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EMS1 | 2021 EMS Trend Report

Written by AAA Staff on . Posted in News, Press.

From EMS1

The 2021 EMS Trend Report, produced in collaboration with Fitch & Associates and the National EMS Management Association, and sponsored by Pulsara, continues our effort to identify how those in EMS perceive growth, change and the challenges impacting the sustainability and future of the industry.

Last year, we said that 2020 would be a “defining year” for EMS. Even at the time, soon after the emergence of the new coronavirus in the U.S., we didn’t realize how much that might be true. It certainly was a defining year for EMS, for healthcare and for the entire global community.

A year later, the long-term impacts of the pandemic on our profession remain uncertain. What we do know is how the pandemic highlighted the adaptability of EMS. The sixth annual EMS Trend Report dives into the impact COVID-19 had, and didn’t have, the changes we’re embracing and the change providers want to see, as we explore the opinions, concerns and hopes of your colleagues across EMS at this critical moment in history.

Download your copy to read:

  • The state of the profession: The more things change, the more they stay the same
  • Roundtable: Incremental change through transformative events
  • Is poor leadership more dangerous than a pandemic?
  • Why EMS systems that scale represent the future of EMS
  • 8 Places to invest in provider safety

Download on EMS1

CMS Announces Timeline for National Expansion of Prior Authorization for Repetitive, Scheduled Non-Emergency Ambulance Transportation

Written by Brian Werfel on . Posted in Government Affairs, Regulatory.

On August 26, 2021, the Centers for Medicare and Medicaid Services (CMS) announced its proposed timeline for the national expansion of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transports (RSNAT).  The formal notice appeared in the Federal Register on August 27, 2021.

Background

In December 2014, the Centers for Medicare and Medicaid Services (CMS) implemented a prior authorization model for payment of repetitive, scheduled non-emergent ambulance transportation.  Under this Model, ambulance suppliers are required to seek and obtain prior authorization for the transportation of repetitive patients beyond the third round-trip in a 30-day period.  Absent prior authorization, the Medicare Administrative Contractors (MACs) are required to subject further claims to prepayment review.

The Model was initially implemented in three states: New Jersey, Pennsylvania, and South Carolina.  These “Year 1” states were selected based on relatively high per-capita expenditures on RSNAT.  The Model was subsequently expanded in January 2016 to five additional states (Delaware, Maryland, North Carolina, Virginia, and West Virginia) and to District of Columbia.  These “Year 2” states were selected based on their inclusion in the same MAC Jurisdiction as one or more of the Year 1 states.

The purpose of the RSNAT Model was to test whether prior authorization would be effective in reducing Medicare expenditures on RSNAT, without adversely impacting beneficiary access to medically necessary services.  CMS engaged Mathematica, a public health care research firm, to study the impact of prior authorization on ambulance utilization in the demonstration states.  Mathematica issued several reports that concluded that the Model was effective in reducing Medicare expenditures without any measurable impact on the quality of care available to Medicare beneficiaries.

On November 23, 2020, CMS published a notice in the Federal Register indicating that it intended to expand the Prior Authorization Model to all remaining states and U.S. territories.  However, citing the current Public Health Emergency, CMS elected not to set a timeline for that national expansion.

The current notice announces that timeline for national expansion

Expansion Timeline

CMS has indicated that the RSNAT Model will be expanded into new states on the following timeline:

Expansion Date Affected States
December 1, 2021 Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas
Not earlier than

February 1, 2022

 Alabama, California, Georgia, Hawaii, Nevada, Tennessee, American Samoa, Guam, and the Northern Mariana Islands
Not earlier than

April 1, 2022

 Florida, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, Wisconsin, Puerto Rico, and the U.S. Virgin Islands
Not earlier than

June 1, 2022

 Connecticut, Indiana, Maine, Massachusetts, Michigan, New Hampshire, New York, Rhode Island, and Vermont
Not earlier than

August 1, 2022

 Alaska, Arizona, Idaho, Kentucky, Montana, North Dakota, Ohio, Oregon, South Dakota, Utah, Washington, and Wyoming

 

An analysis of the proposed timeline suggests that CMS has elected to expand the RSNAT Model based on existing Medicare Administrative Contractor (MAC) Jurisdictions.  For example, each of the states slated to be included in the December 1, 2021 expansion fall within MAC Jurisdiction H.  This MAC Jurisdiction is administered by Novitas Solutions, Inc.  Novitas also administers MAC Jurisdiction L, which has been operating under the RSNAT Model since 2014.  Thus, CMS likely selected MAC Jurisdiction H for the first stage of the national expansion due to Novitas’ experience in administering the RSNAT Model.

The second stage of the national expansion will occur no earlier than February 1, 2022.  This stage will include all states and territories located in MAC Jurisdiction J and MAC Jurisdiction E.  MAC Jurisdiction J is administered by Palmetto GBA, LLC, which has been administering the RSNAT Model in MAC Jurisdiction M since 2014.  MAC Jurisdiction E is administered by Noridian Healthcare Solutions, LLC.  This will be Noridian’s first experience with the RSNAT Model.

