wright State University Boonshoft School of Medicine

Carol A. Cunningham, MD, FAAEM, FAEMS, State Medical Director, Ohio Department of Public Safety, Division of EMS

Q & A and Discussion

Register Now

EMS Education Pipeline

Read as a PDF
National Highway Traffic Safety Administration (NHTSA) staff prepared this summary document on the
status of the Emergency Medical Services (EMS) education pipeline during a series of recent conference
calls with EMS stakeholder organizations. Included is a list of national, state, and local considerations
for EMS stakeholders. These considerations do not necessarily reflect official policy positions of the
organizations that participated during the conference calls. This document is intended to serve as an
informational resource for EMS stakeholders. This summary does not establish legal requirements or
obligations, and its content does not necessarily reflect agency recommendations or policy.

Contributors to its content included representatives from the National Registry of Emergency Medical
Technicians (NREMT), the National Association of EMS Educators (NAEMSE), the Committee on
Accreditation for the EMS Professions (CoAEMSP), the Commission on Accreditation for Pre-Hospital
Continuing Education, the National Association of State EMS Officials, the International Association of
Fire Chiefs, the American Ambulance Association, the National Association of Emergency Medical
Technicians, the American College of Surgeons, and the Interstate Commission for EMS Personnel
Practice.

Challenges Facing EMS Education
Nationwide social distancing measures have led to closures, delays, and other impacts on the national
EMS education system. National, State, and local EMS organizations are collaborating to address these
challenges, but prolonged delays are likely in the education, certification, and licensing of tens of
thousands of entry-level EMS clinicians.

EMS Education Programs Closed
Community colleges, universities, fire academies, and other programs that provide EMS education
throughout the country closed in response to social distancing measures. Many of these institutions
created distance learning programs to help current students complete their didactic education.
However, not every EMS education program has the resources to support online or distance learning
alternatives.

To assist EMS education programs, NAEMSE has led a webinar series on transitioning to the online
classroom2 and is collaborating with NREMT to develop best practices for distance education.
EMS students must also complete in-hospital and pre-hospital clinical rotations to graduate.
Unfortunately, most clinical and field internship sites remain closed to students based on a combination
of factors, such as government restrictions and recommendations on traveling and social distancing, lack
of personal protective equipment (PPE) for students, or the decision of the clinical site to restrict
student access.

CoAEMSP acknowledged the need for its 706 accredited paramedic education programs to modify
current graduation requirements.

On April 5th, 2020, the CoAEMSP Board of Directors issued a
statement regarding Coronavirus Disease 2019 (COVID-19) to clarify that Paramedic educational programs may employ a broad array of approaches, including simulation, in determining competency in
didactic, laboratory, clinical, field experience, and capstone field internship.
Another option suggested by stakeholders for increasing the number of competent, entry-level EMS
clinicians to enter the workforce with advanced life support (ALS) skills may be allowing paramedic
students to graduate early and be tested as Advanced EMTs (AEMTs).

Testing and Certification Delayed
NREMT is the national certification agency for EMS clinicians. NREMT testing and certification (after
completion of approved education) is a requirement for EMS clinician licensure in most States. NREMT’s
cognitive (computer-based written) exam is administered by Pearson VUE. On March 17, 2020, Pearson
VUE closed most of its nearly 700 testing centers nationwide. Over the subsequent weeks,
approximately 450 of Pearson VUE’s testing centers have re-opened at reduced capacity, with more
projected to open in the future. Many testing sites remain closed under State government orders that
closed State colleges and universities. Allowing sites to remain open for the sole purpose of testing EMS
and other healthcare professionals would help alleviate the lack of testing capacity. Open testing centers
are operating at approximately 50% capacity due to social distancing measures.

NREMT is temporarily not requiring the psychomotor (hands-on skills) examination due to social
distancing guidelines. It is offering a provisional certification that requires only the successful completion of
the EMS education course and the cognitive exam. NREMT has accelerated plans for remote proctoring
of the cognitive exam, which will be available for the AEMT examination and the EMT examination in
May 2020. These emergency measures will help to continue certifying new EMS professionals.

Historically, the NREMT tests over 60,000 EMS clinicians in the spring season. NREMT projects that a
significantly lower number of EMS clinicians will be tested this year due to the cancellation of EMS
education courses. Consequently, local EMS agencies will face a severe workforce supply shortage
within the next three months.

