Frequently Asked Questions [FAQs]

Q. Can you please define what is included in the term ‘stipend’? 

A. The response in the Final Rule regarding comments about what should be included when responding to “stipends and benefits” for volunteer labor is: 

“commenters also stated that the definition of stipends and benefits for volunteer labor should be broadened to include all forms of compensation from the ground ambulance organization such as insurance, stipends, or other forms of compensation. The data collection instrument collects information on volunteer hours and total compensation of any type from the ground ambulance organization so we agree that the definition of “stipends and/or benefits” should be broadened to include all forms of compensation from the ground ambulance organization such as insurance, stipends, or other forms of compensation”

This would suggest that any form of compensation or benefit that is provided to the volunteer must be included in the compensation for that volunteer employee. 

Q. Can you please define the term ‘volunteer’?

A. The response from the Final Rule regarding volunteers: 

“Volunteers may receive some form of compensation but are not considered full or part-time employees if they are not paid a minimum wage in return for full or part-time labor.”

Q. Are municipally based ambulance agencies a shared service? 

A. Generally, most government-operated ambulance services are operating on a shared services model. In other words, there is an entity that provides some goods, services, or functions on behalf of the ambulance service that are not reflected or accounted for in their organization’s budget. For example, a fire department-based ambulance typically does not have a person handling human resource-related functions. This is typically handled by a person whose costs are paid by the municipality and not necessarily itemized in the ambulance service’s budget. In this instance, the EMS service would need to find out and allocate a portion of the HR person’s costs to the fire-based EMS service. 

Q. Does the relocation of an ambulance to an area during a surge qualify as a standby, count towards a non-transport, or is it able to be counted at all? 

A. This will be answered in the ‘Ground Ambulance Service Volume’ section (section 5, question 2 in the CMS tool). You will be asked for total responses regardless of the level of service or geography, and those responses should be reported here. 

Q. What year are we meant to be tracking costs? 

A. The original timeline shifted due to COVID-19 related delays. The current schedule is as follows:

  • Services selected in years 1 and 2 will be collecting data in 2022, reporting data in 2023. 
  • Services selected in years 3 and 4 will be collecting data in 2023, reporting data in 2024. 

Q. What is Amber, and how do I get it?

A. Amber is a web-based tool developed by the American Ambulance Association. Amber allows agencies to enter their cost data, and make sure it is correct, before submitting it to CMS.

Amber also offers other surveys and tools, including a PRF reporting tool and a Balance Billing Survey. 

The data agencies put into Amber is secure and only available to the AAA in aggregates. This data is crucial to our advocacy efforts as the data tells our (EMS’s) story. Data = Dollars, and we cannot successfully change reimbursement and funding without data. 

Q. How much does Amber cost? 

A. If you are a AAA member, you already have access to Amber as part of your membership. Not sure how to log in? Email shilker@ambulance.org for help! 

If you are not a AAA member, you can start your membership and get immediate access to Amber. If you are a small, rural service and membership is cost-prohibitive, we encourage you to apply for the Savvik Foundation Cost Collection Grant which will provide your service with a 1-year AAA membership and access to Amber. 

Don’t see the answer to your question? Ask our Experts by emailing hello@ambulance.org.