The third stage of the national expansion will occur no earlier than April 1, 2022.  This stage will include all states and territories located in MAC Jurisdiction 5 (Wisconsin Physicians Service Government Health Administrators), MAC Jurisdiction 6 (National Government Services, Inc.), and MAC Jurisdiction N (First Coast Service Options, Inc.)

The fourth stage of the national expansion will occur no earlier than June 1, 2022.  This stage will include all states and territories located in MAC Jurisdiction 8 (Wisconsin Physicians Service Government Health Administrators) and MAC Jurisdiction K (National Government Services, Inc.).

The final stage of the will occur no earlier than August 1, 2022.  This stage will include all states and territories located in MAC Jurisdiction 15 (CGS Administrators, LLC) and MAC Jurisdiction F (Noridian Healthcare Solutions, LLC).

Outreach and Education

With the formal announcement of CMS’ timeline for the national expansion of the RSNAT Model, the American Ambulance Association will be increasing its educational efforts related to prior authorization.  This will include webinars and other educational materials on the technical elements of the prior authorization process, the importance of third-party documentation, as well as basic best practices related to the transportation of repetitive patients.  We encourage all members that may be impacted by the expansion of prior authorization to take advantage of these educational materials.

Medicare Ambulance Relief Bill introduced in Senate

Written by AAA Staff on . Posted in Advocacy Priorities, Government Affairs, Legislative, Medicare.

Yesterday, Senators Catherine Cortez Masto (D-NV) and Susan Collins (R-ME) introduced the Protecting Access to Ground Ambulance Medical Services Act of 2021 (S. 2037). Senators Cortez Masto and Collins were joined by Senators Debbie Stabenow (D-MI), Bill Cassidy (R-LA), Patrick Leahy (D-VT) and Bernie Sanders (D-VT) as primary cosponsors and leads on the legislation.

S. 2037 is identical to H.R. 2454 by Representatives Terri Sewell (D-AL), Devin Nunes (R-CA), Peter Welch (D-VT) and Markwayne Mullin (R-OK) and would extend the temporary Medicare ground ambulance increases of 2% urban, 3% rural and the super rural bonus payment for five years. The increases are currently scheduled to expire on December 31, 2022. The five-year extension would allow for the increases to remain in place during the two-year delay on ambulance data collection due to the COVID-19 public health emergency, an analysis of the data by MedPAC and subsequent action by the Congress to reform the Medicare ambulance fee schedule.

The legislation would also help ensure that rural zip codes in large urban counties remain rural following geographical changes under the fee schedule as a result of the 2020 census data. The current definition using rural urban commuting areas (RUCA) in Goldsmith Modification areas would be modified for zip codes with 1,000 people or less per square mile would also be rural. Ground ambulance service providers and suppliers could also petition the Centers for Medicare and Medicaid Services (CMS) to make the argument that a specific zip code should be rural. It is vital that this provision be implemented before CMS makes changes from the 2020 census data which will likely occur in 2023.

The AAA has been leading the effort on the legislation with the support of the International Association of Fire Chiefs, International Association of Fire Fighters, National Association of EMTs, National Rural Health Association and the National Volunteer Fire Council.

The AAA will be launching a Call to Action shortly requesting AAA members to ask their Senators to cosponsor S. 2037, and reach out to their Representatives to cosponsor H.R. 2454 if they have not already done so.

We greatly appreciate the leadership of Senators Cortez Masto, Collins, Stabenow, Cassidy, Leahy, and Sanders on this vitally important legislation.

Rescue, Inc. | 2021 EMS Week Featured Service

Written by AAA Staff on . Posted in Events, News, Press.

Rescue, Inc.
Brattleboro, Vermont
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Rescue Inc is a private non-profit service in Southern Vermont. Founded in 1966 as a volunteer organization responding to local emergency calls, Rescue today is mission-driven; providing emergency medical treatment and transportation, specialized rescue services, community education, and transportation of critical patients between area hospitals. Out of two stations, and with a fleet of 9 ambulances and 3 response vehicles, we provide timely and efficient service in our five hundred square mile coverage area in Southern Vermont and Southwestern New Hampshire.

“EMS week gives us the chance to celebrate and spotlight the care, compassion, and skill our providers tirelessly demonstrate. Through long nights, bad weather, and now pandemics, our health care providers continue to inspire. On behalf of grateful patients and families, I thank you!”
– Drew Hazelton, Chief

2020 has brought the challenges of COVID-19 and supply line shortages, but also the development of new programs including EMS ultrasound, EMT hybrid courses, and a mobile vaccination program to our community.

During the COVID-19 crisis, Rescue Inc stepped in with resources to engage in critical work for public health. In collaboration with the health department, Rescue Inc provided expanded transport capabilities; transporting COVID positive persons to isolation facilities for recovery. Our crew of medical providers staffed pop-up testing sites and have screened thousands. As a way to limit exposure, our providers were called upon to facilitate mobile testing and would travel to test a single person or a whole family in their own homes. Once the vaccine became available, Rescue Inc designed a mobile vaccine trailer and worked with the Vermont Department of Health to facilitate clinics all over the state. In the spirit of our mission, we continue to bring healthcare on the road. We have vaccinated thousands – at schools, restaurants, race tracks, and more.