Recertification Deadlines Extended
NREMT has approved a 90-day extension on EMS certifications that were due to expire on March 31,
2020, and waived continuing education requirements for face-to-face instruction. States are beginning
to modify relicensing requirements in line with NREMT’s actions.

Specialty certification courses (such as Cardio Pulmonary Resuscitation, Pediatric Advanced Life Support,
Pre-Hospital Trauma Life Support, Advanced Cardiac Life Support, etc.) are often required as part of EMS
education, certification, licensure, or affiliation. Many specialty certification course providers have
created online courses for didactic materials, and either waived hands-on skills requirements or
provided guidance on safely facilitating in-person instruction. Most have also extended or waived
current expiration dates.

Licensure Modifications Underway
State EMS offices license EMS clinicians, regulate local EMS agencies, and support EMS system
development. Many State EMS staff are currently deployed to state operations centers supporting the
COVID-19 response, including guiding statewide efforts to support crisis standards of care (CSC) planning
for EMS. Multiple States have temporarily waived or modified licensure policies to streamline licensure.

Emergency Medical Service (EMS) Education Pipeline
Twenty States are accepting NREMT provisional certification as a condition of licensure; however, some
States4 have reported that their laws and rules prohibit issuing licenses to holders of the NREMT
provisional certification.

A few states require fingerprinting and a criminal background check as a condition for licensure;
however, social distancing measures and public building closures have made fingerprinting services
largely unavailable. Some States5 are offering provisional licensure that defers a criminal background
check until the public health emergency ends. Employers cannot assume a provisional licensee had a
background check and may now need to do this as part of their hiring process. States are also
reactivating expired licenses within specified time frames.

Twenty States are members of the Interstate EMS Licensure Compact (Compact), which was formally
activated in response to COVID-19. The Compact will enable interstate recognition of EMS clinician
licensure between member States. However, the Compact does not address practice by EMS clinicians in
non-traditional settings, such as hospitals. Many States6 grant physicians authority to delegate certain
aspects of medical practice, which may give hospitals flexibility to use EMS personnel in an expanded
clinical role.

Service Impact
In the United States, more than 18,200 EMS agencies, staffed by a total licensed workforce of more than
1.03 million EMS clinicians, provide ubiquitous 24/7 coverage of the entire Nation. In 2019, these EMS
agencies responded to more than 28.5 million 911 dispatches.

Stakeholders have reported an average 30 percent decline in EMS transports in areas not yet severely
impacted by the public health emergency, which they attribute to less public willingness to be
transported to hospitals. This decline in EMS transports has led to a decline in insurance reimbursement
revenue9 accompanied by an anticipated decline in State and local tax revenue. As a result, EMS
stakeholders have reported widespread hiring freezes and potential future furloughs and layoffs.
Despite the need for 24/7 service, stakeholders anticipate that the inability to hire, coupled with
workforce supply shortages (attributed to the shutdown of EMS education programs), will lead to
prolonged EMS staffing shortfalls. In some cases, these staffing shortfalls may take effect as COVID-19
peaks locally resulting in potentially insufficient staffing to respond to an expected surge of EMS calls.
As components of the workforce pipeline partially resume operations, employers will face additional
challenges, such as delays in fingerprint-based background checks and remedial education and testing
for provisionally certified and licensed EMS personnel.

The long-term impact of system accommodations (e.g., deferred background checks, proctored exams,
provisional certification and licensing) is unknown. In addition, there is also growing concern that the
pandemic may increase EMS workforce turnover.
State and Local Considerations for EMS Stakeholders
Based on the issues and challenges discussed above, stakeholders may consider the following
measures at the State and local levels:
1. Enable EMS clinicians with a NREMT provisional certification to pursue provisional State
licensure.
2. Enable EMS clinicians with expired licenses to pursue provisional State licensure.
3. Prioritize the reopening of EMS clinical skills labs when reopening educational institutions.
4. Encourage EMS education programs to provide distance learning resources to all students. Front-load didactic education for EMS students until clinical skills labs, clinical internships, and field
internships can resume.
5. Enable States, colleges, and educational programs to allow modified approaches to clinical skills
labs, clinical internships, and field internships, when they can be conducted safely.
6. Encourage the sharing of best practices by State and local authorities.
7. Encourage collaboration between educational programs to develop online education
capabilities.
8. Permit public and private education testing centers to administer the NREMT examination
within local jurisdictions, while following strict social distancing protocols.
9. Explore the ability to verify course completion and/or testing paramedic students at the AEMTlevel,
provided the state has approved an AEMT course.