“EMS providers are educated members of your community that provide prehospital care that saves lives every day. When the tone drops they set aside everything and put themselves into emergency situations to care for those that they value; their community.”
~Lee Bookwalter, EMT

This year our community is feeding us for EMS Week! Breakfast, Lunch, and Dinner for our duty crews are being provided by area restaurants for each day of this special week! Our vaccine trailer will be on the road all week, celebrating EMS by supporting the mission of health and wellness for our community.

“When we are called to a scene, whether it be an MVA, a stroke, or an anxiety attack, we legitimately just want to be there for someone during their time of need. Sometimes that means medical intervention, and sometimes just lending a hand to hold. Long story short, we just have love for people!”
~Zach Gilbeau, EMT

“I believe EMS is important because we are always there. No matter what day of the week, time of day, or what your emergency is, we will show up and take care of you.”
~Emily Wilson, Paramedic/Captain

Harris County Emergency Corps | 2021 EMS Week Featured Service

Written by AAA Staff on . Posted in Events, News, Press.

Harris County Emergency Corps
Houston, Texas
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Committed to preserving lives through clinical excellence, progressive medicine, and professional service, Harris County Emergency Corps (HCEC) is a premier EMS agency and the only Commission on Accreditation of Ambulance Services accredited agency with headquarters in Houston. HCEC was the first EMS agency formed in the state of Texas. Serving approximately 400,000 citizens, HECE provides 911 EMS operations in north Houston for Harris County Emergency Services District No. 1. HCEC also provides event medical coverage across Texas, trains clinicians with highly specialized classes, communicates with 11 other agencies through our innovative dispatch center and leads Houston’s first Community Health Paramedic Program.

Our organization changed, I believe, for the better. We overcame obstacles, and our remarkable team worked together like never before. I would like to thank each person involved for your commitment to our organization and the community we serve. I appreciate the work you do each and every day. — Jeremy Hyde, CEO

COVID-19 Response

Year 2020 was a year like no other. The COVID-19 Pandemic affected every person globally, and we are still living in a world of mask-wearing and sanitizing stations.

Our 9-1-1 call volumes were drastically reduced for the first few months of 2020. Almost immediately, PPE was on a national shortage. HCEC preserved resources and did not suffer any PPE shortage. Employees were never in jeopardy for not having protective equipment. Then COVID infection rates started increasing, which increased our 9-1-1 call volume to exceed any previous record in history.

During the time of significant volume increases, employees got the virus. Other staff stepped up to fill needed roles. Event staff helped fill in additional ambulances for COVID response. Field staff took a place in dispatch to help screen calls. The Dispatch Center and field staff worked together to ensure the calls were made appropriately with the right precautions.

EMS Week Celebrations

HCEC is hosting a reunion with a Pediatric CPR family, celebrating service awards, hosting a crawfish boil and hosting a blood drive.

“EMS continues to evolve beyond traditional ambulance transport. Not only do we serve as the community’s medical safety net, but we have also begun the transition to true mobile integrated health care. Progressive EMS agencies across the country are now involved with trauma and disease prevention, implementing community paramedic programs, and reducing preventable hospital admissions. EMS is a critical part of our health care system overhaul. We should be proud of where we are and where we are going!
-Corey Naranjo BSN, RN, LP, CP-C

“EMS is often the link between poor health and a healthy outcome. It can also quite literally be the difference between death and life of a person.” – Steven Nelson MHA, LP, In-Charge Paramedic,

“EMS is a vital corner of the first responder triangle. As EMS personnel we not only increase the survivability of major incidents, but we also bring knowledge to the public to help all in need.” -Blake King EMT-P, FTO-1, In-Charge Paramedic

Waterbury Ambulance | 2021 EMS Week Featured Service

Written by AAA Staff on . Posted in Events, News, Press.

Waterbury Ambulance
Waterbury, Vermont
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Waterbury Ambulance Service was founded in 1971, since then, we’ve grown significantly, but at our core we are still a group of highly skilled, committed volunteers and staff, ready at a moment’s notice to save a life, or just lend a helping hand. We provide 911 coverage to the towns of Waterbury, Duxbury and parts of Moretown, Vermont as well as mutual aid to our neighboring communities. Waterbury Ambulance provide interfacility transfers when we have the staff available. We have two ambulances, 15 advanced EMTs, 19 Emergency Medical Technicians, and four drivers. We also provide CPR, First Aid, Car Seat Fitting and Stop the Bleed Trainings.

Waterbury Ambulance also supports The Waterbury Backcountry Rescue Team which was founded in 2002, in order to lead the search and rescue of patients injured or lost in areas of Vermont where an ambulance is not able to readily access. Waterbury Backcountry Rescue Team is composed of a specially trained crew of rescuers and EMTs, who locate, extricate, and field treat patients, bringing them to an area which can be accessed by ambulance.

“This year has been a remarkable one. I am inspired by the way Waterbury Ambulance’s Team has stepped up in uncertain times to ensure the safety of themselves and our community”
–Mark Podgwaite, Executive Director

Covid-19 impacted Waterbury Ambulance by initially creating additional training and safety requirements. The team responded quickly ensuring that we provide the best possible care to our community during a scary time. The State of Vermont reached out to Waterbury Ambulance asking if we could support the state in Covid-19 testing. Waterbury Ambulance rose to the occasion by teaming up with two other ambulance services and a local ski patrol to provide testing 7 days a week at three different locations throughout our region. To date Waterbury Ambulance has provided tens of thousands of Covid-19 tests to the community. Waterbury Ambulance then hit the road providing vaccines to home-bound Vermonters. We have also helped the State of Vermont staff vaccine clinics and National Guard Clinics.

“EMS is so vitally important because we provide frontline medical care for our communities of neighbors, family, friends, colleagues and even those we haven’t met yet. We do it 24 hours a day, 7 days a week, 365 days a year. Whether it’s a car crash with injuries, heart attack, overdose, or a pandemic, our communities depend on us to jump in and give the best care possible at any moment’s notice.” -Kristen Hamel, AEMT

“I believe that EMS is vital because we all need someone in our times of need to be that outside person to be kind, caring, and compassionate to our personal emergencies. Someone to validate our physical & emotional pain/suffering/ distress. Someone who you can trust with your life to get you the care you need, advocative for you, and ease your worries.” -Vicki Fielding, AEMT

Waterbury Ambulance is celebrating EMS week by supporting and providing Vaccination clinics around the state, covering 911 calls and providing 7-day a week Covid testing.

“EMS plays a key role into the prevention of death and disease processes in a community. The stronger the EMS organization, the better the community can grow and flourish” -Tom Leeman, AEMT

“EMS is important to me because we as ems providers are a small light at the beginning of a very dark tunnel for some people” -Kayla Reed, Driver/Future EMT

 

East Baton Rouge EMS | 2021 EMS Week Featured Service

Written by AAA Staff on . Posted in Events, News, Press.

East Baton Rouge EMS
Baton Rouge, Lousiana
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About East Baton Rouge EMS

East Baton Rouge EMS is a municipal service that originated on August 6th, 1982. The Department is funded by a property tax and insurance billing. EBREMS is the primary ALS provider for the parish of East Baton Rouge, Louisiana. Unlike most systems, all 911 calls in the parish are first answered by EBREMS Medics. East Baton Rouge Parish is 456sq/mi and is comprised of the City of Baton Rouge and the towns of Zachary, Baker and Central. With a total population +440,000, East Baton Rouge is the Capitol of the State of Louisiana and is the home of two major Universities.

EBREMS operates 11 EMS stations with 24 ambulances, 20 sprint vehicles, 1 mass casualty unit and 3 ASAP carts. There are 138 Field Medics, 9 Shift supervisors, Division managers, and 32 communications officers. EBREMS responds to approximately 64,000 calls per year. In addition to responding to 911 calls, EBREMS also offers Telemedicine, Event coverage, HAZ-MAT, CISM, Bicycle, and Special Response Teams. A new Bariatric unit has just been purchased along with 16 new ambulances. The new fleet will go into operation in July.

Our COVID-19 Response

A response plan to COVID was discussed in March 2020. The first order was to acquire enough PPE for our medics in the field. PPE included P-100 masks, goggles, and isolation kits. Two ambulances were converted into “COVID units” by using plastic sheeting to block the walk-through access of the units and the ALS cabinet. The units were stocked with an abundance of disinfectant and PPE. 12 medics volunteered to work on these units and only respond to COVID-related calls. The intention was to isolate the cab of the truck from the patient compartment, and limit exposure to the rest of the field by only using the assigned medics for these types of calls. 911 Operators began asking COVID screening questions, and would relay the information to the responding unit. Every patient was provided a surgical mask and the use of nebulizers was banned due to the aerosolization.

The Mayor declared a local public health emergency on March 13th. Schools, restaurants, bars, and non-essential businesses were closed and a “stay at home order” was implemented. 911 Operators began to see a surge in calls from the public asking COVID-related questions. This overwhelming number of non-emergent calls led to a Public Service campaign to inform the public not to call 911 for COVID questions. A new 211 number was utilized for these types of calls. Several testing sites opened throughout the parish, including one at the EBREMS Headquarters. Despite a large number of tests given, the percentage of positive tests was only about 7%.

East Baton Rouge lifted the Emergency Declaration in May 2020. Schools remained closed for a while, but offered virtual learning. Restaurants, Bars, Churches and non-essential businesses opened with limited capacity and mandated face mask requirements. Today EBR parish is 100% open, and EMS operation is back to pre-COVID status with the exception of continued use of face masks on every response.

“It is my belief that Baton Rouge EMS has some of the finest medics in the country and you would be hard pressed to find a better group of people to work with. Their dedication and professionalism through this last year’s pandemic has been nothing short of impressive. They care for their patients and their fellow first responders and treat them like family. It is an honor to work with all the medics here in Baton Rouge, and they deserve recognitions for the hard job that they do.”
-Chad Guillot
EMS Director
East Baton Rouge Parish EMS

How We Celebrate EMS Week

Every year our Public Information Officers work hard to promote the Department by doing interviews on Morning News shows, Submitting stories to the newspaper, and posting on Social Media. Our Paramedic Association purchases EMS Week gifts for the employees and also funds the annual Award Ceremony that is always held during EMS Week. The Administration Department provides lunch to the crews on each shift, and local hospitals also provide snacks and food at their hospitals for the field medics.