National Considerations for EMS Stakeholders
In addition, stakeholders may consider the following measures at the national level to the extent
permitted by applicable law:
1. Permit fingerprinting centers to open to support criminal background checks for EMS clinicians
as a condition of licensure or employment. Explore other innovative solutions for conducting
criminal background checks.
2. Continue convening national EMS organizations to facilitate collaborative and innovative
problem-solving. Engage additional stakeholders, such as the Accreditation Council for Graduate
Medical Education, to coordinate healthcare education efforts.
3. Consider, as essential critical infrastructure workers, those workers involved in the certification,
licensing, and credentialing of EMS personnel and other healthcare workers.
4. Consider, as essential critical infrastructure workers, those workers supporting public and
private education testing centers for EMS personnel and other healthcare workers.
5. Share EMS educational best practices nationally.
6. Support technology for EMS education programs to conduct remote training, high-fidelity
simulation and other tools for effective training while also supporting social distancing.

EMS Update: Sustaining Mental Health during COVID-19

NORA Public Safety Sector Council Meeting – EMS Sustainability Update

Sustaining Mental Health during COVID-19
Thursday April 30th, 2020 – 11:00am-11:30am EDT

The NORA Public Safety Sector Council, is hosting an EMS Sustainability Update at 11:00 EDT on Thursday April 30, 2020 via Zoom. The topic is Sustaining Mental Health during COVID-19. The attachment includes the agenda for the meeting as well as available resources and tools outlined on page 2.

Register Here

Registration is required using the link above. This is part of an ongoing series of updates to be hosted every other week. The registration link will register you for all occurrences and you can attend those you are interested in.

 

Healthcare Resilience Task Force: Three New Documents Released

The Prehospital [911 and Emergency Medical Services (EMS)] Team of the Healthcare Resilience Task Force has released three more informational documents. The first contains guidance for emergency communications stakeholders on available funding in the CARES Act. The second is a summary document on the status of the Emergency Medical Services (EMS) education pipeline during a series of recent conference calls with EMS stakeholder organizations. The third is a corrected version of the COVID-19 Crisis Standards of Care.

These documents will also be posted on EMS.gov and/or 911.gov (as appropriate).  Two portals for COVID Resources were created which we will continue to update three times a week, with new links and documents containing information on a variety of COVID-related topics.  You will find COVID resources here on EMS.gov, and here on 911.gov.

Read Below:

SAFECOM and NCSWIC Guidance on CARES Act Grants

The Cybersecurity and Infrastructure Security Agency (CISA), in partnership with SAFECOM and the National Council of Statewide Interoperability Coordinators (NCSWIC), prepared guidance for emergency communications stakeholders on available funding in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Stakeholders are encouraged to review this guidance and apply for funding, where applicable. CARES Act money is available to all 50 states, five territories, and the District of Columbia, with several fast-approaching application deadlines

NHTSA EMS Education_Pipeline_Final

National Highway Traffic Safety Administration (NHTSA) staff prepared this summary document on the status of the Emergency Medical Services (EMS) education pipeline during a series of recent conference calls with EMS stakeholder organizations. Included is a list of national, State, and local considerations for EMS stakeholders.

EMS14_EMS Crisis Standards of Care_Final – (Corrected 4/28/2020)

In response to the COVID-19 pandemic, emergency medical services (EMS) agencies (including fire service, third government service, hospital-based, private for-profit, and private non-profit services) may need to adjust operations and standards of care in order to preserve and effectively allocate limited EMS and healthcare system resources in the face of overwhelming demand due to the national pandemic response. This document provides an overview of general considerations, potential strategies, and existing resources that EMS agencies may use to inform changes to their operations and standards of care.

Healthcare Resilience Task Force: Six New Documents Released

Healthcare Resilience Task Force: Six New Documents Released

The Prehospital [911 and Emergency Medical Services (EMS)] Team of the Healthcare Resilience Task Force has released six (6) more documents (attached).  They cover topics including crisis standards of care, PPE, and the behavioral health of 911 and EMS first responders.

These documents will also be posted on EMS.gov and/or 911.gov (as appropriate).  Two portals for COVID Resources were created which we will continue to update three times a week, with new links and documents containing information on a variety of COVID-related topics.  You will find COVID resources here on EMS.gov, and here on 911.gov.

Read Below:

EMS Crisis Standards of Care

Burnout, self-care and COVID-19 exposure for First Responders

Burnout, Selfcare and COVID-19 exposure for families of First Responders

Epidemiology for COVID-19 EMS Providers

Disinfection of Structural Firefighting PPE

COVID-19 Behavioral Health Resources for First Responders

 

CMS Relaxes Physician Certification Statement Signature Requirements During Public Health Emergency for COVID-19

CMS Relaxes Physician Certification Statement Signature Requirements During Public Health Emergency for COVID-19

 By Kathy Lester, J.D., M.P.H.

  The Centers for Medicare & Medicaid Services (CMS) has released guidance that recognizes the difficulty ambulance service providers and suppliers may have during the COVID-19 Public Health Emergency (PHE) in obtaining a physician certification statement (PCS) signed by a physician or other authorized professional. The question and answer below indicates that CMS (and its contractors by extension) will not deny claims during a future medical audit even if there is no signature for non-emergency ambulance transports, absent an indication of fraud or abuse. Ambulance service providers and suppliers should indicate in the documentation that a signature was not able to be obtained because of COVID-19. The AAA advises completing the PCS form and then indicating if a physician, or other appropriate personnel, has not signed it by writing “COVID-19 Public Health Emergency” on the signature line. CMS also reminds providers and suppliers that medical necessity still needs to be met.

The American Ambulance Association has been advocating for CMS to ease its restrictions on signature requirements during the COVID-19 PHE. The FAQ posted by CMS is consistent with our recommendations.

The specific Q&A is below:

Q. For ambulance services that require a physician, or, in lieu of that, certain non-physician personnel, to sign and certify that a non-emergency ambulance transport is medically necessary, are these signature requirements not required during the COVID-19 PHE? 

A. We understand that in certain situations during the COVID-19 PHE it may not be feasible to obtain the practitioner signature. Therefore, for claims with dates of service during the COVID- 19 PHE (January 27, 2020 until expiration), CMS will not review for compliance with appropriate signature requirements for non-emergency ambulance transports during medical review, absent indication of fraud or abuse. Ambulance providers and suppliers should indicate in the documentation that a signature was not able to be obtained because of COVID-19. However, we note that Medicare Part B covers ambulance transport services only if they are furnished to a Medicare beneficiary whose medical condition is such that other means of transportation are contraindicated, and the beneficiary’s condition must require both the ambulance transportation itself and the level of service provided in order for the billed service to be considered medically necessary.

The full Q&A document can be accessed here.

Healthcare Resilience Task Force: Three New Documents Released

Healthcare Resilience Task Force: Three New Documents Released

Documents developed by the Prehospital [911 and Emergency Medical Services (EMS)] Team of the Healthcare Resilience Task Force.

Managing Patient and Family Distress Associated with COVID-19
Intended to provide care instructions for the psychological challenges associated with real or perceived exposure to COVID-19. This document includes practices for therapeutic communication between the EMS provider, their patient and the patient’s family to ensure that every aspect of the patient’s well-being is being managed by EMS.

NOTE: this document is based on the previously approved Managing Patient and Family Distress document for healthcare developed by the Behavioral Health Working Group and has been adapted for the EMS population.

Strategies to Mitigate EMS Clinician Absenteeism
This document provides strategies and techniques to maximize EMS capabilities and
service to the public and to hopefully minimize EMS Workforce Absenteeism. The
resilience of our Nation’s healthcare system depends on our healthcare workforce’s
ability to report for duty. Critical supplies, equipment, and surge capacity rely on
dedicated, trained EMS clinicians and support staff to enable care. Prepare now and
take actions, such as those listed below, to help your EMS agency protect your workers’
psychological health and well-being.

Personal Protective Equipment Supply for EMS
This document is intended to clarify for the EMS community the current Personal Protective Equipment (PPE) supply situation as well as the appropriate requisition process to address local shortages of available PPE supplies.