“We are a family-oriented department, and we treat the community like our own”
-Hillary Duncan, Paramedic

“We strive to meet the goals of our mission statement and continually adapt to fulfill the needs of our community”
-Otha Henry, Training Officer

“As EMS providers we value our community”
-Kerri Avara, Unit Commander

Allina Health EMS | EMS Week 2021 Featured Service

Written by AAA Staff on . Posted in Events, News, Press.

Allina Health EMS
St. Paul, Minnesota
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Founded in 1920, the 600+ employees of Allina Health EMS serves over one million citizens in the communities surrounding the Minneapolis/St. Paul vicinity with 911, Critical Care and Interfacility transports. In addition, we provide Community Paramedics, Tactical Paramedics, EMS Education and Special Event support to the communities we serve. Our Communications Center answers one in ten 911 calls throughout the state of Minnesota, not only providing dispatching services for Allina Health EMS, but other EMS services throughout the state.

Our staff rose (and continues to rise) to the challenges that COVID-19 presents to us. Some parted with facial hair! The collaboration was evident when staff helped to inform our processes and procedures for PPE and communication at the beginning of COVID-19. Each day we were learning something new, whether it was PPE procedures, hospital information such as entrance and transfer of patient care changes or services available to support our essential working employees. Our Communications Center began revising questions asked of our 911 callers to help determine potential risks prior to the arrival of our ambulance crew and to inform the level of PPE needed. Whether it was a 911 response or an interfacility transfer, we continued to improve our processes so our staff was protected and prepared when responding to our patients.
Our Education department tested and transitioned to online platforms for continued internal education and our external educators came into the bases to provide Just in Time Training (JITT) to our staff so the practical application of equipment and PPE changes were able to be understood and practiced prior to use. Our EMS maintenance and inventory technicians helped to implement changes to our ambulances to protect both patients and staff from the virus through protective devices and the task of keeping up with equipment and stocking changes.

Our Emergency Operations Center strived to provide timely updates and information, which we did in traditional written and email form. In addition, to support a mobile and 24/7 workforce, we used technology to provide information through videos and update posts via a closed social media group for our employees.

During the start of the pandemic, a significant event took place in our area. We supported our local EMS and Public Safety partners as we experienced civil unrest as a result of the death of George Floyd. This time was demanding physically pandemic, the unrest and the summer increased our responses and it was emotionally demanding as we saw the toll both of these events took on our staff and our communities.

While COVID became a part of our regular responses, we moved into 2021 and experienced a workplace shooting at one of our clinics that our EMS staff responds to on a regular basis. The response to this event, the level of teamwork and dedication of our staff to providing exceptional care, highlights what makes Allina Health EMS one of the leaders in Minnesota EMS.

“Allina Health EMS providers show up everyday to be ready to respond to the needs of their community, whether it is a multi-vehicle crash on the freeway, a cardiac arrest of a grandparent or a new mom who is just scared and needs reassurance that her baby is okay. Our providers go above and beyond each day to take exceptional care of their patients and their communities. We are proud of everyone who supports the care of our communities and are looking forward to celebrating EMS Week 2021 with the team.” Susan Long, Vice President of Operations

EMS is important on many levels, but being there during a critical time of someone’s life is the most important to me. Being there to providing that voice of comfort to those who really need it, is the most rewarding part of all.
Kymberly Markgraf, EMT

Courage is being scared to death, but jumping in anyway. or Success is knowing another has breathed easier because of your help.
Kelly Pischke, Paramedic

EMS Week Celebrations

Food and fellowship are the highlights of this year’s EMS Week at Allina Health EMS! Physical distancing guidelines prevented us from having our typical EMS gatherings last year and hampered our ability to celebrate our Centennial Year of Service. We are looking forward to recognizing our staff in everyday interaction but especially during their week with safety measures in place during meals and activities during the week

NHTSA EMS.gov | EMS Week Video

Written by AAA Staff on . Posted in Events, News, Press, Regulatory.

From NHTSA’s Office of EMS on May 17, 2021

This week, May 16-22, 2021, we once again recognize the people of EMS by celebrating National EMS Week. We hope you’ll take a minute to watch this special message from the entire team here at the National Highway Traffic Safety Administration Office of EMS.


This year’s EMS Week theme, “This is EMS: Caring for our Communities,” couldn’t be more appropriate. The past year has been a challenge, but it has also reminded people across the nation just how valuable emergency medical services systems—and most important, clinicians—are to our communities. This nation is in debt to all of the EMS clinicians and the people behind the scenes who show up every day with true professionalism and dedication.

From all of us here at the Office of EMS, NHTSA, and the Department of Transportation: Thank you.

St. Charles County Ambulance District | EMS Week 2021 Featured Service

Written by AAA Staff on . Posted in Events, News, Press.

St. Charles County Ambulance District
St. Peters, Missouri
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St. Charles County Ambulance District (SCCAD) began operations in 1975 with three ambulances covering a largely rural 592 square mile service area. Over the past 45 years, the community has grown considerably; today, the population eclipses 400,000 residents. SCCAD, which currently employs 195 full-time staff and 70 part-time employees, has kept pace with the growth, adding stations and ambulances in strategic locations to ensure that response times to 911 emergencies remain short. The District currently staffs 19 advanced life support units from 16 stations serving all municipalities and unincorporated areas of the county. In addition to 911 response, SCCAD offers non-emergency inter-facility transport, which is staffed separately from the 911 division. In 2019, the District implemented a successful critical care ground transport program to help high-acuity patients get from our county’s community hospitals to the larger healthcare centers in St. Louis city and county.