 

CMS | Nursing Home COVID-19 Transparency Effort

From the CMS.gov Newsroom

Trump Administration Announces New Nursing Homes COVID-19 Transparency Effort

 

     Agencies partner with nursing homes to keep nursing home residents safe

Today, under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) announced new regulatory requirements that will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities. In addition, as part of President Trump’s Opening Up America, CMS will now require nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).  This information must be reported in accordance with existing privacy regulations and statute. This measure augments longstanding requirements for reporting infectious disease to State and local health departments. Finally, CMS will also require nursing homes to fully cooperate with CDC surveillance efforts around COVID-19 spread.

CDC will be providing a reporting tool to nursing homes that will support Federal efforts to collect nationwide data to assist in COVID-19 surveillance and response. This joint effort is a result of the CMS-CDC Work Group on Nursing Home Safety. CMS plans to make the data publicly available.  This effort builds on recent recommendations from the American Health Care Association and Leading Age, two large nursing home industry associations, that nursing homes quickly report COVID-19 cases.

“Nursing homes have been ground zero for COVID-19. Today’s action supports CMS’ longstanding commitment to providing transparent and timely information to residents and their families,” said CMS Administrator Seema Verma. “Nursing home reporting to the CDC is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”

“Scientific data derived from solid surveillance is a key element of recommendations to protect Americans, particularly our most vulnerable, from the devastating impact of COVID-19,” said CDC Director Dr. Robert Redfield. “This coordinated effort with CMS will allow CDC to provide even more detailed information to state and local health departments about how COVID-19 is affecting nursing home residents in order to develop additional recommendations to keep them safe.”

This data sharing project is only the most recent in the Trump Administration’s rapid and aggressive response to the COVID-19 pandemic. On February 6, CMS took action to prepare the nation’s healthcare facilities for the COVID-19 threat. On March 4, CMS issued new guidance related to the screening of entrants into nursing homes, informed by CDC recommendations. On March 10, CMS issued guidance related to the use of personal protective equipment (PPE) usage and optimization. On March 13, CMS issued guidance for a nationwide restriction on nonessential medical staff and all visitors, except in compassionate care situations. Shortly after that announcement, President Trump declared a national emergency, enabling the agency to take even stronger action. CMS then announced a suspension of routine inspections, and an exclusive focus on situations in which residents are in immediate jeopardy for serious injury or death, and implemented a new inspection tool based on the latest guidance from CDC. Additionally, on April 2, CMS issued a call to action for nursing homes and state and local governments. It included guidance that reinforced infection control responsibilities and urged leaders to work closely with nursing homes in their communities to determine needs for COVID-19 testing and personal protective equipment. The recommendations also urged state and local officials to work with nursing homes to designate certain sites for COVID-19-positive or COVID-19-negative patients to avoid further transmissions. On April 15, CMS announced the agency will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. This announcement built upon a March 30 announcement that hospitals, laboratories, and other entities can perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital – including nursing homes.

CDC continues to work closely with CMS, state and local health departments, and nursing homes to inform national infection prevention and control policies and strategies to further support nursing homes, residents and families of residents.  CDC built a long-term care toolkit to be distributed to all 50 states to help increase infection prevention and control preparedness in nursing homes and provide remote tools to further assist these important healthcare providers.

In addition, CDC rapidly sent teams of infection control experts to support state and local health departments during the first COVID-19 outbreak in a nursing home in the U.S. Teams were on the ground within 36 hours of the notification to assist with the implementation of measures to detect and contain additional infections in the community.  CDC continues to work closely with state and local health departments to assist long-term care facilities with COVID-19, with on the ground support provided to more than 30 jurisdictions and remote technical assistance from infection control experts across the U.S. with plans to provide additional support underway.

Today’s guidance is available here: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/upcoming-requirements-notification-confirmed-covid-19-or-covid-19-persons-under-investigation-among

This action, and earlier CMS and CDC actions in response to the COVID-19 disease, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website.

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Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS@CMSgov, and @CMSgovPress

NYT: Disposable N95 Masks Can Be Decontaminated

Disposable N95 Masks Can Be Decontaminated, Researchers Confirm

The National Institutes of Health released research showing N95 masks can be used more than once using certain decontamination methods to prevent infection from the coronavirus, a claim that has been proven from previous research but never specifically for COVID-19. The researchers found that using vaporized hydrogen peroxide or ultraviolet light are preferred methods since masks can still function for at least three rounds of decontamination, while dry heat at 158 degrees Fahrenheit was effective for two rounds of decontamination, but ethyl alcohol was not recommended because it degraded the mask material despite killing the virus. (The New York Times)

Read the Article

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NASEMSO 2020 National EMS Assessment Released!

The National Association of State EMS Officials (NASEMSO) has released its 2020 EMS Assessment, updating the 2011 report. This report  provides unparalleled insights into the EMS systems that  provide mobile healthcare across our nation. We highly recommend that you download the full report at  www.nasemso.org/2020-assessment.

(Falls Church, Va.) In the midst of the COVID-19 pandemic and applause for first responders in the United States, the National Association of State Emergency Medical Services Officials (NASEMSO) has released the 2020 National EMS Assessment updating the 2011 assessment. The 2020 assessment provides a comprehensive accounting by state/territory of the numbers and types of all 911 ambulance services and emergency medical services (EMS) professionals.

The 2020 National EMS Assessment is the first set of documentation about these critical emergency medical response personnel and agencies to be published in nearly 20 years. Every year in times of disasters, disease outbreaks and daily medical emergencies, such as heart attacks and car crashes, out-of-hospital emergency medical care systems make life-and-death differences in the lives of millions of Americans. EMS systems are the safety net for hospital emergency departments and public health as the front lines of response to 911 calls. Additionally, responders place themselves in high risk situations on a daily basis, as well as during communicable disease outbreaks and pandemics.

Data collection for this assessment was completed in 2019 by NASEMSO members, who are the staff of the state agencies that license America’s critical EMS personnel and agencies. State EMS offices protect the public by regulating the human and organizational components of EMS systems across the United States, as well as executing their legislative mandates to implement and improve systems of care for time-sensitive emergencies in order to offer every patient an opportunity for survival and optimal outcomes. The assessment provides the following key findings:

  • More than 18,200 local EMS agencies respond to 911 calls for medical emergencies and injuries, utilizing nearly 73,500 ground vehicles such as ambulances and fire engines.

  • Local EMS agencies respond to nearly 28.5 million 911 dispatches every year in 41 states.

  • More than 750 services are licensed by state EMS offices to fly patients, using helicopters and fixed-wing aircraft to provide rapid transportation to critical care.

  • More than 1.03 million personnel are licensed as emergency medical technicians, paramedics, and other levels of EMS patient care capability within all 50 states, the District of Columbia, Puerto Rico and American Samoa.

  • More than 9,300 physicians serve as local EMS Medical Directors, assuring that contemporary and quality care is provided to patients.

  • Sixty percent of 53 state EMS offices participated or expect to participate in mass casualty exercises involving a biological threat during the 18-month evaluation period.

  • The report is available from NASEMSO at www.nasemso.org/2020-assessment.

JEMS: The Ethics of PPE and EMS in the COVID-19 Era

Read the  full piece at JEMS.

By  Brian J Maguire, Dr.PH, MSA, EMT-PKirsty ShearerJohn McKeown, MAScot Phelps, JD, MPHDaniel R. Gerard, MS, RN, NRPKathleen A. Handal, MDPaul Maniscalco, PhD(c), MPA, MS, EMT/P, LP  and Barbara J. O’Neill, PhD, RN

These are trying times for emergency medical services (EMS) personnel on the front lines of the COVID-19 pandemic. In this article we discuss two critical areas of concern. First, we articulate the ethical challenges EMS personnel face in the absence of having proper personal protective equipment (PPE) and offer some guidance on how to frame their decisions.

Second, we give voice to the urgent need for a national dialogue to address the needs of EMS clinicians and leaders. We present key questions that must be answered to improve the future structure of the profession and the safety of all personnel.

These are times that are putting EMS to the test. These are times that will define the future of EMS.

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FEMA Advisory | Supply Chain Stabilization

The following information was delivered by FEMA via email on April 9.

Coronavirus (COVID-19) Pandemic Supply Chain Stabilization 

The Supply Chain Task Force continues executing a strategy maximizing the availability of critical protective and lifesaving resources through FEMA for a whole-of-America response. Efforts to date have focused on reducing the medical supply chain capacity gap to both satisfy and relieve demand pressure on medical supply capacity. The task force is applying a four-prong approach of Preservation, Acceleration, Expansion and Allocation to rapidly increase supply today and expand domestic production of critical resources to increase supply long-term.