Over the past decade, SCCAD has developed and implemented a number of innovative initiatives to better meet the evolving healthcare needs of our community. These include a multi-faceted Mobile Integrated Health (community paramedic) program, which focuses on readmission avoidance in partnership with several hospitals in our area, and SCCAD high-utilization patients identified by our paramedics. In addition, the MIH team collaborates with commercial insurers to offer services to their patients in the county. Also developed in recent years was the American Ambulance Association AMBY award-winning Substance Use Recovery Response Team, which sees specially-trained paramedics helping facilitate overdose patients’ entry into treatment programs if they’re willing to seek help. In 2018, the District launched a successful behavioral health telemedicine program in partnership with Behavioral Health Response. Most recently, SCCAD was one of only three EMS organizations in the state of Missouri selected to pilot the Centers for Medicare & Medicaid Services Emergency Triage, Treat & Transport (ET3) program.

While COVID-19 most certainly presented operational challenges, it also offered EMS providers an opportunity to showcase our industry’s collective ability to adapt in the face of adverse conditions, and develop innovative, mission-driven solutions to meet the mobile health needs of the communities we serve.

From the onset, SCCAD embraced the challenge, working to develop strategies that would meet the needs of our employees, fellow first responders, and the community at large. To this end, our leadership team has worked in tandem with the St. Charles County Department of Public Health. Our Deputy Chiefs of Operations and Special Operations were added to the County’s incident command structure, and worked out of the County’s EOC to ensure a coordinated response. Meanwhile, our Deputy Chief Medical Officer worked tirelessly to develop aggressive contract tracing and quarantine procedures to ensure the safety of our team members, and worked to regularly push updated information out to crews. Under his direction, our training team spent time carefully reviewing donning/doffing and other safety protocols with team members.

In spring of last year, St. Charles County, like most other communities, struggled to scale up COVID-19 testing processes to meet demand. Residents experiencing symptoms were at times unable to get appointments for several days. Given the number of potential exposures that could result from a single infected paramedic, firefighter, or police officer, SCCAD’s MIH Team launched their first effort: a first responder testing program. The testing site enabled local police and fire agencies, along with SCCAD employees, to obtain a testing appointment in an expedited fashion. When local partners added more testing capacity toward autumn, we were able to scale down the testing effort.

Around the same time, Pfizer and Moderna began announcing initial success in clinical trials with their vaccines. With signs pointing toward emergency use authorization being granted by the FDA before year-end, the SCCAD team once again began strategizing on ways to make an impact. In conference with Public Health, it was determined that we would initially take point on first responder vaccinations, then move into other segments of the population while concurrently assisting with large-scale vaccination events being hosted by Public Health. Some of the vulnerable populations we’ve vaccinated have included elderly citizens residing at independent living senior apartments, homebound individuals, and those residing in rural areas of our county.

Though the past 14 months have been a stressful, challenging time, they’ve also shed a spotlight on the strength, determination, and character of many within our industry. In communities large and small across our state and nation, EMS is playing a critical role in getting things back to normal.

“Each and every day, our team of skilled professionals embody our values of dedication, compassion, accountability, integrity and respect. Through interactions on 911 calls, non-emergency transfers, and community safety programs, they are promoting best practices to integrated, community healthcare and enhancing the reputation not only of our organization, but also of the EMS industry.”
Kelly Cope, Chief

“Today’s healthcare landscape is constantly evolving, and paramedics are increasingly being relied upon to deliver the right treatment at the right place, time, and cost. Our team has risen to the occasion, developing and implementing several unique programs to address the unique needs of our community in recent years.”
Dave Lewis, Assistant Chief of Administration

“As is the case in many communities, our paramedics frequently find themselves serving not only a clinical role, but also one of counseling/social services. Our team has helped members of our community navigate everything from bed bug infestations to food instability. No matter the circumstances, patient advocacy is a critical role fulfilled by EMS.”
Kimberlyn Tihen, Mobile Integrated Health Division Captain

“EMS plays an important role in communities every day, but that role is heightened during significant and/or unique events. We’re relied upon to be part of the overall solution, projecting a sense of calm and reassurance. I’m grateful to work for an organization that invests heavily in training and equipment for these unique scenarios, giving me the tools I need to serve residents when the need arises.”
Rees Remington, Battalion Chief

To celebrate EMS Week, we’re patronizing a local small business in our community to show our appreciation to the paramedics and support staff of SCCAD. Prados, an upscale locally-owned Mexican cantina located within our community, will be preparing meal kits on May 17, 19 and 21 so each of our crews can enjoy a handcrafted lunch. Our leadership team will report to Prados at 11 a.m. on each of the aforementioned days, and will deliver the kits to our 16 stations across the county. Of course, our training, service center, maintenance, administration and other non-clinical team members are included.

In addition, we’ll be utilizing our social media feeds to highlight EMS Week and the work of our team.

Presidential Proclamation for EMS Week 2021

Written by AAA Staff on . Posted in Events, Executive, News, Press.

From Whitehouse.gov’s Briefing Room on Presidential Actions

A Proclamation on Emergency Medical Services Week, 2021

Every day, in communities across the country, Emergency Medical Service (EMS) providers put themselves on the line to save lives, safeguard dangerous situations, and deliver hope to families and communities in crisis.  With selflessness, professionalism, and grace under fire, they provide essential care — never more so than during our battle with COVID-19 over the past year.  This year’s Emergency Medical Services Week theme, “THIS IS EMS:  Caring for Our Communities,” honors our heroic frontline workers who provide vital emergency medical care and ease the burden of crisis for Americans in need of help.

Through service, compassion, and dedication, EMS providers represent the very best of the American spirit.  In the face of unprecedented challenges, their expertise, endurance, and hard work have been a literal lifeline for families in every community.  Whether responding to the enormous suffering caused by COVID-19, the devastation of extreme climate events, or daily medical emergencies, EMS providers — many of whom are volunteers — prepare, sacrifice, and put others ahead of themselves.  Not only do they assume the heightened risks associated with emergency care during a pandemic, but they also spend countless hours away from families and friends in order to serve their communities.

In the face of these challenges, EMS providers have not hesitated to take on new roles, including supporting COVID-19 testing, therapeutics, and vaccination sites.  To help support the women and men who do this vital work, my American Rescue Plan included $100 million to support the mental well-being — including the mental health — of our health care professionals, paraprofessionals, public safety officers, and EMS providers.  My Administration has also made it a priority to ensure that our State, local, Tribal, and territorial partners have the resources they need so that EMS providers are trained and equipped to respond to public health emergencies safely and effectively, now and in the future.

During Emergency Medical Services Week, we extend our deepest gratitude to all EMS providers.  Their courage, selflessness, and commitment are extraordinary examples of what it means to serve this great country.  We also extend our sincere condolences to the loved ones of EMS providers who have given their lives in the line of duty.  This week and every week, I urge all Americans to express their appreciation for our Nation’s EMS providers — and to bring greater safety to their lives, and to all of our lives, by getting vaccinated to help bring an end to the COVID-19 pandemic.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 16 through May 22, 2021, as Emergency Medical Services Week.  I call upon public officials, doctors, nurses, paramedics, Emergency Medical Service providers, and all the people of the United States to observe this week with appropriate programs, ceremonies, and activities.

IN WITNESS WHEREOF, I have hereunto set my hand this fourteenth day of May, in the year of our Lord two thousand twenty-one, and of the Independence of the United States of America the two hundred and forty-fifth.

 JOSEPH R. BIDEN JR.

 

 

EMS Week Featured Service Application

Written by AAA Staff on . Posted in AAA HQ, Events, Member-Only, News, Press.

EMS Week will take place from May 16–22, 2021.  To celebrate the extraordinary contributions of ambulance services to the communities they serve, we will be featuring specific services throughout EMS week on AAA’s website and social media.

If you would like to apply to have your service featured, please complete and submit all fields below by May 12. Thank you for your service to your community!

 

 

 

EMS Week is May 16–22

Written by Amanda Riordan on . Posted in Events.


EMS Strong banner

Dear EMS Professional,

Over the last year, the pandemic has given people a small glimpse of the vital role of EMS professionals. The sacrifice and dedication of EMTs, paramedics and other EMS practitioners has rightfully earned them admiration and gratitude in their communities. Calling us heroes sometimes obscures the fact that—behind those masks—are people who, every day, take on many crucial roles: Healthcare professional. Emergency manager. Social worker. Crisis counselor. Consoler. Caregiver.

What is EMS Strong?

EMS Strong is a campaign that seeks to celebrate, unify and inspire the men and women of our nation’s emergency medical services. Learn More

Download the 2021
EMS Week Planning Guide

COLUMBINE TRAGEDY LEADS TO CAREER IN EMS

How does your past impact your decisions and the direction your life will take? For Heather Edwards, one spring day more than 20 years ago set her on a course for a career in emergency medicine. Read More

EMS IN DEATH VALLEY NATIONAL PARK

He’s part EMT, part park ranger and part law enforcement officer: Meet Max Gallegos, a law enforcement ranger in Death Valley National Park.
Read More

PASSING ON A LOVE FOR EMS

Yolanda Johnson spent 10 years on an ambulance in Peoria, IL, before becoming an EMS instructor. Read More

A SEAT AT THE TABLE

It’s time for EMS to take the lead in making sure our healthcare partners know who we are. Read More

TO CARE FOR YOUR COMMUNITY, YOU ALSO MUST TAKE CARE OF YOURSELF

Managing stress and anxiety during the COVID-19 pandemic and beyond Read More

EMS WEEK 2021 IS ALMOST HERE!

Get ready to recognize and honor EMS in your community.
Now more than ever, it’s important to acknowledge all of your team members and educate your community about the valuable role that EMS plays.
Read More

5 THEME DAYS FOR 5 WAYS TO CELEBRATE

National EMS Week, May 16-22, celebrates both the EMS profession and professionals for the vital role they play in the healthcare continuum. Here are the themes for each weekday:

Monday: EDUCATION DAY
Tuesday: SAFETY DAY
Wednesday: EMS FOR CHILDREN DAY
Thursday: SAVE A LIFE DAY (CPR & National Stop the Bleed Day)
Friday: EMS RECOGNITION DAY

Read More

Presented by ACEP in Partnership with NAEMT


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Copyright © 2021 EMS Strong, All rights reserved.