The preservation line of effort focuses on providing federal guidance to responders and the non-medical sector, such as public service (police, fire, EMT), energy distribution and the food industry on how to preserve supplies when possible, to reduce impact on the medical supply chain.

The  acceleration  line of effort provides direct results to help meet the demand for personal protective equipment PPE through the industry to allow responders to get supplies they need as fast as possible.

The  expansion  line of effort is charged with generating capacity with both traditional and non-traditional manufacturers, such as adding machinery or by re-tooling assembly lines to produce new products.

The  allocation  of supplies facilitates the distribution of critically needed PPE to “hot spots” for immediate resupply. States report on supplies and can request assistance when they experience a shortage.

The Supply Chain Task Force is working with the major commercial distributors to facilitate the rapid distribution of critical resources in short supply to locations where they are needed most. This partnership enables FEMA and its federal partners to take a whole-of-America approach to combatting COVID-19. The task force is providing distributors with up-to-date information on the locations across the country hardest hit by COVID-19 or in most need of resources now and in the future. The distributors have agreed to focus portions of their distributions on these areas in order to alleviate the suffering of the American people.

A key example of this partnership in action is Project Airbridge. The airbridge was created to reduce the time it takes for U.S. medical supply distributors to receive PPE and other critical supplies into the country for their respective customers. FEMA covers the cost to fly supplies into the U.S. from overseas factories, reducing shipment time from weeks to days.

Overseas flights arrive at operational hub airports for distribution to hotspots and nationwide locations through regular supply chains. Flight arrivals do not mean supplies will be distributed in the operational hub locations.  Per agreements with distributors, 50 percent of supplies on each plane are for customers within the hotspot areas with most critical needs. The remaining 50 percent is fed into distributors’ normal supply chain to their customers in other areas nationwide.  HHS and FEMA determine hotspot areas based on CDC data.

Working together, we can efficiently distribute these vital resources to hospitals, nursing homes, long-term care facilities, pre-hospital medical services, state and local governments, and other facilities critical to caring for the American people during this pandemic.

FEMA_Adv_SCTF_Supply Chain Stabilization.pdf

EMS.gov | Note from Dr. Krohmer

Read the update from Dr. Jon Krohmer on EMS.gov.

First, let me just say thank you. Thank you to everyone out there who is making a difference during this especially difficult time, by answering 911 calls, responding to emergencies, and staffing operations centers; by performing critical administrative functions that keep our 911 and EMS personnel safe and able to focus on patient care; and by doing what might be the most difficult, especially for us—staying at home when not working.

As people who normally respond to emergencies, locking ourselves inside our homes when asked isn’t easy. But if you’re feeling sick or were asked to quarantine because you were exposed, or you’re watching the kids or helping an elderly family member so others in your family can report to duty, you are performing a critical service. Social distancing can feel like inaction, but it’s one of the most important actions we can take as a community to beat COVID-19 and save lives.

Here in the NHTSA Office of EMS, we are doing everything we can to support state and local EMS systems. I have been asked to serve as the lead of an EMS/prehospital care task force within the national response coordinated by the Federal Emergency Management Agency and working very closely with ASPR. This means that NHTSA’s Office of EMS is representing EMS concerns at FEMA’s National Response Coordination Center seven days a week, sharing information we receive from state and local EMS officials and finding ways to support your efforts.

We are collaborating closely with our federal partners in the Departments of Health and Human Service and Homeland Security and throughout government to ensure that EMS’s needs are considered and understood as we respond to this public health emergency. We are also meeting regularly with national EMS organizations to update the community and learn what we can do for you. Recently we launched a COVID-19 page on EMS.gov, which includes links to important resources, and will be updated regularly.

Our colleagues at the National Association of EMTs and American College of Emergency Physicians recently announced the theme for this year’s National EMS Week: “Ready Today. Preparing for Tomorrow.” Although COVID-19 will likely impact our usual EMS Week celebrations, be assured that our colleagues throughout the federal government appreciate your efforts on the frontlines. We know that no matter what the emergency is, you stand ready to face it and are preparing for tomorrow’s challenges at the same time.

Situations like the one presented by COVID-19 put enormous strain on you, your organizations and your families, but they also bring out the best in our communities—something exemplified by the tens of thousands of EMS clinicians across the nation who are putting others first every day.