 

Medicare 2% Cut Freeze Extended

Written by Tristan North on . Posted in Legislative.

Yesterday, Presiden Biden signed into law legislation (H.R. 1868) to extend the current temporary freeze on the 2% Medicare sequestration cut. H.R. 1868 extends the deadline of the freeze from today until December 31. Contractors had been holding Medicare claims to avoid any issues but will again start processing claims. The AAA as well as other national EMS and fire organizations had pushed for the extension of the freeze.

Congress Passes Ambulance Medicare Add-Ons

Written by Mark Postma on . Posted in Legislative, Medicare, Reimbursement.

 

It is my pleasure to share with you that—just minutes ago—Congress passed the 5 year extension of the Medicare ambulance add-ons. The extension was part of the two-year budget deal reached by congressional leaders and passed by the Senate early this morning and then shortly thereafter by the House. The ambulance provisions in the final deal differ from the provisions passed earlier this week by the House in one key area – the collection of ambulance cost data. This means that we are truly in the endzone of the add-on payment extension process.

While we ask your continued patience as we jump through one last procedural hoop, I am confident that the add-ons will be back in effect as soon as the President signs the legislation. In today’s deeply divided political climate, I am proud of what we have accomplished through collaboration as an association and industry.

Here are the specifics of the final package:

  • 5 year extension of the ambulance Medicare add-ons through December 31, 2022, retroactive to January 1, 2018.
  • AAA’s preferred method of Cost data collection that provides flexibility to the Secretary of HHS in developing the system. Consultation with the industry is required so that it strikes the appropriate balance between obtaining meaningful data while not overly burdening or onerously penalizing the ambulance services.
  • The penalty for failing to report required data would be a reduction in payment up to 10% for the year following the year in which the data should have been submitted. AAA objected to the house proposed penalty of up to a year of Medicare payments clawback or withholding of payments. A clause is included to wave the penalty in cases of hardship.
  • A “pay-for” for the 5-year extension of the add-ons with a 13% cut to non-emergent dialysis transports – the AAA had objected to the offset and pushed for a cut targeted to just those entities which abuse the dialysis transport benefit. We were successful in reducing the initial cut from 22% to 13%. The AAA is actively working on other pay-for options that would replace the 13% cut with something targeting dialysis fraud and abuse.

Next Steps

All that remains to bring the add-ons into effect retroactively to January 1, 2018 are a few administrative formalities and the signature of the President, who has indicated his support of the agreement. Given the government shutdown, we are cautiously optimistic that this will proceed quickly. However, bumps are always a possibility—we will keep you informed! (Follow AAA on Twitter at @amerambassoc or Facebook for instant updates.)

Thank You

This week’s tremendous progress would not have been possible without months of effort by AAA volunteer leaders, advocacy experts, and staff, as well as support from our key champions in Congress.

I’d like to personally thank the AAA Government Affairs Committee, including Chair Jamie Pafford-Gresham and Vice Chair Shawn Baird, as well as the entire AAA Board for their hundreds of hours of hard work on this issue. We are all truly grateful for your dedication to moving mountains to find sustainable funding for EMS.

Last but certainly not least, thank you to the dozens of state ambulance associations and thousands of individual members who wrote letters to their Members of Congress in support of the add-ons. We truly couldn’t have made it this far without your support.

Again, thank you, and please stay tuned for final updates!

Mark Postma
President
American Ambulance Association
“Representing EMS in America”

House Passes Ambulance Medicare Add-Ons

Written by Mark Postma on . Posted in Legislative, Medicare, Reimbursement.

Moments ago, the U.S. House of Representatives passed legislation which includes a five-year extension of the Medicare ambulance add-ons. The House voted 245 to 182 to pass a Continuing Resolution (CR) to fund the federal government beyond the current expiration date of February 8. The CR included a package of Medicare provider extenders including an extension of the temporary Medicare ambulance add-ons.

The ambulance provisions in the CR include the following:

  • A five-year extension of the temporary Medicare ambulance increases of 2% urban and 3% rural to base and mileage rates and 22.6% to the base rate in super rural areas. The extension would be retroactive to January 1, 2018 and expire on December 31, 2022.
  • The requirement for ambulance service suppliers to submit cost reports. The language is based on H.R. 3729 as reported by the House Ways and Means Committee but with new language providing the CMS Administrator with the discretion to apply a payment suspension or overpayment as the penalty for suppliers that do not submit timely, accurate and complete data after the initial two years.
  • To offset the cost of the add-ons extension, a further reduction of 13% in Medicare reimbursement for BLS non-emergency transports to and from dialysis centers. The initial reduction was 22% but the AAA was able to help lower the estimated cost of the add-ons and thus lower the percentage of the offsetting cut.

The CR now goes to the Senate for its consideration. The Senate is likely to act tomorrow, February 7.

We will keep you posted of new developments. Thank you for your continued support of the American Ambulance Association.

Mark Postma
President
American Ambulance Association
“Representing EMS in America”

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